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The clinical examination of an 11.10-year-old girl in permanent dentition showed severe crowding, chewing problems and her right maxillary lateral incisor was in palatal position. The molars were in Class II relationship on both sides. An extraction treatment was planned. Upper second premolars and lower first premolars were extracted. Lower crowding was eliminated using physiological tooth movement called “driftodontics”. Slots sized 0.022 inches and self-ligating brackets were used. The patient also used a high-pull headgear for anchorage and vertical control reasons for a short period. During the correction of the lateral crossbite, a posterior bite plate was used for anterior disarticulation and anterior bite ramps were used at the last stages of the treatment to ease the correction of the curve of Spee. Class I molar and canine relationships and normal overjet and overbite achieved with good alignment of both arches and dental midlines coincided with the facial midline. The treatment results were stable after 2 years of the retention period.

In this case report, orthodontic treatment of a Class II malocclusion of a 12 year old girl with the extraction of discolored maxillary central incisors with root resorptions is presented.

The force applied on the tooth and the consequential tooth movement has been a popular topic for orthodontists for many years. In this article, force magnitude, optimal tooth movement and their relationship will be discussed. Understanding the main problems of determining the optimal force and the kind of studies performed on tooth movement as well as a review of the available literature on these topics could be a basis for the application of appropriate forces in clinical orthodontics and for the design of future research.

The aim of this study was to examine the effects of the newly modified maxillary protraction facemask. 15 patients, having an average age of 12.42 ± 1.87 years, presenting Class III malocclusion with maxillary retrognathism were treated for 7.5 ± 1.02 months. Rapid palatal expansion was performed for 7 days with a full coverage acrylic cap splint type appliance. At the 7th day, protraction therapy was started with the combination of a specially designed face bow and Petit type facemask. The face bow was bent upward to raise the point of force application to pass through the center of resistance of the maxilla. A total of 1000 g (500 g on each side) of protrusive force was applied and the patients were instructed to wear the facemask for 16 h/day. Wilcoxon signed rank test was carried out to evaluate 48 parameters measured on cephalometric radiographs. Results showed that the maxilla was displaced anteriorly without rotation. Maxillary occlusal plane showed a clockwise rotation. Maxillary incisors were extruded and retroclined. Mandible was displaced downward and backward. In conclusion, by introducing our new face bow design, we were able to protract the maxilla bodily and at the same time to have a more effective force-moment system where the whole protractive force was utilized in protracting the maxilla.

A successful orthodontic treatment depends on a variety of factors. Cooperation of the patient during orthodontic treatment is a major determinant of a successful treatment result. Predicting patient cooperation could be helpful in anticipating problems that might arise during orthodontic treatment. In previous studies, it has been hypothesized that personality traits which can be determined by personality tests, and patient's psychological status might at least partly determine a patient's motivation for orthodontic treatment. However, other studies that used persponality variebles to predict adherence during orthodontic treatment have been unsuccessful in obtaining a clear answer or have found contradicting results. More research is needed to investigate the effect of patient's personality traits or psychological status on patient cooperation.

The purpose o1 this study is to evaluate the dental and soft tissue changes in patients treated with the Jasper Jumper appliance which was filled with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 60 lateral cephalometric films which were taken before placement and after removal of the Jasper Jumper appliance in the treatment group, and at inital and six months follow-up in the control group. The patient selection criteria were as follows skeletal and dental Class II malocclusion characterized by retrognathic mandible, normal or low angle vertical growth pattern, and post-peak growth period. The statistical assessment of the data suggested the following conclusions. The mandibular incisors were protructed and intructed while the maxillary incisors were retructed and extructed. The occlusal plane was rotated in clockwise direction as a result of dentoalveoler changes. Overbite and overjet were reduced in all patients. Soft tissue profiile improved significantly. As a result of the overjet reductiuon due to the retrusion of the upper incisors, the upper lip moved back and the lower lip no longer captured at the back of the upper incisors. Moreover, the lower incisors which are proclined supported the lower lip. Lip strength decreased favorably as a result of the upper incisors retrusion. The results of this study revealed that in late-adolescent patients Jasper Jumper appliance corrected Class II discrepancies mosbly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.

