Prospective evaluation of the referral pattern to restorative dentistry consultation clinics in Ireland

The objective of this study was to analyse pattern of referral to Restorative Dentistry Consultation Clinics in a Dental Teaching Hospital. Patient demographic details and referral information were collected on new patient clinics. The majority of patients were female (62.1%). The greatest proportion of patients, 41.6%, was referred from the adjacent urban area. The highest percentage of referrals was from general practitioners, (37.6%). The main referral reasons were periodontal (24.7%), fixed prosthodontics (18.6%), endodontics (10.7%) and removable prosthodontics (8.3%). The study clearly showed that the majority of patients referred were female and from close proximity to the Hospital. Patients were referred for a broad range of restorative reasons.     

Thromboinflammatory response and predictors of outcomes in patients undergoing transcatheter aortic valve replacement

Transcatheter aortic valve replacement (TAVR) has been increasingly used to treat patients with symptomatic aortic stenosis. Despite improvements in valve deployment, patients that have undergone TAVR are at high risk for major adverse events following the procedure. Blood cell numbers, platelet function, and biomarkers of systemic inflammation were analyzed in 58 patients undergoing TAVR with the Edward’s SAPIEN valve. Following valve deployment, platelet count and agonist-induced platelet activity declined and plasma markers of systemic inflammation (interleukin-6 and S100A8/A9) increased. Baseline platelet activity prior to TAVR correlated with perioperative changes plasma interleukin-6 levels. Moreover, perioperative changes in plasma inflammatory markers predicted the decline in platelet count in the days following the TAVR procedure. Additionally, a significant effect of gender on platelet count following TAVR and was observed. Finally, post-procedural mortality was associated with sustained thrombocytopenia after TAVR. Our findings suggest that TAVR elicits a thromboinflammatory state that may contribute to post-procedural thrombocytopenia. Importantly, our results add to the growing body of literature that suggests the thromboinflammatory changes that occur early after TAVR may predict long-term outcomes.     

Arterial remodeling and coronary artery disease: the concept of "dilated" versus "obstructive" coronary atherosclerosis

Traditionally, the development of coronary artery disease (CAD) was described as a gradual growth of plaques within the intima of the vessel. The outer boundaries of the intima, the media and the external elastic membrane (EEM), were thought to be fixed in size. In this model plaque growth would always lead to luminal narrowing and the number and severity of angiographic stenoses would reflect the extent of coronary disease. However, histologic studies demonstrated that certain plaques do not reduce luminal size, presumably because of expansion of the media and EEM during atheroma development. This phenomenon of "arterial remodeling" was confirmed in necropsy specimens of human coronary arteries. More recently, the development of contemporary imaging technology, particularly intravascular ultrasound, has allowed the study of arterial remodeling in vivo. These new imaging modalities have confirmed that plaque progression and regression are not closely related to luminal size. In this review, we will analyze the role of remodeling in the progression and regression of native CAD, as well as its impact on restenosis after coronary intervention.     

Impact of Chronic Thrombocytopenia on In-Hospital Outcomes After Percutaneous Coronary Intervention

Objectives

This study sought to evaluate the impact of chronic thrombocytopenia (cTCP) on clinical outcomes after percutaneous coronary intervention (PCI).

Adventitial hematoma triggering coronary spasm during percutaneous coronary intervention

During percutaneous coronary intervention of the left anterior descending coronary artery, a lumen narrowing was observed proximal to the stent just deployed. Intravascular ultrasound showed a hematoma localized outside the trilaminar wall structure in absence of a dissection flap or evidence of compression of the lumen. The luminal narrowing resolved after intracoronary administration of vasodilators. This finding is compatible with a coronary spasm triggered by an adventitial hematoma following stent deployment.     

Surface hardness of light-activated resin composites cured by two different visible-light sources: an in vitro study.

OBJECTIVE: Microhardness values of upper and lower surfaces of disk specimens of 3 commercially available resin composites were compared and cured using both the traditional halogen source and a plasma arc lamp. METHOD AND MATERIALS: Twenty samples of each of the resin composites were cured in nylon washers. Ten samples of each composite were cured using the appropriate halogen lamp protocol, and 10 samples of each were cured using the plasma lamp protocol. Surface microhardness measurements were carried out using a calibrated Vickers indenter on both top and bottom surfaces after 7 days of storage in air at 20 degrees C. Statistical analysis of the data was carried out using a commercial statistical package. The data for top and bottom surfaces were analyzed separately using a repeated measures analysis of variance (ANOVA). RESULTS: Lamp, composite, and the interaction between lamp and composite were significant in determining the results for both top and bottom surfaces of the disk-shaped specimens. The plasma lamp yielded lower hardness values for all surfaces compared with the halogen source, but the size of the difference depended on the composite. CONCLUSION: Caution must be exercised in the plasma irradiation of resin composites as a curing method due to the possibility of reduced surface microhardness values that may reflect a reduced percent conversion of monomer to polymer.     

Biological effects of gum arabic: A review of some recent research

Gum arabic (GA) is a branched-chain, complex polysaccharide, either neutral or slightly acidic, found as a mixed calcium, magnesium and potassium salt of a polysaccharidic acid. The backbone is composed of 1,3-linked β-d-galactopyranosyl units. The side chains are composed of two to five 1,3-linked β-d-galactopyranosyl units, joined to the main chain by 1,6-linkages. Pharmacologically, GA has been claimed to act as an anti-oxidant, and to protect against experimental hepatic-, renal- and cardiac toxicities in rats. These reports could not be confirmed by others. GA has been claimed to alleviate the adverse effects of chronic renal failure in humans. This could not be corroborated experimentally in rats. Reports on the effects of GA on lipid metabolism in humans and rats are at variance, but mostly suggest that GA ingestion can reduce plasma cholesterol concentrations in rats. GA has proabsorptive properties and can be used in diarrhoea. It enhances dental remineralization, and has some antimicrobial activity, suggesting a possible use in dentistry. GA has been shown to have an adverse effect on electrolyte balance and vitamin D in mice, and to cause hypersensitivity in humans. More studies are needed before the pharmacological properties of GA can be utilized in therapy.     

Detection of right-coronary-artery disease using stress thallium scintigraphy: Importance of considering the right ventricle

Retrospective analyses of the stress thallium studies of 51 patients with a history of previous infarctions or definite stable angina were performed in order to determine the extent of the coronary-artery disease (CAD). The results were correlated with recent coronary-angiography findings in order to assess the effect of including rightventricule (RV) visualization on the accuracy of the detection of right coronary-artery (RCA) disease, as well as the effect of graded stenosis or occlusion of the RCA and the presence of disease of the other coronary vessels on the visualization of the RV. Eight patients had normal coronary arteries. The other 43 patients had CAD, only 5 of whom had single-vessel RCA disease. With regard to the RV, 6 patients had nonvisualization, 30 had patchy visualization, and 15 had normal visualization in the stress thallium studies. Nonvisualization indicated 100% occlusion of RCA in 6 out of 6 patients. Patchy visualization indicated significant occlusion of the RCA in 25 out of 30 patients (83%), while normal visualization indicated a normal RCA in 13 out of 15 patients (86%). Normal visualization did not mean that the possibility of RCA disease could be excluded. When RV visualization data were added to LV images, the sensitivity for detecting RCA increased from 66% to 94% (P<0.05), the specificity decreased from 89% to 72% (P<0.1), and the predictive accuracy increased from 75% to 86% (P>0.1).