Noninvasive ventilation with nursing perspective: Impacts on patient tolerance, short-term adverse effects, and nursing workload.

BACKGROUND: The success of noninvasive ventilation (NIV) treatment is closely related to high levels of clinical support. AIMS: In this study, we sought to analyze patient mask compliance and minor side effects and to evaluate additional nursing workload needed for the NIV care. MATERIALS AND METHODS: The study was designed as a prospective and observational. The data were collected from an intensive care unit. Clinical and physiological data, patient tolerance and adverse effects, subjects' complaints about their experience, and additional nursing workload associated with NIV treatment were assessed. RESULTS: Statistically significant improvements were obtained in arterial blood gas analysis, respiratory rate, and heart rate during treatment. In the first 2 h, 65% of subjects had poor mask compliance, patients' comfort scores were poor, and incompliance was associated with discomfort. The ratio of skin problems was 15% in the first 24 h and reached 60% at 48 h. The pain rate due to mask ties was 80% and then increased to 90% at 48 h. There was a significant relationship between the problems detected by the nurses and problems described by the subjects. Additional nursing workload was found as 110 min for 0-6 h. CONCLUSIONS: We observed that the mask compliance and comfort levels of the subjects were poor. Skin breakdowns increased depending on the duration of treatment. Treatment would require continuous nursing support in seven areas. NIV treatment generated a significant amount of workload for nurses. Additional nursing workforce planning is required for NIV units for successful NIV treatment.

Production of oils and fats by oleaginous microorganisms with an emphasis given to the potential of the nonconventional yeast Yarrowia lipolytica.

Recently, there has been a great upsurge of interest in studies related to several aspects of microbial lipid production, which is one of the top topics in relevant research fields due to the high demand of these fatty materials in food, medical, oleochemical and biofuel industries. Lipid accumulation by the so-called "oleaginous microorganisms" can generate more than 20% w/w of oil in dry biomass and is governed by a plethora of parameters, such as medium pH, incubation temperature, nutrient limitation and C/N (carbon/nitrogen) ratio, which drastically affect the lipid production bioprocess. Until now, considerable work has been undertaken to find the cheapest substrate to enable lipid fermentation by oleaginous microorganisms. This review principally details information regarding microbial lipids, suitable production conditions and focuses attention on using the yeast Yarrowia lipolytica to achieve these objectives. Lipid production by this yeast is discussed and the necessary conditions and suitable substrates are reviewed.

Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers

Recurrent aphthous ulcer (RAU) is an inflammatory condition of the oral mucosa characterized by painful, well-circumscribed, single or multiple round or ovoid ulcerations. The exact etiologic factor(s) of these ulcerations are not yet understood. The objective of this study was to evaluate inflammatory processes and free radical metabolism of 25 patients with RAUs compared to 25 healthy controls. The levels of malondialdehyde (MDA) and glutathione (GSH) were determined by high-performance liquid chromatography. Tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), IL-10, and IL-12 were determined by ELISA. Nitric oxide (NO), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidant status (TOS) levels were measured spectroscopically in serum. The levels of MDA, GSH, TNF-α, IL-2, IL-12, MPO, and TOS, and oxidative stress index (OSI) were higher, and the levels of NO, IL-10, and TAS were lower in patients with RAU than in controls. Statistical analysis showed that GSH, TNF-α, IL-2, IL-10, and OSI differed significantly in patients with RAU compared to controls. These parameters have important roles in oxidant/antioxidant defense.

Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers.

Recurrent aphthous ulcer (RAU) is an inflammatory condition of the oral mucosa characterized by painful, well-circumscribed, single or multiple round or ovoid ulcerations. The exact etiologic factor(s) of these ulcerations are not yet understood. The objective of this study was to evaluate inflammatory processes and free radical metabolism of 25 patients with RAUs compared to 25 healthy controls. The levels of malondialdehyde (MDA) and glutathione (GSH) were determined by high-performance liquid chromatography. Tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), IL-10, and IL-12 were determined by ELISA. Nitric oxide (NO), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidant status (TOS) levels were measured spectroscopically in serum. The levels of MDA, GSH, TNF-α, IL-2, IL-12, MPO, and TOS, and oxidative stress index (OSI) were higher, and the levels of NO, IL-10, and TAS were lower in patients with RAU than in controls. Statistical analysis showed that GSH, TNF-α, IL-2, IL-10, and OSI differed significantly in patients with RAU compared to controls. These parameters have important roles in oxidant/antioxidant defense.

