Effects of air-polishing powders on color stability of composite resins

OBJECTIVES: The purpose of this study was to investigate the effect of different air-polishing powders on the color stability of different types of composite resin restorative materials. MATERIAL AND METHODS: Thirty cylindrical specimens (15×2 mm) were prepared for each of 7 composite resin restorative materials. All specimens were polished with a series of aluminum oxide polishing discs (Sof-Lex). The prepared specimens of each composite resin were randomly divided into 3 groups of 10 specimens each, for control (Group-C) and two air-powder applications (Group-CP: Cavitron Prophy-Jet; Group-PS: Sirona ProSmile prophylaxis powder). A standard air-polishing unit (ProSmile Handly) was used. All specimens were air-powdered for 10 s at 4-bar pressure. The distance of the spray nosel from the specimens was approximately 10 mm and angulation of the nosel was 90°. Specimens were stored in 100 mL of coffee (Nescafe Classic) for 24 h at 37°C. Color measurement of all specimens was recorded before and after exposure to staining agent with a colorimeter (Minolta CR-300). Color differences (∆E*) between the 2 color measurements (baseline and after 24 h storage) were calculated. The data were analyzed with a 2-way ANOVA test, and mean values were compared by the Tukey HSD test (

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6+/-9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; pPeer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Trade openness, Urban concentration and city-size growth in Turkey

Aim of the present study is to investigate two important issues on urban concentration in Turkey. First, we investigate whether population tend to have an uneven distribution across cities between 1965-2012, second, we analyze the determinants of city-size growth by relating it to the process of trade liberalization and to a range of other socio-economic and geographical factors. In terms of methodology, we employ various cross sectional and spatial econometric tools to implement our analysis. Our results indicate three major conclusions: First, urban concentration tends to increase recently, leading to an unevenly growing cities and creating urban giants (i.e. Istanbul). Second, trade liberalization is shown to intensify this process since metropolitan areas, which are more open to trade, tend to grow faster than others. Third, specialization of cities in industrial activities (i.e. manufacturing) and economies of agglomeration are likely to reinforce the spatial concentration of population around larger cities

Yara Yeri Örneklerinden İzole Edilen Mikroorganizmalar ve Antibiyotik Direnç Oranları

Bu çalışmada, hastanemizin mikrobiyoloji laboratuvarına gönderilen yara yeri örneklerinden izole edilenpatojen mikroorganizmaların dağılımı ve antibiyotik duyarlılıkları belirlenerek, epidemiyolojik verilerekatkı sağlanması ve ampirik tedavide yol gösterici olunması amaçlanmıştır.Laboratuvarımıza 02.01.2017-20.07.2020 tarihleri arasında gönderilen yara yeri enfeksiyonu etkenleriretrospektif olarak incelenmiştir. Üreyen mikroorganizmalar konvansiyonel mikrobiyolojik yöntemler veotomatize sistem ile tanımlanmıştır. Antibiyotik duyarlılık testleri Kirby-Bauer disk difüzyon yöntemiveya otomatize sistem ile yapılmış ve EUCAST kriterlerine göre değerlendirilmiştir.Çalışmamızda 722 örnekten izole edilen toplam 956 etkenin 370’i (% 39) Enterobacterales takımı, 286’sı(% 30) Gram pozitif kok, 134’ü (% 14) Pseudomonas spp., 83’ü (% 9) Acinetobacter baumannii, 27’si(% 3) Candida spp. olarak tanımlanmıştır. Stafilokok ve enterokoklarda vankomisin, teikoplanin velinezolid direncine rastlanmamıştır. Staphylocoocus aureus’a karşı en etkili antibiyotiğin trimetoprimsülfametoksazol (TMP-SXT) (% 11), koagülaz negatif stafilokoklara ise gentamisin (% 30) ve TMP-SXT(% 28) olduğu saptanmıştır. Enterokoklarda siprofloksasin (% 48) ve levofloksasin (% 58) direncinin diğerantibiyotiklerden yüksek olduğu belirlenmiştir. Ayrıca, Klebsiella spp. suşlarının diğer Enterobacterales cinsisuşlardan daha yüksek direnç oranlarına sahip olduğu ve A.baumannii ve Pseudomonas spp. suşlarında endüşük direnç oranının kolistine (% 1) karşı olduğu belirlenmiştir. Yoğun bakım ünitelerinde ise enterokoklardışındaki etkenlerde antibiyotik direncinin diğer kliniklerden yüksek olduğu saptanmıştır.Çalışmamızda birçok bakteri türü ve mantarların yara yeri enfeksiyonunda etken olabildiği ve antibiyotiklere oldukça yüksek oranlarda direnç geliştiği görülmüştür. Bu nedenle tüm yara yeri enfeksiyonudüşünülen örneklere kültür ve antibiyogram işlemlerinin yapılarak tedavilerin düzenlenmesi gerektiğidüşünülmüştür.In this study, it was aimed to contribute to available epidemiological data and guide empirical treatment by determining the distribution and antibiotic susceptibility of pathogenic microorganisms isolated from wound samples sent to the microbiology laboratory of our hospital. The agents of wound infection sent to our laboratory between 02.01.2017 and 20.07.2020 were retrospectively analyzed. The microorganisms grown were identified by conventional microbiological methods together with automated system. Antibiotic susceptibility testing was done by Kirby-Bauer disk diffusion method and an automated system and evaluated according to EUCAST criteria. Of the 956 bacteria isolated from 722 samples, 370 (39 %) were order Enterobacterales, 286 (30 %) were Gram positive cocci, 134 (14 %) were Pseudomonas spp., 83 (9 %) were Acinetobacter baumannii and 27 (3 %) were Candida spp. Vancomycin, teicoplanin and linezolid resistance were not found in staphylococci and enterococci. The most effective antibiotic against Staphylococcus aureus was trimethoprim-sulfamethoxazole (TMP-SXT) (11 %), and gentamicin (30 %) and TMP-SXT (28 %) for coagulase negative staphylococci (CNS). Ciprofloxacin (48 %) and levofloxacin (58 %) resistance was higher in enterococci compared to other antibiotics. In addition, Klebsiella spp. strains have higher resistance rates than other Enterobacterales genus strains while A. baumannii and Pseudomonas spp. strains had the lowest resistance rate against colistin (1 %). Antibiotic resistance was higher in intensive care units than in other clinics, except for enterococci. In our study, it was observed that many species of bacteria and fungi could be an agent in wound infection, and high rates of resistance developed against antibiotics. Therefore, it was thought that the treatments should be regulated by performing culture and antibiogram procedures on all samples for which wound infection is suspected

