Alternative material recommendation for facade cladding: High silica-containing stonepaste ceramics.

This study investigated the potential of using stonepaste ceramics, which were widely preferred as a coating and decoration material on the facades of architectural buildings in ancient times and continues to be produced on a workshop scale today as a cladding material on building facades. Stonepaste ceramics, made from a mixture prepared with a high amount of crystalline quartz as well as frit, plastic clay, and bentonite raw materials, were hand-shaped and sintered at 930 °C after glazing. The physico-mechanical properties of stonepaste ceramics, their behaviour under various environmental conditions (resistance to chemicals, frost, and thermal shock), and their microstructures have been characterized. The characterization results were compared with the properties of commonly used facade cladding materials. It was determined that stonepaste ceramics had a very low firing shrinkage value (2.84 %) compared to that of other ceramic cladding materials, a higher water absorption value (11.79 %) than that of porcelain tiles and floor tiles, and close to wall tiles, and a flexural strength value (33.64MPa) higher than wall tiles and close to porcelain tiles despite the high-water absorption value. Ten cycles of thermal shock resistance showed that the body and glaze layer of the stonepaste ceramic material are well bonded to each other, and there is no significant thermal expansion mismatch between them. One hundred cycles of freeze-thaw conditions indicated that the stonepaste ceramic had good adhesion and thermal expansion compatibility between the glaze and the body but only chipping damage under the action of tensile forces caused by the freezing of water entering the pores of the body. In terms of behaviour against various chemicals, stonepaste ceramics were found to be highly resistant to high and low concentrations of household chemicals, swimming pool salts, and alkalis but less resistant to low concentrations of HCl and citric acid and high concentrations of HCl and lactic acid compared to other chemicals. The results show that stonepaste ceramics, despite their high-water absorption potential, have properties close to those of traditional ceramic tiles and, like these materials, can serve for significant periods in various environmental conditions when used as facade cladding. Consequently, it has been revealed that stonepaste ceramics can be used as a facade cladding material in sustainable, long-lasting, contemporary architectural facades thanks to their technical and protective properties.

Treatment Results of Multidrug-Resistant Tuberculosis Patients in the Aegean Region.

OBJECTIVE: We aimed to evaluate 109 rifampicin-resistant or multidrug-resistant tuberculosis patients who are treated in Izmir Chest Diseases MDR Tuberculosis Centre. MATERIAL AND METHODS: The patient profile, side effects, treatment success, and mortality of rifampicin-resistant or multidrugresistant tuberculosis patients who were followed up and treated in our hospital's tuberculosis service between 2010 and 2018 were analyzed retrospectively. RESULTS: Of the rifampicin-resistant or multidrug-resistant tuberculosis patients, 83 (76.1%) were male and the mean age was 46.3 ± 16.3 years. Of the cases 13 (11.9%) had rifampicin resistance without isoniazid. Since 5 out of 109 patients diagnosed with multidrugresistant tuberculosis emigrated to other countries, the treatment results of 104 patients were evaluated. As a result of the treatment, the cure was achieved in 81 (77.9%) patients and treatment was completed in 13 (12.5%). Treatment success was found as 90.4%. No patient experienced recurrence. The mortality rate was determined as 9.6%. The cure rate of patients treated with ≥6 drugs (90.9%) was statistically significantly (P = .029) higher than the group treated with ≤5 drugs (71.8%). CONCLUSIONS: Multidrug-resistant tuberculosis treatment is a long-term, financially burdensome practice that may cause serious side effects and complications, and it requires strict discipline. The fight against tuberculosis can be successful with tuberculosis control programs that are pursued with determination.

Disseminated tuberculosis infection and paradoxical reaction during antimycobacterial treatment related to TNF-alpha blocker agent Infliximab.

Tumor necrosis factor (TNF)-alpha inhibitors play an important role in the treatment of immun-mediated diseases such as Crohn's disease. But they also have been related to increased risk for disseminated Mycobacterium tuberculosis infections and paradoxical response to antimycobacterial treatment. Here we report a disseminated tuberculosis case and a paradoxical response to treatment after receiving TNF-inhibitor agent Infliximab for Crohn's disease. The patient had a severe clinical condition before the antimycobacterial treatment and although proper treatment was initiated his radiological findings were worsened one month after initiation of the treatment. All control microbologic tests for secondary infections were negative and this situation was accepted as a paradoxical response to antimycobacterial treatment and treatment was continued with the same regimen. At the end of the second month of the treatment, most of the symptoms disappeared and chest radiograph findings were better than the previous one. In conclusion, TNF-alpha inhibitor therapy increases risk of mycobacterial infections and patients should be examined carefully about tuberculosis before starting this therapy. Also, it is important for physicians to recognize and know how to manage paradoxical response related to TNF-alpha inhibitors during anti-tuberculosis treatment.