Influence of serous retinal detachment on the outcome of ranibizumab treatment in diabetic macular oedema

Purpose: The purpose of this study was to evaluate the influence of serous retinal detachment (SRD) on the outcome of intravitreal ranibizumab (IVR) therapy in diabetic macular oedema (DME).

Materials and methods: Fifty-one eyes with cystoid macular oedema (CME) and SRD (study group) and 57 eyes with only CME (control group) that received pro re nata (PRN) IVR injections during a 6-month period were retrospectively evaluated. The outcome measures included changes in the central macular thickness (CMT) and best corrected visual acuity (BCVA) and injection numbers.

Results: The mean initial CMT in the study and control groups was 467?±?101 and 440?±?89?µm, respectively. The mean BCVA in the study and control groups was 0.75?±?0.38 and 0.59?±?0.36 logarithm of minimal angle of resolution (LogMAR), respectively (p?=?0.010). The study group received a mean of 2.2?±?0.92 injections, whereas the control group received a mean of 2.54?±?0.9 injections. The decrease in CMT was greater, but not significantly greater, in the study group than in the control group.

Conclusion: The presence of SRD resulted in a less favourable visual acuity (VA) outcome with IVR. Disruption of the ellipsoid zone and abnormality of the foveal avascular zone at the baseline examination were correlated with a lower VA. Both of the pathologies occurred more frequently in the SRD group.     

Bond strengths of three different dentin adhesive systems to sclerotic dentin

The two-fold aims of this study were: (1) to evaluate the microtensile bond strengths of different adhesive systems to sclerotic and sound palatal dentin; and (2) to observe the respective resin-dentin interfaces. Thirty extracted human incisor teeth were divided into two groups. Group I comprised sclerotic defects in the palatal zone. Group II comprised sound palatal dentin surfaces as control. Each group (n=15) was divided into three subgroups according to dentin adhesive systems: self-etch (Clearfil SE Bond), total-etch (Scotchbond Multi-Purpose Plus), and glass ionomer (Reactmer Bond) adhesive systems. The specimens were subjected to tensile forces. Obtained data were analyzed by two-way ANOVA and post hoc Duncan's test. Fracture sites and resin-dentin interfaces were observed using a light microscope and SEM. With sound dentin, Clearfil SE Bond showed a significantly higher bond strength than the other adhesives (p < 0.05). With sclerotic dentin, although there were no significant differences in bond strength among the adhesives groups (p > 0.05), the bond strength values of Clearfil SE Bond and Scotchbond Multi-Purpose Plus were significantly decreased. On resin-dentin interface observation, different images were presented by different bonding systems.     

Three-year clinical evaluation of fiber-reinforced composite fixed partial dentures using prefabricated pontics

PURPOSE: The purpose of this study was to evaluate the clinical performance of surface-retained adhesive composite fixed partial dentures reinforced by an ultra-high molecular weight polyethylene (UHMWP) fiber (Ribbond THM). MATERIALS AND METHODS: Twenty-three surface-retained fiber reinforced composite (FRC) fixed partial dentures (FPD) were placed by two operators in 23 patients, each with a single missing tooth. The restorations included prefabricated composite resin pontics, and no preparations were done on the lingual surfaces of the abutment teeth. The patients were recalled for examinations every year for up to 3 years. Restorations were evaluated directly using the modified Ryge criteria. The minimum observation period was 1 year and the maximum observation period was 3 years. RESULTS: At baseline, 23 restorations were graded as Alpha for all parameters. At one year and two years (n = 21), three Bravos for wear resistance and surface texture/gingival inflammation and two Bravos for color match were observed. Twenty-one of 23 restorations were retained at the end of two years (91.3%) and 78.3% were retained after a maximum of 3 years. CONCLUSION: The results of this clinical study suggestthat UHMWP FRC FPDs are quite acceptable at least forthree years. However, further clinical investigations are still needed for improved long-term clinical performance.     

Propofol with N-Acetylcysteine Reduces Global Myocardial Ischemic Reperfusion Injury More than Ketamine in a Rat Model

