Development of a tool to calculate the probability of hypocalcemia after total thyroidectomy: a prospective study.

PURPOSE: This study aimed to evaluate the ability of the percentage of decrease in serum PTH level in the first 8 h after total thyroidectomy (TT) to predict hypocalcemia requiring Ca supplementation and develop a tool to predict it. METHODS: 97 patients who underwent TT with measurement of preoperative parathyroid hormone (PTH) levels were prospectively evaluated 1 and 8 h after TT; postoperative magnesium (Mg2PO) and phosphorus levels were evaluated on the 2nd day after surgery. The percentage of decrease in PTH level 1 h (%dPTH1h) and 8 h (%dPTH8h) postoperatively and predictors of hypocalcemia requiring Ca supplementation were evaluated and an equation was developed to predict this outcome. RESULTS: %dPTH1h (p = 0.002), %dPTH8h (p = 0.001) and (Mg2PO) (p < 0.01) were isolated predictors of postoperative hypocalcemia requiring Ca supplementation. The data obtained led to the development of two tools to predict this complication. CONCLUSIONS: The percentage of decrease in PTH level 1 h and 8 h postoperatively and the magnesium level on the 2nd day after surgery were predictors of more severe hypocalcemia, and an auxiliary tool for predicting this complication was developed.

Mobile Robot + IoT: Project of Sustainable Technology for Sanitizing Broiler Poultry Litter.

The traditional aviary decontamination process involves farmers applying pesticides to the aviary's ground. These agricultural defenses are easily dispersed in the air, making the farmers susceptible to chronic diseases related to recurrent exposure. Industry 5.0 raises new pillars of research and innovation in transitioning to more sustainable, human-centric, and resilient companies. Based on these concepts, this paper presents a new aviary decontamination process that uses IoT and a robotic platform coupled with ozonizer (O3) and ultraviolet light (UVL). These clean technologies can successfully decontaminate poultry farms against pathogenic microorganisms, insects, and mites. Also, they can degrade toxic compounds used to control living organisms. This new decontamination process uses physicochemical information from the poultry litter through sensors installed in the environment, which allows accurate and safe disinfection. Different experimental tests were conducted to construct the system. First, tests related to measuring soil moisture, temperature, and pH were carried out, establishing the range of use and the confidence interval of the measurements. The robot's navigation uses a back-and-forth motion that parallels the aviary's longest side because it reduces the number of turns, reducing energy consumption. This task becomes more accessible because of the aviaries' standardized geometry. Furthermore, the prototype was tested in a real aviary to confirm the innovation, safety, and effectiveness of the proposal. Tests have shown that the UV + ozone combination is sufficient to disinfect this environment.

Orofacial Deformities in 3 Related Rhesus Monkeys (Macaca mulatta) Resembling Human Binder's Syndrome.

Binder's syndrome is a rare congenital deformity characterized by midface hypoplasia, particularly around the nasomaxillary area. Genetic etiology or developmental failure caused by prenatal exposure to teratological agents has been considered. In this article, we present 3 related rhesus monkeys born with orofacial deformities similar to those found in infants with the Binder phenotype. For the first time, a primate biomodel for this condition is presented. The clinical description and association with management and environmental factors are discussed. These findings reinforce the knowledge about the relationship between possible vitamin K metabolism interference and Binder's syndrome.

Peritoneal Dialysis Exit-Site Care Protocols in Portugal and Its Association with Catheter-Related Infections.

INTRODUCTION: Exit-site infection (ESi) prevention is a key factor in lowering the risk of peritonitis. This study aimed to evaluate the associations between exit-site (ES) care protocols and the annual incidence rates of ESi and peritonitis in Portugal. METHODS: We performed a national survey using two questionnaires: one about the incidence of catheter-related infections and the other characterizing patients' education and ES care protocols. RESULTS: In 2017 and 2018, 14 Portuguese units followed 764 and 689 patients. ESi incidence rate was 0.41 episodes/year, and the peritonitis incidence rate was 0.37. All units monitor catheter-related infections on a yearly basis, use antibiotic prophylaxis at the time of catheter placement, and treat nasal carriage of S. aureus, although with different approaches. Screening for nasal carriage of S. aureus is performed by 12 units, and daily topical antibiotic cream is recommended by 6 out of 14 of the units. We did not find statistical differences in ESi/peritonitis, comparing these practices. The rate of ESis was lower with nonocclusive dressing immediately after catheter insertion, bathing without ES dressing, with the use of colostomy bags in beach baths and was higher with the use of bath sponge. The peritonitis rate was lower with bathing without ES dressing and if shaving of the external cuff was performed in the presence of chronic ESi. CONCLUSIONS: We found potential proceedings associated with ESi and peritonitis. A regular national audit of peritoneal dialysis units is an important tool for clarifying the best procedures for reduction of catheter-related infections.

Effects of different doses of ionizing radiation on alveolar bone repair in post-extraction tooth socket: an experimental study in rats.

OBJECTIVE: This study aimed to evaluate the dose-response effects of ionizing radiation (IR) on alveolar bone repair and bone strength after tooth extraction. MATERIALS AND METHODS: A total of 32 male Wistar rats were used in the study, 28 animals were included in the final analysis, and n = 7 for each experimental group. Mandibular first molars were extracted. After 7 days, the animals were randomly divided into four groups according to single-dose irradiation: NIr, control group; Ir15, irradiated at 15 Gy; Ir20, irradiated at 20 Gy; and Ir30, irradiated at 30 Gy. The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric, and biomechanical analyses 14 days after extraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS: Micro-CT analysis revealed that IR led to lower values of bone volume (BV, in mm3) (0.68 ± 0.08, P < 0.001) and bone volume fraction, ratio of the segmented bone volume to the total volume of the region of interest (BV/TV, in %) (44.1 ± 8.3, P < 0.001) for the Ir30 group compared to the control group. A significantly lower amount of newly formed bone was observed in the Ir30 (P = 0.005) than in the Ir15 group. The histomorphometric results of quantification of bone matrix neoformation and the micro-CT were in agreement, demonstrating greater damage to the Ir30 group. IR30 cells showed a lower percentage of densely packed collagen than control cells. No significant differences were found in the biomechanical parameters. CONCLUSION: IR affects alveolar bone repair. A dose of 30 Gy reduced the bone healing process owing to a smaller amount of newly formed bone and a lower percentage of densely packed collagen. Therefore, a dose of 30 Gy can be used to successfully establish an animal model of an irradiated mandible that mimics the irradiated clinical conditions. CLINICAL RELEVANCE: Radiotherapy can lead to severe side effects and tooth extraction is a major risk factor. A proper understanding of the pathological mechanisms of radiation in alveolar bone repair requires the establishment of a suitable animal model of clinical conditions.

Effect of irradiance and exposure time on the adhesive properties of universal adhesives after 2 years of storage.

OBJECTIVE: This study aims to evaluate the effects of exposure time and irradiance on the dentin bonding properties (microtensile bond strength (µTBS) and nanoleakage (NL)) of the Clearfil Universal Bond Quick (CUQ) adhesive and Scotchbond Universal Adhesive (SBU) immediately and after 2 years of water storage. MATERIAL AND METHODS: Hence, 128 human molars were randomly assigned to 16 groups based on adhesive strategy, irradiance/exposure times, and storage time for each universal adhesive tested. The adhesives were applied using the etch-and-rinse and self-etch strategies and were light-cured using four different irradiance/exposure times: 1400 mW/cm2 for 5 s (1400 × 5), 1400 mW/cm2 for 10 s (1400 × 10), 3200 mW/cm2 for 5 s (3200 × 5), and 3200 mW/cm2 for 10 s (3200 × 10). Then, each sample was restored and sectioned into a resin-dentin bonded stick to be tested for µTBS and NL (immediately and after 2 years of water storage). The mean µTBS and NL of all resin-dentin bonded sticks from the same hemi-tooth (factor time) were statistically analyzed using a three-way ANOVA and Tukey's test (a = 0.05). RESULTS: Despite a significant decrease in the µTBS values for all groups after 2 years of water storage, the 3200 × 5 group showed higher µTBS values, whereas the 3200 × 10 group showed lower µTBS values for both universal adhesives tested. Although a significant increase in the NL values was observed for all groups after 2 years of water storage, the 3200 × 10 group showed higher NL values than the other groups (p < 0.001). CONCLUSION: Results indicate that light-curing the adhesive layer with 14-16 J/cm2 led to an improvement in the stability of the resin-dentin adhesive interface. A longer exposure time (10 s) coupled with a higher irradiance (3200 mW/cm2) resulted in a greater degree of degradation of the adhesive interface. CLINICAL SIGNIFICANCE: To guarantee better stability of the adhesive interface, clinicians could be preferred a light-cured universal adhesive layer with 14-16 J/cm2. Higher irradiances should be avoided.

