Turkish Journal of Medical Sciences最新文献

{"title":"Evaluation of treatment compliance in gout patients: a patient-centered study.","authors":"M Buğra Görgülü, Rıza Can Kardaş, Dilara Koç Şeramet, Rıdvan Mercan, Mehmet Engin Tezcan, Abdurrahman Tufan, Hamit Küçük, Berna Göker, M Akif Öztürk","doi":"10.55730/1300-0144.5985","DOIUrl":"https://doi.org/10.55730/1300-0144.5985","url":null,"abstract":"<p><strong>Background/aim: </strong>Most studies on unsuccessful gout treatment suggest that knowledge gaps and inadequate physician interventions are major contributors. However, there is a lack of research on the extent to which patients, educated by knowledgeable and experienced physicians, adhere to these recommendations.</p><p><strong>Materials and methods: </strong>This study evaluated patients seen in university rheumatology clinics who were adequately informed about diet, target serum uric acid levels, and gout by rheumatologists. We assessed their compliance with treatment, clinical and laboratory findings, and disease status a median of seven years after treatment initiation. A total of 302 gout patients who began treatment in tertiary rheumatology centers and received adequate information were screened. After the initial interview, 195 patients met the study criteria and were included. Treatment compliance was evaluated based on self-reports, and target uric acid level achievement was assessed using medical records.</p><p><strong>Results: </strong>Of the 195 patients included in the study, 87.4% were male, with a median age of 59 years. Common comorbidities included hypertension (50%), hypertriglyceridemia (54.5%), and diabetes mellitus (23.2%). The median BMI was 29.3 kg/m², with 45.1% classified as overweight and 44.6% as obese. At the last follow-up, 68.5% of patients who continued their prescribed medication remained adherent. Nonadherent patients consumed significantly more meat (≥3.5 servings/week) and experienced longer intervals between flares. Nonadherent patients also had higher uric acid levels (7.25 mg/dL vs. 6.0 mg/dL, p < 0.001) and more frequent gout flares. Regular follow-up visits were significantly lower in nonadherent patients.</p><p><strong>Conclusion: </strong>Achieving an acceptable level of treatment adherence and success in gout patients depends on adequate disease knowledge and appropriate education provided by physicians.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 2","pages":"413-422"},"PeriodicalIF":1.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of certain biochemical parameters related to bone cycle with genotype in MPS IIIB patients.","authors":"Seda Gökkurt, İrem Peker Eyüboğlu, Banu Nur Güzel, Ercan Mihçi, Ayşe Özer, Mustafa Akkiprik","doi":"10.55730/1300-0144.5973","DOIUrl":"10.55730/1300-0144.5973","url":null,"abstract":"<p><strong>Background/aim: </strong>The aims of this study are to investigate the genotype-phenotype correlation in Sanfilippo type B (MPS IIIB) patients in terms of bone formation/resorption parameters and to determine the release/inhibition of biomarkers accompanying osteoporosis.</p><p><strong>Materials and methods: </strong>Plasma levels of osteoprotegerin (OPG), matrix metalloproteinases (MMP2 and MMP9), tissue inhibitors of metalloproteinase (TIMP1 and TIMP2) and cathepsin K were examined using the ELISA method for a MPS IIIB patient group and a control group. At the same time, mutations in the NAGLU gene causing the disease were identified by whole exome sequencing, and their correlation with biochemical parameters was investigated.</p><p><strong>Results: </strong>The enzyme analysis results showed that MMP2, MMP9, TIMP1, and TIMP2 were significantly high in the study group, while cathepsin K was low. OPG levels were similar between the two groups. The genetic analysis of patients with MPS IIIB was performed by sequencing all exons and exon-intron junction regions of the NAGLU gene using a next-generation sequencing (NGS) system. In this way, variations were detected qualitatively with high read depths. The analyses found that only two patients had a previously pathogenically defined alteration. In addition, the impact assessment analyses detected alterations with a modifying effect on protein structure.</p><p><strong>Conclusion: </strong>The genetic analysis results indicate the need to consider a variation classified as benign in the OMIM database as pathogenic because the variations found in the patients (p.Arg737Gly and p.Trp103Cys) have somehow altered enzyme activity. The mutation p.Trp103Cys, a novel NAGLU gene mutation in the first exon, was detected in one patient; additionally, SIFT and PolyPhen analyses confirmed it as damaging. Further functional analyses of this variation should be conducted to gather more comprehensive information.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"328-336"},"PeriodicalIF":1.