Can we estimate cytokine storm from initial computed tomography images of Coronavirus disease-2019 patients?

OBJECTIVES: The present study aims to investigate whether elementary lesions detected at the time of the diagnosis, their distribution characteristics, and CT scoring can be predictive of a cytokine storm. BACKGROUND: CT might have a prognostic predictive value beyond its diagnostic value. METHODS: Sixty-eight patients, 32 with cytokine storm and 36 without cytokine storm, were included in the study. Four different scoring methods were created according to elementary lesions, distribution and involvement rate. CT scores and demographic findings of the cases were compared in the cytokine storm and non-cytokine storm groups. RESULTS: The mean age of patients was 57.72 (SD: 13.5) and 40 (58.8 %) of them were male. The cytokine storm was significantly more common among male patients and patients of older age (p=0.04).  The AUC values of CT score 1, CT score 2, CT score 3, and CT score 4 were as follows; 0.772 (95% CI; 0.651-0.892), 0.766 (95% CI; 0.647-0.885), 0.758 (95% CI; 0.639-8.78), and 0.760 (95% CI; 0.640-0.881), respectively. All CT scores had better predictive values in males. CONCLUSIONS: CT scoring at the time of admission can be used to predict cases that may develop cytokine storm later (Tab. 4, Fig. 2, Ref. 15).

Effects of cage type on performance, welfare, and microbiological properties of laying hens during the molting period and the second production cycle.

As most of the unenriched cages will soon switch to enriched cages, it is important to characterize all the effects in the laying hens for sustainable production. Laying hens can be used in several production periods by applying molting. The aim of this study was to determine the cage type (unenriched and enriched) on performance, welfare, and microbiological properties of laying hens during the molting period and the second production cycle. Overall, 840 brown laying hybrids were used in the experiment. Laying hens were reared on two different cage types (unenriched cage (UEC) and enriched cage (EC)) in the same poultry house. When the hybrids were 75 weeks old, they were subjected to force molting with whole grain barley. Performance, welfare, microbiological, and serological data of laying hens were obtained from 73 to 107 weeks of age. Egg production, egg weight, feed conversion ratio, breaking strength, albumen and yolk index, Haugh unit, feather condition, and breaking force of femur and metatarsus were better in the post-molting period. However, keel bone deformities and Newcastle disease virus antibody titers are the worst in the post-molting period. Stiffness of femur and metatarsus was increased with period. These results indicate that necessary precautions should be taken against the problems that may occur in the direction of bone and health. During the molting period, hens kept in EC had lower egg production but they returned to egg production at a high rate. EC type had a positive effect on egg production, feed conversion ratio, feather and foot condition, and breaking force of metatarsus.

Effects of blood contamination and hemostatic agents on bond strength in primary teeth dentin.

BACKGROUND: Contamination is a common problem in pediatric restorative dentistry and there are a few studies that investigate blood contamination, hemostatic agents, and tooth dentin. AIM: The purpose of this study was to evaluate the effects of blood contamination and hemostatic agents on the bond strength of two different bonding systems with the dentin of primary teeth. MATERIALS AND METHODS: Buccal and lingual dentin surfaces of 40 primary second molar teeth were used for this study. Specimens were divided into 4 groups according to the contamination and hemostatic agents (Blood-B, Ankaferd Blood Stopper-A, ViscoStat-V, Control-C) and then every group was further divided into two subgroups according to the bonding systems (Clearfil SE Bond-I, All Bond Universal-II, n = 10 per group). A bulk-fill composite resin was built-up on the surfaces. The specimens were tested in the micro shear mode at a crosshead speed of 1 mm/min on a universal test machine. Statistical analysis was performed with ANOVA and Tukey's tests at P < 0.05. RESULTS: Significant differences have been detected in the micro shear bond strengths only between the Ankaferd Blood Stopper (ABS) (AI = 13.72 ± 4.47 and AII = 9.12 ± 4.4) and control groups (CI = 22.78 ± 10.86 and CII = 16.49 ± 6.55) without regards to the bonding systems. The highest scores were obtained in the control groups. Clearfil SE Bond showed better performance than All Bond Universal in all groups. CONCLUSION: It was determined that only the ABS contamination groups showed statistically significant decreases in the bond strengths when compared with control groups.

Evaluation the oral hygiene conditions, oral Candida colonization and salivary Streptococcus mutans and Lactobacilli density in a group of ß-thalassemic children and adolescence.

BACKGROUND: In this study, the prevalence and distribution of dental caries and oral hygiene conditions in a group of patients with ß-TM are evaluated and the results compared to age-and gender-matched healthy patients. In addition, oral candida colonization and the density of Streptococcus mutans (S.mutans) and Lactobacilli in the total saliva are assessed. MATERIAL AND METHODS: This study involved 59 ß-TM patients between 6-16 years old (mean:11.59±3.22), who applied to the Department of Pedodontics, Faculty of Dentistry, Akdeniz University, with ongoing follow-up, treatment and regular blood transfusions. All enrolled patients were diagnosed with ß-TM by the Department of Pediatric Hematology and Oncology, Faculty of Medicine, Akdeniz University. As a control group, age-and gender-matched healthy 50 patients were included to the study. RESULTS: Plaque ( p=0.001), DMFT ( p=0.009) and DMFS ( p=0.039) indices were significantly higher in the ß-TM patients, whereas, the oral hygiene status was significantly lower ( p=0.004). Saliva buffering capacity average was insignificantly but slightly more in ß-TM patients( p=0.131). While S.mutans values were significantly higher in the ß-TM patients ( p=0.002), no significant difference was found in the Lactobacillus ( p=0.131) and Candida values ( p=0.33). CONCLUSIONS: DMFT, DMFS, Plaque and oral hygiene indices and S.mutans values were found significantly different in ß-TM patients than healthy, control group patients, in this study.

The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities.

OBJECTIVES: The aim of this study was to evaluate the changes in opacities by applying resin infiltrate to developmental enamel opacities and applying resin infiltrate or fluoride varnish to white spot lesions (WSLs). MATERIALS AND METHODS: A total of 132 teeth with WSLs and developmental enamel opacities were included in the study. WSLs were treated with resin infiltrate (Group 1) and fluoride varnish (Group 2), and developmental enamel opacities were treated with only resin infiltrate (Group 3). Lesions were evaluated in accordance with International Caries Detection and Assessment System (ICDAS II) criteria and DIAGNOdent Pen scores before applying the material (T0), just after the application (T1), and after 1 month (T2) and 3 months (T3). RESULTS: A significant decrease in DIAGNOdent Pen scores was observed in all the groups and the most important decrease was seen in Group 2 (P < 0.05). A significant decrease in ICDAS II scores was observed in Groups 2 and 3 (T0-T1) and Group 1 (T1-T2) (P < 0.05). CONCLUSION: DIAGNOdent pen scores decreased and the lesion was partially masked after resin infiltrate was applied to treat developmental enamel opacities; the resin infiltrate application, however, was more successful than fluoride varnish on WSLs. Treating WSLs with resin infiltrate was a good option due to shorter term esthetic recovery and high patient satisfaction.

Comparison of different brown and white layer hybrid embryonic development and uptake of nutrients in the egg.

The objective of this study was to evaluate the comparison of different brown and white layers in embryonic development and uptake of nutrients in the egg. A total of 360 fertilized eggs obtained from two brown (Atak-S and Brown Nick) and two white (Atabey and Nick) layer breeders at 28 wk old. Hatching eggs from each genotype were examined on the day of setting for fresh egg analysis and then at the beginning of the embryonic day (E19) and embryonic day (E21) for egg, embryo and villus analysis. Differences in egg weight, shell percentages, relative weight of yolk and albumen, relative weight and length of embryo, villus height, some values of shell, yolk and albumen and relative chick weight in examined hybrids were significant. Yolk sac utilization of embryos during the incubation in the white layer hybrids was greater than that in the brown layer hybrids. Villus heights in the duodenum, jejenum and ileum of embryos in the brown layer hybrids was greater than that in the white layer hybrids. Genotype is important parameter to determine the egg composition at the same age and in animals being fed the same diet. It was observed that the consumption of yolk and shell nutrients from the embryos during the incubation was not related to whether embryos were from the brown or white layer hybrids. Only uptake of the yolk sac and villus height in the embryo among examined variables varied depending on whether the embryos were from the brown or white layer hybrids.

