The Investigation of Bone-Implant Connection and New Bone Formation in Fasting and High-Fatty Diet Rats.

BACKGROUND: Hyperlipidemia caused by a high-fat diet (HFD) has many adverse effects on the cardiovascular system, including vascular problems. In addition, a HFD also has significant adverse effects on bone health. AIM: The aim of this study is to examine bone-implant osteointegration and new bone formation in peri-implant defects in fasting and high-fatty diet applied rats. MATERIALS AND METHODS: In this study, 28 female Sprague Dawley rats were used. The rats were divided into four groups, with seven rats in each group: the control group on a normal diet (Group 1) (n = 7), the fasted group (Group 2) (n = 7), the high-fatty diet (HFD) group (Group 3) (n = 7), and the fasted and HFD group (Group 4) (n = 7). Titanium implants with a diameter of 2.5 mm and a length of 4 mm were placed in the right tibia bones of the subjects, and a bone graft corresponding to 2 mm of the implant length was placed in the bone defect applied to the neck region. All rats that continued the administered diet for 12 weeks were sacrificed at the end of the experiment period. The implants and surrounding bone tissue were surgically removed and subjected to biomechanical analysis to assess bone-implant osteointegration and peri-implant new bone formation. RESULTS: It was determined that there was no statistically significant difference between the rats in the control group and the other three groups in terms of bone-implant osteointegration and peri-implant new bone formation (P > 0.05). CONCLUSION: As a result of this study, it was determined that fasting or maintaining a HFD does not adversely affect bone-implant osteointegration or peri-implant new bone formation in the tibias of rats.

Appropriateness of aspirin use among diabetic patients in primary prevention of atherosclerotic cardiovascular diseases: an analysis of the ASSOS study.

OBJECTIVE: Aspirin is an essential drug in the prevention of atherosclerotic cardiovascular disease (ASCVD). It is ultimately indicated in a patient with ASCVD. However, its role is debated in primary prevention. We aimed to investigate the appropriateness of aspirin use in diabetic patients according to recommendations of recent guidelines. PATIENTS AND METHODS: ASSOS was a multicenter observational study investigating aspirin use in cardiology outpatient clinics. We evaluated aspirin use in diabetic patients in primary prevention from the ASSOS study. We also assessed the appropriate use of aspirin according to the European Society of Cardiology (ESC), American College of Cardiology/American Heart Association (ACC/AHA), American Diabetes Association (ADA), Consensus Statement of Endocrinology, Cardiology, and Nephrology (ENCARNE), and the United States Preventive Services Task Force (USPTF). RESULTS: A total of 5,007 patients of whom 1,537 had type 2 diabetes mellitus (DM) were included in the study. 1,132 of the total participants used aspirin for primary prevention; 313 of them had type 2 DM. Only 248 (76.7%), 132 (40.8%), and 128 (39.6%) diabetic patients indicated aspirin use according to the ESC/INCARNE, ACC/AHA, and ADA/USPTF guidelines, respectively. CONCLUSIONS: Inappropriate aspirin use was common among diabetic patients, according to clinical practice guideline recommendations. In addition, the differences between the indications for the use of aspirin in diabetic patients according to the guidelines were remarkable. Guidelines that minimize these differences are needed for clinicians, and compliance with these guidelines in clinical practice could reduce inappropriate aspirin use.

IS REPEAT FNAB NECESSARY FOR THYROID NODULES WITH ND / UNS CYTOLOGY?

Context/Objective: The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with non-diagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinical-radiological-pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB. Methods: Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared. Results: The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p <0.020, p <0.002). When looking at the distribution of rFNAB results, a significant correlation was observed with female gender, solid component, hypoechogenicity, border irregularity and halo loss around the nodule in patients with BC-4,5,6 cytology results (respectively, 0.005 / 0.031 / 0.001 / 0.012 / 0.004). Conclusion: rFNAB did not show the expected effect in ND / UNS nodules. We recommend direct surgical excision without rFNAB for nodules with border irregularity, solid structure, halo loss and hypoechogenicity, which should be considered more important in female patients.

Ligula Intestinalis Infection in a Native Leuciscid Hybrid (Alburnus Derjugini x Squalius Orientalis) in The Kürtün Dam Lake, Northeast Anatolia.

Taxonomic evaluations are needed to accurately determine the host selection of fish parasites. The present study is a multidisciplinary research in the field of basic and fish diseases sciences. The description of the hybrid species of Squalius orientalis and Alburnus derjugini and infection of Ligula intestinalis in these hybrid fish were reported for the first time from the Kürtün Dam Lake in northeast Turkey. A total of 450 fish were sampled in March, August, and October in 2020 using gillnets. Detailed morphological characteristics (n = 24) were compared to determine the difference among ancestors and hybrid species. The prevalence of L. intestinalis between the sampling periods and the size groups of fish (0 - 10, 11 - 15, and ≥16 cm in length) were examined. Moreover, the highest prevalence of the parasite was observed in October (78.94 %), with a size range of 0 - 10 cm in length (77.8 %). In addition, the total prevalence of the parasite was 48.44 %. The results revealed that most of the diagnostic metric and meristic features of hybrid fish were ranging between the data of S. orientalis and A. derjugini. According to previous reports, when hybrid individuals were compared with their ancestors in terms of prevalence, hybrid individuals were more susceptible to L. intestinalis infections. This study was unique as it provided the first record of L. intestinalis in a hybrid fish population.

Standardised Sampling Approach for Investigating Pathogens or Environmental Chemicals in Wild Game at Community Hunts.

Wildlife may host pathogens and chemicals of veterinary and public health relevance, as well as pathogens with significant economic relevance for domestic livestock. In conducting research on the occurrence and distribution of these agents in wildlife, a major challenge is the acquisition of a sufficient number of samples coupled with efficient use of manpower and time. The aim of this article is to present the methodology and output of a sampling approach for game animals, which was implemented from 2017/18 to 2020/21 at drive hunts in Brandenburg, Germany. The central element was a framework agreement with the BImA, whereby federal forest officials and other hunters collected most of the samples during field dressing. Further samples of game carcasses were obtained by scientists during subsequent gathering at a collection point. Altogether, 3185 samples from 938 wild ungulates of four species were obtained for various studies analysing-in this case-food-borne agents in game animals. Sampling was representative and reflected the proportional distribution of ungulate species hunted in Brandenburg. Hunting district and hunting season strongly influenced hunting bag and hence sampling success. This sampling approach was demonstrated to be a suitable basis for monitoring programs, that can be adapted to other regions.

¿Cuáles son los factores que afectan la dehiscencia del glande tras la cirugía de hipospadias? / What are the factors affecting glanular dehiscence after hypospadias surgery?

Antecedentes La dehiscencia glandular (DG) es una de las principales complicaciones que se producen tras la cirugía de hipospadias. Existe un número limitado de publicaciones sobre la DG en la literatura.Objetivo Esta revisión tiene como objetivo revelar los factores que afectan la DG mediante una revisión bibliográfica.Adquisición de la evidenciaSe realizó una búsqueda literaria de artículos relacionados en la base de datos utilizando el término de búsqueda dehiscencia del glande sin establecer límite temporal ni ningún otro límite. Se incluyeron en este estudio todos los artículos relacionados con la dehiscencia del glande tras la cirugía de hipospadias. Tras recopilar la información de los textos completos, se incluyeron 71 artículos en esta revisión sistemática. Se obtuvieron los siguientes datos para la realización del estudio: la localización del meato hipospádico, el tipo de cirugía, y otros datos clínicos que se consideraron factores de riesgo de la DG. Se utilizó la prueba de X2 para comprobar las diferencias entre los distintos parámetros, considerando un valor p < 0,05 como estadísticamente significativo.Resultados Tras evaluar los 71 artículos que cumplían los criterios de inclusión, en esta revisión se detectaron 309 casos (3,48%) de DG tras 8.858 reparaciones de hipospadias. Las tasas de DG fueron significativamente altas en el caso de las reparaciones de hipospadias proximales (5%), las reparaciones en dos tiempos quirúrgicos (5%) y las reintervenciones (8,75%) (p = 0,002, 0,022 y 0,004, respectivamente). El ancho del glande de < 14 mm y de la placa uretral de < 7 mm, las cirugías de hipospadias realizadas antes de los seis meses de edad y después de la pubertad, y la anestesia de bloqueo caudal aumentaron la tasa de DG Conclusiones El aumento de la tasa de DG se asocia a cirugías de hipospadias proximales, cirugías previas fallidas (cripple) y reparación por etapas, al ancho de glande

