Efficacy of pulse steroid therapy in patients critically ill with COVID-19.

OBJECTIVES: The aim of this study was to determine the efficacy of pulse steroid therapy administered to patients critically ill with COVID-19 progressing into severe pneumonia. METHODS: A total of 600 patients included in this retrospective study were divided into three groups. Group 1 (control group): 200 patients who did not receive steroid treatment, Group 2: 200 patients who received dexamethasone 1x8 milligram (mg) or methylprednisolone 1x80 mg, Group 3: (pulse steroid therapy group): 200 patients who received 1 g methylprednisolone followed by 1x80 mg methylprednisolone. Demographic and laboratory data were recorded. RESULTS: Mortality rates in groups 1, 2 and 3 were 77 %, 53.55 %, and 58.5 %, respectively. The ratios of intubated patients in groups 1, 2 and 3 were 70 %, 45.5 % and 56 %, respectively. The numbers of patients whose D­dimer values were above 2,250 ng/mL (cut-off value for D-dimer in this study) in groups 2, 1 and 3 were 65, 107, and 105, respectively. CONCLUSION: Pulse steroid therapy does not shorten the duration of hospital stay, does not reduce the need for intubation and increases the risk of thrombosis by significantly increasing the level of D-dimer among patients critically and severely ill with COVID-19 (Tab. 4, Fig. 3, Ref. 20) Keywords: COVID-19, pulse steroid therapy, thrombosis, d-dimer, corticosteroid.

Oral appliance-generated malocclusion traits during the long-term management of obstructive sleep apnea in adults.

OBJECTIVES: To identify malocclusion characteristics generated after using oral appliances (OAs) for at least 5 years for the management of snoring and obstructive sleep apnea (OSA) in adults. MATERIALS AND METHODS: PubMed, MEDLINE (Ovid), Scopus, CINAHL, and Informit were searched without language restrictions through January 20, 2021. Unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and the Pro-Quest Dissertation Abstracts and Thesis database. Authors were contacted when necessary, and reference lists of the included studies were screened. Risk of bias was assessed through the revised Cochrane Risk of Bias tool for randomized controlled trials (RoB2) and Non-Randomized Studies of Interventions for non-RCTs and uncontrolled before-after studies (ROBINS-I). A random-effects meta-analysis was conducted only on studies that used the same OAs to exclude biomechanical differences. Risk of bias across studies was assessed with the Grading of Recommendations, Assessment, Development and Evaluation tool. RESULTS: A total of 12 studies were included in the final qualitative synthesis. Eight included studies had high, one had moderate, and three had low risks of bias. Significant progressive decreases of overjet (OJ; -1.43 mm; 95% confidence interval [CI], -1.66 to -1.20) and overbite (OB; -1.94 mm; 95% CI, -2.14 to -1.74) associated with maxillary incisor retroclination and mandibular incisor proclination were reported long term. Although most studies showed no sagittal skeletal changes, some degree of vertical skeletal changes were noted. CONCLUSIONS: Based on a very low evidence level, inevitable anterior teeth positional changes seem to be a common long-term adverse effect of OAs. The magnitude of those changes could be considered clinically irrelevant for most pretreatment occlusions, but in occlusions with limited OJ and OB, it may be worth clinical consideration.

Evaluation of the intraocular pressure changes during micturition in patients with benign prostatic hyperplasia.

OBJECTIVE: To evaluate the effect of the Valsalva maneuver (VM) during micturition on intraocular pressure (IOP) in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: IOP were measured before and during micturition in uroflowmetry testing by Tonopen-Avia (Reichert Inc., NY, USA) in 35 eyes of 35 patients with BPH. International Prostate Symptoms Score (IPSS) questionnaire was used for quantification of BPH symptoms. The subjects were divided into two groups according to IPSS questionnaire: patients with low IPSS scores and patients with high IPSS scores. RESULTS: The mean IOP before and during micturition in patients with BPH were 15.26 ± 4.39 mmHg and 16.23 ± 4.43 mmHg, respectively (p = 0.047). When patients with BPH were assigned to two distinct groups according to the IPSS scores, IOP did not differ in patients with low IPSS scores (p = 0.590), whereas mean IOP was significantly higher in patients with high IPSS scores (p = 0.007). CONCLUSIONS: The Valsalva maneuver, performed during micturition, can lead to significant IOP increase in patients with BPH, particularly in advanced disease.

