Pub Date : 2021-09-20DOI: 10.32552/2021.actamedica.660
B. Yalıcı-Armağan, Caner Demircan, N. Akdoğan, D. Gülseren, Sibel Doğan-Günaydın, G. Elçin, A. Karaduman, Zehra Nilgun Atakan, S. Ersoy-Evans
Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are dermatologic emergencies. There is a lack of consensus regarding appropriate management of SJS/TEN. The aim of this study was to evaluate demographic and clinical features, management and outcomes of SJS/TEN patients. Materials and Methods: The data of patients who were ≥18 years old and hospitalized with the diagnosis of SJS, SJS-TEN overlap and TEN at Hacettepe University, between 1992 and 2018 were analyzed retrospectively. Patient demographics, medications, time between the first causative drug intake and the onset of symptoms, mucous membrane involvement, treatment modalities including supportive measures, intravenous immunoglobulin, cyclosporine and systemic corticosteroids, duration of hospitalization, and mortality outcomes were recorded from patient charts. Results: A total of 23 patients (11 men; 12 women) with a mean age of 46.4 ± 19.5 years were included in the study. Twelve patients (52.2%) had SJS, 8 patients (34.8%) had SJS/TEN overlap and 3 patients (13%) had TEN. Mean duration of hospitalization was 12.6 ± 6.5 days. Twenty-two patients (95.7%) were attributed to a specific medication, whereas triggering factor was not detected in 1 patient (4.3%). More than one drug was responsible for 9 patients, including antimicrobials (n=11, 47.8%), anticonvulsants (n=8, 34.8%) and/or non-steroid anti-inflammatory drugs (n=5, 21.7%). The median time between the intake of medication and the onset of symptoms was 20 days (IQR 5.5-30). Sixteen patients used systemic corticosteroids (69.6%) and 4 patients used intravenous immunoglobulin (17.4%) whereas 3 patients used systemic corticosteroids in combination with intravenous immunoglobulin (n=2, 8.7%) or cyclosporin (n=1, 4.3%). The median time between the onset of symptoms and the onset of the rash to the treatment was 5 days (IQR 3-7). Mortality was not observed in our cohort. Conclusion: SJS/TEN was most commonly developed because of drugs, mainly antimicrobials, anticonvulsants and/or non-steroid anti-inflammatory drugs. The absence of mortality in our cohort was considered to be associated with younger age, low rate of TEN, prompt initiation of treatment (mainly corticosteroids) following the rapid discontinuation of the suspected drug.
{"title":"Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Retrospective Analysis of 23 Patients","authors":"B. Yalıcı-Armağan, Caner Demircan, N. Akdoğan, D. Gülseren, Sibel Doğan-Günaydın, G. Elçin, A. Karaduman, Zehra Nilgun Atakan, S. Ersoy-Evans","doi":"10.32552/2021.actamedica.660","DOIUrl":"https://doi.org/10.32552/2021.actamedica.660","url":null,"abstract":"Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are dermatologic emergencies. There is a lack of consensus regarding appropriate management of SJS/TEN. The aim of this study was to evaluate demographic and clinical features, management and outcomes of SJS/TEN patients. \u0000Materials and Methods: The data of patients who were ≥18 years old and hospitalized with the diagnosis of SJS, SJS-TEN overlap and TEN at Hacettepe University, between 1992 and 2018 were analyzed retrospectively. Patient demographics, medications, time between the first causative drug intake and the onset of symptoms, mucous membrane involvement, treatment modalities including supportive measures, intravenous immunoglobulin, cyclosporine and systemic corticosteroids, duration of hospitalization, and mortality outcomes were recorded from patient charts. \u0000Results: A total of 23 patients (11 men; 12 women) with a mean age of 46.4 ± 19.5 years were included in the study. Twelve patients (52.2%) had SJS, 8 patients (34.8%) had SJS/TEN overlap and 3 patients (13%) had TEN. Mean duration of hospitalization was 12.6 ± 6.5 days. Twenty-two patients (95.7%) were attributed to a specific medication, whereas triggering factor was not detected in 1 patient (4.3%). More than one drug was responsible for 9 patients, including antimicrobials (n=11, 47.8%), anticonvulsants (n=8, 34.8%) and/or non-steroid anti-inflammatory drugs (n=5, 21.7%). The median time between the intake of medication and the onset of symptoms was 20 days (IQR 5.5-30). Sixteen patients used systemic corticosteroids (69.6%) and 4 patients used intravenous immunoglobulin (17.4%) whereas 3 patients used systemic corticosteroids in combination with intravenous immunoglobulin (n=2, 8.7%) or cyclosporin (n=1, 4.3%). The median time between the onset of symptoms and the onset of the rash to the treatment was 5 days (IQR 3-7). Mortality was not observed in our cohort. \u0000Conclusion: SJS/TEN was most commonly developed because of drugs, mainly antimicrobials, anticonvulsants and/or non-steroid anti-inflammatory drugs. The absence of mortality in our cohort was considered to be associated with younger age, low rate of TEN, prompt initiation of treatment (mainly corticosteroids) following the rapid discontinuation of the suspected drug.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"PP 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84355529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-20DOI: 10.32552/2021.actamedica.550
Y. Şener, U. Canpolat, H. Yorgun, T. Hazırolan, K. Aytemir
Single coronary artery is a rare congenital anomaly associated with sudden cardiac death even though most of the cases are asymptomatic. Cardiac computerized tomography angiography plays an essential role in establishing the diagnosis of single coronary artery and designating the arterial course. Being aware of coronary anomaly is crucial in some cases scheduled for catheter ablation of premature ventricular complex neighboring to coronary arteries to prevent radiofrequency ablation related vascular injury.
{"title":"Incidental Detection of a Rare Coronary Anomaly During Catheter Ablation for Premature Ventricular Complexes: All in One Coronary Ostium","authors":"Y. Şener, U. Canpolat, H. Yorgun, T. Hazırolan, K. Aytemir","doi":"10.32552/2021.actamedica.550","DOIUrl":"https://doi.org/10.32552/2021.actamedica.550","url":null,"abstract":"Single coronary artery is a rare congenital anomaly associated with sudden cardiac death even though most of the cases are asymptomatic. Cardiac computerized tomography angiography plays an essential role in establishing the diagnosis of single coronary artery and designating the arterial course. Being aware of coronary anomaly is crucial in some cases scheduled for catheter ablation of premature ventricular complex neighboring to coronary arteries to prevent radiofrequency ablation related vascular injury.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"79 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83805019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-20DOI: 10.32552/2021.actamedica.559
Nese Unver
Objective: Non-Small Cell Lung Cancer has a high incidence and great clinical importance as the cancer subtype with the highest mortality. It is necessary to investigate cytokines associated with the Programmed death-ligand 1, one of the immunotherapeutic target molecules, in KRas mutant lung cancer cells. Materials and Methods: In this study, the expression of Programmed death-ligand 1 as well as pro-inflammatory interleukins was evaluated in 44 lung cancer cell lines harboring KRas mutations and RNAseq expression data of lung adenocarcinoma patients and correlation analyses were performed. Macrophages and dendritic cells, the major immune cells associated with Interleukin-1, Interleukin-6, Interleukin-12 and Interleukin-23, were also evaluated. Results: In KRas mutant lung cancer cells and lung adenocarcinoma tissues, expression of cytokines Interleukin-1A, Interleukin-6, Interleukin-12 and Interleukin-23 showed a positive correlation with Programmed death-ligand 1 expression (p≤0.05). The quantity of M1 macrophages and dendritic cells, both of which are cytokine-producing immune cells, is less in KRas mutant lung cancer tissues than non-mutants. Conclusion: Detailed studies in clinical samples, especially in blood, primary, and metastatic tissues, will help to create and validate cytokine panels that can be used in therapeutic targeting of KRas mutant subtype lung cancer with high Programmed death-ligand 1 expression.
