Objective: This study aimed to evaluate the level of knowledge of dentistry students on local anesthetic systemic toxicity (LAST),
which will provide important information that will help in scheduling the educational content of the future syllabus before graduation, in order to prepare the students for possible challenges in the future.
Methods: This study included 234 dentistry students who were in the 3rd, 4th, and 5th years of education, at 2018–2019 educational
year of Gaziantep University, Faculty of Dentistry. It was conducted in a cross-sectional questionnaire-based manner. The revised
questionnaire form included questions regarding the frequency of encountered LAST cases,
signs of LAST they had observed, and treatments for LAST that they had used, particularly lipid treatment.
Results: The questionnaire was sent to 234 dentistry students who were in the 3rd, 4th, and 5th degree in the Gaziantep University
Faculty of Dentistry and 215 of them responded to the study (91,88%). The majority of the participants (93%, n = 200) declared that
they had received training about LAs. Among the participants, 38,60% (n = 83) of them preferred only one LA agent, whereas the
remaining participants preferred multiple agents. In addition, most of the participants 79,5% (n = 171) declared that they had not
observed LAST, while only 15 of the students stated that they have encountered LAST (7%) and had used an alternative therapy
rather than the intravenous lipid rescue therapy. None of the students personally administered the lipid rescue therapy.
Conclusion: The results of this current study demonstrate the evident need for additional educational effort to create awareness
regarding LA use and the effective management of LAST among dentistry students.
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The human microbiota is an essential and individual part of the human body composed of microorganisms that live in symbiosis
with the human body. It is formed prenatally and changes throughout a person’s life due to endogenous and exogenous factors
such as birth, geography, gender, sex hormones, genetics, mode of birth, age, lifestyle, nutrition, use of antibiotics, and disease-related changes. Studies on the microbiota have mostly focused on its relation to diseases, but the gut microbiota is also very sensitive to xenobiotics, which directy or indirectly alter the pharmacokinetics of drugs used by the host. Although the gut microbiota
recovers in a few weeks, some changes may be permanent. It is important to consider changes in drug bioavailability in patients
who were recently or currently treated with antibiotics for the safe and efficient pharmacotherapy of patients. With advanced
knowledge about the microbiota and advances in the field of microbiome genetics, it may be possible that in the future, a person’s
microbiota map is used in personalizing drug treatment. In this review, we aim to emphasize the importance of microbiota and
drug interactions.
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Helminths are multicellular organisms causing chronic infections affecting nearly one-third of the global population. They are experts at immunomodulation, and pathologic outcomes are generally observed in patients with immunodeficiencies or with exaggerated levels of anti-helminth immune responses. Elimination of helminths is usually mediated by T-helper type-2 (Th2) immune responses, characterized by the induction of Immunoglobulin E (IgE) release, increase in eosinophil and mast cell levels, and elevation in the production levels of Th2 cytokines. However, the triggered mechanisms may also depend on the location of the parasite. This is because tissue invasion, an immune evasion strategy for parasites, was considered to activate more Thelper type 1 (Th1) cells in tissues. During chronic infections, immune response regulatory pathways become more influential, there-by reducing the levels of the peripheral T-cell-mediated responses against parasitic antigens. The resultant immune response is termed as “modified Th2 response” and is characterized by enhanced levels of anti-inflammatory cytokine production and regu-latory immune cells as well as high IgG4/IgE ratios. Immunomodulation during chronic helminth infection is not limited to only parasite-specific responses. It can influence the efficiency of vaccination, host susceptibility to infections, and allergen or autoan-tigen responses. This review discusses anti-helminth immune responses. Moreover, it highlights current literature on the effects of chronic helminth infections on host health as well as their possible use as a treatment strategy against autoimmune, autoinflam-matory, and allergic diseases.
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Objective: Otitis media is one of the most common ear disorders occurring in childhood, which causes alterations in commu-nication between parents and children, thereby having a significant effect on the health-related quality of life. Otitis Media-6 questionnaire (OM-6) is a Likert-type scale used to assess the health-related quality of life in children with otitis media. In this study, our aim was to create a consistent, reliable, and valid Turkish version of the OM-6.Methods: Children with otitis media presenting with effusion and healthy children were enrolled in this study between February 2019 and September 2019. The OM-6 test was administered to three different groups, including preoperative, postoperative, and control, among the children who had undergone ventilation tube insertion operation and among the healthy children.Results: The overall scores of children with otitis media presenting with effusion exhibited a changing pattern, indicating a statistical significance in the evaluation of the health-related quality of life. The Turkish version of OM-6 includes the scores of construct validity (Spearman values between 0, 58-0, 89), internal consistency (Cronbach’s alpha values between 0, 88-0, 96), and reliability (Pearson correlation value between 0, 67-0, 91). These scores exhibited a statistical significance.Conclusion: The Turkish version of OM-6 is a stable, valid questionnaire with internal consistency.
