The necessity and timing of exercise after lumbar disc herniation surgery.

OBJECTIVE: Physical therapy and rehabilitation may improve low back pain and quality of life after lumbar disc herniation. However, there is no agreement on its optimal start time and rehabilitative methods. This study evaluates the effects of early and late rehabilitation on low back pain and quality of life following unilateral microdiscectomy. PATIENTS AND METHODS: A total of 204 patients who underwent surgery for lumbar disc herniation were included and subsequently randomized into five groups: 1. No exercise, 2. The 2nd-week walking group, 3. 1st-month walking group, 4. 2nd-week waist exercise, 5. 1st-month waist exercise. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were assessed at the 1st week, 1st, 3rd, and 6th, and 12th-month follow-up after surgery. RESULTS: 1st-month VAS scores were analyzed, and a significant difference was found between the VAS scores of the 2nd-week walk (3.60±0.78) and 2nd-week waist exercise (3.38±0.67) groups and the other groups (p<0.001). 3rd-month VAS results were analyzed, and the VAS scores of the 1st-month walk group (2.67±0.48) were significantly higher than those of the 2nd-week walk group (1.73±0.45) (p<0.001). A significant difference was observed between the no-exercise group (2.93±0.91) and the other groups according to the 12-month VAS scores, with the VAS scores of the no-exercise group being significantly higher than the other groups (p<0.001). There was a significant difference between the ODI scores of both the 2nd-week walk (38±8.55) and the 2nd-week waist (33.8±6.61) exercise groups and the other groups according to the 1st-month ODI scores (p<0.001). A significant difference was observed between the no-exercise group (35.2±8.25) and the other groups according to the 12-month ODI scores, and the ODI scores of the no-exercise group were significantly higher than the other groups (p<0.001). CONCLUSIONS: Regular exercise is highly recommended for long-term pain relief, as well as for achieving a speedy recovery after surgery, which is crucial to maintaining a high quality of life and preventing loss of earning potential. We believe that early implementation of exercises is ideal, but even if initiated later, standard back exercises can still expedite rehabilitation.

Under what conditions is the intra-articular steroid injection superior to nonsteroidal anti-inflammatory drugs for treating sacroiliac joint pain?

OBJECTIVE: The purpose of this prospective study was to determine the conditions under which intra-articular injection therapy may be superior to nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with sacroiliac joint pain in the outpatient setting at our hospital. PATIENTS AND METHODS: Patients with sacroiliac pain were divided into two groups: NSAID and the sacroiliac injection group. The NSAID group received 25 mg of indometacin orally once a day and 750 mg of naproxen orally once a day. In the sacroiliac injection group, 5 mg of betamethasone were injected into the sacroiliac joint. The patients' history of lumbar surgery, whether they had sacroiliitis, and the duration of pain were recorded. The patients' VAS (Visual analogue scale) scores at week 1 and month 1 were evaluated. RESULTS: VAS scores were decreased after the first week and first month in the sacroiliac injection group compared to the NSAID group (p<0.001). Sacroiliac steroid injection was found to be superior to NSAIDs in reducing VAS scores in patients with sacroiliitis, a history of lumbar surgery, and pain lasting more than 30 days (p<0.001). In patients without sacroiliitis, without a history of lumbar surgery, and with less than 30 days of pain, no difference was observed between the groups in reducing VAS scores at the end of the first month. CONCLUSIONS: In patients with sacroiliac joint pain, sacroiliac joint injection is superior to NSAIDs in pain relief in patients with pain for more than 30 days, those with MRI-diagnosed sacroiliitis, and those who have undergone lumbar surgery.

Antibacterial and antibiofilm efficacy of colistin & meropenem conjugated silver nanoparticles against Escherichia coli and Klebsiella pneumoniae.

