The Frequency of Association of Nail Involvement and Psoriatic Arthritis in Psoriasis Patients.

OBJECTIVE: While the relationship between psoriatic arthritis and skin findings is well-known in patients with psoriasis, the relationship between psoriatic arthritis and nail involvement is less known. In this study, it was aimed to examine the frequency of association between nail involvement and psoriatic arthritis in patients with psoriasis. MATERIALS AND METHODS: Our study is a retrospective observational study. It was conducted with 250 regis- tered patients who applied to the dermatology polyclinic and clinic of our university hospital. The follow-up forms of the patients were scanned retrospectively and the findings were recorded. RESULTS: The average age of the 250 patients evaluated in this study was 39.62 ± 9.30, and 133 (53.2%) of them were women. The frequency of nail involvement in psoriasis patients was determined to be 36.8% (n=92) and the frequency of arthritis was determined to be 8.8% (n=22). Nail involvement was statisti- cally significantly more common in those with arthritis, and nail involvement was present in all of those with arthritis (P < .001). Nail involvement was significantly more common in those with only arthralgia (P < .001). A significantly higher average of nail psoriasis severity index was found in those with both joint and nail involvement compared to those with only nail involvement (P < .001). There was no statistically significant difference in terms of psoriasis area severity index average (P=.235). Proximal and distal interphalangeal arthralgia and sacroiliac arthralgia were found significantly more frequently in those with nail involvement than in those without nail involvement (respectively P = .007 and P < .001). There was no statistically signifi- cant relationship between nail involvement with the presence of arthritis and the clinical type (respectively P = .288 and P = .955). CONCLUSION: Joint involvement and nail involvement in patients with psoriasis are closely related, and we think that nail and joint involvement in psoriasis patients should be evaluated together.

Etiological causes in patients with acute urticaria and angioedema: A cross-sectional study.

BACKGROUND: Acute urticaria and angioedema are emergency dermatological conditions associated with various etiologic factors. OBJECTIVE: To determine the etiological causes in patients with acute urticaria and angioedema, and to investigate whether more than one etiological cause was present, along with the patients' laboratory values. METHODS: The study was conducted in a tertiary hospital with one center. Etiological causes and laboratory parameters in 284 patients diagnosed with acute urticaria and angioedema were retrospectively studied. RESULTS: A total of 284 patients were included in the study. The mean age of the patients was 42.7 ± 15.6 years, where 163 (57.4%) were women and 121 (42.6%) were men. Acute urticaria and angioedema occurred together in 149 (52.5%) patients. At least one precipitating factor among the predisposing risk factors was present in 220 (77.5%) patients, and more than one precipitating factor was found in 51 (18%) patients. Medication use was found in 157 (55.3%) patients and infection in 54 (19%). The development of urticaria after food consumption was noted in nine (3.2%) individuals. A history of infection and medication intake was present in 50 (17.6%) patients. A joint history of food consumption and medication intake was present in only one patient. Elevated C-reactive protein level was found in 178 (62.7%) patients and elevated anti-streptolysin O titer in 41 (14.4%) patients. Vitamin B12 deficiency was found in 116 (40.8%) patients and vitamin D deficiency in 254 (89.4%). CONCLUSION: Acute urticaria and angioedema may occur as a result of multiple etiological factors, in which different triggers may be present simultaneously.

Etiological causes in patients with acute urticaria and angioedema: A cross-sectional study

Background: Acute urticaria and angioedema are emergency dermatological conditions associated with various etiologic factors. Objective: To determine the etiological causes in patients with acute urticaria and angioedema, and to investigate whether more than one etiological cause was present, along with the patients’ laboratory values. Methods: The study was conducted in a tertiary hospital with one center. Etiological causes and laboratory parameters in 284 patients diagnosed with acute urticaria and angioedema were retrospectively studied. Results: A total of 284 patients were included in the study. The mean age of the patients was 42.7 ± 15.6 years, where 163 (57.4%) were women and 121 (42.6%) were men. Acute urticaria and angioedema occurred together in 149 (52.5%) patients. At least one precipitating factor among the predisposing risk factors was present in 220 (77.5%) patients, and more than one precipitating factor was found in 51 (18%) patients. Medication use was found in 157 (55.3%) patients and infection in 54 (19%). The development of urticaria after food consumption was noted in nine (3.2%) individuals. A history of infection and medication intake was present in 50 (17.6%) patients. A joint history of food consumption and medication intake was present in only one patient. Elevated C-reactive protein level was found in 178 (62.7%) patients and elevated anti-streptolysin O titer in 41 (14.4%) patients. Vitamin B12 deficiency was found in 116 (40.8%) patients and vitamin D deficiency in 254 (89.4%). Conclusion: Acute urticaria and angioedema may occur as a result of multiple etiological factors, in which different triggers may be present simultaneously (AU)

Vitamin D in Behcet's Disease, a Brief Review of the Literature.

