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BACKGROUND: MRI-derived left atrial (LA) longitudinal strain has been shown to be a marker for mitral regurgitation, but the utility of LA circumferential strain remains unclear. PURPOSE: To assess feasibility and reproducibility of LA circumferential strain, identify changes in mitral regurgitation patients compared to healthy volunteers, and determine strain's association with mitral regurgitation severity and cardiac function. STUDY TYPE: Retrospective. POPULATION: 52 mitral regurgitation patients, 12 healthy volunteers. FIELD STRENGTH/SEQUENCE: Steady-state free precession cine and 2D phase contrast sequences at 1.5T. ASSESSMENT: Peak LA circumferential strain was computed in each of three short-axis slices (superior, mid, and inferior) and longitudinal strain computed from long-axis slices using MRI feature-tracking software. Strain test-retest reproducibility was determined from two repeat studies in healthy volunteers. STATISTICAL TESTS: LA circumferential strain test-retest reproducibility was assessed by intra-class correlation coefficient (ICC). Strain was compared between cohorts using Student's t-test or Mann-Whitney U. Mitral regurgitation severity association with strain and LV function was assessed using Spearman correlation and multivariable regression. Significance was defined as P < 0.05. RESULTS: LA circumferential strain assessment was feasible in all subjects with moderate reproducibility in the superior (ICC = 0.74), mid LA (ICC = 0.71), and inferior LA (ICC = 0.63). In mitral regurgitation patients, LA circumferential strain was significantly lower in the superior (11.86% [6.5%,19.2%] vs. 18.73% ± 6.7%) and mid LA slices (18.41% ± 9.5% vs. 28.7% ± 10.4%) compared to healthy volunteers. Mitral regurgitation severity significantly associated with mid LA circumferential strain (ß = -0.03) and LAV significantly associated with superior LA circumferential strain (ß = -2.09), both independent of LA longitudinal strain and CO. DATA CONCLUSION: LA circumferential strain assessment is feasible with moderate reproducibility. Compared to healthy volunteers, patients had significantly lower LA circumferential strain. Mitral regurgitation severity and LAV were significantly associated with LA circumferential strain independent of LA longitudinal strain. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.
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Ischemia with no obstructive coronary arteries (INOCA) is a relatively newly discovered ischemic phenotype that affects patients similarly to obstructive coronary artery disease (CAD) but has a unique pathophysiology and epidemiology. Patients with INOCA present with ischemic signs and symptoms but no obstructive CAD seen on coronary CTA or invasive coronary angiography, which can assess epicardial vessels. The mechanisms of INOCA can be grouped into three endotypes: coronary microvascular dysfunction, epicardial coronary vasospasm, or a combination of both. Accurate and comprehensive assessment of both epicardial and microvascular disease in suspected cases of INOCA is crucial for providing targeted therapy and improving outcomes in this underrepresented population. This review aims to clarify the complex pathophysiology of INOCA, present an overview of invasive and non-invasive diagnostic methods, and examine contemporary approaches for coronary perfusion assessment using cardiac magnetic resonance (CMR). We also explore how recent advancements in quantitative CMR can potentially revolutionize the evaluation of suspected INOCA by offering a rapid, accurate, and non-invasive diagnostic approach, thereby reducing the alarming number of cases that go undetected.
