Evaluation of preoperative model surgery and the use of a maxillary sinus surgical template in sinus floor augmentation surgery

Maxillary sinus augmentation is an accepted technique for dental implant placement in presence of insufficient maxillary bone. There are various techniques in the literature, either by crestal or lateral approach in maxillary sinus augmentation that have high percentage of success, while all have complications. Schneiderian membrane perforation is the most common complication encountered during surgery. The aim of this study was to evaluate the benefits of preoperative model surgery and the ease of use of a maxillary sinus surgical template (MSST) during maxillary sinus augmentation surgery with a lateral approach. Ten patients included in the study needed rehabilitation of a partially or totally edentulous maxilla with an implant-supported fixed prosthesis and requiring sinus augmentation. A questionnaire was asked to performing surgeons, and study results showed the use of an MSSTwas found to be effective in terms of adaptation (62.5%), window preparation (87.5%), ease of elevation (95.9%), ease of grafting (95.9%), reduction of perforation risk (91.7%), and achieving immobility during the procedure (62.5%); however, the use of an MSST was also found to prolong the surgical procedure (100%) and restrict the view of the surgical area (79.2%). Maxillary sinus augmentation appears to be a useful tool for locating an appropriate entrance to the sinus cavity, allowing for safe elevation of the sinus membrane and effectively grafting the sinus floor

Tip A Aort Diseksiyonlarında Operasyon Sonrası Erken Dönem Mortalite ve Morbidite Üzerine Etki Eden Faktörlerin Retrospektif İncelenmesi

Amaç: Aortik diseksiyon günümüzde hala önemli bir mortalite ve morbidite nedenidir. Tip A aort diseksiyonu nedeniyle ameliyat edilen hastalarda birçok faktör cerrahi sonuçları etkilemektedir. Bu faktörlerin yeterince belirlenmesi tedavinin başarılı olmasına etki edecektir. Yöntemler: Kliniğimizde Ocak 2006 - Aralık 2016 yılları arasında Tip A aort diseksiyonu tanısı ile opere edilen 140 hastanın preoperatif, intraoperatif, ve postoperatif verileri, hasta dosyaları ve hastane bilgi yönetim sistem kayıtlarından retrospektif olarak araştırıldı. Gruplar arası niceliksel parametreler Student t veya Mann-Whitney U testleri ile, niteliksel veriler ise Ki-Kare testi ile karşılaştırıldı. Bulgular: Hastalarda ortalama yaş 57.1±12.3 (min: 27 ile max: 84), 31’i (%22,2) kadın, 109’u (%77,8) erkekti. Hastaların çoğunluğuna izole asendan aorta replasmanı veya asendan aorta ile birlikte hemiarkus replasmanı uygulandı (%70). Beyin koruma yöntemi olarak çoğunlukla antegrad serebral perfüzyon (ASP) nadiren retrograd serebral perfüzyon (RSP) kullanıldı. Tüm hastalarda total mortalite 37 kişi (%26,4) idi. Başvuru anında sistolik tansiyonun 90 mmHg altında olması, majör nörolojik defisit varlığı, hastada geçirilmiş kardiyak cerrahi öyküsü olmasının mortaliteyi anlamlı oranda etkilediği saptanmıştır (p<0.05). Mortalite olan hastalarda perfüzyon süreleri uzun, inotrop ihtiyacı fazla, yoğun bakım yatış süreleri istatiksel olarak anlamlı derecede yüksekti (p<0.05). RSP yapılan grupta yoğun bakımda kalış süreleri ve mortalite, ASP uygulanan hastalara göre anlamlı oranda yüksekti (sırası ile p=0.02, p=0.04). Sonuç: Tip A aortik diseksiyonlarda mortalite üzerine etki eden faktörlerin daha büyük hasta serilerinde ortaya konulması ve bu faktörlere yönelik tedbirlerin alınması mortalite ve morbiditenin azaltılmasında etkili olabilir

Protective Role of Genistein in Acute Liver Damage Induced by Carbon Tetrachloride

Aim. In the present study, we investigated the protective effect of genistein in experimental acute liver damage induced by CCl4. Method. Forty rats were equally allocated to 5 groups. The first group was designated as the control group (group 1). The second group was injected with intraperitoneal CCl4 for 3 days (group 2). The third group was injected with subcutaneous 1 mg/kg genistein for 4 days starting one day before CCl4 injection. The fourth group was injected with intraperitoneal CCl4 for 7 days. The fifth group was injected with subcutaneous 1 mg/kg genistein for 8 days starting one day before CCl4 injection. Plasma and liver tissue malondialdehyde (MDA) and liver glutathione levels, as well as AST and ALT levels were studied. A histopathological examination was conducted. Results. Liver tissue MDA levels were found significantly lower in group 3, in comparison to group 2 (P < .05). Liver tissue MDA level in group 5 was significantly lower than that in group 4 (P < .001). Liver tissue glutathione levels were higher in group 5 and 3, relative to groups 4 and 2, respectively (P > .05 for each). Inflammation and focal necrosis decreased in group 3, in comparison to group 2 (P < .001 for each). Inflammation and focal necrosis in group 5 was lower than that in group 4 (P < .001). Actin expression decreased significantly in group 5, relative to group 4 (P < .05). Conclusion. Genistein has anti-inflammatory and antinecrotic effects on experimental liver damage caused by CCl4. Genistein reduces liver damage by preventing lipid peroxidation and strengthening antioxidant systems

Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn’s disease, and chronic hepatitis C. Each condition went into remission by treatment of leukocytoclastic vasculitis, regardless of the underlying disease

EVALUATION OF CLINICAL PROGRESS AND THERAPY RESPONSE OF PATIENTS WITH IMMUNE THROMBOCYTOPENİC PURPURA; SINGLE CENTER EXPERIENCE

Amaç: İmmun Trombositopeni (İTP), trombositlere karşı oluşan otoantikorların trombositlerin yaşam sürelerini kısaltması sonucu gelişen ve trombositopeni ile seyreden edinsel bir hastalıktır. Trombositopeninin derecesine bağlı olmak üzere, sıklıkla, purpurik deri lezyonları, mukozal kanamalar, nadiren iç organ kanamaları gibi hayatı tehdit eden kanamalar gelişir. Yöntemler: Bu çalışmada 1988 - 2011 yılları arasında tedavi ve takiplerine merkezimizce devam edilen 76 hastanın sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: 76 hastanın 49'u kadın (%64,5), 27'si erkek (%35,5) olup, ortanca yaş 50,7 (19 - 83 yıl) idi. Olguların 20'si tedavisiz takip edilmiş, tedavi uygulanan 56 olgunun 53'ünde (%92) ise başlangıç tedavisi olarak 1 mg/kg metil prednizolon uygulanmıştı. Bu hastaların 24'ünde (%44,6) tam yanıt, 13'ünde (%23,2) yanıt elde edilmiş ve 17 (%31,5) olguda ise yanıt alınamamıştı. Steroide yanıt vermeyen ya da yanıt sonrası nüks eden hastalara splenektomi uygulanmıştı (37 hasta). Bu hastalardan 33'ünde tam yanıt, 2'sinde yanıt elde edilirken, 2 hastada yanıt alınamadı. Toplamda 8 hastaya Rituksimab verildi. 3 hastada tam yanıt, 2 hastada yanıt alındı. 3 hastada ise yanıt elde edilemedi. Sonuç: ITP hastalarında başlangıç prednizolon tedavisi ve splenektomi, olguların çoğunda etkili bir tedavi seçeneği olmakla birlikte, bu tedavilere cevap vermeyen refrakter ITP olgularında ise ritüksimab kullanımı etkili bir tedavi seçeneğidir. Objective: Immune thrombocytopenia (ITP) is an autoimmune thrombocytopenic disease characterized by destruction of platelets mainly at spleen in reticuloendothelial system. The initiation of ITP is mostly insidious, usually defined with mild to moderate history of hemorrhage. Rarely, life threatining bleeding episodes are documented. Methods: 76 ITP patients diagnosed at Dokuz Eylul University Faculty of Medicine Hospital from 1988 to 2011 are included in this retrospective study. Results: 49 of 76 (64.4%) patients were female and 27 patients diagnosed as ITP were male (35,5%) (F/M: 1.81). At diagnosis the median age of patients was 50.7 (Interval; 19 - 83). 20 patients were followed without any treatment. 53 of 56 patients (92%) in treated group received 1 mg/kg methyl prednisolone. 24 patients (44.6%) achieved complete response after initial steroid therapy, 13 patients (23.2%) were followed with partial response and 17 patients (31.5%) had no response. Splenectomy was applied to patients that were not responded or relapsed after steroid treatment. After splenectomy 33 patients achieved complete response, 2 patients achieved partial response and 2 patients were followed as nonresponders to splenectomy. Totally 8 patients received rituximab. 3 of 8 patients (37.5%) were complete responders, 2 of 8 patients (25%) were partial responders on the other hand 3 of 8 patients (37.5%) were nonresponders. Conclusion: Most of the patients are successfully treated with steroids or splenectomy. Hence, in relapsed and refractory ITP after splenectomy rituximab is an effective treatment option

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

Recent Advances in Health Biotechnology During Pandemic

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in 2019, cut the epoch that will make profound fluctuates in the history of the world in social, economic, and scientific fields. Urgent needs in public health have brought with them innovative approaches, including diagnosis, prevention, and treatment. To exceed the coronavirus disease 2019 (COVID-19) pandemic, various scientific authorities in the world have procreated advances in real time polymerase chain reaction (RT-PCR) based diagnostic tests, rapid diagnostic kits, the development of vaccines for immunization, and the purposing pharmaceuticals for treatment. Diagnosis, treatment, and immunization approaches put for- ward by scientific communities are cross-fed from the accrued knowledge of multidisciplinary sciences in health biotechnology. So much so that the pandemic, urgently prioritized in the world, is not only viral infections but also has been the pulsion in the development of novel approaches in many fields such as diagnosis, treatment, translational medicine, virology, mi- crobiology, immunology, functional nano- and bio-materials, bioinformatics, molecular biol- ogy, genetics, tissue engineering, biomedical devices, and artificial intelligence technologies. In this review, the effects of the COVID-19 pandemic on the development of various scientific areas of health biotechnology are discussed