Investigating the Effect of Internal Bleaching With 10% Carbamide Peroxide on the Color Change of Three Types of Common Endodontic Sealers.

Background and purpose Color change caused by materials used for endodontic treatment is an important clinical issue. The current research examined the impact of internal bleaching with 10% carbamide peroxide on discolored teeth resulting from various types of sealers. Materials and methods In this study, 36 anterior teeth were cut from 1 mm beneath the cementoenamel junction (CEJ), and the samples were divided into three groups of 12. Then, AH26 (Tulsa Dental, Tulsa, OK), Endofill (Herpo Produtos Dentários Ltda, Petrópolis, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany) color change potential sealers were placed inside the pulp chamber. The cervical access cavity was covered with a thin layer of glass ionomer. After one month, the material was removed, and bleaching was done with 10% carbamide peroxide. The color of the samples was measured by a spectrophotometer before bleaching, one week after bleaching, and one week after bleaching again. The data were subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS) software version 16 (IBM SPSS Statistics, Armonk, NY), with a significance level set at P<0.05. Results The results showed that the factor of time and material used and the opposing effect of these two on the amount of L and ΔE were statistically significant (P<0.05). After one to two weeks of internal bleaching, all groups showed some degree of reduction in sealer-induced discoloration. In addition, in all groups, the largest difference in L was related to the difference in L0 and L2 (before bleaching and one week after bleaching again), and the lowest difference was related to the difference in L0 and L1. Also, the highest ΔE(T0,T1) belonged to the Endofill group, and this significantly differed from the AH26 group. AH26 showed the lowest value of ΔE(T0,T1), and after two weeks, the ΔE of all groups was higher than the clinically observable limit. The highest ΔE(T2,T0) among the groups belonged to the Endofill group. The ΔE(T2,T0) of AH26 and Endofill was significantly higher than AH Plus. Among all ΔE values, the AH Plus group had the lowest values. Conclusion Color change caused by Endofill and AH26 sealers showed a better response to internal bleaching than the AH Plus sealer.

Return to driving after total hip and knee arthroplasty - the perspective of employed patients.

PURPOSE: To address the paucity of research on patient perspectives regarding return to driving after Total Hip and Total Knee arthroplasty (THA; TKA), and how this impacts on return-to-work. MATERIALS AND METHODS: Employed participants, who had undergone THA or TKA, took part in semi-structured telephone interviews. They were asked about support received regarding driving, who provided this information, and the impact of this on their return to driving and consequently work. RESULTS: Thirty-eight people were interviewed. Although sources of information and advice were available, patients struggled to know who to approach. Interviewees reported variations and contradictions in the advice given on when they could safely return to driving after surgery. Of note, there was little difference in the advice given to those who had undergone THA compared to TKA. Many participants devised their own plan for returning to driving. CONCLUSIONS: There is inconsistency in driving advice provided after THA and TKA. Consequently, patients make their own decisions about how and when to drive, and develop strategies to accelerate the process. Greater clarity is required from healthcare professionals on time frames for driving post-surgery and for advising patients on their responsibilities around informing the DVLA and insurance companies of their surgery.IMPLICATIONS FOR REHABILITATIONHealthcare professionals should be aware of medico-legal requirements when advising patients about their legal responsibilities regarding driving after joint arthroplasty.Given the pivotal role of driving in the resumption of work after joint arthroplasty, there needs to be greater importance placed on the provision of explicit advice and support on driving for those undergoing orthopaedic surgery.As driving is a complex skill, the advice given to patients should be individualised.Factors to be considered should be the type of vehicle driven e.g., automatic/manual transmission; height of the vehicle from the ground; the side of the surgery; any medication prescribed which might impact on driving, and consideration of any comorbidities.

Return to work advice after total hip and knee replacement.

BACKGROUND: Little is known about the information and advice on return to work received by patients undergoing total hip and knee replacement. AIMS: To investigate patients' views and experiences of work-related advice provided by clinicians, and how this might be improved. METHODS: Semi-structured interviews with patients who had undergone total hip and knee replacement, were working prior to surgery and intended to return to work. Data were analysed thematically. RESULTS: Forty-five patients from three UK regions were consented. Eight themes were identified including lack of information, lack of an individualized approach and accessibility and acceptability of information dissemination methods. Patients identified their information needs and who they felt was best placed to address them. CONCLUSIONS: Patients receive little information and advice on return to work following total hip and knee replacement, although not all patients required this. However, more focus is needed on providing this, and patients should be screened to ensure resources are best targeted with interventions being tailored to the individual.

Antibacterial Susceptibility Pattern of the Pseudomonas aeruginosa and Staphylococcus aureus after Exposure to Electromagnetic Waves Emitted from Mobile Phone Simulator.

BACKGROUND: The increasing use of telecommunication devices such as Wi-Fi modems and mobile phones in the recent years can change the cellular structure of microorganisms so the generation of electromagnetic waves has led to concern in the community whenever be exposed to these fields and may have harmful effects on human health. MATERIAL AND METHODS: In this experimental study, standard strains of bacteria were prepared on Mueller-Hinton agar for bacterial growth to obtain 0.5 McFarland turbidity (1.5 × 108 CFU) of bacteria. Antibiotic susceptibility test using the Kirby-Bauer disk diffusion method was done. For Staphylococcus aureus and Pseudomonas aeruginosa, antibiotics susceptibility test was conducted. The test group was exposed to electromagnetic waves emitted by mobile phone simulator with a frequency of 900 MHz and the control group were not exposed. RESULTS: The results revealed that increasing duration of exposure to electromagnetic waves emitted by the mobile simulators with a frequency of 900 MHz especially after 24 h of exposure, can increase bacterial resistance in S. aureus, and P. aeruginosa. CONCLUSION: Several factors can cause bacterial resistance against antibiotics. One of these factors is the electromagnetic waves emitted from mobile simulator with a frequency of 900 MHz, which can increase the permeability of the cell wall of bacteria.

Engaging workplace representatives in research: what recruitment strategies work best?

Background: Workplaces are key stakeholders in work and health but little is known about the methods used to recruit workplace representatives (WRs), including managers, occupational health advisers and colleagues, to externally funded healthcare research studies. Aims: To detail the strategies used in recruiting WRs from three areas of the UK to a qualitative study concerning their experience of employees undergoing hip or knee replacement, to compare the strategies and inform recruitment methods for future studies. Methods: Six strategies were used to recruit WRs from organizations of different sizes and sectors. Data on numbers approached and responses received were analysed descriptively. Results: Twenty-five WRs were recruited. Recruitment had to be extended outside the main three study areas, and took several months. It proved more difficult to recruit from non-service sectors and small- and medium-sized enterprises. The most successful strategies were approaching organizations that had participated in previous research studies, or known professionally or personally to team members. Conclusions: Recruiting a diverse sample of WRs to healthcare research requires considerable resources and persistence, and a range of strategies. Recruitment is easier where local relationships already exist; the importance of building and maintaining these relationships cannot be underestimated. However, the potential risks of bias and participant fatigue need to be acknowledged and managed. Further studies are needed to explore how WRs can be recruited to health research, and to identify the researcher effort and costs involved in achieving unbiased and representative samples.

Exposure to Visible Light Emitted from Smartphones and Tablets Increases the Proliferation of Staphylococcus aureus: Can this be Linked to Acne?

BACKGROUND: Due to rapid advances in modern technologies such as telecommunication technology, the world has witnessed an exponential growth in the use of digital handheld devices (e.g. smartphones and tablets). This drastic growth has resulted in increased global concerns about the safety of these devices. Smartphones, tablets, laptops, and other digital screens emit high levels of short-wavelength visible light (i.e. blue color region in the visible light spectrum). MATERIAL AND METHODS: At a dark environment, Staphylococcus aureus bacteria were exposed to the light emitted from common tablets/smartphones. The control samples were exposed to the same intensity of light generated by a conventional incandescent light bulb. The growth rate of bacteria was examined by measuring the optical density (OD) at 625 nm by using a spectrophotometer before the light exposure and after 30 to 330 minutes of light exposure. RESULTS: The growth rates of bacteria in both smartphone and tablet groups were higher than that of the control group and the maximum smartphone/control and tablet/control growth ratios were observed in samples exposed to digital screens' light for 300 min (ratios of 3.71 and 3.95, respectively). CONCLUSION: To the best of our knowledge, this is the first study that investigates the effect of exposure to light emitted from digital screens on the proliferation of Staphylococcus aureus and its association with acne pathogenesis. Our findings show that exposure to short-wavelength visible light emitted from smartphones and tablets can increase the proliferation of Staphylococcus aureus.

Evaluation of the Effect of Radiofrequency Radiation Emitted From Wi-Fi Router and Mobile Phone Simulator on the Antibacterial Susceptibility of Pathogenic Bacteria Listeria monocytogenes and Escherichia coli.

Mobile phones and Wi-Fi radiofrequency radiation are among the main sources of the exposure of the general population to radiofrequency electromagnetic fields (RF-EMF). Previous studies have shown that exposure of microorganisms to RF-EMFs can be associated with a wide spectrum of changes ranged from the modified bacterial growth to the alterations of the pattern of antibiotic resistance. Our laboratory at the nonionizing department of the Ionizing and Non-ionizing Radiation Protection Research Center has performed experiments on the health effects of exposure to animal models and humans to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, magnetic resonance imaging, and Helmholtz coils. On the other hand, we have previously studied different aspects of the challenging issue of the ionizing or nonionizing radiation-induced alterations in the susceptibility of microorganisms to antibiotics. In this study, we assessed if the exposure to 900 MHz GSM mobile phone radiation and 2.4 GHz radiofrequency radiation emitted from common Wi-Fi routers alters the susceptibility of microorganisms to different antibiotics. The pure cultures of Listeria monocytogenes and Escherichia coli were exposed to RF-EMFs generated either by a GSM 900 MHz mobile phone simulator and a common 2.4 GHz Wi-Fi router. It is also shown that exposure to RF-EMFs within a narrow level of irradiation (an exposure window) makes microorganisms resistant to antibiotics. This adaptive phenomenon and its potential threats to human health should be further investigated in future experiments. Altogether, the findings of this study showed that exposure to Wi-Fi and RF simulator radiation can significantly alter the inhibition zone diameters and growth rate for L monocytogenes and E coli. These findings may have implications for the management of serious infectious diseases.

Intake of legumes and the risk of cardiovascular disease: frailty modeling of a prospective cohort study in the Iranian middle-aged and older population.

BACKGROUND/OBJECTIVES: The purpose of this study was to explore the association of legume intake (beans, chickpeas, lentils and so on), as part of a low-glycemic index diet, with the risk of cardiovascular events in the Iranian middle- and old-aged people. SUBJECTS/METHODS: A total of 6504 subjects living in the three counties of Iran participated in the Isfahan Cohort Study. Totally, 6323 were free of cardiovascular disease (CVD) at their baseline examination. Of the 6323 individuals, 5398 participants remained in the study for 7 years of follow-up. They have been contacted every 2 years for possible occurrence of CVD events including fatal and non-fatal myocardial infarction, unstable angina, fatal and non-fatal stroke, and sudden cardiac death. The frequency of legume intake was estimated using a food frequency questionnaire. Cox proportional hazards models with shared gamma frailty terms were used to model time to event outcomes. RESULTS: After a median follow-up of 6.8 years, 427 cardiovascular events occurred. The intake of legumes in different tertiles of consuming measure was associated with 34% lower risk of CVD in old-aged people, after controlling for the other probable confounders (hazard ratio and 95% CI: 0.66 (0.45, 0.98), P-value=0.039). However, there was no significant association between the frequency of consuming legumes and CVD events in the middle-aged people. CONCLUSIONS: The present study indicated a strong inverse relationship between legume intake and the risk of cardiovascular events in old-aged Iranian people.

Klebsiella pneumonia, a Microorganism that Approves the Non-linear Responses to Antibiotics and Window Theory after Exposure to Wi-Fi 2.4 GHz Electromagnetic Radiofrequency Radiation.

BACKGROUND: Drug resistance is widely believed to be an increasingly serious threat to global public health. We have previously reported that short term exposure of microorganisms to diagnostic ultrasound waves could significantly alter their sensitivity to antibiotics. In our previous studies, Klebsiella pneumoniae showed major differences in the sensitivity to antibiotics in exposed and non-exposed samples. This study was aimed at investigating the alteration of antibiotic resistance of Klebsiella pneumonia, after exposure to Wi-Fi 2.4 GHz electromagnetic radiofrequency radiation. MATERIALS AND METHODS: In this in vitro study, three replicate agar plates were used for each test. The antibiotic susceptibility test was carried out using disc diffusion method on Mueller Hinton agar plates and the inhibition zones in both control and exposed groups were measured. A common Wi-Fi router was used in this study as the radiofrequency exposure source. Irradiated samples were exposed to Wi-Fi radiofrequency radiation for 3, 4.5 and 8 hours. RESULTS: Statistically significant variations of sensitivity to antibiotics were found for all studied antibiotics after 4.5 hours of RF exposure, compared to non-exposed bacteria. Interestingly, the mean diameters of the inhibition zones after 3 hours of exposure were less than those exposed for 4.5 hours. Following this rise in the sensitivity to antibiotics, a fall was observed in the bacteria exposed for 8 hours for all studied antibiotics. CONCLUSION: The findings of this study show a statistically significant rise in the sensitivity of Klebsiella pneumoniae to different antibiotics after 4.5 hours of exposure to 2.4 GHz Wi-Fi radiation, followed by a fall after 8 hours of exposure. These observations can be interpreted by the concept of non-linearity in the responses of Klebsiella pneumoniae to different antibiotics after exposure to electromagnetic radiofrequency radiation. As in this study a minimum level of effect was needed for the induction of adaptive response, these results also confirm the validity of the so-called "window theory".

Characterization of hydrocortisone bioconversion and 16S RNA gene in Synechococcus nidulans cultures.

A unicellular cyanobacterium, Synechococcus nidulans (Pringsheim) Komárek, was isolated from paddy-fields and applied in the biotransformation experiment of hydrocortisone (1). This strain has not been previously tested for steroid bioconversion. Fermentation was carried out in BG-11 medium supplemented with 0.05% substrate at 25 degrees C for 14 days of incubation. The obtained products were chromatographically purified followed by their characterization using spectroscopic methods. 11beta,17beta-dihydroxyandrost-4-en-3-one (2), 11beta-hydroxyandrost-4-en-3,17-dione (3), and androst-4-ene-3,17-dione (4) were the main bioproducts in the hydrocortisone bioconversion. The observed bioreaction characteristics were the side chain degradation of the substrate to prepare compounds (2) and (3) following the 11beta-dehydroxylation for accumulation of the compound (4). Time course study showed the accumulation of the product (2) from the second day of the fermentation and compounds (3) and (4) from the third day. All the metabolites reached their maximum concentration in seven days. Cyanobacterial 16S rRNA gene was also amplified by PCR. Sequences were amplified using the universal prokaryotic primers which amplify a approximately 400-bp region of the 16S rRNA gene. PCR products were sequenced to confirm their authenticity as 16S rRNA gene of cyanobacteria. The result of PCR blasted with other sequenced cyanobacteria in NCBI showed 99% identity to the 16S small subunit rRNA of seven Synechococcus species.

Study of interpolation method in diagnosis of carpal tunnel syndrome and comparison with midpalm antideromic sensory method.

Carpal tunnel syndrome (CTS) is the most common focal compression neuropathy. There are a significant number of different methods available to evaluate a patient for median nerve compromise at the carpal tunnel. One of them is interpolation method created by Dr E.B. Bodofski. In our study Sensitivity of interpolation method was 85.5%, Specificity was 85%, Positive predictive value was 94.6% and Negative predictive value was 65.4%. These results are lower than Dr Bodofski results. Also in our study sensitivity of midpalm antidromic sensory method was 95.1%, Specificity was 95%, Positive predictive value was 98.3% and Negative predictive value was 86.4%, these results are higher than results of interpolation method. These show interpolation method is a good method (with high sensitivity & specificity) for diagnosis of mild CTS, but it's sensitivity & specificity are lower than antideromic sensory stimulation method at wrist & midpalm.

The effectiveness of EMG biofeedback in the treatment of arm function after stroke.

The study was designed to evaluate the effect of electromyographic (EMG) biofeedback on the recovery of arm function after stroke. Patients who had impaired arm function and were between 2 and 8 weeks after stroke were randomly allocated to receive either treatment incorporating EMG biofeedback or a control treatment in addition to their routine physiotherapy. The two groups of 20 patients were compared before and after 6 weeks of treatment and at follow-up 6 weeks later. There were no significant differences between the groups before treatment or at follow-up, but at the end of treatment those who received EMG biofeedback scored significantly higher on tests of arm function. Patients with severe impairment were shown to benefit most from EMG biofeedback but there was no difference in response to treatment according to patient's age or side of stroke. Men had higher arm function scores than women before and at the end of treatment, but not at follow-up.

