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1.
Health Econ Rev ; 11(1): 39, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34623528

RESUMO

BACKGROUND: During the COVID-19 pandemic, health care systems are under extreme pressure. This study analyzed health care resource use (HCRU) and costs in patients admitted to the hospital for COVID-19 and aimed to estimate the one-year direct medical cost of the disease in Turkey. METHODS: This retrospective cohort study was conducted between March and July 2020 in a tertiary hospital (n = 1056) in Istanbul. Patient demographics, clinical and treatment characteristics at admission, comorbidities, disease severity, and costs from a payer perspective were evaluated using the microcosting method. The results include LOS, hospital costs, and univariate and generalized linear models to investigate influencing factors. The data were extrapolated to provide a country-level estimate. RESULTS: The mean length of stay was 9.1 days (SD 6.9). The mean length of stay was 8.0 days (4.7) for patients hospitalized in wards versus 14.8 days (SD 12.0) for patients hospitalized in the ICU. In univariate analysis, several factors, including O2 therapy (+ 3.7 days), high CRP > 41.8 mg/L (+ 3.8 days), and elevated ferritin (+ 3.5), were found to be associated with a longer LOS (p < 0.05). The direct annual medical cost of COVID-19 was estimated at PPP$ 2.1 billion. The COVID-19 pandemic resulted in a direct medical burden that corresponds to 2.0% of the government health expenditures and 0.8 per thousand of Turkey's gross domestic product (GDP). CONCLUSIONS: Estimating the impact of this pandemic in terms of HCRU and costs to the health care system can help design strategies to manage the pandemic.

2.
J Cosmet Dermatol ; 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34601819

RESUMO

BACKGROUND: Radiofrequency is a commonly used method to non-invasively tighten the skin that can be safely applied to any skin type. AIMS: The aim of our study was to evaluate the safety and efficacy of the focused radiofrequency and ultrasound hybrid device for face and neck rejuvenation, in terms of improvement of facial wrinkles and jaw sagging. METHODS: A total of 158 patients had undergone four weekly sessions of focused radiofrequency and ultrasound to face and neck area. Photodocumentation was obtained before first visit and two weeks after last visit. An independent, blinded dermatologist evaluated the severity of wrinkles and sagging of seven different anatomical regions on a validated scale of 0-4 (0: no lines/sagging, 1: mild, 2: moderate, 3: severe, 4: very severe) before and after the procedure. Patients rated their satisfaction with the result of the treatment on a scale of 1-5 (1: dissatisfied, 2: poorly satisfied 3: satisfied, 4: very satisfied, 5: perfectly satisfied). RESULTS: For seven anatomical regions, statistically significant reduction was observed in mean wrinkle/sagging scores (p = < 0.001). Patients were satisfied with the effects of the procedure, with a mean satisfaction score of 4.61 ± 0.55. CONCLUSIONS: Our findings demonstrate that combined focused radiofrequency and ultrasound is an effective and safe method for the rejuvenation of different sub-areas of the face and neck with high patient satisfaction scores.

