Dental patients' tinnitus profile: prevalence, types, and associated factors with oral and maxillofacial diseases.

INTRODUCTION: Maxillofacial diseases may pose a risk factor for the onset of tinnitus, and may influence the severity of its symptoms. The objective of this study was to investigate the prevalence of tinnitus among patients routinely visiting the Faculty of Dentistry and to assess the relationship between tinnitus and maxillofacial diseases. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted on 3,626 patients. Demographic data, information on tinnitus symptoms, temporomandibular disorder (TMD) presence, the existence of trigger points in masticatory muscles, toothache, and bruxism were evaluated. RESULTS: Tinnitus was detected in 385 patients, resulting in a prevalence rate of 10.61%. Of the patients, 38.4% were male and 61.6% were female, and the mean age was 42.66 ± 16.34 years. Tinnitus was categorised as normal in 47.8% of the patients and pathological in 52.2% of the patients. Bruxism was identified in 65.5% of the patients, toothache in 42.9%, TMD in 33.8%, and masticatory trigger points in 27.0% of the patients. A tendency towards tinnitus provoked by toothache was observed in 5.9% of the patients. The presence of pathological tinnitus was found to increase the risk by 1.839 times for toothache and 1.456 times for bruxism. CONCLUSION: There may be an association between oral and maxillofacial diseases and tinnitus, especially bruxism and toothache. Therefore, the evaluation of these conditions may be a routine part of tinnitus management.

Protective effects of hesperidin in gastric damage caused by experimental ischemia-reperfusion injury model in rats.

PURPOSE: This study evaluated the protective effect of hesperidin on injury induced by gastric ischemia-reperfusion. METHODS: Fifty male Sprague Dawley rats (250-300 g) were divided into five groups: control (C), sham (S), ischemia (I), ischemia-reperfusion (I/R) and hesperidin + ischemia-reperfusion (Hes + I/R). Hesperidin was injected intraperitoneally at the dose of 100 mg/kg one hour before the experimental stomach ischemia-reperfusion. Celiac artery was ligated. After 45 minutes ischemia and 60 minutes reperfusion period, blood samples were obtained under anesthesia. Then, animals were sacrificed, stomach tissues were excised for biochemical, and histopathological analyses were performed. Malondialdehyde levels and superoxide dismutase, glutathione peroxidase activities and total antioxidant status (TAS), total oxidant status (TOS), protein, total thiol parameters were measured in plasma, and tissue homogenate samples. H + E, periodic acid-Schiff, hypoxia inducible factor, terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end-labeling (TUNEL), and proliferating cell nuclear antigen (PCNA) for cell proliferation as immunohistochemical parameters were determined. RESULTS: Upon biochemical and histopathological assessment, hesperidin decreased stomach tissue changes in comparison with IR group. Ischemia-reperfusion injury led to a considerably increase in malondialdehyde, protein, and TOS levels (p < 0.001) in stomach tissue. Hesperidin treatment significantly decreased malondialdehyde, protein, and TOS levels (p < 0.001). Hesperidin increased superoxide dismutase, TAS, total thiol and glutathione peroxidase activities in comparison with IR group. Hesperidin reduced damage and also increased TUNEL and PCNA immunoreactivity in stomach tissue. CONCLUSIONS: Hesperidin was able to decrease I/R injury of the stomach tissue due to inhibition of lipid peroxidation and protein oxidation, duration of antioxidant, and free radical scavenger properties. Consequently, hesperidin can provide a beneficial therapeutic choice for preventing stomach tissue ischemia-reperfusion injury in clinical application.

Evaluation of Retinal Layers in Individuals With Pseudoexfoliation Syndrome and Ocular Hypertension.

PRCIS: This study investigated the retinal segmental thicknesses in individuals with pseudoexfoliation syndrome and ocular hypertension. Maximum thinning was found at 6 mm inferior to the inner plexiform layer. This layer is very important for the early diagnosis of glaucoma. PURPOSE: To analyze the thickness of the peripapillary retinal nerve fiber layer and 8 macular layers using optical coherence tomography in eyes with ocular hypertension (OHT) and pseudoexfoliation syndrome (PXS) and healthy eyes and to evaluate between-group differences. MATERIALS AND METHODS: In a prospective study, the macular segmentation of retinal layers in 120 eyes of 120 participants was performed automatically using current Heidelberg Spectralis optical coherence tomography software, which provides measurements for 8 retinal layers. Thickness maps divided into nine subfields (ie, 1, 3, and 6 mm) were extracted from the software for each retinal layer and compared between groups. RESULTS: The thinnest macular layers appeared in the ocular hypertensive PXS, normotensive PXS, and OHT groups in that order. In the inner retinal layers (macular retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer), statistically significant differences emerged between the PXS and control groups in all quadrants of the 3 and 6 mm areas. No significant difference between the OHT group and control group appeared except in the 6 mm temporal quadrant of the inner plexiform layer (IPL). Receiving operating characteristic analysis revealed quadrants with high area-under-the-curve values at 3 and 6 mm in macular segments in all 3 groups compared with the control group. CONCLUSION: In macular segment analysis, the inner retinal layers showed the most thinning in patients with ocular hypertensive PXS. According to receiving operating characteristic curve analysis, examinations performed 6 mm inferior to the IPL, as the quadrant with the highest area under the curve in all 3 groups, are critical for the early diagnosis of glaucoma.

