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COVID-19 pandemic has a significant impact on public health, whether directly or indirectly. The first case was seen in Turkey on March 11, and the World Health Organization (WHO) declared a pandemic on March 12, 2020. The study aimed to document the effect of pandemic on dermatology outpatient clinics in Turkey. Fifteen tertiary hospitals from 13 provinces were included in the study, which was conducted between January 12 and May 12, 2020. The International Codes of Diseases (ICD-10) categories and patients' characteristics were evaluated before and after the pandemic. A total of 164 878 patients, 133 131 before and 31 747 after the pandemic, were evaluated. The daily hospital applications were found reduced by 77%. The three of the most frequent diagnoses; dermatitis, acne, and psoriasis remained unchanged after the pandemic. While the frequency of herpes zoster, scabies, urticaria, pityriasis rosea and sexually transmitted diseases increased significantly; allergic and irritant contact dermatitis decreased after the pandemic. The applications regarding cutaneous neoplasms were considerably reduced during the pandemic, and this effect was more pronounced in cities with higher COVID incidence. The pandemic caused a noteworthy reduction in the number of patients accessing dermatological care. The pandemic caused significant changes in the frequency of a wide range of dermatological diseases. The application of cutaneous neoplasms is considerably reduced after the pandemic, and this effect was more pronounced in cities where pandemics are frequent. Therefore, the pandemic has resulted on numerous impacts on many critical issues in dermatology and dermatological care. C1 [Kartal, Selda Pelin] Univ Hlth Sci Turkey, Dept Dermatol, Diskapi Educ & Res Hosp, Ankara, Turkey. [Celik, Gokcen] Yozgat State Hosp, Dermatol Clin, Yozgat, Turkey. [Sendur, Neslihan] Adnan Menderes Univ, Dept Dermatol, Fac Med, Aydin, Turkey. [Aytekin, Sema] Univ Hlth Sci Turkey, Dept Dermatol, Haydarpasa Educ & Res Hosp, Istanbul, Turkey. [Serdaroglu, Server] Cerrrahpasa Univ, Dept Dermatol, Fac Med, Istanbul, Turkey. [Dogan, Bilal] Univ Hlth Sci Turkey, Dept Dermatol, Abdulhamid Han Educ & Res Hosp, Istanbul, Turkey. [Yazici, Ayca Cordan] Mersin Univ, Dept Dermatol, Fac Med, Mersin, Turkey. [Cicek, Demet] Firat Univ, Dept Dermatol, Fac Med, Elazig, Turkey. [Borlu, Murat] Erciyes Univ, Dept Dermatol, Fac Med, Kayseri, Turkey. [Kacar, Nida Gelincik] Pamukkale Univ, Dept Dermatol, Fac Med, Denizli, Turkey. [Ozden, Muge Guler] Ondokuz Mayis Univ, Dept Dermatol, Fac Med, Samsun, Turkey. [Bayramgurler, Dilek] Kocaeli Univ, Dept Dermatol, Fac Med, Kocaeli, Turkey. [Dogramaci, Asena Cigdem] Mustafa Kemal Univ, Dept Dermatol, Fac Med, Antakya, Turkey. [Balci, Didem Didar] Univ Hlth Sci Turkey, Dept Dermatol, Tepecik Educ & Res Hosp, Izmir, Turkey. [Saricaoglu, Hayriye] Uludag Univ, Dept Dermatol, Fac Med, Bursa, Turkey. [Serdar, Zehra Asiran] Bahcesehir Univ, Dept Dermatol, Fac Med, Istanbul, Turkey. [Donmez, Levent] Akdeniz Univ, Dept Publ Hlth, Fac Med, Antalya, Turkey. [Alpsoy, Erkan] Akdeniz Univ, Dept Dermatol, Fac Med, Antalya, Turkey.

