Investigation of the monocyte/high-density lipoprotein ratio as a prognostic criterion in burn patients.

In this study, it was aimed to investigate the monocyte/high-density lipoprotein ratio as a prognostic criterion in adult burn patients. A descriptive and cross-sectional method was adopted in this study. The sample included 177 patients with burn injuries. This study was conducted in a research and training hospital in Turkey. Data were collected by the researchers in the burn unit. Descriptive methods, Kruskal-Wallis, Mann-Whitney U, ROC curve, and correlation analyses were used for the statistical analyses of the data. While 66.1% of the patients were second-degree burn patients, 96.6% of all patients recovered and were discharged from the hospital, and the rest died. In this study, the monocyte/high-density lipoprotein ratios of the patients decreased as their clinical condition worsened. The mean C-reactive protein value of the patients was 8.52 ± 5.02 on the 7th day. A statistically significant correlation was found between an increase in monocyte counts and a decrease in high-density lipoprotein concentrations at the 24th hour, 3rd day and 7th day after the burn (p < 0.01). The monocyte/high-density lipoprotein ratio can be considered a biomarker in the identification and follow-up of sepsis and morbidity durations in burn patients. A low monocyte/high-density lipoprotein ratio in burn patients can provide an insight into the severity of sepsis.

Validity and reliability of the Turkish version of breathlessness beliefs questionnaire.

BACKGROUND: Dyspnea is often the main symptom that limits exercise; however, the vicious cycle of dyspnea limiting exercise participation is also an important contributor to the reduced exercise capacity. OBJECTIVE: The aim of our study was to investigate the reliability and validity of Turkish Breathlessness Beliefs Questionnaire (BBQ) in patients with Chronic Obstructive Pulmonary Diseases (COPD). METHODS: Seventy-seven COPD patients were included in the study. Sociodemographic and physical characteristics were recorded. Turkish version of BBQ, Saint George Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS) were applied. Second evaluation of BBQ was conducted via telephone calls with no drop-outs. Reliability of the questionnaire was explored by calculating the internal consistency and test-retest analysis. Construct validity was assessed calculating correlation coefficients of BBQ with HADS and SGRQ scores. Known group validity was also explored. RESULTS: Cronbach alpha coefficients for total score of BBQ were 0.78, indicating that the questionnaire has 'good' internal consistency. Initial and test-retest BBQ total scores were 41.42 ± 6.47 and 41.18 ± 6.24, respectively. Intra-class correlation coefficients (ICC2,1) values of BBQ and its sub-scales varied between 0.973 and 0.983, indicating strong test-retest reliability. Correlation coefficient between BBQ total and SGRQ-Activity (0.619) was highest among the variables of interest, followed by BBQ total and SGRQ total (0.611). There was a significant correlation between BBQ total and HADS (0.390). One-way analysis of variance revealed that BBQ total and BBQ-Activity Avoidance scores were significantly differ in disease stages. CONCLUSION: Turkish version of BBQ was found to be a valid and reliable tool for measuring dysfunctional beliefs related to the dyspnea in patients with COPD.

The effectiveness of small heterodimer partner and FGF 19 levels in prediction of perinatal morbidity in intrahepatic cholestasis of pregnancy.

Fibroblast growth factor 19 (FGF19) and small heterodimer partner (SHP) are molecules responsible for controlling serum bile acid levels. We designed this study for evaluating the effects of FGF 19 and SHP in intrahepatic cholestasis of pregnancy (ICP). Fifty-six pregnant women having ICP and 20 healthy pregnant women were included in the study. The patients were followed up until delivery in terms of pregnancy-related morbidity/mortality. Serum FGF 19 and SHP levels were determined by enzyme-linked immunosorbent assay (ELISA). Serum FGF 19 and SHP levels were significantly higher in the patient group compared to the control group (p: .04, p: .003, respectively). In ROC analysis, SHP level above 1995 ng/L was found effective in predicting the need for neonatal intensive care unit (ICU) follow-up with 53.8% sensitivity and 77.8% specificity. High SHP levels were correlated with perinatal morbidity, mortality and neonatal ICU hospitalisation.Impact StatementWhat is already known on this subject? Itching, elevated serum transaminase and serum total bile acid (TBA) levels are the most important clinical and biochemical findings of intrahepatic cholestasis of pregnancy (ICP). Fibroblast growth factor 19 (FGF19) and small heterodimer partner (SHP) are molecules - responsible for controlling serum bile acid levels. ICP is associated with preterm labour, asphyxia, foetal distress, stillbirth and preeclampsia.What do the results of this study add? Serum FGF 19 and SHP levels were significantly higher in the patient group compared to the control group. High SHP level was found effective in predicting the need for neonatal intensive care unit and showed a negative correlation with birth week and birth weight.What are the implications of these findings for clinical practice and/or further research? Checking SHP levels can help to predict perinatal mortality and morbidity. Treatments to be developed through the mechanism of action of FGF 19 and SHP can be promising in the treatment of ICP and other cholestatic liver diseases.

Tocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls.

Coronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case-control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching. Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion-exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels.

Serum levels of NLRC4 and MCP-2/CCL8 in patients with active Crohn's disease.

Crohn's disease (CD) is characterized by malfunction of immune-regulatory mechanisms with disturbed intestinal mucosal homeostasis and increased activation of mucosal immune cells, leading to abnormal secretion of numerous pro- and anti-inflammatory mediators. MCP2/CCL8 is produced by intestinal epithelial cells and macrophages, and is a critical regulator of mucosal inflammation. NLRC4 is expressed in phagocytes and intestinal epithelial cells and is involved in intestinal homeostasis and host defense. However, no study to date has assessed the circulating levels of NLRC4 and MCP2/CCL8 in patients with CD. The study was aimed to investigate the serum levels of MCP2/CCL8 and NLRC4 in patients with active CD. Sixty-nine patients with active CD and 60 healthy participants were included in the study. Serum levels of NLRC4 and MCP2/CCL8 were determined using an enzyme-linked immunosorbent assay. The median serum NLRC4 levels were lower in the patient group than in the controls (71.02 (range, 46.59-85.51) pg/mL vs. 99.43 (range 83.52-137.79) pg/mL) (P < 0.001). The median serum levels of MCP2/CCL8 were decreased in patients with CD (28.68 (range, 20.16-46.0) pg/mL) compared with the controls (59.96 (range, 40.22-105.59) pg/mL) (P < 0.001). Cut-off points of NLRC4 (<81 pg/mL) and MCP2/CCL8 (<40 pg/mL) showed high sensitivity and specificity for identifying active CD. In conclusion, this is the first study to examine circulating levels of MCP2/CCL8 and NLRC4 in patients with active CD. Our results suggest that serum NLRC4 and MCP2/CCL8 levels may be involved in the pathogenesis of CD and may have a protective effect on intestinal homeostasis and inflammation. Serum levels of MCP2/CCL8 and NLRC4 could be used as a diagnostic tool and therapeutic target for CD.

Prognostic Nutritional Index and CRP, age, platelet count, albumin level score in predicting mortality and intensive care unit admission for COVID-19.

Aim: In our study, we investigated the efficiency of the prognostic nutritional index (PNI) score and the CRP, age, platelet count, albumin level (CAPA) score predicting mortality and intensive care unit (ICU) admission in COVID-19 disease. Materials & methods: PNI and CAPA score of patients confirmed with COVID-19 calculated by using the complete blood count and biochemical parameters at admission to the hospital, in predicting the COVID-19-associated mortality and ICU admission were analyzed. Results: PNI and CAPA scores in predicting mortality were detected as AUC: 0.67 (p < 0.001), AUC: 0.71 (p < 0.001), respectively. For predicting ICU admission AUC was 0.66 (p < 0.001), AUC was 0.77 (p < 0.001), respectively. Conclusion: PNI and CAPA scores are effective scores in COVID-19, with CAPA score being better in predicting mortality and ICU admission.

Lay abstract The COVID-19 pandemic is a global health problem that affects all societies. In order to deal with this urgent situation, the rapid spread of the disease in outbreaks requires categorizing patients according to risk group and regulating follow-up and use of resources accordingly. Effective, practical and inexpensive biomarkers are needed. We present to you the CAPA score calculated from CRP, age, platelet count, albumin levels, which is an effective score in predicting mortality and ICU admission in COVID-19.

Elevation of Serum Transaminase Levels Due to Favipiravir Use in the Treatment of COVID-19.