Effect of Mesoappendix Volume on Preoperative Pain of Acute Appendicitis.

OBJECTIVE: To investigate the relationship between preoperative pain scores and the mesoappendix volume and the presence of complications in patients with acute appendicitis. STUDY DESIGN: Cross-sectional observational study. Place and Duration of the Study: Department of General Surgery at Kutahya Health Sciences University, Kutahya, Turkey, from January to December 2021. METHODOLOGY: Pain degrees in patients with acute appendicitis were measured by Numerical Rating Scale (NRS) and Wong-Baker Scale (WBS). Mesoappendix volume was calculated using the formula: mesoappendix length x width x height. Appendicitis type (as complicated or uncomplicated) was grouped. RESULTS: There was a positive and statistically significant correlation (17%) between the NRS and mesoappendix volume (p=0.065). In addition, there was a positive and statistically significant correlation (17%) between the WBS and mesoappendix volume (p=0.057). Additionally, there was a statistically significant relationship between the NRS, WBS, and complicated appendicitis (p=0.022, p=0.022, respectively). CONCLUSION: The mesoappendix volume might contribute to preoperative pain process in acute appendicitis patients. Specifically, there is a statistically significant correlation between complicated appendicitis and preoperative pain scores. KEY WORDS: Appendicitis, Pain, Mesentery, Complicated appendicitis.

Correlations of Clinical and Audio-Vestibulometric Findings with Coexisting Anxiety and Depression in Ménière's Disease Patients.

INTRODUCTION: Ménière's disease (MD) is an inner ear disorder, characterized by vertiginous attacks, fluctuating sensorineural hearing loss, tinnitus, and a feeling of ear fullness. Endolymphatic hydrops has been proven as the underlying pathology. Frequently, psychopathologies accompany the disease. The aim of this study was to investigate the correlation of anxiety and depression with demographic, clinical, and audio-vestibular findings in MD patients. METHODS: The study included 40 consecutive unilateral MD patients. Demographic data (age, sex, education, employment, and marital status), clinical variables of drop attacks, the duration, frequency and severity of vertigo attacks, and tinnitus disturbance levels were recorded. Hearing threshold levels were graded between 1 and 4. Vestibulometric variables were taken as the presence of saccades and vestibulo-ocular reflex (VOR) gain deficits in the video head impulse tests (vHIT) and canal paresis in bithermal caloric tests. Becks's depression and anxiety scales were used for psychometric evaluations and graded by 4 and 5 from normal to severe and normal to very severe, respectively. RESULTS: The median age of the patients was 48.94 years, and the numbers of both sexes were almost equal (male/female = 19/21). All patients reported at least one vertigo attacks within the last year. The duration of attacks was most commonly (62.5%) 1-3 h, ranging from <1 h to 17 h. Most attacks were graded as mild (67.5%), and the frequency was 2-3 episodes per year in 22 (55%) patients. The number of attacks within the last year was 1-12. Three patients reported having drop attacks. Hearing loss in the affected ear was moderate/moderately severe in 20 (50%) patients. Thirty-seven (92.5%) patients had complaints of tinnitus. In vHIT, saccades and VOR gain deficits were found in 33 (82.5%) and 11 (27.5%) patients, respectively. Canal paresis was present in 18 (45%) patients. The depression and anxiety rates were 35% and 90%, respectively. Depression scores were correlated with education, marital status, and the presence of saccades. Anxiety was correlated only with tinnitus severity and VOR gain deficits. Depression and anxiety were also correlated. CONCLUSION: Vertigo appears to be more intrusive than the other MD symptoms, and a higher correlation with anxiety than depression was demonstrated in this cohort. However, depression was seen less among married and educated patients, suggesting the role of coping capability, and had more pronounced clinical/vestibulometric correlates. Overall, these results indicated that it is mainly the severity of organic/physiological pathology which determines the degree of depression and anxiety in MD rather than vice versa.

