The polymerization efficiency of a bulk-fill composite based on matrixmodification technology

Objectives@#To evaluate the polymerization efficiency of a matrix-modified bulk-fill composite, and compare it to a conventional composite which has a similar filler system.The degree of conversion (DC%) and monomer elution were measured over different storage periods. Additionally, fillers' content was examined. @*Materials and Methods@#Cylindrical specimens were prepared, in bulk and incrementally, from Filtek Bulk Fill (B) and Filtek Supreme XTE (S) composites using a Teflon mold, for each test (n = 6). Using attenuated total reflection method of Fourier transformation infrared spectroscopy, DC% was measured after 24 hours, 7 days, and 30 days. Using high-performance liquid chromatography, elution of hydroxyethyl methacrylate, triethylene glycol dimethacrylate, urethane dimethacrylate, and bisphenol-A glycidyl dimethacrylate was measured after 24 hours, 7 days and 30 days. Filler content was examined by scanning electron microscopy (SEM). Data were analyzed using 2-way mixed-model analysis of variance (α = 0.05). @*Results@#There was no significant difference in DC% over different storage periods between B-bulk and S-incremental. Higher monomer elution was detected significantly from S than B.The elution quantity and rate varied significantly over storage periods and between different monomers. SEM images showed differences in fillers' sizes and agglomeration between both materials. @*Conclusions@#Matrix-modified bulk-fill composites could be packed and cured in bulk with polymerization efficiency similar to conventional composites.

The polymerization efficiency of a bulk-fill composite based on matrixmodification technology

Objectives@#To evaluate the polymerization efficiency of a matrix-modified bulk-fill composite, and compare it to a conventional composite which has a similar filler system.The degree of conversion (DC%) and monomer elution were measured over different storage periods. Additionally, fillers' content was examined. @*Materials and Methods@#Cylindrical specimens were prepared, in bulk and incrementally, from Filtek Bulk Fill (B) and Filtek Supreme XTE (S) composites using a Teflon mold, for each test (n = 6). Using attenuated total reflection method of Fourier transformation infrared spectroscopy, DC% was measured after 24 hours, 7 days, and 30 days. Using high-performance liquid chromatography, elution of hydroxyethyl methacrylate, triethylene glycol dimethacrylate, urethane dimethacrylate, and bisphenol-A glycidyl dimethacrylate was measured after 24 hours, 7 days and 30 days. Filler content was examined by scanning electron microscopy (SEM). Data were analyzed using 2-way mixed-model analysis of variance (α = 0.05). @*Results@#There was no significant difference in DC% over different storage periods between B-bulk and S-incremental. Higher monomer elution was detected significantly from S than B.The elution quantity and rate varied significantly over storage periods and between different monomers. SEM images showed differences in fillers' sizes and agglomeration between both materials. @*Conclusions@#Matrix-modified bulk-fill composites could be packed and cured in bulk with polymerization efficiency similar to conventional composites.

Evaluation of volume-targeted versus pressure-limited ventilation for Preterm Neonates with respiratory distress

Objectives: To evaluate the efficiency of volume targeted versus pressure-limited ventilation for preterm infants with respiratory distress

Methods: 60 newborn infants with gestational age 28-34 weeks in the NICU at Alexandria University Children's Hospital randomly divided in to 2 groups ventilated with either volume targeted ventilation [VTV] or pressure limited time cycled ventilation [PLV] as primary mode or secondary to failure of NCPAP using SLE 4000 or 5000 ventilators

Results: The demographic and clinical characteristics, values of tidal volume [VT], peak inspiratory pressure [PIP], mean airway pressure [MAP], fraction of inspired oxygen [Fio2], alveolar arterial oxygen gradient [A-aDo2], carbon dioxide tension, and pH were similar for all participating infants initially. During the follow-up, the PIP, MAP and FIO2 levels were significantly decreasing in the VTV group during the first 48 hrs. Moreover, The VTV group showed significantly lower incidence of hypocarbia and non-permissible hypercarbia. The VTV group showed significantly shorter duration of ventilation. There was no statistical significant difference between both groups as regards IVH, air leaks BPD, PDA or nosocomial infection

Conclusion: The use of VTV achieves adequate gas exchange using lower MAP and with less variability in tidal volume reducing the risk of hypocarbia and non-permissible hypercarbia. The use of VTV also shortens the duration of ventilation in premature infants with respiratory distress

Assessment of endothelial dysfunction in idiopathic pulmonary fibrosis

Background: Idiopathic pulmonary fibrosis [IPF] is defined as a specific form of chronic fibrosing interstitial pneumonia limited to the lung, with the histopathology of UIP on surgical lung biopsy. Recent epidemiological evidence indicates that patients with IPF have an increased risk of cardiovascular disease. The vascular endothelium acts to maintain vascular homeostasis through multiple mechanisms, and alteration in its function precedes the development, progression and clinical expression of atherosclerosis

Aim of the work: To assess the prevalence of endothelial dysfunction in patients with idiopathic pulmonary fibrosis and its correlation with pulmonary hypertension

