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Item Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis(WILEY) Isik, E; Aydinok, Y; Albayrak, C; Durmus, B; Karakas, Z; Orhan, MF; Sarper, N; Aydin, S; Unal, S; Oymak, Y; Karadas, N; Turedi, A; Albayrak, D; Tayfun, F; Tugcu, D; Karaman, S; Tobu, M; Unal, E; Ozcan, A; Unal, S; Aksu, T; Unuvar, A; Bilici, M; Azik, F; Ay, Y; Gelen, SA; Zengin, E; Albudak, E; Eker, I; Karakaya, T; Cogulu, O; Ozkinay, F; Atik, TObjectivesIn congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA.MethodsOne hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction.ResultsMolecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR.ConclusionsIn this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.Item Insulin resistance is an evolutionarily conserved physiological mechanism at the cellular level for protection against increased oxidative stress(WILEY) Erol, ASeveral protective cellular mechanisms protect against the accumulation of reactive oxygen species (ROS) and the concomitant oxidative stress. Therefore, any reduction in glucose or fatty acid flux into cells leading to a decrease in the production of reducing equivalents would also lead to a decreased ROS production and protect cells against oxidative stress. In the presence of insulin, FOXO proteins are localized from the nucleus to the cytoplasm and degraded. An increase in cellular glucose uptake will lead to increased production of ROS. This in turn activates the stress-responsive Jun-N-terminal kinase (JNK), which promotes nuclear translocation of FOXO proteins, upregulating some important target genes including stress resistance. Consequently, insulin resistance should result in decreased cellular ROS production. For this reason, insulin resistance could be a physiological mechanism activated at the cellular level in response to conditions stimulating ROS production and leading to the prevention of oxidative stress, and extension of life. Concerning the whole organism, however, IR is a maladaptive process in the long term causing a diabetic state. BioEssays 29:811-818, 2007. (c) 2007 Wiley Periodicals, Inc.Item Effect of insulin on rat ovarian leptin expression by immunohistochemical staining(WILEY) Kuscu, NK; Ozbilgin, K; Inan, S; Giray, G; Ceylan, E; Koyuncu, FAim: Leptin and insulin may interact in regulating ovarian steroid synthesis. The objective of this study was to investigate immunohistochemical staining of leptin in normal rat ovarian tissues and in rats treated with insulin and insulin plus human chorinoic gonadotropin (hCG). Methods: Paraffin blocks of rat ovarian tissues from a previous study, in which 18 adult, female Wistar rats with an average weight of 250 g were divided into three groups to receive either saline solution, human insulin (2 U/day) or human insulin (2 U/day) plus hCG (4 U/day) for 4 weeks, were used in this study to compare the effects on leptin staining. The results were analysed using a semiquantitative scoring system, such as mild, moderate and strong. Results: No staining was observed in granulosa cells and theca interna cells of normal ovarian tissues. Theca externa cells had mild staining intensity (+), corpus luteum had moderate (+ +) and stroma had mild (+) staining intensity. Histological structure was impaired in the insulin group, luteinized cells had mild staining, there was no difference in other cell groups. Only theca externa cells of the developing follicles were stained in insulin plus hCG group, luteinized cells again had mild staining. Conclusions: Besides damaging the rat ovarian structure, insulin reduced staining intensity of leptin in luteinized cells. Insulin may stimulate ovarian steroid synthesis not only through its own receptors, but also by acting on the leptin expression of these cells.Item Effect of methyl orange as the modifier on the mechanical, thermal, and thermo-mechanical properties of clay/epoxy composites(WILEY) Basturk, SBIn this study, bentonite clay/epoxy composites were simply and successfully produced via conventional casting method for 0.5, 1, and 2 wt% filler content. Previously modified clay (surfactant and silane agent applied) was treated with methyl orange (MO) and its effects on composites were investigated in terms of crystallographic, thermal, thermo-mechanical, morphologic, and topographic aspects as well as quasi-static characteristics. According to XRD graphs, MO presence led to the increase of interlayer distance and resulted in partial intercalation for modified clay (MC) based mixture, while an opposite case was seen in neat clay (NC) blend. The 2 wt% MO/MC loaded composite achieved the highest tensile modulus, flexural stiffness, and hardness values among all samples-increase of 14%, 40%, and 3%, respectively. Same composite system exhibited improved results for both glass transition temperature (similar to 7%up arrow) and storage modulus (similar to 35%up arrow), in spite of insufficient thermal characteristics. Irregular particles/tactoids were present in the fracture images, which probably promoted the stress concentration and caused the reduction of strength parameter for all composites. Furthermore, independent of clay type (MC or NC) whole structures showed similar surface roughness values but different topographic textures in terms of surface profiles.Item The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis(WILEY) Taneli, F; Aydede, H; Vatansever, S; Ulman, C; Ari, Z; Uyanik, BSPolypropylene mesh is the most widely used material in inguinal hernia repair. Although polypropylene mesh is known as an inert material, it is experimentally proven that mesh generates a chronic inflammatory tissue reaction. The aim of the present study was to investigate the long-term effects of polypropylene mesh material used in inguinal hernia operations on testicular function, testicular nitric oxide (NO) metabolism and germ cell-specific apoptosis in rats. The study comprised 40 male rats that were randomly allocated into two groups. In group 1, the left spermatic cord was elevated and a 0.5 x 1 cm polypropylene mesh was placed behind the left inguinal spermatic cord and group 2 consisted of the sham-operated controls. Blood samples were taken at 6 months preoperatively and postoperatively after to assess luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels for hormonal evaluation. Testicular NO was evaluated by the Griess method, apoptosis by a TUNEL method and inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expressions by immunohistochemical staining. Mild (+) eNOS expression was observed in all specimens. Mild (+) iNOS expression was only detected in ipsilateral testis of the mesh-implanted study group. Apoptotic cells were not detected in any samples. We are of the opinion that long-term polypropylene mesh implantation has no effect on testicular hormonal function and only a limited effect on nitric oxide levels and this effect is not sufficient to cause apoptosis in testis that could lead to infertility. It seems that mesh implantation is a reliable method in inguinal hernia repair; however, further work is required by more sensitive methods to fully elucidate the potential testicular damage. Copyright (c) 2004 John Wiley & Sons, Ltd.Item Docetaxel/zoledronic acid combination triggers apoptosis synergistically through downregulating antiapoptotic Bcl-2 protein level in hormone-refractory prostate cancer cells(WILEY) Karabulut, B; Erten, C; Gul, MK; Cengiz, E; Karaca, B; Kucukzeybek, Y; Gorumlu, G; Atmaca, H; Uzunoglu, S; Sanli, UA; Baran, Y; Uslu, RDocetaxel, a semi-synthetic taxane analogue, is used effectively in the treatment of metastatic prostate cancer. Zoledronic acid, the most potent member of bisphosphonates, has shown pleiotropic anti-tumoral effects on prostate cancer cells. We have explored the possible additive/synergistic effects and the apoptotic pathways induced by combination treatment of docetaxel and zoledronic acid in hormone and drug refractory, PC-3 and DU-145 prostate cancer cells. Combination of docetaxel and zoledronic acid synergistically inhibits cell growth in PC-3 and DU-145 cells. Moreover, this effect was due to downregulation of antiapoptotic protein Bcl-2 in PC-3 and DU-145 cells. In conclusion, docetaxel/zoledronic acid combination is potentially a novel and effective approach for the treatment of prostate cancer. (C) 2008 International Federation for Cell Biology. Published by Elsevier Ltd. All rights reserved.Item Anxiety, depression, and nature of acne vulgaris in adolescents(WILEY) Aktan, S; Özmen, E; Sanli, BBackground The reported prevalence of acne in adolescence is variable; improved treatment may have modified its prevalence and severity; acne has been related to psychiatric morbidity for many years. Methods Two thousand six hundred and fifty-seven high school students were