Mortality predictors on the day of healthcare-associated Acinetobacter baumanni bacteremia in intensive care unit.

INTRODUCTION: Mortality of healthcare-associated Acinetobacter baumannii bacteremia can be 50-60% in intensive care units (ICUs). We aimed to determine the risk factors for 28-day mortality in patients with sepsis due to A. baumannii bacteremia during their ICU follow-up. METHODOLOGY: Demographic characteristics, disease severity scores on admission and bacteremia day (BD), resistance status, invasive interventions, and laboratory values showing the infection and severity of the BD, were compared between groups with and without mortality as a retrospective cohort study in the ICU of a tertiary hospital. RESULTS: Of a total of 2411 patients, there were 192 cases of bacteremia. After applying the exclusion criteria, 39 patients were recruited for the study, 25 of whom died (mortality rate 64.1%). Higher age, Simplified Acute Physiology Score II (SAPS II) on admission and high Sequential Organ Failure Assessment Score (SOFA), Red Blood Cell Distribution Width (RDW) (p < 0.001), and C-Reactive Protein (CRP) (p = 0.002) on the BD and invasive intervention in follow-up were associated with mortality. When CRP and RDW were both positive, sensitivity was 72%, specificity was 100%, negative predictive value was 33%, and positive predictive value was 100% for the 28-day mortality after BD. Based on multivariate analysis, CRP and RDW values on the BD were independent risk factors for mortality. CONCLUSIONS: It is critical to monitor SOFA, RDW, and CRP values in older ICU patients with SAPS II scores and who undergo invasive intervention in follow-up. Increases in these parameters may indicate bacteremia with high mortality due to A. baumannii.

How did the general surgeons intend to treat acute calculous cholecystitis during COVID-19 era?Results of online survey.

BACKGROUND: Acute calculous cholecystitis is one of the most encountered surgical pathologies. While early cholecystectomy is the first treatment choice during the first index hospitalization, it may change during COVID-19 era when hospital resources are restricted, and health-care personnel try to overcome pandemic difficulties. In this survey, our aim is to investigate surgeons' preferences and possible changing paradigms for acute cholecystitis therapy during COVID-19 pandemic. METHODS: An online survey was conducted on an internet site through private invitation by social media sent to general surgeons. The survey consisted of 13 questions, including surgeons' hospital properties, and it questioned treatment preferences against acute calculous cholecystitis during the pandemic. After 3 months of data collection, responded answers were analyzed statistically. RESULTS: About 56% of the surgeons stated that their treatment strategy changed during the COVID-19 pandemic partially or totally. About 48.8% of surgeons preferred early cholecystectomy for cases with acute cholecystitis before COVID-19 era; when only 23.2% of the surgeons preferred early surgery during COVID-19 era. However, patients who had received antibiotics as primary medical therapy had medical therapy failure with a range of 40.2%. Percutaneous cholecystostomy rate was raised to 20.7% from 4.9% before the COVID era. CONCLUSION: Although 96.3% of the surgeons did not have seen any unusual complication related to the COVID-19 disease, more than half of the surgeons who preferred early cholecystectomy changed their treatment strategy during the COVID-19 pandemic. According to the survey results, although the medical therapy failure rate is high, 48.8% of the surgeons may persist in this non-operative approach after the pandemic.

Comparison of Fenestrating and Reconstituting Subtotal Cholecystectomy Techniques in Difficult Cholecystectomy.

Purpose Cholecystectomy is one of the most frequently performed surgeries. Although laparoscopy is considered the gold standard approach, it cannot prevent biliary injuries. Subtotal cholecystectomy has been performed mainly to prevent biliary injuries during difficult cholecystectomies. This study aimed to analyse our subtotal cholecystectomy results for difficult cholecystectomy cases and to evaluate the fenestrating and reconstituting techniques. Methods Retrospective data were collected and analysed statistically for cases that underwent subtotal cholecystectomy in a single referral centre between 2015 and 2020. Comparisons were made of the patients' age, gender, preoperative American Society of Anaesthesiologists (ASA) score, comorbidities, surgical timing, surgical procedure choice, postoperative complications, and mortality. Results The number of patients who underwent subtotal cholecystectomy was 46; 30.4% underwent emergent surgery and 69.6% underwent elective surgery. Twelve patients had subtotal fenestrating cholecystectomy and 34 had subtotal reconstituting cholecystectomy. Wound issues were noted in 17.4% of the patients, while 10.9% had temporary biliary fistulas that resolved spontaneously. Reoperation was performed in one patient due to high-output biliary drainage. Patients with postoperative complications had significantly higher co-morbid conditions (p=0.000), but surgery timing (p=0.192) and type of subtotal cholecystectomy (p=0.409) had no statistically significant effect on complications. Mortality showed a statistically significant correlation with patient comorbidities, surgery timing, and the type of procedure (p<0.05). Postoperative complications showed a statistically significant correlation with mortality (p<0.05). Conclusion Subtotal cholecystectomy prevents major biliary complications after cholecystectomy. Yet, the frequency of postoperative complications after subtotal cholecystectomy is incontrovertible. Intraoperative characteristics and the surgeon's expertise decide the optimal choice of the subtotal cholecystectomy technique.

