Evaluation of the seroprevalence and the demographic and clinical findings of fascioliasis patients in the Dicle River Basin in Turkey: a nine-year experience at a university hospital.

OBJECTIVE: Fasciola hepatica and Fasciola gigantica are liver trematodes that cause fascioliasis in humans and animals. In Turkey, the medical importance of fascioliasis has been increasing in humans, and it continues to cause great economic loss in the field of animal husbandry. Therefore, it is important to diagnose fascioliasis quickly and reliably. The aim of this study is to show that the ELISA test is a reliable and specific method for diagnosing fascioliasis both in the early stage and in the acute stage. PATIENTS AND METHODS: In this study, 640 individuals aged 7-75 years who showed one or more symptoms of fascioliasis, such as abdominal pain, fever, weight loss, weakness, fatigue, headache, sweating, nausea, vomiting, allergic urticaria, liver mass, hypereosinophilia, or liver enzyme elevation, were recruited from the Dicle University Research and Application Hospital in southeastern Turkey. Serum and fecal samples were taken from them to investigate if the Fasciola hepatica IgG antibody was present in the serum and if eggs were present in the feces. To detect the IgG antibodies, an enzyme-linked immunosorbent assay (ELISA) kit was used. The stool samples were analyzed for three consecutive days in mini Parasep fecal parasite concentrator tubes using the native-lugol and sedimentation methods. Abdominal ultrasonography and computed tomography were performed in all the patients. RESULTS: Among the subjects of this study, 90 (14%) were positive for fascioliasis, of whom 85 (94.4%) were adults and 5 (5.5%), children; 73 (81.1%) were women and 17 (18.8%), men; 57 (63.3%) lived in the rural areas and 33 (36.6%), in the city center; 90 (14%) were positive for Fasciola hepatica IgG antibodies; (20%) had helminth eggs in their stools; and 85 (94.4%) had a history of eating watercress. CONCLUSIONS: According to the epidemiological classification for fascioliasis by Mas-Coma, the Dicle Basin, which is the setting of this study, is indeed a hyperendemic region. Thus, ELISA is a reliable and specific method of diagnosing fascioliasis, both in the early phase and in the acute phase, when the eggs are no longer seen in the stool.

Clinical Performance of a Glass Hybrid Restorative in Extended Size Class II Cavities.

OBJECTIVE: To evaluate the clinical performance of a glass hybrid restorative compared with a resin composite in the restoration of large and deep Class II cavities after 24 months. METHODS AND MATERIALS: A total of 108 extended size, with the width of the proximal box not interfering with the peak of the cusps and the proximal box in occlusion, Class II lesions in 37 patients were either restored with a glass hybrid restorative or with a micro-hybrid composite resin in combination with selective etching by two experienced operators according to the manufacturer's instructions. Two independent examiners evaluated the restorations at baseline and at the six-, 12-, 18-, and 24-month recalls according to the modified US Public Health Service criteria. Negative replicas at each recall were observed under scanning electron microscopy (SEM) to examine surface characteristics. Data were analyzed statistically. RESULTS: After 24 months, 90 restorations were evaluated in 32 patients (recall rate: 86.5%). Four glass hybrid restorations were missing; three were due to bulk and one was due to proximal fracture at 12 months. Only six restorations were scored as bravo at baseline and at the six-, 12-, 18-, and 24-month recalls for color (p<0.05). No significant differences were observed between the two restorative materials for the other criteria evaluated (p>0.05). SEM observations exhibited acceptable surface and marginal adaptation characteristics for both restorative materials at 24 months. CONCLUSIONS: Although glass hybrid restorations showed significant mismatch in color, both restorative materials exhibited successful performance for the restoration of large Class II cavities after 24 months.

Mechanical performance of a newly developed glass hybrid restorative in the restoration of large MO Class 2 cavities.

