SUMMARY OBJECTIVE Periodontitis may stimulate infectious and immune response and cause the development of atherogenesis, coronary heart disease, and myocardial infarction. The aim of this study was to compare the plateletcrit (PCT) and mean platelet volume (MPV) levels derived from complete blood count (CBC) tests in patients suffering from stage 3 periodontitis with those of healthy individuals without periodontal disease. METHODS The study included 57 patients (28 females and 29 males) with Stage 3 Periodontitis and 57 volunteering individuals (31 females and 26 males) who were periodontally healthy. The age of study participants ranged from 18 to 50 years. Their periodontal condition was investigated with probing depth (PD), clinical attachment level, bleeding on probing, and plaque index. Leukocyte (WBC) and erythrocyte count (RBC), hemoglobin (Hb) and hematocrit (HCT) levels, mean corpuscular volume (MCV) and red cell distribution width (RDW), thrombocyte count, mean platelet volume (MPV), plateletcrit (PCT ), and neutrophil and lymphocyte counts were evaluated based on the CBC test results of the study participants. RESULTS PCT, WBC, Neutrophil, and MPV values were found to be significantly higher in the periodontitis group (p<0.05). There were no significant differences in RBC counts, Hb, HCT, MCV, RDW, and platelet and lymphocyte counts between the two study groups (p>0.05). CONCLUSIONS PCT and MPV levels may be a more useful marker to determine an increased thrombotic state and inflammatory response in periodontal diseases.

SUMMARY OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.

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Tetanus and botulinum A neurotoxins were introduced into the cytosol of chromaffin cells by means of an electric field in which the plasma membrane is forced to form pores of approximately 1 micron at the sites facing the electrodes. As demonstrated by electron microscopy, both [125I] and gold-labelled tetanus toxin (TeTx) diffuse through these transient openings. Dichain-TeTx, with its light chain linked to the heavy chain by means of a disulfide bond, causes the block of exocytosis to develop more slowly than does the purified light chain. The disulfide bonds, which in both toxins hold the subunits together, were cleaved by the intrinsic thioredoxin-reductase system. Single chain TeTx, in which the heavy and light chains are interconnected by an additional peptide bond, was far less effective than dichain-TeTx at blocking exocytosis, which indicates that proteolysis is the rate-limiting step. The toxins were degraded further to low-molecular weight fragments which, together with intact toxins and subunits, were released by the cells. The intracellular half-life of [125I] dichain-TeTx was approximately three days. The number of light-chain molecules required to maintain exocytosis block in a single cell, as calculated by two different methods, was less than 10. The long duration of tetanus poisoning may result from the persistence of intracellular toxin due to scarcity of free cytosolic proteases. This may also hold for the slow recovery from botulism.

Objective: The purpose of this study was to evaluate the occurrence rate of druginduced gingival overgrowth (DIGO) in patients treated with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs) such as amlodipine, lercanidipine, and benidipine, as well as to assess the relationship of those mentioned above with medication variables and oral hygiene.Methods: Sociodemographic details, DIGO, and clinical periodontal parameters were obtained from one hundred and thirty-one patients receiving ACE inhibitors, ARBs, and CCBs for a period of at least 2 years. Results:The occurrence rate of DIGO was 19.6% in patients using CCB, 12.5% in the ARB group, and 7.5% in the ACE inhibitor group. In a subgroup analysis of CCBs, DIGO was found to be 31.8% in the amlodipine group, 13.3% in the lercanidipine group, and 7.1% in the benidipine group. While there was a significant relationship between amlodipine drug dosage and DIGO, no association was found between the duration of therapy and DIGO in all CCB subgroups. Conclusion:There was no difference between the groups in terms of DIGO. Duration of therapy and drug dosage did not affect the severity of DIGO in both ACE inhibitors and ARB groups.

T he development of coronary collateral circulation is very important for bodily functions since it enhances the blood supply of ischemic myocardium [1]. Well-functioning collateral circulation is associated with the lower incidence of adverse outcomes in stable coronary disease [2][3][4]. The causal relationship between ischemia and collateral circulation development is uncertain [5]. Thus, predictors of coronary collateral development (CCD) receive the utmost interest in literature. Novel studies reported a significant association between hemogram parameters and cardiovascular events [6][7][8]. One of these parameters is platelet distribution width (PDW), which has been suggested as a marker of patency of saphenous grafts after coronary artery bypass operations [9]. Platelet activity is reflected by the platelet distribution width (PDW), which measures the variation in platelet size. PDW has been found to be more specific for platelet activation than the ABSTRACT OBJECTIVE: We hypothesized that hemogram parameters should be related to the development of coronary collateral vessels. For this purpose, we aimed to compare platelet distribution width (PDW) and PDW to platelet ratio (PPR) in subjects with stable coronary artery disease having adequate or inadequate coronary collateral development. METHODS:A total of 398 patients with stable angina pectoris undergoing coronary angiography were enrolled and divided on the basis of the development of coronary collateral (CCD) (inadequate CCD (n=267) and adequate CCD (n=131). Routine complete blood count and biochemical parameters were measured before coronary arteriography. RESULTS:Mean PDW and PPR values of inadequate and adequate CCD groups were 17.5% (10-23) and 12.4% (9.8-22) %, p<0.001, respectively. In multivariate analysis, age (p=0.012, 95% CI for OR: 0.958 (0.933-0.983) and PDW (p<0.001, 95% CI for OR: 1.432 (1.252-1.618) were found to be statistically significantly different inadequate CCD group compared to adequate CCD group. Receiver operating curve (ROC) analyses revealed that a PPR value greater than 0.057 had 76% sensitivity and 51% specificity and a PDW higher than 16.2% had 80% sensitivity and 66% specificity in predicting inadequate CCD. CONCLUSION:The present study suggests that PDW and PPR may be associated with the degree of collateral development in chronic stable coronary artery disease (CAD).

A203setting, there is a need for additional information on the clinical and economic impact of idelalisib to inform decisions about utilization, coverage, and reimbursement. OBJECTIVES: The objective of this study was to evaluate the costeffectiveness of idelalisib plus rituximab versus rituximab alone from a payer's perspective. METHODS: We developed a partition survival model to evaluate idelalisib plus rituximab versus rituximab alone. The model included three health states -Pre-Progressed, Progressed, and Death. The pivotal trial Study 116 (Furman et al., 2014) served as the basis for this study by providing data on Progression-Free-Survival (PFS) and Overall-Survival (OS), dosing, and adverse events. We used longer-term data from a trial of bendamustine plus rituximab in CLL plus Weibull cumulative distribution functions to extrapolate incomplete PFS and OS curves. Cost data was derived from Wolters Kluwer Health, Centers for Medicare and Medicaid Services data, and publicly available literature. One-way and probabilistic sensitivity analyses were performed to evaluate uncertainty. We used a lifetime horizon, payer perspective, and a 3% discount rate. RESULTS: Total costs were $585,493 and QALYs were 3.34 for the idelalisib plus rituximab group, while total costs were $66,698 and QALYs were 1.20 for the rituximab alone group.

Catheter-directed intra-arterial thrombolysis for lower extremity arterial occlusions Recombinant tissue plasminogen activator Thrombolysis is the therapy of choice in the case of occlusions of distal stream bed or branches of main vessel by lysis and fragmentation of thrombus. Thrombolysis may be able to achieve recanalization of even distal small runoff vessels (11). Catheter-directed intra-arterial thrombolysis (CDT) is a rational treatment method in patients with acute/subacute and even some chronic occlusions of lower extremity arteries and bypass grafts having salvageable limb ischemia. Immediate vessel patency can be achieved with an acceptable complication rate in many patients, especially those with fresh thrombus or emboli. It can be also an adjuvant treatment modality for endovascular interventions for chronic occlusions. There is no standard method of CDT including thrombolytic agent dose and technique. Selection of treatment strategy should be based on individual judgment based on viability of limb, lesion characteristics, and risks of hemorrhage.