A comparative perspective on brucellar, pyogenic, and tuberculous spondylodiscitis.

OBJECTIVE: Non-specific features of spondylodiscitis lead to a delay and challenge in the diagnosis/differential diagnosis/treatment processes, and thus, serious complications may arise. This study aims to compare brucellar, pyogenic, and tuberculous types of spondylodiscitis, considering their demographic, clinical, and laboratory differences. This may provide more rapid management and good outcomes. PATIENTS AND METHODS: A total of 131 patients with infectious spondylodiscitis were included in the study. The patients were divided into brucellar (n=63), pyogenic (n=53), and tuberculous (n=15) types of spondylodiscitis and compared for demographic, clinical, laboratory, and imaging features. RESULTS: Tuberculous spondylodiscitis had higher scores for weight loss, painless palpation, thoracic spine involvement, and psoas abscess formation than other spondylodiscitis. Also, tuberculous spondylodiscitis had higher rates of neurologic deficit and lower rates of lumbar involvement than brucellar spondylodiscitis. Pyogenic spondylodiscitis is more likely to occur in patients who have a history of spine surgery compared to other forms of spondylodiscitis. Also, pyogenic spondylodiscitis had higher rates of fever, erythema, paraspinal abscess, white blood cell (WBC), and erythrocyte sedimentation rate (ESR) than brucellar spondylodiscitis. On the other hand, brucellar spondylodiscitis had higher rates of rural living and sweating than pyogenic spondylodiscitis. CONCLUSIONS: Weight loss, painless palpation, involved thoracic spine, psoas abscess, and neurologic deficit are symptoms favoring tuberculous spondylodiscitis. History of spine surgery, high fever, skin erythema, and paraspinal abscess are findings in favor of pyogenic spondylodiscitis. Rural living, sweating, and involved lumbar spine are symptoms that indicate brucellar spondylodiscitis. These symptoms can be used to distinguish the types of spondylodiscitis.

COVID-19 pandemic and emergency remote education practices: Effects on dentistry students.

Background: The COVID-19 pandemic has caused not only viral infection-related deaths, but also uncontrollable psychological problems and anxiety in different parts of society. The COVID-19 pandemic has resulted in adaption of a comprehensive online education period that has not been previously experienced in modern education. Aim: This cross-sectional study aims to evaluate dental students' experiences with emergency remote education practices, related levels of anxiety, and sociodemographic factors affecting anxiety during the COVID-19 pandemic. Subjects and Methods: This study was conducted during the period when social isolation measures were applied at the maximum level and face-to-face education was suspended in all dentistry faculties in Turkey due to the COVID-19 pandemic. Sociodemographic data and anxiety experienced by dental students were investigated using an online questionnaire. The anxiety levels were evaluated by using a 10-Item Perceived Stress Scale (PSS-10), and attitudes of the students toward distance education were determined using a 5-point Likert-type scale. Results: The study included 2.290 students. A total of 76.46% of these students attended to emergency remote education practices provided by their faculty. While 66.7% of students were satisfied with the transition process of their faculty to distance education, 18.4% of them found emergency remote learning to be completely unsuccessful. Mean PSS-10 score was 24.68 ± 6.74 and 94.8% of the students experienced moderate-to-high anxiety during the process. The compulsory and emergency remote education was found to significantly increase anxiety in private university students compared to public university students (P = 0.03) and in those students with low family income than the moderate and high ones (P = 0.01). There was a significant relationship between PSS-10 levels and students' anxiety about their academic performance, career plans, transition process to distance education, and their desire to continue remote theoretical online educations. The increase in these aforementioned parameters significantly decreased PSS-10 scores (P = 0.000). Conclusions: The emergency online remote education practices during the COVID-19 pandemic caused anxiety in dentistry students. It is expected that only distance education practices would be insufficient, and blended education models consisting of distance and face-to-face practices should be implemented.

Using of panoramic and posteroanterior cephalometric radiographs to identify the optimal nasal passage for nasotracheal intubation.