BACKGROUND AND AIMS: Favipiravir is a ribonucleic acid (RNA)-dependent RNA polymerase (RdRP) inhibitor antiviral agent used in the treatment of coronavirus disease-2019 (COVID-19). In this study, we investigated the changes in serum transaminase levels of patients and the relationship between serum transaminase elevation with mortality in patients who were hospitalized with the diagnosis of COVID-19 and received favipiravir treatment. MATERIALS AND METHODS: 454 patients who received favipiravir and 113 patients who did not receive favipiravir were evaluated. Serum transaminase levels of the patients were compared at baseline and after five days of treatment, and the relationship between serum transaminase elevation and mortality was investigated. RESULTS: No significant aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation was detected due to favipiravir treatment. AST elevation was found, respectively, as 133 (29.3%), 32 (28.3%) (p=0.100), ALT elevation as 112 (24.7%), 35 (29.3%) (p=0.100) in the groups receiving and not receiving favipiravir. High AST level was found as a risk factor for mortality in all patient groups (p=0.008). CONCLUSIONS: There was no statistically significant elevation in serum transaminase levels due to favipiravir use in patients hospitalized for COVID-19. A high level of AST is a significant risk factor to show mortality and intensive care unit (ICU) admission in patients with COVID-19.

Effect of inspiratory muscle training on dyspnea-related kinesiophobia in chronic obstructive pulmonary disease: A randomized controlled trial.

BACKGROUND: The major symptom of chronic obstructive pulmonary disease (COPD) is dyspnea, which causes dyspnea-related kinesiophobia resulting in avoidance of activities associated with dyspnea or compensation by reducing the rate of activity. The aim of this study was to assess dyspnea-related kinesiophobia and determine the effect of inspiratory muscle training (IMT) on dyspnea-related kinesiophobia in COPD. METHODS: Forty COPD subjects were randomly allocated to either the IMT or sham group. Both groups' maximal inspiratory pressure (MIP) was assessed weekly. All patients were instructed to perform the training exercises for 15 min twice a day, 5 days a week for a total of 8 weeks. In the IMT group, intensity was set at 30% of MIP and adjusted according to weekly MIP value. In the sham group, intensity remained constant at 15% of initial MIP. Pulmonary function test (PFT), respiratory muscle strength, 6-min walk test (6 MWT), Breathlessness Beliefs Questionnaire (BBQ), Modified Medical Research Council scale (MMRC), modified Borg scale, Hospital Anxiety and Depression Scale (HADS), Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT) were assessed before and after the intervention. RESULTS: BBQ scores ranged from 18 to 51, with mean values in the IMT and sham groups of 39.80 ± 7.62 and 43.00 ± 6.58, respectively. When between-group differences of all outcome scores were compared, there was a statistically significant improvement in the IMT group than in the sham group (p < 0.05). After IMT, statistically significant decreases in BBQ and modified Borg scores were observed in within groups (p ≤ 0.001). These decreases were significantly greater in the IMT group (p ≤ 0.001). MMRC decreased significantly only in the IMT group (p < 0.001). There was a statistically significant increase in PFT values in the IMT group (p = 0.007-0.045), but no difference in the sham group (p = 0.129-0.886). Both groups showed statistically significant improvement in respiratory muscle strength, 6 MWT distance, and CAT score after 8 weeks (p < 0.05). All HADS and SGRQ scores decreased significantly in the IMT group (p < 0.001), whereas only the SGRQ activity score decreased significantly in the sham group (p = 0.017). CONCLUSIONS: Our study provides data on the presence and level of dyspnea-related kinesiophobia in COPD patients. All patients had BBQ scores higher than 11, indicating dyspnea-related kinesiophobia. IMT reduced BBQ score and improved respiratory function, and exercise capacity. Our results also support the other known benefits of IMT such as reduced dyspnea and symptom perception, decreased anxiety and depression, and improved quality of life.

Role of serum organic solute transporter alpha/beta and sodium taurocholate cotransporting polypeptide in intrahepatic cholestasis of pregnancy.

OBJECTIVES: This study aimed to assess the role of OST-α, OST-ß and NTCP in patients with ICP, with a view to determine patients with severe prognosis and to minimize adverse fetal outcomes. MATERIAL AND METHODS: Sixty-nine pregnant women diagnosed with ICP and 50 healthy women were included the study. Serum OST-α, OST-ß and NTCP were measured using ELISA kits. RESULTS: The median OST-α levels were 176.3 pg/mL in women with ICP and 201 pg/mL in healthy subjects (p = 0.205). The median OST-ß levels were found to be 51.17 pg/mL in patients with ICP and 40.9 pg/mL in controls (p = 0.033). Median NTCP levels were 519.7 ng/mL in the ICP group and 483.3 ng/mL in healthy women (p = 0.051). CONCLUSIONS: This is the first study to evaluate serum levels of OST-α, OST-ß and NTCP in patients with ICP. It is likely that OST-α, OST-ß and NTCP contribute to the etiopathogenesis of ICP. Serum OST-α and OST-ß levels can be used as diagnostic and monitoring markers of ICP, and the inhibition of these molecules could provide therapeutic benefit in ICP by reducing the circulation of enterohepatic bile acids.