Subjects and methods: The study included two groups. The patient group included 30 IPF patients subdivided into 2 subgroups: Subgroup I [15 IPF cases] with pulmonary hypertension; Subgroup II [15 IPF cases] without pulmonary hypertension. The control group included 10 normal healthy individuals. Patients were subjected to written informed consent, detailed history taking, thorough clinical examination, collagen profile, arterial blood gases [PaO[2], SaO[2]], Pulmonary function tests [spirometry], 6 min walk test, HRCT chest scan, echocardiography, and brachial artery duplex to assess endothelial dysfunction

Results: Subgroup [I] and Subgroup [II] showed a statistically highly significant difference in brachial artery flow mediated dilatation [BADFMD] and endothelium - reactive dilatation [ERD] which indicate endothelial dysfunction compared to the control group

Conclusion: This work concluded that BADFMD and ERD more affected in IPF patients regardless of presence or absence of PH than normal population. So, endothelial dysfunction is a possible link between IPF and cardiovascular disease

Therapeutic effect of captopril, pentoxifylline, and cordyceps sinensis in pre-hepatic portal hypertensive rats

Portal hypertension is an important and potentially fatal complication of liver disease whereby cellular and fibrotic alterations manifest to increase portal venous pressure. The aim of this study is to investigate the effect of captopril, pentoxifylline [PTX], and cordyceps sinensis in pre-hepatic portal hypertensive rats. Wister male rats were divided at random into 3 main groups: the first group: control rats. The second group: sham-operated rats and the third group: prehepatic portal hypertensive rats [PHPHT] induced by regulated pre-hepatic portal vein ligation. After 14 days, Group 3 was subdivided into 5 subgroups. Subgroup [1]: portal vein-ligated [PVL] was killed at once; Subgroup [2]: received distilled water for 30 days [untreated PVL group]; subgroups 3-5 were treated with captopril [60 mg/kg, orally]; PTX [100 mg/kg, orally]; and C. sinensis [200 mg/kg, orally], respectively, as a single daily dose for 30 days. Portal pressure, nitric oxide [NO], antioxidant enzymes, Liver enzymes, and creatinine levels were measured to evaluate the status of the liver state. Portal vein ligation produced significant increments in liver enzymes, NO, creatinine and portal pressure concomitant with significant decrements in glutathione content and superoxide dismutase activity. Treatment with captopril, PTX, and C. sinensis resulted in a significant reduction in liver enzymes, NO, creatinine and portal pressure and observable increase in antioxidant enzymes. Captopril, PTX, and C. sinensis have promising effect in controlling PHPHT and reducing hyperdynamic circulatory state through reduction of portal pressure and NO level

Accuracy of pediatricians' screening and referral for early childhood caries after a training program

Training of pediatricians on early childhood caries [ECC] screening and referral during their medical pediatric practice has been suggested to promote childhood dental care. To assess the accuracy of pediatricians in detection of ECC and trauma and to estimate the rate of referral after being trained by a pedodontist. The study was conducted at pediatric outpatient clinics of a governmental pediatric hospital in Alexandria, Egypt. Dental examination of 137 children- six to thirty six months of age was carried out independently by a pedodontist and pediatricians to identify cases of ECC and trauma after a training program for physicians about diagnosis of dental caries and referral needs. Fifty dental conditions were detected among 33.6% of the children [46 children] with a rate of 36.5%. The rate of ECC among children was 27.7% with pre-cavitated caries as the most common type [16.1%]. The mean age of children with ECC is significantly higher than that of children without ECC [t =3.23, P =0.002]. The rate of dental trauma was 9%. The positive predictive value of pediatricians' detection of ECC was 100%, the sensitivity was 94.74% and the specificity was 100%. The children referred for dental care by pediatricians represented 88% of those referred by the pedodontist. Pediatricians can achieve high accuracy of identification of cases with ECC and of cases in need for dental referral through inservice training

values of serum and ascetic fluid tumor necrosis factor-Alpha [TNF-alpha], TNF-receptor 1 and C-reactive protein [CRP] in patients with cirrhotic ascites

Spontaneous bacterial peritonitis [SBP] is defined as an infection of initially sterile ascitic fluid [AF] without a detectable, surgically treatable source of infection. It is a frequent and severe complication of cirrhotic ascites. Because of the high morbidity and mortality of SBP, the rapid and accurate diagnosis is required. The present study aimed to measure the levels of tumor necrosis factor-alpha [TNF-alpha], tumor necrosis factor receptor [TNF-r p55] and C-reactive protein [CRP] in both ascetic fluid and serum of patients with sterile and infected cirrhotic ascites to show their diagnostic values as compared to ascitic fluid culture and polymorphnuclear leukocyte [PMN] count. TNF-alpha, TNF-r p55 and CRP were measured in both ascetic fluid and serum of 20 patients with spontaneous bacterial peritonitis [SBP], in addition to 22 patients with sterile cirrhotic ascites. The results of clinical examination showed a significant difference as regard abdominal pain, fever jaundice, upper GIT bleedings, encephalopathy and Sclerotherapy among both groups. The serum levels of CRP and TNF-alpha were significantly higher in patients with SBP as comparing to patients have sterile ascites, but TNF-r p55 serum level showed no significant difference. On evaluation of ascetic fluid parameters, total leucocytic count [TLC], plymorphnuclear [PMN] count, CRP, TNF-alpha, TNF-r p55 are significantly higher in SBP patient group than group of sterile ascites. Sensitivity and specificity of ascitic fluid PMN [cut-off value >250 cells/ mm[3]] in discriminating infected ascites from sterile ascites were 70% and 86.4%, respectively. Sensitivity and specificity of ascitic fluid CRP [cut-off value >1.0 mg/dL] in discriminating infected ascites from sterile ascites were 85% and 72.7%, respectively. Sensitivity and specificity of ascitic fluid TNF-alpha [cut off value >12 pg/ml] in discriminating infected ascites from sterile ascites were 80% and 63.6%, respectively. Sensitivity and specificity of TNF-r p55 [cut-off value >6.2 pg/ml] in discriminating infected ascites from sterile ascites were 75% and 68.2%, respectively. We concluded that, the elevated serum and ascetic fluid levels of CRP, TNF-alpha and TNF-r may suggest their role in the pathogenesis of ascetic fluid infection and their higher sensitivity and specificity make them to be good discriminators in ascetic fluid infection [especially a cheap and easy ascitic fluid CRP levels]. Thus may help in rapid diagnosis and early start empirical antibiotic therapy without waiting the culture results

Evaluation of inner ear congenital and developmental lesions by HRCT and MRI

To assess the role of HRCT and MR imaging in the evaluation of congenital and developmental anomalies of the inner ear and how the results could affect the management of such patients, 56 patients [43 males, 13 females, aged 7 days to 70 years] were examined by high resolution computed tomography and/or magnetic resonance imaging between July 2000 and May 2004 for assessment of inner ear abnormalities. Eighty-five developmental and congenital inner ear lesions were detected in 67 temporal bones and were classified into three groups: Group A, lesions involving the proper inner ear structures [23 lesions in 14 temporal bones of 10 patients]; Group B, lesions involving vascular structures [58 lesions in 49 temporal bones of 43 patients]; Group C, facial nerve lesions [4 lesions in 4 temporal bones of 3 patients]. It was concluded that HRCT is the gold standard imaging modality for assessing lesions involving the osseous labyrinth of the inner ear and vascular structures while MRI significantly improves the diagnosis of lesions involving the membranous labyrinth and related cranial nerves. Both imaging modalities significantly help the otologist in treating and establishing the proper management plan for these patients

Helminthes of synanthropic rodents [rodentia: muridae] from Dakahlia and Menoufia, Egypt

A cross-sectional survey was conducted to monitor and compare the prevalence of helminthes in rodents from Dakahlia and Menoufia governorates. The domestic rodents [271] were Rattus norvegicus, Rattus rattus frugivorous, Rattus r. alexandrinus, and Mus musculus. The overall prevalence of helminthes was 52.8%. In Dakahlia, 72/145 rats [49.6%] were infected. The highest prevalence of infection was in R. r. frugivorous 43 [60.4%], then R. r. alexandrinus 44 [47.7%], R. norvegicus 38 [44.7%], and the lowest was M. musculus 20 [40%]. In Menoufia, 71/126 rats [56.3%] were infected. The highest prevalence of infection was in R, r. frugivorous 36 [77.7%], then M. musculus 27 [48.1%], R. norvegicus 23 [47.8%], and the lowest was in R. r. alexandrinus 40 [47.5%]. A total of 24 species of helminthes [11 trem-atodes, 4 cestodes and 10 nematodes] were identified among the 271 rodents. The commonest trematode was Mesostephanus aegypticus followed by Stictodora tridactyla. The commonest cestode was Hym-enolepis diminuta followed by Taenia taeniaformis. The commonest nematode was Capillaria hepatica followed by Trichurus muris. Given the zoonotic potential of rodents' parasites and since several residential, commercial, and agricultural sites exist in the examined geographic areas, the potential health risk should not be ignored

Host-induced phenotypic differences in Egyptian Heterophyes [digenea: heterophyidae]

A comparative morphometric study identified host-related variations in Heterophyes heterophyes. In one study, variations in adult H. heterophyes obtained from different definitive hosts were examined. Significant differences were in size and dimensions of body organs of adults collected from dogs, cats and albino-rats experimentally infected with encysted metacercariae [EMC] from mullet [Mugil cephalus]. Hypotheses on the sources of host-dependent variations were interpreted in terms of adaptation to conditions created by the host. In a second study, comparative morphometric analysis of adults recovered from puppies experimentally fed on EMC isolated from five sympatric fish species was done. No significant differences were in adults H. heterophyes recovered from puppies feed on EMC of different fishes. Constancy in morphological characters of adults reared in the same host, independent of a change of fish was seen. So, the variations depend upon host species where worms develop, and host selection may determine the worm morphology and phenotypic plasticity