3D evaluation of composite resin restoration at practical training using swept-source optical coherence tomography (SS-OCT)

Internal adaptation of restorations to the cavity wall is one of the important topics in clinical dentistry. The purpose of this study was to investigate the possibility to utilize the non-invasive tomographic imaging system for teaching the importance of cavity adaptation at dental school pre-clinical training. Swept-source optical coherence tomography (SS-OCT) was used for detection of marginal and internal defects in the composite resin restorations as an educational device. Class 1 and Class 2 composite restorations to melamine resin molar tooth were assigned to the students and prepared during the skill test, and SS-OCT imaging was performed to evaluate students' works. SS-OCT could detect the internal gaps and voids within the restorations in tomography images synthesized based on the backscatter signal from within the restoration. It is suggested that the SS-OCT is promising diagnostic modality, as well as educational imaging device for the detection of internal gaps in adhesive restorations.     

Pre-etching vs. grinding in promotion of adhesion to intact enamel using self-etch adhesives

This study was aimed to determine the effectiveness of grinding and pre-etching in promotion of adhesion to human intact enamel using the self-etch adhesive (SEA) Adper Easy Bond (3M ESPE). Etch-and-rinse adhesive Adper Single Bond (3M ESPE) served as control. Composite cylinders (AP-X Kuraray) were built and after 24 h micro-shear bond strengths (MSBS) were measured. Bonding interfaces were evaluated under scanning electron microscope (SEM). For evaluation of average roughness (Ra) and morphological analysis, treated enamel surfaces were observed under SEM and confocal laser scanning microscope (CLSM) with 3D surface profiling. Highest bond strengths were obtained by pre-etching and grinding showed a less significant role. Phosphoric acid (PA) etching compare to grinding created significantly rougher surface (Ra: 0.72 and 0.43 μm respectively). Therefore, this study recommends pre-etching the intact enamel prior to application of the adhesive instead of grinding.     

Raloxifene adjunctive therapy for postmenopausal women suffering from chronic schizophrenia: a randomized double-blind and placebo controlled trial

Background

Cumulative evidence from epidemiological, preclinical and clinical studies suggests estrogens may have psychoprotective effects in schizophrenic patients. Selective Estrogen Receptor Modulators could have therapeutic benefits in schizophrenia for both sexes without being hazardous to gynecological tissues or having feminizing effects. Few studies have been conducted regarding the effects of raloxifene on postmenopausal women suffering from schizophrenia. We conducted this placebo-controlled trial to compare the add-on effect of raloxifene to risperidone versus risperidone with placebo.

Methods

This was an 8-week, parallel-group, placebo-controlled trial undertaken at two universities affiliated psychiatric Hospitals in Iran. Forty-six postmenopausal women with the definite diagnosis of schizophrenia were enrolled in the study. Patients received risperidone (6 mg/day in 3 divided doses) combined with either placebo (N = 23) or 120 mg/day of raloxifene (N = 23) for 8 weeks. Patients were assessed by a psychiatrist at baseline and at 2 and 8 weeks after the start of medical therapy. Efficacy was defined as the change from baseline to endpoint in score on Positive and Negative Syndrome Scale (PANSS).

Results

For PANSS scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.77, p = 0.18]. For positive subscale scores, there was marginal significant interaction between intervention type and time [F (2, 47) = 2.93, p = 0.06] and there was substantial main effect for time [F (2, 47) = 24.39, p = 0.001] within both groups showing reduction in positive subscale scores across the three time periods. In addition, the main effect comparing two types of intervention was significant [F (1, 48) = 3.78, p = 0.02]. On the other hand, for negative subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.43, p = 0.23]. For general subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 0.03, p = 0.86].

Conclusions

According to our findings, raloxifene as an adjunctive treatment to risperidone was only superior in improvement of positive symptoms and it was not effective in treating negative and general psychopathology symptoms.

Trial registration

The trial was registered at the Iranian registry of clinical trials: IRCT201205131556N42     

A rare case of solitary colonic fibromatosis mimicking a cystic tumour

Mesenteric fibromatosis or intrabdominal desmoid tumour is a rare proliferative disease that frequently involves the gastrointestinal tract. These tumours account for less than 3% of all tumours among soft tissue neoplasms. Most such lesions are large (10cm or more in diameter) at the time of the excision. Although grossly well-circumscribed, they lesions typically infiltrate the surrounding soft tissues including the bowel wall. The case described here concerns a 62-year-old woman with a partly cystic mesenteric fibromatosis incorporating the large bowel wall, which degenerated into an abscess. A right colectomy was undertaken, and the sample was sent for histological examination. Based on the morphological and immunohistochemical findings, a diagnosis of abdominal fibromatosis was established. The surgical margins were free of disease, and the examined lymph nodes showed cortical hyperplasia and histiocytosis of the lymph sinuses. The patient recovered from surgery with no complications; her fever subsided, and she was discharged from hospital 12 days later. Surgery is the primary therapy for extra-abdominal and intra-abdominal desmoid tumours. Considering the unique biology of desmoid tumours, conservative treatment strategies merit further investigation in both unresectable primary disease and resectable disease. The optimal criteria for choosing surgical or non-surgical treatment still need further evaluation with randomized controlled studies.     

Enterotoxin gene profiles among Staphylococcus aureus isolated from raw milk

Milk is considered a nutritious food because it contains several important nutrients including proteins and vitamins. Conversely, it can be a vehicle for several pathogenic bacteria such as Staphylococcus aureus. This study aimed to analyze the frequency of genes encoding the nine Staphylococcal enterotoxins (SEs) and enterotoxin gene profiles in S. aureus isolates derived from raw bovine milk. A total of 52 S. aureus isolates were obtained from 246 milk samples of 246 dairy cows from eight different farms in Qom, Iran. On the basis of cultural and biochemical properties as well as by amplification of the 23S rRNA specific to S. aureus, all isolates could be identified as S. aureus. Of the 52 isolates studied, 80.7% were positive for one or more genes encoding the enterotoxins, and 12 different genotypes were identified. The gene encoding for enterotoxin A (Sea) was the most frequent (16 isolates, 30.7%), followed by Seb (14 isolates, 26.9%) and Sed (8 isolates, 15.37%). Among the genes encoding the other enterotoxins, Seg and Seh were the most frequently observed (8 isolates each, 15.38%), followed by Sej (6 isolates, 11.5%) and Sei (1 isolates, 3.84%). With the recent identification of new SEs, the frequency of enterotoxigenic strains has increased, suggesting that the pathogenic potential of Staphylococci may be higher than previously thought. These results of enterotoxin genes positivity of milk-derived Staphylococci constitute a potential risk for consumers’ health.Key Words: Staphylococcus aureus, Staphylococcal enterotoxins, Raw milk, PCR     

Graft failure and recurrence of symptoms after coronary artery bypass grafting

Objectives. Saphenous vein grafts (SVGs) most often used in coronary artery bypass grafting (CABG) are subject to graft disease and have poor long-term patency, however the clinical implication of this is not completely known. We aim to assess the influence of graft failure on the postoperative recurrence of coronary artery disease (CAD) symptoms in relation to the contribution from progression of atherosclerosis in the native coronary vessels. Design. Within the SWEDEHEART registry we identified 46,663 CABG cases between 2001 and 2015 with patient age 40–80 years where single internal mammary artery (IMA) anastomosis (IMA), single IMA with one (1SVG) or multiple SVG anastomoses (2+ SVG) had been performed. Clinical characteristics as well as mortality and postoperative incidence of coronary angiography were recorded and multivariable adjusted hazard ratios were calculated. Indications for the angiographies and occurrence of graft failure were also registered. Results. The adjusted hazard ratio for death was similar for the three groups. The adjusted hazard ratio for being submitted to angiography as compared to 2+ SVG was (95% CI) 1.24 (1.06–1.46) for IMA and 1.21 (1.15–1.28) for 1SVG. Failed grafts were found at the first postoperative angiography with preceding CAD symptoms in 21.4% of patients in the IMA group, 41.6% in the 1SVG group and 61.1% in the 2+ SVG group. Conclusions. A substantial amount of angiographies occur in patients without any graft failure and a large part of postoperative recurrence of CAD symptoms and are likely attributed to IMA failure or progression of atherosclerosis in the native coronary arteries.