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could ERAS protocols be integrated into the national Standards for Quality in Healthcare in Türkiye?","authors":"Mine Gürsaç Çelik, Adem Az, Mehmet Çetin, Neslihan Alkiş","doi":"10.55730/1300-0144.5975","DOIUrl":"10.55730/1300-0144.5975","url":null,"abstract":"","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"346-347"},"PeriodicalIF":1.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of empagliflozin on cyclophosphamide-induced neurotoxicity in rats without diabetes.","authors":"Şerife Ezgi Doğan, Şerife Mehlika Kuşkonmaz, Pınar Celepli, Mehmet Şenes, Sema Hücümenoğlu, Cavit Çulha","doi":"10.55730/1300-0144.5943","DOIUrl":"10.55730/1300-0144.5943","url":null,"abstract":"<p><strong>Background/aim: </strong>The objective of this study was to evaluate the effects of empagliflozin on cyclophosphamide-induced neurotoxicity in rats.</p><p><strong>Materials and methods: </strong>A total of 32 male Wistar rats were separated into 4 groups with 8 rats in each: the control group, cyclophosphamide group, empagliflozin group, and cyclophosphamide plus empagliflozin group. At the end of the experiment the rats' brains were removed for biochemical analysis of oxidative stress parameters (malondialdehyde, total sulfhydryl, total oxidant status, and total antioxidant capacity) and histopathological analysis.</p><p><strong>Results: </strong>Total sulfhydryl levels were increased in the empagliflozin group and empagliflozin and cyclophosphamide group compared to the cyclophosphamide group but histopathological findings were not improved. Furthermore, when empagliflozin treatment was used coupled with cyclophosphamide, necrosis was significantly higher.</p><p><strong>Conclusion: </strong>Empagliflozin has no protective effect on cyclophosphamide neurotoxicity, although it may have neurotoxic effects. Clarification of the possible neurotoxic/neuroprotective effects of empagliflozin would be beneficial for diabetic cancer patients who are receiving cyclophosphamide chemotherapy and empagliflozin together.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"65-71"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of multinodular and vacuolating neuronal tumor and dysembryoplastic neuroepithelial tumor based on MRI.","authors":"Burcu Gül, Bora Korkmazer, Ahmet Kürşat Karaman, Esra Koçhan Kizilkiliç, Mahmut Esat Aykan, Çiğdem Özkara, Nil Çomunoğlu, Cihan Işler, Serdar Arslan, Osman Kizilkiliç","doi":"10.55730/1300-0144.5988","DOIUrl":"https://doi.org/10.55730/1300-0144.5988","url":null,"abstract":"<p><strong>Background/aim: </strong>To compare the MRI findings and clinical features of multinodular and vacuolating neuronal tumor (MVNT) and dysembryoplastic neuroepithelial tumor (DNET), and reveal the distinguishing features of these tumors from each other.</p><p><strong>Materials and methods: </strong>Patients with a suspected magnetic resonance imaging (MRI)-based diagnosis of MVNT between 2018 and 2022 were collected from the hospital database. In addition, patients diagnosed with DNET on histopathological examination and who had MRIs in the same time period were included in the study. The MRI findings and clinical features were evaluated for each patient.</p><p><strong>Results: </strong>There were 21 patients in the MVNT group and 20 patients in the DNET group. Headache was the most common symptom in patients with MVNTs (61.9%), whereas seizures were more prevalent in those with DNETs (70%). The most frequent locations for the MVNTs were the frontal and parietal lobes (66.6%), while DNETs were most commonly located in the temporal lobe (60%). All the MVNTs were hyperintense in both fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI). All the DNETs were hyperintense on T2WI. However, on FLAIR, seven (35%) of the DNET lesions were hyperintense, while the remaining 13 lesions showed mixed signal intensity forming a bubbly appearance. Moreover, 20 of 21 (95.23%) MVNTs were hyperintense on diffusion-weighted imaging (DWI) (b800), with no apparent diffusion coefficient hypointensity in the lesions. None of the DNETs showed hyperintensity on DWI.</p><p><strong>Conclusion: </strong>MRI findings, particularly those observed on FLAIR and DWI, may be helpful for distinguishing between MVNTs and DNETs, especially in cases where the differential diagnosis is challenging.