Differences in egg nutrient availability and embryo development in white layer breeder genotypes.

Because of consumers' preferences and also due to changes in production systems, the importance of pure breeds has increased again. There are a lot of differences among breeds which have been studied extensively, however, the differences during the incubation period are not yet fully known. Therefore, the present study was conducted to evaluate the composition of the egg parts, absorption of nutrients, and development of embryos from different genotypes. A total of 354 fresh hatching eggs were obtained from one hybrid (Lohman White, LW) and two pure breeds (Denizli and Gerze). Hatching eggs from each genotype were examined on the day of setting for egg analysis and then at the beginning of the embryonic d 19 (E19) and embryonic d 21 (E21) for egg, embryo, jejunum, and tibia analysis. On d 21 of incubation, the healthy chicks were removed and weighed. Egg weight, shell thickness, percentages of albumen, and some parameters of albumen composition (dry matter, water, ash, protein, energy, Na, Ca, K, and Mg) were higher in fresh eggs obtained from LW hens. Furthermore, the relative yolk sac and embryo weight, some yolk parameters (dry matter, water, protein, fat, and energy) and some shell parameters (dry matter, ash, Na, Ca, and K) were also higher in eggs obtained from LW hens during incubation. However, tibia deformation and villus width were lower in LW embryos than the other genotypes. Relative chick weights were 68.9, 72.0, and 68.0% in LW, Denizli, and Gerze genotypes, respectively. During incubation, differences in all examined parameters were significant except thickness and weight of shell, tibia deformation, and crypt depth. Yolk sac weight, some yolk composition parameters, K level in the shell, Cu level in the tibia, and villus height were also affected by genotype and period interaction. Based on these results, LW was found advantageous in terms of egg composition, however, regarding villus development and tibia deformation in embryos during incubation, pure breeds showed better results.

Oro-dental characteristics of three siblings with Papillon-Lefevre syndrome.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive disorder, showing oral and dermatological manifestations in the form of aggressive periodontitis, leading to the premature loss of both primary and permanent teeth at a very young age and palmar-plantar hyperkeratosis. It was first described by two French physicians, Papillon and Lefevre in 1924. Immunologic, genetic, or possible bacterial etiologies have been thought to account for etiopathogenesis of PLS. Severe gingival inflammation and periodontal destruction occurred after the eruption of primary teeth. This condition should warn the physicians and dentists as a one of the important sign for the diagnosis of PLS. There have been over 250 cases reported in literature about PLS, but a few of these were in the same family. This study presents oro-dental characteristics, dental treatments, and follow-up of three siblings (age of sisters are 13, 6, and 4 years) with PLS, which is rarely seen in the same family.

Probiotics: can they be used to improve oral health?

The role of probiotic bacteria in improving human health has been an attractive subject for researchers since the beginning of the 20(th) century. They have been used to control gastro-intestinal infections, to promote immunity and to prevent various diseases (allergies, urogenital infections, etc.). However, the use of beneficial bacteria in the field of dentistry has only recently gained interest. Investigation of the effects of probiotic bacteria on oral health has become an important research subject. These studies are still in the early stages, however results show that probiotic bacteria are effective against tooth caries, periodontal disease, oral mucosal lesions and oral malodour. This review provides information on the effects of probiotics--well-known for their effects on general health, and therefore more widely used in healthcare--on oral and dental health, in order to promote their use/prescription by physicians and patients.

A rare mutation in EIF2B4 gene in an epileptic child with vanishing white matter disease: a case report.

