Postoperative pain in patients following endodontic treatment by XP-endo Shaper files: A systematic review and meta-analysis.

Context: Postoperative pain occurs in 25%-60% of patients following endodontic treatment. It can significantly impact a patient's quality of life and requires timely management or, preferably, prevention.

Aims: The present systematic review was conducted aiming to analyze randomized controlled trials that compared postoperative pain in patients whose canals were shaped by XPS versus other endodontic file systems.

Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study.

Background: Falls is one of the common problems faced by elderly population and in preventing falls in India, research has largely focused on identification and management of risk factors, but the circumstances of the fall and its associated factors are sparsely researched.

Objectives: The primary objective is to find the prevalence of fall, investigate risk factors, and its circumstances for falls and level of functional independence in elderly population. The secondary objective is to find out fear of fall (FOF) and its association of demographic factors on elderly population.

Impact of a Multimodal Antimicrobial Stewardship Program on Pseudomonas aeruginosa Susceptibility and Antimicrobial Use in the Intensive Care Unit Setting.

Objective. To study the impact of our multimodal antibiotic stewardship program on Pseudomonas aeruginosa susceptibility and antibiotic use in the intensive care unit (ICU) setting. Methods.

Doripenem: position in clinical practice.

Doripenem is a novel carbapenem with a broad spectrum of activity against Gram-positive pathogens, anerobes and Gram-negative bacteria, including Pseudomonas aeruginosa. Doripenem exhibits rapid bactericidal activity with two- to fourfold lower MIC values for Gram-negative bacteria, compared with other carbapenems such as imipenem. Doripenem is approved for the treatment of complicated intra-abdominal infection and urinary tract infections.

Association of medication adherence with workplace productivity and health-related quality of life in patients with asthma.

Objective: Examine the association of medication adherence with workplace productivity and health-related quality of life (HRQL) in asthma patients.

Methods: Adult patients with asthma in a state health insurance program identified from medical claims (July 2001-June 2003) were mailed a three-part survey to measure HRQL (St. George's Respiratory Questionnaire), workplace productivity (Workplace Productivity Short Inventory), and self-reported medication adherence (Morisky Scale).

Rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic, debilitating disease characterized by chronic polyarticular inflammation that leads to erosion of joint and bones and to significant extra-articular, systemic, and cardiopulmonary manifestations. RA affects the patient's psychologic and social well-being as well as physical activity. The economical burden is high.

Trace element homeostasis during continuous sedation with propofol containing EDTA versus other sedatives in critically ill patients.

Objective: To evaluate changes in serum and urinary zinc, cobalt, copper, iron, and calcium concentrations in critically ill patients receiving propofol containing disodium edetate (disodium ethylenediaminetetraacetic acid [EDTA]) versus sedative agents without EDTA.

Design: This was a randomised, open-label, parallel-group study with randomisation stratified by baseline Acute Physiology and Chronic Health Evaluation (APACHE II) scores.

Setting: Intensive care units (ICU) in 23 medical centres.

E5 murine monoclonal antiendotoxin antibody in gram-negative sepsis: a randomized controlled trial. E5 Study Investigators.

Context: Knowledge and understanding of gram-negative sepsis have grown over the past 20 years, but the ability to treat severe sepsis successfully has not.

Objective: To assess the efficacy and safety of E5 in the treatment of patients with severe gram-negative sepsis.

Design: A multicenter, double-blind, randomized, placebo-controlled trial conducted at 136 US medical centers from April 1993 to April 1997, designed with 90% power to detect a 25% relative risk reduction, incorporating 2 planned interim analyses.

Can We protect workers from developing the adverse respiratory effects of isocyanate exposure?

In this review, the authors have attempted to present the difficulty in defining a permissible exposure limit (PEL) to agents that act as sensitizers and may induce asthma-even at exposure levels less than the PEL. One approach to this relatively unaddressed problem may be to define the separate aspects of exposure to the specific sensitizing agent. The first effect is an accelerated rate of decline in lung function in nonsensitized individuals who are exposed to the agent (in this case the model used is isocyanates).

