İmplantolojide doku mühendisliği ve gen tedavisi

Son elli yılda implantoloji alanında büyük adımlar atılmıştır. Günümüzde implantın kemik ile bağlantısı kabul edilebilir derecede başarılı olmasına rağmen inflamasyon, trombozis, fibrozis ve enfeksiyon gibi komplikasyonlar görülebilmektedir. Genetik ve doku mühendisliği alanındaki gelişmelerle birlikte ileri çalışmalara ihtiyaç duyulmaktadır. Görülen komplikasyonları en aza indirmek için implantın yerleştirildiği dokunun yanıtının istenilen düzeyde ve şekilde olması ve immün reaksiyonun düzenlenmesi gerekmektedir. Ayrıca yerleştirilmesi için, kaybedilen alveolar kemik dokusunun genişletilmesi mümkün hale gelmişti

Clinical outcomes and treatment patterns of primary central nervous system lymphoma: Multicenter retrospective analysis

Objectives: Primary central nervous system lymphoma (PCNSL) is a rare malignant disease with poor prognosis. Its low incidence leads to challenges in decision-making for treatment. As a matter of fact, there is still no consensus on the appropriate treatment modalities. In this context, the objective of this study is to investigate and comparatively assess the efficacies of several treatment modalities in the treatment of PCNSL. Methods: Thirty-four patients diagnosed with PCNSL at 5 different hematology centers between 2007 and 2021 were included in the study. Patients’ data from all five centers were collected retrospectively. Since ibrutinib is not approved for this indication in Turkey, consent for off-label use of ibrutinib is obtained from each patient. Ethics committee ap-proval was obtained on June 9, 2021 with decision number 2021/18-05. Results: The median age of the patients was 59 (min.: 22, max.: 78) years. The male-to-female ratio was 1.26/1. Nineteen (55.9%) patients had Eastern Cooperative Oncology Group (ECOG) performance score of ≥2. Fifteen (44.1%) patients had normal lactate dehydrogenase (LDH) levels and only 14.7% of the patients had B symptoms at the time of diagnosis. Magnetic resonance imaging (MRI) revealed a single mass lesion in 14 (41.2%) patients. As an induction therapy, meth-otrexate-based regimen was administered in 29 (85.3%) patients. Only 14 of the 34 patients received 4 or more cycles of high-dose methotrexate (MTX). About 32.4% of the patients received radiation therapy (RT) during follow-up as a part of induction therapy. Five patients received only RT due to poor performance status. Ibrutinib was administered in 5 patients for refractory disease. It was determined that four or more cycles of MTX treatment increased progression-free survival (PFS) (p=0.031) and overall survival (OS) (p=0.012). Moreover, RT improved PFS (p=0.023). Considering that the complete response achieved by induction therapy influences long-term survival, achievement of the best response to the treatment regimens administered in combination with new agents may prolong survival (PFS: p=0.01, OS: p=0.023). Conclusion: The findings of this study indicate that the initial response to treatment is crucial. Additionally, it was found that high-dose MTX treatment should be administered for 4 cycles or more in order to achieve the best results. Furthermore, it was determined that ibrutinib monotherapy was well-tolerated in our patients with relapsed/refractory disease, with excellent clinical benefits. In conclusion, a combination therapy consisting of high-dose MTX, ibrutinib, and rituximab appears to be a promising initial treatment approach in appropriate patients

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Batı Karadeniz bölgesi içsularının balık faunası

Fish fauna of the inland waters in Western Black Sea Region. in this study, it was aimed to present taxonomic status of the freshwater fish fauna in the Western Black Sea region. Fish samples were collected from 78 sampling stations, extending from Sakarya in the west to Sinop in the east and to the various cities such as Bilecik containing Sakarya River and its branches, Eskişehir and Ankara in the south. As a result of this research, 32 taxon including 30 species and 2 subspecies in 10 families were determined.Bu çalışma ile Batı Karadeniz bölgesi içsularındaki tatlısu balık faunasının günümüzdeki taksonomik durumunun ortaya çıkarılması amaçlanmıştır. Balık örnekleri batıda Sakarya’dan doğuda Sinop’a kadar, güneyde ise Sakarya Nehri ve kollarının yer aldığı Bilecik, Eskişehir ve Ankara illerini kapsayan toplam 78 istasyondan toplanmıştır. Çalışma sonucunda 10 familyadan 30 tür ve 2 alttür olmak üzere 32 takson tespit edilmiştir

Türkiye Klinikleri Oral ve Maksillofasiyal Cerrahi - Özel Sayı

ÖZETBaş boyun kanserlerinin görülme sıklığı son yıllarda artmaktadır. Baş ve boyun kanseri tedavisi cerrahi, radyoterapi, kemoterapi veya bu tedavi modalitelerin bir kombinasyonunu içerir. Bu tedavileri alan hastalar, hem kısa hem de uzun süreli etkilere sahip olan istenmeyen birçok oral komplikasyonla yaşayabilirler. Sık görülen komplikasyonlardan bazıları ağrı, ağız kuruluğu, konuşma ve yutma bozuklukları, çiğneme işlevin bozulma, trismus ve estetik kaygıları içerir. Diş hekimleri tedavi sırasında ve sonrasında karşılaşılabilecek bu komplikasyonları iyi bilmeli, gerekli önlemleri almalıdır. Yaşam kalitesi çok faktörlü ve sübjektif olabilse de, tedavi süresince problemleri bilmek ve ele almak suretiyle yaşam kalitesinde bir iyileşme sağlanabilir.Anahtar Kelimeler: Baş boyun neoplazileri; ağız sağlığı; yaşam kalitesiABSTRACTThe incidence of head and neck cancers is increasing in recent years. Treatment of head and neck cancer involves surgery, radiotherapy, chemotherapy or a combination of these treatment modalities. Patients receiving these treatments may experience undesirable oral complications with both short and long-term effects. Some of the most common complications include pain, dry mouth, speech and swallowing disorders, disruption of chewing function, trismus and aesthetic concerns. Dentists should know these complications well during and after treatment and take necessary precautions. Although quality of life can be multifactorial and subjective, quality of life can be improved by knowing and treating problems during treatment.Keywords: Head and neck neoplasms; oral health; quality of lif

Turkiye Klinikleri Oral veMaksillofasiyal Cerrahi-Özel Sayı

ÖZETGünümüzde her alanda bilgisayar teknolojilerinden yararlanılmaya başlanmasıyla birlikte bu sistemler maksillofasiyal protezlerin yapımında da kullanılmaya başlanmıştır. Bilgisayar sistemleri hızlıca konvansiyonel tekniklerin yerini almaya başlamıştır. Bunun başlıca nedeni bilgisayarlı sistemlerin hem hasta hem de hekim için büyük kolaylıklar getirmesi ve kozmetik olarak da oldukça estetik protezlerin yapımına olanak sağlamasıdır. İleri gelecekte maliyetinin de azalmasıyla birlikte bilgisayarlı sistemlerin tamamıyla konvansiyonel tekniklerin yerini alacağı öngörülmektedir.Anahtar Kelimeler: Maksillofasiyal protezler; bilgisayar yardımlı tasarımABSTRACTNowadays, with the introduction of computer technologies in every field, computer systems have been started to use in the construction of maxillofacial prostheses. This is mainly due to the fact that computerized systems bring great convenience to both the patient and the physician, and cosmetically it enables the fabrication of highly aesthetic prostheses. It is predicted that when the cost is decreased computerized systems will be replaced with the conventional techniques.Keywords: Maxillofacial prostheses; computer-aided desig