Editorial

It has been proven that the jaw rehabilitation not only has a crucial role in treatment of both trismus and mandibular hypomobility but also in the rehabilitation of surgical conditions of the temporomandibular joint and the jaw.(1) Today, the commercially available jaw motion rehabilitation systems are specifically designed to treat these conditions.(2) These systems utilize repetitive passive motion and stretching to restore mobility and flexibility of the jaw musculature, associated joints and connective tissues. Major advantages of these systems are that they reduce patients' anxiety by allowing them to control the extent and length of each stretching and provide passive motion for effective jaw rehabilitation therapy allowing patients to perform their necessary therapy while continuing in their daily life.(3) However, these systems are very expensive and mostly unavailable in our country. So, a new alternative jaw motion rehabilitation device 'The Okbite' was developed recently in our hospital (Fig. 1). It is simply adapted from the commercially available nasal specula. The blades of the specula are cut distally and metal bite pads are attached to these sites. The lower bite pad was placed posteriorly and curved anatomically. This device can be produced in a custom-made form according the occlusal pattern and the size of the mandible of the patient. The metal bite pads are covered with plaster bandage by the patient for a soft bite. In our practice, we used this device for the rehabilitation of total temporomandibular joint prosthesis, temporomandibular gap arthroplasties and temporomandibular joint disorders with great success. It costs nearly 1/50 of the commercially available jaw motion rehabilitation systems with almost equal outcomes of pain relief and total mouth opening. The major disadvantage of this system is that it can mimic the anatomical motion pattern of the mandible to a limited extend. We propose the application of this Okbite system, which provides jaw rehabilitation in such conditions.     

Prediction of atopy by skin prick tests in patients with asthma and/or persistent rhinitis

BackgroundPatient history gives important clues about the likelihood of atopy. However, the accuracy of assessment of atopy based on detailed allergy history is low. The objective of this survey was to determine the successful prediction rate of atopy by a questionnaire and the effect of various factors on the successful prediction.MethodsA standard questionnaire including detailed allergy history was filled in by two experienced allergists for 169 patients having bronchial asthma and/or persistent rhinitis symptoms. Skin prick test (SPT) results were predicted based on the clinical data obtained by a questionnaire. Final diagnosis was made after SPT. Sensitivity and specificity analysis of SPT results prediction was investigated using two different cut-off values (3 mm and 5 mm) for positive tests, and factors associated with successful atopy prediction were analysed.ResultsSPT was predicted to be positive in 42.6% and was positive in 36.1%. Depending on SPT results with the cut-off value 3 mm, prediction sensitivity was 77%, specificity was 65.3%, positive predictive value was 65%, and negative predictive value was 86%. Successful positive atopy prediction was associated with age; true negative prediction was also associated with age and high education. With the threshold of 5 mm for a positive test, sensitivity, specificity, positive and negative predicted values were 91%, 61%, 14% and 99%, respectively.ConclusionIt seems that the success rate of detailed history is high for negative prediction. However, detailed history alone does not seem to be efficient for atopy prediction.     

Nonsense β-thalassemia mutation at codon 37 (TGG>TGA), detected for the first time in three Turkish cases

Thalassemias are genetically heterogeneous group of disorders with reduced or absent production of globin. β-Thalassemia major can be caused by homozygosity or compound heterozygosity for β-globin gene mutation. Here we report, for the first time in Turkey, three cases who carry the nonsense β-thalassemia (β-thal) mutation at codon 37 (TGG>TGA; Trp→Stop) causing premature stop codon.     

Intussusception in Adults

To review clinical, radiological and histopathological findings of adult intussusception and its management, 18 adult patients who had been treated surgically because of intussusception were reviewed. Of the patients, 5 (27.8%) had idiopathic intussusceptions, while the other 13 (72.2%) had a definable intraluminal pathology. The site of the intussusception was more common in the small bowel (83.3%) than the colon (16.7%). Ultrasonography and computed tomography were successful in demonstrating “target lesion” in 80% and 75% respectively. Patients with idiopathic intussusception were treated with simple reduction, while the others underwent segmental resection because of the possibility of malignant tumour. In contrast to intussusception in childhood, intussusception in adults usually has a definable lead point and resection of the involved bowel, rather than simple reduction, is indicated.     

Is Interleukin‐17 Involved in the Interaction Between Polycystic Ovary Syndrome and Gingival Inflammation?

Background: Polycystic ovarian syndrome (PCOS) is a hormonal disorder of females of reproductive age that impacts their oral and systemic health. The aim of this study is to evaluate interleukin‐17A (IL‐17A), IL‐17F, IL‐17A/F, and IL‐17E (IL‐25) levels in gingival crevicular fluid (GCF), saliva, and serum of non‐obese females with PCOS and with either a clinically healthy periodontium or gingivitis. Methods: Thirty‐one females with PCOS, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females participated in the study. Clinical periodontal measurements, body mass index, and Ferriman‐Gallwey score (FGS) (a measure of hirsutism in females) were recorded. Circulating levels of sex hormones, cortisol, and insulin were also determined. Levels of IL‐17 cytokines were measured by enzyme‐linked immunosorbent assay. Results: The general linear model multivariate analysis, adjusting for age or plaque index, showed that the two groups with PCOS had higher concentrations of IL‐17A, IL‐17F, and IL‐17A/F in serum and higher levels of IL‐17A and IL‐17F in GCF and saliva but lower serum IL‐17E than systemically healthy females. Levels of IL‐17E were lowest in females with PCOS and gingivitis who also had the highest FGS. Serum IL‐17A and IL‐17F levels correlated positively with FGS and periodontal probing depth (all ρ >0.33; P <0.005). Serum IL‐17E showed the reverse relationship and also correlated negatively with IL‐17A (ρ >?0.28; P <0.05). Conclusions: IL‐17 levels are altered in non‐obese females with PCOS and may influence gingival inflammation. Additional studies are warranted to clarify the relationship between PCOS and gingivitis.     

Effects of different surface treatments on shear bond strength in two different ceramic systems

The purpose of this study was to evaluate the influence of different surface treatments (sandblasting, acid etching, and laser irradiation) on the shear bond strength of lithium disilicate-based core (IPS Empress 2) and feldspathic ceramics (VITA VM 9). One hundred ceramic discs were divided into two groups of 50 discs each for two ceramic systems: IPS Empress 2 (group I) and VITA VM 9 (group II). Each of the two groups was further divided into five surface treatment groups (ten each) as follows: group SB, sandblasting with alumina particles (50 μm); group HF, 5 % hydrofluoric acid etching; group L, Er:YAG laser irradiation (distance, 1 mm; 500 mJ; 20 Hz; 10 W; manually, noncontact R14 handpiece); group SB–L, sandblasting + Er:YAG laser; and group HF–L, 5 % hydrofluoric acid + Er:YAG laser. Luting cement (Panavia 2.0) was bonded to the ceramic specimens using Teflon tubes. After 24 h of water storage, a shear bond strength test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed with a two-way analysis of variance (ANOVA) and Tukey's honestly significant difference tests (α?=?0.05). The two-way ANOVA indicated that the shear bond strength was significantly affected by the surface treatment methods (p?<?0.05), but there was no significant interaction between the ceramic systems. Group SB–L had the highest mean values for each ceramic system. Sandblasting, followed by Er:YAG laser irradiation, enhanced the bond strength, indicating its potential use as an alternative method. The atomic force microscopic evaluation revealed that group SB had the most distinct sharp peaks among the groups.     

Mesangial proliferative glomerulonephritis in familial Mediterranean fever patient with E148Q mutation: the first case report

Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease characterized by recurrent attacks of fever, usually accompanied by sterile polyserositis. Although amyloidosis is the most common renal involvement, non-amyloid renal lesions, such as glomerulonephritis, have been described in patients with FMF. In this report, we present the first case of an FMF patient with heterozygous mutation of E148Q, mesangial proliferative glomerulonephritis, and no amyloidosis. While the association of mutation E148Q with renal involvement is still obscure, colchicine treatment is useful in mesangial proliferative glomerulonephritis with FMF.     

Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose

Background

Prolonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography.

Methods

Thirty patients with IFG (19 males and 11 females; age, 46.9?±?9.5?years) and 30 control subjects (18 males and 12 females; age, 46.7?±?8.2?years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area?Clength method. LA mechanical function parameters were calculated.

Results

LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p?<?0.001 and p?<?0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p?<?0.001 and 15.0 [8.5] vs. 7.5 [2.0], p?<?0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r?=?0.76, p?<?0.001 and r?=?0.68, p?<?0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (???=?0.753, p?<?0.001).

Conclusion

We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.     

Aortitis in a patient with psoriatic arthritis

Aortitis, inflammation of the aortic tissue, is most commonly caused by vasculitic rheumatic conditions, and less frequently infectious organisms. Involvement of the aorta is well defined in HLA-B27-associated spondyloarthropathies such as long-standing ankylosing spondylitis and Reiter's syndrome. However, unlike other spondyloarthropathies, aortic involvement or true aortitis is not a feature of psoriatic arthritis and has been reported in only a few cases. Herein, we report the case of a 22?year-old woman with psoriatic arthritis who developed descending aortitis while using tumor necrosis factor inhibitors.     

Complete blood count parameters to predict retinopathy of prematurity: when to evaluate and what do they tell us?

International Ophthalmology - To evaluate the relationship of novel inflammatory markers neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with retinopathy of prematurity...