Early Orthodontic Treatments

Timing of orthodontic treatments is a highly controversial subject in orthodontics. While some orthodontists advice intervention in early phases of the occlusal development, some suggest waiting for late mixed or early permanent dentition period. However, orthodontic treatments that may be carried out in early stage must be well known by all orthodontists due to the fact that the success in the treatment of some anomalies is related closely with the time the treatment starts. The aim of this review is to examine the treatment timing for different malocclusions and treatment approaches in the early stage

Çocuklarda bir yıllık valproat tedavisi kemik mineral dansitesini azaltıyor mu?

Amaç: Epilepsi uzun sureli antiepileptik tedavi gerektiren kronik bir hastalıktır. Bu çalışmanın amacı, en sık kullanılan antiepileptik ilaç olan valproatın kemik mineral metabolizmasına olan yan etkilerini değerlendirmektir. Hastalar ve Yöntemler: Bu çalışma epilepsi veya febril konvulziyon profilaksisi amacıyla valproat başlanan 61 hastada (38 kız, 28 erkek; ort. yaş 81.2±44.5 ay; dağılım 12-168 ay) yapıldı. Bütün olgularda valproat tedavisi öncesinde ve 12 ay sonrasında, kemik mineral metabolizmasındaki bozukluklar açısından kemik mineral dansitesi ve biyokimyasal parametrelere bakıldı. Bulgular: Bir yıllık valporat tedavisi sonrasında kemik mineralizasyon bozukluğunu gösterebilecek kalsiyum, fosfor, alkalen fosfatazda istatistiksel olarak anlamlı farklılık tespit edilmemiştir. İki hastada (%3.3) osteoporoz tespit edilmiştir. Sonuç: Valproatın kemik mineral metabolizması üzerine yan etkileri tartışmalıdır. Osteopeni belirtilerini değerlendirmek için, kemik biyokimyası, 25-hidroksi D vitamini, hormonal parametreler ve kemik mineral dansitesinin tek başlarına değerlendirilmesi yetersizdir, mutlaka bu parametreler birlikte değerlendirilmelidir. Biyokimyasal parametreler bozulmadan, kemik mineral dansitesi değişiklikleri olacağından, valproat tedavisi alan hastalarda yıllık kemik mineral dansitesi ölçümleri yapılmalıdır.Objectives: Epilepsy is a chronic disease that requires long-term antiepileptic therapy. The aim of this study was to evaluate the side effects of valproate, the most commonly used antiepileptic, on bone mineral metabolism. Patients and Methods: The study comprised of 61 patients (38 girls, 28 boys; mean age 81.2±44.5 months; range 12 to 168 months) who received valproate because of epilepsy or prophylaxis of febrile seizures. All cases were evaluated in terms of bone mineral metabolism disturbances by assessing bone mineral density and biochemistry parameters, before and after 12 months of valproate therapy. Results: At the end of one year of valproate therapy, there were no statistically significant differences in calcium, phosphorus and alkaline phosphatase levels that might show bone mineralization disturbance. Osteoporosis was recorded in two cases (3.3%). Conclusion: The side effects of valproate on bone mineral metabolism are usually contradictory. In order to determine osteopenia signs; bone biochemistry, 25- OH vitamin D3, hormonal parameters and bone mineral density, which are not enough for evaluation alone, have to be evaluated together. Patients taking valproate therapy should have bone mineral density measurements yearly, because mineral changes in bone (defeats) could not be predicted with these biochemical parameters beforehand

Synthesis of an injectable heparin conjugated poloxamer hydrogel with high elastic recoverability for temporomandibular joint disorders

