Overview of asthma patients followed up in a tertiary clinic.

Summary: Background. Asthma is a disease that combines different biological mechanisms, inflammatory pathways, and phenotypic features. Our aim was to investigate the demographic and disease characteristics of patients with asthma and to reveal the distribution with different phenotypes according to endotype groups. Methods. Patients were identified as eosinophilic if the absolute eosinophil count was measured at least once ≥ 300/µL during the oral corticosteroid free period or ≥ 150/µL under oral corticosteroids. Patients sensitive to at least one inhalant allergen with skin prick test and/ or spIgE measurement were defined as allergic. They were categorized into four main endotypes. Results. Data of 405 asthma patients with a median age of 50.9 years were analyzed. The prominent clinical and phenotypic characteristics of the study group were being obese (43.2%) or overweight (32%), severe asthma (49.6%), adult-onset (56.1%) or late-onset asthma (35.3%). The distribution of the four main endotypes according to eosinophilic and/or allergic status, is as follows: 22.7% allergic-eosinophilic (AE), 27.9% nonallergic-eosinophilic (NAE), 22.9% allergic-noneosinophilic (ANE), 26.4% nonallergic-noneosinophilic (NANE). While most severe asthma patients were in the AE and NAE groups, those with early-onset asthma were in AE and ANE, and those with late-onset asthma were in the NAE and NANE groups. The proportion of uncontrolled patients was higher in the NAE group. Among the severe asthma patients, the rate of uncontrolled disease was higher in those with NANE asthma. Conclusions. Different phenotypes were more closely related to some endotypes. This may allow the clinicians to identify patients and predict appropriate treatment modalities and response for individualized care.

Mechanical Analyses of Quadriceps Tendon Graft with Five Different Fixation Techniques on the Femoral Side: an Experimental Study on Sheep Knees.

PURPOSE OF THE STUDY We aimed to evaluate the biomechanical properties of quadriceps tendon graft with a bone plug ending (QTBP) and a quadriceps graft with a tendinous ending(QTT) fixed on the femoral side with different fixation devices. MATERIAL AND METHODS Twenty-five paired 2-year-old calf QTs and 25 paired 2-year-old sheep femurs were used for this study. 90x8 mm central part of the quadriceps tendons with or without a bone plug was harvested. 8×25 mm tunnel was placed in lateral condyles. The QTT was fixed with four different fixation devices, including the adjustable suspensory system (QTT-ASS, group 1), biodegradable interference screws (QTT-BIS, group 2), titanium interference screws (QTT-TIS, group 3), and an adjustable suspensory system + biodegradable interference screws (QTT-(ASS+BIS), group 4); QTBP was fixed with titanium interference screws (QTBP-TIS, group 5). All groups were tested in a servohydraulic materials testing machine. Stiffness(N/mm), slippage of the tendon(mm), and the ultimate tensile load-bearing ability(N) of the groups were tested. The Kruskal-Wallis H test was used with the Monte Carlo simulation technique to compare the nonparametric variables of stiffness, slippage, and ultimate tensile load. Dunn's test was used for the post hoc analyses. RESULTS Group 3 had the stiffest fixation (median 45.09 N/mm). The amount of slippage was highest in group 1(median 6.41mm). Group 1 was the most resistant group against a tensile load during the load-to-failure test(464 N). Fixing the QTT with the ASS and BIS in group 4 increased both stiffness and ultimate tensile load strength. There was no significant difference between the QTBP and QTT fixed with titanium screws. Fixing QTT with titanium screws was significantly superior to fixation with BIS(p < 0.05). CONCLUSIONS This study demonstrates that QTBP fixation with TIS have no advantage over QTT fixation with TIS on the femoral side. Although the QTT group fixed with ASS was the most resistant group against tensile forces during load-to-failure test, amount of slippage was highest for this group as well. Thus, if an ASS is to be used, a strong tension force must be applied prior to tibial side fixation to prevent further slippage of the graft in the tunnel. Key words: anterior cruciate ligament, quadriceps tendon graft, femoral side, fixation, biomechanical properties.

Readmission of older acutely admitted medical patients after short-term admissions in Denmark: a nationwide cohort study.

BACKGROUND: Knowledge of unplanned readmission rates and prognostic factors for readmission among older people after early discharge from emergency departments is sparse. The aims of this study were to examine the unplanned readmission rate among older patients after short-term admission, and to examine risk factors for readmission including demographic factors, comorbidity and admission diagnoses. METHODS: This cohort study included all medical patients aged ≥65 years acutely admitted to Danish hospitals between 1 January 2013 and 30 June 2014 and surviving a hospital stay of ≤24 h. Data on readmission within 30 days, comorbidity, demographic factors, discharge diagnoses and mortality were obtained from the Danish National Registry of Patients and the Danish Civil Registration System. We examined risk factors for readmission using a multivariable Cox regression to estimate adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for readmission. RESULTS: A total of 93,306 patients with a median age of 75 years were acutely admitted and discharged within 24 h, and 18,958 (20.3%; 95% CI 20.1 - 20.6%) were readmitted with a median time to readmission of 8 days (IQR 3 - 16 days). The majority were readmitted with a new diagnosis. Male sex (aHR 1.15; 1.11 - 1.18) and a Charlson Comorbidity Index ≥3 (aHR 2.28; 2.20 - 2.37) were associated with an increased risk of readmission. Discharge diagnoses associated with increased risk of readmission were heart failure (aHR 1.26; 1.12 - 1.41), chronic obstructive pulmonary disease (aHR 1.33; 1.25 - 1.43), dehydration (aHR 1.28; 1.17 - 1.39), constipation (aHR 1.26; 1.14 - 1.39), anemia (aHR 1.45; 1.38 - 1.54), pneumonia (aHR 1.15; 1.06 - 1.25), urinary tract infection (aHR 1.15; 1.07 - 1.24), suspicion of malignancy (aHR 1.51; 1.37 - 1.66), fever (aHR 1.52; 1.33 - 1.73) and abdominal pain (aHR 1.12; 1.05 - 1.19). CONCLUSIONS: One fifth of acutely admitted medical patients aged ≥65 were readmitted within 30 days after early discharge. Male gender, the burden of comorbidity and several primary discharge diagnoses were risk factors for readmission.

Cytotoxic, anti-proliferative and apoptotic effects of noscapine on human estrogen receptor positive (MCF-7) and negative (MDA-MB-231) breast cancer cell lines.

AIM: Noscapine, a naturally occurring alkaloid obtained from opium poppy, is a microtubule-targeting agent. This study is aimed to investigate the effects of noscapine on human breast cancer cell lines by comparing them with those of tamoxifen and docetaxel. METHODS: MCF-7 and MDA MB-23 cell lines were used to observe the effects of docetaxel, tamoxifen, and noscapine on cell proliferation. For each drug, cell blocks were prepared from cultured cells treated with IC50 dose of each drug and these were examined histologically. The expressions of Ki-67, Bcl-2, BAX, and cyclin-D1 were assessed immunohistochemically. RESULTS: Although noscapine showed cytotoxic effects on both cell lines in a time and dose dependent manner, MDA-MB-231 cells were more susceptible to its effects. Noscapine inhibited MCF-7 and MDA-MB-231 cells proliferation in vitro with IC50 value of 29 µM and 69 µM, respectively, which was comparable with IC50 of tamoxifen (40 µM and 50 µM) and docetaxel (43 nM and 32 nM). Noscapine showed anti-proliferative effects by decreasing Ki-67, cyclin-D1 and apoptotic effects by increasing BAX/Bcl-2 ratio in both breast cancer cells. Its effect was comparable with tamoxifen and docetaxel. CONCLUSION: Noscapine may be a good chemotherapeutic agent for the treatment of breast cancer, especially in estrogen receptor­negative breast cancer (Tab. 2, Fig. 7, Ref. 40).

Adrenomedullin and non-dipping circadian pattern in newly diagnosed essential hypertension.

OBJECTIVE: There is frequently a relationship between nocturnal hypertension and non-dipping pattern and endothelial dysfunction. Studies conducted previously have indicated that adrenomedullin (AM) (a potent, long-lasting, vasodilatory peptide) is capable of regulating endothelial cell function. The aim of the current research is to investigate the association between absolute night-time blood pressure (BP) and circadian BP pat-tern with serum AM and high-sensitivity C-reactive protein (hsCRP) levels in cases in whom untreated arterial hypertension has been newly diagnosed. METHODS: Ambulatory BP monitoring was performed in 100 individuals with hypertension (50 dippers,50 non-dippers) and 50 healthy controls for 24 hours. Measurement and recording of AM and hsCRP serum levels were performed. RESULTS: A strong correlation between night-time BP levels and AM and hsCRP levels was determined(p<0.001). On the contrary, higher AM levels were determined in the non-dipper group compared to the dipper and normotensive groups (non-dipper group, 258±27 pg/mL; dipper group, 199±30 pg/mL; normotensive group, 150±11 pg/mL; p<0.001). The non-dipper group exhibited significantly higher hsCRP levels in comparison with the remaining two groups (p=0.017). An independent association was determined between AM (p=0.014) and hsCRP (p=0.032) and a non-dipping pattern in a multivariate logistic regression analysis. CONCLUSIONS: The nocturnal hypertensive and non-dipper groups exhibited increased AM levels. An independent association was identified between AM and hsCRP and a non-dipping pattern. It is implied that increased AM levels in individuals with non-dipper hypertension may be related to a longer exposure time to high BP. The mentioned findings indicate a potential future part of AM in identifying patients with hypertension that are at higher risk of target organ damage (Tab. 3, Fig. 4, Ref. 41).

Detection of the unknown components of the oral microflora of teeth with periapical radiolucencies in a Turkish population using next-generation sequencing techniques.

AIM: To detect the unknown components of the oral microbiome and the effects of root canal treatment in a Turkish population and to evaluate the changes in microbial diversity in the root canals before and after treatment. METHODOLOGY: Single-rooted central and lateral maxillary incisors with one canal were chosen from 20 patients. Baseline samples of intact intracanal microbiota were collected from 20 root canals of permanent teeth with necrotic pulps using sterile paper points. After root canal preparation, the root canals were filled with a calcium hydroxide paste for 7 days. Calcium hydroxide was removed from root canal with 2.5% sodium hypochlorite and 17% EDTA using passive ultrasonic irrigation (PUI). A second bacteriologic samples were taken with sterile paper points prior to root filling. The samples were processes with DNase-I treatment using next-generation sequencing (NGS). Reduction in bacterial numbers during root canal treatment was evaluated using real-time quantitative PCR (qPCR). All statistical analyses were conducted using the MINITAB 17 software (Minitab Ltd. Co., Coventry, UK). A one-sample t-test was used to analyse the data. Statistical significance was accepted at P < 0.05. RESULTS: Relative abundances of Mycoplasma sp., Paludibacter sp., Tannerella sp., Prevotella spp. and an uncultured species from the order Bacteroidales decreased with root canal preparation and medication (98.7%, 99.8%, 98.8%, 97.7% and 99.3%, respectively), whilst the relative abundances of Methylobacterium sp., Corynebacterium sp. and Streptococcus infantis increased (93.1%, 94.8% and 99.4%, respectively). Considerable numbers of Streptophyta species were detected before and after treatment. The ratio of Agrobacterium sp. in the treated teeth community and the ratio of order Streptophyta in the infected canals had negative correlations with the success of bacterial elimination. CONCLUSIONS: The combination of NGS and qPCR techniques resulted in detection of previously unknown components of the oral microbiome and the effects of root canal treatment on their relative abundance in a Turkish population.

The effect of vitamin D on MCF-7 breast cancer cell metabolism.

The role of vitamin D in calcium absorption and bone health is known. The studies revealed that vitamin D modulates breast cancer cell growth and it is also associated with a reduced breast cancer risk. The primary objective of this study was to highlight the metabolic effect of Vitamin D on MCF-7 breast cancer cell line. For that purpose, we checked the apoptosis, energy, amino-acid and acylcarnitine levels in cancer cells, that the study propose, that 1α, 25(OH)2D3 could inhibit cell growth in a dose and time dependent manner. IC50 dose was calculated as 145 nM for vitamin D. We observed the apoptosis level in vitamin D groups, which were 18, 28 and 38.5 % at 24, 48 and 72 hours, respectively. During metabolic screening analysis, it was observed that glutamine, methionine and glutamic acid levels were treated more by Vitamin D groups in cell line and also, that acylcarnitine level was increased in 24 and 48 hour groups when compared to the control, but decreased in 72 hours. Further studies are needed to analyze the role of amino acids and acylcarnitines for early apoptosis and cancer metabolism (Tab. 2, Fig. 4, Ref. 24).

Effect of Erbium:yttrium aluminum garnet laser on bond strength of a total-etch adhesive system to caries-affected dentin on gingival wall.

PURPOSE: To assess the effect of the erbium:yttrium aluminum garnet (Er:YAG) laser on bond strength of a total-etch adhesive system to the caries-affected dentin on the gingival wall. MATERIALS AND METHODS: Ten human molars with proximal carious lesions were randomly divided into two groups. In the first group, the carious dentin was removed with a bur, whereas in the second group it was removed with the Er:YAG laser. Carious lesions were excavated with one of these two techniques until laser fluorescence values decreased to 15 in the center of the lesions. The teeth were then restored with a total-etch adhesive system (Adper Single Bond 2) and composite resin (Filtek Z250). Five teeth from each group were sectioned to obtain 1 mm2 stick-shaped microtensile specimens from each tooth. Twenty-five specimens were obtained for each group with using this technique. The data were analyzed in independent-samples t-test (α = 0.05). For each removal technique, one sample was analyzed using scanning electron microscopy. RESULTS: No statistically significant differences were found between the bond strength of the Er:YAG laser and the bur-treated groups (P > 0.05). CONCLUSION: The Er:YAG laser treatment did not negatively affect the bonding performance of the total-etch adhesive system to caries-affected dentin on the gingival wall.

Comparison of intracoronal bleaching methods on teeth discolored by different antibiotic pastes.

AIM: To compare the bleaching efficacy of sodium perborate with different activation methods on crowns discolored by two different antibiotic pastes. MATERIALS AND METHODS: Eighty-five extracted human incisors were prepared to size #30 using ProTaper rotary instruments. After chemomechanical preparation and irrigation procedures, the specimens received triple antibiotic paste (TAP, n = 40), minocycline paste (MP, n = 40), or calcium hydroxide (n = 5, control group) and coronally sealed with temporary filling material. Spectrophotometric readings were obtained on day 0-week 4. Data were analyzed with the Mann-Whitney U-test and Wilcoxon sign test (P < 0.05). Sodium perborate was then inserted into the pulp chambers of discolored teeth (four subgroups, n = 10) and activated by heat or ultrasonically using two different frequencies and times. Spectrophotometric readings were obtained on days 3-7. Data were analyzed by the Mann-Whitney U-test and Kruskal-Wallis test (P > 0.05). RESULTS: Both groups showed statistically significant coronal discoloration at each time interval (P < 0.01), but their final shades did not significantly differ between the groups (P > 0.05). Although the MP subgroups exhibited more bleaching than the TAP subgroups on days 3 and 7, the difference was not significant (P > 0.05). The bleaching results for the sodium perborate activation techniques did not significantly differ among groups (P > 0.05). CONCLUSIONS: Both antibiotic pastes induced crown discoloration that was reversible using all sodium perborate bleaching techniques.

High cholesterol diet leads to oxidant load and peroxidation in the rabbit kidney tissue.

OBJECTIVES: The aim of this study was to investigate possible effects of high cholesterol diet on oxidant/antioxidant status in rabbit kidney tissues. BACKGROUND: Although a number of experimental animal models have suggested that hyperlipidemia is associated with progressive kidney failure data remain sparse on the role of dietary cholesterol intake on kidney disease. METHODS: Twelve male New Zealand albino rabbits were randomly divided into two groups (control and cholesterol). Both groups were fed on a standard laboratory diet. Animals in the cholesterol group additionally received cholesterol (1 g/kg/day), orally. The study period was 12 weeks. Activities of catalase (CAT), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), nitric oxide synthase (NOS), xanthine oxidase (XO), paraoxonase (PON), adenosine deaminase (ADA) enzymes and levels of malondialdehyde (MDA) and nitric oxide (NO) were measured in kidney tissue samples. Histological examination of the kidney tissue samples was also done. RESULTS: SOD, GSH-Px and XO enzyme activities were found to be decreased and NOS and PON activities increased significantly in cholesterol group compared to controls. As an indication of oxidation, MDA levels were found to be increased in cholesterol group. Histological examination revealed some derangements in the kidney tissue. CONCLUSION: High cholesterol diet creates oxidant load and causes peroxidation, which in turn, leads derangements in the rabbit kidney tissue (Tab. 2, Fig. 2, Ref. 69).

Effect of a re-wetting agent on bond strength of an adhesive to primary and permanent teeth dentin after different etching techniques.

OBJECTIVE: This study investigated the effect of a re-wetting agent on the microtensile bond strengths (mTBS) of primary and permanent dentin after acid or laser etching. MATERIALS AND METHODS: Twelve permanent and 12 primary molar teeth were ground to expose an occlusal dentin surface. Each group teeth were randomly divided into groups; I-II: 37% phosphoric acid etching with/without re-wetting agent, III-IV: Erbium: Yttrium aluminium garnet laser etching with/without re-wetting agent. An etch-and-rinse adhesive was used, and vertical sticks were obtained for the microtensile test. RESULTS: mTBS of permanent teeth was higher than that of primary teeth (P < 0.05). Re-wetting agent groups were similar with control groups in both etching groups in the permanent teeth (P > 0.05). Re-wetting agent group was similar with the control group in acid etch group (P > 0.05) and lower than the control group in laser etch group in primary teeth (P < 0.05). CONCLUSION: Acid etching in permanent teeth; laser etching in primary teeth was found more successful. The use of re-wetting agent did not provide an advance on bond strength of the adhesive in both primary and permanent teeth after acid-etch or laser-etch.

Retinoschisin gene therapy in photoreceptors, Müller glia or all retinal cells in the Rs1h-/- mouse.

X-linked retinoschisis, a disease characterized by splitting of the retina, is caused by mutations in the retinoschisin gene, which encodes a putative secreted cell adhesion protein. Currently, there is no effective treatment for retinoschisis, though viral vector-mediated gene replacement therapies offer promise. We used intravitreal delivery of three different AAV vectors to target delivery of the RS1 gene to Müller glia, photoreceptors or multiple cell types throughout the retina. Müller glia radially span the entire retina, are accessible from the vitreous, and remain intact throughout progression of the disease. However, photoreceptors, not glia, normally secrete retinoschisin. We compared the efficacy of rescue mediated by retinoschisin secretion from these specific subtypes of retinal cells in the Rs1h-/- mouse model of retinoschisis. Our results indicate that all three vectors deliver the RS1 gene, and that several cell types can secrete retinoschisin, leading to transport of the protein across the retina. The greatest long-term rescue was observed when photoreceptors produce retinoschisin. Similar rescue was observed with photoreceptor-specific or generalized expression, although photoreceptor secretion may contribute to rescue in the latter case. These results collectively point to the importance of cell targeting and appropriate vector choice in the success of retinal gene therapies.

Acetylsalicylic acid protects erectile function in diabetic rats.

We aimed to evaluate the effect of acetylsalicylic acid (ASA) treatment on diabetes-induced erectile dysfunction. Adult male Sprague-Dawley rats were divided into four groups as follows: (i) control (C), (ii) diabetic (D), (iii) ASA-treated control (C+ASA) and (iv) ASA-treated diabetic (D+ASA) groups. In groups 2 and 4, diabetes was induced by injection of 35 mg kg(-1) streptozotocin. ASA (100 mg kg(-1) day(-1) , orally) was administrated to rats in groups 3 and 4 for 8 weeks. Both intracavernosal pressure (ICP) and mean arterial blood pressure (MAP) were measured in in vivo studies. In organ bath, the relaxation responses to acetylcholine (ACh), electrical field stimulation (EFS) and sodium nitroprusside were tested in corpus cavernosum (CC) strips. The mRNA expression for neuronal nitric oxide synthase (nNOS) was calculated using reverse transcription polymerase chain reaction technique. In in vivo experiments, diabetic rats displayed reduced ICP/MAP values, which were normalised with ASA treatment. The relaxant response to high-dose ACh and EFS at low frequencies (1-8 Hz) in CC strips from the D+ASA group were significantly higher when compared to the D group. Treatment with ASA normalised the raised mRNA expressions of nNOS in diabetic penile tissues. ASA may be involved in mRNA of protein synthesis of NO released from nonadrenergic and noncholinergic cavernosal nerve in diabetes.

Evaluation of oxidative stress using exhaled breath 8-isoprostane levels on chronic kidney disease.

BACKGROUND: There have been limited numbers of studies on patients with chronic kidney disease (CKD) to determine oxidative stress in exhaled breath condensate (EBC). Those two studies have been carried out on hemodialysis patients, and hydrogen peroxide and nitric oxide have been studied in order to show oxidative stress on EBC. AIMS: We investigated oxidative stress in EBC evaluating 8-isoprostane levels on different stages of CKD. MATERIALS AND METHODS: A total of 81 patients with 2-4 CKD stages have been evaluated prospectively. The patients have been categorized into three groups according to their CKD stages. For biochemical analysis, blood and breathing air samples were taken. 8-isoprostane has been measured using immunoassay method as the indicator of oxidative stress in EBC. RESULTS: 8-isoprostane values were 8.19 ± 4.56, 13.89 ± 8.70, and 14.20 ± 10.68 pg/min group 1, 2, and 3, respectively; and the EBC 8-isoprostane levels increased significantly as CKD stages advanced (P0 = 0.018). There was a statistically significant reverse correlation between 8-isoprostane and glomerular filtration rate (GFR; r = -0.275; P = 0.014), but not between 8-isoprostane and C-reactive protein (r = -0.183; P = 0.177). CONCLUSIONS: We determined the level of 8-isoprostane in EBC of patients with different stages of CKD and showed that the level of 8-isoprostane significantly increased through the progress of CKD. We consider that our study is important because there have been limited number of studies that evaluate oxidative stress in CKD using EBC which is a noninvasive method.

Protective effect of magnesium preloading on cisplatin-induced nephrotoxicity: which dose is more suitable?

OBJECTIVE: Cisplatin is a widely used and potent cytotoxic chemotherapy agent, but its nephrotoxicity is a significant limiting side effect. Various premedication approaches have been implemented to preserve renal function, including magnesium (Mg) preloading. However, the optimal Mg dosage is still unknown. Our study aimed to assess the protective effects of different Mg doses as premedication in cisplatin-based chemoradiotherapy for patients with local/locally advanced cervical and head-neck cancers. PATIENTS AND METHODS: This retrospective, multicenter study involved premedication with saline infusion containing potassium chloride and magnesium sulfate (MgSO4) for all patients before cisplatin treatment. Patients were divided into two groups: 12 mEq MgSO4 (low-dose Mg preload group, low-Mg) and 24 mEq MgSO4 (high-dose Mg preload group, high-Mg). Renal function was evaluated using serum creatinine (sCr, mg/dl) and estimated glomerular filtration rate (eGFR, ml/min). Acute kidney injury (AKI) was defined per the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Renal outcomes and efficacy were compared between the groups. RESULTS: In the low-Mg group (n = 159), sCr levels were significantly higher compared to baseline, various weeks during treatment, and at the 1st, 3rd, 6th, and 12th months post-treatment (p < 0.001). In the high-Mg group (n = 128), no significant changes were observed during treatment and at 1st, 3rd, and 12th months post-treatment (p > 0.05). A significant reduction in mean sCr level from baseline to 6 months was noted in the high-Mg group (p < 0.001). eGFR values are generally correlated with sCr levels. AKI occurred in 21 (13.2%) and 22 (17.7%) patients in the low-Mg and high-Mg groups, respectively (p = 0.292). There was no difference in progression-free or overall survival between the groups. CONCLUSIONS: We clearly demonstrated that saline hydration with 24 mEql MgSO4 supplementation before cisplatin treatment has a better renal protective effect than 12 mEql MgSO4 without reducing efficacy, especially in patients with local/local advanced cervical and head-neck cancer receiving cisplatin with concurrent radiotherapy.

The effect of bleaching agents on the color stability of ceromer and porcelain restorative materials in vitro.

PURPOSE: The aim of this in vitro study was to determine the color changes of five different restorative materials after exposing these materials to two different home bleaching agents. METHODS: This study applied bleaching agents to an ultralow-fusing porcelain, a low-fusing porcelain, two types of heat-pressed glass ceramics, and a ceromer. A total of 24 disc-shaped specimens were fabricated (with a diameter of 10 mm and a thickness of 2 mm) from each material (n=12). The initial color measurements were taken with a spectrophotometer. The first set of specimens were bleached with 10% hydrogen peroxide (HP) for one hour daily for 10 days. The other set of specimens were bleached with 10% carbamide peroxide (CP) bleaching gel for eight hours daily for 14 days. Data were analyzed with the one-way analysis of variance and Kruskal-Wallis statistical test. The difference in the prebleaching and postbleaching color of each material was considered to be statistically significant at p < 0.05. RESULTS: The study found a statistically significant difference among the color changes of the test groups after exposing them to both bleaching agents (p<0.05). Appreciable color change was observed in the Estenia (ΔE=3.99) specimens that were bleached with the HP, and noticeable color changes were observed in the Estenia (ΔE=1.89) and IPS Empress 2 (ΔE=1.66) groups when they were treated with the CP. CONCLUSIONS: Restorations (especially polymer-containing restorative materials) should be protected before any bleaching procedure due to the high risk of color change.

The effect of COVID-19 on patients recieving omalizumab treatment.

Background and aim: Although exposure during drug administration and susceptibility to coronavirus disease-19 (COVID-19) infection secondary to immunomodulatory effects constitute potential risks for patients with chronic spontaneous urticaria (CSU) or asthma on omalizumab (OMZ), there is a risk of loss of response following discontinuation of OMZ. There are few studies describing the clinical course of COVID-19 in patients receiving OMZ. Materials and methods: A total of 103 patients on OMZ were included in the study between February 2021 and January 2022. Results: Fourteen (13.6%) of the patients participating in the study had SARS-CoV-2 infection, of whom 3 (21.4%) required hospitalization and 11 (78.6%) were treated in an outpatient clinic. During the pandemic, 17 (16.5%) of the patients interrupted their OMZ treatment. Patients on OMZ for six months or less had a lower rate of interruption (2.5%) than those on OMZ for more than 6 months (25.4%). Patients interrupted treatment for the following reasons: 3 (17.6%) had COVID-19, 10 (58.9%) did not attend the hospital visit due to concern about contamination with SARS-CoV-2, and 4 (23.5%) thought that OMZ treatment would facilitate contamination with SARS-CoV-2. After interrupting OMZ, 3 (25%) female patients and 5 (100%) male patients presented no worsening of their symptoms. Three (13%) of the patients on OMZ for asthma and 11 (13.8%) of those on the drug for urticaria had COVID-19 infection. Patients presenting CSU and severe asthma are completely different, with different potential consequences of OMZ interruption. Nine (52.9%) patients had aggravated symptoms following interruption of OMZ treatment. Three of them described worsening of asthma symptoms and a need to increment their maintenance therapy due to asthma exacerbation after nearly three weeks of interruption, and 6 of them had hives and pruritus as urticaria exacerbation nearly four weeks after interruption of OMZ. The asthma patients did not stop their other treatments, including inhaled corticosteroids. Conclusion: Use of OMZ does not increase the risk of SARS-CoV-2 infection, COVID-19-related pneumonia, or COVID-19-related hospitalization. We advise patients not to interrupt OMZ treatment during the COVID-19 pandemic unless advised to do so by their doctors, and we recommend that they receive instruction concerning self-administration of OMZ to avoid visiting hospitals in the event of a pandemic.

Buts de l'étude: Bien que l'exposition lors de l'administration du médicament et la susceptibilité individuelle à l'infection par le coronavirus-19 (COVID-19) secondaire aux effets immunomodulateurs soient des risques potentiels pour le patient victime d'urticaire chronique idiopathique (UCI) ou d'asthme recevant de l'omalizumab (OMZ), il existe également un risque de perte de réponse au traitement à la suite de l'arrêt de l'OMZ. Matériels et méthodes: Un total de 103 patients recevant de l'OMZ ont été inclus dans l'étude entre février 2021 et janvier 2022. Résultats: Quatorze (13,6 %) patients participant à l'étude ont été victimes d'une infection à coronavirus, 3 d'entre eux (21,4 %) ont été hospitalisés et 11 (78,6 %) ont été traités en ambulatoire. Durant la pandémie, 17 (16,5 %) patients arrêtèrent le traitement par OMZ. Le taux d'arrêt était plus faible (2,5 %) chez les patients recevant l'OMZ depuis 6 mois ou moins par rapport aux patients recevant l'OMZ depuis plus de 6 mois (25,4 %). L'arrêt du traitement était motivé par l'infection COVID-19 dans 3 cas (17,6 %), par une non-fréquentation de l'hôpital par crainte de contagion dans 10 cas (58,9 %), et dans 4 cas (23,5 %) parce qu'ils pensaient que l'OMZ favorisait l'infection COVID-19. Après l'arrêt de l'OMZ, 3 (25 %) femmes et 5 (100 %) hommes n'ont présenté aucune aggravation de leurs symptômes. Trois (13 %) patients recevant de l'OMZ pour asthme et 11 (13,8 %) pour de l'UCI présentèrent une infection par COVID-19. Les patients souffrant d'UCI ou d'asthme sévère étaient totalement différents, avec des conséquences potentielles différentes de l'interruption de l'OMZ. Neuf (52,9 %) patients aggravèrent leurs symptômes à l'arrêt de l'OMZ. Trois d'entre eux décrivirent une accentuation des symptômes d'asthme avec besoin d'augmenter leur traitement de fond pour exacerbation d'asthme après près de 3 semaines d'arrêt, et 6 d'entre eux présentèrent une exacerbation de l'urticaire avec papules et prurit après près de 4 semaines d'arrêt de l'OMZ. Les asthmatiques n'arrêtèrent pas les autres médicaments dont les corticostéroïdes inhalés. Conclusion: L'OMZ n'augmente pas les risques d'infection par COVID-19, ni les pneumopathies liées à l'infection COVID-19, ni les hospitalisations dues au COVID-19. Nous prévenons les patients de ne pas interrompre leur traitement par OMZ pendant la pandémie par COVID-19 sans avis médical, et nous recommandons une éducation thérapeutique pour l'auto-administration d'OMZ pour éviter les séjours hospitaliers en cas de pandémie.

The percentage of hesitation and factors associated with acceptance or refusal for COVID-19 vaccine: Does training about vaccines by allergist affect personal decision?

Background and aim: As the impact of coronavirus disease (COVID)-19 arises worldwide, the effect of vaccines is protecting its importance. The aim of this study was to investigate the vaccination perspectives of patients and learn how many patients were persuaded to get vaccinated with the effect of the education provided by allergists. Materials and methods: A cross-sectional study was carried out among 200 adult patients in the outpatient clinic between February 2021 and January 2022. Patients filled out the anti-vaccination scale form and a questionnaire form developed by allergists. The training about COVID-19 vaccines has been given to the patients who did not consider getting vaccinated. The patients were called by phone and questioned whether they have been vaccinated or not, after 22 weeks. Results: Out of 200 patients participants, 60.5% were considering getting vaccinated. Patients who did not consider getting vaccinated comprised 45.7% of women and 31% of men. While 52.4% of primary school graduates considered getting vaccinated, 75% of high school graduates and 60.8% of higher education graduates were considering getting vaccinated. Major reasons for rejecting vaccination were concerns about side effects and allergy. While the majority of women (47.2%) who did not want to get vaccinated were concerned about vaccine side effects, the majority of men (34.6%) did not want to get vaccinated because they did not trust the efficacy of the vaccine. Vaccination rates have been increased with the training we provided to our patients who did not consider getting the vaccine. 76 patients could be reached by phone and 81.6% of them were vaccinated, and 18.4% were not. Conclusion: The vaccination rates of allergy patients who did not consider getting vaccinated were increased with the information provided by allergists. So, the allergists should give more attention for giving information and increasing the vaccination rates of covid-19.

But de l: 'étude Alors que l'épidémie de maladie à coronavirus (COVID-19) impacte le monde entier, l'effet préventif de la vaccination est de première importance. Le but de cette étude était d'évaluer les souhaits de vaccination des patients et d'apprécier combien d'entre eux étaient persuadés de l'intérêt de celle ci après avoir bénéficié d'un parcours éducatif auprès des allergologues. Matériel et Méthodes: Une étude transversale a été menée parmi 200 patients adultes suivis en ambulatoire entre février 2021 et janvier 2022. Les patients renseignaient une échelle analogique de refus de vaccination et un questionnaire élaboré par des allergologues. Une éducation thérapeutique sur les vaccins pour la COVID-19 était dispensée aux patients refusant la vaccination. Les patients étaient ensuite contactés par téléphone pour savoir s'ils avaient été ou non vaccinés après 22 semaines. Résultats: Parmi les 200 patients, 60,5 % étaient considérés comme vaccinés. Les patients non vaccinés concernaient 45 % des femmes et 31 % des hommes. Alors que 52,4 % des patients ayant suivi une scolarité primaire étaient vaccinés, 75 % des patients de, niveau lycée et 60,8 % de niveau université se déclaraient vaccinés. Les raisons principales de refus de vaccination concernaient la crainte d'effets secondaires et le risque allergique. Alors que la majorité des femmes (47,2 %) refusant la vaccination alléguait le risque d'effets secondaires, la majorité des hommes (34,6 %) ne souhaitait pas être vaccinée pour non confiance dans l'efficacité du vaccin. Les désirs de vaccination étaient augmentés après éducation thérapeutique chez les patients ne souhaitant pas être vaccinés. Ainsi 76 patients ont pu être joints par téléphone et 81,6 % d'entre eux avaient pu être vaccinés et 18,4 % ne l'étaient pas. Conclusion: Les taux de vaccination des patients allergiques qui ne souhaitaient pas être vaccinés ont été augmentés après l'information fournie par les allergologues. Ainsi les allergologues devraient apporter toute leur attention à donner des informations visant à augmenter la vaccination pour la COVID-19.

High efficiency radio frequency antennas for amplifier free quantum sensing applications.

Radio frequency (RF) signals are frequently used in emerging quantum applications due to their spin state manipulation capability. Efficient coupling of RF signals into a particular quantum system requires the utilization of carefully designed and fabricated antennas. Nitrogen vacancy (NV) defects in diamond are commonly utilized platforms in quantum sensing experiments with the optically detected magnetic resonance (ODMR) method, where an RF antenna is an essential element. We report on the design and fabrication of high efficiency coplanar RF antennas for quantum sensing applications. Single and double ring coplanar RF antennas were designed with -37 dB experimental return loss at 2.87 GHz, the zero-field splitting frequency of the negatively charged NV defect in diamond. The efficiency of both antennas was demonstrated in magnetic field sensing experiments with NV color centers in diamond. An RF amplifier was not needed, and the 0 dB output of a standard RF signal generator was adequate to run the ODMR experiments due to the high efficiency of the RF antennas.

A prospective, multi-center study: factors related to the management of diabetic foot infections.

The Turkish Association of Clinical Microbiology and Infectious Diseases, Diabetic Foot Infections Working Group conducted a prospective study to determine the factors affecting the outcomes of diabetic foot infections. A total of 96 patients were enrolled in the study. Microbiological assessment was performed in 86 patients. A total of 115 causative bacteria were isolated from 71 patients. The most frequently isolated bacterial species was Pseudomonas aeruginosa (n = 21, 18.3%). Among cases with bacterial growth, 37 patients (43%) were infected with 38 (33%) antibiotic-resistant bacteria. The mean (±SD) antibiotics cost was 2,220.42 (±994.59) USD in cases infected with resistant bacteria, while it was 1,206.60 (±1,160.6) USD in patients infected with susceptible bacteria (p < 0.001). According to the logistic regression analysis, the risk factors related to the growth of resistant bacteria were previous amputation (p = 0.018, OR = 7.229) and antibiotics administration within the last 30 days (p = 0.032, OR = 3.796); that related to the development of osteomyelitis was wound size >4.5 cm(2) (p = 0.041, OR = 2.8); and that related to the failure of the treatment was the growth of resistant bacteria (p = 0.016, OR = 5.333). Diabetic foot osteomyelitis is usually a chronic infection and requires surgical therapy. Amputation is the accepted form of treatment for osteomyelitis. Limited limb-saving surgery and prolonged antibiotic therapy directed toward the definitive causative bacteria are most appropriate. This may decrease limb loss through amputations. As a result the infections caused by resistant bacteria may lead to a high cost of antibiotherapy, prolonged hospitalization duration, and failure of the treatment.