Mirtazapine-induced acute angle closure

Acute angle closure (AAC) is an ocular emergency with symptoms including blurred vision, eye pain, headache, nausea, vomiting and reddening of the eye those results from increased intraocular pressure. This clinical condition can lead to permanent damage in vision, thus causing blindness by generating progressive and irreversible optic neuropathy if left untreated. There are several reasons of AAC, including several types of local and systemic medications; mainly sympathomimetics, cholinergics, anti-cholinergics, mydriatics, anti-histamines, antiepileptics like topiramate, tricyclic and tetracyclic antidepressants, serotonin reuptake inhibitors, antipsychotics, sulfa-based drugs and anticoagulants. Mirtazapine, a noradrenergic and specific serotonergic antidepressant, is an atypical antidepressant with a complex pharmacological profile. This case report describes a patient with major depressive disorder, who experienced AAC after the first dosage of mirtazapine treatment, and highlights the importance of close monitoring of individuals under antidepressant treatment particularly immediately after initiation of the drug.     

Is Transforming Stem Cells to Pancreatic Beta Cells Still the Holy Grail for Type 2 Diabetes?

Diabetes is a progressive disease affecting millions of people worldwide. There are several medications and treatment options to improve the life quality of people with diabetes. One of the strategies for the treatment of diabetes could be the use of human pluripotent stem cells or induced pluripotent stem cells. The recent advances in differentiation of stem cells into insulin-secreting beta-like cells in vitro make the transplantation of the stem cell-derived beta-like cells an attractive approach for treatment of type 1 and type 2 diabetes. While stem cell-derived beta-like cells provide an unlimited cell source for beta cell replacement therapies, these cells can also be used as a platform for drug screening or modeling diseases.     

Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life?

Background

It is important to determine the quality of life (QoL) and level of participation in children with Cerebral Palsy (CP). Previous research has used reports from adolescents or caregivers, but there is no evidence that caregivers' reports accurately reflect the experiences of the adolescents they are interested in.

Do Anti-TNF Agents Increase the Risk of Inflammatory Bowel Disease Evolution in Patients with Ankylosing Spondylitis? Real Life Data

ObjectiveThe aim of this study was to determine whether there is any association with anti-tumor necrosis factor (TNF) agent administration and development of new-onset inflammatory bowel disease (IBD) in ankylosing spondylitis (AS) patients.MethodsRecords of the patients who met 1984 modified New York criteria for AS between 1998 and 2016 at Rheumatology Department were evaluated retrospectively and data about the patients, IBD properties and medication were obtained.ResultsAmong 420 patients, 310 were male, the average age was 42.9 ± 1.3 years, average disease duration was 16.7 ± 10.4 years. Anti-TNF agents were in use by 154 patients, 52 patients were receiving etanercept (ETN), infliximab (INF), adalimumab (ADA), and golimumab (GO) treatments were ongoing in 50, 41, and 11 patients, respectively. New-onset IBD developed in 10 patients; 3 from the group treated with non-anti-TNF drugs (1.1%) and 7 from the group treated with anti-TNF agents (4.5%) (p = 0.042). No significant difference was detected between three anti-TNF agent forms in relation with the risk of IBD onset. In AS patients, existence of familial AS (OR 4.69 (95%CI 1.28-17.19, p = 0.020) and anti-TNF agent treatment (OR 4.17 (95%CI 1.06-16.38, p = 0.041) were independent risk factors for new-onset IBD development.ConclusionDespite the increased risk of new-onset IBD development during the course of AS, paradoxical response to anti-TNF drugs must also be considered as a source that triggers onset of IBD.     

The role of nickel accumulation and epithelial cell proliferation in orthodontic treatment-induced gingival overgrowth

The aim of this study was to investigate the role of nickel in orthodontic treatment-induced gingival hyperplasia. The nickel concentration in gingival tissues with and without overgrowth, histopathology of gingival overgrowth, and epithelial cell proliferation response to different nickel concentrations were analysed. Ten patients receiving orthodontic therapy (eight females and two males, mean age 15.4 years) were included in the study. Hyperplastic and healthy gingiva samples were collected from the same patients. The amount of nickel in the gingival tissue samples was analysed using the atomic absorption spectrometry technique. The tissues removed from hyperplastic areas during gingivectomy were also used for histological analysis. To analyse the effect of nickel on epithelial cell proliferation, four different nickel concentrations (0.5, 2, 5, and 10 microg) were incubated with keratinocyte cells for 11 days. Mann-Whitney U-test, analysis of variance, and Tukey's test were used in the statistical analyses. The results did not show any difference in nickel concentration between the study and control gingiva tissue samples, but histological analysis demonstrated an increase in epithelial thickness and a significant increase (P = 0.031, 0.02, 0.02) in epithelial cell proliferation in response to low-dose nickel concentrations, with a toxic response to a higher dose. In the limitations of this study, it is plausible that the effect of a continuing low-dose nickel release to epithelium is the initiating factor of gingival overgrowth induced by orthodontic treatment.     

Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis

Type 2 diabetes mellitus and obesity are the most common nutritional disorders in developed and developing countries. Increased prevalence of periodontal disease is a well-known complication of type 2 diabetes mellitus (DM). As obesity is generally the first step toward type 2 diabetes mellitus, it is possible to find exacerbated periodontal disease in obese patients, also. The purpose of this cross-sectional study was to investigate the periodontal status and aspartate aminotransferase and lactate dehydrogenase enzyme activities in gingival crevicular fluid (GCF) of type 2 diabetic and/or obese chronic periodontitis patients. A total of 39 chronic periodontitis patients participated in the study. The study population was divided into four groups according to body mass index and type 2 DM status: 1) type 2 DM obese patients, n = 8; 2) type 2 DM patients, n = 12; 3) obese patients, n = 8; 4) systemically healthy control group, n = 11. Enzyme activities in gingival crevicular fluid and periodontal status were evaluated. No significant differences in age, gingival index, plaque index, aspartate aminotransferase and lactate dehydrogenase enzyme activities were observed, but probing depths were significantly higher in the DM groups than in the control group. Obesity did not seem to be a significant factor in any parameters evaluated. The present study showed increased probing depth values for the diabetic groups but failed to show any significant relation between obesity and enzyme activity or periodontal status. However, the slightly increased probing depth values in the obese groups might be a clue to an impaired immune response and predisposition to periodontitis in that patient group.     

Effect of storage duration on tensile bond strength of acrylic or silicone-based soft denture liners to a processed denture base polymer

OBJECTIVE: To investigate the effect of storage duration on the tensile bond strength of acrylic and silicone-based denture base materials with liners either heat-cured or auto-cured. MATERIAL AND METHODS: The denture liners investigated were Vertex soft (acrylic-based, heat-cured), Coe soft (acrylic-based, auto-cured), Molloplast-B (silicone-based, heat-cured), and Mollosil plus (silicone-based, auto-cured). The soft liner specimens were 10 x 10 x 3 mm and were processed between two PMMA blocks. They were tested following immersion in water at 37 degrees C for 1 day, 1 week, and 1, 3, and 6 months. Tensile bond strength was measured using a universal testing machine (Testometric Micro 500) at a crosshead speed of 20 mm/min (n = 10 specimens per experimental group). Multiple ANOVA and Tukey HSD were used to analyse the data at a pre-set alpha of 0.05. RESULTS: The results indicate that the tensile bond strength of acrylic-based soft liners is greater than that of silicone-based materials. The bond strength of all lining materials decreases with storage duration; the decrease being greatest for the acrylic-based soft liners. The decrease in bond strength of the auto-cured materials is greater than that of the heat-cured products. CLINICAL SIGNIFICANCE: Comparison of the materials in this study indicates that the silicone-based, heat-cured soft liner is superior, based on the tensile bond strength property. Use of silicone-based, heat-cured soft liners may provide better clinical success over a long period. These laboratory results need to be verified by clinical testing.     

Effect of storage duration on the hardness and tensile bond strength of silicone- and acrylic resin-based resilient denture liners to a processed denture base acrylic resin

STATEMENT OF PROBLEM: Two potential problems commonly identified with a denture base incorporating a resilient liner are a failure of the bond between the acrylic resin and resilient liner material and a loss of resiliency of the resilient liner material over time. PURPOSE: This investigation evaluated the effect of storage duration on the tensile bond strength and hardness of acrylic resin- and silicone-based resilient liners that were either heat- or autopolymerized onto denture base acrylic resin. MATERIAL AND METHODS: The denture liners investigated were a definitive acrylic resin-based heat-polymerized (Vertex Soft), interim acrylic resin-based autopolymerized (Coe-Soft), definitive silicone-based heat-polymerized (Molloplast-B), and definitive silicone-based autopolymerized (Mollosil Plus) resilient liner. The resilient liners were processed according to manufacturers' instructions. The resilient liner specimens for tensile bond strength testing (n=10) were 10 x 10 x 3 mm and were processed between 2 polymethyl methacrylate (PMMA) (Meliodent) blocks (40 x 10 x 10 mm). The resilient liner specimens for hardness testing (n=10) were 20 mm in diameter and 12 mm in height. Specimen shape and liner thickness were standardized. Specimens were stored for 1 day, 1 week, or 1, 3, or 6 months in water at 37 degrees C. Tensile bond strength was measured in a universal testing machine at a crosshead speed of 20 mm/min, and hardness was measured using a Shore A durometer. Two-way ANOVA and Tukey HSD tests were used to analyze the data (alpha=.05). RESULTS: The results indicated that there were significant differences both in the hardness and bond strength values of resilient liner materials. The definitive silicone-based heat-polymerized (Molloplast-B) resilient liner had significantly higher bond strength and lower hardness values than the others. Prolonged exposure to water produced significantly higher hardness values and lower bond strength values. CONCLUSIONS: Within the limitations of this in vitro study, specimens of resilient liners immersed in water demonstrated significantly (P<.001) lower bond strength values and higher hardness values over time.