Assesment of accessory branches of canalis sinuosus on CBCT images

The aim of this study is to describe the presence, to reveal the frequency and characteristics of accessory canals (ACs) of the canalis sinuosus (CS) by cone beam computed tomography (CBCT). A total of 326 CBCT examinations were scanned retrospectively. The anatomical views were evaluated on sagittal, axial, coronal and cross sectional imaging. The following parameters were recorded: age, sex, presence or absence of ACs, location in relation to the adjacent teeth and distance to the nasal cavity floor (NCF), alveolar ridge crest (ARC) and buccal cortical bone (BCB), and incisive canal. All the collected data were statistically analyzed. 113 patients (34,7%); presented ACs in total 214 foramina of the sample. There were no statistically significant changes in the presence of ACs regarding age groups excluding 80-89 years. But there is a statistically significant difference regarding the frequency of ACs and the gender. The prevalence for male patients was higher than female patients. Curved-shape configuration of CS prevalence is found as 69,15%. The prevalence of vertical tracing is 26,16% and Y-shape configuration of CS prevalence is 4,67%. Diameter of the foramens of the CS branches was 1.30 mm. The mean distance of the AC to the NCF, BCB, and ARC were found 13,83 mm, 6,60 mm and 5,32 mm, respectively. In the anterior palatal region, ACs are mostly related to CS?s branches. So; knowing the course of CS branches in surgical planning and radiographic evaluations in this region is extremely important for preventing complications and avoiding misdiagnosis

Transformer-based end-to-end classification of variable-length volumetric data

The automatic classification of 3D medical data is memory-intensive. Also, variations in the number of slices between samples is common. Naive solutions such as subsampling can solve these problems, but at the cost of potentially eliminating relevant diagnosis information. Transformers have shown promising performance for sequential data analysis. However, their application for long-sequences is data, computationally, and memory demanding. In this paper, we propose an end-to-end Transformer-based framework that allows to classify volumetric data of variable length in an efficient fashion. Particularly, by randomizing the input slice-wise resolution during training, we enhance the capacity of the learnable positional embedding assigned to each volume slice. Consequently, the accumulated positional information in each positional embedding can be generalized to the neighbouring slices, even for high resolution volumes at the test time. By doing so, the model will be more robust to variable volume length and amenable to different computational budgets. We evaluated the proposed approach in retinal OCT volume classification and achieved 21.96% average improvement in balanced accuracy on a 9-class diagnostic task, compared to state-of-the-art video transformers. Our findings show that varying the slice-wise resolution of the input during training results in more informative volume representation as compared to training with fixed number of slices per volume. Our code is available at: https://github.com/marziehoghbaie/VLFAT

Tesadüfi saptanan Rinolith vakaları

Rinolitler; nazal kavitede yerleşimli, bir nidus etrafında biriken mineraller kaynaklı oluşan kalsifiye kitleler olup, çok nadir olarak görülmektedirler. Bu olgu serisinin amacı; rinolit tanısı konulan hastaların klinik özelliklerini ve radyolojik bulgularını sunmaktır. 18 ve 28 yaşlarında iki erkek hasta dental ağrı şikayeti nedeniyle Recep Tayyip Erdoğan Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Radyolojisi Bölümü'ne başvurmuştur. Panoramik radyografilerinde nazal kavite içerisinde kalsifiye kitle gözlenen hastalardan konik ışınlı bilgisayarlı tomografi alınmıştır. Rinolit ön tanısı ile hastalar kulak-burun-boğaz polikliniğine yönlendirilmiştir. Hastalardan birinin nazal kavitesi opere edilmiştir ve ön tanı biyopsi sonuçları ile uyumlu bulunmuştur. Bu sunumda rinolit tanısında diş hekiminin rolü vurgulanmaktadır

Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy : retrospective case series with up to 12 years of follow-up

Odontogenic keratocysts have been reported with high recurrence rates in the literature so various treatment modalities from simple enucleation to resection have been performed to achieve the cure. The purpose of this retrospective study was to investigate the recurrence rate of odontogenic keratocysts (OKCs) treated by enucleation and peripheral ostectomy. An electronic search of the database of the Hacettepe University, Faculty of Medicine, Department of Pathology, was undertaken to identify patients histologically diagnosed with OKCs treated at Department of Oral and Maxillofacial Surgery between 2001 and 2015. In total, 81 patients were studied. The mean age at the time of diagnosis was 42 years, and the male:female ratio was 1:0.7. OKCs were located primarily in the posterior mandibular region (41%). Twenty-seven patients were re-examined to determine the recurrence rate. The mean follow-up period was 5 years (range, 1?12 years). The recurrence rate was 14.8%. The relationship between location of the lesion and recurrence was not statistically significant (p = 0.559). There was also no statistically significant relation between the recurrence rate and treatment option of teeth involved in the lesion (p = 0.579). The authors conclude that treatment of OKCs by enucleation with peripheral ostectomy is associated with minimal morbidity and is preferred over other aggressive treatment modalities. Meticulous radiographic examination and careful surgical resection may decrease the recurrence rate of OKCs

