Search

AMAÇ: Stronsiyum (Sr), osteoporoz tedavisinde uzun yıllardır kullanılan bir ilaçtır. Son dönemlerde Sr’nin pro-inflamatuvar sitokinleri inhibe ederek anti-inflamatuvar etkiler yaptığı gösterilmiştir. Bu çalışmanın amacı, Sr kloridin anti-inflamatuvar etkilerini ratlarda Freund’s Complete Adjuvan (FCA) kullanılarak oluşturulan deneysel artrit modelinde klinik, histopatolojik, immunohistokimyasal TNF-α ve TNF-α, IL-1 β, IL-6 serum seviyeleri ile değerlendirmektir. YÖNTEM: Çalışmaya 48 adet wistar-albino cinsi dişi rat alınmıştır. Ratlar randomize olarak her grupta 8 rat olacak biçimde toplam 6 gruba ayrıldı. Grup I kontrol grubudur, diğer gruplarda deneysel artrit modeli oluşturulmuştur. Grup II artrit kontrol olarak ayrılmıştır. Grup III, Grup IV ve Grup V’e Sr klorid oral olarak verilmiştir. Grup VI’ya diklofenak sodyum oral olarak verilmiştir. Deney sürecinde aralıklı olarak grupların ağırlık ölçümleri, sağ pençe çevresi ölçümleri ve klinik artrit skorları takip edilmiştir. Deney sonunda deneklerden alınan kan örneklerinden serum TNF-α, IL-1 β, IL-6 çalışılmıştır. Alınan doku örneklerinden histopatolojik olarak inflamasyon skoru, sinovyal hiperplazi, kıkırdak erozyonu ve kemik erozyonu değerlendirilmiştir. Alınan doku örneklerinden immunohistokimyasal TNF-α değerlendirilmiştir. BULGULAR: Sr kloridin anti-inflamatuvar etkileri değerlendirmelerde gösterilmiştir. Serum örneklerinden çalışılan TNF-α, IL-1 β, IL-6 seviyelerinde gruplar arasında anlamlı farklılık yoktu. İmmunohistokimyasal TNF-α değerlendirmesinde kontrol grubu hariç diğer gruplarda anlamlı farklılık yoktu. SONUÇ: Çalışmamızda Sr kloridin anti-inflamatuvar etkileri klinik ve histopatolojik değerlendirmeler ile gösterilmiştir. Bu sonuçlar Romatoid Artrit tedavisinde Sr kloridin kullanılabileceğini düşündürmektedir.

Mutation of protein-coding genes and non-coding genes is a factor in psoriasis etiology. Non-coding RNA (ncRNA), which does not have protein-coding capacity, is available in the human genome. HOTAIR (HOX Antisense Intergenic RNA) and 7SL-RNA are known as ncRNA. They may play a role in psoriasis pathogenesis.In our study, we aimed to investigate the level of HOTAIR and 7SL-RNA gene expression in the lesional and perilesional healthy skin of psoriasis patients.Total RNA isolation from the skin samples was achieved by modifying the RNeasy Mini Kit (Qiagen, Cat No: 74104) protocol. Real Time Polymerase Chain Reaction (qPCR) phase was performed in accordance with the protocol of the relevant brand (WizPure qPCR).7SL-RNA gene expression decreased in the skin with psoriatic lesions (FC: 0.01; p: 0.028), and this decrease was statistically significant. HOTAIR gene expression decreased (FC: 0.92; p: 0.218), but this decrease was not statistically significant.lncRNAs may play a role in the pathogenesis of psoriasis disease.

Seborrheic dermatitis (SD) is a chronic inflammatory disease. The etiology of the disease is still unknown. The systemic immune-inflammation index (SII), red cell distribution width (RDW), mean platelet volume (MPV), C-reactive protein (CRP), monocyte to HDL cholesterol ratio (MHR), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR) have all been reported as inflammatory markers in recent studies. However, these inflammatory markers have not been explored in SD patients. This study aimed to explore inflammatory and hematological parameters in SD patients with healthy controls (HCs) and evaluate their possible relationship with disease severity.One hundred patients who presented to our hospital were diagnosed with SD and 74 HCs were retrospectively included in our study. The seborrheic dermatitis area severity index (SDASI) score was used to assess the severity of the SD.The patient group's mean PLR, MPV ve CRP levels were statistically significantly higher than the HCs (p 0.05). There was no statistically significant difference in the patients compared with the control group regarding RDW, NLR, MHR, and SII levels (p 0.05). There was no statistically significant correlation between NLR, PLR, MPV, monocyte/HDL cholesterol, SII levels with age, and SDASI in the patient group. There was a significant correlation between CRP with age and RDW with SDASI score.Hematological parameters and CRP are low-cost tests. These tests can be used to define inflammation levels in inflammatory diseases. This study shows that PLR, CRP, and MPV may be used as novel inflammatory markers in SD.

Purpose In the treatment of cutaneous leishmaniasis (CL), developing drug resistance, existing toxic effects of drugs and failure respond to treatment cause the need to try different treatment methods. We investigated the effect of gold-conjugated macrophage-specific antibody on amastigotes under infra-red light for the treatment of CL. Methods Female BALB/c (4-8 weeks old, 20 +/- 5 g weight) mice were used in the study. The L. major strain was inoculated on the soles of mice in amastigote form and subpassed. Nanogold (Au), Au + macrophage-specific antibody (MSA) modification and near infra-red (NIR) (5 seconds) were applied to mice groups that developed cutaneous leishmaniasis on their soles. On the 5th and 10th days of the treatment, the lesions were examined clinically and pathologically. Results When the erythema values were examined, the highest decrease was calculated in the Au + MSA + NIR group in the measurements made on the 10(th) day (p < 0.014). The best improvement in 10(th) day measurements is in the NIR and Au + MSA + NIR groups when area values were examined (p = 0.011, p = 0.001). There was a statistically significant difference between the groups in terms of parasite load (PL) (p < 0.005) in pathological evaluation. According to PL grouping, the best result is NIR (p = 0.002). When both main titles (clinical and pathological) are examined, the Au + MSA + NIR group is thought to have an optimal therapeutical feature. Conclusions Au + MSA + NIR combination could be a new treatment approach for CL treatment.