OBJECTIVE: To evaluate the mechanical properties of a glass hybrid (GH) restorative system (EQUIA Forte/GC) and compare it with a microhybrid composite (G-aenial Posterior/GC) by compressive strength (CS) and fracture resistance (FR) tests. MATERIALS AND METHODS: Cylindrical specimens were subjected to a CS test (n = 12). There were about 48 mandibular molars were used for a FR test and divided into four groups: Group 1 (positive control), sound teeth; Group 2 (negative control), extended size Class 2 cavities prepared on the mesial surfaces of teeth; Group 3, extended size Class 2 cavities restored with a composite; and Group 4, extended size Class 2 cavities restored with GH. Specimens were subjected to loading until a fracture occurred. Data were analyzed statistically (α = 0.05). RESULTS: The fracture modes were examined by scanning electron microscope (SEM). The CS values of the composite and GH were 278.20 ± 17.34 MPa and 164.62 ± 25.72 MPa, respectively (P < 0.05). No differences were observed between the FR of restored groups (P > 0.05). CONCLUSIONS: The GH exhibited sufficient mechanical properties as a restorative material, and could be preferred for extensive caries lesions on posterior teeth.

Comparison of two different composite resins used for tooth reshaping and diastema closure in a 4-year follow-up.

AIMS: This aim of this study is to evaluate and to compare the clinical performances of two nanohybrid composite resin systems used for diastema closure and tooth reshaping at 4 years. SUBJECTS AND METHODS: Twenty-three patients with midline or multidiastema problem were enrolled in this study. Nanohybrid resin composite systems to be used on each patient were randomly selected. Thirty seven teeth of 10 patients were restored with Filtek-Z550 (3M/ESPE) in combination with Adper™ Single Bond 2 (3M/ESPE) etch and rinse adhesive in Group 1 whereas 39 teeth of 13 patients were restored with Charisma-Diamond (Heraeus Kulzer) in combination with Gluma2 Bond (Heraeus Kulzer) etch and rinse adhesive in Group 2, by two operators. Esthetic, functional, and biological properties of the restorations were evaluated at baseline, 1, 2, 3, and 4 years using foreign direct investment criteria by two independent examiners. STATISTICAL ANALYSIS USED: The data were evaluated using Fisher's Chi-Square (P = 0.05). RESULTS: Fifty-eight restorations (19 patients) with a mean service time of 43.4 months were evaluated (recall rate 82.6%). One Filtek-Z550 and two Charisma-Diamond restorations were repaired due to partial fracture (Score 4). Survival rates of Group 1 and Group 2 were 96.3% and 93.5%, respectively (Kaplan-Meier) (P > 0.05). Qualitative deteriorations were observed within each group according to baseline regarding surface luster, surface/marginal staining, marginal adaptation, patient's view, and periodontal response (P < 0.05). However, there were no significant differences between two restorative materials for any of the criteria assessed (P > 0.05). CONCLUSIONS: Both nanohybrid composite resin systems revealed esthetically, functionally, and biologically acceptable clinical performance when used for diastema closure and tooth reshaping at 4 years.

Four-year randomized clinical trial to evaluate the clinical performance of a glass ionomer restorative system.

OBJECTIVE: The aim of this study was to evaluate the clinical performance of a glass ionomer restorative system compared with a microfilled hybrid posterior composite in a four-year randomized clinical trial. METHODS: A total of 140 (80 Class 1 and 60 Class 2) lesions in 59 patients were either restored with a glass ionomer restorative system (Equia, GC, Tokyo, Japan), which was a combination of a packable glass ionomer (Equia Fil, GC) and a self-adhesive nanofilled coating (Equia Coat, GC), or with a microfilled hybrid composite (Gradia Direct Posterior, GC) in combination with a self-etch adhesive (G-Bond, GC) by two experienced operators according to the manufacturer's instructions. Two independent examiners evaluated the restorations at baseline and at one, two, three, and four years postrestoration according to the modified US Public Health Service criteria. Polyvinyl siloxane impression negative replicas at each recall were observed under scanning electron microscopy (SEM) to evaluate surface characteristics. The statistical analyses were carried out with McNemar, Pearson Chi-square, and Cochran Q-tests (p<0.05). RESULTS: After four years, 126 (76 Class 1 and 50 Class 2) restorations were evaluated in 52 patients, with a recall rate of 88.1%. None of the restorations showed trends to downgrade in anatomical form, secondary caries, surface texture, postoperative sensitivity, and color match (p>0.05). Significant differences in marginal adaptation and discoloration were found at four years compared to baseline for both restorative materials for Class 1 and Class 2 restorations (p<0.05). Only one Class 2 Equia restoration was missing at three years (3.9%), and another one was missing at four years (7.7%) (p>0.05). SEM evaluations were in accordance with the clinical findings. CONCLUSIONS: The use of both materials for the restoration of posterior teeth exhibited a similar and clinically successful performance after four years.

