Increased serum adenosine and interleukin 10 levels as new laboratory markers of increased intra-abdominal pressure

Background  

Increased intra-abdominal pressure (IAP), intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are severe complications of surgical interventions with a high rate of mortality. The technique of IAP measurement is accurate, precise, reproducible and cost-effective. However, laboratory measures for monitoring of IAH have not been defined. We investigated the linkage between the serum levels of adenosine and interleukin 10 (IL-10) with IAP.     

Dying at home or in the hospital? An observational study in German general practice

Background Although determinants of place of death have been investigated in several studies, there is a lack of knowledge on factors associated with dying at home from the general practice perspective.

Objectives To identify factors associated with dying at home for patients in German general practice.

Methods In a retrospective study, general practitioners of 30 general practices were asked to provide data for all patients aged 18 years or older who died within the last 12 months, using a self-developed questionnaire. ‘Dying in hospital’ was defined as dying in hospital or hospice and ‘dying at home’ as dying at one’s usual residence including the nursing home. Multiple logistic regression analyses were used to determine factors associated with ‘dying at home’; odds ratios (ORs) and their 95% confidence intervals (CI) were calculated as measures of effect size.

Results Of 439 deceased patients, 52.2% died at home, and 47.8% died in hospital or hospice. Determinants for dying at home were patients’ care in the last 48 hours of life by family members (OR: 7.8, 95% CI: 3.4–18.0), by general practitioners (GPs) (OR: 7.3, 4.2–12.9) and living in a nursing home (OR: 3.8, 1.7–8.3). In the adjusted model, low comorbidity was positively associated (OR: 3.2, 1.4–7.0), and low functional health status (Karnofsky performance status) was negatively associated with dying at home (OR: 0.3, 0.1–0.7).

Conclusion Apart from patient-related factors such as comorbidity and health status, care by family members and GPs respectively, were determinants of dying at home.     

Tuberculate and odontoma type supernumerary teeth

An 8-and-a-half-year-old girl with supernumerary teeth of tuberculate and odontoma type is described. Treatment of the patient is carried out on conventional lines with a combination of surgical and orthodontic methods. The upper tuberculate type supernumerary teeth were extracted and, after surgical exposure, the upper permanent first incisors were aligned with removable appliances. After secondary dentition was completed, the lower odontoma type supernumerary tooth was removed surgically, and also the maxillary and mandibular first premolars were extracted because of severe crowding, and fixed orthodontic appliances were used to align the permanent dentition. Early diagnosis and treatment of this anomaly is necessary to avoid more serious consequences and to prevent severe orthodontic disturbances.     

Prevalence of impacted permanent upper canine and its treatment in 11-18-year-old orthodontic patients

Data of literature show very high prevalence of impacted upper permanent canine. The aim of the present study was to evaluate prevalence of retentioned or impacted upper permanent canines and to present their therapy. Data on 11-18-year-old children presented for treatment at the Department of Dentistry for Children and Orthodontics in Budapest over a period of 10 years (between 1990 and 2000) were analysed. OP X-ray films of 1858 children and adolescents--1102 female and 756 male--were examined and the data of anamnesis and the administered therapy were considered. Results revealed 101 cases of impacted cuspids, the male:female ratio was 46:55. Considering the totality of administered treatment methods, both surgical exposure and orthodontic treatment of the affected canines were needed in a high rate, i.e. 96.92% of the analysed cases. In 40.91% of the cases extraction of the correspondent upper first premolar was needed. Following the premolar extraction spontaneous occlusions of the impacted canine was established in 3.03%. Authors present the complex therapy of one case of palatally impacted upper permanent canine.     

Literature survey of apexification in connection with three cases

Endodontic treatment of three non-vital immature teeth is discussed. According Moorrees et al. root formation was in the stage two, six and four respectively. After access to the root canal, removing necrotic pulp and effective chemo-mechanical cleansing, Ca(OH)2 paste was used as a temporary filling material in each case. In two cases after closing the apical opening, permanent obturation was performed with half heated gutta-percha and lateral condensation to obtain a good seal. In one case permanent filling of the canal occurred with gutta-percha and AH26 as a sealer. In the first case two years, in the second case five years after obturation of the root canal with gutta-percha, periapical healing was evident in the control radiograph. In the third case using gutta-percha with AH26 as a sealer after two years new periapical lesion has developed. On the bases of literature data and our experiences in the case of non-vital immature teeth. Ca(OH)2 paste is the best temporary filling material to induce apexification process, and the half heated gutta-percha obturation is the most suitable permanent root filling material.     

Silymarin and Vitamin E do not Attenuate and Vitamin E Might Even Enhance the Antiarrhythmic Activity of Amiodarone in a Rat Reperfusion Arrhythmia Model

Oxidative stress and lysosomal phospholipoidosis, which also might be partly attributed to free radicals induced by amiodarone (AM), may be involved in AM toxicity, which can be prevented by antioxidants. Our aim was to study if vitamin E (E) or silymarin (S), a lipid and a water-soluble antioxidant, modified the antiarrhythmic efficacy of AM in a rat reperfusion arrhythmia test. The following groups of male Sprague-Dawley rats (15 rats/group) were treated by gavage once a day for 4 weeks: 1. methylcellulose (MC, 0.4%), 2. sunflower seed oil (SSO), 3. AM, suspended in MC (30 mg/kg), 4. E, dissolved in SSO (100 mg/kg), 5. AM + E, 6. S, suspended in MC (80 mg/kg), 7. AM + S. The mean duration of ventricular tachycardia + fibrillation (MDVT + VF) and sinus rhythm (MDSR) the incidence of ventricular fibrillation (VF) and ventricular tachycardia (VT) and mortality were measured during a 10-min reperfusion after a 5-min coronary artery occlusion in anaesthetized rats. An arrhythmia score, representing the combined incidence and duration of different types of ventricular arrhythmia, was calculated. Compared with the MC group, MDSR was longer and MDVT + VF was shorter in all drug treated groups and in the SSO group. In the AM + E treated group MDSR was prolonged more and MDVT + VF was shortened more than in the AM, E or SSO groups. Compared with the MC group, the incidence of VF and mortality was similarly decreased in the SSO group and in most drug treated groups. No significant difference in the incidence of VT was found among all groups. The arrhythmia score was reduced by all drug treatments. Combined treatment with AM + E decreased arrhythmia score more than treatment with AM or SSO alone, but arrhythmia score was similar in the AM + E and E groups. In conclusion, both AM and antioxidant treatments alone or together resulted in a marked reduction of reperfusion arrhythmias in this model. SSO also exerted a moderate antiarrhythmic effect. Antioxidants administered together with AM did not attenuate and E might have even enhanced the antiarrhythmic effect of AM, therefore the combination of antioxidants with AM may be advantageous to reduce AM toxicity.