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Journal of Conservative Dentistry and... May 2024The aim of this study was to compare the accuracy of two different electronic apex locators (EALs) in detecting simulated incomplete vertical root fractures (VRFs).
AIM
The aim of this study was to compare the accuracy of two different electronic apex locators (EALs) in detecting simulated incomplete vertical root fractures (VRFs).
MATERIALS AND METHODS
Thirty freshly extracted single-rooted teeth were randomly divided into three groups of 10 teeth each labeled as Groups A, B, and C. Incomplete VRFs were simulated in the coronal, middle, and apical one-third of the roots for Groups A, B, and C, respectively. The teeth were embedded in alginate mold and fracture location was determined with Root ZX and Propex EALs for each sample and each group. To calculate the actual length (AL), each sample was sectioned at the upper level of the vertical fracture, and the length was measured by setting the stopper of the #10 K file under a stereomicroscope at ×30 magnification. The electronic lengths and ALs were compared using computer software, and the results were analyzed using SPSS 28.0 at a 95% confidence level.
RESULTS
No significant differences were seen in the accuracy of the two EALs when compared with ALs. Root ZX showed significantly longer measurements than ALs in groups B and C.
CONCLUSION
The tested EALs showed low accuracy (20%) in detecting simulated incomplete VRFs with a tendency for longer measurements compared to ALs.
PubMed: 38939546
DOI: 10.4103/JCDE.JCDE_132_24 -
Journal of Conservative Dentistry and... May 2024The aim of the study is to check the antibacterial efficacy of various ayurvedic oils used as a solvent with zinc oxide for preparing endodontic sealers.
AIM
The aim of the study is to check the antibacterial efficacy of various ayurvedic oils used as a solvent with zinc oxide for preparing endodontic sealers.
MATERIALS AND METHODS
Forty-five extracted premolars were taken and were cut coronally and apically such that 7 mm of tooth specimen was prepared. Teeth were sterilized by autoclaving inoculated with and incubated for 24 h. The specimens were divided into three groups of 15 each. Group 1 - ZnO powder + Eugenol, Group 2 - ZnO powder + Aremidadi Oil, and Group 3 - ZnO powder + Dashmool oil. Bacterial growth in each specimen was calculated before and after sealer application and noted as the initial and final colony count. The antimicrobial effect of each sealer was measured by calculating the percentage reduction in colony count (%). One-way analysis of variance and tests will be used for statistical analysis.
RESULTS
The Zn + Arimedadi oil group showed the maximum antibacterial effect among the sealers tested and the Zn + eugenol sealer showed the least antimicrobial effect In comparison, there was a statistically significant difference between all the groups.
CONCLUSION
Ayurvedic oil-based root canal sealers showed better antibacterial efficacy than eugenol-based sealers. Arimedadi oil showed the highest antibacterial activity against and Eugenol showed the least when used as a solvent.
PubMed: 38939540
DOI: 10.4103/JCDE.JCDE_119_24 -
Journal of Conservative Dentistry and... May 2024To evaluate cleaning efficacy and debris extrusion of supplementary file systems XP Endo Finisher (XPEF) and XP Endo Finisher R (XPEFR) in endodontic retreatment.
AIM
To evaluate cleaning efficacy and debris extrusion of supplementary file systems XP Endo Finisher (XPEF) and XP Endo Finisher R (XPEFR) in endodontic retreatment.
MATERIALS AND METHODS
Thirty single-rooted teeth with single canals were selected, canal preparation done till file #30 6% and obturation completed using lateral condensation technique with AH Plus sealer. The samples were stored at 37°C in a 100% humidity incubator for 7 days. The samples were distributed across the three groups according to the method of retreatment ( = 10): Group I: Neo Endo retreatment (NER) files, Group II: NER files + XPEF, and Group III: NER files + XPEFR. Removal of gutta percha using each file system according to the distributed groups was performed. The extruded debris was collected in an Eppendorf tube, dried in a hot air oven, and weighed. Teeth were sliced longitudinally using carborundum discs. Coronal, middle, and apical thirds were assessed for cleaning efficacy under a stereomicroscope. Results were tabulated and subjected to the statistical analysis using the Kruskal-Wallis -test followed by turkey HSD test. All statistical tests were carried out at significance level < 0.05.
RESULTS
It was seen that Group II (NER files + XPEF) exhibited better cleaning efficacy than Group III (NER files + XPEFR), although the results were not statistically significant. Greater debris extrusion was seen with Group III when compared to Group II.
CONCLUSION
Supplementary files XPEF/XPEFR enhance the cleaning efficacy in endodontic retreatment, but the debris extrusion of XPEFR is more than XPEF.