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Enfermedad de la Arteria Coronaria , Corazón , Humanos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Espectroscopía de Resonancia Magnética , IsquemiaRESUMEN
PURPOSE: The purpose of this study was to evaluate the accuracy of four-dimensional (4D) flow MRI for direct assessment of peak velocity, flow volume, and momentum of a mitral regurgitation (MR) flow jets using an in vitro pulsatile jet flow phantom. We systematically investigated the impact of spatial resolution and quantification location along the jet on flow quantities with Doppler ultrasound as a reference for peak velocity. METHODS: Four-dimensional flow MRI data of a pulsatile jet through a circular, elliptical, and 3D-printed patient-specific MR orifice model was acquired with varying spatial resolution (1.5-5 mm isotropic voxel). Flow rate and momentum of the jet were quantified at various axial distances (x = 0-50 mm) and integrated over time to calculate Voljet and MTIjet . In vivo assessment of Voljet and MTIjet was performed on 3 MR patients. RESULTS: Peak velocities were comparable to Doppler ultrasound (3% error, 1.5 mm voxel), but underestimated with decreasing spatial resolution (-40% error, 5 mm voxel). Voljet was similar to regurgitant volume (RVol) within 5 mm, and then increased linearly with the axial distance (19%/cm) because of flow entrainment. MTIjet remained steady throughout the jet (2%/cm) as theoretically predicted. Four and 9 voxels across the jet were required to measure flow volume and momentum-time-integral within 10% error, respectively. CONCLUSION: Four-dimensional flow MRI detected accurate peak velocity, flow rate, and momentum for in vitro MR-mimicking flow jets. Spatial resolution significantly impacted flow quantitation, which otherwise followed predictions of flow entrainment and momentum conservation. This study provides important preliminary information for accurate in vivo MR assessment using 4D flow MRI.
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Enfermedades de las Válvulas Cardíacas , Insuficiencia de la Válvula Mitral , Velocidad del Flujo Sanguíneo , Humanos , Imagen por Resonancia Magnética , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Flujo Pulsátil , UltrasonografíaRESUMEN
The initial host response to fungal pathogen invasion is critical to infection establishment and outcome. However, the diversity of leukocyte-pathogen interactions is only recently being appreciated. We describe a new form of interleukocyte conidial exchange called "shuttling." In Talaromyces marneffei and Aspergillus fumigatus zebrafish in vivo infections, live imaging demonstrated conidia initially phagocytosed by neutrophils were transferred to macrophages. Shuttling is unidirectional, not a chance event, and involves alterations of phagocyte mobility, intercellular tethering, and phagosome transfer. Shuttling kinetics were fungal-species-specific, implicating a fungal determinant. ß-glucan serves as a fungal-derived signal sufficient for shuttling. Murine phagocytes also shuttled in vitro. The impact of shuttling for microbiological outcomes of in vivo infections is difficult to specifically assess experimentally, but for these two pathogens, shuttling augments initial conidial redistribution away from fungicidal neutrophils into the favorable macrophage intracellular niche. Shuttling is a frequent host-pathogen interaction contributing to fungal infection establishment patterns.
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Aspergilosis/inmunología , Interacciones Huésped-Patógeno , Macrófagos/fisiología , Neutrófilos/fisiología , beta-Glucanos/inmunología , Animales , Aspergillus fumigatus , Ratones , Fagocitosis , Fagosomas , Esporas Fúngicas , Talaromyces , Pez CebraRESUMEN
BACKGROUND AND OBJECTIVES: Low-grade appendiceal mucinous neoplasms (LAMNs) are generally treated by surgical resection, but posttreatment surveillance protocols are not well-established. The objectives of this study were to characterize posttreatment surveillance and determine the risk of recurrence following surgical resection of LAMN. METHODS: Patients who underwent surgical resection of localized LAMNs in an 11-hospital regional healthcare system from 2000 to 2019 were identified. Posttreatment surveillance regimens were characterized, and rates of disease recurrence were evaluated. RESULTS: A total of 114 patients with LAMNs were identified. T-category was pTis for 92 patients (80.7%), pT3 for 7 (6.1%), pT4a for 14 (12.3%), and pT4b for 1 (0.9%). Two patients (1.8%) had a positive resection margin. Posttreatment surveillance was performed for 39 (34.2%) patients and consisted of office visits for 32 (82%) patients, computerized tomography imaging for 30 (77%), magnetic resonance imaging for 5 (13%), colonoscopy for 15 (38%), and serum tumor marker measurement for 12 (31%). After a mean follow-up duration of 4.7 years, no patients experienced tumor recurrence. CONCLUSIONS: Posttreatment surveillance is common among patients with LAMNs. However, no patients experienced tumor recurrence, regardless of T-category or margin status, suggesting that routine surveillance following surgical resection of LAMN may be unnecessary.