{"title":"In-Silico Analysis of The Correlation Between PD-L1 and Pro-Inflammatory Type Interleukins and The Distribution of Their Potential Primary Sources in KRAS-Mutated Non-Small Cell Lung Carcinoma","authors":"Nese Unver","doi":"10.32552/2021.actamedica.559","DOIUrl":"https://doi.org/10.32552/2021.actamedica.559","url":null,"abstract":"Objective: Non-Small Cell Lung Cancer has a high incidence and great clinical importance as the cancer subtype with the highest mortality. It is necessary to investigate cytokines associated with the Programmed death-ligand 1, one of the immunotherapeutic target molecules, in KRas mutant lung cancer cells. \u0000Materials and Methods: In this study, the expression of Programmed death-ligand 1 as well as pro-inflammatory interleukins was evaluated in 44 lung cancer cell lines harboring KRas mutations and RNAseq expression data of lung adenocarcinoma patients and correlation analyses were performed. Macrophages and dendritic cells, the major immune cells associated with Interleukin-1, Interleukin-6, Interleukin-12 and Interleukin-23, were also evaluated. \u0000Results: In KRas mutant lung cancer cells and lung adenocarcinoma tissues, expression of cytokines Interleukin-1A, Interleukin-6, Interleukin-12 and Interleukin-23 showed a positive correlation with Programmed death-ligand 1 expression (p≤0.05). The quantity of M1 macrophages and dendritic cells, both of which are cytokine-producing immune cells, is less in KRas mutant lung cancer tissues than non-mutants. \u0000Conclusion: Detailed studies in clinical samples, especially in blood, primary, and metastatic tissues, will help to create and validate cytokine panels that can be used in therapeutic targeting of KRas mutant subtype lung cancer with high Programmed death-ligand 1 expression.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"77 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77404466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-15DOI: 10.32552/2021.actamedica.571
A. Erdemir, Ekim Gümeler, O. Öcal, T. Hazırolan
Objective: For a correct estimation of extracellular volume, patients’ blood samples must be taken at least within 24 hours after cardiac magnetic resonance imaging, which may cause problems in immediate or retrospective evaluation. The aim of this study is to demonstrate the applicability of synthetic hematocrit for the calculation of extracellular volume. Materials and Methods: Cardiac magnetic resonance images including T1 mapping were retrospectively reviewed. Medical records of each patient were also collected and patients who had blood samples including hematocrit values within 24 hours of cardiac magnetic resonance imaging were included in the study. Simple linear regression along with intraclass correlation coefficient were used to calculate the coefficient of determination and agreement between the two measurements of hematocrit and extracellular volume values. The compatibility of the synthetic extracellular volume with the native extracellular volume was analysed using “Kappa Analysis”. Results: Synthetic and native hematocrit values showed significant correlation (p<0.001). Synthetic hematocrit had a high intraclass correlation coefficient (0.833). Kappa analysis for each region (Apex κ=0.88, Mid κ=0.75, Basal κ=0.87) showed significant interobserver reliability (p<0.001). Conclusion: Synthetic hematocrit formulas for each vendor may help improve synthetic extracellular volume values without contrast administration.
{"title":"Utilization of Synthetic Hematocrit Derived from Cardiac MRI for Estimating Extracellular Volume","authors":"A. Erdemir, Ekim Gümeler, O. Öcal, T. Hazırolan","doi":"10.32552/2021.actamedica.571","DOIUrl":"https://doi.org/10.32552/2021.actamedica.571","url":null,"abstract":"Objective: For a correct estimation of extracellular volume, patients’ blood samples must be taken at least within 24 hours after cardiac magnetic resonance imaging, which may cause problems in immediate or retrospective evaluation. The aim of this study is to demonstrate the applicability of synthetic hematocrit for the calculation of extracellular volume. \u0000Materials and Methods: Cardiac magnetic resonance images including T1 mapping were retrospectively reviewed. Medical records of each patient were also collected and patients who had blood samples including hematocrit values within 24 hours of cardiac magnetic resonance imaging were included in the study. Simple linear regression along with intraclass correlation coefficient were used to calculate the coefficient of determination and agreement between the two measurements of hematocrit and extracellular volume values. The compatibility of the synthetic extracellular volume with the native extracellular volume was analysed using “Kappa Analysis”. \u0000Results: Synthetic and native hematocrit values showed significant correlation (p<0.001). Synthetic hematocrit had a high intraclass correlation coefficient (0.833). Kappa analysis for each region (Apex κ=0.88, Mid κ=0.75, Basal κ=0.87) showed significant interobserver reliability (p<0.001). \u0000Conclusion: Synthetic hematocrit formulas for each vendor may help improve synthetic extracellular volume values without contrast administration.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"2013 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82605423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-06DOI: 10.32552/2021.actamedica.583
U. Kartoglu, Deniz Nala Kartoglu, L. Eker, Hamza Ozdemir, N. Ozaydin
online descriptive study was planned to understand how health professionals and non-health professionals rank the risks of 43 everyday activities from a COVID-19 perspective in the Istanbul metropolitan area. The study hyperlink was shared through social media channels, as well as professional associations targeting health professionals. Responses were analyzed in SPSS.11. The statistical significance level was accepted as p<0.05. Results: We received 1,614 valid responses through online submissions, of which 738 (45.7%) were health professionals, and 876 (%54.3) were from non-health sectors. Mask use and the respect of the 1.5 m distance from others were found to be similar in participants from health and non-health sectors. Hand washing and the use of hand sanitizers were found to be significantly higher among health professionals. Health professionals, women, and participants with higher education ranked the risk of everyday activities higher than other groups. The activities that were ranked as high-risk share some common features like closed spaces, crowded places, and activities that require people to be close to each other and, in some cases, touching. Conclusion: Based on the rankings of the 738 health professionals, an infographic illustrating the ranking scores of the 43 everyday activities, both through labels and colors, was developed, using a cartoon-style Istanbul metropolitan landscape.