The importance of systemic immune-inflammation index in obstructive sleep apnea syndrome.

OBJECTIVE: This study aims to explore the importance of systemic immune-inflammation index (SII) in patients diagnosed with obstructive sleep apnea (OSA). MATERIALS AND METHOD: In this study planned as a retrospective cohort, the files of the patients who presented with sleep apnea/snoring complaint between 10.01.2017 and 10.01.2021 and underwent polysomnography (PSG) and complete blood count analyses were reviewed. PSG findings (age, sex, body mass index (BMI), apnea-hypopnea index (AHI), mean oxygen saturation) were compared with SII in 194 patients meeting study eligibility criteria. RESULTS: Patients included in this study were divided into 4 groups by AHI value. Statistical difference was detected between the groups in terms of age, sex, body mass index (BMI), and mean oxygen saturation (p < 0.05). There is an approximately 30% positive statistically significant correlation between the severity of OSA and SII (p < 0.001). As for the mean SII values of the AHI groups, it was observed that the more severe AHI is, the higher the mean SII value is. The correlation between SII and the severity of OSA was found to be more significant than the correlation with neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). CONCLUSION: There is a significant correlation between SII and the severity of OSA. This correlation is stronger compared to NLR and PLR. SII can be used to demonstrate the chronic systemic inflammation observed in OSA patients, and can be utilized as a simple and inexpensive biomarker as it can be easily calculated from the parameters present in routine blood analyses.

Antibiotic Use among Patients Hospitalized with COVID-19 and Treated in Three Different Clinics.

Objective: In this study, we aimed to determine and compare the rates of empirical antibiotic use and duration between the chest diseases clinic (CDC), infectious disease clinic (IDC), and internal medicine clinic (IMC) among patients hospitalized because of COVID-19. Methods: This cross-sectional study was performed in a single university hospital. The study included all patients aged 18 years and older hospitalized with a PCR-confirmed COVID-19 between May 30, 2021, and August 30, 2021. Clinical and laboratory findings were recorded from the electronic medical records database. Results: The study included a total of 581 inpatients, of whom 310 (53.4%) were women. Of the 581 patients, 475 (81.8%) were prescribed antibiotics. The rate of antibiotic prescription was 71.6% for IDC, 88.5% for CDC, and 87.4% for IMC. The most commonly used antibiotic was moxifloxacin in all groups. The mean treatment duration was 8.9±6.16 days. The mean duration of antibiotic treatment was 11.1±5.90 days for CDC, 11.3±6.74 days for IMC, and 5.3 days±3.76 for IDC. Conclusion: Patients with COVID-19 who were treated in IDC had a lower rate and shorter duration of antibiotic use compared to the other clinics. However, the rate of antibiotic prescription in all three groups was very high. Therefore, antimicrobial management programs should be meticulously conducted to reduce unnecessary antibiotic use.

Corrective Effect of Verbascoside on Histomorphological Differences and Oxidative Stress in Colon Mucosa of Rats in Which Colon Ischemia-Reperfusion Injury was Induced.

BACKGROUND: This study aims to show the corrective effect of verbascoside on histomorphological and biochemical differences in the colon mucosa of rats in which colon ischemia-reperfusion (I/R) injury was induced. METHODS: Fifty Sprague Dawley male rats were divided into 5 groups, of control, sham, ischemia (I), I/R, and I/R+verbascoside. Ischemia and reperfusion were applied to the suitable groups for 30 minutes and 120 minutes respectively, and 10 mg/kg verbascoside was administered intraperitoneally. Histomorphological assessment was done in the colon tissues obtained, and the goblet cells were assessed using the Alcian blue method. Proliferating cell nuclear antigen (PCNA), TUNEL, and hypoxia-induced factor 1 (HIF-1α) assays were used to assess oxidative stress with the immunohistochemical method. Malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and total thiol (TT) levels were checked, for a biochemical analysis of oxidative stress. RESULTS: Compared with the I/R group, histomorphological differences were seen to be corrected in colon epithelium in the I/ R+verbascoside group. The goblet cell number increased and cell proliferation was increased, as seen with the PCNA assay; and apoptosis was decreased, as seen with the TUNEL assay. HIF-1α expression also decreased in the drug group. In the drug group, SOD, GSH-Px, TAS, and TT levels increased, but TOS, OSI, and MDA levels decreased. CONCLUSION: It was seen that verbascoside had a corrective effect on histomorphological and biochemical differences caused by I/R injury.

