Četverogodišnja studija učinkovitosti i sigurnosti entekavira u bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4}41.5 IU /L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU /mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Entekavir je analog gvanozina koji djeluje protiv virusa hepatitisa B. Cilj ove četverogodišnje studije bio je procijeniti liječenje entekavirom kod bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije. Ukupno je 49 bolesnika primalo entekavir, a devetoro ih se povuklo s terapije na kraju 96. tjedna. Početna srednja vrijednost alanin aminotransferaze bila 79,4}41,5 IU /L, dok je nakon 4 godine vrijednost alanin aminotransferaze bila u normalnim granicama kod 90% bolesnika. U 96. tjednu je <300 kopija HBV DNA zabilježeno u 91,7% bolesnika, a u 48. mjesecu je 48,90% bolesnika imalo <50 IJ/mL HBV DNA. Gubitak HBeAg zabilježen je u 7,1% bolesnika u 96. tjednu te u 12,5% bolesnika u 48. mjesecu. Stopa serokonverzije HBeAg iznosila je 4,8% u 96. tjednu i 7,5% u 48. mjesecu. Stopa serokonverzije HBsAg bila je 2,1% u 96. tjednu i 2,5% u 48. mjesecu. Sigurnost terapije bila je dobra. Bolesnici su dobro podnosili entekavir, snažan i siguran lijek koji dovodi do ustaljenog suzbijanja virusa

Güçlendirilmiş dental seramiklerin vickers sertlikleri ve yük altında kırılma davranışları

Objective: The objectives of this study were to determine the Vicker`s hardness of reinforced dental ceramics and determine the modes of fractures under load. Methods: Four ceramic core groups (n=7/group) from leucite (Evopress,Wegold&amp;De), low leucite (Finesse, Ceramco), glass-infiltrated (Inceram Alumina,Vita) and lithium disilicate materials (E.max press, Ivoclar) were fabricated according to each manufacturers’ instructions (thickness: 3 mm, diameter: 5 mm). Their individual veneering ceramics were vibrated, condensed in a stainless steel mold (diameter: 5 mm, height: 5 mm) and fired on the core materials. The specimens were stored in distilled water at 37°C for 24 hours prior to indentation tests and embedded in polyesther moulds. Vickers hardness values (DUH±SD) were measured (cross-head speed:7,2 gf/s, load:200 gf) and statistically analysed (ANOVA). A load of 400 N was applied on the surfaces of specimens with a diamond indentor (diameter:1 mm) at the macro hardness test machine for crack formation. The crack modes for each group were observed under the scanning electrone microscope. Results: The Vickers hardness values for low leucite veneering ceramic were significantly (P&lt;0.05) higher (236±17), followed by the leucite (129±51), glass-infiltrated (117±38), and lithium disilicate (85±34) veneering ceramic materials in decreasing order. Mainly radial or cone cracks were observed after the application of load. Conclusion: The increase in the hardness of the material led to more crack formation and resulted in longer cracks. No crack formation extending to the core materials were observed in neither of the ceramic groups under these experimental conditions. ÖZET Amaç: Bu çalışmanın amacı güçlendirilmiş dental seramiklerin Vickers sertlik değerlerinin ve yük altındaki kırılma şekillerinin belirlenmesidir. Gereç ve Yöntem: Lösit (Evopress,Wegold&amp;De), düşük lösit (Finesse, Ceramco), cam infiltrasyonlu aluminöz seramik (Inceram Alumina,Vita) ve lityum disilikat (E.max press, Ivoclar) bazlı dört farklı seramik alt yap_ materyali (n=7/grup) her bir üretici firmanın önerileri doğrultusunda hazırlandı (3 mm kalınlıkta; 5 mm çapta). Her bir alt yapı seramiğine özgü kaplama seramikleri; paslanmaz çelik bir metal kalıpta (5mm çap 5mm yükseklikte) vibrasyonla kondanse edildi ve alt yapı seramiklerinin üzerine pişirildi. Örnekler batırma testlerinden önce 37°C’ de 24 saat distile suda bekletildikten sonra polyester kalıplara gömüldü. Vickers sertlik değerleri (DUH±SD) ölçüldü (çene hızı:7,2 gf/s, yük:200 gf) ve veriler istatistiksel olarak analiz edildi (ANOVA). Çatlak oluşumu için örneklerin üst yüzeylerine makro sertlik test cihazında batıcı elmas uç ile (1 mm çaplı) 400 N yük uygulandı. Alınan taramalı elektron mikroskop görüntüleri ile her bir gruba ilişkin çatlak şekilleri gözlemlendi. Bulgular: Gruplar arasında ortalama Vickers sertlik değerleri düşük lösit grubu için anlamlı olarak (P&lt;0.05) en yüksek bulunur iken (236±17), bunu lösit (129±51), cam infiltrasyonlu aluminöz seramik (117±38), ve lityum disilikat (85±34) kaplama seramik materyalleri azalan sırayla izledi. Yük uygulaması sonrasında genellikle ışınsal ya da koni şekilli çatlakların oluştuğu gözlendi. Sonuç: Seramik materyalin sertliğinin artması daha fazla ve daha uzun çatlak oluşumuna yol açtı. Bu çalışmadaki deneysel koşullar altında kaplama seramik gruplarının hiçbirinde alt yapı seramiklerine ulaşan çatlak oluşumu gözlenmedi

