Comment on “The effect of omalizumab on hematological and inflammatory parameters in patients with chronic spontaneous urticarial”: reply from authors

Abstract

We read Cosansu’s commentary entitled “Effectiveness of the new inflammatory parameters in patients with chronic spontaneous urticarial” to our study with great interest. The author remarked that a limited number of patients had C-reactive protein levels and it was not specified whether there were any other drugs used by the patients and no information was given about the severity of the disease in our study.     

A short story of Klotho and FGF23: a deuce of dark side or the savior?

Fibroblast growth factor 23 (FGF23) is an osteocyte and osteoblast derived peptide hormone, which requires Klotho as a cofactor for its biologic actions. FGF23 acts as a phosphaturic agent and it is capable of reducing serum inorganic phosphate (Pi) via direct inhibition of renal NaPi-2a transporter in the proximal tubuli, as well as indirectly, via the suppression of calcitriol synthesis. In patients with chronic kidney disease (CKD), circulating FGF23 levels are markedly elevated, while Klotho production is decreased. Experimental observations indicating that lack of activities of both Klotho and FGF23 may cause decreased life span, premature aging and accelerated atherosclerosis and generalized vascular calcifications have raised the question whether FGF23 could be a new risk factor and predictor of cardiovascular (CV) disease in both renal and non-renal patient groups. Clinical studies, however, have yielded conflicting results. Some of these studies have found that serum FGF23 is independently associated with mortality and CV events in CKD patients, while others have failed to show any relationship. Furthermore, some studies have even suggested that FGF23 may have a protective role against vascular calcifications and CV disease. Thus, there is clearly a need for further research in this area, and special interest should be paid to the physiologic consequences of high FGF23/low Klotho state, which is typical for patients with CKD.     

A complication of nasotracheal intubation after mandibular subcondylar fracture

Among the potential risks of nasotracheal intubation are nasal bleeding, sinusitis, bacteremia, accidental turbinectomy, and some other structural damages. Retropharyngeal dissection is reported as a very rare complication of nasotracheal intubation, mostly encountered in elective surgery patients. A case with traumatic subcondylar fracture of the mandible is presented here, which is suspected to be the cause of the nasopharyngeal dissection that was observed during attempted nasotracheal intubation.     

A salvage procedure in cleft palate repair: suturing nasal mucosa directly to palatine process.

OBJECTIVE: Palatal fistulas are among the complications of cleft palate repair requiring additional surgery. Suturing the nasal mucosa and mucoperiosteal flaps together in a tension-free manner to create a double-layered closure in the hard palate is one of the most important points in prevention of dehiscence and fistula formation. In this report, we describe a salvage procedure to repair nasal mucosa that might be lacerated while being freed from the upper surface of the palatal process. METHOD: To restore the nasal lining, an ipsilateral vomer mucoperiosteal flap or the opposite nasal mucosa flap is advanced to the palatine bone and sutured directly to the palatal process in order to guarantee an intact cleft palate repair. RESULTS: This method is an easy, simple, and time-saving procedure. It should be a useful addition to the armamentarium of every plastic surgeon, especially those working as consultants in training units.     

Evaluation of the effect of different ferrule designs on the fracture resistance of endodontically treated maxillary central incisors incorporating fiber posts, composite cores and crown restorations

AIM: The purpose of this study was to evaluate the fracture resistance of endodontically treated maxillary central incisors restored with quartz fiber posts, composite cores, and crowns when different types of ferrule designs were incorporated. METHODS AND MATERIALS: Sixty maxillary incisors were divided into six groups: Group 1 (control): teeth with root canal treatments having a full crown prosthesis; Group 2: teeth with a 2 mm circumferential ferrule; Group 3: teeth with a 2 mm ferrule only in the vestibular region; Group 4: teeth with a 2 mm ferrule only in the palatal region; Group 5: teeth with a 2 mm ferrule in the vestibular and palatal region, having cavities in both proximal areas; and Group 6: teeth with no ferrule. The teeth in the experimental groups were restored with quartz fiber posts-composite cores and full metallic crowns. All experimental teeth were subjected to an increasing compressive force with a crosshead speed of 1 mm/min, until fracture occurred. RESULTS: The median fracture values of groups were as follows: Group 1: 574.4 N, Group 2: 472.4 N, Group 3: 474.3 N, Group 4: 480.7 N, Group 5: 463.1 N, and Group 6: 297.9 N. A statistically significant difference was found between Group 1 and Group 6 (p< 0.01). CONCLUSION: It was concluded different ferrule designs did not have any influence on the fracture resistance of teeth with fiber posts. The results of this study indicate fiber posts can safely be used for their reinforcing properties. Furthermore, there is no significant change in the resistance of teeth with fiber posts regardless of which ferrule design is incorporated. The property of these types of posts is an additional advantage in clinical practice.     

Polymerization shrinkage and microleakage in Class II cavities of various resin composites

This study investigated the polymerization shrinkage of restorative materials and microleakage in the proximal box of Class II restorations. Twenty caries free extracted human molars were prepared on the mesial and distal, making 40 slot cavities. Groups (n=10) were classified as: Group 1: Single bond/Filtek Z-250; Group 2: Single Bond/Filtek Flow/Filtek Z-250; Group 3: Admira Bond/Admira; Group 4: Ariston Liner/Ariston. Dentin bonding systems and resin composites were applied according to the manufacturer's instructions. The specimens were stored in distilled water for one week at 37 degrees C, thermocycled (5 degrees-55 degrees C x 2000), stained with 50% aqueous silver nitrate, immersed in a diluted developer solution (24 hours), rinsed and sectioned in two pieces with a low speed saw (Isomet). Dye penetration (Score 0-4) was determined separately at the occlusal enamel margin and cementoenamel junction. The volumetric polymerization shrinkage of materials was determined with the apparatus of Watts and Cash (Watts Cash, 1991) for 300 seconds. Polymerization shrinkage results were as follows: Filtek Flow (3.5% +/- 0.1) > Admira (2.1% +/- 0.1) = Ariston AT (2.3% +/- 0.1) > Filtek Z-250 (1.8% +/- 0.1) (One-way Anova, post hoc Bonferroni test at p = 0.05 level). No statistical difference was found at the enamel margins for any of the materials (Score 0-1). At the cemento-enamel junction, all test groups showed significantly higher microleakage when compared to the enamel margins (Kruskal-Wallis test, Mann-Whitney U). Dye penetration results at dentin were as follows: Filtek Flow + Filtek Z-250 = Admira < Ariston AT = Filtek Z-250. microleakage than the ion-releasing and hybrid composites lined only with bonding agent at the cementoenamel junction in Class II cavities.     

Lymphocyte and monocyte vitamin D receptor expression during paricalcitol or calcitriol treatments in patients with stage 5 chronic kidney disease

International Urology and Nephrology - In this study, we aimed to investigate the effect of paricalcitol and calcitriol usage on vitamin D receptor (VDR) contents of CD8+?,...