Background and Aim: Selecting the optimum nasal passage for nasotracheal intubation is quite important in the maxillofacial surgeries for the success of intubation and the reduction of potential complications such as nasal mucosal laceration, epistaxis, avulsion of the inferior and middle turbinates, and septal laceration. Materials and Methods: The present study evaluates standard panoramic radiographs (PR) and posteroanterior cephalometric radiographs (PACR) to determine the optimal nasal passage for nasotracheal intubation and compares the results with those of routine anesthesiological occlusion and spatula tests (ST). The results of occlusion tests (OT), ST, and radiological assessments of 60 patients prior to nasotracheal intubation were compared with the nasal endoscopic assessment results, and complications were evaluated. Results: There was no significant association between the OT and nasal endoscopy results (P = 0.075). A significant association was found between the ST and nasal endoscopy results (P = 0.000), and between the radiological assessments and the nasal endoscopy results (P = 0.000). Compatibility with nasal endoscopy was 54% when the occlusion and ST were evaluated together, 75% when the OT and radiological assessments were evaluated together, and 86% when the ST and radiological assessments were evaluated together. The highest level of compatibility was 92% when all the tests were evaluated together. Conclusion: The simple tests alone were found to be inadequate for the selection of the optimal nasal passage. Evaluation of PR and PACR, which are commonly used in maxillofacial surgeries, together with simple anesthesiological examination tests would increase nasotracheal intubation success and decrease complications.

Nasotracheal intubation performance with the mcgrath videolaryngoscope versus macintosh laryngoscope in oral and maxillofacial surgery- An observational study.

Background and Aim: Nasotracheal intubation is the main route to secure the airway in oral and maxillofacial surgery patients. This study was aimed to compare the intubation times and glottis visualization of McGrath video laryngoscope with the Macintosh laryngoscope for routine nasotracheal intubation. Materials and Methods: Records of seventy-one ASA (American Society of Anesthesiologists) I-II patients were evaluated and allocated into two groups (McGrath video laryngoscope (VL) and Macintosh groups). Intubation times, modified intubation difficulty scale (MIDS) scores, and hemodynamic parameters (heart rate and mean arterial pressure) were compared after the anesthesia induction and the intubation. Results: Mean intubation time in the McGrath group (24.9 ± 5.9 seconds) was significantly lower than that of the Macintosh group (28 ± 6.2 seconds; P = 0.037). Magill forceps were needed less in the McGrath group compared to the Macintosh group (13.89% vs. 42.86%; P = 0.009). Total MIDS scores were similar (P = 0.778). There was no significant difference in the hemodynamic parameters between the groups. Conclusion: The McGrath VL significantly reduced the intubation time and the use of Magill forceps compared with Macintosh direct laryngoscope and can be utilised effectively for routine nasotracheal intubation.

Maxillary sinus septa and anatomical correlation with the dentition type of sinus region: a cone beam computed tomographic study.

Maxillary sinus septa increase the risk of membrane perforation during sinus floor elevation and grafting operations. This study was designed to evaluate the prevalence, morphology, localisation, aetiology, and orientation of maxillary sinus septa in dentate, completely edentulous, and partially edentulous sinus regions using cone beam computed tomography (CBCT), and possible patient-related factors were also assessed. Data from 300 patients (600 sinuses), 160 women and 140 men, with a mean (SD) age of 50.72 (13.99) years (range 20-83), who were undergoing treatment planning for implant-supported restorations in posterior maxillae, were analysed from reformatted CBCT scans. Sinus septa were detected in 132 (44%) patients. A total of 208 septa were found, and 187 (31.17%) single maxillary sinuses presented septa in 600 sinuses. Unilateral septa were found in 77 patients (58.3%) and bilateral septa in 55 patients (41.7%). Out of the 208 septa, 42 (20.19%) were in the anterior third, 124 (59.62%) were in the middle third, and 42 (20.19%) were in the posterior third. Further, 106 (50.96%) septa were in completely edentulous regions, 64 (30.77%) were in partially edentulous regions, and 38 (18.27%) were in dentate regions. The prevalence of septa was significantly higher in the middle third area of the completely edentulous sinus regions. The mean (SD) height of septa was 6.34 (3.05) mm, and the mean orientation was buccopalatal in 204 patients (98.08%). Maxillary sinus septa are common anatomical structures. To avoid possible complications during sinus augmentation, a detailed radiographic identification of anatomical structures in maxillary sinuses is needed.

