A Study on Free Light Chain Assay and Serum Immunofixation Electrophoresis for the Diagnosis of Monoclonal Gammopathies

Abstract

Demonstration of monoclonal immunoglobulin molecule in serum forms the mainstay in the diagnosis of monoclonal gammopathies. The major tests that help in this regard are serum protein electrophoresis (SPEP), serum immunofixation electrophoresis (sIFE) and serum free light chain assay (sFLC). Our objectives were to study the accuracy of sFLC and sIFE in the diagnosis of monoclonal gammopathies and also to study the role of combination of SPEP + sIFE + sFLC in the diagnosis of the same. 46 patients who attended the hemato-oncology clinic with signs and symptoms suggestive of monoclonal gammopathy were enrolled in this study. SPEP, sIFE, sFLC and pre-treatment serum beta-2 microglobulin levels were analysed among the study population. Both SPEP and sIFE were performed in the Interlab Genios fully automated machine. Serum beta-2 microglobulin and sFLC were estimated by immunoturbidimetry in Beckman Coulter AU 2700 analyzer. The accuracy of sIFE came to be 80% with respect to sFLC assay. Sensitivity, specificity, positive and negative predictive value of sIFE with respect to sFLC were 81.3, 78.6, 89.7 and 64.7% respectively. It was observed that a combination panel of SPEP + sIFE + sFLC could detect all the cases of myeloma included in this study. Further testing in large samples is required for generalising the findings of this study. The pre-treatment beta-2 microglobulin levels were significantly higher in the group which was positive for myeloma. A combination panel of SPEP + sIFE + sFLC prove to be more useful than individual tests for the detection of myeloma.

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Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Association With Intimate Partner Homicide

Abstract

In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs), based on the strength of the policies. We posit that the association of firearm laws with IPHs depends on the laws': 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from prohibited persons; and 3) systems of accountability that prevent prohibited persons from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust negative binomial regression models with state fixed effects, domestic violence restraining order firearm prohibition laws are associated with 9% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (−10%) and ex parte orders (−12%). Laws prohibiting access to those convicted of non-specific violent misdemeanors were associated with a 23% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against intimate partner homicide.

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Orthodontic bracket slot size: does it influence treatment outcomes?

Only 4 mainly retrospective studies were identified for this review of the influence of orthodontic bracket size on treatment outcomes. While greater efficiency was suggested with the 0.018-inch bracket the quality of the evidence is limited a higher quality studies are needed.

The post Orthodontic bracket slot size: does it influence treatment outcomes? appeared first on National Elf Service.

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Induction of DNA double-strand breaks in human gingival fibroblasts by eluates from titanium dioxide modified glass ionomer cements

Publication date: Available online 27 November 2017
Source:Dental Materials
Author(s): Arunee Laiteerapong, Franz-Xaver Reichl, Yang Yang, Reinhard Hickel, Christof HÖgg
Objectives(1) To investigate the genotoxicity of a glass ionomer cement (GIC) and GIC incorporated with titanium dioxide nanopoarticle (TiO2NPs) and with microparticle (TiO2MPs) on DNA double-strand breaks of human gingival fibroblast cells (HGFs). (2) To compare the genotoxic differences between GIC and two modified cements.MethodsTiO2NPsGIC and TiO2MPsGIC were prepared by adding 10% w/w of TiO2NPs and TiO2MPs to the GIC powder and hand-mixed followed the manufacturer instruction. Dulbecco's Minimum Essential Medium (DMEM) was used as a culture medium for HGFs and eluate preparation. Eluates from all groups were collected for XTT cell viability assay to obtain EC50 values. γ-H2AX immunofluorescence assay was performed to detect DNA double-strand breaks (DSBs) of HGFs.ResultsEC50 values were from 38% to 60% and eluate concentrations at 20% and 5% were selected for γ-H2AX immunofluorescence assay. At both concentrations, HGFs exposed to eluates from all cements groups had fewer mean foci per cell and higher percentage of free foci cells than H2O2 (p<0.05). At 20% concentration, cells exposed to eluates from both TiO2NPsGIC and TiO2MPsGIC groups had fewer mean foci per cell and higher percentage of free foci cell than GIC and culture medium (p<0.05).SignificanceNeither GIC nor 10% TiO2-modified GICs had a genotoxic effect on HGFs. Both TiO2NPsGIC and TiO2MPsGIC demonstrated less genotoxic effect than GIC. When comparing between the two modified cements, there was no genotoxic difference between the modified cements from different particle sizes (nanoparticle and micro-particle) of TiO2.



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Bisphenol A release from an orthodontic resin composite: A GC/MS and LC/MS study

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Marc Deviot, Isabelle Lachaise, Christof Högg, Jürgen Durner, Franz-Xaver Reichl, Jean-Pierre Attal, Elisabeth Dursun
ObjectivesFirst, to analyse the in vitro release of BPA and Bis-GMA from an orthodontic resin composite (Transbond XT, 3M Unitek), stored in various conditions, by gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS); then to extrapolate the data to the clinical situation. Secondly, to explore the thermal stability of Bis-GMA.MethodsCylinders of resin composite were prepared and stored according to 3 different protocols: (1) they were light-cured 20s, then placed in artificial saliva; (2) they were light-cured 2s, then placed in acetonitrile; (3) they were light-cured 2s, then placed in methanol. For each group, BPA and Bis-GMA release were determined with GC/MS and/or LC/MS at least after one week. Besides, 120 brackets (10 of each type) were bonded over metal teeth, then debonded, and the weight and the surface of resin composite residues were measured. BPA and Bis-GMA release of adhesive residues were extrapolated from the data obtained with the cylinders. Besides, BPA release from a heated Bis-GMA solution was measured.ResultsWith GC/MC, BPA was detected in all samples. With LC/MS, BPA was detected only from samples immersed in MeOH; Bis-GMA was detected, in varying amount according to the extraction media and the light-curing time. BPA was found after heating of the Bis-GMA solution.SignificanceContamination risk and the heat applied in GC/MS may overestimate the BPA release from resin composite. Based on the LC/MS results, the risk of BPA release after orthodontic bonding would be more than 42000 times lower than the TDI for a 30-kg child.



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Using glass-graded zirconia to increase delamination growth resistance in porcelain/zirconia dental structures

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Herzl Chai, Adam J. Mieleszko, Stephen J. Chu, Yu Zhang
ObjectivePorcelain fused to zirconia (PFZ) restorations are widely used in prosthetic dentistry. However, their tendency to delaminate along the P/Z interface remains a practical problem so that assessing and improving the interfacial strength are important design aspects. This work examines the effect of modifying the zirconia veneering surface with an in-house felspathic glass on the interfacial fracture resistance of fused P/Z.MethodsThree material systems are studied: porcelain fused to zirconia (control) and porcelain fused to glass-graded zirconia with and without the presence of a glass interlayer. The specimens were loaded in a four-point-bend fixture with the porcelain veneer in tension. The evolution of damage is followed with the aid of a video camera. The interfacial fracture energy GC was determined with the aid of a FEA, taking into account the stress shielding effects due to the presence of adjacent channel cracks.ResultsSimilarly to a previous study on PFZ specimens, the fracture sequence consisted of unstable growth of channel cracks in the veneer followed by stable cracking along the P/Z interface. However, the value of GC for the graded zirconia was approximately 3 times that of the control zirconia, which is due to the good adhesion between porcelain and the glass network structure on the zirconia surface.SignificanceCombined with its improved bonding to resin-based cements, increased resistance to surface damage and good esthetic quality, graded zirconia emerges as a viable material concept for dental restorations.



