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The evaluation of the cochlear aqueduct and internal acoustic canal in patients with unilateral subjective tinnitus and normal hearing
(Aves, 2023) Yılmazsoy, Yunus; Muluk, Nuray Bayar; Özdemir, Adnan; Şencan, Ziya
Objective: We investigated the relationship between idiopathic subjective tinnitus and internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements by temporal magnetic resonance imaging. Methods: In this retrospective study, temporal magnetic resonance imaging sections of 25 patients (8 males and 17 females) with unilateral tinnitus and normal hearing were included. The internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements and internal acoustic canal and cochlear aqueduct shape classification were determined in the ipsilateral tinnitus side and contralateral non-tinnitus side. Results: The cochlear aqueduct length and width and internal acoustic canal opening width, length, width, and area of the ipsilateral tinnitus side were not different from the contralateral side. Similarly, the vestibule area and lateral semicircular canal height and width values were not different between the ipsilateral tinnitus side and the contralateral side. The main cochlear aqueduct type was type 2 in both ipsilateral and contralateral sides. For the internal acoustic canal types, cylindrical and funnel shapes were the most common types for the ipsilateral tinnitus side and contralateral side. There were positive correlations between the internal acoustic canal and vestibule areas; cochlear aqueduct length and internal acoustic canal areas; cochlear aqueduct width and width of the lateral semicircular canal; internal acoustic canal area and length and cochlear aqueduct length; internal acoustic canal opening width and height of the lateral semicircular canal; and width of the lateral semicircular canal dimensions. In older patients, the ipsilateral internal acoustic canal area was found to be smaller. Conclusions: In idiopathic subjective tinnitus, there were no important pathologies detected in the internal acoustic canal, cochlear aqueduct, vestibule area, and lateral semicircular canal. We concluded that there are no statistically significant morphometric differences compared to the healthy side in the internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal areas detected by temporal magnetic resonance imaging in patients with unilateral subjective tinnitus and normal hearing.
The effect of the tarsal joint positions on the tibial nerve motor action potential latency in dog: Electrophysiological and anatomical studies
(M H Schaper Gmbh Co Kg, 2007) Turan, Erkut; Bölükbaşı, O.; Ömeroğlu, Sabri Alp
This study has been carried out to determine the effect of neutral position, hyperextension and hyperflexion of the tarsal joint on the tibial nerve, motor action potential latency and tarsal canal compartment pressure in dogs with the aid of electrophysiological and anatomical methods. Totally twenty healthy mongrel dogs were used. Latency of motor nerve action potential (MNAPL) studies of tibial nerve via surface stimulating and needle recording electrodes was performed on right hind limbs of all the dogs. The compartment pressures of the tarsal canal with the pressure transducer were determined from both limbs from ten of the dogs. In one dog, tarsal regions of both left and right limbs were demonstrated using magnetic resonance imaging (MRI). Two dogs were euthanatized and tarsal regions of the dogs were sectioned for correlative anatomy. Nerve conduction studies showed that the MNAP latency of the tibial nerve were 3.55 +/- 0.097 ms, 3.76 +/- 0.087 ms and 3.39 +/- 0.097 ms in neutral, hyperextension and hyperflexion positions, respectively. Hyperflexion of the tarsal joint caused prolongation of the MNAP latency of the tibial nerve with the highest pressure value being determined in tarsal canal. From the anatomical viewpoint, the distance between the flexor hallucis longus muscle and the superficial digital muscle was the shortest during hyperflexion and the plantar branch of saphenous artery, lateral and medial plantar nerves located more laterally in cadaver and MR imaging sections. As a result of this study, it is thought that tarsal region diseases as well as long time splint in the hyperflexion position as applied in the Ehmer sling can affect the compartment pressure and nerve tension because of occupying in the tarsal canal. Raising pressure and nerve stretching in the tarsal canal compartment could cause deficiencies in the conduction velocity of the tibial nerve. This might be a result of tarsal tunnel syndrome in the dog. Clinicians could consider this syndrome in cases of tarsal region diseases as well as application of long time splint in hyperflexion of tarsal joints in dogs.
