Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. AIM: In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. METHODS: In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. RESULTS: The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. CONCLUSIONS: Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.

Investigation the anterior mandibular lingual concavity by using cone-beam computed tomography.

BACKGROUND: In the presence of lingual concavity in the mandible, the cortical perforation and consequently the life-threatening intraoral haemorrhages obstructing the upper respiratory tract may be seen during the surgical intervention. The present study was aimed to determine the prevalence of lingual concavity in the interforaminal region and its relationship with gender and dentate status. MATERIALS AND METHODS: The images of 106 patients who underwent cone-beam computed tomography (CBCT) between 2016 and 2017 in Department of Dental and Maxillofacial Radiology Department of Faculty of Dentistry of Ondokuz Mayis University were retrospectively examined. The images were obtained using a Galileos device (98 kVp, 15-30 mA). The bone height and width in interforaminal region and the frequency of lingual concavity were analysed. RESULTS: Of patients involved in the present study, 42.5% were male and 57.5% were female After the examinations performed, the bone was morphologically classified into four classes as type I lingual concavity, type II inclined to lingual, type III enlarging towards labiolingual and type IV buccal concavity. Type III (77.9%) was the most common type in the anterior region, followed by type II (16.5%), type I (4.7%) and type IV (0.9%). The lingual concavity angle was 76.5 ± 3.69º and the concavity depth was 2.09 ± 0.34 mm. CONCLUSIONS: The lingual concavity can be detected by using the cross-sectional CBCT images and the complications related with lingual cortical perforation can be prevented.

Morphological assessment of the stylohyoid complex variations with cone beam computed tomography in a Turkish population.

BACKGROUND: The aim of this investigation was to evaluate the length, thickness, sagittal and transverse angulations and the morphological variations of the stylohyoid complex (SHC), to assess their probable associations with age and gender, and to investigate the prevalence of it in a wide range of a Turkish sub-population by using cone beam computed tomography (CBCT). MATERIALS AND METHODS: The CBCT images of the 1000 patients were evaluated retrospectively. The length, thickness, sagittal and transverse angulations, morphological variations and ossification degrees of SHC were evaluated on multiplanar reconstructions (MPR) adnd three-dimensional (3D) volume rendering (3DVR) images. The data were analysed statistically by using nonparametric tests, Pearson's correlation coefficient, Student's t test, c2 test and one-way ANOVA. Statistical significance was considered at p < 0.05. RESULTS: It was determined that 684 (34.2%) of all 2000 SHCs were elongated (> 35 mm). The mean sagittal angle value was measured to be 72.24° and the mean transverse angle value was 70.81°. Scalariform shape, elongated type and nodular calcification pattern have the highest mean age values between the morphological groups, respectively. Calcified outline was the most prevalent calcification pattern in males. There was no correlation between length and the calcification pattern groups while scalariform shape and pseudoarticular type were the longest variations. CONCLUSIONS: We observed that as the anterior sagittal angle gets wider, SHC tends to get longer. The most observed morphological variations were linear shape, elongated type and calcified outline pattern. Detailed studies on the classification will contribute to the literature. (Folia Morphol 2018; 77, 1: 79-89).

Influence of oval and circular post placement using different resin cements on push-out bond strength and void volume analysed by micro-CT.

AIM: To evaluate the percentage volume of voids within cement layers, to determine the push-out bond strength of circular and oval fibre posts luted with different commercial resin cements in oval cross-sectional root canals, and to correlate push-out bond strength values and volume of voids of circular and oval fibre posts. METHODOLOGY: Seventy-two mandibular premolars with oval-shaped root canals were selected. The specimens were divided into two main groups according to the post type (oval and circular). Groups were further divided into three subgroups (n = 24) according to resin cement type: Maxcem Elite, Rely-X Unicem and Duo-Link. The volumes of voids within the cements were analysed by micro-computed tomography (micro-CT). The bond strength was then measured using a push-out test with an Instron universal testing machine. The failure modes were evaluated. Statistical analyses were performed using a three-way anova, Tukey's post hoc, Pearson's correlation and chi-square test (P = 0.05). RESULTS: The push-out bond strength values were significantly affected by root canal region, post type and cement type (P < 0.001). Root canal region, post type and cement type also significantly affected void volume (P < 0.001). There was a significant interaction between post type and cement type (P < 0.001). The most frequent failure type was adhesive failure in all the groups. There was no significant correlation between the push-out bond strength and void volume (P > 0.05). CONCLUSIONS: Void volume did not affect push-out bond strength of oval and circular posts luted in oval canals.