3.
Int J STD AIDS ; : 9564624211043711, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34565234

RESUMO

This study aimed to document the dermatoses and their relationships with CD4+ T lymphocyte counts and clinical stages of disease among people living with HIV followed by our Clinical Department, to investigate the effect of antiretroviral therapy (ART) on findings and to compare with real-world data. Medical records of people living with HIV were analyzed retrospectively in our outpatient clinic from January 2005 to June 2017. A total of 500 patient files were examined. 179 patients with dermatoses were included in the study. Demographic data, clinical and laboratory findings, dermatological findings, type and distribution of lesions, serological and histopathological examinations, diagnosis, treatment, and follow-up of patients were transferred to data forms. 84.4% of the patients were male and the mean age was 38.65 ± 11.6 years. The median CD4+ T lymphocyte count was 253/mm3 (range:0-1067). At least one dermatosis was present in 69.3% of the patients. Compared with their median CD4+ T lymphocyte counts, the ratio of CD4+ T lymphocytes was significantly lower in the group with three or more dermatoses (p = 0.019). Condyloma acuminatum (15.1%), drug eruption (13.4%), seborrheic dermatitis (11.7%), oral candidiasis (11.2%), dermatophytoses (11.2%), syphilis (8.4%), Kaposi's sarcoma (8.4%), and telogen effluvium (8.4%) were the most common dermatoses. Kaposi sarcoma (KS), oral candidiasis, onychomycosis, and molluscum contagiosum were significantly higher in the CD4+ T lymphocyte <200/mm³ group when CD4+ T lymphocyte threshold value was determined as 200/mm³. Compared with other TDF/FTC-containing regimens, a significantly higher proportion of alopecia was reported in patients receiving TDF/FTC/EVG/c (p = 0.007). Dermatoses may be a good clinical marker for detecting clinical stage and diagnosing HIV infection; also, there may be a significant increase in the number of dermatoses in advanced stages. Although there are only a few studies in the literature, it should be kept in mind that ART-associated alopecia rates may increase nowadays when ART is targeted at everyone.

4.
Adv Ther ; 38(9): 4935-4948, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34379304

RESUMO

INTRODUCTION: This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. METHODS: We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO2 < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer's perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 × per capita gross domestic product-GDP) and USD 25.797 (3 × GDP) per QALY was used. RESULTS: In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. CONCLUSIONS: Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO2 < 94% who require oxygen support.


Assuntos
COVID-19 , Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , COVID-19/tratamento farmacológico , Análise Custo-Benefício , Humanos , Oxigênio , SARS-CoV-2 , Turquia
5.
Mikrobiyol Bul ; 55(3): 342-356, 2021 Jul.
Artigo em Turco | MEDLINE | ID: mdl-34416801

RESUMO

Limited data exists to date on the predictors for the development of pneumonia in patients with mild and moderate coronavirus (COVID-19). In this study, it was aimed to evaluate the demographic characteristics and clinical findings of mild and moderate COVID-19 and to determine the risk factors for the development of COVID-19 pneumonia in patients admitted to the pandemic outpatient clinic of a university hospital. A total of 414 patients with laboratory confirmed COVID-19 were included. Of these, 220 (53.1%) were male, the mean age was 38.3 ± 12.7. Median duration of hospital admission from the onset of symptoms was three days (0-11). Of the confirmed COVID-19 cases, 154 (37.2%) had a history of family contact and the most common symptoms were weakness (68.4%), myalgia (61.8%), headache (56.5%), loss of smell (45.2%), loss of taste (43.2%) and anorexia (42.8%). Among females, weakness (p= 0.016), headache (p= 0.008), sore throat (p= 0.032), nausea (p= 0.003), anorexia (p= 0.045), loss of taste (p= 0.005) and loss of smell (p<0.001) were more common. Loss of taste (47.6% vs. 25%, p<0.001) and loss of smell (50% vs. 26.3%, p<0.001) were more common in patients with under the age of 50 and cough (43.4% vs. 29.3%, p= 0.003) was more common in patients with above the age of 40. Among 46 (11.1%) patients with asymptomatic COVID-19, there was no significant difference (p= 0.500) between the genders. Pneumonia was detected in 150 (43.8%) of 339 patients who underwent thorax computed tomography. In the univariate analysis; advanced age (p<0.001, odds ratio (OR)= 1.44), obesity (p<0.001 OR= 2.5), not being actively smoking (p<0.001, OR= 6.19), fever at first admission (p= 0.002, OR= 2.02), cough (p<0.001, OR= 3.26), shortness of breath (p<0.001, OR= 23.37), weakness (p= 0.042, OR= 1.63), anorexia (p= 0.009, OR= 1.79) and elevation of D-dimer (p= 0.014, OR= 1.92) were associated with the development of pneumonia. In multivariate analysis, obesity (p= 0.005, OR= 2.69), not being actively smoking (p<0.001, OR= 5.43), cough at first admission p= 0.017, OR= 2.16) and shortness of breath (p= 0.008, OR= 16.22) was determined as an independent risk factor for the development of pneumonia. CRP (p<0.001), D-dimer (p<0.001), ferritin (p<0.001) values among 108 (26.1%) patients with a body-mass index(BMI) >30 were high, and 60.9% of the patients had pneumonia (p<0.001) . CRP (p<0.001), D-dimer (p= 0.010) values were low, lymphocyte count (p= 0.001) was high among 106 (25.6%) active smokers, and 15.6% of the patients had pneumonia (p<0.001). Of the patients reported with persistent symptoms, 25.9% had loss of smell, 25% had weakness, and 23.1% had loss of taste on the seventh day; 21.1% had loss of smell, 21.1% had myalgia, and 19.7% had loss of taste on the 14th day. During their follow-up, the COVID-19 polymerase chain reaction (PCR) test was studied in 286 patients for control purposes. The median time of being negative for COVID-19 PCR test was eight days (3-56). In conclusion, symptoms may last longer than 14 days in 20- 30% of patients presenting with mild-moderate clinical findings. In addition, obesity should be considered as an important risk factor for COVID-19 pneumonia.


