PubMed Açık Erişimli Yayınlar
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Item Peri- and Postanalgesic Properties of Lidokain, Lornoxicam, and Nitroglycerine Combination at Intravenous Regional Anesthesia(2014) Cakmak, Biricik Melis; Cakmak, Gokhan; Akpek, Elif; Arslan, Gulnaz; Sahin, Mehmet SukruBackground. This study was conducted to compare and evaluate the effect of adding lornoxicam or nitroglycerine as adjuncts to lidocaine in intravenous regional anesthesia (IVRA). Methods. 60 patients were randomly separated into three groups, lidocaine group (group L), lidocaine + lornoxicamgroup (group LL), and lidocaine + lornoxicam + transdermal nitroglycerine group (group LL-N). Hemodynamic parameters, sensory and motor blocks onset, and recovery times were recorded. Analgesic consumption for tourniquet pain and postoperative period were recorded. Results. Sensory block onset times and motor block onset times were shorter in the LL-N and LL groups compared with L group. Sensory block recovery time and motor block recovery time were prolonged in the LL and LL-N groups compared with group L. The amount of fentanyl required for tourniquet pain was less in group LL and group LL-N when compared with group L. VAS scores of tourniquet pain were higher in group L compared with the other study groups. Postoperative VAS scores were higher for the first 4 hours in group L compared with the other study groups. Conclusion. The adjuvant drugs (lornoxicam or TNG) when added to lidocaine in IVRA were effective in improving the overall quality of anesthesia, reducing tourniquet pain, increasing tourniquet tolerance, and improving the postoperative analgesia.Item Effect of HLA on Hepatitis C Virus Clearance and Persistence in Anti-HCV-positive End-stage Renal Disease Patients(2014) Ocal, Serkan; Selcuk, Haldun; Korkmaz, Murat; Altun, Reskan; Yildirim, Abdullah E.; Akbas, Enver; 24976281Background/Aims: The efficacy of immune response against hepatitis C virus (HCV) is determined by human leukocyte antigen (HLA) molecules of the host which present HCV antigens to CD4+ and CD8+ Tlymphocytes. In this study, we aimed to investigate the possible relationship between the frequencies of certain HLA class I-II alleles and the natural history of HCV in patients with end-stage renal disease (ESRD). Settings and Design: This is a retrospective cohort study conducted in a university hospital. Patients and Methods: The present study comprised 189 ESRD patients (candidates for renal transplantation) who had positive anti-HCV antibody test. The results concerning HCV and HLA status were gathered from patients files. The viral persistence was compared between the groups that were determined by HLA sub-typing. Statistical Analysis: Statistical evaluation was performed using Mann-Whitney U-test, Chi-square test, and Fisher's exact test. Level of error was set at 0.05 for all statistical evaluations, and P values < 0.05 were considered statistically significant. Results: We found possible association between the course of HCV infection and specific HLA alleles. HLA class I Cw*6 and HLA class II DRB*10 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I B*38 allele group was more prone to develop chronic hepatitis C (P < 0.01). Conclusions: These findings suggest that HLA class I Cw*6 and HLA class II DRB*10 alleles may be associated with immunological elimination of HCV in Turkish patients on hemodialysis. HLA sub-typing could help predict the prognosis of HCV infection.Item Can serial monitoring of serum Vascular Endothelial Growth Factor (VEGF), Nitric Oxide (NO), and Angiotensin II (ANGII) levels have predictive role during Bevacizumab treatment?(2014) Sumbul, Ahmet Taner; Disel, Umut; Sezgin, Nurzen; Sezer, Ahmet; Kose, Fatih; Besen, Ali Ayberk; Sumbul, Zehra; Abali, Huseyin; Ozyilkan, OzgurBackground: Standard treatment of colorectal cancer includes both cytostatic chemotherapy and targeted therapies. Bevacizumab, targeting the VEGF receptor, is one of the primary targeted therapies that achieve better response rate and survival rate as compared to combination chemotherapy. To the best of our knowledge, there is no established single marker that can be used as a predictive marker in bevacizumab therapy. Material/Methods: We enrolled 24 patients with the diagnosis of metastatic colorectal cancer in our study. During the study, 2 blood samples were drawn from patients before the first cycle and after the sixth cycle of bevacizumab therapy. Serum levels of VEGF, ANG II, and NO were recorded. Results: While the change across VEGF levels was found to be a statistically significant decreasing trend (p=0.009), this decrease was not found to be correlated with treatment response and hypertension development. Additionally, no statistically significant difference was found in terms of NO and ANG II levels. Conclusions: This study showed a significant decrease in serum VEGF, but failed to show a significant change in NO and ANG II levels during bevacizumab treatment. Although no significant correlation was found between the presence of hypertension and markers, most patients (83%) had an increase in their blood pressure. Our results suggest that dynamic monitoring of NO and ANG II, along with VEGF, may not be useful as predictive markers for bevacizumab treatment in colorectal cancer.Item Analysis and injury paterns of walnut tree falls in central anatolia of turkey(2014) Ersoy, Suleyman; Sonmez, Bedriye Muge; Yilmaz, Fevzi; Kavalci, Cemil; Ozturk, Derya; Altinbilek, Ertugrul; Alagoz, Fatih; Cesur, Fatma; Yildirim, Ali Erdem; Uckun, Ozhan Merzuk; Akin, TezcanIntroduction: Falls are the second most common cause of injury-associated mortality worldwide. This study aimed to analysis the injuries caused by falls from walnut tree and assess their mortality and morbidity risk. Methods: This is a retrospective hospital-based study of patients presenting to emergency department (ED) of Ahi Evran Univercity between September and October 2012. For each casualty, we computed the ISS (defined as the sum of the squares of the highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions). Severe injury was defined as ISS >= 16. The duration of hospital stay and final outcome were recorded. Statistical comparisons were carried out with Chi-Square test for categorical data and non-parametric spearman correlation tests were used to test the association between variables. A p value less than 0.05 was considered to be statistically significant. Results: Fifty-four patients admitted to our emergency department with fall from walnut tree. Fifty (92.6%) patients were male. The mean age was 48 +/- 14 years. Spinal region (44.4%) and particularly lumbar area (25.9%) sustained the most of the injuries among all body parts. Wedge compression fractures ranked first among all spinal injuries. Extremities injuries were the second most common injury. None of the patients died. Morbidity rate was 9.25%. Conclussion: Falls from walnut trees are a significant health problem. Preventive measures including education of farmers and agricultural workers and using mechanized methods for harvesting walnut will lead to a dramatic decrease in mortality and morbidity caused by falls from walnut trees.Item TREATMENT PATTERNS AND QUALITY OF LIFE OF PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: AN EXPERIENCE OF A TERTIARY HEALTH CARE CENTERS (TREQ-AF STUDY)(2014) Ozin, B.; Aytemir, K.; Arslan, O.; Ozcan, T.; Kanadasi, M.; Demir, M.; Gokce, M.; Sucu, M. M.; Ozdemir, M.; Yiğit, Z.; Yavuzkir, M.F.; Oto, A.; 27201487Item Endovascular treatment of an iliac artery rupture caused by invasive Salmonella spondylodiscitis(2014) Kursun, Ebru; Turunc, Tuba; Ozkan, Ugur; Demiroglu, Yusuf Ziya; 25230272The rate of non-typhoid Salmonella infections has increased remarkably in recent years. Endovascular system infection is one of the most serious forms of extraintestinal Salmonella infection. The abdominal aorta is frequently involved, while bone and joint involvement are rarely seen. We present a rare case of successful endovascular treatment of a left iliac artery rupture and pseudoaneurysm both occurring due to the direct invasion of lumbar spondylodiscitis caused by Salmonella typhimurium.Item Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies(2014) Ozyilmaz, Ezgi; Ugurlu, Aylin Ozsancak; Nava, StefanoBackground: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. Results: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance. Conclusions: Every clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation.Item Therapeutic Potential of Apigenin, a Plant Flavonoid, for Imatinib-Sensitive and Resistant Chronic Myeloid Leukemia Cells(2014) Solmaz, Soner; Gokbulut, Aysun Adan; Cincin, Birsu; Ozdogu, Hakan; Boga, Can; Cakmakoglu, Bedia; Kozanoglu, Ilknur; Baran, YusufDespite the presence of many therapeutic regimens like imatinib and other tyrosine kinase inhibitors, the development of resistance, intolerance, and side effects makes chronic myeloid leukemia (CML) therapy challenging. Thus, there is a need to discover novel drugs for CML patients. In this study, we attempted to assess apigenin, a common plant dietary flavonoid, in terms of its cytotoxic, apoptotic, and cytostatic effects on imatinib-sensitive and resistant Philadelphia-positive CML cells. We analyzed apigenin's effects on cell proliferation, apoptosis, caspase-3 activity, loss of mitochondrial membrane potential, and cell cycle progression in K562 and K562/IMA3 cells. Furthermore, we described genes and gene networks that are modulated in CML in response to apigenin. Results of our study revealed that apigenin has cytotoxic and apoptotic effects on both cell types. We also displayed that apigenin induced G2/M arrest in K562 cells while arresting K562/IMA3 cells in S phase especially at the highest apigenin concentration. The expression analysis identified a set of genes that were regulated by apigenin in K652 and K562/IMA3 cells. Association of modulated genes with biological functional groups identified several networks affected by apigenin including cell survival, proliferation, cell death, cell cycle, and cell signalling pathways.Item Gastrointestinal endoscopy in pregnancy(2014) Savas, Nurten; 25386072Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Item Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study(2014) Sarifakioglu, B.; Afsar, S.I.; Yalbuzdag, S.A; Utaomer, K.; Ayas, S.; 25000951Study design: Retrospective review of medical notes. Objective: To describe clinical, laboratory and examination findings of acute abdominal emergencies (AAE) in Turkish patients with spinal cord injury (SCI) and to examine diagnosis and management of AAE in early stages. Setting: Inpatient rehabilitation unit of tertiary research hospital. Methods: The medical records of 237 SCI patients were reviewed. The SCI patients who were recruited in the study had been diagnosed with AAE and treated medically or surgically while they were inpatients at the rehabilitation clinic. Results: Nine out of 237 SCI patients had been diagnosed with one of the AAE. Three patients were AIS A, three patients were AIS B and three patients were AIS C. The most common AAE was acute cholecystitis; three patients were diagnosed with this. The others were single cases of intra-abdominal hemorrhage, intra-abdominal abscess, tuba-ovarian abscess, subileus, Crohn's disease and cholangitis. Three of the patients were treated with surgery and six were treated medically. The most common symptoms in patients were fever, abdominal pain and abdominal discomfort (four of AAE). Three patients had abdominal tenderness and abdominal distension. The expected findings of AAE, rebound and defense, were positive only in two patients. Conclusion: Gall bladder disease is a common cause of AAE. The classic symptoms and examination findings will usually not facilitate acute abdomen diagnosis in the SCI group, so we should be aware of patients' subjective complaints and when necessary use advanced imaging techniques immediately.Item The relationship between coronary collateral artery development and inflammatory markers(2014) Oguz, Didem; Atmaca, Yusuf; Ozdol, Cagdas; Ozdemir, Ayhan Ongun; Kaya, Cansin Tulunay; Erol, CetinObjective: This study aims to show the effect of myeloperoxidase (MPO), hsCRP, TNF-alpha values and leukocyte count on the development of coronary collateral arteries in patients with severely diseased coronary arteries. Methods: Current study is an observational cross-sectional study. In the study, 295 patients who had functional obstruction or total coronary occlusion at least 1 month on their angiograms were included. We divided the study population into two groups according to their collateral grade as good collateral (Group 1) (169 patients) and poor collateral (Group 2) (126 patients). Multiple logistic regression analysis was used for independent variables associated with the coronary collateral grade. Results: History of stable angina pectoris was statistically more prevalent in good collateral group (61.5% and 48.4%, p=0.025). Furthermore, MPO activation was higher in good collateral group and the difference was statistically significant (3.7 U/mL and 3.0 U/mL p=0.001). In multiple logistic regression analysis, stable angina pectoris [OR 1.7, 95% CI (1.05-2.8), p=0.03] and high MPO levels [OR 2.7, 95% CI (1.7-4.3), p<0.001] were found to be independent predictors of good collateral development. Conclusion: We think that proinflammatory enzymes and cytokines released from these cells rather than inflammatory cells themselves may play an important role on the collateral development.Item THE COST-EFFECTIVENESS ANA LYSIS FOR HIV TREATMENT ALTERNATIVES IN TURKEY(2014) Kockaya, G.; Yenilmez, F.B.; Zengin, Elbir T.; Dalgic, C.; Malhan, S.; Cerci, P.; Oksuz, E.; Tayfun, K.; Unal, S.; 27202504Item Effect of Topical Tetracycline on Seroma Formation in the Lichtenstein Technique: A Prospective Randomized Study(2014) Turk, Emin; Karagulle, Erdal; Coban, Gokcen; Yildirim, Erkan; Moray, GokhanWe sought to investigate whether application of topical tetracycline has a limiting effect on seroma formation in patients undergoing hernia repair using a polypropylene mesh. This study was conducted in 96 patients undergoing an elective groin hernia repair. Patients were randomized and divided into 2 groups. After the graft was placed, and before external oblique muscle aponeurosis was closed, 5 mL tetracycline was administered on the graft in the tetracycline group (tetra group, n = 50), and 5 mL isotonic saline was administered in the control group (n = 46) without putting in a drain. Seroma checks via surface ultrasonography were done. Seroma amounts measured on the first day were significantly higher in the tetra group (P = 0.04). There were no significant differences regarding seroma measurements on the seventh day or in the first and second months. Topical tetracycline application has no limiting effect on seroma formation after a groin hernia operation.Item Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, HaldunObjective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.Item Surgical Interventions for Late Complications of Arteriovenous Fistulas(2014) Belli, Sedat; Yabanoglu, Hakan; Aydogan, Cem; Parlakgumus, Alper; Yildirim, Sedat; Haberal, Mehmet; 25058786Our aim was to determine the most effective surgical treatment for arteriovenous fistula (AVF) complications after all other methods of salvage have failed. We evaluated 110 patients for 139 complications that occurred after the initial AVF placement and for whom surgical intervention was the last hope for retaining fistula access. Vascular steal syndrome and venous hypertension were the most common complications seen in our patients. The anastomoses of 17 of the vascular steal syndrome cases were narrowed either by stitches or by a polytetrafluoroethylene graft. The second most performed revision surgery was excision of the aneurysm and repair with primary suturing, followed by excision of the aneurysm and interposition grafting. Successful surgical outcomes were achieved in 111 of 139 procedures after revision surgery without constructing a new AVF. AVF salvage surgery is of paramount importance in order to increase the patency rate, which prolongs survival and increases the patient's quality of life.Item Surgical and interventional management of complications caused by acute pancreatitis(2014) Karakayali, Feza Y.; 25309073Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Item Effects of ozone therapy and taurine on ischemia/reperfusion-induced testicular injury in a rat testicular torsion model(2014) Aydos, Tolga Resat; Basar, Mehmet Murad; Kul, Oguz; Atmaca, Hasan Tank; Uzunalioglu, Tuba; Kisa, Ucler; Efe, Oguzhan Ekin; 25539540Background/aim: To investigate the effect of ozone and/or taurine treatment comparatively on testicular damage due to ischemia/reperfusion (I/R) injury in an experimental torsion model in rats. Materials and methods: Adult Wistar rats with and without torsion/detorsion were used. In order to monitor the effect of ozone and/or taurine treatment on testicular damage due to I/R injury, following histopathological investigation apoptotic indexes were scored by TUNEL method. Moreover, tumor necrosis factor receptor 1 (TNFR1), caspase 3, caspase 8, endothelial nitric oxide synthase (eNOS), tumor necrosis factor alpha (TNF alpha), and cytochrome C immunostainings were performed and the levels of malondialdehyde, glutathione peroxidase, superoxide dismutase, catalase, total sulthydryl, and nitric oxide were determined in the testicular tissue. Results: Intraperitoneal ozone and/or taurine treatment prevented both histopathological damage and increase in the apoptotic index. Torsion did not exert an effect on the levels of TNFa and cytochrome C. Ozone and/or taurine treatment prevented increases in TNFR1, caspase 3, and caspase 8. The level of oxidative stress markers was unchanged. The increases in NO level and eNOS expression were prevented by ozone and/or taurine treatment in I/R groups. Conclusion: Using ozone therapy and/or taurine before reperfusion may be a solution for germ cell degeneration resulting from testicular torsion and related infertility.Item Is it Accurate to Separate Glucose-6-Phosphate Dehydrogenase Activity in Neonatal Hyperbilirubinemia as Deficient and Normal?(2014) Kilicdag, Hasan; Gokmen, Zeynel; Ozkiraz, Servet; Gulcan, Hande; Tarcan, AylinBackground: The aim of this study was to investigate glucose 6-phosphate dehydrogenase (G6PD) activity in term and late preterm babies with severe neonatal hyperbilirubinemia and its relationship to the severity and treatment of this disorder, regardless of level of G6PD activity (deficient/normal). Methods: A total of 529 term and late preterm (>= 35 weeks) infants (228 female, 301 male) who were diagnosed with severe hyperbilirubinemia were included in this study. In each case, serum was collected to evaluate blood group, direct Coombs' test, complete blood cell count, total and direct bilirubin, thyroid-stimulating hormone, and G6PD activity. A partial correlation analysis was carried out to assess the relationship between G6PD activity and total bilirubin levels. Results: A significant correlation was found between the severity of hyperbilirubinemia and G6PD activity in both males and females. Male neonates who had G6PD levels <12 U/g Hb required more phototherapy time than neonates who had G6PD levels >12 U/g Hb; and female neonates who had G6PD levels <16 U/g Hb required more phototherapy time than neonates who had G6PD levels >= 16 U/g Hb (p < 0.0001). When we analyzed only breastfed infants, a significant difference also emerged in both sexes. Decreased G6PD activity was associated with increased phototherapy time and the need for exchange transfusion. Conclusion: Routine checks of G6PD level in hyperbilirubinemic neonates are very important in providing proper medical management to prevent bilirubin-induced neurological dysfunction.Item Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration(2014) Boncuk, Yasemen; Cehreli, Zafer C.; Polat-Ozsoy, OmurObjective: To investigate the color alterations in enamel following the use of different orthodontic bonding resins and adhesive residue removal burs. Materials and Methods: Metal brackets were bonded to extracted human premolars (n = 175) by using an etch-and-rinse adhesive system, a self-etch adhesive system (SEP), or a resin-modified glass ionomer cement (RMGIC). After 24 hours of photoaging, the brackets were removed and the adhesive residue on the tooth surfaces was cleaned with either a tungsten carbide bur or a Stainbuster bur. Tooth colors were measured with a spectrophotometer at baseline, after adhesive removal, and after additional photoaging. Color evaluation was made, and color differences induced by photoaging were calculated. Statistical evaluation was made using the Kruskal-Wallis test and the Mann-Whitney U-test, with Bonferroni correction. Results: All specimens showed discoloration at varying levels. The highest color change was observed in the etch-and-rinse adhesive/tungsten carbide bur group. When the etch-and-rinse and self-etch adhesives were used, adhesive-remnant removal with Stainbuster burs resulted in significantly lower discoloration. The type of bur did not affect the extent of enamel discoloration in the RMGIC group. Conclusions: Orthodontic treatment alters the original color of enamel, and both the adhesive system and the resin-removal methods are responsible for this change. When brackets are bonded with the etch-and-rinse system or the SEP, cleaning the adhesive residuals with Stainbuster burs is recommended for minimal change. RMGIC can be safely cleaned with tungsten carbide burs.Item Skin Care in Organ Transplant Patients Europe Meeting Report from Annual Meeting, Leiden, The Netherlands, 15-18 May 2014(2014) Hofbauer, Guenther F.L.; Seckin, Deniz; Gjersvik, Petter; Bavinck, Jan Nico Bouwes; 25381765