Effect of chlorhexidine and benzalkonium chloride on the long-term push-out bond strength of fiber posts.

Background and Aim: Fiber posts are widely used in endodontically treated teeth with extensive loss of coronal structure. The purpose of this study was to investigate immediate and the long-term effects of chlorhexidine (CHX) and benzalkonium chloride (BAC) application, on the push-out bond strength of fiber posts. Material and Methods: Sixty mandibular premolars were decoronated, and root canal treatment was performed. After post space preparation, the specimens were divided into three groups according to the post space-surface pretreatment (n = 20); no surface treatment (control group-Group 1), 2% CHX application (Group 2), and 1% BAC application (Group 3). A self-curing adhesive cement and an etch and rinse adhesive were used for the cementation of posts. Three sections (one cervical, one middle, and one apical) of 1 mm thickness were prepared from each specimen. A push-out test was performed immediately on the half of the specimen sections (n = 10). The other half of the specimen sections were subjected to 20.000 thermal cycles before applying the push-out test (n = 10). The failure mode of each specimen was observed under a stereomicroscope at ×40 magnification. Results: The data were analyzed by one-way analysis of variance (ANOVA), Tukey Honestly significant difference (HSD), and Tamhane tests (P = 0.05). The cervical thirds displayed the highest, and the apical thirds showed the lowest values in all groups (P < 0.05), except the control-aged group (P = 0.554). The aged control groups' values were found to be significantly lower than the aged CHX and BAC groups (P < 0.001). Aging significantly reduced the bond strength values of specimens in control groups (P < 0.001). However, aging did not significantly affect the push-out bond strength values of CHX and BAC groups (P > 0.050). The failure types were adhesive between the post and cement (type 1) in all groups, except control-aged group (type 2). Conclusion: The application of 2% chlorhexidine or 1% BAC may be an essential step that can be taken to preserve the bond strength of fiber posts.

A new scoring system to predict mortality in community-acquired pneumonia: CURB (S)-65.

OBJECTIVE: The first decision to be made in the case of community-acquired pneumonia (CAP) is whether hospitalization of the patient is mandatory. In this study, we aimed to investigate whether the addition of oxygenation parameters to CURB-65 has diagnostic value in predicting mortality in CAP. PATIENTS AND METHODS: A total of 903 CAP patients were included in the study. Patients with a CURB-65 score of 0 and 1 were classified as Group 1 and patients with a CURB-65 score of 2 or more were classified as Group 2. The prediction of mortality through Pneumonia Severity Index (PSI), CURB-65 and CURBS-65/CURBP-65 with the addition of SaO2 and PaO2 values; hence the four different models, was compared among all patient groups. RESULTS: As a result, 3.3% of the cases in Group 1 and 12.7% of the cases in Group 2 died. In both CURB-65 groups, it was noted that the frequency of patients with SaO2 <90% was significantly higher in the dead group than in the alive patient group (p=0.009 and p=0.001, respectively). In the univariate analysis, PaO2<60, and SaO2<90 were significantly associated with mortality. Model 2 (CURBS-65) and Model 3 (CURBP- 65) were examined, SaO2<90 (OR 2.08) was found to have an effect on death. In predicting mortality by the receiver operating characteristics (ROC) analysis, it was understood that the CURBS-65 score had a slightly higher area under the curve (AUC) value than CURB-65. CONCLUSIONS: As a result, it has been shown that the use of CURBS-65 scoring instead of CURB-65 clinical scoring may be more useful in predicting mortality.

Enhancing Expert Panel Discussions in Pediatric Palliative Care: Innovative Scenario Development and Summarization With ChatGPT-4.

This study presents a novel approach to enhance expert panel discussions in a medical conference through the use of ChatGPT-4 (Generative Pre-trained Transformer version 4), a recently launched powerful artificial intelligence (AI) language model. We report on ChatGPT-4's ability to optimize and summarize the medical conference panel recommendations of the first Pan-Arab Pediatric Palliative Critical Care Hybrid Conference, held in Riyadh, Saudi Arabia. ChatGPT-4 was incorporated into the discussions in two sequential phases: first, scenarios were optimized by the AI model to stimulate in-depth conversations; second, the model identified, summarized, and contrasted key themes from the panel and audience discussions. The results suggest that ChatGPT-4 effectively facilitated complex do-not-resuscitate (DNR) conflict resolution by summarizing key themes such as effective communication, collaboration, patient and family-centered care, trust, and ethical considerations. The inclusion of ChatGPT-4 in pediatric palliative care panel discussions demonstrated potential benefits for enhancing critical thinking among medical professionals. Further research is warranted to validate and broaden these insights across various settings and cultures.

Evaluating the performance of memory type logarithmic estimators using simple random sampling.

