Influence of repeated firings on marginal, axial, axio-occlusal, and occlusal fit of metal-ceramic restorations fabricated with different techniques.

STATEMENT OF PROBLEM: Ill-fitting restorations can jeopardize dental, periodontal, and systemic health. Repeated ceramic firing may influence the fitting accuracy of restorations, but scientific information regarding this issue is lacking. PURPOSE: The purpose of this in vitro study was to assess and compare the influence of repeated firings on the marginal, axial, axio-occlusal, and occlusal fit of metal-ceramic 3-unit fixed partial dentures (FPDs) manufactured with different framework methods, including casting, fully sintered hard alloy milling (FHAM), presintered soft alloy milling (PSAM), and selective laser sintering (SLS). MATERIAL AND METHODS: A total of 60 Co-Cr metal frameworks for 3-unit FPDs were fabricated with 3 different computer-aided design and computer-aided manufacturing (CAD-CAM) techniques and conventional casting for a typodont model. The discrepancy values for premolar and molar abutments were measured by using the silicone replica technique after fabrication of the framework, second firing, fourth firing, and seventh firing. The replicas were separated into mesiodistal and buccolingual cross-sections, and digital images of the cross-sections were obtained with a stereomicroscope at ×80 magnification. The measurement points were examined to record the discrepancy values (µm) with in-built measuring software. The recorded data were subjected to repeated-measures 4-way ANOVA and the Bonferroni post hoc test (α=.05). RESULTS: For all measurement periods, the marginal, axial, axio-occlusal, and occlusal discrepancy values differed significantly among the manufacturing groups (P<.001). Moreover, the repeated firings had a statistically significant influence on the discrepancy values of PSAM, FHAM, and SLS groups (P<.05). The cast group was not significantly affected by repeated firings (P>.05). The PSAM group revealed the lowest discrepancy values at all measurement periods (P<.05), except after the second firing in the marginal and axial locations. CONCLUSIONS: The PSAM-fabricated restorations demonstrated superior fitting accuracy. All manufacturing groups were influenced by repeated firings, except the cast group. The marginal discrepancy values of all manufacturing groups were within the range of clinical acceptability (<120 µm).

Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome.

There is a strong relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease (CVD). Chronic intermittent hypoxia, inflammation, oxidative stress, and endothelial dysfunction may constitute etiologic mechanisms, linking OSAS to CVD. Inflammation play an important role in the development of CVD. Platelet-lymphocyte ratio (PLR) is a new biomarker showing inflammation. No previous study has ever investigated the association between PLR, CVD and OSAS severity in patients with OSAS. This study was designed to investigate the association between PLR and CVD in patients with OSAS, and relationship between severity of OSAS, polysomnographic parameters and PLR. This was a cohort study in which patients who had undergone a full night polysomnoraphy for diagnosis of OSA were recruited. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (Group 1: AHI < 5), mild (Group 2: AHI, 5-15), moderate (Group 3:AHI,15-30), and severe OSAS (Group 4: AHI > 30) groups. The presence of heart failure, coronary artery disease or arrhythmia was defined as CVD. A total of 424 patients were included in this study. There were 57, 93, 82, and 192 patients in Groups 1, 2, 3, and 4, respectively. PLR were significantly different between groups (Group 1: 87.38; Group 2: 95.07; Group 3: 97.01, Group 4: 126.9, P < 0.05). PLR were significantly correlated with AHI, oxygen desaturation index, average and minimum O2 saturation values (P < 0.05). Values of PLR were significantly higher in patients with CVD compared with those without. Multiple regression analysis demonstrated that PLR is an independent predictor of CVD. PLR cut-off value for demonstrating the presence of CVD is higher than 108.56. In the light oh findings, PLR is strongly associated with the severity of OSAS and cardiovascular disease in OSAS patients. PLR might be used as a biomarker to predict CVD in OSAS patients.

The reference intervals of thyroid stimulating hormone in healthy individuals with normal levels of serum free thyroxine and without sonographic pathologies.

