In vitro comparative study on the friction of stainless steel wires with and without Orthospeed® (JAL 90458) on an inclined plane.

BACKGROUND: During the treatment of orthodontics, in the mechanics of slide, there takes place friction, which they reduce the slide of the arch across bracket. Therefore, clinical there takes place an increase of the time of treatment. There are different the technologies that try to reduce this friction, as the self-ligating braces. The purpose of this study was to research the in vitro behavior of JAL 90458 as a buffering agent which reduces friction between brackets and stainless steel arch wires of different cross sections and sizes. MATERIAL AND METHODS: Three types of stainless steel wires with different cross sections and three types of ligatures were used with and without JAL 90458 to measure the friction according to the time and distance traveled by the brackets on an inclined plane with two angulations. The Kruskal-Wallis one-way analysis of variance by ranks was applied to determine the degree of friction between the group using and the group not using the product (P ≤ .05). RESULTS: Separate analysis of the arch wires, ligatures and angulation with and without the compound revealed statistically significant differences between the groups, showing that friction was reduced significantly when JAL 90458 was used (P ≤ .01). The 0.021x0.025" arch wires and the arch wires attached using elastic ligatures produce the least resistance to sliding among all of those analyzed when the product was not used (P ≤ .05). CONCLUSIONS: The results show that JAL 90458 reduces friction independently of arch wire cross section, type of ligature and angulation of the measuring instrument. KEY WORDS: Friction, JAL 90458, arch wires, ligatures, in vitro.

Mortality and complications in elderly patients undergoing cardiac surgery.

PURPOSE: The purpose of the study was to analyze postoperative complications, mortality, and related factors of elderly patients undergoing cardiac surgery. METHODS: An observational, retrospective, and multicenter study of cardiac surgery patients, obtained from the ARIAM registry, was performed between 2008 and 2011. Clinical-surgical data, postoperative complications, and mortality were analyzed in a group of patients older than 75 years and in a younger group. RESULTS: A total of 4548 patients were analyzed, with 882 (19.4%) patients at least 75 years old. Elderly patients had worse functional status (New York heart Association class) and comorbidities. The complication rate was higher in the elderly group (40.4% and 33.5%, respectively; P = .0001). Mortality in the elderly was 1.1%, 12%, and 15.1% (during surgery, intensive care unit [ICU], and 30-day mortality, respectively). Thirty-day mortality in elderly patients was higher when adjusted for EuroSCORE (European System for Cardiac Operative Risk Evaluation) and cardiopulmonary bypass time. The interaction between multiorgan dysfunction syndrome (MODS) and age more than 75 years was assessed by logistic regression, obtaining an odds ratio of 9.27 (5.88-14.60) for younger patients and 29.44 (12.22-70.94) for elderly patients who died during the ICU stay. CONCLUSIONS: Age more than 75 years is an independent risk factor for ICU mortality when adjusted for EuroSCORE and cardiopulmonary bypass time. Elderly patients also have a higher rate of complications during ICU stay. Elderly patients develop MODS more frequently and present a higher mortality rate than younger patients with MODS.

Role of the paclitaxel-eluting stent and tirofiban in patients with ST-elevation myocardial infarction undergoing postfibrinolysis angioplasty: the GRACIA-3 randomized clinical trial.

BACKGROUND: A catheter-based approach after fibrinolysis is recommended if fibrinolysis is likely to be successful in patients with acute ST-elevation myocardial infarction. We designed a 2x2 randomized, open-label, multicenter trial to evaluate the efficacy and safety of the paclitaxel-eluting stent and tirofiban administered after fibrinolysis but before catheterization to optimize the results of this reperfusion strategy. METHODS AND RESULTS: We randomly assigned 436 patients with acute ST-elevation myocardial infarction to (1) bare-metal stent without tirofiban, (2) bare-metal stent with tirofiban, (3) paclitaxel-eluting stent without tirofiban, and (4) paclitaxel-eluting stent with tirofiban. All patients were initially treated with tenecteplase and enoxaparin. Tirofiban was started 120 minutes after tenecteplase in those patients randomly assigned to tirofiban. Cardiac catheterization was performed within the first 3 to 12 hours after inclusion, and stenting (randomized paclitaxel or bare stent) was applied to the culprit artery. The primary objectives were the rate of in-segment binary restenosis of paclitaxel-eluting stent compared with that of bare-metal stent and the effect of tirofiban on epicardial and myocardial flow before and after mechanical revascularization. At 12 months, in-segment binary restenosis was similar between paclitaxel-eluting stent and bare-metal stent (10.1% versus 11.3%; relative risk, 1.06; 95% confidence interval, 0.74 to 1.52; P=0.89). However, late lumen loss (0.04+/-0.055 mm versus 0.27+/-0.057 mm, P=0.003) was reduced in the paclitaxel-eluting stent group. No evidence was found of any association between the use of tirofiban and any improvement in the epicardial and myocardial perfusion. Major bleeding was observed in 6.1% of patients receiving tirofiban and in 2.7% of patients not receiving it (relative risk, 2.22; 95% confidence interval, 0.86 to 5.73; P=0.14). CONCLUSIONS: This trial does not provide evidence to support the use of tirofiban after fibrinolysis to improve epicardial and myocardial perfusion. Compared with bare-metal stent, paclitaxel-eluting stent significantly reduced late loss but appeared not to reduce in-segment binary restenosis. CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov. Unique identifier: NCT00306228.