Cardiac tamponade with primary certain non-malignancy in clinic: Case report
(Düzce Univ, 2014) Duran, Arif; Ocak, Tarık; Üyetürk, Ümmügül; Erdem, Alim; Önder, Hüsnü; Maltaş, Mehmet Şakir
Cardiac tamponade is a major life threatening condition characterized with accumulation of fluid in pericardial cavity which prevents heart contractions. Etiology includes trauma, renal failure, myocardial infarction, cardiovascular surgery, coronary angiography, and malignancies. Clinical signs vary depending on the development rate of tamponade. Malignancy related tamponade is caused by different factors that associated with the type and the extension of malignancy. We present a patient who admitted to our emergency department with cardiac tamponade caused by a malignancy of an unknown primary
Systemic immune-inflammation index as a novel hematological marker for predicting the recurrence of deep venous thrombosis
(Sage Publications Ltd, 2024) Dönmez, İbrahim; Müdüroğlu, Ayhan
Objective To determine whether there was a possible predictive relationship between systemic immune-inflammation index (SII) and recurrence of deep venous thrombosis (DVT).Methods A total of 231 patients with DVT who met the study criteria and whose data could be accessed were enrolled to this retrospective single-centered cross-sectional study. Of them 26 patients with DVT recurrence consisted of the study group (Group 1) while remaining 205 cases without recurrence were considered as the control population (Group 2). The patients' basic clinical features and laboratory results from the complete blood count (CBC) test were recorded and compared between groups. Following univariate analyses, a multivariate logistic regression analysis was performed to identify the independent predictors of the recurrence of DVT. Additionally, a receiver-operating characteristic (ROC) curve analysis was performed to detect the cut-off values of the predictors with sensitivity and specificity rates.Results There were no significant differences between the groups for basic clinical features, except for diabetes mellitus, pulmonary embolism, and atrial fibrillation. Although the univariate analysis revealed that the median values of NLR, PLR, and SII were significantly higher in the DVT recurrence group, only SII was determined to be a significant and independent predictor of DVT recurrence in the multivariate logistic regression analysis. According to ROC curve analysis, SII of 1685 x 103/mm3 constituted the cut-off value for predicting DVT recurrence with 61.5% sensitivity and 76.6% specificity (AUC = 0.686, p = .001).Conclusion The present study demonstrated for the first time in the literature that SII significantly predicted the recurrence of DVT.
Traumatic dissecting aneurysm of superficial temporal artery: A case report
(Derman Medical Publ, 2014) Gezici, Ali Rıza; Dağıstan, Yaşar; Güler, Kamil; Dağıstan, Emine; Özkan, Nezih
Traumatic aneurysms of the superficial temporal artery (STA) are a rare occurrence. Here, we report a very rare case of dissecting aneurysm of superficial temporal artery caused by blunt trauma. 22 year man, admitted with a solitary painless, pulsatile swelling in the right temporal region. 8 mounts ago, he had closed head injury over right temporal region without a skull fracture. A traumatic aneurysm of the STA was diagnosed. Under anesthesia, the aneurysm was completely excised.
Thickness of anterior sclera and corneal layers in systemic sclerosis
(Springer, 2024) Ün, Emine Şeker; Pekel, Gökhan; Taşçı, Murat; Bahar, Alperen; Pekel, Evre; Çetin, Ebru Nevin; Subaşı, Mustafa
Purpose To evaluate the thickness of anterior sclera and corneal layers in patients with systemic sclerosis. Methods The present cross-sectional study included 41 patients with systemic sclerosis and 41 age- and gender-matched healthy controls. The study and control groups were compared in terms of the thickness of anterior sclera, corneal epithelium, Bowman's layer, corneal stroma, and Descemet's membrane-endothelium complex. The thickness measurements were obtained using the anterior segment module of spectral-domain optical coherence tomography. Results The thickness of anterior sclera, corneal epithelium, Bowman's layer, and Descemet's membrane-endothelium complex were similar in the patients with systemic sclerosis and healthy controls (P > 0.05). Total corneal thickness at the apex was 511.1 +/- 33.5 mu m in the systemic sclerosis group and 528.4 +/- 29.5 mu m in the control group (P = 0.015). The corneal stroma was thinner in the systemic sclerosis patients compared to the healthy controls (P = 0.02). Conclusions The corneal stroma was thinner in the patients with systemic sclerosis compared to that of healthy controls, while the thickness of the anterior sclera was similar in both groups.
