ABSTRACT
This laboratory study aimed to evaluate the effects of zirconium dioxide (ZrO2) slurry surface treatment on the bond strength of ultratranslucent zirconia to resin cement using different ceramic primers. The surface morphology was evaluated by scanning electron microscopy (SEM) and atomic force microscopy (AFM), and the interface was evaluated by SEM. Additionally, the phase composition was analyzed by X-ray diffraction (XRD). Specimens of zirconia (n=120) were obtained and divided into two groups according to the surface treatment: (1) airborne particle abrasion with 50-µm aluminum oxide (n=60) and (2) ZrO2 slurry (n=60). The 60 specimens were then further divided into three groups (n=20) according to the ceramic primer application: no primer (NP), Monobond N (MB), and Clearfil ceramic primer (CP). Four resin cement cylinders were built on each ceramic specimen. Half of the specimens (n=10) were subjected to a microshear bond strength (µSBS) test after 24 hours of storage in distilled water, and the other half (n=10) were subjected to a µSBS test after thermocycling. Additional specimens were prepared for SEM, AFM, and XRD analyses. According to the Kruskal-Wallis and Student-Newman-Keuls post hoc tests, the µSBS values were significantly higher for MB and CP than for NP (p<0.05), and there were no significant differences in µSBS for both surface treatments associated with MB and CP after 24 hours of storage (p>0.05). Thermocycling significantly decreased the µSBS values for all specimens, especially for the NP groups and ZrO2 slurry treatment groups, and gaps at the interface were observed by SEM. SEM and AFM analyses showed agglomerate-type irregularities on the ceramic surface for ZrO2 slurry treatment. XRD spectra showed that ZrO2 slurry did not cause phase transformation. It was concluded that ZrO2 slurry promoted irregularities on the ultratranslucent zirconia surface, not causing phase transformation; moreover, the values of µSBS were comparable to those of airborne particle abrasion with aluminum oxide. However, neither surface treatment nor ceramic primer prevented the degradation of the interface.
ABSTRACT
The aim of this laboratory study was to evaluate the pull-out force of a prefabricated fiberglass post (PP), relined fiberglass post (RP), or milled fiberglass post (MP) luted with Multilink N (MN), RelyX Unicem 2 (RXU2) or RelyX Ultimate (RU) to enlarged root canals. The thickness of the resin cements and the presence of voids in the resin cement film were observed. The root canals of 90 bovine incisors were enlarged, endodontically treated, and randomly divided into 9 groups (n=10) according to the post type and resin cement. The specimens were scanned using micro-CT to analyze the thickness of the resin cement and the presence of voids. The specimens were submitted to mechanical cyclic loading (500,000 cycles at 50 N load) and subjected to pull-out force testing. Two-way ANOVA and Tukey's test analyzed the pull-out force and resin cement thickness data. Kruskal-Wallis and Bonferroni tests analyzed the void scores. The interaction between factors (post × resin cement) was significant (p=0.0001) for the pull-out force. Higher pull-out forces were obtained for RP and MP compared to PP. The post factor was significant (p=0.0001) for resin cement thickness, which was higher for PP (1054 µm), followed by MP (301 µm) and RP (194 µm). More void formation occurred for PP, being less for RP, differing significantly among the posts. Post customization (RP and MP) decreased resin cement thickness and void formation, favoring a higher pull-out force. Resin cements requiring an adhesive application (MN and RU) favored higher pull-out force than self-adhesive resin cement (RXU2).
