Operators' radiation exposure reduction during cardiac catheterization using a removable shield.

Cardiac catheterization through radial access is associated with significant ionizing radiation exposure for the operator. We aimed at evaluating whether a removable shield placed upon the patient could impact favorably on annual radiation exposure for the operator. We designed a pre-post study comparing radiation exposure in a total of five operators under standard protection procedures (first period) and after applying a removable shield (second period). Each period included all the procedures performed in 1 year. Radiation exposure was measured through three dosimeters on each operator. A total of 1610 procedures were performed during the first period, and 1670 during the second period. For each operator, Fluoroscopy Time (FT) per exam did not differ between the two periods (13.1 ± 1 vs 12.9 ± 2 min/exam, p = 0.73), whereas Dose-Area Product (DAP) per procedure was slightly higher in the second period (5.247 ± 651 vs 6.374 ± 967 mGy/cm2, p < 0.01). The use of a removable shield significantly reduced operators' radiation dose at the left bracelet (64.3 ± 13.3 µSv/exam vs 23.8 ± 6.0 µSv/exam, p = 0.003). This remained significant even after adjustment for DAP per procedure (p = 0.015) and number of operators participating to each procedure (p = 0.013), whereas no significant difference was observed for card (5.6 ± 10.5 µSv/exam vs 0.9 ± 0.3 µSv/exam, p = 0.36) and neck bands (3.3 ± 4.5 µSv/exam vs 2.0 ± 2.0 µSv/exam, p = 0.36) dosimeters. The use of a removable shield during cardiac catheterization reduces radiation exposure at the level of the operator's upper limb, whereas no difference was found for other body parts. This may help in reducing radiation exposure of operator's hand. DAP increase merits further investigation.

Genetic detection and characterization of emerging HoBi-like viruses in archival foetal bovine serum batches.

Bovine viral diarrhea viruses (BVDV) are members of the Pestivirus genus within the family Flaviviridae. Based on antigenic and nucleotide differences, BVDV are classified into two recognized species, BVDV-1 and BVDV-2. More recently, a new putative pestivirus species, tentatively called "HoBi-like", has been associated with bovine viral diarrhea. HoBi-like viruses were first identified in fetal bovine serum (FBS) imported from Brazil. Subsequently, a number of HoBi-like viruses have been detected as contaminants in FBS or cell culture and in live ruminants. To further investigate the possible pestivirus contamination in commercially available FBS batches, 26 batches of FBS with various countries of origin, were tested in this study for the presence of bovine pestiviruses. All the 26 batches were positive by RT-PCR for at least one species of bovine pestiviruses. HoBi-like viruses were detected in 15 batches. Analysis of the 5'UTR and N(pro) sequences of 15 newly identified HoBi-like viruses combined with analysis of additional sequences from GenBank, identified 4 genetic groups tentatively named 3a-3d. The current study confirmed the presence of the emerging HoBi-like viruses in FBS products labeled with different geographic origins. This finding has obvious implications for the safety of biological products, such cell lines and vaccines.

Spontaneous-idiopathic left anterior descending artery dissection: is watchful waiting better than immediate stenting?

Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, nowadays poorly understood yet. The lack of firm recommendations about this issue is a great limitation which makes any therapeutic decision controversial. The case described is that of a young, otherwise healthy woman, who presented with an ostial dissection of the left anterior descending (LAD) artery. Due to patient's stable clinical and hemodynamic parameters, we used a cautious approach based on watchful waiting and medical therapy, postponing stenting in order to achieve a partial vessel reopening with a more comfortable access to PCI.

Phylogenetic analysis of small ruminant lentivirus (SRLV) in Italian flocks reveals the existence of novel genetic subtypes.

In order to investigate the genetic heterogeneity of small ruminant lentivirus (SRLV) isolates in Italy, 55 clinical samples collected between 1998 and 2010 were analysed. The phylogenetic study was based on analysis of gag-pol sequences. Our findings revealed that the SRLVs belonged to the subtype A9 (n = 3, sheep), B1 (n = 5, goat), B2 (n = 3, sheep) and E2 (n = 5, goat). Interestingly, 39 isolates from both sheep and goat, significantly differed from all the other SRLVs previously described and formed two separate clusters within genotypes A and B tentatively named A11 (n = 27, goat and sheep) and B3 (n = 12, goat and sheep), which have never been shown before. These results revealed a marked diversity among Italian field SRLV strains which might reflect the absence of any systematic control measures.

Modulation of BDNF and TrkB expression in rat hippocampus in response to acute neurotoxicity by diethyldithiocarbamate.

In this study, we examined the expression profile of brain-derived neurotrophic factor (BDNF) and its receptor TrkB in adult rat hippocampus following acute administration of diethyldithiocarbamate (DDTC), a neurotoxic compound which was previously shown to induce microglia activation and cell death. Semiquantitative RT-PCR analysis detected significant variations of BDNF mRNA levels in whole hippocampus homogenates, with a peak at 24h after DDTC injection. Increased BDNF protein expression was demonstrated by immunohistochemistry in various hippocampal subfields. The most relevant increase was observed in the hilus of the dentate gyrus where BDNF levels at 120h were found to be almost four times those of basal levels. Full-length TrkB (TrkB.FL) encoding mRNA was also shown to undergo an earlier increase in the hippocampus of DDTC-treated rats. TrkB immunostaining with an antibody binding both full-length and truncated (TrkB.T) isoforms was found to increase at 120h in the hippocampal CA2 and CA3 regions. These results demonstrate that DDTC modulates the expression of BDNF and its receptor in the adult rat hippocampus and suggest a possible involvement of this neurotrophin in the protective response to DDTC-induced neuronal damage.

