The Effect of Using Different Kinematics Single File Systems with Coronal Preflaring Instruments on Postoperative Pain with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

INTRODUCTION

The aim of this study was to investigate the effect of using coronal preflaring file (One Flare; OF) with rotational (One Curve; OC) and reciprocal (WaveOne Gold; WOG) single file systems on postoperative pain in mandibular premolar teeth with symptomatic irreversible pulpitis.

METHODS

Eighty patients were included in this prospective, superiority, parallel, and randomized controlled clinical trial. The patients were randomly divided into four groups (n = 20) based on the use of coronal preflaring and the kinematics of the shaping instrument: WOG (without coronal preflaring), WOG with coronal preflaring (OF), OC (without coronal preflaring), and OC with coronal preflaring (OF). Patients recorded their postoperative pain intensity at 6, 24, 48, and 72 hours using a 10-cm visual analog scale. Friedman and Wilcoxon's tests were used for intragroup comparisons, and Kruskal-Wallis test was used for intergroup comparisons. The post hoc analysis was performed using Dunn's test. The Chi-square test was used to compare gender and tooth localization according to the groups, and Kruskal-Wallis test was used to compare age and preoperative pain (P < .05).

RESULTS

At 6 and 24 hours, WOG and OC with coronal preflaring groups showed statistically significantly lower pain scores than WOG and OC groups without coronal preflaring (P < .05). No significant difference was found between the groups in terms of analgesic medication intake.

CONCLUSIONS

The use of coronal preflaring with both rotational and reciprocal single file systems in root canal preparation resulted in less postoperative pain in mandibular premolar teeth diagnosed with symptomatic irreversible pulpitis.

Panoramic dental X-ray exposure leads to oxidative stress, inflammation and apoptosis-mediated developmental defects in zebrafish embryos

Panoramic x-ray units are widely used in dental radiodiagnostics. Patients are exposed to relatively low radiation doses with panoramic imaging, but considering lifetime frequency of exposure, even a small risk can have serious health consequences. Our aim was to assess the effects of panoramic x-rays at two different exposure times on developing zebrafish embryos, focusing on oxidative stress, inflammation, apoptotic pathways, and development. Zebrafish embryos were divided into three groups: control, standard panoramic (SPE, 5.5 s exposure time) and pedodontic panoramic x-ray group (PPE, 4.8 s exposure time). Optically stimulated luminescence dosimeters were used to measure absorbed doses. Mean radiation doses for SPE and PPE were 7.83 mSv and 5.83 mSv respectively. At the end of 96 h post-fertilization, lipid peroxidation (LPO), nitric oxide (NO), reduced glutathione (GSH), glutathione S-transferase and superoxide dismutase were measured in the embryos. Expressions of genes related with inflammation (tnfα, il6, ill15, il21), immunoregulation (ifng) and apoptosis (p53, bax, casp2, casp3, casp8) were determined by RT-PCR. Even at reduced doses at high-speed mode, developmental toxicity was observed in both groups as evidenced by decreased pigmentation, yolk sac oedema, and spinal curvature. While deterioration of oxidant-antioxidant balance, suppression of immune response, induction of inflammation and apoptosis were observed through increased LPO, NO, decreased GSH, ifng, and increased expressions of genes related with inflammation and apoptosis, these effects were more pronounced in the SPE group. These results demonstrate the influence of exposure time and indicate the need for further consideration of optimal panoramic modes from a radiation-induced damage perspective.

The effects of laser and ultrasonic irrigation activation methods on smear and debris removal in traditional and conservative endodontic access cavities

