Pretreatment and gaseous radiocarbon dating of 40-100 mg archaeological bone.

Radiocarbon dating archaeological bone typically requires 300-1000 mg material using standard protocols. We report the results of reducing sample size at both the pretreatment and 14C measurement stages for eight archaeological bones spanning the radiocarbon timescale at different levels of preservation. We adapted our standard collagen extraction protocol specifically for <100 mg bone material. Collagen was extracted at least twice (from 37-100 mg material) from each bone. Collagen aliquots containing <100 µg carbon were measured in replicate using the gas ion source of the AixMICADAS. The effect of sample size reduction in the EA-GIS-AMS system was explored by measuring 14C of collagen containing either ca. 30 µg carbon or ca. 90 µg carbon. The gas dates were compared to standard-sized graphite dates extracted from large amounts (500-700 mg) of bone material pretreated with our standard protocol. The results reported here demonstrate that we are able to reproduce accurate radiocarbon dates from <100 mg archaeological bone material back to 40,000 BP.

Usefulness of the pain sensitivity questionnaire to discriminate the pain behaviour of chronic pain patients.

BACKGROUND: Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS: We compared three populations: healthy (HS, n=280), with acute pain (AP=110 patients), and chronic pain (CP=280 patients) by assessing their pain behaviour with the pain sensitivity questionnaire (PSQ-total and PSQ-minor). The influence of central sensitisation syndrome (CSS) on chronic pain behaviour, including catastrophising, was further investigated by using the central sensitisation inventory. RESULTS: Compared with the AP patients and HS, the CP patients exhibited significantly higher catastrophising scores; higher PSQ-minor scores [29.0 (21.0-39.0), than for AP 24.0 (14.0-32.5), and for healthy subjects 25.0 (17.0-34.0); and PSQ-total scores of for CP, 63.5 for AP, and 64.0 for HS. No significant difference was observed between the HS and AP populations. Significant differences were observed between the CP patients with and without CSS. The median PSQ-minor for patients with CSS was 33.0 and without CSS was 25.0 (P<0.05); the median PSQ-total for patients with CSS was 82.0 and without CSS was 65 (P<0.05). The CP patients without CSS did not show any significant difference compared with the AP and HS groups, except for catastrophising. CONCLUSIONS: This study highlights the influence of CSS in the results of PSQ and catastrophising by chronic pain patients in comparison with healthy controls and acute pain patients. CLINICAL TRIAL REGISTRATION: P2014/134.

Effect of ultraviolet photofunctionalisation on the cell attractiveness of zirconia implant materials.

Ultraviolet (UV) light treatment of implant surfaces has been demonstrated to enhance their bioactivity significantly. This study examined the effect of UV treatment of different zirconia surfaces on the response of primary human alveolar bone-derived osteoblasts (PhABO). Disks of two zirconia-based materials with two different surface topographies (smooth, roughened) were exposed to UV light. Qualitative and quantitative assessment of PhABO on zirconia surfaces, by means of immunofluorescence, scanning electron microscopy and DNA quantification at 4 and 24 h revealed a higher number of initially attached osteoblasts on UV-treated surfaces. Cell area and perimeter were significantly larger on all UV-treated surfaces (p<0.05). The proliferation activity was significantly higher on both roughened UV-treated surfaces than on untreated samples at day 3 of culture (p<0.05). The expression levels of collagen I, osteopontin and osteocalcin at day 14 and alkaline phosphatase activity at day 7 and 14 of culture period were similar among UV-treated and untreated surfaces. Alizarin-Red-Staining at day 21 demonstrated significantly more mineralised nodules on UV-treated samples than on untreated samples. Contact angle measurements and X-ray photoelectron spectroscopy showed that UV light transformed zirconia surfaces from hydrophobic to (super-) hydrophilic (p<0.05) and significantly reduced the atomic percentage of surface carbon. The results showed that UV light pre-treatment of zirconia surfaces changes their physicochemical properties and improves their attractiveness against PhABO, primarily demonstrated by an augmented cell attachment and spreading. This may result in faster healing and better bone-to-implant contact of zirconia implants in vivo following such a pre-treatment.

Success rates of prosthetic restorations on endodontically treated teeth; a systematic review after 6 years.