Objective: In the present study, the purpose was to investigate the relationship between health literacy levels and drug use attitudes and behaviors of patients admitting to dermatology outpatient clinics.Method: A total of 295 volunteers admitting to Sivas Cumhuriyet University Dermatology Clinic between 1/03/2020 and 31/12/2020 were included in the study. Two forms were used to collect the data in the study. These were the Data Collection Form and the Health Literacy Scale.Results: The mean age of the participants was 33.0 ±16.36; and 62.0% of them were women. The mean score of the participants in Health Literacy Scale was 4.60±0.2; and it can be argued that the health literacy levels of the participants were high. The relations between health literacy and dermatological drug use attitudes and behaviors were evaluated with the Correlation Analysis; and a significant relation was detected between the two variables (p

Purpose: The purpose of the present study was to determine the Turkish validity and reliability of the LEE Scale (short version) in patients admitted to the Dermatology Clinic, and to ensure its use in patient evaluations for dermatology and other branches.Material and Methods: The LEE Scale (short version) had 38 items, and was developed originally in English. The scale was translated into Turkish by following the proper translation steps. The Turkish scale that was created was applied to the patients. A total of 510 people, 279 of whom were women (54.7%), and 231 men (45.3%), applying to Sivas Cumhuriyet University Hospital Dermatology Clinic were included in the study. The internal structure consistency and test-retest reliability were measured for reliability analyses. The Cronbach’s Alpha Coefficient was estimated for internal consistency. The scale was applied to 50 patients twice, at baseline and two weeks later for test-retest reliability, which was also statistically evaluated with the Pearson Correlation Test. The Exploratory Factor Analysis was performed to evaluate the construct validity of the scale. The significance level was taken as p

Background Sensitive skin is subjective cutaneous hyperreactivity to environmental factors. Demodicosis is a skin disorder caused by Demodex mites. There may be a link between demodicosis and sensitive skin. Aim This study aimed to examine facial Demodex mites density and other factors associated with sensitive skin in patients. Methods and methods A total of 349 randomly selected patients presented to the dermatology department. The research data were collected using a questionnaire form that included the participants' sociodemographic and lifestyle characteristics, a sensitive skin questionnaire, the Dermatology Life Quality Index (DLQI), and European Health Interview Survey (EHIS). Patients underwent standardized superficial skin surface biopsy of 4 areas of the face. D. folliculorum count greater than 5 mites/cm2 was considered positive. Results In relation to Demodex, there was an increase in skin sensitivity with higher Demodex density (p = 0.04). There was a statistically significant, weak positive correlation between skin sensitivity and DLQI score (r = 0.33, p = 0.00), and there was also a significant but very weak negative correlation between skin sensitivity and EUROHIS (r = -0.164, p = 0.002). Skin sensitivity was more common in patients with a concomitant dermatological disease (p = 0.01) and increased with more frequent cosmetic use (p = 0.00). Conclusion Alongside other risk factors, for the patients presenting with complaints of sensitive skin, investigating Demodex population density may help alleviate sensitive skin symptoms with appropriate therapies and preventive measures.

Tam Metin / Full Text Interoception, defined as the perception of internal bodily changes. The aim of this study is to evaluate the Turkishvalidity and reliability study of the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA 2) scale developed byWilliam Mehling et al. (2018).Material and Method: The research is methodological. Research data was collected between April 2020 and May 2020 (n=400).Forward and backward translation were used to translate the MAIA 2 into Turkish. We conducted exploratory factor analysis(EFA) and confirmatory factor analysis (CFA) to analyze the psychometrics of the MAIA 2 in a 70:30 split sample. Statisticalanalysis were done with R Project.Results: The Kaiser-Meyer-Olkin value (KMO=0.910) was acceptable, and there exists a significant correlation structure withBartlett’s test of sphericity (χ2=5134.120, p0.60). Standardized loadings were positive and >0.40 with significant results (p

Acne vulgaris is a chronic inflammatory skin disease that mostly develops during adolescence and continues throughout adulthood. It affects the face, the main location of cosmetic appearance. Despite many developments in acne treatment, various combination therapies are needed to create the best option. Ninety patients were included in this study. We used the global acne grading system (GAGS) and the lesion counting and photographic standards that were used by Hayashi et al., to assess acne severity. The patients were randomly divided into three groups as group 1 (using only 5% BPO, twice a day), group 2 (using only the combination of 5% BPO + 3% erythromycin, twice a day), and group 3 (using only the combination of 4% niacinamide + 1% gallic acid + 1% lauric acid, twice a day). Thirty patients were included in each group. The scores were evaluated at weeks 0, 2, 4 and 8, and compared with each other. As a result of the study, all three treatment types were found to be effective. The combination of 4% niacinamide + 1% gallic acid + 1% lauric acid can be used as an alternative topical treatment for acne vulgaris to prevent resistance against topical antibiotics and the side effects of some other treatments.

Neurogenic inflammation plays a role in the pathophysiology of allergic rhinitis. Highly effective in reducing the sensory irritation caused by some substances, strontium salts directly affect C-type nerve fibers. The aim of this study was to compare the efficacy of mometasone furoate and strontium chloride on early-phase symptoms in a rat model of allergic rhinitis. Wistar albino rats (n = 24) were randomly divided into three groups: the mometasone group, receiving 1 μg mometasone furoate (2 µl/site); the strontium 3% group, receiving 3% strontium chloride (2 μl/site); and the strontium 5% group, receiving 5% strontium chloride (2 μl/site). To induce significant nasal symptoms of allergic rhinitis, 5 µmol of histamine dihydrochloride (HDC) (2 µl/site) was administered. Symptoms of allergic rhinitis were recorded as frequencies of sneezing and nasal rubbing during a 15-minute interval. On days 1 and 2, respectively, 0.9% sodium chloride (NaCl) (2 μl/site to each nasal cavity) and HDC were administered in all of the study groups. On days 3 and 4, the study drugs were administered 10 and 30 minutes before the administration of HDC. On day 5, the study drugs were administered 10 minutes after the administration of HDC. The results of the present study revealed that when strontium chloride or mometasone furoate was administered 30 minutes before the onset of symptoms, a significant decrease was observed in sneezing and nasal rubbing. The number of sneezing occurrences was significantly lower and the number of nasal rubbing occurrences was higher in the strontium 3% group compared to the groups in which mometasone furoate and 5% strontium chloride were administered after onset of symptoms. Recent studies have investigated the efficacy and safety of strontium chloride nasal drops compared with common pharmacologic treatments of allergic rhinitis. These studies have revealed that allergic rhinitis can be successfully and safely treated with strontium-chloride-containing products, thus offering a potential new treatment strategy.