In this study, it was aimed to evaluate the smear and debris removal efficiency of laser and ultrasonic irrigation activation methods in traditional and conservative endodontic access cavity preparations. 60 freshly extracted human mandibular molar teeth were randomly divided into 2 groups according to the access cavity preparation (n = 30): Traditional endodontic access cavities (TEC) and Conservative endodontic access cavity (CEC). After the access cavity preparation, the mesiobuccal root canals were prepared to 35/0.4 with the VDW Rotate file system. Teeth with completed root canal preparation were randomly divided into 3 subgroups according to the final irrigation activation protocol (n = 30): Conventional needle irrigation, passive ultrasonic activation and laser activation. The crowns of the teeth were removed and the mesiobuccal roots were divided longitudinally into two halves, mesial and distal. Samples were scanned with scanning electron microscopy. Photomicrographs in the coronal, middle, and apical thirds of each specimen were taken at a magnification of 200 for debris and 1000 for evaluation of the smear layer. Data were analysed using the three-way Robust Anova test and Bonferroni test.The effect of access cavity design on remaining smear (p = 0.057) and debris (p = 0.5) was not statistically significant. The effect of the interaction of access cavity and irrigation activation on the remaining smear and debris was not statistically significant (p = 0.556, p = 0.333). Significantly fewer smears were detected in the laser activation group than in the ultrasonic activation and control groups. Conservative access cavities did not differ from conventional access cavities in terms of debris and smear.

Effectiveness of different rotary file systems in removing the root canal filling material: A micro-computed tomography study

Background. This study aimed to examine the retreatment efficiency of four NiTi rotary file systems with micro-computed tomography (micro-CT). Methods. Forty premolar teeth were shaped up to F2 using the ProTaper Universal rotary file system and obturated with MTA Fillapex. The root canals were scanned with micro-CT to evaluate the volume of root canal filling before retreatment. The samples were randomly divided into four groups according to the file system used to remove root canal filling material (n=10): ProTaper Universal Retreatment, ProTaper NEXT, EdgeFile XR, and EdgeFile® X3 NiTi system. All the samples were scanned with a micro-CT device for the second time to evaluate the amount of residual filling material in the root canals. The percentages of filling material removed from root canals were calculated. Additionally, the time spent on the removal of the root canal filling material was recorded. The data were analyzed using the Shapiro-Wilk and Kruskal-Wallis tests. Results. There were no significant differences between the groups in the percentage of root canal filling material removal. However, a statistically significant difference was found between the groups in the time required to reach the apex and remove the entire filling material. The time required to remove the root canal filling material was higher in the EdgeFile® X3 group. Conclusion. NiTi files manufactured for root canal preparation can be used effectively and safely to remove root canal filling materials. EdgeFile XR produced for retreatment can be used as an alternative to ProTaper Universal Retreatment files.

Investigation of the cortical activity during episodic future thinking in schizophrenia: A functional near-infrared spectroscopy study

Episodic future thinking (EFT) refers to mental simulation of possible future events, a process that mostly depends on episodic memory (EM). EFT impairment in schizophrenia was proposed to disturb continuity in self-functioning. Schizophrenia patients are also impaired in EM as well as executive functions (EFs). In the present study, we aimed to clarify the relationship between EFT and memory functions in schizophrenia by assessing (a) whether a group of individuals with schizophrenia (schizophrenia group [SG]) who have relatively intact long-term memory functions differ from healthy controls (control group [CG]) in terms of EFT performance, and (b) whether such difference is biologically represented in terms of cortical activity. We also aimed to clarify the role of EFs in EFT in 3 task conditions: past remembering with a single cue (PR), future imagination with a single cue (FI-1C), and future imagination with 3 given cues (FI-3C). Cortical activity was monitored by functional near-infrared spectroscopy. Although the two groups showed a comparable performance in the PR, the SG performed worse than the CG in the two future-imagination conditions. In the CG, mental flexibility predicted EFT, and EM predicted PR. No such relationship was observed in the SG. In the CG only, activity was higher in the FI-1C than the PR in the middle and superior temporal cortices. In the SG, activity in the rostral prefrontal cortex (rPFC) was negatively correlated with performance in FI-3C. These results suggest that EFT is still observed but not associated with EFs in individuals with schizophrenia having relatively intact memory functions. Altered activity in the rPFC may be associated with EFT impairment in schizophrenia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Dentin moisture conditions strongly influence its interactions with bioactive root canal sealers

Objectives

It is known that bioactive materials interact with the dentin to undergo biomineralization. The exact role of moisture in this interaction is unknown. Here, we investigate the effects of dentin moisture conditions on the dislocation resistance of two bioactive root canal sealers (MTA Fillapex [Angelus Solucoes Odontologicas] and GuttaFlow BioSeal [Colténe/Whaledent AG]) at 3 weeks and 3 months after obturation.

Materials and Methods

Mandibular premolars (n = 120) were prepared and randomly divided into 3 groups based on the dentin condition: group 1, dry dentin; group 2, moist dentin; group 3, wet dentin. Each group was divided into 2 subgroups for root canal filling: MTA Fillapex and GuttaFlow BioSeal. Dislocation resistance was evaluated by measuring the push-out bond strength at 3 weeks and 3 months. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by Kruskal-Wallis test with a significance level of 5%.

Results

Moist dentin resulted in higher bond strength values for both materials at both time points. This was significantly higher than wet and dry dentin for both the sealers at the 3 months (p < 0.05), while at 3 weeks it was significant only for GuttaFlow Bioseal. The different moisture conditions demonstrated similar trends in their effects on the dislocation resistance of the 2 root canal sealers.

Conclusions

The dentin moisture conditions had a significant impact on its interaction with the bioactive materials tested. Maintaining moist dentin, but not dry or wet dentin, may be advantageous before the filling root canals with bioactive sealers.

Percutaneous Coronary Intervention for Chronic Total Occlusion versus Percutaneous Coronary Intervention for Non-Complex Coronary Lesions: Is There a Different Impact on Thyroid Function?

OBJECTIVE

This study assessed whether high levels of iodide administered during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) differentially influenced thyroid function compared to PCI for non-complex coronary lesions.

SUBJECTS AND METHODS

A total of 615 patients were enrolled in the study; 205 underwent elective PCI for CTO lesions (Group I) and 410 underwent elective PCI for non-complex lesions including non-CTO, non-bifurcation, non-calcified, and non-tortuous lesions (Group II). Patients were monitored for development of incidental thyroid dysfunction between 1 and 6 months after PCI.

RESULTS

The patients in Group I were administered a median of 255 mL of contrast medium during PCI for CTO; a median of 80 mL was administered to the patients in Group II during non-complex PCI (p =0.001). Ten (5.4%) of the 186 euthyroid patients in Group I and 19 (5%) of the 379 eu-thyroid patients in Group II developed subclinical hyper-thyroidism (p = 0.854). However, 7 (50%) of the 14 subclinical hyperthyroid patients in Group I and only 3 (12%) of the 25 subclinical hyperthyroid patients in Group II developed overt hyperthyroidism (p = 0.019).

CONCLUSION

In euthyroid patients, PCI for coronary CTO lesions did not increase the risk for subclinical hyperthyroidism when compared to PCI for non-complex coronary lesions. However, in patients with subclinical hyperthyroidism at baseline, PCI for coronary CTO lesions significantly increased the development of overt hyperthyroidism when compared to PCI for non-complex coronary lesions.

Twin Circumflex Arteries: A Rare Coronary Artery Anomaly

A circumflex artery originating from an ostium apart from the left main artery is one of the most common coronary artery anomalies. However, a dual origin of the circumflex artery is an extremely rare anomaly. We describe a 55-year-old male patient admitted to our clinic with the diagnosis of unstable angina. Angiography revealed twin circumflex arteries: one from the left main artery and the other from the proximal right coronary artery and a stenotic left anterior descending coronary artery (LAD). The patient was treated with percutaneous coronary intervention on the LAD lesion. His overall condition was good at 2 weeks' follow-up.

Assessment of left atrial appendage function during sinus rhythm in patients with obstructive sleep apnea

Objective:

Obstructive sleep apnea (OSA) is associated with thromboembolic events. Compromised left atrial appendage (LAA) function due to left ventricular (LV) performance abnormality, often present in patients with OSA, may play an important role. The purpose of this study is to evaluate LV and LAA mechanical functions during sinus rhythm (SR) in patients with OSA.

Methods:

LV and LAA functions were assessed in 43 OSA patients and compared with that of 20 control patients in SR. Tissue Doppler velocities of the LAA apex and emptying velocities (EV) of LAA were obtained on parasternal short-axis view.