Purpose/background: It is still not well known whether antipsychotic monotherapy versus polypharmacy differs in terms of efficacy in the emergency department (ED) utilization, presentation with agitation/aggression, and rehospitalization in schizophrenia spectrum disorders (SSD) patients. This study aimed to determine the effectiveness of antipsychotic monotherapy and polypharmacy for these outcomes in the real world., Methods/procedures: The study was conducted with electronic health records of 669 SSD patients admitted to the ED. Patients were evaluated in 4 groups according to antipsychotic use at the first admission to ED: antipsychotic noncompliance for more than 90 days, antipsychotic noncompliance for 15 to 90 days, antipsychotic monotherapy, and polypharmacy. All patients followed up for at least 1 year after index admission. The primary outcomes determined an association between antipsychotic monotherapy versus polypharmacy and all-cause psychiatric hospitalization between the groups after index admission in the SSD., Findings/results: The groups, including patients with antipsychotic noncompliance, had higher ED visits, more hospitalizations, and more admissions with agitation/aggression compared with antipsychotic monotherapy or polypharmacy. However, no differences were found between monotherapy and polypharmacy groups regarding these outcomes. In addition, there was no difference in the risk of hospitalization in monotherapy antipsychotic users compared with polypharmacy users. Patients discharged with monotherapy or polypharmacy also had similar rehospitalization rates at follow-up., Implications/conclusions: There is no positive evidence that recommending polypharmacy over antipsychotic monotherapy is superior with regard to the resulting frequency of ED visits, ED admissions with agitation/aggression, hospitalization, and rehospitalization. In this context, antipsychotic monotherapy may be preferred over polypharmacy in patients who are not resistant to treatment., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Long-acting injectable (LAI) antipsychotics are recommended in the treatment non-adherence. Despite the widespread use of LAI antipsychotics, there is limited data on clinical outcomes in bipolar I disorder (BD-I) patients with real-world data. We aimed to compare BD-I patients treated with LAI and oral antipsychotics (OAP) in terms of treatment effectiveness in a 1-year follow-up period., Methods: The study was conducted retrospectively with electronic health records of 116 BDI patients. The primary outcomes were whether patients in the LAI group and the OAP group differed in relapse, rehospitalization, emergency room (ER) visits, and all-cause treatment discontinuation at 1-year follow-up after a mania episode. Cox regression modeling was used to predict the recurrence of any mood episode and all-cause treatment discontinuation during follow-up. The secondary outcomes evaluated were the effects of sociodemographic and clinical parameters and concomitant psychotropic medications on the course of the illness and treatment adherence., Results: Of all 116 patients, 33 (28.4%) were under LAI, and 83 (71.6%) were under OAP treatment. LAI users had a history of more hospitalizations and total mood episodes. Patients in the LAI group had more treatment non-adherence before the index hospitalization. At 1-year follow-up, there was no difference between the groups in terms of any mood relapse, rehospitalization, ER visits, and all-cause treatment discontinuation. As a secondary outcome, lithium users were found to have fewer new episodes and discontinuations of treatments., Conclusions: In real-world data, there is no evidence that LAI antipsychotics (compared to OAP) are superior in the maintenance treatment of BD. These results are important in terms of reflecting clinical practices for the treatment of BD-I. These results do not devalue the use of LAI therapy in BD; however, more studies are needed to identify positive predictors for LAI treatments in BD.

Introduction: Alcohol withdrawal delirium, commonly known as "delirium tremens (DT)", is the most severe clinical condition of alcohol withdrawal syndrome (AWS). Symptoms of DT include changes in consciousness and cognitive and perceptual impairments that fluctuate during the day. Treatment includes general support, such as helping the patient to re-orientate, close monitoring of vital signs and adequate hydration, and symptomatic treatment for agitation, autonomic instability, and hallucinations. In symptomatic treatment of DT, benzodiazepines are most commonly preferred due to their GABA-ergic effects. Diazepam, a benzodiazepine, has a faster onset of action than other benzodiazepines when administered intravenously (iv) and effectively controls symptoms. Although low doses of diazepam usually relieve DT symptoms, very high doses may be required in some patients. This case series discusses patients receiving high doses of diazepam to relieve DT symptoms., Case Report: Four male patients aged from 43 to 57 years who regularly consumed alcohol with a daily average of 20-100 standard drinks and developed DT afterwards and were followed up in the intensive care unit are presented. In these patients, the symptoms of DT were relieved, and somnolence was achieved with the administration of very high-dose IV diazepam (260-480 mg/day), contrary to routine treatment doses. All patients were successfully treated and discharged without any morbidity., Conclusion: Severe AWS can potentially result in death otherwise managed quickly and adequately. Diazepam is a suitable agent for severe AWS or DT treatment. Clinicians should keep in mind that high-dose diazepam treatment may be required in the treatment of DT that develops after a long-term and high amount of alcohol consumption. Publications reporting the need for very high doses of diazepam in DT are limited and usually published long ago; in this context, our findings are significant. The evidence is often based on case reports and uncontrolled studies, so controlled trials are needed to determine optimal treatment doses in severe DT.