Local Effects of Papaverine on Normal, Atherosclerotic, and Vasospastic Carotid Arteries of Rabbits: An Experimental Study

Objective: Papaverine is a direct-acting vasodilating agent that is frequently used in the treatment of vasospasm after subarachnoid hemorrhage. However, not much knowledge is available about the effect of papaverine on atherosclerotic vessels.Material and Methods: Twenty-four New Zealand-type male rabbits were divided into 4 groups: normal, atherosclerotic, normal vasospastic, and atherosclerotic vasospastic vessels. The atherosclerotic groups (2 and 4) were fed with high cholesterol diet and the other groups with a normal diet for 4 weeks. Cholesterol levels were measured before and after exposure to these diets. In groups 3 and 4, a vasospasm model for common carotid arteries was established. In all subjects, papaverine was applied topically on the left common carotid artery (study subgroups a) and serum physiologic on the right (control subgroups b). Before and 10, 20, 30, 40, 50, and 60 minutes after topical application, vessel diameter was measured and compared between the groups. Histological evaluation of the artery was also performed in all subjects.Results: In the atherosclerosis groups (Groups 2 and 4), blood cholesterol levels were significantly higher after 4 weeks of high cholesterol diet. Atherosclerosis and vasospasm development were confirmed with histological examination in the respective groups. Papaverine application lead to significant dilation in all groups according to the SF application. Its most prominent vasodilating effect was seen in normal vessels, while its effect gradually decreased from groups 2 to 4.Conclusions: The vasodilating effect of papaverine decreased in the presence of atherosclerosis. New experimental and clinical studies are required to determine the effective local papaverine doses in atherosclerotic cases

Güçlendirilmiş dental seramiklerin vickers sertlikleri ve yük altında kırılma davranışları

&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objectives of this study were to determine the Vicker`s hardness of reinforced dental ceramics and determine the modes of fractures under load.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Four ceramic core groups (n=7/group) from leucite (Evopress,Wegold&amp;amp;De), low leucite (Finesse, Ceramco), glass-infiltrated (Inceram Alumina,Vita) and lithium disilicate materials (E.max press, Ivoclar) were fabricated according to each manufacturers’ instructions (thickness: 3 mm, diameter: 5 mm). Their individual veneering ceramics were vibrated, condensed in a stainless steel mold (diameter: 5 mm, height: 5 mm) and fired on the core materials. The specimens were stored in distilled water at 37°C for 24 hours prior to indentation tests and embedded in polyesther moulds. Vickers hardness values (DUH±SD) were measured (cross-head speed:7,2 gf/s, load:200 gf) and statistically analysed (ANOVA). A load of 400 N was applied on the surfaces of specimens with a diamond indentor (diameter:1 mm) at the macro hardness test machine for crack formation. The crack modes for each group were observed under the scanning electrone microscope.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The Vickers hardness values for low leucite veneering ceramic were significantly (P&amp;lt;0.05) higher (236±17), followed by the leucite (129±51), glass-infiltrated (117±38), and lithium disilicate (85±34) veneering ceramic materials in decreasing order. Mainly radial or cone cracks were observed after the application of load.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The increase in the hardness of the material led to more crack formation and resulted in longer cracks. No crack formation extending to the core materials were observed in&lt;/p&gt; &lt;p&gt;neither of the ceramic groups under these experimental conditions.&lt;/p&gt; &lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt; &lt;p&gt;&lt;strong&gt;ÖZET&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Amaç: &lt;/strong&gt;Bu çalışmanın amacı güçlendirilmiş dental seramiklerin Vickers sertlik değerlerinin ve yük altındaki kırılma şekillerinin belirlenmesidir.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Gereç ve Yöntem: &lt;/strong&gt;Lösit (Evopress,Wegold&amp;amp;De), düşük lösit (Finesse, Ceramco), cam infiltrasyonlu aluminöz seramik (Inceram Alumina,Vita) ve lityum disilikat (E.max press, Ivoclar) bazlı dört farklı seramik alt yap_ materyali (n=7/grup) her bir üretici firmanın önerileri doğrultusunda hazırlandı (3 mm kalınlıkta; 5 mm çapta). Her bir alt yapı seramiğine özgü kaplama seramikleri; paslanmaz çelik bir metal kalıpta (5mm çap 5mm yükseklikte) vibrasyonla kondanse edildi ve alt yapı seramiklerinin üzerine pişirildi. Örnekler batırma testlerinden önce 37°C’ de 24 saat distile suda bekletildikten sonra polyester kalıplara gömüldü. Vickers sertlik değerleri (DUH±SD) ölçüldü (çene hızı:7,2 gf/s, yük:200 gf) ve veriler istatistiksel olarak analiz edildi (ANOVA). Çatlak oluşumu için örneklerin üst yüzeylerine makro sertlik test cihazında batıcı elmas uç ile (1 mm çaplı) 400 N yük uygulandı. Alınan taramalı elektron mikroskop görüntüleri ile her bir gruba ilişkin çatlak şekilleri gözlemlendi.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Bulgular: &lt;/strong&gt;Gruplar arasında ortalama Vickers sertlik değerleri düşük lösit grubu için anlamlı olarak (P&amp;lt;0.05) en yüksek bulunur iken (236±17), bunu lösit (129±51), cam infiltrasyonlu aluminöz seramik (117±38), ve lityum disilikat (85±34) kaplama seramik materyalleri azalan sırayla izledi. Yük uygulaması sonrasında genellikle ışınsal ya da koni şekilli çatlakların oluştuğu gözlendi.&lt;/p&gt; &lt;strong&gt;Sonuç: &lt;/strong&gt;Seramik materyalin sertliğinin artması daha fazla ve daha uzun çatlak oluşumuna yol açtı. Bu çalışmadaki deneysel koşullar altında kaplama seramik gruplarının hiçbirinde alt yapı seramiklerine ulaşan çatlak oluşumu gözlenmedi

Is the platelet-to-lymphocyte ratio a new prognostic marker in multiple myeloma?

BACKGROUND: Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as a predictor of progression-free survival (PFS) and overall survival (OS) in various malignancies. MATERIALS AND METHODS: We retrospectively examined the PLR, NLR, and MLR in a cohort of 186 newly diagnosed multiple myeloma (MM) patients. This study investigated the prognostic relevance of NLR, PLR, and MLR in MM patients. NLR, PLR, and MLR were calculated from whole blood counts before therapy. The Kaplan–Meier curves and multivariate Cox models were used for the evaluation of survival. RESULTS: Applying cutoff of 1.9 (NLR), 120.00 (PLR), and 0.27 (MLR), decreased PLR showed a negative impact on the outcome. Decreased PLR is an independent predictor for PFS and OS. There were no significant differences in median survival between the high and low NLR (P = 0.80) and MLR (P = 0.87) groups. CONCLUSIONS: In this study, thrombocytopenia and low PLR are associated with poor survival in MM patients does this P value apply to thrombocytopenia or low PLR and may serve as the cost-effective prognostic biomarker

Ergotamine-induced vasospastic ischemia mimicking arterial embolism: unusual case

WOS: 000344217100012PubMed ID: 25135025Ergotamine toxicity is an important and rare condition, including tachycardia, arterial spasm which occurring as a result of accidental overdosing or drug interactions. We assessed the consequences of delayed diagnosis of peripheral arterial vasoconstriction occurring after simultaneous macrolide use by a 35-year-old woman using an ergot-derived drug for migraine. Diagnosis of ergotamine intoxication begins with suspicion. Interventional radiologists and surgeons should be aware of this acute dangerous condition