bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Storage Solution on Surface Roughness of Provisional Crown and Fixed Partial Denture Materials
Authors: Haselton Debra R. , Diaz‐Arnold Ana M. , Dawson Deborah V. 
Published: September 2010

Purpose:
This study evaluated the surface roughness of polished provisional materials at baseline and after storage in artificial saliva and artificial saliva–coffee solutions.
Materials and Methods:
Ten specimens (25 mm × 25 mm × 2 mm) of 12 commercially available provisional crown materials (5 methacrylate and 7 bis‐acryl resins) were fabricated and polished. Baseline surface roughness measurements (Ra) were made using a surface roughness tester. Specimens were divided into 2 groups and stored in artificial saliva or artificial saliva–coffee solution at 37°C for 2 weeks. Baseline surface roughness data were analyzed using the analysis of variance; multiple comparisons adjustment was made using the Tukey method. Multiple linear regression methods were used to analyze change in roughness relative to baseline and to assess the impact of storage medium, material, and baseline roughness on this change, including potential interactions among these 3 factors; descriptors of poststorage surface roughness were obtained.
Results:
Alike demonstrated the greatest surface roughness, both at baseline and after storage (p < 0.05 after adjustment for all Pairwise comparison by Tukey method). Temphase, Temporary Bridge Resin, Instatemp, Unifast, Jet, and Zeta had the lowest baseline surface roughness measurements. The lowest poststorage roughness scores were associated with Protemp Garant, Jet, and Integrity. Five materials (Protemp Garant, Instatemp, Unifast, Jet, and Zeta), formed the group having the lowest rough poststorage outcomes. The data provided strong evidence of a material effect (p < 0.0001) at baseline. Evaluation of change in Ra following storage indicated that surface roughness increased for the majority of materials after storage in a moist environment, and that provisional crown materials that exhibit less initial surface roughness tend to undergo greater surface roughness change in a moist environment. Strong indications were found that the effect of the type of storage solution used differed among the materials.
Conclusions:
There were significant differences in surface roughness of provisional crown materials when polished under the same conditions. Methacrylate resins in general exhibited smoother surfaces after initial polishing. Surface roughness increased for nearly all materials after storage in either moist environment.
In Vitro Wear of Nano‐Composite Denture Teeth
Authors: Suzuki Shiro 
Published: September 2010

Purpose:
Few laboratory tests have been able to substantiate and quantify the wear resistances of polymeric denture teeth. This study evaluated the relative wear resistance of several types of denture teeth using an in vitro wear testing device.
Material and Methods:
Four different types of denture teeth [nano‐filled (Veracia) and micro‐filled composites (SR‐Orthosit, Endura, Duradent, Surpass), cross‐linked acrylic (SR‐Postaris, Genios‐P, Creapearl, Vitapan Physiodens, Premium 8, Integral), and a conventional acrylic (Biotone)] were used. The flattened buccal surface of each denture tooth was subjected to the evaluation of Knoop hardness (n = 5) and localized wear for 100,000 cycles (n = 10). Wear values were determined in micrometers using a profilometer. The data for the hardness, wear depth, and worn surface areas were individually analyzed by one‐way ANOVA.
Results:
Knoop hardness values (KHN) ranged from 28.2 to 29.8 for micro‐filled composite, 18.9 to 21.6 for cross‐linked acrylic, 22.7 for nano‐composite, and 18.6 for conventional acrylic teeth. All micro‐filled composite teeth were significantly harder than other teeth (p < 0.0001). The wear depth values were 90.5 μm for the nano‐composite, 69.8 to 93.0 μm for the micro‐filled composite, 80.8 to 104.0 μm for the cross‐linked acrylic, and 162.5 μm for conventional acrylic teeth. The worn surface areas were 5.1 mm2 for the nano‐composite, 2.6 to 3.6 mm2 for the micro‐filled composite, 4.4 to 5.7 mm2 for the cross‐linked acrylic, and 10.1 mm2 for conventional acrylic teeth. The wear values of the acrylic control were significantly different from all other denture teeth (p < 0.001).
Conclusion:
The nano‐composite tooth was harder and more wear resistant than the acrylic teeth but not significantly different from most of the cross‐linked and micro‐filled composite teeth tested.
Anesthesia (10)
Authors: Reuben Scott S. , Reuben John P. 
Published: September 2010

Brachial plexus anesthesia with verapamil and/or morphine. (Baystate Medical Center and the Tufts University School of Medicine, Springfield, MA) Anesth Analg 2000;91:379–383.This study examined the analgesic effects of administering morphine, verapamil, or its combination into the brachial plexus sheath with lidocaine in 75 patients undergoing upper extremity orthopedic surgery. All patients received brachial plexus anesthesia with 40 mL of 1.5% lidocaine and epinephrine 5 μg/mL. Patients were randomized to 1 of 5 groups: Group 1 received IV saline; Group 2 received IV verapamil 2.5 mg and morphine 5 mg; Group 3 received IV verapamil 2.5 mg and morphine 5 mg was added to the lidocaine solution; Group 4 received IV morphine 5 mg and verapamil 2.5 mg was added to the lidocaine solution; and Group 5 received verapamil 2.5 mg and morphine 5 mg was added to the lidocaine solution. Postoperatively, patients rated their pain (0–10) at 1, 6, 12, and 24 h. Patients were instructed to take 1 acetaminophen 325 mg/oxycodone 5 mg tablet every 3 h whenever the pain score exceeded 3. Analgesic duration was significantly increased in those patients receiving brachial plexus blocks with morphine (Groups 3 and 5) (P < 0.005). The total 24 h acetaminophen/oxycodone was also less in Groups 3 and 5 (P < 0.03). Duration of anesthesia (time of abolition of pinprick response) was significantly increased in those patients receiving brachial plexus blocks with verapamil (Groups 4 and 5) (P = 0.002). Conclude that the addition of verapamil to the brachial plexus block with lidocaine can prolong the duration of sensory anesthesia, but it had no effect on analgesic duration of 24‐h analgesic use. Comment by Alan David Kaye, MD, PhD.It is well established that calcium channel blockers potentiate analgesic effects of both local anesthetics and opioids. A desire for improvement of the quality and duration of brachial plexus blockade has led many investigators to study various agents in addition to standard local anesthetics. This interesting double‐blinded study involving 82 patients scheduled for elective upper extremity orthopedic surgery involved 5 groups. Interestingly, the combination of verapamil and morphine via the brachial plexus did not provide any additional analgesic effect, which is different than previous studies. The subjectivity of telephone data and the relatively small sample size in each arm of this study make statistically significant findings harder to ascertain and relevant changes in clinical practice less convincing. Further, the authors do not appropriately note the complexity of calcium channel pharmacology and its overall role in opioid as well as local anesthetic modulation. Future studies with more precise endpoints for efficacy and duration are warranted if clinical practice is to be altered and accepted by the practitioner.
Anesthesia (12)
Authors: Silverstein Wendy B. , Saiyed Moin U. , Brown Anthony R. 
Published: September 2010

A deltoid motor response is a satisfactory endpoint for successful block. (Columbia Presbyterian Medical Center, New York, NY) Reg Anesth Pain Med 2000;25:356–359.This study investigates the notion that a deltoid twitch may be just as effective as one in the biceps for predicting a successful motor block. Patients (N = 160) scheduled for shoulder surgery were studied prospectively. Interscalene blocks (ISBs) were performed using neurostimulation according to our standard technique. Twitches of the deltoid or biceps or both, whichever appeared first, were accepted and used as the endpoint for needle placement and injection of local anesthetic. Motor block success, i.e., patient inability to lift the arm against gravity, and minutes to motor block onset were recorded. Of the 160 ISBs performed, a biceps twitch was elicited in 61 patients. In 54 patients, a deltoid twitch was elicited and in 45 patients, both a biceps and deltoid contraction were elicited simultaneously. The failure rate did not differ widely among the groups; there was 1 failed motor block in the deltoid group and none in the other groups. There was no statistically significant difference in onset times between the 3 muscle twitch groups. Conclude that a deltoid twitch is as effective as a biceps twitch in determining accurate needle placement for ISB and in predicting successful motor block. Acceptance of a deltoid twitch during ISB eliminates the need for further probing and may translate into better patient acceptance and in a smaller risk of needle‐induced nerve damage. Comment by Alan David Kaye, MD, PhD.Interscalene brachial plexus block provides a valuable technique for shoulder surgery. The literature is in agreement with elicitation of paresthesias versus peripheral nerve stimulation. The literature is somewhat unclear regarding deltoid muscle versus biceps twitch as a satisfactory endpoint, prior to injection of local anesthetic. This prospective study involved 160 patients presenting for elective shoulder surgery. A biceps twitch was elicited in 61 patients; 54 had a deltoid twitch, and in 45 patients, both a biceps and deltoid twitch were elicited. There was no statistically different onset time in the 3 groups; however, the failure rate did not differ in the 3 groups either (only 1 patient in the deltoid group had a failed block). The authors conclude that a deltoid twitch is as effective as one in the biceps at ensuring a successful interscalene brachial plexus block and that repositioning is not warranted if either muscle group is elicited. The authors should be applauded for this study because it strongly suggests that essentially any elicitation of deltoid or biceps twitch will result in a highly successful and clinically useful block.
Anesthesia (14)
Authors: Jahangir Salim M. 
Published: September 2010

Tip‐holed spinal needle: a new design concept. (Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh) Reg Anesth Pain Med 2000;25:403–407.This article discussed new technology regarding the production of finer spinal needles and described a new spinal needle tip design. Complications associated with dura‐arachnoid puncture for spinal anesthesia were taken into account. Postdural puncture headache (PDPH) and needle bending are stated as being significant complications. Although pencil‐point needles significantly reduce PDPH, it is stated that these needles also have their limitations such as obstruction of the delivery port by tissues affecting both cerebrospinal fluid flash back and drug delivery. The problem of tip bending was also addressed. At the center of the discussion was the newly designed spinal needle tip that was created to overcome the disadvantages of other spinal needles. Analyzing the performance of the existing needles, the conclusion was drawn that the criteria of an ideal spinal needle may be as follows: (1) the external diameter of the needle should be as thin as possible and the tip should be a dural fiber‐spreading variety; (2) the shaft and tip should be capable of withstanding forces during needle placement; and (3) it should also have a drug delivery hole that does not weaken the needle or become obstructed by tissue. Comment by Andrew D. Rosenberg, MD.This article introduces a new type of needle for performing spinal anesthesia techniques. According to the authors, classic Quincke‐type needles are associated with postdural puncture headache (PDPH), while side port blunt needles may be associated with mechanical problems such as back flow or having tissue obstruct side port. Therefore, the authors designed a new type of needle that is pencil point in shape, but the removal stylet is the component that forms the pencil point. When the stylet is removed, the needle has a conical distal shape with the opening at the end. The authors believe that this “new spreading beveled needle tip” will help alleviate problems with PDPH as well as the problems associated with side port holes. While the idea is very intriguing, it remains to be seen how successful the needle will be.
Headache (44)
Authors: Rapoport Alan , Edmeads John 
Published: September 2010

Migraine: the evolution of our knowledge. (The New England Center for Headache, Stamford, CT) Arch Neurol 2000;57:1221–1223.This brief article described the evolution of knowledge regarding headache pain, namely migraines. By exploring historical literature, quotes related to headache pain and treatments are discussed. Early clinical developments are outlined with references to Hippocrates, Aretaeus the Cappadocian, and Galen. The theories of Thomas Willis regarding pain sensitivity are also provided. Conclude that the history of headache illustrates that the acquisition of understanding is a long‐term, evolving process.
Medicine (47)
Authors: Zylicz Zbigniew 
Published: September 2010

Ethical considerations in the treatment of pain in a hospice environment. (Hospice Rozenheuvel, Rozendaal, The Netherlands) Patient Education and Counseling 2000;41:47–53.This article discussed some specific ethical problems encountered in hospice practice. Patient's autonomy with all its advantages and disadvantages are highlighted. Ethical considerations with regard to risk taking and the treatment of pain are discussed. The needs of the patients are central to the discussion. Myths regarding opioids and pain therapy goals are addressed, as are approaches to treating intractable pain and dealing with patients who request assisted death. Acceptance of death may result in an active and creative attitude. Conclude that although scientific evidence of the processes taking place is still lacking, the modern hospice may be seen as a complementary, mainstream institution contributing to the development of whole medicine.
Anesthesia (5)
Authors: Montes A. , Warner W. , Puig M.M. 
Published: September 2010