Biomechanical effects of a hard insert and air space in mouthguards on the shock absorption and protection against fractures of direct resin composite veneers from trauma.

BACKGROUND/AIM: Mouthguards (MTG) are used to prevent dental trauma. However, their protective effect on esthetic restorations and whether modified MTGs are beneficial is uncertain. The aim of this study was to evaluate the effect of hard inserts and air spaces in MTGs in protecting direct resin composite veneers during impact. MATERIALS AND METHODS: Twenty resin composite veneers (1.0 mm) were prepared on upper right central incisors on printed maxilla models using polyether. The effect of the MTGs was evaluated in four groups (n = 5): Con-MTG, conventional custom-fit MTGs made with two layers of ethylene vinyl acetate (EVA); Air-MTG, MTGs with the insertion of 2.0 mm air space between the two layers of EVA and tooth surface; PETG-MTG, MTGs with 1.0 mm of polyethylene terephthalate glycol-modified (PETG) inserted between the EVA layers; and No-MTG, comprising resin composite veneers without MTG. The printed models were fixed in a pendulum device, and the impact was performed at 30°. The strain (µS) and shock absorption (%) of the MTG were recorded using strain gauges. Failure modes and cracks were evaluated using macro photography and transillumination and analyzed using the chi-square test. Strain and shock absorption data were analyzed using the one-way analysis of variance followed by Tukey's test (α = 0.05). RESULTS: Mouthguards reduced strain and enhanced shock absorption, regardless of the MTG type (p < .001). Con-MTG, Air-MTG, and PETG-MTG had shock absorption rates of 76.1%, 72.3%, and 33.4%, respectively (p < .001). The single No-MTG model had a root fracture, while all the others had superficial damage. None of the MTG models had cracks or fractures. CONCLUSIONS: Mouthguards protected the resin composite veneers. The Con-MTG and Air-MTG groups had lower strain and greater shock absorption than the PETG-MTG. Resin veneers had no cracks or damage following MTG use. However, 80% of the veneers had surface damage when no MTG was used.

Fluorescence-aided identification technique using a low-cost violet flashlight and rotatory instruments for dental trauma splint removal.

BACKGROUND/AIM: Removing resin composites used for bonding dental trauma splints may result in irreversible damage to the enamel. This in vitro study evaluated the influence of additional violet illumination and different bur types on damage caused to tooth enamel. MATERIALS AND METHODS: Fifteen maxillary models with four bovine incisor teeth were prepared. All models were scanned using a laboratory scanning system (s600 ARTI; Zirkonzahn). Six experimental groups (n = 10) were generated by two study factors: lighting type (three levels), (1) low-cost (5-7 US$) violet LED flashlight (LUATEK, LT 408); (2) VALO Cordless light curing unit (Ultradent) with black lens; or (3) without additional illumination; and rotatory instrument (two levels), (1) diamond bur or (2) multifluted tungsten-carbide bur. New scanning was performed after splint removal, and the generated files were superimposed on the initial scans using Cumulus software. The light emitted by both violet light sources was characterized by using integrating sphere and beam profile. A qualitative and quantitative analysis of enamel damage and two-way ANOVA followed by Tukey's post hoc was used at an α = 0.05. RESULTS: The use of low-cost violet flashlight that emitted the violet peak light at 385 nm and VALO Cordless with black lens at 396 nm resulted in significantly lower damage to the enamel surface than those in the groups without additional violet light (p < .001). An interaction between rotatory instruments and lighting was found. When no additional violet lighting was used, the diamond bur presented higher mean and maximum depth values. CONCLUSIONS: Fluorescence lighting facilitated the removal of remnant resin composite dental trauma splints, leading to less invasive treatment. The diamond bur resulted in higher enamel damage than that affected by the multifluted bur when no violet lighting was used. A low-cost violet flashlight is a useful fluorescence-aided identification technique for removing resin composite dental trauma splints.

