Lignin and green solvent extracted phenolic compounds from date palm leaves as functional ingredients for the formulation of soy protein isolate biocomposite packaging materials: A circular packaging concept.

The current study investigated valorization of lignin nanoparticles (LNPs) and phenolic compounds loaded in chitosan (DLECNPs) extracted from date palm leaves into the soy protein isolate (SPI) biocomposite films. The mechanical, structural, barrier, physiochemical, thermal, optical, antioxidant, and antimicrobial properties of the formulated composite films were investigated. The findings showed that the incorporation of DLECNPs into the SPI films significantly improved the film's antioxidant properties by more than 3 times and showed antibacterial inhibition zone in the range of 10-15 mm against six pathogenic bacteria. Further, incorporating LNPs into SPI-DLECNPs films notably improved the mechanical properties from 4.32 MPa and 29.27 % tensile strength and elongation at break, respectively to 10.13 MPa and 54.94 %, the water vapor permeability from 7.38 g/Pa s m to 5.59 g/Pa s m, and the antibacterial inhibition zone from a range of 10.2 mm to 15.0-21.5 mm as well as making the films more heterogeneous and stronger than control SPI film. Moreover, LNPs changed the initial films' color from light yellow to dark red and reduced the films' transparency. The results indicated that LNPs reinforced SPI composite films showed significant improvements in several properties and thus can be used as a potential ingredient for formulation of biodegradable packaging films.

Spray drying and ultrasonication processing of camel whey protein concentrate: Characterization and impact on bioactive properties.

The production of whey protein concentrates (WPCs) from camel milk whey represents an effective approach to valorize this processing by-product. These concentrates harbor active ingredients with significant bioactive properties. Camel WPCs were spray-dried (SD) at inlet temperature of 170, 185 and 200°C, or Ultrasonicated (US) for 5, 10 and 15 min, then freeze-dried to obtain fine powder. The impact of both treatments on protein degradation was studied by sodium dodecyl sulfate-PAGE and reverse-phase ultraperformance liquid chromatography (RP-UPLC) techniques. Significantly enhanced protein degradation was observed after US treatment when compared with SD. Both SD and US treatments slightly enhanced the WPCs samples' antioxidant activities. The US exposure for 15 min exhibited highest 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) scavenging activity (12.12 mmol TE/g). Moreover, US treatment for 10 min exhibited the highest in vitro anti-diabetic properties (α-amylase and α-glucosidase inhibition), and dipeptidyl-peptidase-IV inhibitory activity among all samples. In addition, the ultrasonication for 10 min and SD at 170°C showed the lowest IC50 values for in vitro anti-hypercholesterolemic activities in terms of pancreatic lipase and cholesteryl esterase inhibition. Conclusively, these green techniques can be adapted in the preservation and processing of camel milk whey into active ingredients with high bioactive properties.

Clinical and ex-vivo effect of LASERs on prevention of early-enamel caries: systematic review & meta-analyses.

To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic brackets, around restoration and in caries susceptible pits and fissures). PubMed was searched using the following keyword sequence; (Laser therapy OR laser irradiation OR laser application) AND (enamel caries prevention OR enamel demineralization OR enamel remineralization OR early enamel caries OR early-enamel caries OR enamel resistance OR enamel decalcification OR white spot lesions WSLs OR incipient lesion OR enamel decay OR enamel Dissolution OR enamel microhardness) AND (clinical trial OR Randomized clinical trial OR In situ study). The latest literature search was ended by "30 January 2023". PubMed was used as a primary data base for study selection. Scopus, EBSCO, and Google scholar are checked in our study after results of systematic search on PubMed. Only duplicates were found. Two meta-analyses were carried out. The first, clinical meta-analysis on incidence of white spot lesions (WSLs) following CO2 laser irradiation of enamel. The second meta-analysis on ex-vivo/in situ effect of CO2 laser on microhardness of enamel. In each meta-analysis three studies were included. Risk of bias was assessed. The search identified eight studies (four ex-vivo and four clinical trials). Regarding the clinical meta-analysis, the overall standardized mean difference was 0.21 [ 95% confidence interval (CI): 0.15-0.30, p < 0.00001]. This indicates that the incidence of new WSLs in patients who received low power CO2 laser treatment was highly significantly lower than placebo groups. The heterogeneity was considerable (I2 = 71%). In the second meta-analysis, the overall standardized mean difference was 49.55 [ 95% confidence interval (CI): 37.74, 61.37, p < 0.00001]. This indicates that microhardness of enamel receiving low power (0.4-5 W) CO2 laser irradiation is highly significantly lower than control untreated enamel. The heterogeneity was substantial (I2 = 48%). Within the limitations of this study, Low level laser therapy concept with CO2 laser seems to be effective in preventing enamel caries.Prospero registration number: CRD42023437379.

