Paecilomyces variotii peritonitis in a patient on continuous ambulatory peritoneal dialysis.

Paecilomyces variotii (P. variotii) is an extremely rare cause of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. When diagnosed, it usually portends poor prognosis. Patient's survival depends on early laboratory diagnosis and proper treatment. We herein report a P. variotii peritonitis in a patient on CAPD which is a quite rare clinical entity. Laboratory diagnosis was confirmed via both morphological analysis and DNA sequencing. Antifungal susceptibility tests were performed and interpreted according to the Clinical Laboratory Standards Institute M38-A2 guidelines. After laboratory diagnosis, the patient was treated succesfully with liposomal amphotericin B and itraconazole combination and the peritoneal catheter was removed. This case is worthy of reporting since P. variotii is an uncommon cause of peritonitis and leads to dilemmas in both laboratory diagnosis and treatment strategies.

Influence of different final irrigation regimens and various endodontic filling materials on vertical root fracture resistance.

AIM: The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture (VRF) resistance. MATERIALS AND METHODS: Eighty human teeth were prepared then assigned into two groups (n = 40) according to the final irrigations. G1: 5 mL, 5.25% sodium hypochlorite (NaOCl), G2: 5 mL, 2% chlorhexidine gluconate (CHX). Each group was assigned into four subgroups according to the obturation system used (n = 10): A: iRoot SP/single gutta-percha cone (SGP), B: Only iRoot SP, C: Mineral trioxide aggregate (MTA)-Fillapex/SGP, D: AH26/SGP. The specimens were embedded in acrylic molds and subjected to compressive loading at a rate of 1 mm min until VRF occurred. Data were analyzed via three-way ANOVA tests. RESULTS: The statistically significant difference was found among groups (P < 0.05). The G1A and G1B and G1D revealed significantly higher-VRF values than G1C (P = 0.023). The roots filled with MTA-Fillapex revealed lower-VRF values than the other subgroups (P < 0.05). Groups irrigated with NaOCl had significantly lower-VRF values than the groups irrigated with CHX (P < 0.05). CONCLUSION: Final irrigation regimens could alter VRF resistance of root canals filled with different obturation technique and root canal sealers.

Evaluation of the amount of apically extruded debris during retreatment of root canals filled by different obturation techniques.

OBJECTIVE: To evaluate the amount of apically extruded debris during retreatment (with or without solvent) of root canals filled by two obturation techniques. MATERIALS AND METHODS: Forty-eight root canals were prepared using ProTaper Universal F3 and filled with Gutta-percha and AH 26 sealer using single cone or lateral condensation techniques. The root canal fillings were removed using ProTaper Universal Retreatment system with or without solvent, and the canals were further prepared with ProTaper F4. The operating time was measured. The debris extruded was collected into preweighed Eppendorf tubes. The dry weight of the extruded debris was calculated by subtracting the weight of the empty tube from that of the tube containing debris. Statistical analysis was performed with two-way analysis of variance test, with Bonferroni correction at a 95% confidence level. RESULTS: There was no statistically significant difference in the amount of extruded debris between the two obturation techniques (P=0.332). The mean amount of debris was higher in the nonsolvent groups than the solvent groups, particularly with the single cone technique (P=0.013). There was a significant difference between groups with regard to the retreatment time (P<0.001). Gutta-percha removal took less time in the single cone group than in the lateral condensation group (P<0.001). Gutta-percha removal in the nonsolvent groups took significantly less time than that in the solvent groups (P<0.001). CONCLUSIONS: The amounts of apically extruded debris were similar in both obturation techniques. A greater amount of apically extruded debris was observed in the nonsolvent groups than the solvent groups.

The role of neutrophil to lymphocyte ratio as a predictor of diastolic dysfunction in hypertensive patients.

OBJECTIVE: Neutrophil to lymphocyte ratio (NLR) is a novel parameter for cardiovascular research area. The higher values of NLR have been found to be associated with worse clinical outcomes in atherosclerotic heart disease, heart failure, heart valve disease and other various cardiovascular disorders. Although the relationship between NLR and almost all cardiovascular disorders have been investigated, the association between NLR and diastolic dysfunction remains unclear. We herein evaluated the association between NLR and diastolic dysfunction. PATIENTS AND METHODS: The study population consisted of 41 hypertensive patients with any grade of diastolic dysfunction and 41 hypertensive patients without diastolic dysfunction determined by echocardiographic evaluation constituted the control group. RESULTS: Mean NLR value was found to be 2.07 ± 0.82 in the diastolic dysfunction group while the control group had a mean value of 1.69 ± 0.60 (p = 0.020). The patients with diastolic dysfunction had significantly higher values of NLR. When grades of diastolic dysfunction were evaluated, NLR was 1.80 ± 0.82, 2.32 ± 0.73 and 2.75 ± 0.45 in patients with grade 1, grade 2 and grade 3 diastolic dysfunction, respectively. The patients with higher grade of diastolic dysfunction had higher values of NLR (p = 0.001). None of the other hematologic parameters differed significantly in patients with diastolic dysfunction when compared to controls. CONCLUSIONS: Patients with diastolic dysfunction had higher values of NLR compared to subjects without diastolic dysfunction. Furthermore higher grades of diastolic dysfunction were associated with higher levels of NLR. Further studies are needed to search the possible use of NLR as a marker for prognostic stratification in diastolic dysfunction which is associated with worse cardiovascular outcomes.