Effect of three root canal sealers on the retentive strength of endodontic posts luted with a resin cement.

AIM: This investigation examined what effect three different sealers had on retention of endodontic posts (Parapost) luted with a resin cement (Panavia 21 OP). METHODOLOGY: Sixty-four single-rooted teeth were decoronated, filed, cleaned, and shaped with a size 5 Gates-Glidden drill and 0.12 taper G.T. rotary instrumentation (Dentsply/Tulsa Dental). Teeth were then divided into four groups of 16 each. Group 1 was not obturated, and served as a control. The other three groups were obturated with gutta-percha using a different sealer for each group. Group 2 used a eugenol containing sealer (Kerr Pulp Canal Sealer), group 3 a resin sealer (AH-26), and group 4 a calcium hydroxide sealer (Sealapex). After 1 week's storage at 100% humidity, 10-mm deep post spaces were prepared with a size 6 Gates-Glidden drill, and size 5 Paraposts were cemented. Following 48 h of storage, samples were mounted in a PVC pipe with acrylic, and the posts were removed vertically using a universal testing machine at 1 mm min-, with data recorded in kilograms. RESULTS: The mean values of force required to remove the posts were: group 1 = 61.80, SD = 16.21; group 2 = 43.14, SD = 14.66; group 3 = 48.54, SD = 17.84; group 4 = 53.52, SD = 18.77. Using anova and Bonferroni tests, group 1 demonstrated significantly greater mean retention strength values than group 2, but no other significant differences existed between groups. CONCLUSION: The chemical formulation of root canal sealers did not significantly affect the retention of endodontic posts luted with resin cement.

Clinical and laboratory features of measles in hospitalized adults.

PURPOSE: Description of the epidemiology, morbidity, and mortality of hospitalized adults with typical measles. PATIENTS AND METHODS: Retrospective case analysis of 33 adults who required acute care for complications of measles in a public hospital in Los Angeles, California. The diagnosis of measles was established on standard clinical or serologic grounds. RESULTS: Of 68 patients (age greater than 14) with signs and symptoms of measles who presented for medical care, 33 (19 males and 14 females) required hospitalization; 18 were natives of the United States. The patient age was 26.1 +/- 7.3 (mean +/- SD) years; four patients, all natives of the U.S., were born before 1957. The duration of hospitalization was 6.8 +/- 8.8 days for all patients and 13.4 +/- 14.2 days for the nine patients who required intensive care unit (ICU) care. Six of the ICU patients required mechanical ventilation for 11.0 +/- 15.0 days; two deaths occurred among these patients. During the course of their illness, 7 of 25 (28%), 11 of 28 (39%), 6 of 28 (21%), and 5 of 16 patients (31%) had peak lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and creatine kinase values, respectively, that were greater than 5 times the upper limit of normal. Fifteen of 28 patients (54%) developed total serum calcium levels less than or equal to 2.0 mmol/L. Ten cases were serologically confirmed; 23 cases were diagnosed as probable measles on clinical grounds. There were no significant demographic, clinical, or laboratory differences between patients with confirmed and probable measles. No patients had characteristic manifestations of atypical measles. The sole immunocompromised patient died. CONCLUSIONS: Measles in adults may result in severe, life-threatening complications that utilize substantial medical resources. Physicians need to appreciate the clinical presentations and manifestations of severe measles in adults and to provide measles vaccine to nonimmune adults during community-wide outbreaks.

Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion.

Malaria during pregnancy may be associated with significant morbidity and mortality in both mother and fetus. Treatment of severe chloroquine-resistant malaria during pregnancy may be problematic since quinine and related compounds may have a deleterious effect on the course of labor. This article reports the case of a 21-year-old primigravida Liberian woman who presented with high-grade (greater than 12%) parasitemia with Plasmodium falciparum. The patient was initially treated with chloroquine; however, she developed bilateral pulmonary infiltrates and premature labor, and her condition appeared to clinically deteriorate. Therapy was changed to intravenous quinidine, and red blood cell exchange transfusion was instituted. This resulted in a decreased parasitemia and clinical improvement. The patient underwent a cesarean section, and a healthy child was delivered. Although most cases of malaria may be managed with conventional chemotherapy, the use of intravenous quinidine in combination with exchange transfusion with careful monitoring should be considered in selected cases of severe, complicated malaria in pregnant women.