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We investigated the predictive values of the expanded Simplified Acute Physiology Score (SAPS) II and Acute Physiologic Score and Chronic Health Evaluation (APACHE) II score in predicting in-hospital mortality in coronary care unit (CCU) patients.In this study, expanded SAPS II and APACHE II scores were calculated in the CCU of a single-center tertiary hospital. Patients admitted to CCU with any cardivascular indication were included in the study. Both scores were calculated according to previously determined criteria. Calibration and discrimination abilities of the scores in predicting in-hospital mortality were tested with Hosmer-Lemeshow goodness-of-fit C chi-square and receiver operating characteristics (ROC) curve analyses.A total of 871 patients were included in the analysis. The goodness-of-fit C chi-square test showed that both scores have a good performance in predicting survivors and nonsurvivors in CCU. Expanded SAPS II score has a sensitivity of 80% and a specificity of 91.8% with the cut-off value of 5.55, while APACHE II has a sensitivity of 75.9% and a specificity of 87.4% with the cut-off value of 16.5 in predicting mortality.Expanded SAPS II and APACHE II scores have good ability to predict in-hospital mortality in CCU patients. Therefore, they can be used as a tool to predict short-term mortality in cardiovascular emergencies.

Sodium glucose transporter-2 (SGLT-2) inhibitors are employed in the treatment of cardiovascular diseases such as heart failure and coronary artery disease. In the present study, we aimed to investigate how Empagliflozin in SGLT 2 inhibitors affects cardiac contraction and pump efficiency in patients who have Diabetes Mellitus (DM) without cardiovascular disease.The conventional echocardiographic records and biochemical values ​​of 62 patients who had DM without a history of cardiovascular disease were evaluated before using Empagliflozin. The myocardial mechano-energetic (MME) activity and index, and global longitudinal strain (GLS) were also calculated. After 3 months of Empagliflozin use, the tests were repeated and compared with previous data. A p .05 was considered statistically significant.Left ventricular GLS and MME efficiency were found to be significantly higher after treatment (-17.71 ± 2.12, -19.15 ± .71; p .001 and 62.14 ± 18.21, 72.24 ± 26.57; p: .019).An increase was detected in left ventricular longitudinal strain and MME efficiency after using Empagliflozin for 3 months in patients with DM. This result suggests that Empagliflozin improves left ventricular pump efficiency and contraction.

Objective: This study aimed to determine factors related to physical activity and dietary compliance in hypertensive elders living in Isparta. Method: This cross-sectional study included a population living in Isparta city aged >65 years with hypertensive symptoms diagnosed at least 3 months ago. A total of 411 patients were included, with an attainment rate of 91.9% according to the sample size. Dependent variables were physical activity and dietary compliance, and independent variables were sociodemographic and hypertension characteristics. Data was collected using face to face interviews. The chi square test, Fisher’s exact test, independent samples t-test, Mann–Whitney U test, ANOVA, logistic and multiple regression analyses were used for data evaluation. Results: Physical activity compliance was 43.6%, and dietary compliance scores were 5.3 ± 0.9 SD. Physical activity compliance was higher; 3.58 times (p, Amaç: Bu çalışmanın amacı Isparta il merkezinde yaşayan yaşlı ve hipertansif hastalarda fizik aktivite ve diyet uyumu ve bunları belirleyen etmenlerin belirlenmesidir. Yöntem: Kesitsel tipteki çalışmanın evreni Isparta il merkezinde yaşayan 65 yaş ve üzeri hipertansiyon hastalarıdır. Araştırmanın örnek büyüklüğü 447 kişi olarak belirlenmiştir ve örnek büyüklüğü fizik aktivite ve diyet uyumu için ayrı ayrı hesaplanmıştır. 411 kişiye ulaşılmıştır. Ulaşma oranı %91.9’dur. Araştırmanın bağımlı değişkenleri fizik aktivite ve diyet uyumu, bağımsız değişkenleri sosyodemografik ve hipertansiyonla ilgili özelliklerdir. Veri yüz-yüze görüşme yöntemiyle toplanmıştır. Verinin değerlendirilmesinde sayı, yüzde, ortalama, standart sapma, minimum ve maksimum değerler, Ki-kare, Fisher’in kesin testi, bağımsız gruplarda t testi, Mann-Whitney U, ANOVA, Lojistik ve Çoklu Regresyon Analizi kullanılmıştır. Bulgular: Fizik aktivite uyumu %43.6, diyet uyum puanı ortalaması ise 5.3±0.9 bulunmuştur. Fiziksel aktivite uyumu erkeklerde 3.58 kat (p

Background: The interatrial block (IAB) is a condition that occurs due to the delay of conduction in the right atrium to the left atrium, and can be partial (pIAB) or advanced (aIAB), and also is associated with atrial arrhythmia. Diastolic dysfunction (DD) is an important condition frequently encountered in most healthy middle-aged individuals and plays a role in the development of many cardiovascular diseases. It is noteworthy that frequent paroxysmal atrial fibrillation (PAF) attacks are observed especially in individuals with DD in clinical life, and its relationship with the presence of interatrial block is still unclear in these patients. Our aim in this study was to evaluate the relationship between the presence of DD and the development of interatrial block and PAF. Material and Method: A total of 146; 92 patients with DD and 54 control (proven by echocardiography) were enrolled in this cross-sectional and prospectively study. The properties of the P wave were evaluated in leads D2-3 aVF and V1. Echocardiography and electrocardiography results of the two groups were compared. Results: The mean age of the DD and the control group was (62.3±0.74 and 61.2±0.61 years, p=0.481) respectively. The frequency of IAB was significantly higher in the DD than the control group (37%-46.7%-16.3%, 77.8%-18.5%-3.7%, and none-pIAB-aIAB, respectively). In the correlation analysis, there was a strong correlation between the presence of DD and IAB (r: 0.439, p