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Effects of different sterilization methods on surface characteristics and biofilm formation on zirconia in vitro

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Aifang Han, James K.H. Tsoi, Jukka P. Matinlinna, Yu Zhang, Zhuofan Chen
ObjectiveThe current laboratory study was to investigate the effect of different sterilization treatments on surface characteristics of zirconia, and biofilm formation on zirconia surface after exposure to these sterilization treatments.MethodsCommercially available zirconia discs (Cerconbase, Degu-Dent, Hanau, Germany) were prepared and polished to the same value of surface roughness. The discs were treated with one of the following sterilization methods steam autoclave sterilization, dry heat sterilization, ultraviolet C (UVC) irradiation, and gamma (γ) ray irradiation. The characteristics of zirconia surfaces were evaluated by scanning electron microscopy (SEM), surface roughness, surface free energy (SFE), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) measurements. Then, Staphylococcus aureus (S.a.) and Porphyromonas gingivalis (P.g.) bacteria were used and cultured on the respective sterilized zirconia surfaces. The amount of biofilm formation on zirconia surface was quantified by colony forming unit (CFU) counts.ResultsSignificant modifications were detected on the colour and SFE of zirconia. The colour of zirconia samples after UVC irradiation became light yellow whilst dark brown colour was observed after gamma ray irradiation. Moreover, UVC and gamma ray irradiation increased the hydrophilicity of zirconia surface. Overall, dry heat sterilized samples showed the significantly lowest amount of bacteria growth on zirconia, while UVC and gamma ray irradiation resulted in the highest.SignificanceIt is evident that various sterilization methods could change the surface which contribute to different biofilm formation and colour on zirconia.



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Effect of tribochemical treatments and silane reactivity on resin bonding to zirconia

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Raphael Pilo, Maria Dimitriadi, Anna Palaghia, George Eliades
ObjectiveThe aim of the study was to assess the roughness, structure and bond strength with zirconia of four grit-blasting treatments combined with three silane types, the reactivity of which was evaluated, as well.MethodsThe grit-blasted treatments performed on zirconia (Lava) were alumina (ALU), CoJet (COJ), SilJet (SLJ) and SilJet Plus (SJP, with silica-encapsulated silane). The other two silanes selected were the S-Bond (SB, prehydrolyzed) and Clearfil Ceramic Primer Plus (CP, prehydrolyzed with 10-MDP). The activity of the silanols in the silanes was evaluated by FTIR spectroscopy. Optical profilometry and Raman microspectroscopy were used for the assessment of roughness (Sa, Sz, Sdr parameters) and structure (monoclinic volume-Vm) of zirconia, before (REF) and after grit-blasting, and a shear bond strength (SBS) with a flowable resin composite, for the investigation of the bonding capacity of the treatments.ResultsOnly SB demonstrated reactive silanols. CP and the SJP silanes were mostly in a polymerized siloxane state. Roughness was increased after grit-blasting as follows: ALU>SLJ,SJP>COJ>REF (Sa,Sz) and ALU>SLJ,COJ,SJP>REF (Sdr). ALU demonstrated the highest Vm (7.52%) from all other treatments (4.16–4.81%) and the REF (0%). COJ and SLJ showed the highest SBS (14–15.94MPa) regardless of the silane type used. SJP showed no significant differences from SLJ-SB and COJ-SB. Weibull analysis showed a reliability (β) ranking of COJ, SJP, SLJ, ALU-CP>ALU-SB>REF and a characteristic life (η) ranking of COJ, SLJ, ≥SLJ-SB, SJP, ALU≥ALU-SB,REF-CP>REF-SB.SignificanceThe reactivity of the silanes used showed great variations to support a predictable effect in all treatments. CP with deactivated silanols demonstrated a) the most reliable and strongest treatment with a silica-rich powder (COJ), despite the lowest Sa,Sz substrate values and b) high strength with a low-silica powder (SLJ) with higher Sa,Sz substrate values. Therefore, it may be concluded that 10-MDP greatly contributes to the bonding mechanism of the silane containing primers.



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The effect of chewing simulation on surface roughness of resin composite when opposed by zirconia ceramic and lithium disilicate ceramic

Publication date: Available online 27 November 2017
Source:Dental Materials
Author(s): Ting Khee Ho, Julian D. Satterthwaite, Nikolaos Silikas
ObjectiveTo assess the change in surface roughness of nanohybrid resin composite (Tetric EvoCeram) after antagonist wear against monolithic zirconia and lithium disilicate ceramics through a simulated chewing test using a three-dimensional (3D) profilometer.MethodsA total of 40 Tetric EvoCeram™ resin composite specimens against either a Lava™ Plus zirconia antagonist (n=20) or IPS e.max Press lithium disilicate antagonist (n=20) were prepared for the study. The surface roughness profiles of each resin composite before and after an in-vitro simulated chewing test were analysed using a 3D profilometer and Talymap software. After the simulated chewing, the surface profiles of representative Tetric EvoCeram specimens from each group were analysed using scanning electron microscopy. Independent t-test and paired t-test were used for statistical analysis.ResultsFor both lithium disilicate and zirconia groups, all surface roughness parameters (Ra, Rt, Sa, Sq,) of Tetric EvoCeram were significantly higher post-chewing compared to pre-chewing (p<0.05); the post-chewing surface roughness parameters of Tetric EvoCeram for the lithium disilicate group were significantly higher (p<0.05) than in the zirconia group.SignificanceThis chewing simulation test showed that Tetric EvoCeram composites exhibited a rougher surface when opposing lithium disilicate ceramic compared to opposing zirconia ceramic.



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Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Lorenzo Breschi, Tatjana Maravic, Sandra Ribeiro Cunha, Allegra Comba, Milena Cadenaro, Leo Tjäderhane, David H. Pashley, Franklin R. Tay, Annalisa Mazzoni
ObjectivesEfforts towards achieving durable resin–dentin bonds have been made for decades, including the understanding of the mechanisms underlying hybrid layer (HL) degradation, manufacturing of improved adhesive systems, as well as developing strategies for the preservation of the HL.MethodsThis study critically discusses the available peer-reviewed research concerning the formation and preservation of the HL, the mechanisms that lead to the degradation of the HL as well as the strategies to prevent it.ResultsThe degradation of the HL occurs through two main mechanisms: the enzymatic degradation of its collagen fibrils, and the leaching of the resin from the HL. They are enabled by residual unbound water between the denuded collagen fibrils, trapped at the bottom of the HL. Consequently, endogenous dentinal enzymes, such as the matrix metalloproteinases (MMPs) and cysteine cathepsins are activated and can degrade the denuded collagen matrix. Strategies for the preservation of the HL over time have been developed, and they entail the removal of the unbound water from the gaps between the collagen fibrils as well as different modes of silencing endogenous enzymatic activity.SignificanceAlthough there are many more hurdles to be crossed in the field of adhesive dentistry, impressive progress has been achieved so far, and the vast amount of available research on the topic is an indicator of the importance of this matter and of the great efforts of researchers and dental material companies to reach a new level in the quality and longevity of resin–dentin bonds.



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Effect of titania content and biomimetic coating on the mechanical properties of the Y-TZP/TiO2 composite

Publication date: Available online 26 November 2017
Source:Dental Materials
Author(s): Ranulfo Benedito de Paula Miranda, Walter Gomes Miranda, Dolores Ribeiro Ricci Lazar, Valter Ussui, Juliana Marchi, Paulo Francisco Cesar
ObjectiveTo investigate the effect of titania addition (0, 10 and 30mol%) on the microstructure, relative density, Young's modulus (E), Poisson's ratio (υ), mechanical properties (flexural strength, σf, and Weibull modulus, m) of a Y-TZP/TiO2 composite. The effect of the presence of a biomimetic coating on the microstructure and mechanical properties was also evaluated.MethodsY-TZP (3mol% of yttria) and Y-TZP/TiO2 composite (10 or 30mol% of titania) were synthesized by co-precipitation. The powders were pressed and sintered at 1400°C/2h. The surfaces, with and without biomimetic coating, were characterized by X-ray diffraction analysis and scanning electron microscopy. The relative density was measured by the Archimedes' principle. E and υ were measured by ultrasonic pulse-echo method. For the mechanical properties the specimens (n=30 for each group) were tested in a universal testing machine.ResultsTitania addition increased the grain size of the composite and caused a significant decrease in the flexural strength (in MPa, control 815.4^a; T10 455.7^b and T30 336.0^c), E (in GPa, control 213.4^a; T10 155.8^b and T30 134.0^c) and relative density (control 99.0%^a; T10 94.4%^c and T30 96.3%^b) of the Y-TZP/TiO2 composite. The presence of 30% titania caused substantial increase in m and υ. Biomimetic coating did not affect the mechanical properties of the composite.SignificanceThe Y-TZP/TiO2 composite coated with a layer of CaP has great potential to be used as implant material. Although addition of titania affected the properties of the composite, the application of a biomimetic coating did not jeopardize its reliability.



