Surgical Delay Increases the Perioperative Blood Transfusion Rate In Percutaneous Nephrolithotomy.

Objectives: We aimed to investigate the effect of prolonged time from diagnosis to treatment (TDT) on surgical outcomes in patients undergoing percutaneous nephrolithotomy (PNL). Methods: This study included a total of 544 patients who underwent PNL in our clinic between November 2017 and November 2021. Clinicodemographical, radiological, and perioperative data of the patients were recorded. The stone-free rate as assessed by abdominal computed tomography at 3 months was estimated. The possible relation of the stone-free rate and perioperative complications with TDT was examined. Results: The median age was 48 (range, 38-58) years, the median stone size was 405 (range, 250-700) mm2, and the median stone density was 1,000 (range, 730-1,221) Hounsfield units. The median TDT was 75 (range, 42-133) days. Twenty-seven patients (5.0%) required perioperative blood transfusion (PBT). There was a statistically significant correlation between TDT and the need for PBT (p=0.022). However, there was no significant correlation between TDT and stone-free rate (p>0.05). Using a cutoff value of 90.5 days, TDT could predict the need for PBT with 59.3% sensitivity and 60% specificity. Conclusion: Our study results suggest that the need for PBT increases in patients undergoing PNL longer than 90.5 days after the diagnosis. However, further large-scale, prospective studies are warranted to elucidate the effect of prolonged TDT on surgical outcomes in this patient population.

Potential and promising marker for serious bacterial infections in children: Delta neutrophil index.

AIM: This study aimed to evaluate the usefulness and accuracy of the delta neutrophil index (DNI), an index expressing the number of immature granulocytes as a proportion of the total, as an inflammatory marker in predicting serious bacterial infections (SBIs). METHODS: Paediatric patients admitted to our hospital with fever were divided into four groups: SBI, non-SBI, COVID-19 and control group. White blood cell count, absolute neutrophil count, C-reactive protein and the DNI were recorded, and their accuracy in predicting SBI was evaluated. RESULTS: Mean DNI was 4.96 ± 8.38 in the SBI group (150 patients), 0.67 ± 1.68 in the non-SBI group (397 patients), 0.29 ± 0.99 in the COVID-19 group (112 patients) and 0.14 ± 0.21 in the control group (102 patients). The DNI was significantly higher in the SBI group compared with the non-SBI (P < 0.001); the non-SBI group also had higher levels than the COVID-19 group (P = 0.005). One percent increase in the DNI increased the SBI rate 1.36 times (odds ratio 1.36 (95% confidence interval 1.23-1.49), P < 0.001). Based on the determined cut-off value (>2.5%), the DNI (odds ratio 6.27 (95% confidence interval 3.85-10.21), P < 0.001) significantly predicted SBIs with 90.4% specificity and 47.7% sensitivity. CONCLUSIONS: SBIs in childrenare associated with an increase in DNI levels. Compared to other biomarkers, the DNI had higher specificity in predicting SBIs. The DNI may also be usefulin differentiating bacterial and non-bacterial infections in individualclinical syndromes. Currently, there is no evidence that serum DNI aids indifferentiating COVID-19 and upper respiratory tract infection.

Effects of polishing systems and storage media on color stability and surface roughness of bulk-fill restorative composites.

PURPOSE: To determine the effect of polishing systems and storage media on surface roughness and color change of four bulk-fill restorative composites. METHODS: Four bulk-fill restorative composites and one micro-hybrid resin composite were used in this study. 72 cylindrical specimens were prepared for each resin composite. The specimens were divided into three polishing groups and further solution subgroups (n= 8). Surface roughness (Ra) and color were measured before and after the immersion periods. Statistical analyses were performed using three-way analysis of variance and Bonferroni tests (P< 0.05). RESULTS: Baseline Ra values were lower in the unpolished groups. Immersion in solutions increased the Ra of all resin composites tested. The lowest ΔE*ab was observed in Filtek One Bulk-Fill groups immersed in artificial saliva. Filtek One Bulk-Fill polished with Twist Dia showed lower ΔE*ab values than polished with Sof-Lex and the unpolished groups (P< 0.05). A weak positive correlation was observed between the baseline Ra and ΔE*ab. CLINICAL SIGNIFICANCE: Color stability and surface roughness of bulk-fill restorative composites seems to be dependent on the composition of the material and polishing system used. Surface pre-reacted glass-ionomer filler containing bulk-fill restorative composite was the most stain-susceptible resin composite.

Prediction of non-muscle-invasive bladder cancer recurrence during intravesical BCG immunotherapy by use of peripheral blood eosinophil count and percentage: a preliminary report.

OBJECTIVES: To determine whether there is an association between blood eosinophil count and percentage with the recurrence of nonmuscle invasive bladder cancer (NMIBC) during Bacillus Calmette-Guérin (BCG) maintenance therapy with our preliminary results. METHODS: A total of 53 patients with NMIBC underwent BCG immunotherapy between January 2015 and September 2018, and met our inclusion criteria were included in the study. The parameters age, gender, smoking status, comorbidity, blood neutrophil, lymphocyte and eosinophil counts, blood eosinophil percentage, previous single postoperative intravesical chemotherapy instillation, tumor characteristic, and total and maintenance dose numbers of BCG were extracted from our medical records and compared between patients with response and with recurrence. RESULTS: Blood eosinophil count and percentage were significantly higher in patients with recurrence compared to patients with response (0.263 ± 0.37 vs. 0.0134 ± 0.021, p = 0.01 and 0.31 ± 0.29 vs. 0.17 ± 0.27, p = 0.01). Other parameters were similar in patients with recurrence and response. Receiver-operating characteristic analysis showed a considerable diagnostic value of blood eosinophil count and percentage in the prediction of bladder cancer recurrence during BCG immunotherapy. CONCLUSION: Blood eosinophil count and percentage in patients with NMIBC can predict the disease recurrence during the BCG immunotherapy. Our research raised new questions and assumptions about the role of eosinophils during BCG immunotherapy.

Clinical effects of dehydration on tooth color: How much and how long?

OBJECTIVE: To evaluate effects of dehydration on tooth color determine whether color returns to baseline after 30 min or 24 h. MATERIALS AND METHODS: Thirty participants with intact maxillary central and lateral incisors were recruited for the study. Color measurements were performed with a spectrophotometer (SpectroShade Micro) at baseline and at 10, 20, and 30 min of dehydration, as well as 30 min and 24 h of rehydration. CIEDE2000 color parameters were used to calculate color difference. The data were analyzed for color changes over time by repeated-measures analysis of variance (ANOVA), and the Bonferroni-Tukey test was used for post-ANOVA comparisons (P < .05). RESULTS: After 30 min of dehydration, all the tested teeth were above the perceptibility threshold (ΔE00 = 0.8), and 85% of the teeth were above the acceptability threshold (ΔE00 = 1.8). After 30 min of rehydration, 78.3% of the tested teeth were above the perceptibility threshold, and 31.6% of the teeth were above the acceptability threshold. After 24 h of rehydration, 99.2% of the teeth were below the acceptability threshold, and 90% of the values were below the perceptibility threshold. CONCLUSIONS: Thirty-minute tooth dehydration can result in a clinically significant color change. After a 24-h rehydration period, reliable color assessment can be performed. CLINICAL SIGNIFICANCE: Tooth dehydration causes significant color change, thus assessment of final color or clinical success should be considered after tooth rehydration for esthetic restorations and tooth bleaching.