Behcet's disease is a chronic vasculitis of unknown etiopathogenesis. Serum vitamin D levels have been reported to be associated with a variety of inflammatory and autoimmune diseases one of which is Behcet's disease. The previous studies about vitamin D in Behcet's disease seem to be focused on 4 main categories; the studies evaluating serum vitamin D levels between patients with Behcet's disease and controls, the studies evaluating serum vitamin D in the susceptibility and pathogenesis of Behcet's disease, the studies evaluating serum vitamin D in clinical involvements and activity of Behcet's disease, and the studies evaluating the effect of serum vitamin D replacement in Behcet's disease. The aim of this manuscript was to evaluate the results of the studies on serum vitamin D in Behcet's disease and review the literature.

A multicentre prospective analysis of the incidence of pemphigoid diseases in Turkey.

BACKGROUND: The differentiation between the pemphigoid diseases is essential for treatment and prognosis. In Turkey, data on the incidence of these diseases are insufficient. Our aim in this study is to determine the incidence, demographics and clinical characteristics associated with diseases of the pemphigoid group. METHODS: We prospectively analysed 295 patients with pemphigoid who visited dermatology clinics of tertiary referral hospitals in 12 different regions of Turkey within a year. The diagnosis was based on clinical, histopathological, direct immunofluorescence (DIF) and serological (multivariant enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence and mosaic-based BIOCHIP) examinations. Clinical and demographic findings, aetiological factors and concomitant diseases observed in the patients were recorded. RESULTS: A total of 295 (female/male ratio: 1.7/1) patients with pemphigoid were diagnosed in 1-year period. The overall incidence rate of pemphigoid diseases was found to be 3.55 cases per million-years. The ratio of pemphigoid group diseases to pemphigus group diseases was 1.6. The most common pemphigoid type was bullous pemphigoid (BP, 93.2%). The others were epidermolysis bullosa acquisita (3.1%), pemphigoid gestationis (2.4%), linear IgA disease (1%) and mucous membrane pemphigoid (0.3%). The most common (26.8%) possible trigger of the bullous pemphigoid was gliptin derivative drugs. The most common concomitant diseases with pemphigoid were cardiovascular (27.8%) and neurological diseases (23.7%). CONCLUSIONS: This study showed that the increased frequency of bullous pemphigoid reversed the pemphigoid/pemphigus ratio in Turkey. Further studies are warranted regarding the reasons for this increase.

Predictive modelling for the growth kinetics of Pseudomonas spp. on button mushroom (Agaricus bisporus) under isothermal and non-isothermal conditions.

Baranyi model was fitted to experimental growth data of Pseudomonas spp. on the button mushrooms (Agaricus bisporus) stored at different isothermal conditions (4, 12, 20 and 28 °C), and the kinetic growth parameters of Pseudomonas spp. on the button mushrooms were obtained. The goodness of fit of the Baranyi model was evaluated by considering the root mean squared error (RMSE) and the adjusted coefficient of determination (adjusted-R2). The Baranyi model gave RMSE values lower than 0.193 and adjusted-R2 values higher than 0.975 for all isothermal storage temperatures. The maximum specific growth rate (µmax) was described as a function of temperature using secondary models namely, Ratkowsky and Arrhenius models. The Ratkowsky model described the temperature dependence of µmax better than the Arrhenius model. Therefore, the differential form of the Baranyi model was merged with the Ratkowsky model, and solved numerically using the fourth-order Runge-Kutta method to predict the concentration of Pseudomonas spp. populations on button mushrooms under non-isothermal conditions in which they are frequently subjected to during storage, delivery and retail marketing. The validation performance of the dynamic model used was assessed by considering bias (Bf) and accuracy (Af) factors which were found to be 0.998 and 1.016, respectively. The dynamic model developed also exhibited quite small mean deviation (MD) and mean absolute deviation (MAD) values being -0.013 and 0.126 log CFU/g, respectively. The modelling approach used in this work could be an alternative to traditional enumeration techniques to determine the number of Pseudomonas spp. on mushrooms as a function of temperature and time.

The results of radiotherapy for squamous cell carcinomas of the skin.

Skin cancer patients with nonmelanoma skin cancer who have the highest risk of disease-specific death are squamous cell carcinoma (SCC). The aim of this study is to determine the characteristics (age, sex), indications, and doses of lesions and radiotherapy (RT), locoregional control (LRC), relapse-free survival (RFS), and overall survival (OS) rates in SCCs of the skin patients treated and followed at our clinic. For this purpose, 153 patients treated with RT and followed between 1996, January and 2018, December were included in the study. Of the patients, 95 (62%) were men and 58 (38%) woman. The mean age was 56.4 ± 13.9 (44-93) years. The primary tumor sites were 132 (86%) head and neck, 12 (8%) extremity and 9 (6%) trunk. The 3-year LRC, RFS, and OS rates were 88% (95% confidence interval [CI]: 82-98), 87% (95% CI: 80-96), and 92% (95% CI: 88-98), respectively. Men gender received significantly worse prognosis than female sex (p = .02). The recurrence-free rate of tumors 2 cm or smaller was significantly lower than tumors larger than 2 cm (p < .001). Cosmetic results were good in 29% of the patients, fair in 50%, and poor in 21%. RT plays an integral role in the treatment of primary and postoperative SCCs.

Radiotherapy in the management of classic Kaposi's sarcoma: A single institution experience from Northeast Turkey.

Kaposi sarcoma is a rare adult neoplasm and there has been no certain consensus on standard treatment, either local or systemic. Radiotherapy is an effective, suitable treatment modality. Between 1996 and 2016, patients who were diagnosed with Kaposi sarcoma and referred to our clinic for radiotherapy were included in this retrospective study. Ninety-two patients were examined in total and it was diagnosed that all the patients had non-HIV associated Kaposi's sarcoma. There were 36 (39%) females and 56 (61%) males and female to male ratio was 2/3. Median age at presentation was 72 (30-93) years. Sixty-eight patients (77%) were treated with 8 Gy (1 fraction), 15 patients (16%) were treated with 20 Gy (2 Gy/fraction), four patients (4%) were treated 25 Gy (2.5 Gy/fraction), and five patients (6%) were treated 30 Gy (3 Gy/fraction). The median follow-up time was 72 (5-192) months. The complete response at 5 years was 91.6% with >20 Gy and 89.6% with 8 Gy. Radiotherapy is an effective, suitable treatment modality of Classic Kaposi sarcoma and usually, radiotherapy is well tolerated with minimal side effects.

Mathematical modelling of temperature effect on growth kinetics of Pseudomonas spp. on sliced mushroom (Agaricus bisporus).

The growth data of Pseudomonas spp. on sliced mushrooms (Agaricus bisporus) stored between 4 and 28°C were obtained and fitted to three different primary models, known as the modified Gompertz, logistic and Baranyi models. The goodness of fit of these models was compared by considering the mean squared error (MSE) and the coefficient of determination for nonlinear regression (pseudo-R2). The Baranyi model yielded the lowest MSE and highest pseudo-R2 values. Therefore, the Baranyi model was selected as the best primary model. Maximum specific growth rate (rmax) and lag phase duration (λ) obtained from the Baranyi model were fitted to secondary models namely, the Ratkowsky and Arrhenius models. High pseudo-R2 and low MSE values indicated that the Arrhenius model has a high goodness of fit to determine the effect of temperature on rmax. Observed number of Pseudomonas spp. on sliced mushrooms from independent experiments was compared with the predicted number of Pseudomonas spp. with the models used by considering the Bf and Af values. The Bf and Af values were found to be 0.974 and 1.036, respectively. The correlation between the observed and predicted number of Pseudomonas spp. was high. Mushroom spoilage was simulated as a function of temperature with the models used. The models used for Pseudomonas spp. growth can provide a fast and cost-effective alternative to traditional microbiological techniques to determine the effect of storage temperature on product shelf-life. The models can be used to evaluate the growth behaviour of Pseudomonas spp. on sliced mushroom, set limits for the quantitative detection of the microbial spoilage and assess product shelf-life.

Sleep Quality and its Association with Disease Severity in Psoriasis.