PubMed: 38939537
DOI: 10.4103/JCDE.JCDE_90_24 -
JACC. Advances Aug 2023Detection of heart failure with preserved ejection fraction (HFpEF) involves integration of multiple imaging and clinical features which are often discordant or...
BACKGROUND
Detection of heart failure with preserved ejection fraction (HFpEF) involves integration of multiple imaging and clinical features which are often discordant or indeterminate.
OBJECTIVES
The authors applied artificial intelligence (AI) to analyze a single apical 4-chamber transthoracic echocardiogram video clip to detect HFpEF.
METHODS
A 3-dimensional convolutional neural network was developed and trained on apical 4-chamber video clips to classify patients with HFpEF (diagnosis of heart failure, ejection fraction ≥50%, and echocardiographic evidence of increased filling pressure; cases) vs without HFpEF (ejection fraction ≥50%, no diagnosis of heart failure, normal filling pressure; controls). Model outputs were classified as HFpEF, no HFpEF, or nondiagnostic (high uncertainty). Performance was assessed in an independent multisite data set and compared to previously validated clinical scores.
RESULTS
Training and validation included 2,971 cases and 3,785 controls (validation holdout, 16.8% patients), and demonstrated excellent discrimination (area under receiver-operating characteristic curve: 0.97 [95% CI: 0.96-0.97] and 0.95 [95% CI: 0.93-0.96] in training and validation, respectively). In independent testing (646 cases, 638 controls), 94 (7.3%) were nondiagnostic; sensitivity (87.8%; 95% CI: 84.5%-90.9%) and specificity (81.9%; 95% CI: 78.2%-85.6%) were maintained in clinically relevant subgroups, with high repeatability and reproducibility. Of 701 and 776 indeterminate outputs from the Heart Failure Association-Pretest Assessment, Echocardiographic and Natriuretic Peptide Score, Functional Testing (HFA-PEFF), and Final Etiology and Heavy, Hypertensive, Atrial Fibrillation, Pulmonary Hypertension, Elder, and Filling Pressure (H2FPEF) scores, the AI HFpEF model correctly reclassified 73.5% and 73.6%, respectively. During follow-up (median: 2.3 [IQR: 0.5-5.6] years), 444 (34.6%) patients died; mortality was higher in patients classified as HFpEF by AI (HR: 1.9 [95% CI: 1.5-2.4]).
CONCLUSIONS
An AI HFpEF model based on a single, routinely acquired echocardiographic video demonstrated excellent discrimination of patients with vs without HFpEF, more often than clinical scores, and identified patients with higher mortality.
PubMed: 38939447
DOI: 10.1016/j.jacadv.2023.100452 -
Cureus May 2024Reverse takotsubo cardiomyopathy is a rare variant of the classic stress-induced takotsubo cardiomyopathy. It is associated with transient left ventricular (LV) systolic...
Reverse takotsubo cardiomyopathy is a rare variant of the classic stress-induced takotsubo cardiomyopathy. It is associated with transient left ventricular (LV) systolic dysfunction characterized by basal hypokinesis and apical hyperkinesis. We present a case of a 27-year-old woman who presented to an outside facility for a scheduled cesarean section and developed perioperative chest tightness, hypoxemia, and hypotension. Her electrocardiogram (ECG) showed sinus rhythm with marked ST segment depressions in leads V4-V6. High sensitivity troponin was elevated to 474 ng/L. Transthoracic echocardiography revealed an LV ejection fraction of 52% (Simpson's) with hypokinesis of the basal myocardial segments and hyperdynamic systolic function of the apical segments. Subsequent coronary angiography showed angiographically normal epicardial coronaries. Left ventriculography showed ballooning of the basal segments with apical hyperkinesis. She was subsequently diagnosed with reverse takotsubo cardiomyopathy and managed conservatively with beta-blockers. In this case, we highlight the need for collaboration between the cardiology and obstetric teams for tailored management strategies to ensure the well-being of both mother and baby.
PubMed: 38939286
DOI: 10.7759/cureus.61225 -
International Journal of Dentistry 2024To determine the minimum dentin thickness in the mesial and distal walls of the mesiobuccal (MB) and mesiolingual (ML) canals of the mandibular first molars using...
AIM
To determine the minimum dentin thickness in the mesial and distal walls of the mesiobuccal (MB) and mesiolingual (ML) canals of the mandibular first molars using cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
CBCT examinations of 624 mandibular first molars from an Indian subpopulation were analyzed. The mesial and distal minimum dentin thickness was evaluated in 1 mm intervals apical to the furcation area. Independent -test was used to analyze the data ( = 0.05). Using Cohen's kappa coefficient, the interexaminer and intraexaminer reliability was evaluated.