Use of intravenous patient‐controlled analgesia for the documentation of synergy between tramadol and metamizol. (Hospital Universitario del Mar, Barcelona, Spain) Br J Anaesth 2000;85:217–223.This study involved 101 posthysterectomy patients who received at the time of analgesia request (TAR) tramadol (100 mg, Group I) or metamizol (1.2 g, Group II) alone, or combined in 1:1 (Group III), 1:0.3 (Group IV), or 1:3 (Group V) ratio. After 15 min, they received the same treatment by IV patient‐controlled analgesia. Pain intensity (VAS‐PI), analgesic consumption, and adverse effects were assessed at TAR, and periodically for 24 h. Data were analyzed using interaction indexes and isobolograms. All treatments produced equivalent VAS‐PI, percent efficacy, and adverse effects; all other treatments were addictive. Comment by Octavio Calvillo, MD, PhD.Synergistic interactions either beneficial or adverse between analgesic drugs remains to be studied quantitatively. The authors propose a new method to quantitate such interactions; this is based on analgesic requirements (IV‐PCA) and pain intensity (VAS‐PI). Data were analyzed using interaction indexes and isobolograms. Isobols are graphic representations of equally effective doses of 2 or more agents. The mean doses of each drug that produces a given response are plotted on the axes of the graph. A zero interaction line (isobol) connects these isoeffective doses in the axis. Using this approach the authors studied 101 posthysterectomy patients. Patients received at the time of analgesia request (TAR) tramadol (100 mg, Group I) or metamizol (1.2 g, Group II), alone or combined 1:1 (Group III), 1:0.3 (Group IV) or 1:3 (Group V). All treatments produced equivalent VAS‐PI, percent efficacy, and adverse effects. Drugs combined in 1:1 ratio synergy became evident both for the analgesic and adverse effects; all other treatments were additive.
Neurology (51)
Authors: Van Hilten J.J. , Van de Beek W.J.T. , Roep B.O. 
Published: September 2010

Regional pain syndrome: a distinct clinical entity associated with HLA‐DR13. (Leiden University Medical center. Leiden, The Netherlands) Ann Neurol 2000;48:113–116.This report discussed 26 patients with a distinct phenotype of complex regional pain syndrome that progressed toward a multifocal or generalized tonic dystonia. The dystonia initiated distally, involved mainly flexor muscles, and was associated with sensory and autonomic symptoms. Dryness of the eyes or mouth and bladder and bowel disturbances were frequently reported. There was no increase in the familial prevalence of autoimmune‐mediated disease. Compared with controls, a significant elevation of HLA‐DR13 was found in the patients. Thus, HLA‐DR13 may be a factor indicating susceptibility to this distinct phenotype of complex regional pain syndrome.
Neurology (53)
Authors: Goldstein David S. , Tack Cees , Li Sheng‐Ting 
Published: September 2010

Sympathetic innervation and function in reflex sympathetic dystrophy. (National Institutes of Health, Bethesda, MD) Ann Neurol 2000;48:49–59.This study examined sympathetic neurocirculatory function and the role of sympathetic postganglionic nerve traffic in maintaining the pain in 30 patients with reflex sympathetic dystrophy. Most had had the condition for more then 1 year, and 14 had undergone sympathectomy for the pain. Positron emission tomographic scanning after administration of 13N‐ammonia was used to assess local perfusion, and 6‐[18F]fluorodopamine was used to assess sympathetic innervation. Rates of entry of norepinephrine in the regional venous drainage (spillovers) and regional plasma levels of L‐dihydroxyphenylalanine (the immediate product of the rate‐limiting enzymatic step in norepinephrine biosynthesis) and dihydroxyphenylglycol (the main neuronal metabolite of norepinephrine) were measured with and without intravenous trimethaphan for ganglion blockade. 13N‐ammonia‐derived radioactivity was less on the affected side than on the unaffected side, whereas 6‐[18F]fluorodopamine‐derived radioactivity was symmetrical. Thus, perfusion‐adjusted 6‐[18F]fluorodopamine‐derived radioactivity was higher on the affected side. Norepinephrine spillover and smaller arteriovenous increments in plasma levels of L‐dihydroxyphenylalanine and dihydroxyphenylglycol did not differ significantly between affected and unaffected limbs, although 4 patients had noticeably less norepinephrine spillover and smaller arteriovenous increments in plasma dihydroxyphenylglycol on the affected side. Trimethaphan decreased the pain in only 2 of 12 nonsympathectomized patients. The results indicate that patients with chronic unilateral reflex sympathetic dystrophy have decreased perfusion of the affected limb, symmetrical sympathetic innervation and norepinephrine synthesis, variably decreased release and turnover of norepinephrine in the affected limb, and failure of ganglion blockade to improve the pain in most cases. These findings suggest augmented vasoconstriction, intact sympathetic terminal innervation, possibly impaired sympathetic neurotransmission, and pain usually independent of sympathetic neurocirculatory outflows.
Neurology (57)
Authors: Argoff Charles E. 
Published: September 2010

