Endodontic surgery using 2 different magnification devices: preliminary results of a randomized controlled study.

PURPOSE: The introduction of microsurgical instruments and magnification devices has brought advantages in root-end management and the application of root-end filling materials. The main purpose of this prospective clinical study was to monitor the outcome of ultrasonic root-end preparation using magnification loupes or an endoscope. Tooth location and the presence of post restoration were also examined as potentially affecting the outcome. MATERIALS AND METHODS: Teeth treated surgically showed a periradicular lesion of strictly endodontic origin. A total of 59 patients were included in the study, according to specific selection criteria. Following the reflection of a full mucoperiosteal tissue flap, residual soft tissues were curetted, root ends were resected, and root-end cavities were prepared ultrasonically with a zirconium nitrate tip, and zinc oxide EBA-reinforced cement root-end fillings were placed. Thirty-two root-end management procedures were performed using magnification loupes and 39 using an endoscope. All cases followed for a period of 1 year were classified into 3 groups (success, uncertain healing, and failure) according to radiographic and clinical criteria. RESULTS: Of the 71 teeth evaluated at 1-year follow-up, 67 teeth (92.95%) successfully healed, 3 teeth had uncertain healing, and 2 failed. In the group using endoscopy, 94.9% of successful healing was achieved, while for the other group, 90.6% was recorded. We found no statistically significant differences in treatment results related to the arch (P = .20), post restoration (P = .21), or type of magnification device (P = .08). CONCLUSIONS: In the present study, adherence to a strict endodontic surgical protocol and the use of modern surgical endodontic procedures, together with visual magnifications, resulted in an overall high success rate.     

A treadmill test of sprint running

Anaerobic power is characterized by a high degree of specificity regarding both the recruited muscles as well as the recruitment pattern. The popular Wingate Anaerobic Test (WAnT) is a cycling test that does not satisfy the need for a running-specific anaerobic test. We describe such a test, using a novel type of a commercially available treadmill (BRL 1800, Gymrol, France). The ergometer is equipped with a torque motor to neutralize the frictional resistance of the treadmill belt, and a hip-belt harness connected to a horizontal rod. Force applied to the harness is monitored by a strain gauge mounted on the rod, while vertical movement is monitored by a potentiometer at the posterior fixed end of the rod. These, in conjunction with the treadmill belt speed, enable the computation of horizontal and vertical power as well as the combined total output. Power is calculated both as 'peak' power (highest 2.5 s segment) and 'mean' power (20 s duration). Preliminary results of young athletes were generally consistent with the expected age-related changes in anaerobic power. Values obtained on the anaerobic treadmill were always higher than the corresponding WAnT values previously obtained in comparable age groups. The higher values were probably due to the larger muscle mass involved and the shorter peak and mean power durations (2.5 and 20 s versus 5 and 30 s in the WAnT, respectively). This test should enable not only running-specific anaerobic power monitoring but also the characterization of the relationship between the horizontal and vertical components of that power.     

Uncovering psychiatric test information with graphical techniques of Exploratory Data Analysis.

This article illustrates how Exploratory Data Analysis (EDA) can complement conventional statistical methods in evaluating psychiatric tests. Using one recent EDA computer program, we evaluated the ability of repeated psychiatric screening tests (the General Health Questionnaire [GHQ]) to predict medical and psychiatric service use in a Health Maintenance Organization (HMO), the Harvard Community Health Plan (HCHP). Using a stratified random sample of 244 new HCHP enrollees and viewing three-dimensional graphs of their data from multiple perspectives, we found two subpopulations: low GHQ scorers, for whom the tests did not predict service use; and high scorers, for whom they did. Surprisingly, improving scores forecast increased use and chronically high scores predicted diminished use. Using another stratified random sample of 213 new HCHP enrollees, and with scatterplot matrices from another interactive computer program, we found that high and unchanging GHQ scores forecast HMO dropout. We examine possible interpretations--for example, that chronically distressed patients may become immobilized, diminish service use, and ultimately leave the HMO. We also explain how EDA methods may help uncover elusive results in other data (e.g., mental health outcomes).     

Responsiveness and calibration of the general well-being adjustment scale in patients with hypertension

We examined the discriminant ability and responsiveness of the General Well-Being Adjustment Scale in patients enrolled in a randomized clinical trial of antihypertensive therapy. We also tried to translate the effects of physical symptoms on general well-being. This secondary analysis used demographic, clinical, physical symptom, and general well-being data for 545 white, male hypertensive patients. General well-being was measured by the General Well-Being Adjustment Scale (GWB) collected on 2 occasions over 8 weeks of treatment. Patients with any one of 14 physical symptoms or problems, compared to those without symptoms, had lower GWB scores (p < 0.003 to p < 0.0001). Decreases of 2.83–8.76 points in GWB scores were observed in patients developing physical symptoms over the 8 week study period (p < 0.05 to p < 0.0001). These effects were demonstrated in patients developing cold sensitivity, sexual problems, chest pain, shortness of breath, loss of taste, nausea, hot or cold spells, numbness and tingling, dry mouth, blurred vision, and dizziness. We conclude that the GWB is responsive to clinically meaningful changes in symptoms and may provide a more complete evaluation of the effects of medical treatment. The GWB is a valid and responsive measure of health status outcomes in the evaluation of antihypertensive treatment.     

A method of simultaneous dual-radionuclide cardiac imaging with technetium 99m and thallium 201. I: Analysis of interradionuclide crossover and validation in phantoms

Background  

Simultaneous dual-radionuclide technetium 99m/thallium 201 scintigraphy can potentially produce perfectly aligned stress and rest images in less time than conventional protocols. However, interradionuclide crossover limits diagnostic accuracy. Accordingly, we evaluated^99mTc and²⁰¹Tl crossover in line and heart phantoms.