Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Evaluation of maxillofacial characteristics in individuals with anterior open bite using denture frame analysis

Keywords: The aim of this study was to evaluate the effectiveness of denture frame analysis (DFA) in individuals with anterior open bite who had completed pubertal peak growth (post-peak).Methods: This retrospective study was conducted using the cephalometric radiographs and hand-wrist X-rays of 50 individuals with open bite (mean age: 17.33 +/- 3 years; 35 female, 15 male) and a control group of 50 individuals without open bite (mean age: 17.38 +/- 2.72; 35 female, 15 male). All individuals included in the study were skeletal Class I and had completed or nearly completed skeletal growth. Skeletal and dental measurements pertaining to DFA were done and the data were analyzed using independent samples t test and Mann-Whitney U test.Results: Measurements assessing the vertical dimension showed that GoGn/SN, Frankfurt horizontal (FH)/mandibular plane (MP), palatal plane (PP)/MP, occlusal plane (OP)/MP, and OP-MP/PP-MP measurements were significantly greater in the open bite group (p<0.001). AB/MP angle was significantly larger in the control group (p<0.05). The open bite group had shorter A'-P' (posterior maxillary length; p<0.05) and, therefore, higher A'-6'/A'-P' ratio (p<0.01).Conclusion: Our results suggest that there may be a close association between maxillary OP inclination and mandibular position in individuals with open bite, and that open bite may arise due to maxillary denture base deficiency, especially in the posterior region. DFA may be useful in the differential diagnosis of open bite and in treatment planning, particularly when determining the need for tooth extraction

Evaluation of temporomandibular joint, masticatory muscle, and brain cortex activity in patients treated by removable functional appliances: A prospective fMRI study

Objectives: The aim of this study is to evaluate the effects of functional orthodontic appliances on the masticatory muscles, temporomandibular joint (TMJ), and brain to determine whether using functional appliances full-time or only at night yields different results. Methods: 16 patients with Class II malocclusion were included in this study. Eight patients were instructed to wear their appliances (monoblock/twinblock) full-time and the other eight patients were instructed to wear them at night while sleeping. An additional 10 patients with Class II malocclusion were later included as a pre-treatment control group. Signal intensity ratios (SIR) of TMJ structures and morphological evaluations of the masticatory muscles were done for all patients. Functional MRI (fMRI) data were also obtained from the patients while performing chewing and biting movements. Results: ANB angle was reduced significantly in both the full-time and night wear groups, by values of 1.17° and 1.35°, respectively (p < 0.05). MRI showed that SIRs were significantly increased in both groups in the masticatory muscles, retrodiscal pad, condylar process, and articular disc (p < 0.05). Both resting and task-based fMRI evaluation revealed significant increases in blood oxygen level dependent signals in several regions of the brain in both groups (p < 0.05). Conclusions: The cephalometric and MRI findings of this study indicate that the treatment effects were similar for both wear schedules. Functional appliances should be regarded not as simple devices that treat Class II malocclusion through skeletal and dental correction alone, but as exercise devices that lead to neuromuscular changes by facilitating muscle adaptation and activating various brain regions.Ankara University Scientific Research Projects Center (BAP