Evaluation of the relationship between computed tomography angiography collateral scores and clinical outcome
(Assoc Arquivos Neuro- Psiquiatria, 2024) Yabalak, Ahmet; Ögün, Muhammed Nur; Önalan, Ayşenur; Yılmaz, Murat; Tokmak, Hilmiye; Ersoy, Sadettin; Bilgili, Fatma
Background The relationship between collateral circulation and prognosis after endovascular treatment in anterior circulation strokes has been reported in many studies. Objective In this study, we aimed to compare the predictive power of clinical outcome by comparing five different collateral scores that are frequently used. Methods Among the patients who underwent endovascular treatment in our clinic between November 2019 and December 2021, patients with premorbid mRS < 3, intracranial ICA and/or MCA M1 occlusion, and a pre-procedural multiphase CTA examination were included in the study. Demographic, technical, and duration information about the procedure, major events after the procedure, and clinical outcomes at 3 months were recorded. The mCTA, Tan, Maas, Miteff, and rLMC collateral scores of the patients were evaluated. Results Clinical outcome at 3 months were good in 37 of the 68 patients included in the study (mRS <= 2). Only the mCTA and rLMC collateral scores were statistically significantly higher in those with a good clinical outcome. Significant correlation with 3-month mRS was detected only in mCTA and rLMC scores. Although rLMC and mCTA collateral scores showed a statistically significant association with prognosis, they were not sufficient to be an independent predictor of prognosis. Conclusion mCTA and rLMC were found to have the highest predictive power of clinical outcome and the highest correlation with the 3-month clinical outcome. Our study suggests that it would be beneficial to develop a new scoring system over multiphase CTA, which combines regional and temporal evaluation, which are the strengths of both collateral scoring.
Periton diyalizat sıvısının ısıtılmadan kullanımına bağlı şimik peritonit: Olgu sunumu
(Türk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Alçelik, Aytekin; Bicik, Zerrin; Albayrak, Sinan; Çalışkan, Şerife
Sterile peritonitis have been reported dependent on some agents such as icodextrin, vancomycin, and amphotericin B. We have reported a case of sterile peritonitis which was not related with these agents. The patient who had been on continuous ambulatory peritoneal dialysis for six months developed abdominal pain after using peritoneal dialysis fluid without heating. Her complaints had started immediately after that. The patient admitted to the hospital for peritonitis and initial analysis of the dialysate revealed 2000 cell/mm(3) (PMNL). Intraperitoneal ceftazidime has been started and the patient's abdominal pain decreased immediately and subsequent analysis of the dialysate showed no cells in 24 hours after the treatment. This quick response of acute peritonitis can be related with cold usage of peritoneal dialysis fluid. Therefore, chemical peritonitis secondary to the usage of cool peritoneal dialysis might be the diagnosis in our case. In conclusion, the physical factors that effect the peritoneal membrane, such as cold usage of peritoneal dialysis fluid, should be considered in the diagnosis of culture negative peritonitis.
Küçük hücreli akciğer kanseri olgusunda tümör lizis sendromu
(Aves, 2005) Arbak, Peri; Bilgin, Cahit; Balbay, Öner; Bicik, Zerrin
As a result of large tumor burden, acute tumor lysis syndrome (TLS) is most often seen with lymphoproliferative disorders. An uncommon association of solid tumors and TLS also have been reported. We present a patient with metastatic lung carcinoma who developed TLS. A 58-year-old male was hospitalized for a mass in left lower lobe of lung and multiple low attenuation lesions in liver revealed by computed tomography. Liver biopsy specimen revealed metastatic small cell lung carcinoma. Cisplatin (60 mg/m(2), day1), Etoposide (120 mg/m(2), day 1,2,3) regimen was started. Biochemical parameters of the patient were in normal ranges before chemotherapy, one and two days after chemotherapy. At the seventh day of discharge from the hospital, our patient admitted to emergency department with acute renal insufficiency. Patient was recruited to hemodialysis for TLS. After 3 cycles of hemodialysis biochemical parameters were normalized. Since then etoposide regimen (100 mg/day for 14 days/monthly) was used. After 4 cycles of oral Etoposide regimen symptomatic relief and incomplete response according to chest radiograph were observed. Our case was presented with a later occurence of TLS when compared with the other cases from literature. We concluded that especially in disseminated small cell lung cancer (SCLC), clinicians must be aware of this rare but fatal complication.