Türkiye’de diş hekimlerinin bifosfonatlar konusundaki farkındalık ve bilgilerinin değerlendirilmesi

Aim: Bisphosphonates (BPs) are inorganic pyrophosphate analogs used for the treatment of various diseases. This study aimed to evaluate the knowledge and attitudes of general dental practitioners (GDP), specialist trainees (ST), and specialists (S) in Turkey toward medication-related osteonecrosis of the jaw (MRONJ) and to optimize future training programs in this field. Materials and Methods: A self-report questionnaire consisting of 7 questions about demographic data, knowledge about BPs, MRONJ and treatment modalities was prepared and send to the members of Turkish Dental Association via email. Results: A total of 209 participants were included in this survey. The mean age of the ST group was significantly lower than the mean ages of the GDP and S groups (P= 0.003, P= 0.038). GDP are less likely to think of BPs administration and radiotherapy treatment than S or ST upon observation of an exposed bone in the head-and-neck region (P=0.048, P=0.008). In comparison to the S and ST groups, the GDP group displayed less knowledge regarding the radiological and intraoral examination of patients undergoing BP therapy (P= 0.034). Conclusion: The increasing awareness of dentists about usage and side effects of BPs is important for preventing MRONJ. The GDP group displayed significantly less knowledge regarding the radiological and intraoral examinations of patients undergoing BP therapy. Greater efforts are required to increase education and knowledge of MRONJ and BPs among dental practitioners.Amaç: Bisfosfonatlar çeşitli hastalıkların tedavisinde kullanılan inorganik pirofosfat analoglarıdır. Bu çalışma uzman olmayan diş hekimlerinin, uzmanlık öğrencilerinin ve uzmanların ilaca bağlı gelişen çene osteonekrozuna yönelik bilgi ve tutumlarını değerlendirmenin yanında, gelecekteki eğitim programlarını optimize etmeyi amaçlamıştır. Materyal ve Metot: Çalışmaya 209 katılımcı dahil edilmiştir. Türk Dişhekimleri Birliği’nin desteğiyle bir anket hazırlanmış ve üyeler arasında e-posta ile paylaşılmıştır. Katılımcıların demografik bilgiler, ilaca bağlı çene osteonekrozları, bisfosfonatlar ve tedavi yaklaşımları ile ilgili 7 sorudan oluşan anketi yanıtlamaları istenmiştir. Bu anket sorularına hekimlerin verdiği cevaplar sayı ve yüzde ile tanımlanmıştır. Bulgular: Ankete katılan uzmanlık öğrencilerinin ortalama yaşı, uzman olmayan diş hekimleri ve uzmanlardan anlamlı olarak düşük bulunmuştur (P = 0.003, P = 0.038). Uzman olmayan diş hekimleri, baş-boyun bölgesinde gözlemlenen ekspoze kemiğin bisfosfonat tedavisi ya da radyoterapiye bağlı olabilme ihtimalini diğer gruplara göre daha az değerlendirmiştir (P=0.048, P=0.008). Uzman ve uzmanlık öğrencilerine kıyasla uzman olmayan diş hekimleri, bisfosfonat kullanan hastaların radyolojik ve ağız içi bulguları hakkında daha az bilgi sahibi olduğunu belirtmiştir (P = 0.034). Sonuç: Diş hekimlerinin bisfosfonatların kullanımı ve yan etkileri konusunda artan farkındalığı MRONJ’un önlenmesi için önemlidir. Diş hekimleri arasında MRONJ ve bisfosfonatlar ile ilgili bilincin artırılması için daha fazla çaba gösterilmesi ve hedef kitleye yönelik eğitim planları oluşturulması gerekmektedi

A Prospective Study of Etiology of Childhood Acute Bacterial Meningitis, Turkey

Vaccines to prevent bacterial meningitis in this region must provide reliable protection against serogroup W-135

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Common Limitations of Image Processing Metrics:A Picture Story

While the importance of automatic image analysis is continuously increasing, recent meta-research revealed major flaws with respect to algorithm validation. Performance metrics are particularly key for meaningful, objective, and transparent performance assessment and validation of the used automatic algorithms, but relatively little attention has been given to the practical pitfalls when using specific metrics for a given image analysis task. These are typically related to (1) the disregard of inherent metric properties, such as the behaviour in the presence of class imbalance or small target structures, (2) the disregard of inherent data set properties, such as the non-independence of the test cases, and (3) the disregard of the actual biomedical domain interest that the metrics should reflect. This living dynamically document has the purpose to illustrate important limitations of performance metrics commonly applied in the field of image analysis. In this context, it focuses on biomedical image analysis problems that can be phrased as image-level classification, semantic segmentation, instance segmentation, or object detection task. The current version is based on a Delphi process on metrics conducted by an international consortium of image analysis experts from more than 60 institutions worldwide.Comment: This is a dynamic paper on limitations of commonly used metrics. The current version discusses metrics for image-level classification, semantic segmentation, object detection and instance segmentation. For missing use cases, comments or questions, please contact [email protected] or [email protected]. Substantial contributions to this document will be acknowledged with a co-authorshi