Psoriatic arthritis, biologic therapy experience, body mass index, and onset age of psoriasis were independent factors of secukinumab discontinuation in patients with psoriasis.

INTRODUCTION: Despite the availability of several treatments for psoriasis (PsO), factors influencing the persistence of secukinumab (SEC) therapy remain inadequately understood. This study aimed to identify predictors of SEC persistence in PsO. METHODS: A retrospective analysis was conducted on 109 PsO patients who received SEC treatment at least 1 year. Patients were categorized based on continued or discontinued SEC therapy. RESULTS: Among the 109 patients, 64 continued SEC treatment while 45 discontinued. Univariate analysis demonstrated that PsA presence and previous biologic therapy use increased the risk of SEC discontinuation 3.56- and 2.33-fold (p = 0.001, %95 CI: 1.66-7.65 and p = 0.032, %95 CI: 1.08-5.04, respectively). Additionally, the risk of SEC discontinuation is 57% higher in patients with a body mass index (BMI) above 26.5 compared to those with a BMI below 26.5 (p = 0.016, %95 CI: 0.22-0.85). Additionally, patients with PsO onset age below 26.5 years were found to have a 2.93-times higher risk of discontinuing SEC compared to those with PsO onset age above 26.5 years (p = 0.004, %95 CI: 1.40-6.13). CONCLUSION: PsA presence, previous biologic therapy experience, BMI, and PsO onset age were identified as independent predictors of SEC discontinuation. These findings underscore the importance of personalized treatment strategies for PsO patients receiving SEC therapy.

Evaluation of Methylene Blue as An Effective Antiseptic for Medicinal Leeches (Hirudo verbana).

Objective: Medicinal leeches (Hirudo spp.) have been used for therapeutic purposes in humans since ancient times. Because of their growth conditions, leeches carry certain bacteria and endosymbionts (e.g., Aeromonas spp). In both leech farms and hirudotherapy clinics, there are no reliable antiseptics that can be used with leeches. This study aimed to determine whether methylene blue (MB) is a safe antiseptic for medicinal leeches and assess its safe usage. Methods: This study evaluated the efficacy of MB by determining lethal concentrations (LC), effective concentrations (EC), and lethal times (LT) for the medicinal leech Hirudo verbena Carena, 1820. A total of 570 H. verbana specimens obtained from a local farm were used in this study. Eighteen different concentrations of MB (between 1 ppm and 512 ppm) were tested. Results: The LC50 and EC50 values for H. verbana were determined to be 60.381 (53.674-66.636) ppm and 2.013 (1.789-2.221) ppm, respectively. The LT50 durations for MB concentrations of 32 and 512 ppm were calculated as 212.92 h (138.43 h-1485.78 h) and 17.82 h (8.08 h-23.90 h), respectively. Conclusion: The results show that MB concentrations between 2 and 19 ppm can be safely used as antiseptics in hirudotherapy clinics and leech farms to address bacterial concerns caused by medicinal leeches.

Expression of brain-derived neurotrophic factor and formation of migrasome increases in the glioma cells induced by the adipokinetic hormone.

OBJECTIVE: It has been previously shown that brain-derived neurotrophic factor is linked with various types of cancer. Brain-derived neurotrophic factor is found to be highly expressed in multiple human cancers and associated with tumor growth, invasion, and metastasis. Adipokinetic hormones are functionally related to the vertebrate glucagon, as they have similar functionalities that manage the nutrient-dependent secretion of these two hormones. Migrasomes are new organelles that contain numerous small vesicles, which aid in transmitting signals between the migrating cells. Therefore, the aim of this study was to investigate the effects of Anax imperator adipokinetic hormone on brain-derived neurotrophic factor expression and ultrastructure of cells in the C6 glioma cell line. METHODS: The rat C6 glioma cells were treated with concentrations of 5 and 10 Anax imperator adipokinetic hormone for 24 h. The effects of the Anax imperator adipokinetic hormone on the migrasome formation and brain-derived neurotrophic factor expression were analyzed using immunocytochemistry and transmission electron microscope. RESULTS: The rat C6 glioma cells of the 5 and 10 µM Anax imperator adipokinetic hormone groups showed significantly high expressions of brain-derived neurotrophic factor and migrasomes numbers, compared with the control group. CONCLUSION: A positive correlation was found between the brain-derived neurotrophic factor expression level and the formation of migrasome, which indicates that the increased expression of brain-derived neurotrophic factor and the number of migrasomes may be involved to metastasis of the rat C6 glioma cell line induced by the Anax imperator adipokinetic hormone. Therefore, the expression of brain-derived neurotrophic factor and migrasome formation may be promising targets for preventing tumor proliferation, invasion, and metastasis in glioma.

Determination of Antimicrobial Resistance Gene Variations Using Tet and Str Genes in Freshwater Fish Species.

With the rapid development of aquaculture, antibiotics are widely used for prophylactic and therapeutic purposes to reduce economic losses caused by disease outbreaks. Considering that most antibiotics applied to humans and animals are partially metabolized and not eliminated, it is evident that these antibiotic residues can have negative effects on natural aquatic organisms after reaching the receiving environment, such as rivers and reservoirs. Therefore, it is believed that this indiscriminate use of antibiotics is now beginning to affect aquatic organisms in natural environments, outside of closed environments. In this study, tissue samples were taken from seven fish species in the Firat River. Specific primer sets were designed for Tet and Str genes, which are known to play a role in antibiotic resistance mechanisms. The changes in gene expression levels were then examined. The results showed that the expression levels of Tet and Str genes associated with antibiotic resistance were more than two-fold higher in Cyprinus carpio and Chondrostoma regium species compared to a control group that did not use antibiotics. A moderate expression level was observed in Capoeta trutta, Acanthobrama marmid, Capoeta umbla, and Barbus grypus species. In addition, in Luciobarbus mystaceus species, the Tet gene was expressed at a meaningless level, while the Str gene was downregulated. Therefore, it is believed that this species may not have encountered or has previously encountered antibiotics at low levels, leading to the control levels of the resistance mechanism.

Diagnostic Role of Direct Immunofluorescence Assay in Determining The Etiology of Erythroderma: Experience in a Tertiary Referral Hospital.

Introduction: Erythroderma is a life-threatening dermatologic emergency which is characterized by diffuse erythema and exfoliation affecting more than 90% of the body surface area. Most common cutaneous diseases associated with erythroderma are systemic contact dermatitis, psoriasis, drug eruption and atopic dermatitis. Clinical-pathological correlation is used to determine the underlying disease. In addition, direct immunofluorescence (DIF) may provide significant clues for etiology of erythroderma especially in the case of autoimmune bullous skin diseases (ABSDs). Objectives: In our study, we aimed to analyze the demographic data, clinical pre-diagnoses, final diagnosis, histopathological and DIF examination findings, accompanying systemic signs and laboratory abnormalities of erythrodermic patients. Methods: We conducted a retrospective study of 31 erythroderma patients in a referral hospital between 2014 and 2021. Cutaneous biopsies were taken from all patients for H&E and DIF examination. Results: Average age was 54.6 ± 23 years, 48.4% of the patients were female (N = 15) whereas 51.6 % of the patients were male (N = 16). Average time between the onset of rash and biopsy was 18.8 days. DIF analysis showed immune deposits in 19.4% (N = 6) of the patients; whereas no immune deposits were detected in 80.6% (N = 25) of the patients. The most frequent final diagnosis was adverse cutaneous drug eruption followed by ABSDs. Conclusions: Our findings suggest that DIF may be used in conjunction with clinical-pathologic and clinical findings to reveal the associated skin diseases in erythrodermic patients. Erythrodermic patients presenting with clinical findings of ABSD should be considered for DIF examination.

The Effect of Quinoa Seed (Chenopodium quinoa Willd.) Extract on the Performance, Carcass Characteristics, and Meat Quality in Japanese Quails (Coturnix coturnix japonica).

This research was conducted to determine the effect of quinoa seed (Chenopodium quinoa Willd.) extract on the performance, carcass parameters, and meat quality in Japanese quails. In this study, 400 quail chicks were divided into a control group (without quinoa seed extract addition) and 3 experiment groups (4 replicates containing 25 quails in each). Commercial feed and the addition of different concentrations of quinoa seed extract (QSE) 0.1 g/kg, 0.2 g/kg, and 0.4 g/kg were used in the study. During the second week of the experiment, the highest feed intake was obtained from the supplemented groups (p < 0.01). After 5 weeks of experimentation, the highest feed consumption was noticed in the group with 0.4 g of QSE additive. The QSE additive affected the live weight gain values of all experimental groups during 1 week of the experiment. The highest values of hot carcass weight were noticed in groups with 0.2 and 0.4 g of QSE additive (p < 0.01). While the highest value of cold carcass weight was noticed in a group with 0.2 g of QSE additive (p < 0.05). Thigh, breast, back and neck ratio, and internal organs (except gizzard) were not affected by the supplementation of QSE. As a result of storage of breast meat at 4 °C for 0, 1 days, 3 days, 5 days, and 7 days, it was determined that the number of pH, thiobarbituric acid, peroxide, and total psychrophilic bacteria were lower in the groups with QSE as compared to the control group (p < 0.05). In conclusion, the best results of quail performance were obtained with 0.2 g/kg and 0.4 g QSE/kg of the quail's fodder. While the addition of 0.4 g QSE/kg of the quail's fodder had a significant effect on meat shelf life and could be used in poultry mixed feed to prevent or delay lipid oxidation of meat.

Effect of Dietary Supplementation of Black Cumin Seeds (Nigella sativa) on Performance, Carcass Traits, and Meat Quality of Japanese Quails (Coturnix coturnix japonica).

The current study was conducted to determine the effect of adding black cumin (Nigella sativa) powder (BCP) to the Japanese quail diet on the carcass characteristics and meat quality. In this research, 240 Japanese quail chicks (mean initial body weight 9.15 ± 0.12) were divided into four groups of four replications each. Treatments consisted of the addition of BCP at levels 1, 2, and 4% to the mixed feed and control group without the BCP additive. Compared to the other groups, the group with the 2% BCP diet had a higher live weight (LW), body weight gain (BWG), and a better feed conversion ratio (FCR, p < 0.05). BCP administration had no impact on the carcass characteristics, however, BCP had a significant effect on the thigh and breast meat. The animal study protocol was approved by the Nigde Governorship, Provincial Directorate of Agriculture and Forestry, Turkey (protocol code: E-15018773-050.01.04-75932 and date of approval: 26 April 2021) for studies involving animals. Lower thiobarbituric acid (TBA), pH, peroxide, and total psychrophilic bacteria levels were found in the BCP added groups compared to the control group (p < 0.05). When compared with the control, the sensory properties such as color, juiciness, softness, and flavor were significantly higher in the BCP treated groups, especially when fed the 2% BCP diet. It can be concluded that BCP as an additive to quail feeds had a significant effect on the performance of quails as well as on the shelf life of the meat. In order to avoid health and environmental concerns, it was concluded that BCP can be used as a natural additive to replace synthetic antimicrobials and antioxidants at the level of 1−2% in quail compound feeds.

Effects of Monobenzyl ether of hydroquinone on 3T3 mouse fibroblast viability and ultrastructure.

Monobenzyl ether of hydroquinone (MBEH) is a topical depigmentation agent used by vitiligo patients to even the skin tone. We aimed to investigate the effects of MBEH on 3T3 mouse fibroblasts. Fibroblasts were treated with 250 µM, 500 µM, and 750 µM MBEH and vehicle (EtOH:DMSO) for 24 hours. Cell numbers of 250 µM, 500 µM, and 750 µM MBEH treated and vehicle groups decreased significantly compared to control group. TUNEL positive cell rate increased with MBEH concentration. In electron microscopic examination, control and vehicle groups showed active cells features, while mitochondrial swelling and cristae loss were seen in 250 µM MBEH-treated group. In cytoplasm of 500 µM MBEH-treated group, there were many multivesicular bodies and autophagic vacuoles. As an indication of apoptosis, cell membrane blebs and reduction in cell size were observed. In 750 µM MBEH-treated group, cells were completely degenerated. Our findings show that MBEH, which is used as a depigmentation agent to lighten the skin by destroying melanocytes, may also have dose-dependent negative effects on the viability of 3T3 mouse fibroblasts, and these may be mediated through autophagic and apoptotic cell death mechanisms.

The effect of COVID-19 on patients with chronic spontaneous urticaria treated with omalizumab and antihistamines: A cross-sectional, comparative study.

INTRODUCTION: Chronic spontaneous urticaria (CSU) is defined as recurrent attacks of urticaria present for more than six weeks. The monoclonal anti-immunoglobulin E antibody, omalizumab, was approved for the treatment of CSU in patients who remain refractory to H1-antihistamines. Biologic agents are shown not to increase the risk of COVID-19 infection in different studies. OBJECTIVE: In the present study, we aimed to determine the prevalance of COVID-19 infection in relation to the age, gender, presence of other comorbidities, and treatment given for CSU. METHODS: We conducted a descriptive cross-sectional study of 233 patients diagnosed with CSU in a tertiary referral hospital. Demographical data, treatment given for CSU, the presence of COVID-19-related symptoms, history of close contact to a person with COVID-19 and COVID-19 real-time polymerase chain reaction (RT-PCR) results were determined via a telephone survey and checked from medical data records. RESULTS: One hundred sixty patients were female; whereas 73 were male. The mean age was 44.76. Out of 233 patients with chronic urticaria, 125 had symptoms related to COVID-19 infection. RT-PCR testing for COVID-19 was performed in 156 patients. Of 156 patients with COVID-19 RT-PCR test, RT-PCR result was positive in 15 cases. CONCLUSIONS: No statistically significant relationship was found between COVID-19 RT-PCR positivity and the type of treatment administered for chronic urticaria when the patients are divided into omalizumab ± oral antihistamines and only oral antihistamines treatment groups (p = 0.150). Omalizumab seems to be safe in the era of COVID-19.