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Cross-linking effect on dentin bond strength and MMPs activity

Publication date: Available online 24 November 2017
Source:Dental Materials
Author(s): Annalisa Mazzoni, Valeria Angeloni, Allegra Comba, Tatjana Maravic, Milena Cadenaro, Arzu Tezvergil-Mutluay, David H. Pashley, Franklin R. Tay, Lorenzo Breschi
ObjectiveThe objectives of the study were to evaluate the ability of a 1-ethyl-3 (3-dimethylaminopropyl) carbodiimide (EDC)-containing primer to improve immediate bond strength of either self-etch or etch-and-rinse adhesive systems and to stabilize the adhesive interfaces over time. A further objective was to investigate the effect of EDC on the dentinal MMPs activity using zymographic analysis.MethodsFreshly extracted molars (n=80, 20 for each group) were selected to conduct microtensile bond strength tests. The following groups were tested, immediately or after 1-year aging in artificial saliva: G1: Clearfil SE (CSE) primer applied on unetched dentin, pretreated with 0.3M EDC water-solution for 1min and bonded with CSE Bond; G2: as G1 but without EDC pre-treatment; G3: acid-etched (35% phosphoric-acid for 15s) dentin pretreated with 0.3M EDC, then bonded with XP Bond (XPB); Group 4 (G4): as G3 without EDC pre-treatment. Further, gelatinase activity in dentin powder treated with CSE and XPB with and without EDC pre-treatment, was analyzed using gelatin zymography.ResultsThe use of 0.3M EDC-containing conditioner did not affect the immediate bond strength of XPB or CSE adhesive systems (p>0.05), while it improved the bond strength after 1year of aging (p<0.05). Pre-treatment with EDC followed by the application of CSE resulted in an incomplete MMPs inactivation, while EDC pretreatment followed by the application of XPB resulted in an almost complete inactivation of dentinal gelatinases.SignificanceThe μTBS and zymography results support the efficacy of EDC over time and reveal that changes within the dentin matrix promoted by EDC are not adhesive-system-dependent.



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An interproximal model to determine the erosion-protective effect of calcium silicate, sodium phosphate, fluoride formulations

Publication date: Available online 24 November 2017
Source:Dental Materials
Author(s): Natalie J. Wood, Siân Bodfel Jones, Nick Chapman, Andrew Joiner, Carole J. Philpotts, Nicola X. West
ObjectivesPrevious work has shown the effectiveness of a newly developed interproximal model to differentiate between the amount of remineralization caused by toothpastes used with or without a dual-phase gel treatment system containing calcium silicate, sodium phosphate salts and fluoride to repair acid-softened enamel. The aim of this study was to utilize the same interproximal model to identify how effective calcium silicate phosphate toothpastes are at reducing surface softening in the early stages of erosion. The model was also used to identify the effect of increasing the frequency of acid exposure on the reduction in surface hardness.MethodsHuman enamel specimens were prepared and mounted in an interproximal face-to-face arrangement and exposed to a cycling regime of whole human saliva, treatment, artificial saliva and 1% citric acid pH 3.75. Specimens were measured by surface microhardness at baseline and after three and seven days. The frequency of acid exposure was increased from 2 to 4 cycles a day for the second part of the study.ResultsThe results showed that specimens treated with the calcium silicate phosphate toothpastes softened less than those treated with control fluoridated or non-fluoride toothpastes at each time point and following an increase in the frequency of acid exposure.SignificanceThis work has demonstrated how an interproximal model can also be successfully used to determine differences in the erosion protection of various treatments as well as determining how they perform when the frequency of acid exposure is increased.



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Mechanism of bioactive molecular extraction from mineralized dentin by calcium hydroxide and tricalcium silicate cement

Publication date: Available online 24 November 2017
Source:Dental Materials
Author(s): Xue-qing Huang, John Camba, Li-sha Gu, Brian E. Bergeron, Domenico Ricucci, David H. Pashley, Franklin R. Tay, Li-na Niu
ObjectivesThe objective of the present study was to elucidate the mechanism of bioactive molecule extraction from mineralized dentin by calcium hydroxide (Ca(OH)2) and tricalcium silicate cements (TSC).Methods and resultsTransmission electron microscopy was used to provide evidence for collagen degradation in dentin surfaces covered with Ca(OH)2 or a set, hydrated TSC for 1–3 months. A one micron thick collagen degradation zone was observed on the dentin surface. Fourier transform-infrared spectroscopy was used to identify increases in apatite/collagen ratio in dentin exposed to Ca(OH)2. Using three-point bending, dentin exposed to Ca(OH)2 exhibited significant reduction in flexural strength. Using size exclusion chromatography, it was found that the small size of the hydroxyl ions derived from Ca(OH)2 enabled those ions to infiltrate the intrafibrillar compartment of mineralized collagen and degrade the collagen fibrils without affecting the apatite minerals. Using ELISA, TGF-β1 was found to be extracted from dentin covered with Ca(OH)2 for 3 months. Unlike acids that dissolve the mineral component of dentin to release bioactive molecules, alkaline materials such as Ca(OH)2 or TSC released growth factors such as TGF-β1 via collagen degradation.SignificanceThe bioactive molecule extraction capacities of Ca(OH)2 and TSC render these dental materials excellent for pulp capping and endodontic regeneration. These highly desirable properties, however, appear to be intertwined with the untoward effect of degradation of the collagen matrix within mineralized dentin, resulting in reduced flexural strength.



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Hierarchical microcrack model for materials exemplified at enamel

Publication date: Available online 23 November 2017
Source:Dental Materials
Author(s): H. Özcoban, E.D. Yilmaz, G.A. Schneider
ObjectiveThis article investigates the mechanical properties of a material with hierarchically arranged microcracks.MethodsHierarchically structured biomaterials such as enamel exhibit superior mechanical properties as being stiff and damage tolerant at the same time. The common mechanical explanation for this behavior is based on the hierarchically structured arrangement of hard minerals and soft organics and their cooperative deformation mechanisms. In situ mechanical experiments with mm-sized bovine enamel bending bars an scanning electron microscope reveal that enamel is able to withstand mechanical loading even if it contains microcracks on different lengths scales. To clarify this issue an analytical hierarchical microcrack model of non-interacting cracks is presented.Results and SignificanceThe model predicts a decrease of the elastic modulus and the fracture strength with increasing levels of hierarchy. The fracture strain on the other hand may decrease or increase with the number of hierarchical levels, depending on the microcrack density. This simple hierarchical microcrack model is able to explain already published experiments with focused ion beam prepared μm-sized enamel cantilevers on different hierarchical levels. In addition it is shown that microcracking during loading in hierarchical materials may lead to substantial pseudoplastic behavior.