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 2","pages":"443-450"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic disc herniations: diagnosis, surgical techniques, and complication insights.","authors":"Mehmet Denizhan Yurtluk, Aydın Sinan Apaydin, Hakan Kina, Khoi D Than","doi":"10.55730/1300-0144.5939","DOIUrl":"10.55730/1300-0144.5939","url":null,"abstract":"<p><p>Thoracic disc herniations (TDHs) are rare conditions, comprising 0.1% to 5% of all reported herniation cases, and affecting up to 1 in 1,000,000 individuals. The mid to lower thoracic spine, particularly between the T11 and T12 vertebrae, is most frequently affected and often associated with trauma. Conditions like Scheuermann's disease can predispose patients to TDHs. This study explores the clinical manifestations, diagnostic methods, surgical techniques, and complications associated with TDHs. Diagnosis relies on magnetic resonance imaging and computed tomography myelography to identify the level and nature of the herniation. Various surgical approaches, including posterolateral, lateral, and anterior, have been implemented, each with specific indications, advantages, and pitfalls. Complications range from lung-associated to neurological deterioration to dural breaches. Clinical presentation primarily includes thoracic back pain. Patients can present with significant neurological deficits depending on the herniation's characteristics, namely giant centrally located. Surgical intervention is indicated in cases of failed conservative treatment or acute trauma with significant cord compression. This review aimed to delve into the literature to provide insights into the clinical manifestations of TDHs, diagnosis, surgical techniques, and associated complications.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"17-23"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New index for distinguishing between critical illness myopathy and neuromyopathy: CMAP amplitude/duration index.","authors":"Handan Uzunçakmak Uyanik, Fatma Gökçem Yildiz, Çağrı Mesut Temuçin","doi":"10.55730/1300-0144.5949","DOIUrl":"10.55730/1300-0144.5949","url":null,"abstract":"<p><strong>Background/aim: </strong>Critical illness-associated weakness is a common neuromuscular syndrome that may manifest as critical illness myopathy (CIM), critical illness polyneuropathy (CIP), or an overlapping syndrome known as critical illness polyneuromyopathy (CIPM). Distinguishing between these subtypes can be challenging due to technical issues, patient-related factors such as insufficient cooperation with needle electromyography (EMG) or edema, and the need for sophisticated, time-consuming electrophysiological methods and invasive procedures such as biopsy. This study aimed to contribute to the electrophysiological distinction between CIM and CIPM.</p><p><strong>Materials and methods: </strong>A new index was designed based on distal compound muscle action potential (CMAP) amplitude and negative peak duration values. Comparative and receiver operating characteristic curve analyses were performed on the parameters of patients with CIM and CIPM, as well as between patient groups and controls.</p><p><strong>Results: </strong>The median and ulnar CMAP index cut-off values for distinguishing between CIM and CIPM were determined to be 0.35 and 0.51, respectively. Values below these cut-off points support a diagnosis of CIPM while higher values indicate CIM. The best parameter for distinguishing both CIM and CIPM patients from healthy controls was the peroneal CMAP index, with a cut-off value of 0.45.</p><p><strong>Conclusion: </strong>The CMAP index can be easily calculated from CMAP values obtained during routine nerve conduction studies. This index may serve as a practical and guiding method for differentiating between CIM and CIPM, contributing to the electrophysiological diagnosis of critically ill patients, and particularly those with unreliable sensory nerve action potentials and needle EMG examinations.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"112-120"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does CD47 expression have prognostic significance in classical Hodgkin lymphoma?","authors":"Aydan Kiliçarslan, Gülnaz Kurt Çevik, Mehmet Doğan, Ayşegül Aksoy Altinboğa, Funda Ceran, Gülşah Efecik, Mine Bakanay Öztürk","doi":"10.55730/1300-0144.5958","DOIUrl":"10.55730/1300-0144.5958","url":null,"abstract":"<p><strong>Background/aim: </strong>Hodgkin lymphoma (HL) is highly treatable, but new chemotherapy agents are needed for patients with progression or recurrence. CD47 regulates antiphagocytic activity by signaling through the signal regulatory protein alpha (SIRPα) pathway on macrophages. This study aimed to assess the expression of CD47 in HL cases and explore its relationship with Epstein-Barr virus (EBV) status and the International Prognostic Index (IPI).</p><p><strong>Materials and methods: </strong>One hundred twenty patients diagnosed with classical HL, characterized by the presence of Hodgkin and Reed-Sternberg (HRS) cells, and for whom IPI scores were available were included. Their demographic data and EBV status were retrieved from hospital records. CD47 immunohistochemical expression in HRS cells was evaluated based on its prevalence and intensity. The product of these two values was used to calculate the CD47 expression score.</p><p><strong>Results: </strong>Of the 120 patients, 76 (63.33%) were male and 44 (36.66%) were female, with an average age of 38.77 years. EBV ISH test results were available for 93 patients, of which 48 (51.61%) were positive. CD47 expression was 67% on average, and patients were categorized based on CD47 expression scores of ≤6 and >6 and IPI scores of ≤2 and >2. No significant relationship was found between CD47 expression score and age (p: 0.990), sex (p: 0.086), EBV status (p: 0.374), or IPI score (p: 0.805). However, higher IPI scores were significantly associated with increased EBV positivity (p: 0.041).</p><p><strong>Conclusion: </strong>CD47 was widely expressed, but no significant relationship with clinical parameters was observed. Further studies are required to validate its role as a biomarker.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"203-208"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between uncoupling protein 1 (UCP1) levels and psoriasis.","authors":"Fikret Akyürek, Fatma Tuncez Akyürek, Fatma Şengül Bağ","doi":"10.55730/1300-0144.5960","DOIUrl":"10.55730/1300-0144.5960","url":null,"abstract":"<p><strong>Background/aim: </strong>Psoriasis is a common chronic autoimmune skin disease. Comorbidities increase the mortality risk of the disease. The aim of this study was to investigate the changes in uncoupling protein 1 (UCP1) level in psoriasis patients and evaluate its possible role in the pathogenesis of the disease, focusing on disease severity (Psoriasis Area and Severity Index), dyslipidemia, inflammation, and cardiovascular risk.</p><p><strong>Materials and methods: </strong>This study included 30 psoriasis patients and 30 healthy individuals as a control group. Serum UCP1 was measured using an ELISA test kit. The laboratory results of psoriasis patients and healthy controls were compared.</p><p><strong>Results: </strong>UCP1 level was a significant candidate marker for the prediction of psoriatic disease (AUC: 0.708, 95% CI: 0.577-0.819, p = 0.002) with sensitivity of 66.67%, specificity of 76.67%, negative predictive value of 69.7%, and positive predictive value of 74.1%. Simple logistic regression analysis showed that an individual with a UCP1 value below 7.561 had a 73% lower probability (OR: 0.27, 95% CI: 0.08-0.94, p = 0.039) of developing psoriasis than an individual with a UCP1 value above 7.561. Among the biochemical parameters, the high-sensitivity C-reactive protein and triglyceride levels of the patients were significantly higher compared to those of the healthy controls while their high-density lipoprotein levels were lower.</p><p><strong>Conclusion: </strong>According to the sensitivity (66.67%) and specificity (76.67%) of UCP1, it may be a valuable candidate marker in the diagnosis of psoriasis patients in symptomatic and asymptomatic phases. Further work is needed to substantiate these findings.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"215-222"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pemphigus herpetiformis: a single-center tertiary care experience.","authors":"Merve Hatun Erkayman, Handan Bilen, Zeynep Karaca Ural, Elif Demirci","doi":"10.55730/1300-0144.6020","DOIUrl":"10.55730/1300-0144.6020","url":null,"abstract":"<p><strong>Background/aim: </strong>Pemphigus herpetiformis (PH) is a rare variant of pemphigus with a complex pathogenesis that is often difficult to diagnose. The literature generally presents data based on small case series. This study aims to broaden the understanding of PH by presenting our cases' clinical, histopathological, and immunological characteristics.</p><p><strong>Materials and methods: </strong>A retrospective analysis of the medical charts of patients diagnosed with PH between 2008 and 2023 from the Dermatology Clinic at Atatürk University's Faculty of Medicine was performed. The diagnostic criteria proposed by Kasperkiewics et al. were applied. All patients had lesional and perilesional skin biopsies for histopathologic examination and direct immunofluorescence microscopy. Circulating autoantibodies were detected by ELISA.</p><p><strong>Results: </strong>Four patients with a diagnosis of PH were observed. The ratio of women to men was 3:1, and the average age of the patients was 59.25 years. Pruritus was present in all patients. The oral mucosa and the scalp were affected in one and two cases, respectively. One patient showed concurrent C3 deposits at the basement membrane zone and intercellular IgG deposits on direct immunofluorescence microscopy. Peripheral eosinophilia was found in 50% of the patients. Dapsone monotherapy led to complete remission in only one patient. At least partial remission was achieved in three patients with systemic steroids ± azathioprine. No concomitant malignant disease was detected.</p><p><strong>Conclusion: </strong>Establishing a diagnosis of PH may be delayed and requires a high level of clinical suspicion. Unusual direct immunofluorescence findings suggest a complex pathogenesis. A long but less severe disease course can be expected, even if dapsone monotherapy does not result in a satisfactory result in every patient.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 3","pages":"719-726"},"PeriodicalIF":1.2,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}