RESULTS
The mesial dentin thickness was significantly higher than the distal dentin thickness for MB and ML canals (=0.01). The average dentin thickness in the distal and mesial plane of the MB canal was 1.15 ± 0.15 mm and 1.52 ± 0.19 mm at the 1 mm level and 0.83 ± 0.13 and 1.08 ± 0.18 at the 5 mm level, respectively. For the ML canal, the average dentin thickness in the distal plane and the mesial plane was 1.24 ± 0.18 mm and 1.44 ± 0.21 at the 1 mm level and 0.91 ± 0.16 and 1.01 ± 0.17 at the 5 mm level, respectively. Statistical analysis between the MB and ML canals showed significant differences in the dentin thickness at 4 and 5 mm levels in both the distal and the mesial planes (=0.01). In more than 85% of the cases, the minimum dentin thickness was seen at the 5 mm level in both the distal and mesial planes in MB and ML canals.
CONCLUSION
The distal planes of the mesiolingual and mesiobuccal canals were thinner in most cases, making the distal surface more prone to iatrogenic perforations. Considerably, at 4 and 5 mm from the furcation, the distal wall was significantly thinner than the mesial walls. Understanding the anatomy of the danger zone in the mesial roots of the mandibular first molars may serve to minimize the risk of endodontic mishaps such as strip perforations.
PubMed: 38938693
DOI: 10.1155/2024/8823070 -
JACC. Advances Jun 2023Abnormal left ventricular (LV) rotational mechanics in biventricular hearts are associated with adverse outcomes; however, these are less well characterized for hearts...
BACKGROUND
Abnormal left ventricular (LV) rotational mechanics in biventricular hearts are associated with adverse outcomes; however, these are less well characterized for hearts with functionally single ventricles.
OBJECTIVES
The purpose of this study was to characterize ventricular rotational mechanics in the Fontan circulation and their relationship to outcomes.
METHODS
Single-center, retrospective analysis of magnetic resonance examinations for 329 Fontan patients (15 [IQR: 10-21] years) and 42 controls. The ventricular cine short-axis stack was analyzed to derive torsion metrics. Torsion calculated as the difference between apical and basal rotation normalized to ventricular length.
RESULTS
Fontan patients had higher indexed ventricular end-diastolic volume (97 mL/body surface area vs 72 mL/body surface area), lower ejection fraction (53% vs 60%), and lower proportion of basal clockwise rotation (62% vs 93%), apical counterclockwise rotation (77% vs 95%), and positive torsion (82% vs 100%); < 0.001 for all. A composite outcome of death or heart transplant-listing occurred in 31 (9%) patients at a median follow-up of 3.9 years. Torsion metrics were associated with the outcome; although, on multivariate analysis only right ventricular (RV) morphology and indexed ventricular end-diastolic volume were independently associated. LVs with negative torsion, and RVs regardless of torsional pattern, had worse outcomes compared to LVs with positive torsion ( = 0.020).
CONCLUSIONS
Single ventricles in a Fontan circulation exhibit abnormal torsional mechanics, which are more pronounced for RV morphology. Abnormal torsion is associated with death or need for heart transplantation. Fontan patients with LV morphology and preserved torsion exhibit the highest transplant-free survival and torsion may offer incremental prognostic data in this group of patients.
PubMed: 38938250
DOI: 10.1016/j.jacadv.2023.100360 -
Journal of the Association For Research... Jun 2024Tone-pip-evoked otoacoustic emissions (PEOAEs) are transient-evoked otoacoustic emissions (OAEs) that are hypothesized to originate from reflection of energy near the...
PURPOSE
Tone-pip-evoked otoacoustic emissions (PEOAEs) are transient-evoked otoacoustic emissions (OAEs) that are hypothesized to originate from reflection of energy near the best-frequency (BF) cochlear place of the stimulus frequency. However, individual PEOAEs have energy with a wide range of delays. We sought to determine whether some PEOAE energy is consistent with having been generated far from BF.
METHODS
PEOAEs from 35 and 47 dB SPL tone pips were obtained by removing pip-stimulus energy by subtracting the ear-canal sound pressure from scaled-down 59 dB SPL tone pips (which evoke relatively small OAEs). PEOAE delays were measured at each peak in the PEOAE absolute-value waveforms. While measuring PEOAEs and auditory-nerve compound action potentials (CAPs), amplification was blocked sequentially from apex to base by cochlear salicylate perfusion. The perfusion time when a CAP was reduced identified when the perfusion reached the tone-pip BF place. The perfusion times when each PEOAE peak was reduced identified where along the cochlea it received cochlear amplification. PEOAEs and CAPs were measured simultaneously using one pip frequency in each ear (1.4 to 4 kHz across 16 ears).