Effects of air-polishing powders on color stability of composite resins

OBJECTIVES: The purpose of this study was to investigate the effect of different air-polishing powders on the color stability of different types of composite resin restorative materials. MATERIAL AND METHODS: Thirty cylindrical specimens (15×2 mm) were prepared for each of 7 composite resin restorative materials. All specimens were polished with a series of aluminum oxide polishing discs (Sof-Lex). The prepared specimens of each composite resin were randomly divided into 3 groups of 10 specimens each, for control (Group-C) and two air-powder applications (Group-CP: Cavitron Prophy-Jet; Group-PS: Sirona ProSmile prophylaxis powder). A standard air-polishing unit (ProSmile Handly) was used. All specimens were air-powdered for 10 s at 4-bar pressure. The distance of the spray nosel from the specimens was approximately 10 mm and angulation of the nosel was 90°. Specimens were stored in 100 mL of coffee (Nescafe Classic) for 24 h at 37°C. Color measurement of all specimens was recorded before and after exposure to staining agent with a colorimeter (Minolta CR-300). Color differences (&#8710;E*) between the 2 color measurements (baseline and after 24 h storage) were calculated. The data were analyzed with a 2-way ANOVA test, and mean values were compared by the Tukey HSD test (p.05) and these groups demonstrated the highest &#8710;E* values. For Filtek Silorane and IntenS, the highest &#8710;E* values were observed in Group-PS. The lowest &#8710;E* values for all composite resin groups were observed in Group-C. When comparing the 7 composite resin restorative materials, Aelite Aesthetic Enemal demonstrated significantly less &#8710;E* values than the other composite resins tested. The highest &#8710;E* values were observed in Quixfil. CONCLUSION: Except for Quixfil, all control groups of composite resins that were polished Sof-Lex exhibited clinically acceptable &#8710;E values (<3.7). Air-polishing applications increased the color change for all composite resin restorative materials tested. Composite restorations may require re-polishing after air-polishing

Duzce COVID 19 PCR Tests are Worked How, Where and Under Which Conditions?

