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Abstract

Introduction: Studies regarding antibiotics administration during pregnancy and atopic dermatitis (AD) in children are only few. In this context, the objective of our study was to investigate the potential association between the timing of intrauterine exposure to antibiotics or prenatal antibiotic administration in general and AD occurrence in children.

Methods: This was a cross-sectional study in 1046 subjects. The exposure to antibiotics during pregnancy was initially evaluated using simple logistic regressions. Then, each period of antibiotics administration was adjusted with the other periods of antibiotics exposure (model 1) and with the other variables associated with AD in our database (model 2).

Results: In simple logistic regression analysis, the administration of antibiotics during pregnancy, as a whole period, presented a trend of association with AD (OR = 1.28, %CI: 0.99 – 1.65). When we analyzed antibiotic administration during each trimester of pregnancy, only antibiotherapy during the 3rd trimester was associated with AD (OR = 2.94, %CI: 1.21 – 7.12). After adjusting with all the other important risk factors associated with AD in the database, antibiotics administration during the 3rd trimester of pregnancy was still independently associated with AD (OR=2.64, %CI: 1.01 – 6.91).

Conclusion: Antibiotic administration during the 3rd trimester of pregnancy was independently associated with AD in children.

Abstract

Sufficient caloric intake is important to maintain the balanced health status, especially during the period of aging, as aging and sickness share paths. Maintaining adequate nutritional balance is the best preventive measure to counteract the risk of malnutrition. There are several causes for malnutrition in elderly people, and some techniques like anthropometric measurements, laboratory and clinical parameters could help to diagnose malnutrition in these patients. The use of a simple validated questionnaire called the ‘Mini Nutritional Assessment’ measures the nutritional status of elderly patients. In this review, we discuss about the malnutrition in elderly people with and without a known cause and we present some of nutritional intervention. There are promising strategies that help overcoming malnutrition.

Abstract

Introduction. Central obesity is characterized by the accumulation of abdominal fat which may lead to several diseases including insulin resistance. The prevalence of central obesity is higher in male and the incidence in young adult males is increased. Central obesity is also related to low testosterone levels. The research aimed to assess the relationship between the testosterone levels and insulin resistance of young adult males with central obesity.

Methods. This was a cross-sectional study, the subjects were young adult males of 18 to 25 years old. The central obesity consisted of 50 samples and non-central obesity comprised 90 samples. The examination of testosterone and insulin was performed by the ECLIA method, glucose used the enzymatic method, the insulin resistance was calculated by using the HOMA-IR index.

Results. The mean of the testosterone level in central obesity was lower than non-central obesity (5.24+1.17 vs 7.18+1.54 ng/mL, p<0.001). HOMA-IR index in central obesity was higher than non-central obesity (4.29 + 2.23 vs 2.46 + 1.72), p<0.001). Testosterone levels had negative correlation with HOMA-IR (r=-0.470, p<0.001). There was significant difference in HOMA-IR among the quartiles of testosterone levels.

Conclusion. There is negative correlation between testosterone level with HOMA-IR, the lower the testosterone level the higher the insulin resistance in young adult males.

Abstract

The European Society of Cardiology and the European Atherosclerotic Society are recommending in the 2019 guideline for dyslipidemia the best management strategies for an individual patient with a given condition.

The guideline recommends the use of new tests to help identify high-risk patients. These include both coronary artery calcium imaging and biomarker tests.

Modifications have also been made to the risk stratification categories, so that patients with atherosclerotic artery disease, diabetes mellitus with target organ damage, familial hypercholesterolaemia and severe chronic kidney disease are all included in very-high risk patients.

The new ESC/EAS guideline for dyslipidemia management compared with the 2016 version include more intensive reduction of LDL-c across CV risk categories. If the goals are not achieved with the maximum tolerated dose of statin, combination with ezetimibe is recommended. An important message of the new guideline is that until this moment there are no known adverse effects of very low LDL-c concentrations.

Abstract

Current Guidelines for the diagnosis and management of acute pulmonary embolism (PE), as well as all other Guidelines, summarize and evaluate the already available evidence and consensus “with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition”.

In this review we present the most important new recommendations of the latest ESC Guidelines on the diagnosis and management of acute pulmonary embolism.

Abstract

Apoptosis is an inborn process that has been preserved during evolution; it allows the cells to systematically inactivate, destroy and dispose of their own components thus leading to their death. This program can be activated by both intra and extracellular mechanisms. The intracellular components involve a genetically defined development program while the extracellular aspects regard endogenous proteins, cytokines and hormones as well as xenobiotics, radiations, oxidative stress and hypoxia. The ability of a cell to enter apoptosis as a response to a „death” signal depends on its proliferative status, the position in the cell cycle and also on the controlled expression of those genes that have the capacity of promoting and inhibiting cell death. The fine regulation of these parameters needs to be maintained in order to ensure the physiological environment required for the induction of apoptosis.

