Influence of hydrostatic pulpal pressure on the microtensile bond strength of all-in-one self-etching adhesives

Purpose: To evaluate the microtensile bond strength (mu TBS) of two all-in-one self-etching adhesive systems and two self etching adhesives with and without simulated hydrostatic pulpal pressure (PP). Materials and Methods: Flat coronal dentin surfaces of extracted human molars were prepared. Two all-in-one self-etching adhesive systems, One-Up Bond F (OBF; Tokuyama) and Clearfil S-3 Bond (Tri-S, Kuraray Medical) and two self-etching primer adhesives, Clearfil Protect Bond (PB; Kuraray) and Clearfil SE Bond (SE; Kuraray) were applied to the dentin surfaces according to manufacturers' instructions under either a pulpal pressure (PP) of zero or 15 cm H(2)0. A hybrid resin composite (Clearfil AP-X, Kuraray) was used for the coronal buildup. Specimens bonded under PP were stored in water at 37 degrees C under 15 cm H20 for 24 h. Specimens not bonded under PP were stored under a PP of zero. After storage, the bonded specimens were sectioned into slabs that were trimmed to hourglass-shaped specimens, and were subjected to microtensile bond testing (mu TBS). The bond strength data were statistically analyzed using two-way ANOVA and the Holm-Sidak method for multiple comparison tests (alpha = 0.05). The surface area percentage of different failure modes for each material was also statistically analyzed with three one-way ANOVAs and Tukey's multiple comparison tests. Results: The mu TBS of OBF and Tri-S fell significantly under PP. However, in the PB and SE bonded specimens under PP, there were no significant differences compared with the control groups without PP. Conclusions: The mu TBS of the two all-in-one adhesive systems decreased when PP was applied. However, the mu TBS of both self-etching primer adhesives did not decrease under PR9543744

Prognostic value of simple frailty and malnutrition screening tools in patients with acute heart failure due to left ventricular systolic dysfunction

Background: Frailty and malnutrition are common in patients with heart failure (HF), and are associated with adverse outcomes. We studied the prognostic value of three malnutrition and three frailty indices in patients admitted acutely to hospital with HF. Methods: 265 consecutive patients [62% males, median age 80 (interquartile range (IQR): 72–86) years, median NTproBNP 3633 (IQR: 2025–6407) ng/l] admitted with HF between 2013 and 2014 were enrolled. Patients were screened for frailty using the Derby frailty index (DFI), acute frailty network (AFN) frailty criteria, and clinical frailty scale (CFS) and for malnutrition using the geriatric nutritional risk index (GNRI), controlling nutritional status (CONUT) score and prognostic nutritional index (PNI). Results: According to the CFS (> 4), DFI, and AFN, 53, 50, and 53% were frail, respectively. According to the GNRI (≤ 98), CONUT score (> 4), and PNI (≤ 38), 46, 46, and 42% patients were malnourished, respectively. During a median follow-up of 598 days (IQR 319–807 days), 113 patients died. One year mortality was 1% for those who were neither frail nor malnourished; 15% for those who were either malnourished or frail; and 65% for those who were both malnourished and frail. Amongst the malnutrition scores, PNI, and amongst the frailty scores, CFS increased model performance most compared with base model. A final model, including CFS and PNI, increased c-statistic for mortality prediction from 0.68 to 0.84. Conclusion: Worsening frailty and malnutrition indices are strongly related to worse outcome in patients hospitalised with HF