The progressive increase in infections caused by multidrug-resistant (MDR) Gram-negative bacteria and the emergence of resistance to last-resort antimicrobial drugs in recent years necessitate the development of new therapeutic strategies. This study was conducted to obtain nanostructured antimicrobials by conjugating colistin (COL) and meropenem (MEM) antibiotics with biosynthesized silver nanoparticles (bio-AgNPs) via the green synthesis method using Rosa damascena extract, and to investigate the antibacterial and antibiofilm activity of these nanostructures against Escherichia coli and Klebsiella pneumoniae strains. Ultraviolet-visible spectrophotometry, high-resolution-transmission electron microscopy, atomic force microscopy, X-ray diffraction, and Fourier transform-infrared spectroscopy analyses were performed to determine the physical and chemical properties of synthesized bio-AgNPs, COL@bio-AgNPs, MEM@bio-AgNPs, and COL&MEM@bio-AgNPs. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration of nanoparticles were determined on standard and MDR clinical strains. The antibiofilm efficacy and cytotoxic effect of nanoparticles were evaluated by the crystal violet dye method and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide dye method, respectively. The characterization analyses demonstrated that the synthesized nanoparticles had crystal structure and spherical morphology (5.6-30.2 nm in size). Antibiotic conjugated nanoparticles exhibited better antimicrobial activity and lower MIC values (0.125-4 µg/mL) on the tested strains compared to free antibiotics, and MIC values were decreased up to 1024-fold (p < 0.05). Antibiotic conjugated nanoparticles were found to be more effective in biofilm eradication than free antibiotics and bio-AgNPs and had a less inhibitory effect on peripheral blood mononuclear cell viability. The findings revealed that antibiotic-conjugated nanoparticles have the potential to be used as an effective antimicrobial drug against MDR E. coli and K. pneumoniae strains.

A randomized trial of the effects of platelet- rich plasma on postoperative complications after meningomyelocele sac repair.

OBJECTIVE: Meningomyelocele is a common congenital neural tube defect. To reduce complications, we need early surgery and a multidisciplinary approach. In this study, we administered platelet-rich plasma (PRP) to babies with meningomyelocele following corrective surgery to minimize cerebrospinal fluid (CSF) leakage and accelerate the healing of the immature pouch tissue. We compared these with a control group that did not receive PRP. PATIENTS AND METHODS: Of the 40 babies who had surgery with the diagnosis of meningomyelocele, 20 patients received PRP after surgical repair, and 20 were followed up without PRP. In the PRP group, 10 of the 20 patients underwent primary defect repair, the other 10 underwent flap repair. In the group that did not receive PRP, primary closure was performed in 14 patients and flap closure in six. RESULTS: In the PRP group, CSF leakage occurred in one (5%) patient, and none developed meningitis. Partial skin necrosis occurred in three (15%) patients and wound dehiscence in three (15%) patients. In the group that did not receive PRP, CSF leakage occurred in nine (45%) patients, meningitis in seven (35%), partial skin necrosis in 13 (65%), and wound dehiscence in seven (35%) patients. The rate of CSF leakage and skin necrosis in the PRP group was significantly (p<0.05) lower than that in the PRP group. Furthermore, wound closure and healing were also improved in the PRP group. CONCLUSIONS: We have shown that PRP treatment of postoperative meningomyelocele infants facilitates healing and lowers the risk of CSF leakage, meningitis, and skin necrosis.

The impact of distance education on the neck pain among teachers in times of COVID-19.

OBJECTIVE: In the course of the COVID-19 pandemic the format of education was forced to change from formal to distance in a considerably short time. The study aimed to analyze the changes in the prevalence and the severity of neck pain among teachers during the pandemic. SUBJECTS AND METHODS: The study analyzed the Neck Disability Index (NDI), a self-report questionnaire designed to assess the individual's neck pain experience in daily life and rate a disability score due to neck pain, and numerical rating scale (NRS) report pairs completed by teachers. RESULTS: The mean age of the participants was 41.67±9.57. The majority were female (67.9 %) and were employed for less than 20 years in teaching (68.9%). The survey results collected at the beginning and at the end of the first year of the pandemic showed that: the mean session hours per week were 21.19±9.21 and 21.61±9.45, the mean NDI scores were 11.61±6.17 and 12.65±7.76, and the mean NRS scores were 3.05±2.96 and 4.75±3.13. The female participants scored significantly higher disability scores (p<0.001). The NRS scores were increased in both genders (p<0.001). The NDI scores, the disability grouping, and NRS were significantly associated with weekly session hours (p=0.011, p<0.001 and p<0.001, respectively). The NRS scores were increased in all age groups (p<0.001). The increase in weekly session hours was related to the NRS scores (p<0.001). CONCLUSIONS: In one year during the pandemic, despite unchanged telework hours, a significant increase in neck pain incidence and pain severity was noted among teachers. Unexperienced employees in the line of distance working should receive adequate training to avoid not only musculoskeletal disorders but other physical and psychological unwanted effects.