Relationship between trait anxiety, dental anxiety and DMFT indexes of Turkish patients attending a dental school clinic.

The aims of this study were to evaluate possible relationships between trait anxiety, dental anxiety and the total number of decayed, missing and filled teeth (DMFT) index of patients attending a dental school clinic. A sample of 558 patients was surveyed with the Turkish version of the Spielberger Trait Anxiety Inventory and Dental Anxiety Scale. DMFT index was calculated by clinical and radiographic examination. A significant linear correlation was observed between trait and dental anxiety, but there was no correlation between DMFT index, trait anxiety and dental anxiety. Trait anxiety has an impact on dental anxiety, but does not affect the DMFT index.

Reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire.

The aim of this study was to evaluate the reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire. Forty-three patients with gagging problems and 89 patients who showed no signs of gagging during dental examination were included in the study. The patients completed the patient portion of the gagging problem assessment questionnaire, as well as the modified dental anxiety scale, dental fear scale and Spielberger trait anxiety scale for comparison. Two experienced dentists subsequently completed the dentist portion of the gagging problem assessment questionnaire by performing clinical examinations with a dental mirror. The results indicate that patients with gagging problems had significantly higher mean scores than the control group (P < 0.001). The internal consistency of the questionnaire was found to be adequate, and good intra- and inter-observer reliability was present. Patients with a gagging reflex had significantly higher anxiety scores, indicating the validity of the questionnaire. The Turkish translation of the shorter form of the gagging problem assessment questionnaire was found to be reliable and valid for distinguishing among patients with and without a gagging reflex.

Influence of Williopsis saturnus yeasts in combination with Saccharomyces cerevisiae on wine fermentation.

AIM: To examine the growth and survival of Williopsis saturnus strains along with wine yeast Saccharomyces cerevisiae in grape must. METHODS AND RESULTS: For this study, fermentations were performed in sterilized grape must at 18 degrees C. Inoculum level was 5 x 10(6) cells per ml for each yeast. The results showed that W. saturnus yeasts exhibited slight growth and survival depending on the strain, but they died off by day 5. Saccharomyces cerevisiae, however, dominated the fermentation, reaching the population of about 8 log CFU ml(-1). It was observed that ethanol formation was not affected. The concentrations of acetic acid, ethyl acetate and isoamyl acetate were found higher in mixed culture experiments compared to control fermentation. The results also revealed that higher alcohols production was unaffected in general. CONCLUSION: Fermentations did not form undesirable concentrations of flavour compounds, but production of higher levels of acetic acid in mixed culture fermentations may unfavour the usage of W. saturnus in wine making. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides information on the behaviour of W. saturnus together with S. cerevisiae during the alcoholic fermentation.

Relationship between trait anxiety, dental anxiety and DMFT indexes of Turkish patients attending a dental school clinic

The aims of this study were to evaluate possible relationships between trait anxiety, dental anxiety and the total number of decayed, missing and filled teeth [DMFT] index of patients attending a dental school clinic. A sample of 558 patients was surveyed with the Turkish version of the Spielberger Trait Anxiety Inventory and Dental Anxiety Scale. DMFT index was calculated by clinical and radiographic examination. A significant linear correlation was observed between trait and dental anxiety, but there was no correlation between DMFT index, trait anxiety and dental anxiety. Trait anxiety has an impact on dental anxiety, but does not affect the DMFT index

Sorption of radioactive cesium and barium ions onto solid humic acid.

In this study, the sorption behavior of two important fission product radionuclides ((137)Cs and (140)Ba) onto sodium form of insolubilized humic acid (INaA) were investigated as a function of time, cation concentration and temperature, utilizing the radiotracer method. The sorption processes are well described by both Freundlich and Dubinin-Radushkevich type isotherms. Thermodynamic constants such as; free energy (DeltaG(ads)), enthalpy (DeltaH(ads)), entropy (DeltaS(ads)) of adsorption were determined. It was found that Ba(2+) was adsorbed five times more than Cs(+) onto structurally modified humic acid and kinetic studies indicated that adsorption behavior of both ions obey the pseudo second order rate law. The effect of pH change on sorption was also examined. FTIR and solid-state carbon NMR ((13)CNMR) spectroscopic techniques were used to understand the structural changes during insolubilization process. Quantitative determination of adsorption sites was carried out using potantiometric titration.

A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximal caries detection in posterior teeth.

OBJECTIVES: The aim of this study was to investigate the diagnostic accuracy of conventional bitewing, periapical radiographs, unfiltered and filtered digital panoramic images for the assessment of approximal carious lesions in posterior teeth. METHODS: 20 patients who required bitewing, periapical and panoramic radiographs participated in the study. The digital panoramic images were treated with the "sharpen", "smooth" and "emboss" filters. Three experienced observers evaluated the bitewing and periapical radiographs, and the unfiltered and filtered digital panoramic images for the presence or absence of approximal carious lesions according to a 5-point confidence scale. Intra- and interobserver reliability was analysed with the Cronbach alpha test and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: According to the results, the intra- and interobserver agreement levels were found to be almost perfect. The highest diagnostic accuracy was found for the bitewing, followed by the periapical and panoramic images. Compared with the unfiltered panoramic images, the filtered images had an almost equal or slightly higher diagnostic accuracy. The largest increase in diagnostic accuracy was observed for those images filtered with the emboss filter. CONCLUSIONS: The accuracy of unfiltered and filtered digital panoramic images is lower than conventional bitewing and periapical radiographs. The filtration of the digital panoramic images, especially the emboss filter, may have some value for the detection of approximal carious lesions.

A fatty tissue lesion of the floor of the mouth mimicking an odontogenic lesion.

The floor of the mouth is a rare location for fatty tissue lesions. These lesions could cause resorption of the adjacent bone and lead to a radiolucent appearance on radiographs. In this case report, a non-capsulated lesion composed of mature adipose tissue located on the floor of the mouth causing a well-circumscribed oval radiolucent lesion close to the roots of the molar teeth due to resorption of mandible in a 33-year-old woman is reported.

Possible role of the adhesin ace and collagen adherence in conveying resistance to disinfectants on Enterococcus faecalis.

INTRODUCTION: This study aimed to evaluate whether the presence of the ace gene and Ace-mediated binding to collagen confers on Enterococcus faecalis resistance against common endodontic disinfectants. METHODS: Isogenic strains of E. faecalis: OG1RF (wild-type) and TX5256 (ace insertion mutant of OG1RF) were grown in brain-heart infusion broth at 46 degrees C overnight. Standardized bacterial suspensions were pretreated for 1 h either with acid-soluble collagen or acidified phosphate-buffered saline (ac-PBS). Bacteria were challenged with chlorhexidine digluconate (CHX), iodine potassium-iodide (IKI), sodium hypochlorite (NaOCl), and calcium hydroxide [Ca(OH)(2)]. Samples were removed at 1, 3, and 6 h, and cultured on Todd-Hewitt agar plates. Colonies were counted, the absolute values were log transformed, and the data were statistically analyzed using Fisher's least significant differences test and t-test. RESULTS: OG1RF was more resistant than TX5256 to IKI, NaOCl, and Ca(OH)(2) (P < 0.05). Collagen-exposed OG1RF was more resistant than the ac-PBS-pretreated OG1RF against CHX at 3 h and against IKI at 1 h (P < 0.05); no significant difference was found against NaOCl. As expected, the ace mutant strain, TX5256, pretreated with collagen or ac-PBS did not differ significantly in viability when challenged with CHX, IKI, and NaOCl. An unexpected result was found for Ca(OH)(2): collagen-pretreated OG1RF and TX5256 were both more susceptible than ac-PBS-pretreated OG1RF and TX5256, respectively (P < 0.05). CONCLUSION: The presence of the ace gene confers resistance against IKI, NaOCl, and Ca(OH)(2) on E. faecalis. Exposure to collagen makes the wild-type bacterium more resistant against CHX and IKI; however, exposure to collagen apparently decreases resistance to Ca(OH)(2).