Mitral valve prolapse (MVP) is the most common cause of mitral regurgitation in developed countries. The role of inflammation in the pathogenesis of MVP is still not clear. In this study, we aimed to investigate how inflammatory markers such as monocyte/high-density lipoprotein ratio (MHR), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), and platelet/neutrophil ratio (PLR) are affected in MVP patients.In this retrospective study, we included 461 patients with MVP and 459 normal echocardiographic patients, matched with gender and age. Inflammatory markers and all variables were compared between the two groups.There were no statistically significant differences in age, sex, or body mass index between the two groups. Neutrophil counts (4,960 [3,900-6,780]. 4,200 [3,800-5,600], p0.001), NLR (2.488 [1.72-4.51], 1.857 [1.49-2.38], p0.001), MHR (14.9 [11.9-18.6], 12.2 [9.4-17.3], p = 0.003), PLR (122.4 [85-171], 104.4 [85-130], p0.001), and CRP (0.71 ± 0.50, 0.67 ± 0.33 p0.001) were significantly higher, and LMR (3.75 [2.75-5.09], 4.06 [3.12-4.83] p = 0.016) was significantly lower in the MVP group than the control group, respectively. In logistic regression analysis, NLR (odds ratio [OR]: 1.058 [1.047-1.072]; p0.001), LMR (OR: 1.560 [1.211-2.522]; p = 0.027), and PLR (OR: 1.015 [1.012-1.019]; p = 0.003) were found to be independent predictors for MVP presence.These parameters can be used as a simple, low-cost, practical tool to detect inflammation in MVP.El prolapso de la válvula mitral (MVP) es la causa más común de insuficiencia mitral en los países desarrollados. El papel de la inflamación en la patogenia del MVP aún no está claro. En este estudio, nuestro objetivo fue investigar cómo los marcadores inflamatorios como la proporción monocitos/HDL (MHR), la proporción linfocitos/monocitos (LMR), la proporción neutrófilos/linfocitos (NLR) y la proporción plaquetas/neutrófilos (PLR) se ven afectados en pacientes con MVP.En este estudio retrospectivo, incluimos a 461 pacientes con PVM y 459 pacientes ecocardiográficos normales, emparejados por sexo y edad. Se compararon los marcadores inflamatorios y todas las variables entre los dos grupos.No hubo diferencias estadísticamente significativas en edad, sexo o índice de masa corporal entre los dos grupos. El recuento de neutrófilos (4,960 [3,900-6,780], 4,200 [3,800-5,600], p0.001), NLR (2.488 [1.72-4.51], 1,857 [1.49-2.38], p0.001), MHR (14.9 [11.9-18.6]), (12.2 [9.4-17.3], p = 0.003), PLR (122.4 [85-171], 104.4 [85-130], p0.001) y PCR (0.71 ± 0.50, 0.67 ± 0.33 p0.001) fueron significativamente mayores y LMR (3.75 [2.75-5.09], 4.06 [3.12-4.83] p = 0.016) fue significativamente menor en el grupo MVP que en el grupo de control, respectivamente. En el análisis de regresión logística; NLR (OR: 1.058 [1.047-1.072]; p0.001), LMR (OR: 1.560 [1.211-2.522]; p = 0.027) y PLR (OR: 1.015 [1.012-1.019]; p = 0.003) se encontraron como predictores independientes para la presencia de MVP.Estos parámetros pueden utilizarse como una herramienta sencilla, práctica y de bajo costo para detectar la inflamación en el PVM.

To evaluate the effect of drug interactions with chronic direct oral anticoagulants (DOAC) on mortality in older atrial fibrillation (AF) patients during the Coronavirus disease 2019(COVID-19) pandemic.We followed a total of 601 elderly patients (65 years of age) from the NOEL-Drug Registry cohort who were referred to a tertiary outpatient clinic between 9 March 2020 and 1 March 2021. We recorded clinical characteristics and medications for the last 3 months. In addition, all drug interactions were identified using Lexicomp®. Finally, we recorded retrospectively all death events, COVID-19 diagnosis, and relevant deaths from the database at the end of the study. According to logistic regression, we performed propensity score (PS) matching to reduce potential bias. Factors associated with total mortality in the 12 months were analyzed using multivariable Cox proportion hazard analysis.The mean age [standard deviation (SD)] was 74.5 (±6.9), and the male/female ratio was 337/264. The prevalence of total mortality was 16.9% (n=102). A total of 4472 drugs were analyzed for DOAC interaction. 81.8% of older AF patients were not at risk in terms of potential interaction. In the Cox proportional hazard model after PS-matching, previous DOAC use with class X interaction was associated with significantly higher mortality risk (adjusted hazard ratio: 2.745, 95% confidence interval: 1.465-5.172, p=0.004).Our study showed that while most co-medications do not have significant interactions with DOACs, few serious drug interactions contribute to mortality in elderly patients with AF during the pandemic.

To evaluate the association between the myocardial mechanoenergetic efficiency index (MEEi) and the Apnea-Hypopnea Index (AHI) in the initial phase of obstructive sleep apnea (OSA) diagnosis.In this cohort study, we included a total of 382 eligible participants without cardiovascular disease in a tertiary outpatient clinic between January 2013 and January 2015. We recorded demographic, clinical, polysomnographic and echocardiographic variables of the patients. In addition, myocardial mechanoenergetic efficiency (MEE) and MEEi were calculated by an echocardiography-derived validated measurement.The mean (±SD) age of the participants was 48.47 ± 12.13, and male/female ratio was 287/95. Comparing with non-OSA, MEEi was significantly lower in OSA patients at all stages (0.35 ± 0.08 vs. 0.42 ± 0.05; p .001). MEEi was negatively correlated with hypertension (r = -0.518, p .001), body mass index (r = -0.382, p .001), AHI (r = -0.656, p .001), total apne (r = -0.525, p .001), hypopnea (r = -0.415, p .001), systolic pulmonary pressure (r = -0.318, p .001), relative wall thickness (RWT; r = -0.415, p .001), and positive correlated with left ventricular ejection fraction (r = 0.586, p .001). According to multiple linear regression analysis AHI (β = -0.625, p .001), total apnea (β = -0.402, p = .001), hypopnea (β = -0.395, p = .001), LV ejection fraction (β = 0.478, p .001) and RWT (β = -0.279, p .001) have an independent relationship with MEEi.MEEi was lower in OSA patients. A reduced MEEi may reflect a disturbance in energy use of the myocardium. Consequently, our results may provide insight into the mechanisms leading to structural cardiac diseases in OSA patients.

Objective: Hypertension is a challenging problem in the older population because of poor drug adherence (DA). We aimed to determine the DA and examine the drug interaction index (DII) on DA in older patients with hypertension. Methods: In this cross-sectional, observational study, we enrolled 418 eligible patients aged ≥ 65 years between 1 February 2020 and 30 September 2020 in a tertiary hospital outpatient cardiology clinic. We prepared a questionnaire to record sociodemographic characteristics, morbidities, and drugs used by the population. The Morisky Medication Adherence Scale-8 (MMAS-8) was used for DA assessment. We identified drug interactions using the Lexicomp application. We calculated the DII from a ratio of clinically relevant interaction to total interaction. Descriptive tests and multiple linear regression analyses were performed to find independent factors on DA. Results: The mean age (± standard deviation [SD]) was 72.91 (±6.47), and 272/146 were female/male in the study population. The most frequent comorbid disease was diabetes mellitus (23.5%). The percentage of patients having polypharmacy was 39.5, and the mean daily drug (±SD) use was 4.27 (±2.57). The most prescribed antihypertensive drugs were thiazide/derivates (29.8%) and angiotensin receptor blockers (24.8%). The mean MMAS-8 (±SD) was 4.55±0.98, and 321 (76.8%) participants had a poor DA. A total of 33.4% of patients had significant drug interaction. The mean DII (±SD) was 0.345±0.017. The area under the receiver operating characteristic (ROC) curve for DII was 0.616 (95% confidence interval [CI]: 0.547-0.686). Conclusion: We defined a new index for drug interaction intensity. Furthermore, the DII may be a useful tool to study aspects of DA in older patients with hypertension. Amaç: Hipertansiyon, yaşlılarda tedaviye uyum düşük olduğu için yönetimi güç bir hastalıktır. Çalışmamızda yaşlı hipertansiflerde ilaç etkileşim endeksinin (İEE) ilaç uyum üzerine etkisini değerlendirmeyi amaçladık. Yöntemler: Kesitsel gözlemsel çalışmamıza, 01.02.2020 ile 30.09.2020 arasında üçüncü basamak hastanenin kardiyoloji polikliniğine başvuran 65 yaş ve üzeri, 418 hastayı dahil ettik. Hastaların sosyo-demografik özelliklerini, ek hastalıklarını ve aldıkları ilaçları sorgulayan bir anket hazırladık. İlaç uyumu için Morisky ilaç uyum skalası-8 (MMAS8) kullanıldı. İlaç etkileşimleri, Lexicomp® uygulaması ile değerlendirildi. İlaç uyumunu etkileyen faktörlerin tespiti için tanımlayıcı testler ve çoklu lineer regresyon analizleri yapıldı. İlaç uyum indeksi, klinik ilişkili ilaç etkileşimlerinin toplam ilaç etkileşimlerine oranından hesaplanmıştır. Bulgular: Araştırma popülasyonunun ortalama yaşı [± standart sapma (SS)] 72.91 (±6.47) idi ve 272/146’ü kadın/erkekti. En sık eşlik eden hastalık diyabetes mellitustu (%23.5). Hastaların %39.5’inde polifarmasi mevcuttu, günlük ortalama (SS) 4.27 (±2.57) sayıda ilaç alıyordu. En sık reçete edilen anti-hipertansifler tiazid ve türevleri (%29.8), anjiyotensin reseptör blokerleri (24.8%), anjiyotensin dönüştürücü enzim inhibitörü (%14.9) idi. Ortalama MMAS-8 skoru (SS) 4.55±0.98 idi ve katılımcıların 321 (%76.8)’inin ilaç uyumu kötüydü. Hastalarının %33.4’ünde klinik ilişkili ilaç etkileşimi vardı. Yeni ilaç etkileşim indeksini ortalama (SS) 0.345±0.017 idi. MMAS8 skorunu belirlemede İEE’nin tahmini için yapılan receiver operating characteristic (ROC) eğrisi analizinde eğri altı alanı 0.616 saptadık [95% güven aralığı (GA): 0.547- 0.686]. Sonuç: Yaşlı hipertansiflerde ilaç etkileşim yoğunluğunu belirlemek için yeni bir endeks tanımladık. Bu endeks, ilaç uyumu tahmininde kullanışlı bir araç olabilir.