The influence of functional pinealectomy and exogenous melatonin application on healing of a burr hole in adult rat calvaria: a histological and immunohistochemical study.

BACKGROUND: Even today, repair of the cranial defects still represents a significant challenge in neurosurgery and various options have been used for their reconstruction to date. However, there are very few studies investigating the effects of exogenous administration of melatonin (MEL) as an agent that promotes bone regeneration. The goal of this study was to investigate the effects of functional pinealectomy (Px) and exogenous MEL administration on the bone repair properties and surrounding connective tissue alterations in a rat calvaria model. MATERIALS AND METHODS: The total of 30 adult female Wistar-Albino rats was randomly divided into three groups (n = 10): control group (CO; 12 h light/12 h dark exposure), functional Px group (24 h light exposure, light-induced functional Px), and Px+MEL group (light-induced Px + MEL, 20 mg/kg/day for 12 weeks). Critical-sized burr-hole defects (diameter: 3.0 mm) were surgically created by a single operator in the calvarium of all rats, using an electric drill. Animals in Px+MEL group received MEL 20 mg/kg/day for 12 weeks. At the end of the study, bone healing and connective tissue alterations surrounding drilled defect area in the rat calvaria were determined in haematoxylin-eosin-stained and Mallory Azan slices applied in anti-bone sialoprotein. Image Pro Express 4.5 programme was used for histomorphometric calculation of areas of new bone and fibrotic tissue. Normality control was performed by Shapiro-Wilk test. Variance homogeneities were examined by Shapiro-Wilk and Levene tests; Tukey HSD test was used as a post hoc method since there was no homogeneity problem. All hypothesis tests were performed at the 0.05 significance level. RESULTS: Histological analysis showed that the bone repair process in the Px+MEL group was similar to that of the CO group, whereas the functional Px group showed a delay. Histomorphometrically, it was found that the Px group had the largest hole diameter and the most fibrotic scar area, although no binary statistical significance was found between the CO and Px+MEL groups (p = 0.910). In terms of vascularisation, it was observed that the most vascular structure was found in the Px+MEL group among the scar tissue and ossification areas, while the vascularisation was the least in the Px group (p < 0.001). CONCLUSIONS: Our findings revealed that bone repair process was impaired in functional Px group, but exogenous MEL replacement was able to restore this response. Thus, it is concluded that utilisation of MEL may improve the bone repair in calvarial defects.

Evaluation of the effects of Ankaferd haemostat application on bone regeneration in rats with calvarial defects: histochemical, immunohistochemical and scintigraphic study.

BACKGROUND: Bone wax, a haemostatic agent, is widely used in craniospinal surgical procedures for a long time, in spite of controversial results regarding its negative influence upon bone regeneration. In this experimental study, the effects of Ankaferd Blood Stopper (ABS), as an alternative haemostatic agent, were evaluated through histochemical, immunohistochemical and scintigraphic studies. MATERIALS AND METHODS: The total of 30 adult female Wistar albino rats was randomly divided into three groups: intact control group (n = 10), bone wax group (n = 10), and ABS group (n = 10). Surgically, a 3.0 mm hole in diameter was drilled on the right side of calvarium of the rats using a Class Mini Grinder set in all three groups, as described previously. At the end of 8 weeks, bone healing and connective tissue alterations surrounding drilled calvarial defect areas of the rats were determined via haematoxylin and eosin and the Mallory's trichrome staining and anti-bone sialoprotein immunohistochemistry. Image Pro Express 4.5 programme was used for histomorphometric calculation of new bone and fibrotic tissue areas. All statistical analyses were made with SPSS 25.0 and analysis of variance (one-way ANOVA) followed by Bonferroni post hoc test was performed, p < 0.001 was considered as significance level. RESULTS: Histomorphometrically, it was found that he had the largest hole diameter and the least fibrotic scar area in the bone-wax group. In the bone wax group, it was observed that the material closed the hole and there was only a fibrotic scar tissue in the area between the bone tissue at the edge of the hole and bone wax, and a fibrotic tissue was formed in the bone wax area. During the histological procedure, this bone-wax material was poured and the sections were seen as a gap in this area. In the ABS haemostat group, the smallest hole diameter and the least fibrotic scar tissue were observed. Fibrotic scar tissue close to each other was found in the ABS haemostat and bone wax groups. Histological analysis of samples also showed a statistical significance for fibrotic connective tissue area between groups (p < 0.05). Scintigraphically, osteoblastic activity related to blood flow in the animal taken from the group with application of ABS haemostat was more pronounced compared to the other two groups. CONCLUSIONS: In our study, it has been concluded that the ABS yields affirmative effects on the bone healing, while bone wax leads to negative impact on the bone regeneration. Scintigraphic, histochemical and immunohistochemical data support the affirmative impact of the ABS haemostat application upon the bone regeneration apart from the quick stop of haemorrhage.

Protective effect of oxytocin through its anti-inflammatory and antioxidant role in a model of sepsis-induced acute lung injury: Demonstrated by CT and histological findings.

Although several studies demonstrate the anti-inflammatory effect of oxytocin in different pathophysiological processes, there are limited data describing the impact of oxytocin on acute respiratory distress syndrome (ARDS). We aimed to elucidate the protective effect of oxytocin in ARDS with histopathological evaluation and radiological imaging in addition to biochemical markers.Fecal intraperitoneal injection procedure (FIP) was performed on 24 of 32 rats included in the study for creating a sepsis model. Rats were randomly assigned into four groups: control group (no procedure was applied, n = 8), untreated septic group [was operated (FIP) and received no treatment, n = 8], placebo group (FIP, treated with 10 ml/kg of saline at once, n = 8), and treated group (FIP, treated with 0.1 mg/kg of oxytocin at once, n = 8). Chest CT was performed for all rats 20 hours after the procedure and density of the lungs were measured manually by using HU. All animals were sacrificed for histopathological examination of lung damage and blood samples were collected for biochemical analysis.Plasma malondialdehyde (MDA), lactic acid (LA), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interleukin 1-beta (IL 1-ß) levels were significantly increased in the placebo (FIP + saline) and the untreated (FIP) groups, and plasma levels of all biomarkers were reversed by oxytocin. Further, the density of the lung parenchyma (Hounsfield unit) on CT images and the histopathological lung damage score values were closer to the control group in the oxytocin-treated group compared to the placebo group.Our findings suggested that oxytocin could exert anti-inflammatory, antioxidant and protective effects in FIP-induced ARDS.

Antibacterial effect of silver nanoparticles mixed with calcium hydroxide or chlorhexidine on multispecies biofilms.

The purpose is to evaluate the antibacterial effects of the silver nanoparticles (AgNPs) (Nanografi, METU Teknokent, Ankara, Turkey) mixed with calcium hydroxide (Ca(OH)2) (Ultracal XS, Ultradent, St Louis, US) or chlorhexidine gel (CHX) (Gluco-Chex, Cerkamed, Stalowa Wola, Poland) against a multispecies biofilm, by confocal laser scanning microscopy (CLSM) and culture-based analysis. Dentine blocks were inoculated with Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus and Actinomyces naeslundii for 1 week. Infected dentine blocks were randomly divided into groups according to medication; saline solution (SS), Ca(OH)2, Ca(OH)2 + AgNP, 2%CHX gel and 2%CHX gel + AgNP and time of application: 1 and 7 days (all groups, n = 5). Bacterial samples were collected before and after medication to quantify the bacterial load. Biofilm elimination was quantitatively analyzed by Live/Dead BacLight Bacterial Viability staining and CLSM. The addition of AgNPs to Ca(OH)2 increased the effectiveness of medicament in terms of bacterial reduction in both application times (1 and 7 days) (p < 0.05: ANOVA, Tukey's test) according to culture-based analysis. The CLSM images revealed that mixture of AgNP with CHX killed significantly more bacteria when compared with all other medicaments at 1- and 7-day application times (p < 0.05 and p > 0.05, respectively: Kruskal-Wallis, Dunn post hoc tests). The efficacy of Ca(OH)2 mixed with AgNPs was superior to Ca(OH)2 used alone in both application times (p < 0.05) according to CLSM analysis. The present study put forth the potential use of AgNPs mixed with Ca(OH)2 or CHX on multispecies (Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus and Actinomyces naeslundii) biofilm in 1 and 7day application periods.