Effect of fluoride on root resorption following heavy and light orthodontic force application for 4 weeks and 12 weeks of retention.

OBJECTIVE: To evaluate the null hypothesis that fluoride intake via drinking water has no effect on orthodontic root resorption in humans after orthodontic force application for 4 weeks and 12 weeks of retention. MATERIALS AND METHODS: Forty-eight patients who required maxillary premolar extractions as part of their orthodontic treatment were selected from two cities in Turkey. These cities had a high and low fluoride concentration in public water of ≥2 pm and ≤0.05 pm, respectively. The patients were randomly separated into four groups of 12 each: group 1HH, high fluoride (≥2 ppm) and heavy force (225 g); group 2LH, low fluoride (≤0.05 ppm) and heavy force; group 3HL, high fluoride and light force (25 g); and group 4LL, low fluoride and light force. Light or heavy buccal tipping force was applied on the upper first premolars for 28 days. At day 28, the left premolars were extracted (positive control side); the right premolars (experimental side) were extracted after 12 weeks of retention. The samples were analyzed with microcomputed tomography. RESULTS: On the positive control side, under heavy force application, the high fluoride groups exhibited less root resorption (P  =  .015). On the experimental side, it was found that fluoride reduced the total volume of root resorption craters; however, this effect was not statistically significant (P  =  .237). Moreover, the results revealed that under heavy force application experimental teeth exhibited more root resorption than positive control groups. CONCLUSION: The null hypothesis could not be rejected. High fluoride intake from public water did not have a beneficial effect on the severity of root resorption after a 4-week orthodontic force application and 12 weeks of passive retention.

Effects of long-term occlusal hypofunction and its recovery on the morphogenesis of molar roots and the periodontium in rats.

OBJECTIVES: To investigate the effects of long-term, artificially created, hypofunctional occlusion and its recovery on the morphology of rat molar roots. MATERIAL AND METHODS: Eighteen 5-week-old Wistar-strain male rats were randomly divided according to their periodontal conditions into normal, hypofunctional, and recovery groups (n = 6 in each). In the experimental hypofunctional and recovery groups, a bite-raising appliance was set to produce hypofunction at the molar region. All groups were analyzed at 16 weeks of age using three-dimensional micro-computed tomography. Root length, width, and area as well as the thickness and the area of the periodontal ligament (PDL) space of the maxillary first molar were calculated. RESULTS: Roots were longer and narrower in the hypofunctional group than in the control group. The mesial root in particular showed a dramatic change. Root area also decreased significantly in the hypofunctional group compared to the other groups. Moreover, the PDL thickness and area decreased significantly in the hypofunctional group compared to the control group, but increased in the recovery group compared to the hypofunctional group. CONCLUSIONS: These findings suggest that root size and PDL structure may be reduced due to disuse atrophy resulting from a defect in occlusal function, but may be recovered following a gain of occlusal stimuli.

Association of age-related macular degeneration with age-related hearing loss.

OBJECTIVE: To assess the association between age-related macular degeneration and age-related hearing loss in Turkish subjects aged 50 years or older. STUDY DESIGN AND SETTING: Prospective, case-control study within a tertiary university hospital. SUBJECTS AND METHODS: Fifty subjects with age-related macular degeneration and 43 healthy subjects underwent ophthalmological and otolaryngological examination. Statistical analyses were conducted for the poorer eye and ear, comparing age-related hearing loss and pure tone average in the macular degeneration group versus controls. RESULTS: Median pure tone average was significantly poorer in the macular degeneration group (35 dBHL) compared with controls (23 dBHL). In the macular degeneration group, hearing loss was significantly greater in dry type (43 dBHL) than wet type (32 dBHL) cases. There was a significant difference between the prevalence of varying degrees of hearing loss in the macular degeneration versus control groups, being respectively: mild, 50 and 35 per cent; moderate, 20 and 5 per cent; and severe, 6 and 0 per cent. There was a weak, but significant correlation between each patient's visual acuity and pure tone average results (r(s) = -0.37, p < 0.001). CONCLUSION: Age-related hearing loss is more common in patients with age-related macular degeneration. Such patients should be questioned regarding hearing difficulty, and referred to an otolaryngologist if appropriate.