Influence of different luting agents on the marginal discrepancy of Procera Allceram alumina crown copings--an experimental study

Two maxillary first molars and two central incisor typhodont teeth were prepared with 0.8 mm chamfer, 2.0 mm occlusal reduction, and 6 degree taper. The prepared teeth were duplicated 9 times to obtain 36 die stone models and divided into three groups (n = 12). Luting agents tested were zinc phosphate, glass ionomer and resin cement. Procera AllCeram 0.6 mm coping was fixed with a calibrated finger force of 50 N. The absolute marginal discrepancy was measured using the scanning electron microscope on four axial walls with 4 measurements on each wall to obtain a total of 16 readings for one tooth. Mann Whitney U test was applied to find significant differences between luting cements and Kruskal Wallis tests among groups. Results The absolute marginal discrepancies of cements were in reducing order zinc phosphate (AZ) 53 microm; resin (AR) 44.5 microm, glass ionomer (AG) 29 microm. There was a significant difference among luting cements AG V/s AZ (p = 0.001) and AR V/s AG (p = 0.003), except AR V/s AZ (p = 0.213). All axial surfaces except mesial showed a significant difference. Conclusion The study concluded that different luting media have a definite effect over the final fit of AllCeram coping. Absolute marginal discrepancy was within the accepted level of 100 microm. Distal axial surface demonstrated a wider gap among all the luting agents.     

Giving blood donors something to drink before donation can prevent fainting symptoms: is there a physiological or psychological reason?

The vasovagal reaction has been widely studied but its anatomic and physiological nature remains uncertain. The mechanisms underlying vasovagal reaction related to blood donation are not completely understood either. Does its occurrence depend on the blood donors' physical characteristics and health variables or psychological factors? On the basis that a psychological approach considerably prevents donor reactions, the effect of fruit juice ingestion was studied in a group of 1849 first-time high-school students as a simple strategy to avoid systemic reactions at blood donation. The reasons for the psychological effect of this hydration protocol are stressed also in light of previous physiological studies on the hemodynamic effects of water or carbohydrate drinks.     

Cost-of-illness analysis and regression modeling in cystic fibrosis: a retrospective prevalence-based study

Background

Economic data pertaining to cystic fibrosis (CF), is limited in Europe generally, and completely lacking in Central and Eastern Europe. We performed an analysis of all direct costs associated with CF relative to key disease features and laboratory examinations.

Methods

A retrospective prevalence-based cost-of-illness (COI) study was performed in a representative cohort of 242 CF patients in the Czech Republic, which represents about 65 % of all Czech CF patients. Medical records and invoices to health insurance companies for reference year 2010 were analyzed.

Results

The mean total health care costs were €14,486 per patient, with the majority of the costs going towards medicinal products and devices (€10,321). Medical procedures (€2676) and inpatient care (€1829) represented a much smaller percentage of costs. A generalized linear model showed that the strongest cost drivers, for all cost categories, were associated with patient age and lung disease severity (assessed using the FEV1 spirometric parameter), when compounded by chronic Pseudomonas aeruginosa airway infections. Specifically, maximum total costs are around the age 16 years; a FEV1 increase of 1 % point represented a cost decrease of: 0.9 % (medicinal products), 1.7 % (total costs), 2.8 % (procedures) and 7.0 % (inpatient care).

Conclusions

COI analysis and regression modeling using the most recent data available can provide a better understanding of the overall economic CF burden. A comparison of our results with other methodologically similar studies demonstrates that although overall costs may differ, FEV1 can nonetheless be utilized as a generally transferrable indicator of the relative economic impact of CF.

     

Which questionnaires should we use to evaluate quality of life in patients with chronic graft-vs-host disease?

