2,130 research outputs found

    Microtensile bond strength of resin-post interfaces created with interpenetrating polymer network posts or cross-linked posts

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    Objective: The purpose of this study was to evaluate the microtensile strength of composite bonded to interpenetrating polymer network (IPN) or cross-linked glass fibre posts and to observe the failure modes by using light and scanning electron microscopy. Methods: Twenty posts containing IPN resin matrix and 20 posts containing cross-linked epoxy polymer matrix were used for testing. One half of the posts from each type was treated with Stick Resin, the other half was treated with OptiBond. Composite resin was used to build up a block on the bonding surface. Tensile strength data was analysed statistically using the non-parametric Kaplan-Meier survival analysis. The distribution of failure modes as a function of post type/bonding agent was evaluated using the ?² test. Results: The mean tensile strength values were lower for the groups bonded with OptiBond and higher for the groups bonded with Stick Resin (p = 0.017), the type of post used had no statistical significance (p = 0.263). All the IPN posts showed cohesive failure within the post The cross-linked posts demonstrated a higher number of adhesive failures and lower number of cohesive failures within the post (?² = 0.0001). Conclusions: Stick Resin was more effective than OptiBond in bonding composite cores to fibre posts. Post fracture was the failure mode of IPN posts, debonding of the composite core was the failure mode of most of cross-linked posts. These different failure modes may appear clinically in endodontically treated teeth restored with the post types tested in this study

    Management of tooth resorption

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    The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.A correct diagnosis and an understanding of the aetiology and dynamics of the processes involved in tooth resorption is critical to effective management. Tooth resorptions can be classified as: (1) trauma induced; (2) infection induced; or (3) hyperplastic invasive. Some transient trauma induced resorptions require no treatment but must be carefully monitored to check that there are no complicating issues such as infection. In cases of trauma induced replacement resorption, a multidisciplinary approach is usually necessary to ensure an optimal long-term solution. Infection induced tooth resorptions require the removal of the invading micro-organisms by endodontic therapy including intra-canal medication which can also facilitate repair of the resorbed tooth structure. The hyperplastic invasive tooth resorptions pose considerable challenges in management due to the complexity and aggressive nature of the resorptive process. With careful case selection and complete inactivation of resorptive tissue successful management can be achieved.GS Heithersa

    The Na+/Glucose Cotransporter Inhibitor Canagliflozin Activates AMPK by Inhibiting Mitochondrial Function and Increasing Cellular AMP Levels

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    Canagliflozin, dapagliflozin and empagliflozin, all recently approved for treatment of Type 2 diabetes, were derived from the natural product phlorizin. They reduce hyperglycemia by inhibiting glucose re-uptake by SGLT2 in the kidney, without affecting intestinal glucose uptake by SGLT1. We now report that canagliflozin also activates AMP-activated protein kinase (AMPK), an effect also seen with phloretin (the aglycone breakdown product of phlorizin), but not to any significant extent with dapagliflozin, empagliflozin or phlorizin. AMPK activation occurred at canagliflozin concentrations measured in human plasma in clinical trials, and was caused by inhibition of Complex I of the respiratory chain, leading to increases in cellular AMP or ADP. Although canagliflozin also inhibited cellular glucose uptake independently of SGLT2, this did not account for AMPK activation. Canagliflozin also inhibited lipid synthesis, an effect that was absent in AMPK knockout cells and that required phosphorylation of ACC1 and/or ACC2 at the AMPK sites. Oral administration of canagliflozin activated AMPK in mouse liver, although not in muscle, adipose tissue or spleen. As phosphorylation of acetyl-CoA carboxylase by AMPK is known to lower liver lipid content, these data suggest a potential additional benefit of canagliflozin therapy compared to other SGLT2 inhibitors

    The activity view of inner speech

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    We distinguish two general approaches to inner speech (IS)—the “format” and the “activity” views—and defend the activity view. The format view grounds the utility of IS on features of the representational format of language, and is related to the thesis that the proper function of IS is to make conscious thinking possible. IS appears typically as a product constituted by representations of phonological features. The view also has implications for the idea that passivity phenomena in cognition may be misattributed IS. The activity view sees IS as a speaking activity that does not have a proper function in cognition. It simply inherits the array of functions of outer speech. We argue that it is methodologically advisable to start from this variety of uses, which suggests commonalities between internal and external activities. The format view has several problems; it has to deny “unsymbolized thinking”; it cannot easily explain how IS makes thoughts available to consciousness, and it cannot explain those uses of IS where its format features apparently play no role. The activity view not only lacks these problems but also has explanatory advantages: construing IS as an activity allows it to be integrally constituted by its content; the view is able to construe unsymbolized thinking as part of a continuum of phenomena that exploit the same mechanisms, and it offers a simple explanation for the variety of uses of IS.Research for this paper was funded by the Spanish Government through Research Projects FFI2011-30074-C01 &C02

    Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan

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    BACKGROUND: General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. METHODS: A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. RESULTS: Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. CONCLUSIONS: This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam or intra-canal medicaments

    Does the aldosterone: renin ratio predict the efficacy of spironolactone over bendroflumethiazide in hypertension? A clinical trial protocol for RENALDO (RENin-ALDOsterone) study

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    <p>Background: High blood pressure is an important determinant of cardiovascular disease risk. Treated hypertensives do not attain a risk level equivalent to normotensives. This may be a consequence of suboptimal blood pressure control to which indiscriminate use of antihypertensive drugs may contribute. Indeed the recent ALLHAT[1]study suggests that thiazides should be given first to virtually all hypertensives. Whether this is correct or whether different antihypertensive therapies should be targeted towards different patients is a major unresolved issue, which we address in this study.</p> <p>The measurement of the ratio of aldosterone: renin is used to identify hypertensive subjects who may respond well to treatment with the aldosterone antagonist spironolactone. It is not known if subjects with a high ratio have aldosteronism or aldosterone-sensitive hypertension is debated but it is important to know whether spironolactone is superior to other diuretics such as bendroflumethiazide in this setting.</p> <p>Methods/design: The study is a double-blind, randomised, crossover, controlled trial that will randomise 120 hypertensive subjects to 12 weeks treatment with spironolactone 50 mg once daily and 12 weeks treatment with bendroflumethiazide 2.5 mg once daily. The 2 treatment periods are separated by a 2-week washout period. Randomisation is stratified by aldosterone: renin ratio to include equal numbers of subjects with high and low aldosterone: renin ratios.</p> <p>Primary Objective – To test the hypothesis that the aldosterone: renin ratio predicts the antihypertensive response to spironolactone, specifically that the effect of spironolactone 50 mg is greater than that of bendroflumethiazide 2.5 mg in hypertensive subjects with high aldosterone: renin ratios.</p> <p>Secondary Objectives – To determine whether bendroflumethiazide induces adverse metabolic abnormalities, especially in subjects with high aldosterone: renin ratios and if baseline renin measurement predicts the antihypertensive response to spironolactone and/or bendrofluazide.</p> <p>Discussion: The numerous deleterious effects of hypertension dictate the need for a systematic approach for its treatment. In spite of various therapies, resistant hypertension is widely prevalent. Among various factors, primary aldosteronism is an important cause of resistant hypertension and is now more commonly recognised. More significantly, hypertensives with primary aldosteronism are also exposed to various other deleterious effects of excess aldosterone. Hence treating hypertension with specific aldosterone antagonists may be a better approach in this group of patients. It may lead on to better blood pressures with fewer medications.</p&gt

    Seasonal variation in the relative dominance of herbivore guilds in an African savanna

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    African savannas are highly seasonal with a diverse array of both mammalian and invertebrate herbivores, yet herbivory studies have focused almost exclusively on mammals. We conducted a 2-yr exclosure experiment in South Africa's Kruger National Park to measure the relative impact of these two groups of herbivores on grass removal at both highly productive patches (termite mounds) and in the less productive savanna matrix. Invertebrate and mammalian herbivory was greater on termite mounds, but the relative importance of each group changed over time. Mammalian offtake was higher than invertebrates in the dry season, but can be eclipsed by invertebrates during the wet season when this group is more active. Our results demonstrate that invertebrates play a substantial role in savanna herbivory and should not be disregarded in attempts to understand the impacts of herbivory on ecosystems

    Rationale, design and population baseline characteristics of the PERFORM Vascular Project: an ancillary study of the Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack (PERFORM) trial

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    <p><b>Purpose</b></p> <p>PERFORM is exploring the efficacy of terutroban versus aspirin for secondary prevention in patients with a history of ischemic stroke or transient ischemic attacks (TIAs). The PERFORM Vascular Project will evaluate the effect of terutroban on progression of atherosclerosis, as assessed by change in carotid intima-media thickness (CIMT) in a subgroup of patients.</p> <p><b>Methods and results</b></p> <p>The Vascular Project includes structural (CIMT, carotid plaques) and functional (carotid stiffness) vascular studies in all patients showing at least one carotid plaque at entry. Expected mean follow-up is 36 months. Primary endpoint is rate of change of CIMT. Secondary endpoints include emergent plaques and assessment of carotid stiffness. 1,100 patients are required for 90% statistical power to detect treatment-related CIMT difference of 0.025 mm. The first patient was randomized in April 2006.</p> <p><b>Conclusions</b></p> <p>The PERFORM Vascular Project will investigate terutroban’s effect on vascular structure and function in patients with a history of ischemic stroke or TIAs.</p&gt
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