Background Glanular dehiscence (GD) is one of the main complications after hypospadias surgery. There is a limited number of publications regarding GD in the literature.Objective The aim of this work is to reveal the factors that affect GD after a literature review.Evidence acquisitionA literature search for relevant articles was performed in database using the search term glans dehiscence without setting date range limit or any other limits. All articles related to GD after hypospadias surgery were included in this study. After collecting the information from full text articles, 71 articles were included in this systematic review. In these studies, localization of hypospadic meatus, type of surgery, and other clinical data which were thought to behave as risk factors for GD were obtained. Chi-Square test was used to evaluate the differences between the parameters, where p < 0.05 was taken as statistically significant.ResultsAfter evaluating the 71 articles that met the inclusion criteria, 309 cases (3.48%) of GD after 8858 hypospadias repairs were obtained in this review. GD rates were found significantly high for proximal hypospadias (5%), two-stage hypospadia repairs (5%) and re-do hypospadias repair (8.75%) (p = 0.002, 0.022, and 0.004, respectively). Glans width < 14 mm, urethral plate (UP) width < 7 mm, hypospadias surgeries performed before 6 months of age and after puberty, and caudal block anesthesia increased the rate of GD.Conclusions The rate of GD increases after proximal, cripple and staged hypospadias surgeries, a glans width < 15 mm and UP width < 8 mm, postpubertal surgeries, and caudal anesthesia use during surgery (AU)

Early step-down weaning of dairy calves from a high milk volume with glutamine supplementation.

Weaning dairy calves from a high milk volume (≥8.0 kg/d) can negatively affect the growth and welfare even if it is performed in a step-down manner. Supplementation of Gln improved gut development of preweaning calves and mitigated weaning stresses of piglets to extents achieved with antibiotics. The study objective was to examine the effect of initiating a step-down weaning scheme with a Gln supplement at an early age on calf starter intake (CSI), average daily gain (ADG), and paracellular permeability of the intestinal epithelium of calves fed a high volume of milk (9.0 kg/d). Thirty-six Holstein heifer calves were assigned to 3 treatments (n = 12) as follows: (1) initiating weaning at 49 d of age (LW), (2) initiating weaning at 35 d of age (EW), and (3) initiating weaning at 35 d with a Gln supplement (2.0% of dry matter intake) from 28 to 42 d of age (EWG). Calves were fed 9.0 kg/d of whole milk until weaning was initiated by abruptly decreasing the milk volume to 3.0 kg/d. Weaning was completed once calves achieved ≥1.0 kg/d of CSI. The paracellular permeability of the intestinal epithelium was assessed with lactulose-to-mannitol ratio (LMR) in the blood on 1 d before, and 3 and 7 d after the initiation of weaning. The blood was analyzed for haptoglobin, lipopolysaccharide-binding protein (LBP), and metabolites including AA. The CSI increased once milk volume was restricted in all treatments. The CSI of LW was greater than that of EW and EWG during the first week of weaning. The LW, EW, and EWG took 11, 19, and 16 d to achieve ≥1.0 kg/d of CSI and were weaned at 60, 54, and 51 d of age, respectively. The body weight (BW) of LW, EW, and EWG at the initiation of weaning were 68.2, 58.7, and 59.5 kg, respectively. Both LW and EWG achieved similar ADG, but ADG of EW was lower than LW during the first week of weaning. All calves had similar ADG during the second week of weaning. The BW of LW, EW, and EWG at weaning were 74.8, 66.5, and 66.4 kg, representing a 2.0, 1.8, and 1.8-fold increase in birth weight, respectively. All calves had similar BW of 88.6 and 164.3 kg at 10 and 20 wk of age, respectively. Regardless of the age, serum haptoglobin and plasma LBP concentrations increased on d 3 and returned to baseline concentrations on d 7 during weaning. The EW had a lower plasma LBP concentration than LW and EWG on d 3 during weaning. The LMR was similar between treatments on d 3 but increased by 44% for EW and LW on d 7, whereas the LMR of EWG remained unchanged during weaning. The postprandial serum concentration of Gln, Met, Trp, and ß-hydroxybutyrate were greater for EWG than EW during weaning. Beginning step-down weaning at 35 d with a Gln supplement can help maintain the gut barrier function and wean dairy calves with a satisfactory CSI at 7 wk of age without affecting postweaning growth.

