Biomedical subjects

Pantelis Andreou

Publications and source records attributed to Pantelis Andreou.

18 recordsLinked to original sources

PubMed2007

A comparison of factors used by physicians and patients in the selection of antidepressant agents.

OBJECTIVES: Involving patients in treatment decisions may reduce premature antidepressant treatment terminations and improve clinical and health economic outcomes. However, a first step is to determine what information to provide to patients to facilitate their decision making. The authors therefore identified, valued, and ranked factors of antidepressant treatment selection that are relevant to patients and compared them with the opinions of general practitioners. METHODS: Matching surveys were developed for patients and physicians with feedback from focus groups. In the patient group, participation was requested from consecutive patients at four family practice sites in Nova Scotia, Canada. Surveys were mailed to 247 randomly selected general practitioners. RESULTS: Surveys were completed by 127 patients and 110 physicians, representing return rates of 70% and 46%, respectively. The most valued of the 12 differentiating factors when selecting an antidepressant, ranked first by both patients and physicians, was common side effects. Also ranked highly by both groups were precautions with antidepressant use, physician antidepressant experience, and discontinuation problems. Groups differed in their ranking of uncommon serious side effects, time since antidepressants were marketed, cost, and dosing schedule. The ranking distributions were significantly different for six of 12 factors between patients and general practitioners (Wilcoxon ranked-sum test). Patient experience with antidepressants did not influence factor value. CONCLUSIONS: The data demonstrate moderate disagreement between patients and general practitioners regarding the relative value of antidepressant selection factors. The effect of this disagreement on treatment adherence and other outcomes requires further investigation, as improving patient-physician concordance regarding antidepressant choices may lead to improved treatment acceptance.

Antidepressive Agents↗

PubMed2006

Effect of reduced exposure times on the microhardness of 10 resin composites cured by high-power LED and QTH curing lights.

PURPOSE: To compare the effect of reduced exposure times on the microhardness of resin composites cured with a "second-generation" light-emitting diode (LED) curing light and a quartz-tungsten-halogen (QTH) curing light. METHODS: Ten composites were cured with a LED curing light for 50% of the manufacturers" recommended exposure time or a QTH light at the high power setting for 50% of the recommended time or on the medium power setting for 100% of the recommended time. The composites were packed into Class I preparations in extracted human molar teeth and cured at distances of 2 or 9 mm from the light guide. The moulds were separated, and the Knoop microhardness of the composites was measured down to 3.5 mm from the surface. RESULTS: The LED light delivered the greatest irradiance at 0 and 2 mm, whereas the QTH light on the standard (high power) setting delivered the highest irradiance at 9 mm. According to distribution-free multiple comparisons of the hardness values, at 2 mm from the light guide the LED light (50% exposure time) was ranked better than or equivalent to the QTH light on the high power setting (50% exposure time) or on the medium power setting (100% exposure time). At 9 mm, the LED light was ranked better than or equivalent to the QTH light (both settings) to a depth of 1.5 mm, beyond which composites irradiated by the LED light were softer (p < 0.01). At both distances, the QTH light operated on the high power setting for 50% of the recommended exposure time produced composites that were as hard as when they were exposed on the medium power setting for 100% of the recommended exposure time. CONCLUSIONS: The ability to reduce exposure times with high-power LED or QTH lights may improve clinical time management.

Acrylic Resins↗

PubMed2006

Third-generation vs a second-generation LED curing light: effect on Knoop microhardness.

Third-generation light-emitting diode (LED) curing lights use several different types of LEDs within the light to deliver a broader spectral output compared with the narrower spectral output of second-generation curing lights. This study determined the benefits of this broader spectral output. A third-generation LED curing light was modified so that the 4 peripheral LEDs, which provide the lower wavelengths, could be turned on or off, allowing the light to be used as a third- or a second-generation LED curing light. Twelve composites of A2 and lighter shades were packed into molds 2 mm deep with an internal diameter of 12 mm, and then irradiated for 20 seconds. A laboratory-grade spectroradiometer was used to ensure that all the specimens received the same irradiance and total energy (16.82 J/cm2) from the curing light in both the second- and third-generation modes. The results showed the benefits of using a broader spectrum third-generation LED curing light. This light produced composites that were as hard as when the narrower spectrum second-generation LED curing light was used (P < or = .01). In 7 of the 12 resin composites, the top surface was harder when the third-generation LED curing light was used (P < or = .01).

