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BACKGROUND: Microcrystalline cellulose (MCC) is a novel organic material developed by one of the authors in this study. When MCC was incorporated with conventionally available denture base resin, it demonstrated increased flexural strength and flexural modulus. However, it was speculated that because the material is organic, it can promote the growth of Candida. The purpose of this study is to evaluate the Candida albicans biofilm formation on polymethyl methacrylate (PMMA) denture base resin incorporated with MCC. MATERIALS AND METHODS: MCC is an organic material extracted from the oil palm empty fruit bunch (OPEFB). The growth of C. albicans and biofilm formation in three test groups were compared by biofilm assay and imaging techniques like microscopy (by safranin staining) and scanning electron microscopy. The three test groups were comprised of MCC-reinforced PMMA containing OPEFB fibers of 50-micrometer thickness at 5% weight reinforcement, conventionally and commercially available heat cure PMMA, and an empty well to assess any discrepancies from the environment. RESULTS: The test groups showed increased biofilm formation by C. albicans compared to commercially and conventionally available heat cure PMMA. Reinforcement with MCC showed higher biofilm formation of 1.43 times higher compared to conventional PMMA. Biofilms formed by Candida albicans on MCC-reinforced PMMA appeared heterogeneous in structure, comprised of yeast cells and hyphae, surrounded by a higher density of polysaccharide extracellular matrix material compared to that of conventionally available heat cure PMMA. CONCLUSION: Biofilm formation is increased in denture base resin incorporated with MCC. More investigation is warranted to study the antifungal efficacy of the addition of antifungal agents to the reinforced denture base resin.
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In the field of removable prosthodontics, computer-aided design and computer-aided manufacturing (CAD/CAM) have become widely recognized. The traditional method, which uses heat-polymerized resins for injection or compression molding, necessitates up to five patient visits and laborious laboratory processes. A digital workflow combined with a CAD/CAM methodology can provide prompt prosthesis delivery for patients with time constraints. This article's goal is to outline the steps and the limitations in the fabrication of digital dentures as well as the challenges, limitations, and solutions developed while developing a clinical workflow for the rehabilitation of completely edentulous patients with the CAD/CAM System.
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Purpose: To prepare a module on 'Digital Dentistry", which can be used to sensitize dental undergraduate students during their final year Prosthodontics curriculum. Methods: Ethical approval (167/Ethics/2022) was taken from the Institution before starting the study. Need assessment was achieved using focused group discussion (Online Zoom meeting) of various stakeholders of the Department of Prosthodontics of the institution. A preliminary module content was prepared in google questionnaire form after thorough literature review by the research team and final content was developed using modified Delphi technique in 3 questionnaire rounds with the help of 27 experts. Result: Thematic analysis of Need Assessment focussed group discussion led to the emergence of both theoretical and practical aspect of learning in digital dentistry. The final module was developed with the process followed in modified Delphi technique. Conclusion: Within the limitations of the study the module of Digital dentistry was developed which can be implemented in most of the dental institutes depending on the resources and available infrastructure.
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Aim: The fabrication of an accurate prosthesis depends mainly on precise recording of the maxillo-mandibular relationship of the patient and transferring it to the articulator. BDIMPRESS is a new thermoplastic material that has been proposed as a potential material to be used as an inter-occlusal registration, but there has been no literature evidence regarding its application as a bite registration. The main purpose of this study is to evaluate and compare the dimensional stability, detail reproduction, and compressive resistance of new interocclusal recording material with other two commonly used materials. Settings and Design: In Vitro Comparative study. Materials and Methods: The study was conducted according to ADA Specification standards of testing for dimensional stability, detail reproduction and compressive resistance. Specimens were prepared for three different materials (Thermoplastic resin, Polyvinyl siloxane, and Bis- acrylic) with 12 samples each. Statistical Analysis Used: One way ANOVA was done for statistical analysis. Results: Polyvinyl siloxane material was dimensionally stable (mean at 1 hr: 24.928 mm; 24 hrs: 24.919 mm & 48 hrs: 24.912 mm) followed by Bis- acrylic material (mean at 1 hr: 24.851 mm; 24 hrs: 24.825 mm & 48 hrs: 24.815 mm). On one way ANOVA, strong significance was observed between groups (P = 0.00). Thermoplastic resin showed higher amount of detail reproduction with 10 (out of 12 samples) samples showing satisfactory results. While bis- acrylic material showed the least compressive resistance (Strain %: 0.484%; Displacement- 0.0990mm). One-way ANOVA showed presence of significance between the groups (P = 0.024). Conclusion: Polyvinyl siloxane showed superior dimensional stability, thermoplastic resin showed better detail reproduction and bis- acrylic showed high resistance to compression over other materials.