Nephron-sparing surgery for renal cell carcinoma of the allograft after renal transplantation: report of two cases.

The risk of renal transplanation patients developing de novo malignancy is increased 100-fold compared with the healthy nontransplantation population. Renal cell carcinoma (RCC) arising from native kidneys is diagnosed among up to 4.6% of the renal transplant recipients as a consequence of immunosuppression. These tumors tend to behave more aggressively.(1) Although tumors occurring in allografted kidneys can be treated by partial (to save functional graft) or total nephrectomy, there is a paucity of data the outcomes. From 1978 to 2012, we performed 804 kidney transplantations including two cases in which RCC arose from the allografted kidney, both of which were treated with nephron-sparing surgery. The first patient has been followed for 30 months with a well functioning graft without an RCC recurrence. The second patient has returned to dialysis after 6 months due to an insufficient remnant nephron mass. In conclusion, nephron-sparing surgery is a novel alternative to total nephrectomy for allograft RCC. The remaining kidney can preserve function and the patient may not need chronic dialysis.

Accuracy of imaging-guided biopsy in diagnosis of malignancy versus infection.

AIMS: Imaging-guided biopsies obtain samples for pathologic testing in addition to therapeutic interventions in patients with cancer. Our aim was to determine the diagnostic accuracy of percutaneous biopsies of pediatric solid tumors and infectious complications of cancer treatment. MATERIALS AND METHODS: This study was performed by gathering pediatric oncology patients between 1998 and 2008. A total of 41 percutaneous biopsies were performed in order to establish a diagnosis for a suspected malignancy or an infectious complication of cancer treatment. RESULTS AND CONCLUSIONS: An accurate diagnosis was achieved in 21 of 26 (87.6%) percutaneous biopsies for suspected malignancy cases or recurrence. The remaining 15 percutaneous biopsies were done for the diagnosis of infectious complications of cancer treatment with an accurate diagnosis of 60%. Imaging-guided percutaneous biopsy technique is highly accurate and safe, particularly in diagnosis of a suspected tumor.

Effects of malnutrition on oxidative burst functions and infection episodes in children with acute lymphoblastic leukemia.

INTRODUCTION: The aim of this study was to determine the effect of malnutrition on oxidative burst functions (OBF) of neutrophils in children with acute lymphoblastic leukemia (ALL). MATERIALS AND METHODS: Twenty-eight patients with ALL and thirty healthy controls were enrolled to the study. Thirteen patients with ALL were found to have malnutrition. While neutrophil OBF of ALL patients without malnutrition were studied both before induction chemotherapy and 3 months after, the same functions in ALL patients with malnutrition were studied both before induction chemotherapy and when the nutritional status improved. Control group were studied at admission and 3 months later. RESULTS: The OBF of ALL patients with and without malnutrition before induction chemotherapy were found to be significantly lower than the control group (P = 0.009), whereas the OBF were found to be similar in both patient groups with ALL (P = 0.27). The median infection episode rate and the duration of antibiotics therapy during the study period were similar in both patient groups with ALL. The repeated OBF of both patient groups with ALL were shown to increase to similar values with the control group in the third month of chemotherapy (P = 0.002). The median infection episode rate during the first month of chemotherapy was shown to decrease significantly during the third month of chemotherapy in both patient with ALL groups (P < 0.001). CONCLUSIONS: We have not been able to demonstrate an overt effect of malnutrition on OBF. However, our results still need to be verified via further larger scaled studies of OBF in leukemic children with and without malnutrition.