Results:

The baseline clinical characteristics were similar except for AHI (apnea-hypopnea index), minimal SaO₂, mean SaO₂, hypertension, and body-surface area. Most of the LV echocardiographic parameters significantly deteriorated in OSA patients in comparison with those in the control group. LAA EV, LAA systolic relaxation velocity (S_M), LAA early-diastolic velocity (E_M), LAA contraction velocity (A_M), left atrial (LA) minimum volume index, LA ejection fraction, LA conduit volume index, and LA reservoir volume index were lower in OSA patients compared with those in the control group (p<0.05). LAA A_M was negatively correlated with AHI and the ratio of peak early diastolic flow velocity (E) to early-diastolic (E’) and positively correlated with LA conduit volume (p<0.05). Multiple predictors for LAA A_M were AHI, presence of diastolic dysfunction, and E/E’ values (p<0.05).

Conclusion:

LAA mechanical function is significantly depressed in patients with OSA and SR. LAA dysfunction may predispose these patients to thromboembolic events. The evaluation of LAA mechanical function by tissue Doppler study using transthoracic echocardiography (TTE) may become an alternative for routine work-up in OSA patients.

Torsades de pointes induced by concomitant use of chlorpheniramine and propranolol: An unusual presentation with no QT prolongation

Drug-induced torsades de pointes (TdP) is a rare but potentially fatal adverse effect of commonly prescribed medications including cardiac and noncardiac drugs. Importantly, many drugs have been reported to cause the characteristic Brugada syndrome-linked electrocardiography (ECG) abnormalities and/or (fatal) ventricular tachyarrhythmias. Chlorpheniramine and propranolol have the arrhythmogenic effects reported previously. A review of literature revealed a large number of case reports of chlorpheniramine or propranolol use resulting in QTc prolongation, TdP, or both. However, we wish to report the case of a patient who was treated with a combination of chlorpheniramine and propranolol, whose ECG showed no QT prolongation but who suffered from cardiac arrest due to TdP.

Evaluation of radiation safety in (177)Lu-PSMA therapy and development of outpatient treatment protocol

The aim of this study is to investigate the outpatient treatment protocol and radiation safety of a new-emerging lutetium-177 ((177)Lu) prostate specific membrane antigen (PSMA) therapy. This work analyzed the dose rate of 23 patients treated with 7400 MBq (177)Lu-PSMA at different distances (0, 0.25, 0.50, 1.0 and 2.0 m) and variable time marks (0, 1, 2, 4, 18, 24, 48 and 120 h) after the termination of infusion. Blood samples were withdrawn from 17 patients within the same group at 3, 10, 20, 40, 60 and 90 min and 2, 3, 24 h after termination of infusion. Seven different patients were asked to collect urine for 24 h and a gamma well counter was used for counting samples. Family members were invited to wear an optically stimulated luminescence dosimeter whenever they were in the proximity of the patients up to 4-5 d. The total dose of the medical team including the radiopharmacist, physicist, physician, nurse, and nuclear medicine technologist was estimated by an electronic personnel dosimeter. The finger dose was determined using a ring thermoluminescent dosimeter for the radiopharmacist and nurse. The mean dose rate at 1 m after 4 h and 6 h was 23  ±  6 μSv h(-1) and 15  ±  4 μSv h(-1) respectively. The mean total dose to 23 caregivers was 202.3  ±  42.7 μSv (range: 120-265 μSv). The radiation dose of the nurse and radiopharmacist was 6 and 4 μSv per patient, respectively, whereas the dose of the physicist and physician was 2 μSv. The effective half life of blood distribution and early elimination was 0.4  ±  0.1 h and 5  ±  1 h, respectively. Seven patients excreted a mean of 45% (range: 32%-65%) from the initial activity in 6 h. Our findings demonstrate that (177)Lu-PSMA is a safe treatment modality to be applied as an outpatient protocol, since the dose rate decreases below the determined threshold of  <30 μSv h(-1) after approximately 5 h and degrades to 20 μSv h(-1) after 6 h.

ASSESSMENT OF WARFARIN TREATMENT EFFICACY BY MEANS; OF USING COAGULATION TEST RESULTS WITHIN THE THERAPEUTIC RANGE

Time in Therapeutic Range (TTR) is a value used to assess the efficacy of Warfarin treatment. The aim of our study is to determine the effective INR levels and the rate of TTR in patients on Warfarin regimen due to Atrial Fibrillation (AF) or Mechanical Prosthetic Valve (MPV). A total of 94 patients (58 female, and 36 male, mean age: 64.9±11years) on Warfarin treatment due to AF or MPV with at least 10 INR levels measurements in the last 6 months were included in this retrospective study. The patients were divided into 2 groups. Group 1 consisted of the patients with Valvular AF (n=47); Group 2 included the patients with Non-Valvular AF (n=47); TTR and INR levels were compared. The average of INR values were found as 2,4 (min: 1,3, max: 4,3) in all patients; 2,3 (min: 1,3, max: 4,2) in Group 1; 2,6 (min: 1,3, max: 4,3) in Group 2. The average of TTR values was found 40.3% (min: 10%, max: 80%) in all patients; 43.8% (min: 10%, max: 80%) in Group 1; 36,8% (min: 10%, max: 80%) in Group 2. INR and TTR values are needed to assess the effectiveness of the Warfarin treatment. The patients in treatment with Warfarin should be well trained and frequently monitored. On the other hand, the underlying factors of the TTR values being determined as lower in the Turkish patient population might be due to the lower socio-economic and socio-cultural status, inadequate education levels, and the insufficient information on use of the medication provided by the doctors to the patients.

Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography

BACKGROUND

Obstructive sleep apnea (OSA) is a common syndrome in patients with metabolic syndrome (MetS). Epicardial fat thickness (EFT), an indicator of visceral adiposity, is a novel parameter for studying patients with OSA. Our aim was to investigate the effects of continuous positive airway pressure therapy (CPAP) therapy on EFT.

METHODS

A total of 162 subjects (68 women and 94 men) were included and divided into three groups: Group I: Apnea-hypopnea index (AHI) < 5 (n  = 45), Group II: AHI 5-15 (n  = 22), and Group III: AHI > 15 (n  = 95). All participants underwent full-night polysomnography and transthoracic echocardiography. There were 28 symptomatic patients with AHI > 15 who received compliant CPAP therapy for 24 weeks.

RESULTS

MetS was more frequent, and systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose were higher in Group III compared with I (p  < 0.05). High-density lipoprotein (HDL) levels were lower in Group III compared with I (p < 0.05). Triglyceride levels and waist circumference were higher in Group III compared with I and II (p  < 0.05). EFT was higher in Group III compared with I and higher in Group II compared with I (p < 0.05). EFT was predicted by MetS and AHI. After CPAP therapy high-sensitive C-reactive protein (hsCRP) and EFT were reduced (p < 0.05).

CONCLUSION

EFT was significantly higher in patients with AHI > 15 and predicted by MetS and AHI. CPAP therapy reduced hsCRP levels and EFT.

Echocardiographic Evaluation of Biventricular Function in Patients with Euthyroid Hashimoto's Thyroiditis

OBJECTIVE

The aim of this study was to evaluate the left (LV) and right (RV) ventricular function in euthyroid Hashimoto's thyroiditis (eHT) patients.

SUBJECTS AND METHODS

Forty-five patients diagnosed with eHT and 45 age- and gender-matched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities (E, A, E', A'), isovolumic relaxation (IVRT) and contraction (IVCT) times, ejection time (ET), deceleration time (DT), Tei index, pulmonary acceleration time (PAcT) and tricuspid annular plane systolic excursion (TAPSE) of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signed-rank test.

RESULTS

Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index (0.6 ± 0.2 vs. 0.4 ± 0.1, p < 0.001), higher DT (p < 0.001) and IVRT (p < 0.001) values, and higher E/E' ratios (p = 0.04). In contrast, the peak E wave velocity (p = 0.02), E/A ratio (p = 0.01) and ET (p = 0.02) were significantly lower in the eHT group than amongst the controls. The RV, Tei index (0.40 ± 0.11 vs. 0.28 ± 0.07, p < 0.001), TAPSE (2.0 ± 0.3 vs. 2.2 ± 0.2 mm, p < 0.001), PAcT (124.3 ± 22.6 vs. 149.4 ± 18.3 ms, p < 0.001), A' (p = 0.007) and IVCT (p = 0.001) were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio (p = 0.01), E' (p = 0.03) and E'/A' ratio (p = 0.001) were significantly lower in the eHT patients than the control group.

