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Examining the life satisfaction, job satisfaction, intention to leave and burnout levels of employees according to the compliance of workplaces with the well building standard- mind concep
No full textComparative evaluation of the effectiveness of various intracanal medicaments in eliminating Enterococcus faecalis from simulated internal resorption cavities
No full textThis study aimed to evaluate the antibacterial efficacy of calcium hydroxide (Ca(OH)2), Ca(OH)2 + resveratrol (RV), Ca(OH)2 + silver nanoparticles(AgNPs), and Ca(OH)2 + salicylic acid (SA) against Enterococcus faecalis (E. faecalis) using culture methods and field emission scanning electron microscopy (FE-SEM). Fifty-four extracted single-rooted teeth were prepared with standardized internal resorption cavities and inoculated with E. faecalis (ATCC 29212). After 21 days of incubation, baseline bacterial counts were determined. The teeth were randomly assigned to five groups (n=10) based on the applied medicament. After 14 days of incubation, bacterial counts were reassessed, and two samples from each group were analyzed using FE-SEM. Data were analyzed using one-way ANOVA and Duncan’s test (p<.05). All medicament groups significantly reduced bacterial counts (p<.001), with Ca(OH)2 + RV, Ca(OH)2 + AgNPs, and Ca(OH)2 + SA demonstrating superior antibacterial activity compared to Ca(OH)2 alone (p<.001). The saline group exhibited the highest bacterial counts(p<.001). Combining Ca(OH)₂ with RV, AgNPs, or SA significantly enhances antibacterial efficacy in internal root resorption cases. These combinations may serve as effective alternatives to Ca(OH)2 alone in endodontic disinfection. Intracanal medicament application plays a vital role in eliminating microorganisms and enhancing the success of endodontic treatment, particularly in cases of internal root resorption. This study highlights the superior antibacterial efficacy of Ca(OH)2 combined with RV, AgNPs, or SA against E. faecalis. These findings suggest that incorporating these adjuncts into intracanal medicaments may improve disinfection outcomes, offering potential clinical benefits in managing internal root resorption cases.</p
Therapeutic effects of finerenone and exenatide on diabetes-induced heart failure: A combined approach targeting inflammation and oxidative stress
No full textCardiovascular complications, particularly diabetic cardiomyopathy and heart failure, are leading causes of morbidity and mortality in patients with diabetes mellitus. This study aimed to investigate the therapeutic potential of finerenone and exenatide, individually and in combination, in mitigating diabetes-induced cardiac injury. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, exhibits strong anti-fibrotic and anti-inflammatory properties in cardiovascular and renal diseases. Exenatide, a glucagon-like peptide-1 receptor agonist, is recognized for its glucose-lowering effects and additional cardioprotective actions, including antioxidant and anti-inflammatory activities. The combination of these agents was hypothesized to exert synergistic effects by targeting complementary pathological pathways involved in diabetic cardiomyopathy progression. Type 1 diabetes was induced in rats by a single high-dose streptozotocin injection. Animals were divided into five groups: control, STZ, STZ with finerenone, STZ with exenatide, and STZ with both finerenone and exenatide. Cardiac tissues and serum samples were analyzed for oxidative stress markers (TOS, TAS), inflammatory cytokines (IL-6, IL-1β, TNF-α), and myocardial injury biomarkers (cTnT, cTnI) through RT-qPCR and Western blotting. NRF2 pathway activation was also evaluated to assess antioxidant responses. STZ-induced diabetic rats showed significant increases in hyperglycemia, inflammation, oxidative stress, and myocardial injury. Treatment with either finerenone or exenatide alone improved several parameters; however, the combination therapy provided the most substantial cardioprotective effects, with marked reductions in oxidative stress and inflammation and enhanced NRF2 expression. These findings suggest that the combined administration of finerenone and exenatide offers superior protection against diabetes-induced cardiac injury compared to monotherapies, supporting a dual-targeted therapeutic approach for diabetic cardiomyopathy
Probiotic Bactolac alleviates depression-like behaviors by modulating BDNF, NLRP3 and MC4R levels, reducing neuroinflammation and promoting neural repair in rat model
No full textDepression, a prevalent psychiatric disorder, exerts severe and debilitating impacts on an individual's mental and physical well-being, and it is considered a chronic mental illness. Chronic stress plays an important role in the pathophysiology of depression. Lactobacillus plantarum and Streptococcus thermophilus are psychobiotic bacteria and synthesize some neurotransmitters that play a role in the pathogenesis of depression. In this study, we aimed to investigate the therapeutic effects of Bactolac (Lactobacillus plantarum NBIMCC 8767 + Streptococcus thermophilus NBIMCC 8258) on chronic stress-induced depression in rats. Behavioral tests, including the sucrose preference test, elevated plus maze test, forced swim test, and three-chamber sociability test, were employed to assess depressive and anxiety-like behaviors. The expression level of the 5-HT1A, DRD1, ADRA-2A, GABA-A α1, CNR1, NR3C2, NOD1, NLRP3 and MC4R; BDNF levels, glial activity and intestinal permeability were determined in chronic stress-induced depression in rats. In conclusions, chronic stress decreased the expression levels of 5-HT1A, DRD1, ADRA-2A, GABA-A α1, CNR1, NR3C2, NOD1 and BDNF level; increased the expression levels of NLRP3 and MC4R, caused neurodegeneration and glial activity, ultimately led to depressive effects. Bactolac was effective in reducing depressive-like behaviors according to the results of behavioral tests. Bactolac treatment provided high neuronal survival rate increasing BDNF level, prevented the excessive release of pro-inflammatory cytokines by reducing the expression levels of NLRP3 and MC4R, therefore, prevented the excessive activation of the hypothalamus–pituitary–adrenal (HPA) axis and accordingly, reduced neurodegeneration and glial cell activation in depressed rats. We can suggest that Bactolac supplementation may be beneficial in coping with stress, alleviate the effects of chronic stress and help to protect mental health
An International Expert-Based Consensus on the Treatment Strategies for Early and Locally Advanced Rectal Cancer
No full textMAKSİLLOFASİYAL BÖLGEDE GÖRÜLEN MİYOFASİYAL AĞRILAR VE TEDAVİ YÖNTEMLERİ
No full textMiyofasiyal ağrı sendromu lokalize ve/veya generalize ağrılar içeren, yansıyan ağrılar ile karakterize kronik kas rahatsızlığıdır. Tetik noktaları ve gergin bantlar hastalarda fonksiyon kısıtlanmasına, ağrıya ve yaşam kalitesinin düşmesine sebep olmaktadır. Etiyolojisi henüz tam olarak aydınlatılamamış olsa da kastaki ani gerilmeler ve sürekli mikro kronik travmalar asıl neden olarak düşünülmektedir. Stres ve emosyonel değişimler, postür bozuklukları ağrıların ve gerginliklerin ilerlemesine zemin hazırlamaktadır. Özellikle diş hekimliğinde temporomandibular eklem ağrıları ile karıştırılabilen bu durum ciddi bir problem oluşturmaktadır. Diş hekimliği ve çene cerrahisi ele alındığında çiğneme, boyun, ense ve sırt kaslarının detaylı muayenesi ve fizik tedavi ile multidisipliner yaklaşımı teşhis/tedavi açısından en önemli unsurları oluşturmaktadır. Bu kaslardaki tetik noktalarından kaynaklanan lokalize veya yansıyan ağrıları tespit etmek tedavinin etkinliğinin ve devamlılığının anahtarıdır. Diş hekimlerinin bu konuda gerekli klinik ve radyolojik muayeneleri yapmaları, gerekli ayırıcı tanılara ulaşmaları hasta konforu açısından en önemli noktaları oluşturmaktadır. Tedavi prosedürü literatürde çeşitlilik göstermesine rağmen birçoğunun etkinliği hala tartışma konusudur. Bunun yanında lidokain gibi anestezi enjeksiyonları ve kuru iğneleme yöntemlerinin hasta tedavisinde daha fazla yarar sağladığı bilinmektedir. Nonsteroid anti-inflamatuar ilaçlar, diklofenak, botulinum toksini ve transkutanöz elektriksel sinir stimülasyonu tedavi açısından yetersiz kanıt düzeyinde işlemler olarak kalırken destekleyici tedavi özelliklerini sürdürmektedir. Bu kitap bölümü diş hekimliği ve çene cerrahisi kliniklerinde özellikle baş-boyun bölgesinde görülen, temporomandibuler eklem ağrıları ile karışan ve hasta açısıdan oldukça zorlu bir sürece sebep olan bu sendromun tanısı, tedavisi, muayene yöntemleri ve düzeltici eylemleri klinisyenler için kolay ve rahat uygulanabilir şekilde anlatmayı amaçlamaktadır.Myofascial pain syndrome is a chronic muscle disorder with localized and/or generalized pains and referred pains. The restriction of the separate functions of trigger points and taut bands causes pain and loss of vitality. Although its etiology has not yet been fully elucidated, sudden tensions in the muscle and continuous micro chronic traumas remain the main cause. Stress and emotional changes, posture disorders pave the way for the progression of pain and tensions. This situation, which can be confused with temporomandibular joint pains, especially in dentistry, constitutes a serious problem. Dentistry and jaw surgery, seizure, deterioration, examination of neck, nape and back muscles and physical therapy and multidisciplinary approach constitute the most important elements in terms of diagnosis/treatment. It is the key to efficiency and continuity in detecting localized or referred pains originating from trigger points in these muscles. It is important for dentists to perform the necessary clinical and radiological examinations on this subject and to reach the necessary differential opinions in terms of patient comfort. Despite the diversity of the treatment procedure in the literature, the effectiveness of its abundance is still debated. In addition, anesthetics such as lidocaine and dry needling methods are licensed to provide more benefit to patient treatment. Nonsteroidal anti-inflammatory systems, diclofenac, botulinum toxin and transcutaneous electrical nerve stimulation remain as procedures with insufficient evidence level in terms of treatment, while maintaining their therapeutic properties. This book section provides an easy and convenient way for clinicians to explain this treatment method, which is seen especially in the head and neck region in dentistry and maxillofacial surgery clinics, is confused with temporomandibular change pain and is a very difficult process for the patient.</p
Kalp Damar Cerrahisi Geçirecek Hastaların Umut, Depresyon ve Sosyal Destek Düzeylerinin Belirlenmesi
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Clinical Impact of Red Blood Cell Transfusion Location on Gastrointestinal Bleeding Outcomes: Emergency Department vs. Inpatient Unit
No full textBackground: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in patients with GI bleeding. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between 1 June 2021, and 1 June 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between the groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes
Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
No full textBackground: Upper gastrointestinal bleeding (UGIB) can lead to significant morbidity and mortality. Assessing the need for endoscopic interventions and predicting in-hospital mortality are critical, particularly where access to endoscopy is limited. Objective: This study evaluates the predictive accuracy of pre-endoscopy risk-scoring systems for identifying the need for endoscopic interventions and assessing in-hospital mortality in UGIB patients. Methods: We conducted a retrospective cohort study in a tertiary emergency department with 450,000 annual visits. Patients aged ≥18 years presenting with UGIB and undergoing endoscopy between June 1, 2021, and July 31, 2022, were included. Glasgow-Blatchford, pre-endoscopic Rockall, AIMS65, and modified age blood test comorbidity (ABC) scores were calculated using clinical and laboratory data. Results: Of 795 patients, 142 required endoscopic interventions and 653 did not. The Glasgow-Blatchford score predicted intervention needs (p = 0.007) but lacked clinical relevance. All scores predicted mortality (p < 0.001); however, AIMS65 and the modified ABC score had the highest predictive accuracy, especially in those requiring interventions (p < 0.001). Conclusion: Pre-endoscopy scores have limited utility in predicting intervention needs. Male gender, hematemesis, melena, elevated urea, and low red cell distribution width (RDW) may indicate intervention requirements. The modified ABC score demonstrated strong predictive value for mortality, making it a clinically relevant tool for UGIB risk stratification