examined, and adolescents with acne were interviewed about the subject of acne vulgaris. The severity of acne was graded using the Global Acne Grading System (GAGS). The Hospital Anxiety and Depression (HAD) scale was evaluated for one of every two subjects with acne (n = 308) and for the same number of sex-matched control subjects (n = 308) to determine the prevalence of depression and anxiety. Results Six hundred and fifteen of the subjects (23.1%) were determined to have acne. Acne prevalence in girls and boys was 16.1% and 29.2%, respectively (P < 0.001). Two hundred and twenty-five (15.8%) of 1424 boys and only 109 (8.8%) of 1233 girls had moderate or severe/very severe acne (P < 0.001), but the GAGS scores in the groups of boys and girls with acne were not significantly different. The acne and control groups showed no significant differences in the HAD anxiety and depression subscale scores. The HAD anxiety subscale scores of girls were significantly higher than those of boys in the acne group. The severity of acne was not correlated with the HAD anxiety or depression subscale scores. Conclusions Acne results in higher anxiety in adolescent girls. Although acne and moderate/severe acne are more common in adolescent boys, the severity of acne was found to be similar in boys and girls with acne. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne.Item Vestibular migraine, demographic and clinical features of 415 patients: a multicenter study(WILEY) Ak, A; Çelebisoy, N; Özdemir, H; Gökçay, F; Saruhan, G; Karti, DT; Toydemir, H; Yayla, V; Isikay, AC; Erkent, I; Özçelik, P; Akdal, G; Ataç, C; Bicakci, S; Goksu, EO; Gulec, FItem Development of a Set of ASAS Quality Standards for Adults with Axial Spondyloarthritis(WILEY) Kiltz, U; Landewé, RBM; van der Heijde, D; Rudwaleit, M; Weisman, M; Akkoç, N; Boonen, A; Brandt-Jürgens, J; Carron, P; Dougados, M; Gossec, L; Jongkees, M; Machado, P; Marzo-Ortega, H; Molto, A; Navarro-Compán, V; Niedermann-Schneider, K; Sampaio-Barros, PD; Slobodin, G; Van den Bosch, F; van Tubergen, A; van Weely, S; Wiek, D; Braun, JItem Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study(WILEY) Dikici, B; Ozgenc, F; Kalayci, AG; Targan, S; Ozkan, T; Selimoglu, A; Doganci, T; Kansu, A; Tosun, S; Arslan, N; Kasirga, E; Bosnak, M; Haspolat, K; Buyukgebiz, B; Aydogdu, S; Girgin, N; Yagci, RVBackground and Aim: The aim of the present study was to compare the therapeutic efficacy of three different regimens in childhood chronic hepatitis B (CHB) infection. Methods: A total of 182 children with CHB infection were prospectively allocated to three random groups. Sixty-two patients in the first group received high-dose interferon (IFN)-alpha 2b (10 MU/m(2)) thrice/weekly alone for 6 months. In the second (n = 60) and third groups (n = 60), IFN-alpha was used for 6 months (5 MU/m(2)) thrice/weekly in combination with lamivudine (LAM) (4 mg/kg, maximum 100 mg/day) for 12 months. Lamivudine was started simultaneously with IFN in the second group, while it was started 2 months prior to IFN injections in the third group. Results: The initial mean alanine aminotransferase (ALT) values for the first, second and third groups were 109 +/- 93 IU/L, 101 +/- 64 IU/L and 92 +/- 42 IU/L, respectively (P > 0.05). At the end of the therapy, ALT values decreased to 82 +/- 111 IU/L, 38 +/- 41 IU/L and 29 +/- 16 IU/L in groups 1, 2 and 3, respectively. The mean ALT value of the first group was significantly different to the second and third groups (P = 0.046 and P = 0.002, respectively) at the end of the therapy and these differences were found to be sustained after 18 months. However, results in the second and third groups were similar (P > 0.05). There were no significant differences in HBeAg clearance and anti-HBe seroconversion at the initial stage, 12 months and 18 months between the three groups (P > 0.05). Hepatitis B virus (HBV) DNA clearance in the first group was different from the second and third groups, while the second and third groups had similar HBV DNA clearance ratios at 12 and 18 months. No significant difference was found in the complete response (normalization of ALT, clearance of HBV DNA and seroconversion of anti HBe) ratios of all groups (at 12 months: 28.8, 45.5, 35.8% and at 18 months 33.3, 49 and 34% in groups 1, 2 and 3, respectively, P > 0.05). Conclusions: Although the ALT normalization and HBV DNA clearance ratios of IFN plus