INTRODUCTION: The aim of the present study was to investigate the reference intervals for thyroid stimulating hormone (TSH) in healthy individuals with normal levels of serum free thyroxine (fT4) and without sonographic pathologies, and determine the effects of age, gender, and residence on the TSH reference intervals. SUBJECTS AND METHODS: This research was a population-based study conducted in 70 regions. The random sampling method was used to select the 1095 subjects of the study among inhabitants aged 18 and above. Patients who had a previous history of thyroid disease and had been taking medication were excluded from the study as this may have affected their fT4 or TSH levels. In addition, subjects who had serum fT4 without a reference range and abnormal ultrasonography findings were also excluded. A total of 408 subjects were used for establishing the reference intervals for TSH. RESULTS: The data for TSH in the study group were not normally distributed according to the Kolmogorov-Smirnov index. The geometric mean was 1.62 mIU/L, the median was 1.40 mIU/L, and the 95% reference intervals were 0.38-4.22 mIU/L. The median TSH level was higher in females compared to males (p < 0.05). In the female subjects 2.5th percentile of TSH was lower and 97.5th percentile was higher than those of males. The reference intervals of TSH were of lower values in subjects over 50 years old (p < 0.001). DISCUSSION: Studies suggest that determination of the TSH reference intervals may differ due to environmental influences or due to age, gender, and race. It is suggested that the lower limit of normal TSH for the adult Turkish population would be 0.38 mIU/L and the upper limit similar to the traditional value of 4.2 mIU/L. If each clinician uses their population-specific reference interval for TSH, thyroid function abnormalities can be accurately estimated.

The opinion of catering sector about the smoking ban and the evaluation of establishments.

INTRODUCTION: We aimed to evaluate the knowledge and perspective of employees/employers in the catering sector in our city regarding the smoking ban, as well as to determine the changes in the number of customers and income after the bans implementation. MATERIALS AND METHODS: In this two phased cross-sectional study 337 and 310 adults were evaluated respectively. Before the smoking ban was implemented we visited 84 workplaces in city center, after 18 months later 97 workplaces were visited in the same region. In both phases, the participants' opinions about the necessity/applicability of the ban were evaluated. In the second phase, they were also asked whether they had any changes in their income. RESULTS: In both phases, participants' general characteristics were similar. When all participants were evaluated, we determined that their knowledge and belief in the necessity/applicability of the ban did not change over time. It was determined that non-smokers more strongly believed in the necessity/applicability of the ban. Thirty-eight participants were included in both phases; 44.7% of them reported a decrease in the number of customers, and 60% of employers reported an increase in their income. CONCLUSION: The smokers were less convinced about the applicability/necessity of this ban than non-smokers. According to our results it could be said that smoking can also adversely affect implementation of the related ban. Employers should be informed that the ban will not affect their income.

Boosting the Performance of Artificial Intelligence-Driven Models in Predicting COVID-19 Mortality in Ethiopia.

Like other nations around the world, Ethiopia has suffered negative effects from COVID-19. The objective of this study was to predict COVID-19 mortality using Artificial Intelligence (AI)-driven models. Two-year daily recorded data related to COVID-19 were trained and tested to predict mortality using machine learning algorithms. Normalization of features, sensitivity analysis for feature selection, modelling of AI-driven models, and comparing the boosting model with single AI-driven models were the main activities performed in this study. Prediction of COVID-19 mortality was conducted using a combination of four dominant feature variables, and hence, the best determination of coefficient (DC) of AdaBoost, KNN, ANN-6, and SVM in the prediction process were 0.9422, 0.8618, 0.8629, and 0.7171, respectively. The Boosting model improved the performance of the individual AI-driven models KNN, SVM, and ANN-6 by 7.94, 22.51, and 8.02 percent, respectively, at the verification stage using the testing dataset. This suggests that the boosting model has the best performance for prediction of COVID-19 mortality in Ethiopia. As a result, it suggests a promising potential performance of boosting ensemble model to be applied in predicting mortality and cases from similarly recorded daily data to predict mortality due to COVID-19 in other parts of the world.