Subject(s)
Dental Bonding , Post and Core Technique , Animals , Cattle , Dental Pulp Cavity , Glass , Materials Testing , Resin Cements/therapeutic useABSTRACT
Red blood cell distribution width (RDW) has been studied as a prognostic biomarker for different chronic inflammatory diseases. In this paper we aim to evaluate its potential role in the prediction of early relapse in patients affected by polymyalgia rheumatica (PMR). We revised retrospectively clinical records of patients who received a diagnosis of PMR, according to 2012 ACR/EULAR classification criteria, for whom baseline clinical and laboratory data were available. The baseline RDW variation coefficient was correlated to the risk of relapse, in the first 6 months of the disease. We identified 44 patients [females 15 (34.0%)/males 29 (66.0%); median age 80 (72-83)], 9 of whom had an early relapse. These patients showed a larger median RDW than patients who did not relapse [13.7 (13.5-14.9)% vs 13.5 (12.7-14.2)%; p=0.04). The two groups were comparable for all the other clinical and laboratory parameters considered. Interestingly, patients in the higher half of the RDW distribution showed a shorter relapse-free survival (p<0.03). In a stepwise logistic regression, RDW (p=0.01) predicted the risk of relapse at 6 months, while age, gender, CRP, ESR, Hb, MCV and prednisone dose did not fit the model. Our results show that RDW is an independent biomarker of early relapse, making this parameter a potentially promising predictive marker in PMR.
Subject(s)
Giant Cell Arteritis , Polymyalgia Rheumatica , Aged, 80 and over , Erythrocyte Indices , Female , Humans , Male , Polymyalgia Rheumatica/diagnosis , Polymyalgia Rheumatica/drug therapy , Recurrence , Retrospective StudiesSubject(s)
COVID-19 , Lung Diseases, Interstitial/physiopathology , Pulmonary Arterial Hypertension/physiopathology , Raynaud Disease/physiopathology , Scleroderma, Systemic/physiopathology , Ulcer/physiopathology , Adrenal Cortex Hormones/therapeutic use , Antirheumatic Agents/therapeutic use , Cohort Studies , Female , Humans , Hydroxychloroquine/therapeutic use , Italy , Lung Diseases, Interstitial/therapy , Male , Middle Aged , Oxygen Inhalation Therapy , Pulmonary Arterial Hypertension/therapy , Retrospective Studies , SARS-CoV-2 , Scleroderma, Systemic/drug therapy , Telemedicine , TelephoneABSTRACT
Red cell distribution width (RDW) is an unconventional biomarker of inflammation. We aimed to explore its role as a predictor of treatment response in rheumatoid arthritis (RA). Eighty-two RA patients (55 females), median age [interquartile range] 63 years [52-69], were selected by scanning the medical records of a rheumatology clinic, to analyze the associations between baseline RDW, disease activity scores and inflammatory markers, as well as the relationship between RDW changes following methotrexate (MTX) and treatment response. The lower the median baseline RDW, the greater were the chances of a positive EULAR response at three months, 13.5% [13.0-14.4] being among those with good response, vs 14.0% [13.2-14.7] and 14.2% [13.5- 16.0] (p=0.009) among those with moderate and poor response, respectively. MTX treatment was followed by a significant RDW increase (p<0.0001). The increase of RDW was greater among patients with good EULAR response, becoming progressively smaller in cases with moderate and poor response (1.0% [0.4-1.4] vs. 0.7 [0.1-2.0] vs. 0.3 [-0.1-0.8]; p=0.03). RDW is a strong predictor of early response to MTX in RA. RDW significantly increases after MTX initiation in parallel to treatment response, suggesting a role as a marker of MTX effectiveness.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/drug therapy , Erythrocyte Indices , Methotrexate/therapeutic use , Aged , Biomarkers/blood , Female , Humans , Male , Middle Aged , ROC Curve , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Whether the insulin resistance commonly observed in patients with inflammatory arthritis is a disease-specific feature and/or is limited to a disease phase (i.e., it occurs only during phases of high disease activity) is unknown. Fifty-three rheumatoid arthritis (RA) and 44 psoriatic arthritis (PsA) patients were recruited consecutively along with 194 controls matched for age, sex and body mass index for a case-control study. All underwent an oral glucose tolerance test, the results of which were analysed to derive the following indexes: homeostatic model of insulin resistance (HOMA-IR), insulin sensitivity index (ISI) and early insulin sensitivity index (EISI). These data were related to anthropometric, clinical and laboratory findings. Metabolic parameters of patients and controls were similar. Neither inflammatory markers nor disease activity scores were related to glucose metabolism for the generality of RA and PsA patients; however, by restricting the analysis to the subset of RA patients with residual disease activity, an association emerged between erythrocyte sedimentation rate, on the one hand, and fasting insulin (ß=0.46, p=0.047) and HOMA-IR (ß=0.44, p=0.02), on the other. Moreover, C-reactive protein (CRP) levels were associated with plasma glucose and insulin levels measured 120 min after the glucose load (ß=0.91, p=0.0003 and ß=0.77, p=0.0006, respectively); ISI and EISI were predicted by CRP (ß=-0.79, p=0.0006; ß=-0.80, p=0.0001, respectively). The same did not hold true for PsA patients. The association between systemic inflammation and insulin resistance indexes is a feature of RA with residual disease activity, not a universal feature of inflammatory arthritides.
Subject(s)
Arthritis, Psoriatic/blood , Arthritis, Rheumatoid/blood , Insulin Resistance , Aged , Biomarkers/blood , Case-Control Studies , Female , Humans , Inflammation/blood , Male , Middle Aged , Predictive Value of TestsABSTRACT
Not available.
Subject(s)
Giant Cell Arteritis , Paraneoplastic Syndromes , Polymyalgia Rheumatica , Humans , MyalgiaABSTRACT
BACKGROUND AND AIMS: Despite the lack of evidence that assessing the global cardiovascular risk leads to a decreased incidence of cardiovascular events, accurate patient profiling is paramount in preventive medicine. An excess of visceral fat (VF) is associated with an enhanced cardiovascular risk; importantly, VF is quantifiable rapidly, cheaply and safely by ultrasound, which makes it suitable for use in clinical practice. In the present study, we aimed to evaluate if US-measured VF (USVF) could be a better predictor of glucose homeostasis and cardiovascular risk than simple anthropometric measures. METHODS AND RESULTS: One-hundred sixty-two patients attending a Metabolic Disorders Clinic underwent a cross-sectional study for which USVF, anthropometric measures, a standard oral glucose tolerance test (OGTT), and calculation of cardiovascular Framingham score and vascular age were obtained. USVF was directly correlated with fasting and 2-h plasma glucose (respectively: r = 0.26, p < 0.001; r = 0.28, p < 0.0001), fasting and 2-h plasma insulin (for both: r = 0.41, p < 0.0001), homeostatic model assessment of insulin resistance (HOMA-IR; r = 0.42, p < 0.0001), cardiovascular Framingham score (r = 0.44 p < 0.0001) and vascular age (r = 0.30 p < 0.001). In receiver operator characteristic curves USVF had good diagnostic abilities for type 2 diabetes mellitus, fatty liver and metabolic syndrome, in both genders. At multivariate analysis, body mass index (BMI) outperformed USVF in the prediction of HOMA-IR; neverthless, USVF, not BMI, was an independent predictor of cardiovascular risk. Finally, models including USVF were the most parssimonious to predict Framingham score, vascular age and HOMA-IR. CONCLUSION: In overweight and obese subjects, USVF could usefully complement other parameters for cardiovascular risk stratification.