{"title":"Ranking of Everyday Activities by Risk of Coronavirus in the Istanbul Metropolitan Area, Turkey","authors":"U. Kartoglu, Deniz Nala Kartoglu, L. Eker, Hamza Ozdemir, N. Ozaydin","doi":"10.32552/2021.actamedica.583","DOIUrl":"https://doi.org/10.32552/2021.actamedica.583","url":null,"abstract":"online descriptive study was planned to understand how health professionals and non-health professionals rank the risks of 43 everyday activities from a COVID-19 perspective in the Istanbul metropolitan area. The study hyperlink was shared through social media channels, as well as professional associations targeting health professionals. Responses were analyzed in SPSS.11. The statistical significance level was accepted as p<0.05. Results: We received 1,614 valid responses through online submissions, of which 738 (45.7%) were health professionals, and 876 (%54.3) were from non-health sectors. Mask use and the respect of the 1.5 m distance from others were found to be similar in participants from health and non-health sectors. Hand washing and the use of hand sanitizers were found to be significantly higher among health professionals. Health professionals, women, and participants with higher education ranked the risk of everyday activities higher than other groups. The activities that were ranked as high-risk share some common features like closed spaces, crowded places, and activities that require people to be close to each other and, in some cases, touching. Conclusion: Based on the rankings of the 738 health professionals, an infographic illustrating the ranking scores of the 43 everyday activities, both through labels and colors, was developed, using a cartoon-style Istanbul metropolitan landscape.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"16 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85029899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-03DOI: 10.32552/2021.actamedica.563
Dilara Bal Topcu, Ahmet Ozsoy, F. Uçar, A. Yalçındağ, Yesim Er Oztas
{"title":"Analytical Process Evaluation of Biochemistry Laboratory by Using Six Sigma Method","authors":"Dilara Bal Topcu, Ahmet Ozsoy, F. Uçar, A. Yalçındağ, Yesim Er Oztas","doi":"10.32552/2021.actamedica.563","DOIUrl":"https://doi.org/10.32552/2021.actamedica.563","url":null,"abstract":"","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"5 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82711133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.32552/2021.actamedica.578
G. Kavalci, Selvi Ceran Kayipmaz
Objective: The ongoing Covid-19 pandemic further increased this stress of employees. This disease, which did not have a cure and a vaccine at the beginning, increased the anxiety of the employees and forced them to live separately due to the risk of infecting family members. This study aimed to investigate the burnout levels of doctors and technicians working in Yenimahalle Training and Research Hospital Anaesthesiology and Reanimation Clinic. Materials and Methods: This study was conducted prospectively by using a questionnaire method in the Yenimahalle Training and Research Hospital. Maslach Burnout questionnaire applied to the participants. Quantitative data were expressed as %, the number of subjects as (n). The distribution of continuous variables was evaluated with the Kolmogorov-Smirnow test. Qualitative data were expressed in mean±SD (standard deviation). X2 test was used for comparison of categorical variables. Independent Student T-test was used for comparison of continuous variables. The relationship between burnout level and variables was determined by Pearson Correlation Test. The value of p<0.05 was considered statistically significant. Results: A total of 52 volunteers participated in the study. The average emotional exhaustion score of the volunteers participating in the study was 31.13±4.6, the average depersonalization score was 15.06±3.3, and the mean personal achievement score was 23.60±3.7. There was no statistically significant relationship between any of the variables and the burnout level (p>0.05). Conclusion: The high level of burnout in a clinic that is at the forefront of the fight against Covid-19, such as anesthesiology and reanimation, is important in terms of determining the situation.
{"title":"Investigation of Burnout Levels of Anaesthesiologists and Technicians in Covid-19 Pandemic Period","authors":"G. Kavalci, Selvi Ceran Kayipmaz","doi":"10.32552/2021.actamedica.578","DOIUrl":"https://doi.org/10.32552/2021.actamedica.578","url":null,"abstract":"Objective: The ongoing Covid-19 pandemic further increased this stress of employees. This disease, which did not have a cure and a vaccine at the beginning, increased the anxiety of the employees and forced them to live separately due to the risk of infecting family members. This study aimed to investigate the burnout levels of doctors and technicians working in Yenimahalle Training and Research Hospital Anaesthesiology and Reanimation Clinic. \u0000Materials and Methods: This study was conducted prospectively by using a questionnaire method in the Yenimahalle Training and Research Hospital. Maslach Burnout questionnaire applied to the participants. Quantitative data were expressed as %, the number of subjects as (n). The distribution of continuous variables was evaluated with the Kolmogorov-Smirnow test. Qualitative data were expressed in mean±SD (standard deviation). X2 test was used for comparison of categorical variables. Independent Student T-test was used for comparison of continuous variables. The relationship between burnout level and variables was determined by Pearson Correlation Test. The value of p<0.05 was considered statistically significant. \u0000Results: A total of 52 volunteers participated in the study. The average emotional exhaustion score of the volunteers participating in the study was 31.13±4.6, the average depersonalization score was 15.06±3.3, and the mean personal achievement score was 23.60±3.7. There was no statistically significant relationship between any of the variables and the burnout level (p>0.05). \u0000Conclusion: The high level of burnout in a clinic that is at the forefront of the fight against Covid-19, such as anesthesiology and reanimation, is important in terms of determining the situation.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"41 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80177049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.32552/2021.actamedica.624
S. Demir, Müşerref Kasap Cüceoğlu, Y. Bilginer
Objective: Enthesitis-related arthritis is a subtype of juvenile idiopathic arthritis category, characterized by enthesitis, arthritis, and the risk of axial involvement. We aimed to summarize the demographics, clinical, and laboratory findings of enthesitis-related arthritis patients and to identify the distinguishing features of enthesitis-related arthritis patients with HLA B27 positive compared to the patients who were HLA B27 negative. Materials and Methods: This retrospective study included patients with Enthesitis-related arthritis who followed up between 2015 and 2018. Demographical, clinical, and laboratory data were retrospectively reviewed from the patient files and computerized medical charts. Results: A total of 72 patients diagnosed with enthesitis-related arthritis were included in the study. The male/female ratio was 2.1/1. Fifty-three (73%) of them presented with peripheral arthritis. The most commonly affected joint was knee (81.1%), followed by the ankle (43%), hips (32%), and wrist (5%). HLA B27 was positive in 36 (50%) patients. During follow-up, the number of patients who developed enthesitis-related arthritis -associated uveitis was 8 (11.1%). During follow-up, 56 patients with inflammatory back pain and/or sacroiliac tenderness underwent spinal MRI. Ten (17.8%) patients had only thoracal and/or lumbar involvement, 18 (32%) had only sacroiliitis, and 9 (16%) patients had both of them on spinal MRI. In comparison with HLA-B27-negative children, HLA-B27-positive patients were more likely to have enthesitis (16 (44.4%) vs 8 (22.2%), p=0.046), MRI proven sacroiliitis (19 (52.7%) vs 8 (22.2%), p=0.031), MRI proven spinal involvement (13 (36.1%) vs 6 (16.6%), p=0.031), and uveitis (8 (100%) vs 0(0%), p=0.014). During follow up, 65/72 (90.2 %) of them needed disease-modifying antirheumatic drugs (DMARD), and 51/72 (70.8%) needed anti-tumor necrosis factor-α (TNF-α) therapy. Conclusion: We found that patients who were HLA-B27- positive had significantly more enthesitis, MRI-proven sacroiliitis, MRI-proven spinal involvement, and acute anterior uveitis, in comparison to patients who were HLA B27 negative. It is crucial to carefully assess those patients with concern for enthesitis-related arthritis to determine the expected prognosis and make therapeutic decisions appropriately.