Objective: : Recent evidence suggests that oxidative stress contributes to the pathophysiology of schizophrenia. This study aimed to compare thiol-disulphide homeostasis in acute and stable phases of schizophrenia for the first time., Methods: : Among the patients with schizophrenia, 61 in the acute-phase and 61 in the stable phase of their illness were enrolled in the study. Native thiol (NT), total thiol (TT), disulphide (SS), disulphide/native thiol, disulphide/total thiol, and native thiol/total thiol for thiol-disulphide homeostasis were compared between the groups. The Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive/Negative Symptoms (SAPS/SANS), Clinical Global Impression-Severity Scale (CGI-S), Barnes Akathisia Rating Scale, and Simpson-Angus Scale were used to assess symptoms., Results: : After controlling for age, sex, body mass index, and smoking status there were significant differences in NT, TT, SS/NT, SS/TT, and NT/TT, but not SS. Thiol/disulphide homeostasis has shifted in favour of the oxidative side in patients with acute-phase compared to that in stable schizophrenia. BPRS, SAPS, and CGI-S scores were significantly correlated with all six thiol-disulphide parameters, but not SANS, when controlling for age and sex. Significant receiver operating characteristic (ROC) curves were obtained for all thiol-disulphide homeostasis parameters. Discriminant analysis was found to be statistically significant in discriminating between groups., Conclusion: : These results show that oxidative status increases thiol-disulphide homeostasis in patients with acute-phase schizophrenia compared to those with stable schizophrenia. These findings suggest that thiol-disulphide parameters can be used as biomarkers for the acute exacerbation of schizophrenia.

Background: Although deficits in facial emotion recognition (FER) significantly affect interpersonal communication and social functioning, there is no consensus on how FER affects Alzheimer's disease (AD). In this study, we aimed to investigate the clinical and neuropsychological factors affecting the possible deficits in the FER abilities of patients with AD., Methods: This cross-sectional study included 37 patients with mild [clinical dementia rating (CDR) scale score = 1] or moderate (CDR = 2) AD, in whom vascular dementia and depression were excluded, and 24 cognitively normal (CDR = 0) subjects. FER ability was determined using the facial emotion identification test (FEIT) and facial emotion discrimination test (FEDT). All participants underwent mini-mental state examination (MMSE), frontal assessment battery (FAB), and geriatric depression scale (GDS). The neuropsychiatric inventory-clinician rating scale (NPI-C), Katz index of independence in activities of daily living, and Lawton instrumental activities of daily living were also administered to patients with AD., Results: The FEIT and FEDT total scores showed that patients with mild and moderate AD had significant FER deficits compared to healthy controls. However, no significant difference was observed between patients with mild and moderate AD in the FEIT and FEDT total scores. FEIT and FEDT scores were not correlated with the MMSE and NPI-C total and subscales scores in patients with AD. Linear regression indicated that FEIT and FEDT total scores were significantly related to age and FAB scores. The GDS score negatively moderated the relationship between FAB and FEDT., Conclusions: This study demonstrated a decreased FER ability in patients with AD. The critical point in FER deficits is the presence of dementia, not the dementia stage, in AD. It has been determined that executive functions and depression (even at a subsyndromal level), which have limited knowledge, are associated with FER abilities., (© 2024 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Objectives: There is much recent evidence that inflammation contributes to the pathophysiology of acute mania in bipolar disorder (BD). However, no study was evaluated in which the change in thiol-disulphide homeostasis, ischemia-modified albumin (IMA), complete blood count-derived inflammatory markers (CBC-IMs) and C-reactive protein (CRP) levels in bipolar patients was followed-up from acute mania to early remission., Methods: Seventy-seven bipolar patients in acute mania and ninety-one HC were enrolled. We measured levels of thiol-disulphide parameters, IMA, and CBC-IMs such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red-cell-distribution-width (RDW)-to-platelet ratio (RPR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI), CRP and platelet-to-albumin ratio (PAR), after adjusting for age, gender, body-mass index (BMI) and smoking status, during acute mania to subsequent early remission. The results were compared with HC., Results: The levels or ratios of all thiol-disulphide parameters except for disulphide, IMA and CRP of bipolar patients in both acute mania and early remission were significantly different from HC, after adjusting for confounders. The NLR, SII, CRP and PAR values of bipolar patients were significantly higher in only acute mania compared to HC. Significant changes in thiol-disulphide parameters and IMA levels were not found in early remission after acute mania., Limitations: Short follow-up period and lack of drug-naive patients., Conclusions: Our results suggest that thiol-disulphide parameters, IMA level and SIRI value might be a trait biomarkers of inflammation in BD. In addition, NLR, SII and PAR values and CRP level might be a state biomarker of inflammation in bipolar patients in a manic phase., Competing Interests: Declaration of competing interest No potential conflict of interest is relevant to this article., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: Recent studies show that inflammation is related to the pathogenesis of acute mania of bipolar disorder. Neutrophil/high-density lipoprotein (HDL) ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL ratio (MHR) and platelet/HDL ratio (PHR) have recently been investigated as novel markers of inflammation. In addition, the atherogenic index of plasma (AIP) and atherogenic coefficient (AC) are the leading atherogenic indices. The study aimed to investigate these inflammation and atherogenic index markers in acute mania of bipolar disorder. Another aim was to determine whether there is a relationship between these markers and disease severity and psychotic symptoms., Methods: A total of 109 BD-M and 101 (HC) were enrolled in the study. The differences in NHR, LHR, MHR, PHR, AIP and AC and their association with illness severity and psychotic symptoms were analyzed after adjusting for age, sex, total cholesterol level, body-mass index and smoking status. Then, a receiver operating characteristic (ROC) curve and linear discriminant analysis (LDA) were used to analyze these parameters' diagnostic potential. Moreover, the Young Mania Rating Scale (YMRS) and Clinical Global Impression Scale for use in bipolar illness-Severity subscale (CGI-BP-S) were used to assess the severity of clinical symptoms., Results: We found higher levels of NHR, MHR, PHR and AIP, but not LHR and AC, after adjusting confounding factors in patients with BD-M compared to HCs. In logistic regression analysis, higher levels of MHR and NHR were associated with BD-M. MHR, NHR and PHR were predictors for differentiating the BD-M group from the HC group. However, the severity of the illness or the psychotic feature of the manic episode did not significantly affect the parameters. In the ROC curve analysis of BD-M, the indicators with an area under the curve (AUC) higher than 0.6 were the MHR, NHR, PHR and LHR., Conclusions: These results provide information about the role of inflammation in the pathophysiology of BD-M. Even after controlling for confounding factors, MHR, NHR, PHR and AIP are potential biomarkers for BD-M. Moreover, the increase in AIP may explain the co-morbidity between BD and cardiovascular diseases. However, the severity of the illness or the psychotic feature of the manic episode did not significantly affect the levels of inflammation ratios used in our study. Due to the low cost and widespread use of lipid metabolism and related inflammation rates, it may be beneficial to know the MHR, NHR, PHR and AIP levels in BD-M patients.

