Pulpal reactions to surface-sealed silicate cement and composite resin restorations

abstract – The effect of surface sealing and presence of bacteria in connection with pulpal response to silicate cement and composite resin restorations was tested in monkey teeth. Surface-sealing of silicates reduced the pulpal reactions to this material, whereas no such effect was observed when composites were sealed. Bacteria regularly occurred on the cavity walls except underneath zinc oxide/eugenol (ZOE) fillings and when silicates were sealed with ZOE. The frequency of bacteria was higher in teeth with unacceptable pulpal responses (44 of 49) than in teeth with acceptable reactions (48 of 79).     

Monkey pulpal response to composite resin restorations in cavities treated with various cleansing agents

Abstract— Pulpal response to composite resin restorations placed in experimentally prepared cavities treated with various cavity cleansing and etching agents were studied in monkey teeth. The use of etching agents and cleansers with a demineralizing potential enhanced the pulpal response to composite resin restorations. Bacterial proliferation on the cavity walls around the composite restorations may be one of several factors causing the harmful pulpal responses found. The protective effect of a calcium hydroxide-containing cavity lining material was confirmed.     

Correlates of alcoholic beverage preference: traits of persons who choose wine, liquor or beer

We studied correlates of wine, hard liquor or beer preference among 53172 white men and women in a Northern California prepaid health plan. Preference for a beverage type was reported by 51% of drinkers; 22% of persons with a preference reported exclusive use of the preferred beverage. Persons who prefer wine are likely to be women, temperate, young or middle-aged, non-smokers, better educated and free of symptoms or risk of illness. Persons who prefer liquor are likely to be men, heavier drinkers, middle-aged or older, less educated and afflicted with symptoms or risk factors for major illnesses. Persons who prefer beer are likely to be young men who are intermediate between wine and liquor preferrers for most traits. The traits of persons reporting exclusive use of a beverage type were similar. These data identify correlates of beverage choice which need to be controlled for in alcohol-health studies.     

Simulated Ischemia Does Not Protect Against Efferent Sympathetic Denervation Following Acute Myocardial Infarction in Canine Hearts

Effect of Simulated Preconditioning on Neural Response During Ischemia. Introduction: Preconditioning the myocardium with brief episodes of ischemia preserves efferent autonomic responsiveness of noninfarcted myocardium apical to a site of acute transmural ischemia by mechanism(s) still unknown. We hypothesized that repeated brief exposure of the myocardium to a simulated ischemic milieu including hypoxia, high K. low pH, and adenosine would be as effective as brief coronary occlusions in creating this protection. Methods and Results: Open chest anesthetized dogs received an extra corporeal bypass between the left carotid artery and a diagonal branch of the left anterior descending coronary artery. We analyzed the effects of simulated ischemia on the time course and extent of efferent sympathetic denervation during a subsequent 3-hour sustained ischemia in three groups of dogs: two groups of dogs underwent four cycles of 5-minute intracoronary perfusion with either hypoxic altered Tyrode's solution (12 mM K⁺, 6.8 pH, and 10 μ adenosine; n = 11) or normal Tyrode's solution mil. Each Tyrode's perfusion was separated by 5 minutes of blood perfusion prior to permanent coronary occlusion by latex remobilization of the annulated coronary artery. A third group received a continuous 3-hour blood perfusion before the final ischemic episode (n = 5). Shortening of effective refractory periods (ERPs) induced by bilateral ansae subelaviae stimulation (2 to 4 Hz) basal and apical to the intervention site was determined before and after perfusions and 20, 60, 120, and 180 minutes after sustained occlusion. In all groups, sympathetically-induced ERP shortening was unchanged at basal sites throughout the experiment. ERP shortening at apical sites was unchanged after perfusions with either the altered or normal Tyrode's solution or after a continuous 3-hour blood perfusion. However, EKP shortening became significantly attenuated at apical sites after coronary occlusion in all groups. Neither the size in reduction of sympathetically-induced ERP shortening at apical test sites nor the cumulative percentage of denervated apical test sites (≤ 2-msec shortening) during a 3-hour period of permanent ischemia differed significantly among groups (P = 0.052 and P = 0.752, respectively). The degree of subepicardial involvement in the myocardial infarction was comparable among groups. Conclusion: Thus, brief exposure of the left ventricular myocardium to ischemic metabolites prior to a subsequent permanent coronary occlusion does not trigger mechanism(s) that are responsible for protection against efferent sympathetic denervation apical to an area of trans-mural myocardial infarction/ischemia.     

Long‐Term Follow‐Up of Coronary Venous Bypass Graft Lesions Treated with a New Generation Drug‐Eluting Stent with Bioabsorbable Polymer

Background

To date, no published data are available regarding long‐term follow‐up of new generation DES implanted in coronary artery bypass graft (CABG) lesions.

Objectives

To assess the long‐term clinical outcome of patients receiving the new generation Biolimus A9‐coated drug‐eluting stent (DES) with biodegradable polymer in saphenous vein grafts (SVG).

Methods

Three thousand sixty‐seven patients were included in the NOBORI 2 registry: 71 patients with a total of 117 lesions received at least 1 biolimus A9 DES in SVG lesions and 2,959 patients received percutaneous coronary intervention in other lesions. Clinical follow‐up was performed at 1, 6, and 12 months, and annually up to 3 years.

Results

Compared to the non‐CABG group, patients with CABG lesions were older (P < 0.001), had a higher Charlson Comorbidity Index (P = 0.004), and presented more often with acute coronary syndrome (P = 0.02). At 3‐year follow‐up, cardiac death occurred in 9.7% versus 2.1% (P < 0.001), myocardial infarction (MI) in 8.3% versus 3.0% (P = 0.02), target lesion failure in 13.9% versus 6.4% (P = 0.03), and major adverse cardiac event in 18.1% versus 8.6% (P = 0.01). No differences were observed in TV‐MI and TLR, nor stent thrombosis (ST) which was generally low in both groups (1.4% vs 0.8%, P = NS).

Conclusion

Albeit 3‐year outcomes were less favorable in the CABG group, the higher cardiac mortality was apparently not driven by ST, target vessel MI, or TLR, but is likely due to advanced disease and age as well as comorbidity. The low TLR rate as well as the absence of late and very late ST suggest that BES are safe and effective for the treatment of CABG lesions. (J Interven Cardiol 2013;26:425‐433)

     

Clinical Value of Electrocardiographic Parameters in Genotyped Individuals with Familial Long QT Syndrome

MOENNIG, G., et al. : Clinical Value of Electrocardiographic Parameters in Genotyped Individuals with Familial Long QT Syndrome. Rate corrected QT interval (QTc) and QT dispersion (QTd) have been suggested as markers of an increased propensity to arrhythmic events and efficacy of therapy in patients with long QT syndrome (LQTS). To evaluate whether QTc and QTd correlate to genetic status and clinical symptoms in LQTS patients and their relatives, ECGs of 116 genotyped individuals were analyzed. JTc and QTc were longest in symptomatic patients (  n = 28  ). Both QTd and JTd were significantly higher in symptomatic patients than in asymptomatic (  n = 29  ) or unaffected family members (  n = 59  ). The product of QTd/JTd and QTc/JTc was significantly different among all three groups. Both dispersion and product put additional and independent power on identification of mutation carriers when adjusted for sex and age in a logistic regression analysis. Thus, symptomatic patients with LQTS show marked inhomogenity of repolarization in the surface ECG. QT dispersion and QT product might be helpful in finding LQTS mutation carriers and might serve as additional ECG tools to identify asymptomatic LQTS patients.