Effect of different materials for conventional and 3D-printed models on the mechanical properties of ethylene-vinyl acetate utilized for fabricating custom-fit mouthguards.

BACKGROUND/AIM: The interaction between the ethylene-vinyl acetate (EVA) with distinct materials utilized for obtaining dental models can affect the performance of resulting mouthguards. This study attempted to evaluate the effect of different materials for conventional (dental stone) or 3D-printed (resin) models on EVA's physical and mechanical properties and surface characteristics. MATERIAL AND METHODS: EVA sheets (Bioart) were laminated over four model types: GIV, conventional Type IV dental stone model (Zhermak); ReG, resin-reinforced Type IV dental stone model (Zero Stone); 3DnT, 3D resin printed model (Anycubic) without surface treatment; 3DT, 3D-printed model (Anycubic) with water-soluble gel (KY Jelly Lubricant, Johnson & Johnson) coating during post-curing process. The EVA specimens were cut following the ISO 37-II standard (n = 30). Shore A hardness was measured before and after plasticization on the contact (internal) or opposite (external) surfaces with the model. The breaking force (F, N), elongation (EL, mm), and ultimate tensile strength (UTS, MPa) were measured using a universal testing machine. Macro-photography and scanning electron microscopy were adopted for classifying the EVA surface alteration. Data were analyzed by one-way ANOVA with repeated measures, followed by Tukey's test (α = .05). RESULTS: Plasticization significantly decreased Shore A values for the tested EVA regardless of the model type (p < .001). Higher F, El, and UTS values were verified for the EVA with 3DT and GIV models compared to ReG and 3DnT (p < .001). 3DnT models resulted in severe surface alteration and a greater reduction of the mechanical properties of the EVA. CONCLUSION: The interaction of EVA with 3D resin-printed models without surface treatment or resin-reinforced Type IV dental stone models significantly affected the physical and mechanical properties of this material. The utilization of water-soluble gel coating during the post-curing process of 3D resin printed models improved the mechanical properties of the EVA, similarly when this material was plasticized over conventional Type IV dental stone model.

Effect of surface treatment of ethylene vinyl acetate on the delamination of custom-fitted mouthguards.

BACKGROUND/AIM: Contamination of ethylene vinyl acetate (EVA) during mouthguard fabrication can cause delamination. The study evaluated the effects of different EVA surface treatments on the contact angle, laminate bond strength, and elongation capacity. MATERIALS AND METHODS: Specimens of two bonded EVA plates were prepared (n = 30). The Shore A hardness of standardized EVA plate specimens was measured before and after thermo-plasticization. The EVA plates were randomly allocated to one of five different surface treatment groups: no treatment (control); isopropyl alcohol, 100%; chloroform, 99.8%; self-cure acrylic resin monomer (methacrylate, ethylene glycol dimethacrylate, and chemical initiator-amine type); and ethyl alcohol, 70%. The maximum breaking force and elongation at the site of fracture were recorded using a universal testing machine. The contact angle surface was measured using ImageJ software. Scanning electron microscopy of the EVA surface was performed. The laminate bond strength was obtained by dividing the maximum breaking force by the bonding area between the two EVA plates. The laminate bond strength and maximum elongation data were analyzed by one-way ANOVA, followed by the Tukey's and the Dunnet test. The failure mode data was analyzed using the chi-square test (α = .05). RESULTS: EVA surface treatment significantly influenced the laminate bond strength and maximum elongation (p < .001). The control group had a higher contact angle and significantly lower laminate bond strength and maximum elongation than the other groups (p < .001). The acrylic resin monomer and chloroform-treated specimens had similar laminate bond strength and maximum elongation. The acrylic resin monomer group had a significantly lower contact angle (p < .001). CONCLUSIONS: All treatments had a significantly higher laminate bond strength and maximum elongation than the control group. The acrylic resin monomer and chloroform groups had a significantly higher laminate bond strength and maximum elongation and the acrylic resin monomer group had a lower contact angle than the other groups. The chloroform should be avoided due its hazardous effects.