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Light irradiance through novel CAD–CAM block materials and degree of conversion of composite cements

Publication date: Available online 21 November 2017
Source:Dental Materials
Author(s): Diogo Pedrollo Lise, Annelies Van Ende, Jan De Munck, Kumiko Yoshihara, Noriyuki Nagaoka, Luiz Clovis Cardoso Vieira, Bart Van Meerbeek
ObjectiveTo assess light irradiance (LI) delivered by two light-curing units (LCU's) and to measure the degree of conversion (DC) of three composite cements, when cured through different thicknesses of two novel CAD–CAM block materials.Methods100-μm-thick films of a dual-curable composite cement (G-CEM LinkAce, GC), a light-curable flowable resin-based composite (RBC) (G-ænial Universal Flo, GC) and a micro-hybrid RBC (G-ænial Posterior, GC) were investigated as luting agents. Two 'polymer–ceramic' CAD–CAM blocks (Cerasmart, GC; Enamic, Vita Zahnfabrik) were sectioned in slabs with different thicknesses (1, 3 and 5mm). LI at the bottom of the specimens was measured using a calibrated spectrometer, while being light-cured through the CAD–CAM block slabs for 40s with a low- (±500mW/cm²) or high- (±1,600mW/cm²) irradiance LCU (n=5). After light-curing, micro-Raman spectra of the composite films were acquired to determine DC at 5min, 10min, 1h and 24h. LI data were statistically analyzed by Kruskal–Wallis followed by post-hoc comparisons, while a linear mixed-effect model was applied for the DC analysis. In addition, the CAD–CAM blocks ultrastructure was characterized upon argon-ion slicing using scanning transmission electron microscopy (STEM). Finally, light transmission (LT) through each CAD–CAM block material was assessed using a spectrophotometer.ResultsCuring-light attenuation and DC were significantly influenced by thickness and type of the overlying material. LCU only had a significant effect on DC of the micro-hybrid RBC. DC significantly increased over time for all composite cements. CAD–CAM block structural analysis revealed a relatively small and homogenous filler configuration (mean filler size of 0.2–0.5μm) for Cerasmart, while Enamic contained ceramic grains varying in shape and size (1–10μm), which were interconnected by the polymer-based network. LT was much higher at a wavelength range of 300–800nm for Cerasmart than for Enamic.SignificanceLight-curable composite cements can be cured through a restoration up to 2.7-mm thickness, depending on the kind of CAD–CAM material. A high-irradiance LCU only has a limited effect on the maximum thickness of the polymer–ceramic CAD–CAM material that can be cured through.



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Node making process in network meta-analysis of non-pharmacological treatment are poorly reported

Publication date: Available online 28 November 2017
Source:Journal of Clinical Epidemiology
Author(s): Arthur James, Amélie Yavchitz, Philippe Ravaud, Isabelle Boutron
ObjectiveIdentify methods to support the node-making process in network meta-analyses (NMAs) of non-pharmacological treatments.DesignWe proceeded in two stages. First, we conducted a literature review of guidelines and methodological articles about NMAs to identify methods proposed to lump interventions into nodes. Second, we conducted a systematic review of NMAs of non-pharmacological treatments to extract methods used by authors to support their node-making process.Data sourcesMEDLINE and Google Scholar were searched to identify articles assessing NMA guidelines or methodology intended for NMA authors. MEDLINE, CENTRAL and EMBASE were searched to identify reports of NMAs including at least one non-pharmacological treatment. Both searches involved articles available from database inception to March 2016.Data extraction and analysisFrom the methodological review, we identified and extracted methods proposed to lump interventions into nodes. From the systematic review, the reporting of the network was assessed as long as the method described supported the node-making process.ResultsAmong the 116 articles retrieved in the literature review, 12 (10%) discussed the concept of lumping or splitting interventions in NMAs. No consensual method was identified during the methodological review, and expert consensus was the only method proposed to support the node-making process. Among 5187 references for the systematic review, we included 110 reports of NMAs published between 2007 and 2016. The nodes were described in the introduction section of 88 reports (80%), which suggested that the node content might have been a priori decided before the systematic review. Nine reports (8.1%) described a specific process or justification to build nodes for the network. Two methods were identified: 1) fit a previously published classification and 2) expert consensus.ConclusionsDespite the importance of NMA in the delivery of evidence when several interventions are available for a single indication, recommendations on the reporting of the node-making process in NMAs are lacking and reporting of the node-making process in NMAs seems insufficient.



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Image analysis of interarytenoid area to detect cases of Laryngopharyngeal Reflux: An objective method

Publication date: Available online 28 November 2017
Source:American Journal of Otolaryngology
Author(s): Anindya Nayak, Sunil Kumar, Rubeena Arora, Gautam Bir Singh
PurposeTo diagnose Laryngopharyngeal Reflux by observing colour (Red, Green, Blue) at the interarytenoid area during 70° laryngeal endoscopy.Materials and methodsEndoscopic images from 50 normal controls and 50 patients of LPR were obtained in this observational study. LPR patients were selected on the basis of RSI and RFS. Images were analysed using ImageJ, a free image analysis software, developed by the National Institute of Health (NIH). Colour changes in the form of RGB (red, green, blue) values were calculated and analysed at the interarytenoid area. The values in the normal and patient group were compared and correlated with RSI and RFS.ResultsRGB values of the LPR group and the normal group were statistically different (P value<0.01). Strong correlation was also found between R and G values and both RFS and RSI. However, no correlation was seen with B values.ConclusionImage analysis is an easy, economical and objective method to diagnose LPR.



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Letter to the editor

Publication date: Available online 28 November 2017
Source:American Journal of Otolaryngology
Author(s): Satvinder Singh Bakshi




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Dexmedetomidine as an adjuvant to 0.5% ropivacaine in ultrasound-guided axillary brachial plexus block

Summary

What is known and objective

The aim of this study was to elucidate the effect of dexmedetomidine added to ropivacaine on the onset and duration of sensory and motor block and duration of analgesia of ultrasound-guided axillary brachial plexus block.

Methods

Thirty-seven ASA physical status I-II patients with elective forearm and hand surgery under ultrasound-guided axillary brachial plexus block were randomly divided into 2 groups. Patients in ropivacaine-dexmedetomidine group (group RD, n = 19) received 15 mL of 0.5% ropivacaine with 100 μg (1 mL) dexmedetomidine, and patients in ropivacaine group (group R, n = 18) received 15 mL of 0.5% ropivacaine with 1 mL of normal saline. Onset time and duration of sensory and motor block and duration of analgesia were assessed.

Results and discussion

Duration of sensory block (U-value = 35, P < .001), duration of motor block (P = .001) and duration of analgesia (P < .001) were extended in group RD compared to group R. Onset time of sensory block in group RD was significantly faster than in group R (U-value = 65.5, P = .001). Onset time of motor block showed no significant difference between the 2 groups (U-value = 116.5, P = .096). Adverse reactions were reported only in group RD (bradycardia in 2 and hypotension in 3 patients).

What is new and conclusion

Our study indicated that dexmedetomidine 100 μg as adjuvant on ultrasound-guided axillary plexus block significantly prolonged the duration of sensory block and analgesia, as well as accelerated the time to onset of sensory block. These results should be weighed against the increased risks of motor block prolongation, transient bradycardia and hypotension and allow for attentive optimism, only if prolonged clinical trials provide a definitive answer.

Results of ultrasound-guided axillary brachial plexus block.

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Dear Abby: Wife's private photo album makes its way onto the web

Dear Abby: Six months ago, I asked a close female friend to help me prepare a gift for my husband for our fifth wedding anniversary. I wanted to create a photo album of sexy nude photos of myself.

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Comparison of atopy patch testing to skin prick testing for diagnosing mite-induced atopic dermatitis: a systematic review and meta-analysis

Atopic dermatitis (AD) can occur after contact with aeroallergens like house dust mites, pollen, and animal dander. Despite its controversial diagnostic value, the atopy patch test (APT) has been used as an im...

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Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy

Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy

Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy, Published online: 29 November 2017; doi:10.1038/s41430-017-0032-7

Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy

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Dentists, dental professionals and volunteers can give the needy something to smile about

The Central Arizona Dental Society Foundation is looking for dentists and volunteers to help out in its annual Dental Mission of Mercy event. Did you know not properly taking care of your teeth can affect other parts of your body too? Maria Mercedes Galuppo has more.

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Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: Three-year results of a randomized clinical study

Abstract

Background

Several treatment options exist for the implant-supported rehabilitation of edentulous posterior maxilla.

Purpose

To compare maxillary sinus floor augmentation associated to standard length implants, with direct placement of implants of reduced length in the available residual bone.

Materials and Methods

Patients with edentulous posterior maxilla and a residual height of 4-7 mm were randomly allocated to the test (short implants [SIs], 6.5 to 8.5mm long) or the control (sinus augmentation [SA] and implants ≥10mm long) group. Anorganic bovine bone was the grafting material for the control group. In both groups pure platelet-rich plasma was used to bioactivate implant surface prior to insertion. Implant and prosthesis survival, clinical variables, radiographic bone level change, quality of life, and patient satisfaction were assessed.