Bisphenol A-Glycidyl Methacrylate↗

PubMed2005

Improved prediction of early-onset coronary artery disease using APOE epsilon4, BChE-K, PPARgamma2 Pro12 and ENOS T-786C in a polygenic model.

OBJECTIVES: Coronary artery disease (CAD) is often polygenic due to multiple mutations that contribute small effects to susceptibility. Since most prior studies only evaluated the contribution of single candidate genes, we therefore looked at a combination of genes in predicting early-onset CAD [apolipoprotein E (APOE) epsilon4, butyrylcholinesterase (BChE) K, peroxisome proliferator-activated receptor gamma2 (PPARgamma2) Pro12Ala and endothelial nitric oxide synthase (ENOS) T-786C]. DESIGN AND METHODS: We examined the frequencies, individually and in combination, of all four alleles among patients with early-onset CAD (n = 150; <50 years), late-onset CAD (n = 150; >65 years) and healthy controls (n = 150, age range 47-93 years). Differences in the proportion of subjects in each group with the given gene combination were assessed and likelihood ratios (LR) were calculated using logistic regression to combine the results of multiple genes. RESULTS: Early-onset CAD patients had increased, but non-significant, frequencies of PPARgamma2 Pro12/Pro12 (P = 0.39) and ENOS T-786C (P = 0.72), while BChE-K was only significantly higher in early-onset CAD patients compared to controls (P = 0.03). There were significantly more APOE epsilon4 alleles alone (P = 0.02) or in combination with BChE-K (P = 0.02) among early-onset CAD patients compared to late-onset CAD ones or controls. When combined, there was a higher prevalence of all four alleles in early-onset CAD (early-onset CAD patients: 10.7%, late-onset CAD patients: 3.3% and controls: 2.7%, P = 0.01). LR for early-onset CAD for a single allele was relatively small (1.08 for PPARgamma2 to 1.70 for APOE epsilon4). This increased to 2.78 (1.44-5.37) when combining all four alleles, therefore increasing the pre-test probability of CAD from 5% to a post-test probability of 12.7%. CONCLUSIONS: While any single mutation causes only a mildly increased LR (none > 1.7), in combination, the likelihood of early-onset CAD increased to 2.78 with four mutations. The genetics of early-onset CAD appear to be multifactorial, requiring polygenic models to elucidate risk.

Age of Onset↗

PubMed2005

Randomized placebo-controlled study of low-dose warfarin for the prevention of central venous catheter-associated thrombosis in patients with cancer.

PURPOSE: In this multicenter, randomized, placebo-controlled clinical trial, we studied whether warfarin 1 mg daily reduces the incidence of symptomatic central venous catheter (CVC) -associated thrombosis in patients with cancer. PATIENTS AND METHODS: Two hundred fifty-five patients with cancer who required a CVC for at least 7 days were randomly assigned to receive warfarin 1 mg or placebo. RESULTS: There were 11 (4.3%) symptomatic CVC-associated thromboses among 255 patients, with no difference in the incidence of symptomatic CVC-associated thrombosis between patients taking warfarin 1 mg daily (six of 130 patients; 4.6%) and patients taking placebo (five of 125 patients; 4.0%; hazard ratio, 1.20; 95% CI, 0.37 to 3.94). Warfarin had no effect on CVC life span (84 days v 63 days in control and warfarin groups, respectively; 95% confidence limit, -16 to 55 days; P = .09), and it did not affect the number of premature CVC removals (23.2% v 25.4% in control and warfarin groups, respectively; 95% confidence limit of difference -8.34 to 12.71; P = .68) or the frequency of major bleeding episodes (2% v 0% in control and warfarin groups, respectively; P = .5, Fisher's exact test). CONCLUSION: Symptomatic CVC-associated thrombosis in patients with cancer, although significant, is less common than previously reported. In this study, the administration of warfarin 1 mg daily did not reduce the incidence of symptomatic CVC-associated thrombosis in patients with cancer. However, the low rate of symptomatic CVC-associated thrombosis means that a much larger trial is required to address this issue definitively.

