Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and NOACs: Insight from AFTER-2 Trial

BACKGROUND: We aimed to compare the long-term follow-up results of patients with atrial fibrillation (AF) who use vitamin K antagonist (VKA) with effective time in therapeutic range (TTR) and non-vitamin K antagonist oral anticoagulants (NOACs). METHODS: A total of 1140 patients were followed at 35 different centers for five years. During the follow-up period, the INR values were studied at least 4 times a year and the TTR values were calculated according to the Roosendaal method. The effective TTR level was accepted as >60% as recommended by the guidelines. There were 254 patients in the effective TTR group and 886 patients in the NOACs group. Ischemic cerebrovascular disease/ transient ischemic attack (CVD/TIA), hemorrhagic CVD, and mortality were considered primary endpoints based on one-year and five-year follow-ups. RESULTS: Ischemic CVD/TIA (3.9% vs. 6.2%; P = 0.17) and hemorrhagic CVD (0.4% vs. 0.5%, P = 0.69), the one-year mortality rate (7.1% vs. 8.1%; P = 0.59), five-year mortality rates (24% vs. 26.3%; P = 0.46) were not different between the effective TTR and NOACs groups during the follow-up respectively. The CHA2DS2-VASC score was similar between warfarin with the effective TTR group and NOACs group (3 [2–4] vs. 3 [2–4]; P = 0.17, respectively]. Additionally, survival free-time did not differ between the warfarin with effective TTR group and each NOAC in the Kaplan-Meier analysis (dabigatran, P = 0.59; rivaroxaban, P = 0.34; apixaban, P = 0.26; and edoxaban, P = 0.14). CONCLUSION: There was no significant difference in primary outcomes between the effective TTR and NOAC groups in AF patients

Data-driven Bayesian network approach to maritime accidents involved by dry bulk carriers in Turkish search and rescue areas

In the case of maritime accidents, they cause very serious vital, economic, and environmental problems. As a matter of fact, maritime accidents emerge as an important issue due to the risks brought by the increasing ship tonnage and ship traffic. In this sense, the Turkish Search and Rescue Areas, which include the Aegean Sea islands, the Turkish coasts, and the Turkish Straits, are among the regions with risks in maritime accidents. In this study, the accidents that took place between the years 2001–2019 in the Turkish Search and Rescue Areas were examined, and maritime accident analysis was carried out using Bayesian networks on the accidents involving dry-bulk carriers. Considering accident type as a target variable, this study concentrates on the probabilistic relationships among the factors (i.e., ship type, grt, flag, survival status, navigation region, accident month, accident time, and accident causes) which are thought to influence the occurrence of accidents. According to the research outcomes, it has been determined as probabilistic that there are seasonal and regional differences in the occurrence of accident causes and the occurrence of accidents. In dry bulk carriers, it has been determined that the white flag ships in the Paris Mou ranking are much less likely to be involved in a fatal accident at night. In addition, while the probability of fatal maritime accidents occurring during the daylight hours (06:00–17:59) in accidents in the Çanakkale navigational area is 28%; at night (18:00–05:59), this rate is 41%. Another important matter is that some ships have been found to be involved in accidents repeatedly. In this sense, suggestions have been made for the stakeholders

The Effect of Peracetic Acid on Removing Calcium Hydroxide from the Root Canals

Introduction: The goal of this study was to evaluate the efficiencies of different irrigation solutions in the removal of calcium hydroxide (CH). Methods: Forty-eight maxillary central incisor teeth were used. Root canals were prepared with the ProTaper system (Dentsply Maillefer, Baillagues, Switzerland). Five milliliters 2% NaOCl, 5 mL 17% EDTA, and 10 mL saline were used for final irrigation. The canals were filled with CH paste. Specimens were randomly divided into 4 experimental groups (n = 10) according to irrigation protocols. Positive and negative control groups (n = 4) were used. Group 1 used 2.5 mL 17% EDTA, group 2 used 2.5 mL 2.5% NaOCl + 2.5 mL 17% EDTA, group 3 used 2.5 mL 1% peracetic acid (PAA), and group 4 used 2.5 ml 0.5% PM. The specimens were evaluated with scanning electron microscope analysis and scored. Kruskal-Wallis and Student Newman-Keuls post hoc tests were used for Statistical analysis. Results: In the apical thirds, 1% PAA was superior to the other groups (P .05). In the middle thirds, no significant differences were found among the groups (P > .05). In the coronal thirds, 1% PM was superior to the other groups. There were significant differences among all the other groups (P < .05). Conclusions: According to the findings of the present study, 1% PM could be recommended for the removal of CH from the root canals. (J Endod 2012;38:1197-1201

Metallic nanoparticles as X-Ray computed tomography (CT) contrast agents: A review

X-ray computed tomography vastly used in both medical purposes and in the research of biological and non-biological materials/samples. Some of the medical applications performed in the clinics requires special protocols where contrast agents may be needed to enhance the contrast. Iodine based contrast agents are commonly used in such applications. Iodine based contrast agents were found hazardous to the environment and some patients has iodine in tolerance due to thyroid origin diseases. Scientists from different fields try to develop contrast agents which can be an alternative to iodine based contrast agents. Metallic nanoparticles have potential to be used as CT contrast agent since metals has high X-ray attenuation and high density. Metal nanoparticles considered as toxic to the living organisms. Covering nanoparticles with organic molecule often reduce toxicity and enhance the biocompatibility. Decoration of nanoparticles with function groups give them targeting properties where special organ and/or tissue can be targeted. Up to now, different studies illustrated the importance of the multipurpose properties of the metallic nanoparticles. In this report, we assessed the metal nanoparticles reported as X-ray computed tomography contrast agent. For the first time in the literature we listed in vivo contrast enhancement, targeted drug delivery and dual/multipurpose imaging properties of each metallic nanoparticles. Therapeutic effects of metallic nanoparticles such as photothermal therapy and magnetic hyperthermia were also addressed. A chart showing relative contrast enhancement properties of the nanoparticles were produced. (C) 2020 Elsevier B.V. All rights reserved.WOS:0005693830000072-s2.0-8508637879

Koroner angiografi işlemi esnasında tesadüfen saptanan ciddi aort koarktasyonu

Aortic coarctation (AC) represents about 5-8 % of all congenital cardiac diseases and a combination with other bicuspid aortic valve is commonly seen. AC is typically a disease of childhood and early adulthood, reducing life expectancy in patients who have not undergone correction. Death in patients who do not undergo repair is usually due to heart failure, coronary artery disease, aortic rupture/ dissection, infective endocarditis/ endarteritis or cerebral hemorrhage. In this report, a 60-year-old patient administered to our emergency department due to unstable angina pectoris with asymptomatic aneurysm of the ascending aorta, AC and a bicuspid aortic valve is presented.Konjenital kalp hastalıkları içerisinde % 5-8 oranında sıklığa sahip aort koarktasyonuna biküspit aort kapağı sıklıkla eşlik etmektedir. Aort koarktasyonu tipik olarak çocukluk ve erken erişkin döneminin hastalığıdır ve onarım yapılmazsa yaşam süresi azalır. Onarım yapılmayan hastalarda ölüm; sıklıkla kalp yetersizliği, koroner arter hastalığı, aort rüptürü/ diseksiyonu, enfektif endokardit/ endarterit veya serebral hemorajiye bağlıdır. Bu yazıda, 60 yaşında çıkan aort anevrizması, aort koarktasyonu ve biküspid aort kapağı olan kararsız angina pektoris ile acil servise gelen hasta takdim edilmiştir