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Zeynel Abidin SAYİNER, Esen SAVAŞ, Seval KUL, Donald E. MORİSKY
Zeynel Abidin SAYİNER, Esen SAVAŞ, Seval KUL, Donald E. MORİSKY
Objective: Diabetes mellitus (DM) is a common disorder that causes undesirable medical and economic consequences. A simple, reliable, and validated self-report instrument could provide a better understanding of non-adherence to treatment and may help identify new treatment modalities. Thus, the eight-item Morisky Medication Adherence Scale (MMAS-8) was developed. The aim of this study was to evaluate the validity and reliability of the MMAS-8 among Turkish diabetes mellitus patients. Methods: This cross-sectional descriptive study enrolled 199 patients. The Turkish translation of the Morisky-8 item scale consisted of forward translation, reconciliation, back translation, back translation review, developer review, pilot testing, and final translation. Results: Cronbach’s alpha test of internal consistency was calculated at alpha=0.890 for the eight items of the MMAS-8 scale. CFA demonstrated the scale fitted CMIN/DF=1.194, GFI=0.970, CFI=0.995, RMSEA=0.031. Poor glycemic control (HbA1c<7) was significantly higher in the low-adherence group than in the high- and medium-adherence groups (p=0.001, LR=21.79). Approximately 94% of the low-adherence group patients were in the poor glycemic control group. Conclusion: The MMAS-8 Turkish version was found to be a valid and reliable scale in diabetic patients. This self-reported scale could function as a screening tool in busy clinics to identify patients with low adherence to medication treatment. Moreover, the MMAS-8 Turkish version could help improve adherence and develop new treatment strategies.
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Objective: Ischemic postconditioning in limb skeletal muscle may decrease the size of the cerebral hypoperfused area after stroke. We compared the effects of ischemic postconditioning with the effects of the pharmacologic agents infliximab and leflunomide in the management of stroke.Methods: Thirty-two rats were divided into four groups: postconditioning, infliximab, leflunomide, and saline (control). Global cerebral ischemia was induced by clamping the bilateral common carotid arteries for 20 min, and subsequently reperfusion was allowed for 2 h. Rats in the infliximab group received 7 mg/kg of infliximab immediately after and 6 h after the induction of stroke. Rats in the leflunomide group received 10 mg/kg of leflunomide immediately after and 6 h after the induction of stroke. In the postconditioning group, the unilateral limb muscle was clamped for 180 min immediately after the induction of stroke, and subse-quently reperfusion was allowed for 120 min. Rats in the control group received saline immediately after and 6 h after the induc-tion of stroke. Glutathione peroxidase, malondialdehyde, and ischemia-modified albumin were measured, and histopathologic evaluation of cerebral tissue was performed.Results: The area of hemorrhage was significantly decreased in the infliximab group. Loss of the gray matter–white matter bound-ary was significantly decreased in the infliximab and leflunomide groups. Brain glutathione peroxidase was significantly increased in the infliximab group. There were no significant differences between the infliximab, leflunomide, and postconditioning groups and the control group in serum malondialdehyde and ischemia-modified albuminConclusion: Immunosuppression by infliximab and leflunomide, but not ischemic postconditioning, may attenuate brain isch-emia–reperfusion injury. Although the curative effects of postconditioning treatment on brain injury were documented, the lengths of the postconditioning cycles are important for its efficacy.
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Objective: The aim of this study was to evaluate the level of consciousness of local anesthetic systemic toxicity (LAST) among dentistry students, which would provide helpful information for scheduling the educational content of future syllabus be-fore graduation to prepare students for possible challenges in the future.Methods: This study included 234 dentistry students, who were in the 3rd, 4th, and 5th degrees during the period 01 December 2018–01 April 2019, and was conducted using a cross-sectional, questionnaire-based design. The revised questionnaire form includes questions addressing the frequency of encountered LAST cases, signs of LAST they had seen, and treatments for LAST, particularly lipid treatment, they had used.Results: The questionnaire was sent to 234 dentistry students in the 3rd, 4th, and 5th degrees at the Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey, of whom 215 (91.88%) responded. The majority of participants (93%, n=200) de-clared that they received training about local anesthetics (LAs). Only one LA agent was preferred among 38.60% (n=83) of participants, whereas other participants preferred multiple agents. A significant majority of the participants (79.5%; n=171) declared that they did not observe LAST before this study, whereas only 15 (7%) students mentioned that they had encoun-tered LAST but used an alternative therapy rather than intravenous lipid rescue therapy. None of the students personally applied lipid rescue therapy.Conclusion: The results of this study implicate the evident need for additional educational effort to create awareness about LA use and effective management of LAST among dentistry students.