Assessment of consumer demographics and food safety risks associated with ready-to-eat (RTE) homemade foods purchased online in the UAE.

In the UAE, female entrepreneurs, termed "Tajrat", sell a variety of homemade food products over online social media (OSM) platforms. Some of these food products are prepared and sold outside regulatory channels, with serious public health consequences. The study aimed to identify consumer demographics associated with purchasing of RTE, homemade food sold over in OSM platforms in the UAE and to assess the food quality by evaluating microbiological quality and fat percentage in RTE foods. A representative survey of the population of the UAE (n = 1303) was conducted, covering consumer demographics, frequency of purchase, and respondents' perception towards safety and nutritional value. 66 % of respondents were Emiratis, fifty percent of whom purchased RTE foods online. Moreover, 61 % of participants purchased from "Tajrat" via OSM as opposed to other sources. Convenience (47 %) and taste (41 %) were the main drivers for purchasing RTE homemade foods. Although 76 % of respondents have at least one member of their family considered vulnerable, the safety levels, quality, and nutritional value of such products did not carry the same significance. Microbiological analysis of 35 food samples purchased online from "Tajrat" was conducted. Listeria spp. was isolated from 22 % of the samples, 43 % showed positive Staphylococcus aureus, and 31 % of the samples had coliform bacteria. Total Fat Content of RTE homemade food samples ranged between 2.6 and 30 g/100 g which is considered high and can cause serious health issues if consumed frequently. Recommendations from this study will help policy makers and regulators in the UAE to develop and implement education strategies targeting homemade food handlers.

Valorization of different low-grade date (Phoenix dactylifera L.) fruit varieties: A study on the bioactive properties of polyphenolic extracts and their stability upon in vitro simulated gastrointestinal digestion.

Nowadays, the development of suitable strategies for the management and valorization of agri-food products is one of the most important challenges worldwide. In this context, the current research study aimed to explore a valorization strategy for different varieties (Khalas, Jabri, Lulu, Booman, and Sayer) of low-grade date fruit by extracting polyphenolic compounds and investigating their health-promoting bioactive properties. The generated extracts were comparatively analyzed for their phenolic contents, antioxidant, anti-inflammatory, anti-hemolytic, and enzyme inhibitory activities upon in vitro simulated gastrointestinal digestion (SGID). The total phenolic contents (TPC) ranged from 217.3 to 1846.9 mg GAE/100 g fresh weight. After complete SGID, the TPC remarkably increased from 570.8 mg GAE/100 g fresh weight (undigested), reaching the highest value of 1606.3 mg GAE/100 g fresh weight with the Khalas cultivar. Overall, gastric and complete-SGID-treated extracts exhibited higher antioxidant activities, compared to the undigested extracts for the five selected date varieties. Similarly, the gastric and complete SGID promoted the release of bioactive components endowed with significantly higher inhibition levels towards digestive enzymes related to diabetes. Moreover, extracts from all varieties revealed an increase in the inhibition of lipidemic-related enzymatic markers and anti-inflammatory activities when subjected to the gastric digestion phase, which decreased after complete SGID. Principal component analysis (PCA) suggested that higher bioactive properties were influenced by the TPC present in the samples. Overall, low-quality dates could be considered as a potential source of bioactive polyphenols with interesting nutraceutical properties, released upon their transit through the gastrointestinal tract.

Metabolomics approach for the identification of bioactive compounds released from young and mature soybean upon in vitro gastrointestinal digestion and their effect on health-related bioactive properties.

The aim of the present study was to comparatively investigate the relative phytochemical profiles (phenolic content, organic and amino acids, free sugars, and other metabolites using metabolomics approach), and bioactive potentials of young (YS) and mature soybean (MS) upon in vitro simulated gastrointestinal digestion (SGID). Cumulatively, a total of 198 metabolites were identified in MS and YS, 119 metabolites in undigested YS, and a total of 136 metabolites in undigested MS, which further increased to 156 and 152 in YS and MS upon SGID, respectively. Gastric digesta of both YS and MS exhibited higher inhibitory properties towards α-amylase and DPP-IV enzymes than their intestinal digesta. Furthermore, the intestinal digesta of MS showed higher antioxidant and anti-inflammatory activities compared to the YS intestinal digesta. Overall, the results suggested that the gastrointestinal digestion of YS and MS displayed distinctive metabolic profiles together with varied bioactive potentials.

Seroprevalence of hepatitis B virus surface antigen (HBsAg) in Egypt (2000-2022): a systematic review with meta-analysis.

BACKGROUND: Hepatitis B infection seriously threatens global public health, especially in developing nations. Despite several investigations on HBV incidence, the national pooled prevalence remains unknown, particularly in populations at-risk at whom interventions should be primarily aimed. METHODS: A comprehensive literature search of the following databases: Medline [PubMed], Scopus, Google Scholar, and Web of Science was conducted following the PRISMA guidelines. I-squared and Cochran's Q were used to measure the heterogeneity between the studies. Publications that matched the following were included: Primary studies published in Egypt from 2000 to 2022 reported HBV prevalence based on HBsAg. We excluded any studies that were not performed on Egyptians or that were performed on patients suspected of acute viral hepatitis or studies focusing on occult hepatitis or vaccination evaluation studies, or national surveys. RESULTS: The systematic review included 68 eligible studies reporting a total of 82 incidences of HBV infection based on hepatitis B surface antigen with a total sample size of 862,037. The pooled national prevalence among studies was estimated to be 3.67% [95% CI; 3: 4.39]. Children under 20 with a history of HBV vaccination during infancy had the lowest prevalence of 0.69%. The pooled prevalence of HBV infection among pregnant women, blood donors, and healthcare workers was 2.95%, 1.8%, and 1.1%, respectively. While patients with hemolytic anemia and hemodialysis patients, patients with malignancies, HCC patients, and chronic liver disease patients had the highest prevalences at 6.34%, 25.5%, 18.6%, and 34%, respectively. Studies reporting HBV prevalence in urban settings compared to rural settings revealed a similar HBV prevalence of 2.43% and 2.15%, respectively. Studies comparing HBV prevalence in males and females revealed a higher prevalence among males (3.75%) than females (2.2%). CONCLUSION: In Egypt, hepatitis B infection is a significant public health issue. The blocking of mother-to-infant hepatitis B transmission, the scaling up of the scope of the existing vaccination program, and implementing new strategies, including screen-and-treat, may reduce the prevalence of the disease.

Multifunctional bioactive properties of hydrolysates from colocynth (Citrullus colocynthis) seeds derived proteins: Characterization and biological properties.

Citrullus colocynthis (Colocynth) has gained a great deal of interest in their applications as indigenous nutraceutical and as a functional food ingredient. The intact colocynth seed protein was enzymatically hydrolyzed using proteolytic enzymes (alcalase, bromelain, and chymotrypsin) at different time intervals of 3, 6, and 9 h. The highest degree of hydrolysis (87.82%) was observed in chymotrypsin derived colocynth seed protein hydrolysates (CSPH) for 9 h. The CSPHs was further investigated through in-vitro assay to explore its potential biological activity such as antioxidant, inhibition of enzymatic marker related to diabetes (DPP-IV, α-glucosidase and α-amylase) and hyperlipidaemia (cholesteryl esterase and pancreatic lipase). Chymotrypsin hydrolysate showed the strongest DPPH (65.7 mM TEAC) and ABTS (525.2 mM TEAC) radical scavenging activity after 6 h of hydrolysis. Moreover, chymotrypsin-treated CSPH for 6 h inhibited cholesteryl esterase (IC50 = 13.68 µg/mL) and pancreatic lipase (IC50 = 14.12 µg/mL) significantly when compared to native protein. Whereas, bromelain and alcalase treated hydrolysate for 6 h effectively inhibited α-glucosidase and α-amylase at an inhibitory concentration of IC50 = 13.27 µg/mL and of IC50 = 17 µg/mL. Overall, the findings indicated that protein hydrolysates exhibited superior biological activity than intact colocynth seed proteins isolate (CSPI) and could be a sustainable source of bioactive peptides.