An investigation of factors affecting progress of patients on a stroke unit.

The aim of the study was to identify factors affecting the progress in physical abilities and activities of daily living of patients admitted to a stroke unit. A series of 70 patients admitted consecutively were assessed on a series of tests of motor, functional and cognitive abilities at admission. They were assessed for level of motor abilities and activities of daily living at discharge and 9 months after stroke. Predictive equations were developed which account for between 61% and 33% of the variance in motor abilities and activities of daily living at discharge and at 9 months after stroke. The most important factor influencing outcome was the degree of motor loss.

Fitness to drive and the general practitioner.

This study investigates general practitioners' (GPs') knowledge and opinions on fitness to drive after stroke. Questionnaires were sent to 650 GPs. Despite a low response rate (24%) results suggest that most GPs rarely see stroke patients regarding driving fitness. There appears to be some confusion over terms used in the handbook issued to medical practitioners. Only a quarter of GPs knew of any driving assessment facilities and very few had ever referred a patient to a clinical psychologist for cognitive assessment. Almost all responding GPs (98%) wanted the opportunity to refer patients for assessment based on research findings. The current approach to assessment of driving fitness after stroke appears inconsistent. It is hoped that new assessment methods being developed will help to improve on the present system.

Affective illness after stroke.

Mood assessments were made after six months of 149 survivors taken from a register of all patients admitted to hospital with acute stroke. Using a General Health Questionnaire score of 12 or more as a criterion of important affective illness, its prevalence was 23%. There was no difference in risk of affective illness between left and right hemisphere strokes. Affective illness was strongly associated with functional ability, with limb weakness and with longer hospital stay in those with good functional recovery. Only 15% of those with high scores were receiving antidepressant drugs. The general practitioner is in the best position to detect psychiatric illness in stroke survivors; the use of mood rating scales such as the GHQ, in conjunction with clinical assessment, may improve detection.

Caring for stroke patients at home.

The extent and type of care provided by relatives and friends living with a stroke patient was studied among 120 6-month survivors. Eighty-one (68%) carers felt that they had to give more help than before the stroke. The patients looked after by these 81 carers were more functionally disabled, more cognitively impaired, more often had speech impairment and urinary incontinence than the 39 patients whose companions did not give any extra help. Only a third of patients had been left unattended for all or part of the day prior to the interview and 18 per cent required attention every night. The majority (85%) of patients receiving help from companions were under regular review by health or social services. Over two-thirds of carers felt that providing support had had an adverse effect on their lives.

An audit of follow-up services for stroke patients after discharge from hospital.

A register was kept of all patients admitted to hospital in Nottingham with acute stroke, and survivors were followed up at 1 and 6 months. A quarter of the 183 survivors seen at home 6 months after their strokes were still unable to perform some everyday activities. Only 18% of discharged patients ever received outpatient occupational therapy but 42% received physiotherapy. Those attending outpatient rehabilitation were more likely to improve in functional ability between 1 and 6 months. A third of patients interviewed had not seen their GP since discharge and many with severe disabilities did not receive potentially useful therapy or aids.

Cognitive ability and driving after stroke.

This study investigated the relationship between cognitive ability and driving after stroke. Thirty-nine pre-stroke drivers were assessed using a battery of cognitive tests followed by a road test over a set route. Subjects were graded into Pass, Borderline of Fail categories on the basis of the road test. Cognitive test results were compared across grades of driving performance and significant differences were found on nine of the 23 measures. A discriminant function analysis identified 10 tests which together predicted the grading of 94% of subjects into Pass or Fail categories.

Use of the Nottingham Health Profile with patients after a stroke.

The Nottingham Health Profile (NHP) is easy to use with stroke patients and may be used with those who cannot manage more complicated mood questionnaires, such as the General Health Questionnaire (GHQ). Stroke patients rate their health, and especially emotions and feelings of social isolation, as much worse than that of people of similar age. NHP emotion scores correlate with objective measures of disability, length of hospital stay, and GHQ scores. The NHP is a valid indicator of depressed mood, and combining its components into a total score gives the greatest accuracy in detecting depression. Patients with high scores at one month continued to report large numbers of problems at six months after their stroke. Many patients experienced pain, disturbed sleep, and social isolation, which are important, potentially treatable problems not usually considered in the management of stroke patients. Many patients with problems did not see their general practitioner or any other source of help, and additional follow up was needed.