LAM combination groups were better than the high-dose IFN-alpha monotherapy group, no significant difference was found in the complete response ratios of all three groups. (C) 2004 Blackwell Publishing Asia Pty Ltd.Item The evaluation of antifungal consumption: a point-prevalence survey(WILEY) Senol, S; Eren-Kutsoylu, OO; Turhan, O; Alp-Cavus, S; Tasbakan, M; Ozturk, B; Sayin-Kutlu, S; Cetin, CB; Kaya, O; Ozhak, B; Pullukcu, H; Ertugrul, B; Kutlu, M; Mermut, G; Ergin, C; Metin, DY; Yapar, N; Avkan-Oguz, VItem The effect of background audio and audiovisual stimuli on students' autonomic responses during and after an experimental academic examination(WILEY) Balikçi, I; Tok, S; Binboga, EBackgroundDue to the Covid-19 pandemic lockdown during the online-distant education period, certain students tended to combine their courses and homework with TV or social media news or other media content, such as classical music, including a wealth of audio and audiovisual stimuli. As the audio and audiovisual stimuli existing in a learning environment may affect students' autonomic nervous system (ANS) responses negatively, the present study aimed to monitor the impact of background TV, classical music, and silence on students' ANS activity represented by heart rate (HR), heart rate variability (HRV), blood volume amplitude (BVA), and skin conductance level (SCL) during and after an experimental academic examination. MethodSeventy-six students were randomly allocated to background TV, classical music, or silence groups. The experiment with repeated measures design consisted of four consecutive periods: baseline, anticipation, challenge, and recovery, lasting 4 min each. ResultsWithin-subject analyses indicated significant HRV decrement only in the background TV group. Regardless of the experimental groups, HR and SCL increased while BVA decreased during the task. In addition, the between-subject analysis showed that the background TV group experienced significantly larger changes in HR and HRV parameters compared to the other experimental groups relative to their respective baseline measurements. ConclusionsBased on these results, we concluded that relative to classical music and silence, background TV, including audiovisual and verbal stimuli, extant in a learning environment might raise students' sympathetic activity. Further, classical music, without lyrics, may suppress the withdrawal of vagal activity and elevate the autonomic regulation capacity during the academic reading comprehension task. HRV is a more valid and reliable indicator of students' autonomic responses during a challenging academic task.Item The trefoil factor family 1 (TFF-1) and 3 (TFF-3) are upregulated in the saliva, gingival crevicular fluid and serum of periodontitis patients(WILEY) Yucel, ZPK; Afacan, B; Ilhan, HA; Kose, T; Emingil, GObjective This study aimed to investigate the levels of trefoil factor family (TFF)-1, TFF-3 and interleukin (IL)-1 beta in gingival crevicular fluid (GCF), saliva and serum of patients with gingivitis, stage 3 periodontitis and healthy individuals. Materials and Methods A total of 100 individuals consisting of 25 periodontally healthy, 25 gingivitis and 50 stage 3 periodontitis, were enrolled in the study. Clinical periodontal examinations were recorded and GCF, saliva and serum samples were obtained. TFF-1, TFF-3 and IL-1 beta were measured by ELISA. Results TFF-1 and TFF-3 levels in both GCF, saliva and serum were higher in periodontitis patients than healthy controls (p < .001) and gingivitis group (p < .01). The levels of these peptides in all biofluids were similar between gingivitis and healthy control groups (p > .05). GCF, saliva and serum IL-1 beta levels were also higher in periodontitis patients than the controls (p < .01). Periodontitis patients had elevated GCF and saliva IL-beta levels than gingivitis group (p < .001). Conclusion Elevated TFF-1 and TFF-3 levels both locally and systemically in periodontitis in parallel to increased IL-1 beta levels might suggest that these peptides are involved in host response during the periodontal tissue destruction.Item The Systemic Score May Identify Life-Threatening Evolution in Still Disease: Data from the GIRRCS AOSD-Study Group and the AIDA Network Still Disease Registry(WILEY) Ruscitti, P; Masedu, F; Vitale, A; Caggiano, V; Di Cola, I; Cipriani, P; Valenti, M; Giardini, HAM; Antonelli, IPDB; Dagostin, MA; Lopalco, G; Iannone, F; Maria, M; Almaghlouth, IA; Asfina, KN; Ali, HH; Ciccia, F; Iacono, D; Pantano, I; Mauro, D; Sfikakis, PP; Tektonidou, M; Laskari, K; Berardicurti, O; Dagna, L; Tomelleri, A; Tufan, A; Kardas, RC; Hinojosa-Azaola, A; Martín-Nares, E; Kawakami-Campos, PA; Ragab, G; Hegazy, MT; Direskeneli, H; Alibaz-Oner, F; Fotis, L; Sfriso, P; Govoni, M; La Torre, F; Maggio, MC; Montecucco, C; De Stefano, L; Bugatti, S; Rossi, S; Makowska, J; Del Giudice, E; Emmi, G; Bartoloni, E; Hernández-Rodríguez, J; Conti, G; Olivieri, AN; Lo Gullo, A; Simonini, G; Viapiana, O; Wiesik-Szewczyk, E; Erten, S; Carubbi, F; De Paulis, A; Maier, A; Tharwat, S; Costi, S; Iagnocco, A; Sebastiani, GD; Gidaro, A; Brucato, AL; Karamanakos, A; Akkoç, N; Caso, F; Costa, L; Prete, M; Perosa, F; Atzeni, F; Guggino, G; Fabiani, C; Frediani, B; Giacomelli, R; Cantarini, LObjective. We aimed to evaluate the clinical usefulness of the systemic score in the prediction of life-threatening evolution in Still disease. We also aimed to assess the clinical relevance of each component of the systemic score in predicting life-threatening evolution and to derive patient subsets accordingly. Methods. A multicenter, observational, prospective study was designed including patients included in the Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale Adult-Onset Still Disease Study Group and the Autoinflammatory Disease Alliance Network Still Disease Registry. Patients were assessed to see if the variables to derive the systemic score were available. The life-threatening evolution was defined as mortality, whatever the clinical course, and/or macrophage activation syndrome, a secondary hemophagocytic lymphohistiocytosis associated with a poor prognosis. Results. A total of 597 patients with Still disease were assessed (mean +/- SD age 36.6 +/- 17.3 years; male 44.4%). The systemic score, assessed as a continuous variable, significantly predicted the life-threatening evolution (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.07-1.42; P = 0.004). A systemic score >= 7 also significantly predicted the likelihood of a patient experiencing life-threatening evolution (OR 3.36; 95% CI 1.81-6.25; P < 0.001). Assessing the clinical relevance of each component of the systemic score, liver involvement (OR 1.68; 95% CI 1.48-2.67; P = 0.031) and lung disease (OR 2.12; 95% CI 1.14-4.49; P = 0.042) both significantly predicted life-threatening evolution. The clinical characteristics of patients with liver involvement and lung disease were derived, highlighting their relevance in multiorgan disease manifestations. Conclusion. The clinical utility of the systemic score was shown in identifying Still disease at a higher risk of life-threatening evolution in a large cohort. Furthermore, the clinical relevance of liver involvement and lung disease was highlighted.Item The natural history study of hidradenitis suppurativa: A large-scale multicenter study in turkey(WILEY) Alpsoy, E; Karaman, BF; Demirseren, D; Cinar, L; Kacar, N; Ermertcan, AT; Baskan, EB; Ucmak, D; Mammadli, K; Kilinç, F; Yazici, S; Temiz, SA; Akbulut, TÖ; Ataseven, A; Aktürk, AS; Saricaoglu, H; Türkmen, M; Gülbasaran, F; Engin, B; Ozden, HK; Durmaz, K; Ozden, MG; Ozdemir, H; Cemil, BC; Solak, SS; Yavuz, IH; Yavuz, GO; Guven, M; Ekinci, AP; Atici, T; Balci, DD; Oztürk, A; Altunay, IK; Ozkur, E; Ugurer, E; Karadag, AS; Kalkan, G; Erdogan, B; Yayli, S; Selcuk, LB; Donmez, L; Bilgic, AItem Solving the burgers' and regularized long wave equations using the new perturbation iteration technique(WILEY) Bildik, N; Deniz, SIn this study, an efficient framework provided to handle nonlinear partial differential equations by implementing perturbation iteration method. This method is recovered and amended to solve the Burgers' and regularized long wave equations. Comparing our new solutions with the exact solutions reveals that this technique is extremely accurate and effective in solving nonlinear models. Convergence analysis and error estimate are also supplied using some critical theorems.Item NONCOVID-19 VIRAL RESPIRATORY INFECTIONS IN CHILDREN WITH CANCER DURING THE COVID-19 PANDEMIC: A MULTICENTER OBSERVATIONAL STUDY(WILEY) Kebudi, R; Kacar, D; Ozyoruk, D; Tugcu, D; Yarali, N; Ilhan, I; Bahadir, A; Ozdemir, Z; Ozguven, A; Orhan, MF; Yildirim, AT; Albayrak, C; Kartal, I; Ozbek, NY; Sari, N; Tokgoz, H; Albayrak, M; Aydin, AC; Eroglu, N; Aydin, S; Uzel, H; Zulfikar, B; Buyukavci, M; Gulen, H; Toret, E; Bor, OItem