CONCLUSIONS

This study demonstrated that both RV and LV functions were impaired in patients with eHT.

Relationship between CHA2DS2-VASc score and atrial electromechanical function in patients with paroxysmal atrial fibrillation: A pilot study

BACKGROUND

CHA2DS2-VASc score is the most widely preferred method for prediction of stroke risk in patients with atrial fibrillation. We hypothesized that CHA2DS2-VASc score may represent atrial remodeling status, and therefore echocardiographic evaluation of left atrial electromechanical remodeling can be used to identify patients with high risk.

METHODS

A total of 65 patients who had documented diagnosis of paroxysmal atrial fibrillation (PAF) were divided into three risk groups according to the CHA2DS2-VASc score: patients with low risk (score=0, group 1), with moderate risk (score=1, group 2), and with high risk score (score ≥2, group 3). We compared groups according to atrial electromechanical intervals and left atrium mechanical functions.

RESULTS

Atrial electromechanical intervals including inter-atrial and intra-atrial electromechanical delay were not different between groups. However, parameters reflecting atrial mechanical functions including LA phasic volumes (Vmax, Vmin and Vp) were significantly higher in groups 2 and 3 compared with group 1. Likewise, LA passive emptying volume (LATEV) in the groups 2 and 3 was significantly higher than low-risk group (14.12±8.13ml/m(2), 22.36±8.78ml/m(2), 22.89±7.23ml/m(2), p: 0.031). Univariate analysis demonstrated that Vmax, Vmin and Vp were significantly correlated with CHA2DS2-VASc score (r=0.428, r=0.456, r=0.451 and p<0.001). Also, LATEV (r=0.397, p=0.016) and LA active emptying volume (LAAEV) (r=0.281, p=0.023) were positively correlated with CHA2DS2-VASc score. In the ROC analysis, Vmin≥11ml/m(2) has the highest predictive value for CHA2DS2-VASc score ≥2 (88% sensitivity and 89% specificity; ROC area 0.88, p<0.001, CI [0.76-0.99]).

CONCLUSION

Echocardiographic evaluation of left atrial electromechanical function might represent a useful method to identify patients with high risk.

Slow ventricular response atrial fibrillation related to mad honey poisoning

Mad honey poisoning which is induced by Grayanotoxin (Andromedotoxin), is also known to have adverse effects in the cardiovascular system leading to different clinical entities. This toxin is produced by a member of the Rhododendron genus of plants of two R. Luteum and R. Panticum. In this article, we presented a case of slow ventricular response atrial fibrillation complaints with nausea, vomiting, dizziness and chest pain about an hour after eating honey produced in the Black Sea Region.

Dose evaluation in criticality accidents using response of Panasonic TL personal dosemeters (UD-809/UD-802)

This study gives the results of dosimetry measurements carried out in the Silène reactor at Valduc (France) with neutron and photon personal thermoluminescence dosemeters (TLDs) in mixed neutron and gamma radiation fields, in the frame of the international accident dosimetry intercomparison programme in 2002. The intercomparison consisted of a series of three irradiation scenarios. The scenarios took place at the Valduc site (France) by using the Silène experimental reactor. For neutron and photon dosimetry, Panasonic model UD-809 and UD-802 personal TLDs were used together.

The cardiac effects of a mobile phone positioned closest to the heart

OBJECTIVE

The aim of this study was to evaluate the effect of mobile phone (MP) on cardiac electrical activity by examining the heart rate variability (HRV), QT, P dispersions and blood pressure (BP) while the MP is located on the precordium.