Sleep quality, pain, anxiety, depression and quality of life in patients with frozen shoulder1.

BACKGROUND: Nocturnal shoulder pain could play an essential role in frozen shoulder (FS) and can lead to disturbed sleep, anxiety, depression and reduced quality of life (QoL). OBJECTIVE: The aim of this study was to examine anxiety, depression, sleep quality and quality of life in patients with FS and compare these to healthy controls. METHODS: We prospectively evaluated 148 participants (76 FS patients and 72 healthy controls). We obtained Visual Analogue Scale (VAS) pain score, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life Scale short form (WHOQoL-BREF). RESULTS: FS patients had significantly higher scores for VAS and BAI (p< 0.001) than the control group. There was no significant difference between the BDI scores of the groups (p= 0.067). The WHOQoL-BREF scale of the physical, mental and environmental fields were significantly lower in the FS group (p< 0.001). FS patients had significantly lower sleep efficiency, and sleep disorders in terms of PSQI section scores (p< 0.001). CONCLUSION: Our study demonstrated that there is a high prevalence and close relationships of pain, anxiety and sleep disturbance in patients with FS. Adding a psychiatric evaluation to the treatment of patients with FS may be beneficial.

Electro-optical effects of high aspect ratio P3HT nanofibers colloid in polymer micro-fluid cells.

This Letter reports the electro-optical (EO) effect of Poly(3-hexylthiophene-2,5-diyl) (P3HT) nanofibers colloid in a polymer micro-fluidic EO cell. P3HT nanofibers are high aspect ratio semiconducting nanostructures, and can be collectively aligned by an external alternating electric field. Optical transmission modulated by the electric field is a manifestation of the electro-optical effect due to high inner crystallinity of P3HT nanofibers. According to our results, the degree of alignment reaches a maximum at 0.6 V/µm of electric field strength, implying a big polarizability value due to geometry and electrical properties of P3HT nanofibers. We believe that one-dimensional crystalline organic nanostructures have a large potential in EO devices due to their significant anisotropy, wide variety of properties, low actuation voltages, and opportunity to be tailored via adjustment of the fabrication process.

Removal of chromium (VI) from aqueous solutions using surface modified composite nanofibers.

A novel material composite nanofibers (PAN-CNT/TiO2-NH2) based on adsorption of Cr(VI) ions, was applied. Polyacrylonitrile (PAN) and carbon nanotube (CNTs)/titanium dioxide nanoparticles (TiO2) functionalized with amine groups (TiO2-NH2) composite nanofibers have been fabricated by electrospinning. The nanostructures and the formation process mechanism of the obtained PAN-CNT/TiO2-NH2 composite nanofibers are investigated using FTIR, XRD, XPS, SEM, and TEM. The composite nanofibers were used as a novel adsorbent for removing toxic chromium Cr(VI) in aqueous solution. The kinetic study, adsorption isotherm, pH effect, initial concentration, and thermodynamic study were investigated in batch experiments. The composite nanofibers had a positive effect on the absorption of Cr(VI) ions under neutral and acidic conditions, and the saturated adsorption reached the highest when pH was 2. The adsorption equilibrium reached within 30 and 180min with an initial solution concentration increasing from 10 to 300mg/L, and the process can be better described using nonlinear pseudo first than nonlinear pseudo second order model and Intra-particle diffusion. Isotherm data fitted well using linear and nonlinear Langmuir, Freundlich, Redlich-Peterson, and Temkin isotherm adsorption model. Thermodynamic study showed that the adsorption process is exothermic. The adsorption capacity can remain up to 80% after 5 times usage, which show good durability performance. The adsorption mechanism was also studied by UV-vis and XPS.