Results

Twenty-five patients were treated in the control group (58 standard length implants) and 27 in the test group (42 SIs). After 3 years of follow-up no implant failure and biological or mechanical complications were recorded. Marginal bone loss, soft tissue, and oral hygiene parameters were similar in the 2 groups at both 1 and 3 years' follow-up. Postoperative pain, swelling and other symptoms and daily activities were better in the SIs group than in the SA group, while patients' satisfaction after 1 year was similar.

Conclusions

In spite of comparable medium-term clinical and radiographic outcomes, when the residual ridge height is sufficient for a safe placement, SIs may be preferred due to simplified protocol, less invasiveness, shorter treatment time, and reduced postoperative discomfort as compared to SA.

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Improved outcome for AML patients over the years 2000–2014

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Effects of two pre-workout supplements on concentric and eccentric force production during lower body resistance exercise in males and females: a counterbalanced, double-blind, placebo-controlled trial

Pre-workout supplements purportedly enhance feelings of energy, reduce fatigue and improve exercise performance. The purpose of this study was to examine the performance effects of caffeinated and non-caffeina...

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Metabolic syndrome and its components among university students in Kenya

Metabolic syndrome refers to a cluster of interrelated disorders which occur together causing an increase in the risk of developing cardiovascular disease and diabetes. The university population is an understu...

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A systematic review of data mining and machine learning for air pollution epidemiology

Data measuring airborne pollutants, public health and environmental factors are increasingly being stored and merged. These big datasets offer great potential, but also challenge traditional epidemiological me...

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Theories, models and frameworks used in capacity building interventions relevant to public health: a systematic review

There is limited research on capacity building interventions that include theoretical foundations. The purpose of this systematic review is to identify underlying theories, models and frameworks used to suppor...

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Prescribing patterns of rural family physicians: a study in Kermanshah Province, Iran

The inappropriate use of drugs due to irrational prescriptions is a common problem in Iran, but there is little evidence of prescription patterns in rural family physicians. This study aimed to explore the pre...

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HIV and hepatitis B and C co-infection among people who inject drugs in Zanzibar

People who inject drugs are at high risk of acquiring hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) due to risky injection and sexual practices. The objective of this study is to...

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Letter to the editor

This is in reference to a very well written article titled 'Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life' by Katharina Stölzel et al. [1]. The study has been well planned and tackles an important and clinically relevant condition, namely inferior turbinate hypertrophy. However there are some concerns regarding the methodology which I would like to bring out.

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Image analysis of interarytenoid area to detect cases of Laryngopharyngeal Reflux: An objective method

To diagnose Laryngopharyngeal Reflux by observing colour (Red, Green, Blue) at the interarytenoid area during 70° laryngeal endoscopy.

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Leaflets and continual educational offerings led to increased coverage rate of newborn hearing screening in Akita

Newborn hearing screening (NHS) has been actively performed in Japan since 2001. The NHS coverage rate has increased each year in Akita Prefecture. We analyzed the details of the NHS program and how the Akita leaflets and the many educational offerings about the importance of NHS led to the high NHS coverage rate.

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Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study

Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study

Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study, Published online: 28 November 2017; doi:10.1038/bjc.2017.400

Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study

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Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites, Published online: 28 November 2017; doi:10.1038/bjc.2017.381

Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

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Node making process in network meta-analysis of non-pharmacological treatment are poorly reported

Identify methods to support the node-making process in network meta-analyses (NMAs) of non-pharmacological treatments.

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Barriers to pediatric cochlear implantation: A parental survey

This study aims to (1) determine barriers in the pediatric cochlear implantation process specific to publicly insured patients, wherein delayed implantation has been reported, and (2) compare the perceived barriers between publicly and privately insured patients.

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Citation for the 2016 Down Surgical Prize – Michael Thomas Simpson

I am honoured to give the supporting citation for Michael Thomas Simpson for the 2016 BAOMS Downs Prize. The Prize is awarded to a colleague for outstanding services to Oral and Maxillofacial Surgery throughout his or her career. While it is impossible to do justice to a lifetime of service in a few minutes, I hope to show you why Mike is a worthy recipient of the Downs Prize.

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Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy

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Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study

Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study

Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study, Published online: 28 November 2017; doi:10.1038/s41371-017-0019-9

Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study

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Harvest gives $600,000 to Dental Health Foundation

Piedmont Virginia Dental Health Foundation received a three-year grant from The Harvest Foundation totaling $603,195 to operate the Community Dental Clinic.

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Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study

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Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

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Quality of life outcomes after endoscopic approaches to intracranial tumors

Purpose of review To review the literature on quality of life (QOL) in endoscopic approaches to anterior and central intracranial skull-base disease. As endoscopic surgical techniques have gained widespread acceptance and complications and morbidity remain low and comparable with microscopic and open approaches, a shift to focusing on patients' perception of their own well being as an important outcome parameter has been made. In addition to the traditional measurements of surgical outcomes (extent of resection, recurrence rate, morbidity, survival, and complication rate), the success of a surgery can now be assessed using QOL measures. Recent findings The main tools for assessing QOL in endoscopic skull-base surgery (anterior skull-base questionnaire and 22-item sinonasal outcome test) were not specifically designed for endoscopic skull-base approaches, and recently, a new tool was introduced and validated, the skull-base inventory, adding to our armamentarium, but it has not yet been widely employed. Endoscopic skull-base surgery leads to improved or sustained long-term QOL overall but it is significantly influenced by tumor disease. Specific endoscopic surgical technique (such as nasoseptal flap closure) appears to have less impact on QOL. Summary It is becoming critical to assess therapeutic interventions in terms of impact on a patient's QOL. QOL can be useful in comparing efficacy of surgical interventions, and in the future, it will likely become a reportable indicator of surgical outcome and guide our surgical technique recommendations. Large-scale prospective multicenter trials would be beneficial. Correspondence to Assistant Prof Madeleine R. Schaberg, MD, MPH, Department of Otorhinolaryngology Head and Neck Surgery, The New York Eye and Ear Infirmary of Mount Sinai, The Icahn School of Medicine at Mount Sinai, 310 East 14th Street 6th Floor, New York NY 10003, USA. Tel: +1 646 943 7931; e-mail: mschaberg@nyee.edu Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Anti-viral Activities of Oroxylum indicum Extracts on Chikungunya Virus Infection

Abstract

Chikungunya virus (CHIKV) is a re-emerging mosquito-borne alphavirus that poses a threat to human worldwide. Driven by the lack of approved medication and vaccination, research on anti-Chikungunya agents has received great attention. In an effort to determine potential inhibitor of CHIKV, this study aimed at investigating the potential anti-viral activity of Oroxylum indicum extracts towards CHIKV-infected Vero cells. The virucidal, pre- and post-treatment effects of O. indicum were evaluated, using the maximum non-toxic dose of O. indicum methanol and aqueous extracts as determined by cytotoxicity assay. The viral inhibitory effect was assessed by the morphological changes of Vero cells and further confirmed by plaque assay. Both methanol and aqueous extracts of O. indicum had similar cytotoxicity in Vero cells. Interestingly, the virucidal effect of O. indicum aqueous extract revealed a significant reduction on the viral titre (p < 0.05). The prophylactic effect of aqueous extract was demonstrated when the pre-treated cells exhibited a significant anti-CHIKV activity (p < 0.05). However, methanol extract of this plant exerted an anti-viral activity against CHIKV only to a certain extent. Therefore, the aqueous extract of this plant has a potential to inhibit the virus and acts as prophylactic agent against CHIKV. Further studies however are needed to substantiate the finding and to determine the important compound of this plant as well as the mechanism of action in treating CHIKV infection.

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Could mouthwash be putting you at risk of diabetes?

It might help to reduce bad breath and tooth decay, but a surprising new study suggests that mouthwash could also increase the risk of diabetes.

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Electroencephalographic evaluation of acoustic therapies for the treatment of chronic and refractory tinnitus

To date, a large number of acoustic therapies have been applied to treat tinnitus. The effect that produces those auditory stimuli is, however, not well understood yet. Furthermore, the conventional clinical p...

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Correlation between subjective and objective hearing tests after unilateral and bilateral cochlear implantation

There are many methods for assessing hearing performance after cochlear implantation. Standard evaluations often encompass objective hearing tests only, while patients' subjective experiences gain importance i...

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Endoscopic repair of lateral sphenoid Encephaloceles: a case series

Lateral sphenoid encephaloceles present a surgical challenge. These encephaloceles may be difficult to access given their lateral location and proximity to the neural and vascular structures of the sphenoid fl...

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LA Times: Rural Voters Hardest Hit by a Repeal of ACA Mandate

Dentists perform oral surgery in a mobile unit parked at the Remote Area Medical clinic on July 22, 2007 at the Wise County Fairground in Wise, Virginia. Rural families, most with little or no insurance, lined up for hours to receive free health care from hundreds of doctors, nurses, dentists, and other health workers.

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84 year old man in China receives “world first” 3D printed tantalum knee

An 84 year old patient suffering from osteoarthritis has reportedly become the first man in the world to receive a 3D printed tantalum knee implant. The news has been circulated by Chongqing News (CQNews.net), a local source set up by Chongqing State Council, a south-west municipality of China. The surgery was conducted at a First Affiliated […]

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Frequency of visits and examinations in the Public Dental Service in Finland – a retrospective analysis, 2001–2013

Abstract

Background

This study aimed to investigate longitudinally examination and visiting patterns in the Finnish Public Dental Service (PDS) and to relate these to patients' treatment needs and international recommendations on examination intervals.

Methods

Data on patients and their dental visits in the period 2001–2013 were collected from five municipal PDS-units serving a total population of 320,000 inhabitants and using the same database system. Ethical approval was given by the National Institute for Health and Welfare (THL) and permissions to use local data by the directors of health services in each unit. For each year, the numbers of visitors, those examined and those in need of basic periodontal or caries treatment (CPI >2 and D + d > 0) were calculated separately for young people (< 18 years), the working-aged (18–64 years) and the elderly (65+ years). Each individual's examination and visiting intervals were counted. Multilevel modelling was used to study probabilities of being examined or in need of treatment and differences in examination and visiting intervals between groups and over time.

Results

From 2001 to 2013, the number of visitors increased by 39.3% and the working-aged became the biggest patient group rather than the young. Compared with adults, the young were five times more likely to be examined (OR = 4.97) and three times less likely to require treatment (OR = 0.31). On average, 37% of the young, 73% of the working-aged and 63% of the elderly needed basic treatment. Multi-level analysis showed that the young had the shortest examination intervals and the working aged the longest (0.50 years longer). Most examination intervals of the young and the elderly were 1 year (65.2 - 77.0%), but only half (49.5%) of the working-aged were re-examined within 1 year. Over time, the examination intervals increased slightly in all groups. Most visiting intervals remained at 1 year.

Conclusion

Young patients had mostly annual or biannual examinations, in line with recommendations. The examination intervals of working aged adults were considerably longer, and more of them needed treatment. The share of elderly among visitors remained low. The PDS seems to have access barriers for adults.

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Cervical metastasis of gingival carcinoma misdiagnosed as branchiogenic carcinoma, a rare entity - report of a case and review of literature

Abstract

Background

A cervical cystic mass is associated with a number of pathologies that present with similar symptoms. These conditions are difficult to differentiate using fine-needle aspiration (FNA), ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Another dilemma in the differential diagnosis of cervical cystic masses is due to the controversies associated with the existence of branchiogenic carcinoma (BC). BC is an extremely rare disease that must be differentiated from other conditions presenting with cervical cystic masses, especially cystic metastasis from occult primary lesions.

Case presentation

We present a case report of a right cervical cystic metastasis from a significantly small squamous cell carcinoma primary gingival lesion misdiagnosed as BC by histopathology. A 62-year-old female presented with a painless progressively enlarging cervical mass at the anterior edge of the sternocleidomastoid muscle in the right submandibular region. Preoperative MRI and US revealed a well-defined cystic round mass. Postoperative histological examination indicated BC. Positron emission tomography/computed tomography (PET/CT) revealed high 18F–FDG (18F 2-fluoro-2-deoxy-D-glucose) uptake in surgical regions with a SUV (standard uptake value) max 4.0 and ipsilateral nasopharynx with a SUVmax 4.4, without any distant metastasis. Pathologic results revealed nasopharyngeal lymphadenosis. Considering the low incidence of BC and the limitation of diagnosis in one institution, the patient was referred to another hospital. Physical examination detected a significantly small neoplasm (~3 mm diameter) in the right lower gingiva. Histopathological examination of the neoplasm revealed a well-differentiated squamous cell carcinoma. Surgery, including a partial mandibulectomy and modified neck dissection (neck level I–V and submental lymph nodes) were undertaken. Postoperative histopathological results revealed a well-differentiated squamous cell carcinoma of right lower gingiva and two metastatic lymph nodes in the 18 lymph nodes of level II. A month later, recurrence occurred in the right cervical level II. The patient was placed on postoperative concurrent chemo-radiotherapy and supportive care. The patient suffered from cachexia and survived for only six months after surgery.

Conclusions

In cases of cervical cystic masses that appear after the age of 40, clinicians should bear in mind that occult primary lesions should be excluded and examination of the gingiva should be undertaken. PET/CT has a limited role in identifying small occult primary lesions and a comprehensive physical examination must be carefully performed.

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Evaluation of the efficacy of tongue-lip adhesion in Pierre Robin sequence

Publication date: Available online 28 November 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): H. Broucqsault, M.-D. Lamblin, G. Hosana, P. Fayoux
ObjectiveTongue-lip adhesion may be used to relieve obstructive sleep apnoea in infants with Pierre Robin sequence (PRS), but only a few studies have objectively evaluated its efficacy. The purpose of this study was to evaluate the results of tongue-lip adhesion by polysomnography.Materiel and methodsA single-centre retrospective study was conducted in infants with PRS treated by tongue-lip adhesion from 2004 to 2015, in whom at least laryngotracheal endoscopy and polysomnography were performed. The variables collected were the syndromic diagnosis, demographic data, respiratory management before tongue-lip adhesion, symptoms, and additional airway interventions. Obstructive sleep apnoea was classified into 3 groups according to severity. Polysomnography was performed one month after tongue-lip adhesion. Statistical analysis was performed with Wilcoxon signed-rank test with a limit of statistical significance of P<0.005.ResultsThirty-seven subjects in whom tongue-lip adhesion was performed at a mean age of 45 days (8 to 210 days) were included. Thirty-one patients had isolated PRS and 6 patients had associated anomalies. All patients had confirmed severe obstructive sleep apnoea. All patients required respiratory support prior to surgery: 8 intubated patients, 15 patients with noninvasive ventilation and 14 patients with nasopharyngeal airways. Eight patients had bradycardia before tongue-lip adhesion. All parameters were improved on postoperative polysomnography: oxygen saturation, hypercapnia, apnoea-hypopnoea index, bradycardia (P<0.005). Only 8 patients had persistent severe obstructive sleep apnoea and required tracheostomy (n=5) or noninvasive ventilation (n=3). No significant correlation was observed between treatment success and any predictive variables.ConclusionTongue-lip adhesion improved airway obstruction in all infants with PRS and resolved obstructive sleep apnoea in 29 patients. However, 8 patients required additional airway interventions.



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Visceral Leishmaniasis in Traveler to Guyana Caused by Leishmania siamensis, London

S. D. Polley et al.

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Melioidosis, Singapore, 2003–2014

L. Pang et al.

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Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013–2014

M. Hassan et al.

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Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic

C. H. Hsu et al.

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Phylogeny and Immunoreactivity of Norovirus GII.P16-GII.2, Japan, Winter 2016–17

K. Nagasawa et al.

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Whole-Genome Analysis of Recurrent Staphylococcus aureus t571/ST398 Infection in Farmer, Iowa, USA

S. E. Wardyn et al.

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Pneumonic Plague in Johannesburg, South Africa, 1904

C. M. Evans et al.

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Pre-diagnostic dynamic HPV16 IgG seropositivity and risk of oropharyngeal cancer: Methodological issues.