{"title":"Enthesitis Related Arthritis: A Single Center Experience","authors":"S. Demir, Müşerref Kasap Cüceoğlu, Y. Bilginer","doi":"10.32552/2021.actamedica.624","DOIUrl":"https://doi.org/10.32552/2021.actamedica.624","url":null,"abstract":"Objective: Enthesitis-related arthritis is a subtype of juvenile idiopathic arthritis category, characterized by enthesitis, arthritis, and the risk of axial involvement. We aimed to summarize the demographics, clinical, and laboratory findings of enthesitis-related arthritis patients and to identify the distinguishing features of enthesitis-related arthritis patients with HLA B27 positive compared to the patients who were HLA B27 negative. \u0000Materials and Methods: This retrospective study included patients with Enthesitis-related arthritis who followed up between 2015 and 2018. Demographical, clinical, and laboratory data were retrospectively reviewed from the patient files and computerized medical charts. \u0000Results: A total of 72 patients diagnosed with enthesitis-related arthritis were included in the study. The male/female ratio was 2.1/1. Fifty-three (73%) of them presented with peripheral arthritis. The most commonly affected joint was knee (81.1%), followed by the ankle (43%), hips (32%), and wrist (5%). HLA B27 was positive in 36 (50%) patients. During follow-up, the number of patients who developed enthesitis-related arthritis -associated uveitis was 8 (11.1%). During follow-up, 56 patients with inflammatory back pain and/or sacroiliac tenderness underwent spinal MRI. Ten (17.8%) patients had only thoracal and/or lumbar involvement, 18 (32%) had only sacroiliitis, and 9 (16%) patients had both of them on spinal MRI. In comparison with HLA-B27-negative children, HLA-B27-positive patients were more likely to have enthesitis (16 (44.4%) vs 8 (22.2%), p=0.046), MRI proven sacroiliitis (19 (52.7%) vs 8 (22.2%), p=0.031), MRI proven spinal involvement (13 (36.1%) vs 6 (16.6%), p=0.031), and uveitis (8 (100%) vs 0(0%), p=0.014). During follow up, 65/72 (90.2 %) of them needed disease-modifying antirheumatic drugs (DMARD), and 51/72 (70.8%) needed anti-tumor necrosis factor-α (TNF-α) therapy. \u0000Conclusion: We found that patients who were HLA-B27- positive had significantly more enthesitis, MRI-proven sacroiliitis, MRI-proven spinal involvement, and acute anterior uveitis, in comparison to patients who were HLA B27 negative. It is crucial to carefully assess those patients with concern for enthesitis-related arthritis to determine the expected prognosis and make therapeutic decisions appropriately.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"15 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90547145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-26DOI: 10.32552/2021.actamedica.561
Övsen Önay, C. Aydın
Objective: To evaluate the lifestyle factors possibly related with premenstrual syndrome which were body mass index, coffee intake, smoking, regular physical exercise, and alcohol consumption, and investigate the impact of these lifestyle factors and premenstrual syndrome on sleep quality. Methods and Methods: This cross-sectional study included 265 participants, and all applied Pittsburgh Sleep Quality Index and Premenstrual Syndrome Scale questionnaires. Results: The prevalence of premenstrual syndrome among the participants was 57% (n:150). Participants with premenstrual syndrome had shorter total sleep time (p:0.001). Also, they needed longer time to fall asleep (p:0.001). The Pittsburgh Sleep Quality Index scores of the participants with premenstrual syndrome were higher than those without premenstrual syndorme (p<0.001), indicating poor sleep quality. It was observed that the participants with premenstrual syndrome had more coffee intake (p:0.040) and more regular physical activity (p:0.009), which were risk factors of premenstrual syndrome. premenstrual syndrome positivity was associated with increased poor sleep quality in both univariate and multivariate analyses (OR:5.93 95% CI: 3.46-10.15, p<0.001; OR:5.61 95% CI: 3.19-9.88, p<0.001, respectively). The remaining variables, which were risk factors of premenstrual syndrome, didn’t have any statistically significant association with sleep quality. Conclusion: The important relation between premenstrual syndrome and sleep quality is highlighted. Relief of premenstrual syndrome complaints may lead to better sleep quality and enhancement of quality of life for a woman.
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