ANGLE SINIF II DİVİZYON 1 TEDAVİSİNDE FARKLI BİR YAKLAŞIM: OLGU SUNUMU

Sınıf II divizyon 1 maloklüzyonlara ortodonti kliniğinde sıklıkla karşılaşılmaktadır. Sınıf konumlanması, konumlanması kombinasyonu farklılıklar ve bu farklılıkların doğru teşhis edilmesi düzeltilmesinde çok önemlidir. Bu vaka raporunda, iskeletsel sınıf II anomali, dişsel Angle Sınıf II divizyon 1 maloklüzyona sahip adelosen anlatılmaktadır. Tedavi hedefleri; Angle Sınıf I molar ve kanin ilişkiyi elde etmek, overjet ve overbite miktarlarını azaltmak ve hasta profilini düzeltmektir. Tedavi planı iki aşamalı olarak düşünülmüştür. İlk aşamada slow maksillar ekspaniyon uygulanmıştır. Aynı anda mandibulanın sagital yön büyümesini stimule etmek amacıyla, plağa ısırtma izi, Angle Sınıf I molar ve kanin ilişkiyi sağlayacak aşamada; yeterli genişletme elde edildikten sonra, ısırtma izleri plaktan kaldırılmıştır. Yeni ısırtma izleri overbiteı düzeltebilmek amacıyla anterior Maksillomandibular ardından, sabit ortodontik tedavi uygulanmıştır. Aktif tedavi süresi 15 aylık ortopedik tedaviyi takip eden 12 aylık sabit ortodontik tedaviyi içeren 27 aydır. Angle Sınıf I molar ilişki elde edilmiştir ve hasta profili düzeltilmiştir. Isırma izi plağı iskeletsel Sınıf II anomalilerin tedavisinde aktivatörlere iyi bir alternatif olabilir

Evaluating the effects of functional orthodontic treatment on mandibular osseous structure using fractal dimension analysis of dental panoramic radiographs

Objective: To evaluate the effects of functional appliance treatment on mandibular trabecular structure using fractal dimension (FD) analysis of dental panoramic radiographs.Materials and Methods: This study was conducted using digital panoramic radiographs of 45 patients with Class II malocclusion treated with functional appliances (treatment group, mean age: 11.39 +/- 0.97 years; 23 girls, 22 boys) acquired before (T-0) and after (T-1) treatment and the panoramic radiographs of 45 control subjects who had undergone no orthodontic treatment (control group, mean age: 11.31 +/- 0.87 years; 23 girls, 22 boys). FD values in the condylar process, mandibular corpus, and mandibular angle were analyzed from the panoramic radiographs of both groups.Results: Analysis of changes in FD between T-0 and T-1 revealed significant increases in the FD values of the right and left condylar processes and right mandibular corpus in the treatment group (P<.001) and in the right condylar process in the control group (P<.05). Between-group comparisons demonstrated that the treatment group showed greater changes in the condylar process (right, P<.001; left, P<.05) and right mandibular corpus (P<.05) compared to controls. Correlation analysis between the cephalometric and FD changes in the treatment group showed the right condylar process changes were negatively correlated with GoGn/SN angle (P<.05) and positively correlated with Co-Go (P<.05), although these correlations were weak.Conclusions: FD analysis demonstrated significant changes in trabeculation of the condyle and mandibular corpus in the treatment group compared to the control group. Functional appliance treatment may lead to skeletal correction by altering skeletal form and trabeculation of the mandibular bone

Acute effects of Yo-Yo intermittent recovery test level 1 (Yo-YoIR1) on hemorheological parameters in female volleyball players

In the present study,we investigated possible alterations in red blood cell (RBC) deformability, plasma and whole blood viscosities (WBV) and hematological parameters in response to Yo-Yo intermittent recovery test level 1 (Yo-YoIR1) which is currently used to assess endurance performance, in female volleyball players. Eight volleyball player volunteers from Pamukkale University (mean age19,9±2,2 years; mean body height 177.5±1.99 cm; mean body mass index 21.66±0.64 kg/m2) participated to the study. Blood samples were collected before and immediately after test. Red blood cell (RBC) deformability was determined by ektacytometer, plasma and whole blood viscosities (WBV) by a cone-plate rotational viscometer. Hematological parameters were determined using an electronic hematology analyzer. The Yo-YoIR1 applied, induced acute increments inWBV at native hematocrit (Hct) measured at a shear rate of 150 s-1 and 375 s-1, RBC deformability and WBC count. The results of the current study indicate that, the Yo-Yo IR1 test used to determine physical capacity of the player, by resulting in increments in RBC deformability contributes blood flow and thus, athletic performance of the individual. © 2015 - IOS Press and the authors

Early neonatal outcomes of very-low-birth-weight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323WOS: 000534242500056PubMed: 31851725Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.Turkish Neonatal Society [2-2016]; Turkish Neonatal SocietyThis study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript