Dual antiplatelet therapy plus postoperative heparin and dextran is safe and effective for reducing risk of embolic stroke during aneurysm coiling

Background

Thromboembolic events represent a clinically significant cause of neurological morbidity during the endovascular management of cerebral aneurysms. We have implemented an anti-thromboembolic regimen consisting of pre- and postoperative dual antiplatelet therapy, as well as postoperative anticoagulation using heparin and dextran. The aims of our study were to examine the effect of this regimen on thromboembolic rates during elective aneurysm coiling, and to elucidate risk factors associated with the development of thromboembolic events in this setting.

Methods

We conducted a retrospective review of patients who underwent elective intracranial aneurysm coiling between January 2005 and February 2012. The primary outcome of interest was the occurrence of a clinically significant peri-procedural thromboembolic event. Secondary outcomes included the occurrence of a central nervous system (CNS) or systemic hemorrhage.

Results

During the study period, 312 patients underwent elective aneurysm coiling and six (2 %) thromboembolic events occurred; three (1 %) occurred in the group that received the anti-thromboembolic regimen (261 patients) and three (6 %) occurred in the group that did not receive the regimen (51 patients), resulting in a statistically significant difference (P?=?0.024). Both the presence of a hypercoagulable state (P?=?0.014) and the lack of the anti-thromboembolic regimen (P?=?0.043) were significantly associated with the occurrence of a thromboembolic event.

Conclusions

This study provides evidence that the regimen described here is safe and reduces thromboembolic complications during elective aneurysm coiling. Ours is likely the most aggressive regimen in the published literature and significantly reduced the rate of thromboembolism without any significant increase hemorrhagic complications.     

In vitro genotoxic and cytotoxic effects of some paraben esters on human peripheral lymphocytes

Parabens (PBs) are p-hydroxybenzoic acid ester compounds commonly employed as antimicrobial preservatives, mainly in food, cosmetic, and pharmaceutical products. The aim of the present study was to investigate the genotoxic and cytotoxic effects of some paraben esters (butyl paraben, propyl paraben, isobutyl paraben, and isopropyl paraben) on human peripheral lymphocytes, using in vitro sister chromatid exchange (SCE), chromosome aberration (CA), and cytokinesis-block micronucleus (CBMN) tests. Lymphocyte cultures were treated with four concentrations of PBs (100, 50, 25 and 10?µg/mL) for 24 and 48?h. Paraben esters significantly induced MN formations as compared to solvent control. Furthermore, butyl paraben and propyl paraben increased MN formations a concentration-dependent manner at 24 and 48?h. PBs increased the CA at 24 and 48?h. However, this increase was not meaningful for butyl paraben and isopropyl paraben at 48?h when compared with solvent control. Butyl, isobutyl, and isopropyl paraben significantly increased the SCE at 24 and 48?h. However, propyl paraben did not induce SCE meaningfully in both treatment periods. A significant decrease in the cytokinesis-block proliferation index and mitotic index was observed in cells exposed to all concentrations of PBs at 24 and 48?h. However, proliferation index was not affected at all concentrations of PBs after 24?h treatment, although it was decreased at the highest concentration of PBs at 48?h. It is concluded that all of the paraben esters used in this study have highly genotoxic and cytotoxic effects on human lymphocytes cells in vitro.     

Post-Resection Surveillance in GI Cancers

Recurrence after curative resection of gastrointestinal (GI) cancers is common. Early detection of resectable recurrences may result in a curative resection. In un-resectable recurrences, early detection may improve the quality of life by palliation or with the use of newer chemotherapeutic drugs. The guidelines regarding follow-up of patients after curative resection of GI cancers are from the West which is very different from the Indian population in terms of a disease pattern and social milieu. The guidelines which are commonly used are also not strictly followed. We have proposed in this article the protocols which we follow at our centre after curative resection of GI cancer and how these are different from the guidelines proposed by the West.     

Coincidental diagnosis of tuberculous lymphadenitis: a case report

The aim of this case report was to present a case of multiple calcified tuberculous lymph nodes found on a panoramic radiograph coincidently diagnosed in an endodontic clinic. A detailed discussion on the differential diagnosis of similar such calcification found in the same region is also presented. A 14‐year‐old girl was referred to our department with the complaint of painless swelling in the left side of the lower jaw. Clinical and radiographical examinations were performed, leading to the initial diagnosis of chronic periapical abscess. The patient's medical history was re‐evaluated. Advanced imaging and excisional biopsy were performed in order to confirm the final diagnosis. Regarding the presenting signs and symptoms of bilateral carious mandibular molars, a periapical inflammatory process was considered in the provisional diagnosis. A thorough examination and investigations were suggestive of cervical tuberculous lymphadenitis (scrofula), and the patient underwent excision of the same. The clinician should consider the possibility of chronic granulomatous inflammatory lesions in the differential diagnosis of radiopaque lesions.     

Achieving the desired colour in discoloured teeth,using leucite-based cad-cam laminate Systems

Objectives

To evaluate the cumulative effect of the abutment tooth and resin cement colour on the resultant optical properties of porcelain laminate veneers (PLVs) fabricated with leucite-based CAD/CAM blocks with different shades and thicknesses.

Methods

A total of 224 ceramic specimens were prepared from the IPS Empress CAD with four different shades of HT-A1, LT-A1, MT-A1 and Bl-1. Resin composite discs were prepared with shade A3.5. For the cementation, 4 different shades of light-cure resin cements were chosen. L*, a*, and b* values, as well as the chroma (C) and hue (h) values of each cemented ceramic and the A1 shade table, were recorded.

Results

L*, C_ab* and h_ab* values of the cemented ceramics were influenced by ceramic shade, ceramic thickness, cement shade, and interaction terms of the three variables. There were significant differences between the 1-mm-thick ceramic veneers that exhibited higher L* and lower C_ab* values compared with veneers that were 0.5 mm in thickness. Using the Tr shade cement resulted in lower L* and higher C_ab* values for all thicknesses and ceramic shades, whereas the WO shade cement resulted in higher values.

Conclusions

The selected colour of a laminate restoration is significantly affected by the ceramic shade, ceramic thickness and resin cement shade. Using the WO shade resin cement seems to be more effective in masking the discoloured abutment tooth. Clinicians should also select the translucency level of the ceramic block with the shade when a leucite-based CAD/CAM system is chosen to treat a discoloured tooth.     

Effect of Silicon Carbide and Tungsten Carbide on Concrete Composite

Flexural strength of concrete is an important property, especially for pavements. Concrete with higher flexural strength has fewer cracking and durability issues. Researchers use different materials, including fibers, polymers, and admixtures, to increase the flexural strength of concrete. Silicon carbide and tungsten carbide are some of the hardest materials on earth. In this research, the mechanical properties of carbide concrete composites were investigated. The silicon carbide and tungsten carbide at different percentages (1%, 2%, 3%, and 4%) by weight of cement along with hybrid silicon carbide and tungsten carbide (2% and 4%) were used to produce eleven mixes of concrete composites. The mechanical tests, including a compressive strength test and flexural strength test, along with the rapid chloride permeability test (RCPT), were conducted. It was concluded that mechanical properties were enhanced by increasing the percentages of both individual and hybrid carbides. The compressive strength was increased by 17% using 4% tungsten carbide, while flexural strength was increased by 39% at 4% tungsten carbide. The significant effect of carbides on flexural strength was also corroborated by ANOVA analysis. The improvement in flexural strength makes both carbides desirable for use in concrete pavement. Additionally, the permeability, the leading cause of durability issues, was reduced considerably by using tungsten carbide. It was concluded that both carbides provide promising results by enhancing the mechanical properties of concrete and are compatible with concrete to produce composites.     

Correction: Consequences of gamma-ray irradiation on structural and electronic properties of PEDOT:PSS polymer in air and vacuum environments

Correction for ‘Consequences of gamma-ray irradiation on structural and electronic properties of PEDOT:PSS polymer in air and vacuum environments’ by Aswin kumar Anbalagan et al., RSC Adv., 2021, 11, 20752–20759, DOI: 10.1039/D1RA03463D.

The authors regret that incorrect details were given for ref. 18. The correct version of ref. 18 is given here as ref. 1.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.