Shortly after the first cases were reported in late 2019 in Wuhan Province of China, SARS CoV 2 spread all over the world and was declared a pandemic by the World Health Organization on March 12, 2020. In Turkey the first case was in March 10, 2020 and March 25, 2020 in Duzce. Duzce University Faculty of Medicine, Department of Medical Microbiology, PCR laboratory was declared to be T.C. Ministry of Health Duzce authorized Covid 19 PCR laboratory in 28.03.2020. Samples are sent to our laboratory from all provincial and district hospitals, private hospitals and public health institutions in Duzce. This is the only Covid 19 center in our city and it works for 7 days a week. In our laboratory, Covid 19 antibody tests are carried out with card tests and ELISA methods. A total of 8500 COVID 19 PCR tests and 2200 anti Covid 19 ELISA total antibody tests were studied in our laboratory within three months Although covid 19 patients are not followed in our hospital, pandemic process continues in our laboratory. In addition, all PCR studies and IFA studies of the hospital are carried out in this laboratory.WOS:00058856330000

Hastane Çalışanlarında SARS-CoV-2 IgG Seropozitifliğinin Araştırılması

Amaç: Şiddetli akut solunum sendromu koronavirüs 2'nin (SARS-CoV-2) neden olduğu ve devam eden edenkoronavirüs hastalığı (COVID-19) salgını, sağlık çalışanları için büyük zorluklar oluşturmaktadır. Sağlık çalışanları,hastalardan veya diğer sağlık çalışanlarından SARS-CoV-2 enfeksiyonu bulaşı açısından yüksek riskli birpopülasyondur. Bu çalışmada, Düzce ilindeki sağlık çalışanlarının cinsiyet, yaş grubu, meslek grubu, çalıştığı birim,bildirdiği semptomlar ve aile içi temas öyküsü durumu göz önüne alınarak SARS-CoV-2'ye karşı IgG yapısındakiantikor oluşturma oranlarının belirlenmesi amaçlandı.Gereç ve Yöntemler: Çalışma grubu, Düzce ilindeki pandemi birimlerinde aktif olarak görev yapan sağlıkçalışanlarından randomize olarak oluşturuldu. Katılımcılara sosyodemografik bilgilerin sorgulandığı bir anket uygulandıve kan örnekleri alındı. Antikor düzeyleri SARS-CoV-2 IgG (Euroimmun, Almanya) kiti kullanılarak mikro ELİSAyöntemi ile mikrobiyoloji laboratuvarında çalışıldı.Bulgular: Çalışmaya dahil edilen 93 sağlık personelinden 25’inde (%27) SARS-CoV-2 IgG pozitifliği saptandı. SARSCoV-2 IgG antikoru pozitif olanların 18’i (%72) asemptomatik olarak COVID-19’u geçirmişti. SARS CoV-2 IgGantikoru pozitif olanların 17’sinde ise (%68) COVID-19 pozitif kişi ile aile içi temas öyküsü yoktu. Semptomatikgeçirenlerde antikor düzeylerinin median değeri 2,90 olarak saptanmışken, asemptomatik geçirenlerde bu değer 1,31olarak bulundu.Sonuç: Sonuç olarak çalışmaya dahil edilen ve antikor pozitifliği olan sağlık çalışanlarının büyük çoğunluğununasemptomatik olarak enfeksiyonu geçirdiği ve bu kişilerdeki antikor düzeylerinin semptomatik olanlardan daha düşükolduğu görülmüştür.Aim: The continuing outbreak of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses enormous challenges for health care workers. Health care workers are a high-risk population for transmission of SARS-CoV-2 infection from patients or other healthcare workers. In this research, it was aimed to determine the rate of IgG antibody formation against SARS-CoV-2 by taking into account the gender, age group, occupational group, unit of work, reported symptoms and family contact history of healthcare workers in Düzce. Material and Methods: The study group was randomly formed from healthcare professionals working actively in the pandemic units in Düzce. A questionnaire questioning sociodemographic information was applied to the participants and blood samples were taken.Antibody levels were studied with the microELISA method using the SARS-CoV-2 IgG (Euroimmun, Germany) kit in microbiology laboratory. Results: SARS-CoV-2 IgG positivity was found in 25 (27%) of the 93 healthcare workers included in the study. 18 (72%) of those who were positive for SARS CoV-2 IgG antibody had passed COVID-19 asymptomatically. 17 (68%) of those who were positive for SARS CoV-2 IgG antibody did not have a family history of contact with a person positive for COVID-19.While the median value of antibody levels was 2.90 in symptomatic patients, this value was found as 1.31 in asymptomatic patients. Conclusion: As a result, it was observed that the majority of those who were included in the study and had antibody positivity had the infection asymptomatically and the antibody levels in these individuals were lower than those who were symptomatic