Çene kemiklerinin yeni tehlikesi: bisfosfonatlar

Bisphosphonate compounds have been used for the improvement of the lives of cancer patients by reducing complications such as hypercalcemia. They are preferred to treat bone metastases of solid tumors such as breast, prostate and lung cancer, and also utilized in the management of lytic lesions of multiple myeloma. Intravenous administration of high doses of bisphosphonates for the management of benign conditions occasionally lead to the development of osteonecrosis of the jaws. In many cases lesions appear spontaneously, or following an infection or a dental extraction. At present, there is no definite treatment for this particular druginduced necrosis of bone except conservative debridement of bone lesions, oral antibiotics and local irrigations. It is important to recognize the clinical and radiographic features of the bisphosohonate osteonecrosis of the jaws in order to provide early diagnosis and to improve the care of these patients.   ÖZET Bisfosfonat bileşikleri malignansiye bağlı olarak gelişen hiperkalseminin düzenlenmesinde ve ayrıca, meme, prostat ve akciğer kanserlerine bağlı tümörlerin ve multipl myelomaya bağlı metastatik lezyonların tedavisinde kanser hastalarının hayat kalitelerini iyileştirmek amacıyla kullanılmaktadır. Bisfosfonatların yüksek dozlarda intravenöz olarak uygulanmaları nedeniyle ilaca bağlı bir yan etki olarak çenelerde osteonekroz gelişebilmektedir. Lezyonlar kendiliğinden oluşabildiği gibi, bir enfeksiyon ve diş çekimi genellikle olayı hızlandırmaktadır. İlaca bağlı olarak gelişen bu özgün kemik nekrozu için henüz kesin bir tedavi bulunmamaktadır. Konservatif yaklaşım uygulanan vakalarda, kemiğin açığa çıkmış olduğu hastaların büyük bölümünde oral antibiyotikler, antienflamatuvarlar ve açık yara bölgesinin lokal irrigasyonu önerilmektedir. Bisfosfonat osteonekrozuna ait klinik ve radyografik özelliklerin iyi bilinmesi ve bu tür hastalarda klinik ve radyolojik belirtilerin değerlendirilmesi, erken tanı ve tedavi açısından da önem taşımaktadır. Anahtar Kelimeler: Bisfosfonatlar, osteonekroz, metastaz, hiperkalsemi, çen

Birth expectations, birth experiences and childbirth‐related post‐traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis

Objectives: During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth‐related post‐traumatic stress symptoms (CB‐PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB‐PTSS. Design: Dyadic longitudinal data from the Self‐Hypnosis IntraPartum Trial. Methods: Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post‐partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post‐partum) and CB‐PTSS (6 weeks post‐partum). Results: Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB‐PTSS. Birth experiences related to CB‐PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB‐PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB‐PTSS. Conclusions: Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB‐PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB‐PTSS. The impact of birth experiences on CB‐PTSS highlights the importance of respectful and supportive maternity care

Prevalencija, enterotoksigena svojstva i antimikrobna osjetljivost bakterije Staphylococcus aureus izolirane iz različitih vrsta hrane životinjskog podrijetla

This study aimed to determine the prevalence, enterotoxigenic properties and antimicrobial resistance profile of Staphylococcus aureus isolated from 850 food samples, including bulk tank milk, Tulum cheese, chicken meat and beef carcasses, in Türkiye. S. aureus contamination rates and the mean contamination levels of 86 positive samples from bulk tank milk, Tulum cheese, chicken meat and beef carcasses were 10.8% (n:49) and 3.01±0.48 log cfu/ml, 17% (n:17) and 3.08±0.42 log cfu/g, 12% (n:12) and 2.89±0.27 log cfu/g, and 4% (n:8) and 1.28±0.54 log cfu/cm2 , respectively. 39 out of 86 isolates (45.3%) had one or more enterotoxin genes (sea-see, seg-selj, sep). sed was the most common classical enterotoxin gene, whereas sei was the most common new enterotoxin gene. Antimicrobial susceptibility testing against 16 antibiotics performed by VITEK 2 showed that 61 isolates (70.9%) were resistant to various antibiotics. 32.8% of the resistant isolates were multidrug resistant (MDR) and the mean multiple antimicrobial resistance (MAR) index was 0.301. The isolates were mostly resistant to penicillin (63.9%), followed by oxacillin (24.4%), clindamycin (19.7%) and erythromycin (12.7%). mecA was detected in 13 isolates (15.1%), but no mecC was found. It was concluded that most of the S. aureus isolates had enterotoxin genes which might cause foodborne intoxications. The high antibiotic resistance rates observed in these strains, including MRSA, may also result in some public health hazards.Cilj je istraživanja bio odrediti prevalenciju, enterotoksigena svojstva i rezistenciju na antimikrobne lijekove bakterije Staphilococcus aureus izolirane iz 850 uzoraka hrane u Turskoj. Navedeno je uključivalo spremnike za mlijeko, sir Tulum, pileće meso i goveđe trupove. Stopa kontaminacije bakterijom S. aureus i srednja stopa kontaminacije u 86 pozitivnih uzoraka iznosile su: 10,8% (n:49) i 3,01±0,48 log cfu/mL za spremnike mlijeka, 17% (n:17) i 3,08±0,42 log cfu/g za sir Tulum, 12% (n:12) i 2,89±0,27 log cfu/g za pileće meso te 4% (n:8) i 1.28±0.54 log cfu/cm2 za goveđe trupove. Trideset i devet od 86 izolata (45,3%) imalo je jedan ili više gena za enterotoksin (sea-see, seg-selj, sep). Najčešći je gen za klasične, poznate enterotoksine bio sed, dok je sei bio najčešći gen za nove enterotoksine. Uporabom VITEK 2 uređaja za 16 antibiotika analizirana je osjetljivost na antimikrobne lijekove a rezultati su pokazali da je 61 izolat (70,9%) bio otporan na antibiotike. Ukupno je 32,8% pozitivnih izolata bilo otporno na više lijekova (engl. multidrug resistant, MDR), a indeks prosječne višestruke otpornosti na antimikrobne lijekove (MAR) bio je 0,301. Izolati su najčešće bili otporni na penicilin (63,9%), zatim na oksacilin (24,4%), klindamicin (19,7%) i eritromicin (12,7%). Gen mecA pronađen je u 13 izolata (15,1%), dok gen mecC nije pronađen. Zaključeno je da je većina izolata bakterije S. aureus imala gene za enterotoksine koji mogu uzrokovati trovanja hranom. Uz navedeno, visoka stopa otpornosti na antibiotike kod izoliranih sojeva, uključujući MRSA-u, upućuje i na javnozdravstveni rizik

Istanbul Metrobüs: first intercontinental bus rapid transit

Whilst debate comparing the technologies of bus-based transit ways with rail systems continues, the comparative cost advantages and capability of responding to rapidly changing mobility needs offered by Bus Rapid Transit (BRT) systems are well acknowledged. Istanbul has recently developed its 42 km BRT network with further extensions currently being constructed. The Istanbul BRT system (Metrobüs) consists of three main sections. The first section (2007) was initially built on the European side of the city through a high demand arterial and its extension as the section was completed in 2008. It received criticism for having been preferred over rail alternatives. The third section (2009) runs over one of the two Istanbul Strait (Bosporus Strait) Bridges connecting Asia and Europe, by which Metrobüs has uniquely acquired the distinction of crossing a major water barrier and connecting two continents. Istanbul Strait is a major transportation bottleneck and source of congestion and Metrobüs is the only transit system for crossings. Shortly after the opening of the bridge section, the whole system has recorded a directional capacity of 24,000 passengers/h and patronage of 620,000 daily ridership. The number of passengers attracted from car users and intermediate forms of public transportation is also notable. This paper first contributes to the BRT literature by introducing this special and recent BRT system with all its planning and operational aspects. Furthermore, for policy guidance, Metrobüs is evaluated as to whether it has made effective inputs for sustainable development and mobility aims in Istanbul

A further step forward in our knowledge of the pathogenetic role of gastroesophageal reflux in pulmonary fibrosis

WOS: 000565205600012PubMed: 32723559[No abstract available

Çene kemiklerinin yeni tehlikesi: bisfosfonatlar

<p>Bisphosphonate compounds have been used for the improvement of the lives of cancer patients by reducing complications such as hypercalcemia. They are preferred to treat bone metastases of solid tumors such as breast, prostate and lung cancer, and also utilized in the management of lytic lesions of multiple myeloma. Intravenous administration of high doses of bisphosphonates for the management of benign conditions occasionally lead to the development of osteonecrosis of the jaws. In many cases lesions appear spontaneously, or following an infection or a dental extraction. At present, there is no definite treatment for this particular druginduced necrosis of bone except conservative debridement of bone lesions, oral antibiotics and local irrigations. It is important to recognize the clinical and radiographic features of the bisphosohonate osteonecrosis of the jaws in order to provide early diagnosis and to improve the care of these patients.</p> <p> </p> <p><strong>ÖZET</strong></p> <p>Bisfosfonat bileşikleri malignansiye bağlı olarak gelişen hiperkalseminin düzenlenmesinde ve ayrıca, meme, prostat ve akciğer kanserlerine bağlı tümörlerin ve multipl myelomaya bağlı metastatik lezyonların tedavisinde kanser hastalarının hayat kalitelerini iyileştirmek amacıyla kullanılmaktadır. Bisfosfonatların yüksek dozlarda intravenöz olarak uygulanmaları nedeniyle ilaca bağlı bir yan etki olarak çenelerde osteonekroz gelişebilmektedir. Lezyonlar kendiliğinden oluşabildiği gibi, bir enfeksiyon ve diş çekimi genellikle olayı hızlandırmaktadır. İlaca bağlı olarak gelişen bu özgün kemik nekrozu için henüz kesin bir tedavi bulunmamaktadır. Konservatif yaklaşım uygulanan vakalarda, kemiğin açığa çıkmış olduğu hastaların büyük bölümünde oral antibiyotikler, antienflamatuvarlar ve açık yara bölgesinin lokal irrigasyonu önerilmektedir. Bisfosfonat osteonekrozuna ait klinik ve radyografik özelliklerin iyi bilinmesi ve bu tür hastalarda klinik ve radyolojik belirtilerin değerlendirilmesi, erken tanı ve tedavi açısından da önem taşımaktadır.</p> <p><strong>Anahtar Kelimeler:</strong> Bisfosfonatlar, osteonekroz, metastaz, hiperkalsemi, çene</p&gt

Epigenetic Alterations from Barrett’s Esophagus to Esophageal Adenocarcinoma

Barrett’s esophagus (BE) is a disease entity that is a sequela of chronic gastroesophageal reflux disease that may result in esophageal adenocarcinoma (EAC) due to columnar epithelial dysplasia. The histological degree of dysplasia is the sole biomarker frequently utilized by clinicians. However, the cost of endoscopy and the fact that the degree of dysplasia does not progress in many patients with BE diminish the effectiveness of histological grading as a perfect biomarker. Multiple or more quantitative biomarkers are required by clinicians since early diagnosis is crucial in esophageal adenocancers, which have a high mortality rate. The presence of epigenetic factors in the early stages of this neoplastic transformation holds promise as a predictive biomarker. In this review, current studies on DNA methylations, histone modifications, and noncoding RNAs (miRNAs) that have been discovered during the progression from BE dysplasia to EAC were collated