Comparison of existing disease activity indices in the follow-up of patients with Beh?et’s disease

The objective of this study was to determine the concordance between the Iranian Behçet’s disease dynamic activity measure (IBDDAM) or the Behçet’s disease current activity form (BDCAF) and expert physician global assessment (PGA) in the evaluation of disease activity changes in Behçet’s disease (BD). In a prospective study, 117 consecutive patients with BD were evaluated in their two consecutive follow-up visits by IBDDAM and BDCAF. The change in disease activity was determined (increased, unchanged or decreased) according to the PGA. We used receiver operating characteristic (ROC) curve to determine an appropriate cutoff point for disease activity change. Comparison was made by Stata and kappa analysis. Comparing the area under the ROC curve showed a significant difference between IBDDAM and BDCAF (p < 0.03). The difference was more significant between nonocular IBDDAM and BDCAF (p < 0.002). Better concordance was also observed for IBDDAM (nonocular and total) with PGA than BDCAF. The difference was not significant for ocular IBDDAM. The best cutoff point for nonocular IBDDAM was 0.45, for ocular IBDDAM was 3.5, and for BDCAF was 1 point. IBDDAM was the preferred method for the evaluation of disease activity change in patients with BD (without ocular involvement) considering a change of at least 0.45.     

Randomized,single‐blind,trial of sertraline and buspirone for treatment of elderly patients with generalized anxiety disorder

Aim: Generalized anxiety disorder (GAD) in elderly people is common, but few systematic studies regarding the best treatments have been performed. The aim of the present study was to evaluate the efficacy and safety of sertraline and buspirone in the treatment of elderly patients with GAD. Methods: Based on selection criteria, 46 patients were recruited who met DSM‐IV criteria for GAD. Patients were randomly assigned to sertraline (50–100 mg/day) or buspirone (10–15 mg/day) for 8 weeks in a single‐blind trial. The primary outcome measure used in the present study was the Hamilton Rating Scale for Anxiety (HRSA). Results: Both sertraline and buspirone had significant anxiolytic efficacy. A steady decrease in the total HRSA scores for both groups was observed throughout the study period. After 2 and 4 weeks, buspirone was found to be significantly superior to sertraline (P < 0.001), but at the end of study period this difference did not reach statistical significance (P = 0.16). The mean HRSA score after 8 weeks significantly decreased in subjects treated with sertraline (P < 0.001), and buspirone (P < 0.001). No clinically adverse events or changes in laboratory test results were observed during the study period. Conclusion: Both sertraline and buspirone appear to be efficacious and well tolerated in the treatment of GAD in elderly patients. Further studies with larger sample size, evaluating the effect of medical illness, cognitive impairment, depression, and combined therapy with support and psychotherapy are needed.     

Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique

Study ObjectiveTo compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique.DesignA prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2).SettingFive University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco).PatientsTwenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination.InterventionsMeasurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids.Measurements and Main ResultsEligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements.ConclusionSurgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.     

Obesity,a challenge in the management of inflammatory bowel diseases

Immunologic Research - Obesity, a morbid condition snowballing in the world, may cause many health issues in healthy and ill people. Many disorders are known to be influenced by obesity, mainly in...     

Calcium silicate cement interface with restorative materials through layering after different time intervals

Odontology - The aim was to evaluate the interfacial characteristics of Biodentine, CEM Cement, and ProRoot MTA when restored with different final restorative materials after different time...     

Depression in patients with pemphigus: Is it a major concern?

It is suggested that some dermatological diseases due to their chronicity, impact on the body image, unlikelihood of complete recovery and frequent recurrences are one of the major predisposing factors towards depression. Therefore, we aimed to evaluate the rate and level of depression among pemphigus vulgaris and pemphigus foliaceus patients, two of the most common causes of hospitalization in dermatology units. This research was conducted on 55 patients with active pemphigus vulgaris and pemphigus foliaceus referring to pemphigus clinics or admitted as inpatients to the dermatology ward of Qaem and Imam Reza hospitals, Mashhad, Iran, from April 2008 to September 2009. The research tool was the Beck Depression Inventory. Collected data was analyzed by χ²‐test Student's t‐test. Twenty‐six (47.3%) patients were female and 29 (52.7%) were male. The mean age was 42.34 ± 18.98 years. The prevalence rate of clinical depression was 28% in pemphigus vulgaris and 20% in pemphigus foliaceus cases. Depression prevalence showed no significant difference between these two groups (P = 0.873). In conclusion, pemphigus patients are at risk for mild depression.     

Effect of Acid Etching Procedures on the Compressive Strength of 4 Calcium Silicate–based Endodontic Cements

Introduction

The purpose of this study was to evaluate the effect of acid etching on the compressive strength of 4 calcium silicate–based cements.

Methods

One gram of each corresponding powder of ProRoot MTA (Dentsply Tulsa Dental, Johnson City, TN), MTA Angelus (Angelus, Londrina, PR, Brazil), and CEM cement (BioniqueDent, Tehran, Iran) and a 0.33-g aliquot of liquid were placed in a plastic mixing capsule that was then mechanically mixed for 30 seconds at 4500 rpm in an amalgamator. For the preparation of Biodentine (Septodont, Saint Maur-des-Fossés, France), the liquid provided was added to the powder within the plastic capsule supplied by the manufacturer and then mechanically mixed for 30 seconds at 4500 rpm using the amalgamator. The resulting slurries were then placed incrementally into 40 cylindrical molds to give a total of 160 specimens that were incubated at 37°C for a week. Twenty specimens of each material were then subjected to the acid etch procedure. The compressive strength of the samples was then calculated in megapascals using a universal testing machine. The results were then subjected to 2-way analysis of variance analysis of variance followed by the Tukey post hoc test.

Results

The application of acid etch significantly reduced (P < .0001) the compressive strength of Angelus MTA and CEM cement; however, it did not reduce the compressive strength of ProRoot MTA or Biodentine. Regardless of the acid etch application, Biodentine showed significantly higher compressive strength values than the other materials (P < .0001), whereas CEM cement had the lowest compressive strength values. There was no significant difference between CEM cement and MTA Angelus. The compressive strength of ProRoot MTA was significantly lower (P < .0001) than Biodentine but significantly higher (P < .0001) than MTA Angelus and CEM cement in both the test and control groups.

Conclusions

When the application of acid etchants is required, Biodentine and ProRoot MTA seem to be better options than MTA Angelus or CEM cement.     

Bonding to caries affected dentine

Objectives

Dentine replacement materials are often placed over caries affected dentine (CAD). The aim of this study was to compare the bonding characteristics and interactions of selected hydraulic calcium silicate-based dentine replacement materials to CAD and sound dentine.