Comparative evaluation of fracture resistance of self adapting PFS and elastic FRC post and core systems – An invitro study

Background:  Endodontically treated teeth (ETT) with extensive coronal destruction are more prone to fracture, so restoring these teeth with techniques that will not compromise the integrity of remaining tooth structure with the use of Post and core systems to retain full and final crown restorations seems mandatory. Anatomic posts have been introduced which have better adaptability to the canal anatomy and conserve more amount of tooth structure. Aim: This study was done to compare the fracture resistance of ETT restored with two anatomic post systems elastic FRC post (everStick) and self adapting PFS (Spirapost). Materials and Methods: Twenty single rooted maxillary central incisors were selected for the study. All the samples were endodontically treated and randomly divided into 2 groups (n=10) according to the post system used (PFS post – Group I, FRC– Group II). In all the samples, post space preparation was done and the posts were luted using dual cure resin cement (Para core, Coltene, Mumbai, India).The remaining core was built using composite resin (Filtek, 3M, ESPE, USA). The samples were stored in saline for one week. All the samples were thermocycled for 500 cycles from 5 to 55 0 c ±5 0 c with a dwelling time of 30 seconds in each bath and a transfer time of five seconds. Fracture resistance of the samples was measured using universal testing machine. The obtained data was statistically analyzed by using independent t test. Results: There was no statistically siginificant difference between fracture resistance values of FRC and PFS groups. 30% and 70% of the samples of PFS and FRC showed favourable fractures respectively. Conclusion: In this study it was concluded that fracture resistance of PFS was comparable to that of FRC post. However FRC group showed predominantly more number of favourable fractures. &nbsp

A Phase I Dose-Escalation Study of Lenalidomide in Combination with Gemcitabine in Patients with Advanced Pancreatic Cancer

Purpose Lenalidomide have both immunomodulatory and anti-angiogenic properties which could confer anti-cancer effects. The aim of this study was to assess the feasibility of combining lenalidomide with the standard treatment gemcitabine in pancreatic cancer patients with advanced disease. Patients and Methods Eligible patients had locally advanced or metastatic adenocarcinoma of the pancreas. Patients received lenalidomide days 1-21 orally and gemcitabine 1000 mg/m(2) intravenously (days 1, 8 and 15), each 28 day cycle. Three cohorts of lenalidomide were examined (Cohort I = 15 mg, Cohort II = 20 mg and Cohort III = 25 mg daily). The maximum tolerated dose (MTD) of lenalidomide given in combination with gemcitabine was defined as the highest dose level at which no more than one out of four (25%) subjects experiences a dose-limiting toxicity (DLT). Patients should also be able to receive daily low molecular weight heparin (LMWH) (e.g. dalteparin 5000 IU s.c. daily) as a prophylactic anticoagulant for venous thromboembolic events (VTEs). Twelve patients (n = 4, n = 3 and n = 5 in cohort I, II and III, respectively) were enrolled in this study. Results Median duration of treatment was 11 weeks (range 1-66), and median number of treatment cycles were three (range 1-14). The only DLT was a cardiac failure grade 3 in cohort III. Frequent treatment-related adverse events (AEs) (all grades) included neutropenia, leucopenia and fatigue (83% each, but there was no febrile neutropenia); thrombocytopenia (75%); dermatological toxicity (75%); diarrhea and nausea (42% each); and neuropathy (42%). Discussion This phase I study demonstrates the feasibility of the combination of lenalidomide and gemcitabine as first-line treatment in patients with advanced pancreatic cancer. The tolerability profile demonstrated in the dose escalation schedule of lenalidomide suggests the dosing of lenalidomide to be 25 mg daily on days 1-21 with standard dosing of gemcitabine and merits further evaluation in a phase II trial