Artificial-Intelligence-Based Models Coupled with Correspondence Analysis Visualization on ART-Cases from Gombe State, Nigeria: A Comparative Study.

Antiretroviral therapy (ART) is the common hope for HIV/AIDS-treated patients. Total commitments from individuals and the entire community are the major challenges faced during treatment. This study investigated the progress of ART in the Federal Teaching Hospital in Gombe state, Nigeria by using various records of patients receiving treatment in the ART hospital unit. We combined artificial intelligence (AI)-based models and correspondence analysis (CA) techniques to predict and visualize the progress of ART from the beginning to the end. The AI models employed are artificial neural networks (ANNs), adaptive neuro-fuzzy inference systems (ANFISs) and support-vector machines (SVMs) and a classical linear regression model of multiple linear regression (MLR). According to the outcome of this study, ANFIS in both training and testing outperformed the remaining models given the R2 (0.903 and 0.904) and MSE (7.961 and 3.751) values, revealing that any increase in the number of years of taking ART medication will provide HIV/AIDS-treated patients with safer and elongated lives. The contingency results for the CA and the chi-square test did an excellent job of capturing and visualizing the patients on medication, which gave similar results in return, revealing there is a significant association between ART drugs and the age group, while the association between ART drugs and marital status (93.7%) explained a higher percentage of variation compared with the remaining variables.

The Role of Femoral Head Size and Femoral Head Coverage in Dogs with and without Hip Dysplasia.

The subject of hip dysplasia in dogs is still current and preoccupies both animal owners and veterinarians. Major factors affecting the development of the disorder are hip laxity and incongruent joints. Many studies on etiology, pathogenesis, and early diagnosis have been performed to reduce prevalence and select healthy dogs for breeding. The purpose of the present study was to investigate a possible relationship between dysplasia and femoral head area (FHA), femoral coverage by the acetabulum (CFH) and cranio-caudal distance of the dorsal acetabular rim (CrCdAR). Radiographs of a total of 264 skeletally mature dogs with similar physical characteristics (German wirehaired pointers (GWP), German shepherd dogs (GSD) and Labrador retrievers (LAB)) presented for routine hip dysplasia screening were recruited for the study. FHA, CFH and CrCdAR were measured and related to dysplasia status. Evaluations of FHA (p = 0.011), CFH (p < 0.001) and CrCdAR length (p = 0.003) measurements revealed significant interactions between breed, sex and FCI scores, so they had to be assessed separately. The results revealed that FHA tends to decrease as the hip dysplasia score worsens. There was no significant relationship between FHA and dysplasia assessment. FHA is breed-specific and is larger in normal and near-normal male (p = 0.001, p = 0.020) and female (p = 0.001, p = 0.013) GWP compared to GSD, respectively. FHA is greater in normal male GWP (p = 0.011) and GSD (p = 0.040) compared to females. There was a significant and strong positive correlation between FHA and CrCdAR in all breeds and sexes. Additionally, FCI scoring had a medium (GWP, GSD) to strong (LAB) negative correlation with CFH.

Increased discharge heart rate might be associated with increased short-term mortality after acute coronary syndrome.

BACKGROUND: In acute coronary syndrome (ACS) patients there are mostly studies evaluating prognostic value of admission heart rate. We tried to understand the prognostic value of discharge heart rate in a spectrum of ACS patients. METHODS: A total of 473 consecutive ACS patients were included in the study. Forty-three (9.1%) of them were unstable angina pectoris, 268 (56.7%) were non-ST elevation myocardial infarction and 162 (34.2%) of them were ST elevation myocardial infarction patients. Discharge heart rates of the patients were recorded and the patients were followed-up for 1 year. The primary end-point was all-cause mortality. RESULTS: The mean age of the patients was 64 ± 12. The patients were divided into three subgroups according to discharge heart rates (<78, 78-89, ≥90 beats per minute). Patients with a higher discharge heart rate had higher serum troponin, glucose levels and higher admission heart rates, had lower ejection fraction values and had acute heart failure complication more frequently than the patients with a lower discharge heart rate. A total of 72(16%) patients died during 1 year follow-up. In multivariate logistic regression analysis, an increased discharge heart rate was independently associated with 1-month mortality after ACS, but it was not independently associated with 6-month or 1-year mortality after ACS. Every 1 bpm increase in discharge heart rate resulted in a significant increased risk of 8.2% in 1-month all-cause mortality. CONCLUSION: Increased heart rate at discharge is an independent predictor of 1-month mortality in ACS patients. This relationship disappears after 1-month through 1-year follow-up.