Inhalation of toluene diisocyanate is associated with increased production of nitric oxide by rat bronchoalveolar lavage cells.

Isocyanates are used commercially, particularly in the manufacture of polyurethane coatings and foam. These compounds can pose an occupational health hazard since there is a risk of respiratory disease following isocyanate exposure. The purpose of the present study was to investigate whether a single, sublethal isocyanate inhalation is associated with increased production of the free radical nitric oxide (NO).

Reduction of lung dust burden in pneumoconiosis by whole-lung lavage.

Pneumoconioses are characterized as irreversible, progressive respiratory diseases. No effective therapy exists to prevent progression of these diseases. Whole-lung lavage (WLL) might limit the rate of disease progression through the removal of dust, inflammatory cells, and cytokines.

Hyperoxia-induced alterations of rat alveolar lavage composition and properties.

Although lethal exposures of most animal species to oxygen result in a reduced amount of surfactant phospholipids (PL), hyperoxia in rats leads to elevated levels of PL on the alveolar surface. Because of this different response, a study was made of the amount, composition, surface properties, and subfraction distribution (obtained by differential centrifugation) of alveolar lavage materials from rats exposed to > 95% oxygen for 64 h. The exposures lead to severe lung damage, which includes the appearance of pleural effusion, pulmonary edema, and increased protein levels on the alveolar surface.

Pulmonary response to hyperoxia: effects of magnesium.

Animals and humans rapidly develop respiratory failure and die within a few days when exposed to 100% oxygen. Postmortem examination of the lungs shows histopathologic features characteristic of diffuse alveolar damage, clinically recognized as adult respiratory distress syndrome (ARDS). At the present time, there is no effective therapy available to alter outcomes in ARDS.

Exposure of rats to hyperoxia: alteration of lavagate parameters and macrophage function.

Exposure of rats to hyperoxia (100% oxygen for 64 h) resulted in striking alterations in the properties of samples obtained by bronchoalveolar lavage. The yield of neutrophils, lymphocytes, and red blood cells was increased, while the number of harvested alveolar macrophages decreased. The acellular lavage fluid level of protein was elevated, indicating lung damage.

Retrieval of an aspirated bullet fragment by flexible bronchoscopy in a mechanically ventilated patient.

We report the case of a 28-year-old man who aspirated a bullet fragment following a gunshot. Review of the literature indicates this to be a rare finding. Bedside flexible bronchoscopy provided visualization of the foreign body and facilitated its removal while the patient was on a ventilator.

High-dose magnesium sulfate attenuates pulmonary oxygen toxicity.

Background And Methods: Rats rapidly develop respiratory distress when exposed to 100% oxygen and die within a few days. Autopsy of the lung shows severe histologic damage characteristic of the adult respiratory distress syndrome. The purpose of this study was to evaluate the effects of magnesium sulfate loading in a rat model of acute oxygen toxicity.

Positive-pressure ventilation with positive end-expiratory pressure and atrial natriuretic peptide release.

The effect of positive-pressure ventilation (PPV) with PEEP on the release of alpha-atrial natriuretic peptide (ANP) was investigated in both humans and an experimental model. In the human study, systemic artery blood samples from 22 critically ill patients were analyzed for ANP. Seventeen of these patients received PPV with different levels of PEEP (5 to 15 cm H2O).

Beneficial effect of norepinephrine in the treatment of circulatory shock caused by tricyclic antidepressant overdose.

The beneficial effect of dopamine in circulatory shock induced by tricyclic antidepressants (TCA) overdose may be decreased due to compromise of the endogenous stores of norepinephrine caused by TCA. The successful outcome of two cases of TCA overdose complicated by hypotension, unresponsive to an initial treatment with physostigmine fluid challenge and dopamine (greater than 15 micrograms/kg/min) but subsequently responsive to an infusion of norepinephrine is reported.

Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the Nd:YAG laser.

We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fire occurred. The patient survived without complications of the fire and was followed-up until death over 22 months after the fire. The events leading to the fire are presented and recommendations provided to prevent similar occurrences.