Kayseri ili pediatrik hasta popülasyonunda üçüncü molar diş eksikliğinin prevalansının incelenmesi

Amaç: Diş agenezisi, bir veya daha fazla sayıda sürekli diş germinin konjenital olarak eksikliği olarak tanımlanır ve dentisyon gelişiminde en sık görülen anomalilerden biridir. Etiyolojisi hala tartışmalı olan bu anomaliye, travma, enfeksiyon, Down sendromu, dudak-damak yarığı, radyoterapi, kemoterapi gibi durumların neden olabileceği belirtilmektedir. Bu çalışmanın amacı, Kayseri ilinde yaşayan bireylerde yirmi yaş dişi konjenital eksiliğinin görülme sıklığının ve cinsiyetler arasındaki yatkınlık oranının değerlendirilmesidir. Bu çalışmanın yirmi yaş dişlerinin evrimsel süreçte incelenmesi bakımından literatüre katkı sağlayacağı düşünülmüştür.Gereç ve Yöntemler: Çalışma Erciyes Üniversitesi Diş Hekimliği Fakültesi’ne çeşitli nedenlerle müracaat etmiş bireylerden seçilen 8-14 yaş arası 2500 hastaya ait panoramik görüntüler üzerinde retrospektif olarak tasarlandı. Konjenital kraniyofasiyal deformiteleri, sistemik hastalıkları olan; ortodontik tedavi görmekte veya çekim hikayesi olan bireyler çalışma dışı bırakıldı. Bireylere ait panoramik görüntüler, yirmi yaş dişi konjenital eksikliğinin tespit edilmesi amacıyla 6 gözlemci tarafından değerlendirildi. İstatistiksel analiz SPSS yazılımı kullanılarak yapıldı.Bulgular: Bu çalışmada 1145 erkek 1355 kadın hastadan oluşan toplam 2500 hastanın panoramik görüntüleri incelendi. Sağ maksiller 3. Molar diş eksikliğine sahip birey sayısı 830 (% 33.2), sol maksiller 3. molar diş eksikliğine sahip birey sayısı 644 (% 25.76), sağ mandibular 3. molar diş eksikliğine sahip birey sayısı 376 (% 15.04), sol mandibular 3. molar diş eksikliğine sahip birey sayısı 345 (% 13.84) olarak tespit edilmiştir.Sonuç: Çalışmamızda elde edilen sonuçlara göre Kayseri ilinde yaşayan bireylerde yirmi yaş dişi konjenital eksikliği; çok sık rastlanılan bir anomali olarak karşımıza çıkmaktadır. Kadınlarda bu anomali daha sık gözlenmektedir. Maksillada mandibuladan daha yüksek oranda yirmi yaş dişi eksikliği görülmüştür.ANAHTAR KELİMELER Agenezi, Dental Anomali, Konjenital Diş Eksikliği, Yirmi Yaş Diş

KALP

Venöz sistem hastalıkları, telenjiektazilerden ciddi venözyetmezlik sonucu gelişen cilt ülserlerine, derin ven trombozlarına (DVT) kadar değişik formlarda ortaya çıkabilir.Venöz sistem hastalıkları daha sıklıkta venöz tromboz/tromboemboli ve venöz yetmezlik olarak karşımıza çıkmaktadır. Kronik venöz yetmezlik (KVY), kanın uygunsuz dönüşüne yol açan alt ekstremitede damarlarındabasınç artışı ve kapakçıklarda meydana gelen patolojilersonucunda gelişir. Venöz yetmezlik, venöz ülserasyonlagüçlü bir şekilde ilişkilidir bu nedenle KVY, iyileşmesi zorve tekrarlayan venöz ülserlere neden olabilir. KVY’ye yolaçan çok sayıda risk faktörü vardır. 50 yaş üstü, hamilelik,genetik, sigara kullanımı, uzun süre ayakta kalma, obeziteve iyatrojenik durumlar bu risk faktörlerinden bazılarıdır (1). DVT genelde ekstremite derin venlerinde oluşantrombozlardan kaynaklanır. DVT, asemptomatik olabildiği gibi pulmoner emboliye kadar çeşitli derecelerde klinik durumlarla karşımıza çıkabilir. DVT’ de tekrarlayantromboz ve posttrombotik sendrom en önemli morbiditenedenleridir (2). Hem KVY hemde DVT birbirinin oluşumunu tetikler ve görülme sıklıklarını arttırır. Bu bölümdeKVY ve DVT’den bahsedilmiştir</p

A Novel “Mean Platelet Volume-Age- Total Protein-Hematocrit (MAPH)” Score for Blood Viscosity: Predictive Capabilities for Coronary Slow-Flow Phenomenon

Objectives: The coronary slow-flow (CSF) phenomenon is a unique clinical angiographic entity defined as delayed coronary opacification without significant occlusive coronary artery disease. Although the etiology has not been clearly revealed, multifactorial causes that affect blood viscosity and thrombus formation are considered in the pathogenesis. We aim to investigate the usability of the novel Mean Platelet Volume-Age-Total Protein-Hematocrit (MAPH) score in predicting the CSF phenomenon. Materials and Methods:A total of 266 patients, 98 diagnosed with CSF and 168 with normal flow, were included in this retrospective cohort study. Coronary angiography images of these patients and blood samples during their hospitalization were retrospectively evaluated by two experienced cardiologists. CSF diagnosis was made according to TIMI-flow and TIMI frame-rate criteria. Results: In the analysis of the study, there were significant differences regarding age, smoking, hematocrit percentage, mean platelet volume, total protein, and MAPH score parameters (all p-values <0.01). In addition, multivariate analysis revealed that smoking, hematocrit percentage, total protein, and MAPH score parameters were independent predictors of the CSF phenomenon (all p-values <0.05). After the receiver operating characteristic curve analysis to show the discrimination of the MAPH score in the formation of CSF, the area under the curve was found to be 0.719 (95% confidence interval 0.656- 0.781, p<0.001). With a cut-off 2.5, the MAPH score sensitivity is 43%, and the specificity is 86% for predicting CSF. Conclusion: According to the findings of our study, we believe that the novel MAPH score can be used to predict blood viscosity in CSF. There is also a need for multicenter studies involving more patients on the subject. In the current situation, our study will contribute to the literature and can guide future studies

Rotational atherectomy treatment before drug-eluting stent implantation in severe calcific coronary lesion

Rotational atherectomy can effectively destroy calcified plaques and facilitate stent insertion and expansion in many cases. In this article, we present a successful application of rotational atherectomy with rotablator and drug-eluting stent implantation treatment in a 43-year-old male patient with severe calcific stenosis in the right coronary artery that could not be dilated with a high-pressure balloon. During the follow-up, the patient did not have any complaints as long as he was hospitalized, and no recent adverse events, such as acute stent thrombosis and bleeding, were observed.</p

Evaluation of arrhythmia frequency with Holter electrocardiography in pregnants with palpitation complaints

Objectives: The aim of this study was to investigate the underlying etiology and the frequency of arrhythmia by Holter electrocardiography (ECG) in pregnant women with palpitations. Patients and methods: Between January 2019 and March 2021, a total of 64 pregnant women (mean age: 29.1±5.3 years; range, 20 to 46 years) who were admitted to the cardiology outpatient clinic with the complaint of palpitations and had a Holter ECG were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, Holter ECG records, imaging findings, and biochemical data were recorded. Results: The mean systolic blood pressure was 118.7±16.4 mmHg and the mean heart rate was 96.2±18.2 bpm. There was an arrhythmia on Holter ECG in 32 (50%) of the patients. The most common arrhythmias were ventricular extrasystoles in 21.9% and supraventricular tachycardia in 14.1% of the patients. The frequency of paroxysmal atrial fibrillation was 4.7%. Non-sustained ventricular tachycardia (VT) was detected in two (3.1%) patients. Conclusion: Identifying underlying arrhythmias in pregnant women with palpitation is of utmost importance for both the maternal and fetal health. The incidence of arrhythmias that should be treated in this patient group is too high to be ignored

Association between coronary artery lesion severity in coronary computed tomography angiography and hemoglobin A1c in nondiabetic patients with chronic coronary syndrome

Objectives:&nbsp;In this study, we aimed to investigate whether there is a relationship between coronary artery lesion severity detected on coronary computed tomography angiography (CTA) and the hemoglobin A1c (HbA1c) value in nondiabetic patients with chronic coronary syndrome (CCS).Patients and methods:&nbsp;The retrospective observational study included 125 patients (64 males, 61 females; median age: 55 years; IQR, 46.5-63.0) who underwent coronary CTA with the diagnosis of CCS and applied between March 2020 and July 2022. Two groups were formed according to the severity of coronary artery lesion by coronary CTA: Group 1 (n=71), with &lt;70% coronary lesion severity, and Group 2 (n=54), with &gt;70% coronary lesion severity.Results:&nbsp;The two groups were similar in terms of median age, (p=0.09) and male sex ratios (47% vs. 55%, p=0.47). The HbA1c value in Group 2 was statistically significantly higher than in Group 1 [5.89 (5.43-6.15) vs. 5.42 (5.1-5.8), p=0.001]. The HbA1c cut-off value was determined as 5.66. The ideal HbA1c cut-off value, calculated by the Youden index, had a sensitivity of 64% and a specificity of 63% in predicting the severity of coronary artery lesions in nondiabetic patients with CCS.Conclusion:&nbsp;In nondiabetic patients with CCS, HbA1c is associated with the presence of severe CAD lesions detected in coronary CTA.</p