Anaphylaxis in Turkish children: a multi-centre, retrospective, case study(WILEY) Orhan, F; Canitez, Y; Bakirtas, A; Yilmaz, O; Boz, AB; Can, D; Kuyucu, S; Harmanci, K; Tahan, F; Reisli, I; Karakas, T; Baki, A; Cokugras, H; Cakir, M; Yuksel, HBackground Anaphylaxis is a serious and potentially lethal systemic reaction affecting more than one organ or system. Objective We aimed to describe the demographic characteristics, clinical features, causes, settings, and administered therapy in Turkish children. Methods This retrospective, case note study included all children referred to the outpatient clinics of the Pediatric Allergy Departments of the participating study centres from 1 July 1999 to 30 June 2009 for investigation of anaphylaxis or who were seen by us at the moment of the reaction during the same period and who met the clinical criteria of anaphylaxis. Results Two hundred and twenty-four cases of anaphylaxis were reported in 137 children (88 boys, P = 0.0001). The mean +/- SD age at the referral was 7.7 +/- 4.2 years (range: 4 months-17 years). Ninety-eight episodes (43.8%) occurred at home. The symptoms were cutaneous in 222 (99.1%) episodes, respiratory in 217 (96.9%), neuro-psychiatric in 118 (52.7%), cardiovascular in 92 (41.1%), and gastrointestinal in 88 (39.3%). Biphasic reaction was reported in seven episodes (3.1%, 95% CI: 1.5-6.3). Death occurred in one case (0.4%, 95% CI: 0.08-2.4). Treatment was available in 158 episodes (70.5%). Of them, 148 (93.7%) received antihistamines, 132 (83.5%) corticosteroids, 51 (32.3%) epinephrine, and 17 (10.8%) beta-2-mimetics. The causative agents were foods in 86 (38.4%) episodes, hymenoptera venom in 84 (37.5%), drugs and medications in 47 (21.0%), and latex in 5 (2.2%). In two episodes (0.9%), the causative agent was unidentified. Allergy to the trigger was known prior to anaphylaxis in 116 (51.8%) episodes. An epinephrine autoinjector had been prescribed for 70 children (51.1%). Conclusions and Clinical Relevance Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.Item Comparison of the effects of collagenase and extract of Centella asiatica in an experimental model of wound healing(WILEY) Ermertcan, AT; Inan, S; Ozturkcan, S; Bilac, C; Cilaker, SIn this study, we compared the effects of collagenase and Centella asiatica in the rat model. Twenty-seven female rats were divided into three groups, and two full-thickness wounds were made for each animal. Collagenase ointment was applied topically to Group I and C. asiatica ointment to Group II rats. In Group III, no treatment was applied. On the third day of treatment, wounds on the left side of three animals of each group were excised. On the fifth and eighth day of the treatments, the same procedure was performed for the remaining animals. Indirect immunohistochemical examination was performed to detect transforming growth factor beta (TGF)-beta, endothelial and inducible nitric oxide synthase (eNOS and iNOS), vascular endothelial growth factor, TGF-alpha, laminin, fibronectin, collagen I, and interleukin-1 beta. According to the measurements of the wound areas and wound healing periodo, collagenase was superior to the control group. Immunohistochemical examinations showed strong (+++) iNOS and TGF-beta immunoreactivities in C. asiatica group. eNOS immunoreactivity was moderate (++) in this group. For the collagenase group, iNOS, eNOS, and TGF-beta immunoreactivities were moderate (++). In the collagenase group, while TGF-beta and iNOS immunoreactivities were weaker, laminin and fibronectin reactivities were stronger than in C. asiatica and control groups. Collagenase was superior to C. asiatica according to the immunohistochemical findings. Collagenase ointment significantly improves the quality of wound healing and scar formation and is a more appropriate treatment choice than extract of C. asiatica in the early stages of the wound healing process.Item Internalized stigma in psoriasis: A multicenter study(WILEY) Alpsoy, E; Polat, M; Fettahlioglu-Karaman, B; Karadag, AS; Kartal-Durmazlar, P; Yalcin, B; Emre, S; Didar-Balci, D; Bilgic-Temel, A; Arca, E; Koca, R; Gunduz, K; Borlu, M; Ergun, T; Dogruk-Kacar, S; Cordan-Yazici, A; Dursun, P; Bilgic, O; Gunes-Bilgili, S; Sendur, N; Baysal, O; Halil-Yavuz, I; Yagcioglu, G; Yilmaz, E; Kavuzlu, U; Senol, YInternalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.