Investigation of cardiopulmonary parameters, motor development and muscle strength in children with Down syndrome with and without congenital heart disease.

BACKGROUND: Children with Down syndrome (DS) frequently have concomitant clinical problems. There are no studies in the literature evaluating gross motor development and handgrip strength in the presence of congenital heart disease (CHD), which is one of the most common comorbidities in population with DS. The aim of this study was to compare cardiopulmonary parameters, gross motor development and handgrip strength in children with DS with and without CHD. METHODS: A total of 28 children with DS (14 with CHD and 14 without CHD) were evaluated. Demographic data and cardiopulmonary parameters were recorded. Gross motor development and handgrip strength were assessed. RESULTS: Children with DS and CHD had lower GMFM-88 scores and right handgrip strength and higher Wang respiratory score than children with DS and no CHD (P < 0.05). GMFM-88 scores were moderately correlated with resting oxygen saturation (r = 0.46, P = 0.01) and right handgrip strength (r = 0.67, P < 0.001). CONCLUSIONS: Peripheral muscle strength and oxygen saturation may be factors affecting gross motor development in children with DS. From this point of view, evaluating cardiopulmonary parameters, motor development and handgrip strength in children with DS and CHD is important to identify risks, provide early intervention and support development.

The effect of physical activity on mother-child relationship and parental attitudes: a follow-up study examining the long-term effects of COVID-19.

OBJECTIVE: This study was planned to evaluate effects of game-based physical activity model on mother-child relationship and parental attitudes during the prolonged COVID-19 pandemic period. SUBJECTS AND METHODS: This study was designed using a web-based quasi-experimental model with a pre-test/post-test evaluation, with a control group. The mothers who accepted to participate in the study and their children were divided into experimental (group I, n=28) and control groups (group II, n=31). The mothers and children in the experimental group were asked to apply web-based game-based physical activity model for 20 minutes/day for 4 weeks. The online questionnaire included socio-demographic data form, Child Parent Relationship Scale (CPRS), and Parental Attitude Scale (PAS). RESULTS: There were no significant differences between mean scores of pre-test and post-test subscales of the PAS in group I (p>0.05 for all subscales). It was found that post-test scores of democratic subscales of PAS statistically significant decreased (p=0.047) and the authoritarian attitude subscale scores significantly increased (p=0.033) in group II. The mean pre- and post-activity scores of positive/close relationship and conflictual relationship subscales of CPRS differ between groups (p<0.05 for both subscales). Pre-post test scores of group II were found to be significantly lower compared to group II. CONCLUSIONS: Our study provides a moderate improvement in parameters evaluated; however, we suggest that longer-term activities may have a more permanent and statistically significant effect.

Once-Daily Topical Phosphosulindac Is Efficacious in the Treatment of Dry Eye Disease: Studies in Rabbit Models of Its Main Clinical Subtypes.

Purpose: Dry eye disease (DED) is classified as aqueous deficient, evaporative, or mixed. We investigated the therapeutic effect of the novel anti-inflammatory drug phosphosulindac (PS) in rabbit models of DED encompassing its pathogenesis, and its transition to chronicity. Methods: We treated three rabbit models of DED with PS (hydrogel formulation) or vehicle topically applied 1 × /day. We induced aqueous-deficient DED (acute and chronic) by injecting Concanavalin A into lacrimal glands; evaporative DED by injecting into the upper eyelid inactivated Mycobacterium tuberculosis in complete Freund's adjuvant; and mixed DED through desiccative stress, induced by holding open the eye for 3 h. We determined corneal sensitivity, tear break-up time (TBUT), Schirmer's tear test (STT), tear osmolality, and fluorescein staining of the ocular surface. Results: PS reversed all abnormal DED parameters. In acute DED, PS dose dependently normalized corneal sensitivity and tear osmolality; and improved TBUT, STT, and fluorescein staining. PS normalized corneal sensitivity and improved all other parameters in chronic aqueous-deficient DED. In evaporative DED, PS normalized corneal sensitivity and improved TBUT and fluorescein staining (osmolality and STT were not significantly changed in this model). In the desiccative stress model, PS improved TBUT and fluorescein staining but had no effect on STT or tear osmolality. Conclusions: PS rapidly reversed almost all DED parameters in its three subtypes. The normalization of the suppressed corneal sensitivity suggests the possibility of marked symptomatic relief by PS. The hydrogel formulation allows once-daily dosing. PS merits further development as a potential treatment for DED.

Investigation of BK Virus by Real-Time Polymerase Chain Reaction in Patients With Allogeneic Bone Marrow Transplantation.

INTRODUCTION: BK virus (BKV) is a common human polyomavirus and causes latent infection. Especially in immunosuppressive patients, early diagnosis and treatment are very important in reducing the high mortality rate. In this study, we investigated BKV DNA in serum and plasma and urine specimens by real-time polymerase chain reaction (PCR) method in allogeneic hematopoietic stem cell transplantation patients. MATERIALS AND METHODS: BKV DNA was isolated in QIAsymphony SP/AS (Hilden, Germany) equipment using QIAsymphony DSP Virus/Pathogen Midi Kit, Version 1 (QIAGEN, Hilden, Germany) in urine and serum samples collected from 100 patients post-transplantation. Artus BKV QS-RGQ, V1 (Qiagen, Hilden, Germany) kit for BKV PCR was prepared according to the company recommendations and loaded on Qiagen Rotor Gene (Hilden, Germany). It was evaluated with PCR, and >27 copies/mL was considered as positive. RESULTS: BKV DNA was positive in 57% of the urine specimens obtained; only 25% of the patients were found to have a significant BKV burden in the urine according to the American Society of Transplantation, suggesting a risk of developing nephropathy. Serum samples of the same patients were negative for BKV DNA in 94 cases and they were positive for BKV DNA at interval between 44 and 319 copies/mL in 6 patients, and none of the patients had clinically significant BKV DNA in serum samples. CONCLUSIONS: Monitoring the viral load with urine samples were thought to be more convenient for the detection of BKV reactivation in our study.

Combined application of Er:YAG and Nd:YAG lasers in treatment of chronic periodontitis. A split-mouth, single-blind, randomized controlled trial.

BACKGROUND: The aim of the present study was to compare the effectiveness of combined Er:YAG and Nd:YAG laser therapy to that of scaling and root planing with hand instruments in non-surgical treatment of chronic periodontitis. MATERIAL AND METHODS: Twenty-five systemically healthy patients with chronic periodontitis were selected for this study. The quadrants were randomly allocated in a split-mouth design to either combined Er:YAG (160 mJ/pulse, 10 Hz) and Nd:YAG laser (100 mJ/pulse, 20 Hz) therapy (test group) or scaling and root planing alone (control group). At baseline, 1 month and 3 months after treatment, plaque index, gingival index, probing depth, clinical attachment level and bleeding on probing (%), were recorded and gingival crevicular fluid and subgingival plaque samples were taken. The gingival crevicular fluid levels of interleukin-1ß and tumor necrosis factor-α were analyzed by enzyme-linked immunosorbent assay. Quantitative analysis of red complex bacteria was performed using quantitative real-time polymerase chain reaction. RESULTS: The clinical parameters had significantly improved for both groups after treatment. There were statistically significant differences in probing depth and clinical attachment level between the test and control groups only for deep pockets (≥7 mm) (P<.05). No significant differences between the two groups were observed for the biochemical and microbiological parameters at any time points (P>.05). CONCLUSIONS: The present study suggests that a combined course of Er:YAG and Nd:YAG laser therapy may be beneficial particularly in inaccessible areas such as deep pockets on a short-term basis. Further, well-designed studies are required to assess the effectiveness of the combination of these lasers.

Interleukin-33 could play an important role in the pathogenesis of periodontitis.

BACKGROUND AND OBJECTIVE: Interleukin-33 (IL-33) controls T-helper type 2 (Th2) cytokines and the development of mast cells. This study aimed to investigate the expression of IL-33 and its association with RANKL and osteoprotegerin (OPG) in periodontal health and experimental periodontitis. MATERIAL AND METHODS: Eighteen Wistar rats were assigned to two study groups of nine animals each: ligature only (LO) and nonligated (NL). Silk sutures were placed subgingivally, surrounding the right lower first molars. The animals were killed on day 11 after ligature placement, and the alveolar bone loss at the first molars was determined histometrically. Periodontal tissues were examined histopathologically to evaluate the differences between the groups. The expression of IL-33, RANKL and OPG was detected immunohistochemically. RESULTS: The LO group showed significantly greater alveolar bone loss compared with the NL group (p < 0.05). The numbers of osteoclasts, osteoblasts and inflammatory cells were significantly higher in the LO group compared with the NL group (p < 0.05). Osteoblastic activity was significantly lower in the LO group than in the NL group (p < 0.05). There was significantly higher expression of IL-33 and RANKL and a greater number of OPG-positive cells in the LO group (p < 0.05). IL-33 expression showed a positive correlation with RANKL expression and with the number of mast cells (p < 0.05). CONCLUSION: The experimental periodontitis group exhibited increased expression of IL-33 and RANKL compared with the healthy group. Additionally, there was a positive correlation between these expressions. According to these results, IL-33 could be associated with the pathogenesis of periodontal disease.

Levels of interleukin-37 in gingival crevicular fluid, saliva, or plasma in periodontal disease.

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the levels of levels of interleukin-37 (IL-37) in gingival crevicular fluid, saliva and plasma in patients with periodontal disease and patients with healthy periodontium and to correlate these levels with clinical parameters. MATERIAL AND METHODS: Samples of gingival crevicular fluid, whole saliva and plasma were collected from systemically healthy, nonsmoker periodontally healthy controls (group 1, n = 20), gingivitis patients (group 2, n = 20) and chronic periodontitis patients (group 3, n = 20). Full-mouth clinical periodontal parameters, including probing depth, plaque index, gingival index and bleeding on probing, were also recorded. IL-37 levels in the biofluid samples were determined by ELISA. Data were tested statistically using the Kruskal-Wallis test followed by the Mann-Whitney U-test. RESULTS: The concentration of IL-37 in gingival crevicular fluid was significantly lower in group 3 than in groups 1 and 2 (p = 0.001), whereas the total amounts in gingival crevicular fluid samples were similar (p > 0.05). The salivary and plasma concentrations of IL-37 were similar in the study groups (p > 0.05). There were negative correlations between gingival crevicular fluid IL-37 concentrations and gingival crevicular fluid volume in all groups (p < 0.05). There was also a negative correlation between the gingival crevicular fluid IL-37 concentration and gingival index in group 3 (p < 0.05). CONCLUSIONS: IL-37 was expressed in all biofluids. According to our findings, the total amount of IL-37 in gingival crevicular fluid, or salivary or plasma concentrations of IL-37, may not be useful diagnostic markers to differentiate periodontal disease and the periodontally healthy condition. The difference in gingival crevicular fluid IL-37 concentration between the study groups may be a result of the variation in gingival crevicular fluid volume, as suggested by the negative correlation between gingival crevicular fluid volume and gingival crevicular fluid IL-37 concentration. In the light of our findings, it seems that IL-37 is not involved in periodontal disease. Further comprehensive studies may clarify this issue more clearly.

Monitoring bone morphogenetic protein-2 and -7, soluble receptor activator of nuclear factor-κB ligand and osteoprotegerin levels in the peri-implant sulcular fluid during the osseointegration of hydrophilic-modified sandblasted acid-etched and sandblasted acid-etched surface dental implants.

BACKGROUND AND OBJECTIVE: The implant surface plays a major role in the biological response to titanium dental implants. The aim of this study was to investigate levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), bone morphogenetic protein-2 (BMP-2) and -7 (BMP-7) in the peri-implant crevicular fluid (PICF) of different implants during the osseointegration period. MATERIAL AND METHODS: Forty-seven patients (22 females and 25 males, mean age 47.34 ± 10.11) were included in this study. Forty-seven implants from two implant systems (group A1 (sandblasted acid-etched [SLA]-16), group A2 (hydrophilic-modified SLA [SLActive]-16), and group B (sandblasted acid-etched [SLA]-15) were placed using standard surgical protocols. PICF samples, plaque index, gingival index and probing depth measurements were obtained at 1 and 3 mo after surgery. PICF levels of sRANKL, OPG, BMP-2/-7 were analyzed by ELISA. RESULTS: No complications were observed during the healing period. No significant differences were observed in the PICF levels of sRANKL, OPG, BMP-2 and BMP-7 for all groups at any time point (p > 0.05). A significant decrease was observed in BMP-2 levels in group A1 (p < 0.05). A significant increase in BMP-7 levels was observed only for group A2 (p < 0.05). There was a strong negative correlation between OPG and gingival index and a negative correlation between BMP-7 and plaque index (p < 0.05). CONCLUSION: Considering the correlations between clinical and biochemical parameters, the levels of these cytokines in PICF during early healing of implants reflects the degree of peri-implant inflammation, rather than differences in the implant surfaces.

Boric acid inhibits alveolar bone loss in rats by affecting RANKL and osteoprotegerin expression.

BACKGROUND AND OBJECTIVE: The goal of the present study was to evaluate the effects of systemic boric acid on the levels of expression of RANKL and osteoprotegerin (OPG) and on histopathologic and histometric changes in a rat periodontitis model. MATERIAL AND METHODS: Twenty-four Wistar rats were divided into three groups of eight animals each: nonligated (NL); ligature only (LO); and ligature plus treatment with boric acid (BA) (3 mg/kg per day for 11 d). A 4/0 silk suture was placed in a subgingival position around the mandibular right first molars; after 11 d the rats were killed, and alveolar bone loss in the first molars was histometrically determined. Periodontal tissues were examined histopathologically to assess the differences among the study groups. RANKL and OPG were detected immunohistochemically. RESULTS: Alveolar bone loss was significantly higher in the LO group than in the BA and NL groups (p < 0.05). The number of inflammatory infiltrate and osteoclasts in the LO group was significantly higher than that in the NL and BA groups (p < 0.05). The numbers of osteoblasts in LO and BA groups were significantly higher compared with NL group (p < 0.05). There were significantly more RANKL-positive cells in the LO group than in the BA and NL groups (p < 0.05). There was a higher number of OPG-positive cells in the BA group than in the LO and NL groups (p < 0.05). CONCLUSION: The present study shows that systemic administration of boric acid may reduce alveolar bone loss by affecting the RANKL/OPG balance in periodontal disease in rats.

Gaze stabilization in chronic vestibular-loss and in cerebellar ataxia: interactions of feedforward and sensory feedback mechanisms.

During gaze shifts, humans can use visual, vestibular, and proprioceptive feedback, as well as feedforward mechanisms, for stabilization against active and passive head movements. The contributions of feedforward and sensory feedback control, and the role of the cerebellum, are still under debate. To quantify these contributions, we increased the head moment of inertia in three groups (ten healthy, five chronic vestibular-loss and nine cerebellar-ataxia patients) while they performed large gaze shifts to flashed targets in darkness. This induces undesired head oscillations. Consequently, both active (desired) and passive (undesired) head movements had to be compensated for to stabilize gaze. All groups compensated for active and passive head movements, vestibular-loss patients less than the other groups (P < 0.001, passive/active compensatory gains: vestibular-loss 0.23 ± 0.09/0.43 ± 0.12, healthy 0.80 ± 0.17/0.83 ± 0.15, cerebellar-ataxia 0.68 ± 0.17/0.77 ± 0.30, mean ± SD). The compensation gain ratio against passive and active movements was smaller than one in vestibular-loss patients (0.54 ± 0.10, P=0.001). Healthy and cerebellar-ataxia patients did not differ in active and passive compensation. In summary, vestibular-loss patients can better stabilize gaze against active than against passive head movements. Therefore, feedforward mechanisms substantially contribute to gaze stabilization. Proprioception alone is not sufficient (gain 0.2). Stabilization against active and passive head movements was not impaired in our cerebellar ataxia patients.

Using diffusion weighted MR imaging in a lipomatous chest wall lesion.

Hibemoma is a rare benign soft tissue tumor derived from brown fat.The tumor is also known as "fetal lipoma, lipoma of embryogenic fat and lipoma of immature adipose tissue. Hibemomas are slow-growing, painless soft tissue tumors which do not recur after surgical resection. Preferred locations are brown fat containing sites as thigh, interscapular region, shoulder, axilla, and mediastinum.The tumor occurs most commonly in adults, with a mean age of 38 years (age range, 2-75 years). We present a rare case of hibernoma with radiological and pathological findings.

Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography.

The purpose of our investigation was to determine the anatomical variations in the coeliac trunk-hepatic arterial system and the renal arteries in patients who underwent multidetector CT (MDCT) angiography of the abdominal aorta for various reasons. A total of 100 patients were analysed retrospectively. The coeliac trunk, hepatic arterial system and renal arteries were analysed individually and anatomical variations were recorded. Statistical analysis of the relationship between hepatocoeliac variations and renal artery variations was performed using a chi(2) test. There was a coeliac trunk trifurcation in 89% and bifurcation in 8% of the cases. Coeliac trunk was absent in 1%, a hepatosplenomesenteric trunk was seen in 1% and a splenomesenteric trunk was present in 1%. Hepatic artery variation was present in 48% of patients. Coeliac trunk and/or hepatic arterial variation was present in 23 (39.7%) of the 58 patients with normal renal arteries, and in 27 (64.3%) of the 42 patients with accessory renal arteries. There was a statistically significant correlation between renal artery variations and coeliac trunk-hepatic arterial system variations (p = 0.015). MDCT angiography permits a correct and detailed evaluation of hepatic and renal vascular anatomy. The prevalence of variations in the coeliac trunk and/or hepatic arteries is increased in people with accessory renal arteries. For that reason, when undertaking angiographic examinations directed towards any single organ, the possibility of variations in the vascular structure of other organs should be kept in mind.

Aberrant right bronchial artery originating from right coronary artery - MDCT angiography findings.

Aberrant bronchial arteries are rarely seen and may originate from various vascular structures. In our case, a 48-year-old man with recurrent chest pain underwent multidetector CT (MDCT) coronary angiography. MDCT images demonstrated an aberrant right bronchial artery originating from the right coronary artery. To our knowledge, this is the first case report of an aberrant right bronchial artery originating from the right coronary artery.

Case report. Isolated complete congenital sternal cleft in an adult: MDCT imaging findings.

Sternal cleft is a very rare midline defect. Incomplete forms are more common than complete ones. In this challenging anomaly, the underlying mediastinal structures (especially the heart and great vessels) can easily be injured by external trauma. In addition, the deformity is cosmetically unpleasant and quite alarming to the young patient and the patient's family. In this report, we describe the multidetector CT (MDCT) images that demonstrate the complete sternal cleft.

Bilateral maxillary sinus hypoplasia and aplasia: radiological and clinical findings.

Maxillary sinus hypoplasia (MSH) is classified into three types depending upon embryological development of the sinus and uncinate process. Type III MSH is characterized by a near-absence of the uncinate process and an almost absent cleft-like sinus. Bilateral maxillary sinus aplasia or severe hypoplasia with associated paranasal sinus abnormalities is extremely rare. Two cases with severe maxillary sinus hypoplasia/aplasia (one of them with other associated paranasal sinus abnormalities) are presented in this article. This extremely rare abnormality should be kept in mind to prevent misdiagnosis and possible complications during endoscopic sinus surgery.

Carpal laxity syndrome in forty-three puppies.

Forty-three dogs with carpal laxity syndrome were included in the study. The cases were assessed with clinical and radiographical examinations. The case histories were obtained from patient owners. We recommended exercise and commercially available balanced diets for the treatment. In all cases, the clinical recovery period varied between one to four weeks. Healing occurred by the second week in the majority of cases (65.11%). The deformity was observed more frequently in male dogs (n = 30) than in female dogs (n = 13), and in six- to eight-week-old dogs. Carpal Laxity Syndrome is a more general term, used for both hyperextension and hyperflexion deformity. Malnutrition or over-nutrition of rapidly growing large breed puppies causes weakness and irregular tension between extensor and flexor muscle groups, which leads to laxity of the carpal joint. Exercise and commercially available balanced diets without any other treatment is usually enough to achieve physical and functional recovery.