Relationship between pruritus and autotaxin in intrahepatic cholestasis of pregnancy / Relación entre el prurito y la autotaxina en la colestasis intrahepática del embarazo

Objective: Intrahepatic cholestasis of pregnancy is a temporary, pregnancy-specific disease that resolves with delivery, characterized by itching (pruritus), as well as high transaminase and serum bile acid levels in the third trimester of pregnancy. Due to the effects of Autotaxin on the physiology of pregnancy, we aimed to investigate Autotaxin activity in patients with intrahepatic cholestasis of pregnancy. Patients and methods: Sixty-nine patients diagnosed with intrahepatic cholestasis of pregnancy and 20 healthy pregnant women were enrolled in the study. Fasting serum bile acid, pruritus intensity, serum parameters, gestational week of the patients at the time of diagnosis were recorded, and birth week and birth weight were monitored. Autotaxin serum level was measured enzymatically. Results: The mean serum bile acid level (n=69; 38.74±35.92μmol/L) in patients with intrahepatic cholestasis of pregnancy (n=69) was detected to be higher than healthy pregnant women (n=20; 5.05±1.88μmol/L) (p<0.001). Weak correlation was detected between serum bile acid level and itch intensity (p=0.014, r=0.295), while no relation was detected between Autotaxin and itch intensity (p=0.446, r=0.09). Although mean Autotaxin (intrahepatic cholestasis of pregnancy: 678.10±424.42pg/mL, control: 535.16±256.47pg/mL) levels were high in patients with intrahepatic cholestasis of pregnancy, it was not statistically significant (p=0.157). Conclusion: In our study, we observed that the serum Autotaxin level did not make a significant difference in patients with intrahepatic cholestasis of pregnancy compared to healthy pregnant women. These findings suggest that larger clinical studies are required to reveal the physio-pathological effects of Autotaxin on pregnancy.(AU)

Objetivo: La colestasis intrahepática del embarazo es una enfermedad temporal específica del embarazo caracterizada por picazón (prurito), niveles elevados de transaminasas y ácidos biliares séricos elevados en el tercer trimestre del embarazo que se resuelve con el parto. Debido a los efectos de la autotaxina en la fisiología del embarazo, nuestro objetivo fue investigar la actividad de la autotaxina en pacientes con colestasis intrahepática del embarazo. Pacientes y métodos: En el estudio se incluyeron 69 pacientes con diagnóstico de colestasis intrahepática del embarazo y 20 mujeres embarazadas sanas. Registramos los ácidos biliares séricos en ayunas, la intensidad del prurito, los parámetros séricos y la semana de gestación de las pacientes en el momento del diagnóstico, y controlamos la semana del parto y el peso al nacer. Los niveles séricos de autotaxina se midieron de forma enzimática. Resultados: Se observó que el nivel medio de ácidos biliares en suero era mayor en pacientes con colestasis intrahepática del embarazo (n=69; 38,74±35,92μmol/l) que en mujeres embarazadas sanas (n=20; 5,05±1,88μmol/l) (p<0,001). Se detectó una correlación débil entre el nivel de ácidos biliares en suero y la intensidad del prurito (p=0,014; r=0,295), mientras que no se observó ninguna relación entre la autotaxina y la intensidad del prurito (p=0,446; r=0,09). Aunque los niveles medios de autotaxina fueron altos en pacientes con colestasis intrahepática del embarazo (678,10±424,42 frente a 535,16±256,47pg/ml en los controles), la diferencia no fue estadísticamente significativa (p=0,157). Conclusión: Observamos que el nivel de autotaxina sérica no supuso una diferencia significativa en pacientes con colestasis intrahepática del embarazo en comparación con las mujeres embarazadas sanas. Estos hallazgos sugieren que se requieren estudios clínicos más amplios para determinar los efectos fisiopatológicos de la autotaxina en el embarazo.(AU)

Evaluation of G-Protein-Coupled Bile Acid Receptor 1 (TGR5) Levels in Intrahepatic Cholestasis of Pregnancy.

Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-protein-coupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.

Relationship between pruritus and autotaxin in intrahepatic cholestasis of pregnancy.

OBJECTIVE: Intrahepatic cholestasis of pregnancy is a temporary, pregnancy-specific disease that resolves with delivery, characterized by itching (pruritus), as well as high transaminase and serum bile acid levels in the third trimester of pregnancy. Due to the effects of Autotaxin on the physiology of pregnancy, we aimed to investigate Autotaxin activity in patients with intrahepatic cholestasis of pregnancy. PATIENTS AND METHODS: Sixty-nine patients diagnosed with intrahepatic cholestasis of pregnancy and 20 healthy pregnant women were enrolled in the study. Fasting serum bile acid, pruritus intensity, serum parameters, gestational week of the patients at the time of diagnosis were recorded, and birth week and birth weight were monitored. Autotaxin serum level was measured enzymatically. RESULTS: The mean serum bile acid level (n=69; 38.74±35.92µmol/L) in patients with intrahepatic cholestasis of pregnancy (n=69) was detected to be higher than healthy pregnant women (n=20; 5.05±1.88µmol/L) (p<0.001). Weak correlation was detected between serum bile acid level and itch intensity (p=0.014, r=0.295), while no relation was detected between Autotaxin and itch intensity (p=0.446, r=0.09). Although mean Autotaxin (intrahepatic cholestasis of pregnancy: 678.10±424.42pg/mL, control: 535.16±256.47pg/mL) levels were high in patients with intrahepatic cholestasis of pregnancy, it was not statistically significant (p=0.157). CONCLUSION: In our study, we observed that the serum Autotaxin level did not make a significant difference in patients with intrahepatic cholestasis of pregnancy compared to healthy pregnant women. These findings suggest that larger clinical studies are required to reveal the physio-pathological effects of Autotaxin on pregnancy.

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA).

INTRODUCTION: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. MATERIALS AND METHODS: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. RESULT: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency. CONCLUSIONS: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.

Comparison of serum biochemical markers in patients with mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos.

BACKGROUND: In this study, we aimed to compare serum biochemical markers in patients with malignant pleural mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos. METHODS: Between September 01, 2010 and March 31, 2011, a total of 540 participants (354 males, 186 females; mean age 61.4 years; range, 35 to 89 years) were included in the study. The participants were divided into four groups as follows: (1) patients with pleural plaques (n=277); (2) healthy individuals with normal chest X-rays who were exposed to environmental asbestos (n=121); (3) healthy individuals with normal chest X-rays who were not exposed to environmental asbestos (n=118); and (4) patients with malignant pleural mesothelioma (n=24). Serum levels of carcinoembryonic antigen, cancer antigen 125, 15-3, 19-9, free T3, free T4, thyroidstimulating hormone, vitamin B12, folate, and ferritin were measured. RESULTS: Serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels were higher with lower free T3 levels in Group 4 than the other groups. The areas under the curve for cancer antigen 125 and 15-3 were 0.78 and 0.67, respectively in the differential diagnosis of mesothelioma from other pathologies (p<0.001 for both). Optimal limits of these biomarkers were 13.63 and 18.43 ng/mL, respectively with 83% and 75% sensitivity and 69% and 48% specificity, respectively. CONCLUSION: The combination or individual use of serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.

Combined orthodontic-orthopedic treatment of an adolescent Class II Division 2 patient with extreme deepbite using the Forsus Fatigue Resistant Device.

Class II Division 2 malocclusion is often characterized by severe, traumatic deepbite with lingually inclined and overerupted incisors. Combined orthodontic-orthopedic treatment of this malocclusion is a challenging issue for orthodontists. This case report describes the combined orthodontic-orthopedic treatment of an adolescent Class II Division 2 patient with an extreme deepbite and a retrognathic mandible using the Forsus Fatigue Resistant Device.

Relationship of CTLA4 and CD28 polymorphisms with lung involvement, HRCT findings and pulmonary function tests in Turkish patients with ankylosing spondylitis.