Procalcitonin: Is it a predictor of noninvasive positive pressure ventilation necessity in acute chronic obstructive pulmonary disease exacerbation?

BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AeCOPD) are important causes of morbidity and mortality. In this study, we analyzed procalcitonin (PCT) levels in AeCOPD and stable period of COPD in order to evaluate usage of PCT in the prediction of the severity of AeCOPD, and its value on the planing of noninvasive positive pressure ventilation (NPPV). MATERIALS AND METHODS: In this cross sectional study (2009-2010) 118 COPD patients were enrolled, 68 of them (58%) were in acute exacerbations (case group). The others had stabile COPD and they were defined as control group. RESULTS: In case group the mean levels of PCT (0.19 ± 0.02) C-Reactive Protein (44.7 ± 5.92), erythrocyte sedimentation rate (28.4 ± 2.65), white blood cell (9.4 ± 0.43) and %neutrophils (69.9 ± 1.22) were significantly higher than controls (P = 0.0001). There was no difference between PCT levels based on stages of COPD. There were significiant differences in mean PCT levels according to type and severity of AeCOPD. Mean PCT level in hospitalized patients receiving NPPV was 0.36 ng/ml, while it was 0.15 ng/ml for those treated without NPPV (P = 0.0001). PCT cut-off value for NPPV indication was determined to be 0.10 ng/ml. CONCLUSIONS: PCT levels were found to be higher in AeCOPD patients than in stable COPD patients, as expected. Also mean PCT levels increased especially in cases with severe AeCOPD and those receiving NPPV among them. In the present study, we determined a cut off value of PCT as 0.10 ng/ml as a predictor of necessity of NPPV in AeCOPD.

Artificial Intelligence-Driven Ensemble Model for Predicting Mortality Due to COVID-19 in East Africa.

East Africa was not exempt from the devastating effects of COVID-19, which led to the nearly complete cessation of social and economic activities worldwide. The objective of this study was to predict mortality due to COVID-19 using an artificial intelligence-driven ensemble model in East Africa. The dataset, which spans two years, was divided into training and verification datasets. To predict the mortality, three steps were conducted, which included a sensitivity analysis, the modelling of four single AI-driven models, and development of four ensemble models. Four dominant input variables were selected to conduct the single models. Hence, the coefficients of determination of ANFIS, FFNN, SVM, and MLR were 0.9273, 0.8586, 0.8490, and 0.7956, respectively. The non-linear ensemble approaches performed better than the linear approaches, and the ANFIS ensemble was the best-performing ensemble approach that boosted the predicting performance of the single AI-driven models. This fact revealed the promising capability of ensemble models for predicting the daily mortality due to COVID-19 in other parts of the globe.

[Prevalence of hepatitis B virus infection in children of HBsAg positive parents]. / HBsAg Pozitif Ebeveynlerin Çocuklarinda Hepatit B Virusu Enfeksiyonu Prevalansi