Surface functionalized composite nanofibers for efficient removal of arsenic from aqueous solutions.

A novel composites nanofiber was synthesized based on PAN-CNT/TiO2-NH2 nanofibers using electrospinning technique followed by chemical modification of TiO2 NPs. PAN-CNT/TiO2-NH2 nanofiber were characterized by XRD, FTIR, SEM, and TEM. The effects of various experimental parameters such as initial concentration, contact time, and solution pH on As removal were investigated. The maximum adsorption capacity at pH 2 for As(III) and As(V) is 251 mg/g and 249 mg/g, respectively, which is much higher than most of the reported adsorbents. The adsorption equilibrium reached within 20 and 60 min as the initial solution concentration increased from 10 to 100 mg/L, and the data fitted well using the linear and nonlinear pseudo first and second order model. Isotherm data fitted well to the linear and nonlinear Langmuir, Freundlich, and Redlich-Peterson isotherm adsorption model. Desorption results showed that the adsorption capacity can remain up to 70% after 5 times usage. This work provides a simple and an efficient method for removing arsenic from aqueous solution.

Magnetically Recyclable Fe3O4@His@Cu Nanocatalyst for Degradation of Azo Dyes.

Fe3O4@His@Cu magnetic recyclable nanocatalyst (MRCs) was synthesized by reflux method using L-histidine as linker. The composition, structure and magnetic property of the product were characterized by X-ray powder diffraction (XRD), Scanning electron microscopy (SEM), Fourier Transform infrared spectroscopy (FT-IR) and vibrating sample magnetometry (VSM). Powder XRD, FT-IR and EDAX results confirmed that the as-synthesized products has Fe3O4 with spinel structure and Cu nanoparticles with moderate crystallinity without any other impurities. The surface of the Fe3O4@His nanocomposite was covered by tiny Cu nanoparticles. We examine the catalytic activity of Fe3O4@His@Cu MRCs for the degradation of two azo dyes, methyl orange (MO) and methylene blue (MB) as well as their mixture. The reusability of the nanocatalyst was good and sustained even after 3 cycles. Therefore this innovated Fe3O4@His@Cu MRCs has a potential to be used for purification of waste water.

Composite nanofibers for highly efficient photocatalytic degradation of organic dyes from contaminated water.

In this study highly efficient photocatalyst based on composite nanofibers containing polyacrylonitrile (PAN), carbon nanotubes (CNT), and surface functionalized TiO2 nanoparticles was developed. The composite nanofibers were fabricated using electrospinning technique followed by chemical crosslinking. The surface modification and morphology changes of the fabricated composite nanofibers were examined through SEM, TEM, and FTIR analysis. The photocatalytic performance of the composite nanofibers for the degradation of model molecules, methylene blue and indigo carmine, under UV irradiation in aqueous solutions was investigated. The results demonstrated that high photodegradation efficiency was obtained in a short time and at low power intensity compared to other reported studies. The effective factors on the degradation of the dyes, such as the amount of catalyst, solution pH and irradiation time were investigated. The experimental kinetic data were fitted using pseudo-first order model. The effect of the composite nanofibers as individual components on the degradation efficiency of MB and IC was evaluated in order to understand the overall photodegradation mechanism. The results obtained showed that all the components possess significant effect on the photodegradation activity of the composite nanofibers. The stability studies demonstrated that the photodegradation efficiency can remain constant at the level of 99% after five consecutive cycles.

Evaluation of Lp-PLA2 mass, vitronectin and PAI-1 activity levels in patients with preeclampsia.