WOS: 000442947000002, Aim of the study: The aim of this study was to determine whether patients with psoriasis are affected by expressed emotion in their family environment. Material and methods: Participants included 62 patients with psoriasis and 83 healthy controls and their biological parent, wife or husband, or adult child as a key relative. Sociodeinographic data were recorded. Psoriasis area severity index was used to evaluate psoriasis severity. Hamilton depression and anxiety scales and the Expressed Emotion Questionnaire form were used to evaluate depression, anxiety, and expressed emotion. Results: The levels of expressed emotion and its subgroups in the patient group were higher than in the group of healthy controls (p < 0.05). Gender, disease duration, disease severity, and key relatives did not affect the levels of expressed emotion (LEEtotal) in the patients with psoriasis (p > 0.05). The LEEtotal of those with low educational level in the patient group was statistically significantly higher than those with higher educational level (p < 0.05). There was no correlation between the presence depression or anxiety and expressed emotion (p> 0.05). There was a negative correlation between age and the levels of expressed emotion in the patient group (p < 0.05). There was a negative correlation between age and intrusiveness in healthy controls (p < 0.05). Conclusions: Although decreasing with age, expression of emotion in patients with psoriasis is high, and psychosocial support should be provided to these patients.

WOS: 000435795800001, Background and Design: This study aimed to investigate whether 5% strontium (Sr) chloride hexahydrate has preventive or therapeutic effects on the radiotherapy (RT)-induced adverse skin effects. Materials and Methods: Sixty-four female Wistar albino rats weighing 200-210 g, aged 4.5-5 months were divided into eight groups. Results: There were significant differences between control group and the other groups according to the Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria (RTOG) and histopathological findings (p0.05). In addition, there were no significant differences among treatment groups (p>0.05). Statistical results were as follows according to the immunohistochemical evaluation of transforming growth factor-beta: group 1 and 4 (p=0.015), group 1 and 5 (p=0.014), group 1 and 6 (p=0.035), group 1 and 8 (p=0.046), group 2 and 6 (p-0.047), group 4 and 6 (p=0.031); and according to the immunohistochemical evaluation of tumor necrosis factor-alpha: group 1 and 2 (p=0.024), group 1 and 8 (p=0.045). Conclusion: Topical treatment with Sr at a concentration of 5% is insufficient to prevent the side effects of RT involving the skin, as assessed by the RTOG scoring, histopathological findings, and immunological markers., Coordination Department of Scientific Research Projects of Cumhuriyet University [T607], This study was supported by Coordination Department of Scientific Research Projects of Cumhuriyet University. Project number: T607.

Amac: Kalsinorin inhibisyonunun Caenorhabditis elegans ( C. elegans ) bireylerinde yasam suresini uzattigi bilinmektedir. C. elegans genlerinin onemli bir kismi insan genlerine buyuk benzerlik gostermektedir. Bu calismada kalsinorin inhibisyonunun C. elegans bireylerindeki yasamsal fonksiyonlar uzerine olan etkilerinin degerlendirilmesi amaclandi. Yontem: Calisma icin bir kalsinorin inhibitoru olan siklosporin A’nin 1 μM (1.doz), 0.1 μM (2.doz), 0.01 μM (3.doz) ve 0.001 μM (4.doz) dozunda cozeltileri hazirlanarak her bir cozeltiden 1’er ml, iclerinde 10’ ar ml Nematod Growth Media (NGM) bulunduran petrilere eklenmistir. Kontrol grubu siklosporin eklenmemis besiyerinde beslenmistir. Senkronizasyonu yapilmis C. elegans ’lardan siklosporinin belirtilen dozlari ile hazirlanmis her bir petriye 20’ ser adet aktarilmistir. 6X–50X arasinda buyutme saglayan alttan isiklandirmali stereo mikroskop ile C. elegans ’lar izlenmistir. Butun petrilerdeki C. elegans ’lar olene kadar her gun ayni saatte canli hayvanlar sayilmis ve kontrol grubuyla karsilastirilmistir. Bulgular: Calisma sonucunda siklosporine maruz birakilan C. elegans ’larin kontrol grubuna gore yasam surelerinde doz artisina bagli istatistiksel olarak anlamli bir artis oldugu tespit edilmistir (p 0,05). Sonuc: Kalsinorin inhibisyonu, C. elegans ’larin gelisimsel surecini yavaslatir ve yasam suresini uzatir. Kalsinorin inhibitorleri, benzer mekanizmalarla insanlarda deri yaslanmasi uzerine olumlu etki yapabilir. Bu nedenle kalsinorin inhibisyonunun, deri yaslanmasi uzerine etkinligini ve etki mekanizmasini aciklayacak ileri calismalar gereklidir.

WOS: 000465640200009, BACKGROUND: Pruritus may emerge as affective or sensorial in psoriasis patients. It is not known whether the mediating effect of pruritus or disease severity on the quality of life is more pronounced. This study was conducted to determine the mediating effects and interactions between disease severity, pruritus and life quality in psoriasis patients. METHODS: 105 patients with psoriasis vulgaris were included in the study. Psoriasis Area and Severity Index (PAST) values, Dermatology Life Quality Index (DLQI), and visual analog scales for pruritus of each patient were analyzed by determining the correlations and the mediating interactions between these parameters. RESULTS: There was a moderate correlation between pruritus and DLQI (P=0.0001, r=0,528), a weak correlation between pruritus and PASI (P=0.005, r=0.273) and a moderate correlation between PASI and DLQI. The mediation effects of DLQI to pruritus, PASI to pruritus, PASI to DLQI and pruritus to DLQI were 25%, 0.047%, 22% and 25%, respectively. Also, the mediation effect of PASI plus pruritus to DLQI was 38%. CONCLUSIONS: The most obvious factor for pruritus is the impairment of DLQI rather than PASI in psoriasis patients. The mediating effect of PASI to DLQI increases the pruritus significantly.