Sarcopenia detected in aged patients in intensive care units is associated with poor prognosis
(Asia Pacific League Clinical Gerontology & Geriatrics, 2024) Akan, Belgin; Gökçınar, Derya; Damgacı, Lale; Çakır, Esra; Özer, Hamza; Turan, Işıl Özkoçak
Background/Purpose: Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass. The aim of this study was to evaluate effects of sarcopenia on the prognosis of the critical aged patients admitted to intensive care unit (ICU). Methods: The study was planned as a retrospective and observational study and performed after the approval from the ethics committee (approval number is E. Kurul-E-18-1928). Patients older than 40 years of age having abdominal tomography and admitted to the ICU were included. All patients were divided into two groups as sarcopenic and non-sarcopenic by muscle mass measuring by abdominal tomography. We compared the prognosis and clinical features of the patients with and without sarcopenia. Results: A total of 105 patients were included in the study. Fifty five (59%) of the patients were found as sarcopenic and 70.8% over 70 years of age. The length of stay in ICU and in hospital were 27.8 +/- 29.7 and 33.0 +/- 31.2 days in sarcopenic patients, 15.1 +/- 17 and 23.8 +/- 21.3 days in nonsarcopenic patients respectively ( p <0.05). Thirty day mortality was found 49.1% in sarcopenic patients ( p <0.05). Conclusion: The presence of sarcopenia in critically aged patients is important because it is associated with increased 30 -day mortality, prolonged ICU and hospital stay. ISSN 2663-8851/Copyright (c) 2024, Asian Association for Frailty and Sarcopenia and Taiwan Association for Integrated Care. Published by Full Universe Integrated Marketing Limited.
Peculiar word use as a possible trait marker in schizophrenia
(Elsevier, 2008) Başkak, Bora; Özel, E. Tuğba; Atbaşoğlu, E. Cem; Başkak, Seda C.
Peculiar word use in schizophrenia has been emphasized by many authors, however the definition or the linguistic and clinical correlates of this phenomenon are not clear. We propose a new, standard and reliable method to extract a numerical measure of peculiar word use with operationalized definitions. We applied a modified version of the Controlled Word Association Test (Turkish version) to a pool of healthy subjects (N=55) and used the data as norm to compare the degree of peculiarity and patterns of word association among patients with schizophrenia (N=33), their healthy siblings (N=31) and healthy controls (N=32). We also explored the relationship of peculiar word use with patterns of word association (semantic versus phonologic) and formal thought disorder. Patients and their siblings performed worse on measures of verbal fluency. They also generated more peculiar words and relied less on semantic associations, compared to healthy controls. Peculiar word use was associated with the severity of formal thought disorder and the tendency to make use of phonologic associations in the patient group and their siblings, whereas neither of the word association patterns predicted peculiar word use in the control group. Our results provide empirical Support to previous observations about the peculiarity of schizophrenic speech. Peculiar word use could be associated with a deficit to employ semantic classifications in verbal fluency tasks and thus relying more on sound-based associations. Excess use of phonologic associations may be playing a mediating role between semantic processing abnormalities and formal thought disorder. (C) 2008 Elsevier B.V. All rights reserved.
Volumetric segmentation analysis of the levator ani muscle using magnetic resonance imaging in pelvic floor function assessment
(Turkish Soc Radiology, 2024) Yaşar, Ayşenur Buz; Yüzok, Rüveyde Begüm; Dağıstan, Emine
PURPOSE In this case-control study, we aimed to evaluate how muscle volume affects pelvic floor function by analyzing the levator ani muscle (LAM) using volumetric segmentation in addition to standard magnetic resonance (MR) defecography assessments. METHODS We enrolled 85 patients with varying degrees of pelvic floor dysfunction (PFD) and 85 age- and gender-matched controls in this retrospective study. All patients had MR defecography images, while all controls had pelvic MR images obtained for other reasons. Group comparisons were performed using independent samples t-tests and Mann-Whitney U tests. The receiver operating curve (ROC) was constructed to establish a cut-off value for a normal LAM volume. Interrater reliability was assessed by calculating the intraclass correlation coefficient. A P value of less than 0.05 was considered statistically significant. RESULTS Volumetric measurements revealed that the control group had higher LAM volumes, and the ROC curve analysis indicated a cut-off value of 38934.3 mm 3 with a sensitivity of 0.812 and specificity of 0.8 for PFD assessment using LAM volumetric measurement. Gender did not significantly affect LAM volume in the control group. CONCLUSION Alongside the useful structural and functional information acquired from MR defecography images, volumetric analysis, and three-dimensional reconstructions of LAM may help to improve the accuracy of the diagnosis.
