IgG4 levels are evidently increased in patients with GD, and there is a possible relationship between IgG4 and GO. Our results suggest that IgG4 may be helpful in screening GD patients with high risk for GO and may well become a good indicator for the selection of right medication in the future.
The PsA registry of Turkey had similarities with previously published registries, supporting its external validity. The finding that women had more fatigue and worse functioning as well as the high percentage of active disease state highlight the unmet need in treatment of PsA.
SUMMARY
Granulomatous polyangitis (Wegener granulomatosis): clinical findings and results of long-term follow-upIntroduction: To evaluate long-term outcome of patients with granulomatous polyangitis (GPA) followed up in a tertiary university hospital. (p= 0.046). Survival in the patients with and without URT involvement was 124.6 ± 6.9 months and 59.7 ± 22.9 months, requiring dilaysis and cardiac involvement were associated with mortality (p= 0.022 and p= 0.026, respectively Prompt diagnosis and treatment are important in preventing mortality and/or permanent organ damage. Remission occurs in 85%-90% of treated patients (2). Despite current advances in diagnosis and treatment, relapse and refractory disease remain as challenges (3). Relapse rate within 5 years is ~50% (4).
Patients and Methods: We reviewed medical records of 22 patients with GPA diagnosis confirmed by tissue biopsies between 2004 and 2014.
Results: The mean time from the onset of symptoms to diagnosis was 7.8 ± 12.3 months [interquartile range (IR)= 4.0]. The most commonly involved organs were the upper respiratory tract (URT) (72.7%), lower respiratory tract (81.8%) and kidneys (72.7%). URT involvement indicated good prognosisThe present study aimed to investigate clinical and laboratory characteristics of GPA in patients followed for 11 years in a tertiary university hospital, as well as the results of long-term follow-up and survival, and related factors. A follow-up protocol was used in 21 patients. The remaining one patient died at diagnosis before the treatment is started. Patients received baseline therapy as inpatients. After achieving complete or partial remission, they were regularly followed in outpatient clinics. First-line treatment consisted of combined methylprednisolone and cyclophosphamide (CYC).
MATERIALS and METHODS
225Pulse methylprednisolone therapy was started at a dose of 500 mg/day for 3-5 days depending on disease activity. Subsequently, treatment continued with prednisolone at a dose of 1 mg/kg/day. It was targeted to reduce corticosteroid dose to 15-20 mg/day within 3-4 months. Simultaneously, intravenous CYC was commenced at a dose of 500 mg/day at 2-week intervals for the first 3 months and then continued every 4-6 weeks depending on disease activity. After 2011, patients with refractory disease and serious disease activity received an additional 1 g rituximab (RTX) (an anti-CD20 monoclonal antibody) every 6 months on two occasions at 2-week intervals. Plasmapheresis was performed 7-10 times in cases with serious renal injury and alveolar hemorrhage. Maintenance therapy was started within 12-18 months in the patients with remission. This consisted of azathioprine (AZA), methotrexate (MTX) or mycophenolate mofetil (MMF). The dose of methylprednisolone was increased in the patients that developed relapse and combined with CYC or RTX; frequency of administration was increased in the patients already receiving CYC. All patients that received CYC and RTX also received trimethoprimsulfamethoxazole therapy 3 days a week f...
Amaç: Candida türlerinin etken olduğu kan dolaşım enfeksiyonları, hastanede yatan hastalarda morbidite ve mortaliteyi artıran en önemli nedenlerden biridir. Fungusların etken olduğu kan dolaşım enfeksiyonları içerisinde en sık Candida türleri izole edilmektedir. Candida türlerinden C. albicans (CA)'ların yanı sıra non-albicans Candida (NAC) türlerinin prevelansı giderek artmaktadır. Çalışmamızda; üç yıllık süreçte, pediatrik ve erişkin yaş grubundaki hastaların kan kültüründe CA ve NAC türlerinin etken olarak izole edildiği kandidemilerdeki risk faktörlerini belirlemek ve iki türün etken olduğu hastaları karşılaştırmak amaçlanmıştır. Yöntem: Kandidemi şüpheli hastalardan kan kültürü için alınan örnekler BACTEC Aerobik/F şişesine inoküle edilmiş ve BACTEC 9240 (Becton Dickinson, Maryland, USA) cihazına yerleştirilmiştir. Pozitif üreme alarmı veren kan kültürü şişeleri çıkarılarak %5 koyun kanlı ve çikolata agar içeren besiyerlerine ekimleri yapılmıştır. Üreyen maya kolonilerine Germ tüp testi yapılmıştır. Germ tüp testi negatif olan kolonilerin, API 20C AUX (bioMérieux, Fransa) kitleri ile tür düzeyinde tanımlamaları yapılmıştır.
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