Multiple GIST and pheochromocytoma - A rare association in neurofibromatosis type 1.

We describe a case of coexistence of multiple gastrointestinal stromal tumors (GIST) and pheochromocytoma in a 32-year-old patient with neurofibromatosis type 1. The coexistence of these two conditions in patients with this syndrome is extremely rare.

Photobiomodulation effect of red LED (630 nm) on the free radical levels produced by pulp cells under stress conditions.

The aim of this study was to assess the ability of red light emitting diodes (LED) to modulate oxidative stress in human dental pulp fibroblasts (HDPFs) when different irradiation parameters are employed. Cells from primary teeth were seeded (100,000 cells/well) in 24-well plates in culture medium (DMEM). At 24 h after incubation, the culture medium was replaced with DMEM containing 10 µg/mL lipopolysaccharide (LPS). Thereafter, the cells were irradiated (LED 630 nm, 0.04 W/cm2 and 0.08 W/cm2) at 0 J/cm2 (control group), 4 J/cm2, 15 J/cm2, and 30 J/cm2; and their viability (MTT assay), number (Trypan Blue), synthesis of nitric oxide (NO) (Griess reagent), and reactive oxygen species (ROS) (fluorescence probe, DCFH-DA) were assessed. The Kruskal-Wallis and Mann-Whitney statistical tests using Bonferroni correction were employed (significance level of 5%). Compared to that in control fibroblasts, increased viability was observed in HDPFs exposed to LPS and irradiated with 15 J/cm2 and 30 J/cm2 at 0.04 W/cm2 and 4 J/cm2 and 15 J/cm2 at 0.08 W/cm2 (p < 0.05). Exposure to 4 J/cm2 at 0.04 W/cm2 and 15 J/cm2 and 30 J/cm2 at 0.08 W/cm2 modulated the oxidative stress in cells relative to that observed in non-irradiated LPS-treated pulp cells (p < 0.05). It was concluded that the irradiation strategies of using red LED with radiant exposures of 15 J/cm2 and 30 J/cm2 at 0.04 W/cm2 and 15 J/cm2 at 0.08 W/cm2 were the best parameters to decrease NO and ROS concentration and to stimulate viability of HDPFs exposed to LPS challenge.

Evaluation of the Utilization of FilmArray Meningitis/Encephalitis in Children With Suspected Central Nervous System Infection: A Retrospective Case Series.

BACKGROUND: The etiology of central nervous system infections is often difficult to establish. FilmArray meningitis/encephalitis (ME) panel is a multiplex polymerase chain reaction for rapid identification of 14 pathogens. The aim of this study was to evaluate potential real-life contributions of the use of this method in the pediatric population. METHODS: We herein report the results obtained with FilmArray ME in a retrospective case series of 367 children with suspected central nervous system infection. We identified viral and bacterial agents by FilmArray, and we evaluated the potential diagnostic contributions of the use of the panel taking into account the cytological, biochemical, and microbiological results of the cerebrospinal fluid (CSF) analysis. RESULTS: The FilmArray ME panel detected a viral infection in 186 cases (50.7%) and a bacterial infection in 12 cases (3.3%). Fifty-three cases (28.4%) of viral infection had at least 1 CSF finding that could be mistaken for bacterial meningitis. Enterovirus was identified in 2 cases with normal CSF findings. Among 12 bacterial infection cases, only 6 (50%) had a positive result with conventional microbiology analysis (Gram stain and culture). The CSF findings suggestive of bacterial meningitis were found in all 6 cases in which FilmArray was the only method to identify bacterial etiological agent. CONCLUSIONS: FilmArray ME panel identified an etiological agent in cases in which conventional CSF analysis failed, providing potential clinical contributions to the management of such cases.