BACKGROUND AND AIMS: Ankylosing spondylitis (AS) is a multisystem disorder with ocular, pulmonary, and cardiovascular involvement. The incidence of pulmonary involvement varies from 1 to 52%. Abnormal T-cell function-derived immune responses are involved in AS pathogenesis. Numerous genes such as CTLA4 and CD28 control T-cell functions. In this study, we aimed to address the relationship between CTLA4 and CD28 polymorphisms and lung involvement in Turkish patients with AS. METHODS: A cross-sectional evaluation of 80 healthy and 89 AS subjects with no active infection or malignancy was performed to determine the relationship between pulmonary involvement and CTLA4 and CD28 gene polymorphisms. All patients were assessed for clinical, radiological, and spirometric findings. Descriptive statistics, chi-square tests, and independent-sample t-tests were used for statistical analyses. RESULTS: All patients with the CD28 CC genotype (n = 4) had abnormal HRCT, but it was not significant (p = 0.47). All of the normal HRCT patients have CD 28 T alleles. In addition to this data ; 4 patients who have not any T alleles have abnormal HRCT finding. It was significant and was considered that T genotype have protective effect (p= 0,047) on radiologic involvement but no other association was found between CTLA4 and CD28 gene polymorphism with respect to pulmonary function tests (PFT), diffusion capacity, and clinical characteristics in the Turkish patients with AS. CONCLUSION: Our results suggest a possible association of CTLA4 and CD28 variants with AS pulmonary involvement. Furthermore, these results may lead to the development of new therapeutic agents to control more aggressive forms of the disease. However, further studies are needed in larger populations.

Six-Year Survival of a Mini Dental Implant-Retained Overdenture in a Child with Ectodermal Dysplasia.

Patients with ectodermal dysplasia (ED) experience several problems caused by abnormal development and functioning of the head and neck region. In addition to developmental nasal cartilage abnormalities and absence of sweat glands, hair, and eyebrows, edentulism or developmental disorders of teeth (cone-shaped teeth) are commonly observed in these types of patients. ED is also characterized by underdeveloped alveolar ridges, a decreased occlusal vertical dimension, reduced salivary secretion, and dry oral mucosa, which make prosthetic rehabilitation difficult. Few studies of intraosseous dental implant-retained prostheses have described adverse effects on craniofacial growth and esthetic and functional disadvantages, while some researchers have described the advantages of this treatment option as an alternative option in these cases. Due to the associated alveolar bone deficiency, dental mini-implant therapy may be a treatment option for these patients; however, there are isolated cases in the literature regarding the rehabilitation of ED patients with mini-implant-supported overdentures. This clinical report describes the rehabilitation of a 6-year-old child with ED using a maxillary removable partial prosthesis and a mini-implant-retained mandibular overdenture. The clinical and radiographic findings of this prosthetic rehabilitation during the 6-year follow-up are also presented.

Effects of casein phosphopeptide-amorphous calcium phosphate application after interproximal stripping on enamel surface: An in-vivo study.

INTRODUCTION: The aim of this study was to investigate the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application after interproximal stripping on enamel surface structures in vivo. METHODS: Fifteen patients with a mean age of 15.8 years participated in this study. For each patient, the extraction of 4 first premolars was part of the orthodontic treatment plan. The patients were randomly divided into 5 groups of 3 patients. With the exception of group 1, the mesial and distal surfaces of all first premolars were stripped with a stripping disc (Komet; Gebr Brasseler, Lemgo, Germany) under air cooling and then polished with Sof-Lex polishing discs (3M Dental Products, St Paul, Minn). In group 1, no stripping was performed, and the teeth were removed immediately. In group 2, the teeth were removed immediately after the stripping. In group 3, the stripped teeth were extracted after exposure to oral conditions for 3 months. In groups 4 and 5, CPP-ACP (Recaldent Tooth Mousse; GC Europe, Leuven, Belgium) or fluoride varnish (Bifluoride 12; Voco, Cuxhaven, Germany) was applied to the stripped surfaces for 3 months, respectively, before the teeth were extracted. Surface roughness and microhardness values were evaluated with 1-way analysis of variance and Tukey HSD tests. RESULTS: The CPP-ACP and the fluoride varnish applications increased the surface roughness and microhardness values that had been decreased by stripping. No statistically significant differences were found between groups 3, 4, and 5 for microhardness or between groups 4 and 5 for surface roughness (P > 0.5). CONCLUSIONS: The saliva and saliva plus remineralizing agents (fluoride varnish and CPP-ACP) increased the microhardness and surface roughness values of stripped enamel surfaces that had been decreased by stripping.