PURPOSE: The aim of the current study is to determine, correlate and compare the plasma lipoprotein-associated phospholipase A2 (Lp-PLA2), vitronectin (Vn), Plasminogen activator inhibitor-1 (PAI-1) activity and tissue plasminogen activator (t-PA) levels in early-onset preeclampsia, late-onset preeclampsia and in control pregnant women. METHODS: A total of 79 individuals, 30 early-onsets, and 22 late-onset preeclamptic and 27 control pregnant women were included into the scope of this study. Enzyme-linked immunosorbent assay procedure was used to determine the serum Lp-PLA2 and plasma Vn, t-PA antigen and PAI-1 activity levels. Serum C-reactive protein (CRP) levels were measured immunoturbidimetrically in routine clinical chemistry analyser. RESULTS: In patients with preeclampsia, Lp-PLA2, PAI-1, t-PA, CRP and blood pressures levels were increased (p = 0.000) and correlated with each other. Vn levels were decreased (p = 0.016) but not correlated with other parameters in preeclamptic patients. CONCLUSION: We are of the opinion that increased Lp-PLA2 levels may partially contribute to endothelial dysfunction by the progression of inflammation. In addition, increased complex formation with Vn is likely to bring about the increase of PAI-1 activity in patients with preeclampsia. Moreover, increased t-PA and decreased Vn levels may also be the consequences of compensatory mechanisms against disease progression.

Studies on the adsorption of chromium(VI) onto 3-Mercaptopropionic acid coated superparamagnetic iron oxide nanoparticles.

Chromium (Cr) in the form of Cr(VI) is deemed toxic in water due to its mutagenic and carcinogenic properties. For the successful removal of Cr(VI), we demonstrate a novel adsorbent consisting of superparamagnetic iron oxide nanoparticles (SPION) functionalized with 3-Mercaptopropionic acid (3-MPA). Fourier transform infrared spectroscopy (FT-IR) confirmed the functionalization of nanoparticles and presence of sulfonate groups. Batch adsorption experiments showed that the functionalized adsorbent recovered 45 mg of Cr(VI)/g of 3-MPA coated SPION at initial concentration of 50mg/L aqueous solution at pH 1 with less than 1% of Fe dissolution from SPION. The results from X-ray photoelectron spectroscopy confirmed that Cr(VI) chemisorbed onto the adsorbent. Hence, the XPS spectra did not indicate any reduction of Cr(VI) to Cr(III) upon adsorption. The adsorption data were better fitted for the Freundlich model. Moreover, the Cr(VI) adsorption kinetics on functionalized SPION followed a pseudo-second order rate, revealing chemisorption as the dominant mechanism. The high Cr(VI) removal, rapid adsorption kinetics and stability of adsorbent indicate that 3-MPA coated SPION could be an efficient adsorbent for the removal of Cr(VI).

Seasonal disease activity and serum vitamin D levels in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis.

BACKGROUND: Vitamin D is a steroid hormone that plays essential roles in calcium and phosphorus metabolism, bone formation and mineralization homeostasis, also has a role in the maintenance of immune-homeostasis. OBJECTIVE: We aimed to investigate seasonal serum vitamin D levels and seasonal disease activity in patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis. METHODS: Seventy-one Rheumatoid Arthritis patients, 72 Ankylosing Spondylitis patients, 74 knee Osteoarthritis patients and 70 healthy controls were recruited for the study. Bi-seasonal measurements of serum 25(OH)D vitamin were checked in either in July or August or September for summertime and either in December or January or February for wintertime. Disease activity were evaluated by Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index in groups of Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis respectively. RESULTS: We did not find any correlation between serum 25(OH)D levels and Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index scores in winter and summer. The difference of Disease Activity Score-28 and Western Ontario and McMaster Universities Osteoarthritis Index scores between winter and summer seasons were not significant in Rheumatoid Arthritis and Osteoarthritis patients (p>0.05). The mean Bath Ankylosing Spondylitis Disease Activity Index score was significantly higher in winter than in summer (p<0.05). Consequently we did not find any correlation between variations of seasonal serum 25(OH)D and the disease activity in the patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis. CONCLUSION: These results suggest that vitamin D does not have an important role in the seasonal disease activity of these diseases and that seasonal changes in disease activity may play an important role in evaluating Ankylosing Spondylitis patients rather than Rheumatoid Arthritis and Osteoarthritis patients and should be taken into account when examining these patients. These conclusions need to be validated in multicenter studies with high number of patients.