Objective: Even though mixed bacterial-viral infections are very common in other respiratory tract conditions such as acute otitis media and pneumonia, concurrent GAS-influenza virus pharyngotonsillitis is generally not considered. We share our experience of mixed infection of GAS and influenza in children with this report. Methods: The rapid antigen test for streptococcus group A (Quidel, USA) was applied to the throat samples. The throat samples were also cultured in sheep blood agar at 37 degrees C for 24 h incubation. The rapid antigen test for influenza (Quidel, USA) was applied to the nasal samples at the same time. Results: Between January and April 2016, among 541 children, 11 cases had concurrent influenza and GAS; 3 cases with influenza B and 8 cases with influenza A. Conclusion: There is a number of data alerting the clinicians about bacterial coinfections because of the rapid progression to severe illnesses. (C) 2017 The Egyptian Pediatric Association. Production and hosting by Elsevier B.V.

Background To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. Methods A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)=1500 g or gestational age (GA) 1500 g or GA> 32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses. Results The TR-ROP study included 6115 infants: 4964 (81%) with a GA 32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW=1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW

Introduction: The concept of maintaining apical patency (AP) is a controversial issue in endodontics. The primary objectives of this systematic review of randomized controlled trials (RCTs) were to determine the influence of maintaining AP during instrumentation on postoperative pain severity and the prevalence of flare-ups. A second objective was to assess the effect of maintaining AP on the use of analgesics. Methods: RCTs and controlled clinical trials were searched for in MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library. Four reviewers independently screened all identified articles for eligibility. The included studies were assessed for bias using the Cochrane Risk of Bias Tool. The Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of the body of evidence. Because of the considerable heterogeneity of the studies, a meta-analysis was not possible. Therefore, the results were analyzed narratively. Results: Five RCTs that included a total of 848 patients were found eligible and included in the review. An assessment of the risk of bias in the included studies provided results that classified the studies as showing a low risk (n = 1), high risk (n = 1), or unclear risk (n = 3) of bias. The available evidence indicated that maintaining AP (1) did not increase postoperative pain in teeth with nonvital pulp, (2) did not increase postoperative pain in teeth with vital pulp, and (3) did not cause (0%) flare-ups. The available evidence also indicated that maintaining AP did not increase analgesic use. The available evidence indicated that maintaining AP did not increase postoperative pain when a single-visit or 2-visit root canal treatment approach was used. Conclusions: In light of the current evidence, maintaining AP does not increase postoperative pain in teeth with vital/nonvital pulp when compared with nonapical patency (low to moderate quality evidence). Furthermore, maintaining AP did not cause flare-ups (low evidence) and did not increase analgesic use (moderate evidence). © 2018 American Association of Endodontists

The purpose of this study was to compare the differences between physiological and performance response to different repeated sprint tests (RSTs). Nine young soccer players (age 18.3 +/- 1.0 years; height 176.8 +/- 5.0 cm; body-mass 74.1 +/- 6.9 kg) performed Yo-Yo Intermittent Recovery Test Level 1 (YIRT1), Wingate Anaerobic Test (WAnT) and four different RST's; including two straight tests (6 x 40 m, and 8 x 30 m) and shuttle tests (6 x 40 m and 8 x 30 m) maximal runs starting every 25s. Blood lactate (La-) was measured three minutes following each RST. Significantly higher average speed responses were determined from 6 x 40 m straight than other RSTs, Additionally, a strong correlation (r=0.80) was found between the best sprint times for 6 x 40 m and the 8 x 30 m straight RST protocols. Moderate correlations were found between YIRT1 performance and the 8 x 30 m straight test performance (range: r= 0.69 to 0.72) (p

Introduction: There is very few data on the epidemiological features of interstitial lung diseases (ILD) in the literature. These studies on this subject suffer from limited number of patients. Objective: The goal of this study was to evaluate the epidemiological features of ILD in Turkey. Methods: Fifty-four investigators, 31 centres in 19 cities from six regions of Turkey, participated in the study. Two thousand two hundred forty-five newly diagnosed patients (51.8% females), led by Turkish Thoracic Society Clinical Problems Study Group, enrolled in this prospective study. Results: The mean age was 51.8±16.7 years. The mean age among males was 50.5±18.6 years and 53.0±14.6 years among females (P, Okumus, G.; Istanbul Medical Faculty, Department of Pulmonary Diseases, Istanbul University, 34 390, Capa-Istanbul, Turkey; email: gulferokumus@yahoo.com

