Does base excess predict kidney injury in neonates with hypoxic-ischemic encephalopathy?

In neonates with hypoxic-ischemic encephalopathy (HIE), we studied the correlation between cord blood base excess (BE) and kidney function. Among 225 infants, 29 % had oliguria. BE levels differed significantly between oliguric and non-oliguric infants (p < 0.01), with a negative correlation to kidney injury (r = -0.544, p < 0.01). BE < -18 had 85 % specificity and 76 % sensitivity in predicting kidney injury (AUC = 0.88). These findings suggest BE as a valuable indicator of impending kidney injury in HIE infants, though underlying mechanisms may vary.

Medical faculty students risk perception, attitudes, and behaviors regarding protection from COVID-19 infection.

OBJECTIVE: This study aims to determine the risk perception, attitude, and behavior characteristics of Pamukkale University Faculty of Medicine students towards protection from COVID-19. SUBJECTS AND METHODS: A total of 698 (48.2%) students of Pamukkale University Faculty of Medicine participated in this analytical cross-sectional study. Dependent variables were attitudes and behaviors related to protection from COVID-19, and independent variables were socio-demographic characteristics, sources of information about COVID-19, and health status. Data was collected through a survey using Google Forms. SPSS 17.0 (Inc., Chicago, IL, USA) software package was used for statistical analysis. Descriptive statistics were expressed as numbers and percentages for nominal data and mean and standard deviation for numerical data. Numerical data were compared with Mann Whitney U and Kruskal Wallis tests. Spearman correlation and backward linear regression analyses were used. A p-value of <0.05 was considered significant. RESULTS: The mean age of 698 students participating in the study was 21.8±2.2, and 60% of them were female. The mean attitude score was 54.99±5.17 and the mean behavior score was 50.64±6.06. The information sources of the students about COVID-19 were TV news (69.3%). Linear regression analysis revealed that attitude scores of the female gender were higher than male gender (ß=0.757±0.364 p=0.038, 95% CI: 0.440-1.471) and scores for using websites/social media accounts of professional organizations and professional associations as information sources were higher than not using (ß=0.981 ± 0.388 p=0.011 95% CI: 0.230-1.732). CONCLUSIONS: Medical students' attitude and behavior score towards protection against COVID-19 infection is slightly above the average level. Medical education should prepare students to manage epidemics.

Evaluation of a novel mid-infrared pyrometer for dynamic material experiments.

Temperature is a complicated thermodynamic parameter to measure in dynamic compression experiments. Optical pyrometry is a general-purpose "work-horse" technique for measuring temperature from a radiant surface on these experimental platforms. The optical pyrometry channels are commonly held to the visible or Near-Infrared spectrum, which provides high fidelity temperature measurement for shock temperature above ∼1200-1500 K. However, low temperature (T < 1200 K) dynamic material experiments, including low pressure or quasi-isentropic studies, as well as experiments with complex thermodynamic paths, require Mid-Infrared (Mid-IR) for high fidelity measurements. This article outlines the design, testing, and characterization of a novel Mid-IR pyrometer system that can be configured between 2.5 and 5.0 µm, suitable for lower temperature measurements and for increasing the fidelity and precision of higher temperature measurements. Experimental validation was done on two separate gas gun platforms, with two separate impact velocities, achieving temperatures between 450 and 1100 K.

Associations of coronary plaque characteristics and coronary calcification with bone mineral density in postmenopausal women.

OBJECTIVE: We aimed at investigating the association of postmenopausal osteoporosis in different measurement locations, with the coronary plaque burden and morphology detected by coronary computed tomography angiography (CCTA). PATIENTS AND METHODS: We analyzed a total of 223 postmenopausal women who had undergone both dual-energy X-ray absorptiometry (DXA) and CCTA. Coronary plaque characteristics were analyzed using CCTA. RESULTS: The number of burdens was higher in the osteoporosis/osteopenia group of patients than in the normal group. Agatston score and BMI were not significantly different between the two groups. T-score femur and bone mineral density (BMD) femur were higher in patients with severe coronary artery disease (CAD as compared to those with mild CAD (p=0.036 and p=0.049, respectively), whereas T-score lumbar and BMD lumbar were not significantly different. Non-calcified/mixed plaque burden was an independent predictor of osteopenia/osteoporosis (OR: 1.396, 95% CI 1.007-1.934; p=0.045) together with age (OR: 1.053, 95% CI 1.015-1.093; p=0.006). CONCLUSIONS: Non-calcified/mixed plaque burden was significantly and independently associated with osteoporosis/osteopenia at femoral neck but not at lumbar spine. Osteopenia/osteoporosis was not significantly associated with CAC.