A 12-month old boy presented with intractable seizures present since 3-month of age. He had, previously, been admitted numerous times to the pediatric emergency room for intractable and prolonged seizures during the course of his disease. Differential diagnosis was made to exclude several inborn metabolic disorders, including vitamin B6 deficiency, biotinidase deficiency and nonketotic hyperglycinemia. Although the initial brain MRI revealed a mild cerebral and cerebellar white matter involvement, follow-up images showed diffuse cerebral and cerebellar white matter dysmyelination, progressive rarefaction and cystic degeneration. A genetic analysis was performed for vanishing white matter (VWM) disease and a homozygote c. 1091G>A mutation was detected at the EIF2B4 gene. This case emphasizes the fact that VWM disease may present with refractory seizures since early infancy.

Validity of the Demirjian method for dental age estimation for Southern Turkish children.

OBJECTIVE: The aim of this study was to evaluate the applicability of the Demirjian method for southern Turkish population. MATERIALS AND METHODS: Panoramic radiographs of 535 patients (276 females, 259 males aged from 10 to 18 years) selected retrospectively. Dental age was calculated using the Demirjian's method. Chronologic age was calculated by subtracting the date of the birth from the date of the panoramic radiograph after having converted both to a decimal age. The chronologic and dental ages were compared using the paired t-test. RESULTS: The mean difference between the chronologic and dental ages ranged from 0.02 to 0.79 years in females. These differences in females between the chronologic and dental ages were statistically significant in total (P < 0.050) and in G1 (10-10.90 years) (P < 0.010) and G2 (11-11.90 years) (P < 0.001). The mean difference between the chronologic and dental ages ranged from 0.04 to 0.85 years in males. These differences in males between the chronologic age and dental age were statistically significant in total (P < 0.010) and in G4 (13-13.90 years) G5 (14-14.90 years) G6 (15-15.90 years) groups (P < 0.050). CONCLUSIONS: It is appropriate to use the Demirjian method in southern Turkish children; however, a revision is needed in some age groups.

Comprehensive dental management in a Hallermann-Streiff syndrome patient with unusual radiographic appearance of teeth.

Hallermann-Streiff syndrome (HSS) is a genetic disorder characterized by proportionate dwarfism, birdlike facies, hypotrichosis, skin atrophy, dyscephaly, bilateral microphthalmia, congenital cataracts, a narrow, weak, beaked nose, a hypoplastic mandible, and orodental anomalies. Occurrence is sporadic and distinct patterns of inheritance have not been found. This case report describes the dental management of a 3-year-old girl patient with HSS, who had unusual radiographic appearance of teeth. Furthermore, dental treatments and a 30-month follow-up period of the patient with this rare tooth structure malformation have been presented.

A RETT SYNDROME CASE WITH NOVEL NON-IDENTICAL MUTATION IN MECP2 GENE.

The Rett syndrome (RTT; OMIM #312750) is a rare genetic disease observed predominantly among girls that affects neurological development. The incidence of this disorder is approximately 1 in 10,000 female births. Diagnosis of the RTT is based on specific clinical criteria and the identification of a mutation in the methyl-CpG-binding protein (MECP), which mainly occurs on exons 3 and 4 of the gene. Mutations in the X-linked methyl-CpG binding protein 2 gene (MECP2) are observed in nearly 95% of RTT cases. RTT is associated with considerable genotypic and phenotypic heterogeneity. Recently, it has been observed that mutations in the genes Netrin G1 and cyclin-dependent kinase like 5 (CDKL5) also lead to clinical pictures resembling RTT. In this case report, we describe a 4-years-old female patient who met all the relevant criteria for the diagnosis of RTT. Sequence analyses performed on the patient identified a de novo, heterozygous c.489G>A mutation at exon 4 of the MECP2 gene.

Who will win the race in childrens' oral cavities? Streptococcus mutans or beneficial lactic acid bacteria?

