Effectiveness and safety of ustekinumab for the treatment of psoriasis; six years of clinical experience.

BACKGROUND: This work aimed to investigate the long-term clinical experience with ustekinumab in cases with psoriasis. MATERIALS AND METHODS: This retrospective cohort research group consisted of cases who presented to the dermatology outpatient clinics between January 2015 and January 2021, diagnosed with psoriasis, and were treated with ustekinumab. Data including gender, age, weight, disease duration, naïve and non-naïve status, psoriasis type, duration of medication, comorbidities, psoriasis area and severity index scores, the causes of treatment discontinuation, and previous treatments were retrospectively reviewed and analyzed. RESULTS: 160 cases with psoriasis were treated with ustekinumab during the research period. Twenty-four patients were excluded. Among 136 cases, 84 (61.8%) were male and 52 (38.2%) were female. We determined 80.55% of the non-naïve cases responded to ustekinumab. CONCLUSION: Ustekinumab can be a suitable treatment option for non-naïve and resistant patients. Our data suggest the positive effect persists in cases with favorable responses to the first or second dose of ustekinumab. Also, we determined male cases gave more rapid and more robust responses than female cases, and patients were more willing about continuing the treatment.

Mastoid Emissary Vein Canal Incidence and Its Relationship with Jugular Bulb and Sigmoid Sulcus Anatomical Variations.

Objective: We aimed to investigate the mastoid emissary vein (MEV) canal incidence and to identify its relationship with jugular bulb (JB) and sigmoid sulcus anatomical variations. Methods: We retrospectively reviewed 1,300 patients with temporal bone computed tomography (CT) scans in January 2016 to March 2020. The presence and the diameter of the MEV canal, and the anatomical variations of the sigmoid sulcus and the JB were reviewed by two radiologists. High riding JB, JB diverticulum, dehiscent JB, and anterior and lateral protrusion of the sigmoid sulcus were evaluated. All variables were summarized using descriptive statistics. The differences between the groups for categorical data were investigated using the chi-square test. Numeric variables were compared with the Mann-Whitney and the Kruskal-Wallis tests. Logistic regression models were constructed. Results: The study included 1,269 patients of whom 694 were female (54.7%) and 575 were male (45.3%). Their mean age was 39.01±18.47. Among them 915 (72.1%) had the right and 871 (68.6%) had the left MEV canal. Men were more likely to have the MEV canal on both sides. The presence of the right and left MEV canals was associated with the ipsilateral dominant JB/sigmoid sulcus. The left MEV canal was associated with the left high riding JB and right dehiscent JB. Conclusion: This is the largest patient population reported in the literature and allows a more precise estimate of the MEV canal incidence. We also classified the diameter of the MEV canal to identify clinically relevant, prominent MEV incidence. This is also the first study to demonstrate a relationship between the presence of the MEV canal, and the JB and sigmoid canal variations. Since both the prominent MEV and the JB variations may be symptomatic, knowing this association between them may have clinical relevance.

Investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea.

We aimed to investigate the relationship between rosacea and thyroid diseases by analyzing thyroid blood tests and ultrasound findings of our patients recently diagnosed with rosacea. This study was designed as a prospective, single-center study. Dermatological examination findings, lesion locations were recorded, and rosacea clinical scores were calculated for all study group patients. The control group consisted of completely healthy women presented to our hospital during the study period for check-up purposes. Serum-free thyroxine, free triiodothyronine, thyroid-stimulating hormone, antithyroglobulin antibody, antithyroid peroxidase antibody levels were measured, and thyroid ultrasound examinations were performed for all study participants. The entire study cohort consisted of 123 patients (63 cases and 60 controls). There was no significant difference between the groups in terms of mean patient age (P < .05). Cheek was the most common lesion location (96.8%). There was no difference between the groups in terms of thyroid-related laboratory parameters. However, anti-TPO levels differed significantly with increasing disease severity (ie, RCSs). There were significant relationships between cheek lesions and fT4 (P = .021), while nose and chin lesions were associated with fT3 (P = .01, P = .001). Thyroid ultrasound findings revealed that rosacea patients tended to have larger thyroid nodules and more heterogeneous thyroid parenchymas than controls. Our findings indicate that thyroid blood tests, including thyroid autoantibodies, should be tested and thyroid ultrasounds should be performed in patients diagnosed with rosacea. However, these findings need to be validated by prospective studies conducted in larger patient series with more extended follow-up periods.

Effects of irradiation dose and O(2) and CO(2) concentrations in packages on foodborne pathogenic bacteria and quality of ready-to-cook seasoned ground beef product (meatball) during refrigerated storage.

Combined effects of gamma irradiation and concentrations of O(2) (0, 5, 21%) and CO(2) (0, 50%) on survival of Escherichia coli O157:H7, Salmonella enteritidis, Listeria monocytogenes, lipid oxidation, and color changes in ready-to-cook seasoned ground beef (meatball) during refrigerated storage were investigated. Ground beef seasoned with mixed spices was packaged in varying O(2) and CO(2) levels and irradiated at 2 and 4 kGy. Irradiation (4 kGy) caused about 6 Log inactivation of the inoculated pathogens. Inactivation of Salmonella was 0.9- and 0.4-Log lower in 0 and 5% O(2), respectively, compared to 21% O(2). Irradiation at 2 and 4 kGy increased thiobarbituric acid reactive substances in meatballs by 0.12 and 0.28 mg malondialdehyde kg(-1), respectively, compared to control. In reduced-O(2) packages, radiation-induced oxidation was lower, and the initial color of an irradiated sample was maintained. Packaging with 0% + 50% CO(2) or 5% O(2) + 50% CO(2) maintained the oxidative and the color quality of irradiated meatballs during 14-day refrigerated storage. MAP with 5%O(2) + 50% CO(2) combined with irradiation up to 4 kGy is suggested for refrigerated meatballs to reduce the foodborne pathogen risk and to maintain the quality.

Maintenance of safety and quality of refrigerated ready-to-cook seasoned ground beef product (meatball) by combining gamma irradiation with modified atmosphere packaging.

UNLABELLED: Meatballs were prepared by mixing ground beef and spices and inoculated with E. coli O157:H7, L. monocytogenes, and S. enteritidis before packaged in modified atmosphere (3% O2 + 50% CO2 + 47% N2) or aerobic conditions. The packaged samples were irradiated at 0.75, 1.5, and 3 kGy doses and stored at 4 °C for 21 d. Survival of the pathogens, total plate count, lipid oxidation, color change, and sensory quality were analyzed during storage. Irradiation at 3 kGy inactivated all the inoculated (approximately 106 CFU/g) S. enteritidis and L. monocytogenes cells in the samples. The inoculated (approximately 106 CFU/g) E. coli O157:H7 cells were totally inactivated by 1.5 kGy irradiation. D¹°-values for E. coli O157:H7, S. enteritidis, and L. monocytogenes were 0.24, 0.43, and 0.41 kGy in MAP and 0.22, 0.39, and 0.39 kGy in aerobic packages, respectively. Irradiation at 1.5 and 3 kGy resulted in 0.13 and 0.36 mg MDA/kg increase in 2-thiobarbituric acid-reactive substances (TBARS) reaching 1.02 and 1.49 MDA/kg, respectively, on day 1. Irradiation also caused significant loss of color and sensory quality in aerobic packages. However, MAP effectively inhibited the irradiation-induced quality degradations during 21-d storage. Thus, combining irradiation (3 kGy) and MAP (3% O2 + 50% CO2 + 47% N2) controlled the safety risk due to the potential pathogens and maintained qualities of meatballs during 21-d refrigerated storage. PRACTICAL APPLICATION: Combined use of gamma irradiation and modified atmosphere packaging (MAP) can maintain quality and safety of seasoned ground beef (meatball). Seasoned ground beef can be irradiated at 3 kGy and packaged in MAP with 3% O2 + 50% CO2 + 47% N2 gas mixture in a high barrier packaging materials. These treatments can significantly decrease risk due to potential pathogens including E. coli O157:H7, L. monocytogenes, and S. enteritidis in the product. The MAP would reduce the undesirable effects of irradiation on quality, and extend the shelf life of the product for up to 21 d at 3 °C.

Subacute sclerosing panencephalitis: clinical and magnetic resonance imaging evaluation of 36 patients.

We studied 36 patients (24 males, 12 females), all of whom had definite subacute sclerosing panencephalitis with typical periodic complexes in their electroencephalograms and increased titers of measles antibody in serum and cerebrospinal fluid. Their clinical and laboratory findings on admission were reviewed retrospectively. The age at onset of symptoms varied from 4 to 23 years. The average age at onset of disease was 13.1 +/- 4.18 years. The mean of the duration from the infection to the onset of subacute sclerosing panencephalitis was 9 years. Unusual symptoms, especially in the early periods of disease, included hemiparesis (7 patients), headache (3), generalized tonic-clonic seizures (6), absence seizure (1), nausea (3), and vomiting (3). Twenty-six cranial magnetic resonance imaging (MRI) and 12 computed tomography examinations were performed. Nine patients had normal MRI. In the early stages, lesions usually involved parieto-occipital corticosubcortical regions asymmetrically. In time, symmetric periventricular white-matter changes became more prominent. In addition to the common clinical findings in cases of subacute sclerosing panencephalitis reported in the literature, there were some different clinical features of the disease. Eventually, we concluded that there seems to be no correlation between the clinical stages and either the duration from the onset of subacute sclerosing panencephalitis or the MRI findings.