The present study was conducted in order to investigate the pharmacological activities of three heterobimetallic coordination compounds: [Cd( N -bishydeten) 2 ][Ni(CN) 4 ] ( C1 ), [Cu 2 ( N -bishydeten) 2 Co(CN) 6 ].3H 2 O ( C2 ), and K[Cd( N -bishydeten)Co(CN) 6 ].1.5H 2 O ( C3 ) ( N -bishydeten = N,N -bis(2-hydroxyethyl)-ethylenediamine). This paper describes the ability of complexes to inhibit cell growth, cell migration and human topoisomerase I and to interact with DNA/BSA; this paper also evaluates the potential mechanisms of action exhibited by these compounds via the use of powerful measurement techniques. Studies on HT29, HeLa, C6 and Vero cells revealed that each compound demonstrated significant antiproliferative activity in conjunction with regressed cell migration velocity and caused apoptotic changes in morphology. There are strong data suggesting that the mechanisms of action exhibited by these compounds are associated with their DNA/BSA binding features. The IC 50 and binding constant range for the compounds are 20-180 µM and 1.2-3.2 x 10 4 M -1 , respectively. Moreover, we observed that these compounds alter the P53-Bcl-2 ratio and inhibit the relaxation activity of human topoisomerase I. Furthermore, a correlation between the antiproliferative effects of these compounds and their cytotoxic activity was observed. In conclusion, preliminary information demonstrates that these compounds have been found to exhibit effective antiproliferative activity against cancer cell lines, indicating that they are a potent candidate for further pharmacological study.

Introduction: Hemsley and Garety described the "jumping to conclusions bias" in which patients with delusions may reach unreasonable results with insufficient information. In this study patients with bipolar disorder and healthy volunteers were compared in terms of jumping to conclusions bias using the beads in the jar task., Methods: 37 patients with DSM-5 diagnosis of bipolar disorder and 30 healthy controls were tested with the Beads Task (BT), Tower of London Test (ToL) and Barrat Impulsiveness Scale (BIS)., Results: In the BT, the mean score of DtD (draws to decision) and JTC (jumping to conclusions) scores were not statistically different between the two groups. In the ToL test, the duration of the total execution and the total time were significantly longer in the bipolar group than the control group. BIS scores were significantly higher in the bipolar group. YMRS (Young Mania Rating Scale) scores were not correlated with BT., Conclusions: This study is the first clinical study to assess the jumping to conclusions bias in patients with bipolar disorder. No JTC bias was detected in bipolar disorder. Further studies may assess JTC in larger samples to determine the effects of clinical state changes, psychotic symptoms, medication and impulsivity.