A retrospective analysis of prevalence and characteristics of pre-eruptive intracoronal resorption in unerupted teeth of the permanent dentition: a multicentre study.

AIM: This multicentred study aimed to investigate the prevalence of pre-eruptive intracoronal resorption (PIR) in unerupted teeth of the permanent dentition using a large sample of panoramic radiographs of a Turkish population. METHODOLOGY: Records of 28 612 patients from three cities in the different regions of Turkey were screened retrospectively in this multicentred study. Patient records and panoramic radiographs were evaluated by three oral and maxillofacial radiologists in the sites. The following data were recorded: age, gender, number of unerupted teeth, number of teeth showing intracoronal resorption, affected tooth type and number of intracoronal resorptions in each case. RESULTS: Overall, 5554 patients had at least one unerupted tooth in 28 612 patients, with a prevalence of 19.4%. Of the 5554 patients screened, 2267 were female and 3287 were male. Intracoronal resorption was observed in 40 of 5554 subjects, with a frequency of 0.7%. The mean age of the patients was 35.9 years. CONCLUSION: Pre-eruptive intracoronal resorption defects occurred in 40 subjects. Increased awareness and careful radiographic examination of unerupted teeth may improve early detection and treatment of PIR defects.

The effects of α-lipoic acid on immature rats with traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality during childhood. TBI enhances formation of reactive oxygen species that cause neuron damage and apoptosis. α-Lipoic acid (LA) is a free radical scavenger and biological antioxidant. We investigated the effects of LA treatment on the parietal and prefrontal cortex, and on the hippocampal regions of the brain in 7-day-old rat pups that had been subjected to contusion injury. Forty-two male rats were divided randomly into a control group, a TBI group and a TBI + LA treated group. LA was administered 30 min after TBI through an intragastric tube once daily for 2 days. Forty-eight hours after TBI, the animals were sacrificed and tissues were examined for apoptosis and density of neurons. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) and active caspase-3 immunostaining were used to detect apoptosis. Glutathione peroxidase (GPx), superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels also were measured. Histological evaluation showed that LA treatment significantly reduced TBI-induced neuronal death in the hippocampus, prefrontal and parietal cortex; TUNEL- and caspase-3-positive cells also were decreased in the same regions. In addition, LA administration increased GPx and SOD activity in the prefrontal cortex. It appears that LA may be beneficial for TBI in rats.

Primary double teeth and their effect on permanent successors.

AIM: Understanding the effects of primary double tooth (PDT) on permanent successors is important to ensure healthy permanent occlusion and aesthetics. The aim of this study is to determine the prevalence and type of PDT, their effect on permanent successors, and the accompanying dental anomalies/pathologies in a Turkish population. MATERIALS AND METHODS: Study design: The records of 63 PDTs in 54 healthy Caucasian children among 10,000 patients were investigated. PDTs were classified according to Aguilo's classification. RESULTS: The prevalence of PDT was 0.6%. Of the 63 PDTs, 14.3% were type I, 11.1% were type II, 31.7% were type III, and 41.3% were type IV; one (1.6%) was a triple tooth. Aplasia of the permanent lateral incisor was observed most frequently in association with type I (56%) PDT. All PDTs associated with a supernumerary permanent tooth were type IV. Dental anomalies/pathologies such as odontoma, talon cusp were observed. Caries involvement was observed most frequently in type IV (58.3%) PDT. STATISTICS: The chi-squared test was used to determine whether successor aplasia depended on PDT type, and contingency coefficients (%) were calculated to determine the degree of association between aplasia and PDT type. CONCLUSION: Clinicians should assess PDT clinically and radiographically to determine whether they are associated with aplasia of permanent lateral incisors (type I) or supernumerary permanent teeth (type IV). Type IV of PDT should be sealed with sealant or resin.

The multidisciplinary management of a fused maxillary central incisor with a talon cusp.

BACKGROUND: A fused maxillary incisor required complex multidisciplinary treatment to preserve health and restore aesthetics. This report presents a rare case of a dental fusion between the maxillary right central incisor and a supernumerary tooth of a 9-year-old male patient with the chief complaint of the presence of a large anterior tooth. METHODS: Radiographic investigation and computerized tomography indicated there was no connection between pulp chambers. After dividing the crown with a diamond bur, the supernumerary tooth was removed and the diastema between the maxillary central incisors was closed by orthodontic treatment. The tooth was then restored with composite resin. RESULTS: The maxillary right central incisor was still healthy after a follow-up examination period of 24 months. CONCLUSIONS: A multidisciplinary approach with the cooperation of different practitioners can contribute to the success of a treatment plan.

Toll-like receptors and skin.

Toll-like receptors are important pattern recognition receptors which have key roles in both innate and adaptive immune responses. They are strongly associated with the pathogenesis of inflammatory and autoimmune diseases. Furthermore, Toll-like receptors have also been implicated in the pathogenesis of several skin diseases such as skin infections, psoriasis, acne vulgaris, lichen planus, Behçet's disease, leprosy, syphilis, Lyme disease, atopic dermatitis and allergic contact dermatitis, mycosis fungoides, non-melanoma skin cancers and melanoma. In this manuscript, the structure and functions of Toll-like receptors in immune responses, their impact on skin diseases and recent advances on therapeutic usage have been reviewed.

Karyological features of wild and cultivated forms of myrtle (Myrtus communis, Myrtaceae).

Myrtle is an evergreen shrub or small tree widespread throughout the Mediterranean region. In Turkey, both cultivated and wild forms, differing in plant and fruit size and fruit composition, can be found. These differences may have resulted from the domestication of the cultivated form over a long period of time. We investigated whether wild and cultivated forms of myrtle differ in karyological features (i.e., number of somatic chromosomes and relative genome size). We sampled two wild forms and six cultivated types of myrtle. All the samples had the same chromosome number (2n = 2x = 22). The results were confirmed by 4',6-diamidino-2-phenylindole (DAPI) flow cytometry. Only negligible variation (approximately 3%) in relative fluorescence intensity was observed among the different myrtle accessions, with wild genotypes having the smallest values. We concluded that despite considerable morphological differentiation, cultivated and wild myrtle genotypes in Turkey have similar karyological features.

Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters.

PURPOSE: To determine whether altered eating habits and periods, especially the pre-dawn meal, during Ramadan fasting have any significant effect on intraocular pressure (IOP), tear secretion, corneal and anterior chamber parameters. METHODS: IOP, basal tear secretion (BTS), reflex tear secretion (RTS), and Pentacam measurements of 31 healthy volunteers were performed at 0800 and 1600 hours during Ramadan fasting and 1 month later during non-fasting period. RESULTS: Comparison of measurements between fasting and non-fasting periods at 0800 hours revealed significantly higher values for IOP (P=0.005), RTS (P=0.006), and BTS (P=0.014) during fasting. Conversely at 1600 hours, IOP was significantly lower during fasting (P=0.013) and no statistically significant difference was noted for RTS and BTS. IOP showed a diurnal variation of 2.45 mmHg (P<0.001) and BTS showed a 3.06 mm decrease (P=0.04) during the fasting period. No significant differences could be found in the corneal and anterior chamber parameters during fasting and non-fasting periods. CONCLUSIONS: Our results revealed that fluid loading at the pre-dawn meal during Ramadan fasting might increase the IOP and tear secretion in the early morning period and these values decrease remarkably at the end of 12 h of fasting due to dehydration.

Review of fundus autofluorescence in choroidal melanocytic lesions.

Fundus autofluorescence (FAF) imaging takes advantage of the fluorescent properties of some molecules, especially lipofuscin. FAF derives mainly from retinal pigment epithelium (RPE) and Bruch's membrane. Using confocal scanning laser ophthalmoscope (cSLO) we have previously shown that FAF associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) within the RPE. Other causes of FAF include hyperpigmentation, drusen, or fibrous metaplasia probably because they also cause lipofuscin accumulation in the overlying RPE. There is a total or partial correlation between FAF and the foci of lipofuscin and hyperpigmentation in about 90% of the cases. The FAF patterns of choroidal melanocytic lesions were classified as patchy or diffuse. The patchy pattern was defined as the presence of distinct areas of increased FAF between areas of normal autofluorescence. The diffuse pattern was characterized by the presence of increased FAF with indistinct borders over a larger part (>50%) of the tumour in the absence of such intervening areas. Choroidal melanomas presented with either a diffuse or patchy pattern, whereas choroidal naevi demonstrated only the patchy pattern. Diffuse FAF pattern was more often associated with larger choroidal melanomas as well as with early venous and late hyperfluorescence on fluorescein angiography. Limitations of these observations depend on the field of depth of cSLO; thus, FAF from other planes could not be detected. Increased retinal thickness, intraretinal oedema, or presence of subretinal fluid may also affect the FAF signal.

Well-circumscribed orbital venous-lymphatic malformations with atypical features in children.

AIM: To report well-circumscribed orbital lymphatic-venous malformations (VLMs) with atypical clinical, imaging and pathological features in four paediatric patients. METHODS: Retrospective non-comparative case series of four patients aged 5-18 years old having a well-circumscribed orbital mass diagnosed histopathologically as orbital VLM. All patients underwent orbitotomy and total excision of the VLM. Pre- and postoperative visual acuity, proptosis and globe displacement produced by the orbital VLM, MRI findings, histopathological features, treatment, follow-up and prognosis were evaluated. RESULTS: No proptosis, visual acuity change or globe displacement was induced by the orbital VLM. One lesion was located superiorly, one medially and two inferonasally. On MRI, the orbital VLMs were isointense on T1-weighted images and hyperintense on T2-weighted images, demonstrated moderate contrast enhancement and had a heterogenous internal structure. Signal void areas and fluid-fluid levels were not observed on MRI. At a mean follow-up of 50 months, all patients remained free of recurrence clinically and retained preoperative visual acuities. Several histopathological features of the excised lesions supported an initial diagnosis of cavernous haemangioma, but the lesions were subsequently rediagnosed as orbital VLM when aggregates of lymphocytes and randomly arranged smooth muscle were noted. CONCLUSIONS: Well-circumscribed orbital VLMs in children can display atypical clinical, imaging and pathological features. MRI features of this entity are not characteristic of typical orbital VLMs. It may be possible to totally excise well-circumscribed orbital VLMs as in this series of four patients. Careful histopathological evaluation indicates the correct diagnosis.

Changes in fundus autofluorescence of choroidal melanomas following treatment.

PURPOSE: We have previously shown that fundus autofluorescence (FAF) associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) but also to hyperpigmentation, drusen, or fibrous metaplasia. The purpose of this study is to describe the effects of treatment on FAF in choroidal melanomas after plaque radiotherapy alone or in combination with transpupillary thermotherapy (TTT). METHODS: Retrospective chart review of eight consecutive patients with choroidal melanoma treated with plaque radiotherapy alone or in combination with TTT who underwent FAF photography before and after treatment. The correlation between FAF patterns and foci of orange pigment, hyperpigmentation, drusen, or fibrous metaplasia was evaluated. RESULTS: The median follow-up time was 4 (range 2-9) months. Foci of orange pigment and hyperpigmentation became larger and more numerous after treatment. Fibrous metaplasia was also increased. A complete correlation between increased FAF and orange pigment was found in all eight tumours (100%) before and after treatment. No correlation between hyperpigmentation and increased FAF was found before treatment but a partial correlation was found in all eyes after treatment. Before treatment, correlation between fibrous metaplasia was present in three eyes and increased FAF was partial in two eyes with no correlation in one case. After treatment, this correlation was partial in all presenting eyes (7). CONCLUSIONS: Following treatment, choroidal melanomas may show increased FAF, mainly due to an increase in the amount of lipofuscin (orange pigment) and hyperpigmentation.