A radiotracer study of the adsorption behavior of aqueous Ba(2+) ions on nanoparticles of zero-valent iron.

Recently, iron nanoparticles are increasingly being tested as adsorbents for various types of organic and inorganic pollutants. In this study, nanoparticles of zero-valent iron (NZVI) synthesized under atmospheric conditions were employed for the removal of Ba(2+) ions in a concentration range 10(-3) to 10(-6) M. Throughout the study, (133)Ba was used as a tracer to study the effects of time, concentration, and temperature. The obtained data was analyzed using various kinetic models and adsorption isotherms. Pseudo-second-order kinetics and Dubinin-Radushkevich isotherm model provided the best correlation with the obtained data. Observed thermodynamic parameters showed that the process is exothermic and hence enthalpy-driven.

The precision of the panoramic mandibular index.

OBJECTIVES: This study evaluates the precision of the panoramic mandibular index (PMI). MATERIALS AND METHODS: Measurements were made by two observers on both of the left and right sides of the mandible on the radiographs taken from 41 young individuals and the inferior and superior PMI were calculated. Two weeks later the same observers repeated their measurements to assess intrarater reliability. Paired t-test, Pearson correlation coefficients and precision values were calculated to assess levels of association. RESULTS: There was a significant difference between the first rater's first and second measurements (intrarater repeatability) for both the inferior and superior PMI, while no significant difference was observed for the second rater. The intrarater and inter-rater precision values for the inferior PMI were calculated as 0.005319 and 0.005594 for the first rater and 0.005663 and 0.005594 for the second, respectively. The intrarater and inter-rater precision values for the superior PMI were similar for both observers, calculated as 0.002558, 0.002766; and 0.003046, 0.002766, respectively. The precision of both inferior and superior indices was not very good, but precision figures for the superior PMI demonstrated consistency almost twice better than those for the inferior PMI for both observers. CONCLUSIONS: The precision values for the PMI seem to be sufficient according to the results of this study, but they are still questionable and more studies need to be done on this aspect.

A characterization study of some aspects of the adsorption of aqueous Co2+ ions on a natural bentonite clay.

The natural bentonite used in this study contained montmorillonite in addition to low cristobalite. The uptake of aqueous Co(2+) ions was investigated as a function of time, concentration, and temperature. In addition, the change in the interlayer space of montmorillonite was analyzed using XRPD, and the distribution of fixed Co(2+) ions on the heterogeneous clay surface was recorded using EDS mapping. The sorbed amount of Co(2+) appeared to closely follow Freundlich isotherm, with the sorption process showing apparent endothermic behavior. The relevance of the apparent DeltaH(o) values is briefly discussed. Analysis of the Co-sorbed bentonite samples using SEM/EDS showed that the montmorillonite fraction in the mineral was more effective in Co(2+) fixation than the cristobalite fraction. XRPD analysis demonstrated that the interlayer space of montmorillonite was slightly modified at the end of sorption.

Short-term antibacterial activity of root canal sealers towards Enterococcus faecalis.

AIM: To investigate the antimicrobial activity of root canal sealers on Enterococcus faecalis, either allowing or avoiding direct contact between sealers and bacteria. METHODOLOGY: Filter paper discs were immersed in standardized E. faecalis suspensions and exposed to freshly mixed sealers (MCS, AH Plus, Grossman's sealer, Sealapex, Apexit) in teflon wells for 30 min, with or without a filter membrane placed between filter paper discs and sealers (membrane-restricted contact test and direct contact test, respectively). After exposure, the filter paper discs were transferred to vials containing phosphate-buffered saline (PBS) and glass beads, and vigorously vortexed. PBS with resuspended bacterial cells was serially diluted and 25 microL droplets were seeded on TSA plates. The plates were incubated in air at 37 degrees C for 24 h and colony-forming units were counted. Using alpha = 0.05 as level for statistical significance, the data obtained were analysed using Student's t-test. RESULTS: In the direct contact test, MCS and AH Plus killed the bacteria to a level below the detection limit. They were followed in decreasing order of efficacy by Grossman's sealer, Sealapex and Apexit. In the membrane-restricted contact test, the sealers ranked: MCS, AH Plus, Grossman's sealer, Apexit and Sealapex, in descending order of antibacterial potency. MCS, AH Plus and Grossman's sealer significantly reduced the number of viable bacteria in both tests. Sealapex and Apexit were not statistically different from control. CONCLUSIONS: MCS, AH Plus and Grossman's sealer were effective in reducing the number of cultivable cells of E. faecalis. Calcium hydroxide-based sealers, Sealapex and Apexit were ineffective in this short-term experiment.

Growth at high pH increases Enterococcus faecalis adhesion to collagen.

AIM: To evaluate the effect of growth at pH levels from 7.1 to 9.5 on the adherence of Enterococcus faecalis to bovine serum albumin (BSA) and collagen type I. METHODOLOGY: Enterococcus faecalis strain A197A was grown in broth of adjusted pHs varying between 7.1 and 9.5. Aliquots of bacterial suspensions were added to wells coated either with BSA or with collagen type I. Bacteria adhering to the surfaces were stained with crystal violet. Spectrophotometric measurements of the dissolved stain were used to assess the number of bacteria adhering to the surfaces. The data obtained were analysed using the Kolmogorov-Smirnov test, Levene's test and Student's t-test, with alpha = 0.05 as the level for statistical significance. RESULTS: The adhesion of E. faecalis to BSA-coated surfaces decreased inversely with alkalinity of the growth medium. The pH 7.1-grown bacteria bound to BSA significantly more than the other BSA groups. On the contrary, the adhesion to collagen type I-coated surfaces of bacteria grown at pH 8.0 and 8.5 was significantly greater than for those grown at pH 7.1. CONCLUSIONS: A minor increase in pH up to 8.5, which may be a consequence of insufficient treatment with alkaline medicaments such as calcium hydroxide, increases the collagen-binding ability of E. faecalis, in vitro. This can be a critical mechanism by which E. faecalis predominates in persistent endodontic infections.

ToF-SIMS depth profiling analysis of the uptake of Ba2+ and Co2+ ions by natural kaolinite clay.

The sorption behavior of Ba(2+) and Co(2+) ions on a natural clay sample rich in kaolinite was studied using time-of-flight secondary ion mass spectrometry (ToF-SIMS). Depth profiling at 10-A steps was performed up to a 70-A matrix depth of the clay prior to and following sorption. The results showed that Co(2+) is sorbed in slightly larger quantities than Ba(2+), with significant numbers of ions fixed on the outermost surface of the clay. Depletion of the ions K(+), Mg(2+), and Ca(2+) from the clay lattice was observed to accompany enrichment with Co(2+) and Ba(2+) ions. The data obtained using X-ray powder diffraction (XRPD) and scanning electron microscopy (SEM) indicated insignificant structural and morphological changes in the lattice of the clay upon sorption of both Ba(2+) and Co(2+) ions. Analysis using energy dispersive X-ray spectroscopy (EDS) showed that the average atomic percentage (+/-S.D.) of Ba and Co on kaolinite surface were 0.49 +/- 0.11 and 0.61 +/- 0.19 , respectively, indicating a limited uptake capacity of natural kaolinite for both ions.

Influence of Saccharomyces cerevisiae strains on fermentation and flavor compounds of white wines made from cv. Emir grown in Central Anatolia, Turkey.

The effect of inoculation with selected Saccharomyces cerevisiae strains was studied on fermentation and flavor compounds of wines made from Vitis vinifera L. cv. Emir grown in Central Anatolia, Turkey. Flavor compounds were analysed and identified by GC-FID and GC-MS, respectively. The total concentrations of flavor compounds did not increase with the addition of indigenous and commercial wine yeasts, but differences were noted in individual volatile compounds. Cluster and factor analyses of flavor compounds also showed that wines produced were different depending on the wine strain used. Wines were completely fermented to less than 1.4 g/l residual sugar. Yeasts other than S. cerevisiae survived longer than previously reported. Inoculation with selected strains increased the ethanol level.