Elastosis perforans serpiginosa and down syndrome:A case

Background and Design: Micrographic surgery is an intraoperative microscope-controlled surgery which aims at the excision of the entire tumor by achieving 100% control of the surgical margins with horizontal sectioning. In micrographic surgery, the healthy skin is preserved maximally due to the stepwise excision of the tumor using narrow margins. Due to its highest cure rates and maximal tissue preserving properties, it is the treatment of choice for high-risk non-melanoma skin cancers. Micrographic surgery is not routinely included in the dermatologic surgical procedures in Turkey. The aim of this study was to provide the availability of micrographic surgery for selected patients. Materials and Methods: During 2010-2015, 116 non-melanoma skin cancers that belong to 102 patients (53 male, 49 female) were treated with micrographic surgery. All tumors were located on the head or neck, and exhibiting at least one high-risk factor for recurrence. Micrographic surgery was performed with the Munich method between 2010 and 2013, and with Mohs surgery between 2013 and 2015. Results: The mean age of patients was 65.86±12.33 years (range: 33-90 years). The localization of the tumors was the head (n=112) and the neck (n=4). The number of micrographic surgery sessions to eliminate the tumor was 1 session for 55 (47.41%), 2 sessions for 55, and more han 2 sessions for 8 (6.89%) of the tumors. Six of the defects were left for secondary intention healing, 31 were repaired primarily and 13 defects were repaired with full thickness skin grafts whereas 66 were repaired with flaps. Conclusion: The results of this study showed that microscopic eradication of non-melanoma skin cancer necessitates more than one session for more than half of the cases, illuminating that microscopic extension of non-melanoma skin cancer beyond clinically apparent tumor is very likely. The results support that for tumors located on the head and neck where healthy skin should be preserved maximally for functional and cosmetic reasons, the use of micrographic surgery is a necessity.

WOS: 000427835700005, PubMed ID: 28468507, Background: Numerous growth factors, cytokine, mitogen and chemotactic factors are involved in wound healing. Even though inflammation is important for the stimulation of proliferative phase, excessive inflammation also causes impairment in wound healing. Strontium salts suppress keratinocyte-induced TNF-alpha and interleukin-1 and interleukin-6 in in vitro cultures. This study was conducted to determine the effects of administration of topical strontium chloride hexahydrate on wound healing through TNF-alpha and TGF-beta in surgical wound healing model of in-vivo rat skin.Material and methods: Twenty-four rats were used in the study. After approximately 2cm cutaneous-subcutaneous incision was horizontally carried out on the mid-neckline of the rats, the incision was again closed using 2.0 vicryl. The rats were assigned into three groups including eight rats in each group. Placebo emollient ointment and also the ointments, which were containing 5% and 10% strontium chloride hexahydrate and were prepared at the same base with placebo ointment, were administered to the groups by a blind executor twice a day for a week. At the end of seventh day, the rats were sacrificed and cutaneous and subcutaneous tissue of their wound site was resected for histopathological examination. Scoring of histopathological wound healing and scoring of tissue TNF-alpha and TGF-beta level with immunohistochemical staining were performed.Results: The groups, to which both 5% and 10% strontium chloride hexahydrate was administered, had lower immunohistochemical TNF-alpha levels and histopathological wound scores compared to controls, which was statistically significant (p

WOS: 000441340900015, PubMed ID: 31149265, Background and aims. There are numerous intrinsic and extrinsic factors associated with the pathophysiology of rosacea, including immune dysregulation. The aim of this study is to determine the relationship between rosacea and thyroid autoimmunity. Methods. Seventy-two patients with rosacea and 62 rosacea-free control subjects were included in the study. Serum free triiodothyronine (fT3), free thyroxine (fT4), thyrotropin releasing hormone (TSH), antithyroidperoxidase antibody (ATPO), antithyroglobulin (anti-Tg), prolactin, dehydroepiandrosterone sulfate (DHEAS), basal cortisol, serum CRP concentrations and erythrocyte sedimentation rate were measured. Results. The number of the cases with high levels of CRP, anti-M and prolactin in rosacea group were significantly higher than the controls (p < 0.05), there was no significant difference according to other parameters in both groups (p > 0.05). There was no significant difference according to the presence of a thyroid disease in both groups (p > 0.05). The decrease in the CRP parameter in patients with the disease duration of 1-5 years was found to be statistically significant (beta CRP=-0.251, pCRP < 0.05). There was no statistically significant difference according to disease severity or disease duration (p > 0.05). Conclusions. Rosacea may be associated with high thyroid autoantibodies, prolactin and CRP levels, in which immune-endocrine interactions are important.

WOS: 000418448500004, PubMed ID: 29211352, Background. Mandibular fractures are the most common facial fractures. They can be treated by conservative techniques or by surgery. The authors hypothesized that the application of a single local dose of strontium chloride would accelerate the healing of subcondylar mandibular fractures, shorten the recovery time and prevent complications. Objectives. The aim of the present pilot study was to evaluate the effects of a single local dose of strontium chloride on the healing of subcondylar mandibular fractures in rats. Material and methods. This randomized experimental study was carried out on 24 male Wistar albino rats. The rats were randomly divided into 3 groups: experimental group 1, receiving 3% strontium chloride; experimental group 2, receiving 5% strontium chloride; and the control group. A full thickness surgical osteotomy was created in the subcondylar area. A single dose of strontium solution (0.3 cc/site) was administered locally by injection on the bone surfaces of the fracture line created. Nothing was administered to the control group. The mandibles were dissected on postoperative day 21. The fractured hemimandibles were submitted to histopathological examination. Results. The median bone fracture healing score was 9 (range: 7-9) in experimental group 1; 8 (range: 7-10) in experimental group 2; and 7.50 (range: 7-8) in the control group. When the groups were compared in terms of bone healing scores, there was a statistically significant difference between experimental group 1 and the control group (p < 0.05). Conclusions. This study is the first to show that local strontium may have positive effects on the healing of subcondylar mandibular fractures. In the authors' opinion, 3% strontium was beneficial for accelerating facial skeleton consolidation and bone regeneration in rat subcondylar mandibular fractures. This treatment procedure may be combined with closed fracture treatment or a conservative approach.