Acute effects of postural changes and lower body positive and negative pressure on the eye.

Introduction: Entry into weightlessness results in a fluid shift and a loss of hydrostatic gradients. These factors are believed to affect the eye and contribute to the ocular changes that occur in space. We measured eye parameters during fluid shifts produced by lower body negative pressure (LBNP) and lower body positive pressure (LBPP) and changes in hydrostatic gradient direction (supine-prone) in normal subjects to assess the relative effects of fluid shifts and hydrostatic gradient changes on the eye. Methods: Ocular parameters (intraocular pressure (IOP), ocular geometry, and optical coherence tomography measures) were measured in the seated, supine, and prone positions. To create a fluid shift in the supine and prone positions, the lower body chamber pressure ranged from -40 mmHg to +40 mmHg. Subjects maintained each posture and LBNP/LBPP combination for 15 min prior to data collection. A linear mixed-effects model was used to determine the effects of fluid shifts (as reflected by LBNP/LBPP) and hydrostatic gradient changes (as reflected by the change from seated to supine and from seated to prone) on eye parameters. Results: Chamber pressure was positively correlated with both increased choroidal thickness (ß = 0.11 , p = 0.01) and IOP (ß = 0.06 p < 0.001). The change in posture increased IOP compared to seated IOP (supine ß = 2.1, p = 0.01, prone ß = 9.5, p < 0.001 prone) but not choroidal thickness. IOP changes correlated with axial length (R = 0.72, p < 0.001). Discussion: The effects of hydrostatic gradients and fluids shifts on the eye were investigated by inducing a fluid shift in both the supine and prone postures. Both hydrostatic gradients (posture) and fluid shifts (chamber pressure) affected IOP, but only hydrostatic gradients affected axial length and aqueous depth. Changes in choroidal thickness were only significant for the fluid shifts. Changes in hydrostatic gradients can produce significant changes in both IOP and axial length. Fluid shifts are often cited as important factors in the pathophysiology of SANS, but the local loss of hydrostatic gradients in the head may also play an important role in these ocular findings.

The effect of halofuginone and pirfenidone on wound healing in experimental glaucoma filtration surgery.

PURPOSE: To investigate the effects of halofuginone and pirfenidone on wound healing in experimental glaucoma filtration surgery (GFS). STUDY DESIGN: Animal experimentation. METHODS: A total of 42 male New Zealand albino rabbits were separated into 6 equal groups. A limbal-based trabeculectomy was performed on 5 groups, and Group I (control group) underwent no surgery and received no postoperative medication. For Group II (sham group), 1 drop 0.9% NaCl was instilled qid for 14 days. For Group III, 1% topical corticosteroid (prednisolone acetate) was instilled 1 drop qid for 14 days. For Group IV, 0.4mg/mL mitomycin-C (MMC) was applied intraoperatively to the region of the scleral flap. For Group V, 0.5% pirfenidone was instilled 1 drop qid for 14 days postoperatively. For Group VI, a sponge soaked in 10ng/mL halofuginone was applied to the surgical region for 3 mins. In addition, 1% topical corticosteroid was instilled ×1 drop qid for 14 days postoperatively for Groups IV, V and VI. After 14 days, sections prepared from the bleb regions of the enucleated eyes were evaluated histopathologically and immunohistochemically. Statistical analyses of the study were performed with Kruskal-Wallis variance analysis and the Mann-Whitney U test. RESULTS: With regard to fibroblasts, suppression of the number of mononuclear cells and immunohistochemical staining intensity of transforming growth factor-b (TGF-ß), fibroblast growth factor-b (FGF-ß) and platelet derived growth factor (PDGF), the corticosteroid, MMC, pirfenidone and halofuginone groups were seen to exhibit more effect than the sham group (P<0.05). Compared to the pirfenidone and fuginone groups, inhibition of fibroblast and monocyte proliferation was determined to be lower in the MMC group (P<0.05). The intensity of TGF-ß and FGF-ß staining was seen to be lower in these two treatment groups than in the MMC group (P<0.05). CONCLUSIONS: Halofuginone and pirfenidone may be used as effective alternative agents in delaying wound healing in glaucoma filtration surgery.

A multi-wavelength streaked optical pyrometer for dynamic shock compression measurements above 2500 K.

This article presents a concept and implementation of a calibrated streaked spectral pyrometer (SSP) temperature diagnostic used in dynamically driven shock experiments on a two-stage gas gun. This system relies upon measuring the total system response using a tunable monochromator, a NIST-traceable calibrated power meter, and a SSP. The diagnostic performance is validated against previously measured temperatures of shock driven z-cut quartz at 99 GPa and 93 GPa. The results are found to agree with the literature to within 5% and are discussed in this manuscript. The experimental setup utilizes measurements from multiple SSP systems per sample, providing several independent measurements and substantially increasing confidence in the extrapolated shock driven sample temperature.

The comparison of the efficacy of diffusion weighted imaging (DWI) sequences with 3 different T2-weighted sequences in the detection of focal liver lesions.

PURPOSE: In this study we aimed to compare and evaluate the efficacies of the low and high b value diffusion weighted imaging (DWI) sequences with three different T2-weighted (T2W) sequences. MATERIALS AND METHODS: 255 liver lesions of 147 patients who had undergone MR examinations of the upper abdomen were evaluated. A maximum number of 4 lesions was taken for consideration in patients with multiple lesions. Low and high b valued DWI and 3 different T2W sequences (SSFSE, FIESTA, and PROPELLER FSE) were utilized. The evaluations were done by 3 different radiologists, by utilizing the double blind principle. RESULTS: The lesion detection performances of the b 0 DWI, b 600 DWI, FIESTA T2W, SSFSE T2W, and PROPELLER FSE T2W sequences, were 95.7 %, 66.3 %, 94.4 %, 92.8 %, and 93.8 %, in sequence order. The high b value DWI sequence was able to detect malignant lesions with a higher accuracy rate than the T2W sequences. There was a moderate to high rate of agreement among the interpreters, and the lesion-detection rates of the interpreters were in line with their levels of expertise. CONCLUSION: Even though the higher lesion detection rates of the DWI sequences were not found to be statistically significant, it was concluded that making the evaluations with the addition of DWI to the imaging protocol would certainly decrease the lesion-missing rate, and it would be wise to utilize the DWI technique in routine liver MR imaging.

Knowledge and attitude changes of pregnant women regarding prenatal screening and diagnostic tests after counselling.

OBJECTIVES: This study aimed to reveal the knowledge level of pregnant women about prenatal diagnostic tests, Down syndrome (DS) and amniocentesis, their attitudes toward uptaking these tests, undergoing amniocentesis, and the termination of pregnancy. It also aimed to evaluate the effects of providing information, as well as a written information brochure about all the issues concerning women's knowledge and attitudes. MATERIALS AND METHODS: The gynecologists provided verbal and written information on prenatal screening tests (PSTs) and invasive prenatal diagnostic tests. Data were collected using an anonymous questionnaire, which was designed by the researchers on the basis of the literature. RESULTS: Knowledge of both DS and amniocentesis was found to be significantly higher after the education (p = 0.000 and p = 0.000, respectively). Attitudes toward amniocentesis changed significantly after the education. CONCLUSIONS: This study has shown that women had an inadequate knowledge about PSTs, DS, and amniocentesis. It has also revealed that education provided by gynecologists along with a written brochure of information tended to increase women's knowledge about PSTs.

Linking initial microstructure and local response during quasistatic granular compaction.

We performed experiments combining three-dimensional x-ray diffraction and x-ray computed tomography to explore the relationship between microstructure and local force and strain during quasistatic granular compaction. We found that initial void space around a grain and contact coordination number before compaction can be used to predict regions vulnerable to above-average local force and strain at later stages of compaction. We also found correlations between void space around a grain and coordination number, and between grain stress and maximum interparticle force, at all stages of compaction. Finally, we observed grains that fracture to have an above-average initial local void space and a below-average initial coordination number. Our findings provide (1) a detailed description of microstructure evolution during quasistatic granular compaction, (2) an approach for identifying regions vulnerable to large values of strain and interparticle force, and (3) methods for identifying regions of a material with large interparticle forces and coordination numbers from measurements of grain stress and local porosity.

Dental pulp stone formation during orthodontic treatment: A retrospective clinical follow-up study.

OBJECTIVE: The aim of this study was two-fold: (1) To assess the incidence of dental pulp stone formation during orthodontic treatment, and (2) to determine the correlations between the presence of dental pulp stones and age, gender, and dental arches. MATERIALS AND METHODS: A sample of 545 patients (334 girls and 211 boys, age range; 12-22 years) who had undergone nonextraction orthodontic treatment were included in this study. 8442 teeth (T1) and 8410 teeth (T2), including the first and second maxillary and mandibular premolars and molars were evaluated from the pre- (T1) and post-treatment (T2) panoramic radiographs of the patients. The Pearson Chi-square test was used to investigate the associations between the presence of dental pulp stone, gender, age, tooth type and arches. RESULTS: Dental pulp stones were detected in 3% of the teeth at pretreatment panoramic radiographs and 5.2% of the teeth at posttreatment panoramic radiographs. Pulp stone prevalence increased pointedly (2.2%) in the pre- and post-treatment radiographs (P < 0.001). Also, there was a significant difference between the age groups (P < 0.001). In the maxilla, dental pulp stones were found significantly more than that in the mandible at T1 and T2 panoramic radiographs. Maxillary first molars exhibited dental pulp stones the most frequently, followed by the maxillary second molars and mandibular first molars. CONCLUSION: Orthodontic treatment may trigger the formation of dental pulp stones. However, further studies are required to determine the relationship between the pulp stone formation and orthodontic treatment.

Reduction in serum paraoxonase level in newborns with hyperbilirubinemia as a marker of oxidative stress.

OBJECTIVE: Indirect bilirubin exerts an antioxidant effect when increased mildly. This study aimed to investigate whether increased bilirubin levels lead to an oxidant effect in newborns with hyperbilirubinemia requiring phototherapy. PATIENTS AND METHODS: The study included 30 term newborn infants aged 0-7 days with indirect hyperbilirubinemia requiring phototherapy and no comorbid disease as the study group. In addition, 30 term healthy newborn infants aged 0-7 days without indirect hyperbilirubinemia were employed as a control group. Serum triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), serum paraoxonase (PON) levels and malondialdehyde (MDA) levels were compared between the groups. RESULTS: Serum MDA, total bilirubin, and LDL and HDL levels were significantly higher and the serum PON level was significantly lower, in the study group compared with the controls (p < 0.05). CONCLUSION: In newborns with hyperbilirubinemia requiring phototherapy, an increased bilirubin level causes oxidative stress by decreasing the level of serum PON and increasing the level of MDA.

Single-pulse x-ray diffraction using polycapillary optics for in situ dynamic diffraction.

Diagnostic use of single-pulse x-ray diffraction (XRD) at pulsed power facilities can be challenging due to factors such as the high flux and brightness requirements for diffraction and the geometric constraints of experimental platforms. By necessity, the x-ray source is usually positioned very close, within a few inches of the sample. On dynamic compression platforms, this puts the x-ray source in the debris field. We coupled x-ray polycapillary optics to a single-shot needle-and-washer x-ray diode source using a laser-based alignment scheme to obtain high-quality x-ray diffraction using a single 16 ns x-ray pulse with the source >1 m from the sample. The system was tested on a Mo sample in reflection geometry using 17 keV x-rays from a Mo anode. We also identified an anode conditioning effect that increased the x-ray intensity by 180%. Quantitative measurements of the x-ray focal spot produced by the polycapillary yielded a total x-ray flux on the sample of 3.3 ± 0.5 × 10(7) molybdenum Kα photons.

Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia.

INTRODUCTION: We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia. PATIENTS AND METHODS: This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study. RESULT: Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis.

The effect of OK-432 (Picibanil) injection on the histopathology of nasal turbinate.

OBJECTIVE: This study aimed to assess the histopathological effect of OK-432 (Picibanil) on rabbit nasal turbinates. METHODS: A total of 21 rabbits were divided into 3 treatment groups and various parts of both nasal turbinates were injected with 0.5 ml OK-432, 0.2 ml OK-432 or 0.6 ml saline (control). Bilateral nasal turbinates were later excised and studied under light microscopy to assess any histopathological changes. RESULTS: Animals in the 0.2 ml and 0.5 ml OK-432 groups exhibited mild ciliary loss, goblet cell loss and epithelial damage, and a marked increase in inflammatory cell infiltration, submucosal vascularisation and fibrosis. There was a significant difference in histopathological changes between the two OK-432 treated groups. In addition, each OK-432 treated group had significantly more inflammatory cell infiltration, increased submucosal vascularisation and fibrosis compared with controls. CONCLUSION: The marked fibrosis observed in OK-432-injected turbinates may be responsible for a reduction in turbinate size.

Practical uncertainty reduction and quantification in shock physics measurements.

