Amaç: Ürtiker, geçici eritemli ve ödemli lezyonlarla karakterize, yoğun kaşıntılı dermatolojik bir hastalıktır. İmmünoglobulin E (IgE), mast hücreleri ve histamin patogenezinde önemli rol oynar. H1 anti-histaminikler tedavinin temelidir, ancak bazı durumlarda yeterli olmayabilir. Son kılavuzlar dirençli ürtikeri olan hastalar için anti-IgE monoklonal antikoru olan omalizumab, kullanımını önermektedir. Amacımız kronik spontan ürtiker hastalarında omalizumabın etkinliğini ve güvenliğini değerlendirmek ve hastalarımızdaki gerçek yaşam deneyimlerini paylaşmaktır.Gereç ve Yöntem: Nisan 2014 ile Haziran 2018 arasında 50 ayı kapsayan bu çalışma, aylık subkütan omalizumab enjeksiyonları ile tedavi edilen 124 kronik spontan ürtiker hastasının verilerini içermektedir. Tedavi öncesi ve sonrası hastalık şiddetini karşılaştırmak için 7 günlük ürtiker aktivite skoru (ÜAS7) kullanılmıştır.Bulgular: Toplam 124 hastadan 75’i kadın (%60,4) ve 49’u erkek (%39,6) idi. Tedavi öncesi ve sonrası ortalama ÜAS7 skorları sırasıyla 32,4 ve 2,8 idi. Tedavi öncesi 124 hastanın 107’sinde (%86,2) şiddetli ürtiker, 17’sinde (%13,8) orta derecede hastalık vardı. Tedavi edilen 78 hastanın (%63) ürtikeryal lezyonları tamamen kayboldu. Hastaların 31’i (%25) kontrol altındaydı. On iki hastada (%9,6) hala hafif bir hastalık vardı ve geriye kalan üç hastada (%2,4) dirençli orta derecede semptomlar vardı. Tedaviye yanıt oranları ile tiroid otoantikorları veya yüksek IgE düzeyleri arasında korelasyon yoktu. Tedavi sırasında 36 aya kadar (ortalama 11 ay) ciddi bir yan etki görülmedi.Sonuç: Sonuçlarımız omalizumabın kronik spontan ürtiker için hızlı etkili, etkin ve güvenli tedavi seçeneği olduğunu gösteren literatürü desteklemektedir

Background and Design: Urticaria is an intensely pruritic dermatologic disorder characterized by temporary erythematous and edematous lesions. Immunoglobulin E (IgE), mast cells, and histamine play a major role in its pathogenesis. H1 antihistamines are the basis of the treatment, but they may not be sufficient for some cases. The latest guidelines advise using omalizumab, anti-IgE monoclonal antibody, for patients with refractory urticaria. Our aim was to evaluate the efficacy and safety of omalizumab in patients with chronic spontaneous urticaria and share the real-life experiences in our patients. Materials and Methods: This study, which covers the 50 months between April 2014 and June 2018, includes data of 124 chronic spontaneous urticaria patients treated with monthly subcutaneous injections of omalizumab. The 7-day urticaria activity score (UAS7) was used to compare the disease severity before and after the treatment. Results: A total of 124 patients, consisting of 75 females (60.4%) and 49 males (39.6%), were enrolled. The mean UAS7 scores before and after the treatment were 32.4 and 2.8, respectively. Before the treatment, 107 of 124 patients (86.2%) had severe urticaria, while the remaining 17 patients (13.8%) had a moderate disease. Urticarial lesions of 78 patients (63%) completely disappeared under treatment. Thirtyone patients (25%) had the disease under control. Twelve patients (9.6%) still had mild disease, and the remaining three patients (2.4%) had moderate refractory symptoms. There was no correlation between treatment response rates and the presence of thyroid autoantibodies or high IgE levels. There was no severe side effect observed during the treatment of up to 36 months (mean 11 months). Conclusion: Our results supported the literature showing that omalizumab is a rapid-acting, effective, and safe treatment choice for chronic spontaneous urticaria.

Objectives: Osteochondral lesions (OCL) are the damage of the hyaline cartilage and subchondral bone on the joint surface, which may develop posttraumatically or developmentally. Primary treatment is arthroscopic debridement of the talus osteochondral defects and bone marrow stimulation. Especially after the failure of the failed primer, surgery remains a problem. Resurfacing articular implant (HemiCAP, Artrosurface) shaped in the treatment of large lesions of the medial talar roof is an alternative treatment. The purpose of this study was to examine the clinical results after HemiCAP implantation for the OCLs of the medialtalar dome, which had previously failed with surgical treatment. Material and Methods: In this study, were trospectively analyzed 17 patients who under went arthroscopic debridement bone marrow stimulation treated with OKL diagnosis, or who were treated between June 2011 and June 2015, and who were treated with a primary OCL lesion over 50 years of age and 7 men and 10 women. Patients were evaluated preoperatively and postoperatively during rest and walking on VAS pain score, AOFAS score, radiologically implant relaxation, pseudoarthros is of osteotomyline, malunion and osteoarthritis.Results:The mean age was 49.5 ± 10.3 (29-68) years. The follow-up period was 44.2 ± 11.7 (24-63) months. The VAS pain score was found to be 1.4 ± 1.2 (0-4) in the preoperative period at rest, 0.5 ± 0.7 (0-2) at the end of the first postoperative period and during walking, 6 ± 1.4 (3-8) in the preoperative period and 1 ± 0.7 (0-2) at the end of 1 year were determined. AOFAS was 67.3 ± 12.1 (38-80) preoperatively and 92.5 ± 9.2 (68-100) at 1 year postoperatively. All patients had union on the osteo to myline. In one patient, a superficial infection was observed. In one patient, the implant was remove dearly due to the length of the fixation screw used in the osteo to myline. One patient was used to fix the bioabsorbable screw in the osteo to myline and due to the stabilization, consolidation on the graft was detected late and union was observed without any complication. Subchondral scleros is was detected on the tibial surface in 1 patient’s follow-up. Conclusion: As a result of the study, metallic implantation technique is a successful surgical procedure in medial roof OKL treatment. In cases where primary care is unsuccessful and over 50 years of age, ankle arthrodesis is a surgical procedure that may be prefer red before ankle arthroplasty surgery.