[Short version of the 2nd edition of the German-Austrian S3 guidelines "Cardiogenic shock complicating myocardial infarction-Diagnosis, monitoring and treatment"]. / Kurzversion der 2. Auflage der deutsch-österreichischen S3-Leitlinie "Infarkt-bedingter Kardiogener Schock ­ Diagnose, Monitoring und Therapie".

BACKGROUND: The present guidelines ( http://leitlinien.net ) focus exclusively on cardiogenic shock due to myocardial infarction (infarction-related cardiogenic shock, ICS). The cardiological/cardiac surgical and the intensive care medicine strategies dealt with in these guidelines are essential to the successful treatment and survival of patients with ICS; however, both European and American guidelines on myocardial infarction and heart failure and also position papers on cardiogenic shock focused mainly on cardiological aspects. METHODS: Evidence on the diagnosis, monitoring and treatment of ICS was collected and recommendations compiled in a nominal group process by delegates of the German Cardiac Society (DGK), the German Society for Medical Intensive Care Medicine and Emergency Medicine (DGIIN), the German Society for Thoracic and Cardiovascular Surgery (DGTHG), the German Society for Anaesthesiology and Intensive Care Medicine (DGAI), the Austrian Society for Internal and General Intensive Care Medicine (ÖGIAIM), the Austrian Cardiology Society (ÖKG), the German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR) and the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), under the auspices of the Working Group of the Association of Medical Scientific Societies in Germany (AWMF). If only poor evidence on ICS was available, general study results on intensive care patients were inspected and presented in order to enable analogue conclusions. RESULTS: A total of 95 recommendations, including 2 statements were compiled and based on these 7 algorithms with defined instructions on the course of treatment.

Correction of rotational deformity and restoration of thoracic kyphosis are inversely related in posterior surgery for adolescent idiopathic scoliosis.

Adolescent Idiopathic Scoliosis (AIS) is a complex three dimensional deformity the treatment of which remains to be surgical correction of the deformity as it had progressed over certain thresholds. The main focus in surgical treatment had, for decades, been the amount of correction in the coronal plane whereas corrections in sagittal and rotational (axial) planes have also been recognized as almost as important as the coronal over the recent decades. The hypotheses presented and discussed in this study is the virtual adversity between the rates of correction in these two (sagittal and axial) planes. Namely, we are suggesting that due to an elongated anterior spinal column as an intrinsic component of AIS, posterior surgery cannot correct both the axial plane deformity and the thoracic hypokyphosis in the sagittal plane at the same time, unless the posterior spinal column is substantially lengthened. This hypothesis is supported by 3D modeling of the AIS spine as well as the relative inability in changing the sagittal alignment of the thoracic spine demonstrated by a literature search by us. Understanding and internalization of this hypothesis by AIS surgeons is important as it suggests that by posterior instrumentation, unless a riskier approach of substantially lengthening the spinal column is taken, surgeons need to make the choice of correcting the hypokyphosis OR axial rotation.

Mechanical reduction in intracanal Enterococcus faecalis when using three different single-file systems: an ex vivo comparative study.

AIM: To evaluate the bacterial reduction achieved by WaveOne Gold (Dentsply Sirona Endodontics, Ballaigues, Switzerland), Hyflex EDM (Coltene-Whaledent, Altstätten, Switzerland), and XP-endo Shaper (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) in canals infected with Enterococcus faecalis. The null hypothesis (H0 ) was that there would be no difference amongst the NiTi systems in reducing the root canal bacterial load. METHODOLOGY: Seventy-four mandibular premolar teeth with straight and round root canals were selected. Sixty-two root canals were contaminated with E. faecalis for 4 weeks and subjected to mechanical preparation with one of three single-file NiTi rotary systems (WaveOne Gold, Hyflex EDM, and XP Endo Shaper). Twelve non-contaminated root canals were used as negative controls. Bacterial samples were collected with sterile paper points (Dentsply Sirona Endodontics) before and after rotary instrumentation to quantify the bacterial load. Five roots from each instrumentation group were evaluated topographically from the coronal, middle and apical thirds by SEM. The bacterial reduction was calculated and analysed statistically by the Kruskal-Wallis and Dunn post hoc tests, all at 5% significance. RESULTS: The samples taken before instrumentation showed approximately 9.64 log CFU bacterial load. Instrumentation with the Hyflex EDM and XP-endo Shaper resulted in significantly greater bacterial reduction than those with WaveOne Gold (P = 0.00). All specimens had bacterial growth. SEM images supported the CFU/mL data. Thick and dense debris was observed in WaveOne Gold samples. Instrumentation resulted in the disruption of the biofilm-like structure, and both areas of clean and open dentinal tubules and areas with thick debris were observed in Hyflex EDM and XP-endo Shaper samples. CONCLUSIONS: Instrumentation in straight and round canals of premolar teeth with the Hyflex EDM and XP-endo Shaper resulted in significantly greater bacterial reduction than WaveOne Gold. No instrumentation system rendered root canals completely free from bacteria.

The apoptotic effects of silibinin on MDA-MB-231 and MCF-7 human breast carcinoma cells.

BACKGROUND: Silibinin is a bioactive flavonolignan extracted from milk thistle, known as Silybum marianum. Silibinin exerts strong antiproliferative, proapoptotic, and anti-inflammatory effects. Many studies have shown that silibinin inhibits experimentally induced malignancies of the liver, prostate, skin, and colon as well as promotes inhibition of the proliferation of cancer cell lines in vitro. This study aimed to investigate the effects of silibinin on the human breast carcinoma cell lines MDA-MB-231 and MCF-7 in monolayer and spheroid cultures. METHOD: The MDA-MB-231 and MCF-7 cell lines were cultured in both monolayer and spheroid cultures. Cells were treated with silibinin at 24, 48, and 72 h of incubation. The 5-bromo-2'-deoxyuridine labeling index was used to determine the cells of the synthesis phase. Poly-ADP-ribose-polimerase immunohistochemical staining and the terminal deoxynucleotidyl transferase dUTP nick and labeling assay were used to determine the death of cells in both the monolayer and spheroid cultures. RESULTS: An half maximal inhibitory concentration dose of silibinin in MDA-MB-231 and MCF-7 cells was 100 µM/mL at 24, 48, and 72 h of incubation. Terminal deoxynucleotidyl transferase dUTP nick and labeling positive cells and active poly-ADP-ribose-polimerase were detected after treatment with silibinin in both the monolayer and spheroid cultures. The dead cell count was higher in the MDA-MB-231 and MCF-7 cell lines with silibinin applied than in the controls. CONCLUSIONS: Our study demonstrated that silibinin applications enhanced terminal deoxynucleotidyl transferase dUTP nick and labeling positive cells and active poly-ADP-ribose-polimerase in comparison to the control in both the monolayer and spheroid cultures.

The effect of volatile oil mixtures on the performance and ilio-caecal microflora of broiler chickens.

The aim of this study was to investigate the individual and combined effects of rosemary, oregano and fennel volatile oil (FVO) supplementation on the performance and ilio-caecal bacteriological flora of broiler chickens. A total of 800 male Ross-308 broiler chickens were divided equally into 8 groups; each contained 100 chickens. The study included a control treatment (NC) with no dietary additives that was supplemented with oils according to the following 7 treatments: 200 mg α-tocopherol acetate/kg (PC), 100 mg oregano volatile oil (OVO)/kg, 100 mg rosemary volatile oil (RVO)/kg, 100 mg FVO/kg and an equal mixture of oregano+rosemary+fennel VO (100, 200, 400 mg/kg, VOM-1, VOM-2 and VOM-3, respectively). The experiment lasted for 6 weeks. At the end of the experiment, dietary supplementation with α-tocopherol, oregano, rosemary and FVO and two different volatile oil mixtures (VOMs) (VOM-2; VOM-3) significantly increased the body weights (BWs) of broilers at 7, 14 and 21 d of age compared to the negative control (NC) (-) and VOM-1 groups. At 0-42 d, birds fed on VOM-3 were considerably heavier and also gained more weight than NC (-) and VOM-1 groups. The blend of VOs at 400 mg/kg significantly increased Lactobacillus spp. in faeces. The blends of oregano, rosemary and FVOs (VOM-3) at 400 mg/kg concentration and also VOM-3 group exhibited stronger antibacterial activity against coliform bacteria compared to the NC (-) group. In conclusion, the blend of oregano, rosemary and fennel VOs at higher concentrations (400 mg/kg concentration) in diets can be used to stimulate the growth and can improve the intestinal microbial balance (including a reduction of coliform bacteria and an increase in Lactobacillus spp. counts) of broiler chickens.

Coronary slow flow phenomenon: Not only low in flow rate but also in myocardial energy expenditure.

BACKGROUND AND AIM: Coronary slow flow phenomenon (CSFP) is a miscellaneous clinical entity leading to angina-like symptoms, and electrocardiographic and scintigraphic evidence of ischemia. The impact of this syndrome on myocardial performance has not been comprehensively evaluated. In this study, we sought to evaluate the myocardial energy expenditure (MEE) in patients with CSFP and its relationship with exercise capacity. METHODS AND RESULTS: A total of 64 patients (64.1% male, mean age 53.2 ± 10.3 years) with CSFP and 64 patients (60.9% male, mean age 52.2 ± 10.9 years) with normal coronary artery as control group were included. MEE was calculated by a validated formula that uses transthoracic echocardiography (TTE) parameters, including left ventricular circumferential end-systolic stress, stroke volume, and ejection time CSFP patients had significantly lower MEE (0.79 cal/systole ± 0.15 vs. 0.91 cal/systole ± 0.09, p < 0.001). In correlation analysis, MEE had a significant negative correlation with mean corrected TIMI frame count (mTFC) (ß = -0.523; p < 0.001) and positive correlations with metabolic equivalents (METs) (ß = 0.560; p < 0.001), rate pressure product (ß = 0.649; p < 0.001), and exercise duration (ß = 0.408; p < 0.001). At multivariate analysis, MEE was demonstrated as an independent predictor of CSFP (OR 1.863, CI 95% 1.485-2.338 p < 0.001). CONCLUSION: Myocardial energy consumption, as a calculation obtained from TTE parameters, was reduced in patients with CSFP, and it had a significant relationship with exercise capacity. Considering its significant correlation with exercise capacity, myocardial energy consumption seemed to use evaluation of myocardial performance and functional status in another cardiovascular disease.

Chorio-retinal thickness measurements in patients with acromegaly.

PURPOSE: To compare choroidal, foveal, and peripapillary retinal thickness between patients with acromegaly and healthy adults. METHODS: This prospective, cross-sectional, and comparative study included 30 patients with acromegaly (study group) and 30 healthy subjects (control group). The subfoveal choroidal thickness (SFCT), foveal thickness, and peripapillary retinal nerve fibre layer thickness were measured with spectral domain optical coherence tomography. RESULTS: The mean SFCT in the study group and in the control eyes was 374.4±98.1 and 308.6±77.3 µm, respectively (P<0.001). The mean thinnest foveal thickness value was 233.2±22.4 µm in the acromegaly group and 222.8±13.9 µm in the control group (P=0.003). The mean peripapillary retinal nerve fibre layer thickness did not differ significantly between the groups (P=0.34). CONCLUSION: The SFCT and foveal thickness were significantly higher in patients with acromegaly, whereas peripapillary retinal nerve fibre layer thickness was similar between the groups.

Efficacy of endodontic applications of ozone and low-temperature atmospheric pressure plasma on root canals infected with Enterococcus faecalis.

UNLABELLED: This study aimed to compare the antimicrobial efficacy of low-temperature atmospheric pressure plasma (LTAPP) design and gaseous ozone delivery system with 2.5% NaOCl on Enterococcus faecalis in root canal walls and dentine tubules. The samples were divided into LTAPP (n = 12), ozone (n = 12), NaOCl (positive control, n = 12) and saline (negative control, n = 6) groups. Microbial samples were collected using paper points and dentin chips from root canals. Antimicrobial efficacy was assessed by counting the colony-forming units of Ent. faecalis before and after each irrigation protocol. Data were analysed using Kruskal-Wallis, Wilcoxon signed-rank, Friedman and Bonferroni t (Dunn's test)-tests (P = 0.05). The microbial sampling with paper points showed antibacterial efficacy of NaOCl, LTAPP, ozone and saline in descending order, respectively (P < 0.05). The microbial sampling with dentin chips demonstrated a superior efficacy of LTAPP compared with NaOCl in the middle third (P < 0.05), while both had similar effects in coronal and apical thirds (P > 0.05). NaOCl and LTAPP were better than ozone at the coronal and middle parts of the root canals (P < 0.05). These findings led us to suggest that LTAPP, which has no thermal and chemical effects, may be of great aid in endodontic treatment. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study handles different perspectives on chemomechanical preparation of root canals. Ozone and low-temperature atmospheric pressure plasma (LTAPP) were investigated to determine whether they could be an alternative for NaOCl. Up to now, chemical solutions (NaOCl, chlorhexidine digluconate, etc...) have been used to disinfect the root canals. When the reported effects of LTAPP on biological and chemical decontamination were taken into consideration, a question rose whether it has antimicrobial efficacy in root canals infected with E. faecalis. According to the findings of the present study, LTAPP may constitute a promising aid in endodontics in disinfection of root canals.

Incision wound healing activity of pine bark extract containing topical formulations: a study with histopathological and biochemical analyses in albino rats.

The present study was designed to identify and compare the in vivo wound healing capacity of a bark extract from Pinus brutia and Pycnogenol in an incision wound model in rats. O/W cream formulations were prepared incorporating 2% Pycnogenol and P. brutia bark extract. The rats were divided into three groups (n = 8). Subsequently placebo and test formulations were applied to animals once a day from day "0" until the 9th day. Malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) were studied in addition to histopathological examinations. Treatment with F. brutia extract containing cream inhibited lipid peroxidation by a 35% decrease in MDA and 46.8% increase in SOD activity, whereas 19.3% decrease in MDA and 34.7% increase in SOD activity were attained with Pynogenol compared to control. The histological data revealed a better performance of P. brutia extract enriched formulation in terms of degeneration of hair roots, increased vascularization and a decrease in necrotic area. Consequently, a high wound healing activity was observed in animals treated with P. brutia extract significantly accelerating the wound healing process.

Plasma AGE-peptides and C-peptide in early-stage diabetic nephropathy patients on thiamine and pyridoxine therapy.

AIM: The aim of the study was to evaluate circulatory AGE-peptide levels in diabetic nephropathy and to observe the effects of thiamine (vitamin B1) and pyridoxine (vitamin B6) therapy. METHODS: Type 2 diabetic patients (N.=57) were divided into two groups as "with nephropathy" (N.=27) and "without nephropathy" (N.=30). Diabetic nephropathy patients were treated with either B6 (N.=12) (250 mg/day) or B1+B6 (N.=15) (250 mg/day, each) for five months. At the beginning and the end of the experimentation period, glucose, HbA1c, triglyceride, cholesterol, insulin, C-peptide, thiamine pyrophosphate, pyridoxal phosphate and AGE- peptides were measured. RESULTS: AGE-peptides were higher in the diabetic group with nephropathy than without nephropathy (P=0.005). Within five months AGE-peptides increased in the diabetic group without nephropathy (P=0.042) but not in the group with nephropathy treated either with B1+B6 or B6. In B6 treated group a substantial decrease was observed in HbA1c (P=0.033). B1+B6 or B6 treatment both caused an increase in C-peptide (P=0.006, P=0.004). CONCLUSION: Among the parameters measured, plasma AGE-peptides was the only parameter found to be higher in type 2 diabetes mellitus patients "with nephropathy" than "without nephropathy". However, patients with nephropathy treated with B1+B6 or B6 did not display any further increase in AGE-peptides within five months. Both of the treatments caused an increase in C-peptide.