In survey research, various types of estimators have been suggested that consider only the current sample information to compute the unknown population parameters. Therefore, we utilize the past sample information along with the current sample information in the form of hybrid exponentially weighted moving averages to suggest the memory type logarithmic estimators for time-based surveys. The expression of the mean square error of the suggested estimators is determined to the first order of approximation. A relative comparison of the suggested estimators with the existing estimators is performed and efficiency conditions are obtained. Further, a simulation study is accomplished using a hypothetically rendered population and a real data illustration to improve the theoretical results. The results of the simulation study and the real data application exhibit that the consideration of past and current sample information meliorates the efficiency of the suggested estimators.

Prognosis of hospitalized patients with community-acquired pneumonia.

INTRODUCTION: The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality. PATIENTS AND METHODS: The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed. RESULTS: The study included 785 patients, 68% of whom were male and the mean age was 67±16 (18-92). The median duration of follow-up was 61.2±11.8 (37-90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8±4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality. CONCLUSION: Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients.

Effects of resveratrol on high-fructose-induced testis injury in rats.

This study investigated whether a high-fructose (HFr) diet changes the morphology of seminiferous tubules (ST) in rats and resveratrol (RES) has a possible restoring effect in this sense. Fructose (30%; w/v) was administered to rats alone or together with RES (50 mg/L) in drinking water for 8 weeks. In the HFr group, destruction of the germinal epithelium led to the detection of immature germ cells in the lumen. HFr diet gave rise to a decrease in the ST diameters (p < 0.05), Johnsen's tubular biopsy score values (p < 0.001), and an increase in the apoptotic index (p < 0.05). Ultrastructurally, HFr feeding increased lipid accumulation (p < 0.01), mitochondrial damage, and acrosomal abnormalities in spermatogenic cells. Treatment of HFr -fed rats with RES improved the reduced ST diameters and overall general histological and ultrastructural abnormalities of the STs, but did not change the increased apoptotic index.

Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities.

PURPOSE: To compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia. METHODS: The data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated. RESULTS: A total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P=0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P=0.000). CONCLUSIONS: The risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients.

Digital holographic microscopy and focusing methods based on image sharpness.

Digital holographic microscope allows imaging of opaque and transparent specimens without staining. A digitally recorded hologram must be reconstructed numerically at the actual depth of the object to obtain a focused image. We have developed a high-resolution digital holographic microscope for imaging amplitude and phase objects with autofocusing capability. If the actual depth of an object is not known a priori, it is estimated by comparing the sharpness of several reconstructions at different distances, which is very demanding in means of computational power when the recorded hologram is large. In this paper, we present 11 different sharpness metrics for estimating the actual focus depths of objects. The speed performance of focusing is discussed, and a scaling technique is introduced where the speed of autofocusing increases on the order of square of the scale ratio. We measured the performance of scaling on computer-generated holograms and on recorded holograms of a biological sample. We show that simulations are in good agreement with the experimental results.

Real-time, auto-focusing digital holographic microscope using graphics processors.

The most significant advantage of holographic imaging is that one does not need to do focusing alignment for the scene or objects while capturing their images. To focus on a particular object recorded in a digital hologram, a post-processing on the recorded image must be performed. This post-processing, so called the reconstruction, is essentially the calculation of wave propagation in free space. If the object's optical distance to the recording plane is not known a priori, focusing methods are used to estimate this distance. However, these operations can be quite time consuming as the hologram sizes increase. When there is a time constraint on these procedures and the image resolution is high, traditional central processing units (CPUs) can no longer satisfy the desired reconstruction speeds. Then, especially for real-time operations, additional hardware accelerators are required for reconstructing high resolution holograms. To this extend, today's commercial graphic cards offer a viable solution, as the holograms can be reconstructed tens of times faster with a graphics processing unit than with the state-of-the-art CPUs. Here we present an auto-focusing megapixel-resolution digital holographic microscope (DHM) that uses a graphics processing unit (GPU) as the calculation engine. The computational power of the GPU allows the DHM to work in real-time such that the reconstruction distance is estimated unsupervised, and the post-processing of the holograms are made completely transparent to the user. We compare DHM with GPU and CPU and present experimental results showing a maximum of 70 focused reconstructions per second (frps) with 1024 × 1024 pixel holograms.

Association of serum paraoxonase activity and coronary artery calcification.

