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Clarifying the etiology of diarrhea cases of unknown cause is important in the fight against enteric infections. In this study, we aimed to investigate the role of canine kobuvirus (CaKoV), in cases of diarrhea of unknown origin in dogs. A total 121 swab samples from dogs with diarrhea were collected. Molecular analyses of the samples were performed. For this purpose, after the sequence reaction, a phylogenetic tree was created, and bioinformatics analyses were performed. The prevalence rate of CaKoV in the sampled population was determined as 16.5% (20/121). The presence of parvovirus and coronavirus, which are common viral agents in CaKoV-positive dogs, was determined as 35% (7/20) and 10% (2/20), respectively. The rate of dogs with only CaKoV detected was 65% (13/20). Phylogenetic analysis of CaKoV strains clustered together closely related to reference strains. There are very limited studies on the role of CaKoV in the etiology of diarrhea cases of unknown cause in dogs around the world. So far, only one study has been done on CaKoV in Turkey. In this report which includes molecular characterization and epidemiological data on CaKoV determined the importance of CaKoV in cases of diarrhea of unknown origin. More comprehensive studies are needed to better understand the pathogenesis, epidemiology, and biology of CaKoV and to determine effective strategies to combat it.
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Diarreia , Doenças do Cão , Kobuvirus , Filogenia , Infecções por Picornaviridae , Cães , Animais , Kobuvirus/genética , Kobuvirus/isolamento & purificação , Kobuvirus/classificação , Diarreia/virologia , Diarreia/veterinária , Diarreia/epidemiologia , Doenças do Cão/virologia , Infecções por Picornaviridae/veterinária , Infecções por Picornaviridae/virologia , Infecções por Picornaviridae/epidemiologia , Turquia/epidemiologia , Fezes/virologiaRESUMO
Drug resistance is arguably one of the biggest challenges facing cancer research today. Understanding the underlying mechanisms of drug resistance in tumor progression and metastasis are essential in developing better treatment modalities. Given the matrix stiffness affecting the mechanotransduction capabilities of cancer cells, characterization of the related signal transduction pathways can provide a better understanding for developing novel therapeutic strategies. In this review, we aimed to summarize the recent advancements in tumor matrix biology in parallel to therapeutic approaches targeting matrix stiffness and its consequences in cellular processes in tumor progression and metastasis. The cellular processes governed by signal transduction pathways and their aberrant activation may result in activating the epithelial-to-mesenchymal transition, cancer stemness, and autophagy, which can be attributed to drug resistance. Developing therapeutic strategies to target these cellular processes in cancer biology will offer novel therapeutic approaches to tailor better personalized treatment modalities for clinical studies.
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Resistencia a Medicamentos Antineoplásicos , Transição Epitelial-Mesenquimal , Matriz Extracelular , Mecanotransdução Celular , Neoplasias , Humanos , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Matriz Extracelular/metabolismo , Matriz Extracelular/efeitos dos fármacos , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Neoplasias/metabolismo , Mecanotransdução Celular/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Animais , Antineoplásicos/uso terapêutico , Antineoplásicos/farmacologiaRESUMO
BACKGROUND: Copper (Cu), zinc (Zn), and the copper/zinc ratio (Cu/Zn), which have been studied in gastrointestinal disorders of humans, may facilitate disease prognosis. OBJECTIVE: Evaluate the predictive potential of Cu, Zn, cobalamin, and serum amyloid A (SAA) as prognostic indicators in cats with feline panleukopenia (FPV) on admission. ANIMALS: Client-owned cats diagnosed with FPV and controls. METHODS: Serum Cu and Zn concentrations were assessed using the spectrophotometric method and serum concentrations of SAA and cobalamin were measured by chemiluminescent immunoassay. RESULTS: On admission, survivor cats with FPV had significantly higher serum Cu and SAA concentrations and Cu/Zn ratios and significantly lower serum Zn and cobalamin concentrations than controls. Furthermore, non-survivor cats with FPV had significantly higher serum Cu and SAA concentrations and Cu/Zn ratios and significantly lower cobalamin concentrations than survivors and controls. Prognostic thresholds were calculated, with positive predictive value (PPV) for survival of 90% for Cu (≥120.3 µg/dL), 90% for Cu/Zn (≥1.34), 90% for cobalamin (≤430.4 pg/mL), and 90% for SAA (≥0.85 mg/L). CONCLUSIONS AND CLINICAL IMPORTANCE: Cu (0.93 area under curve [AUC]), Cu/Zn (0.95 AUC), cobalamin (0.98 AUC), and SAA (0.98 AUC) were excellent biomarkers for predicting prognosis in cats with FPV. Their effectiveness, as assessed by sensitivity (100%), specificity (80%), AUC (0.98), and PPV (90%) from receiver operating characteristic analysis, emphasizes the performance of cobalamin and SAA.
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Cobre , Panleucopenia Felina , Proteína Amiloide A Sérica , Vitamina B 12 , Zinco , Animais , Gatos , Proteína Amiloide A Sérica/análise , Proteína Amiloide A Sérica/metabolismo , Cobre/sangue , Zinco/sangue , Vitamina B 12/sangue , Feminino , Masculino , Prognóstico , Panleucopenia Felina/sangue , Estudos de Casos e Controles , Doenças do Gato/sangue , Biomarcadores/sangueRESUMO
Objectives: This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods: Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results: The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions: In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.
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BACKGROUND: Canine parvoviral enteritis (CPE) is a fatal disease worldwide. The treatment of CPE is based mainly on supportive and symptomatic treatment. Antiviral addition to the treatment may result in a higher survival. OBJECTIVES: This study evaluated the effects of antiviral treatments with a standardized treatment (ST) on the clinical and inflammatory response of dogs with naturally occurring CPE. METHODS: Twenty-eight dogs with CPE caused by canine parvovirus type 2 were divided randomly into treatment groups. The ST group received fluid, antibiotic, antiemetic, and deworming treatments. The antiviral treatment groups received the same ST with an additional antiviral drug, recombinant feline interferon omega (rFeIFN-ω), oseltamivir (OSEL) or famciclovir (FAM). RESULTS: Compared to the healthy control, the tumor necrosis factor-α, interleukin-1ß, interferon (IFN)-α, IFN-γ, haptoglobin, and C-reactive protein values were high (p < 0.05) on day zero. At presentation, mild lymphopenia, neutropenia, and a high neutrophil to lymphocyte (LYM) ratio (NLR) were also observed. Adding rFeIFN-ω to the ST produced the best improvement in the clinical score with a decreased NLR, while leucocytes remained low and inflammatory markers stayed high on day three. The survival rates of the groups were 85.7% in ST+IFN, 71.4% in ST+OSEL, 71.4% in ST+FAM, and 57.1% in ST groups on day seven. CONCLUSIONS: Antiviral drugs may be valuable in treating CPE to improve the clinical signs and survival. In addition, the decrease in NLR in favor of LYM may be an indicator of the early prognosis before the improvement of leukocytes, cytokines, and acute phase proteins in CPE.
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Doenças do Gato , Doenças do Cão , Enterite , Infecções por Parvoviridae , Parvovirus Canino , Animais , Cães , Gatos , Infecções por Parvoviridae/tratamento farmacológico , Infecções por Parvoviridae/veterinária , Oseltamivir/uso terapêutico , Antivirais/uso terapêutico , Enterite/tratamento farmacológico , Enterite/veterinária , Doenças do Gato/tratamento farmacológicoRESUMO
Microphysiological systems involving microfluidic 3D culture of cancer cells have emerged as a versatile toolkit to study tumor biological problems and evaluate potential treatment strategies. Incorporation of microfluidic technologies in 3D tissue culture offers opportunities for realistic simulation of tumor microenvironment in vitro by facilitating a dynamic culture environment mimicking features of human physiology such as reconstituted ECM, interstitial flow, and gradients of drugs and biomacromolecules. This protocol describes development of 3D microfluidic cell culture based on Tumor-Microenvironment-on-Chip (T-MOC) platform modeling tumor blood and lymphatic capillary vessels and the interstitial space in between. Based on earlier applications of T-MOC for transport characteristics, drug response, and tumor-stroma interactions in mammary carcinoma and pancreatic adenocarcinoma, this protocol provides detailed description of device fabrication, on-chip 3D culture, and drug treatment assays. This protocol can easily be adapted for applications involving other cancer types.