WOS: 000437833900024, PubMed ID: 29663351, Background Cutaneous leishmaniasis ( CL) is a vector- born parasitic disease characterized by various skin lesions that cause disfiguration if healed spontaneously. Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees. Thus far, a limited number of national guidelines have been proposed, but no common Turkish consensus has emerged. Objectives The aim of this study was to develop diagnostic and therapeutic guidelines for the management of CL in Turkey. Methods This guideline is a consensus text prepared by 18 experienced CL specialists who have been working for many years in areas where the disease is endemic. The Delphi method was used to determine expert group consensus. Initially, a comprehensive list of items about CL was identified, and consensus was built from feedback provided by expert participants from the preceding rounds. Results Evidence- based and expert- based recommendations through diagnostic and therapeutic algorithms according to local availability and conditions are outlined. Conclusion Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.

WOS: 000369629100007, Background and Design: Psoriasis causes impairments in many daily activities, such as sleeping and occupational performance. One of the most important factors determining the quality of life of a person is sleeping. Studies about sleep quality in psoriasis are quite limited. In this study, we aimed to assess the quality of sleep and to examine the factors affecting the quality of sleep in patients with psoriasis. Materials and Methods: Seventy-three patients with psoriasis and 73 healthy subjects were included in the study. A sociodemographic data form was completed by all the participants and the Pittsburgh Sleep Quality Index (PSQI), 36-item Short-form Health Survey (SF-36), Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A) were administered to the patients and controls. Body Mass Index (BMI) was calculated in patient and control groups. The Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) were administered and pruritus was assessed in patient group. Results: PSQI global scores in patient group were found to be higher than in control group. Quality of sleep was worse in patient group. Severity of disease and sociodemographic features were found to be factors not affecting the quality of sleep. In patient group, the patients with higher sleep disturbances had higher rates of depression and anxiety scores. In patient group, the patients with severe pruritus had worse sleep quality. Conclusion: Psoriasis and psoriatic symptoms including pruritus impair sleep quality. Assessment of sleep quality and new strategies to improve sleep quality in patients with psoriasis may help improve quality of life.

Background: We aimed to investigate whether or not we achieved a bone recovery similar to or better than positive results we obtained in single dose local administration of strontium into fracture line we made previously by using spongostan as strontium carrier. Material and Methods: The study was conducted with 24 male Wistar-albino rats. They were randomly divided into three groups: group SC3 [receiving 3% SC-soaked spongostan ( n=8), group SC5 [receiving 5% SC-soaked spongostan (n=8); and group C [only spongostan (n=8)]. A full thickness surgical osteotomy was performed in the subcondylar area. A 0.5x0.5 cm spongostan soaked with 3% SC in group SC3 and 5% SC in group SC5 was placed in the fracture area and in group C, only spongostan was placed in fracture line. Postoperative 21 day, the animals mandible was dissected and fractured hemimandibles were obtained for histopathological examination. The amount of the ossification was scored out of 10 for each section. Results: There was significantly immature bone and small amount of cartilage in the group SC3, completely immature bone in the group SC5 and the group C. When the groups were compared in terms of bone healing scores, there was no statistical difference between the groups (p>0.05). Conclusions: Because the efficiency of using strontium alone was revealed in our first study, we are of the opinion that it is required to conduct future studies in which repeating local strontium injections are tried or different carrier systems are used in order to increase the positive effect of strontium on bone recovery., Amaç: Çalışmamızda mandibula fraktürü oluşturulan ratlarda spongostana emdirilerek uygulanan stronsiyumun kemik iyileşmesi üzerinde ki etkilerinin lokal stronsiyum uygulamasındakine benzer ya da daha iyi bir iyileşme sağlayıp sağlayamayacağını araştırmayı amaçladık. Materyal ve Metot: Bu çalışmada 24 erkek Wistar-albino sıçan kullanıldı. Sıçanlar tesadüfi olarak üç gruba ayrıldı; grup SC3 (%3 stronsiyım klorür emdirilmiş spongostan uygulnana n=8), grup SC5 (%5 stronsiyım klorür emdirilmiş spongostan uygulnana n=8) ve grup C (kontrol grubu, sadece spongostan uygulanan n=8). Sıçanların subkondiler bölgesine tam kat cerrahi osteotomi uygulandı. Fraktür bölgesine 0,5x0,5 cm boyutunda grup SC3'e %3; grup SC5'e %5 stronsiyum klorür emdirilmiş ve grup C'ye ise sadece spongostanlar yerleştirildi. Postoperatif 21 günde sıçanlara ötenazi uygulanıp hemimandibulaları çıkartılarak histopatolojik inceleme için gönderildi. Ossifikasyon oranı her bir sıçan için ayrı ayrı 10 üzerinden puanlandırıldı. Bulgular: Grup SC3 de olgunlaşmamış kemik ve az miktarda kıkırdak dokusu , grup SC5 de ve grup C de ise tamamen olgunlaşmamış kemik dokusu izlendi. Kemik iyileşme skorları açısından gruplar karşılaştırıldığında istatistiksel açıdan anlamlı bir farklılık izlenmedi (p>0.05). Sonuç: Sonuç olarak ilk çalışmamızda tek başına stronsiyum kullanımının etkinliği ortaya konduğundan insanlar üzerinde stronsiyumun lokal kullanımının etkinliğinin araştırılacağı çalışmaların öncesinde daha farklı taşıyıcı sistemlerin kullanıldığı ya da tekrarlayan lokal stronsiyum enjeksiyonlarının denendiği hayvan çalışmaların yapılmasının daha uygun olacağı kanısındayız.

WOS: 000416301900017, PubMed ID: 29168468, Background & objectives: Neurogenic inflammation plays a role in the pathophysiology of allergic rhinitis (AR). Strontium salts are highly effective in reducing the sensory irritation. This study was aimed to investigate the efficacy of strontium chloride (SC) on AR symptoms based on the duration of SC use before the symptoms begin. Methods: Wistar albino rats (n= 18) were randomly divided into three groups: Group 1, received 1 mu g mometasone furoate (MF); Group 2, three per cent SC; and Group 3 received five per cent SC (2 mu l/site). Drugs were administered to the each nasal cavity for three weeks every morning. On the days 7, 14 and 21, histamine dihydrochloride (HD) 5 mu mol (2 mu l/site) was administered and the frequencies of nasal rubbing and sneezing were counted for 15 min. Results: After 7, 14 and 21 day medication period, the groups were compared in terms of the frequency of sneezing and nasal rubbing following HD. There was a significant difference among the groups in terms of the frequency of sneezing on the day 7 (P< 0.05). Intragroup comparisons for the nasal rubbing showed significance (P< 0.05). In Group 3, there was a decrease in the number of nasal rubbings on the day 14 and 21; however, the difference was not significant. Interpretation & conclusions: Our results showed that three and five per cent SC were less effective than MF for sneezing during the first week, but the efficiency was equal to that of MF after the first 14 days. Long-term use of SC was as effective as MF on nasal rubbing. SC can be as effective as MF on both sneezing and nasal rubbing on regular use over three weeks.

Amaç: Kalsinörin inhibisyonunun Caenorhabditis elegans (C. elegans) bireylerinde yaşam süresini uzattığı bilinmektedir. C. elegans genlerinin önemli bir kısmı insan genlerine büyük benzerlik göstermektedir. Bu çalışmada kalsinörin inhibisyonunun C. elegans bireylerindeki yaşamsal fonksiyonlar üzerine olan etkilerinin değerlendirilmesi amaçlandı. Yöntem: Çalışma için bir kalsinörin inhibitörü olan siklosporin A'nın 1 ?M (1.doz), 0.1 ?M (2.doz), 0.01 ?M (3.doz) ve 0.001 ?M (4.doz) dozunda çözeltileri hazırlanarak her bir çözeltiden 1'er ml, içlerinde 10' ar ml Nematod Growth Media (NGM) bulunduran petrilere eklenmiştir. Kontrol grubu siklosporin eklenmemiş besiyerinde beslenmiştir. Senkronizasyonu yapılmış C. elegans'lardan siklosporinin belirtilen dozları ile hazırlanmış her bir petriye 20' şer adet aktarılmıştır. 6X-50X arasında büyütme sağlayan alttan ışıklandırmalı stereo mikroskop ile C. elegans'lar izlenmiştir. Bütün petrilerdeki C. elegans'lar ölene kadar her gün aynı saatte canlı hayvanlar sayılmış ve kontrol grubuyla karşılaştırılmıştır. Bulgular: Çalışma sonucunda siklosporine maruz bırakılan C. elegans'ların kontrol grubuna göre yaşam sürelerinde doz artışına bağlı istatistiksel olarak anlamlı bir artış olduğu tespit edilmiştir (p< 0,05). Siklosporine maruz bırakılan C. elegans'ların fiziksel gelişimlerinin doz artışına bağlı olarak anlamlı derecede azaldığı saptanmıştır (p< 0,05). Siklosporin dozundaki artış farinks pompalama sayısında istatistiksel olarak anlamlı bir değişikliğe neden olmamıştır (p> 0,05). Sonuç: Kalsinörin inhibisyonu, C. elegans'ların gelişimsel sürecini yavaşlatır ve yaşam süresini uzatır. Kalsinörin inhibitörleri, benzer mekanizmalarla insanlarda deri yaşlanması üzerine olumlu etki yapabilir. Bu nedenle kalsinörin inhibisyonunun, deri yaşlanması üzerine etkinliğini ve etki mekanizmasını açıklayacak ileri çalışmalar gereklidir., Objective: It is known that calcineurin inhibition prolongs life in individuals with Caenorhabditis elegans (C. elegans). An important part of C. elegans genes shows great similarity to human genes. This study aims to evaluate the effects of a calcineurin inhibitor on vital functions in C. elegans individuals. Method: In this study, solutions of cyclosporine A which is a calcineurin inhibitör 1 ?M (1.dose), 0.1 ?M (2.dose), 0.01 ?M (3.dose) and 0.001 ?M (4.dose) were prepared and 1 ml from each solution was taken and added to petri dishes, containing 10 ml Nematode Growth Media (NGM). The control group was fed the medium which was not added cyclosporine. The indicated doses of cyclosporine whose synchronization has been completed were transferred to petri dishes in order that each would have 20 pieces. C. elegans were observed using bottom light stereo microscop that provided 6X-50X magnification. Live animals at the same time every day were counted and compared with the control group until all C. elegans in all petri dishes died. Results: The results have showed that there was a statistically significant increase in life span periods of C. elegans exposed to cyclosporin depending on dose increase (p< 0,05). It has been found out that physical development of C. elegans exposed to increased doses of cyclosporin decreased significantly (p< 0,05). The increase in doses of cyclosporin have not caused statitically significant change in the number of pharynx pumping (p> 0,05). Conclusions: Calcineurin inhibition slows down the developmental process in C. elegans and prolongs survival, and may produce positive effects on aging.