Adhesion to oral soft and hard tissue is crucial for bacterial colonisation in the mouth. The aim of this work was to select strains of oral lactic acid bacteria that could be used as probiotics for oral health. To this end, the adhesive properties of some lactic acid bacteria were investigated. Seventeen lactic acid bacteria including two Streptococcus mutans strains were isolated from the oral cavity of healthy children, while other strains were isolated from fermented meat products. The bacterial strains were applied to teeth surfaces covered with saliva or without saliva. A significant diversity in adhesion capacity to teeth surfaces among the lactic acid bacteria was observed. Lactic acid bacteria isolated from the oral cavity adhered the best to teeth surfaces covered with saliva, whereas lactic acid bacteria isolated from fermented meat samples adhered the best to tooth surface without saliva. All strains of lactic acid bacteria were able to reduce the number of S. mutans cells, in particular on saliva-coated tooth surface. Therefore, they might have potential as probiotics for the oral cavity.

Nitric oxide concentrations, estradiol-17ß progesterone ratio in follicular fluid, and COC quality with respect to perifollicular blood flow in cows.

The objectives were to investigate relationships among concentrations of nitric oxide (NO), estradiol 17 beta (E2), and progesterone (P4) in follicular fluids (FF), and quality of cumulus oocyte complexes (COCs) with respect to perifollicular blood flow (FBF). In Experiment I, follicles (138) were classified according to the presence or absence of FBF (assessed with transvaginal Doppler ultrasonography) and diameter of follicles (small, 2-4 mm; medium, 5-8 mm; and large, ≥9 mm). Concentrations of NO in FF did not differ significantly among these size categories. However, NO concentrations in FF with FBF (54.4 ± 7.4 µmol/l) were higher (P<0.05) than in those without FBF (36.6 ± 4.1 µmol/l). There was a positive correlation (r=0.30, P<0.05) between NO concentrations and the E2:P4 in FF. Rate of E2 active (E2:P4 ≥ 1) follicles were numerically 1.2 (0.8-1.8) times higher in follicles with FBF (38.1%) compared to those without FBF (25.0%). Moreover, rates of E2 active follicles were 6.1 (0.7-55.2) and 1.3 (0.1-17.3) times higher (P<0.06) in large (43.3%) and medium (14.3%) compared to small follicles (11.1%), respectively. In Experiment II, quality of COCs from 2 to 8 mm follicles, obtained by transvaginal ovum pick up (OPU), was investigated with respect to FBF. Odds ratio to obtain higher quality COCs from follicles with FBF (47.1%) was 3.3 (1.1-9.6) fold higher (P<0.05) compared to those from follicles without FBF (14.6%). In conclusion, E2:P4, and NO concentrations in FF, as well as FBF, could be used to determine the functionality of ovarian follicles in cows. Moreover, determination of FBF could be useful to predict quality of COCs in cattle.

Trimethylaminuria (fish malodour syndrome) in chronic renal failure.

Trimethylaminuria (fish malodour syndrome) is a rare genetic metabolic disorder presented with a body odour which smells like a decaying fish. This odour is highly objectionable, that can be destructive for the social, and work life of the patient. Trimethylamine is derived from the intestinal bacterial degradation of foods that are rich of choline and carnitine. Trimethylamine is normally oxidised by the liver to odourless trimethylamine N-oxide which is excreted in the urine, so, uremia may worsen the condition. Uremia itself may cause more or less unpleasant odour. Poor uremic control may worsen the odour. We reported this case because Trimethylaminuria is not usually considered in the differential diagnosis of malodour in chronic renal failure and it is the first case that shown the association with Trimethylaminuria and chronic renal failure in the literature.

Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients.

BACKGROUND: Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control. METHODS: From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices. RESULTS: Patients were younger (47.6±14. 5 and 53.1±11.8 years, p< 0.05), daily urine volume higher (1068±926 vs 290±444 ml, p <0.001) and dialysis vintage was shorter (30.1±18.6 vs 53.6±35.4 months, p<0.001), systolic blood pressure was lower (127.5±15.4 vs 140.3±18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p<0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R(2):0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41±0.24 and 159.6±48.2 vs. 1.27±0.17 cm and 115.8±37 g/m(2), p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly. CONCLUSION: Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration.