Good prognosis for pericarditis with and without myocardial involvement: Results from a multicenter, prospective cohort study

Background The natural history of myopericarditis/perimyocarditis is poorly known, and recently published studies have presented contrasting data on their outcomes. The aim of the present article is to assess the prognosis of myopericarditis/perimyocarditis in a multicenter, prospective cohort study. Methods and Results A total of 486 patients (median age, 39 years; range, 18-83 years; 300 men) with acute pericarditis or a myopericardial inflammatory syndrome (myopericarditis/perimyocarditis; 85% idiopathic, 11% connective tissue disease or inflammatory bowel disease, 5% infective) were prospectively evaluated from January 2007 to December 2011. The diagnosis of acute pericarditis was based on the presence of 2 of 4 clinical criteria (chest pain, pericardial rubs, widespread ST-segment elevation or PR depression, and new or worsening pericardial effusion). Myopericardial inflammatory involvement was suspected with atypical ECG changes for pericarditis, arrhythmias, and cardiac troponin elevation or new or worsening ventricular dysfunction on echocardiography and confirmed by cardiac magnetic resonance. After a median follow-up of 36 months, normalization of left ventricular function was achieved in >90% of patients with myopericarditis/perimyocarditis. No deaths were recorded, as well as evolution to heart failure or symptomatic left ventricular dysfunction. Recurrences (mainly as recurrent pericarditis) were the most common complication during follow-up and were recorded more frequently in patients with acute pericarditis (32%) than in those with myopericarditis (11%) or perimyocarditis (12%; P<0.001). Troponin elevation was not associated with an increase in complications. Conclusions The outcome of myopericardial inflammatory syndromes is good. Unlike acute coronary syndromes, troponin elevation is not a negative prognostic marker in this setting

Study of the doubly charmed tetraquark T+cc

Quantum chromodynamics, the theory of the strong force, describes interactions of coloured quarks and gluons and the formation of hadronic matter. Conventional hadronic matter consists of baryons and mesons made of three quarks and quark-antiquark pairs, respectively. Particles with an alternative quark content are known as exotic states. Here a study is reported of an exotic narrow state in the D0D0π+ mass spectrum just below the D*+D0 mass threshold produced in proton-proton collisions collected with the LHCb detector at the Large Hadron Collider. The state is consistent with the ground isoscalar T+cc tetraquark with a quark content of ccu⎯⎯⎯d⎯⎯⎯ and spin-parity quantum numbers JP = 1+. Study of the DD mass spectra disfavours interpretation of the resonance as the isovector state. The decay structure via intermediate off-shell D*+ mesons is consistent with the observed D0π+ mass distribution. To analyse the mass of the resonance and its coupling to the D*D system, a dedicated model is developed under the assumption of an isoscalar axial-vector T+cc state decaying to the D*D channel. Using this model, resonance parameters including the pole position, scattering length, effective range and compositeness are determined to reveal important information about the nature of the T+cc state. In addition, an unexpected dependence of the production rate on track multiplicity is observed

Apatite-forming ability of TheralCal pulp capping.

Objective: A liner must perform as a barrier and protect the dental pulpal complex. Calcium-silicate MTA materials recently used for pulp capping demonstrate the ability to form hydroxyapatite when immersed in simulated body fluid (Gandolfi et al. 2009, 2010). TheraCal is a light-curable resin formula which contains CaO mineral oxides, designed to be used as liner and pulp capping material that demonstrates good biocompatibility/absence of cytotoxicity. The aim of this study is to evaluate the ability of this material to form hydroxyapatite when immersed in a phosphate-containing solution. Method: TheraCal (Bisco Inc, USA), Control paste (without mineral oxides) (Bisco Inc, USA), ProRoot MTA (Dentsply, USA) were used. Sample discs (n=10 for each material) were prepared. The materials were placed in a PVC mold (8mm dia x 1.6mm) and light-cured on both surfaces for 20 seconds (per manufacture) using a LED light, after the application of a transparent polyester strip. The discs were de-molded, immersed in 10mL of a phosphate-containing solution (Dulbecco's Phosphate Buffered Saline, DPBS) in a sealed container and stored at 37\ub0C. The surface chemistry, morphology and formation of apatite on samples surface after 1, 7, 14 and 28 days of immersion in DPBS was assessed by ESEM-EDX, micro-Raman and FT-IR techniques. Results: TheraCal demonstrated the capacity to form apatite on its surface after 24 hours immersion in DPBS, as did ProRoot MTA. Amorphous apatite (952 cm-1 Raman band) was detected within the first 24 hours, while a more crystalline apatite (960 cm-1 Raman band) was noticed at 7days. No deposit was detected on the Control. Conclusions: TheraCal is a calcium-releasing material able to induce the formation of apatite and represents a promising material in direct pulp-capping clinical/surgical procedures. The ability to form apatite may play a critical/positive role in new dentin formation

Biomimetic dentine remineralization by a novel bioactive light-curing calcium-silicate composite

Objectives: A light-curing resin-modified calcium-silicate cement was designed to obtain a bioactive calciumreleasing remineralizing material (Ic-MTA) for rehabilitation of deciduous teeth and remineralization of dentine lesions. Materials and methods: Ic-MTA was prepared by mixing a tailored calcium-silicate bioactive filler with an anphiphilic HEMA/TEGDMA-based resin. Calcium release and alkalinizing activity (i.e. pH of soaking water) of the cement were tested. The dentine remineralization capability and the bioactivity (i.e. apatite-forming ability) were investigated by ATR-FTIR and ESEM/EDX analyses after immersion in DPBS at 37 &#9702;C for 7 days. Dentine disks 0.8\ub10.2mm thick were obtained from coronal side of healthy third molars and demineralized in 15mL of sterile 17% EDTA for 2h. EDX element distribution maps confirmed the complete absence of apatite on dentine disks from the surface to a 10 microns depth. Results: The experimental material releases calcium (200ppm at 3 h), increases the environmental pH to 10\u201311 and showed marked bioactivity. After 7 days a thick layer of carbonated apatite (Ap) was noticed on dentine surface. Apatite precipitates obturated the dentinal tubules. Conclusions: Calcium-silicate materials are bioactive. Silanol groups from the mineral particles induce heterogeneous nucleation of apatite by sorption of calcium and phosphate ions. The improved bioactivity of Ic-MTA is related to the oxygen-containing groups from HEMA/TEGDMA, which provide additional apatite nucleating sites through the formation of calcium chelates. An improved biomimetic remineralization of dentine and a faster bioactive behaviour was proved by the novel light-curing calcium-silicate material. The coupling of a hydraulic calcium-silicate powder with a HEMA-TEGDMA hydrophilic resin creates conditions (enhanced calcium release and functional groups able to chelate Ca ions, with a consequent rapid apatite deposition) promising for the remineralization and regeneration of mineral hard tissues

Studio della bioattivit&#224; in vitro di cementi endodontici a base di silicati di calcio.

I cementi Portland, a base di silicati di calcio, hanno ricevuto grande attenzione in campo odontoiatrico per la loro capacit\ue0 di indurirsi in presenza di sangue e altri fluidi biologici. Negli anni \u201990 \ue8 stato messo a punto il primo cemento calcio-silicato per endodonzia, l\u2019MTA (Mineral Trioxide Aggregate). I cementi Portland bianchi contengono alite, belite, tricalcio alluminato; nei cementi grigi sono presenti anche l\u2019alluminoferrite e altri metalli di transizione (Cr and Mn). I calcio solfati sono in genere aggiunti per ritardare l\u2019indurimento. L\u2019MTA e i cementi Portland sono materiali bioattivi, cio\ue8 in grado di rivestirsi di uno strato apatitico in presenza di fluidi fisiologici; questo strato apatitico \ue8 responsabile della buona attivit\ue0 osteogenica di questi cementi. Questo studio intende confrontare la bioattivit\ue0 di cementi endodontici commerciali MTA bianchi e grigi di diverse case produttrici con quella di un cemento sperimentale bianco avente un pi\uf9 basso tempo di indurimento (questa caratteristica \ue8 importante perch\ue9 migliora la lavorabilit\ue0 e permette una ricostruzione pi\uf9 veloce). I cementi sono stati caratterizzati mediante spettroscopia micro-Raman e ATR/FT-IR prima e dopo immersione per tempi diversi (1-28 giorni) a 37\ub0C, in DPBS (Dulbecco\u2019s Phosphate buffered saline). Le tecniche spettroscopiche hanno mostrato differenze significative nella composizione dei cementi, principalmente per quanto riguarda le componenti solfato e silicato e la quantit\ue0 relativa di tricalcio alluminato. Dopo un giorno di storaggio in DPBS, tutti i cementi si sono ricoperti di uno strato apatitico che \ue8 andato aumentando in grado di maturazione, spessore e omogeneit\ue0 a tempi pi\uf9 lunghi. L\u2019MTA grigio si \ue8 dimostrato il cemento pi\uf9 bioattivo; il cemento sperimentale ha mostrato bioattivit\ue0 leggermente minore, ma comunque comparabile a quella dei cementi commerciali bianchi e appare quindi una buona alternativa alla luce del suo tempo di indurimento pi\uf9 breve

Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids.

Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1\u201328 days at 37 _C, in Dulbecco\u2019s Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery

Efficiency of statistics of stereology

SIGLEAvailable from British Library Document Supply Centre-DSC:DX210759 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Development of the foremost light-curable calcium-silicate MTA cement as root-end in oral surgery. Chemical\u2013physical properties, bioactivity and biological behavior

AIM: An innovative light-curable calcium-silicate cement containing a HEMA-TEGDMA-based resin (lc-MTA) was designed to obtain a bioactive fast setting root-end filling and root repair material. METHODS: lc-MTA was tested for setting time, solubility, water absorption, calcium release, alkalinizing activity (pH of soaking water), bioactivity (apatite-forming ability) and cell growth-proliferation. The apatite-forming ability was investigated by micro-Raman, ATR-FTIR and ESEM/EDX after immersion at 37\ub0C for 1-28 days in DPBS or DMEM+FBS. The marginal adaptation of cement in root-end cavities of extracted teeth was assessed by ESEM/EDX, and the viability of Saos-2 cell on cements was evaluated. RESULTS: lc-MTA demonstrated a rapid setting time (2min), low solubility, high calcium release (150-200ppm) and alkalinizing power (pH 10-12). lc-MTA proved the formation of bone-like apatite spherulites just after 1 day. Apatite precipitates completely filled the interface porosities and created a perfect marginal adaptation. lc-MTA allowed Saos-2 cell viability and growth and no compromising toxicity was exerted. SIGNIFICANCE: HEMA-TEGDMA creates a polymeric network able to stabilize the outer surface of the cement and a hydrophilic matrix permeable enough to allow water absorption. SiO(-)/Si-OH groups from the mineral particles induce heterogeneous nucleation of apatite by sorption of calcium and phosphate ions. Oxygen-containing groups from poly-HEMA-TEGDMA provide additional apatite nucleating sites through the formation of calcium chelates. The strong novelty was that the combination of a hydraulic calcium-silicate powder and a poly-HEMA-TEGDMA hydrophilic resin creates the conditions (calcium release and functional groups able to chelate Ca ions) for a bioactive fast setting light-curable material for clinical applications in dental and maxillofacial surgery. The first and unique/exclusive light-curable calcium-silicate MTA cement for endodontics and root-end application was created, with a potential strong impact on surgical procedures

Apatite-type phases on MTA cements depend on soaking medium volume.

Objectives: The examination of the apatite formation (i.e.bioactivity) on a material surface dipped in a simulated body fluid is useful for predicting its in vivo bone bonding ability. The purpose of this study was to investigate the influence of the volume of DPBS (Dulbecco\u2019s phosphate buffered saline used as simulated body fluid) on the apatite phases formed upon a commercial self-setting calcium\u2013silicate MTA cement for endodontics that showed bioactivity. Materials and methods: White ProRoot MTA (Dentsply, Maillefer, Tulsa Dental Products, Tulsa, OK, USA)was prepared according to manufacturer directions to produce a cement paste. Cement disks (13mm diameter 1.6mm thickness) were prepared and immediately immersed in sealed containers into 5, 10 or 20mL of DPBS (i.e. 20 mL, 40mL and 80mL of medium for 1 g of cement paste, respectively). The surface of the disks was analyzed by ATR-FTIR spectroscopy after soaking for 7 days at 37&#9702;C. Results: The B-type carbonated apatite (Ap) phase formed under the three different soaking conditions showed phosphate bands with different widths and different wavenumber positions. The amount of carbonate (C) decreased, increasing the volume of the DPBS soaking solution (i.e. the bands at about 1410 and 870cm&#8722;1 progressively decreased in intensity). Conclusions: The volume of the soaking simulated body fluid affects the nature of the apatite phase as well as the carbonate content. This must be taken into consideration in in vitro apatite-forming ability tests on biomaterials