Cardiac effects of granisetron in a prospective crossover randomized dose comparison trial.

PURPOSE: Cardiac side effects of granisetron have been studied mostly in adult patients that are using cardiotoxic chemotherapeutics. There is limited evidence in pediatric age group and no information in pediatric oncology patients with non-cardiotoxic chemotherapeutics. METHODS: In this prospective, crossover randomized study, the cardiac side effects of granisetron are compared in pediatric oncology patients who had carboplatin based chemotherapy. They were randomized to receive either 10 or 40 µg kg(-1) dose(-1) of granisetron before each cycle of chemotherapy. We drew blood for creatine phosphokinase (CPK), CPK-muscle band (MB) and Troponin-T before and 24 h after administering granisetron. Electrocardiography (ECG) tracings were taken at 0, 1, 2, 3, 6 and 24 h of granisetron. Twenty-four hours Holter ECG monitorisation was performed after each granisetron infusion. RESULTS: A total of 16 patients (median 8.7 years of age) were treated with weekly consecutive courses of carboplatin. There was bradycardia (p = 0.000) in patients that had granisetron at 40 µg/kg and PR interval was shortened in patients that had granisetron at 10 µg/kg dose (p = 0.021). At both doses of granisetron, QTc interval and dispersion were found to be similar. CPK, CK-MB and Troponin-T values were found to be normal before and 24 h after granisetron infusion. CONCLUSIONS: As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 µg kg(-1) dose(-1) causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 µg kg(-1) dose(-1). However, our results should be supported by prospective randomized studies with larger samples of patient groups.

Seroconversion status after single dose and double doses of varicella vaccination in children with leukemia.

Although varicella is a benign self-limiting disease in healthy children, it can be fatal when it occurs in immunocompromised hosts. Despite that immunosuppressed children are suggested to require 2 doses of vaccine to achieve seroconversion, conflicting results are reported in the literature. The aim of this study was to investigate the seroconversion status and mean antibody titers at first year after single dose and double doses of varicella vaccination in acute lymphoblastic leukemia patients. Patients with leukemia in remission for at least 1 year who were seronegative for varicella-zoster virus immunoglobulin G (IgG) were vaccinated. Titers above the cutoff level (0.65) were accepted as seroconversion. Seventeen patients were vaccinated with single dose whereas 24 patients were vaccinated with double doses. Mean prevaccination antibody titers were 0.56 ± 0.05 in patients with single dose and 0.51 ± 0.08 in patients with double doses (P > .05, Student t test). The mean antibody titers at first year were 0.61 ± 0.05 in patients with single-dose vaccination (P > .05, Wilcoxon signed-rank test) and 1.48 ± 0.04 in patients with double doses (P < .001, Wilcoxon signed-rank test). Seroconversion after single-dose vaccination was achieved in 29% of patients (n = 5/17) and in 75% of patients with double doses (n = 18/24) at first year (P = .004, chi-square test). These results suggest that seroconversion after single-dose vaccination might not persist at first year in malignancy patients. Double doses should be applied in order to provide long-term seroconversion.

The effect of bleaching systems on the gingiva and the levels of IL-1ß and IL-10 in gingival crevicular fluid.