Hepatitis B virus (HBV) is one of the important causative agents of chronic liver disease in the world. Since HBV transmission is mainly by parenteral way and sexual contact, vertical (from infected mother to newborn) and horizontal (contact with infected subjects) transmission ways play important roles. The aim of this study was to retrospectively evaluate the intrafamilial transmission risk of HBV in our region. A total of 838 subjects (age range: 1-52 years; mean age: 19.5 years) whose parents were HBsAg positive and were admitted to our outpatient clinics in 2009, have been included to the study. Of them 389 (46.4%) had HBsAg positive mothers, 404 (48.2%) had HBsAg positive fathers and 45 (5.4%) cases had both parents as HBsAg positive. The rate of chronically [corrected] infected subjects (HBsAg positive, anti-HBs negative) with HBsAg positive parents was 14.4% (121/838), the rate of non-infected susceptible subjects (HBsAg negative, anti-HBs negative) was 38.4% (322/838), and the rate of subjects who developed immunity (HBsAg negative, anti-HBs positive) was 5.3% (44/838). HBsAg positivity rate was found to be high in subjects whose mothers were HBsAg positive (25.2%; 98/389), than those whose fathers were HBsAg positive (2.5%; 10/404) and the difference was found statistically significant (p= 0.0001). Similarly the rate of HBV infection (HBsAg positive or anti-HBs positive subjects) among the offsprings whose mothers were HBsAg positive was determined to be higher (30.3%) than those whose fathers were HBsAg positive (8.2%) (p< 0.001). According to these data, the risk of HBV transmission was estimated to be three fold higher in subjects whose mothers were HBsAg positive than those whose fathers were HBsAg positive (OR= 2.96, 95% CI 2.109-4.156). In our study it was also detected that the rate of HBsAg positivity increased with age, being 10.3% (6/58) in children below 10 years old and increasing to 33% (29/88) in 11-20 years, 47% (31/66) in 21-30 years and 65% (26/40) in > 30 years age groups. There was no significant difference between consecutive age groups, however the difference between < 10 years and > 30 years age groups was found statistically significant (p= 0.0001). In addition having HBsAg positive mother or father did not affect HBV infection rate at 0-10 years age group, however, having HBsAg positive mother significantly increased the infection rate more than HBsAg positive father in 11-20 years and over 21 years age groups (p= 0.001 and p= 0.0001, respectively). In conclusion, the transmission rate of HBV infection among the family members was found high in our region and especially mothers played an important role for the transmission of the virus to their offsprings.

In vitro Anti-Leishmanial Activity of Essential Oils Extracted from Plants Growing in Northern Cyprus Against Leishmania tropica

Objective: Natural plant products are considered as a source of novel and effective compounds for the treatment of leishmaniasis. In this study, the in vitro activities of essential oils obtained from Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) and Laurus nobilis (LN) plants in Northern Cyprus were investigated against Leishmania tropica. Methods: Leishmania tropica strain (MHOM/TR/2012/CBCL-LT) was obtained. RPMI-1640 was added to 96-well plates in 100 µL aliquots, 100 µg/mL essential oil was added to the first well of each row and serial 2-fold dilutions were performed. A promastigote suspension was pipetted into all wells, and the plates were incubated. The promastigotes were enumerated using a haemocytometer. Results: OD essential oil was effective at killing all promastigotes at a minimum inhibitor height (MIC)=0.2 µg/mL and had high activity at the lowest concentrations. Both SF and LN oils had MIC=1.56 µg/mL and LD50=0.78 µg/mL. SF was observed to impair promastigote morphology at the lowest concentrations, while LN did not exert any effect at concentrations <0.2 µg/mL. OM essential oil was found to have a MIC=3.13 µg/mL and a LD50=1.56 µg/mL. Conclusion: All tested essential oils inhibited promastigotes of Leishmania tropica. OD essential oil demonstrated the highest anti-leishmanial activity. Amaç: Bitkilerden elde edilen dogal ürünlerin leishmaniasis tedavisi için yeni ve etkili bilesiklerin üretilmesine öncülük edecegi düsünülmektedir. Çalismamizda, Kuzey Kibris'ta yetisen Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) ve Laurus nobilis (LN) bitkilerinden elde edilen uçucu yaglarin Leishmania tropica'ya karsi in vitro etkinlikleri arastirilmistir. Yöntemler: Çalismamizda, Leishmania tropica susu (MHOM/TR/2012/CBCL-LT) kullanildi. Düz tabanli 96'lik plaklarda, tüm kuyucuklara 100 µL RPMI-1640 ve ilk kuyucuklara 100 µg/mL uçucu yaglar eklenerek, seri dilüsyonlari yapildi. Ardindan tüm kuyucuklara Leishmania tropica promastigot süspansiyonundan pipetlendi ve inkübe edildi. Hemositometre yöntemiyle promastigotlarin sayisi incelendi. Bulgular: OD yaginin minimum inhibitör konsantrasyonu (MIK)=0,2 µg/mL'de tüm promastigotlari öldürürken, en düsük konsantrasyonlarda bile etkili oldugu görülmüstür. SF ve LN uçucu yaglarinin ikisinde de MIK=1,56 µg/mL, LD50=0,78 µg/mL olarak saptanmistir. SF'nin en düsük konsantrasyonlarinin bile promastigot morfolojisini bozdugu görülürken, Laurus nobilis'in ise 0,2 µg/mL'den sonraki konsantrasyonlarda etkisini kaybettigi belirlenmistir. OM uçucu yaginin MIK=3,13 µg/mL, LD50=1,56 µg/mL oldugu görülmüstür. Sonuç: Kullanilan tüm uçucu yaglarin Leishmania tropica promastigotlarini inhibe ettigi görülürken, en yüksek anti-leishmanial etkinlik Origanum dubium uçucu yaginda bulunmustur.