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Adenocarcinoma Mucinoso/cirugía , Neoplasias del Apéndice/cirugía , Continuidad de la Atención al Paciente , Recurrencia Local de Neoplasia , Apendicectomía , Biomarcadores de Tumor/sangre , Antígeno Ca-125/sangre , Antígeno Carcinoembrionario/sangre , Colonoscopía , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To evaluate safety and efficacy of segmental yttrium-90 (Y90) radioembolization for hepatocellular carcinoma (HCC) after transjugular intrahepatic portosystemic shunt (TIPS) placement. The hypothesis was liver sparing segmental Y90 for HCC after TIPS would provide high antitumor response with a tolerable safety profile. MATERIALS AND METHODS: This single-arm retrospective study included 39 patients (16 women, 23 men) with ages 49-81 years old who were treated with Y90. Child-Pugh A/B liver dysfunction was present in 72% (28/39) with a median Model for End-stage Liver Disease score of 18 (95% confidence interval, 16.4-19.4). Primary outcomes were clinical and biochemical toxicities and antitumor imaging response by World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria. Secondary outcomes were orthotopic liver transplantation (OLT), time to progression (TTP), and overall survival (OS) estimates by the Kaplan-Meier method. RESULTS: The 30-day mortality was 0%. Grade 3+ clinical adverse events and grade 3+ hyperbilirubinemia occurred in 5% (2/39) and 0% (0/39), respectively. Imaging response was achieved in 58% (22/38, WHO criteria) and 74% (28/38, EASL criteria), respectively. Median TTP was 16.1 months for any cause and 27.5 months for primary index lesions. OLT was completed in 88% (21/24) of listed patients at a median time of 6.1 months (range, 0.9-11.7 months). Median OS was 31.6 months and 62.9 months censored and uncensored to OLT, respectively. CONCLUSIONS: Segmental Y90 for HCC appears safe and efficacious in patients after TIPS. Preserved transplant eligibility suggests that Y90 is a useful tool for bridging these patients to liver transplantation.
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Carcinoma Hepatocelular/terapia , Embolización Terapéutica , Neoplasias Hepáticas/terapia , Derivación Portosistémica Intrahepática Transyugular , Radiofármacos/administración & dosificación , Radioisótopos de Itrio/administración & dosificación , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/mortalidad , Bases de Datos Factuales , Progresión de la Enfermedad , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/mortalidad , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Derivación Portosistémica Intrahepática Transyugular/efectos adversos , Derivación Portosistémica Intrahepática Transyugular/mortalidad , Radiofármacos/efectos adversos , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Radioisótopos de Itrio/efectos adversosRESUMEN
BACKGROUND: Quantitative evaluation of mitral regurgitation (MR) in hypertrophic cardiomyopathy (HCM) by cardiovascular magnetic resonance (CMR) relies on an indirect volumetric calculation. The aim of this study was to directly assess and quantify MR jets in patients with HCM using 4D flow CMR jet tracking in comparison to standard-of-care CMR indirect volumetric method. METHODS: This retrospective study included patients with HCM undergoing 4D flow CMR. By the indirect volumetric method from CMR, MR volume was quantified as left ventricular stroke volume minus forward aortic volume. By 4D flow CMR direct jet tracking, multiplanar reformatted planes were positioned in the peak velocity of the MR jet during systole to calculate through-plane regurgitant flow. MR severity was collected for agreement analysis from a clinical echocardiograms performed within 1 month of CMR. Inter-method and inter-observer agreement were assessed by intraclass correlation coefficient (ICC), Bland-Altman analysis, and Cohen's kappa. RESULTS: Thirty-seven patients with HCM were included. Direct jet tracking demonstrated good inter-method agreement of MR volume compared to the indirect volumetric method (ICC = 0.80, p = 0.004) and fair agreement of MR severity (kappa = 0.27, p = 0.03). Direct jet tracking showed higher agreement with echocardiography (kappa = 0.35, p = 0.04) than indirect volumetric method (kappa = 0.16, p = 0.35). Inter-observer reproducibility of indirect volumetric method components revealed the lowest reproducibility in end-systolic volume (ICC = 0.69, p = 0.15). Indirect volumetric method showed good agreement of MR volume (ICC = 0.80, p = 0.003) and fair agreement of MR severity (kappa = 0.38, p < 0.001). Direct jet tracking demonstrated (1) excellent inter-observer reproducibility of MR volume (ICC = 0.97, p < 0.001) and MR severity (kappa = 0.84, p < 0.001) and (2) excellent intra-observer reproducibility of MR volume (ICC = 0.98, p < 0.001) and MR severity (kappa = 0.88, p < 0.001). CONCLUSIONS: Quantifying MR and assessing MR severity by indirect volumetric method in HCM patients has limited inter-observer reproducibility. 4D flow CMR jet tracking is a potential alternative technique to directly quantify and assess MR severity with excellent inter- and intra-observer reproducibility and higher agreement with echocardiography in this population.