Pre-diagnostic dynamic HPV16 IgG seropositivity and risk of oropharyngeal cancer: Methodological issues.

Oral Oncol. 2017 Nov 22;:

Authors: Ayubi E, Safiri S

PMID: 29174636 [PubMed - as supplied by publisher]

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Counter-intuitive influence of Himalayan river morphodynamics on Indus Civilisation urban settlements

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Put safety first

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Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study

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Location of unaccessible implant surface areas during debridement in simulated peri-implantitis therapy

Abstract

Background

An in vitro model for peri-implantitis treatment was used to identify areas that are clinically difficult to clean by analyzing the pattern of residual stain after debridement with commonly employed instruments.

Methods

Original data from two previous publications, which simulated surgical (SA) and non-surgical (NSA) implant debridement on two different implant systems respectively, were reanalyzed regarding the localization pattern of residual stains after instrumentation. Two blinded examiners evaluated standardized photographs of 360 initially ink-stained dental implants, which were cleaned at variable defect angulations (30, 60, or 90°), using different instrument types (Gracey curette, ultrasonic scaler or air powder abrasive device) and treatment approaches (SA or NSA). Predefined implant surface areas were graded for residual stain using scores ranging from one (stain-covered) to six (clean). Score differences between respective implant areas were tested for significance by pairwise comparisons using Wilcoxon-rank-sum-tests with a significance level α = 5%.

Results

Best scores were found at the machined surface areas (SA: 5.58 ± 0.43, NSA: 4.76 ± 1.09), followed by the tips of the threads (SA: 4.29 ± 0.44, NSA: 4.43 ± 0.61), and areas between threads (SA: 3.79 ± 0.89, NSA: 2.42 ± 1.11). Apically facing threads were most difficult to clean (SA: 1.70 ± 0.92, NSA: 2.42 ± 1.11). Here, air powder abrasives provided the best results.

Conclusion

Machined surfaces at the implant shoulder were well accessible and showed least amounts of residual stain. Apically facing thread surfaces constituted the area with most residual stain regardless of treatment approach.

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Dental caries experience and determinants in young adults of the Northern State Medical University, Arkhangelsk, North-West Russia: a cross-sectional study

Abstract

Background

Little information exists about the experience of and risk factors for dental caries in young adults in Russia. We investigated dental caries experience and determinants in medical and dental students in North-West Russia.

Methods

This cross-sectional study included 442 medical and 309 dental undergraduate students of Russian nationality aged 18–25 years from the Northern State Medical University, Arkhangelsk, Russia. Information on socio-demographic factors and oral health behaviour (regularity of dental visits, frequency of tooth-brushing, using toothpaste with fluoride, and skipping tooth-brushing) was obtained from a structured, self-administered questionnaire. Dental caries experience was based on the decayed (D) missing (M) filled (F) teeth (T) index and the Significant Caries (SiC) index, which were assessed through dental examination. Students with a DMFT index ≥9 were placed in the SiC group. Negative binomial hurdle and multivariable binary logistic regressions were used for statistical analyses.

Results

The prevalence of dental caries (DMFT >0) was 96.0%, overall mean DMFT index was 7.58 (DT: 0.61, MT: 0.12, and FT: 6.84), and the corresponding SiC index was 12.50. Age 21–25 years (incidence rate ratio [IRR] = 1.09, 95% confidence interval [CI]: 1.01–1.18), being a female (IRR = 1.10, 95% CI: 1.01–1.20), high subjective socioeconomic status (SES) [IRR = 1.11, 95% CI: 1.02–1.21], and skipping tooth-brushing (IRR = 1.09, 95% CI: 1.00–1.19) were associated with a higher DMFT index. DMFT index also increased among students who reported regular dental visits (IRR = 1.22, 95% CI: 1.10–1.36), but their odds of being in the dental caries-free group decreased (odds ratio [OR] = 0.38, 95% CI: 0.18–0.82). Significant predictors of being categorised to the SiC group were older age (OR = 1.41, 95% CI: 1.03–1.92), high subjective SES (OR = 1.57, 95% CI: 1.13–2.19), and regular dental visits (OR = 2.34, 95% CI: 1.56–3.51).

Conclusions

A high prevalence of dental caries and high DMFT index, with a dominance of FT, were observed in our Russian medical and dental students. Age, sex, subjective SES, regular dental visits, and skipping tooth-brushing were determinants of dental caries experience.

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Dentist accused of improperly prescribing medications seeks dismissal of charges

A Scranton Times-Tribune All Access subscription gets you complete access to both our print and digital publications, delivered to your home, desktop and mobile devices 7 days a week Manage your account Manage your account 24 hours a day. You can activate all access, pay your bill, update your account information, pause home delivery while you're away or ask a question.

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Why is my tongue tingling?

We look at a range of causes for a tingling tongue, including dental injuries, migraine, multiple sclerosis, and allergies. Learn more.

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RE-Europe, a large-scale dataset for modeling a highly renewable European electricity system

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Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate?

Squamous cell carcinomas of the hard palate and maxillary alveolar ridge are rare tumours with a poor prognosis. Lymph node dissection is recommended for tumours with nodal involvement, and is rarely performed in the absence of adenopathy. We report a series of patients with squamous cell carcinomas and evaluate the rate of lymph node invasion and its impact on survival. This is a retrospective study of 72 patients treated for squamous cell carcinoma of the hard palate and maxillary alveolar ridge between January 1, 1998 and December 31, 2008 in two cancer centres. Using clinical and radiological assessment, tumours were classified as T1-T2 in 25 patients (34.7%) and T3-T4 in 47 patients (65.3%). At diagnosis, 16 (22.2%) patients had clinical and/or radiological nodal involvement and 7 patients (9.7%) distal metastasis. Among N0 patients, 13 (18%) experienced isolated lymph node recurrence. Two-year global survival was 60%; 5-year survival was 34%. The rate of lymph node invasion observed in squamous cell carcinoma of the hard palate and maxillary alveolar ridge does not differ from other oral cavity sites. Because nodal recurrence worsens the prognosis of such a patient, lymph node dissection should be considered at an early stage, even among N0 patients.
ORL 2017;79:314-322

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Differential Expression of the Aryl Hydrocarbon Receptor and Transforming Growth Factor Beta 1 in Chronic Rhinosinusitis with Nasal Polyps with Allergic Rhinitis

Objective: This study aimed to determine the aryl hydrocarbon receptor (AhR) and transforming growth factor beta 1 (TGF-β1) expression levels in chronic rhinosinusitis (CRS) and their possible correlation with allergic state and tissue remodeling. Methods: Patients were enrolled and divided into the following groups: CRS without nasal polyps (NP) without allergic rhinitis (AR) (CRSsNPsAR; n = 20), CRS with NP with AR (CRSwNPwAR; n = 20), CRS with NP without AR (CRSwNPsAR; n = 20), and controls (n = 15). Tissue samples were analyzed by Masson trichrome staining for collagen, while the location and expression of AhR and TGF-β1 were analyzed by immunohistochemistry, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and Western blotting. Results: The collagen amounts as well as AhR and TGF-β1 mRNA and protein expression levels were significantly increased in the CRSsNPsAR group compared with the CRSwNP (CRSwNPsAR and CRSwNPwAR) samples (p p p p p Conclusions: Elevated AhR expression may be involved in the progression of tissue remodeling in CRSsNPsAR similar to TGF-β1 expression. Conversely, lower AhR expression may be involved in allergic reactions in CRSwNPwAR.
ORL 2017;79:295-305

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Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

Background/Aims: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. Methods: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy. Results: TORS allowed for exceptional visualization and access to the plunging ranula and sublingual gland while avoiding critical neurovascular structures. The patient healed well without recurrence or complications. Conclusion: The TORS approach with sialendoscopy for plunging ranulas described in this case report shows promise and should be considered for certain clinical presentations. Additional studies evaluating the effectiveness of TORS for plunging ranulas may be indicated.
ORL 2017;79:306-313

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Dentist giving back

It's been almost 10 years since Sgt. 1st Class Matt Kahler died in Afghanistan, but he hasn't been forgotten by his family and organizations that support veterans and fallen heroes.

