Age-specific reference ranges of prostate-specific antigen in the elderly of Amirkola: A population-based study.

OBJECTIVE: To determine the age-specific reference ranges of prostate-specific antigen (PSA) in the older men in the city of Amirkola. METHODS: This cross-sectional study is a part of Amirkola Health and Ageing Project (AHAP) which has been conducted as a cohort study since 2011 in Amirkola, a city in northern Iran. The demographic information of all men aged 60 and older were collected through questionnaires and interviews and the PSA measurements were performed using ELISA and Diametra kit. The acquired data were analyzed afterwards. RESULTS: A number of 837 elderly men with a mean age of 69.99±7.72 years participated in this study. The serum PSA level (95th percentile) was determined to be 0.9 (0-4.89) ng/mL in the age group of 60-64 years, 1.1 (0-4.88) ng/mL in the age group of 65-69 years, 0.93 (0-9.01) ng/mL in the age group of 70-74 years, 1.3 (0-7.95) ng/mL in the age group of 75-79 years, 1.9 (0-11.98 ng/mL) in the age group of 80-84 years, and 1.45 (0-33.17) ng/mL in the 85 and older group. The serum PSA level was significantly correlated with age (p=0.000). CONCLUSION: This study indicated that there is a direct correlation between the age and serum PSA levels. The use of age-specific reference range could guide clinicians on the incidence of prostate cancer in this population and perhaps reduce the number of unnecessary tests in this population group.

The effect of metal artifacts on the identification of vertical root fractures using different fields of view in cone-beam computed tomography

PURPOSE: The aim of this study was to investigate the effects of metal artifacts on the accurate diagnosis of root fractures using cone-beam computed tomography (CBCT) images with large and small/limited fields of view (FOVs). MATERIALS AND METHODS: Forty extracted molar and premolar teeth were collected. Access canals were made in all teeth using a rotary system. In half of the teeth, fractures were created by the application of mild pressure with a hammer. The teeth were then randomly put into a wax rim on an acryl base designed in the shape of a mandible. CBCT scans were obtained using a Newtom 5G system with FOVs of 18 cmx16 cm and 6 cmx6 cm. A metal pin was then placed into each tooth, and CBCT imaging was again performed using the same fields of view. All scans were evaluated by two oral and maxillofacial radiologists. The specificity, sensitivity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) were calculated. RESULTS: The maximum levels of sensitivity and specificity (100% and 100%, respectively) were observed in smallvolume CBCT scans of teeth without pins. The highest negative predictive value was found in the small-volume group without pins, whereas the positive predictive value was 100% in all groups except the large-volume group with pins. CONCLUSION: The specificity of CBCT decreased with the presence of a pin in the large-volume group, but not in the small-volume group.

Assessment of vertical root fracture using cone-beam computed tomography

PURPOSE: The aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures in a tooth with gutta-percha and prefabricated posts. MATERIALS AND METHODS: This study selected 96 extracted molar and premolar teeth of the mandible. These teeth were divided into six groups as follows: Groups A, B, and C consisted of teeth with vertical root fractures, and groups D, E, and F had teeth without vertical root fractures; groups A and D had teeth with gutta-percha and prefabricated posts; groups B and E had teeth with gutta-percha but without prefabricated posts, and groups C and F had teeth without gutta-percha or prefabricated posts. Then, the CBCT scans were obtained and examined by three oral and maxillofacial radiologists in order to determine the presence of vertical root fractures. The data were analyzed using IBM SPSS 20.0 (IBM Corp., Armonk, NY, USA). RESULTS: The kappa coefficient was 0.875+/-0.049. Groups A and D showed a sensitivity of 81% and a specificity of 100%; groups E and B, a sensitivity of 94% and a specificity of 100%; and groups C and F, a sensitivity of 88% and a specificity of 100%. CONCLUSION: The CBCT scans revealed a high accuracy in the diagnosis of vertical root fractures; the accuracy did not decrease in the presence of gutta-percha. The presence of prefabricated posts also had little effect on the accuracy of the system, which was, of course, not statistically significant.

A comparative study of cone-beam computed tomography and digital periapical radiography in detecting mandibular molars root perforations

PURPOSE: The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. MATERIALS AND METHODS: In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ("root perforation"). Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. RESULTS: The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. CONCLUSION: For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

Correlation of splenectomy with portal vein thrombosis in beta-thalassemia major.

OBJECTIVE: To evaluate the correlation of portal vein thrombosis and splenectomy in beta-thalassemia major patients visiting Babol Medical University, Iran. METHODS: This cohort study was done from 1997 to 2008. In our study, major beta-thalassemic patients visiting for transfusion at least once a month at Amirkola Children's Hospital were selected. Portal vein thrombosis was diagnosed through Doppler ultrasound in symptomatic patients. Cases were 160 beta-thalassemia major patients who underwent splenectomy and 160 remaining thalassemic patients without splenectomy were controls. Statistical comparison with Fisher exact test was performed. RESULTS: Five cases had suffered from portal vein thrombosis (P = 0.03). Majority patients with portal vein thrombosis had their symptoms after first month of the operation. CONCLUSION: Correlation of splenectomy with portal vein thrombosis is statistically significant among beta-thalassemic children from Iran.