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Cardiomiopatía Hipertrófica , Insuficiencia de la Válvula Mitral , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Humanos , Imagen por Resonancia Cinemagnética , Espectroscopía de Resonancia Magnética , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
In this work, the growth and stability towards O2exposure of two dimensional (2D) TaS2on a Cu(111) substrate is investigated. Large area (â¼1 cm2) crystalline 2D-TaS2films with a metallic character are prepared on a single crystal Cu(111) substrate via a multistep approach based on physical vapor deposition. Analytical techniques such as Auger electron spectroscopy, low energy electron diffraction, and photoemission spectroscopy are used to characterize the composition, crystallinity, and electronic structure of the surface. At coverages below one monolayer equivalent (ML), misoriented TaS2domains are formed, which are rotated up to±13orelative to the Cu(111) crystallographic directions. The TaS2domains misorientation decreases as the film thickness approaches 1 ML, at which the crystallographic directions of TaS2and Cu(111) are aligned. The TaS2film is found to grow epitaxially on Cu(111). As revealed by low energy electron diffraction in conjunction with an atomic model simulation, the (3 × 3) unit cells of TaS2match the (4 × 4) supercell of Cu(111). Furthermore, the exposure of TaS2to O2, does not lead to the formation of a robust tantalum oxide film, only minor amounts of stable oxides being detected on the surface. Instead, the exposure of TaS2films to O2leads predominantly to a reduction of the film thickness, evidenced by a decrease in the content of both Ta and S atoms of the film. This is attributed to the formation of oxide species that are unstable and mainly desorb from the surface below room temperature. Temperature programmed desorption spectroscopy confirms the formation of SO2, which desorbs from the surface between 100 and500 K.These results provide new insights into the oxidative degradation of 2D-TaS2on Cu(111).
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In heart failure (HF), the impaired heart loses its ability to competently eject blood during systole or fill with blood during diastole, manifesting in multifaceted abnormal intracardiac or intravascular flow dynamics. Conventional imaging techniques are limited in their ability to evaluate multidirectional multidimensional flow alterations in HF. Four-dimensional (4-D) flow magnetic resonance imaging (MRI) has emerged as a promising technique to comprehensively visualize and quantify changes in 3-dimensional blood flow dynamics in complex cardiovascular diseases. This article reviews emerging applications of 4-D flow MRI hemodynamic markers in HF and etiologies at risk of progressing to HF.
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Vasos Sanguíneos/diagnóstico por imagen , Insuficiencia Cardíaca/diagnóstico , Hemodinámica/fisiología , Imagen por Resonancia Cinemagnética/métodos , Miocardio/patología , Vasos Sanguíneos/fisiopatología , Insuficiencia Cardíaca/fisiopatología , Humanos , Espectroscopía de Resonancia MagnéticaRESUMEN
BACKGROUND AND OBJECTIVES: Delayed gastric emptying (DGE) occurs commonly following pancreaticoduodenectomy (PD), but the rate of DGE in the absence of other intra-abdominal complications is poorly understood. The objectives of this study were to define the incidence of DGE and identify risk factors for DGE in patients without pancreatic fistula or other intra-abdominal infections. METHODS: Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program pancreatectomy variables to identify patients with DGE following PD without evidence of fistula or intra-abdominal infection. Multivariable models were developed to assess preoperative, intraoperative, and technical factors associated with DGE. RESULTS: The rate of DGE was 11.7% in 10502 cases without pancreatic fistula or intra-abdominal infection. Patients were more likely to develop DGE if age ≥75 (odds ratio [OR], 1.22; P = 0.003), male (OR, 1.29; P < 0.001), underwent pylorus-sparing PD (OR, 1.27; P = 0.004), or had a prolonged operative time (OR, 1.38 if greater than seven vs less than 5 hours; P = 0.005). Factors not associated with DGE included BMI, pathologic indication, and surgical approach. CONCLUSION: The incidence of DGE after PD is notable even in patients without other abdominal complications. Identification of patients at increased risk for DGE may aid patient counseling as well as decisions regarding surgical technique, enteral feeding access, and enhanced-recovery pathways.
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Gastroparesia/epidemiología , Gastroparesia/etiología , Pancreaticoduodenectomía/efectos adversos , Pancreaticoduodenectomía/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Vaciamiento Gástrico , Gastroparesia/fisiopatología , Humanos , Infecciones Intraabdominales/epidemiología , Persona de Mediana Edad , Análisis Multivariante , Fístula Pancreática/epidemiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
Metformin, an established first-line treatment for patients with type 2 diabetes, has been associated with gastrointestinal (GI) adverse effects that limit its use. Histamine and serotonin have potent effects on the GI tract. The effects of metformin on histamine and serotonin uptake were evaluated in cell lines overexpressing several amine transporters (OCT1, OCT3 and SERT). Metformin inhibited histamine and serotonin uptake by OCT1, OCT3 and SERT in a dose-dependent manner, with OCT1-mediated amine uptake being most potently inhibited (IC50 = 1.5 mM). A chemoinformatics-based method known as Similarity Ensemble Approach predicted diamine oxidase (DAO) as an additional intestinal target of metformin, with an E-value of 7.4 × 10(-5). Inhibition of DAO was experimentally validated using a spectrophotometric assay with putrescine as the substrate. The Ki of metformin for DAO was measured to be 8.6 ± 3.1 mM. In this study, we found that metformin inhibited intestinal amine transporters and DAO at concentrations that may be achieved in the intestine after therapeutic doses. Further studies are warranted to determine the relevance of these interactions to the adverse effects of metformin on the gastrointestinal tract.
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Proteínas de Transporte de Membrana/metabolismo , Metformina/metabolismo , Amina Oxidasa (conteniendo Cobre)/metabolismo , Transporte Biológico/fisiología , Línea Celular , Diabetes Mellitus Tipo 2/metabolismo , Células HEK293 , Humanos , Mucosa Intestinal/metabolismo , Cinética , Factor 3 de Transcripción de Unión a Octámeros/metabolismo , Transportador 1 de Catión Orgánico/metabolismo , Proteínas de Transporte de Serotonina en la Membrana Plasmática/metabolismoRESUMEN
BACKGROUND: Aerosols generated during dental procedures have taken the forefront of discussion in dentistry. Due to the nature of their work, dental professionals face a significant risk of exposure to various biological hazards, such as saliva, blood, aerosols, and droplets. Aerosols, which are tiny particles with a diameter of less than 50µm, have a unique property that allows them to stay suspended in the air for extended periods. This is primarily due to their small size and lightweight nature which makes them highly susceptible to air currents and prevents them from quickly settling down. As a result, these aerosols can linger in the atmosphere, creating a potential risk for respiratory infections. AIM: The aim is to evaluate and compare the efficacy of rubber dams in preventing aerosols generated cross-contamination. METHODS AND MATERIAL: This in-vivo experimental study comprised 60 individuals who were suggested for root canal treatment in the mandibular first permanent molar tooth. The passive air sampling technique using "settle plates" was applied to investigate microbial fallout during access opening with and without rubber dam application. Sheep blood agar plates were used to do the colony forming unit (CFU) count. All patients were randomly divided into two groups comprising 30 patients each based on usage of rubber dam application or not, i.e., Group I: Without rubber dam application and Group II: With rubber dam application. RESULTS: Using a rubber dam while performing an endodontic procedure significantly impacts decreased aerosol generation at 0.5-m and 2-m distances than its counterpart with a p-value < 0.01. CONCLUSION: Using a rubber dam during endodontic procedures reduces the likelihood of aerosol generation, thereby decreasing the risk of cross-contamination and lowering the susceptibility of dental professionals to respiratory illnesses.