The effect of mechanical and chemo-mechanical temporary cement cleaning methods on shear bond strength with self-adhesive resin cement (an in-vitro study).

BACKGROUND: Adhesive tooth-colored restorations are strongly dependent on the substrate surface cleanliness to allow intimate contact between resin cement and dentin surface, so several methods were adopted for the total cleaning of temporary cement residues. This study aimed to assess the effect of mechanical and chemo-mechanical cleaning methods of temporary cement on the immediate shear bond strength of self-adhesive resin cement to dentin surface. METHODS: Forty freshly extracted lower first premolars were cut to expose a flat dentin surface. Discs of temporary crown composite resin material were constructed and cemented to the flat dentin surface using resin-based and non-eugenol temporary cement then stored at room temperature in distilled water. Dividing of samples into two groups according to the method of temporary cement cleaning. Group I (n = 20) mechanical cleaning using the rotary instrument, and group II (n = 20) chemo-mechanical cleaning using chlorhexidine-containing scrub. CAD/CAM reinforced Composite discs were bonded to the dentin surface using self-adhesive composite resin cement, then measurement of shear bond strength was done using a universal testing machine. Further analysis of failure mode after debonding was performed by Scanning electron microscope. RESULTS: No statistically significant difference was found between the mean shear bond strength of the two cleaning methods (P-value = 0.636). Regardless of the cleaning method, the group cemented with resin-based temporary cement showed statistically significantly higher mean shear bond strength than non-eugenol temporary cement (P-value = 0.048). CONCLUSION: Both cleaning methods (mechanical and chemo-mechanical) applied in this study were effective in cleaning temporary cement remnants from the dentin substrate surface with statistically significant differences between results of shear bond strength with significantly higher values recorded with resin-based temporary cement.

Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients.

Purpose: Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. Methods: This clinical trial included 50 patients aged 3-18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. Results: After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. Conclusion: A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

Utilization of natural deep eutectic solvents and ultrasound-assisted extraction as green extraction technique for the recovery of bioactive compounds from date palm (Phoenix dactylifera L.) seeds: An investigation into optimization of process parameters.

The green extraction of bioactive compounds from date seeds was investigated using seven natural deep eutectic solvents (NADES) coupled with ultrasound-assisted extraction (UAE). The seven NADESs mainly consisted of choline chloride as hydrogen bond acceptors (HBA) and four sugars, two organic acids, and one polyalcohol as hydrogen bond donors (HBD) were utilized in this study. When the extraction efficiency of the NADESs was compared to that of the conventional solvents, all the NADESs showed superior bioactive compounds recovery efficacy. The lactic acid-based NADES had the highest extraction efficiency and was further optimized using the response surface method and Box-Behnken design. A four-factors including extraction time (10, 20, and 30 min), ultrasound amplitude (70, 80, and 90 %), % NADES content (30 %, 50 %, and 70 %) and solid-to-solvent ratio (1:30, 1.5:30, and 2:30 g/ml) each at three levels (-1, 0 and 1) using Box-Behnken design was applied. The % NADES content and the solid-to-solvent ratio were the major factors influencing the extraction efficiency of the total phenolic content (TPC) and the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity. The optimum extraction conditions included an extraction time of 15 min, ultrasound amplitude of 90 %, % NADES content of 70 % and solid-to-liquid ratio of 1:30 g/ml. The experimental values for TPC and DPPH at optimum extraction conditions were 145.54 ±â€¯1.54 (mg GAE/g powder) and 719.19 ±â€¯2.09 (mmol TE/g powder), respectively. The major phenolic compounds observed in the date seeds extracted using ChCl-LA were 3,4-dihydroxybenzoic acid, catechin and caffeic acid. This study reveals that the extraction of date seeds with NADES in combination with UAE technique was able to recover significantly higher amounts of phenolic compounds which could find useful applications in the food, pharmaceutical, and cosmetics industries.

A novel strategy for producing nano-particles from date seeds and enhancing their phenolic content and antioxidant properties using ultrasound-assisted extraction: A multivariate based optimization study.