Objective: We examined the cardioprotective effects of propofol and ketamine with and without N-acetylcysteine (NAC). Methods: 60 rats were divided into six groups of 10 rats each. Anesthesia induction was produced with an intraperitonal injection of ketamine in Groups 1–3 and propofol in Groups 4–6. NAC (200 mg kg^{? 1}) was given intraperitonally during anesthesia induction in Groups 3 and 6. Groups 2, 3, 5, and 6 were subjected to 90 s of myocardial ischemia by clamping the ascending aorta, and then reperfusion was begun by unclamping the ascending aorta. After 60 min of reperfusion, blood samples were taken from the ascending aorta for biochemical analyses, and heart tissue samples were taken for biochemical and histopathological analyses. Results: Creatine kinase (CK), myocardial band of creatine kinase (CK-MB), and troponin-I (Tn-I) levels were significantly higher in the ischemia–reperfusion groups (2, 3, 5, 6) compared to the nonischemic groups (1, 4). CK, CK-MB, and Tn-I levels did not differ significantly between the ketamine groups (1–3) and the propofol groups (4–6) p >. 05). Malondialdehyde levels were significantly higher in Groups 2 and 3 than in Group 1 and were significantly lower in Groups 4 and 6 than in Group 5 (p <. 05). Malondialdehyde levels in the propofol groups (4–6) were significantly lower than in the ketamine groups (1–3; p <. 05). Catalase levels in propofol groups were higher than ketamine groups. Superoxide dismutase levels were significantly higher in Group 6 than in Group 3 (p <. 05). Conclusions: In this rat model of global cardiac ischemia, propofol with NAC attenuates myocardial injury more than ketamine (with or without NAC).     

Cranial magnetic resonance imaging findings in patients with migraine

OBJECTIVE: To investigate the frequency of cranial magnetic resonance imaging abnormalities in patients with migraine and their relationship to type, duration, and frequency of migraine attacks. METHODS: Forty-five patients (43 women, 2 men) with migraine whose ages ranged between 19 and 53 years (mean, 40.91 [SD, 7.69]) were evaluated. Of the 45 patients, 20 had migraine with aura and 25 had migraine without aura, according to the diagnostic criteria of the International Headache Society. RESULTS: In 13 (28.8%) of 45 patients, white matter foci were present on magnetic resonance imaging. Eight of these patients (61.5%) had migraine with aura, and 5 patients (38.4%) had migraine without aura. The presence of white matter foci was significantly higher in the patients with aura (8 [40%] of 20) than in those without aura (5 [20%] of 25). It was found that as the frequency of attacks per month increased, the number of patients with white matter foci also increased. Although the mean duration of migraine was longer in patients with white matter foci (149.5 months [SD, 87.9]) than in those without white matter foci (134.1 months [SD, 88.3]), there was no significant difference (P >.05). CONCLUSION: Although there are no specific magnetic resonance imaging findings peculiar to migraine, detection of white matter foci should be taken into consideration in patients with migraine (especially migraine with aura). Frequency of attacks is an important indicator of existence of white matter foci.     

Synthesis and kinetics studies of N′‐(2‐(3,5‐disubstituted‐4H‐1,2,4‐triazol‐4‐yl)acetyl)‐6/7/8‐substituted‐2‐oxo‐2H‐chromen‐3‐carbohydrazide derivatives as potent antidiabetic agents

A novel series of N′‐(2‐(3,5‐disubstituted‐4H‐1,2,4‐triazol‐4‐yl)acetyl)‐6/7/8‐substituted‐2‐oxo‐2H‐chromen‐3‐carbohydrazides were synthesized and studied for their α‐glucosidase inhibition activity. Most of the synthesized compounds exhibited potential α‐glucosidase inhibition activity with IC₅₀ values ranging from 0.96 ± 0.02 to 32.86 ± 0.73 µg/ml. Among them, compounds 3e and 4e , having a methoxy group on the coumarin ring, proved to be the most potent ones, showing an enzyme inhibition activity with IC₅₀ = 0.96 ± 0.02 and 1.44 ± 0.06 µg/ml, respectively. The kinetic study through Lineweaver–Burk plots revealed that the inhibition mechanism of the most active compounds 3d, 3e, 4d , and 4e , on the α‐glucosidase activity, was found to be in the competitive mode.     

Neonatal diabetes mellitus accompanied by diabetic ketoacidosis and mimicking neonatal sepsis: a case report

Neonatal diabetes mellitus (DM) develops within the first six weeks of life with basic findings including dehydration, hyperglycaemia, and mild or no ketonemia/ketonuria. It can be either transient or permanent. Here, we report a case of a one-month-old infant with permanent neonatal diabetes, due to pancreatic hypoplasia, accompanied by diabetic ketoacidosis (DKA). The hyperglycaemia and ketoacidosis resolved by the 14(th) hour of treatment, consisting of IV insulin and rehydration. Subsequently, insulin treatment was continued with neutral protamine hagedorn (NPH) insulin. Breastfeeding was started and was continued at intervals of three hours. Following initiation of breastfeeding, the stools became watery, loose, yellow-green in color, and frequent (8-10 times a day). They contained no blood or mucus. Replacement of pancreatic enzymes resulted in decreased stool frequency. Neonatal DM due to pancreatic hypoplasia and associated with DKA may mimic sepsis and should be kept in mind in all newborns who present with fever, dehydration, and weight loss.     

Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management

Purpose

The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA.