Radiographic and histopathologic evaluation of radiolucent lesions involving impacted teeth: A multicenter study

Objective: The purpose of this retrospective study was to evaluate the radiographic and histopathologic features of the pathologic lesions associated with an impacted tooth in the maxilla and mandible of patients who were admitted to three different university hospitals located in different cities. Materials and Methods: One hundred one patients (36 females and 65 males) aged between 8 and 67 and who have radiolucent lesions associated with the impacted teeth were included in this study. Data related to the age and gender of the patients, and the findings of cone-beam computed tomography, and histopathologic diagnosis of the lesions were recorded and analyzed. Results: Majority of the lesions were in the posterior region of the mandible (62.4%), related to the mandibular third molars (59.4%), and were diagnosed as a dentigerous cyst. The most common features of the lesions were unilocular radiolucency (91.1%), well-circumscribed (90.1%), and expansive (85.1%). A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the expansion of the lesion (p<0.01) according to gender. A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the histopathological diagnosis of the lesion (p<0.01) according to age groups. Conclusion: Knowing all of the clinical, radiological and histopathological features of the lesions provide the surgeon to reach the correct diagnosis. Thus, the doctors achieve high success in treatment with the right treatment plan.Amaç: Bu retrospektif çalışmanın amacı, farklı şehirlerde bulunan üç farklı üniversite hastanesine başvuran hastaların üst ve alt çenesindeki gömülü diş ile ilişkili patolojik lezyonların radyografik ve histopatolojik özelliklerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya gömülü diş ile ilişkili radyolüsent lezyonu olan 8-67 yaş aralığındaki 101 hasta (36 kadın ve 65 erkek) dahil edildi. Hastaların yaşı ve cinsiyeti, lezyonların konik-ışınlı bilgisayarlı tomografi bulguları ve histopatolojik tanısı ile ilgili veriler kaydedildi ve analiz edildi. Bulgular: Lezyonların çoğu mandibula posterior bölgede (%62,4), mandibular üçüncü molar dişlerle (%59,4) ilişkiliydi ve dentigeröz kist tanısı aldı. Lezyonlarda en fazla görülen özellikler uniloküler radyolüsensi (%91,1), iyi sınırlı (%90,1) ve ekspansif (%85,1) olması idi. Cinsiyete göre lezyon ile ilişkili gömülü diş/dişlerin migrasyonu (p<0,05) ve lezyonun ekspansiyonu (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Yaş gruplarına göre lezyon ile ilişkili diş/dişlerin migrasyonu (p<0,05) ve lezyonun histopatolojik tanısı (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Sonuç: Lezyonların tüm klinik, radyolojik ve histopatolojik özelliklerinin bilinmesi cerrahın doğru tanıya ulaşmasını sağlar. Böylece hekimler doğru tedavi planı ile tedavide yüksek başarı elde ederler

Germline Pathogenic Variants Identified by Targeted Next-Generation Sequencing of Susceptibility Genes in Pheochromocytoma and Paraganglioma

The aim of this study was to evaluate germline variant frequencies of pheochromocytoma and paraganglioma targeted susceptibility genes with next-generation sequencing method. Germline DNA from 75 cases were evaluated with targeted next-generation sequencing on an Illumina NextSeq550 instrument. KIF1B, RET, SDHB, SDHD, TMEM127, and VHL genes were included in the study, and Sanger sequencing was used for verifying the variants. The pathogenic/likely pathogenic variants were in the VHL, RET, SDHB, and SDHD genes, and the diagnosis rate was 24% in this study. Three different novel pathogenic variants were determined in five cases. This is the first study from Turkey, evaluating germline susceptibility genes of pheochromocytoma and paraganglioma with a detection rate of 24% and three novel variants. All patients with pheochromocytoma and paraganglioma need clinical genetic testing with expanded targeted gene panels for higher diagnosis rates

The effects of Covid-19 on physical medicine and rehabilitation in Turkey in the first month of pandemic

