Comparison of the effects of dexketoprofen trometamol,meloxicam and diclofenac sodium on fibular fracture healing,kidney and liver: An experimental rat model

Objectives

Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly used in patients with bone fractures, but there are limited studies on whether one NSAID is superior to another. In this study, we used histopathological and biochemical parameters to determine whether there are differences between the effects of the administration of clinical doses of dexketoprofen trometamol (DEXT), meloxicam (MEL) and diclofenac sodium (DIC) on the healing of closed fibular fractures and the toxicity of both the liver and kidney.

Methods

Twenty-eight male Sprague-Dawley rats were randomly divided into four groups of seven each. Closed diaphyseal fractures were formed in the left fibulas of all of the rats. The NSAIDs dexketoprofen trometamol (DEXT) (Arveles^®), meloxicam (MEL) (Melox^®) and diclofenac sodium (DIC) (Voltaren^®) were intramuscularly administered to Groups I, II, and III, respectively, for a period of 10 days after the fibular fractures were performed. No pharmacological agents were administered to Group IV (Control group). Blood samples were collected from all of the rats after the fractures were performed, and the rats were sacrificed on day 28. The histopathological findings were compared, and the blood samples were evaluated to determine any differences between the levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA).

Results

Our results suggest that DEXT and MEL impair the healing of bone fractures and that DIC does not histopathologically affect the healing process of bone fractures. We also found that DEXT, MEL, and DIC impaired the renal histopathology compared with the control group. However, the liver histopathological analysis showed that DEXT and MEL caused a higher degree of parenchymal necrosis compared with DIC.

Conclusion

Based on our results, DIC can be considered a relatively safe medication in patients with fractures.     

Duration of ultrasonic activation causing secondary fractures during the removal of the separated instruments with different tapers

Objectives

The aim of the present study was to determine the effect of taper (.08, .06, and .04) of separated K3XF instruments on duration taken for the secondary fracture formation during ultrasonic activation.

Materials and methods

Ten 25/.08 K3XF (SybronEndo, Orange, CA, USA), ten 25/.06 K3XF, and ten 25/.04 K3XF instruments were used for the study. The apical 5 mm of the instruments was cut to simulate the fragments in root canals. Fragments of the instruments were sandwiched between two straight dentin blocks. An ultrasonic tip was used to cause a secondary fracture of the fragment. The time needed for the secondary fracture was recorded for each instrument. The data were statistically analyzed using the Kruskal-Wallis H test (alpha = 0.05).

Results

Secondary fractures occurred in all instruments. In the .08 taper group, secondary fractures took longer than in the case of the .06 and the .04 taper groups (P < 0.05). There were no significant differences between the .06 and the .04 taper groups in terms of the time required for the occurrence of a secondary fracture (P > 0.05).

Conclusions

In the .08 taper group, secondary fracture took longer time than in the case of the .06 and the .04 taper groups due to its larger cross-sectional area involved.

Clinical relevance

Typically, when removing separated instruments, a much lower power setting is chosen. The purpose of this in vitro study was to determine which tapered files were more resilient to secondary fracture, thus allowing a higher power setting to be chosen. Thus, the results of the present study cannot be used in clinical practice. If the clinician knows the taper of the broken file, the clinician should be very careful with regard to secondary fractures when using ultrasonics to remove the separated smaller tapered instruments.

     

Food web effects of titanium dioxide nanoparticles in an outdoor freshwater mesocosm experiment

Over the course of 78?days, nine outdoor mesocosms, each with 1350?L capacity, were situated on a pontoon platform in the middle of a lake and exposed to 0?μg?L^?1 TiO₂, 25?μg?L^?1 TiO₂ or 250?μg?L^?1 TiO₂ nanoparticles in the form of E171 TiO₂ human food additive five times a week. Mesocosms were inoculated with sediment, phytoplankton, zooplankton, macroinvertebrates, macrophytes and fish before exposure, ensuring a complete food web. Physicochemical parameters of the water, nutrient concentrations, and biomass of the taxa were monitored. Concentrations of 25?μg?L^?1 TiO₂ and 250?μg?L^?1 TiO₂ caused a reduction in available soluble reactive phosphorus in the mesocosms by 15 and 23%, respectively, but not in the amount of total phosphorus. The biomass of Rotifera was significantly reduced by 32 and 57% in the TiO₂ 25?μg?L^?1 and TiO₂ 250?μg?L^?1 treatments, respectively, when compared to the control; however, the biomass of the other monitored groups—Cladocera, Copepoda, phytoplankton, macrophytes, chironomids and fish—remained unaffected. In conclusion, environmentally relevant concentrations of TiO₂ nanoparticles may negatively affect certain parameters and taxa of the freshwater lentic aquatic ecosystem. However, these negative effects are not significant enough to affect the overall function of the ecosystem, as there were no cascade effects leading to a major change in its trophic state or primary production.     

Further delineation of spondyloepimetaphyseal dysplasia Faden‐Alkuraya type: A RSPRY1‐associated spondylo‐epi‐metaphyseal dysplasia with cono‐brachydactyly and craniosynostosis

Our understanding of the molecular basis of the genetic disorders of the skeleton has steadily increased, as the application of high‐throughput sequencing technology has expanded. One of the newcomers is Spondyloepimetaphyseal dysplasia Faden‐Alkuraya type. In this study, we aimed to further delineate the clinical, radiographic, and molecular findings of this entity in five affected individuals from two unrelated families. All patients have short stature, extremity deformities, facial dysmorphism and intellectual disability. The skeletal hallmarks include (a) mild spondylar dysplasia, (b) epimetaphyseal dysplasia of the long bones associated with coxa vara and genu valgum, (c) brachymesophalangy with cone‐shaped epiphyses, and (d) craniosynostosis. Unlike the previously reported clinical findings, all patients except one are normocephalic, and all share the clinical findings including craniosynostosis, varying degrees of intellectual disability, facial dysmorphism, and skeletal findings including pes planus, prominent heels, and pectus deformity. Interestingly one of the patients presented with a cemento‐ossifying fibrous lesion of the maxilla. Whole exome sequencing revealed a novel homozygous [c.377delT] [p.Ile126fs*] frameshift mutation at exon 2 in one family, while Sanger sequencing revealed a novel homozygous splice site mutation [c.516+2T>A] at exon 4/intron 4 border of RSPRY1 in the other family. In conclusion; we provide further evidence that Spondyloepimetaphyseal dysplasia Faden‐Alkuraya type is a RSPRY1‐associated skeletal dysplasia with a distinctive phenotype composed of spondyloepimetaphyseal dysplasia, cono‐brachydactyly, and craniosynostosis along with recognizable facial features and intellectual disability.     

Sleep problems,anxıety,depressıon and fatıgue on famıly members of adult intensıve care unıt patıents

The purpose of this study was to determine the levels of sleep problems, anxiety, depression and fatigue in family members of intensive care patients in Turkey and factors affecting these complaints. This cross‐sectional study was carried out with 350 first‐degree relatives of intensive care patients at a university and state hospital. Data were collected between 5 January and 30 May 2014 using a personal information form, the Visual Analogue Scale for Fatigue, the Hospital Anxiety and Depression Scale and the modified Post Sleep Inventory. Of the 350 family members, 76% reported moderate or more serious problems. Anxiety was reported by 81.4% of the family members, and depression by 94.2%. Family members in the study had fatigue, with average scores of 79.42. There were significant correlations between the Visual Analogue Scale for Fatigue and anxiety, depression and scores on the Modified Post‐Sleep Inventory (P < 0.05). Family members of intensive care patients experienced symptoms of fatigue, anxiety, depression and sleep problems. The prevalence of symptoms of sleep problems, anxiety and depression and complaints of fatigue was significantly higher in the family members of intensive care patients in Turkey than reported in the literature.