METHODS

A total of 24 healthy volunteers were included in this prospective study. In the first step; 12-lead electrocardiogram (ECG) and BP recordings of the subjects without MP, while the MP is off, on, and ringing were recorded. In the second step; rhythm and BP were recorded for 30 minutes with the Holter without MP, and when the MP was "on" at the precordial location. P-wave and QT interval dispersions were measured from 12-lead ECG, while Holter 24-hour recordings were used for HRV analysis. Statistical analysis was performed using paired t test for comparison of hemodynamic and HRV variables without MP and during MP on. ANOVA for repeated measures was used to compare hemodynamic and ECG variables through baseline and 3 experimental settings: MP on, off and ringing.

RESULTS

There were no statistically significant differences between the groups in the BP, heart rate, P-wave dispersion, QT dispersion and QT corrected dispersion parameters (p>0.05) in the first step of the study. In the second step, there were no significant differences between two groups in the BP, heart rate and HRV parameters (p>0.05).

CONCLUSION

We conclude that MP has no effect on hemodynamic (heart rate, blood pressure) and cardiac electrical activity (P-wave and QT dispersions) parameters when it is positioned on the chest in immediate proximity to the heart, and it does not cause cardiac autonomic dysfunction examined by HRV analysis in healthy adult subjects.

Embolised stent into the circumflex coronary artery during percutaneous coronary intervention

Dislodgement and embolisation of the new generation of coronary stents before deployment are rare. If it is impossible to withdraw the embolised stent from the coronary artery, the stent may be crushed into the side wall of the coronary artery with a balloon over a wire passed alongside the embolised stent.

Occupational exposure to ionising radiation with thermoluminescence dosimetry system in Turkey, in 2003

The individual annual dose information on classified workers who are occupationally exposed to extended radiation sources by using thermoluminescence dosimetry system, in Turkey, was assessed and analysed by the Ankara Nuclear Research and Training Centre (ANAEM) dosimetry service at the Turkish Atomic Energy Authority (TAEK) for the year 2003. A total of 3721 persons were monitored with TLD and the data presented in this report were obtained by using TLD technology in 2003. The annual mean effective doses received from external radiation in different fields of activities and the distribution of the annual effective dose by dose intervals are presented. The collective annual dose by field of activity is estimated and the contribution to the total annual collective dose is determined.

Cardiac emergencies caused by honey ingestion: a single centre experience

An unusual type of food poisoning is commonly seen in the Black Sea coast of Turkey attributable to andromedotoxin containing toxic honey ingestion. This study is a retrospective case series of 19 patients admitted to an emergency department in 2002, poisoned by "mad" honey. All of the patients had the complaints of nausea, vomiting, sweating, dizziness, and weakness, several hours after ingesting "mad" honey. Physical examination showed hypotension in 15 patients, sinus bradycardia in 15, and complete atrioventricular block (AVB) in four patients on admission. Two patients with bradycardia and two with AVB fell and injured their heads. Three of them presented with local haematoma. One patient had a 6 cm cut on his head without any neurological deficit and his cranial computed tomography imaging was normal. Hypotension and conduction disorders resolved with atropine treatment, resulting in complete recovery within 24 hours.

Isolated Interrupted Aortic Arch: A Case Report and Review of the Literature

An 18-years-old male presented to emergency department after a car accident with the diagnosis of femoral bone fracture. Arterial blood pressure was 160/90 mmHg in both arms. Bilateral femoral and popliteal pulses were extremely weak and there was systolic ejection murmur on the left second intercostals area. Chest X-ray showed rib notching with normal cardiac silhouette. Transthoracic echocardiography showed the aortic interruption just below the left subclavian artery. Aortography showed a complete interruption of the aortic arch (IAA) just distal to the origin of the left subclavian artery. Femoral bone fracture was treated by conservative strategy. A gadolinium contrast-enhanced magnetic resonance angiogram (1.5 T scanners) clearly reaffirmed a complete interruption of the descending aorta, 3.6 cm from the left subclavian artery with extensive collateralizations. Mild degree hypertension was controlled by a long acting calcium channel blocker. Later the patient has been scheduled for elective surgical repair. We aimed to discuss the diagnostic and treatment options of the interrupted aortic arch as being a rare anomaly.

Hepatitis B carriage and Brucella seroprevalence in urban and rural areas of Bolu province of Turkey: a prospective epidemiologic study

BACKGROUND/AIMS

In this study, we aimed to investigate the prevalence of hepatitis B surface antigen positivity and antibodies against Brucella in rural and urban areas of Bolu province of Turkey.

METHODS

A total of 4,234 [corrected] people were screened from the urban and rural regions (3084 [corrected] versus 1150, respectively). All sera were evaluated for HBsAg and Brucella antibody.

RESULTS

HBsAg, rose bengal and serum tube agglutination positivity were found to be 2.85%, 1.0%, 0.46%, respectively, in the urban area, versus 2.6%, 1.7%, 1.1%, respectively, in rural areas (P>0.05).

CONCLUSIONS

HBsAg seropositivity in Bolu is lower than in many other centers in Turkey. Brucella prevalence is 1%, which is higher than that in the Ministry of Health records. This shows that the recording system in our country is not very efficient. Similar studies should be carried out in different regions of our country to determine the actual values, which requires the cooperation of scientific foundations and the Ministry of Health.

Occupational exposure to ionising radiation in the region of Anatolia, Turkey for the period 1995-1999

For this study, the individual annual dose information on classified workers who are occupationally exposed to extended radiation sources in Turkey, was assessed and analysed by the Ankara Nuclear Research and Training Centre dosimetry service at the Turkish Atomic Energy Authority for the years 1995-1999. The radiation workers monitored are divided into three main work sectors: conventional industry (8.24%), medicine (90.20%) and research-education (1.56%). The average annual dose for all workers in each particular sector was 0.14, 0.38 and 0.08 mSv, respectively, in 1995-1999. This paper contains the detailed analysis of occupational exposure. The statistical analysis provided includes the mean annual dose, the collective dose, the distributions of the dose over the different sectors and the number of workers who have exceeded any of the established dose levels.

Serum trace elements status of rabbits supplemented with Nigella sativa, vitamins C and E, and selenium against damage by N-methyl-N'-nitro-N-nitrosoguanidine

In this study, we investigated the effects of Nigella sativa, vitamins C and E, and selenium on the levels of trace elements in the serum of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-injected rabbits. The rabbits were separated into one control and three experimental groups, each consisting of eight rabbits. MNNG was administered to all rabbits at a dose of 20 mg/kg. Group A received a suspension of N. sativa, group B received a combination of vitamins C and E and selenium, and group C received MNNG without any additional treatment. Group D did not receive any treatment and acted as control. The concentrations of serum zinc, copper, and iron were determined for groups A, B, C, and D. The zinc levels were 155.3+/-25.8, 304.7+/-14.22, 117.2+/-27.9, and 87.0+/-8 ng/dL for groups A-D, respectively; copper was measured at 234.8+/-31.9, 214.3+/-14.2, 196.5+/-19.3, and 359.2+/-19.9 ng/dL and iron levels were 276.3+/-10.71, 260.8+/-7.15, 211.2+/-13.47, and 223.4+/-9.5 ng/dL, in the stated group order. There were statistically significant differences between groups (p<0.05). The results obtained in this work may be of use for monitoring and preventing the nocive effects of N-methyl-N'-nitro-N-nitrosoguanidine and similar carcinogens.

The effects of growing conditions on oil content, fatty acid composition and tocopherol content of some sunflower varieties produced in Turkey

The properties of some extensively cultivated sunflower seed varieties in Turkey and their oils were investigated. 1991-1992 crop year sunflower varieties harvested from Trakya University, Tekirdag Agricultural Faculty, Experiment field of Crop Science Department were used as research materials. The oil content, fatty acid composition and tocopherol content of sunflower seeds in 1991 and 1992 crop years were determined as 44.2-51.2% (on dry weight basis), 43.0-51.5% (on dry weight basis); oleic acid 14.8-18.5%, 32.9-40.1%; linoleic acid 69.5-74.5%, 49.7-55.7% and tocopherol content (as alpha-tocopherol) 648-860 mg/kg, 524-880 mg/kg, respectively. It was determined that the growing conditions significantly affected the fatty acid compositions of sunflower varieties studied. While the oleic acid content of the 1992 crop increased, the linoleic acid content of the same crop decreased compared to the 1991 crop.