Adolescent↗

PubMed2005

Knoop hardness of ten resin composites irradiated with high-power LED and quartz-tungsten-halogen lights.

This study compared a high-power light-emitting-diode (LED) curing light (FreeLight 2, 3M ESPE) with a quartz-tungsten-halogen (QTH) light (TriLight, 3M ESPE) to determine which was the better at photo-polymerising 10 resin composites. Class I preparations were prepared 4-mm deep into human teeth and filled with 10 different composites. The composites were irradiated for 50% or 100% of their recommended times using the LED light, and for 100% of their recommended times with the QTH light on either the high or medium power setting. Fifteen minutes later, the Knoop hardness of the composites was measured to a depth of 3.5 mm from the surface. When irradiated by the LED light for their recommended curing times, the Knoop hardness of all 10 composites stayed above 80% of the maximum hardness of the composite to a depth of at least 1.5 mm; three composites maintained a Knoop hardness that was more than 80% of their maximum hardness to a depth of 3.5 mm. Repeated measurements analysis of variance indicated that all the two-way and three-way interactions between the curing light, depth, and composite were significant (p < 0.01). To eliminate the choice of composite as a factor, an overall comparison of the lights was performed using the Kruskal-Wallis test and distribution free multiple comparisons of the ranked hardness values. The LED light, used for the composite manufacturer's recommended time, was ranked the best at curing the composites to a depth of 3mm (p < 0.01). The LED light used for 50% of the recommended time was not significantly different from the QTH light used for 100% of the recommended time on the high power setting.

Composite Resins↗

PubMed2005

The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada.

BACKGROUND: Abdominal aortic aneurysms (AAAs) are frequently familial. The aim of this study was to compare the prevalence of AAA among the siblings of AAA patients with that in the spouses' siblings. METHODS: The siblings of 375 AAA patients and the siblings of the spouses of the AAA patients were included in this study and offered ultrasonography screening for AAA. Participants were asked to complete a questionnaire to collect demographic and general health information. Statistical analysis was done with Fisher's exact test. Odds ratios and 95% confidence intervals were also calculated. RESULTS: Abdominal ultrasonography examinations were done for 309 individuals. The results indicated that 11 (11.2%) of 98 brothers of AAA patients, 4 (2.7%) of 147 sisters, and none of the 64 siblings of the spouses of the AAA patients were found to have an AAA. Combining the information from the ultrasonography screening and medical records on already known cases of AAA in these families, altogether 29.0% (44/152) of the brothers of AAA patients, 11.1% (20/181) of the sisters of AAA patients, and 2.3% (2/88) of the siblings of the spouses had an AAA. CONCLUSION: There was a significant difference between the siblings of the AAA patients and those of the spouses both in the frequency of AAA detected by ultrasonography screening and in the overall prevalence of AAA. The overall prevalence of AAA in the siblings of AAA patients was about eight times that observed among the siblings of their spouses (19.2% vs 2.3%). These findings confirmed previous reports on high prevalence of AAA among siblings of AAA patients and emphasized the importance of an ultrasonography screening program for siblings of AAA patients.

Age Distribution↗

PubMed2005

Achievement of non-cognitive goals of undergraduate medical education: perceptions of medical students, residents, faculty and other health professionals.

BACKGROUND: Professionalism is increasingly emphasised in medical education. Non-cognitive goals, including values, attitudes and skills, remain challenging to define and measure. The purpose of this study was to better understand these goals and their achievement in the MD programme. METHODS: Graduating medical students, faculty preceptors, residents and other health professionals (OHPs) completed a systematically developed mailed survey, rating achievement of 25 attribute statements. Following analyses of means and standard deviations, factor analysis of responses was conducted. Responses were compared across respondent groups. RESULTS: The overall response rate was 50.1% (191/396), comprising 57.5% of the students, 54.1% of the faculty members, 30.9% of the residents and 50% of the OHPs. Five items received mean ratings over 4/5; none were below 3/5. Five factors explained 65% of variance. They were: 'Teamwork and interprofessional skills'; 'Duty and responsibility'; 'Communication and interpersonal skills'; 'Professionalism and values', and 'Trustworthiness and ethical behaviour'. The groups differed significantly on 2 factors: Teamwork and interprofessional skills (P < or = 0.0001) and Communication and interpersonal skills (P < or = 0.001). CONCLUSIONS: Important curriculum goals received high mean ratings. Ratings differed significantly across groups, suggesting differing perceptions of the extent to which goals were met. More study is needed to understand the basis of these perceptions.

