In therapeutically anticoagulated patients tooth extractions can be safely performed without altering the dose of anticoagulant medication if efficient local hemostasis is provided. In most cases; in patients with INR ≤ 3.0 after extraction of one or two teeth postoperative bleeding can be controlled with local pressure, without any additional local hemostatic measures.
Background: Little is known about the impact of socioeconomic status (SES) as a key element of social determinants of health on intensive care unit (ICU) outcomes for adults. Objective: We assessed whether a validated individual SES index termed HOUSES (HOUsing-based SocioEconomic status index) derived from housing features was associated with short-term outcomes of critical illness including ICU mortality, ICU-free days, hospital-free days, and ICU readmission. Methods: We performed a population-based cohort study of adult patients living in Olmsted County, Minnesota, admitted to 7 intensive care units at Mayo Clinic from 2011 to 2014. We compared outcomes between the lowest SES group (HOUSES quartile 1 [Q1]) and the higher SES group (HOUSES Q2-4). We stratified the cohort based on age (<50 years old and ≥50 years old). Results: Among 4134 eligible patients, 3378 (82%) patients had SES successfully measured by the HOUSES index. Baseline characteristics, severity of illness, and reason for ICU admission were similar among the different SES groups as measured by HOUSES except for larger number of intoxications and overdoses in younger patients from the lowest SES. In all adult patients, there were no overall differences in mortality, ICU-free days, hospital-free days, or ICU readmissions in patients with higher SES compared to lower SES. Among older patients (>50 years), those with higher SES (HOUSES Q2-4) compared to those with lower SES (HOUSES Q1) had lower mortality rates (hazard ratio = 0.72; 95% CI: 0.56-0.93; adjusted P = .01), increased ICU-free days (mean 1.08 days; 95% CI: 0.34-1.84; adjusted P = .004), and increased hospital-free days (mean 1.20 days; 95% CI: 0.45-1.96; adjusted P = .002). There were no differences in ICU readmission rates (OR = 0.74; 95% CI: 0.55-1.00; P = .051). Conclusion: Individual-level SES may be an important determinant or predictor of critical care outcomes in older adults. Housing-based socioeconomic status may be a useful tool for enhancing critical care research and practice.
Key advantages of Poly(methyl methacrylate)—PMMA for denture application are related to aesthetics and biocompatibility, while its main deficiency is related to mechanical properties. To address this issue, SiO2 nanoparticle reinforcement was proposed, containing 0 to 5% nanosilica, to form nanocomposite materials. Flexural strengths and elastic moduli were determined and correlated to nominal nanoparticle content and zeta potential of the liquid phase nanoparticle solutions. Another issue is the biocompatibility, which was determined in terms of cytotoxicity, using L929 and MRC5 cell lines. The addition of nanoparticle was proved to be beneficial for increasing flexural strength and modulus, causing a significant increase in both strength and moduli. On the other hand, the formation of agglomerates was noted, particularly at higher nanoparticle loadings, affecting mechanical properties. The addition of nanosilica had an adverse effect on the cytotoxicity, increasing it above the level present in unmodified specimens. Cytotoxic potential was on the acceptable level for specimens with up to 2% nanosilica. Consequently, nanosilica proved to be an effective and biocompatible means of increasing the resistance of dental materials.
The degree of polymerization for dimethacrylate resin-based materials (BisGMA, TEGDMA, UDMA, HEMA) ranges from 55 to 75%. Literature data indicate that polymerization efficacy depends, among other factors, on the type of methacrylate resin comprising the material. The aim of this study was to evaluate the polymerization efficacy of four dental cement materials characterized by different polymerization mechanisms using FTIR analysis. In the present study, the FTIR method was adopted to analyze the degree of polymerization efficacy of four resin-based dental cement materials, two of which were self-cured and two were dual-cured cements. The IR spectral analysis was performed 24 h after the polymerization of the cementitious material. RelyX ARC cement exhibits the lowest polymerization efficacy (61.3%), while that of Variolink II (85.8%) and Maxcem Elite is the highest (90.1%). Although the efficacy of self-cured cements appears to be superior, the difference is not statistically significant (p = 0.280). Polymerization efficacy largely depends on the chemical structure of the material in terms of the presence of a particular methacrylate resin and less on the polymerization mechanism itself, i.e., whether it is a self-cured or dually cured dental cement. Thus, in clinical practice, cementitious materials with a higher proportion of TEGDMA compared with BisGMA are recommended.
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