Virulence factors and antimicrobial susceptibility of Escherichia coli isolated from calves in Turkey.

Escherichia coli isolates from calves were investigated by multiplex PCR assays for the presence of genes encoding K99, F41, F17-related fimbriae, heat-stabile enterotoxin a (STa), intimin (eae) and Shiga toxins (stx1 and stx2). A total of 120 E. coli isolates, 75 isolated from diarrhoeic or septicemic calves and 45 from clinically healthy calves aged between 1 day and 2 months were tested. Each isolate was obtained from different calves in different herds. Among the isolates from diseased animals, 12 (16%) isolates from 1- to 7-day-old diarrhoeic calves were detected as enterotoxigenic E. coli which possessed K99, F41 and STa in combination; F17-related fimbriae genes were detected in 33 (44%) isolates and they were found in combination with K99 + F41 + STa in two isolates. Of 120 isolates, 16 carried eae, eight stx1 and five stx2 genes alone or in combination. None of the eae- or stx-positive strains was identified as O157:H7. However, results indicate that calves may be carrier of Shiga toxin-producing E. coli which have potential as a human pathogen. Antimicrobial susceptibility of 75 isolates from diseased calves was determined by agar disk diffusion method for 14 antimicrobial agents. In 77.3% of the isolates, multiresistance was detected. Higher resistance rates were detected for cephalothin (72%), tetracycline (69.3%), kanamycin (69.3%), ampicillin (65.3%), nalidixic acid (53.3%), trimethoprim-sulphamethoxazole (52%) and enrofloxacin (41.3%), respectively. No resistance was found for ceftiofur and cefoxitin.

Intravitreal bevacizumab for macular oedema secondary to branch retinal vein occlusion.

PURPOSE: To report short-term results of intravitreal bevacizumab (IVB) injection for macular oedema (ME) associated with branch retinal vein occlusion (BRVO). METHODS: Retrospective interventional case series of 12 eyes of 12 consecutive patients. IVB injections (1.25 mg/0.05 ml) were given as needed based on the presence of ME on optical coherence tomography. Changes in Snellen visual acuity (VA) and central macular thickness (CMT) were analysed using the Student's paired t-test. RESULTS: At a mean follow-up of 9.8 months (range: 6-17 months), the mean number of IVB injections given was 4 (range: 1-6). No ocular or systemic side effects were noted. The differences in logMAR VA between baseline and 1 month, between baseline and 6 months, and between baseline and final follow-up were statistically significant (P<0.05). The differences in CMT between baseline and 1 month, baseline and 6 months, and between baseline and final follow-up were also statistically significant (P<0.05). CONCLUSION: Short-term results indicate that IVB is useful in decreasing ME and improving VA in eyes with BRVO.

Field evaluation of a PCR for the diagnosis of chlamydial abortion in sheep.

A total of 94 vaginal swab samples and 195 serum samples collected from aborted ewes in 15 flocks were examined by pcr and a complement fixation test, respectively. In addition, 172 samples of stomach contents from fetuses from different flocks submitted for the diagnosis of abortion during the four lambing periods between 2000 and 2004 were tested by pcr. Chlamydial dna was detected in seven vaginal swabs obtained from five of the 15 flocks and in six samples of fetal stomach contents. The results of pcr and flock serology for Chlamydia were positive in five of the 15 flocks and negative in eight.