The temporomandibular joint (TMJ) is commonly affected during fundamental oral activities, reducing the quality of life. Herein, we synthesized a heparin-conjugated poloxamer hydrogel (HEP) as a thermo-responsive injectable hydrogel for the treatment of TMJ disorders. While the gelation temperature of synthesized HEP (25% [w/v]) was 29.8-30.0 degrees C, there was a slight difference between loss and storage modulus. HEP decreased the friction of the TMJ, thus requires less energy during load-bearing jaw movement in comparison to POL. Moreover, the oscillation test dependent on strain ranges from 0.01% to 1000% validated that POL and HEP3 hydrogels showed a similar critical strain of about 5.6%. The total elastic recovery percentage of HEP3 (53.50%) was higher than POL (45.55%), indicating a better recovery of the deformed hydrogel structure. Along with the suitable viscoelastic properties for temporomandibular cavity, both hydrogels increased the proliferation of fibroblasts (L929) and chondrocytes (ATDC5) (cell viabilities were above 100%). However, newly synthesized HEP induced differentiated cell proliferation of chondrogenic cells at increasing concentrations up to 0.0156 mg/mL (p < 0.0001) compared to POL and the control group. The promising rheological properties and effects on chondrogenic cell proliferation of injectable heparin-conjugated hydrogel make them candidates for intra-articular injections used for the treatment of TMJ

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Ayvalıtohma Çayı havzası aşağı çığırının jeomorfolojisi

Ayvalıtohma Çayı Havzası, Fırat Nehri’nin batı kollarından olan Tohma Çayı’nın bir alt havzasıdır. Darende- Hekimhan (Malatya) Gürün, Kangal (Sivas) arasında kalan çalışma alanı, Doğu Torosların sıradağları ile çevrelenmiştir. Genel olarak bölge Uzunyayla Platosu ile Malatya Havzası arasında kalan ve akarsularla derin bir şekilde yarılmış platolardan oluşmaktadır. Havza’nın batısındaki Köroğlu, doğusundaki Akbabaçalı, güneyindeki Cuma Dağı gibi dağ sıraları ise bu platolar üzerinde yumuşak sırtlar halinde yükselmektedir. Çalışma alanında platolara gömülen Ayvalıtohma Çayı derin ve sarp boğazlar açarak; Uzunyayla, Ayvalı-Kuluncak, Darende-Balaban depresyonlarını birbirine bağlamaktadır. Gürün, Darende, Kuluncak dolaylarında tipik olarak görülen ve karstik temele gömülen bu boğazlar, Ayvalı ve Balaban Ovası’nın oluşumunda önemli bir rol oynamışlardır. Çalışma alanının merkezini oluşturan Ayvalı-Kuluncak Depresyonu Oligosen devrinde gelişmiş dağarası havza özelliği taşımaktadır. Bu dönemde depolanmış ve aşınmaya karşı dayanıklı olmayan çakıltaşı, kumtaşı, çamurtaşı gibi çökeller üzerinde, elverişli iklim, topografya, bitki ve toprak örtüsü şartlarının oluşmasıyla, bu alanlar havzada en fazla erozyona uğrayan alanlar olarak ortaya çıkmıştır.Çalışma alanındaki dağlık alanlar, Alp orojenezin Austrik fazı ile kıvrılmış ve deniz seviyesi üstüne yükselmişlerdir. Bu dönemden sonra Üst Kretase’de transgresyon olmasıyla şelf ortam koşulları gelişmiş ve Laramiyen fazı ile dağlar tekrar yükselerek bir daha deniz istilasına uğramamıştır. Miyosen’e kadar aşınarak peneplen haline gelen dağlık sahalar, Orta Miyosen’den itibaren yeni tektonik hareketlere bağlı olarak bölgede faylanmalar gerçekleşmiş ve saha toptan yükselerek tekrardan dağlık alanları oluşturmuştur. Bu dağlık alanlar ile birlikte yükselen Miyosen aşınım satıhları, Kuvaterner başlarında bölgeye yerleşen Ayvalıtohma Çayı tarafından yarılarak bölgedeki platoları oluşturmuştur. Ayrıca Miyosen’deki faylanmalara bağlı olarak Leylek Dağı, Karadağ gibi volkanik dağlar meydana gelmiştir ki bölgenin karstik karakterini yer yer kesintiye uğratmıştır. --------------------Ayvalıtohma Stream Basin is a sub-basin of Tohma Stream, which is one of the western branches of the Euphrates River. The study area between Darende-Hekimhan (Malatya) Gürün and Kangal (Sivas) is surrounded by the mountain ranges of the Eastern Taurus Mountains. In general, the region consists of plateaus between Uzunyayla Plateau and Malatya Basin and deeply cleaved by streams. Mountain ranges such as Köroğlu in the west of the basin, Akbabaçalı in the east and Cuma Mountain in the south rise as soft ridges on these plateaus. Ayvalıtohma Stream, which is buried in plateaus in the study area, opens deep and steep gorges; Uzunya and Ayvalı-Kuluncak link Darende-Balaban depressions. These straits, which are typically seen around Gürün, Darende, Kuluncak and embedded on a karstic foundation, played an important role in the formation of Ayvalı and Balaban Plain. Ayvalı-Kuluncak Depression, which constitutes the center of the study area, has the characteristics of developed intermountane basin during the Oligocene period. During this period, with the formation of favorable climate, topography, vegetation and soil cover conditions on deposits such as conglomerate, sandstone, mudstone, which are not abrasion resistant, these areas have emerged as the most erosion areas in the basin.The mountainous areas in the study area are curled by the Austrik phase of Alp orogeny and have risen above sea level. After this period, with the transgression in the Upper Cretaceous, the ambient conditions of shelf developed and the mountains of the Laramian phase rose again and did not undergo a sea invasion. The mountainous areas, which have become peneplen by the Miocene, have been faulted in the region due to the new tectonic movements since the Middle Miocene and the area has risen to the top, forming mountain areas. The Miocene erosion surfaces rising with these mountainous areas formed the plateaus in the region by the Ayvalıtohma Stream, which settled in the region at the beginning of the Quaternary. In addition, depending on the faulting in Miocene, volcanic mountains such as Mount Leylek and Montenegro have occurred, which interrupted the karstic character of the region

Nonsterodial anti-inflamatuvar ilaçların yan etkileri üzerine proton pompa inhibitörleri ve h2reseptör blokörlerinin etkisinin değerlendirilmesi

Bu çalı mada, çe itli nedenlerle uzun süreli NSA kullanması gereken hastalarda, builaçların mide mukozasında sebep oldukları de i iklikler üzerine Lansoprazol ve Famotidintedavilerinin etkileri ara tırıldı.120 olgu A grubu (Lansoprazol), B grubu (Famotidin) ve hızlı üreaz testi ile Hp tesbitedilen C grubu (Eradikasyon tedavisi) olmak üzere üç gruba randomize edildi. A grubundaya ları 49,7 ± 10,7 (26-70) yıl olan 37 olguya Lansoprazol 30 mg kapsül 12 saat ara ile oralyoldan (PO) verildi. B grubunda ya ları 49,8 ± 12,9 (18-68) yıl olan 32 olguya famotidin 40mg tablet günde bir kez PO verildi. C grubunda ya ları 46,01 ± 10,18 (21-67) yıl olan 51olguya 14 gün Klaritromisin 500 mg günde iki kez, 1000 mg Amoksisilin günde iki kez ve 1ay süreyle Lansoprazol 30 mg günde iki kez PO verildi. Tüm olgular 3 ay süreyle NSAolarak 550 mg Naproksen sodyum 12 saatte bir kullandılar. Gruplarda birinci ve ikinci aydakiendoskopik skorlar, ilaçlara ba lı yan etkiler, hematolojik ve biyokimyasal parametrelerüzerine olan etkiler de erlendirildi.Lansoprazol, Famotidin ve eradikasyon tedavisi gruplarında NSA alımının devametmesine ra men 1. ve 2. aydaki endoskopik skorlar bazal skorlara göre istatistiksel olarakanlamlı düzeyde dü ük bulundu (p0,05).Çalı madaki tüm ilaçlar olgular tarafından iyi tolere edildiler. Gruplar arasında yanetki görülme sıklı ı açısından karın a rısı dı ında farklılık görülmedi (p0.05).Sonuç olarak; Uzun dönem NSA kullanması gereken olgularda gastrik hasargeli imini önlemede lansoprazol ve famotidin benzer etkinlikte bulundu.In this study, we aimed to investigate the effects of Lansoprazole and Famotidine drugtherapies on the changes of gastric mucosae in patients who used long term NSA D forseveral reasons.In our investigation, we arranged the 120 patients in three groups as group A(Lansoprazole), group B (Famotidine) and group C who were found Hp positive with rapidureas test (Eradication therapy). In group A, 37 patients whose ages were 49,7 ± 10,7 years(26-70 ) were applied oral 30 mg Lansoprazole per 12 hours intervals. In group B, 32patients ages ranging 49,8 ± 12,9 (18-68) years treated with 40 mg Famotidine therapy twotimes a day per oral. In group C,51 patients whose ages were 46,01 ± 10,18 (21-67) wereundergo 500 mg Clarithromycin therapy twice a day for 14 days, 1000 mg Amoxicillintherapy twice a day for 14 days and 30 mg Lansoprozole therapy twice a day for during onemonth per oral. During 3 months, all the patients were applied 500 mg Naproxen sodium per12 hours intervals. At the first and second months the effects of these three drugs wereinvestigated about endoscopy scores, drugs side effects, hematological and chemicalparameters in these groups.Although countinuing to the taking of NSAID in the gorups of lansoprazole,famotidine and eradication treatment, the endoscopic scores in the first and second monthshave been found clearly low towards the basal scores for statistical (p0,05).All drugs used in the study have been tolerated well by the patients. There was nodifference among the groups for having side effects, expect abdominal pain (p>0,05).Abdominal pain was more frequent in the group taking eradication treatment (p<0,05).The drugs had no effect to the hematologic and the biochemistrical parameters in thegroups of lansoprazole, famotidine and eradication treatment.As a result, it has been found that lansoprazole and famotidine have similiar effects forpreventing gastric erosion in the patients who must use NSAID for a long time

The remains of mammals in the owl pellets from Nevşehir province

Bu çalışmada Eylül-2010’da Nevşehir ili Devlet Hastanesi civarındaki ağaçların diplerinden Athene noctua, Tyto alba ve Bubo bubo türlerine ait 96 pelet toplanmış ve içerikleri incelenmiştir. 96 pelet içerisinde toplam 246 adet memeli kalıntısı bulunmuştur. Genel olarak her pelette bir veya üç hayvan kalıntısı bulunurken, maksimum altı (ortalama 2.2) hayvan kalıntısına rastlanmıştır. Peletlerde Soricimorpha’dan Crocidura suaveolens ve Rodentia takımından Microtus guentheri, Microtus socialis, Microtus sp., Mus macedonicus, Mus musculus, Mus sp., Cricetulus migratorius, Meriones tristrami, Apodemus sylvaticus’a ait kalıntılar tespit edilmiştir. Memelilerin büyük kısmını %99.6 oranı ile Rodentia ordosu; bunların çoğunluğunu da Microtinae türlerinin (%79.7) oluşturduğu gözlenmiştir. Microtus guentheri %46.7 oran ile kalıntılarda baskın olurken Microtus socialis %23.2 oranı ile en sık görülen ikinci, Microtus sp. %9.8 oranı ile sık bulunan üçüncü tür olmuştur. Meriones tristrami ile Apodemus sylvaticus kalıntılarda birbirlerine eşit (%7.3) oranda bulunurken, Crocidura suaveolens (%0.4) kalıntılar içinde en az yoğunlukta tespit edilen tür olmuştur. Bunların dışında kuş (%4) böcek (%2) ve bir adet sürüngen kalıntısı da bulunmuşturIn this study in total 96 pellets that belongs to species of Athene noctua, Tyto alba and Bubo bubo were collected from under the tree near State Hospital of Nevşehir city and remains were analyzed. Maximum six (in average 2.2) animal remains were found in each pellet, while one or tree animal remains were found generally. Crocidura suaveolens belong to Soricimorpha and Microtus guentheri, Microtus socialis, Microtus sp., Mus macedonicus, Mus musculus, Mus sp., Cricetulus migratorius, Meriones tristrami, Apodemus sylvaticus belong to order Rodentia, in total 246 mammal remains were identified. The Rodentia order was the mostly found with a ratio of 99.6% in mammal remains. It was observed that the majority of these were consisted by Microtinae species (79.7%). Microtus guentheri was the predominant species with a ratio of 46.7%, the second most common species was Microtus socialis with a ratio of 23.2%, the third most common species was Microtus sp. with a ratio of 9.78% in remains. Crocidura suaveolens was least common species with a ratio of 0.4% in remains, as Meriones tristrami and Apodemus sylvaticus’s ratio (7.3%) were equal. Additionally, birds (4%), insects (2%) and one reptilian remains were found