Achievement↗

PubMed2005

Evaluation of a dual peak third generation LED curing light.

This study compared 3 light-emitting diode curing lights (UltraLume 5, FreeLight 2, LEDemetron I) with a quartz-tungsten-halogen light (Optilux 401) to determine which was the better at photopolymerizing 5 resin composites. The composites were 2 mm thick and were irradiated for the manufacturers' recommended curing times at distances of 2 mm and 8 mm from the light guide. The Knoop hardness at each of 22 points over a 10-mm diameter footprint at the top and bottom of the composites was used to compare the lights. The 4 curing lights and irradiation distances did not have the same effect on all the composites (P < .001). It was concluded that overall the UltraLume 5 dual peak third generation LED curing light was able to polymerize these 5 resin composites as well as or better than the other curing lights.

Composite Resins↗

PubMed2004

Effects of resin composite composition and irradiation distance on the performance of curing lights.

This study determined the effect of using five resin composites and two irradiation distances to test the performance of dental curing lights. Three types of curing lights with similar spectral distributions, but each delivering a different power density, were used for irradiation times ranging from 3 to 60 s. Power densities were measured at 2 and 9 mm from the tip of the light guide. Five composites 1.6 mm thick and of the same shade were irradiated at 2 and 9 mm from the light guide with energy densities of 1.2-38.0 J/cm(2). The Knoop hardness at the top and bottom of the composite specimens was measured 15 min after irradiation and again after immersion in water at 37 degrees C for 24 h. There was a linear relationship between the hardness and the logarithm of the energy density received by the composite (r2 > 0.81). The analysis of variance showed that the composite, the side tested, the distance from the light guide, and the curing light/irradiation time combination all had a significant effect on the hardness (p < 0.01). Plots of the hardness at the bottom 15 min after irradiation by each light were generated for all the composites. These plots illustrated that the effects of the different curing light/irradiation time combinations on hardness were not the same for each composite. The effects of each curing light/time combination on hardness were also different at 2 and 9 mm from the light guide. In conclusion, when comparing the effects of different light sources on resin polymerization, several different composites should be irradiated at clinically relevant distances from the light guide. Using high-powered curing lights for 3 or 5 s did not deliver sufficient energy to cure the 1.6-mm thick specimens of composites used in this study.

Cementation↗

PubMed2004

Factors associated with optic disc hemorrhages in glaucoma.

PURPOSE: To evaluate factors associated with optic disc hemorrhages (ODHs) in patients with open-angle glaucoma. DESIGN: Cohort study. PARTICIPANTS: One hundred thirty-seven patients with open-angle glaucoma, with an initial mean age of 60.0 years (standard deviation [SD], 11.0 years) followed up for a mean of 9.5 years (SD, 5.0 years). METHODS: The association between ODHs and various patient-related variables (diabetes, systemic hypertension, heart disease, hypercholesterolemia, migraine, hypothyroidism, use of platelet antiaggregant agents) and eye-related variables (mean and range of intraocular pressure, refractive error, and severity of disease) was investigated using multivariate time-to-event analyses in patients with open-angle glaucoma. To determine the influence of the level of intraocular pressure (IOP) on the occurrence of ODHs, we compared the IOP at the time the first ODH was noted with the mean IOP of the previous 3 visits. As a control, a similar analysis was performed on the same eyes using a randomly selected visit before the occurrence of the first ODH. MAIN OUTCOME MEASUREMENTS: Patient-related and eye-related variables associated with ODHs and the comparative level of IOP in which these ODHs were observed. RESULTS: Fifty eyes of 38 patients (28%) had 1 or more ODHs during the follow-up period. The ODHs were associated with presence of diabetes (hazard ratio, 4.43; 95% confidence interval [CI], 1.8-10.50; P = 0.001) and use of aspirin (hazard ratio, 2.30; 95% CI, 1.2-4.6; P = 0.019). The IOP at the time of the first ODH was, on average, 1.4 mmHg lower than the mean IOP of the 3 previous visits (95% CI, -2.2 to -0.6 mmHg; P<0.001), whereas in the control analysis, the respective value was 0.3 mmHg lower (95% CI, -1.0 to 0.5; P = 0.410). CONCLUSIONS: Optic disc hemorrhages were associated with diabetes and aspirin use and were observed at relatively lower IOP during follow-up.

Adult↗

PubMed2003

Mortality, morbidity, and costs of ruptured and elective abdominal aortic aneurysm repairs in Nova Scotia, Canada.

Ruptured abdominal aortic aneurysms (RAAA) have a 78-94% mortality rate. If cost-effectiveness of screening programs for abdominal aortic aneurysms (AAA) are to be assessed, direct costs for RAAA repairs and elective AAA (EAAA) repairs are required. This study reports mortality, morbidity, and direct costs for RAAA and EAAA repairs in Nova Scotia in 1997-1998 and also compares Nova Scotia and U.S. costs. We performed a retrospective study of 41 consecutive RAAA and 48 randomly selected EAAA patients. Average total costs for RAAA repair were significantly greater than those for EAAA repair (direct costs: $15,854 vs. $9673; direct plus overhead costs: $18,899 vs. $12,324 [pricing in 1998 Canadian dollars]). Intensive care unit length of stay and blood product usage were the most substantial direct cost differentials ($3593 and $2106). Direct cost for preoperative testing and surveillance was greater in the EAAA group ($839 vs. $33). Estimates of U.S. in-hospital RAAA and EAAA repair costs are more than 1.5 times Nova Scotia costs. Direct in-hospital RAAA repair costs are $6181 more than EAAA repair costs. These in-hospital cost data are key cost elements required to assess the cost-effectiveness of various screening strategies for earlier detection and monitoring of AAA within high-risk populations in Canada. Further studies are required to estimate cost per quality-adjusted-life-year gained for various AAA screening and monitoring strategies in Canada.

Aged↗

PubMed2003

The effect of two configuration factors, time, and thermal cycling on resin to dentin bond strengths.

Most in vitro testing of bonding systems is performed using specimens made in a mold with a low configuration (C) factor (ratio of bonded/unbonded surfaces) whereas clinically the C-factor is usually much greater. This study compared the effect of thermal cycling on the measured shear bond strength of 3M Single Bond dental adhesive bonded to dentin using molds with two different C-factors. The hypothesis was that neither C-factor nor thermal cycling would affect measured bond strengths. Resin composite was bonded to human dentin in cylindrical molds with an internal diameter of 3.2mm and either 1mm or 2.5mm deep. The 1mm deep molds had a C-factor of 2.2 and the 2.5mm deep molds had a C-factor of 4.1. Specimens were debonded either 10min after they had been bonded to dentin, or after they had been stored for 7 days in water at 37+/-1 degrees C, or after thermal cycling 5000 times for 7 days. Two-way ANOVA showed that overall both the C-factor and the storage condition had a significant effect on bond strength (p<0.001). There was a significant interaction (p<0.001) between the C-factor and how the specimens had been stored. The GLM/LSMEANS procedure with Sidak's adjustment for multiple comparisons showed that overall the specimens made in the mold with a high C-factor (4.1) had a lower bond strength than those that had been made in the mold with a lower (2.2) C-factor (p<0.001). Thermal cycling had a negative effect on the bond strength only for specimens made in molds with a C-factor of 4.1 (p<0.001).

Acrylic Resins↗

PubMed2003

Evaluation of a second-generation LED curing light.

