The direct/indirect composite resin veneers: a case report

Veneer restorations are well suited for conservative and aesthetic improvement of the anterior dentition. Laboratory fabricated porcelain and composite resin veneers present optimal aesthetics and durability. Although there are disadvantages associated with direct bonding, it provides control of color and contour for the operator, particularly in the case of a single anterior central incisor. Direct/indirect composite resin veneers utilize the advantages of both direct and indirect techniques in reconstruction of restorations with improved physical properties. The learning objective of this article is to review the available composite resins, opaquers, and tints, and present a step-by-step protocol for predictable restoration of discolored anterior dentition with direct/indirect heat-treated composite resin veneers in a single appointment. Patient evaluation, preoperative aesthetic considerations, selection of the restorative composite resins, and the clinical procedure are discussed.     

Comparison of morphologic assessment of hypertrophic cardiomyopathy by magnetic resonance versus echocardiographic imaging

To compare the value of echocardiography and magnetic resonance imaging (MRI) in the assessment of the amount and extent of hypertrophy in hypertrophic cardiomyopathy (HC) and, second, to correlate the degree of hypertrophy, as assessed by MRI, with clinical and electrocardiographic parameters, 30 consecutive patients (16 men and 14 women, aged 20 to 74 years) with HC were studied. Measurements of left ventricular wall thickness were performed at 11 predetermined segments (5 basal, 5 midventricular, and 1 apical) by 2-dimensional echocardiography and MRI. Two parameters derived from MRI studies were considered as indicators of the degree and extent of hypertrophy: (1) mean of the measured wall thickness at the 11 segments, and (2) the number of segments with thickness > 15 mm. Results showed that, from a total of 330 myocardial segments, thickness could be measured by echocardiography in 221 (67%), whereas MRI allowed measurement of 320 segments (97%). When compared with clinical and electrocardiographic data, no correlation was found regarding mean wall thickness and number of hypertrophied segments by MRI except for the presence of an abnormal electrocardiographic repolarization pattern. It is concluded that MRI allows a better assessment of the degree and extension of left ventricular hypertrophy than echocardiography in HC. Despite the precise information on hypertrophy provided by MRI, the amount and degree of hypertrophy bears no correlation with most of the clinical data in these patients.     

Complement resistance of capsulated strains of Aeromonas salmonicida

1. We investigated the effect of exercise on plasma adrenomedullin, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations and studied the relationship between these peptides and haemodynamic parameters in nine patients with old myocardial infarction (MI) and in eight normal subjects. 2. The exercise protocol consisted of two fixed work loads (40 and 80 W) for 4 min each and venous blood samples were taken at rest, during each exercise stage and after exercise while monitoring the mean arterial pressure (MAP) and heart rate (HR). In MI, pulmonary arterial pressure (PAP), pulmonary capillary wedge pressure (PCWP), left ventricular end-diastolic pressure (LVEDP) and cardiac output (CO) were measured throughout exercise. 3. Adrenomedullin levels did not significantly increase with exercise. Adrenomedullin levels correlated with PAP and PCWP at rest (P < 0.05). Atrial natriuretic peptide levels correlated with PAP, PCWP and LVEDP throughout exercise (P < 0.05) but, on multiple regression analysis, PCWP correlated only with ANP (P < 0.01). Brain natriuretic peptide levels correlated with LVEDP throughout exercise (P < 0.01) and its increment correlated closely with basal BNP levels at rest (P < 0.01). 4. These results suggest that adrenomedullin does not respond to the acute haemodynamic changes of exercise, whereas ANP responds to it and PCWP is the major stimulus factor. Brain natriuretic peptide responds to exercise in proportion to the basal synthesis of BNP in patients with left ventricular dysfunction and LVEDP may play a role in increasing BNP during exercise.     

Organizational determinants of IT adoption in the pharmaceutical distribution sector

The aim of this paper is to propose new organizational factors that might explain the differences in the extent and the speed of IT adoption. With this in mind, we carried out an analysis of 16 cases in the pharmaceutical distribution sector in Spain. The results indicate that there are certain intangible assets that favour the introduction and development of IT. Among these are a frank and fluid communication between departments and members of the organization, low levels of conflict, the explicit support of top management towards IT adoption and learning and creative skills of IT-staff. In addition to these factors, we found others that we propose as catalysts of IT adoption. Among these we might mention the special relationship between the member-clients and the company in the case of cooperative firms.     

New telechelic polymers and sequential copolymers by polyfunctional initiator transfer agents (inifers)

Summary The Kennedy-Smith plot routinely used for the characterization of end-reactive (telechelic) polyisobutylenes has been recast to increase its accuracy and thus to increase its diagnostic value for the compositional analysis of telechelic polymers containing chromophores. A detailed error estimation is given. The plotting method and error limits are shown for representative mono-, di-, and tri-ended telechelic polyisobutylenes.     

Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome

BACKGROUND: Fever is commonly observed in patients with human immunodeficiency virus (HIV) disease and frequently eludes diagnosis. The role of bone marrow biopsy in the diagnosis of fever of unknown origin in patients infected with HIV remains controversial. PATIENTS AND METHODS: One hundred twenty-three consecutive patients with 137 episodes of fever lasting 10 or more days without diagnosis after 1 week of hospitalization were evaluated by bone marrow biopsy. RESULTS: Overall, a specific diagnosis was achieved in 52 episodes by means of culture and histopathological examination (diagnostic yield, 37.9%). Three types of disease were found: mycobacterial infections (n = 36, 69% of documented episodes), including 18 patients with disseminated tuberculosis and 14 with Mycobacterium avium-intracellulare complex infections; non-Hodgkin lymphomas (n = 12, 23%); and visceral leishmaniasis (n = 4, 8%). Although bone marrow cultures were more sensitive than microscopic examination with special stains for the diagnosis of mycobacterial infections, the pathological examination of bone marrow led to a more rapid diagnosis of disease. In addition, the histopathological examination of bone marrow alone led to the diagnosis of a specific condition in 43 episodes (31.3% of all episodes). CONCLUSIONS: Bone marrow biopsy is a useful procedure for the diagnosis of fever in patients with advanced HIV disease, particularly in areas where tuberculosis and leishmaniasis are prevalent. Involvement of the marrow may be the first indication of the existence of extranodal non-Hodgkin lymphoma. For Mycobacterium avium-intracellulare complex infection, blood cultures were more sensitive than bone marrow biopsy.     

Development of an octocalcium phosphate cement

From previous studies it is known that alpha-tertiary calcium phosphate and dicalcium phosphate form a cement upon mixing with water. In this study this cement was optimized in terms of the milling of the constituents, their molar ratio, the amount of hydroxyapatite added and the water/powder ratio. The optimum Ca/P molar ratio of the cement mixture was 1.36±0.03. X-ray diffraction showed the reaction product to be octocalcium phosphate. Addition of precipitated hydroxypatite of over 3% diminished the final strength of the cement significantly. However, admixtures of only 2% of precipitated hydroxyapatite (a) kept the final compressive strength at 30±5 MPa after soaking in Ringers solution at 37°C, (b) diminished the initial setting time from 27.5 to 10 min and the final setting time from 65 to 40 min, (c) diminished the time in which the final strength was reached from 36 to less than 14 h. The tensile strength of this cement is 19±1% of its compressive strength. The optimum water/powder ratio as found in this study was 0.30 g/g.     

Using artificial intelligence to model heavy plate mill rolling

This research summary discusses the application of neural networks, evolutionary strategies, and other artificial intelligence techniques in the modeling and optimization of the models used for temperature, rolling force, and torque calculation in heavy plate milling.