In this review, we first describe evidence for the role of apoptotic pathways in ischemic acute renal failure, and then consider the potential mechanisms that may participate in this model of acute renal tubular injury. Potential therapeutic interventions to prevent tubular apoptosis in renal disease include angiotensin system inhibition, whereby the angiotensin II AT2 receptor blockade seems more promising in apoptosis inhibition than the inhibition of other receptor subtypes. A better understanding of the mechanisms of apoptosis could lead to safer and more specific therapeutic interventions for acute kidney injury.

Summary

Background/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.

Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.

Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.

Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.

Summary

Background/Aim: The purpose of this in-vitro study was to compare the resin-bonded fixed partial dentures (RBFPD) fabricated using two different structural designs and two different antibacterial adhesive lutting protocols in regard to their resistance to debonding.

Material and Methods: Forty samples for a model with single missing molar were divided into 4 groups (M1, M2, C1, C2) (n=10). M1 and M2 were prepared in accordance with modified inlay slot-cavity retained RBFPD design; C1 and C2 were prepared according to conventional inlay slot-cavity retained RBFPD design. M1 and C1 cavities were treated with 2% chlorhexidine-based (CHX) cavity disinfectant and 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing adhesive system; M2 and C2 cavities were treated with MDP and 12-methacryloyloxydodecylpyridinium bromide (MDPB) containing adhesive system featuring antibacterial cavity cleansing effect. The RBFPDs were made of base-metal alloy and their fit surfaces sandblasted with aluminium oxide (Al2O3). Adhesive resin cement was used for cementation, and the RBFPD retainers were interlocked into their corresponding inlay cavities using composite resin. After 1 week being immersed in aqueous environment, the RBFPDs were subjected to tensile loading at a crosshead speed of 1 mm/min until failure. One way ANOVA and Tukey HSD tests were used for statistical evaluation (α=0.05). Mode of failure and tooth damage was also noted.

Results: Mean tensile bond strength values were 356 N for M1, 305 N for M2, 467 N for C1, and 455 N for C2. Tensile strength values of C1 and C2 were significantly higher than those of M1 and M2 (p<0.05). The mode of failure was mostly adhesive in character at the metal-cement interface in all groups. Tooth fracture was observed nearly in all specimens. No significant difference was detected between the antibacterial adhesive lutting protocols (p>0.05).

Conclusions: The RBFPDs with the conventional design were found to be more retentive than those with the modified design. Using an adhesive system featuring antibacterial properties with no need of separate antibacterial agent application during bonding may be favourable.

Abstract

Determination of plasma level of D-dimers in patient with acute ischemic stroke can be used as a potential predictor of survival and correlated with the degree of disability of the patient. This study shows a correlation between the serum level of D-dimers in the diabetic patients with acute ischemic stroke, which may result that the level of D-dimers could be a good predictor of survival in acute ischemic stroke but not a predictor of disability and prognosis.

Summary

Background/Aim: The aim of this study was to evaluate the risk factors in caries formation and relationships between each other in children.

Material and Methods: A total of 84 children aged between 5-15 years were included in the study. The children were randomly selected among the patients who came to the clinic. Oral disorders and oral hygiene were evaluated with the oral examination. Examination of the children was carried out by two calibrated pediatric dentists. Plaque index, dmf-t index (decay-missed-filled primary tooth) and DMF-T index (decay-missed-filled permanent tooth) scores were evaluated by clinical examination. Plaque index was evaluated using Sillness & Loe plaque index. In addition, a questionnaire was performed about children’s age, tooth brushing habits, sweet consumption, dentist visit and dental treatment experience. Statistical analysis was conducted with Mann Whitney-U test, Chi-Square test, Independent t-test and Correlation test.

Results: When the survey data is examined, there was no significant difference between boy and girl patients regarding dmft, DMFT, frequency of tooth brushing, sweet consumption and plaque index scores (p>0,05). There was no relationship between frequency of sweet consumption and DMF-T, dmf-t and plaque index scores (p>0,05). No significant relationship was found between the frequency of tooth brushing and DMF-T and dmf-t scores (p>0,05). The examinations were revealed that there were no children with regular tooth brushing habits and the plaque index scores of children with irregular tooth brushing habit was lower than the children with no brushing habits (p<0,05). In addition, a positive correlation was also observed between age and plaque index and DMFT scores. However, a negative correlation was observed between age and dmft scores.

Conclusions: It is observed that there was a significant relationship between tooth brushing habits and plaque index values of children.