Background: Hormonal factors have long been proposed to play a role in Behçet’s disease (BD). Male sex, systemic onset, HLA-B51 positivity and a younger age of onset in BD are associated with severer disease, and the disease generally runs a milder course in women. Vascular involvement is more common, and the skin pathergy test (SPT) is more strongly positive in men. BD rarely develops before puberty or after the age of 50 years. Clinical manifestations of the disease, with the exception of eye symptoms, tend to improve with time. Therefore, BD may be androgen driven to some degree. Objectives: We aimed to investigate androgen receptor (AR) levels of oral ulcers (OU), genital ulcers (GU) and SPT areas and compared them with those of adjacent normal-appearing skin/mucosa from patients with BD. Methods: Thirty-eight patients with BD (16 female, 22 male; mean ± SD age, 36.45 ± 10.2 years), diagnosed according to the criteria of the International Study Group for Behçet’s Disease, were included in the study with blind histological examination. Biopsies from OU of 10 patients, GU of 11 patients, SPT areas of 17 patients and adjacent (approximately 2 cm distant) normal-appearing skin/mucosa in patients with BD were performed. Nuclear AR levels were studied by an immunohistochemical technique, using monoclonal antibodies. The percentage of positively staining cells was recorded as the AR index (ARI). In addition, the prevalence and the positivity rate of SPT has also been evaluated. Results: ARI values in the lesional and control (non-lesional adjacent) skin/mucosa were found to be 14.5 versus 18% for OU, 28.7 versus 25.5% for GU and 36.3 versus 21.8% (p = 0.068) for SPT areas. The positive SPT areas in male patients showed a higher ARI than those of female patients (43.36 and 23.33%; p = 0.078). The ARI values of SPT areas in male patients but not in female patients were found to be significantly higher as compared with non-lesional skin (21.63%; p = 0.039). The SPT positivity was also more common in male patients compared with female patients (86.4% and 62.5%), although the difference was not significant (p = 0.88). SPT have been found to be more strongly positive among the males (4.63 ± 3.3) compared with female patients (3.18 ± 1.9), and the difference was statistically significant (p = 0.022). Conclusions: Our findings indicate that androgens seem to play a role both in the formation and increased positivity of the SPT areas in male patients with BD.

Results: Of 382 elderly people included to the study, 53,7% were female, mean age was 69,80±4,55 years and 36,9% of the participants had educational degree lower high school. 27% of participants had healthy lifestyle behaviours according to "Healthy Lifestyle Composite Scale" score. When healthy lifestyle behaviors of participants were evaluated it was seen that 87,7% of them didn't have excessive alcohol consumption, and 70,2% slept at least 7 hours a day. It was found that women, married, those graduated from the University, those having good economic status and those who rated their health as good had more healthy lifestyle behaviors than other groups (p<0,05). In analysis, to have lower monthly income (OR=2,30), to work in any job before (OR=1,57), to rate their health as bad (OR=1,18) or moderate (OR=1,103), to not apply for health care services because of economic reasons (OR=4,50), inadequate fruit and vegetable consumption (OR=4,652) and to not do exercise regularly (OR=1,894) were defined as the important risk factors for low quality of life (p<0,05). Conclusion:It has been concluded that healthy lifestyle behaviors of elderly people, especially fruit and vegetable consumption and regularly doing exercise, were determined as an important determinant of the quality of life.

We found that there was a discrepancy during the PUVA, Re-PUVA and NB-UVB treatments. We believe that VEGF plasma levels could not be a useful monitor of psoriasis activity and/or treatment response.

The aim of this study is to test the validity and reliability of Turkish version of Deprivation in Primary Care Questionnaire (DiPCare-Q). Method: In the study, a survey, consisting of socio-demographic information, living standard indicators and DiPCare-Q Turkish form, was applied with face to face interviews to 160 people who are literate, older than 18 years age and applied to Family Health Center in Akyurt district of Ankara. The validity of the scale was assessed by content validity, construct validity and discriminant validity. To test the reliability of the scale, internal consistency and item total correlation coefficients were calculated. Results: 61.3% of the participants were women, 74.4% were married and 62.5% were under high school. In the content validity, Kendall's Coefficient of Condordance W was calculated as 0,441 and p <0,05. In construct validity, the results of Principal component analysis showed that the model explained 68.49% of the total variance with 3 factors. For dicriminant validity, DiPCare-Q total and subscale scores of participants were compared according to objective indicators of poverty. And it was determined that there were statistically significant differences in scores of social deprivation dimension, material deprivation dimension and total DiPCare-Q according to objective indicators of poverty DiPCare-Q. In the evaluation of reliability of scale, the Kuder-Richardson 20 coefficient was calculated as 0,80 which is the result that the scale is reliable. In addition, correlations of the items with the total score were determined above the standard value of 0.40. Conclusion: The results of the study showed that Turkish version of DiPCare-Q is valid and reliable, so its usage was recommended in primary care services.

A 53-year-old woman diagnosed with invasive ductal-type breast carcinoma was referred to our clinic with red-purple lesions on the hands and legs. She had neither pruritus nor pain.The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy.Dermatologic examination revealed reddish-violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints ( Fig. 1). Multiple red-purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2).The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal.A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3).Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection.In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy.Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed.

Background: Few studies on the effects of early life factors on the health and quality of life of adults have been conducted in Turkey. We aimed to investigate the effects of early life factors on the health and quality of life of older adults. Methods: We administered a questionnaire to 350 adults, aged 50-89 years, living in Cankaya, Ankara. The questionnaire covered sociodemographic characteristics, early life characteristics, health status, and the World Health Organization Quality of Life-Ageing scale. Data were analyzed using χ 2 tests, independent samples t-tests, one-way ANOVA, and binary

Purpose Turkish Ministry of Health (MoH) has Health Transformation Program (HTP). The purpose of this program has been to modify the structure of the current system in order to enhance health system productivity, quality, and access in the Turkish health system. The paper aims to discuss these issues. Design/methodology/approach To measure the productivity, a data envelopment analysis-based Malmquist index approach was employed. Findings Results showed that the overall HTP have had a considerable positive impact on the productivity of general hospitals. Research limitations/implications The limitation is the availability of some data that might not be collected or reported to the MoH in Turkey. Practical implications This research’s findings will have an impact on reforming the health care system in Turkey to be competitive and efficient as possible. Social implications The research will have implication on reducing cost and provide value to the Turkish population. Originality/value This is one of the very few articles that targeted the efficiency of hospital system in Turkey.

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