Success Rate of 3 Injection Methods with Articaine for Mandibular First Molars with Symptomatic Irreversible Pulpitis: A CONSORT Randomized Double-blind Clinical Trial

Introduction

Previous studies have reported that it is difficult to obtain proper anesthesia in mandibular molars with symptomatic irreversible pulpitis, and supplemental injections are usually unavoidable. The aim of the present study was to determine the anesthetic efficacy of articaine in mandibular first molars with symptomatic irreversible pulpitis with 3 injection methods: an inferior alveolar nerve block (IANB), an IANB with an intraligamentary injection, and an IANB with buccal infiltration before initiating the endodontic treatment.

A DFT study on nanocones,nanotubes (4,0), nanosheets and fullerene C60 as anodes in Mg-ion batteries

In this article, we studied the interactions between Mg atom and Mg²⁺ ion and four nanostructures, including a nanocone, nanotube (4,0), nanosheet, and C₆₀ nanocage, to obtain the cell voltages (V) for Mg-ion batteries (MIBs). Total energy, geometry optimization, frontier molecular orbital (FMO) and density of states (DOS) analyses have been performed using the ωB97XD level of theory and the 6-31G(d) basis set. The DFT calculations clarified that the changes in energy adsorption between Mg²⁺ ion and the nanostructures, E_ad, are in the order tube > cone > sheet > cage. However, V_cell for the nanocone is the highest. The changes in V_cell of the MIBs are in the order cone > tube > sheet > cage. This study theoretically considers the possibilities of Mg as an anode in batteries due to its high V_cell values.

In this article, we studied the interactions between Mg atom and Mg²⁺ ion and four nanostructures, including a nanocone, nanotube (4,0), nanosheet, and C₆₀ nanocage, to obtain the cell voltages (V) for Mg-ion batteries (MIBs).     

Bremsstrahlung parameters of praseodymium-142 in different human tissues: a dosimetric perspective for 142Pr radionuclide therapy

Objective

Praseodymium-142 [T _1/2?=?19.12?h, $ E_{\beta^{-}}$ ?=?2.162?MeV (96.3%), E???=?1575?keV (3.7%)] is one of the ¹⁴¹Pr radioisotopes. Many studies have been attempted to assess the significance of usage ¹⁴²Pr in radionuclide therapy. In many studies, the dosimetric parameters of ¹⁴²Pr sources were calculated by modeling ¹⁴²Pr sources in the water phantom and scoring the energy deposited around it. However, the medical dosimetry calculations in water phantom consider Bremsstrahlung production, raising the question: ??How important is to simulate human tissues instead of using water phantom??? This study answers these questions by estimation of ¹⁴²Pr Bremsstrahlung parameters.

Methods

The Bremsstrahlung parameters of ¹⁴²Pr as therapeutic beta nuclides in different human tissues (adipose, blood, brain, breast, cell nucleus, eye lens, gastrointestinal tract, heart, kidney, liver, lung deflated, lymph, muscle, ovary, pancreas, cartilage, red marrow, spongiosa, yellow marrow, skin, spleen, testis, thyroid and different skeleton bones) were calculated by extending the national council for radiation protection model. The specific Bremsstrahlung constant (?? _Br), probability of energy loss by beta during Bremsstrahlung emission (P _Br) and Bremsstrahlung activity (A _release)_Br were estimated. It should be mentioned that Monte Carlo simulation was used for estimation of ¹⁴²Pr Bremsstrahlung activity based on the element compositions of different human tissues and the calculated exposures from the anthropomorphic phantoms.

Results

?? _Br for yellow marrow was smallest amount (1.1962?×?10^?3 C/kg-cm²/MBq-h) compared to the other tissues and highest for cortical bone (2.4764?×?10^?3 C/kg-cm²/MBq-h), and, overall, ?? _Br for skeletal tissues were greater than other tissues. In addition, ?? _Br breast was 1.8261?×?10^?3 C/kg-cm²/MBq-h which was greater than sacrum and spongiosa bones. Moreover, according to (A _release)_Br of ¹⁴²Pr, the patients receiving ¹⁴²Pr do not have to be hospitalized for radiation precautions and the Bremsstrahlung production does not prevent the therapy for outpatients.

