Individual Lithium Disilicate Crowns in a Full‐Arch,Implant‐Supported Rehabilitation: A Clinical Report

This clinical report presents the clinical outcome of a maxillary full‐arch implant‐supported fixed rehabilitation with lithium disilicate reinforced glass ceramic monolithic crowns opposing a mandibular metal‐acrylic implant‐supported fixed rehabilitation in a 62‐year‐old woman. Eight implants were successfully placed (four maxillary, four mandibular), and no complications occurred in the postoperative or maintenance periods. Six months after delivery, the maxillary and mandibular prostheses were found to be clinically, biologically, and mechanically stable, and the patient was satisfied with the esthetics and her ability to function. Although the present indications for the use of lithium disilicate are still restricted to tooth‐borne restorations, it is possible to successfully rehabilitate edentulous patients through implant‐supported fixed prostheses using lithium disilicate reinforced glass ceramic monolithic crowns.     

Dental student perceptions of the elderly: Measuring negative perceptions with projective tests

Stereotypic perceptions of older patients have been documented to influence relationships with older adults. To assess the impact of age and dentate status on dental student treatment decisions and perceptions of patients, we designed a qualitative study utilizing projective tests. Seventy first- and third-year dental students wrote stories about two cue statements, one describing a young patient and one an older patient. Each cue varied by dentate status, having either a complete dentition or seven remaining teeth. The stories were evaluated for negativity and for general themes of stereotypic statements. The results indicated that while patient age did not influence the dental care prescribed, a high level of negativity existed toward old patients in general (45%, older patient with teeth; 47%, older patient with seven teeth) and toward a younger patient with few remaining teeth (57.6%). The level of negativity expressed toward the young patient with full dentition (27%) may suggest a patient gender bias among dental students in this sample .     

Comparison of central venous saturation by standard ABG machine versus co-oximeter: Is 18 carat as good as the 24 carat gold standard?

Aims:

Aggressive therapy aimed at desired end-points of Early Goal Directed Therapy (EGDT) is the cornerstone of septic shock management. A key endpoint that improves outcomes is achieving central venous saturation (ScvO₂) >70%. The gold standard to measure ScvO₂ is by a co-oximeter (co-ox).

Settings and Design:

This prospective, observational study from a multidisciplinary pediatric intensive care unit (PICU) was conducted to assess the validity of ScvO₂ levels by standard ABG (stand ABG) machine in comparison with co-ox in conditions that shifted the oxygen dissociation curve (ODC) to the right or left in sick children and controls.

Materials and Methods:

Data from paired samples was tested for correlation coefficient for pH, paCO₂, paO₂, and ScvO₂. Tests for correlation (Pearson''s coefficient) and agreement (Bland–Altman analysis) were performed on ScvO₂ values obtained in various subgroups. Sensitivity and specificity for ScvO₂ values determined by standard ABG machine versus co-ox were calculated in reference to EGDT endpoints.

Results:

A total of 141 paired samples were collected from 82 children. Despite a statistically significant difference in the pH and ScvO₂, there was good linear correlation between these parameters. Limits of agreement between ScvO₂ measured by standard ABG machine and co-ox by Bland–Altman gave 2.3% bias with 95% CI of -24.2% to 19.5%. Sensitivity and specificity of standard ABG machine in detecting low ScvO₂ in shock was 84.21% and 93.18% respectively, while it was false positive in 4 samples.

Conclusions:

The less expensive standard ABG machine showed satisfactory correlation with gold standard co-ox over a range of patient conditions; however, the wide range for agreement was of concern and it performed particularly poorly in anemic patients.     

High affinity electrophilic and photoactivatable covalent endocannabinoid probes for the CB1 receptor

We have designed and synthesized the first two high affinity covalent anandamide probes for the CB1 receptor by introducing either an electrophilic isothiocyanato or a photoactivatable azido group at the terminal carbon of the arachidonic acid moiety. The headgroup of these anandamide analogues was optimized by using a cyclopropylamide substituent to impart optimal CB1 affinity. Both 20-isothiocyanato-eicosa-5,8,11,14-tetraenoic acid cyclopropylamide (1, AM3677) and 20-azido-eicosa-5,8,11,14-tetraenoic acid cyclopropylamide (2, AM3661) exhibited high selectivities for the CB1 receptor with K(i) values of 1.3 and 0.9 nM, respectively. Using suitable experimental conditions, both ligands were shown to covalently label the CB1 receptor with high efficiency. These two covalent probes for the endocannabinoid CB1 binding site open the door for exploring the ligand binding motifs involved in the activation of the CB1 receptor by its endogenous ligand, anandamide.