Association of vaspin rs2236242 gene variants and circulating serum vaspin concentrations with coronary artery disease in a Turkish population.

Coronary artery disease (CAD) is the primary cause of death worldwide. Vaspin was a recently described adipokine, playing a protective role in many metabolic and cardiovascular diseases. This study aimed to assess the relation of serum vaspin levels and vaspin rs2236242 polymorphisms with CAD. The study included 105 healthy subjects and 105 CAD patients. Serum vaspin concentrations and vaspin rs2236242 polymorphisms were determined by enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. There was a statistically significant difference between the genotypes of CAD patients (TT 26.7%, TA 71.4%, and AA 1.9%) and controls (TT 70.5%, TA 28.6%, and AA 1%; χ2 = 40.3; df = 2; p = .000). The TA genotype increased the risk of CAD (odds ratio [OR] = 6.60; 95% confidence interval [CI] = 3.60-12.1; p = .000) as compared to the TT genotype. There was a statistically significant difference between the allelic distribution of CAD patients (T 62.4% and A 37.6%) and controls (T 84.8% and A 15.2%; χ2 = 27.0; df = 1; p = .000). Those carrying the A allele had a higher risk of CAD compared to those with the T allele (OR = 3.35; 95% CI = 2.10-5.36; p = .000). The serum vaspin concentrations of the patients with TT, TA, and AA genotypes were 30.4 ± 1.72, 28.4 ± 2.89, and 36.4 ± 6.38 pg/ml, respectively, and there was no significant difference between the serum vaspin levels and vaspin genotypes (p = .696). All of the above suggested that the vaspin rs2236242 polymorphism was associated with CAD in the Turkish population.

Association between well-known histopathological criteria and overall survival in invasive ductal carcinoma.

UNLABELLED: We investigated the effect of clinical features and well-known histomorphological parameters on survival of breast cancer. MATERIAL AND METHODS: 44 patients with invasive ductal carcinoma were included in this study. We investigated the effect of age, breast cancer location (right/left), histological grade, largest diameter of the tumor, lymphovascular and perineural invasion on patient survival. IBM SPSS (Statistical Package for Social Sciences) 20 program was used for statistics. Cox proportional hazard regression model for survival analysis, log-log plot, life function graphs were used. Results were 95% confidence interval, significance (P < 0.05). RESULTS: In univariate analysis, the left breast localization, high histological grade, large tumor size, lymphovascular invasion, perineural invasion has been shown that reduced the overall survival (P < 0.05). In multivariate analysis, only high histological grade, large tumor size and perineural invasion were identified as parameters negatively associated with patient survival (P < 0.05). On univariate and multivariate analysis, age was not associated with survival. CONCLUSION: The above results should be considered in the follow-up and treatment planning of invasive ductal carcinoma patients.

Visfatin and ghrelin: can they be forthcoming biomarkers or new drug targets for asthma?

BACKGROUND & AIM: Asthma represents chronic inflammation of the airways and is associated with bronchial hyperresponsiveness and reversible airway obstruction. A novel adipokine visfatin and an appetite-modulating hormone ghrelin play a role in several diseases related with inflammation. Although visfatin is a pro-inflammatory adipokine, ghrelin mainly exerts anti-inflammatory effects. However, very little is known about the role of visfatin and ghrelin in asthma. In the present study, we aimed to investigate the role of visfatin and ghrelin in asthma by evaluating their serum levels in asthmatic patients. MATERIALS AND METHODS: This study was performed on 27 asthma and 23 healthy controls. Blood samples were collected in tubes without EDTA. Serum levels of visfatin and ghrelin were measured by human ELISA assay kits. Statistical analyses were performed by SPSS 16.0 package program and differences were considered statistically significant at p < 0.05. RESULTS: Serum levels of visfatin and ghrelin were significantly higher in asthma group (respectively; p = 0.001, p = 0.002). CONCLUSION: While visfatin has a pro-inflammatory role, ghrelin exerts an anti-inflammatory effect in asthma. Therefore, visfatin can be a forthcoming biomarker and ghrelin may be a new anti-inflammatory drug target to diagnose and treat asthmatic patients.