Microleakage in alloy-glass ionomer lined amalgam restorations after thermocycling

Marginal microleakage was measured around amalgam restorations lined with alloy-glass ionomer cement and coated with a glass ionomer varnish. Preparations were made in 48 human extracted mandibular molar teeth. Alloy-glass ionomer liners and varnishes were placed into selected preparations. Tytin amalgam was inserted into all of the teeth and left unburnished and unpolished. Half of the total samples were thermocycled for 5 days and the remainder were left in deionized water. The teeth were immersed in a 0.5% methylene blue dye and sectioned vertically with a diamond saw. Microleakage was scored visually at x100 magnification, and the data were analysed using the Mann-Whitney U-test (P less than or equal to 0.05). Thermocycling did not have a significant effect on microleakage, except when both an alloy-glass ionomer liner and varnish were used. Overall, the use of an alloy-glass ionomer liner made the most significant difference in reducing microleakage.     

Magnetic Resonance Imaging and Signal-Averaged Electrocardiography in Patients with Repetitive Monomorphic Ventricular Tachycardia and Otherwise Normal Electrocardiogram

Early or localized forms of arrhythmogenic right ventricular dysplasia (ARVD) have been proposed as the arrhythmogenic substrate of repetitive monomorphic ventricular tachycardia (RMVT) originating in the right ventricular outflow tract in patients without any underlying cardiac abnormality on clinical examination and echocardiography. To further examine this hypothesis, magnetic resonance imaging (MRI) and signal-averaged electrocardiography (SAECG) were performed on 23 patients with RMVT and normal 12-lead standard ECG of conducted sinus beats. MRI was performed using ECG-gated turbo spin-echo images of the heart in order to detect signs of early or localized forms of ARVD, such as localized wall thickness reductions, signal intensity increase indicating adipose tissue infiltrates, and regional bulgings or aneurysms. MRI was normal in 22 (96%) of 23 study patients. In the remaining patient (4%), MRI demonstrated signal intensity increase in the intraventricular septum but not in the right ventricular outflow tract. Time-domain analysis of the SAECG was normal in 21 (91 %) of 23 patients and revealed ventricular late potentials in 2 study patients (9%). Frequency-domain analysis of the SAECG was normal in 22 (96%) of 23 patients and revealed ventricular late potentials in one study patient (4 %). We conclude that normal MRI findings of the heart and absence of ventricular late potentials in the SAECC in most patients with RMVT and otherwise normal ECG do not support the hypothesis that early or localized forms of ARVD create the arrhythmogenic substrate in the majority of these patients.     

Biochemical characterization of variants of the Ehlers-Danlos syndrome type VI

Three variants of the Ehlers-Danlos syndrome type VI are described: a severe form with skeletal, dermal and ocular manifestations associated with a lack of hydroxylysine in skin and little lysyl hydroxylase activity in cultured fibroblasts; a similarly affected form with a nearly normal hydroxylsine content in skin, but with only little enzyme activity in cultured fibroblasts; and a predominantly ocular form with no biochemical abnormality in skin or cultured skin fibroblasts. The activities of prolyl 4-hydroxylase and the two hydroxylysyl glycosyltransferases were normal in all cases, and the failure to find lysyl hydroxylase activity was not due to altered solubility characteristics of the enzyme or to the presence of an enzyme inhibitor. The collagen produced in cell culture, however, was hydroxylated to a markedly higher extent than that found in skin. In both the mutant and control cells hydroxylation of lysyl residues was less sensitive to ascorbate deficiency than that of prolyl residues.     

The Lipoid Pneumonia of Blackfat Tobacco Smokers in Guyana

In Guyana, a large number of patients have been diagnosed ashaving a diffuse pulmonary fibrosis of unknown aetiology, characterizedby typical radiological appearances, dyspnoea, cough, weightloss, and eventually pulmonary heart disease. Investigation of 56 patients showed that all had smoked a tobaccoknown as ‘blackfat’ or ‘black tobacco’.In a community survey 20·4 per cent of the populationaged 55 years and over smoked this tobacco. 19·6 percent of the blackfat smokers but no non-blackfat smokers showeddefinite radiological evidence of pulmonary fibrosis. Smokerswith, but not those without fibrosis, had severe airways obstruction. Immunological studies made it unlikely that an extrinsic allergicalveolitis had caused the radiological changes. Three post-mortem open-lung specimens were obtained and in eachcase the histology showed a diffuse interstitial fibrosis andvasculitis associated with large deposits of lipid surroundedby black amorphous material. Blackfat is a tobacco leaf to which mineral oil and vaselineare added for flavouring and as humectants. The presence ofoil in the tobacco, and the post-mortem findings of oil in thelungs, indicate that the diffuse pulmonary fibrosis can be moreaccurately described as a lipoid pneumonia caused by the inhalationof mineral oils when blackfat is smoked. The potential health hazards of many tobacco additives, particularlyoils, employed by the tobacco industry should be recognized.A similar type of disease as that found in Guyana may be presentin other parts of the world where blackfat, or related tobaccos,are smoked.     

The relationship between structural empowerment and psychological empowerment for nurses: a systematic review

wagner j.i.j., cummings g., smith d.l., olson j., anderson l. & warren s. (2010) Journal of Nursing Management 18 , 448–462
The relationship between structural empowerment and psychological empowerment for nurses: a systematic review Aim To describe the findings of a systematic review examining the relationship between structural empowerment and psychological empowerment for registered nurses (RNs). Background Workplace empowerment research reveals a link between empowerment and positive work behaviours and attitudes. Research demonstrating the essential relationship between structural empowerment and psychological empowerment will provide direction for future interventions aimed at the development of a strong and effective health care sector. Methods Published research articles examining structural empowerment and psychological empowerment for nurses were selected from computerized databases and selected websites. Data extraction and methodological quality assessment were completed for the included research articles. Results Ten papers representing six studies reveal significant associations between structural empowerment and psychological empowerment for RNs. Implications for nursing management Creation of an environment that provides structural empowerment is an important organizational strategy that contributes to RNs’ psychological empowerment and ultimately leads to positive work behaviours and attitudes. Critical structural components of an empowered workplace can contribute to a healthy, productive and innovative RN workforce with increased job satisfaction and retention.     

Trends in dental caries in 1‐ to 4‐year‐old children in a Brazilian city between 1997 and 2008

International Journal of Paediatric Dentistry 2010; 20: 125–131 Objective. The objective of this study was to assess trends in dental caries prevalence and severity in 1‐ to 4 year‐old children living in Diadema, Brazil, over a 11‐year period, from 1997 to 2008. Methods. In 2008 an epidemiological oral health survey was carried out and the results on caries were compared with five cross‐sectional studies carried out using the same methods and criteria in 1997, 1999, 2002, 2004, and 2006 in the same city. In all surveys, children were randomly selected from those attending a National Day of Children’s Vaccination. Calibrated dentists carried out the clinical examination using WHO criteria. Caries trends were assessed by time‐lag analysis. In total, 5348 children were examined in the six surveys over the 11‐year period. Results. Time‐lag analysis showed a marked and statistically significant decline in the prevalence (χ² for trends: P < 0.001) and severity (Kruskal–Wallis: P < 0.001) of dental caries between 1997 and 2008. Conclusion. In conclusion, the last cohort of preschool children in Diadema had much better dental caries status than those in 1997.     

Induction of Life-threatening Ventricular Tachyarrhythmias by Serial Inappropriate AICD-pulsing in the Hyperthyroid State

A patient treated with the automatic implantable defibrillator exhibited serial inappropriate shacks during amiodarone-induced hyperthyroidism. This case illustrates the elective effectiveness of the AICD in the termination of ventricular tachyarrhythmias as well as its potency to induce them by serial erroneous interventions on supraventricular tachyarrhythmias so that external life-saving efforts are needed.