Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

Background: Although more than a year past since COVID-19 was defined, there is no specific treatment yet. Since COVID-19 management differs over time, it is hard to determine which therapy is more efficacious. In this study, we aimed to evaluate the efficacy of the regimen with Favipiravir (FPV) and determine if the timing of FPV addition offers any improvement. Methods: A retrospective observational case-controlled cohort study was performed between March and September 2020, including adults with COVID-19 in a single-center in Turkey. We categorized patients into age-sex matched three groups, group 1 (n = 48) and group 2 (n = 48) included patients treated with the combination of FPV plus Hydroxychloroquine (HQ) early and late, respectively. Group 3 (n = 48) consisted of patients on HQ monotherapy. In Group 2, if the respiratory or clinic condition had not improved sufficiently, FPV was added on or after day 3. Results: We found that starting FPV early had an impact on PCR negativity and the progression of the disease. 'No progression' was defined as the absence of a new finding in the control radiological examination and the absence of accompanying clinical deterioration. Also, the decrease in C-reactive protein (CRP) was greater in Group 1 than Group 3 (p < 0.001). However, we found that early initiation of FPV treatment did not have a positive effect on the estimated survival time. Conclusions: According to this retrospective study results, we believe that for better clinical outcomes, FPV treatment should be started promptly to enhance antiviral effects and improve clinical outcomes.

Serum uric acid level increases in many inflammatory conditions. Uric acid triggers the vascular inflammation and artery damage, which causes to an increased risk of endothelial dysfunction and atherosclerosis. It is not clear in the literature whether uric acid contributes to uveitis by similar mechanisms. We investigated whether uric acid level increases in Behcet’s disease patients with thrombosis or anterior uveitis. We reviewed the medical records of 914 Behcet’s disease. After screening for exclusion criteria, there were 50 Behcet’s disease patients with thrombotic complication and as the control group 202 BD patients without any vascular complication were included to the study. In the Anterior uveitis group, there were 53 Behcet’s disease patients. The Control group consisted of 39 Behçet’s disease patients without eye findings. Mean uric acid value was 4.96 ± 1.06 mg/dl in Behcet’s disease patients with thrombosis whereas 4.08 ± 0.94 mg/dl in controls, indicating a significant difference (p < 0.001). There was no significant difference between the mean ages of the patients in both groups. The mean age of the BD group without eye findings was 39.31 ± 10.47 years and that of the Behcet’s disease with Anterior Uveitis group was 37.72 ± 9.65 years (p = 0.453). The mean serum UA in the BD group without eye findings was 4.21 ± 1.21 mg/dl, while in the BD with Anterior Uveitis group it was 4.57 ± 1.37 mg/dl (p = 0.201). The extent of increase in uric acid level was greater in Behcet’s disease patients that have a thrombotic complication compared to those without thrombotic complication. Uric acid seems to play a role in the pathogenesis of thrombosis. It is concluded that the elevation of serum uric acid level in patients with anterior uveitis with Behcet’s disease is not statistically significant.

Citation: Avcı A, Avcı A, Ulaş Y, Etaş R. Can Biologic Agents Improve Treatment Success in Obese Patients with Psoriasis Vulgaris: A Retrospective Review of 320 Patients with Psoriasis Vulgaris. Dermatol Pract Concept. 2024;14(1):e2024058. DOI: https://doi.org/10.5826/dpc.1401a58 Accepted: August 29, 2023; Published: January2024 Copyright: ©2024 Avcı et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding author: Atıl Avcı, MD. (Associate professor), Kayseri City Education and Research Hospital, Department of Dermatology and Allergy- Kayseri, Turkey. Tel: +90 352 315 77 00 E-mail: atilavci@hotmail.com Introduction: Obesity plays a major role in the development of many inflammatory disorders including psoriasis. Objectives: We aimed to demonstrate how treatment responses change according to body mass index among patients with psoriasis. Methods: In our study, Psoriasis Area and Severity Index (PASI) 75 and PASI 90 responses were assessed at baseline and at months 1 and 3 among patients who received TNF-α inhibitors, ustekinumab, IL-17 blockers, and IL-23 blockers. The same responses were also assessed with methotrexate and acitretin for a comparison group. Analyses were performed retrospectively. Results: The study included 317 patients who received 222 biological and 95 conventional treatments. In the group with BMI of ≥30, the proportion of patients who achieved PASI 75 response was 40.0% (n=26) at month 1 and 55.4% (n=36) at month 3. The proportion of patients who achieved PASI 90 response was 33.8% (n=22) at month 1 and 44.6% (n=29) at month 3 among those receiving biological agents. Improvement was significantly more difficult among obese patients. While the presence of joint involvement affected the success of treatment among obese patients with psoriasis, no relationships were found for smoking, the presence of concomitant psychiatric diseases, or the presence of pruritus in psoriasis. Conclusion: Biological agents were more successful in achieving PASI 75 and PASI 90 responses in both non-obese and obese individuals. Based on our study, among biological agents, IL-17 and IL-23 inhibitors may be more successful among obese individuals, but neither of them shows superiority over the other. Keywords : psoriasis, obesity, body mass index, biological agents This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Background: We provided a comparative presentation of complications seen in 114 patients with port catheter implantation. In addition, we addressed whether patients with catheter-related thrombosis have distinctive features by assessing patients who developed thrombosis either at the catheter implant site or vascular bed. Methods: In this study, we analyzed data from 114 patients who underwent subclavian venous port catheter implantation by a single surgeon at Kayseri Teaching Hospital (Turkey) during 2013 to 2016. Subclavian port catheter was inserted in all cases. The diagnosis of port thrombosis was made by Doppler sonography or thorax CT scan with contrast enhancement in patients presenting with edema at upper extremity, swelling or pain at neck, and/or dysfunctional port. Results: Seroma was detected in only one case, lymphedema developed in one case (0.8%), and pneumothorax was observed in 3 cases. The subclavian vein was implanted on the right side in all patients with pneumothorax. None of these cases were associated with thrombosis. Port infection was observed in one case (0.8%). There was also one case (0.8%) of skin necrosis. The port was removed in 15 patients due to several reasons, which are indicated in Table 2. Thromboembolic events were observed in 11 of the 114 patients while port thrombosis was observed in 7 patients. The rate of hypertension in the thromboembolism group was 61.1% (11/18 individual) while the rate of hypertension in the group without thromboembolism was 28.1% (27/96 individuals); this difference was statistically significant (p = 0.006). Conclusion: In this study, based on complications observed in patients with catheter-related thrombosis, factors such as smoking or diabetes mellitus were seen to be linked to thromboembolism and should be taken into consideration. Moreover, it was observed that hypertension had a significant association with thromboembolism.