A new cephalometric diagnostic method for Down’s Syndrome patients with open bite

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Vertical cephalometric analysis is a new cephalometric diagnostic method, created and studied by the author, which allows us to identify objectively the dental and skeletal components found in certain types of open bites.Down’s Syndrome patients frequently have this type of malocclusion which produces a significant dysfunction of the whole stomatognathic system. The primary complication of the treatment lies in the difficulty of identifying exactly how much of an open bite is dental and how much is skeletal; indeed, it is precisely this extremely important factor where this diagnostic method will be useful. Only two indexes are needed. The first, called SOBI (skeletal open bite index), measures the skeletal component, while the DOBI (dental open bite index) measures the dental component. The quantitative value of both components will establish a diagnosis-prognosis for the patient

A new cephalometric diagnostic method for Down's Syndrome patients with open bite.

Vertical cephalometric analysis is a new cephalometric diagnostic method, created and studied by the author, which allows us to identify objectively the dental and skeletal components found in certain types of open bites. Down's Syndrome patients frequently have this type of malocclusion which produces a significant dysfunction of the whole stomatognathic system. The primary complication of the treatment lies in the difficulty of identifying exactly how much of an open bite is dental and how much is skeletal; indeed, it is precisely this extremely important factor where this diagnostic method will be useful. Only two indexes are needed. The first, called SOBI (skeletal open bite index), measures the skeletal component, while the DOBI (dental open bite index) measures the dental component. The quantitative value of both components will establish a diagnosis-prognosis for the patient.

A vertical cephalometric analysis.

Correctly assessing open-bite malocclusions has remained problematic because clinicians have not had entirely reliable methods of determining the exact amount of skeletal and dental contributions to the problem. A new cephalometric technique, the vertical cephalometric analysis, offers orthodontists a system that precisely identifies the percentage of skeletal and dentoalveolar components that open-bite patients have. The vertical cephalometric analysis offers a discriminating diagnostic method for evaluating, diagnosing, and treatment planning for patients with open bite. This technique will allow clinicians to classify patients with accuracy, as well as to establish prognoses and select therapies.

Egg colour reflects the amount of yolk maternal antibodies and fledging success in a songbird.

Blue-green colours in avian eggs have been proposed as post-mating signals of female phenotypic quality to their mates. Egg colour may not only indicate female value, but also the quality of the eggs themselves and of resulting offspring. To date, there has been no demonstration of an association between egg colour and egg or offspring immune quality. We here show that the intensity of blue-green colour of pied flycatcher Ficedula hypoleuca eggs reflects the amount of maternal antibodies in the yolk, a form of passive immunity crucial for offspring performance. Moreover, egg colour predicts fledging success. Also, incubating females in better condition lay more colourful eggs. The immunoglobulin level in incubating females is positively associated with that in the eggs. These results support the signalling hypothesis of eggshell coloration, underlining its role as an indicator of trans-generational transmission of immune defences in birds.

Influence of sympathetic activity on blood pressure and vascular damage evaluated by means of urinary albumin excretion.

To analyze the influence of sympathetic activity on blood pressure (BP) and its effects on urinary albumin excretion (UAE), the authors carried out a cross-sectional study in their local health coverage area. The following variables were monitored in a representative sample of the general population made up of 495 individuals: anthropometric parameters; blood glucose, creatinine, and lipid levels; 24-hour urinary albumin, norepinephrine, and epinephrine excretion; and BP of patients with known hypertension and newly discovered BP > or =140/90 mm Hg, evaluated by ambulatory monitoring. In the multivariate analysis, only gender, systolic BP, and UAE were associated with norepinephrine levels; only gender, systolic BP, and body mass index were associated with epinephrine. After excluding those patients with chronic kidney disease, the multivariate analysis showed a strong association between UAE > or =30 mg/d and elevated norepinephrine and epinephrine levels. The authors concluded that in the subject population there is an association between elevated adrenergic activity and higher UAE, independent of factors such as age and BP.