Assuntos
COVID-19 , Pneumonia , Adulto , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/epidemiologia , Pneumonia/etiologia , Fatores de Risco , SARS-CoV-2
6.
Eye Contact Lens ; 47(11): 604-610, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34310352

RESUMO

PURPOSE: The comparison of the efficacy of swabs containing tea tree oil and chamomile oil and baby shampoo (BS) in the treatment of seborrheic blepharitis was aimed. METHODS: This randomized, double-blind, parallel-group, active control, multicenter clinical trial included patients with seborrheic blepharitis using block randomization (BS, n=23; swabs, n=26). Patients were treated with BS or swabs for 8 weeks followed by 4 weeks of treatment withdrawal. Change in Blepharitis Symptom measure (BLISS), Demodex count, Ocular Surface Disease Index (OSDI) score, Schirmer test, tear breakup time (TBUT), noninvasive TBUT (NI-TBUT), corneal staining, and meibography at different visits (baseline, fourth, , and 12th week) were the main outcome measures. RESULTS: Patients in both groups showed similar baseline parameters (P>0.05). Patients using swabs showed significantly lower BLISS scores compared with patients using BS at the 4th, 8th, and 12th week visits (3.6±6.1 vs. 6.3±4.5 P=0.011; 1.1±2.8 vs. 6.6±6.7, P<0.001; 0.9±2.8 vs. 5.7±6.6, P=0.002, respectively). Patients using swabs showed improvement in OSDI scores after 8 weeks of treatment compared with the baseline visit (P<0.001). Despite a similar Demodex reduction effect in both treatment arms even after 4 weeks of treatment (P<0.001), both treatment modalities did not show any effect on the other parameters. CONCLUSION: Although both swabs and BS showed efficacy for the treatment of seborrheic blepharitis in terms of the Demodex reduction and symptomatic improvement, swabs may provide better symptomatic improvement. Four weeks of treatment discontinuation may not cause any recurrence in the symptoms or Demodex infestation.