Does polishing of bleached enamel affect roughness and tooth color stability after exposure to coffee?

OBJECTIVE: This laboratory randomized study was designed to evaluate the effect of polishing on roughness and color stability of bleached teeth after coffee immersion. MATERIALS AND METHODS: Ninety bovine crowns were randomly allocated to six groups (n = 15), according to bleaching protocols: At-home: standard protocol using 10% hydrogen peroxide (HP) or In-office: standard protocol using 35% HP; and with polishing protocols: (1) no polishing, (2) bleached enamel polished with #0.5 µm or (3) #2-4 µm diamond particles grit pastes. Samples were daily immersed into coffee solution for 45 min followed by mechanical brushing simulation (30 s) for 30 days. The surface roughness (Ra) and color alteration, expressed by ΔEab , ΔE00 , and whitening index (WI) were analyzed at baseline, after bleaching/polishing protocols and after coffee solution staining. The surface from each group was examined using a scanning electron microscope. Data were analyzed by two-way repeated measure analysis of variance followed by the Tukey test (α = 0.05). RESULTS: Staining increases Ra, ΔEab , ΔE00 , and decreases WI values. Polishing after bleaching did not prevent staining, however, tooth polished with #0.5 µ-grit polishing paste showed better performance than #2-4 µ-grit (ΔEab : p = 0.001/ΔE00 : p = 0.003). Scanning electron microscope revealed a more irregular surface after coffee staining for all groups regardless bleaching/polishing protocols. CONCLUSIONS: Using #0.5 µ-grit diamond paste to polish 35%HP in-office bleached enamel reduces the roughness and tooth staining. However, polishing after 10%HP at-home bleached enamel neither affects roughness nor improves tooth color stability after exposure to coffee. CLINICAL SIGNIFICANCE: Polishing after at-home bleaching does not have benefits but after 35% hydrogen peroxide in-office bleaching, the polishing with #0.5 µ-grit polishing paste is indicated to reduce roughness and the tooth staining over time.

Dental trauma splints for the mixed dentition - A finite element analysis of splint material, splint extension, missing teeth, and PDL representation.

BACKGROUND/AIMS: Dental traumatic injuries are common in children during the mixed dentition stage. These injuries usually require splinting for stabilization, which is complicated by the various stages of the permanent tooth development and primary tooth exfoliation. The aim of this study was to evaluate the effect on mobility of splint materials and extensions for an avulsed central incisor, stabilized with and without the adjacent incisor under intrusive and extrusive loading with different periodontal ligament (PDL) conditions. MATERIALS AND METHODS: Seventeen 3D model variations were created from a CBCT scan of a 7-year-old patient without erupted permanent upper lateral incisors. A 1000 N palatal load on the right central incisor simulated the avulsion injury and created an increased alveolus and bone deformation, resulting in an increased PDL thickness of 0.45 mm. Wire-resin composite splints with 0.9 mm cross-section (WCS) or 1.0 mm diameter nylon-resin composite splints (NCS) were created. The models simulated conditions with and without the adjacent upper central incisor. Two PDL conditions were investigated, simulating detached PDL or PDL with polyether impression material-like properties. Mobility was calculated under simulated biting loads in horizontal and vertical (intrusive and extrusive) directions. RESULTS: The NCS allowed greater tooth mobility of the avulsed incisor than the WCS, irrespective of splint extension, PDL condition, or load application. During horizontal loading, polyether-like properties for the PDL allowed around 0.2 mm mobility of the avulsed tooth with the WCS, similar to the intact tooth, whereas a simulated detached PDL allowed 25% more mobility with a WCS than with a NCS. CONCLUSIONS: Based on the FEA analysis, a 1.0 mm NCS may be suitable for splinting avulsion injuries during the mixed dentition stage compared to the considerably more rigid WCS. The NCS models provided flexibility for PDL healing while maintaining stability, even when missing adjacent teeth increased span widths. Extensions beyond directly adjacent teeth did not alter the mobility with the NCS but should still be considered an extra protection in case of bond failure or exfoliation.

