BACKGROUND. The introduction of highly active antiretroviral therapy for HIV led to significant declines in HIV-associated morbidity and mortality in children. Nonadherence to antiretroviral therapy is the leading cause of treatment failure in HIV-infected patients. The ability to recognize nonadherence is suboptimal, and differentiating it from other causes of inadequate viral suppression may be difficult. OBJECTIVES. The purpose of this work was to examine the efficacy of hospital-based directly observed therapy in assessing adherence to antiretroviral medications in HIV-infected children and adolescents suspected of nonadherence and failing other interventions. METHODS. The medical charts of all HIV-infected patients admitted to the University of Chicago Comer Children's Hospital for directly observed therapy from July 2004 to June 2006 were reviewed. Patients were hospitalized for 7 days. Data collected included demographics, clinical and immune class category, previous and current antiretroviral medications, viral resistance tests, HIV-1 RNA viral load, and CD4+ T-cell number and percentage before and after directly observed therapy. RESULTS. There were 9 perinatally infected patients with a total of 13 admissions. The median age was 13 years, and 8 had been treated with multiple antiretroviral regimens. Three common patterns of changes in the viral load over time were observed. In the first, the viral load dropped at the end of the directly observed therapy period and stayed low thereafter. In the second, the drop in the viral load seen at the end of the period was not sustained. In the third, there was no change in the viral load during or after the directly observed therapy period. Compared with the viral load at admission, the viral load at the end of directly observed therapy was lower in 8 patients with a mean ± SD decrease of 0.8 ± 0.55 log10 copies per mL. CONCLUSIONS. Short, hospital-based directly observed therapy was helpful in confirming nonadherence to antiretroviral medications, therefore impacting future therapeutic decisions in HIV-infected children and adolescents. Short, hospital-based directly observed therapy should be considered in patients with poor virological control for whom outpatient interventions have failed.
dimensional obturation. During the process, the debris of the root canal system is pushed out from the canals, leading to treatment failure and flare-ups. 1 Many factors contribute to debris extrusion. According, 2 irrigation of the root canal space during instrumentation is one of the factors that led to an increased amount of debris extrusion. Teeth with necrotic pulp permitted more irrigant extrusion compared with vital teeth. The depth of file insertion into the root canal is another factor affecting debris extrusion. Studies conducted 3,4 showed that instrumentation short of apical foramen decreased the amount of debris extrusion with both endosonic and k-files. Canal preparation done with step-back techniques showed greater amount of periapical extrusion, whereas canal preparation having special design of nickel-titanium files with crown-down technique decreases the amount of extrusion periapically.2 The amount of apical extrusion can also vary according to the technique used. It is generally accepted that instrumentation techniques that incorporate rotational action generate less debris than push/ pull instrumentation, and the crown-down technique has been associated with the least amount of debris extrusion, compared with techniques involving a linear filing motion. Thus, engine-driven rotary systems have tended to extrude less debris than hand techniques. Recently, newer file system WaveOne Gold has been introduced, which was compared with F360, One Shape, and Reciproc.The Reciproc files are composed of M-Wire nickeltitanium, which offers increased flexibility. The reciprocating movement of the instrument reduces the risk of cyclic fatigue.One Shape files, on the contrary, employ traditional continuous rotation. They have a triangle-shaped cutting edge and two additional cutting edges, in the apical and coronal parts, as well as a cross-section that progressively changes from three to two cutting edges between the apical and coronal parts. This design offers optimal cutting action. 1,3 F360 has a double S-shaped cutting edges and a lower bending ability increasing the flexibility of file. It has a ABSTRACTIntroduction: Root canal therapy comprises three main steps, namely access preparation, biomechanical preparation, and three-dimensional obturation. During the process, the debris of the root canal system is pushed out from the canals, leading to treatment failure and flare-ups.
Aim of the Study: The purpose of this study is to compare and analyze the antimicrobial activity of three different root canal sealers. Materials and Methods: In this study, the antimicrobial activity of three different root canal sealers were compared against two strains of bacteria Enterococcus faecalis which is known to be common isolates of necrotic pulp and endodontic lesions. This test was done at various time intervals (1, 6, 15, and 60 min) using agar diffusion test and direct contact test. Results: Bioceramic showed the best antimicrobial activity against E. faecalis among the three groups of sealers used. Moreover, the results were statistically analyzed. Conclusion: Within the limitations of this study, it can be concluded that Bioceramic sealer showed the best antimicrobial activity followed by MTA Fillapex and Apexit.
Abstract:Curing of composites is a complex mechanism. Light is used to activate the photo-initiator system in the light curing units. Ideal requirements for curing light have been mentioned in the article. The article also sums up the various generations focusing on advantages, disadvantages and various advances in the same field. It has been concluded that an appropriately polymerized material has a positive influence on both the physical and biological properties of the restoration and should aid in promoting clinical success.
Aim:In vitro study evaluation of the cyclic fatigue resistance of reciprocating and rotary single-file system [Wave One Gold (WOG), Reciproc, Hyflex electrical discharge machining (EDM) file systems] utilizing cyclic fatigue testing device. Materials and methods:Three nickel-titanium rotary systems (Hyflex EDM size #25, 0.06 taper and Reciproc and WOG size #25, 0.06 taper) were used in this study. Ten files were used in each file system, which are 25 mm long and tested with cyclic fatigue and torsional resistance tests.Results: Each file was tested in the simulated root canal until instrument fracture occurred. Hyflex EDM has high mean and standard deviation of 116.23 ± 4.41, followed by WOG (64.85 ± 3.34) and Reciproc (35.28 ± 2.32). Conclusion:Within the limitations of this study, Hyflex EDM exhibited the greater cyclic fatigue resistance when compared with other rotary and reciprocating files.
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