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Odontomas are one of the slow-growing odontogenic tumors. They are not a true neoplasm and are considered to be hamartoma. Odontomas consist of four distinct tissues, i.e., enamel, dentin, pulp, and cementum. Odontomas develop from fibroepithelial and undifferentiated mesenchymal cells which are essential for the development of the tooth. These are mostly asymptomatic and are incidentally detected on routine radiographic examination. This case report presents a unique case of a composite compound odontoma in an adult patient with flaring of teeth. A 28-year-old male patient reported to the Department of Dentistry for the correction of spacing in the upper front tooth region. Prompt diagnosis and management, including odontoma removal and aesthetic correction, were initiated. This case highlights the possibility of the presence of malformed tooth-like structures associated with flaring of teeth. It also focuses on the need for increased vigilance in individuals undergoing aesthetic correction procedures in the anterior maxillary region.
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Real-time detection of intermediate species and final products at the surface and near-surface in interfacial solid-gas reactions is critical for an accurate understanding of heterogeneous reaction mechanisms. In this article, an experimental method that can simultaneously monitor the ultrafast dynamics at the surface and above the surface in photoinduced heterogeneous reactions is presented. This method relies on a combination of mass spectrometry and femtosecond pump-probe spectroscopy. As a model system, the photoinduced reaction of methyl iodide on and above a cerium oxide surface is investigated. The species that are simultaneously detected from the surface and gas-phase present distinct features in the mass spectra, such as a sharp peak followed by an adjacent broad shoulder. The sharp peak is attributed to the species detected from the surface, while the broad shoulder is due to the detection of gas-phase species above the surface, as confirmed by multiple experiments. By monitoring the evolution of the sharp peak and broad shoulder as a function of the pump-probe time delay, transient signals are obtained that describe the ultrafast photoinduced reaction dynamics of methyl iodide on the surface and in the gas-phase. Finally, SimION simulations are performed to confirm the origin of the ions produced on the surface and in the gas-phase.
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Complications of overshunting, including hepatic encephalopathy and hepatic insufficiency, remain prevalent following transjugular intrahepatic portosystemic shunt (TIPS) creation. Smaller diameter TIPS may reduce the risk of overshunting, but the use of smaller stents must be weighed against the risk of undershunting and persistent or recurrent hemorrhage, ascites, and other complications of portal hypertension. This article explores the question of optimal shunt diameter by examining outcomes for smaller diameter TIPS stent-grafts (<10 mm), underdilated stent-grafts, and variable diameter stent-grafts.
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Introduction: Retention of the natural tooth without any symptoms in the oral cavity is one of the prime desires of endodontic treatment. Root canal therapy usually leads to failure when treatment is not up to the mark of acceptable standards. To address these deficiencies, non-surgical endodontic retreatment is the most accepted option with the success rate ranging from 65% to 83%. Forty-five single-rooted mandibular premolars with undeviated canals (as per Schneider's criteria) were obtained and divided further into three groups with 15 specimens along with resin-based sealer solvent in each group: Group 1 - Retreatment rotary file system, Group 2 - Ultrasonics, and Group 3 - Diode laser. Specimens were then evaluated under a stereomicroscope at ×10 after cutting in two halves followed by evaluation of the remaining filling material using Hulsmann and Bluhm criteria. Context: Nonsurgical retreatment. Aims: The aim of the study was to evaluate and compare the efficacy of various retreatment techniques for the elimination of root canal filling material. Settings and Design: The sample size was determined using the formula n = (Zα/2)2 s2/d2. The design of the study is in vitro experimental study. Subjects and Methods: A sum of 45 single-rooted extracted human permanent mandibular premolars were included in this study. All teeth were biomechanically prepared and obturated followed by decoronating the samples. All specimens were randomly divided into 3 groups comprising 15 specimens along with solvent based on the technique for the filling material elimination from the root canal, i.e. Group I: retreatment rotary files, Group II: ultrasonics, and Group III: diode laser. Statistical Analysis Used: The Tukey's post hoc tests and one-way analysis of variance were used for comparison of the study parameters among the groups. Results: Results revealed that ultrasonics showed the least amount of remaining filling material within the root canal which had a significant difference from other groups, i.e. retreatment rotary files and diode laser. Conclusions: Ultrasonics with a resin-based sealer solvent can be considered a preferred option for nonsurgical retreatment. However, none of the groups shows complete elimination of filling material inside the root canal system.