Date seeds from the date palm fruit are considered as a waste and they are known to contain several bioactive compounds. Producing nanoparticles from the date seeds can enhances their effectiveness and their utilization as novel functional food ingredients. In this study, date seed nanoparticles (DSNPs) synthesized using acid (HCl) hydrolysis method (HCl concentration of 38% and hydrolysis time of 4 days) was found to have particle size between 50 and 150 nm. The obtained DSNPs were characterized by measuring particle size and particle charge (Zetasizer), morphology using scanning electron microscope (SEM), and determination of the functional groups using fourier-transform infrared spectroscopy (FTIR). DSNPs were further treated with green extraction technology [ultrasound-assisted extraction (UAE)] using water-based and methanol-based solvent for optimizing the extraction of the bioactive compounds by implementing response surface methodology (RSM). The UAE of DSNPs were analysed for set of responses including total phenolic content (TPC), total flavonoid content (TFC), 1,1-diphenyl-2-picrlthydrazyl (DPPH) radical scavenging activity, ferric ion reducing antioxidant power (FRAP), and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activity. Three-factor and four-factor Box-Behnken design (BBD) of three models (Synthesis of DSNPs, UAE with water, and UAE with methanol) was performed. The results showed that in UAE of DSNPs using water-based solvent, the key independent factors effecting the TPC and TFC and antioxidant activities were S:L ratio (40:1 mg/ml) and treatment time (9 min). Whereas the methanol-based UAE of DSNPs was mostly affected by US amplitude/power (90%) and methanol concentration (80%). All models were further optimized using response optimizer in Minitab and the generated predicted values were very comparable to the actual obtained results which confirm the significance and validity of all RSM models used. The phenolic compounds identified from DSNPs consisted mainly of 3,4-Dihydroxy benzoic acid, ferulic acid, and p-coumaric acid. The present study demonstrated a successful method for synthesising DSNPs as well as documented the optimum UAE conditions to maximize the extraction of polyphenolic compounds from DSNPs and enhancing their antioxidant activities to be used in food application.

Rectovestibular fistula: Which surgical approach is suitable? A randomized controlled trial.

The management of a vestibular fistula is a challenge for pediatric surgeons. We compared four different operative techniques in terms of postoperative complications, continence, and cosmetic appearance. This prospective, randomized, comparative study included female children with rectovestibular fistulae who were selected from patients with Anorectal Malformations (ARMs) treated between January 2016 and July 2020. The patients were randomly divided into four groups based on the operative technique: Trans-Sphincter Anorectoplasty (TSARP), Posterior Sagittal Anorectoplasty (PSARP), Classic Anterior Sagittal Anorectoplasty (ASARP), and modified ASARP. The incidence of vestibular fistulae among all patients with ARMs was 13.4%. The total number of patients with vestibular fistula was 112, including eighty-four (75%) with rectovestibular fistulae and twenty-eight (25%) with anovestibular fistulae. Associated congenital anomalies were found in nineteen (22.6%) patients. The percentage of parents satisfied with the cosmetic appearance and continence of their children was the highest after TSARP. PSARP had the lowest incidence regarding vaginal wall injuries. TSARP is the best operative technique for handling rectovestibular fistulae and is suitable for infants and children. In the TSARP technique, the external sphincter muscle can be preserved following complete dissection of the rectum without the need for a midline skin incision. A midline skin incision is required in the modified ASARP technique.

Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients / 대한소아소화기영양학회지

Purpose@#Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. @*Methods@#This clinical trial included 50 patients aged 3–18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. @*Results@#After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. @*Conclusion@#A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

The Nomenclature of Electroconvulsive Therapy.

ABSTRACT: Electroconvulsive therapy (ECT) is an established but stigmatized psychiatric treatment. The term ECT reflects the treatment's modality and action. Several authors proposed different names for ECT to deal with stigma; however, available literature that promoted different names did not address the risk/benefit ratio or offer evidence-based approach to the efficacy of this approach. We aim to examine proposed names for their specificity, accuracy, understandability, and popularity. In addition, we aim to find evidence-based methods to combat the ECT-related stigma. We reviewed the literature relating to the proposed names using snowballing technique for literature search. Known ECT alternative names were used for search, and whenever another name appears, it was added to our search list. We conducted Medline, PsycINFO, Google Scholar, and PubMed search to check for popularity and cross examine whether proposed terms refer back to ECT. We searched for ECT and stigma, to find evidence for methods to tackle ECT-related stigma. Once, the search stopped yielding newer ideas, we stopped the search at a point of saturation, where no more ideas where generated. Our name search yielded 14 terms. Nine names avoided "electricity" and "convulsion," because of perceived associated stigma. Presence of different terminology can affect the clarity of patient-doctor communication, with no evidence of added benefit. Alternative names may affect doctor-doctor communication about this treatment. We concluded that it is safer to retain the term ECT for the sake of consistency and clarity of communication. Education and experience are evidence-based effective methods of tackling ECT-related stigma.