Coronavirus disease outbreak in Wuhan City in Hubei Province, China, in December 2019, soon spread to over a hundred countries. In March 2020, WHO declared COVID-19 a pandemic. Carrying high numbers of cases and mortality rates, far-reaching consequences of the global pandemic continues to be the prime global agenda. Communication efforts were maintained continuously during the epidemic to inform the public, raise awareness, take precautions and to eventually mitigate the pandemic so as to prevent the national health system from collapsing. Media played a key role as the public and health authorities disclosed information. Nevertheless, modern communication technologies and the infodemic spreading from social media hindered the communication of accurate information. Given the insufficient health literacy in Turkey, the rapidly changing and unstable pandemic environment resulted in information gaps and in overlooked information. The significance of critical media literacy and health literacy, particularly in digital media, was once again underlined. This study evaluates the influence of risk communication and media on society during the COVID-19 pandemic. In addition, the study assesses important concerns for media during risk periods, including a pandemic.

Background: Rehospitalizations with acute coronary syndromes (ACSs) have declined over the last years, but there is a remaining need for potential further reduction of rehospitalization after ACS to determine the most predominant predictors that can guide strategies to reduce re-hospitalizations burden. Aim: This multi-center study aimed to evaluate the demographic, clinical characteristics, and medications of rehospitalized patients who suffered a new cardiac event in 12 months after admission due to ACS. Material and Methods: Patients age >18 years who have been hospitalized between November 1 2017, and April 1 2018, for ACS within12 months before the readmission for a new acute coronary event were enrolled. Results: The present study included a total of 628 (65.9% from Turkey) consecutive patients rehospitalized with ACS (ST-elevation myocardial infarction [STEMI], 23.0%; ACS without ST-elevation [NSTE-ACS], 76.9%) from 15 different countries. The majority of the rehospitalized patients were men (67.9%), and the mean age was 63.1 ± 12.53 years. 406 (64.6%) had typical, 209 (33.2%) of patients had atypical chest pain and 13 (2.07%) had not any chest pain complaint during readmission. 304 (48.41%) of patients were discharged from hospital earlier than 3 days and 107 (17.04%) of patients stayed more than 7 days. The subcategories of first index diagnosis were 227 (36.1%) STEMI; 401 (63.8%) NSTE-ACS. The mean time from index discharge to rehospitalization was 189.25 ± 118 days. 248 (39.4%) patients were re-hospitalized more than once after index discharge. The most common risk factors were diabetes mellitus (471, 75.0%). 175 (27.87%) of patients stopped taking medication before re-hospitalization. Most of the patients (69.4%) had multivessel disease. Conclusion: Several factors identify patients at higher risk of rehospitalization with ACS. Understanding and preventing these causes can prevent rehospitalization and improve their outcome.

Purpose: This study aims to evaluate left ventricular (LV) functions using speckle-tracking echocardiography (STE)-based analyses in the early stages of obstructive sleep apnea (OSA). Methods: Twenty-one healthy individuals and 79 OSA patients enrolled in the study. The OSA group was classified according to Apnea-Hypopnea Index (AHI) as mild, moderate, and severe. Two-dimensional tissue Doppler imaging and STE was performed. Results: The control and OSA groups were comparable for sex (P = 0.450) and age (P = 0.560), while diabetes (P < 0.001) and hypertension (P < 0.001) diagnoses and body mass index (P < 0.001) were higher in the OSA patients. In OSA group, global longitudinal strain (GLS) (-13.32±3.19%, P < 0.001), global circumferential strain (GCS) (-18.33±3.40%, P < 0.001) and global radial strain (GRS) (37.91±8.11%, P = 0.005) were reduced. GLS and GCS have a decreasing trend toward severe OSA, while GRS increased in mild and moderate OSA. According to linear regression analysis, GRS (β: −1.47, P = 0.001], GCS (β: −1.34, P = 0.001), GLS (β: −1.54, P < 0.001), systolic pulmonary artery pressure (β: 0.99, P = 0.001), and deceleration time (β: 0.13, P = 0.03) have an independent relationship with AHI. Conclusions: In our study, STE technique can be a practical method for manifesting LV functional impairment at the early stages of OSA.

OBJECTIVE Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. METHODS The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: ≥50%). RESULTS A total of 1098 patients (male, 47.5%; mean age, 83.5+-3.1 years) aged ≥80 years and 4596 patients (male, 50.2 %; mean age, 71.1+-4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were ≥80 years and 27.1% for patients 65-79 years old. For patients aged ≥80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p

The aim of this study was to make a comparison between the cyclic fatigue (CF) resistance of F360, twisted files (TF), FlexMaster (FM) and RaCE instruments with 4% taper. A total of 40 instruments were evaluated 8 mm from the tip. A stainless steel block with a simulated canal of 1.5 mm diameter, and a 60° angle of curvature was tested using CF testing. One-way ANOVA and posthoc Tukey's test (P 0.05). F360 instruments with a double S cross-section had the highest CF resistance among the group. The TF led the NiTi rotary files to be more resistant to fatigue than the FM and RaCE instruments.

The aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented using ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne systems. Eppendorf tubes containing apically extruded debris were weighed three times, and mean values were calculated. The net mass of the extruded debris was calculated by subtracting the initial mass from the final mass. The groups were compared using one-way analysis of variance and Tukey's post hoc tests at a significance level of P

The purpose of this study was to compare the fracture resistance of Co-Cr post-cores fabricated with 3 different techniques: traditional casting (TC), computer-aided design and manufacturing (CAD/CAM) milling (CCM) and direct metal laser sintering (DMLS).Forty intact human mandibular premolar were endodontically treated. The roots were then randomly divided into four groups according to the post systems: the control group was only filled with gutta percha. Co-Cr metal posts were fabricated with TC, CCM and DMLS in the other three groups. The posts were luted with a resin cement and subjected to compression test at a crosshead speed of 1mm/min. The statistical analysis of the data was performed using one-way analysis of variance (ANOVA) and multiple comparison post hoc Tukey tests (α=.05). The samples were examined under a stereomicroscope with ×20 magnification for the evaluation of the fracture types.The mean fracture loads were 432.69 N for control, 608.89 N for TC, 689.40 N for DMLS and 959.26 N for CCM. One-way ANOVA revealed significant difference between the groups (p0.01). In the post hoc Tukey test, there were significant differences between groups except DMLS and TC.While Co-Cr posts fabricated by TC and DMLS systems performed similarly in terms of fracture resistance, posts fabricated by CCM techniques showed higher fracture resistance values.Co-Cr metal posts fabricated by CCM and DMLS could be an alternative to TC processing in daily clinical application.

The purpose of the present study was to assess the effect of root canal instrumentation using Twisted File Adaptive instruments (Axis/SybronEndo, Orange, CA) with different kinematics (adaptive motion, 90° clockwise [CW]-30° counterclockwise [CCW], 150° CW-30° CCW, 210° CW-30° CCW, and continuous rotation) on crack formation.One hundred five mandibular central incisor teeth were selected. Fifteen teeth were left unprepared (control group), and the remaining 90 teeth were assigned to the 5 root canal shaping groups as follows (n = 15): adaptive motion, 90° CW-30° CCW, 150° CW-30° CCW, 210° CW-30° CCW, continuous rotation, and hand file. All the roots were sectioned horizontally at 3, 6, and 9 mm from the apex with a low-speed saw under water cooling, and the slices were then viewed through a stereomicroscope at 25× magnification. Digital images of each slice were captured using a camera to determine the presence of dentinal cracks.No cracks were observed in the control group, and the continuous rotation group had more cracks than the reciprocation groups (90° CW-30° CCW, 150° CW-30° CCW, and 210° CW-30° CCW) (P.05). Both the continuous rotation and adaptive motion groups had significantly more dentinal cracks than the hand file group (P.05). Regarding the different sections (3, 6, and 9 mm), there was a significant difference between the experimental groups at the 9-mm level (P.05).The incidence of dentinal cracks is less with TF Adaptive instruments working in 210° CW-30° CCW reciprocating motion compared with working in continuous rotation and adaptive motion.

To compare the cyclic fatigue resistance of ProTaper Gold (PTG, Dentsply Tulsa Dental Specialities, Tulsa, OK, USA), ProTaper Next (PTN, Dentsply Tulsa Dental Specialities) and ProTaper Universal (PTU, Dentsply Tulsa Dental Specialities) instruments at different levels.A total of 72 files were used to evaluate the cyclic fatigue of PTU (F2), PTN (X2) and PTG (F2) at 5 mm (n = 12) and 8 mm (n = 12) from the tip in 3-mm-radius steel canals with a 60° angle of curvature. The time to fracture was recorded. The Kolmogorov-Smirnov test was used to assess the normality of the samples distribution, and the statistical analysis was performed using the independent sample t-test (P0.01).Significant differences were found amongst the instruments 5 mm from the tip (P0.01). The PTG files had the highest CF resistance, and the PTN files displayed greater CF resistance than the PTU files. No significant differences were found between the PTG and PTN files 8 mm from the tip (P0.01). The PTG and PTN files demonstrated greater CF resistance than the PTU files (P0.01).The PTG instruments were the most resistant 5 and 8 mm from the tip; however, at 8 mm, there was no difference between the PTG and PTN instruments. The PTU files had the lowest CF resistance at all levels.

Aim: The aim of this study was to compare the fracture resistance of teeth filled with AH Plus and MTA Fillapex root canal sealers by using different root canal obturation techniques. Materials and Methods: One hundred and twenty pieces of single-rooted-and-canalled mandibular premolar teeth were selected. After the crowns were removed from the cemento-enamel junction, they were divided into 10 groups (n = 12). All the root canals except for the Group 1 were shaped until F4 file with ProTaper Nickel- Titanyum (Ni-Ti) rotary system. Group 1: was not instrumented. Group 2: the root canals were shaped but not filled. Group 3: roots were filled with cold lateral condensation technique (CLC) by using AH Plus. Group 4: roots were filled with CLC by using MTA Fillapex. Group 5: roots were filled with single cone technique by using AH Plus. Group 6: roots were filled with single cone technique by using MTA Fillapex. Group 7: roots were filled with AH Plus by using vertical compaction method with continuous heat. Group 8: roots were filled with MTA Fillapex by using vertical compaction method with continuous heat. Group 9: roots were filled with AH Plus by using thermoplastic core carrier method. Group 10: roots were filled with MTA Fillapex by using thermoplastic core carrier method. Before embedding the samples in acrylic resin after standing in an oven at 37°C for 2 weeks for the hardening of the root canal sealers the 5 mm apical portion of the roots were immersed in wax in order to imitate the surrounding tissues. Polyvinyl siloxane impression material was used for the samples which were embedded in acrylic resin in a way that the coronal 8 mm remained outside in order to imitate the periodontal ligament. Lateral force was applied to the samples with 1 mm/min speed in the Universal Tester. The maximum force values (F-max) which cause fractures in the examples were determined and the results were subjected to statistical evaluation by using one-way Anova and Tukey HSD tests with the significance set at (P

Objective: The aim of this study was to evaluate the effect of citric acid irrigation on root fracture in different concentrations and at various time exposures on root fracture. Materials and Methods: Forty-eight human mandibular incisors with similar dimensions were selected. The specimens were decoronated, then divided into 6 groups as follows: A group without instrumentation and filling (G1) and the 5 other groups with canal preparation and irrigation of distilled water (G2), 10% citric acid for 1 min (G3), 50% citric acid for 1 min (G4), 10% citric acid for 10 min (G5), and 50% citric acid for 10 min (G6). In the experimental groups, the canals were obturated and subjected to the strength test. Statistical analysis was performed using Kruskal-Wallis test (P = 0.05). Results: G6 showed the highest fracture resistance (629.97 N), and G3 showed the lowest fracture resistance (507.76 N). However, there was no statistically significant difference among the groups. Conclusions: The results of this study suggest that use of citric acid is safe in terms of fracture resistance.

Failure to decrease blood pressure (BP) normally during nighttime (non-dipping) in hypertension is associated with higher cardiovascular morbidity and mortality. In addition, non-dipping BP is associated with increased platelet activity and inflammatory response; however, there has been no study to evaluate the relationship of non-dipping BP to indices of platelet activity and inflammation in uncontrolled hypertensive patients. In the present study, hypertensive subjects with uncontrolled office BP were firstly divided into three groups: 84 subjects with white coat effect and 365 subjects with true uncontrolled hypertension. Then, true uncontrolled hypertensive patients were divided into two groups: 158 patients with dipping and 207 patients with non-dipping. Mean platelet volume (MPV), uric acid (UA), γ-glutamyltransferase (GGT), C-reactive protein (CRP), and high-sensitivity CRP (hs-CRP) levels were studied. The general characteristics and risk factors for coronary artery disease (CAD) of the study population were similar among the groups. MPV, UA, GGT, CRP, and hs-CRP levels were significantly higher in non-dipper group than both dipper and white coat effect groups, and were significantly higher in dipper group than in white coat effect group (MPV: 9.1 ± 1.3, 8.7 ± 1.1, and 8. ± 0.9 fL; UA: 6.9 ± 1.2, 5.9 ± 1.4, and 4.1 ± 0.8 mg/dL; GGT: 38.9 ± 11.1, 33.6 ± 14.9, and 25.2 ± 9.2 U/L; CRP: 7.1 ± 2.4, 6.2 ± 1.9, and 3.9 ± 0.8 mg/dL; hs-CRP: 3.8 ± 1.5, 3.3 ± 1.2, and 2.0 ± 0.6, non-dipper, dipper, and white coat effect groups, respectively, all p values0.01). All study parameters strongly correlated with each other. In conclusion, in hypertensive patients with uncontrolled office BP, presence of non-dipping BP is associated with increased platelet activity and inflammation, which can be one of the underlying plausible mechanisms of non-dipping BP status.

WOS: 000333663900009 PubMed ID: 23564022 Thromboembolic events may be seen in patients with hypertrophic cardiomyopathy (HCM). We investigated the mean platelet volume (MPV), an indicator of platelet activation in patients with HCM. This study included 112 patients with HCM, in which 40 were patients with hypertrophic obstructive cardiomyopathy (HOCM), and 106 were control participants. The MPV was significantly higher in patients with HCM than in controls (9.1 +/- 0.3 vs 7.9 +/- 0.3 fL, P = .01). In the subgroup analyses, MPV was also higher in patients with HOCM compared to those with hypertrophic nonobstructive cardiomyopathy (HNCM; 9.3 +/- 0.3 vs 9.0 +/- 0.2 fL, P = .01). Similarly, patients with HNCM had higher MPV values than controls (9.0 +/- 0.2 vs 7.9 +/- 0.3 fL, P = .01). The MPV was significantly and positively correlated with left ventricular outflow tract (LVOT) obstruction (r = .42, P = .001) and septal thickness (r =.62, P = .001). In linear regression analysis, MPV was independently associated only with septal thickness (beta = .07, 95% confidence interval: 0.04-0.09, P = .001). The MPV can be elevated in patients with HCM regardless of the obstruction of LVOT and may be associated with the severity of septal thickness.

WOS: 000395146100001 PubMed ID: 27905214 Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevation myocardial infarction (STEMI). Oxidative stress and inflammation may cause structural and electrical remodeling in the atria making these critical processes in the pathology of AF. In this study, we aimed to evaluate the association between total oxidative status (TOS), total antioxidative capacity (TAC) and high-sensitivity C-reactive protein (hs-CRP) in the development of AF in patients presenting with STEMI. This prospective cohort study consisted of 346 patients with STEMI. Serum TAC and TOS were assessed by Erel's method. Patients were divided into two groups: those with and those without AF. Predictors of AF were determined by multivariate regression analysis. In the present study, 9.5% of patients developed AF. In the patients with AF, plasma TOS and oxidative stress index (OSI) values were significantly higher and plasma TAC levels were significantly lower compared to those without AF (p=.003, p=.002, p

The aim of this study was to compare the efficacy of the XP-endo Finisher and TRUShape 3D Conforming File to conventional and ultrasonic irrigation techniques for removing calcium hydroxide from artificially created grooves on root canals. The study used 32 human mandibular premolar teeth, which were decoronated and instrumented up to ProTaper Universal F5 (Dentsply Maillefer; Ballagiues, Switzerland). The teeth were split longitudinally, two standardised grooves were prepared in the apical and coronal portions and filled with calcium hydroxide. Each tooth was reassembled with wax. The samples were stored at 100% humidity at 37°C for 1 week, after which the specimens were grouped and irrigated using needle irrigation, ultrasonic irrigation, XP-endo Finisher via continuous irrigation or TRUShape 3D Conforming File via continuous irrigation. Two calibrated observers scored the amount of calcium hydroxide remaining, and the data were statistically analysed using the Kruskal-Wallis and Mann-Whitney U-tests, (P < 0.05). Needle irrigation had the poorest scores (P < .001), while the XP-endo Finisher, TRUShape 3D Conforming File via continuous irrigation and ultrasonic irrigation groups had similar results in removing calcium hydroxide.

Aim: The aim of this in vitro study was to compare the effect of Ledermix paste and Calcium hydroxide (Ca(OH)2) on root fracture resistance. Materials and Methods: Sixty extracted human mandibular premolars with single canals and straight roots were used. After the crowns were removed, the root canals were prepared with Reciproc R50 files. Smear layer of roots were removed using 17% EDTA followed by 5.25% NaOCl and distilled water. The roots were then randomly divided into four groups (n = 15) according to the medicaments used: Ledermix paste, Ca(OH)2, negative control, and positive control. Samples were stored at 37°C and 100% humidity for 3 weeks. The specimens in experimental and control groups were obturated with cold lateral compaction technique before fracture resistance assessment. Then the apical ends of the roots were embedded vertically inside 4 mm of the acrylic resin. A load was applied on the roots of all teeth to their long axis until fracture occurred. Data were analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey tests. Results: There were statistically significant differences between the groups. According to the post-hoc Tukey test, there was statistically significant difference between negative control group and Ca(OH)2 group (p0.05). Additionally, there was no statistically significant difference between Ledermix Paste, negative control and positive control group (p>0.05).Conclusion: The fracture resistance of the teeth was not significantly affected with 3 week application of Ledermix Paste and Ca(OH)2.Keywords: Calcium hyrdoxide, Ledermix Paste, root fracture, vertical root fracture KALSİYUM HİDROKSİT VE LEDERMİX PASTA’NIN VERTİKAL KÖK KIRIĞINA OLAN ETKİSİNİN KARŞILAŞTIRILMASI ÖZ Amaç: Bu in vitro çalışmanın amacı, kök kanal medikamenti olarak kullanılan Ledermix pasta and Kalsiyum Hidroksit’in (Ca(OH)2 vertikal kök kırığına olan etkisini karşılaştırmaktır. Gereç ve Yöntem: Bu çalışmada tek köklü ve tek kanallı 60 adet alt çene küçük azı dişleri kullanıldı. Kronlar mine sement sınırından uzaklaştırıldıktan sonra kök kanalları Reciproc R50 eğelerle genişletildi. Smear tabakası % 17 EDTA, % 5,25 NaOCl ve distile su kullanılarak uzaklaştırıldı. Kullanılan medikamen tipine göre kök kanalları dört gruba (n = 15) ayrıldı: Ledermix patı, Ca(OH)2, negatif kontrol ve pozitif kontrol. Örnekler 37 °C and %100 nemli ortamda 3 hafta bekletildi. Deney ve kontrol gruplarında kök kanalları soğuk lateral kondensasyon tekniği kullanılarak dolduruldu. Daha sonra köklerin apikal 4 milimetrelik kısmı akrilik rezin bloklara gömüldü. Universal test cihazında kökün uzun aksına dik gelecek şekilde kuvvet kırık gerçekleşene kadar uygulandı. Veriler tek yönlü varyans analizi ve Tukey çoklu karşılaştırma testi ile analiz edildi.Bulgular: Gruplar arasında anlamlı fark vardı. Tukey çoklu karşılaştırma testi sonucuna göre Ca(OH)2 ve negatif kontrol grubu arasında istatistiksel olarak anlamlı fark bulundu (p0.05). Ayrıca Ledermix patı, negatif kontrol ve pozitif kontrol arasında da istatistiksel olarak fark yoktur (p>0.05).Sonuç: Kök kanal medikamenti olarak kullanılan Ca(OH)2 ve Ledermix Patı’nın 3 haftalık uygulaması dişlerin kırılma direncini etkilememiştir.Anahtar Kelimeler: Kalsiyum Hidroksit, Ledermix patı, kök kırığı, vertikal kök kırığ

WOS: 000329760400003 PubMed ID: 23064218 Thromboembolic events can be seen in patients with mitral valve prolapse (MVP). It is unclear whether platelet activation may contribute to these events in patients with MVP. Thus, we aimed to evaluate mean platelet volume (MPV) in patients with MVP and its association with the severity of MVP. This study included 312 patients with MVP and 240 control participants. Mean platelet volume was significantly higher in patients with MVP than in controls (8.9 +/- 0.7 vs 7.9 +/- 0.6 fL, P = .001). In linear regression analysis, MPV was independently associated with the degree of mitral regurgitation ( = .23, 95% confidence interval (CI): 0.14-0.32, P = .001), maximal leaflet displacement ( = .24, 95%CI: 0.17-0.31, P = .001), and mean thickness of the anterior ( = .47, 95%CI: 0.27-0.61, P = .001) and posterior leaflets ( = .22, 95%CI: 0.03-0.41, P = .02). Our findings show that MPV can be elevated in patients with MVP and may be independently associated with severity of mitral regurgitation, leaflet displacement, and thickness of the leaflets.

The aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented using ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne systems. Eppendorf tubes containing apically extruded debris were weighed three times, and mean values were calculated. The net mass of the extruded debris was calculated by subtracting the initial mass from the final mass. The groups were compared using one-way analysis of variance and Tukey's post hoc tests at a significance level of P 0.05. The PTG group extruded less debris than the PTU group, and the WOG group extruded less debris than the WO group (P 0.05). All the instrumentation systems tested in the present study were associated with apical extrusion of debris.

The aim of this study was to make a comparison between the cyclic fatigue (CF) resistance of F360, twisted files (TF), FlexMaster (FM) and RaCE instruments with 4% taper. A total of 40 instruments were evaluated 8 mm from the tip. A stainless steel block with a simulated canal of 1.5 mm diameter, and a 60° angle of curvature was tested using CF testing. One-way ANOVA and posthoc Tukey's test (P0.05) were used. The F 360 files showed the highest CF resistance while the TF files had greater CF resistance than the FM and RaCE (P0.05). There was no significant difference between the FM and RaCE (P0.05). F360 instruments with a double S cross-section had the highest CF resistance among the group. The TF led the NiTi rotary files to be more resistant to fatigue than the FM and RaCE instruments.

The aim of this study was to determine the effect of oral cholecalciferol treatment on vascular calcification, left ventricular mass index (LVMI) and other cardiac functions in dialysis patients.A six-month course of oral cholecalciferol treatment was recommended to dialysis patients with vitamin D insufficiency. While 26 patients were given cholecalciferol treatment, 17 patients who could not tolerate to therapy received standard therapy. Initial biochemical parameters were measured, and they were measured again after 6 months of treatment. Echocardiographic measurements were also performed, and the vascular calcification score (VCS) was calculated at baseline and at the 6th month.The cholecalciferol replacement group showed no significant change in LVMI and VCS values (p 0.05). However, while LVMI was similar between groups at initial evaluation, it was lower in the cholecalciferol group at the 6th month when compared to the standard treatment group (141.8 ± 40.2 g/m(2) vs. 166.3 ± 31.4 g/m(2); p = 0.04). Likewise, left ventricular diastolic diameters (48.8 ± 5.1 mm vs. 47.5 ± 4.6 mm; p = 0.023) and left atrial diameters (41.2 ± 8.9 mm vs. 38.9 ± 8.1 mm; p = 0.006) decreased in the cholecalciferol group. Additionally, significant increases were observed in serum 25-hydroxyvitamin D (25(OH)D) and albumin levels, with a significant decrease in serum C-reactive protein levels.A lesser increase in left ventricular mass and better diastolic functions was observed in dialysis patients after 6 months of cholecalciferol treatment.

The aim of this study was to compare the fracture resistance of teeth filled with AH Plus and MTA Fillapex root canal sealers by using different root canal obturation techniques.One hundred and twenty pieces of single-rooted-and-canalled mandibular premolar teeth were selected. After the crowns were removed from the cemento-enamel junction, they were divided into 10 groups (n = 12). All the root canals except for the Group 1 were shaped until F4 file with ProTaper Nickel- Titanyum (Ni-Ti) rotary system. Group 1: was not instrumented. Group 2: the root canals were shaped but not filled. Group 3: roots were filled with cold lateral condensation technique (CLC) by using AH Plus. Group 4: roots were filled with CLC by using MTA Fillapex. Group 5: roots were filled with single cone technique by using AH Plus. Group 6: roots were filled with single cone technique by using MTA Fillapex. Group 7: roots were filled with AH Plus by using vertical compaction method with continuous heat. Group 8: roots were filled with MTA Fillapex by using vertical compaction method with continuous heat. Group 9: roots were filled with AH Plus by using thermoplastic core carrier method. Group 10: roots were filled with MTA Fillapex by using thermoplastic core carrier method. Before embedding the samples in acrylic resin after standing in an oven at 37°C for 2 weeks for the hardening of the root canal sealers the 5 mm apical portion of the roots were immersed in wax in order to imitate the surrounding tissues. Polyvinyl siloxane impression material was used for the samples which were embedded in acrylic resin in a way that the coronal 8 mm remained outside in order to imitate the periodontal ligament. Lateral force was applied to the samples with 1 mm/min speed in the Universal Tester. The maximum force values (F-max) which cause fractures in the examples were determined and the results were subjected to statistical evaluation by using one-way Anova and Tukey HSD tests with the significance set at (P 0.05).The control group showed the maximum fracture resistance (P 0.05). Thermafil group showed higher fracture resistance than single cone technique, cold lateral condensation technique, and system B (P 0.05).It was concluded that shaping and widening of the root canals reduced the fracture resistance of teeth while Thermafil increased the resistance of roots against fracture.

Numerous studies have shown an association between patent foramen ovale (PFO) and cryptogenic stroke suggesting that paradoxical emboli may be an important cause of stroke. In addition, some authors have proposed that platelet activation is present in PFO patients and this might be the cause of the stroke. The aim of this study was to assess the mean platelet volume (MPV), an indicator of platelet activation and/or reactivity in patients with PFO. The study group consisted of 77 patients with PFO. An age, sex, BMI-matched control group was composed of 43 healthy volunteers. We measured serum MPV values in patients and controls. MPV was significantly higher among PFO patients when compared with control group (9.0±0.8 vs. 8.3±0.9 fl, respectively; P0.001). We have shown that MPV was significantly elevated in patients with PFO compared with controls.