Biomonitoring of Heavy Metal(oid)s in the Residents of Abandoned Mining District in Northern Cyprus.

Several heavy metal(oid)s are known mutagens and/or carcinogens. Exposure to these elements can lead to the development of malignancies. Gemikonagi, which is in the western part of Cyprus, was the hometown of mining operations. It is believed that the mining site is a significant heavy metal(oid) source for the environment and residents. In this biomonitoring study, a total of 60 blood samples from Gemikonagi region (n = 30) and from a control region located 40 km northeast from the mining site, Tepebasi (n = 30), and 5 soil samples from each region were collected to conduct heavy metal analysis using ICP-MS. To conduct genotoxicity analysis, alkaline comet assay and in vivo micronucleus assays were used. t test for independent samples and Mann-Whitney U tests were applied. Copper and iron were found to be enriched in Gemikonagi, while arsenic was found to be enriched in Tepebasi. Genotoxicity analyses demonstrated a statistically significant increase in parameters of micronuclei frequency (p value = 0.0001) and Comet Assay statistics upon exposure to some elements, such as arsenic (p value = 0.04) and copper (p value = 0.012). The results indicate that a general enrichment in heavy elements is not endemic to Gemikonagi, but a problem that might be generalized to the entirety of Cyprus. Graphical abstract.

[Evaluation of the knowledge and manner of workers of workplaces in Tokat about the ban on restriction of indoor smoking]. / Tokat'da kapali alanlarda sigara içiminin engellenmesine dair yasaya iliskin isletme çalisanlarinin bilgi ve tutumlarinin degerlendirilmesi.

To evaluate the knowledge and manner of cafe, pub and restaurant (with/without alcohol) workers in our city center about the ban on restriction of indoor smoking. To determine the preparation about the ban, smoking characteristics of workers, the knowledge on passive smoking. A questionnaire was performed to workers. The type of workplace, the number of workers, existence of a restriction of indoor smoking, any preparation about the ban were asked. The job of worker, whether the worker has a knowledge on the ban or not, the idea of the workers on the necessity and practicability of the ban were asked. Smoking history and the knowledge about passive smoking of workers were recorded. Fagerstrom nicotine dependent test (FNDT) was performed to smokers. Eighty four work places with 568 workers included in the study. The questionnaire was performed to 337 workers whose mean age was 29.1/years. 292 of workers were male. 190 of cases were current smokers. 166 of cases (49.3%) know the meaning of passive smoking. Alcohol offering was made at 8 of workplaces. Smoking was forbidden in 20 of workplaces. A preparation was performed about the ban in 30 of (46.9%) other workplaces. 88.4% of workers have knowledge on the ban, 64.7% of them know the punishment of the noncompliance of the ban. 81.3% of the workers believe the necessity and 45.7% of them believe the practicability of the ban. Smokers and especially who's FNBT > 5 have a stronger belief on the necessity and practicability of the ban. We determined that the preparation about the ban was inadequate although there was an little time for the put into practice the law. So we think that the controls of workplaces should be happened frequent.

Unmet need for education by professionals and inconsistency in knowledge and behavior of dental patients.

In order to identify what knowledge dental patients have of oral health and to analyze the potential relationship between knowledge, behavior and oral health status, 250 randomly selected patients were asked to complete a self-administered questionnaire. Responses were analyzed based on the age, gender and educational status of participants. It was determined that oral health-related behavior and knowledge were generally inadequate. Although knowledge had some influence on behavior, this was not constantly observed. The unmet need of patients with regard to getting information from professional resources emphasizes the need for dental professionals to dedicate more time to prevention and the promotion of oral health through efficient strategies.

Expressions of p53, cyclinD1 and histopathological features in basal cell carcinomas.

BACKGROUND: We planned this study to analyze probable associations between p53, cyclinD1, Ki67 and histopathological features in basal cell carcinomas (BCC). METHODS: Histological differentiation types, histological growth patterns and tissue responses were analyzed in 50 cases of BCC. In immunohistochemical analysis, p53, cyclinD1 and Ki67 antibodies were investigated. P53 expression was evaluated based on a cut-off value of 25% positivity. CyclinD1 expression was graded from 0 to 3+ according to the percentage of positive nuclear staining. The percentage of positively staining cells for Ki67 was recorded. RESULTS: The following significant correlations were detected. Solid infiltrative type differentiation was related to the infiltrative histological growth pattern. The rates of p53 positivity and severe fibrosis in the groups of mixed and infiltrative growth patterns were higher than others. Besides, p53-positive cases showed more severe fibrosis and had a higher mean value for Ki67 index. Epidermal p53 and cyclinD1 clones in normal epidermal areas adjacent to tumors were noticed in 42% and 52% of the cases, respectively. CONCLUSIONS: P53 expression seems to be related to Ki67 index and some histopathological features of BCC, such as infiltrative histological growth pattern and probably fibrosis.

Total antioxidant capacity and total oxidant status in patients with major depression: impact of antidepressant treatment.

AIM: The purpose of the present study was to investigate whether total antioxidant capacity (TAC) and total oxidant status (TOS) are associated with major depressive disorder (MDD) and to evaluate the impact of antidepressant treatment on TAC and TOS in MDD. METHODS: Fifty-seven MDD patients and 40 healthy controls participated in the study. Serum TAC and TOS were measured both in patients and controls using Erel's methods. Patients were treated with antidepressant drugs for 12 weeks. The treatment course was evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS) in all patients. RESULTS: TOS and oxidative stress index (OSI) were higher (P = 0.0001 for both) and TAC was lower (P = 0.0001) in the MDD group compared with those of the controls. After 3 months of antidepressant treatment, TOS and OSI were decreased and TAC was increased compared with the pretreatment values (P = 0.0001, for all). Furthermore, there were significant positive correlations between the severity of the disease and serum TOS and OSI (r = 0.584, P = 0.0001; r = 0.636, P = 0.0001, respectively). A negative correlation was found between the severity of the disease and serum TAC (r = -0.553, P = 0.0001) at the pre-treatment stage. CONCLUSION: Treatment administered for 3 months to MDD patients increases TAC while decreasing TOS and OSI.

Prevalence of chronic kidney disease in the Black Sea Region, Turkey, and investigation of the related factors with chronic kidney disease.