Objectives: The outbreak of novel coronavirus-2019 (COVID-19) has affected Turkey very seriously, as well as all around the world. Many urgent and radical measures were taken due to the high contagious risk and mortality rate of the outbreak. It is noteworthy that isolation recommendations and the provision of health services for pandemic have a negative impact on Physical Medicine and Rehabilitation (PMR) services. In this study, we aimed to evaluate the effects of COVID-19 on the PMR services and physiatrists immediately after the first month of pandemic in Turkey. Patients and methods: An online survey consisting of 45 items was sent to the members of the Turkish Society of Physical Medicine and Rehabilitation. The main goal of the survey was to evaluate the changes in the provided service of PMR and conditions of physiatrists one month after the first reported COVID-19 case in Turkey. Results: A total of 606 PMR specialists and residents responded to the survey. The mean number of the patients visited the outpatient clinics was 148.2 +/- 128.5 per week before the pandemic, it significantly decreased to 23.4 +/- 33.1 per week after the first month of the reported first COVID-19 case. Similarly, the mean number of the patients of inpatient service significantly decreased from 21.7 +/- 39.3 per week to 2.5 +/- 10.0 per week after the first month of the pandemic. Most of the residents (69%) reported that their training was seriously affected due to pandemic. From the economic aspect, 69.2% of the participants who were working at private hospitals reported a decrease in their monthly salary, and 21% of them were sent to an unpaid vacation. A total of 21.9% of private-practice institutions paused their services. During the first month, 46.9% of the participants were assigned to the different services such as COVID-19 inpatient service, emergency or COVID-19 outpatient clinics. According to the Republic of Turkey, Ministry of Health guideline and algorithm, 15.7% of the physicians were in the category of healthcare workers with suspected COVID-19. Conclusion: The COVID-19 pandemic affected seriously both the services and the PMR physicians as early as the first month. This effect is expected to become worse, when the duration of pandemic prolongs. Proper arrangements and measures should be planned to ameliorate the negative effects of the pandemic on the patients and PMR physicians

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Kadavra Donörden Organ Nakli Oranlarını Arttırmada Hemşirenin Sorumlukları: Sahada Neler Yapabiliriz?

Solid organ nakli, son dönem organ yetmezliklerinde hayat kurtarıcı bir tedavi yöntemidir. Her ne kadar teknoloji, cerrahi ve immünolojik alanlarda büyük gelişmeler yaşanmış olsa da kadavradan organ temini hala büyük bir sorun teşkil etmeye devam etmektedir. Türkiye, canlı donörden yapılan nakillerde dünyada ilk sıralarda olmasına rağmen kadavra donörden organ naklinde aynı başarıyı elde edememiştir. Önümüzdeki yıllarda amaç, kadavradan yapılan organ nakil sayılarının arttırılması olmalıdır. Kadavra donörden organ nakillerinin arttırılmasında toplumun bilgi ve tutumunun rolü kadar sağlık profesyonellerinin de rolü önem taşımaktadır. Ulusal ve uluslararası literatürde sağlık profesyonellerinin organ bağışına yönelik bilgi, tutum ve farkındalıkları incelendiğinde, organ bağışını arttırmada bilgi sahibi olmanın ve eğitim programlarının önemi ortaya çıkmaktadır. Organ bağış sürecinde aktif görev alan hemşireler, toplum farkındalığını arttıracak uygulamaların yanı sıra hastane ortamında da kadavra donör oranlarının artmasına katkıda bulunabilirler. Bu makalede, organ nakli sürecinin her adımında yer alan hemşirelerin olası donör saptanmasında, bakımında, koordinasyonunda ve donör ailesine yaklaşımda organ nakli sürecine sağlayabilecekleri olumlu katkılar ele alınacaktır

25-Hydroxyvitamin D3 deficiency: Prevalance and its impact on disease activity in small-medium vessel vasculitis

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