7.
Eye (Lond) ; 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34183794

RESUMO

PURPOSE: To investigate the efficacy of lid wipes (LWs) containing terpinen-4-ol and sodium hyaluronate (Hy-ter®) for the treatment of seborrheic blepharitis compared to baby shampoo (BS). METHODS: This randomized, double-blind, active control, parallel group, multicentre clinical trial included 48 eyes of 48 patients with seborrheic blepharitis who were randomly divided into two treatment arms (1:1, n = 24) using block randomization. LWs or BS were prescribed twice a day for 8 weeks followed by a discontinuation period of 4 weeks. Change in Blepharitis Symptom measure (BLISS), Schirmer's test, tear breakup time (TBUT), noninvasive TBUT (NI-TBUT), ocular surface disease index (OSDI) score, corneal and conjunctival staining, meibography, and Demodex count at different visits (Baseline, 4th, 8th, and 12th week) were the main outcome measures. RESULTS: The baseline values of both groups were similar (p > 0.05). Despite high clinical efficacy in both treatment arms, patients using LWs showed a lower BLISS score at the 8th and 12th-week visit (1.9 ± 2.2 versus 7.2 ± 6.6, p = 0.003; 4.0 ± 1.3 versus 5.8 ± 6.3, p = 0.026). NI-TBUT showed a significant increase starting from the 4th week for patients using LWs and 8th week for patients using BS. Both treatment modalities caused a reduction in the Demodex count after 4 weeks of treatment (p < 0.001). The treatment withdrawal did not cause any recurrence in both treatment arms. CONCLUSION: BS or LWs containing Hy-ter® can be used with good efficacy for the treatment of seborrheic blepharitis. However, LWs may provide a better symptomatic relief compared to BS after 8 weeks of treatment.

8.
Dermatol Surg ; 47(8): 1167-1168, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-33625131
9.
Turk J Med Sci ; 51(1): 124-133, 2021 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32892539

RESUMO

Background/aim: Autoimmune bullous diseases, if left untreated, are life-threatening conditions affecting primarily skin and mucous membranes. These blistering disorders are characterized by epidermal or subepidermal detachment. Autoimmunity plays a key role in pathogenesis; therefore, immunosuppressive agents are the treatment of choice. The aim of this study is to document relative frequencies of different autoimmune bullous diseases, patient characteristics, treatment options, and side effects in patients presenting to our bullous skin disease center at Istanbul University, Cerrahpasa, Cerrahpasa Medical Faculty. Materials and methods: Medical files were examined retrospectively for all patients with autoimmune bullous diseases who were followed up between 2003 and 2019 at the Bullous Skin Disease Center at Istanbul University, Cerrahpasa. Results: A total of 346 patient files were examined. Pemphigus vulgaris was the most frequent autoimmune bullous disease, followed by bullous pemphigoid and pemphigus foliaceus, according to our study. There is a general female predominancy for all autoimmune bullous diseases. The most commonly preferred treatment options were high-dose daily corticosteroids. Conclusion: This retrospective study summarizes the patient characteristics, comorbidities, treatment choices, and side effects during 16 years of clinical practice.

10.
Dermatol Ther ; 34(1): e14647, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33296557

RESUMO

Rituximab is a monoclonal antibody that targets CD20, a B-lymphocyte antigen; that leads to a decline in the B-cell counts for at least a year. The patients who have received rituximab treatment in the previous 5 years with the diagnosis of pemphigus group of diseases at Cerrahpasa Medical Faculty were questioned for COVID-19 infection. A total of 48 patients were included in this study; only one male patient had COVID-19 infection which had a mild course. There is no significant difference in the total number of lymphocytes between patients who have received rituximab within the previous 5 years or last year. The number of lymphocytes is independent of the number of courses of rituximab treatment received. Therefore, we suggest that all pemphigus patients who have received rituximab treatment within the previous 5 years should be careful of the preventive measures against the COVID-19 infection irrespective of the number of treatment courses or the number of years which has passed since the treatment. The disease course was mild in the only infected patient. Thus, rituximab may be used in the treatment of pemphigus vulgaris during the COVID-19 pandemic if its use is necessary.


