Evaluation of shear bond strength of zirconia to composite resin using different adhesive systems

To evaluate shear bond strength of zirconia to composite resin using different universal and conventional adhesives and a zirconia primer. Forty zirconia blocks were fabricated of zirconium ingots (10×10×5 mm) and sintered at 1530°C for 2 hours. They were then air-abraded with Al2O3 particles. The specimens were divided into 4 groups and subjected to one of the following bonding agents: Futurabond U (group 1), Clearfil Universal Bond, universal adhesives (group 2), Z-Prime Plus, zirconia primer (group 3) and Adper Single Bond 2, conventional adhesive (group 4). Composite resin was then applied in a diameter of 5 mm and in a thickness of 2 mm. All the specimens were stored in distilled water at 37°C for 24 hours and then thermocycled between 5°C and 55°C for 5000 cycles with a 30-second dwell time. The shear bond strength was then evaluated with a universal testing machine at a crosshead speed of 1 mm/min. Data (MPa) were analyzed using ANOVA and LSD test (P?0.05). The specimens were evaluated under a stereomicroscope to determine the mode of failure. The mean shear bond strength was 16,874 MPa in group I, 13.4434 MPa in group II, 11.6500 MPa in group III and 6.8700 MPa in group IV. ANOVA revealed that the shear bond strength in group IV was significantly lower than that in other groups (P?0.05). The shear bond strength in group I was significantly higher than that in groups III and IV. So Universal adhesives could provide higher shear bond strength of zirconia to composite resin after thermocycling compared to zirconia primers

How to apply the evidence-based medicine concept to nuclear medicine diagnostic studies - a review

Evidence-based medicine (EBM) is defined as using the best available evidence for managing patients in daily healthcare practice. Although this approach has been applied successfully in many medical fields, it has not been addressed fully in the radiological discipline in general and nuclear medicine in particular. In this review, the concept of EBM has been introduced briefly and four steps of EBM practice have been explained. Asking answerable questions and finding the best evidence that constitutes the first two parts of EBM practice are explained in brief. The next two steps (appraising the available evidence and applying the best evidence) are explained in more detail. Since the bulk of nuclear medicine studies are of a diagnostic nature and most of the daily practice of a nuclear medicine specialist is involved in diagnosis, we have focused on the diagnosis studies. Systematic reviews are also explained to some extent. Appraisals of other kinds of study, such as interventional or prognosis studies, are not included in this review

Predicting of disease free survival in patients with thyroid cancer and its influencing factors during 1978 to 2012

زمینه و هدف: سرطان تیروئید نوعی بدخیمی غدد درون‌ریز است که بروز آن به‌طور پیوسته در بسیاری از مناطق جهان در حال افزایش است. با توجه به این‎که ممکن است، عوامل متفاوتی بر بقای عاری از بیماری در مبتلایان به سرطان تیروئید موثر باشد؛ لذا هدف این مطالعه شناسایی این عوامل است. روش بررسی: در این مطالعه هم‌گروهی تاریخی، 785 بیمار مبتلا به سرطان تیروئید تمایز یافته مراجعه‌کننده به بخش پزشکی هسته ای بیمارستان امام رضا (ع) و بیمارستان قائم (عج) شهر مشهد طی سال های 1357 تا 1391 مورد بررسی قرار گرفت. پیگیری تمام بیماران از طریق مراجعات دوره‌ای و تماس تلفنی انجام شد. اثر عوامل مختلف دموگرافیکی و بالینی بر بقای عاری از بیماری مبتلایان با استفاده از مدل بقای وایبل ارزیابی شد. یافته ها: میانه زمان بقای عاری از بیماری مبتلایان برابر 05/1±15 سال به‎دست آمد. ارزیابی ویژگی‎های کلینیکی و پاتولوژی در حالت یک‌ متغیره نشان داد که تأثیر متغیرهای جنس، سن در زمان تشخیص، نوع سرطان، مرحله سرطان، نوع درمان، تیروگلوبولین اولیه، اندازه تومور، وضعیت گره‌های لنفاوی درگیر، وضعیت متاستاز و جراحی ناکامل و در حالت چندگانه نیز اندازه تومور، وضعیت متاستاز، وضعیت گره‌های لنفاوی درگیر و سن در زمان تشخیص رابطه معنی‎داری بر بقای عاری از بیماری مبتلایان داشت (05/0>P). نتیجه گیری: با توجه به عوامل متعدد تأثیرگذار بر خطر عود مجدد بیماران و تأثیرگذار بودن وضعیت متاستاز، اندازه تومور، وضعیت گره‌های لنفاوی درگیر و سن در زمان تشخیص در حالت تعدیل شده، به نظر می‌رسد افرادی که دارای متاستاز دوردست می‌باشند و در مرحله چهارم مرحله‎بندی اندازه تومور، دارای درگیری غدد گره‌های لنفاوی و بالای 45 سال می‌باشند، در خطر عود مجدد بیشتری قرار دارند