Conclusion

However, modeling ¹⁴²Pr source in water phantom for simulation of ¹⁴²Pr source in soft tissues could be acceptable due to similarity of ?? _Br in water and soft tissues; this approximation is a gross computation in the mediums encompassing high atomic numbers. These data may be practical in the investigation of Bremsstrahlung absorbed dose where ¹⁴²Pr is involved in radionuclide therapy.     

Cytomegalovirus Localization in Atherosclerotic Plaques is Associated with Acute Coronary Syndromes: Report of 105 Patients

It has been shown that cytomegalovirus (CMV) is present in coronary atherosclerotic plaques, but the clinical rele-vance of this presence remains to be elucidated. In this study we sought to examine CMV infection in atherosclerosis patients defined by different methods and to identify the clinical significance of CMV replication in the atherosclerotic plaques. The study included 105 consecutive patients who were admitted to our department and underwent coronary artery bypass grafting (CABG) surgical interventions. Coronary atherosclerotic specimens as well as 53 specimens from the mamillary artery of these same patients were analyzed. Enzyme-linked immunosorbent assay (ELISA) and poly-merase chain reaction (PCR) methods were used for evaluations. The CMV PCR test result was positive for 28 (26.7%) of patients with coronary artery atherosclerosis. After adjusting for other risk factors, coronary artery disease patients with a history of acute coronary syndrome were more likely to be positive for CMV PCR test (P=0.027; odds ratio: 4.2; 95% CI: 1.18-15.0). They were also more likely to have a positive family history for cardiovascular diseases (CVD). This study confirms previous evidence about the replication of CMV virus in the atherosclerotic plaques of coronary arteries and brings clinical significance to this observation by showing a higher prevalence of acute coronary syndromes in those patients with CMV-infected plaques. Our study also suggests a familial vulnerability to CMV replication in the coronary artery walls.     

Comparison of the effects of gelatin,Ringer’s solution and a modern hydroxyl ethyl starch solution after coronary artery bypass graft surgery

Objective

The aim of this study was to compare the effect of 6% hydroxyl ethyl starch solution with 4% gelatin and Ringer’s solutions on the haemodynamic stability of patients after coronary artery bypass graft (CABG) surgery and immediately after discontinuation of cardiopulmonary bypass (CPB).

Methods

This was a randomised, double-blind clinical trial of 92 patients who were candidates for on-pump CABG. After discontinuation of CPB, all patients were transferred to the intensive care unit (ICU) and divided randomly into three groups. The first group received Ringer’s solution, the second group 4% gelatin, and the third 6% hydroxyl ethyl starch (HES) solution (Voluven). Haemodynamic parameters such as heart rate, mean arterial pressure, systolic blood pressure, diastolic blood pressure, central venous pressure, cardiac output and the presence of arrhythmias were documented.

Results

The volume needed for maintaining normal blood pressure and central venous pressure in the range of 10–14 mmHg was less in the HES group than in the other groups. The volume was similar however in the gelatin and Ringer’s groups in the first 24 hours after surgery. Urinary output in the first four and 24 hours after surgery were significantly higher in the HES group than in the other two groups. Mean creatinine levels were significantly lower in the HES group.

Conclusion

HES (6%) had a better volume-expanding effect than gelatin (4%) and Ringer’s solutions, and its short-term effects on renal function were also better than gelatin and Ringer’s solutions.     

Special problems in Fontan-type operations for complex cardiac lesions

Four patients with complex cardiac lesions, who underwent successfully a Fontan type of operation are presented, each case representing a particular problem in surgical management. The first exhibited displacement of a trileaflet straddling and overriding left atrioventricular valve in addition to tricuspid atresia, while the second one had unilateral lung perfusion. In the third case, a stenosis had developed near the origin of the right pulmonary artery, and pulmonary vascular resistance could not be determined prior to the definite palliation procedure, whereas the fourth patient presented with stenosis of the left atrioventricular valve. Surgery was planned after detailed evaluation of the morphologic and hemodynamic features by means of echocardiography and cardiac catheterization. Our results illustrate the common tendency to extend the limits for modified Fontan procedures, which also includes revision of the original criteria for selection.     

Risk factors associated with diabetic foot ulcer-free survival in patients with diabetes

Aims

This study was done to assess the risk factors associated with diabetic foot ulcer-free survival in patients with diabetes.