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Adenocarcinoma , Neoplasias da Mama , Neoplasias Pancreáticas , Humanos , Feminino , Microambiente Tumoral , Microfluídica/métodos , Dispositivos Lab-On-A-ChipRESUMO
OBJECTIVE: This study aimed to examine the mandible form features of the mandible, such as inter-second molar width, anteroposterior length, arch perimeter length, arch breadth, corpus height/width in the mandibular second molars (MnSM) region, and arch form, and the relation for the occasion of the 1-rooted/C-shaped. METHODS: The study analyzed cone-beam computed tomography images of 215 male and 215 female Turkish patients to determine the prevalence of 1-rooted and C-shaped MnSM. Mandibular dentoalveolar characteristics of individuals with bilateral (1R-1R group) and unilateral (1R-2R group) 1-rooted MnSM were examined and compared with those with bilateral 2-roots (2R-2R group) MnSM. Statistical tests were performed using Chi-square, one-way ANOVA, Tukey, and binary logistic regression analysis at the 5% significance level. RESULTS: The prevalence of 1-rooted and 1-rooted/C-shaped MnSM was 12.79% and 9.65%, respectively. Root fusion was more commonly present in females (p<0.05). In the 1R-1R group, the anteroposterior length was shorter than in the 2R-2R group (p<0.05). There was no difference between the groups for other features (p>0.05). CONCLUSION: Although the study found a shorter anteroposterior length in the 1R-1R group, no feature was a predictive variable for 1-rooted/C-shaped MnSM.
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Dente Molar , Raiz Dentária , Humanos , Masculino , Feminino , Raiz Dentária/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , PrevalênciaRESUMO
OBJECTIVE: The aim of this study was to evaluate the performance of the Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, steroid use score in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding and compare it with the Glasgow-Blatchford score; the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score; the age, blood tests, and comorbidities score; and Complete Rockall score. METHODS: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were obtained from the hospital automation system by using the classification of disease codes and analyzed in this retrospective study. Adult patients with endoscopically confirmed nonvariceal upper gastrointestinal bleeding were included in the study. Patients with bleeding from the tumor, bleeding after endoscopic resection, or missing data were excluded. The prediction accuracy of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score was calculated using the area under the receiver operating characteristic curve and compared with that of Glasgow-Blatchford score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, the age, blood tests, and comorbidities score, and Complete Rockall score. RESULTS: A total of 805 patients were included in the study, and the in-hospital mortality rate was 6.6%. The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score (area under the receiver operating characteristic curve 0.812, 95%CI 0.783-0.839) was better than Glasgow-Blatchford score (area under the receiver operating characteristic curve 0.683, 95%CI 0.650-0.713, p=0.008), and similar to the the age, blood tests, and comorbidities score (area under the receiver operating characteristic curve 0.829, 95%CI 0.801-0.854, p=0.563), the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score (area under the receiver operating characteristic curve 0.794, 95%CI 0.764-0.821, p=0.672), and Complete Rockall score (area under the receiver operating characteristic curve 0.761, 95%CI 0.730-0.790, p=0.106). CONCLUSION: The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score in predicting in-hospital mortality for our study population is better than Glasgow-Blatchford score and similar to the the age, blood tests, and comorbidities score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, and Complete Rockall score.
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Albuminas , Hemorragia Gastrointestinal , Adulto , Humanos , Idoso , Estudos Retrospectivos , Medição de Risco , Curva ROC , Esteroides , Índice de Gravidade de Doença , PrognósticoRESUMO
The use of minimally invasive surgery in colon cancers is becoming widespread and developing day by day Laparoscopic right hemicolectomy (LRHC) with complete mesocolic excision is gradually becoming the standard oncological surgical principle for right hemicolectomy. The aim of our study was to evaluate the safety and efficacy of laparoscopic right hemicolectomy in a small-volume center. METHODS: Clinical outcomes were analyzed in a study comparing laparoscopic right hemicolectomy with conventional right hemicolectomy. By standardizing laparoscopic right hemicolectomy in our center, data on patient characteristics, surgical details, tumor, lymph node, and metastasis stage (TNM), postoperative recovery, and survival were retrieved and analyzed from retrospective databases. RESULTS: Patients underwent open (n. 63) and laparoscopic (n. 51) right hemicolectomies in our units. In the laparoscopic group, the rate of conversion to open was 5.8%, and there was no mortality for 30 days. In the open group, the first-month mortality was 6.3%, and the rate of complications was 15.9%. The mean age of the patients in the laparoscopic group (65.7±13.46) was statistically significantly higher than that of the open group 60.49±12.67) (p=0.042). Operation time was 147.53±57 minutes in the laparoscopic group and 132.84±34 minutes in the open batch, and there was no statistically significant difference between them. Significant correlations were found between stage and cancer subgroup information (p=0.001). Adenocarcinoma (42%) and mucinous (43.8%) type cancers were found more frequently in patients with stage III, while signet ring cancers were more common (100%) in stage IV patients. CONCLUSIONS: LRHC and laparoscopic conventional right hemicolectomy offered similar oncologic outcomes for right colon cancers in small volume centers. LRHC can be performed safely, and sufficient laparoscopic experience is essential for it to be considered the gold standard procedure. With an improved standard technique and systematic learning method, patient safety and surgical results can be achieved as successfully as in the open surgical approach. KEY WORDS: Colorectal cancer, Intracorporeal anastomosis, Right laparoscopic hemicolectomy, Side-to-side anastomosis.
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Neoplasias do Colo , Laparoscopia , Humanos , Estudos Retrospectivos , Laparoscopia/métodos , Linfonodos/patologia , Neoplasias do Colo/cirurgia , Colectomia/métodos , Resultado do TratamentoRESUMO
OBJECTIVES: To compare the crown and root metric properties of two- and single-rooted/multi-canal mandibular canines (MnCn) with single-rooted/single-canal MnCn. METHODS: Cone-beam computed tomography images of 1000 patients (500 women and 500 men) with both right and left MnCn were analyzed. First, the root and canal morphologies of all teeth were examined. Then, the teeth were divided into three groups; (a) 2-rooted, (b) 1-rooted and multi-canals, (c) 1-rooted and single-canal. Crown lengths/sizes and tooth lengths were compared between the three groups. Statistical analyses were performed using Chi-square, one-way ANOVA, Welch, post hoc pairwise comparison, and independent sample t-tests. The significance level was set at 5%. RESULTS: Of all the teeth, 2.35% were 2-rooted, and 6.3% were 1-rooted/multi-canal. The frequency of double roots was higher in women (p < 0.05). Double-rooted teeth had longer crown lengths but shorter tooth lengths than single-rooted teeth (p < 0.05). In 2-rooted teeth, buccal and lingual root lengths were similar, root bifurcation levels were mostly at the mid-root, and the mean distance of the bifurcation points of the canals to the cemento-enamel junction was 4.09 mm. Double-rooted teeth were mostly observed unilaterally. CONCLUSIONS: Since 2-rooted MnCn do not differ significantly from other teeth in terms of crown sizes, it is not possible to differentiate between single- vs. double-rooted MnCn based on clinical examination.
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Dente Canino , Raiz Dentária , Feminino , Animais , Dente Canino/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodosRESUMO
SUMMARY OBJECTIVE: The aim of this study was to evaluate the performance of the Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, steroid use score in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding and compare it with the Glasgow-Blatchford score; the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score; the age, blood tests, and comorbidities score; and Complete Rockall score. METHODS: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were obtained from the hospital automation system by using the classification of disease codes and analyzed in this retrospective study. Adult patients with endoscopically confirmed nonvariceal upper gastrointestinal bleeding were included in the study. Patients with bleeding from the tumor, bleeding after endoscopic resection, or missing data were excluded. The prediction accuracy of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score was calculated using the area under the receiver operating characteristic curve and compared with that of Glasgow-Blatchford score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, the age, blood tests, and comorbidities score, and Complete Rockall score. RESULTS: A total of 805 patients were included in the study, and the in-hospital mortality rate was 6.6%. The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score (area under the receiver operating characteristic curve 0.812, 95%CI 0.783-0.839) was better than Glasgow-Blatchford score (area under the receiver operating characteristic curve 0.683, 95%CI 0.650-0.713, p=0.008), and similar to the the age, blood tests, and comorbidities score (area under the receiver operating characteristic curve 0.829, 95%CI 0.801-0.854, p=0.563), the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score (area under the receiver operating characteristic curve 0.794, 95%CI 0.764-0.821, p=0.672), and Complete Rockall score (area under the receiver operating characteristic curve 0.761, 95%CI 0.730-0.790, p=0.106). CONCLUSION: The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score in predicting in-hospital mortality for our study population is better than Glasgow-Blatchford score and similar to the the age, blood tests, and comorbidities score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, and Complete Rockall score.
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OBJECTIVE: To identify which Machine Learning (ML) algorithms are the most successful in predicting and diagnosing breast cancer according to accuracy rates. METHODS: The "College of Wisconsin Breast Cancer Dataset", which consists of 569 data and 30 features, was classified using Support Vector Machine (SVM), Naive Bayes (NB), Random Forest (RF), Decision Tree (DT), K-Nearest Neighbor (KNN), Logistic Regression (LR), Multilayer Perceptron (MLP), Linear Discriminant Analysis (LDA), XgBoost (XGB), Ada-Boost (ABC) and Gradient Boosting (GBC) ML algorithms. Before the classification process, the dataset was preprocessed. Sensitivity, accuracy, and definiteness metrics were used to measure the success of the methods. RESULT: Compared to other ML algorithms used in the study, the GBC ML algorithm was found to be the most successful method in the classification of tumors with an accuracy of 99.12%. The XGB ML algorithm was found to be the lowest method with an accuracy rate of 88.10%. In addition, it was determined that the general accuracy rates of the 11 ML algorithms used in the study varied between 88-95%. CONCLUSION: When the results obtained from the ML classifiers used in the study are evaluated, the efficiency of the GBC algorithm in the classification of tumors is obvious. It can be said that the success rates obtained from 11 different ML algorithms used in the study are valuable in terms of being used to predict different cancer types.
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Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Teorema de Bayes , Aprendizado de Máquina , Algoritmos , Máquina de Vetores de SuporteRESUMO
BACKGROUND: The COVID-19 pandemic has profoundly affected the habits of patients, as well as its negative effects on human health. The aim of this study is to investigate the factors associated with discharge against medical advice (DAMA) from the emergency department (ED) during the COVID-19 pandemic. METHODS: We conducted a retrospective study of the charts of DAMA cases (pandemic group) between May 1 and October 30, 2021 in a tertiary hospital in Istanbul, Turkey. Our data were compared with DAMA cases between May 1 and October 30, 2019 (pre-pandemic group-control group). RESULTS: During the pandemic period, DAMA cases increased by 24.5% in the ED compared to the previous period. Compared to the pre-COVID-19 period, among DAMA cases during the COVID-19 period, the rate of those arriving by ambulance (10.9 vs. 18.8%), those with one or more comorbid diseases (8.9 vs. 18.4%), those with a high triage level (4.0 vs. 7.4%), those with health tourism or refugee/asylum insurance (2.9 vs. 6.1%), those with trauma (11.5 vs. 19.9%) or alcohol/drug abuse (2.7 vs. 4.0%) increased significantly (p < 0.001). It was observed that DAMA cases' waiting times for total ED and from the door to doctor decreased during the pandemic period compared to the pre-pandemic period. CONCLUSION: During the COVID-19 pandemic period, it was observed that the rate of those with severe disease increased among DAMA cases. Necessary precautions should be taken for all patients, especially seriously ill patients, to feel safe in the hospital and to be treated, and the negative consequences that may develop should be prevented by addressing the concerns of the patients and their relatives.
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COVID-19 , Alta do Paciente , COVID-19/epidemiologia , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos RetrospectivosRESUMO
Deciding on the early discharge of low-risk patients with chest pain is still controversial in emergency care. Beyond the validated tools for risk assessment, high sensitive troponin levels on admission, whether to take the next serial sampling or when to take are the main issues affecting the unnecessary follow-ups that lead to the emergency crowd. We aimed to investigate the prediction performance of emergency department assessment of chest pain score and accelerated diagnostic protocol (EDACS-ADP) and calculation of MI risk probabilities to manage patients with suspicion of myocardial infarction (COMPASS-MI). We conducted a prospective cross-sectional study that included patients with chest pain followed-up in the emergency department with a serial troponin sampling. We calculated the performance tests of the risk scores after recording the patients' risk factors, chest pain types, troponin levels as defined in the risk assessment tools. Nine hundred eleven patients were included in the study. Thirty-eight patients had significant adverse cardiovascular events (MACE) within 30 days. Patients with a not-low-risk score at EDACS-ADP had a 3.975 (95% CI 2.136-7.396) fold higher risk of MACE than the patients with low-risk EDACS-ADP, and the absolute risk increase was 7.3%. Patients with high-risk late-stage risk in COMPASS-MI had a 3.581 (95% CI 1.660-7.726) fold higher risk of MACE than those with low-risk late-stage risk in COMPASS-MI, and absolute risk increase was 4.6%. We found EDACS-ADP and COMPASS-MI at a late time point (2 h hsTnI) with a high negative predictive value as a risk assessment tool for discharging chest pain patients.
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Dor no Peito , Serviço Hospitalar de Emergência , Alta do Paciente , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Estudos Transversais , Eletrocardiografia , Humanos , Estudos Prospectivos , Medição de Risco/métodos , TroponinaRESUMO
This study aimed to determine the prevalence of additional roots in maxillary second molar (MSM), maxillary first premolar (MxFP), mandibular first molar (MnFM) and mandibular first premolar (MnFP) teeth and evaluate the correlations between the number of roots for these teeth. Images of 630 Turkish patients, in which all dental groups examined in the study were present bilaterally, were analyzed using cone-beam computed tomography. The images for the presence of the fourth root in MSMs, third root in MxFPs, distolingual root in MnFMs and complicated-root structure in MnFPs were assessed and divided additional roots into subgroups. The Chi-square test was used for categorical variables such as sex and tooth position. Logistic regression analysis was performed to understand the predictor variability of other teeth in teeth with extra roots. A p < 0.05 was considered statistically significant. Prevalence of the fourth root in MSMs was 1.75%, third root in MxFPs was 6.35%, third root in MnFMs was 3.57%, and complicated root in MnFPs was 21.9%. Positive correlations were observed between MSM, MxFP and MnFP teeth for increasing root numbers (P < 0.05). There was no significant correlation between root numbers of MnFM teeth and other tooth groups (P > 0.05) In the tooth groups examined, there was at least one explanatory variable (except for the right MnFM) tooth in addition to the contralateral tooth for the presence of additional roots.
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Dente Molar , Raiz Dentária , Dente Pré-Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar , Humanos , Dente Molar/diagnóstico por imagem , Estudos Retrospectivos , Raiz Dentária/diagnóstico por imagemRESUMO
BACKGROUND: This study aims to compare emergency trauma visits' severity, emergency surgical needs, and characteristics between the pandemic and pre-pandemic periods. METHODS: This retrospective observational study was conducted in a tertiary training and research hospital between 1 and 30 April 2020 (pandemic group) and compared with the previous year's same dates (pre-pandemic group). Trauma patients aged 18 and over were included in the study. Emergency Severity Index (ESI) levels, trauma surgery needs, and injury characteristics were compared. RESULTS: A total of 2097 patients (592 pandemic and 1505 pre-pandemic) were included. There was an approximately 60% reduction in total and daily visits. ESI levels 1 (0.2% vs. 1.4%) and 2 (0.8% vs. 1.9%) patients increased during pandemic period. Trauma surgery needs (1.6% vs. 2.2%), intensive care unit (ICU) admission (0.4% vs. 0.2%), and ward admission (6.3% vs. 7.9%) did not change during pandemic period. CONCLUSION: Despite the decrease in the visit frequency of adult trauma patients during the pandemic period, the needs for trauma surgery, ICU, and ward admission did not change. Trauma teams should continue their duties during the pandemic period.
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COVID-19 , Adolescente , Adulto , COVID-19/epidemiologia , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Centros de TraumatologiaRESUMO
Objective: This study aimed to evaluate the prevalence of root fusion and the incidence of C-shaped canals in maxillary first molar (MFM) and maxillary second molar (MSM) teeth using cone-beam computed tomography. Material and Methods: In this study, a total of 1233 MFMs and 1406 MSMs from 802 patients were analyzed. First, the number of fused rooted teeth and the type of root fusion were determined. Subsequently, incidence and number of C-shaped canals were ascertained according to the type of fusion, location, position, and level of canal merging in teeth with fused roots. Six types were established according to the C-shape configurations observed. Presence of root fusion and the C-shaped canal according to gender, age, and tooth position were evaluated by chi-square test. Values with p< 0.05 were considered significant in statistical tests. Results: The incidence of fusion in the MFM and MSM teeth was 6.16% and 22.40%, respectively. Only three MFMs (0.24%) and 3.77% of the MSMs had C-shaped canals. While the incidence of fusion was higher in women (p< 0.05), the C shaped morphology was not affected by sex (p> 0.05). Individuals over the age of 50 years had a lower incidence of C-shaped canals (p< 0.05). Conclusion: C-shaped canal morphology was more commonly associated with complex types of root fusion involving three roots; 16.83% of MSMs with fused roots had C-shaped canals (AU).
Objetivo: o objetivo deste estudo foi avaliar a prevalência de fusão radicular e a incidência de canais em C nos dentes do primeiro molar superior (MFM) e do segundo molar superior (MSM) por meio da tomografia computadorizada de feixe cônico. Material e Métodos: Neste estudo, um total de 1233 MFMs e 1406 MSMs de 802 pacientes foram analisados. Primeiro, o número de dentes com raízes fundidas e o tipo de fusão radicular foram determinados. Posteriormente, a incidência e o número de canais em forma de C foram verificados de acordo com o tipo de fusão, localização, posição e nível de fusão do canal nos dentes com raízes fundidas. Seis tipos foram estabelecidos de acordo com as configurações em forma de C observadas. A presença de fusão radicular e do canal em C de acordo com sexo, idade e posição dentária foram avaliadas pelo teste do qui-quadrado. Valores com p <0,05 foram considerados significativos nos testes estatísticos. Resultados: A incidência de fusão nos dentes MFM e MSM foi de 6,16% e 22,40%, respectivamente. Apenas três MFMs (0,24%) e 3,77% dos MSMs tinham canais em forma de C. Enquanto a incidência de fusão foi maior em mulheres (p <0,05), a morfologia em forma de C não foi afetada pelo sexo (p> 0,05). Indivíduos com mais de 50 anos apresentaram menor incidência de canais em C (p <0,05). Conclusão: a morfologia do canal em forma de C foi mais comumente associada a tipos complexos de fusão radicular envolvendo três raízes; 16,83% dos HSH com raízes fundidas tinham canais em forma de C (AU).
Assuntos
Humanos , Raiz Dentária , Cavidade Pulpar , Tomografia Computadorizada de Feixe Cônico , Dente MolarRESUMO
OBJECTIVE: To determine the frequency of taurodontism in maxillary and mandibular molar teeth using cone-beam computed tomography (CBCT) and to compare the differences in root and canal morphologies between taurodont and nontaurodont molars. METHODS: CBCT images of 1200 patients were analysed. First, the frequency of taurodontism in maxillary and mandibular molar teeth was calculated. The Shifman and Chanannel taurodontic index was used to diagnose taurodontic teeth. Subsequently, the root and canal morphologies were compared with those of 250 normal teeth randomly selected from each tooth group. P < 0.05 values were considered significant in statistical tests. The chi-square test was used for differences according to sex, age and tooth position. Z-test was used for comparing percentages between independent groups. RESULTS: The occurrence rate of taurodontism was 7.78 % and 12.72 % in maxillary first and second molar teeth, respectively, and 1.99 % and 2.41 % in mandibular first and second molar teeth, respectively. Women had more taurodont teeth than men. The frequency of root fusion was greater in taurodont maxillary molars. The percentage of C-shaped roots in taurodont mandibular second molars was significantly higher than in cynodonts (19.15 % and 8.4 %, respectively). CONCLUSIONS: Taurodont teeth show wide variations in root and canal morphology. The degree of change in morphology is associated with the severity of taurodontism.
Assuntos
Dente Molar , Raiz Dentária , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anormalidades , Feminino , Humanos , Masculino , Dente Molar/diagnóstico por imagem , Estudos Retrospectivos , Anormalidades Dentárias , Raiz Dentária/diagnóstico por imagemRESUMO
Anomalous origin of coronary artery originating from the pulmonary artery in conjunction with the aorticopulmonary window (APW) is a rare but a significant anomaly in the era of congenital cardiac diseases. The occurrence of anomalous origin of the right coronary artery from the pulmonary artery among the associated anomalies is less than 5%. The severity of the clinical condition of these patients depends on the degree of left-right shunt and compromise of the pulmonary blood flow. We report surgical management of a case of a 45-day-old infant with APW, ventricular septal defect, and anomalous origin of coronary artery originated from the pulmonary artery.
Assuntos
Defeito do Septo Aortopulmonar , Anomalias dos Vasos Coronários , Defeito do Septo Aortopulmonar/diagnóstico por imagem , Defeito do Septo Aortopulmonar/cirurgia , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/cirurgia , Humanos , Lactente , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Circulação PulmonarRESUMO
Canine coronavirus (CCoV) generally causes an infection with high morbidity and low mortality in dogs. In recent years, studies on coronaviruses have gained a momentum due to coronavirus outbreaks. Mutations in coronaviruses can result in deadly diseases in new hosts (such as SARS-CoV-2) or cause changes in organ-tissue affinity, as occurred with feline infectious peritonitis virus, exacerbating their pathogenesis. In recent studies on different types of CCoV, the pantropic strains characterized by hypervirulent and multi-systemic infections are believed to be emerging, in contrast to classical enteric coronavirus infections. In this study, we investigated emerging hypervirulent and multi-systemic CCoV strains using molecular and bioinformatic analysis, and examined differences between enteric and pantropic CCoV strains at the phylogenetic level. RT-PCR was performed with specific primers to identify the coronavirus M (membrane) and S (spike) genes, and samples were then subjected to DNA sequencing. In phylogenetic analysis, four out of 26 samples were classified as CCoV-1. The remaining 22 samples were all classified as CCoV-2a. In the CCoV-2a group, six samples were in branches close to enteric strains, and 16 samples were in the branches close to pantropic strains. Enteric and pantropic strains were compared by molecular genotyping of CCoV in dogs. Phylogenetic analysis of hypervirulent pantropic strains was carried out at the amino acid and nucleotide sequence levels. CCoV was found to be divergent from the original strain. This implies that some CCoV strains have become pantropic strains that cause multisystemic infections, and they should not be ruled out as the cause of severe diarrhea and multisystemic infections.