RESULTS
Most PEOAE peaks received amplification primarily between the BF place and 1-2 octaves basal of the BF place. PEOAE peaks with short delays received amplification basal of BF place. PEOAE peaks with longer delays sometimes received amplification apical of BF place, consistent with previous stimulus-frequency-OAE results.
CONCLUSION
PEOAEs provide information about cochlear amplification primarily within ~ 1.5 octave of the tone-pip BF place, not about regions > 3 octaves basal of BF.
PubMed: 38937327
DOI: 10.1007/s10162-024-00955-0 -
Parasitology International Jun 2024A new genus, Cordicestus, is proposed to accommodate proteocephalid tapeworms parasitising gars (Lepisosteiformes: Lepisosteidae) in North and Central America that were...
A new genus, Cordicestus, is proposed to accommodate proteocephalid tapeworms parasitising gars (Lepisosteiformes: Lepisosteidae) in North and Central America that were previously placed in the polyphyletic genus Proteocephalus Weinland, 1858. The new genus differs from other proteocephalid genera by the particular morphology of the scolex, which is small, protrudes apically but has no apical organ, and bears flat, heart-shaped (= cordis) suckers. In addition, the species of the new genus have an elongated cirrus sac with an almost straight internal vas deferens, and wide, sinuous ventral osmoregulatory canals with secondary canals directed outwards. The type species of the new genus, Cordicestus singularis (La Rue, 1911) n. comb., is redescribed based on new material from the shortnose gar, Lepisosteus platostomus Rafinesque (type host), and the spotted gar, L. oculatus Winchell, in the United States. Cordicestus rafaeli n. sp. is described from the tropical gar, Atractosteus tropicus Gill, in Mexico. The new species differs from its relatives primarily by the presence of craspedote proglottids (acraspedote in other species) and some biometric features. The species of Cordicestus are discussed, including unidentified specimens from A. tropicus and the Cuban gar A. tristoechus (Bloch and Schneider) in Nicaragua and Cuba, respectively, which may be new species, and a key to identification of these taxa is provided. Molecular data available for two nominal species of the new genus indicate the possible existence of another species of Cordicestus in Lepisosteus in the USA.
PubMed: 38936764
DOI: 10.1016/j.parint.2024.102916 -
Assessment of Global and Regional Lung Compliance in Pulmonary Fibrosis With Hyperpolarized Gas MRI.Journal of Magnetic Resonance Imaging :... Jun 2024Lung compliance, a biomarker of pulmonary fibrosis, is generally measured globally. Hyperpolarized Xe gas MRI offers the potential to evaluate lung compliance...
BACKGROUND
Lung compliance, a biomarker of pulmonary fibrosis, is generally measured globally. Hyperpolarized Xe gas MRI offers the potential to evaluate lung compliance regionally, allowing for visualization of changes in lung compliance associated with fibrosis.
PURPOSE
To assess global and regional lung compliance in a rat model of pulmonary fibrosis using hyperpolarized Xe gas MRI.
STUDY TYPE
Prospective.
ANIMAL MODEL
Twenty Sprague-Dawley male rats with bleomycin-induced fibrosis model (N = 10) and saline-treated controls (N = 10).
FIELD STRENGTH/SEQUENCE
7-T, fast low-angle shot (FLASH) sequence.
ASSESSMENT
Lung compliance was determined by fitting lung volumes derived from segmented Xe MRI with an iterative selection method, to corresponding airway pressures. Similarly, lung compliance was obtained with computed tomography for cross-validation. Direction-dependencies of lung compliance were characterized by regional lung compliance ratios (R) in different directions. Pulmonary function tests (PFTs) and histological analysis were used to validate the pulmonary fibrosis model and assess its correlation with Xe lung compliance.
STATISTICAL TESTS
Shapiro-Wilk tests, unpaired and paired t-tests, Mann-Whitney U and Wilcoxon signed-rank tests, and Pearson correlation coefficients. P < 0.05 was considered statistically significant.
RESULTS
For the entire lung, the global and regional lung compliance measured with Xe gas MRI showed significant differences between the groups, and correlated with the global lung compliance measured using PFTs (global: r = 0.891; regional: r = 0.873). Additionally, for the control group, significant difference was found in mean regional compliance between areas, eg, 0.37 (0.32, 0.39) × 10 mL/cm HO and 0.47 (0.41, 0.56) × 10 mL/cm HO for apical and basal lung, respectively. The apical-basal direction R was 1.12 ± 0.09 and 1.35 ± 0.13 for fibrosis and control groups, respectively, indicating a significant difference.
DATA CONCLUSION
Our findings demonstrate the feasibility of using hyperpolarized gas MRI to assess regional lung compliance.
EVIDENCE LEVEL
2 TECHNICAL EFFICACY: Stage 1.
PubMed: 38935670
DOI: 10.1002/jmri.29497