What are the factors affecting glanular dehiscence after hypospadias surgery?

BACKGROUND: Glanular dehiscence (GD) is one of the main complications after hypospadias surgery. There is a limited number of publications regarding GD in the literature. OBJECTIVE: The aim of this work is to reveal the factors that affect GD after a literature review. EVIDENCE ACQUISITION: A literature search for relevant articles was performed in database using the search term glans dehiscence without setting date range limit or any other limits. All articles related to GD after hypospadias surgery were included in this study. After collecting the information from full text articles, 71 articles were included in this systematic review. In these studies, localization of hypospadic meatus, type of surgery, and other clinical data which were thought to behave as risk factors for GD were obtained. Chi-Square test was used to evaluate the differences between the parameters, where p < 0.05 was taken as statistically significant. RESULTS: After evaluating the 71 articles that met the inclusion criteria, 309 cases (3.48%) of GD after 8858 hypospadias repairs were obtained in this review. GD rates were found significantly high for proximal hypospadias (5%), two-stage hypospadia repairs (5%) and re-do hypospadias repair (8.75%) (p = 0.002, 0.022, and 0.004, respectively). Glans width <14 mm, urethral plate (UP) width <7 mm, hypospadias surgeries performed before 6 months of age and after puberty, and caudal block anesthesia increased the rate of GD. CONCLUSIONS: The rate of GD increases after proximal, cripple and staged hypospadias surgeries, a glans width <15 mm and UP width <8 mm, postpubertal surgeries, and caudal anesthesia use during surgery.

Effects of branched-chain amino acids on glucose uptake and lactose synthesis rates in bovine mammary epithelial cells and lactating mammary tissue slices.

