Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.

In the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM), we relied on expert clinician diagnoses to enroll patients from 7 specialty clinics in the United States in order to perform a systematic collection of data on measures of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS). Healthy persons and those with other illnesses that share some features with ME/CFS were enrolled in comparison groups. The major objectives were to: 1) use standardized questionnaires to measure illness domains of ME/CFS and to evaluate patient heterogeneity overall and between clinics; 2) describe the course of illness, identify the measures that best correlate with meaningful clinical differences, and assess the performances of questionnaires as patient/person-reported outcome measures; 3) describe prescribed medications, orders for laboratory and other tests, and management tools used by expert clinicians to care for persons with ME/CFS; 4) collect biospecimens for future hypothesis testing and for evaluation of morning cortisol profiles; and 5) identify measures that best distinguish persons with ME/CFS from those in the comparison groups and detect subgroups of persons with ME/CFS who may have different underlying causes. Enrollment began in 2012 and is planned to continue in multiple stages through 2017. We present the MCAM methods in detail, along with an initial description of the 471 patients with ME/CFS who were enrolled in stage 1.

New supplemental landmark for the greater palatine foramen as found deep to soft tissue: application for the greater palatine nerve block.

PURPOSE: Many researches have investigated the morphology of the greater palatine foramina using dry skulls and cone-beam computed tomography. In most studies, some structures in the hard tissue have been measured and statistically analyzed. However, none of the studies has analyzed this foramen in regard to its location with overlying soft tissues, which is so clinically relevant. Therefore, this study was performed to provide the knowledge about relationship between the greater palatine foramen and foveola palatina for a better understanding of dental procedures such as greater palatine nerve block. METHODS: Thirty sides, from fifteen fresh cadaveric heads, were used in this study. The specimens were derived from eight males and seven females. A 27-gauge needle was inserted into the fossa, which was palpated at the edge of a dental mirror at a 45° angle to the occlusal plane and parallel to the sagittal plane. The anteroposterior distance, which was parallel to the midline, between the penetration site and foveola palatina was measured. RESULTS: All the penetrations advanced to the greater palatine foramen. The distances ranged from 2.0 to 8.3 mm on right sides, and 1.1 to 8.2 mm on left sides, respectively. CONCLUSION: The results of this study could help dentists identify the correct location of the greater palatine foramen with a supplemental landmark.

Push-out bond strength of gutta-percha with a new bioceramic sealer in the presence or absence of smear layer.

The purpose of this study was to compare the bond strength of a new bioceramic sealer (EndoSequence BC Sealer) and AH Plus in the presence or absence of smear layer. Extracted single-rooted human teeth were prepared and randomly divided into four groups. In groups 1 and 3, the root canals were finally irrigated with 5.25% NaOCl and smear layer was not removed, but in groups 2 and 4, the root canals were finally irrigated with 17% EDTA followed by 5.25% NaOCl in order to remove the smear layer. In groups 1 and 2, the root canals were obturated with gutta-percha/AH Plus, but in groups 3 and 4, obturation was performed with gutta-percha/EndoSequence BC Sealer. Push-out bond strength and failure modes were evaluated. The bond strength of gutta-percha/AH Plus and gutta-percha/EndoSequence BC Sealer was not significantly different (P = 0.89). The presence or absence of smear layer did not significantly affect the bond strength of filling materials (P = 0.69). The mode of bond failure was mainly cohesive for all groups. In conclusion, the bond strength of the new bioceramic sealer was equal to that of AH Plus with or without the smear layer.