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Polivinil , Siloxanas , Humanos , Registro da Relação Maxilomandibular/métodos , Resinas Vegetais , Polimetil MetacrilatoRESUMO
Aim: Hypersensitivity is the most common clinical problem which is encountered by most of dental patients undergoing a vital tooth preparation for a fixed crown prosthesis. The aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation. Settings and Design: This study is a randomized control trial performed on 119 teeth of 68 patients who are in need of fixed prosthesis treatment. Materials and Methods: After a thorough clinical examination, patients were allocated into any of the randomly assigned four groups (Control, silver diamine fluoride, potassium nitrate, and glutaraldehyde) and the level of hypersensitivity was measured by blasting air on the surface of tooth at five different intervals (before preparation, after preparation, after application of desensitizers, before cementation and after a follow up period of about 30 days) and is graded using Schiff 's cumulative hypersensitivity index. Statistical Analysis Used: Kruskal wallis test is used to compare the rate of sensitivity between the 4 groups. Friedman and Wilcoxon test is used to compare the rate of sensitivity at 5 different intervals. Results: All the desensitizers used in this study reduced the level of hypersensitivity. Among which, silver diamine fluoride was found to be more effective after application, before cementation, and after a follow up period of about 30 days followed by GLUMA and potassium nitrate. Conclusion: The results of this study suggest that silver diamine fluoride was found to be more effective after application, before cementation of the definitive prosthesis and after a follow up period of 30 days.
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Sensibilidade da Dentina , Humanos , Sensibilidade da Dentina/prevenção & controle , Sensibilidade da Dentina/diagnóstico , Sensibilidade da Dentina/tratamento farmacológico , Compostos de Potássio/uso terapêutico , Preparo do DenteRESUMO
The loss of teeth affects the aesthetics, function (mastication and speech), confidence, mental state, and the overall quality of life of an individual. Aggressive periodontitis is a destructive condition leading to loss of teeth at early stages of the disease. Individuals facing this inevitable condition of losing the teeth and replacement at a younger age experience formidable psychological distress. The prosthodontic procedure when supported with psychotherapeutic interventions can support the patient in accepting the prognosis and treatment. We report the scenario where psychological intervention was provided in a systematic manner adopting the SPIKES protocol for a 42-year-old man presenting with aggressive periodontitis.
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The current pandemic due to the fast spreading of SARS-CoV-2 infection has caused severe impairment in health, social, economic, scientific, and medical sectors across the globe. Owing to the not so well understood mechanism of disease pathogenesis in terms of variations in immune responses, there remains obscure why some of the patients who are infected by the novel SARS-CoV-2 develop an unpredictable clinical course that rapidly causes severe and deadly complications/manifestations. Currently, several assays are available for the confirmation of SARS-CoV-2 infection at the point of care. However, none of these assays can predict the severity of the COVID-19 disease. Thus, the identification of a prognostic biomarker that forecasts the condition of SARS-CoV-2 patients to develop a severe form of the disease could enable the clinicians for more efficient patient triage and treatment. In this regard, the present review describes the role of selected biomolecules that are crucially involved in the immune-pathogenesis of SARS-CoV-2 infection such as hyper-immune responsiveness, bradykinin storm and vascular leakage assuming these may serve as an effective prognostic biomarker in COVID-19 to understand the outcome of the disease. Based on the review, we also propose the development of a cost-effective SERS-based prognostic biosensor for the detection and quantification of biomolecules for use as a point-of-care system during a disease outbreak.
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COVID-19 , SARS-CoV-2 , Biomarcadores , Humanos , PandemiasRESUMO
The key challenges to any health care setup during emergency situations, such as that of the COVID-19 pandemic would be to rapidly address hospital preparedness and response tailored to the local population, societal influences, political factors within the existing infrastructure, and workforce. Second, to adopt and moderate policies, standard operating procedures (SOPs) and guidelines issued by national and international agencies, such as WHO, CDC, and the Indian Council for Medical Research (ICMR) were tailor-made to the local conditions of the hospital and community. In this publication, we have discussed the challenges and experiences in preparation and responses to the ongoing COVID-19 pandemic at a tertiary teaching hospital situated at a suburban locale in a small union territory. Puducherry is located in the South Eastern Coromandel Coast of India. The core processes, such as hospital preparedness, adoption, and amendments to SOPs based on dynamic changes in guidelines released by the central and local government, training given to health care workers, setting up the in-house diagnostic facility, surge capacity, management of supplies during the lockdown, infection prevention, and control and patient care are discussed. We have also reinforced our experiences in translating COVID-related opportunities for research and innovation in the form of awards and research proposals for the faculty and students of our institute. The lessons learned in terms of strength and limitations on the ground level of public health during this process is worth sharing as it would provide guidance in preparing the health care setups for pre- and post-pandemic.
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COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Hospitais de Ensino , Humanos , Índia/epidemiologia , SARS-CoV-2 , Atenção Terciária à SaúdeRESUMO
BACKGROUND: The DREAMtherapy (Dual REctal Angiogenesis MEK inhibition radiotherapy) trial is a novel intertwined design whereby two tyrosine kinase inhibitors (cediranib and selumetinib) were independently evaluated with rectal chemoradiotherapy (CRT) in an efficient manner to limit the extended follow-up period often required for radiotherapy studies. PATIENTS AND METHODS: Cediranib or selumetinib was commenced 10 days before and then continued with RT (45 Gy/25#/5 wks) and capecitabine (825 mg/m2 twice a day (BID)). When three patients in the cediranib 15-mg once daily (OD) cohort were in the surveillance period, recruitment to the selumetinib cohort commenced. This alternating schedule was followed throughout. Three cediranib (15, 20 and 30 mg OD) and two selumetinib cohorts (50 and 75 mg BID) were planned. Circulating and imaging biomarkers of inflammation/angiogenesis were evaluated. RESULTS: In case of cediranib, dose-limiting diarrhoea, fatigue and skin reactions were seen in the 30-mg OD cohort, and therefore, 20 mg OD was defined as the maximum tolerated dose. Forty-one percent patients achieved a clinical or pathological complete response (7/17), and 53% (9/17) had an excellent clinical or pathological response (ECPR). Significantly lower level of pre-treatment plasma tumour necrosis factor alpha (TNFα) was found in patients who had an ECPR. In case of selumetinib, the 50-mg BID cohort was poorly tolerated (fatigue and diarrhoea); a reduced dose cohort of 75-mg OD was opened which was also poorly tolerated, and further recruitment was abandoned. Of the 12 patients treated, two attained an ECPR (17%). CONCLUSIONS: This novel intertwined trial design is an effective way to independently investigate multiple agents with radiotherapy. The combination of cediranib with CRT was well tolerated with encouraging efficacy. TNFα emerged as a potential predictive biomarker of response and warrants further evaluation.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia/métodos , Neoplasias Retais/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Benzimidazóis/administração & dosagem , Biomarcadores Tumorais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Prognóstico , Quinazolinas/administração & dosagem , Neoplasias Retais/patologia , Distribuição TecidualRESUMO
BACKGROUND: Establishment of optimal vertical dimension of occlusion (VDO) for prosthetic patients, either complete denture or fixed full mouth rehabilitation, is a vital step to discern at a pleasing esthetics and harmonious function. None of the experiments in the literature studied the hopeful inheritance of the VDO from a parent to offspring. PURPOSE: The aim of this study was to establish the dominant mode of inheritance of VDO from parents to offspring using cephalometric landmarks. MATERIALS AND METHODS: Following the inclusion criteria, 20 families were selected and explained about the study design. Individual cephalograph of father, mother, and offspring were traced out of bony landmarks. The reference planes were delineated for the measurements from maxillary incisal (I) tip and mesio-palatal cusp tip of maxillary first molar (M) to palatal (PP) and inter-foramina (IFP) planes. RESULTS: In all the distances measured, there exists a statistically significant difference between both father and son and mother and son. For the measured IPP, MPP, and IIFP distances, there is no statistically significant difference existed between father and daughter. However, in MIFP distance, there is a significant difference between father and daughter. Except for the IIFP distance between mother and daughter (P = 0.08), in all other measured distances, there existed a statistically significant difference. CONCLUSION: There is no dominant mode of inheritance from the parent to the son with respect to the measured parameters. Inheritance was observed to be stronger between father and daughter than between mother and daughter.
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This paper proposes a fuzzy logic based new control scheme for the Unified Power Quality Conditioner (UPQC) for minimizing the voltage sag and total harmonic distortion in the distribution system consequently to improve the power quality. UPQC is a recent power electronic module which guarantees better power quality mitigation as it has both series-active and shunt-active power filters (APFs). The fuzzy logic controller has recently attracted a great deal of attention and possesses conceptually the quality of the simplicity by tackling complex systems with vagueness and ambiguity. In this research, the fuzzy logic controller is utilized for the generation of reference signal controlling the UPQC. To enable this, a systematic approach for creating the fuzzy membership functions is carried out by using an ant colony optimization technique for optimal fuzzy logic control. An exhaustive simulation study using the MATLAB/Simulink is carried out to investigate and demonstrate the performance of the proposed fuzzy logic controller and the simulation results are compared with the PI controller in terms of its performance in improving the power quality by minimizing the voltage sag and total harmonic distortion.
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AIMS AND OBJECTIVES: One of the factor which affects the strength of the tooth restored with core material is the property of the material. In clinical situation all such restored teeth are protected by crowns. This study evaluated the strength of different core materials on a compromised tooth structure after restoration with a crown. MATERIALS AND METHODS: Seventy extracted intact human premolars were collected and mounted within a mould using auto-polymerizing resin. The teeth were divided in-to four groups - A, B, C and D. Each group contained 20 teeth except group A with 10 teeth. All the teeth were prepared for full veneer cast crown. Except for the teeth in group: A) extensive class-I cavities were prepared in the teeth of all the groups and restored with; B) composite resin, 3M EPSE Filtek P60; C) Silver reinforced glass ionomer, SHOFU Hi Dense XP and; (D) Resin reinforced glass ionomer, GC Gold Label light cure GIC. All the teeth were restored with cast-metal alloy and exposed to 1.2 million cycles of cyclic loading in a chewing simulator. Subsequently, the teeth that survived were loaded till fracture in the universal testing machine. Fracture loads and type of fractures were recorded. RESULTS: All the specimens survived cyclic loading. The mean fracture strength of the silver reinforced glass ionomer was greater with and without crown (p<0.001). Statistical analysis for the mean fracture load of each specimen showed significant difference between the groups. CONCLUSION: Under the condition of this study, core materials when restored with artificial crown had a significant increase in fracture resistance.
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BACKGROUND: High intra-hepatic fat (IHF) content is associated with insulin resistance, visceral adiposity, and increased morbidity and mortality following liver resection. However, in clinical practice, IHF is assessed indirectly by pre-operative imaging [for example, chemical-shift magnetic resonance (CS-MR)]. We used the opportunity in patients undergoing liver resection to quantify IHF by digital histology (D-IHF) and relate this to CT-derived anthropometrics, insulin-related serum biomarkers, and IHF estimated by CS-MR. METHODS: A reproducible method for quantification of D-IHF using 7 histology slides (inter- and intra-rater concordance: 0.97 and 0.98) was developed. In 35 patients undergoing resection for colorectal cancer metastases, we measured: CT-derived subcutaneous and visceral adipose tissue volumes, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), fasting serum adiponectin, leptin and fetuin-A. We estimated relative IHF using CS-MR and developed prediction models for IHF using a factor-clustered approach. RESULTS: The multivariate linear regression models showed that D-IHF was best predicted by HOMA-IR (Beta coefficient(per doubling): 2.410, 95% CI: 1.093, 5.313) and adiponectin (ß(per doubling): 0.197, 95% CI: 0.058, 0.667), but not by anthropometrics. MR-derived IHF correlated with D-IHF (rho: 0.626; p = 0.0001), but levels of agreement deviated in upper range values (CS-MR over-estimated IHF: regression versus zero, p = 0.009); this could be adjusted for by a correction factor (CF: 0.7816). CONCLUSIONS: Our findings show IHF is associated with measures of insulin resistance, but not measures of visceral adiposity. CS-MR over-estimated IHF in the upper range. Larger studies are indicated to test whether a correction of imaging-derived IHF estimates is valid.
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Hepatectomia , Resistência à Insulina , Gordura Intra-Abdominal/diagnóstico por imagem , Fígado/diagnóstico por imagem , Obesidade/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Feminino , Seguimentos , Humanos , Fígado/cirurgia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Obesidade/epidemiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Taxa de Sobrevida/tendências , Reino Unido/epidemiologiaRESUMO
INTRODUCTION: The difficulty in reproducing accurate angle of condylar guidance in semi-adjustable articulators. PURPOSE: The purpose of this study was to determine the correlation between the angle of horizontal condylar inclination obtained on a semi-adjustable articulator and the corresponding angle traced on a temporomandibular joint (TMJ) radiograph in completely edentulous subject. MATERIALS AND METHODS: The horizontal condylar inclination angle was obtained in a semi-adjustable articulator by means of height tracer (extra oral tracing device) and interocclusal records to program the articulator in 21 subjects. TMJ radiograph were recorded by the same operator with same orthopantomogram (OPG) machine (planmeca). Tracings of inclines of articular eminence on the radiograph were compared with the angle obtained on a semi-adjustable articulator. Each measurement was made using manual methods of measuring angle. The results were subjected to the Pearson correlation statistical analysis (α =0.01). RESULTS: The outline of the articular eminence in a TMJ tomogram radiographic image was identified and traced. A significant correlation was found between the horizontal condylar inclination on a semi-adjustable and the corresponding TMJ tomogram radiographic image for both right (R = 0.789; P = 0.001) and left (i = 0.747; P = 0.004) sides. CONCLUSION: The articular eminence traced on a TMJ tomogram image represents the horizontal condylar inclination with a mean difference of 5° in 21 subjects evaluated.
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Focal incidental renal lesions are commonly encountered on positron emission tomography (PET)/computed tomography (CT) imaging. The vast majority of these lesions are benign. However, the interpretation of renal lesions can be problematic if the imaging criteria of simple cysts are not met. Limited literature exists on the characterisation of renal masses with metabolic imaging. The purpose of this article is to focus on the imaging features of benign and malignant renal masses with PET/CT. The lesions discussed include renal cyst, angiomyolipoma, oncocytoma, renal cell carcinoma, renal metastases and other infiltrating neoplastic processes affecting the kidney. Both the anatomical and metabolic features which characterise these benign and malignant entities are described. We emphasise the importance of viewing the CT component to identify the typical morphological features and discuss how to best use hybrid imaging for management of renal lesions. Metabolic imaging has a promising role in the imaging of renal lesions and can help prevent unnecessary biopsies and ensure optimal management of suspicious lesions.
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Carcinoma de Células Renais/diagnóstico , Fluordesoxiglucose F18 , Neoplasias Renais/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X/métodos , Adenoma Oxífilo/diagnóstico , Angiomiolipoma/diagnóstico , Cistos/diagnóstico , Humanos , Achados Incidentais , Rim/diagnóstico por imagem , Nefropatias/diagnóstico , Leucemia/diagnóstico , Linfoma/diagnósticoRESUMO
Gastrointestinal stromal tumours (GISTs) have distinct biological and treatment-related features posing challenges for imaging. In this review the importance of imaging in different stages of patient management is discussed, emphasizing the unique characteristics of GISTs. Potential pitfalls of using the standard response criteria on conventional imaging have been highlighted. These include size measurements, which may not adequately reflect response rates, pseudo-progression, and spurious new lesions. Furthermore, the role of positron emission tomography/computed tomography (PET/CT) in early response evaluation and in the detection of both primary and acquired resistance is explored. The current role and future directions of use of both conventional and metabolic imaging in the management of GISTs are discussed.