Dentinal adhesive with composite restorations: a clinical and microstructural evaluation.

It is generally accepted that the application of dentin-enamel adhesive should involve not only the etched enamel but also the dentinal surface. For this purpose, new bonding agents requiring dentin etching and the combined use of bifunctional groups (Primers) as well as hydrophilic resins have been introduced. This study used scanning electron microscopy to analyze the relationship between dentin and fluid resin of three bonding agents. The results demonstrated that the adhesive monomers easily penetrated the etched dentin, sealing the dentinal tubules and creating a resin dentin interdiffusion zone (hybrid layer). As a result, the microleakage between dentin and resin composite restorations, responsible for postoperative tooth sensitivity, pulpal inflammatory reaction, and secondary decay, is greatly reduced.

Marginal seal and biocompatibility of a fourth-generation bonding agent.

OBJECTIVES: The pulpal reaction and the marginal sealing of in vivo restored samples using resin composite and Scotchbond Multi-Purpose adhesive system (3M Dental Products) were analyzed in this study. METHODS: Twelve Class I non-exposed cavity preparations were placed on premolars to be removed for orthodontic reasons. They were restored and observed at 7 d and 28 d. RESULTS: The examination of the resin-dentin interface under the scanning electron microscope (SEM) revealed: 1) a gap-free attachment between adhesive resin and dentinal surface in 80% of the areas studied, 2) penetration of resin tags into the dentinal tubules, and 3) formation of a 3-5 micrometer thick acid-resistant hybrid layer. Microfissures measuring about 10 micrometers were observed in only 20a% of the areas studied; these were located along the walls of the cavities, especially near the enamel in zones where there was a lower concentration of dentinal tubules. The histological analysis, carried out 7 d after preparation of the restoration, did not show any alteration of the pulp. After 4 wk, reparative dentin was produced in the pulpal areas corresponding to the restored cavities. SIGNIFICANCE: The quantity of newly formed dentin is correlated with the distance from the cavity to the pulp. The results indicate that acid-etching of vital dentin using 10% maleic acid does not impair pulpal healing in deep Class I cavities and that the Scotchbond Multi-Purpose adhesive system is able to preserve the morphological and biological integrity of the pulpo-dentinal complex.

In vivo and in vitro analysis of a bonding agent.

Recently many researchers have become interested in the adhesion of composite resin to the dentinal surface. Because it is easier to obtain good composite resin adhesion when a surface is free from smear plug, several chemical agents (acids or linking agents) have been suggested for surface preparation. Nevertheless, the pretreatment of dentin leads to an increase of pulpal outflow, which can interfere with the bonding agent's adhesion. Thus, new-generation dentinal bonding agents appeared on the market. They use a pool of highly absorbent primers to facilitate the scattering of the agent in the dentin substratum under humid conditions. The present study shows the results, obtained with the help of scanning electron microscopy, of resinous penetration into the tubular structures of dentin using a latest-generation bonding system. The in vivo and in vitro tests showed a deep scattering of intermediate fluid resin into tubules, even in the presence of physiologic outflow of dentinal fluids.

[An ultrastructural analysis of dentin treated with chemical agents]. / Analisi ultrastrutturale della dentina trattata con agenti chimici.

Dental last generation bonding systems require the total removal of smear layer and smear plug by chemical solutions. Intermediate fluid resin can penetrate the dentinal tubes obtaining a better anchorage to the dental structures. The department of Operative dentistry of the University of Rome "La Sapienza" has carried research observing by means of the SEM the ultrastructural aspect of smear layer and the effect of dentin treatment with five different chemical agents.

[An ultrastructural analysis of the peritubular dentin and of the tubular lumen in healthy teeth]. / Analisi ultrastrutturale della dentina peritubulare e del lume tubulare di denti santi.

In this study the authors examined some specimens of fractured dentine of embedded healthy teeth, of people aged between 20 and 30. Connecting the scanning electron microscopy to a system of computerised analysis of spectrometry (EDS) allowed the analysis of the qualitative composition of the specimens. Therefore, the authors described the tubular structure of the sound, the peri- and the intertubular dentine, the winding course of the dentinal tubules and in some specimens, the presence of cylindrical structures inside the tubules. The EDS analysis demonstrated that these tubular structures have the same composition as the intertubular dentine. Former studies described hollow cylindrical structures having a similar morphology solely as a response of the odontoblasts to white spots. On the contrary, in this study it was demonstrated that it is possible to find cylindrical structures which are definitely mineralized in sound teeth without caries. However, the presence of such formations is not concomitant with the disappearance of peritubular dentine which is a typical structural modification of the pathological advancement of the carious lesion.

[Reduced cavities for amalgam fillings]. / Cavità ridotte nelle otturazioni in amalgama.

Teeth with small interproximal lesions can be treated with reduced cavities for amalgam. This kind of reconstruction produces a good retention while removing less healthy dental tissue and safeguarding the aesthetic appearance with the advantages of amalgam, which is better compared with composite resins, especially for proximal contact and marginal adaptation.

[Tetanus prevention in a hospital emergency department]. / Prevenzione contro il tetano nel servizio di pronto soccorso ospedaliero.

Antibody titers to tetanus toxin in a group of 304 patients were estimated by means of the passive haemagglutination with turkey erythrocyte test. It appears that some sorts of workers, particularly the female subjects, do not get vaccinated against tetanus, although vaccination is provided for by law. Furthermore, it has been demonstrated that about 17% of the regularly vaccinated subjects are non protected and that antibody titers keep on protection levels in a high percentage of subjects even at a distance of ten years.