Introduction: Idiopathic membranous nephropathy (iMN) is a rare cause of nephrotic syndrome in ch... more Introduction: Idiopathic membranous nephropathy (iMN) is a rare cause of nephrotic syndrome in children (1%–7%). Anti-phospholipase A2 receptor (PLA2R) antibody positivity in kidney biopsy is observed in 52%–78% of adults and 45% of children with iMN. The objectives of the study are to analyze the clinical profile and outcome of membranous nephropathy in children, to assess the prevalence of anti-PLA2R immunohistochemistry (IHC) in kidney biopsy, and to correlate their presence with disease characteristics. Methods: We are reporting a single-center retrospective study conducted in pediatric nephrology division. Clinical data and outcome parameters of children with membranous nephropathy were analyzed. PLA2R IHC was performed in kidney biopsy specimens retrospectively. Results: We analyzed 43 children with membranous nephropathy (MN) from a single center. 18 (42%) had idiopathic MN (iMN). PLA2R IHC was performed in kidney biopsy specimens in 14/18 (78%) patients with iMN and 7/9 (78%) non-lupus secondary membranous nephropathy (SMN) patients. The most common cause of SMN was lupus nephritis in 16 patients (64%). The mean estimated glomerular filtration rate (eGFR) at onset was 156 ± 81 ml/min/1.73m2. The sensitivity and specificity of PLA2R IHC in diagnosing pediatric MN was 50% and 57%, respectively; positive and negative predictive values were 70% and 36%, respectively. At the final follow-up, chronic kidney disease stage 5 (CKD 5) developed in 2/14 (14.3%) iMN patients. Conclusions: IHC PLA2R staining of glomerular tissue is a useful diagnostic marker of IMN. Though PLA2R prevalence is lower in children, its role in guiding treatment needs further exploration.
India accounts for 22% of the 453,000 global rotavirus deaths among children &amp... more India accounts for 22% of the 453,000 global rotavirus deaths among children <5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India. Children <5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction. A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region. This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important.
IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality... more IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality in children with nearly one million deaths occurring yearly worldwide. [1] Diagnosis of LRTI is generally made based on both clinical and laboratory findings. The main causes of LRTI in young children are viruses and bacteria. Although respiratory pathogens can be identified in about 25%-50% of cases of LRTI, [2-6] initial therapy is generally empiric. This is so because of the inability to determine the causative organisms in most of the patients by the time treatment is initiated. [7] One of the factors contributing to the unidentified etiology in LRTI is the difficulty in identifying atypical pathogens such as Mycoplasma pneumoniae, C. pneumoniae, Legionella spp. that do not respond to routinely used beta-lactam antibiotics for LRTI. The present study was done to determine the incidence of LRTI due to Chlamydia pneumoniae in young children. Introduction: Lower respiratory tract infections (LRTIs) continue to be a major health problem in children. Increasingly "atypical" agents such as Chlamydophila pneumoniae are being recognized as a significant cause of LRTI. The current study evaluated serological and molecular methods in detection of LRTI due to C. pneumoniae in young children. Materials and Methods: Serum and nasopharyngeal aspirate (NPA) were collected from 53 treatment-naïve children (6 months-6 years) with LRTI. Immunoglobulin M (IgM) and IgG antibodies to C. pneumoniae were detected in serum by enzyme-linked immunosorbent assay (ELISA) and microimmunofluorescence (MIF) test. Nonnested polymerase chain reaction (PCR) to detect a 183-bp fragment of the 60-kDa outer membrane protein 2 of C. pneumoniae was performed on DNA extracted from the NPA samples. Results: Of the 53 children tested, 14 (26.4%) children were diagnosed to have acute C. pneumoniae infection according to CDC guidelines. When compared with IgM MIF (reference test), PCR and IgM ELISA showed a sensitivity of 36% and 71%, respectively, and a specificity of 100%. IgG antibodies were positive in an additional 8 cases, by both MIF and ELISA, suggesting "possible" reinfection. Conclusion: This study despite its drawbacks provides evidence that C. pneumoniae is a significant cause of LRTI in young children.
Objective: A new sonic-activated resin system has been introduced that allows for improved placem... more Objective: A new sonic-activated resin system has been introduced that allows for improved placement in bulk. This study will compare its marginal adaptation with other conventional composite resins. Method: Thirty human molars were prepared with Class II restorations standardized to the following dimensions: 4mm bucco-lingually, 5mm mesio-distally, 4mm depth, and the proximal box placed 0.5 mm below the CEJ. The teeth were then randomly divided into three groups: A: SonicFill + Optibond AIO (Kerr Corp.), B: SureFil SDR + Xeno IV + Ceram X (Dentsply) and C:Filtek Supreme Ultra + Adper Easy Bond (3M). The teeth were restored following manufacturers recommendations, polished and thermocycled for 1000 cycles at 5-55 0C. Epoxy replicas were made from PVS impressions and marginal analysis was performed on the replicas under SEM at 200X. The margins were scored as follows: 1 = Continuous margin 2 = Margin imperfections/Hairline crack 3 = Marginal opening < 2μm 4 = Marginal gap > 2μm...