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Oral myiasis, a rare condition caused by the infestation of live maggots in the oral cavity, can present unique challenges in immunocompromised individuals. This case report presents a unique case of oral myiasis in an immunocompromised adult undergoing chemotherapy. A 67-year-old female suffering from metastatic carcinoma of the ovary was undergoing chemotherapy treatment at the time of presentation. Prompt diagnosis and management, including larval removal, wound care, and systemic antibiotics, were initiated. This case highlights the susceptibility of immunocompromised individuals to uncommon complications, such as oral myiasis, due to their compromised immune system. It also emphasizes the need for heightened vigilance in the oral care and monitoring of immunocompromised patients undergoing chemotherapy, as well as the importance of early intervention to prevent potential complications associated with oral myiasis. In this article, we have also included a comprehensive treatment protocol for treating this condition based on our clinical experience.
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Background: Global prevalence of diabetes is rapidly increasing with an estimate to affect 593 million worldwide by 2035. Current evidence clearly states an association between oral diseases and diabetes mellitus with manifestations like periodontitis, peri-implantitis, xerostomia, etc. Despite this obvious link, knowledge, awareness and attitude of general population towards this are not fully understood. Aims: To assess public knowledge and awareness on association between diabetes and oral health and assess their attitude towards oral hygiene care and maintenance. Methods and Materials: A three-part structured questionnaire was developed with multiple choice questions and circulated among patients visiting a private dental college. A total of 502 questionnaires were evaluated, and results were statistically analysed. Statistical Analysis Used: Student-t test and Chi-square test using SPSS software. Results: Majority of the participants were male and lived in urban area. 41.8% respondents had diabetes, out of which 86.7% had no awareness of the type. A significant number of non-diabetic individuals had awareness of excessive sugar intake as a cause of diabetes. Greater number of diabetic patients (96.7%) reported dry mouth, whereas only 53.3% had periodontal complications. 90% participants use tooth brush as oral hygiene aid. Only 10.6% participants follow regular dental visits. Majority of subjects (60.6%) listed their friends and family as major source of information. Conclusion: More people are aware of systemic complications of diabetes as compared to oral problems. A better interdisciplinary relationship is required among dentists and physicians to improve knowledge and awareness of general population.
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Diabetes Mellitus , Salud Bucal , Humanos , Masculino , Femenino , Conocimientos, Actitudes y Práctica en Salud , Higiene Bucal , EstudiantesRESUMEN
In this work, to understand how an amorphous surface influences the dynamics of surface photoinduced reactions, pump-probe spectroscopy in conjunction with mass spectrometry is employed to track the ultrafast evolution of intermediates and final products with time, mass, and energy resolution. As a model system, the photoinduced reaction of CD3I adsorbed on amorphous cerium oxide films is investigated. A fraction of the first intermediates produced on a freshly prepared surface is trapped to passivate the surface. After the A-band excitation, the minimum dissociation time of CD3I indicates that CD3I adsorption geometries with either CD3 or I facing the gas phase exist; however, the transient data suggest that most molecules are adsorbed with the I atom facing the surface. CD3 and I are consumed to form I2 and reform CD3I, which are produced at a steady rate only after the intermediates have lost the excess translational energy released from photodissociation.