ABSTRACT
Endodontically treated teeth are most commonly restored using post-retained foundation restoration and a crown which has certain well-established drawbacks. Nowadays, the emergence of minimal invasive dentistry has led to increased use of endocrowns for restoring such teeth. However, their indications and success rates have not been explored widely enough to merit their full implementation in dental practice. This systematic review attempts to achieve this purpose by accumulating evidence from current literature that underscores endocrowns’ indications and success rates. METHODSThe electronic search strategy was performed in three databases (PubMed, Google Scholar, and EBSCO) using MeSH terms endocrowns, or endocrown success rates of endocrowns or endo crowns in dentistry or endodontically treated teeth or ceramic or monoblock or CAD-CAM, confined to articles published between 1st January 2015 and 20th November of 2019. All selected articles were evaluated to determine as to whether or not they could be included in the SR. Abstracts and titles were screened independently by 2 investigators and duplicates if any were removed. For possible inclusion after reading abstract, full-text assessment of the article was performed based on eligibility criteria. Manual extraction of data from the retrieved publications was done. RESULTSA total of 20 articles was found on related topic from electronic and manual searching, out of which, 2 were duplicates and hence removed. Further 7 articles were removed in screening and again 2 were removed after reading full-text, thus making the final count of 9 articles for the systematic review. Among the nine articles, 3 were clinical studies, 1 was a retrospective patient series study, while remaining were in-vitro studies. Out of 9, 7 articles (77 %) reported endocrowns to be successful and 2 articles (22 %) gave contrary outcomes. CONCLUSIONS Most of the articles included in this SR agree that endocrowns are a desirable restorative tool in dentistry. Other systematic reviews and meta-analyses with a significant number of included publications and studies should be conducted to expand the generalizability potential of such results
ABSTRACT
The cestode Taenia hydatigena uses canids, primarily dogs, as definitive hosts, while the metacestode larval stage cysticercus infects a range of intermediate hosts, including domestic animals such as goats, sheep, and pigs. Cysticercosis due to T. hydatigena has large veterinary and economic drawbacks. Like other taeniids, e.g., Echinococcus, intraspecific variation is found among the members of the genus Taenia. In Africa, few studies are available on the epidemiology and distribution of T. hydatigena, and even fewer studies are available on its genetic variation. In this study, we molecularly identified 11 cysticerci from sheep in Sudan and demonstrated the genetic variation based on the NADH dehydrogenase subunit 1 (nad1) and cytochrome c oxidase subunit 1 (cox1) mitochondrial genes. The isolates were correctly identified as T. hydatigena with more than 99% similarity to those in the GenBank database. Low diversity indices and insignificant neutrality indices were observed, with 3 and 2 haplotypes for the nad1 and cox1 genes, respectively. The results suggest the presence of unique T. hydatigena haplotypes in Sudan, as haplotypes with 100% similarity were not found in the GenBank database. With few available studies on the genetic variation of T. hydatigena in Africa, this report represents the first insights into the genetic variation of T. hydatigena in Sudan and constitutes useful data.
ABSTRACT
Purpose:@#Sepsis is a common acute life-threatening condition that emergency physicians routinely face. Diagnostic options within the Emergency Department (ED) are limited due to lack of infrastructure, consequently limiting the use of invasive hemodynamic monitoring or imaging tests. The mortality rate due to sepsis can be assessed via multiple scoring systems, for example, mortality in emergency department sepsis (MEDS) score and sepsis patient evaluation in the emergency department (SPEED) score, both of which quantify the variation of mortality rates according to clinical findings, laboratory data, or therapeutic interventions. This study aims to improve the management processes of sepsis patients by comparing SPEED score and MEDS score for predicting the 28-day mortality in cases of emergency sepsis.@*Methods:@#The study is a cross-sectional, prospective study including 61 sepsis patients in ED in Suez Canal University Hospital, Egypt, from August 2017 to June 2018. Patients were selected by two steps: (1) suspected septic patients presenting with at least one of the following abnormal clinical findings: (a) body temperature higher than 38℃ or lower than 36℃, (b) heart rate higher than 90 beats/min, (c) hyperventilation evidenced by respiratory rate higher than 20 breaths/min or PaCO2 lower than 32 mmHg, and (d) white blood cell count higher than 12,000/μL or lower than 4000/μL; (2) confirmed septic patients with at least a 2-point increase from the baseline total sequential organ failure assessment (SOFA) score following infection. Other inclusion criteria included adult patients with an age ≥18 years regardless of gender and those who had either systemic inflammatory response syndrome or suspected/confirmed infection. Patients were shortly follow-up for the 28-day mortality. Each patient was subject to SPEED score and MEDS score and then the results were compared to detect which of them was more effective in predicting outcome. The receiver operating characteristic curves were also done for MEDS and SPEED scores.@*Results:@#Among the 61 patients, 41 died with the mortality rate of 67.2%. The mortality rate increased with a higher SPEED and MEDS scores. Both SPEED and MEDS scores revealed significant difference between the survivors and nonsurvivors (p = 0.004 and p < 0.001, respectively), indicating that both the two systems are effective in predicting the 28-day mortality of sepsis patients. Thereafter, the receiver operating characteristic curves were plotted, which showed that SPEED was better than the MEDS score when applied to the complete study population with an area under the curve being 0.87 (0.788-0.963) as compared with 0.75 (0.634-0.876) for MEDS. Logistic regression analysis revealed that the best fitting predictor of 28-day mortality for sepsis patients was the SPEED scoring system. For every one unit increase in SPEED score, the odds of 28-day mortality increased by 37%.@*Conclusion:@#SPEED score is more useful and accurate than MEDS score in predicting the 28-day mortality among sepsis patients. Therefore SPEED rather than MEDS should be more widely used in the ED for sepsis patients.
ABSTRACT
Objective: In the present study, the 3D finite element method was used to investigate the effect of crown material on stress distribution in the bone surrounding immediately loaded single dental
Materials and Methods: A 3D Finite Element model of mandibular first premolar was constructed to evaluate the performance of seven crown materials with different degree of stiffness [Porcelain, zirconium, Porcelain fused to gold, pure titanium, titanium alloy, Poly methyl methacrylate, and Polyether ether ketone PEEK]. The model was constructed using Solid Works version 2010 software. The model simulated also a cement layer between the implant abutment and the crown [Virolink II, Vivadent]. An axial static occlusal force of 200 N was applied to eight points in each functional cusp. The three-dimensional [3D] FE model was analyzed by ABAQUS/CAE version 6.10 software
Results: The results of this study indicated that among all crown materials the maximum von Mises stress values was observed in porcelain crown design [345.390 MPa].The highest von Mises stresses were found in the abutments for all models. In implants, the greatest stress was concentrated on the cervical region. PMMA and PEEK crown designs transferred less stress to abutment and screw. In all models, von Mises stresses increased in the coronal third of cortical bone in which the maximum von Mises stresses observed in the implant cortical interface
Conclusions: Using more rigid material for the superstructure of an implant supports prosthesis did not have any effect on the stress values and stress distribution at the bone tissue surrounding implant. However, in the abutment, cement and crown structure, stress distributions and localizations were affected by the material's rigidity. More clinical studies are needed to evaluate the survival rate of these materials
Subject(s)
Dental Prosthesis, Implant-Supported , Crowns , Dental Stress Analysis , Finite Element AnalysisABSTRACT
To determine the prevalence of defensive medicine among doctors of Civil Hospital and Jinnah Hospital Karachi and to introduce it towards the community of doctors. 200 doctors from different wards of Civil Hospital Karachi and Jinnah Hospital Karachi played crucial role in filling of Performa which was especially designed for this research. Cross sectional study. Civil and Jinnah Hospital Karachi. January 01, 2013 to December 31, 2013. 47.9% doctors already knew about defensive medicine while 52.1% didn't. 40.7% doctors avoid invasive procedures while 50.3% don't. 92.4% of doctors care for high risk patients while 7.6% avoid caring for them. 109 out of 190 doctors agree and 30 doctors strongly agree about the practice of defensive medicine, 34 doctors are neutral and the rest of them disagree with its practice. Mostly ordered tests are CBC 78.9%, urine D/R 3.2%, 1.1% stool D/R, 1.6% MRI, 2.2% CT scan, 1.1% UCE, 2.7% blood cultures, 0.5% LFTs 9.1% other tests and the doctors with experience of 10 or 15 years are found ordering only CBC mostly. The conclusion obtained from the results shows that most of the participants were experienced doctors but many of them were unaware of the defensive medicine and in spite of that too great number of doctors strongly believe in its practice. Majority of the doctors were found caring for high risk patients. However the prevalence and practice of defensive medicine reduced among doctors having experience of more than 5 years
Subject(s)
Humans , Adult , Middle Aged , Residence Characteristics , Physicians , Cross-Sectional Studies , Magnetic Resonance Imaging , Blood CultureABSTRACT
ACS is a clinical diagnosis encompassing three entities; ST-Elevation Myocardial Infarction [STEMI], Non ST-Elevation Myocardial Infarction [NSTEMI], and Unstable Angina. It is one of the biggest causes of hospital admissions and mortality worldwide. As it is preventable problem, we should know the commonest risk factors and address them simultaneously. The aim of study was to determine the common most risk factors of ACS in local patients. It was a cross-sectional, descriptive study conducted at Coronary Care Unit, Bahawal Victoria Hospital, Bahawalpur. The patients from all ages and both sexes who presented with the diagnosis of ACS during December 2008 to May 2009 were included in the study by convenience sampling technique. The patients having additional medical problem [Advanced congestive cardiac failure, cerebrovascular disease, respiratory failure, autoimmune disorders, connective tissue diseases and end stage kidney disease], which could confound the results, were excluded from the study. During the study period of one year, 320 patients fulfilling the inclusion and exclusion criteria were taken in our analysis. The male to female ratio was 2:1. The mean age was 55.06 +/- 18.79 years. The diagnosis was STEMI in 60 [%], NSTEMI in 98 [%] and UA in 162 [%] at the admission. The top most implicated risk factors observed in our study were male gender [66.87%], hyperlipidemia [60.31%], smoking [55.94%]. At least one of the well knownjconventional risk factors was present in almost all [99.38%] patients of ACS while any four risk factors were present in half of the patients