We report the development of a simple error analysis sampling method for identifying intersections and inflection points to reduce total uncertainty in experimental data. This technique was used to reduce uncertainties in sound speed measurements by 80% over conventional methods. Here, we focused on its impact on a previously published set of Mo sound speed data and possible implications for phase transition and geophysical studies. However, this technique's application can be extended to a wide range of experimental data.

Evaluation of treatment outcomes of early-stage endometrial cancer radiotherapy: a single center experience.

BACKGROUND: Postoperative adjuvant radiotherapy (RT) in the management of early stage endometrial cancer (EC) is still controversial. Here we report our institutional experience with patients who received postoperative RT for stage I-II EC over a period of 35 years and assess potential predictors of local recurrence (LR), distant metastasis (DM), and overall survival (OS). MATERIALS AND METHODS: A total of 188 patients undergoing postoperative RT for stage IA-II EC between 1977 and 2012 were evaluated. Some 96 received median 46 Gy whole pelvic radiotherapy (WPRT) (range: 40-60 Gy), 37 were given WPRT with vaginal cuff therapy (VCT), and 55 received only VCT either with brachytherapy (BT) or stereotactic body radiotherapy (SBRT). Chemotherapy was given to 5 patients with uterine papillary serous carcinoma (UPSC). Logistic regression analysis was used to assess the effect of clinicopathological factors on LR, DM, and OS. RESULTS: Median follow-up time was 11 years (range: 1-35 years). At the time of analysis, 34 patients were not alive. Of the 15 patients with LR, 7 (46.7%) recurred in the vaginal stump, 5 (33.3%) in the pelvic region, and 3 (20%) in the paraaortic nodal region, while 12 had distant metastasis. UPSC histology (p=0.027), sole VCT (p=0.041), high histologic grade (p=0.034), and age≥71 (p=0.04) were poor prognostic factors on univariate analysis. CONCLUSIONS: In our patients receiving radiotherapy for early-stage EC, grade III disease and age≥71 were associated with shorter OS whereas UPSC histology was an independent predictor for both LR and DM.

Shear bond strength of a self-adhering flowable composite when used for lingual retainer bonding.

OBJECTIVE: The goal of this work was to assess the shear bond strength (SBS) and fracture mode of a self-adhering flowable composite when used after thermocycling for lingual retainer bonding. MATERIALS AND METHODS: A total of 80 human mandibular incisor teeth were categorized into four equal groups: group 1: Vertise™ Flow (VF) without acid etching; group 2: VF with acid etching; group 3: VF with a self-etching bonding agent accompanied by an additional acid etching; group 4: Transbond LR control. Either VF or Transbond LR was applied to the lingual surface of the teeth by packing the material into cylindrical plastic matrices to simulate the lingual retainer bonding area. After all teeth were thermocycled (5000 cycles, 5 and 55 °C), fracture modes were examined under × 20 magnification. The SBS data were assessed via analysis of variance (ANOVA) and Tukey's tests. Fracture modes were analyzed by the χ(2) test at a significance level of 0.05. RESULTS: Statistically significant differences in SBS values between groups (p < 0.001) were observed. Group 4 exhibited the highest (14.63 ± 1.36 MPa) and group 1 the lowest SBS (2.67 ± 1.35 MPa) values. Statistically significant differences were noted in fracture modes between groups 1, 3, and 4 (p < 0.001). In all the self-adhering flowable composite groups, the adhesive type (tooth-composite interface) fracture occurred more frequently than cohesive and mixed-type fractures. CONCLUSION: When applied to bond lingual retainers to unetched enamel or with self-etching bonding agent accompanied by an additional acid etching, Vertise™ Flow resulted in a significant decrease in bond strength.

[Severe pain and livid discoloration in the left leg of a 32-year-old patient after intravascular heroin injection]. / Massive Schmerzen und livide Verfärbung des linken Beins nach intravaskulärer Heroininjektion bei einem 32-jährigen Patienten.

Acute leg ischemia after intra-arterial drug injection represents a critical vascular emergency scenario. Due to lack of evidence-based standards therapeutic strategies are oriented to the underlying pathomechanisms. For a sufficient therapy a close clinical monitoring and laboratory analyses as well as treatment with analgesics, anticoagulants, anti-inflammatory and spasmolytic agents are of utmost importance. This article reports on the diagnostic and therapeutic approaches in a 32-year-old patient with acute leg ischemia after intra-arterial administration of heroin and secondary infection with Peptostreptococcus and Peptoniphilus species.