Amaç: Bu çalışmada %5'lik stronsiyum (Sr) klorür hekzahidratın radyoterapiye (RT) bağlı gelişen deri toksisitesini önleyici ve/veya tedavi edici etkisinin olup olmadığının araştırılması amaçlandı.Gereç ve Yöntem: Dört buçuk-beş aylık, 200-210 gram ağırlığında 64 adet, dişi Wistar albino sıçan kullanıldı ve sıçanlar her bir grupta 8 sıçan olacak şekilde rastgele 8 gruba ayrıldı.Bulgular: Radyo Terapi Onkoloji Grubu Akut Radyasyon Morbidite Puanlama Kriterleri (RTOG) ve histopatolojik bulgulara göre karşılaştırma yapıldığında kontrol grubu ile diğer gruplar arasındaki fark istatistiksel olarak anlamlıydı (p0,05). Ayrıca tedavi grupları arasında anlamlı farklılık yoktu (p>0,05). Gruplar transforme-edici büyüme faktörü-?'nın immünohistokimyasal değerlendirmesine göre karşılaştırıldığında istatistiki sonuçlar: Grup 1 ve 4 (p=0,015), grup 1 ve 5 (p=0,014), grup 1 ve 6 (p=0,035), grup 1 ve 8 (p=0,046), grup 2 ve 6 (p=0,047), grup 4 ve 6 (p=0,031) şeklindeydi. Gruplar tümör nekroz faktörü-?'nın immünohistokimyasal değerlendirmesine göre karşılaştırıldığında istatistiki sonuçlar: Grup 1 ve 2 (p=0,024), grup 1 ve 8 (p=0,045) şeklindeydi.Sonuç: Topikal olarak kullanılan %5 konsantrasyondaki Sr RT'nin deri üzerinde yan etkilerini önlemek için yeterli değildir. Bu sonuç RTOG puanlama, histopatolojik bulgular ve immünolojik belirteçlerle desteklenmiştir Background and Design: This study aimed to investigate whether 5% strontium (Sr) chloride hexahydrate has preventive or therapeutic effects on the radiotherapy (RT)-induced adverse skin effects.Materials and Methods: Sixty-four female Wistar albino rats weighing 200-210 g, aged 4.5-5 months were divided into eight groups. Results: There were significant differences between control group and the other groups according to the Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria (RTOG) and histopathological findings (p0.05). In addition, there were no significant differences among treatment groups (p>0.05). Statistical results were as follows according to the immunohistochemical evaluation of transforming growth factor-β: group 1 and 4 (p=0.015), group 1 and 5 (p=0.014), group 1 and 6 (p=0.035), group 1 and 8 (p=0.046), group 2 and 6 (p=0.047), group 4 and 6 (p=0.031); and according to the immunohistochemical evaluation of tumor necrosis factor-α: group 1 and 2 (p=0.024), group 1 and 8 (p=0.045). Conclusion: Topical treatment with Sr at a concentration of 5% is insufficient to prevent the side effects of RT involving the skin, as assessed by the RTOG scoring, histopathological findings, and immunological markers

Hindawi Limited, Introduction. Strontium salts are anti-irritants for chemically induced sensory irritation. Interstitial cystitis is a painful disease without definitive therapy. The aim of the study was to determine the effect of strontium in bladder with experimental interstitial cystitis model. Material and Methods. Rats' bladders in control group were instilled with NaCl. Second group was instilled with E. coli LPS. Third group was instilled with strontium. Fourth group was initially instilled with strontiumand then LPS. Fifth group was instilled with LPS initially and then strontium. Urine of rats was collected at the beginning and end of the study. Results. Histamine and TNF-P changes were statistically significant in the second group but were not significant in the third group.When we compared the histamine levels of second via fourth and fifth groups the changes were statistically not significant.When we compared the TNF- P levels of second via fourth and fifth groups the changes were statistically significant. Conclusions. In our model, strontiumdid not make any significant changes in histopathology or histamine levels; however, it significantly reduced the levels of TNF-P. Given the role of TNF-P in the physiopathology of interstitial cystitis, these results suggested that further studies are required to evaluate the potential use of strontium in the management of interstitial cystitis., Korgali, E.; Department of Urology, Urology Clinic, Cumhuriyet UniversityTurkey; email: estkorgali@hotmail.com

WOS: 000338072000001, PubMed ID: 25032214, Background/Aims. Patients with ulcerative colitis still need effective therapy without major side effects. It has been found that strontium can suppress NF kappa B activation induced by TNF-alpha. This opens a gate to a new anti-TNF agent which is cheap and can be given orally. We for the first time aimed to investigate the effect of strontium chloride (SrCl2) on inflammation in experimental colitis. Methods. Thirty female Wistar albino rats were divided into 5 groups each containing 6 rats. The rats in groups 1 and 2 served as the healthy control and colitis group, respectively. The rats in groups 3, 4, and 5 had colitis and received 40 mg/kg SrCl2, 160 mg/kg SrCl2, and 1 mg/kg prednisolone by oral gavage, respectively. The rats were sacrificed for histological evaluation and determination of serum neopterin, TNF-alpha, and IFN-gamma levels. Results. The neopterin, TNF-alpha and IFN gamma levels of group 2 was significantly higher than the other groups. The neopterin, TNF-alpha, and IFN-gamma levels of controls and other treatment groups were comparable. There were a significant difference in macroscopic and microscopic healing between group 2 and other groups histologically. But there was not a significant difference within treatment receiving groups. Conclusion. SrCl 2 had comparable therapeutic efficiency with prednisolone.

Background: Data on seasonal variation and viral etiology in Pityriasis rosea (PR) have been conflicting. The aim of this study was to investigate the association of PR and other herpetic infections, taking seasonal changes into account. Methods: The data were collected retrospectively from electronic health registry systems in Sivas in the Central Anatolia region of Turkey between 2008 and 2016. According to their clinical types, other herpetic infections were investigated. Environmental factors such as humidity, temperature, and rainfall for the relevant period were added into the model. Time series methods (augmented Dickey–Fuller unit root test and regression analysis) were used in the analysis. Results: A total of 1207 PR patients were included in the study. The number of PR patients was calculated to be 0.462 times that of the same period in the previous year. The incidence of PR increased significantly when the rate of infections caused by varicella-zoster virus decreased and the rate of infections caused by herpesvirus Type 1 and humidity increased (P < 0.05). Conclusion: Environmental factors such as humidity are important in the emergence of the PR. Furthermore, the incidence of PR may be inversely affected by varicella-zoster infections contrary to the relationship between PR and herpesvirus Type 1 infections.