A novel marker for prediabetic conditions: Uric acid-to-HDL cholesterol ratio
(Aepress Sro, 2024) Balcı, Sümeyye Buse; Tel, Burçin Meryem Atak; Duman, Tuba; Özkul, Feyza Nihal; Aktaş, Gülali
OBJECTIVES: The objective of this study was to identify a parameter that can facilitate the diagnosis of prediabetes and predict the likelihood of its development in individuals at high risk. METHODS: In this retrospective study, the study population was selected from Bolu Abant Izzet Baysal University Hospital's patients. Participants were divided into two groups, prediabetes and healthy group. We excluded individuals with certain conditions or taking certain medications. The study compared the ratios of uric acid to high-density lipoprotein (HDL) between the two groups and identified the optimal point of differentiation. RESULTS: The study analyzed data from 228 individuals, including 125 with prediabetes and 103 healthy controls. Those with prediabetes had a significantly higher median UHR (0.13 (0.07-0.24) %) compared to healthy individuals (0.09 (0.05-0.16) %) (p < 0.001). Higher UHR values were associated with a greater risk of prediabetes. A UHR cut-off points greater than 0.11 % had a sensitivity of 74 % and specificity of 69 % in detecting prediabetes. CONCLUSION: The study provides evidence that UHR can serve as a practical and valuable diagnostic and screening tool for prediabetes (Tab. 2, Fig. 1, Ref. 23). Text in PDF www.elis.sk
Coroner artery disease and heart failure related with rheumatoid arthritis
(Duzce Univ, 2013) Bulur, Serkan; Bulur, Şule; Yazıcı, Selma
Cardiac involvement is very common in rheumatoid arthritis. It was shown in many studies that cardiovascular mortality increase in these patients and cardiovascular diseases are responsible for 35-50 percent of the deaths. The patients with rheumatoid arthritis, compared with the healthy population. have increased mortality rates as 0,9-3 percent. The main reason for this increase in mortality in rheumatoid arthritis is cardiovascular diseases. In this article. we aimed to summarize the relation between rheumatoid arthritis and cardiovascular disease, especially coronary artery disease and heart failure.
Evaluation of eye and serum findings in different waters in rabbits by drowning and submersion modeling
(Tubitak Scientific & Technological Research Council Turkey, 2024) Yılmaz, Aziz; Hösükler, Erdem; Kaymaz, Abdülgani; Üçgül, Ahmet Yücel; Erkol, Zehra Zerrin
Background/aim: This study investigated serum, vitreous, and anterior chamber fluid electrolyte changes, corneal thickness (CT), corneal volume (CV), anterior chamber volume (ACV), and anterior chamber depth (ACD) as an auxiliary diagnostic method in the identification of drowning in fresh or salt water. Materials and methods: The study used 35 healthy, adult, male, white New Zealand rabbits, seperated into five groups (control, saltwater drowning (SWD), saltwater immersion (SWI), freshwater drowning (FWD), freshwater immersion (FWI)). CT, CV, ACV, and ACD measurements were made with Pentacam topography at 0, 2, and 4 h in all groups. Magnesium (mg), sodium (Na), and chlorine (Cl) were measured in the blood at 0 and 2 h, and in blood, vitreous fluid, and humor aqueous at 4 h. Results: It was determined that CT, CV, ACV, and ACD are not of great value in drowning diagnosis and are affected by the fresh or salt water rather than drowning. Vitreous Na, Cl, and Mg levels are ineffective in determining drowning after one h. Anterior chamber fluid may provide valuable information in the differentiation freshwater - saltwater drownings at the 4th h in corpses retrieved from water. Conclusion: Anterior chamber fluid Na and Cl levels, especially in corpses removed from salt water, can be an easily used test that can help diagnose drowning.