Fracture resistance of primary molars restored with endocrowns versus zirconia crowns (an in vitro study) / Resistência à fratura de molares decíduos restaurados com endocrowns versus coras de zircônia (um estudo in vitro)

Objective: This study aimed to assess the fracture resistance of primary molars restored with endocrowns compared to prefabricated zirconia crowns. Material and Methods: Twelve sound, defect-free primary second molars were selected and divided into two groups: group I included 6 molars restored with zirconia crowns, while group II included 6 teeth restored with endocrowns. For both groups access cavity was prepared for the teeth to open pulp chamber. Fracture resistance of both groups was tested using a universal testing machine. Results: Zirconia crown showed statistically significantly higher mean fracture resistance than Endocrown (P-value = 0.001, Effect size = 2.72). Conclusion: Pulpotomized primary molars restored with Zirconia crowns showed significantly higher mean fracture resistance compared to primary molars restored with endocrowns, meanwhile both restorations have shown higher mean fracture resistance than the maximum biting force in children. (AU)

Objetivo: Este estudo teve como objetivo avaliar a resistência à fratura de molares decíduos restaurados com endocrowns em comparação com coroas de zircônia pré-fabricadas. Material e Métodos: Doze segundos molares decíduos hígidos e livres de defeitos foram selecionados e divididos em dois grupos: o grupo l incluiu 6 molares restaurados com coroas de zircônia, enquanto o grupo ll incluiu 6 dentes restaurados com edocrowns. Para ambos os grupos, foi preparada uma cavidade de acesso à câmara pulpar. A resistência à fratura de ambos os grupos foi testada em uma máquina de ensaio universal. Resultados: A coroa de zircônia apresentou resistência média à fratura estatisticamente significativa maior do que endocrown (p=0,001, Tamanho do efeito = 2,72). Conclusão: Molares decíduos pulpotomizados restaurados com coroas de zircônia apresentam resistência média à fratura significativamente maior em comparação aos molares decíduos restaurados com endocrowns, entretanto, ambas as restaurações mostraram maior média à fratura do que a força máxima de mordida em crianças (AU)

Adult intussusception. An overlooked diagnosis in the emergency department.

OBJECTIVE: To study the appropriate method of diagnosis and management in adult intussusception (AI) focusing on the clinical manifestations, diagnostic tools, and management of this rare disease. METHODS: This retrospective study reviewed and analyzed the demographic data, clinical features, diagnosis, management, and pathology reports of all adult patients (18 years of age and older) with a diagnosis of intussusception admitted to Sohag University Hospital, Sohag, Egypt, and Najran Armed Forces Hospital, Najran, Kingdom of Saudi Arabia (KSA) from January 2004 to August 2012. RESULTS: From 2004-2012, 14 patients with AI were diagnosed and treated. Ages ranged from 22-63 years. Ten patients (71.4%) were males. Thirteen patients (92.9%) presented with abdominal pain. All patients were diagnosed after a CT scan, and confirmed at laparotomy. The lead point was found in all, except for 2 patients. Ileo-ileal and jejuno-jejunal intussusceptions represented most of our cases (64.3%), followed by ileocolic (28.5%), and colocolic (7.1%). The most common causes were Peutz-Jeghers polyps (5 cases), submucosal lipoma (2), and malignancy (2). Surgery was the treatment option in all except one patient. Postoperative complications occurred in 3 cases (21.4%). One patient died 28 days postoperatively due to septic shock and multiorgan failure. CONCLUSION: Owing to its rarity, AI needs a high index of suspicion especially in patients attending ERs with recurrent abdominal pain. A CT scan is of prime importance in the diagnosis, and surgical treatment is the preferred method of management.