Dear Editor, Adult-onset atopic dermatitis (AOAD) (onset >18 years) is a subgroup of atopic dermatitis (AD). This subgroup has been mentioned by Bannister and Freeman from Australia 1 . It may have different morphologic variants. Apart from the most typical flexural localization and eczematous pattern in adults, patients may also have a nonflexural distribution and other morphologic variants such as nummular or prurigo-like pattern 2 . The Hannifin and Rajka criteria can be used to diagnose AOAD 3 . AD is occasionally associated with vitiligo, and patients with vitiligo, especially early onset may appear to have increased risk of AD 4 . We present a rare case with late onset atopic dermatitis and vitiligo. A 16 year old boy suffering from itchy lesions and dryness on his whole body, especially on flexural distributions for 6 months admitted to our out-patient policlinic. He also complained depigmented lesions. No personal history of atopy. His mother has an allergic rhinitis for many years. Dermatologic examination of the patient revealed pruritic dry skin, pilar keratosis, and symmetric lichenified flexural eczema. He has a facial erythema, orbital darkness and Dennie-Morgan folds (Figure 1). Potassium hydroxide preperations were negative. Histopathologic examination of the lesions showed the findings of chronic dermatitis. The diagnosis of atopic dermatitis was made based on Hanifin-Rajka criteria. He has also symmetric depigmented lesions on the popliteal skin area. Wood lamp examination of these lesions revealed blue-white light areas with sharp margins. Haematologic and urine analysis, including IgE, ANA and antithyroid antibodies were in normal range. Atopic dermatitis is a chronic or chronic relapsing, the classic morphology and location of which differs depending on age, and which is usually as sociated with severe pruritus. A D is a common skin disease, both in childhood and adolescence and in adults 5 . The term AO AD (onset >18 years) was introduced by Bannister and Freeman 1 . The onset age of the disease in our case was 16. Because of that, our case is not an AOAD . However, his diagnosis may be accepted as a late-onset atopic dermatitis. There is lack of diagnostic criteria useful in both children and adults. Therefore understanding the natural history of AD is complicated. The UK working party criteria may not perform well among adults 6 . Ozkaya 1 reported that there is no problem in detecting early-onset AD according to The UK working criteria, but approximately one fourth of patients could not be given the diagnosis of AO AD according to this in its current form. The criteria of Hanifin and Rajka have been considered as a gold standard for AD diagnosis for the last 20 years, and this criteria was used in the diagnosis of our case. A diagnostic difficulty may arise when the onset occurs after the adolescence or later, as in these cases the clinical pattern may be atypical. However it may still present with flexural dermatitis 3 . Our case had a typical typical flexural distribution and lichenified eczematous pattern. A D may be associated with specific subsets of vitiligo, and may indicate poor prognostic value for vitiligo. The mechanisms of association between AD and vitiligo are yet unknown. Patients with vitiligo, especially early onset, appear to have increased risk of AD 4 . The onset time was almost the same for both diseases in our case. However, while our case has a late onset time for AD , but early onset for vitiligo. Further studies are needed to explain the association between atopic dermatitis and vitiligo, and common disease mechanisms for both diseases.

Psoriasis is an inflammatory disease whose etiology is not exactly known and which affects approximately 2-3% of the world population, has a psychological aspect and a chronic course

…

Psoriasis is a common, chronic, recurrent, inflammatory disease of the skin with unknown etiology. In addition to skin involvement, joint involvement is often seen in psoriasis; however as comorbidities including metabolic syndrome, cardiovascular diseases, psychological/psychiatric disorders and inflammatory bowel disease accompany psoriasis, the inflammatory process underlying has been shown to damage several organs. It is also known that the risk of mortality is increased in patients with severe psoriasis. What’s more, psoriasis significantly affects the patients quality of life. According to physical/psychological examinations, the quality of life is affected from psoriasis as much as other chronic diseases like cancer or diabetes. Psoriasis leads to massive performance loss because of time and work loss at business and daily life as a result of either disease itself or its treatment. Psoriasis has several treatment modalities either topical or systemic. Topical treatment is sufficient and successful for mild psoriasis but early systemic therapy is recommended for moderate and severe psoriasis to prevent comorbidites due to increased inflammatory effect and to manage psoriatic arthritis. Topical treatment is usually applied alone for mild cases and in combination with systemic therapy or phototherapy for moderate or severe cases. Indications for the systemic therapy includes erythrodermic psoriasis, generalized pustular psoriasis, psoriatic arthritis and moderate-severe plaque psoriasis that causes serious decrease at quality of life which is irresponsive-incompatible to topical modalities or phototherapy. As the role of the immunology in pathophysiology of psoriasis is better understood, new generation of biological therapies affecting molecular mechanisms which take role at onset of psoriasis have been developed. Today, cyclosporine, methotrexate, and acitretin are used systemically; etanercept, infliximab, adalimumab or ustekinumab are used for biologic therapy for treatment of psoriasis. In this guideline severity of psoriasis has been determined, treatment phases and treatment goals have been identified and consensus recommendations have been proposed about appropiate treatment modalities in the light of recent guidelines, meta-analytic studies and experiences in Turkey. This guideline, published in 2012, have been updated in 2016 by adding new information.

WOS: 000307957500014, PubMed ID: 22454038, Nitric oxide synthesized from L-arginine via the nitric oxide synthase enzyme family is the main regulatory molecule in many physiological systems. The level of nitric oxide can now be measured in tissues by a direct real-time amperometric method. The effect of electrical stimulation of the upper cervical spine on the arteries that supply the brain and upper extremities has been established by experimental studies, and thus it has begun to be used in clinical practice to increase blood flow in the brain and the peripheral vascular system. The mechanism of this effect is still a subject of research. This is the first report of real-time nitric oxide measurement in living brain and dermal tissue during electrical stimulation of the upper cervical spine. Using the amperometric method, nitric oxide levels in frontal subcortical and front foot skin were measured before, during and after electrical stimulation of the upper cervical spine in three groups of rabbits that received infusions of saline solution, 7-aminoguanidine or atropine. By electrical stimulation, tissue nitric oxide levels increased significantly and remained increased during stimulation in the brain and skin. The nitric oxide levels dropped back to normal value 1 min after stimulation was turned off. The results we obtained have showed that real-time nitric oxide could also be measured by an amperometric method in living tissues like brain. The effect of stimulation on nitric oxide levels of living tissues disappears immediately when the stimulation is turned off., Scientific Research Project Fund of Cumhuriyet University [T275], This work is supported by the Scientific Research Project Fund of Cumhuriyet University under the project number T275. We thank Mrs. Ziynet Cinar for her assistance in the statistical analysis.