OBJECTIVE: This study aimed to evaluate the color change and clinical periodontal parameters and to analyze the interleukin­1 beta (IL-1ß) and interleukin-10 (IL-10) levels in gingival crevicular fluid (GCF) of patients treated with different bleaching systems. MATERIALS AND METHODS: According to pre-established criteria, 30 healthy volunteers were selected and randomly divided into three groups (n=10): G1, home bleaching (Opalescence 35% Carbamide Peroxide, CP); G2, chemically activated office bleaching (Opalescence Xtra Boost 38% Hydrogen Peroxide, HP); G3, light-activated office bleaching (Opalescence Xtra 35% HP). Treatments were applied according to the manufacturer's recommendations. After shade evaluation, clinical periodontal parameters were evaluated as follows: gingival index (GI), plaque index (PI), and bleeding on probing (BOP). GCF were collected from six maxillary sites per patient at baseline (T0), one day (T1) after bleaching treatments, and 15 days (T2) after bleaching treatments and analyzed for IL-1ß and IL-10 by enzyme-linked immunosorbent assay. Data were subjected to statistical analysis (p<0.05). RESULTS: Spectrophotometer readings exhibited significant differences among the groups (p<0.05). The ΔE values (color change) of G3 were statistically higher than the other groups (p<0.05). The PI of G3 after 15 days was significantly higher than the PI of G2 after 15 days (p<0.05). The GI of G2 was lower than that of G1 and G3 before bleaching (p<0.05). According to BOP, no significant differences were found among the groups at any time intervals (p>0.05). In G3, the total amount of IL-1ß after 15 days was higher than the amount before bleaching (p<0.05). The IL-10 total amount and concentration levels did not exhibit any significant differences among the groups or by time (p>0.05). CONCLUSION: Home and chemically activated bleaching systems could be considered as safer in tooth whitening and maintaining gingival health when compared with a light-activated bleaching system, which might lead to increased proinflammatory cytokine (IL-1ß).

Chemical analysis of enamel and dentin following the application of three different at-home bleaching systems.

PURPOSE: To determine the change in the chemical composition of enamel and dentin as well as to evaluate the differences in surface texture of the same dental hard tissues following three at-home bleaching systems in vitro. METHODS: Sixty extracted intact human anterior teeth were used in this study. Thirty teeth were used as samples for enamel, and the buccal surfaces of the remaining 30 teeth were abraded and used as dentin samples. Prior to bleaching treatments, calcium (Ca), phosphorus (P), potassium (K), sodium (Na), magnesium (Mg), fluoride (F), and oxygen (O) levels of each sample were measured using an energy dispersive spectrometer. The teeth were then randomly allocated into three groups according to the bleaching system used, as follows: GI, 10% carbamide peroxide (CP); GII, 20% CP; GIII, and 35% CP. Following the bleaching treatments, Ca, P, K, Na, Mg, F, and O measurements were repeated. The surface configurations were examined using scanning electron microscopy (SEM). The data were analyzed using Wilcoxon signed rank and Kruskal-Wallis tests followed by the Dunn test. RESULTS: All three bleaching systems tested caused similar changes in the chemical composition of enamel and dentin. Bleaching systems decreased Ca and K, while F and O levels increased in enamel. In dentin, Ca, P, and K levels decreased; however, Na, F, and O levels increased. SEM observations revealed no deleterious effect on enamel and dentin. CONCLUSION: The use of home bleaching agents could affect the chemical composition of dental hard tissues, whereas the change in the chemical composition of enamel and dentin was not affected by the CP concentration of the bleaching systems used.

Greenhouse gas production: a comparison between aerobic and anaerobic wastewater treatment technology.

Anaerobic wastewater treatment offers improved energy conservation with potential reduction in greenhouse gas emissions. Pitfalls exist in that the methane produced in anaerobic treatment can offset any reductions in carbon dioxide emissions, if it is released to the environment. This paper analyzes greenhouse gas emissions from both aerobic and anaerobic treatment systems, including sludge digestion and the losses of dissolved methane in digested biosolids and process effluents. There exists cross over points, ranging from 300 to 700 mg/L influent wastewater BODu, which are functions of the efficiency of the aerobic treatment system. Anaerobic treatment becomes favorable when treating influents higher in concentrations than the cross over values. A technology to recover dissolved methane would make anaerobic treatment favorable at nearly all influent strengths.