Effect of the violet light from polywave light-polymerizing units on two resin cements that use different photoinitiators.

STATEMENT OF PROBLEM: Some light-emitting diode polymerization lights have been promoted as multiple peak or polywave lights that use multiple light-emitting diodes to produce both violet and blue light. However, whether the addition of violet light is required to light-activate resin cements that use bis(4-methoxybenzoyl)diethylgermane (Ivocerin) as the photoinitiator is unclear. PURPOSE: This in vitro study evaluated the effect of violet, blue, or a combination of violet and blue light through ceramic on the degree of conversion of 2 resin cements that use either camphorquinone or Ivocerin as the photoinitiator. MATERIAL AND METHODS: A Bluephase Style polywave light-emitting diode polymerizing unit delivering 6.4 J/cm2 of violet and blue light was used. This comprised 1.4 J/cm2 of violet (385 to 420 nm) and 5.0 J/cm2 of blue light (420 to 515 nm). The light-emitting diode emitters in a second modified Bluephase Style were connected directly to a power supply so that either just violet (1.4 J/cm2) or just blue (5.0 J/cm2) light was emitted. RelyX Veneer and Variolink Esthetic LC resin cements were either directly light-activated or through 0.5 or 1.5 mm of lithium disilicate ceramic (IPS e.max CAD). The degree of conversion was monitored by using Fourier-transform infrared spectroscopy. Data were subject to a 3-way analysis of variance followed by the Tukey honest significant difference multiple comparison tests (α=.05). RESULTS: All factors had a significant effect (P<.001). Increasing the ceramic thickness decreased the degree of conversion only for RelyX Veneer cement (P<.001). The effect of the thickness of ceramic was most noticeable when just violet light was delivered to RelyX Veneer. A significant reduction (P<.001) was found in the degree of conversion of RelyX Veneer when just violet light was delivered. Variolink Esthetic LC had significantly higher degree of conversion values than RelyX Veneer, irrespective of the light type used (P<.001). CONCLUSIONS: A multiple-peak light is not required to photopolymerize a resin cement that uses either camphorquinone or Ivocerin as its photoinitiator. Adding the violet light produced no significant increase in the degree of conversion of the Variolink Esthetic LC cement.

Splint stiffness and extension effects on a simulated avulsed permanent incisor-A patient-specific finite element analysis.

BACKGROUND/AIM: Splinting is an important procedure after avulsion. However, the role of splint stiffness and extension is not fully understood. The aim of this study was to evaluate the effect of splint stiffness and extensions on the mobility and stress on an injured tooth under physiological biting load. MATERIALS AND METHODS: Three-dimensional (3D) finite element models were created from a cone beam computer tomogram of a patient with normal occlusion. An avulsion injury of the right central incisor was created with a 1000 N load application on the palatal of the injured tooth, causing increased socket width. Splints made from four materials were tested: 0.9 mm diameter wire-composite splint (WCS1), 0.4 mm diameter wire-composite splint (WCS2), 1.0 mm diameter nylon-composite splint (NCS), and a 2 mm high by 0.2 mm thick plastic strip composite splint (PSS). Three splint extensions (involving 6, 5, and 3 teeth) were evaluated. Mobility of the avulsed tooth and the maximum principal stress distributions in the adjacent teeth were calculated. RESULTS: The injured incisor tooth mobility was not affected by the splint extensions. The NCS and PSS stabilized the avulsed incisor but allowed, respectively, 10 and 20 times more mobility under horizontal loading than the WCS1, which inhibited most mobility, while the WCS2 allowed double the mobility compared with WCS1. The NCS and PSS allowed more tooth mobility, mainly in the extrusion direction. Splints were 2-3 times more effective in limiting mobility under intrusive loads than extrusive loads. High levels of stress were found at the base of the composite attachments in the adjacent incisors. CONCLUSION: Splinting an avulsed tooth to one or two teeth bilaterally using a nylon splint or a plastic strip is appropriate for tooth stabilization and should be recommended over the 0.4mm wire-composite splint, while the 0.9 mm orthodontic wire is too rigid and not recommended.

What to do when advanced thyroid cancer invades the carotid artery? Therapeutic challenge.

Of all thyroid cancers, anaplastic thyroid carcinoma (ATC) has the lowest incidence and worst prognosis. In this report, we describe a 64-year-old female patient who underwent total thyroidectomy and level VI neck dissection for papillary thyroid carcinoma. During follow-up, she showed signs of regional recurrence and underwent extended neck dissection and cervical esophagectomy. Intraoperatively, there was no cleavage plane between the tumor and the common carotid artery (CCA), so a carotid shunt was implanted and en bloc resection, including the affected CCA and esophagus segments was performed followed by vascular bypass with interposition of a great saphenous vein graft. A pathology review found evidence of anaplastic carcinoma. The patient underwent adjuvant treatment and has no signs of locoregional recurrence. Presented with the possibility of carrying out curative surgery with en bloc resection, the vascular surgeon must be prepared for the surgical options.

Effect of exercise-conditioned human serum on the viability of cancer cell cultures: A systematic review and meta-analysis.

Numerous epidemiological studies have shown the existence of a relationship between exercise and reduced risk of different types of cancer. In vitro studies have identified a direct effect of exercise-conditioned human serum on cancer cell lines of the lung, breast, prostate, and colon. The aim of this systematic review with meta-analysis (SRM) was to estimate the magnitude of the effect that exercise-conditioned human serum produced on the viability of cancer cell cultures. The design followed the PRISMA guidelines and the TREND statement to assess the quality of information (QoI) in each study. Nine in vitro studies were included in the SRM, involving a total of nine cancer cell lines and serum from 244 individuals from different countries, including namely healthy sedentary individuals, at risk of prostate cancer individuals and cancer patients, with ages ranging from 18 to 73 years. The impact of exerciseconditioned human serum on the viability of cancer cell cultures was analysed by a variety of assays, using pre-exercise human serum for comparison purposes. Globally, cultures of cancer cell lines exposed to human serum conditioned by exercise of various intensities exhibited a reduced viability, when compared with control cultures, with an overall effect size of -1.126 (95% CI; -1.300 to -0.952; p < 0.001). When the analysis only included human serum conditioned by high intensity exercise, the effect became more pronounced (ES -1.350; -1.522 to -1.179 (95% CI); p < 0.001). These results are in line with the hypothesis that changes in human serum induced by exercise might play a role in the beneficial effects of physical activity in cancer prevention and management and that these effects depend on exercise intensity.

Ciliate Diversity From Aquatic Environments in the Brazilian Atlantic Forest as Revealed by High-Throughput DNA Sequencing.

Rainforest aquatic ecosystems include complex habitats with scarce information on their unicellular eukaryote diversity and community structure. We have investigated the diversity of ciliates in freshwater and brackish environments along the Brazilian Atlantic Forest, based on the hypervariable V4 region of the 18S-rDNA obtained by high-throughput DNA sequencing. Our analyses detected 409 ciliate taxonomic units (OTUs), mostly attributed to the classes Oligohymenophorea and Spirotrichea. A total of 11 classes, 12 subclasses, 112 genera, and 144 species were reported. We found the following: (a) the ciliate communities are more diverse in freshwater- than in Atlantic Forest-associated brackish environments; (b) the ciliate communities are composed by a small amount of highly abundant OTUs, but a high number of low-abundant or rare OTUs; (c) nearly one-third of the ciliate OTUs share less than 97% sequence identity to reference sequences and (d) phylogenetic inference supports the hypothesis that the V4 region of the Ciliophora 18S-rDNA is a suitable marker for accurate evolutionary inferences at class level. Our results showed that a considerable fraction of the HTS-detected diversity of ciliates from Brazilian Atlantic Forest is not represented in the currently available molecular databases.