Acute mesenteric ischemia: The diagnostic value of QT parameters and their relationship with CT findings
(Bentham Science Publ Ltd, 2024) Alan, Bircan; Alan, Sait; Gürel, Safiye; İnanır, Mehmet; Acar, Emrah; Dönmez, İbrahim; Kalaycıoğlu, Oya
Background: One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings. Materials and Methods: Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system. Grouping was carried out on the basis of AMI (n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations. Results: The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001). In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper-thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found. Conclusion: We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD and a significant relationship between survival and QTc in the AMI group.
Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients
(Mattioli 1885, 2022) Kayıran, Melek Aslan; Karadağ, Ayşe Serap; Topal, İlteriş Oğuz; Emre, Selma; Adışen, Esra; Kılıç, Sevilay; Keskin, Nuray; Polat, Mualla
Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.
Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: A multicenter study of 1521 patients
(Springer, 2024) Erduran, Funda; Emre, Selma; Hayran, Yıldız; Adışen, Esra; Polat, Asude Kara; Üstüner, Pelin; Öztürkcan, Serap; Polat, Mualla
Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.
Platelet function in euthyroid patients undergoing thyroidectomy in women
(Verduci Publisher, 2013) Alçelik, Aytekin; Aktaş, Gülali; Eroglu, M.; Tosun, M.; Şavlı, Haluk; Dikbaş, Oğuz; Zeyrek, A.
BACKGROUND: Several studies have reported several platelet abnormalities in patients with sub-clinical or overt thyroid dysfunctions. The primary mechanism that affects the hemostatic balance is excess or deficiency of thyroid hormones. The different ways of thyroid gland to the platelet function are not yet clearly understood. The relationship between in the thyroid gland and platelet activation without thyroid hormones has not been studied yet. AIM: The aim of our study is to determine the platelet function in euthyroid patients undergoing thyroidectomy in females. PATIENTS AND METHODS: The study group includes 52 female euthyroid patients undergoing thyroidectomy. The control group consisted with 21 healthy euthyroid female. Platelet count (PC), platelet mass (PM), mean platelet volume (MPV), and platelet distribution width (PDW) were measured. PM was calculated by multiplying MPV and PLT. RESULTS: MPV (8.4 +/- 1.3 versus 7.9 +/- 0.8) and PDW (17.8 +/- 1 versus 17.6 +/- 0.8) values were similar between the two groups. CONCLUSIONS: Thyroid gland does not directly affect platelet activation. Accordingly, platelet abnormalities of thyroid disease can be considered to be independent of the underlying thyroid tissue. This finding suggests that association between thyroid diseases and platelet function is dependent on the status of thyroid hormones.
Postoperative pulmonary complications
(Bilimsel Tıp Publishing House, 2005) Annakkaya, Ali Nihat; Tozkoparan, Ergün; Deniz, Ömer; Bedirhan, İbrahim; Bilgiç, Hayati; Ekiz, Kudret; Demirci, Necmettin
The aim of this study was to evaluate postoperative pulmonary complications of patients undergoing operations in 10 different surgery clinics between November 2002 and June 2003. A total of 158 patients, 66 (41.8%) females and 92 males (58.2%), whose mean age was 53 +/- 18 (20-102) were included in the study. The study was mainly based on the postoperative consultations requested by these clinics. The most common causes of consultation requests were dyspnea (31% [49/158]) and abnormal radiological findings (17.7% [28/158]). Hypoxemia was detected in 36.1% (57) of the patients. Chest X rays of 38% (60) of patients were found as normal. Pleural effusion was the most common radiological abnormality (17.1% [27/158]). Thoracic computed tomography was performed in 28 (17.7%) patients, ventilation perfusion lung scan was performed in 16 (10.1%) patients. Respiratory system examination was normal in 13.3% (21) of patients while postoperative pulmonary complications were detected in 64.6% (102) of patients. The most common respiratory complications observed postoperatively were diaphragmatic dysfunction 20.6% (21/102), worsening of obstructive lung disease (bronchospasm) 18.6% (19), atelectasis 17.6% (18) and pneumonia 14.7% (15) respectively. Upper abdominal and thoracic surgeries had significantly higher rates of prolonged mechanical ventilation and pleural effusion complications than other surgeries (p<0.05).

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