Ramus Kaynaklı Otojen Kortikal Kemik Plakaları ile Atrofik Posterior Maksillanın 3 Boyutlu Ogmentasyonu

Giriş: Maksiller posterior bölgedeki diş kayıplarını takiben meydana gelen alveolar kret rezorpsiyonu vemaksiller sinüsün pnömatizasyonu, fizyolojik olaylardır. İleri derecede atrofik rezidüel kret varlığında,horizontal/vertikal sert doku ve sinüs tabanı ogmentasyonları, doğru vaka seçimi ve cerrahi planlamayla birlikteyüksek düzeyde tahmin edilebilirlik ve başarı oranlarıyla kullanılmaktadır. Bu vakada, atrofik maksiller posteriorbölgedeki dişsizliğin implantla tedaviye hazırlanması maksadıyla, lateral yaklaşımlı sinüs tabanıogmentasyonuna ek olarak, ramus kaynaklı otojen kortikal kemik laminalarıkullanılarak vertikal ve horizontalsert doku ogmentasyonu gerçekleştirilmiştir.Materyal ve Metod: Rezidüel kret yüksekliği 1 mm olan dişsiz maksiller sol posterior bölgede tamkalınlık flep elevasyonunu takiben lateral kemik penceresi oluşturuldu, Schneiderian membranı eleve edildi veoluşturulan boşluğa xenogreft yerleştirilerek lateral yaklaşımlı sinüs tabanı ogmentasyonu gerçekleştirildi.Defektif bölgenin boyutlarına uygun olarak sol ramustan piezocerrahi ile alınan 20x10x4 mm boyutlarındakortikal blok greft 2 mm kalınlığında 2 ince plakaya ayrılarak oklüzal ve bukkalden mini vidalarla bölgeyesabitlendi. Aynı bölgeden kemik kazıyıcıyla toplanan otojen greft, xeno greftle 1/1 karıştırılarak bölgeyeyerleştirildi. Kortikal kemik plakalarının kenarları yumuşatıldı. Primer kapatma için periost insizyonlarıylaesnetilen flep, 5.0-polipropilen süturla kapatıldı. 8 ay sonra tam kalınlık flep kaldırılarak mini vidalar çıkarıldı,#25 ve #27 bölgelerine 2 adet 4,5x11,5 mm implant yerleştirildi.Bulgular: Rezidüel kret yükseklikleri 3,5mm ve 1mm olan #25 ve #27 bölgelerinde sırasıyla 20 mm ve17 mm yükseklik ve 7 mm genişlik elde edildi. 8 aylık iyileşme periyodunun sonunda ilgili bölgelere implantlaryerleştirilerek hasta protetik aşamaya hazır hale getirildi.Tartışma ve Sonuç: Diş kaybı sonrası meydana gelen alveolar kret rezorpsiyonu ve sinüspnömatizasyonu sonucunda rezidüel kret yüksekliği ve genişliğinin implant cerrahisi için yetersiz olduğudurumlarda, mandibula ramus bölgesinden elde edilen, aralarına partiküler greft yerleştirilen, oklüzal ve bukkalduvar görevi gören ince kortikal kemik plakalarının kullanımı, horizontal ve vertikal sert doku ogmentasyonundatahmin edilebilir doku kazancı ve minimum greft rezorpsiyonu ile başarılı sonuçlar vermektedir.Introduction: Bone resorption and pneumatization of the maxillary sinus following tooth loss arephysiological processes in posterior maxilla. In advanced atrophic crests, horizontal/vertical bone and sinusaugmentations are performed with high predictability and success rates with proper case selection andplanning. In this case, 3-dimensional bone augmentation was performed using autogenous cortical bonelaminae from ramus, in addition to lateral approached sinus floor augmentation, to prepare the area forimplants.Materials and Methods: Following full-thickness flap elevation in the region with a residual ridge heightof 1 mm, lateral approach sinus floor augmentation was performed with xenograft. Cortical block withdimensions of 20x10x4 mm harvested from the left mandibular ramus with piezosurgery and was seperatedinto 2 laminae of 1,5 mm thickness and fixed with mini screws to create occlusal and buccal walls. Autogenousgraft collected from the donor area with bone scraper was mixed with xenograft and placed between the walls.The edges of the laminae were smoothed. Flap was advanced with periosteal releasing incisions and closedwith 5.0 polypropylene suture. After 8 months, the mini screws were removed and two 4,5x11.5 mm implantswere placed in sites #25 and #27.Results:

Determination of interleukin-6, interleukin-10, and interleukin-18 levels in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma secondary to HBV infection

Giriş ve Amaç: Viral hepatit B enfeksiyonunun kronikleşmesine yol açan mekanizmalar tam olarak anlaşılamamıştır. Sitokin profilindeki değişimin, enfeksiyonun iyileşmesi veya kronikleşmesi şeklinde sonuçlanabileceği bilinmektedir. Bu çalışma, bazı sitokinler ile hepatit B virüsü enfeksiyonu sonrası oluşan farklı klinik formları arasındaki ilişkiyi ortaya koymak amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmada, hepatit B virüsü enfeksiyonuna ikincil kronik hepatit, karaciğer sirozu ile hepa- tosellüler karsinoma gelişmiş hastalarda interlökin-6, interlökin-10, interlökin-18 düzeyleri ve hastalık progresyonu arasındaki ilişki araştırıldı. Kronik hepatitli 29, karaciğer sirozlu 19, hepatosellüler karsinomalı 19, toplam 67 hepatit B hastası ile 15 sağlıklı kontrol çalışmaya alındı. Bulgular: Hepatit B virüsü hasta grupları arasında hepatit B virüsü DNA düzeyleri açısından anlamlı fark yoktu. İnterlökin-6, interlökin-10 ve inter- lökin-18 düzeyleri hasta olan gruplarda, hastalık progresyonu ile daha belirgin şekilde olmak üzere kontrol grubundan anlamlı şekilde yüksek bulundu. İnterlökin-6 düzeyi hepatosellüler karsinoma grubunda, kontrol grubu, kronik hepatit B ve karaciğer sirozu gruplarına göre anlamlı yüksek olup diğer gruplar arasında ise benzerdi. İnterlökin-10 düzeyinde ise sadece hepatosellüler karsinoma ile kontrol grubu arasında anlamlı fark mevcuttu. İnterlökin-18 düzeyleri ise hepatit B virüsü gruplarında (kronik hepatit B, karaciğer sirozu ve hepatosellüler karsinoma) benzer olmakla beraber her üç grupta da kontrol grubundan anlamlı olarak yüksekti. İnterlökin-6, interlökin-10, interlökin-18 ve alfa fetoprotein düzeyleri arasında istatiksel açıdan anlamlı korelasyon saptandı. Ek olarak hepatosellüler karsinoma grubunda yer alan ve alfa fetoprotein düzeyleri normal sınırlarda olan 3 hastadan ikisinde interlökin-18 düzeylerinin ortalama değerin üzerinde olduğu ve bunlardan birinde interlökin-10 düzeyinin de ortalama değerin üzerinde olduğu saptandı. Sonuç: So- nuç olarak, interlökin-6, 10 ve 18 düzeylerinin hepatit B virüsü enfeksiyonunun farklı evrelerinde artmış olduğu saptandı. İnterlökin-6 ve 10 hepatosellüler karsinomada artarken, interlökin-18, tüm hepatit B virüsü formlarında artmış olarak bulundu.Background and Aims: The mechanisms of chronicity in viral hepatitis B are not yet been fully understood. It has been postulated that the changes in balance of cytokine profiles may result in either healing or chronicity. This study was conducted to reveal the relationship among different clinical forms of hepatitis B virus infection with cytokines. Materials nad Methods: This study aims to reveal the relationship among interleukin-6, interleukin-10 and interleukin-18 levels and disease pro- gression in patients with chronic hepatitis B, liver cirrhosis and hepato- cellular carcinoma secondary to hepatitis B virus infection. A total of 67 hepatitis B virus patients with chronic hepatitis B (n=29), liver cirrhosis (n=19), hepatocellular carcinoma (n=19) and 15 healthy controls were included in the study. Results: Hepatitis B virus DNA levels were not significantly different among the groups. Interleukin-6, interleukin-10 and interleukin-18 levels in patients with hepatitis B virus infection were significantly higher than the control group in association with disease progression. The level of interleukin-6 in hepatocellular carcino- ma group was significantly higher than the control, chronic hepatitis B and liver cirrhosis groups. Interleukin-6 levels were similar among the other groups. At the level of interleukin-10, there was only a significant difference between the control and hepatocellular carcinoma groups. interleukin-18 levels were similar among the groups of hepatitis B virus (chronic hepatitis B, liver cirrhosis, hepatocellular carcinoma), and in all three groups these were significantly higher than in the control group. There was statistically significant correlation between interleukin and al- pha fetoprotein levels. In addition, interleukin-18 levels in two of three patients with alpha fetoprotein levels within the normal range in the hepatocellular carcinoma group were found to be on mean values. In one of them the level of interleukin-10 was found to be on mean val- ues. Conclusions: In conclusion, levels of interleukin-6, 10 and 18 were found to be increased at different stages of hepatitis B virus infection. Interleukin-6 and 10 levels increased in the hepatocellular carcinoma group. Interleukin-18 was increased in all forms of hepatitis B virus

SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance.

BACKGROUND: COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. METHODS: 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. CONCLUSIONS: Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission

Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines

© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.Introduction: Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs’ hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. Method: A short survey was carried out in May–June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. Results: In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. Conclusion: Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs

The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients.

Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology