Effects of acute kidney injury on clinical outcomes in patients with upper gastrointestinal bleeding

Aim Upper gastrointestinal bleeding (UGIB) is a very frequently encountered condition that has a high morbidity and which increases treatment costs. Duration of hospital stay and mortality increases in patients with UGIB complicated by acute kidney injury (AKI). The aim of this study was to reveal risk factors in patients with UGIB developing AKI and to compare clinical outcomes and hospital costs between patients with UGIB developing AKI and those with UGIB not developing AKI.

Material and methods This retrospective study included 245 patients admitted to the emergency unit and the intensive care unit for internal diseases at Ankara Numune Education and Research Hospital, Turkey. Results The difference in mortality rates between the patients with AKI and those without AKI was significant (p?0.001). The mean duration of intensive care unit stay was 0.2?±?1.1 days in the patients without AKI (n?=?143) and 2.5?±?5.6 days in the patients with AKI. It was significantly higher in the patients with AKI (p?0.001). Hospital stay was significantly longer in the patients with AKI than those without AKI, and as severity of AKI increased, hospital stay became considerably longer (p?0.001). Hospital costs were significantly higher in the patients with AKI than those without AKI, and as severity of AKI increased, hospital costs considerably rose (p?0.001). Conclusion AKI is a condition that lengthens hospital stay, increases hospital costs and creates a burden on health care systems. Detect kidney injury earlier and administering an appropriate treatment can improve clinical outcomes in patients with UGIB developing AKI.     

Innovative wavelengths in endodontic treatment

BACKGROUND AND OBJECTIVES: The sanitation of the root canal system and the adjacent dentin has always been a key requirement for successful endodontics. In recent years, various laser systems have provided a major contribution to this aim, namely the Nd:YAG-, the 810 nm Diode-, the Er:YAG-, and the Er,Cr:YSGG laser. Numerous studies could prove their efficiency within the endodontic procedure. Recently, two new wavelengths have been introduced to the field of oral laser applications: The KTP laser emitting at 532 nm and the 980 nm diode laser. The present in vitro investigation was performed to evaluate the effects of these laser systems focusing on their antibacterial effect in deep layers of dentin and their impact on the root canal dentin. STUDY DESIGN/MATERIALS AND METHODS: Two-hundred slices of root dentin with a thickness of 1 mm were obtained by longitudinal cuts of freshly extracted human premolars. The samples were steam sterilized and subsequently inoculated with a suspension of either Escherichia coli or Enterococcus faecalis. After the incubation, the samples were randomly assigned to the two different laser systems tested. Each laser group consisted of two different operational settings and a control. The dentinal samples underwent "indirect" laser irradiation through the dentin from the bacteria-free side and were then subjected to a classical quantitative microbiologic evaluation. To assess the temperature increase during the irradiation procedure, additional measurements were carried out using a thermocouple. To assess the impacts on the root canal walls, 20 additional samples underwent laser irradiation at two different settings and were subjected to scanning electron microscopy. RESULTS: Microbiology indicated that both laser systems were capable of significant reductions in both test strains. At an effective output power of 1 W, E. coli was reduced by at least 3 log steps in most of the samples by the tested wavelengths, with the best results for the KTP laser showing complete eradication of E. coli in 75% of the samples. E. faecalis, a stubborn invader of the root canal, showed minor changes in bacterial count at 1 W. Using the higher setting of 1.5 W, significant reductions of E. coli were again observed with both laser systems, where the lasers were capable of complete eradication of E. faecalis to a significant extent. There was no significant relation between the temperature increase and the bactericidal effect. CONCLUSIONS: The present study demonstrates that both wavelengths investigated could be suitable for the disinfection of even the deeper layers of dentin and equal the results achieved by established wavelengths in state-of-the-art endodontics.     

Photobiomodulation therapy does not depend on the differentiation of dental pulp cells to enhance functional activity associated with angiogenesis and mineralization

Lasers in Medical Science - The purpose of this study is to analyze the influence of InGaAlP diode laser (660 nm) with or without an odontogenic medium (OM) in the functional activity of...     

Influence of Heredity and Environment on Peak Bone Density: A Parent-Offspring Study

The aim of the study was to determine the relative influence of heredity and environment on peak bone density and also to estimate the risk of having low peak bone density if the bone density of parents is low. The study comprised 83 families (48 daughters and 35 sons and their parents). The children were at an age when bone density is at its peak at most skeletal sites (22.2 ± 1.8 girls; 23.1 ± 1.2 boys). Bone mineral density (BMD; g/cm²) was determined by dual-energy X-ray absorptiometry. Anthropometric measurements were made, and calcium intake and physical activity were assessed. Heredity accounted for 22–42% of the variation in BMD of the children, depending on the skeletal site. Heritability for cortical BMD of mid-radius was considerably lower than that for spinal trabecular BMD. Children whose parents had low BMDs (T-score ≤ ?1) were 1.1 times more likely to inherit low BMD. Child BMD depended significantly on parent BMD and also on physical activity. In our study, heredity accounted for the total BMD variation more than the environmental factors. This influence was lower in the cortical than in the trabecular parts of the skeleton. Optimal environmental factors, such as physical activity, may influence the risk of inheriting low BMD.     

Effect of interdental brush design on plaque during nonsurgical periodontal therapy

Clinical Oral Investigations - The aim of this randomized controlled trial was to evaluate the interproximal cleaning efficacy of waist-shaped compared with straight soft interdental brushes in...