Assuntos
COVID-19 , Pênfigo , Rituximab/uso terapêutico , Adulto , Feminino , Humanos , Fatores Imunológicos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Pandemias , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Pênfigo/epidemiologia , Rituximab/efeitos adversos , SARS-CoV-2 , Resultado do Tratamento
11.
J Cosmet Dermatol ; 20(8): 2507-2511, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33340220

RESUMO

BACKGROUND: Energy-based devices are increasingly used for noninvasive body contouring. Our aim was to investigate the clinical efficacy of combined radiofrequency and ultrasound device for reduction in body circumference in various body parts. AIMS: The aim of our study was to investigate the clinical efficacy of combined focused radiofrequency and ultrasound device for reduction in body circumference in various body parts. We aimed to report objective measurements in terms of circumference reduction and patient satisfaction scores. METHODS: We retrospectively analyzed data of 64 patients who were treated with focused radiofrequency and ultrasound device during August 2017-December 2019. All patients had received 4 sessions at one-week interval. Body circumference measurements were done before treatment and one month after the last session. Patients were also asked to score their satisfaction with the result of treatment on a scale of 1 to 5. RESULTS: Abdomen was treated in 40 patients, thighs in 18 patients, and arms in 7 patients. One patient had received treatments to both abdomen and thighs. Circumference measurements in all body parts differed significantly between baseline and one month after the 4th session. Patients were satisfied with the result of treatment (score: 4.48 ± 0.66). No adverse events were noted. CONCLUSIONS: Focused radiofrequency and ultrasound combination is a safe and effective treatment modality for body contouring. Patients should be informed about moderate degrees of improvement.


Assuntos
Contorno Corporal , Técnicas Cosméticas , Terapia por Radiofrequência , Humanos , Estudos Retrospectivos , Coxa da Perna/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
12.
North Clin Istanb ; 7(6): 597-602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33381700

RESUMO

OBJECTIVE: Pemphigus vulgaris is an autoimmune blistering disease affecting the mucosal surfaces as well as the skin. Twenty-eight retrospective studies about the epidemiologic data of pemphigus vulgaris patients have been performed previously in the literature. METHODS: In this retrospective study, we evaluated 320 pemphigus vulgaris patients who applied to the bullous diseases clinic of Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Dermatology, between the years 1999-2019. Epidemiologic data, diagnostic modalities, comorbidities and treatment modalities were noted. RESULTS: The female to male ratio was 1.39. The mean age of diagnosis was 50.4±13.7 years, 50.8±12.5 years for males and 50.0±14.5 years for females. The average disease duration was 99.0±74.4 months; it was 91.6±67.2 months for males and 104.5±79.0 months for females. At the time of diagnosis, 88.7% of our patients had mucosal lesions and 68.4% of our patients had cutaneous lesions. The most common side effects were hypertension, diabetes mellitus, osteoporosis and hyperlipidemia. Adjuvant therapy was initiated 332 times. Azathioprine was used in 260 patients,Mycophenolate sodium was used in 30 patients, Mycophenolate mofetil was used in 42 patients, IVIG was used in 52 patients, Rituximab was used in 51 patients. CONCLUSION: Pemphigus vulgaris is a disease that is more commonly seen in female patients. It has a peak incidence in the fifth decade and there is not a statistically significant difference between the age of diagnosis between the genders. It is a chronic disease with a long follow-up period; again, there no statistically significant difference between the two genders. The most commonly encountered comorbidities are hypertension, hyperlipidemia, diabetes mellitus and osteoporosis, which are due to the use of corticosteroids.

13.
Dermatol Ther ; 33(6): e13978, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32633447

RESUMO

Various laser therapies have been used for the treatment of alopecia areata (AA). Enhanced hair regrowth was reported with the use of ablative fractional 2940-nm erbium:yttrium-aluminum-garnet (Er:YAG) laser in a murine model. However, clinical effectiveness of fractional Er:YAG laser for hair disorders has not been investigated in human studies. The aim of our study was to assess the effectiveness of 2940-nm fractional Er:YAG laser in the treatment of chronic AA that is unresponsive to conventional therapies. Twenty-five AA patients underwent three sessions, each 4 to 6 weeks apart, of fractional Er:YAG laser. Clinical evaluation was done at baseline and 1 month post-treatment (follow-up) by photographic assessment. Subjective evaluation by patient satisfaction score was also performed. Photographic evaluation of the patients revealed a mean percent change in SALT score of 17.4 ± 3.5% at follow-up. A total of 16 patients who were treated for patchy AA of the scalp showed 27.8 ± 31.3% regrowth. Five patients who were treated for AA of the beard had 39 ± 34.2% regrowth. Fractional Er:YAG laser might be a therapeutic alternative for patients with patchy AA of the scalp and beard that is unresponsive to conventional therapies.