OBJECTIVE: The main purpose of this research was to crosscheck sleep quality in patients with psoriasis with that in healthy individuals and to evaluate a possible relationship between sleep quality and disease severity in these patients. MATERIALS AND METHODS: Fifty-eight patients with plaque psoriasis and 58 age- and gender-matched healthy individuals were included. The Psoriasis Area and Severity Index (PASI) scoring method was used to assess the disease severity in patients with psoriasis. The sleep quality of the participants was evaluated by the Pittsburgh Sleep Quality Index (PSQI). The sleep quality scores of the patients with psoriasis were compared to those of healthy controls. Pearson's correlation test and independent samples t-test and were used to interpret the data. RESULTS: The mean disease duration was 11.1±7.4 years (mean±standard deviation), and the mean PASI was 14.1±5.3. In total, 60% of the patients with psoriasis (n=35) experienced poor sleep quality, and this frequency was considerably higher in the patients with psoriasis than in the healthy controls (p<0.000). Further, the mean PSQI in the patients with psoriasis (7.01±41.4) was higher than that in the healthy controls (4.18±2.76, p=0.000). The scores of daytime dysfunction, habitual sleep efficiency, and subjective sleep quality, which are the three components of sleep quality, were considerably higher in the patients with psoriasis than in the healthy controls (p=0.007, p=0.032, and p=0.034, respectively). CONCLUSION: Our results showing impaired sleep quality and its association with disease severity in patients with psoriasis may contribute to the management of psoriasis.

Fermentative polyhydroxybutyrate production from a novel feedstock derived from bakery waste.

In this study, Halomonas boliviensis was cultivated on bakery waste hydrolysate and seawater in batch and fed-batch cultures for polyhydroxybutyrate (PHB) production. Results demonstrated that bakery waste hydrolysate and seawater could be efficiently utilized by Halomonas boliviensis while PHB contents between 10 and 30% (w/w) were obtained. Furthermore, three methods for bakery waste hydrolysis were investigated for feedstock preparation. These include: (1) use of crude enzyme extracts from Aspergillus awamori, (2) Aspergillus awamori solid mashes, and (3) commercial glucoamylase. In the first method, the resultant free amino nitrogen (FAN) concentration in hydrolysates was 150 and 250 mg L(-1) after 20 hours at enzyme-to-solid ratios of 6.9 and 13.1 U g(-1), respectively. In both cases, the final glucose concentration was around 130-150 g L(-1). In the second method, the resultant FAN and glucose concentrations were 250 mg L(-1) and 150 g L(-1), respectively. In the third method, highest glucose and lowest FAN concentrations of 170-200 g L(-1) and 100 mg L(-1), respectively, were obtained in hydrolysates after only 5 hours. The present work has generated promising information contributing to the sustainable production of bioplastic using bakery waste hydrolysate.

What affects the quality of life in patients with Behcet's disease?

AIM: The aim of this study was to evaluate the possible associations between quality of life (QoL) and sociodemographic features, disease characteristics and the Behcet's Disease (BD) disease activity of the patients with BD. PATIENTS AND METHODS: One hundred and seven patients with BD were included in this study. Sociodemographic features including age, gender, education level of the patients and the disease characteristics including disease duration, disease onset age, the history BD clinical involvements were recorded. In patients with BD, the BD Current Activity Form was used for the evaluation of disease activity. The short form-36 (SF-36) QoL scale was used to evaluate the QoL in patients with BD. The Student t test, analysis of variance and Spearman's correlation matrix were used for the statistical analysis. RESULTS: Men showed higher mean scores of role-physical and bodily pain domains of SF-36 than women did (p <0.000 and 0.001). Patients over 41 years of age had higher mean general health scores and university graduates patients had higher mean mental health scores than the other groups (p <0,01). Patients with a disease duration more than 5 years and patients have a younger disease onset age showed lower general health score than the others (p <0,01). Also patients with an anamnesis of uveitis, genital ulceration, erythema nodosum, thrombophlebitis, joint and gastrointestinal system involvement showed lower QoL than the patients without these complaints (p <0,05 and p <0,01). In the analysis of disease activity physical subscores of SF-36 were found to be correlated with fatigue, oral ulceration and joint involvement (p <0,01). Bodily pain showed a correlation with fatigue, headache and more highly with joint involvement (p <0,01 and p <0,001 respectively). General health was correlated with GIS and eye involvement and vitality was found to be correlated with fatigue, patient's and doctor's impression of disease activity (p <0,01). Mental and emotional scores were correlated with oral- genital ulceration, eye and joint involvements (p <0,01). CONCLUSION: In addition to demografic features and clinical involvements, BD disease activity can affect QoL in patients with BD. These results highlight the importance of managing the symptoms and the disease activity effectively in order to improve QoL in BD.