The aims of this systematic review were to investigate the success rates of prosthetic restorations on endodontically treated teeth and their manner of failure. PubMed and hand literature searches were conducted on studies published until June 2012. Only clinical studies on human subjects referring to the success rates of prosthetic restorations on endodontically treated teeth with a follow-up period of at least 6 years were reviewed. A total of four studies were identified. Meta-analysis showed the success rate to be 92% (CI 82-98%) for single crowns on endodontically treated teeth and 79% (72-86%) for fixed dental prostheses. Only one study reported on removable dental prostheses with a success rate of 66%. Single crowns on teeth restored without posts demonstrated a success rate of 94% (CI 84-99%), whereas where posts were placed, the success rate was lower (92% CI 82-98%). Single crowns over cast post-and-cores and prefabricated posts showed success rates of 93% (CI 82-99%) and 94% (CI 90-97%), respectively; both differences were not statistically significant (significance level of 5%). The most common reason for failure was post-debonding. Single crowns seem to be the best treatment modality for endodontically treated teeth. However, due to the low number of studies included and their design, the results of this systematic review should be interpreted with caution. Further clinical studies are needed to provide high-quality evidence on the topic.

Prognosis of immediately loaded implants and their restorations: a systematic literature review.

Immediate loading of oral implants has become popular because of the increasing demands of a shortened treatment time. This literature review evaluates the prognosis of immediately loaded implants and their restorations with immediate or delayed implant placement. Special attention was given to the impact of type of jaw, bone quality, implant length, time of implant placement and type of restoration. An electronic (PubMed) and a manual search in relevant journals were conducted until February 2012. Only publications in English, in peer-reviewed journals, were considered. Nine studies met the inclusion criteria: five studies dealt with fixed restorations, two studies with removable rehabilitation of edentulous jaws and two studies dealt with partially edentulous patients. Implant survival rates ranged from 95·8% to 100%, implant success rates in the treatment for the mandible from 79% to 100% and restoration survival rates for both jaws from 96·4% to 100%. Within the limits of this review, appropriate patient selection, primary implant stability, splinting of implants and the expertise of surgeons seem to be important for the prognosis of immediately loaded implants and their restorations. Good bone quality and use of long implants appear to play a role. However, careful interpretation is required because conclusions are based on articles with low level of evidence. While immediate loading of oral implants in the mandible shows encouraging and predictable results, further multicenter randomised controlled clinical trials with sufficient statistical power are needed to examine (i) the outcome of immediately loaded implants in the maxilla and (ii) the outcome of immediate loading of immediately placed implants.

Prognosis of implants and fixed restorations after lateral sinus elevation: a literature review.

Aim of this review was to investigate the prognosis of implants inserted in augmented sinuses and fixed restorations supported by these implants. Special attention was given to the impact of grafting material, time of implant placement, residual bone height and type of fixed restoration. An electronic search in PubMed, the German database medpilot and the Cochrane Library was executed followed by supplementary manual search in relevant journals. The search was limited to human studies published up to November 2010. Only publications in English and German, in peer-reviewed journals, were considered. After the initial search and application of selection criteria on titles and abstracts, a full-text analysis of 67 articles was performed, out of which six prospective and three retrospective studies were finally included in the review. The heterogeneous properties of the identified articles did not allow systematic analysis of the data. Success rates of implants were between 96·3% and 100%, survival rates were between 75% and 100%, and survival rates of single crowns, splinted crowns and fixed partial dentures ranged between 96·4% and 100% after a follow-up of 12-101 months. Within the limits of this review, the prognosis of implants and fixed restorations seemed not to be influenced by the type of restorations, graft material, residual bone height and time of implant placement. However, conclusions of this review are based on studies with low level of evidence; therefore, careful interpretation is required. Multicentre randomised controlled clinical trials with sufficient statistical power concentrating on few factors are needed to reach sound conclusions.

[Long-term outcome of patients treated with spinal cord stimulation for therapeutically refractory failed back surgery syndrome: a retrospective study]. / Évaluation à long terme de la stimulation médullaire dans les douleurs lombosciatiques neuropathiques postopératoires: étude rétrospective.

BACKGROUND AND PURPOSE: Long-term efficiency (>5 years) of spinal cord stimulation for failed back surgery syndrome is poorly described in literature. The aims of our study were to evaluate the long-term efficiency and the quality of life of our series of patients with spinal cord stimulation for failed back surgery syndrome. METHODS: The data of 55 patients implanted successively in our institution between 1995 and 2005 for failed back surgery syndrome were collected retrospectively. We contacted them for a telephone survey focused on efficiency, quality of life and treatment satisfaction. RESULTS: An internal pulse generator was placed in 42 patients. Thirty-two of them were contacted to answer our survey with a mean follow-up of 8.3 years. Seventy-five percent of our population reported a pain decrease of greater or equal to 50%. The efficiency of percutaneous leads was reported as 50% for the quadripolars and 83% for the octopolars. The surgical leads evaluations were positive in 70% for 4 × 1 as well as for 4 × 2 leads. We observed a default of low back pain relief in 84% of patients with an incomplete pain relief (59%). The ability to sit, get out of the bed, and climb stairs increased in 75%. The walk was better in 82%. Decrease in drug consumption of greater or equal to 50% was observed in 66%. CONCLUSIONS: Our retrospective study demonstrates a satisfaction of 75% of the patients after 8.3-years follow-up. Spinal cord stimulation is an effective treatment for refractory failed back surgery syndrome.

[Analgesics and palliative care]. / Antalgiques et soins palliatifs.

Pain is an important and often under-treated symptom of life-threatening illness. A complete evaluation of pain facilitate optimal treatment. Correct use of analgesic medication, following the guidelines of the W.H.O. step ladder, with attention to detail, with addition of adjuvant analgesics, should control the pain in most of the cases. The use of weak and strong opioid analgesics, their tolerance, the breakthrough doses, principle of opioid rotation and the place of adjuvant drugs are discussed. Proper pain management in end-of-life is never easy and require to become more familiar with the use of these analgesics and to surround oneself with a multidisciplinary team.

Fragmentation branching ratios of highly excited hydrocarbon molecules CnH and their cations CnH+ (n

We have measured fragmentation branching ratios of neutral C(n)H and C(n)H(+) cations produced in high velocity (4.5 a.u) collisions between incident C(n)H(+) cations and helium atoms. Electron capture gives rise to excited neutral species C(n)H and electronic excitation to excited cations C(n)H(+). Thanks to a dedicated setup, based on coincident detection of all fragments, the dissociations of the neutral and cationic parents were recorded separately and in a complete way. For the fragmentation of C(n)H, the H-loss channel is found to be dominant, as already observed by other authors. By contrast, the H-loss and C-loss channels equally dominate the two-fragment break up of C(n)H(+) species. For these cations, we provide the first fragmentation data (n>2). Results are also discussed in the context of astrochemistry.

Bispectral index is a topographically dependent variable in patients receiving propofol anaesthesia.

BACKGROUND: As very strong agreement has been reported between bispectral index (BIS) values measured from the occipital and frontal skull areas, we compared BIS values measured from central and parietal areas with those from frontal area to investigate whether BIS is really a topographically dependent or topographically independent variable. METHODS: Twenty patients, ASA I-II, non-obese, aged 18-62 yr and with no neurological disorders were enrolled. Based on the 10-20 international landmarks, five silver dome electrodes were positioned: F7, C3, P7, Cz (common reference) and Fp1 (ground). Using frontal (F7-Cz), central (C3-Cz) and parietal (P7-Cz) electrode montages, the corresponding BIS values were simultaneously recorded with an Aspect A-1000 monitor (software v3.12). The BIS values were recorded at the propofol concentration allowing laryngeal mask insertion, which was maintained during the 10 min data collection period in absence of additional external stimuli. Data were analysed using the Kruskall-Wallis, Wilcoxon paired sign with Bonferroni correction, Bland-Altman and linear correlation tests. RESULTS: At the predicted effect target propofol concentration 4-8 microg ml(-1), the 10 min mean BIS (median [min-max]) were 32 [20-44], 46 [28-68] and 58 [41-72] for the frontal, central and parietal leads, respectively. Differences between these BIS recordings were statistically significant (P<0.0001, Kruskall-Wallis; P<0.005, Wilcoxon paired sign test). CONCLUSIONS: The present results provide evidence that BIS index is a topographically dependent variable in patients receiving propofol anaesthesia.

Correlation between pathological risk factors and pelvic lymph node metastases in stage I squamous carcinoma of the cervix: a multivariate analysis of 194 cases.

This study includes 194 patients with stage I cervical cancer subjected to surgical therapy. Of 14 pathological factors analyzed, microscopic parametrial involvement (P = 0.001), depth of invasion (P = 0.001), and lymphovascular space invasion (P = 0.029) were found to be the most significant factors for positive pelvic lymph nodes. Combination of significant factors permitted categorization of patients into risk groups with pelvic lymph node metastases ranging from 0.0% to 90.9%.