AimTo investigate the ability of two standard quality of life (QOL) questionnaires – The Short Form (36-item) Health Survey (SF-36) and The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ C30) to evaluate QOL in patients with chronic graft-vs-host disease (cGVHD) graded according to National Institutes of Health (NIH) consensus criteria.MethodsIn this cross-sectional study, QOL was assessed in patients who underwent allogeneic stem cell transplantation (allo-SCT) at the University Hospital Centre Zagreb and were alive and in complete remission for more than one year after allo-SCT.ResultsThe study included 58 patients, 38 patients with cGVHD and 20 controls, patients without cGVHD. Patients with cGVHD scored according to the NIH criteria had significantly lower scores of global health status and lower QOL on all SF-36 subscales and most of QLQ C30 functional subscales (P < 0.050 for all comparisons). Furthermore, patients with active cGVHD had significantly lower QOL scores than patients with inactive cGVHD, and this difference was most evident in physical functioning subscale of SF-36 (P = 0.0007) and social functioning subscale of QLQ C30 (P = 0.009).ConclusioncGVHD scored according to the NIH criteria is correlated with patient-reported QOL, particularly in the physical domains as detected by SF-36. QLQ C30 questionnaire adds more information on social functioning and should be used as a valuable tool in the evaluation of social domains in cGVHD patients.Although it is potentially lifesaving for a variety of hematological malignant and non-malignant disorders, allogeneic stem cell transplantation (allo-SCT) carries a significant risk of acute and late post-transplant complications. Improvements in transplantation techniques and supportive care have resulted in a reduction of early transplant-related mortality (1,2). However, the burden of late complications remains high, and two thirds of long-term allo-SCT survivors experience at least one chronic health condition (3). These complications occur due to treatment exposures before and during allo-SCT, cause substantial mortality, and severely impair patients’ functional status and quality of life (QOL). This is why today the aim of the treatment is not just to cure the primary hematological disease, but to facilitate the recovery of the physical and emotional functioning and improve QOL and social reintegration in family and work environment.Health-related QOL is now considered to be one of the relevant treatment outcomes because it provides a broader understanding of the patient’s status beyond simple disease-free survival. It is a multi-dimensional construct comprised of several related domains including physical, emotional, social, and role functioning, as well as a person''s overall evaluation of his or her well-being and ability to function (4,5). Better understanding of QOL in long-term survivors is necessary to provide adapted pre-transplant counseling and recommendations for post-transplant follow-up.With a cumulative incidence of 40%-70% and significant mortality, chronic GVHD (cGVHD) represents the most important late complication following allo-SCT (6,7). Moreover, it seems that the incidence of cGVHD in the recent years has been increasing, probably due to the fact that much older patients undergo allo-SCT, as well as due to the increased use of peripheral blood stem cell grafts and matched unrelated donors, all known risk factors for cGVHD (8). In a series of publications originating from 2005 National Institutes of Health (NIH) Consensus Conference, investigators proposed means to standardize diagnosis, scoring, histopathology, biomarkers, response assessment, and research in cGVHD (9-14). These criteria were developed to advance clinical trials and consequently improve the management of cGVHD and long-term survivorship after allo-SCT.As one of the important treatment outcomes, QOL is increasingly being subjected to the same degree of rigorous study as other significant allo-SCT outcomes. Most of the studies so far have reported a negative, significant association between cGVHD and QOL after allo-SCT (15-20). However, some of the studies have found no association (21-25), and this relationship still needs to be elucidated. The awareness of the relationship between QOL and cGVHD is necessary to further facilitate the prevention and treatment of cGVHD.The aim of this study was to examine the effect of cGVHD on QOL in our cohort of long-term allo-SCT survivors with the use of two standard QOL questionnaires; The Short Form (36-item) Health Survey (SF-36) and The EORTC Quality of Life Questionnaire (QLQ C30). Furthermore, we assessed QOL according to cGVHD severity and activity defined by the NIH consensus criteria.     