The effect of the COVID-19 pandemic on dermatology consultation requests from adult and paediatric emergency departments.

AIM: This study aimed to determine the characteristics of dermatology consultation requests from the adult and paediatric emergency departments (EDs) of a university hospital during 8 months of the COVID-19 pandemic in 2020 and to compare them with the same 8 months of 2019. MATERIALS AND METHODS: Electronic medical records of dermatology consultation requests from adult and paediatric EDs between 15 March 2019 and 15 November 2019, and between 15 March 2020 and 15 November 2020 were retrospectively reviewed. RESULTS: The study included 495 consecutive dermatology consultation requests. In total, 283 (57%) consultation requests occurred in 2019, vs 212 (43%) between in 2020 during the COVID-19 pandemic. The number of consultation requests per day was significantly lower in 2020 (0.9 ± 0.1 per day) than in 2019 (1.15 ± 0.1 per day; P = .002), and was significantly lower in March, April and May 2020, as compared with March, April, and May 2019 (P = .004, P = .001, and P = .001, respectively). The median time from onset of dermatological symptoms to ED presentation was significantly longer in 2020 than in 2019 (4 days in 2019 vs 7 days in 2020; P < .001). Dermatological emergencies in 2019 and 2020 constituted 6.7% of all emergency presentations, with no significant difference between the 2 years (7.1% of all ED presentations in 2019, vs 6.1% in 2020; P = .795). CONCLUSION: COVID-19 restrictions and fear of COVID-19 infection might have discouraged patients from presenting to EDs because of skin problems; however, the easing of COVID-19 restrictions might lead to an increase in ED presentations, including non-urgent dermatological disorders. In order to reduce unnecessary use of EDs and prevent ED overcrowding, the general public should be educated about what constitutes a dermatological emergency.

Age and psoriatic arthritis are important predictors of biologic agent switch in psoriasis.

BACKGROUND: The demand of biologic switching is increasing for different reasons.We aimed to define reasons for switching biologics and possible predictors for switching risk,and to estimate data on drug survival. METHODS: 115 patients treated with biologics who switched to a second, third,and/or fourth biologic were eligible for this retrospective study.Patients were divided into 2 groups as switched once,and switched twice or more.Drug survival rates were calculated using the Kaplan-Meier method. RESULTS: All patients switched at least one, 36 patients switched twice, and 9 switched thrice. First-, second-, and third-line biologics were mostly switched due to secondary lack of efficacy for skin disease.Each unit increase in age decreased the risk of having ≥2 switches 4% (p=0.038,OR:0.964,95%CI:0.93-0.998),whereas PsA increased the risk of having ≥2 switches 2.69-fold (p=0.026,OR:2.69,95%CI:1.12-6.44).There was significant difference between biologics in terms of drug survival(p=0.001).Adalimumab had a lower drug survival compared to ustekinumab(p<0.001) and secukinumab(p=0.003) in transition from second-line biologic to third-line biologic. CONCLUSION: Switching biologics was most commonly due to secondary lack of efficacy for skin disease.Lower ages and the presence of PsA were associated with a higher need for switching in long-term.Ustekinumab and secukinumab are superior to adalimumab in clinical practice in terms of drug survival of second-line biologics.

Serial Quantiferon-TB Gold test results in 279 patients with psoriasis receiving biologic therapy.

The risk of active tuberculosis is still a concern in patients receiving biologics. To determine the risk of latent tuberculosis infection (LTBI) reactivation by Quantiferon-TB Gold (QFT) assay in psoriatic patients treated with biologics in 11 years' follow-up, along with chest radiography alterations. This retrospective study included 279 patients with plaque-type and/or pustular, or nail psoriasis who were treated with biologics, and had results for ≥2 LTBI tests. The QFT outcomes were defined according to the baseline and the follow-up QFT results; seroconversion as from negative to positive, seroreversion as from positive to negative, persistently seronegative as invariantly negative, persistently seropositive as invariantly positive, and other any result was accepted as indeterminate. Demographic features, the presence and the type of any chest X-ray abnormality was noted during the follow-up. Of 279 baseline QFT tests, the vast majority were negative (n = 193; 69%), with a less of positive (n = 86; 31%). Ten (5.2%) of 193 patients converted from negative to positive QFT status after starting biologic therapy (P < 0.001) during 11 years' follow-up. Although these 10 patients exhibited seroconversion of QFT from negative to positive, only one patient was diagnosed with active TB. There was no statistically significant difference among biologics as regards with QFT seroconversion risk (P = .09). This study showed that 5.2% of patients showed seroconversion. Annual QFT testing remains a necessary and mandatory tool to prevent further TB reactivation in psoriasis patients taking biologic therapy although only one patient was diagnosed with active TB in this cohort.

The effect of music therapy on the physical and mental parameters of cancer patients during hematopoietic stem cell transplantation.

PURPOSE: Music therapy has been used for relaxation in traditional medicine. This study explored the effect of music therapy on the physical and mental parameters of cancer patients during hematopoietic stem cell transplantation (HSCT). DESIGN AND METHODS: Thirty patients who were hospitalized for bone marrow transplantation were included. Traditional Music Therapy of Islamic Turkish Culture was applied to the patients during the transplantation process. Specific physical and psychological parameters of patients were evaluated before and after music therapy. FINDINGS: A positive relationship between anxiety and distress scores was observed. Music therapy had a significant impact on increasing levels of oxygen saturation, and decreasing anxiety and distress levels of the HSCT patients (P < .05). PRACTICE IMPLICATIONS: Music therapy may provide positive effects for patients during HSCT.

Psychosocial problems of family caregivers of palliative care patients and their spiritual coping styles.

PURPOSE: The aim of the study was to examine the psychosocial problems and spiritual coping styles of the family caregivers related to patients receiving palliative care. DESIGN AND METHODS: The research sample consisted of 76 family caregivers related to palliative care patients. The data collection method used were questionnaire forms. The two forms used were Hospital Anxiety Depression Scale and Religious Coping Methods Scale. FINDINGS: The mean anxiety score of the participants was 10.86 ± 4.30, mean depression score was 9.38 ± 3.66, mean positive coping scale score was 25.31 ± 3.85, and mean negative coping scale score was 10.32 ± 3.38. PRACTICE IMPLICATIONS: Healthcare professionals involved in palliative care are encouraged to evaluate the spiritual experiences of family caregiver to support their wellbeing.

Long-term effects of biologic therapies on peripheral blood eosinophils in patients with psoriasis: a 3-year single-center study.

Background: Biologic therapies (BTs), etanercept, infliximab, adalimumab, and ustekinumab, are generally well-tolerated and safe agents in psoriasis management.Objectives: To determine the overall effect of BTs on peripheral blood eosinophil count (PBEc) and percentage (PBEp), peripheral blood basophil count (PBBc) and percentage (PBBp), white blood cell count (WBCc), erythrocyte sedimentation rate (ESR), and serum C-reactive protein (s-CRP) level during a 3-year follow-up in patients with psoriasis.Methods: This retrospective cohort study included 200 patients (116 men; 84 women) treated continuously with BTs for 3 years for plaque-type, pustular, or nail psoriasis. Patient data were reviewed from medical charts. During routine laboratory investigation at baseline and every 3 months thereafter up to 3 years, the PBEp, PBEc, PBBp, PBBc, WBCc, ESR, and s-CRP level were monitored. Generalized estimating equations were used to compare consecutive data.Results: Seventy patients received infliximab (35%); 34 (17%), etanercept; 44 (22%), adalimumab; and 52 (26%), ustekinumab. The mean PBEp and PBEc significantly increased starting from 3 months after BT (both p<.001). The mean PBEp and PBEc significantly increased during follow-up compared with the baseline values (PBEp (%): 1.49 ± 0.1 (1st month) vs. 2.29 ± 0.14 (3rd month), p<.001 and 1.49 ± 0.1 (1st month) vs. 2.17 ± 0.18 (36th month), p=.004; PBEc (×103/µL): 115.80 ± 6.32 (1st month) vs. 174.9 ± 10.08 (3rd month), p<.001 and 115.80 ± 6.32 (1st month) vs. 162.9 ± 12.86 (36th month), p<.001). However, the mean PBBp, PBBc, WBCc, ESR, and s-CRP level did not change significantly.Conclusions: The PBEc and PBEp increase with BTs up to 3 years in patients with psoriasis. This increase is observed at as early as 3 months of BT and maintained thereafter.