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Background/aim: Spontaneous wheals and/or angioedema lasting longer than six weeks are described as chronic spontaneous urticaria (CSU). Omalizumab is used for the treatment of antihistamine-resistant CSU. The neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) are considered important indicators of inflammation and platelet activation in chronic diseases. We aimed to determine the NLR, PLR, MPV, and PDW levels in patients with CSU compared with healthy controls. We also aimed to investigate the effects of omalizumab therapy on these parameters in CSU patients. Materials and methods: This hospital-based, retrospective study included 143 patients with CSU and 132 healthy controls with a mean age of 40.0 ± 13.17 and 42.0 ± 16.34, respectively. Patients with equal or higher-than-baseline UAS scores at week 12 of omalizumab treatment were considered nonresponders, others were considered responders. We analyzed the neutrophils, lymphocytes, platelet counts, NLR, PLR, MPV, and PDW before, during, and after omalizumab treatment and compared the results with those of healthy controls. Results: CSU patients presented higher baseline MPV (P = 0.035) and lower baseline PDW values (P < 0.001) than healthy controls. There were statistically significant increases in the MPV (P < 0.001), MPV/platelet count (P = 0.005), and PDW (P = 0.003) and there was a statistically significant decrease in the NLR (P = 0.018) during omalizumab treatment. The percent increase of MPV was low in nonresponders (P = 0.009). Nonresponders had lower PDW values than responders (P = 0.040). Conclusion: The increase in the MPV and PDW may be due to platelet activation during omalizumab treatment. The decrease in the NLR may be regarded as an antiinflammatory effect of omalizumab. The effect of omalizumab on platelet and inflammatory markers may be used to discriminate the responders from nonresponders.

It is effective, safe and economic to use misoprostol vaginally in PROM cases with low Bishop scores at term.

IntroductionThe purpose of this study was to compare the value of hematological parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV), as indicators of anterior uveal segment involvement in patients with Behcet’s disease (BD).Patients and methodsHospital-based records of a total of 912 patients with BD from the dermatology clinic and healthy volunteers from the checkup clinic were assessed retrospectively. After applying the exclusion criteria of the study, 71 of the BD patients with anterior uveitis, 69 of the BD patients without ophthalmological pathology and 151 healthy volunteers were included in the study. MPV, PLR, and NLR values of patients and healthy volunteers were compared.ResultsAll MPV, PLR, and NLR values of patients who had anterior uveitis were significantly higher than those of other patients and healthy volunteers. Statistically, considering area under curves (ratio): NLR was 0.725 (0.653–0.797), P<0.001; PLR was 0.600 (0.523–0.676), P=0.012, and MPV was 0.358 (0.279–0.437), P<0.001.ConclusionMPV, PLR, and NLR are all valuable for assessment of anterior uveal segment involvement in patients with BD. However, the NLR seems to be better than the PLR and MPV for indicating anterior uveitis due to BD.

The Dd of patients before PDL treatment was 13.0 (interquartile range (IQR): 5.0-28.0) and after 3 weeks of PDL treatment it was 6.0 (IQR: 3.0-12.0) with SSSB. After PDL treatment, the Dd was significantly lower than pretreatment the Dd (p = 0.002). The present study shows that PDL significantly reduced Dd in facial skin with one session.

Objective: The aim of this study was to investigate the relationship between psoriasis and heart rate recovery (HRR) index. Patients and Methods: A total of 50 patients with a diagnosis of psoriasis and 32 healthy volunteers were included in the study. In all patients, a stress test was performed to calculate the HRR index in a manner which aimed to reach the age-specific maximum heart rate. HRR indices were calculated in all patients and controls. Results: HRR (beats/minute) indices after the 1st (HRR₁, 26 ± 10 vs. 33 ± 8, p = 0.002), 2nd (44 ± 11 vs. 50 ± 6, p = 0.002), 3rd (51 ± 7 vs. 63 ± 8, p < 0.001), 4th (54 ± 7 vs. 65 ± 8, p < 0.001) and 5th (57 ± 8 vs. 70 ± 10, p < 0.001) minutes of the recovery period were significantly lower in the psoriasis group compared to healthy controls. In addition, HRR₁ was significantly correlated with duration of psoriasis (r = 0.541, p < 0.001) and psoriasis area and severity index score (r = 0.511, p < 0.001). Conclusion: HRR was lower in patients with psoriasis. Given the prognostic value of this test, patients with psoriasis might be at risk for future cardiovascular events and cardiovascular mortality.

Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Etofenamate is a non-steroidal anti-inflammatory drug and a non-selective cyclooxygenase inhibitor. Cutaneous adverse findings caused by etofenamate are uncommon. Herein, we present a case with diagnosis of Nicolau syndrome due to etofenamate injection, which is a rare occurrence.

Background:Behçet’s disease (BD) is a systemic vasculitis of all types of vessels of both the venous and arterial sites. Mean platelet volume (MPV) is the most commonly used measure of platelet (Plt) size and is also a potential marker of Plt activity. In this study, we wanted to evaluate the MPV value and the MPV/Plt ratio in patients with deep venous thrombosis (DVT) in BD.Methods:Overall, 228 patients – 49 BD patients with a thrombotic complication and 179 BD patients without a thrombotic complication (as the control group) – were included the study.Results:Of the 49 patients with thrombosis, there was a very significant difference between the genders: 41 (83.6%) were males while only eight (16.4%) were females (p<0.0001). There was a statistically significant difference among the patients with and without thrombosis according to the median MPV value and the MPV/Plt ratio (p<0.0001).Conclusions:Increased MPV can predict the risk of DVT development as well as the male sex among BD patients. The MPV/Plt ratio may also be used for predicting DVT.