AIM: It has been known that there was a relation between the activities of serum paraoxonase (PON) and the severity of the coronary artery disease. However, little is known about association of coronary artery calcification (CAC) and serum PON activities. The aim of this study is to evaluate the relationship between CAC and serum PON activities. PATIENTS AND METHODS: We measure serum PON activities from 122 patients (42 female, mean age = 62±10 years) with angiographically documented CAC (Group I), and 138 patients (54 female, mean age = 60±10 years) without CAC (Group II). Coronary calcification was detected with fluoroscopy before coronary angiography. Serum PON activities were measured by spectrophotometrically method. Patient characteristics and baseline data were recorded from patient's files. RESULTS: The triglyceride levels is lower in group I than group II (p = 0.040). Diastolic blood pressure and frequency of diabetes mellitus was higher in the group I than group II (respectively p = 0.012 and p = 0.022). The other clinic and laboratory parameters were similar in two groups (all p > 0.05). The only statistically significant differences between with CAC and without CAC groups in respect to serum PON activities were present (170.6 ± 59.6 vs. 209.6 ± 69.8 U/ml; respectively, p < 0.001). There was a negative correlation between serum PON activities and presence of CAC (p < 0.001). CONCLUSIONS: These data indicate that the serum PON activities are decreased in patients with CAC. The serum PON activities may play a role in development of the CAC and reduced serum PON activity might represent a biochemical marker of CAC.

Evaluation of ceruloplasmin levels in patients with pulmonary cystic echinococcus.

AIM: In this study, we aimed to evaluate serum CP levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE). MATERIALS AND METHODS: Forty-eight patients with pulmonary CE who underwent surgery and 48 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=48) consisted of patients with pulmonary CE, and group 2 (n=48) consisted of healthy subjects. Before and after surgical interventions serum CP levels were measured. RESULTS: Compared to group 2, group 1 had significantly higher CP levels at baseline (p <0.001). In group 1, CP levels were significantly decreased after the surgical intervention (p <0.001). CONCLUSIONS: The present study showed that CP levels increased in patients with pulmonary CE; chronic inflammation may cause these rises, and may be an immune response of the host, and these levels decreased after the surgical intervention.

The effect of day and night shifts on oxidative stress and anxiety symptoms of the nurses.

BACKGROUND: Oxidative stress is believed to have a role in the development of chronic diseases. It is also known that long-term night and shift work in nurses might be associated with many health-related problems like fatigue, sleep problems, anxiety and difficulties in maintaining regular lifestyles. AIM: In this study, we aimed to evaluate the changes of oxidative stress parameters and anxiety indexes of the nurses on day and night shifts. MATERIALS AND METHODS: One hundred and twenty nurses in ordinary service and intensive care unit (ICU) were enrolled to the study. Subjects were divided into 2 groups; group 1 (n = 60) consisted of nurses working in a day shift and group 2 (n = 60) as working in the night shift. Further, both groups were divided in to 2 groups again; group la and 2a (both n = 30) who working in the ICU, group 1b and 2b (both n = 30) in the ordinary service. Just before and the end of the shifts, blood samples were obtained to measure total antioxidant status (TAS) and total oxidant status (TOS). Oxidative stress index (OSI) was calculated. Anxiety index were determined at the end of the shift using State-Trait Anxiety Inventory index. RESULTS: Oxidative stress parameters were increased in all nurses at the end of the day and night shifts (p < 0.05). However, both in service and ICU nurses TAS, TOS, and OSI levels were not significantly different at the beginning and the end of the shifts (p > 0.05). Anxiety indexes of each ordinary service and ICU nurses were found to be similar (p > 0.05). CONCLUSIONS: Ordinary service and ICU nurses' oxidative stress parameters and anxiety indexes were not different and all nurses suffer the similar effects of the shifts both in day and night.

Evaluation of pre- and post-surgical oxidative stress parameters in patients with pulmonary cystic echinococcus.

BACKGROUND: Hydatid cyst secretes numerous immunomodulatory molecules to the host, and the host reacts these molecules by activating immune response. It is also known that, immune cells generally produce more oxidative products. AIM: In this study, we aimed to evaluate the antioxidant enzyme using catalase (CAT) and oxidant enzyme using lipid hydroperoxide (LOOH) levels in the serum samples before and after the surgical interventions in patients with pulmonary cystic echinococcus (CE). PATIENTS AND METHODS: Forty patients with pulmonary CE who underwent surgery and 40 healthy individuals were enrolled to the study. Patients were divided in two groups; group 1 (n=40) consisted of patients with pulmonary CE, and group 2 (n=40) consisted of healthy subjects. Before and after surgical interventions serum CAT and LOOH levels were measured. RESULTS: Compared to group 2, group 1 had significantly lower CAT and higher LOOH levels before surgery (both p < 0.001). In group 1; CAT levels were significantly increased and LOOH levels significantly increased after the surgical intervention (both p < 0.001). CONCLUSIONS: The present study showed that oxidative stress increased in patients with pulmonary CE, may be consequence of immune response of the host, and these levels decreased after the surgical intervention.

The detection of mood and anxiety in people with epilepsy using two-phase designs: experiences from a tertiary care centre in Oman.