The relationship between shoulder impingement syndrome and sleep quality.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine potential relationship between subjective sleep quality and degree of pain in patients with shoulder impingement syndrome (SIS). MATERIALS AND METHODS: Fourty patients with shoulder impingement syndrome were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Shoulder Disability Questionnaire (SDQ). Forty three of age and sex matched healthy subjects were included in the control group. RESULTS: There was a significant difference between the patient and control groups in terms of all PSQI global scores and subdivisions (p < 0.01). The pain scores assessed by SDQ were positively correlated with the scores for subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, and sleep disturbance (r = 0.49/p < 0.01, r = 0.44/p < 0.01, r = 0.36/p < 0.05, r = 0.40/p < 0.05, and r = 0.37/p < 0.05 respectively). The comparison of total SDQ pain and global PSQI scores also revealed a significant correlation (r = 0.54/p < 0.01). CONCLUSIONS: Subjective sleep disturbance connected to shoulder pain was found obviously in patients with SIS. For this reason, patients with shoulder pain due to SIS may benefit from the pain killers and cognitive-behavioral interventions that specifically target sleep disturbances. Further studies which contain polysomnographic assessments, as well as determine psychologic status are still needed to put forth sleep quality in patients with SIS.  

Restless legs syndrome in Behçet's disease.

The prevalence of restless legs syndrome (RLS) and its association with the clinical features of Behçet's disease (BD) has not previously been elucidated. The inflammatory character, central nervous system involvement and neuropathies of BD led to this investigation of RLS risk in BD patients. A total of 116 BD patients and 104 healthy control subjects were included; seven BD patients were excluded because of concurrent diseases, pregnancy or alcohol misuse that might cause RLS symptoms, and the remaining 109 BD patients were included in the analysis. The prevalence of RLS was significantly higher in patients with BD (32/109; 29.4%) than in controls (5/104; 4.8%). No significant differences were found between BD patients with and without RLS with regard to the clinical features of BD. RLS severity positively correlated with age in BD patients. In conclusion, BD-related RLS should be considered in symptomatic RLS secondary to rheumatological disorders and BD patients should be examined for RLS. Further studies are needed to clarify the pathogenetic mechanisms underlying BD-related RLS.

Negative outcome factors for addicted migrants.

Several risk factors as well as protective factors are discussed in the development of mental disorders among migrants. With respect to addiction there are reports of an increased prevalence despite a higher threshold for utilisation of the treatment system. A case report is presented that exemplifies psychosocial and legal factors affecting the development and treatment possibilities of addicted migrants. It calls for a closer co-ordination between institutions and authorities in favour of the addicted individual.

Oesophageal perforation subsequent to anterior cervical spine screw/plate fixation.

We report three cases of oesophageal complications due to pressure necrosis secondary to screws post anterior plate fixation of the cervical spine. Two of the patients were treated using primary closure; and the third by conservative treatment, which consisted of wound drainage and an external orthotic device application. We recommend the early surgical closure and removal of the metallic implant with debridement as the first option of treatment. In the event that this option is not suitable, we suggest that wound drainage, tube feeding and parenteral antibiotics may be an appropriate alternative.

Surgical treatment of pulmonary hydatidosis in children: experience in 92 patients.

Ninety-two patients with a total of 112 pulmonary hydatid cysts underwent surgical treatment in our clinic between January 1980 and January 1992. Nine patients were found to have concomitant liver and pulmonary hydatid cysts. There were 65 boys and 27 girls; the age range was 5 to 14 years. The authors performed cystotomy and capitonnage in 78 patients, lobectomy in 9, segmentectomy in 3, and wedge resection in 2. Of 9 cases with concomitant liver and pulmonary hydatid cysts, 8 were approached by right thoracophrenotomy and 1 by median sternotomy and right phrenotomy. A one-stage operation via median sternotomy was performed in 3 patients who had bilateral pulmonary hydatid cysts. To prevent the development of secondary hydatid cysts because of spillage of hydatid fluid, the authors used 10% povidone-iodine poly (1-vinyl-2-pyrrolidone)-iodine complex intraoperatively as a scolicidal agent. There was no mortality or recurrence in the series.