Even though supplementations of essential AA (EAA) are often related to increased lactose yields in dairy cows, underlying mechanisms connecting EAA availability to the mammary glands and lactose synthesis are poorly understood. The objective of this study was to examine the effects of branched-chain AA (BCAA) including Leu, Ile, and Val on (1) glucose transporter (GLUT1) abundance and glucose uptake, (2) the abundance of proteins regulating lactose synthesis pathway, and (3) fractional synthesis rates of lactose (FSR) using bovine mammary epithelial cells (BMEC) and mammary tissues slices (MTS). The BMEC (n = 4) were allocated randomly to regular Dulbecco's Modified Eagle Medium with Ham's F12 (DMEM/F12) medium (+EAA) or +EAA deficient (by 90%) in all EAA (-EAA), all BCAA (-BCAA), only Leu (-Leu), only Ile (-Ile) or only Val (-Val). Western immunoblotting analyses, depletion of glucose in media, and a proteomic analysis were performed to determine the abundance of GLUT1 in the cell membrane, net glucose uptake, and the abundance of enzymes involved in lactose synthesis pathway in BMEC, respectively. The MTS (n = 6) were allocated randomly to DMEM/F12 medium having all EAA and 13C-glucose at concentrations similar to plasma concentrations of cows (+EAAp), and +EAAp deprived of all BCAA (-BCAAp) or only Leu (-Leup) for 3 h. The 13C enrichments of free glucose pool in MTS (EGlu-free) and the enrichments of glucose incorporated into lactose in MTS and media [ELactose-bound (T&M)] were determined and used in calculating FSR. In BMEC, -BCAA increased the fraction of total GLUT1 translocated to the cell membrane and the fraction that was potentially glycosylated compared with +EAA. Among individual BCAA, only -Leu was associated with a 63% increase in GLUT1 translocated to the cell membrane and a 40% increase in glucose uptake of BMEC. The -BCAA tended to be related to a 75% increase in the abundance of hexokinase in BMEC. Deprivation of Leu tended to increase glucose uptake of MTS but did not affect EGlu-free, ELactose-bound (T&M), or FSR relative to +EAAp. On the other hand, -BCAAp did not affect glucose uptake of MTS but was related to lower ELactose-bound (T&M), or FSR relative to +EAAp. Considering together, decreasing Leu supply to mammary tissues enhances GLUT1 and thus glucose uptake, which, however, does not affect lactose synthesis rates. Moreover, the deficiency of other BCAA, Ile, and Val alone or together with the deficiency of Leu seemed to decrease lactose synthesis rates without affecting glucose uptake. The data also emphasize the importance of addressing the effect of the supply of other nutrients to the mammary glands than the precursor supply in describing the synthesis of a milk component.

Comparison of Direct and Indirect Toxoplasma gondii Detection and Genotyping in Game: Relationship and Challenges.

The importance of game as a source of Toxoplasma gondii (T. gondii) infection in humans is largely unknown. New data on the presence of T. gondii in game hunted in the Federal State of Brandenburg, Germany, were obtained by direct and indirect detection (ELISA). DNA extracted either directly (5 g heart or foreleg muscle, DE) or after acid pepsin digestion (50 g heart, PD) or enriched by magnetic capture (50 g heart, MC) was examined by real-time PCR (qPCR). ELISA revealed seroprevalences of 20% in wild boar (Sus scrofa), 11% in roe deer (Capreolus capreolus) and 6% in red deer (Cervus elaphus). T. gondii DNA was detected by at least one direct detection method in 12% of wild boar, 6% of roe deer, 2% of fallow deer (Dama dama) and 2% of red deer. In both, positive wild boar and roe deer, T. gondii type II specific alleles were the most prevalent, as assessed by PCR-restriction fragment length polymorphism. The highest proportion of positive animals was detected by MC qPCR, followed by PD qPCR with a similar proportion of positive findings. Investigation of 50 g of heart muscle revealed a significantly higher proportion of positive qPCR results than analysis of 5 g (p = 0.048). An association between seropositivity and direct detection was evident in wild boar and roe deer (p < 0.001). Infectivity of T. gondii DNA-positive samples was confirmed by bioassay (4/4), providing evidence that game could represent a relevant source of viable T. gondii posing a risk for human infection.

Comparison of decentration, tilt and lenticular astigmatism of intraocular lens between sutured and sutureless scleral fixation techniques.

PURPOSE: To evaluate at six months the intraocular lens (IOL) decentration, tilt and lenticular astigmatism between foldable sutured and sutureless scleral fixation IOLs compared to conventional phacoemulsification surgery. METHODS: We retrospectively reviewed records for 22 eyes with sutureless scleral fixation, 16 eyes with sutured scleral fixation and 23 eyes with conventional phacoemulsification. IOL decentration and angle of IOL tilt were compared on Scheimpflug images 6 months after surgery. Lenticular astigmatism is described as the difference between refractive and net corneal astigmatism. RESULTS: The angle of tilt in both meridians was significantly lower in the sutureless group than in the sutured group (P=0.008 horizontally and P=0.002 vertically). IOL decentration did not show a significant difference between the three groups in either horizontal or vertical meridians (P˃0.05). Lenticular astigmatism was significantly lower in the sutureless and control groups than in the sutured group (P=0.003 and P<0.001). CONCLUSION: In addition to being relatively quick and easy to perform, the sutureless scleral fixation technique showed superior results in terms of IOL tilt and lenticular astigmatism at the six-month follow-up compared to the sutured technique.

Anestesia para reparación abierta de hernia inguinal con bloqueo ecoguiado en el plano del músculo transverso del abdomen en un paciente anciano de alto riesgo: caso clínico / Anesthesia for open inguinal hernia repair with ultrasound-guided transversus abdominis plane block in a high-risk elderly patient: case report

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WHICH FACTORS ARE ASSOCIATED WITH MALIGNANCY IN THYROID NODULES CLASSIFIED AS BETHESDA CATEGORY 3 (AUS/FLUS) AND HOW DO THEY INFLUENCE THE PATIENT'S MANAGEMENT?

BACKGROUND: Thyroid nodules are a common pathology worldwide. Fine needle aspiration biopsy (FNAB) is an important diagnostic method for the investigation of malignancy in thyroid nodules. However, according to the Bethesda System used to classify the results, patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS / FLUS) may not be classified as benign or malignant. Therefore, it may be necessary to determine some clinical risk factors to apply the best treatment in these patients. AIM: To determine the factors that increase the risk of malignancy in this patient group. METHODS: A retrospective study including 138 patients with an FNAB categorized as AUS/FLUS and operated between June 2015-September 2018. Demographical, Laboratory (TSH) and Ultrasound variables (number, size and characteristics of nodules) of the patients were compared among postoperative histopathological results. RESULTS: Hypo-echoic structure, microcalcification and irregular margin of the nodules were detected to be associated with malignancy in patients with FNAB results of AUS/FLUS (p <0.001). CONCLUSION: We suggest that surgical treatment should be considered if the patients have nodules with the hypo-echoic structure, microcalcification and irregular margin with an FNAB histopathological result of AUS / FLUS.

A new species of Petroleuciscus (Teleostei: Cyprinidae) from the Büyük Menderes River, southwestern Anatolia, Turkey.

Petroleuciscus ninae sp. nov. is described from the Büyük Menderes River drainage. The new species is distinguished by having a black lateral stripe from head to base of caudal fin, stripe distinct anteriorly and posteriorly, wider than eye diameter; numerous black pigments on anal-fin rays; body depth at dorsal-fin origin 27-30% standard length (LS ); head width at posterior margin of eye 16-19% LS ; and eye diameter smaller than snout length. Petroleuciscus ninae is also distinguished from other species in adjacent waters by having six fixed diagnostic nucleotide substitutions in the mitochondrial DNA coI barcode region.

Sedative-analgesic activity of remifentanil and effects of preoperative anxiety on perceived pain in outpatient mandibular third molar surgery.

The aim of this study was to assess the sedative-analgesic activity of different doses of remifentanil and effects of preoperative anxiety on intraoperative pain levels in patients attending a dental clinic. The patients (n=60) were divided into two groups according to the remifentanil infusion dose given: group R1: 0.05µg/kg/min; group R2: 0.1µg/kg/min. The following were evaluated: haemodynamic parameters, State-Trait Anxiety Inventory (STAI) TX-I score, pain level due to local anaesthesia injection, time to reach a Ramsay Sedation Scale (RSS) score of 3, amount of bolus dose, total drug consumption, recovery period, patient and surgeon satisfaction, and complications. The patient satisfaction score on a visual analogue scale (VAS) was 90 in group R1 and 100 in group R2 (P=0.008); the surgeon satisfaction score was 80 in group R1 and 90 in group R2 (P=0.004). The time to reach an RSS score of 3 and the amount of bolus dose were significantly lower in group R2 than in group R1. High levels of anxiety did not affect intraoperative pain levels. In conclusion, high doses of remifentanil can safely be used for various same-day dental surgery interventions.

A successful management of a giant mucinous ovarian tumor with intraoperative controlled fluid aspiration.

BACKGROUND: The aim of this article was to present management of a giant ovarian mass. CASE REPORT: A 61-year-old patient was admitted with compliants of abdominal swelling and dyspnea. Ultrasound revealed a giant ovarian mass with dimesnions 47x43x30 cm. The patient underwent laparatomy and the cyst's content was aspirated before total cyst excision. The total weight of the mass was calculated to be 42.5 kg. Postoperatively, the patient was discharged on her postoperative seventh day. CONCLUSION: Giant ovarian cysts can be managed with controlled aspiration before total cyst excision.

Comparison of injection pain caused by the DentalVibe Injection System versus a traditional syringe for inferior alveolar nerve block anaesthesia in paediatric patients.

AIM: To compare paediatric patients' pain during needle insertion and injection in inferior alveoler nerve block (IANB) anaesthesia injected by either a traditional syringe (TS) or the DentalVibe Injection Comfort System (DV). STUDY DESIGN: the study was a randomised controlled crossover clinical trial, comprised of 60 children aged 6-12 requiring an operative procedure with IANB anaesthesia on their mandibular molars bilaterally. One of the molar teeth was treated with TS and the contralateral tooth was treated with DV. On each visit, subjective and objective pain was evaluated using the Wond-Baker Faces Pain Rating Scale (PRS) and the Face, Legg, Cry, Consolability Scale (FLACC Scale). Patients were asked which anaesthesia technique they preferred. Data were analysed using Wilcoxon signed rank, Spearman correlation, and Mann-Whitney U tests. RESULTS: There were no statistically significant differences for pain evalution during needle insertion and injection of each injection system. However, a negative correlation was found on the FLACC between age and pain scores during injection after using DV. CONCLUSION: Paediatric patients experienced similar pain during IANB anaesthesia administered with TS and DV. With increased age, pain values reduced during anaesthetic agent injection with DV according to FLACC. The traditional procedure was preferred to DV in paediatric patients.

Successful management of a second-trimester post-abortion hemorrhage with the Bakri balloon tamponade.

Hemorrhage after abortion is rare but it is a significant cause of abortion-related mortality and morbidity. Conservative management of hemorrhage is gaining popularity. The authors describe a case which a uterine tamponade balloon which was successfully used to control second-trimester post-abortion hemorrhage.

Effects of Urethral Stricture on Allografts in Kidney Transplantation.

BACKGROUND: Iatrogenic urethral stricture after renal transplantation is mostly seen after urethral manipulations. Early diagnosis and treatment are crucial for the safe continuity of the graft functions. In this study, the effect of urethral strictures on graft functions during the post-transplantation period was investigated. METHODS: A total of 477 kidney transplantations were carried out from both live and cadaveric donors in our center from 2004 to 2014. Thirty-two patients who had insufficient data were excluded from the study. All the patients' urine cultures were negative before the surgery, and antibiotic prophylaxis were applied to all. Urethral catheters were taken out 4-7 days after transplantation. Double-J catheters were removed 6 weeks later. Internal urethrotomy and open urethroplasty surgeries were done for the patients who had urethral stricture. The results of creatinine, post-micturitional residual urine (PMR), International Prostate Symptom Score (IPSS), and uroflow examinations were evaluated. RESULTS: Average preoperative creatinine and postoperative creatinine values were, respectively, 1.74 ± 0.65 mg/dL (range, 0.83-3.03) and 1.24 ± 0.57 mg/dL (range, 0.9-2.24). A meaningful improvement was observed in terms of preoperative and postoperative IPSS values. A significant difference was seen between preoperative and 6th-month postoperative PMR values: 192.6 ± 57.2 mL and 36.7 ± 17.4 mL, respectively. CONCLUSIONS: Urethral strictures in transplant patients may arise due to many factors, such as repetitive urethral catheterization and inflammation. Early diagnosis helps to have better results for the treatment of the kidney functions.