Effects of radioiodine therapy on fertility indicators among men with differentiated thyroid cancer: A cohort study

Background: Following thyroidectomy, radioiodine therapy is the standard management of differentiated thyroid cancer. The effects of such treatment on testicular function remained a concern for cases and clinicians. Objective: We aimed to observe changes in fertility indicators in men treated with ablation. Materials and Methods: In this prospective cohort study, 18 men with differentiated thyroid cancer from June to December 2020 underwent thyroidectomy plus radioiodine therapy. Participants were grouped based on iodine dose (8 men with 30 mCi vs. 10 men with ≥ 150 mCi). Baseline values (VB) of the follicular stimulating hormone, luteinizing hormone, testosterone, and sperm analyses were measured 3 wk before iodine ablation and repeated 3 (V3) and 12 (V12) months later. They were analyzed once as a whole and once based on their groups via ANOVA and Friedman’s tests where appropriate. Results: The mean age of participants was 35.61 ± 9.74 yr. Follicular stimulating hormone levels showed a significant trend among all participants (VB: 12.51 ± 1.72, V3: 13.54 ± 1.41, and V12: 13.10 ± 1.67 IU/mL; p < 0.001). Luteinizing hormone showed a similar pattern (VB: 4.98 ± 1.27, V3: 5.65 ± 1.29, and V12: 5.21 ± 0.95 IU/mL; p < 0.001). Testosterone levels did not differ significantly from baseline. Sperm count decreased at the first checkpoint and returned to normal after 12 months (VB: 38.22 ± 19.40, V3: 32.05 ± 17.96, and V12: 36.66 ± 18.81 million/mL; p < 0.001). Sperm motility and morphology did not change significantly. Conclusion: Our research showed that even less than 5 GBq irradiation could induce a transient testicular dysfunction in the first 3 months of therapy, but it was mostly reversible after 12 months. Key words: Follicle-stimulating hormone, Iodine-131, Male infertility, Semen analyses

Comparison between 99mTc-sestamibi gated myocardial perfusion SPECT and echocardiography in assessment of left ventricular volumes and ejection fraction — effect of perfusion defect and small heart

BACKGROUND: Agreement between gated myocardial perfusion SPECT (GSPECT) and echocardiography (ECHO) in the calculation of left ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and LVEF was assessed. Effect of perfusion defect and small hearts on this agreement was obtained. Because ECHO is a routine and widely used noninvasive modality for this purpose, we chose this technique for comparison with GSPECT. MATERIAL AND METHODS: In a prospective study, 50 consecutive patients (age = 59.7 ± 10.64 years) underwent rest Tc99m-sestamibi GSPECT and 2-D ECHO. The LVEF, EDV and ESV were calculated using QGS (Quantitative Gated SPECT) software. RESULTS: Fourteen (28%) patients had perfusion defect in rest phase tomograms, while 36 (72%) had no perfusion defect. There was a significant correlation between two modalities in calculation of EDV, ESV and LVEF (all: p < 0.001, Pearson’s correlation coefficients: r = 0.764, 0.831 and 0.813, respectively). A good correlation was noticed even in small hearts or in patients with or without previous myocardial infarction. There was a significant difference between GSPECT and ECHO in patients with no perfusion defect as well as in patients with small heart (ESV < 25 ml). On the other hand, no remarkable difference was noticed between two techniques in the presence of perfusion defect or in patients with ESV ≥ 25 ml. CONCLUSION: There was a good agreement between EDV, ESV and LVEF derived from GSPECT and ECHO. There was a significant difference between two modalities in small hearts and in patients without perfusion defect, although in larger ventricles or in the presence of myocardial infarction no remarkable difference between two modalities was noticed.

On the simplified modelling of front shapes of fatigue cracks

A direct three-dimensional (3D) finite element modelling of fatigue crack growth in structural components still represents a formidable task due to a complex singular behaviour of the stress field along the crack front as well as strong non-linearities associated with material plasticity and the change of contact conditions between crack faces during the loading cycle. The complexity of the 3D numerical modelling of fatigue crack growth largely motivates the development of simplified approaches. This paper describes several possible approaches for the evaluation of front shapes of fatigue cracks. These approaches are based on the (1) elimination of the corner singularity effect, (2) predictions based on the first-order plate theory, (3) the equivalent thickness concept, and (4) the Iso-K criterion. This paper briefly outlines these simplified approaches and presents some theoretical predictions for the case of through-the-thickness cracks propagating in plates under quasi-steady-state conditions. The theoretical predictions are also compared with experimental observations.B. Zakavi, A. Kotousov, A. Khanna and R. Branc

Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Introduction: In the current study, we evaluated the accuracy of sentinel node mapping in thyroid cancer patients using both radiotracer and blue dye.Material and methods: 30 patients with a diagnosis of papillary thyroid carcinoma (PTC) were included in the study; 2–3 hours before surgery, 0.5 mCi 99m-Tc-Antimony Sulfide Colloid was injected intra-tumourally. 15 minutes post-injection, lymphoscintigraphy images of the neck were obtained. Immediately after anaesthesia induction, 0.5 mL patent blue V was also injected in the same fashion. Sentinel lymph nodes were detected intraoperatively using gamma probe and blue dye. Total thyroidectomy was performed for all patients with dissection of central neck lymph nodes as well as sampling of the lateral neck lymph nodes.Results: At least one sentinel node could be identified during surgery in 19 patients (63.3%). The median number of sentinel nodes per patient was 1. Sentinel nodes in 12 patients were pathologically involved. No false negative case was noted. Upstaging occurred in six patients (20%).Conclusions: Sentinel node mapping in papillary thyroid carcinoma is a feasible technique with high accuracy for the detection of lymph node involvement. This technique can guide surgeons to perform central lymph node dissection only in patients with pathologically involved sentinel nodes. Although SLN detection in the lateral neck lymph nodes increases the extension of lymphadenectomy, SLN mapping can result in upstaging in older patients (> 45 years of age) or treatment plan change in younger patients (< 45 years of age) by the detection of lateral lymph node involvement. (Endokrynol Pol 2014; 65 (4): 281–286)Wstęp: W badaniu oceniono dokładność mapowania węzłów wartowniczych u chorych na raka tarczycy w przypadku jednoczesnego zastosowania radioznacznika i niebieskiego barwnika.Materiał i metody: Do badania włączono 30 chorych z rozpoznaniem raka brodawkowego tarczycy (PTC, papillary thyroid carcinoma). Dwie do trzech godzin przed zabiegiem do guza wstrzykiwano koloid siarczanu antymonu znakowany 99m-Tc (0,5 mCi). Po upływie 15 minut od wstrzyknięcia radioznacznika wykonywano badanie limfoscyntygraficzne szyi. Bezpośrednio po znieczuleniu w ten sam sposób wstrzykiwano 0,5 ml błękitu patentowego V. Węzły wartownicze wykrywano śródoperacyjnie, używając sondy promieniowania gamma i błękitnego barwnika. U wszystkich pacjentów wykonano totalną tyroidektomię z wycięciem węzłów chłonnych szyjnych środkowego przedziału oraz pobraniem wycinków węzłów szyjnych bocznych.Wyniki: U 19 chorych (63,3%) udało się zidentyfikować w trakcie zabiegu co najmniej jeden węzeł wartowniczy. Mediana liczby węzłów wartowniczych na pacjenta wynosiła 1. U 12 chorych w węzłach wartowniczych wykryto zmiany patologiczne. Nie stwierdzono ani jednego przypadku uzyskania fałszywie ujemnego wyniku. U 6 (20%) chorych zmieniono stopień zaawansowania nowotworu na wyższy.Wnioski: Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy jest dostępną metodą cechującą się dużą dokładnością w wykrywaniu zajętych węzłów chłonnych. Ta metoda może stanowić wskazówkę dla chirurgów, aby usuwać węzły chłonne szyjne środkowego przedziału tylko u pacjentów ze zmianami w węzłach wartowniczych. Mimo że wykrycie węzłów wartowniczych w obrębie węzłów szyjnych bocznych zwiększa zakres limfadenektomii, mapowanie węzłów wartowniczych może spowodować zmianę oceny stopnia zaawansowanie nowotworu u starszych pacjentów (> 45 lat) lub zmianę planu leczenia u młodszych pacjentów (< 45 lat) w związku z wykryciem zmian w węzłach bocznych szyi. (Endokrynol Pol 2014; 65 (4): 281–286

Added value of blue dye injection in sentinel node biopsy of breast cancer patients: Do all patients need blue dye?

AbstractBackgroundIn the current study, we evaluated the incremental value of blue dye injection in sentinel node mapping of early breast cancer patients. We specially considered the experience of the surgeons and lymphoscintigraphy results in this regard.Methods605 patients with early stage breast cancer were retrospectively evaluated in the study. Patients underwent sentinel node mapping using combined radiotracer and blue dye techniques. Lymphoscintiraphy was also performed for 590 patients. Blue dye, radioisotope, and overall success rates in identifying the sentinel lymph node were evaluated in different patient groups. The benefit of blue dye and radioisotope in identifying the sentinel lymph nodes was also evaluated.ResultsMarginal benefits of both blue dye and isotope for overall sentinel node detection as well as pathologically involved sentinel nodes were statistically higher in inexperienced surgeons and in patients with sentinel node visualization failure. In the patients with sentinel node visualization on lymphoscintigraphy, 6 sentinel nodes were detected by blue dye only. All these six nodes were harvested by inexperienced surgeons. On the other hand 8 sentinel nodes were detected by dye only in the patients with sentinel node non-visualization. All these nodes were harvested by experienced surgeons.ConclusionsThe use of blue dye should be reserved for inexperienced surgeons during their learning phase and for those patients in whom lymphoscintigraphy failed to show any uptake in the axilla

Comparison of Religious Cognitive Behavioral Therapy, Cognitive Behavioral Therapy, and Citalopram on Depression and Anxiety among Women with Breast Cancer: A Study Protocol for a Randomized Controlled Trial

There has been evidence supporting the reduction of depression and anxiety by religious psychotherapy in cancer patients,however, there have been scarce randomized controlled trials. Therefore, there is a need for replication in a well-designedstudy to investigate the efficacy of these interventions among depressed women with breast cancer. A randomizedcontrolled trial is designed to be conducted on 160 women with breast cancer. Participants will be screened for anxietyand depression diagnosed by clinical interview based on the DSM-IV criteria and the Hospital Anxiety Depression Scale.Golriz and Baraheni’s Religious Attitude Questionnaire will be used to assess the religious attitude. Individuals meetingthe prerequisites will be randomly allocated to four groups, each containing 40 participants, including three interventiongroups (RCBT, CBT, and citalopram) and one control group (usual breast cancer treatment). An instrument by theEORTCQLQ-C30 and BR-23 will be used to measure the quality of life. Blood tests will be taken to assess biomarkers withthe (ELISA) method. The results will determine whether RCBT is more effective than other treatments. If so, the outcomesof the study will have implications not only for the management of similar problems in cancer patients but also for themanagement of other chronic diseases

Effect of Aquatic Extract of Ferulago angulata Boiss With Aerobic Exercises on Serum Levels of Interleukin-10 and C-Reactive Protein of Obese Males

Objectives: The aim of the present study was to evaluate the impacts of chavir aquatic extract (Ferulago angulata Boiss) along with aerobic exercises on serum levels of interleukin-10 (IL-10) and C-reactive protein (CRP) of obese males. Materials and Methods: In this study, 40 males with body mass index (BMI) > 30 kg/m(2) and average age of 33.63 +/- 4.78 years were randomly categorized into 4 groups of 10 individuals as control, combination (using the aquatic extract of chavir along with aerobic exercises), consumption of chavir aquatic extract, and aerobic exercises. The aerobic exercises in both groups of combination and aerobic exercises consisted of running on treadmill for 20 minutes in 60%-70% maximum oxygen uptake (VO2max). The aquatic extract consumption and the combination groups had to take 50 mg/mL/d of chavir aquatic extract every time. The control group received no intervention. Results: Based on intragroup comparisons, body weight and BMI significantly decreased in the combination group; the content of body fat and waist-hip ratio (WHR) also reduced significantly in the aerobic, combination, and aquatic extract groups. In intergroup and intragroup comparison, CRP faced with a significant decrease in all groups (aerobic exercises, Ferulago aqueous extraction, and combination groups) and a considerable increase was also observed in the combination group regarding IL-10 variable. Conclusions: Therefore, the effectiveness of the combination group regarding increasing IL-10 and decreasing CRP is more than other groups. As a result, using aqueous extract of F. angulata and doing aerobic exercise for 3 months reduced risk factors-cardiovascular, body composition, and increasing anti-inflammatory in obese men. Consequently, the effect of combination group to reduce the proinflammatory indexes and body factors of obese males was more compared to that of the other groups