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Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Progressão da Doença , Fluordesoxiglucose F18 , Tumores do Estroma Gastrointestinal/patologia , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons/tendências , Compostos Radiofarmacêuticos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/tendênciasRESUMO
Cutaneous malignant melanoma is one of the most lethal and widely metastasising cancers with unpredictable pathways of spread. One of the most significant factors associated with survival in patients who have distant metastases is the number of organ sites involved. Innovative treatment options are now available for metastatic melanoma, and diagnostic imaging has become crucial for accurate staging and restaging of disease. The objective of this pictorial review is to illustrate the imaging spectrum of metastatic cutaneous malignant melanoma including both the common and the relatively ubiquitous sites of involvement using both conventional cross-sectional and metabolic molecular imaging. This review also highlights the importance of combining multiple imaging methods for accurate staging of metastatic melanoma.
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Aumento da Imagem/métodos , Melanoma/diagnóstico , Melanoma/secundário , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/secundário , Técnica de Subtração , HumanosAssuntos
Carcinoma Neuroendócrino/secundário , Neoplasias do Ceco/secundário , Neoplasias do Colo do Útero/terapia , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/terapia , Neoplasias do Ceco/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
This study is aimed at identifying a suitable organic thiol for CdS by studying its structural, thermal and photophysical characteristics. Quantum dots of the II-VI semiconductor CdS, in the size regime of 2.0-3.3 nm, were prepared in the cubic phase by a wet chemical method. Five organic thiols were used for capping: (i) 1,4-dithiothreitol (DTT), (ii) 2-mercaptoethanol (ME), (iii) cysteine (Cys), (iv) methionine (Meth), and (v) glutathione (GSH). Structural studies were carried out by x-ray diffraction (XRD) and transmission electron microscopy (TEM), which revealed the cubic phase of CdS. Optical properties were studied by FT-IR, UV-visible and fluorescence spectroscopic techniques, and a comparison was made between uncapped and capped CdS. FT-IR studies suggested two different bonding mechanisms of the capping agents with the CdS. GSH and DTT capped CdS showed significant decrease in absorption wavelengths. An increase in band gap was observed in two cases: when (i) capped and (ii) decreased in size. The band gap was increased from 2.50 eV for the uncapped to 2.77 eV for the DTT capped CdS. DTT was found to be the best capping agent for CdS among these five organic thiols in two aspects: (i) yielding lower grain size in cubic phase, and (ii) good fluorescence properties with efficient quenching of the surface traps.
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AIM: The objective of this study was to determine whether dopamine transporter (DAT) scintigraphy influences the management of movement disorders in clinically indeterminate cases. MATERIALS AND METHODS: Seventeen patients (ten women, seven men; age range 44-84 years) with a presumptive diagnosis of Parkinson's disease (PD) were referred for single-photon emission computed tomography (SPECT) scintigraphy using [(123)I]ioflupane between November 2002 and August 2003. The scintigraphic results, clinical diagnosis, and management intentions pre- and post-examination were recorded. RESULTS: Of the 17 patients who underwent scintigraphy, two patients on neuroleptic medication exhibited features of PD; one had an abnormal scintigraphic examination that confirmed PD, the other had a negative examination, confirming drug-induced parkinsonism, and these were managed accordingly. Of the other cases, the results of 10 examinations were compatible with PD. Five were reported as being normal, the final diagnoses in this group included: cerebrovascular disease (CVD); early Alzheimer's; provisional clinical diagnosis of generalized movement disorder; and possible Wilson's disease. One patient was felt to have a parkinsonian syndrome despite the normal result (this patient had a positive apomorphine test). CONCLUSION: This series illustrates the value of DAT scintigraphy in the management of clinically indeterminate movement disorders at a tertiary referral centre arguing for its use in the initial diagnostic process. However, it is clear that the use of DAT scintigraphy poses significant resource implications. Further evidence should clarify the exact role of DAT scintigraphy in clinically indeterminate cases.