Is there a relation between clinical disease activity and acute phase response in Behcet's disease?

The aim of this study was to evaluate a possible relation between clinical disease activity determined by a scale validated and most widely used acute phase response parameters in patients with Behcet's Disease (BD). One hundred patients with BD were included in this study. The demographic properties including age, sex, and disease durations were recorded. BD Current Activity Form (BDCAF), which scores the history of clinical features that have been present during the four weeks prior to the day of assessment, was used for the evaluation of disease activity. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were evaluated as acute phase response. The independent samples t test and Pearson's correlation test were performed for the statistical analysis. There were 60 male and 40 female patients with an age range of 19-51 years. The disease durations of the patients were between 12 and 240 months. In the comparison of the laboratory parameters of the patients with or without the components of BDCAF, we found significantly higher levels of ESR and CRP in patients with erythema and arthralgia-arthritis versus without these involvements. There were significant positive correlations between ESR-CRP levels and patient's perception of disease activity (P = 0.012 and P < 0.05, respectively), clinician's overall perception of disease activity (P < 0.005), and total BDCAF score (P = 0.008 and P < 0.000, respectively). In conclusion, the presence of a newly-developed erythema nodosum, superficial thrombophlebitis, or joint involvement may be associated with higher levels of ESR and CRP. Also, correlations between these indices and general disease activity scores may contribute the overall disease activity perception in BD.

The prevalence of fibromyalgia in patients with Behçet's disease and its relation with disease activity.

Behçet's disease (BD) is a chronic disorder characterized by mucocutaneous and multisystem manifestations. Fibromyalgia (FM) is characterized by widespread musculoskeletal pain and may be present concomitantly with several rheumatic diseases. Our aims were to investigate the prevalence of FM in patients with BD and to evaluate the possible relation of FM presence with BD disease activity. A total of 104 Behcet patients were included in this study. Age, sex, disease durations and the BD Current Activity Form (BDCAF) scores as disease activity evaluation were recorded. Presence of FM and the Fibromyalgia Impact Questionnaire (FIQ) scores was investigated. Also, ESR and CRP concentrations were determined in all patients. Mann-Whitney U test and Pearson's correlation tests were used for the statistical analysis. There were 60 female and 40 male patients with an age range of 19-51 years. Eighteen of 100 BD patients were diagnosed as FM. Although ages, disease duration and laboratory parameters did not differ between BD patients with and without FM, BD patients with FM were more frequently female (p < 0.000). The presence of FM did not differ significantly between patients with and without systemic manifestations. Also, oral-genital ulcers, erythema nodosum, thrombophlebitis, pustular lesions and doctor's impression of disease activity scores were not found to be different in BD patients with or without FM. However, there were significant differences in fatigue, headache, arthralgia and patient impression of disease activity (today and last 28 days) between these groups (p < 0.000; p < 0.01; p < 0.01; p = 0.021 and p = 0.027, respectively). Also, there were significant correlations between BDCAF and FIQ items that refer pain and fatigue (p < 0.01). FM is a common and important clinical problem that may represent an additional factor that worsens pain and physical limitations in patients with BD. The higher prevalence of FM in patients with BD seems to be affected by BD itself, rather than its severity.

Predisposition of allergy in patients with benign migratory glossitis.

OBJECTIVE: The purpose of this study was to investigate the presence of allergy in patients with benign migratory glossitis (BMG) using patch and prick tests. PATIENTS AND METHODS: Eighty patients (40 BMG and 40 healthy controls) received patch and prick tests. If at least one test result was positive, patients were considered to be allergic. RESULTS: The prick test was positive in 10 patients (25.0%) of the study group and in 4 patients (10.0%) of the control group. The patch test was positive in 12 patients (30.0%) of the study group and in 6 patients (15.0%) of the control group. When results of both tests were evaluated together, the study group showed a positive rate of 47.5% (n = 19), whereas the control group showed a positive rate of 22.5% (n = 9) (P = .02). CONCLUSION: Our results revealed that a combination of prick and patch tests can significantly enhance the diagnostic accuracy of predisposition of allergy in patients with BMG.