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05). RESULTS Group zirconia crown (G1) showed significantly higher fracture strength than Group (G2) lithium disilicate endocrown (p less then 0.05). CONCLUSION The zirconia crown showed higher fracture resistance than lithium disilicate endocrown. However, both tested zirconia crown and lithium disilicate endocrown withstood the application of axial occlusal forces greater than the reference values for posterior occlusal loads. Copyright © 2019 Yasmine El Makawi, Nagwa Khattab.AIM To evaluate and compare the effect of enamel preparation designs bevel, chamfer and stair-step chamfer on the fracture resistance of nanocomposite. METHODS The sample group of this study consisted of 72 non-carious permanent maxillary central incisors. The sample is divided into four groups of 18 each. Group, I control Group II bevel preparation, Group III chamfer preparation, group IV stair step chamfer preparation. After the specific preparation, each tooth is filled with nanocomposite using bulk pack technique. The teeth were subjected to fracture resistance test under Universal testing machine and then were examined under a stereomicroscope to evaluate the type of bond failure. The results were subjected to statistical analysis. RESULTS Results of the One-Way ANOVA revealed a significant difference in the mean peak failure load values of the four different groups. (P less then 0.001) Tukey's Post-Hoc comparison test revealed that there was a significant difference in the mean peak failure load values of the bevel and chamfer preparation. But there was no significant difference between chamfer and stair-step chamfer preparation designs. CONCLUSION Stair-step chamfer preparation demonstrated comparable values to Chamfer preparation but also involved the removal of less amount of tooth structure adjacent to the fractured edge and good esthetic technique. Copyright © 2019 Jyothi Bommanagoudar, Shashidhar Chandrashekhar, Shilpa Sharma, Hiten Jain.BACKGROUND Glomus tumors are rare neoplasms accounting for less than 2% of all soft tissue tumors but multiple lesions may be seen in up to 10% of the patients. Solitary glomus tumor (GT) most frequently appears as small nodule in specific locations such as subungual region or deep dermis. However, rarely these entities have been observed in extracutaneous locations such as the gastrointestinal, cardiovascular, respiratory tracts, and other visceral organs. A small fraction of the GTs may present as tumors of uncertain malignant potential or as malignant glomus tumors. CASE PRESENTATION We report a patient with multiple glomus tumors on the time of diagnosis, which was histologically diagnosed as an atypical glomus tumor following resection of a tumor thrombus in the left renal vein, inferior vena cava trombus with intracardial extension, and mitral valve specimen. The intramuscular lesion from the thigh was diagnosed as a glomus tumor of uncertain malignant potential. Further examinations revealed multiple lesions trough her body kidneys, breast, heart and subcutaneous tissue. The diagnosis of glomus tumor of uncertain malignant potential versus glomus tumor with low malignant potential could be quite challenging, and the clinical course may be as a determining factor for final diagnosis. CONCLUSION To our knowledge, this is the only known case of glomus tumor with multiple organ involvement and aggressive biological behavior at presentation. Selleck Panobinostat Copyright © 2019 Violeta Vasilevska-Nikodinovska, Milan Samardjiski, Rubens Jovanovik, Boro Ilievski, Vesna Janevska.BACKGROUND The occurrence of multiple supernumerary teeth in individuals without any associated syndrome is rare. Supernumerary teeth may occur in any region of the dental arch and are frequently observed in the maxillary region. But the occurrence of distomolars is rare, particularly mandibular distomolars are extremely rare. CASES PRESENTATION In this paper, we present a series of case reports of maxillary and mandibular distomolars. CONCLUSION The occurrence of distomolars is rare, but when detected patients should be kept under observation. Copyright © 2019 Fareedi Mukram Ali, Waseem Hassan Aridhi, Abdulmohsen Moussa Hommadi, Rawan Ali Altharawi, Muzaffer Ali Khan.BACKGROUND Sepsis in children with cardiovascular involvement can increase mortality. Recently, many studies have been conducted to investigate troponin as an early marker of myocardial dysfunction, associated with pediatric sepsis score. Pediatric Logistic Organ Dysfunction 2 (PELOD-2) score is recent scoring to assess organ dysfunction in sepsis children. AIM To determine the correlation between troponin T, troponin I with PELOD-2 score in sepsis as a predictive factor of mortality. METHODS A prospective cohort study was conducted on sepsis children in PICU Haji Adam Malik General Hospital, Medan. Assessment of PELOD-2 score, serum troponin T, and troponin I levels performed on the first day and 48 hours after sepsis was diagnosed. Patients were observed until moved to the ward or died. RESULTS A group of 41 subjects were recruited in this study. Troponin T level at 24 hours did not correlate with PELOD-2 scores. Troponin T level at 48 hours was positively correlated with PELOD-2 score (r = 0.771, p less then 0.001) and had a significant association with the mortality rate (p less then 0.001). Troponin T at 48 hours could be used as a predictive factor of mortality (AUC 86.4%, p less then 0.001) with a cut-off point of 40.3 ng/mL (76% sensitivity, 75% specificity, RR 2.48). Troponin I levels at 24 and 48 hours also had strong correlation with PELOD-2 score (r = 0.326, p = 0.037; r = 0.691, p less then 0.001) and could be used as a predictor of mortality in pediatric patients with sepsis (AUC 74.8%, p 0.008; AUC 92.6%, p less then 0.001). The cut-off point of troponin I at 24 hours was 0.075 ng/mL (68% sensitivity, 68.8% specificity, RR 1.84) and at 48 hours was 0.125 ng/mL (80% sensitivity, 81.3% specificity, RR 3.13). CONCLUSION Serum troponin T and troponin I levels at 48 hours have positive correlation with PELOD-2 score as a predictive factor of mortality in pediatric patients with sepsis. Copyright © 2019 Aileen C. Dauhan, Aridamuriany D. Lubis, Erna Mutiara, Munar Lubis.

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