Prophylometric and SEM Analyses of Four Different Finishing Methods.

Prophylometric and SEM analyses of four different finishing methods.

Oral Implantol (Rome). 2012 Oct; 5(4): 77-85
Chiodera G, Cerutti F, Cerutti A, Putignano A, Mangani F

Adhesion is the pivot of the modern restorative dentistry. Inlays, onlays and veneers have become a valid alternative to the traditional prosthetic treatments even in the rehabilitation of extremely damaged teeth, allowing a consistent saving of sound tooth tissues. Composite resins and dental adhesive are continously investigated and improved, nevertheless the optimization of the tooth-adhesive interface has to be considered: in fact, the long-term stability of adhesion between tooth and composite material depends on the treatment of the amelo-dentinal surfaces. THIS STUDY INVESTIGATED THE QUALITY OF THE OCCLUSAL WALLS OF A CAVITY PREPARED TO RECEIVE AN INLAY AND FINISHED WITH FOUR DIFFERENT SYSTEMS: thin and extra-thin diamond coated burs, a 12-blades carbide burs and a diamond-coated tip driven by sonic instrument. Consequently, prophylometric and SEM analyses were performed on the samples. The average roughness values recorded by the prophylometer were expressed by the parameters Ra and RZ: there is a correspondence between the numeric values and the pictures of the SEM. The results show a better quality (low roughness values) of the surface treated with multi-blade burs, followed by the this and extra-thin diamond coated burs. The 25 micron diamond-coated tip of the sonic instrument obtains the roughest surface and a sensibly higher amount of smear layer than the other tested systems. HubMed – rehab

(18)F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy.

Asian Spine J. 2013 Jun; 7(2): 96-103
Uchida K, Nakajima H, Miyazaki T, Tsuchida T, Hirai T, Sugita D, Watanabe S, Takeura N, Yoshida A, Okazawa H, Baba H

A retrospective study.The aims of this study were to investigate the diagnostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions.Recent studies described limitations regarding how many lesions with abnormal (18)F-FDG PET findings in the bone show corresponding morphologic abnormalities.The subjects for this retrospective study were 227 patients with primary malignant tumors, who were suspected of having spinal metastases. They underwent combined whole-body (18)F-FDG PET/CT scanning for evaluation of known neoplasms in the whole spine. (99m)Tc-methylene diphosphonate bone scan was performed within 2 weeks following PET/CT examinations. The final diagnosis of spinal metastasis was established by histopathological examination regarding bone biopsy or magnetic resonance imaging (MRI) findings, and follow-up MRI, CT and (18)F-FDG PET for extensively wide lesions with subsequent progression.From a total of 504 spinal lesions in 227 patients, 224 lesions showed discordant image findings. For 122 metastatic lesions with confirmed diagnosis, the sensitivity/specificity of bone scan and FDG PET were 84%/21% and 89%/76%, respectively. In 102 true-positive metastatic lesions, the bone scan depicted predominantly osteosclerotic changes in 36% and osteolytic changes in 19%. In 109 true-positive lesions of FDG PET, osteolytic changes were depicted predominantly in 38% while osteosclerotic changes were portrayed in 15%.(18)F-FDG PET in PET/CT could be used as a substitute for bone scan in the evaluation of spinal metastasis, especially for patients with spinal osteolytic lesions on CT. HubMed – rehab

Quantitative assessment of finger motor impairment in multiple sclerosis.

PLoS One. 2013; 8(5): e65225
Bonzano L, Sormani MP, Tacchino A, Abate L, Lapucci C, Mancardi GL, Uccelli A, Bove M

To address the disability impact on fine hand motor functions in patients with Multiple Sclerosis (MS) by quantitatively measuring finger opposition movements, with the aim of providing a new “score” integrating current methods for disability assessment.40 MS patients (Expanded Disability Status Scale (EDSS): 0-7) and 80 healthy controls (HC) performed a repetitive finger-to-thumb opposition sequence with their dominant hand at spontaneous and maximal velocity, and uni- and bi-manually metronome-paced. A sensor-engineered glove was used to measure finger motor performance. Twenty-seven HC were tested twice, one month apart, to assess test-retest reliability.The motor parameters showed a good reproducibility in HC and demonstrated significantly worse performance in MS patients with respect to HC. A multivariate model revealed that rate of movement in the spontaneous velocity condition and inter-hand interval (IHI), indicating bimanual coordination, contributed independently to differentiate the two groups. A finger motor impairment score based on these two parameters was able to discriminate HC from MS patients with very low EDSS scores (p<0.001): a significant difference was already evident for patients with EDSS?=?0. Further, in the MS group, some motor performance parameters correlated with the clinical scores. In particular, significant correlations were found between IHI and EDSS (r?=?0.56; p<0.0001), MS Functional Composite (r?=?-0.40; p?=?0.01), Paced Auditory Serial Addition (r?=?-0.38; p?=?0.02). No motor performance parameter correlated with Timed 25-Foot Walk.A simple, quantitative, objective method measuring finger motor performance could be used to define a score discriminating healthy controls and MS patients, even with very low disability. This sensitivity might be of crucial importance for monitoring the disease course and the treatment effects in early MS patients, when changes in the EDSS are small or absent. HubMed – rehab

Advanced glaucoma: management pearls.

Middle East Afr J Ophthalmol. 2013 Apr; 20(2): 131-41
Gessesse GW, Damji KF

A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient’s perspective. The physician may also feel that they are in a difficult position managing the patient’s disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ‘biopsychosociospiritual’ (BPSS) profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health), psychological considerations (e.g., fear, depression), socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s) what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite), and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life. HubMed – rehab