BACKGROUND: The detection of mood and anxiety disorders is of great clinical importance in patients with chronic disease but data on the occurrence of affective dysfunction is lacking among people with epilepsy (PWE) in non-western populations. Further compounding such situation, the validity of some of the common assessment measures has not been examined. OBJECTIVE: The study aims to investigate the application of the Hospital Anxiety and Depression Scale (HADS) by identifying patients with comorbid affective dysfunctions in an Omani population. The semi structured interview, Composite International Diagnostic Interview (CIDI) will be used to establish the psychometric property of HADS in the Omani population. METHODS: PWE (n=150) were screened with the semi-structured, (CIDI) and the HADS. A receiver operating characteristics (ROC) curve was calculated to discriminate the power of the HADS for every possible threshold score. RESULTS: The semi-structured interview revealed the prevalence rate of 27% for depressive disorder and 45% for anxiety disorder. The best compromise using, the cut-off score of 7 or 8, gave a sensitivity of 99% for depression and 83-91% for anxiety and a specificity of 87.5-100% for depression and 85-94% for anxiety. CONCLUSIONS: Findings suggest that HADS is a useful screening tool for this particular population. This finding is discussed from the socio-cultural perspective of Omani society.

Prognostic factors in patients with small cell lung carcinoma.

BACKGROUND: The current prognosis in patients with small cell lung cancer (SCLC) is unsatisfactory, even though there have been considerable improvements in diagnosis and treatment. METHODS: We retrospectively analyzed all consecutive patients with small cell lung carcinoma between 1995 and 2007 in a Turkish chest hospital. A total of 116 SCLC patients initially presented with limited disease, while 92 small cell lung carcinoma patients were found to be extensive. RESULTS: The mean age of the patients (18 women and 190 men) was 56 years. The median survival was 74 weeks. Performance status, superior vena cava syndrome (SVCS), stage, elevated white blood cell count, elevated lactate dehidrogenase levels, short symptom duration (

Exchange-induced Tm magnetism in multiferroic h-TmMnO(3).

Analysis of (169)Tm Mössbauer spectra recorded for (hexagonal phase) h- TmMnO(3) confirms that the Mn sublattice orders magnetically below  T(N)(Mn) = 82-83 K and reveals the growth of a local Tm moment at the 4b site that is induced by the Mn-Tm exchange interaction. The maximum hyperfine field recorded at the (169)Tm nucleus is 312 T, which is just under half of the free ion value and corresponds to a saturation moment of 3.29 µ(B). The temperature dependence of the fitted magnetic hyperfine interaction is closely represented by a simple two-singlet ground state model for the Tm(3+) crystal field scheme. The saturation molecular field is deduced to lie in the range B(Mn-Tm)(T = 0 K) = 1.2-2.3 T, dependent on the expectation value of the coupling α = ⟨0|J(z)|1⟩ between the two-singlet states. As observed elsewhere for other hexagonal manganites, there is no Mn-based exchange field at the second Tm site (the 2a site) which contributes a paramagnetic subspectrum down to the lowest experimental temperature of 4.2 K.

[Peripheral vascular injuries]. / Periferik damar yaralanmalari.

Between 1994-2000, 60 peripheral vascular injuries were admitted to the Turgut Ozal Medical Center Thoracic and Cardiovascular Surgery Clinic. Forty eight (80%) of patients were male, twelve (20%) were female and their age ranged from 5 to 70 years (mean 28.9 years). The causes of injuries were related to penetrating device in 34 (56.6%), gun shots in 14 (23.3%), blunt trauma in seven (11.6%) and iatrogenic causes in five(8.3%). Total laceration, partial laceration and pseudoaneurysm were observed in 45 (75%), 14 (23.3%) and one (1.6%) respectively. The localization of injuries were the upper limbs in 34(56.6%) and the lower limbs in 26 (43.4%). The vascular injury localizations in order of frequency were femoral artery in 12 cases (20.75%), radial artery in ten cases (17%), popliteal artery in ten cases (15%), brachial artery in nine cases (15%), axillary artery in nine cases (13.2%), ulnar artery in six cases (11.3%) and tibial artery in four cases(7.4%). There were nearby venous injuries in nine patients (15%) and neural injuries in ten patients (16.6%). The patients' mean admission time to the hospital was 3 hours and 30 minutes and mean operation time for revascularization was within 95 minutes. The operative techniques were autogenous saphenous vein graft interposition in 27 cases (45%), resection and end-to-end anastomosis in 19 cases (31.6%), lateral repair in ten cases (16.6%), synthetic graft insertion in three cases (4.8%) and ligation in one case (1.6%). Our success rate was 98.2% in salvaging the limbs. Mean length of hospital stay was 14.4 days. Mortality was not observed during the hospital stay.