Subject(s)
Blood Glucose/metabolism , Cardiovascular Diseases/etiology , Glucose Metabolism Disorders/blood , Intra-Abdominal Fat/diagnostic imaging , Metabolic Syndrome/blood , Metabolic Syndrome/diagnostic imaging , Obesity/diagnostic imaging , Ultrasonography , Adiposity , Aged , Anthropometry , Biomarkers/blood , Body Mass Index , Cardiovascular Diseases/diagnosis , Cross-Sectional Studies , Female , Glucose Metabolism Disorders/complications , Glucose Metabolism Disorders/diagnosis , Glucose Tolerance Test , Homeostasis , Humans , Intra-Abdominal Fat/physiopathology , Male , Metabolic Syndrome/complications , Metabolic Syndrome/physiopathology , Middle Aged , Obesity/complications , Obesity/physiopathology , Predictive Value of Tests , Prognosis , Prospective Studies , Risk Assessment , Risk FactorsABSTRACT
Troponin I (TnI) false positive results have been reported in patients affected by immune disorders. We report the case of a 74-year-old woman affected by cryoglobulinemic vasculitis, admitted to the Emergency Room because of a lipotimic episode. A marked elevation of TnI plasma concentration was confirmed in multiple determinations, despite the absence of symptoms or electrocardiogram findings suggesting myocardial infarction. TnI plasma concentration was reported normal after re-testing with a different commercial kit. A false TnI positivity should be considered in patients with immune disorders, especially if seropositive for rheumatoid factor, when the clinical context does not suggest myocardial infarction.
Subject(s)
Cryoglobulinemia , Systemic Vasculitis/diagnosis , Troponin I/blood , Aged , Biomarkers/blood , Diagnosis, Differential , Emergencies , Female , Humans , Systemic Vasculitis/bloodABSTRACT
The authors identified two novel heterozygous missense transitions in the gene for the mitochondrial polymerase gammaA subunit (POLG) in a family with an autosomal recessive syndrome comprising progressive external ophthalmoplegia (PEO), polyneuropathy, ataxia, sensorineural hearing loss, and affective disorders. These mutations were not detected in 120 healthy control subjects.
Subject(s)
Ataxia/genetics , DNA-Directed DNA Polymerase/genetics , Hearing Loss, Sensorineural/genetics , Hereditary Sensory and Motor Neuropathy/genetics , Mutation, Missense , Ophthalmoplegia, Chronic Progressive External/genetics , Adult , Amino Acid Substitution , Cognition Disorders/genetics , DNA Mutational Analysis , DNA Polymerase gamma , Exons/genetics , Female , Genes, Recessive , Heterozygote , Humans , Male , Middle Aged , Mood Disorders/genetics , Pedigree , Polymorphism, Restriction Fragment Length , SyndromeABSTRACT
OBJECTIVE: This study was conducted to show vascularization of Schmorl's nodes with enhanced MR imaging and to correlate this finding with clinical complaints. MATERIALS AND METHODS: Retrospectively, 412 gadopentetate dimeglumine-enhanced MR imaging examinations of the lumbar and thoracic spine of 372 patients were reviewed for Schmorl's nodes, vascularization of Schmorl's nodes, and associated bone marrow edema. Sagittal T2-weighted spin-echo and unenhanced and enhanced T1-weighted spin-echo images with and without fat suppression were evaluated in symptomatic and asymptomatic patients. RESULTS: Of the 372 patients, 142 (38%) had 341 Schmorl's nodes. Gadopentetate dimeglumine-enhanced MR imaging revealed vascularized tissue in 30 Schmorl's nodes of 23 patients (mean age of patients, 53 years old). Associated bone marrow edema was found in nine of 30 vascularized Schmorl's nodes. The mean diameter (8.2 mm) of the nine vascularized Schmorl's nodes that were surrounded by bone marrow edema was significantly (p < .05) greater than the mean diameter (6.4 mm) of the 21 vascularized Schmorl's nodes that had no bone marrow edema. The vascularized Schmorl's nodes were significantly (p < .05) smaller in the seven asymptomatic patients (mean, 5.2 mm) than in the 23 patients with back pain (mean, 7.9 mm). We saw bone marrow edema adjacent to Schmorl's nodes less frequently in asymptomatic patients (one of seven) than in symptomatic patients (10 of 23). CONCLUSION: Vascularized Schmorl's nodes were larger and more frequently associated with bone marrow edema in patients with back pain than in asymptomatic patients. Enhanced MR images of Schmorl's nodes revealed vascularity, which was not shown on unenhanced MR images.