Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Background: Metabolic syndrome (MetS) is found to be associated with deterioration of the left ventricular (LV) systolic and diastolic functions. One of the factors for this impairment is myocardial fibrosis. Fragmented QRS (fQRS) complexes are found to be associated with myocardial fibrosis. The aim of the study was to evaluate if the presence of fQRS on electrocardiogram (ECG) can detect pronounced impairment in the LV systolic and diastolic functions in MetS patients. Methods: The study included 111 (mean age 47 ± 9, 49.5% male) MetS patients and 96 (mean age 45 ± 9, 58.3% male) control subjects without MetS. ECG was evaluated for the presence of fQRS. Each patient underwent conventional echocardiography and tissue Doppler imaging. Results: Fragmented QRS was more common among MetS patients (26.1% vs. 14.6%, p = 0.041). MetS was associated with subclinical LV systolic and LV diastolic dysfunctions. In subgroup analyses of MetS patients, the presence of fQRS on ECG had a higher E/E’ ratio and lower E’ velocity, indicating pronounced diastolic dysfunction, as well as lower isovolumic acceleration (IVA), indicating profound subclinical LV systolic dysfunction. E/E’ ratio and IVA were independent predictors of fQRS presence in patients with MetS. Conclusions: Fragmented QRS is more common among MetS patients compared to non-MetS patients. The presence of fQRS is associated with pronounced subclinical LV systolic and diastolic dysfunctions in MetS patients

Evaluation of the effect of mitral stenosis severity on the left ventricular systolic function using isovolumic myocardial acceleration

Background: Isovolumic acceleration (IVA) is a new tissue Doppler parameter in the as­sessment of systolic function of both left and right ventricles. It remains unaffected with the changes in pre- and after-load within the physiological range. The aim of our study was to assess the effect of mitral stenosis degree, which is determined by echocardiography, on the left ventricular (LV) function using IVA. Methods: A total number of 62 patients with mitral stenosis (MS) and 32 healthy controls were examined. The severity of MS (mild, moderate, and severe) was determined on the basis of mitral valve area (MVA) and the mean diastolic mitral gradient findings. The peak myocardial velocities during isovolumic contraction, systole, early diastole and late diastole were measured by using tissue Doppler imaging (TDI). Results: All TDI-derived global LV basal wall systolic (peak myocardial isovolumic contra­ction velocity, peak myocardial systolic velocity and IVA), and diastolic velocities (peak early and late diastolic velocities) were significantly decreased in the patients with MS, compared to the healthy patients (p < 0.001, for all). However, IVA was not different when the degree of MS was evaluated (p = 0.114). In addition, IVA was not correlated with the MVA (r = 0.185, p = 0.150). Conclusions: Left ventricular function is impaired in patients with MS regardless of the severity of the disease.

Axial crushing behavior of circular aluminum tubes

The axial crushing behavior and energy absorption ability of metallic tubes are areas in which a large number of academic studies have been undertaken. In this study, the basic steps in the progressive folding behavior of circular-sectioned aluminum tubes under axial loading, changes in tube geometry after deformation and the ability to absorb energy were investigated both experimentally and by the finite element method. The deformation behavior of an aluminum tube wall, derived from finite element analysis was validated by experimental results with a degree of accuracy reaching 99 %. In addition, absorbed energy values approached the experimental results by approximately 93 %. As a result, the folding behavior of aluminum tubes under axial loading was successfully investigated using the finite element method. Thus, some difficulties and costs in experimental studies could be overcome

Cement Thickness of Inlay Restorations Made of Lithium Disilicate, Polymer-Infiltrated Ceramic and Nano-Ceramic CAD/CAM Materials Evaluated Using 3D X-Ray Micro-Computed Tomography

Colak, Hakan/0000-0001-8262-0913; Ozcan, Mutlu/0000-0002-9623-6098WOS: 000435265200010PubMed: 27517616PurposeTo evaluate the marginal and internal cement thicknesses of inlay restorations made of various CAD/CAM materials using 3D X-ray micro-computed tomography (micro-CT) technique. Materials and MethodsCaries-free extracted mandibular molars (N = 30) with similar size were randomly assigned to three groups (N = 10 per group). Mesio-occlusal-distal (MOD) cavities were prepared, and inlay restorations were obtained by milling out CAD/CAM materials namely, (a) IPS: monolithic lithium disilicate (control), (b) VE: polymer-infiltrated ceramic, and (c) CS: nano-ceramic using a CAM unit. Marginal and internal cement thicknesses were measured using 3D micro-CT. Data were analyzed using 1-way ANOVA and Tukey's tests (alpha = 0.05). ResultsThe mean marginal and internal cement thickness were not significant in all inlay materials (p > 0.05). Mean marginal cement thickness (m) was the lowest for the IPS group (67.54 10.16) followed by VE (84.09 3.94) and CS (95.18 +/- 10.58) (p > 0.05). The internal cement thickness (m) was the lowest in the CS group (54.85 +/- 6.94) followed by IPS (60.58 +/- 9.22) and VE (77.53 +/- 12.13) (p > 0.05). ConclusionMarginal and internal cement thicknesses of MOD inlays made of monolithic lithium disilicate, polymer-infiltrated ceramic, and nano-ceramic CAD/CAM materials were similar and all less than 100 m, which could be considered clinically acceptable. Clinical significanceMOD inlays made of different CAD/CAM materials presented similar cement thickness, less than 100 m.Kirikkale University, Research Center, TurkeyThis study was supported by Kirikkale University, Research Center, Turkey

A rare case of bilateral complex odontomas: Clinical, radiological and histopathological findings

Odontoma is the most common odontogenic tumor that is radiographically and histologically characterized by the production of mature enamel, dentin, cementum and pulp tissue. It grows slowly and has nonaggressive behavior. This case report presents clinical, radiological and pathological findings of bilateral complex odontoma that is rarely in literature in a 30-year-old female patient

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: A multicenter study

WOS: 000349695000012PubMed ID: 25532778Objective: The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. Methods: This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. Results: A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Conclusion: Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: A multicenter study

Objective: The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people