Kidney Transplantation and COVID-19: Two Case Reports

Immunocompromised populations are at great risk of the current 2020 global emergency of coronavirus disease 2019 (COVID-19), and treatment of kidney transplant recipients with COVID-19 is currently not declared. Hence, the purpose of the study is to set a clear treatment regimen. We report here a therapeutic course of 2 patients who underwent transplant surgery in March 2020 and got infected soon after. Since the transplant, these 2 patients have received triple maintenance immunosuppressive therapy with oral tacrolimus, mycophenolate mofetil (MMF), and prednisone, and they have been regularly followed up at our hospital. The tacrolimus trough level was between 10 and 12 ng/mL. After the diagnosis of COVID-19, MMF was stopped and the tacrolimus dose was reduced so that blood level was between 4 and 6 ng/mL. The first patient was a 30-year-old man who, despite being treated with hydroxychloroquine, favipiravir, oseltamivir, and azithromycin therapy, died because of the presence of other comorbidities. The second case was a 58-year-old man who fully recovered from COVID-19 pneumonia with treatment with methylprednisolone, MMF, azithromycin, favipiravir, hydroxychloroquine, and reduction in immunosuppression dosage. This reflects the importance of using glucocorticoids in the treatment of COVID-19 along with other medications and the decreased mortality rate associated with their use.     

Protective Effects of Lycopene on Furan-treated Diabetic and Non-diabetic Rat Lung

正We assessed the effects of furan and lycopene on the histopathological and biochemical changes on lungs,body and lung weights,and food consumption of rats.Furan and diabetes caused histopathological changes,increment in malondialdehyde levels,and decrease in     

Cancer-associated thrombosis and drug–drug interactions of antithrombotic and antineoplastic agents

Venous thromboembolism (VTE) is often associated with malignant diseases and notably contributes to morbidity and mortality in patients with cancer. Cancer-associated thrombosis (CAT) brings additional costs to health expenditures and has a negative impact on oncological outcomes. Either the recurrence rate of VTE or bleeding complications are also higher in patients with cancer. Prophylactic anticoagulation has been recommended in peri-surgical periods, inpatient settings, and high-risk ambulatory patients. Although various risk stratification scores are used, none are ideal for identifying patients who can benefit from anticoagulant prophylaxis. New risk scoring systems or biomarkers are needed to identify patients who are more likely to benefit from prophylaxis with low bleeding risk. The questions about the patients who will be given prophylaxis and those who develop thromboembolism, with which drug, and how long they will be treated are still not fully answered. Anticoagulation is the cornerstone of the treatment, but management of CAT remains complex. Low molecular weight heparins and direct oral anticoagulants are effective and safe options for the treatment of CAT. Recognizing adverse effects, drug–drug interactions, and accompanying conditions that cause dose adjustment is crucial. Prevention and treatment of VTE in patients with cancer require a multidisciplinary and patient-based approach.

Plain Language Summary

• Cancer-associated thrombosis is a significant cause of mortality and morbidity in patients with cancer.
• Chemotherapy, surgery, and/or use of central venous access remarkably increase the risk of thrombosis.
• Prophylactic anticoagulation should be considered not only in inpatient follow-up and during peri-surgical period but also ambulatory patients with a high risk of thrombosis.
• Many parameters, such as drug–drug interactions, primary side of cancer, and comorbidities of patients should be considered when selecting anticoagulant drugs.
• More accurate risk stratification scores or biomarkers are still an unmet need.

     

99mTechnetium-labeled methylene diphosphonate uptake in maxillary bone during and after rapid maxillary expansion

The purpose of this study was to evaluate bone activity at the midpalatal suture that had been biomechanically stimulated by rapid maxillary expansion (RME). A rigid acrylic-bonded expansion device with a maxiskeleton screw was used for RME in three patients who were in three different growth periods. The screw was activated twice a day by 1/4 turns. After sufficient expansion, the screw was fixed with acrylic resin, and the same appliance was used as a removable retention plate for three months. Single photone emission computed tomography (SPECT) bone scintigraphy records were obtained before (T1) and at the end of RME (T2) and three months after the retention period (T3). According to the scintigraphic records, the increase in bone activity was highest in the anterior and medial sections on both the left and right sides of the maxilla in all cases. After three months of retention, the bone activity returned to its original level. Therefore, it may be stated that the retention period of three months was sufficient for bone reorganization.     

Efficacy of a fluoridated hydrogen peroxide-based mouthrinse for the treatment of gingivitis: a randomized clinical trial

BACKGROUND: A randomized clinical trial was performed to test the efficacy of a fluoridated hydrogen peroxide-based mouthrinse on gingivitis and tooth whitening in a two-phase study. The first phase (28 days) included the experimental gingivitis phase; the second phase (5 months) was the oral hygiene phase, which included rinsing. METHODS: A total of 99 subjects were included in the study and were randomly assigned to receive either placebo or test mouthrinse. Clinical measures were chosen to reflect the gingival health and tooth whiteness in an intent-to-treat study design. Statistical analyses of clinical parameters related to gingival health and tooth color were conducted, using the method of generalized estimating equations (GEE), with an exchangeable working correlation to accommodate tooth-level data. Baseline differences between the groups were adjusted. Microbial samples taken at the beginning and at the end of the study were analyzed by DNA-DNA hybridization technique, to determine whether there was any adverse shift in supragingival flora. RESULTS: Eastman bleeding index, modified gingival index, intensity of stain, and extent of stain were significantly reduced in the test group at 6 months compared to baseline (P < 0.05). In contrast, only the Eastman bleeding index was significantly reduced in the control group (P < 0.05). The reduction in the index of gingival inflammation for the test group was significantly greater than for the control group (P = 0.004). Subjects using the test rinse were also six times more likely to exhibit an improvement in tooth color after 6 months than were subjects using placebo (P = 0.002). As a result of the clinical evaluations and microbial analysis, test mouthrinse was found to be safe during a 6-month period. CONCLUSION: The results of this study indicate that the fluoridated hydrogen peroxide-based mouthrinse effectively whitens teeth and significantly reduces gingivitis.     

Reattachment of a fractured maxillary tooth: a case report.

A 14-year-old male patient reported with a horizontal fracture of almost the entire crown of a maxillary incisor, extending subgingivally at the palatal side. After root canal therapy and electrosurgery, the tooth fragment was reattached using a total-etch dentin-bonding system and a hybrid composite. Due to enamel cracks and the necessity for more retention, the labial surfaces of the teeth were veneered with a micro-filled composite. The clinical situation of the reattached teeth was confirmed successful by radiographic and photographic assessment after 1, 3, 6, and 12 months. The restoration of an anterior tooth with original tooth fragment in young patients has advantages over conventional composite or prosthetic restorations. However, reattached teeth with fracture extending subgingivally, require long-term follow-up.