Role of mandibular anatomical structures in sexual dimorphism in Turkish population: a radiomorphometric CBCT study.

Sex determination is one of the primary concerns of forensic science. The cranial bones, pelvis, and mandible have been used for determining the sex of specimens. Because the mandible is robust and sexually dimorphic, studies have evaluated its metric and morphological traits. This study was designed as a retrospective study involving cone beam computed tomography (CBCT) images to assess sexual dimorphism of the mandible in the Turkish population. Total sample group consisted of 176 bimaxillary CBCT scans (71 males and 102 females; ages 19-67 years). Sixteen mandibular parameters were measured using two different software programmes. Measurements were recorded in various planes of three-dimensional (3D) reconstructions of the scans. All parameters aside from SIMaCD were found to be statistically significant. The highest diagnostic accuracy rate was associated with IMaF, and the overall accuracy rate of the fourteen parameters was found to be 80%.

Horizontal alveolar transport distraction osteogenesis followed by implant placement.

Alveolar transport distraction osteogenesis (ATDO) is an alternative treatment method to vertical alveolar distraction osteogenesis in cases of large bony defects, especially when the bone is limited in size. ATDO was performed in 10 patients with 12 defects. The mean age of the patients was 39.1years. The average bone length gain was 18.2mm. Implants were inserted following a 3-month consolidation period. Three patients needed additional bone grafting for horizontal widening. Final prosthetic rehabilitation was performed at least 3 months following implant insertion. The mean follow-up period was 63 months and the survival rate of the 25 implants placed was 92%. All failures (n=2) occurred during the early healing period. Although the results are not totally predictable, it can be concluded that ATDO can be effective in the reconstruction of the alveolar crest prior to implant placement.

Anaerobes in nosocomial and community acquired pleural infections.

Anaerobes are important causes of pleural space infections. The aim of the study is to evaluate the role of the anaerobic bacteria in pleural infections. The study involved 278 consecutive clinical samples sent to the Clinical Microbiology Laboratory of Tertiary Chest Hospital. Anaerobes were isolated in 39 community acquired and five nosocomial cases out of 278 anaerobic cultivations (15.8%). Total of 56 anaerobe strains were identified and 21 aerobes were accompanied to anaerobic isolates. Aerobe isolates were associated with anaerobic microorganisms in 19 cases (43.2%). Bacteroides species (21.4%) and Pseudomonas aeruginosa (33.3%) were the most common anaerobic and aerobic isolates.

Diagnosis and treatment of pulmonary cystic hydatidosis.

OBJECTIVE: Hydatidosis is a parasitic infection that is still an important public health problem in Turkey. In the present study, it was planned to review the diagnostic and treatment options. METHODS: The study was conducted in pediatric pulmonary chest ward of Izmir Chest Diseases and Surgery Training Hospital, a referral tertiary hospital for pulmonary diseases in Western Turkey. Cases were evaluated in clinical presentations, radiological, histopathologic and serological features retrospectively. RESULTS: Consecutive 17 (11 male and 6 female; mean age 11.29 + 2.44) pediatric cases between 1996 and 2001 were evaluated. Liver involvement was found in 8 (47%) cases. Casoni skin test and IHA test were found positive in 7 (63.6%) and 8 (72.7%) out of 11 cases, respectively. Surgical treatment was performed only in 7 (41.1%) cases as well as surgical plus medical treatment was given in 3 (17.6%) cases. Seven (41.1%) cases were treated just medically. CONCLUSION: Hydatidosis should be considered in the existence of appropriate clinical and radiological findings as a probable diagnosis in all children in our region. Surgery should be the first choice for treatment but, medical therapy was considered as effective for treatment complicated and/or nonsurgical pediatric cases.

Molecular identification and characterization of rifampicin-resistant Mycobacterium tuberculosis isolates by line probe assay: an approach for rapid diagnosis of multidrug-resistant tuberculosis.

AIM: Early identification and characterization of rifampicin-resistant (R(r)) Mycobacterium tuberculosis isolates recovered from the samples of tuberculosis (TB) patients in the Aegean (West Anatolian) Region was intended. METHODS AND RESULTS: Sixty isolates [47 (78.3%) multidrug-resistant (MDR)], which were identified as M. tuberculosis complex and phenotypically resistant to rifampicin by both BACTEC mycobacteria growth indicator tube (MGIT) 960 and 460 systems were analysed by a commercial line probe assay (INNO-LiPA Rif TB). The concordance of LiPA with the in vitro susceptibility test was found as 98.3%. Among the isolates, S531L (R5 pattern; 46.7%) and L511P/R, S512T, Q513L/K (DeltaS1 pattern; 11.7%) were the most frequent mutation patterns. As compared with the BACTEC systems and conventional techniques for cultivation, identification and in vitro susceptibility testing, INNO-LiPA Rif TB after cultivation in BACTEC MGIT 960 system provided an average of 20 days early diagnosis of R(r)M. tuberculosis isolates. CONCLUSIONS: Rapid molecular identification and characterization of R(r)M. tuberculosis isolates after BACTEC MGIT 960 cultivation would be useful for faster diagnosis, infection control and planning of accurate treatment in MDR-TB patients. SIGNIFICANCE AND IMPACT OF THE STUDY: Patients with MDR-TB need a specified treatment and efficient follow-up strategies. Rapid and practical methodologies to diagnose and follow these patients should be applied in routine use.

Humoral immune response against 38-kDa and 16-kDa mycobacterial antigens in tuberculosis.

Several ELISA tests based on mycobacterial antigens have been used for the rapid diagnosis of tuberculosis (TB), although demonstration of Mycobacterium tuberculosis in a smear or culture is the most reliable method. In the present study, the diagnostic value of 16-kDa and 38-kDa mycobacterial antigens was investigated in patients who were diagnosed with tuberculosis by clinical and/or bacteriological findings in Turkey. The PATHOZYME-TB Complex Plus commercial ELISA kit was used for measuring immunoglobulin G against 38-kDa and 16-kDa recombinant antigens. Humoral immune response was analysed in a group of 179 TB patients (143 smear-positive, 19 smear-negative, eight lymphadenitis and nine pleuritis), 15 inactive TB cases and in control groups consisting of 40 healthy volunteers and 20 subjects with pulmonary diseases other than TB. The sensitivity, specifity, positive predictive value and negative predictive value of the test were determined at 52.5%, 93.3%, 95.9% and 39.7%, respectively in TB cases. Antibodies were detected at above cut-off level in three (20%) out of 15 subjects with inactive TB. In conclusion, the ELISA test has a very good specifity and an acceptable sensitivity and positive predictive value. It is thought that it could be used in combination with other methods to increase diagnostic accuracy, especially for culture-negative tuberculosis cases, which are difficult to diagnose.

Incidence of cross resistance between rifampicin and rifabutin in Mycobacterium tuberculosis strains in Izmir, Turkey.

Rifabutin is a spiro-piperidyl-rifamycin derived from rifamycin-S. This study was planned to determine the minimal inhibitory concentrations (MICs) of rifabutin and rifampicin against Mycobacterium tuberculosis strains and to investigate cross resistance between two drugs. The agar dilution method was performed for detection of MICs of rifabutin and rifampicin for 112 M. tuberculosis strains obtained from patients with active pulmonary tuberculosis. Cross resistance between rifampicin and rifabutin was detected in 73.1%. Rifabutin MICs for rifampicin resistant strains were three- to four-fold higher than rifabutin-susceptible and/or -resistant strains' MIC values for rifampicin. Despite having 73% cross-resistance with rifampicin in M. tuberculosis isolates, it was concluded that rifabutin might be a valid component of combination therapy in rifampicin resistant tuberculosis cases when the isolate is tested and detected susceptible to rifabutin.