Objective: A new sonic-activated resin system has been introduced that allows for improved placem... more Objective: A new sonic-activated resin system has been introduced that allows for improved placement in bulk. This study will compare its microleakage with other conventional composite resins. Method: Thirty human molars were prepared with Class II restorations standardized to the following dimensions: 4mm bucco-lingually, 5mm mesio-distally, 4mm depth, and the proximal box placed 0.5 mm below the CEJ. The teeth were then randomly divided into three groups:A: SonicFill + Optibond AIO (Kerr), B: SureFil SDR + Xeno IV + Ceram X (Dentsply) and C:Filtek Supreme Ultra + Adper Easy Bond (3M). The teeth were restored following manufacturers recommendations, (SonicFill and SureFil placed in bulk and Filtek Supreme placed incrementally). Teeth were polished and thermocycled for 1000 cycles at 5-55 0C. The teeth were sealed except 1mm around the restoration and immersed in 0.5% basic fuchsin dye solution for 24h. Specimens were sectioned and dye penetration was observed under a stereomicrosco...
Objective: The aim of this in vitro study was to evaluate the effect of laser treatment on shear ... more Objective: The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Method: Eighty extracted sound human molar teeth were used for the study. After the teeth were sectioned mesiodistally, they were embedded in acrylic blocks. The dentin surfaces were wet ground with 600-grit silicone carbide(SiC) paper. The teeth were randomly divided into 2 treatment groups; laser(Er:YAG laser, 12 Hz, 350mJ) and control(SiC). Each group was then divided into 2 subgroups according to the flowable resin composite type; a self-adhering, Vertise Flow and a conventional, Premise Flow with Optibond Solo Plus(n=20). Flowable composites were applied according to the manufacturer’s recommendations using Ultradent method for shear bond strength test. The bonded specimens were stored in water for 24 hours, and bond strength was tested at 1 mm/min. The debonded surfaces were observed under a microscope to de...
The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond streng... more The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Eighty extracted sound human molar teeth were used for the study. The teeth were sectioned mesiodistally and embedded in acrylic blocks. The dentin surfaces were ground wet with 600-grit silicon carbide (SiC) paper. They were randomly divided into two preparation groups: laser (Er:YAG laser, with 12 Hz, 350 mJ energy) and control (SiC). Each group was then divided into two subgroups according to the flowable resin composite type (n = 20). A self-adhesive flowable (Vertise Flow) and a conventional flowable resin (Premise Flow) were used. Flowable resin composites were applied according to the manufacturer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s recommendations using the Ultradent shear bond Teflon mold system. The bonded specimens were stored in water at 37 °C for 24 h. Shear bond strength was tested at 1 mm/min. The data were logarithmically transformed and analyzed using two-way analysis of variance and Student-Newman-Keul&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s test at a significance level of 0.05. The self-adhesive flowable resin showed significantly higher bond strength values to laser-prepared surfaces than to SiC-prepared surfaces (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The conventional flowable resin did not show such differences (p = 0.224). While there was a significant difference between the two flowable resin composites in SiC-prepared surfaces (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), no significant difference was detected in laser-prepared surfaces (p = 0.053). The bond strength of a self-adhesive flowable resin composite differs according to the type of dentin surface preparation. Laser treatment increased the dentin bonding values of the self-adhesive flowable resin.
A 12-year-old boy, previously well, presented with increas-ing pallor, lethargy and intermittent ... more A 12-year-old boy, previously well, presented with increas-ing pallor, lethargy and intermittent gross haematuria for 1 month. He also had a history of haemoptysis for the pre-vious 5 days. His blood pressure was normal and he had pedal oedema. There was no hepatosplenomegaly, joint swelling or skin rash. Laboratory investigations (Table 1) revealed anaemia, hypoalbuminaemia and elevated serum creatinine (estimated glomerular filtration rate by Schwartz formula: 13 mL/min/1.73 m2). His white cell count, platelet count and clotting profile were normal. His urine analysis showed 2+ protein, 3+ blood and coarse granular casts. He had nephrotic-range proteinuria. His chest X-ray showed bilateral nodular infiltrates (Figure 1A) and a CT of the chest revealed bilateral diffuse ground glass opacities consistent with alveolar haemorrhage (Figure 1B). A kidney biopsy was performed for further evaluation.
Introduction: Idiopathic membranous nephropathy (iMN) is a rare cause of nephrotic syndrome in ch... more Introduction: Idiopathic membranous nephropathy (iMN) is a rare cause of nephrotic syndrome in children (1%–7%). Anti-phospholipase A2 receptor (PLA2R) antibody positivity in kidney biopsy is observed in 52%–78% of adults and 45% of children with iMN. The objectives of the study are to analyze the clinical profile and outcome of membranous nephropathy in children, to assess the prevalence of anti-PLA2R immunohistochemistry (IHC) in kidney biopsy, and to correlate their presence with disease characteristics. Methods: We are reporting a single-center retrospective study conducted in pediatric nephrology division. Clinical data and outcome parameters of children with membranous nephropathy were analyzed. PLA2R IHC was performed in kidney biopsy specimens retrospectively. Results: We analyzed 43 children with membranous nephropathy (MN) from a single center. 18 (42%) had idiopathic MN (iMN). PLA2R IHC was performed in kidney biopsy specimens in 14/18 (78%) patients with iMN and 7/9 (78%) non-lupus secondary membranous nephropathy (SMN) patients. The most common cause of SMN was lupus nephritis in 16 patients (64%). The mean estimated glomerular filtration rate (eGFR) at onset was 156 ± 81 ml/min/1.73m2. The sensitivity and specificity of PLA2R IHC in diagnosing pediatric MN was 50% and 57%, respectively; positive and negative predictive values were 70% and 36%, respectively. At the final follow-up, chronic kidney disease stage 5 (CKD 5) developed in 2/14 (14.3%) iMN patients. Conclusions: IHC PLA2R staining of glomerular tissue is a useful diagnostic marker of IMN. Though PLA2R prevalence is lower in children, its role in guiding treatment needs further exploration.
India accounts for 22% of the 453,000 global rotavirus deaths among children &amp;amp;amp;amp... more India accounts for 22% of the 453,000 global rotavirus deaths among children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India. Children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction. A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region. This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important.
IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality... more IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality in children with nearly one million deaths occurring yearly worldwide. [1] Diagnosis of LRTI is generally made based on both clinical and laboratory findings. The main causes of LRTI in young children are viruses and bacteria. Although respiratory pathogens can be identified in about 25%-50% of cases of LRTI, [2-6] initial therapy is generally empiric. This is so because of the inability to determine the causative organisms in most of the patients by the time treatment is initiated. [7] One of the factors contributing to the unidentified etiology in LRTI is the difficulty in identifying atypical pathogens such as Mycoplasma pneumoniae, C. pneumoniae, Legionella spp. that do not respond to routinely used beta-lactam antibiotics for LRTI. The present study was done to determine the incidence of LRTI due to Chlamydia pneumoniae in young children. Introduction: Lower respiratory tract infections (LRTIs) continue to be a major health problem in children. Increasingly "atypical" agents such as Chlamydophila pneumoniae are being recognized as a significant cause of LRTI. The current study evaluated serological and molecular methods in detection of LRTI due to C. pneumoniae in young children. Materials and Methods: Serum and nasopharyngeal aspirate (NPA) were collected from 53 treatment-naïve children (6 months-6 years) with LRTI. Immunoglobulin M (IgM) and IgG antibodies to C. pneumoniae were detected in serum by enzyme-linked immunosorbent assay (ELISA) and microimmunofluorescence (MIF) test. Nonnested polymerase chain reaction (PCR) to detect a 183-bp fragment of the 60-kDa outer membrane protein 2 of C. pneumoniae was performed on DNA extracted from the NPA samples. Results: Of the 53 children tested, 14 (26.4%) children were diagnosed to have acute C. pneumoniae infection according to CDC guidelines. When compared with IgM MIF (reference test), PCR and IgM ELISA showed a sensitivity of 36% and 71%, respectively, and a specificity of 100%. IgG antibodies were positive in an additional 8 cases, by both MIF and ELISA, suggesting "possible" reinfection. Conclusion: This study despite its drawbacks provides evidence that C. pneumoniae is a significant cause of LRTI in young children.
Objective: A new sonic-activated resin system has been introduced that allows for improved placem... more Objective: A new sonic-activated resin system has been introduced that allows for improved placement in bulk. This study will compare its marginal adaptation with other conventional composite resins. Method: Thirty human molars were prepared with Class II restorations standardized to the following dimensions: 4mm bucco-lingually, 5mm mesio-distally, 4mm depth, and the proximal box placed 0.5 mm below the CEJ. The teeth were then randomly divided into three groups: A: SonicFill + Optibond AIO (Kerr Corp.), B: SureFil SDR + Xeno IV + Ceram X (Dentsply) and C:Filtek Supreme Ultra + Adper Easy Bond (3M). The teeth were restored following manufacturers recommendations, polished and thermocycled for 1000 cycles at 5-55 0C. Epoxy replicas were made from PVS impressions and marginal analysis was performed on the replicas under SEM at 200X. The margins were scored as follows: 1 = Continuous margin 2 = Margin imperfections/Hairline crack 3 = Marginal opening < 2μm 4 = Marginal gap > 2μm...
Objective: A new sonic-activated resin system has been introduced that allows for improved placem... more Objective: A new sonic-activated resin system has been introduced that allows for improved placement in bulk. This study will compare its microleakage with other conventional composite resins. Method: Thirty human molars were prepared with Class II restorations standardized to the following dimensions: 4mm bucco-lingually, 5mm mesio-distally, 4mm depth, and the proximal box placed 0.5 mm below the CEJ. The teeth were then randomly divided into three groups:A: SonicFill + Optibond AIO (Kerr), B: SureFil SDR + Xeno IV + Ceram X (Dentsply) and C:Filtek Supreme Ultra + Adper Easy Bond (3M). The teeth were restored following manufacturers recommendations, (SonicFill and SureFil placed in bulk and Filtek Supreme placed incrementally). Teeth were polished and thermocycled for 1000 cycles at 5-55 0C. The teeth were sealed except 1mm around the restoration and immersed in 0.5% basic fuchsin dye solution for 24h. Specimens were sectioned and dye penetration was observed under a stereomicrosco...
Objective: The aim of this in vitro study was to evaluate the effect of laser treatment on shear ... more Objective: The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Method: Eighty extracted sound human molar teeth were used for the study. After the teeth were sectioned mesiodistally, they were embedded in acrylic blocks. The dentin surfaces were wet ground with 600-grit silicone carbide(SiC) paper. The teeth were randomly divided into 2 treatment groups; laser(Er:YAG laser, 12 Hz, 350mJ) and control(SiC). Each group was then divided into 2 subgroups according to the flowable resin composite type; a self-adhering, Vertise Flow and a conventional, Premise Flow with Optibond Solo Plus(n=20). Flowable composites were applied according to the manufacturer’s recommendations using Ultradent method for shear bond strength test. The bonded specimens were stored in water for 24 hours, and bond strength was tested at 1 mm/min. The debonded surfaces were observed under a microscope to de...
The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond streng... more The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Eighty extracted sound human molar teeth were used for the study. The teeth were sectioned mesiodistally and embedded in acrylic blocks. The dentin surfaces were ground wet with 600-grit silicon carbide (SiC) paper. They were randomly divided into two preparation groups: laser (Er:YAG laser, with 12 Hz, 350 mJ energy) and control (SiC). Each group was then divided into two subgroups according to the flowable resin composite type (n = 20). A self-adhesive flowable (Vertise Flow) and a conventional flowable resin (Premise Flow) were used. Flowable resin composites were applied according to the manufacturer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s recommendations using the Ultradent shear bond Teflon mold system. The bonded specimens were stored in water at 37 °C for 24 h. Shear bond strength was tested at 1 mm/min. The data were logarithmically transformed and analyzed using two-way analysis of variance and Student-Newman-Keul&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s test at a significance level of 0.05. The self-adhesive flowable resin showed significantly higher bond strength values to laser-prepared surfaces than to SiC-prepared surfaces (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The conventional flowable resin did not show such differences (p = 0.224). While there was a significant difference between the two flowable resin composites in SiC-prepared surfaces (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), no significant difference was detected in laser-prepared surfaces (p = 0.053). The bond strength of a self-adhesive flowable resin composite differs according to the type of dentin surface preparation. Laser treatment increased the dentin bonding values of the self-adhesive flowable resin.
A 12-year-old boy, previously well, presented with increas-ing pallor, lethargy and intermittent ... more A 12-year-old boy, previously well, presented with increas-ing pallor, lethargy and intermittent gross haematuria for 1 month. He also had a history of haemoptysis for the pre-vious 5 days. His blood pressure was normal and he had pedal oedema. There was no hepatosplenomegaly, joint swelling or skin rash. Laboratory investigations (Table 1) revealed anaemia, hypoalbuminaemia and elevated serum creatinine (estimated glomerular filtration rate by Schwartz formula: 13 mL/min/1.73 m2). His white cell count, platelet count and clotting profile were normal. His urine analysis showed 2+ protein, 3+ blood and coarse granular casts. He had nephrotic-range proteinuria. His chest X-ray showed bilateral nodular infiltrates (Figure 1A) and a CT of the chest revealed bilateral diffuse ground glass opacities consistent with alveolar haemorrhage (Figure 1B). A kidney biopsy was performed for further evaluation.
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