End-Stage Renal Disease and Mortality Outcomes Across Different Glomerulonephropathies in a Large Diverse US Population

Objective

To compare renal function decline, incident end-stage renal disease (ESRD), and mortality among patients with 5 common glomerular diseases in a large diverse population.

Echocardiographic segmental approach to complex congenital heart disease in the neonate

A segmental echocardiographic approach to complex congenital heart disease in the neonate allows accurate and precise assessment of intracardiac, as well as extracardiac, anomalies. Determination of abnormalities of atrial and visceral situs, as well as the cardiac situs, provides a fundamental background for the echocardiographic examination. Subsequently, a segmental approach allows precise determination of abnormalities of atrioventricular and ventricular great artery connections. Recent echocardiographic advances including high-frequency (7.5 and 10 MHz) and color flow imaging capabilities have dramatically improved our ability to accurately define abnormalities of anatomy and connection in the neonate. These advances now have expanded our previous echocardiographic criteria and allow application of the echocardiographic segmental approach to characterize complex congenital heart disease in the neonate.     

Focal and segmental glomerulosclerosis in murine models: a histological and ultrastructural characterization with immunohistochemistry correlation of glomerular CD44 and WT1 expression

Aim: Focal segmental glomerulosclerosis (FSGS) is a common progressive chronic renal disease. Podocyte injury and loss are the postulated pivotal events that trigger FSGS. In this study, the authors aim to examine the evolution of FSGS in murine models histologically, ultrastructurally and immunohistochemically with special emphasis on podocytes and parietal epithelial cells (PECs). Material and methods: FSGS resembling primary FSGS in humans was initiated in Wistar rats using intravenous Adriamycin injections. Blood and urine analysis were performed at 0, 8, and 12 weeks. Both the control kidneys and the test kidneys were harvested at 8 and 12 weeks, examined histologically and ultrastructurally and the findings correlated with the glomerular expression of immunostains specific for podocytes (WT-1) and for activated PECs (CD44). Results: FSGS developed in both 8 and 12 weeks test groups showing progressive proteinuria, podocytopathy and segmental glomerular scarring. There was a decrease in the glomerular expression of WT-1 with a concurrent increase in the glomerular expression of CD44, indicating podocyte loss with synchronous increase in activated PECs. The evolving FSGS correlated negatively with podocytes and positively with activated PECs. Conclusion: Our study shows that with podocyte injury there is podocyte effacement and loss, proteinuria, glomerular segmental adhesion and scarring, all culminating in FSGS. In addition, there is activation, hyperplasia and hypertrophy of PECs. This demonstrates that both podocyte loss and PEC activation promote FSGS. Our findings are consistent with recent investigations. More studies are required to further understand the role of these cells in the evolution of FSGS and subsequently introduce new targeted treatment modalities.     

Concentration Fluctuations and Segmental Dynamics in Weakly Dynamic Asymmetric Blends in the Presence of Surface‐Functionalized Multiwall Carbon Nanotubes

Surface‐functionalized multiwall carbon nanotubes (MWCNTs) are incorporated in poly(methyl methacrylate)/styrene acrylonitrile (PMMA/SAN) blends and the pretransitional regime is monitored in situ by melt rheology and dielectric spectroscopy. As the blends exhibit weak dynamic asymmetry, the obvious transitions in the melt rheology due to thermal concentration fluctuations are weak. This is further supported by the weak temperature dependence of the correlation length (ξ ≈ 10–12 Å) in the vicinity of demixing. Hence, various rheological techniques in both the temperature and frequency domains are adopted to evaluate the demixing temperature. The spinodal decomposition temperature is manifested in an increase in the miscibility gap in the presence of MWCNTs. Furthermore, MWCNTs lead to a significant slowdown of the segmental dynamics in the blends. Thermally induced phase separation in the PMMA/SAN blends lead to selective localization of MWCNTs in the PMMA phase. This further manifests itself in a significant increase in the melt conductivity.

     

Structural integrity of extracted teeth restored using three different post-and-core systems: An in vitro comparative study

AimThe objective of the study was to assess the in vitro fracture resistance of endodontically treated teeth restored using different post-and-core materials.Materials and methodsExtracted human mandibular premolars (n = 36) were extracted teeth and equally distributed into four (4) treatment groups: cast metal post-and-core, milled zirconia post-and-core, pre-fabricated post with composite resin core and control group. These samples were then each subjected to the load to fracture test using a universal testing machine. Fracture resistance data were compared among groups by analysis of variance and Fisher’s exact test.ResultsThe highest mean fracture resistance value was observed in the zirconia post-and-core treatment group (1567.26 ± 317.66 N), followed by the cast metal (1355.92 ± 621.56 N) and lastly the pre-fabricated post with composite resin core (725.67 ± 251.05 N) treatment group. Differences among groups were not statistically significantly different (P = 3.77).ConclusionEndodontically treated mandibular premolars with a zirconia post-and-core system exhibited the highest robustness against structural failure based on its mean fracture resistance value. In addition, extracted teeth restored with cast post-and-core resisted a greater stress load than those restored with fiber-reinforced posts. Zirconia showed a more favorable fracture mode than the other restorations.     

基于增材制造的口腔全瓷修复成型工艺研究进展与展望

全瓷修复相比金属和烤瓷修复具有明显优势,临床应用广泛。以等材制造和减材制造为代表,全瓷固定义齿的传统成型工艺发展较为成熟,但仍有许多不足之处。随着科技的快速进步,增材制造技术的出现正在改变口腔修复领域的传统制造模式,已有很多学者尝试将其用于加工全瓷固定义齿。本文将简要阐述全瓷修复成型工艺的技术现状和增材制造技术的原理及优势,着重论述基于口腔修复用陶瓷材料的增材制造技术分类及工艺探索的相关进展。     

Belastungsabhängige Segmentstabilität im Funktions-MRT bei Nachwuchsathleten mit Spondylolisthesis mit und ohne Rückenschmerzen

BackgroundSegmental spinal instability is assumed to be a source of low back pain in adolescent athletes (AA). It is unclear, if imaging techniques allow for differentiation of load-dependent segment stability in AA with spondylolisthesis in dependence of pain.Material and MethodsTwenty-two AA (14.1±1.6 years, 164±9 cm, 59±13 kg) with spondylolisthesis L5/S1 were included. Following an orthopedic examination with history of pain (in everyday life [PE]; during sports [PS]) functional MRI was performed (1. Upright-loaded; 2. Supine-unloaded). Anterior translation [mm], lordosis angle [°] and „lumbar disc degeneration-Index (LDDG [1–5]) were determined within MRI. Absolute values and differences (loaded - unloaded condition) are shown by the factor pain (α=0.05).ResultsEight AA reported PE, 10 PS and 10 AA were pain-free (PF). Lordosis angle and anterior translation were higher during loaded condition (60±10° to 46±11; 7.2±2.0mm° to 5.8±1.9 mm). AA with pain showed loaded/unloaded smaller differences of lordosis angles (PE/NP: 13.8±6.3°/14.9±4.6; PS/PF: 13.3±5.1/15.1±5.1; p>0.05) and higher differences of anterior translation (PE: 1.7±1.3 mm/1.2±1.3; PS: 2.2±1.3/0.7±0.8; p=0.002) compared to PF. LDDG was higher for AA with PS than in PF (PS/PF: Median 2 (1.25;3)/ 3.5 (2;4)).ConclusionsAA with spondylolisthesis and PS show lower lordosis and higher segmental anterior translation as well as disc degeneration. Low back pain during sports in AA with spondylolisthesis might be seen as a predictor for higher segmental spinal instability.Level of evidence2 (Cohort study)     

Flexible Removable Partial Denture Prosthesis: A Survey of Dentists’ Attitudes and Knowledge in Greece and Croatia

Purpose

The aim of this study was to investigate through a questionnaire the knowledge, attitudes and possible differences in the use of flexible RPDPs among dentists in Greece and Croatia.

Material and Methods

A questionnaire of 16 questions was originally created in English, translated into Greek and Croatian language following a two way translation and tested for apprehension, precision, clarity and homogeneity by a number of native English speaking Greek and Croatian dentists. Following the necessary corrections, the questionnaires replicated in two online surveys and their addresses with an informed consent were sent by emails to nearly 4000 dentists in each country to participate. Collected data were analyzed by chi-square tests at a= .05 level of significance.

Results

378 dentists from Greece and 304 from Croatia participated in the study. 137(36.2%) dentists from Greece and 56(18.4%) from Croatia provided flexible RPDPs to their patients. Statistical analysis for all providers indicated no significant difference between genders (P>.05), significant differences between age groups (P<.01), years of practice (P<.05), specialization (P <.001), and instruction on flexible prostheses (P <.001). The analysis between the two countries showed differences for gender and age groups (P<.01) but no differences between experienced, specialized or instructed groups (P >.05).

Conclusion

The survey indicated differences between the two countries in the percentages of dentists using, selecting and providing RPDPs for their patients. Practitioners’ age, years in practice and instruction were associated with the provision of the prostheses, while comfort, esthetics and cost were the reasons for deciding to use the flexible RPDPs.

Conclusion

Although dentists are not educated in their schools about flexible RPDPs, almost a third of them offer this treatment to their patients. Long term success of these devices depends on clinical education, more experience and definitely more research.