National Infection Control Program in Turkey: The healthcare associated infection rate experiences over 10 years

BackgroundThe prevalence of healthcare associated infection (HAI) is generally higher in countries with limited resources than developed countries. To address the high prevalence of HAI, Turkish Ministry of Health introduced a national infection control program in 2005.MethodsDevice associated (DA)-HAIs routinely surveyed included ventilator associated events, urinary catheter associated urinary tract infection and central line associated blood stream infection. Rates in DA-HAI were examined from 2008 to 2017 by type of hospitals, bed capacity, and geographic location of hospitals.ResultsAll DA-HAIs declined significantly from 2008 to 2017 nationally for ventilator associated events from 16.69 to 4.86 per 1,000 device days (IRR = 0.29, P < .0001), catheter associated urinary tract infection from 4.98 to 1.59 per 1,000 catheter days (IRR = 0.31, P < .0001) and central line associated blood stream infection from 5.65 to 2.82 per 1,000 catheter days (IRR = 0.47, P < .0001). The rates for DA-HAIs declined significantly in hospitals with ≥200 beds and <200 bed capacity and in all 4 type of hospitals. By 2017 all DA-HAI had significantly improved across all regions.ConclusionsThe introduction of a new national surveillance system supported by a national infection control program has significantly reduced 3 major DA-HAIs that are associated with risk of treatment failure and death. The next critical step in sustaining this crucial improvement will require timely feedback to hospitals using technology and continued buy-in from clinicians for their commitment to safety associated with DA-HAIs using aspirational DA-HAI rates.     

A case of acute respiratory distress syndrome (ARDS) induced by docetaxel administration for lung metastases from oral cancer

We reported a case of acute respiratory distress syndrome (ARDS) induced by docetaxel in treating lung metastases from oral cancer. The patient was an 84-year-old man who had undergone partial mandibulectomy and radical neck dissection for lower gingival carcinoma. The patient developed ARDS after docetaxel administration (40 mg/body) for multiple lung metastases.     

Contractility Reserve in Children Undergoing Dialysis by Dobutamine Stress Echocardiography

Left ventricular hypertrophy is an adaptive mechanism in children undergoing chronic dialysis to improve contractility at rest. The aim of this study was to determine the left ventricular performance and contractility reserve by “dobutamine stress echocardiography” in children undergoing chronic dialysis. Thirty-five children undergoing dialysis and 24 healthy subjects were enrolled in this prospective study. We evaluated contractility by means of end-systolic wall stress—velocity of circumferential fiber shortening (VCFc) in 24 healthy subjects and 35 dialysis patients. Dobutamine stress echocardiography was obtained only in children undergoing dialysis. Patients were divided into two groups according to left ventricular mass index. Contractile reserve was estimated by the difference in contractility at rest versus during echocardiography. Significantly higher VCFc (p = 0.008) and VCFc (p = 0.002) differences at rest were observed in the patient group compared to healthy subjects. Children undergoing dialysis had a higher left ventricular mass index compared with controls (42.38 ± 12.41 vs. 17.57 ± 3.66 g/m^2.7, respectively; p = 0.001). Patients with left ventricular hypertrophy had a significantly lower contractile reserve compared with patients without left ventricular hypertrophy (p = 0.013). These findings suggest that children undergoing dialysis have increased left ventricular mass and contractility at rest. However, the contractile reserve during dobutamine stress echocardiography was reduced. Dobutamine stress echocardiography may identify children undergoing dialysis at risk of progressing to systolic dysfunction and heart failure.     

Establishment of high and low metastasis cell lines derived from a human tongue squamous cell carcinoma

Malignant tumors are composed of cells with different phenotypic properties and only certain cell subpopulations present metastatic potential. The establishment of cell lines with high or low metastatic potential is necessary to investigate the molecular mechanisms of the metastatic process. However, human oral squamous cell carcinoma (SCC) cell lines that are suitable for the above investigation are scarce. High and low metastatic cells were obtained from a primary lesion of a patient with tongue carcinoma who had not received any therapy. Two distinct cell lines were selected, UM1 with a scattered growth pattern and loose cell-cell adhesion, and UM2 with a colony-formed growth pattern and firm cell-cell adhesion. The expression of E-cadherin in UM1 was clearly lower than that in UM2. UM1 exhibited a higher motility, invasive and metastatic activity than UM2 in vivo and in vitro. A low invasive and a metastatic oral SCC cell line, useful to investigate invasion and metastasis mechanisms, have been established.     

Oral rehabilitation of a patient with hypoplastic amelogenesis imperfecta: a case report

To report a case of oral rehabilitation of a patient diagnosed with hypoplastic amelogenesis imperfecta. A 18-year-old female with hypoplastic amelogenesis imperfecta presented for prosthodontic treatment to eliminate tooth sensitivity while enhancing esthetics and restoring masticatory function. Treatment included, lengthening of the maxillary and mandibular clinical crowns, and placement of metal-ceramic fixed partial dentures. The 1-year recall examination revealed no pathology associated with the rehabilitation, and the patient's esthetic and functional expectations were satisfied. For successful prosthodontic therapy, the clinician should be aware of all condition of patient.     

Removable partial denture in a cleft lip and palate patient: a case report

This clinical report described the oral rehabilitation of a cleft lip and palate patient with removable partial denture. Although implant-supported fixed treatment was presented as part of the optimum treatment plan to achieve the best result, the patient declined this option due to the significant financial burden. Persons with a congenital or craniofacial defect are unique, and oral problems must be evaluated individually to the most ideal treatment. The changes in appearance, function, and psychological wellbeing have an enormous impact on patients' personal lives and are rewarding for the maxillofacial prosthodontist providing this care.