Assuntos
Alopecia em Áreas , Terapia a Laser , Lasers de Estado Sólido , Alopecia em Áreas/terapia , Alumínio , Animais , Érbio , Humanos , Lasers de Estado Sólido/efeitos adversos , Camundongos , Resultado do Tratamento , Ítrio
14.
Dermatol Ther ; 33(6): e13883, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32578309

RESUMO

Since the COVID-19 infection first appeared in December 2019, patient profile of outpatient and inpatient clinics has changed. Various cutaneous findings associated with COVID-19 have been reported in the literature. The main objective of this study was to describe and analyze the profile of the consultations requested from dermatology department during the COVID pandemic. Retrospective, cohort study. In this study, we observed the dermatology consultations of the hospitalized patients over a period of 2 months, corresponding to the peak of COVID outbreak in a tertiary care hospital in Turkey. We reviewed the inpatient dermatology consult database retrospectively. Both pediatric and adult dermatology inpatient consultations were evaluated. A total of 166 inpatient dermatology consultations were requested from dermatology department during March-May, 2020. The mean age of the patients was 53.12 (1-89) years. Almost 32.5% (n = 54) of dermatology consultations were requested from the COVID wards and the COVID intensive care unit. The second most common consultations were requested from internal medicine departments (n = 46, 27.7%). The most common indications for the consultations were cutaneous infections (36%), followed by inflammatory disorders (32%), and urticaria (11%). Dermatology consultations have an essential role on the management of hospitalized patients, especially at that pandemic time. Careful dermatological examination improves diagnostic accuracy in skin disorders and skin manifestations of COVID-19 infection that provides an early diagnosis and treatment, helps to improve the quality of the patient care and management.


Assuntos
COVID-19/virologia , Dermatologia/tendências , Pacientes Internados , Encaminhamento e Consulta/tendências , Dermatopatias Virais/diagnóstico , Centros de Atenção Terciária/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/terapia , Criança , Pré-Escolar , Bases de Dados Factuais , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Dermatopatias Virais/terapia , Dermatopatias Virais/virologia , Turquia , Adulto Jovem
15.
Dermatol Ther ; 33(6): e13896, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32579756

RESUMO

Cutaneous manifestations of COVID-19 disease have not yet been fully described. To describe cutaneous manifestations of COVID-19 disease in hospitalized patients. We examined the cutaneous manifestations of 210 hospitalized patients. Cutaneous findings were observed during COVID-19 infection in 52 of the patients. Lesions may be classified as erythematous scaly rash (32.7%), maculopapular rash (23%), urticarial lesions (13.5%), petechial purpuric rash (7.7%), necrosis (7.7%), enanthema and apthous stomatitis (5.8%), vesicular rash (5.8%), pernio (1.9%), and pruritus (1.9%). Cutaneous manifestations were observed statistically significantly more in certain age groups: patients of 55 to 64 and 65 to 74 years of age complained of more cutaneous manifestations than the other age groups. As for gender, there was no significant difference between male and female patients in terms of cutaneus findings. The relationship between comorbidity and dermatological finding status was statistically significant. The relationship increases linearly according to the comorbidities. According to the statistical results, the patients who were hospitalized in the intensive care unit had a higher risk of having cutaneous findings due to COVID-19 infection. With this study, we may highlight the importance of overlooked dermatological findings in patients that are hospitalized.


Assuntos
COVID-19/virologia , Hospitalização , Pacientes Internados , SARS-CoV-2/patogenicidade , Dermatopatias Virais/virologia , Pele/virologia , Adulto , Idoso , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Pele/patologia , Dermatopatias Virais/diagnóstico , Dermatopatias Virais/epidemiologia , Turquia/epidemiologia
16.
Clin Cosmet Investig Dermatol ; 13: 179-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32110082

RESUMO

Rosacea is a common skin disease that is troublesome for both the patients and the dermatologists. Erythema, telengiectasia, papulopustular changes and phymatous changes are the main problems faced by the patients and dermatologists in everyday practice. Due to the chronic and relapsing nature of the disease, patients are usually unsatisfied with conventional treatment methods. This article aims at redefining rosacea according to the 2017 consensus and reviewing the different treatment modalities for different manifestations of the disease in depth.

17.
Dermatol Ther ; 33(2): e13232, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31985885

RESUMO

BACKGROUND: Hidradenitis suppurativa is a chronic, inflammatory, recurrent disease with recurrent abscesses, and sinus tract formation leading to scarring. Calprotectin has immunomodulatory, antimicrobial, and antiproliferative properties and is a calcium-binding protein primarily found in the neutrophil cytoplasm. In recent years, a significant relationship between the activity of various diseases and the level of calprotectin has led to the conclusion that there may be a similar relationship in hidradenitis suppurativa. OBJECTIVE: To determine the relationship between disease activity and fecal calprotectin levels in patients with hidradenitis suppurativa. METHODS: Fifty patients with hidradenitis suppurativa (case group) who present to the Dermatology and Venerology Department between December 6, 2017, and April 6, 2018, and 36 healthy volunteers (control group) were enrolled in our study. Fecal calprotectin levels we requantitatively calculated using enzyme-linked immunosorbent assay. RESULTS: In patients with active hidradenitis suppurativa, the level of stool calprotectin was higher than that of patientsin remission, and this difference was statistically significant (p < .001). There was no statistically significant correlation between disease stage and fecal calprotectin levels in patients with hidradenitis suppurativa (p = .14). Age, sex, smoking and alcohol use, anti-TNF-α treatment, and fecal calprotectin levels were not significantly correlated. In our study, fecal calprotectin levels in patients with active hidradenitis suppurativa were higher than inpatients in remission (p < .001). CONCLUSION: Fecal calprotectin can beused as a marker of disease activity in hidradenitis suppurativa.


Assuntos
Hidradenite Supurativa , Fezes , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/tratamento farmacológico , Humanos , Inflamação , Complexo Antígeno L1 Leucocitário , Fator de Necrose Tumoral alfa
18.
Int J Dermatol ; 59(2): 207-215, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31531981

RESUMO

BACKGROUND: Psoriasis is a chronic dermatologic disease affecting 2% of the general population. Tumour necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) is a newly defined member of the TNF family. Increased serum levels of TWEAK were reported in inflammatory diseases. The relationship between serum TWEAK levels and severity of psoriasis has not yet been proven. Our aim was to clarify the change in serum TWEAK levels in response to conventional and anti-TNF treatments. MATERIAL AND METHODS: Blood samples were collected from 103 moderate or severe chronic plaque psoriasis patients with or without arthritis who were referred to the Department of Dermatology, Istanbul University Cerrahpasa Medical Faculty between the years 2016 and 2018. Psoriasis Area and Severity Index (PASI) scores were calculated, and serum TWEAK levels were assessed with TWEAK ELISA kit. SPSS 20 was used for statistics. RESULTS: Serum TWEAK levels increased significantly and PASI scores decreased significantly after both conventional and anti-TNF treatments, but the two variables were not correlated. There was no significant difference between conventional and anti-TNF treatments, between patients with or without comorbid arthritis and between genders. CONCLUSIONS: Lower serum TWEAK levels induce psoriasis and higher levels of TWEAK are observed after treatment. It is important to determine a threshold value. Such a cutoff value of serum TWEAK levels could not be calculated in our study similar to previous studies. If its serum levels were to be standardized in further studies, TWEAK can be used as a follow-up marker in psoriasis patients with the PASI score.


Assuntos
Anti-Inflamatórios/uso terapêutico , Citocina TWEAK/sangue , Fármacos Dermatológicos/uso terapêutico , Psoríase/sangue , Psoríase/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Acitretina/uso terapêutico , Adalimumab/uso terapêutico , Adulto , Ciclosporina/uso terapêutico , Etanercepte/uso terapêutico , Feminino , Humanos , Infliximab/uso terapêutico , Ceratolíticos/uso terapêutico , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Índice de Gravidade de Doença
19.
Turk J Med Sci ; 50(8): 1817-1824, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31655499

RESUMO

Background/aim: Alopecia areata (AA) is an inflammatory disease with a genetic and autoimmune basis. Herein, it was aimed to study the efficacy and safety of an immunomodulatory therapeutic agent, diphenylcyclopropenone, while manifesting its association with histopathological features, prognostic factors, and side effects. Materials and methods: In this retrospective study, 98 patients (60 males, 38 females) with alopecia, who were referred to the Hair Disease Polyclinic at the Department of Dermatology, between 2011 and 2015, were included. Together with medical histories and dermatological examinations, a skin biopsy for histopathological examination was conducted for all of the patients prior to therapy. Therapeutic success was evaluated on the basis of the hair regrowth percentage. Results: Regarding the overall treatment success, 33 (34%) patients had complete response, 16 (16%) had partial response (between 50% and 99%), 27 (28%) had minimal response (between 1% and 49%), and 22 (22%) were nonresponders. Both sexs were equally represented in the outcome. Conclusions: There was a significant relation between the severity of alopecia and the treatment outcome (P = 0.038). Patients with AA had significantly better response when compared to those with alopecia totalis and universalis. There was no statistically significant relation with other parameters, such as disease duration, age, sex, atopy history, age of onset, and histopathological features.

20.
Clin Exp Rheumatol ; 37 Suppl 121(6): 111-115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31856937

RESUMO

OBJECTIVES: The efficacy and safety of biosimilar infliximab (bio-IFX) was shown in randomised controlled trials and it was approved for all indications of the reference product in several countries. However, a previous case series of 3 patients with Behçet's syndrome (BS) reported disappointing results. We aimed to share our experience with bio-IFX treatment in different types of organ involvement in patients with BS. METHODS: We reviewed the charts of all BS patients who were prescribed reference infliximab (ref-IFX) or bio-IFX in our BS clinic. Among the 181 BS patients who were prescribed IFX since 2003, 6 (3%) were prescribed bio-IFX due to refractory disease despite conventional immunosuppressives. RESULTS: A total of 6 patients (mean age: 32.1±6.2, mean disease duration: 5.3±1.8 years, 5 men and 1 woman) received bio-IFX for uveitis, nervous system, vascular and joint involvement. Four of the 6 patients obtained remission and stayed in remission during the 16±6.5 months they used bio-IFX. Among the 4 patients who obtained remission, 2 were switched to ref-IFX due to unavailability of bio-IFX infusion set and did not experience adverse events or loss of efficacy. However, relapses occurred during tapering. The other 2 patients are still in remission with bio- IFX. Among the remaining 2 patients, one had to be switched to ref-IFX after the first infusion, due to a change in the reimbursement policy and the other was non-responsive. CONCLUSIONS: Our limited experience showed that bio-IFX may be a safe and effective alternative for patients with BS, refractory to conventional immunosuppressives.


Assuntos
Síndrome de Behçet , Medicamentos Biossimilares , Infliximab/uso terapêutico , Adulto , Síndrome de Behçet/tratamento farmacológico , Medicamentos Biossimilares/uso terapêutico , Feminino , Humanos , Masculino , Resultado do Tratamento , Uveíte/tratamento farmacológico
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