New analgesics for neuropathic pain: the lidocaine patch. (North Shore University Hospital, Syosset, NY) Clin J Pain 2000;16:S62–266.This article reviewed the basis for the development of the lidocaine patch and reviewed the reports of the clinical studies published. Potential uses of the lidocaine patch for other conditions in addition to postherpetic neuralgia (PHN) were also discussed. Conclude that it has been clearly established that the lidocaine patch is a safe and effective treatment for PHN and it is recommended as a first‐line treatment based on demonstrated efficacy, quick onset of action, lack of systemic effects, and ease of use with other treatments. Comment by Enrique Reig, MD.Intravenous lidocaine is used in pain units for the transient relief of chronic neuropathic pain. If the analgesic result is satisfactory, some physicians start treatment with a lidocaine analogue, oral mexylithene. However, the latter drug is not always well tolerated and its efficacy (in my opinion) is far lower than that of intravenous lidocaine. The recently marketed lidocaine patch is a highly recommended therapeutic alternative if we are considering long‐term treatment with lidocaine. Topical agents act locally (skin, soft tissues, peripheral nerves) and do not cause high blood levels (no higher than 0.6 micgr/mL). Topical 5% lidocaine decreases the ectopic discharges from peripheral afferents, reducing nociceptive input to the CNS. There are few side effects and the main indication is postherpetic neuralgia and all those syndromes with peripheral neuropathic pain. The relief that can be expected after using topical 5% lidocaine is not complete, and it can be associated with other types of drugs (anticonvulsants, antidepressants, analgesics, etc.) to obtain a synergistic effect.
Neurology (62)
Authors: Wikberg  , Andersson C. , Lithner F. 
Published: September 2010

Signs of neuropathy in the lower legs and feet of patients with acute intermittent porphyria. (University of Umeå, Umeå, Sweden) J Intern Med 2000;248:27–32.A total of 356 patients were registered and 339 of them (95%) participated in this neuropathy study. The chronic neurological signs were symmetrical and similar to those in type 1 diabetic patients. Significant impairment was found concerning perception, EDB test, lower leg pain, ankle and knee tendon reflexes, but not concerning dry feet, loss of forefoot arch and hammer toes, on comparing patients with manifest versus latent acute intermittent porphyria (AIP). The neurological signs were more severe in the diabetic patients (n = 298). Five AIP patients had permanent quadriplegia after severe attacks. Conclude that patients with manifest AIP had significantly more signs of distal chronic, symmetrical neuropathy of the axonal type than did patients with latent AIP. More grave neurological lesions appear to develop after severe attacks.
Neurology (65)
Authors: Lee Virginia K. , Simpkins Lynn 
Published: September 2010

Herpes zoster and postherpetic neuralgia in the elderly. (University of Virginia, Charlottesville, VA) Geriatr Nurs 2000;21:132–136.This article described herpes zoster (HZ), its causes, diagnosis, treatment, and associated complications. Postherpetic neuralgia (PHN), the most common complication of HZ, is the primary focus of the discussion. PHN is defined broadly as chronic pain that persists after the characteristic vesicular rash of HZ has resolved.