PubMedID: 27388777 Vitamin D deficiency not only causes low bone mass but also may lead to neuropsychiatric disorders. In the present case, vitamin D supplementation reduced obsessive–compulsive disorder (OCD) symptoms associated with streptococcal infection in a 7-year-old boy. Sudden onset of symptoms, including excessive hand washing and fear of touching anything, had occurred 1 month before presentation. Although there are few studies on a possible causal relationship between vitamin D and neuropsychiatric disorders, the present report; together with previous data, suggest an etiological role of vitamin D-related immune processes. © 2016 Japan Pediatric Society

Epilobium hirsutum (EH) is a medicinal plant for treating various diseases. Despite its wide usage, there is no available information about its potential influences on drug metabolism. The present study was undertaken to determine the in vivo effects of EH on hepatic CYP2B, CYP2C, CYP2D, and CYP3A enzymes that are primarily involved in drug metabolism. Male Wistar rats were injected intraperitoneally with EH water extract (EHWE) and ellagic acid (EA) at a daily dose of 37.5 and 20 mg/kg, respectively, for 9 days and hepatic drug-metabolizing enzymes were assessed at activity, protein and mRNA levels. Erythromycin N-demethylase activity was inhibited by 53 and 21 % in EHWE- and EA-treated rats, respectively. Benzphetamine N-demethylase and 7-benzyloxyresorufin-O-debenzylase activities were decreased by 53 and 43 %, and 57 and 57 % in EHWE-and EA-treated rats, respectively. Moreover, protein levels of CYP2B1, CYP2C6, CYP2D2, and CYP3A1 also decreased by 55, 15, 33, and 82 % as a result of EHWE treatment of rats, respectively. Similarly, CYP2B1, CYP2C6, CYP2D2, and CYP3A1 protein levels decreased by 62, 63, 49, and 37 % with EA treatment, respectively. qRT-PCR analyses also showed that mRNA levels of these enzymes were significantly inhibited with bothEHWE and EA treatments. In conclusion, inhibition of drug clearances leading to drug toxicity because of the lowered activity and expression of drug-metabolizing enzymes might be observed in the people who used EH as complementary herbal remedy that might be contributed by its EA content.

In the present study, the possible role of ellagic acid (EA) on antioxidant potential of Epilobium hirsutum (EH) in rat liver was investigated. Wistar rats were intraperitoneally treated with 37.5 mg/kg of EH and 10 mg/kg of EA for 9 days. Effects of EH and EA on antioxidant [glutathione peroxidase (GPx) and superoxide dismutases (SOD)] and Phase II [NADPH quinone oxidoreductase 1 (NQO1) and glutathione S-transferases (GSTs)] enzyme activities, as well as protein and mRNA expressions of those, were investigated. Polyphenolic content of EH was determined by LC-MS/MS analysis. EH and EA injection to rats resulted in a significant increase of NQO1 (3.6-fold and 4.7-fold), GPx (1.45-fold), and SOD (1.34-fold and 1.27-fold) enzyme activities, whereas total GST (46% and 57%) and its isoforms,and GST mu (57% and 72%), and GST theta (60% and 68%) activities were significantly decreased. Western-blot and qRT-PCR analysis showed that NQO1 and GPx protein and mRNA expressions were increased significantly (P < 0.0001), whereas GST mu and GST theta were significantly decreased (P < 0.0001).

A rhizosphere isolate Streptomyces sp. CAH29 was found to possess potent antibacterial and antifungal activity against a variety of test organisms. Based on 16S ribosomal ribonucleic acid sequence homology studies, this strain was found to be similar to Streptomyces stramineus (gene sequence similarity 99 %). The major bioactive metabolite produced by Streptomyces sp. CAH29 isolate was extracted, purified andidentified by nuclear magnetic resonance as tetrangomycin. This known anthraquinone-exhibited antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, methicillin resistant Staphylococcus aureus and Candida albicans with inhibition zones of 14, 10, 12 and 8 mm, respectively. Docking results demonstrate that tetrangomycin has a similar mode of action and a comparable docking score to bind to the dehydrosqualene synthase (CrtM) enzyme of methicillin resistant Staphylococcus aureus compared to the current inhibitor. Hence, this suggests that tetrangomycin has a potential to be used as an anti-methicillin resistant Staphylococcus aureus agent. Tetrangomycin also showed moderate free radical scavenging activity with 1,1-diphenyl-2-picryl-hydrazil. Tetrangomycin apparently decreased all of the studied cytokine (pro-inflammatory: interleukin 1B, interleukin 2, tumor necrosis factor and interleukin L6 and anti-inflammatory: interleukin 10) expression levels at IC50 concentrations in A459 (adenocarcinomic human alveolar basal epithelial) and LNCAP (human prostate adenocarcinoma) cell lines. In addition, it reduced Caspase 8 and 3 mRNA levels in LNCAP and A549 cells. This study describes for the first time novel in vitro immunosuppressive function of tetrangomycin by reducing the transcription of cytokine genes.

In the present study, the possible role of ellagic acid (EA) on antioxidant potential of Epilobium hirsutum (EH) in rat liver was investigated. Wistar rats were intraperitoneally treated with 37.5 mg/kg of EH and 10 mg/kg of EA for 9 days. Effects of EH and EA on antioxidant [glutathione peroxidase (GPx) and superoxide dismutases (SOD)] and Phase II [NADPH quinone oxidoreductase 1 (NQO1) and glutathione S-transferases (GSTs)] enzyme activities, as well as protein and mRNA expressions of those, were investigated. Polyphenolic content of EH was determined by LC-MS/MS analysis. EH and EA injection to rats resulted in a significant increase of NQO1 (3.6-fold and 4.7-fold), GPx (1.45-fold), and SOD (1.34-fold and 1.27-fold) enzyme activities, whereas total GST (46% and 57%) and its isoforms, and GST mu (57% and 72%), and GST theta (60% and 68%) activities were significantly decreased. Western-blot and qRT-PCR analysis showed that NQO1 and GPx protein and mRNA expressions were increased significantly (P < 0.0001), whereas GST mu and GST theta were significantly decreased (P < 0.0001).

Epilobium hirsutum (EH) is a medicinal plant for treating various diseases. Despite its wide usage, there is no available information about its potential influences on drug metabolism. The present study was undertaken to determine the in vivo effects of EH on hepatic CYP2B, CYP2C, CYP2D, and CYP3A enzymes that are primarily involved in drug metabolism. Male Wistar rats were injected intraperitoneally with EH water extract (EHWE) and ellagic acid (EA) at a daily dose of 37.5 and 20 mg/kg, respectively, for 9 days and hepatic drug-metabolizing enzymes were assessed at activity, protein and mRNA levels. Erythromycin N-demethylase activity was inhibited by 53 and 21 % in EHWE- and EA-treated rats, respectively. Benzphetamine N-demethylase and 7-benzyloxy-resorufin-O-debenzylase activities were decreased by 53 and 43 %, and 57 and 57 % in EHWE-and EA-treated rats, respectively. Moreover, protein levels of CYP2B1, CYP2C6, CYP2D2, and CYP3A1 also decreased by 55, 15, 33, and 82 % as a result of EHWE treatment of rats, respectively. Similarly, CYP2B1, CYP2C6, CYP2D2, and CYP3A1 protein levels decreased by 62, 63, 49, and 37 % with EA treatment, respectively. qRT-PCR analyses also showed that mRNA levels of these enzymes were significantly inhibited with bothEHWE and EA treatments. In conclusion, inhibition of drug clearances leading to drug toxicity because of the lowered activity and expression of drug-metabolizing enzymes might be observed in the people who used EH as complementary herbal remedy that might be contributed by its EA content.

The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Hermansky-Pudlak syndrome is a rare disease characterized by bleeding diathesis, oculocutaneous albinism and lysosomal ceroid lipofuscin pigment deposits. Pulmonary fibrosis may also accompany with the disease. A 48-year-old male patient with a diagnosis of Hermansky-Pudlak syndrome admitted with dyspnea. A thorax computed tomography revealed bilateral diffuse interlobular septal thickness which was more prominent in the basal segments of lower lobes. Although pirfenidone therapy was planned, clinical deteroriation developed and patient died because of respiratory failure. In conclusion; this report describes a patient with pulmonary fibrosis caused by lung involvement of Hermansky-Pudlak syndrome which is an extremely rare and mortal disease.

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