We aimed to assess the prevalence of CKD in the Black Sea Region, Turkey, and to evaluate any relationship between age, gender, diabetes, obesity, hypertension, and CKD. This study was conducted in 70 different areas in Tokat Province in the Black Sea Region, in the northern part of Turkey. The estimated glomerular filtration rate (eGFR) was calculated from the serum creatinine using MDRD formulas. CKD-defined estimated GFR was lower than 60 mL/min/1.73 m(2). A total of 1,079 persons were included in this study (mean age 41.4+/-17 years [range: 18-95 years], 49.4% males, 50.6% living in an urban area). Of the 1,079 individuals, 5.28% were diabetic, 22.9% were obese, and 37.8% were hypertensive. CKD was found in 62 of them (5.75%). The prevalence of CKD was 5.58% in non-diabetics and 8.77% in diabetics. No significant differences were found between two groups. The prevalence of CKD was 3.77% in non-hypertensive individuals and 8.82% in hypertensive patients, and 4.46% in non-obese and 9.31% in obese. The evident significant differences were found between groups (p < 0.0001 and p = 0.004, respectively). The prevalence of CKD increased with age within our population. A salient observation was the markedly higher prevalence of CKD in females than males (p = 0.046). There was an inverse correlation between eGFR and age (r = 0.529, p < 0.0001). The overall prevalence of CKD was 5.75% in general population. The prevalence of CKD increased with age within our population. Age, gender, obesity and hypertension were found to be significant risk factors for development of CKD in our population.

HER-2/Neu and Hormone Receptor Analysis in Breast Carcinomas and Their Association with Clinicopathologic Parameters.

OBJECTIVE: Invasive breast carcinomas of no special type (IC-NST) are the heterogeneous tumours showing distinct prognostic features even in patients with similar clinicopathological characteristics. To date, many clinicopathological data have been analyzed to make a guess about prognosis and to determine treatment modality. In this study, HER-2/neu status was analyzed by using both immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) methods, and its correlations with hormone receptor status and clinicopathological parameters were investigated. MATERIALS AND METHODS: The study was included 112 female patients with diagnosis of IC-NST. FISH for HER-2/neu was applied in only primary tumour tissues, while IHC analyses for HER-2/neu, estrogen (ER) and progesterone receptors (PR) were applied on both primary and metastatic lymph node foci. The results were compared with appropriate statistical methods. RESULTS: Our rates of HER-2/neu overexpression and gene amplification in the overall study group were 22.3 and 25%, respectively. In the metastatic group, these rates were higher than those of the overall study group (34% and 40%, respectively). Gene amplification rate of the axilla positive group was 40%, while this rate in non-metastatic group was 6.7% (p=0.015). Overexpression and amplification results were compliant (χ2=77,591, p<0.001). The concordance rates in HER-2/neu negative and overexpression groups were 95.3% and 88%, respectively. Our false negativity rate was 4.7%. While 36% of score 3+ cases were ER positive, 67.1% of HER-2/neu negative cases showed ER positivity (p=0.01). The increase of gene amplification rate in ER negative cases over 50 years age was more than two times and statistically significant (p=0.014). CONCLUSION: The concordance rates between the results of IHC and FISH in the HER-2 negative and the overexpression categories were compatible with the literature and lower than the literature, respectively. In the case of ER negativity, the patient's age over 50 years was associated with a higher rate of gene amplification.

Obesity and carpal tunnel syndrome: is there a causal relationship?

OBJECTIVES: Obesity is defined as a risk factor for carpal tunnel syndrome (CTS). In this study, the presence or absence of recovery in median nerve conduction velocities after weight loss in obese patients was assessed in order to determine whether excess weight or other factors influence the higher prevalence of CTS in obese patients. METHODS: Patients with body mass indexes (BMIs) >or=30 were included in the study. CTS symptoms, age, gender, height, body weight, and concomitant diseases were evaluated. Nerve conduction studies (NCS) were obtained on one upper extremity. All patients were included in dietetic programs. Three months later, NCS were repeated and compared with the first NCS. RESULTS: BMIs were statistically significantly lower on the second visits 3 months later (p = 0.0001). No statistically significant difference was observed in the second NCS of electromyographically diagnosed cases with CTS (p > 0.05). CONCLUSION: We expected a recovery in median nerve conduction velocities in patients with CTS after weight loss. In the literature, even in untreated cases with CTS, spontaneous improvements in second NCS have been reported. This finding suggests that factors other than excess body weight may be influential in the higher prevalence of CTS in obese patients. A more detailed, genetic-factor-targeted investigation may prove more beneficial to clarify this issue.