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Cardiophrenic lymph node resection in advanced ovarian cancer: surgical outcomes, pre- and postoperative imaging

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Neuromodulation of orexin neurons reduces diet-induced adiposity

Neuromodulation of orexin neurons reduces diet-induced adiposity

Neuromodulation of orexin neurons reduces diet-induced adiposity, Published online: 28 November 2017; doi:10.1038/ijo.2017.276

Neuromodulation of orexin neurons reduces diet-induced adiposity

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Materialise and Siemens deliver 3D printing to the world’s radiologists

Materialise and Siemens Healthineers, a medical technology branch of the German conglomerate Siemens AG, have announced a collaboration to bring 3D printing capabilities to hospitals around the world. Together the partners will provide software necessary to make anatomical models using patient data, and add another dimension to the field of medical imaging. From the specialists […]

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Enterprise Introduces New Anesthesia Injection Technology - EZ Flow

 

Over the years we've seen a lot of advances in dentistry and the way we perform procedures.  However, one thing has remained pretty much the same for most doctors and that is the injection.  Most offices are still using the standard stainless steel syringe that has been around since local anesthetic delivery was invented.

 

In the early 2000's there were some attempts at improving the injection process.  It involved using chip driven tech to control the speed of the delivery and became known as CCLAD (Computer Controlled Local Anesthetic Delivery).  Two companies created devices, Milestone Scientific had The Wand and Dentsply had the CCS (Controlled Comfort Syringe).  Of the 2, only Milestone's device is still available.  It is called STA for Single Tooth Anesthesia, although the device can be used for any type of local delivery.

 

Now Denterprise is entering the market with EZ Flow.  It is the first cordless system in the CCLAD category.

 

While I have no hands-on experience… yet, I still think the device looks interesting.

 

 Here is info from the company:

 

When it comes to fear of going to the dentist, it is a well-known fact that the phobia is directly related to the anticipated pain especially the one arising from the ugly and intimidating syringe and needle.

Surveys have revealed that the number 1 reason patients like or do not like their dentist is the anticipated or real pain from the anesthesia.

Our firm is proud to introduce EZ Flow, the newest state of the art anesthetic delivery system.  Unlike other devices using expensive disposable tubing and handpieces, or bulky units with corded handpiece base module, and foot pedals,  EZ Flow is an "all in one" slick portable handpiece.  Among other features, EZ Flow is ergonomic, has fingertip controls, offer 5 programmable modes and uses your standard cartridges, ampule and needles.   For your review, please click here for the EZ Flow presentation detailing significant technical improvement.

Denterprise owns the exclusive distribution rights for EZ Flow and has cleared FDA for this product.  EZ Flow and Acu Flow its sister model are pending evaluation by Clinicians Research (formerly CRA) to show the exciting  but very pragmatic differences compared to any other CCLAD models on the market.

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A meta-proteomics approach to study the interspecies interactions affecting microbial biofilm development in a model community

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Pressure driven spin transition in siderite and magnesiosiderite single crystals

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Evaluation of radionuclides and decay simulation in a terrestrial environment for health risk assessment

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Percolation channels: a universal idea to describe the atomic structure and dynamics of glasses and melts

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Proof of concept for a passive sampler for monitoring of gaseous elemental mercury in artisanal gold mining

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Potential ash impact from Antarctic volcanoes: Insights from Deception Island’s most recent eruption

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The power of monitoring: optimizing survey designs to detect occupancy changes in a rare amphibian population

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Rare earth element geochemistry characteristics of seawater and porewater from deep sea in western Pacific

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Multiple-stressor effects in an apex predator: combined influence of pollutants and sea ice decline on lipid metabolism in polar bears

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CO2 Mitigation Potential of Plug-in Hybrid Electric Vehicles larger than expected

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The epigenetic clock and telomere length are independently associated with chronological age and mortality

First published online: 13 April 2016, 45(2), 424–432, Int J Epidemiol, 2016, doi: http://ift.tt/2BiOSVZ

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Data Resource Profile: The Nordic Obesity Surgery Cohort (NordOSCo)

First published online: 10 October 2017, 46(5), 1367-1367g, Int J Epidemiol, 2017, doi: http://ift.tt/2BiRXW4

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Neuromodulation of orexin neurons reduces diet-induced adiposity

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Impact of Helicobacter pylori on Alzheimer's disease: What do we know so far?

Abstract

Background

Helicobacter pylori has changed radically gastroenterologic world, offering a new concept in patients' management. Over time, more medical data gave rise to diverse distant, extragastric manifestations and interactions of the "new" discovered bacterium. Special interest appeared within the field of neurodegenerative diseases and particularly Alzheimer's disease, as the latter and Helicobacter pylori infection are associated with a large public health burden and Alzheimer's disease ranks as the leading cause of disability. However, the relationship between Helicobacter pylori infection and Alzheimer's disease remains uncertain.

Methods

We performed a narrative review regarding a possible connection between Helicobacter pylori and Alzheimer's disease. All accessible relevant (pre)clinical studies written in English were included. Both affected pathologies were briefly analyzed, and relevant studies are discussed, trying to focus on the possible pathogenetic role of this bacterium in Alzheimer's disease.

Results

Data stemming from both epidemiologic studies and animal experiments seem to be rather encouraging, tending to confirm the hypothesis that Helicobacter pylori infection might influence the course of Alzheimer's disease pleiotropically. Possible main mechanisms may include the bacterium's access to the brain via the oral-nasal-olfactory pathway or by circulating monocytes (infected with Helicobacter pylori due to defective autophagy) through disrupted blood-brain barrier, thereby possibly triggering neurodegeneration.

Conclusions

Current data suggest that Helicobacter pylori infection might influence the pathophysiology of Alzheimer's disease. However, further large-scale randomized controlled trials are mandatory to clarify a possible favorable effect of Helicobacter pylori eradication on Alzheimer's disease pathophysiology, before the recommendation of short-term and cost-effective therapeutic regimens against Helicobacter pylori-related Alzheimer's disease.

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Detection of Helicobacter pylori in stool samples of young children using real-time polymerase chain reaction

Abstract

Background

The aims of this study were to develop and validate a multiplex real-time polymerase chain reaction (q-PCR) assay of Helicobacter pylori in stool samples of healthy children. Additionally, we determined the prevalence of clarithromycin resistance and cagA gene in H. pylori-positive samples.

Materials and methods

Archived stool samples from 188 children aged 6-9 years and 272 samples of 92 infants aged 2-18 months were tested for H. pylori antigens using enzyme immunoassay (EIA). A multiplex q-PCR assay was designed to detect H. pylori 16S rRNA and urease and the human RNase P gene as an internal control. Kappa coefficient was calculated to assess the agreement between q-PCR and EIA.

Results

Laboratory validation of the q-PCR assay using quantitated H. pylori ATCC 43504 extracted DNA showed S-shaped amplification curves for all genes; the limit of detection was 1 CFU/reaction. No cross-reactivity with other bacterial pathogens was noted. Applying the multiplex q-PCR to DNA extracted from fecal samples showed clear amplification curves for urease gene, but not for 16S rRNA. The prevalence of H. pylori infection was 50% (95% CI 43%-57%) by q-PCR (urease cycle threshold <44) vs 59% (95% CI 52%-66%) by EIA. Kappa coefficient was .80 (P < .001) and .44 (P < .001) for children aged 6-9 years and 2-18 months, respectively. Sixteen samples were positive for cagA and three were positive for clarithromycin resistance mutation (A2143G) as confirmed by sequencing.

Conclusions

The developed q-PCR can be used as a cotechnique to enhance the accuracy of H. pylori detection in epidemiological studies and in clinical settings.

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