Electrophysiological testing of visual function after mirror telescope implantation: a case report

Purpose

The implantation of an intraocular telescope increases life quality in patients with end-stage age-related macular degeneration (AMD). The present study monitored changes in electrophysiological markers of visual processing before and during seventeen months after a novel mirror telescope implantation in two patients (OV—male 90 years, MZ—female 70 years) with the final-stage form of AMD.

Methods

Visual evoked potentials were recorded to high-contrast pattern-reversal (PR-VEP for check size 40′ and 10′), low-contrast motion-onset stimuli (in visual periphery M-VEP M20°, and in central part M-VEP C8°), and event-related potentials (ERPs) in the oddball visual paradigm.

Results

MZ’s more systematic responses showed attenuation and prolongation of the M-VEP M20° and the PR-VEP 40′ immediately after the telescope implantation with a slow amplitude recovery with unchanged prolonged latency. The implantation completely eradicated the M-VEP C8° without any restoration. The PR-VEP 10′ were not readable. Only a part of OV’s PR-VEP 40′ and M-VEP M20′ were of a repeatable and expected morphology. These OV’s VEPs were consistent with MZ’s findings. The ERPs did not show any effect of implantation in both patients. Post-implantation visual acuity and reaction time overcame the pre-implantation levels.

Conclusions

The mirror telescope preserved peripheral vision in contrast to classic telescopes; however, the telescope concurrently reduced the luminance of the magnified retinal image, which was likely responsible for the prolongation of the VEP latencies.

     

Asymptomatic hyperuricemia and cardiovascular mortality in patients with chronic kidney disease who progress to hemodialysis

International Urology and Nephrology - Hyperuricemia has been associated with higher mortality in the general population, but less is known about CKD patients. The aim of our study was to determine...     

Epidemiological Characteristics of Brucellosis in Serbia, 1980-2008

Aim

To analyze the epidemiological characteristics of human brucellosis in Serbia from 1980 to 2008 and the most important factors affecting its emergence and spread.

Methods

Public sources of data on brucellosis were used, including official reports of infectious diseases and epidemics, as well as monthly and annual reports of the Serbia and Vojvodina Institutes of Public Health.

Results

From 1980 through 2008, there were 1521 human brucellosis cases in Serbia. The annual number ranged from 2 in 2000 to 324 in 1991. Infections occurred more often in men (67% of cases) than in women (odds ratio, 2.17; 95% confidence interval, 1.57-3.00; χ² = 24.52, P < 0.001). The largest number of patients over the entire study period (1184) was recorded in Kosovo and Metohija, which accounted for 78% of the total number of patients. The maximum incidence rate in Kosovo and Metohija was 12 per 100 000 in 1991. In Vojvodina, the first autochthonous human cases of brucellosis were recorded in 1999, and 101 affected persons were registered by the end of 2008. During the period 1994-2008, the largest number of patients in Serbia was recorded from June to September (310 of 623 cases, 50%). The disease was most prevalent among people aged 30-49 years, accounting for 81 of 177 (46%) of the cases in Serbia from 1999 to 2008.

Conclusion

Brucellosis has been a significant public health concern in Serbia. This problem may be solved by joint efforts of all relevant factors, first of all human and veterinary medical services.Brucellosis is still a significant infectious disease. It primarily affects domestic animals, but humans are often infected due to direct contact with animals or ingestion of contaminated dairy products. The disease is spread all over the world with about 500 000 new human cases occurring annually (1). Human brucellosis is more prevalent in western parts of Asia, India, the Middle East, southern Europe, and Latin American countries (1). It mostly occurs in rural and nomadic communities where people live close to animals. Worldwide, reported incidence of human brucellosis in endemic disease areas varies widely, from <0.01 to >200 cases per 100 000. In Europe, brucellosis affects mainly the Mediterranean countries, but the epidemiology of this infection has changed over the past decade due to various sanitary, socioeconomic, and political factors, and international travel (1). The low incidence rate reported in known brucellosis-endemic areas may reflect absent or deficient surveillance and reporting systems (2).Many countries in the world, especially those with significantly developed small ruminant and cattle breeding sectors, are concerned about the spread of the disease. Large losses in livestock, long-term treatment of infected people, and the costs of brucellosis control and eradication are some of the reasons why the disease is a drain on the economy.In the former Yugoslavia, brucellosis was first recorded in Istria and near the Slovenian coast in 1947 but a few years later it was eliminated (3). In 1978, it appeared in Macedonia (4), where an epidemic broke out in 1980. Since no adequate action for elimination and eradication was taken, a rapid increase in the number of human cases emerged in the former Yugoslavia. Since then, brucellosis has become a significant concern in the country. By the end of the 1990s, brucellosis was reported throughout Macedonia, Kosovo and Metohija, and the southern part of central Serbia.The aim of this study was to determine the frequency and distribution of human brucellosis cases in Serbia from 1980 to 2008 and the most important factors affecting its emergence and spread.     

