Asymptomatic Uterine Torsion in a Pregnant Woman

Some degree rotation of the gravid uterus in the third trimester of pregnancy is not an abnormal finding. However, extreme uterine torsion of 180° around its cervical junction is a relatively rare event in obstetrical practice. We report here such a case that detected at laparotomy for an emergency cesarean section due to rapture of amniotic membrane.     

Acid and Microhardness of Mineral Trioxide Aggregate and Mineral Trioxide Aggregate–like Materials

Introduction

The aim of this study was to compare the surface microhardness of BioAggregate, ProRoot MTA, and CEM Cement when exposed to an acidic environment or phosphate-buffered saline (PBS) as a synthetic tissue fluid.

Methods

Ninety cylindrical molds made of polymethyl methacrylate with an internal diameter of 6 mm and height of 4 mm (according to ASTM E384 standard for microhardness tests) were fabricated and filled with BioAggregate (n = 30), tooth-colored ProRoot MTA (n = 30), or CEM Cement (n = 30). Each group was then divided into 3 subgroups of 10 specimens consisting of those exposed to distilled water, exposed to PBS (pH = 7.4), or exposed to butyric acid (pH = 5.4). After 1 week the Vickers surface microhardness test was performed. Statistical analysis included 2-way analysis of variance, followed by post hoc Dunnett T3 in cases with lack of homoscedasticity and Tukey honestly significant difference in cases with homoscedasticity.

Results

The indentations obtained from the CEM Cement specimens exposed to an acidic pH were not readable because of incomplete setting. There was a significant difference between the microhardness of the materials regardless of the environmental conditions (P < .001). In all the environmental conditions, MTA had significantly higher and CEM Cement had significantly lower microhardness values (P < .001). All experimental cements had significantly higher microhardness values when exposed to PBS (P < .001) and had significantly lower microhardness values when exposed to butyric acid (P < .001).

Conclusions

The surface microhardness of BioAggregate, ProRoot MTA, and CEM Cement was reduced significantly by exposure to butyric acid and increased significantly by exposure to PBS. In all environmental conditions, MTA had significantly higher microhardness values.     

Spezifische physiologische und unspezifische psychische Effekte bei der Akupunkturtherapie des Reizdarmsyndroms: Ergebnisse einer randomisierten kontrollierten Studie

Background and aims

The aim was to evaluate the efficacy of acupuncture (AC) in patients with irritable bowel syndrome (IBS). We investigated psychological and neuroendocrinological parameters to meet the demands of the psychosomatic paradigm. In addition, we wanted to examine the impact of perception of bodily sensations on treatment response.

Methods

43 patients with IBS were randomly assigned to receive either AC (n = 22) or sham acupuncture (SAC) (n = 21) using the ”Streitberger needle„. Primary outcome measure was quality of life (QoL) measured with the functional digestive diseases quality of life questionnaire (FDDQL) and a general quality of life questionnaire (SF-36). QoL was measured before AC treatment (t1), after ten treatment sessions (t2) and three months after treatment (t3). Secondary outcome measures were parameters of the autonomic nervous system (ANS) which were evaluated with tilt-table manoeuvres at t1 and t2. Additionally, salivary cortisol was measured at t1 ant t2. Perception of bodily sensation was measured at t1 with the ”Perception of Bodily Sensation„ (PBS) questionnaire.

Results

QoL improved in both groups (p = 0,022). However, there were no group differences in QoL improvements between AC and SAC. Salivary cortisol decreased in both groups (F = 10,55; p = 0,006). However, the decrease was more pronounced in the AC group (F = 4,07; p = 0,033). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (group difference: F = 9,23; p = 0,005), indicating an increased parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (r² =0,40; F = 10,1; p = 0,006), but not in the SAC group. High PBS was associated with lower QoL before and after treatment (p = 0,033).

Conclusions

The psychosomatic study design made it possible to detect differentiated acupuncture effects. QoL improvement seems to be due to unspecific effects and physiological changes are likely to be induced specifically by AC. Thus, different mechanisms may be involved in sham and real-AC mediated improvements. Patients with high PBS show a more unfavourable course of treatment independently of the kind of acupuncture treatment.     

Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Clostridioides difficile is a major cause of nosocomial infectious diarrhea in hospitalized patients throughout the world. We aimed to characterize C. difficile isolates among hospitalized patients, hospital staffs, and hospital environment samples obtained in three tertiary care hospitals of Iran with regard to their molecular types between June 2016 and November 2017. The toxigenicity of C. difficile isolates was determined by toxigenic culture and multiplex‐PCR. Toxigenic C. difficile isolates collected were ribotyped using capillary gel electrophoresis‐based PCR and the database of WEBRIBO ( http://webribo.ages.at ). Of 500 clinical and non‐clinical samples, toxigenic C. difficile were identified in 35 of 250 stool samples (14%) and in 3 of 250 swabs (1.2%). The most frequently found ribotypes (RTs) were 039, AI‐12, and AI‐21 (15.8, 10.52, and 10.52% of all isolates, respectively). Further RTs were: 017, 001, AI‐3, AI‐15, AI‐18, AI‐10, AI‐4, and PR21195 (as new ribotype). The epidemic RTs (027 and 078) seen in the Europe, North America, and Asia were completely absent in this study.     

The lower incisors as a predictor for the size of unerupted canine and premolars in the Iranian ethnicity

The purpose of this study was to find the correlation coefficients between the mesiodistal widths of the permanent mandibular incisors and the permanent canine and premolars for each quadrant and establish a regression equation for prediction of the sum of canine and premolars based on the dimension of the lower incisors. 90 patients 12–20 years old (45 females and 45 males) were selected. The mesiodistal crown diameters of the permanent teeth were measured. The correlation coefficients between the permanent mandibular incisors and the permanent canine and premolars sizes varied from 0.63 to 0.8. An Iranian mixed dentition analysis based on the Tanaka and Johnston method was constructed with linear regression equations; for maxillary arch y = 6.3 + 0.65x (SEE = 0.8 mm) and for mandibular arch y = 5.1 + 0.67x (SEE = 0.8 mm). No significant sexual dimorphism was found in tooth sizes. This study revealed that Iranian population has smaller teeth than white North American. We found that prediction equations of Tanaka and Johnston or Moyers charts cannot accurately predict the size of buccal segment in Iranian population.     

Anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block using 4% articaine in mandibular premolars with symptomatic irreversible pulpitis: a randomized clinical trial

Clinical Oral Investigations - The aim of this study was to compare the onset, success rate, injection pain, and post-injection pain of mental/incisive nerve block (MINB) with that of inferior...     

Clinical characteristics of Staphylococcus epidermidis: a systematic review

Staphylococci are known as clustering Gram-positive cocci, nonmotile, non-spore forming facultatively anaerobic that classified in two main groups, coagulase-positive and coagulase-negative. Staphylococcus epidermidis with the highest percentage has the prominent role among coagulase-negative Staphylococci that is the most important reason of clinical infections. Due to various virulence factors and unique features, this microorganism is respected as a common cause of nosocomial infections. Because of potential ability in biofilm formation and colonization in different surfaces, also using of medical implant devices in immunocompromised and hospitalized patients the related infections have been increased. In recent decades the clinical importance and the emergence of methicillin-resistant Staphylococcus epidermidis strains have created many challenges in the treatment process.     

Melatonin promotes survival of nonvascularized fat grafts and enhances the viability and migration of human adipose‐derived stem cells via down‐regulation of acute inflammatory cytokines

Nonvascularized fat grafting is a valuable technique for soft tissue reconstruction but poor survival of fat in the host environment remains a problem. A process known as cell‐assisted transfer is used to enhance fat graft retention by adding stromal vascular fraction, an adipose‐derived stem cell (ASC) rich content to lipoaspirate. We have recently shown that the use of melatonin, a reactive oxygen species scavenger, protects human ASCs from hydrogen peroxide‐induced oxidative stress and cell death in vitro but its role as a pharmacological adjunct in clinical fat grafting has not been studied. Herein, the effect of melatonin was examined on human ASCs in vitro using survival and functional assays including the MTT assay, CellTox Green assay, monolayer scratch assay as well as a human cytokine chemoluminescence, and tumour necrosis factor‐α assay. Further, the effect of melatonin‐treated fat grafts was tested in vivo with a murine model. Haematoxylin and eosin staining, perilipin and CD31 immunostaining were performed with morphometric analysis of adipose tissue. The results demonstrate that, in vitro, the addition of melatonin to ASCs significantly improved their cell‐viability, promoted cell migration and preserved membrane integrity as compared to controls. In addition, it induced a potent anti‐inflammatory response by downregulating acute inflammatory cytokines particularly tumour necrosis factor‐α. For the first time, it is demonstrated in vivo that melatonin enhances fat graft volume retention by reducing inflammation and increasing the percentage of adipose volume within fat grafts with comparable volumes to that of cell‐assisted lipotransfer. Based on these novel findings, melatonin may be a useful pharmacological adjunct in clinical fat grafting.     

Tigecycline antibacterial activity,clinical effectiveness,and mechanisms and epidemiology of resistance: narrative review

European Journal of Clinical Microbiology & Infectious Diseases - Tigecycline is unique glycylcycline class of semisynthetic antimicrobial agents developed for the treatment of polymicrobial...