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Objective: The aim of this study is to assess the effects of dapagliflozin, a sodium/glucose cotransporter 2 (SGLT2) inhibitor, on serum triglyceride and low-density lipoprotein (LDL) cholesterol levels in patients with type 2 diabetes mellitus (DM).Methods: A total of 40 patients with type 2 DM, who were followed up regularly in the Endocrinology and Metabolism Out-patient Clinic of State Hospital, were evaluated retrospectively. In these patients, dapagliflozin was added to their regular treatment for glycemic control. The patients’ anthropometric measurements, glycemic regulation status, and serum LDL cho-lesterol and triglyceride levels were retrieved from the system records. A statistical analysis of drug effects was performed using the repeated measures analysis of covariance test, keeping the effects of HbA1c and body mass index (BMI) covariates constant.Results: In addition to the improvement in fasting blood glucose levels, HbA1c, and body weight of the patients, a reduction by 10 mg/dL and 43.04 mg/dL was observed in serum LDL cholesterol and triglyceride levels, respectively. The evaluation of BMI and HbA1c covariates together revealed a statistically significant reduction in triglyceride levels (p=0.032 and p=0.008, respectively).Conclusion: Besides glycemic control and weight loss, addition of dapagliflozin to the type 2 DM therapy is associated with an improvement in serum triglyceride levels, suggesting that together with other benefits, SGLT2 inhibitors appear to pro-vide an additional benefit of reducing the risk of cardiovascular diseases.
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Objective: There is a balance among the free radical production and the antioxidant system suppressing the increase of reactive oxygen species in the body. If this balance is disturbed, then oxidative stress occurs. Free radicals caused by normal metabolism or pathological processes cause deterioration in the structure and functions of thiol-dependent enzymes and change in the thiol / disulfide balance in the cell environment. The aim of our study is to evaluate the dynamic thiol/ disulfide balance in children with acute malnutrition. Methods: The weight, weight Z score, height, height Z score and BMI of the patients in the study group were measured. 52 patients diagnosed with acute malnutrition according to Waterlow classification and 40 healthy children were included in the study. The thiol/ disulfide balance was measured in both groups by using the automatic method developed by Erel and Neselioğlu. Results: There was no statistically significant difference among patient and control group in terms of the average native thiol and total thiol levels. While it was found that the levels of disulfide, disulfide/native thiol and disulfide/total thiol were statistically significant in the patient group, the native thiol/total thiol ratio was found to be lower at a significant level. Conclusion: It was seen that thiol/ disulfide balance weakened in children with acute malnutrition and showed a shift towards disulfide.
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Süreyya GÜL YURTSEVER, Abdurrahman AYGÜL, İsmail Cengiz ÖZTÜRK, Salih Atakan NEMLİ, Selçuk KAYA, Şafak ERMERTCAN
Süreyya GÜL YURTSEVER, Abdurrahman AYGÜL, İsmail Cengiz ÖZTÜRK, Salih Atakan NEMLİ, Selçuk KAYA, Şafak ERMERTCAN
Objective: The objective of this study was to investigate some virulence genes and SCCmec types of methicillin-resistant Staphylococcus aureus (MRSA) isolates and to determine their relationship with virulence factors. Methods: A total of 100 MRSA strains, 64 from healthcare-associated and 36 from community-associated infections, were included in the study. The presence of mecA gene was investigated by PCR. SCCmec types and efb, clfB, agrA gene were detected by multiplex PCR and their relationship with virulence factors has been analyzed. Results: All of the isolates contain the mecA gene. At the same time, in 66 strains (66%) agrA gene, in 58 strains (58%) clfB gene, and in 47 strains (47%) efb gene were positive. In terms of SCCmec types, the distribution of these types among the 64 HA-SA strains was 53% similar-to-type-III, 16% type IV, 2% type I and 30% unclassified. The distribution of the types among the 36 CA-SA strains was 19% similar-to-type-III, 25% type IV, 8% type I and 47% unclassified, respectively. When SCCmec types were evaluated according to clinical sample type, similar-to-type-III isolates were found to be dominant in wound samples. Efb (78%), clfB (85%), agrA (88%) were the dominant genes in similar-to-type-III strains, whereas clfB (74%), agrA (100%) were the main genes detected in the type IV strains. Conclusions: It is of clinical and epidemiological importance to know the origin of MRSA strains because this affects the empirical treatment choice.
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