Levels of multiple proteins in gingival crevicular fluid and intra-amniotic complications in women with preterm prelabor rupture of membranes

Objective: The primary aim of this study was to identify the association between the local inflammatory response in gingival crevicular fluid measured by the levels of multiple proteins and maternal and intra-amniotic inflammatory responses measured by maternal serum C-reactive protein (CRP) and amniotic fluid interleukin (IL)-6 concentrations, respectively, in women with preterm prelabor rupture of membranes (PPROM).

Methods: A prospective study was performed in which 78 women with singleton pregnancies complicated by PPROM between 24?+?0 and 36?+?6 weeks of gestation were included. Transabdominal amniocenteses were performed at the time of admission. A bedside assessment of amniotic fluid IL-6 was performed. Maternal serum CRP concentration was also measured at the time of admission. Gingival crevicular fluid was collected from the pocket of the selected tooth (the tooth with the deepest pocket) using standard sterile paper strips within 72?h after admission. Twenty-six proteins in the gingival crevicular fluid were assessed by multiplex the Meso-Scale technology.

Results: No correlations between the levels of proteins in the gingival crevicular fluid and maternal serum CRP and amniotic fluid IL-6 concentrations were found, except for a weak positive correlation between granulocyte macrophage colony-stimulating factor and CRP.

Conclusions: The local inflammatory response in the gingival crevicular fluid is not related to the maternal and intra-amniotic inflammatory responses in women with PPROM.     

Urinary iodine concentrations in mothers and their term newborns in country with sufficient iodine supply

Objective: The main aim of the study was to evaluate maternal and newborn urinary iodine concentrations according to the usage of iodine supplementation during pregnancy.

Methods: Thirty-seven women with singleton uncomplicated pregnancies and their newborns were included in this study. Maternal urine samples were obtained at the time of delivery and on the third day after delivery. Newborn urine samples were obtained on the third day after delivery. Urinary iodine concentrations were determined by the alkaline ashing of urine specimens followed by the Sandell–Kolthoff reaction using brucine as a colorimetric marker.

Result: The overall rate of the usage of iodine supplementation during pregnancy was 54% (20/37). Women who used the iodine supplementation during the pregnancy did not have different urinary iodine concentrations neither at the time of delivery (p?=?0.23), nor on the third day after delivery (p?=?0.65) in comparison to women without extra iodine supplementation. Newborns from pregnancies with regular iodine supplementation had higher urine iodine concentrations on the third day after delivery (p?=?0.02). When women were split into several subgroups based on the daily dosage of iodine supplementation (200, 150, and 50?μg daily and without iodine supplementation), no differences were found in maternal urine iodine concentrations at the time of delivery (p?=?0.51) and on the third day after delivery (p?=?0.63). Different levels were found in newborn urine iodine concentrations among the subgroups of newborns from pregnancies with different daily doses of iodine supplementation and from pregnancies without iodine supplementation during pregnancy (p?=?0.05).

Conclusions: Iodine supplementation during pregnancy affects newborn urine concentrations but not maternal urine concentrations.