BACKGROUND: Light-emitting diode (LED) curing lights offer advantages over quartz-tungsten-halogen (QTH) lights, but the first-generation LED lights had some disadvantages. PURPOSE: This study compared a second-generation LED light with a QTH light to determine which was better at photopolymerizing a variety of resin composites. METHODS: The ability of a LED light used for 20 and 40 seconds to cure 10 resin composites was compared with that of a QTH light used for 40 seconds. The composites were 1.6 mm thick and were irradiated at distances of 2 and 9 mm from the light guide. The Knoop hardness at the top and the bottom of each composite was measured at 15 minutes and 24 hours after irradiation. RESULTS: The different curing lights and irradiation times did not have the same effect on all of the composites (p < 0.01). For specimens analyzed 24 hours after irradiation, the LED light used for 20 seconds cured 5 of the composites as well as when the QTH light was used for 40 seconds (p > 0.01). When used for 40 seconds, the LED light cured 6 of the composites as well as when the QTH light was used (p > 0.01), and all 10 composites achieved more than 80% of the hardness produced with the QTH light. CONCLUSIONS: This LED light could not polymerize all of the composites as well as the QTH light. However, when used for 40 seconds, it cured more than half of the composites as well as when the QTH light was used, and all of the composites achieved a hardness comparable to that produced with the QTH light.

Composite Resins↗

PubMed2003

Comparison of quartz-tungsten-halogen, light-emitting diode, and plasma arc curing lights.

PURPOSE: This study determined which light source was best at photopolymerizing five representative brands of resin composite. The hypothesis was that there would be no difference in the hardness of the composites when irradiated by any of the lights. MATERIALS AND METHODS: Six curing light/tip combinations were used to photopolymerize five resin composites. In accordance with the manufacturer's instructions, the PAC light was used for 3 s and the high intensity QTH light was used for 5 s. The other QTH and LED lights were used for 40 s. To represent the clinical environment, the samples were irradiated at a distance of 2 and 9 mm away from the tip of the light guide. The Knoop hardness was measured at the top and bottom of the composites after 15 min and again at 24 h. The hardness data were compared using a general linear model analysis with Sidak's adjustment for multiple comparisons with p < 0.01 as the level of significance. RESULTS: The 6 curing light/tip combinations had different effects on the hardness of the 5 composites (p < 0.01). The two LED lights could not cure the neutral shade of Pyramid Enamel in 40 s. As the distance increased from 2 to 9 mm, the decrease in hardness was not similar amongst the different light/tips and composite combinations (p < 0.0012). The curing light/tip combination which delivered the greatest total energy produced the hardest specimens. CONCLUSION: 1) The 6 curing light/tip combinations had different effects on the hardness of the 5 composites (p < 0.01). 2) Neither of the two LED lights used was able to adequately polymerize the five resin composites tested. 3) The QTH light, which delivered the greatest total energy, always produced the hardest resin composite. 4) When the distance of the composites from the light guides was increased, the effect on their hardness was not the same for all light/tip combinations. It is therefore not possible to predict the performance of a curing light at 9 mm based upon power density measurements or hardness data recorded when the tip of the light guide is 2 mm away.

Composite Resins↗

PubMed2002

Blood volume monitoring in intermittent hemodialysis for acute renal failure.

BACKGROUND: Although hypotension commonly accompanies intermittent hemodialysis for acute renal failure (ARF) in the intensive care unit (ICU), little is known about how it may be prevented. Online relative blood volume (RBV) monitoring has been used to reduce hypotension in chronic hemodialysis, but is of unproven benefit in ARF. This study tested the hypothesis that hypotension is predictable using online RBV monitoring in patients dialyzed for ARF in an ICU setting. METHODS: The primary definition of hypotension was mean arterial pressure (MAP) <70 mm Hg; systolic blood pressure (SBP) <100 mm Hg was used as a secondary outcome. Fifty-seven treatments were prospectively studied in twenty consecutive adult patients treated with intermittent hemodialysis. RBV was continuously measured using the Hemoscan device (Gambro). RESULTS: Hypotension occurred in 30% of treatments as defined by MAP, and 18% as defined by SBP. There was no evidence of patient-specific or universal RBV thresholds that were associated with hypotension. Analysis using the kappa statistic showed that concordance of RBV and hypotension (that is, RBV falling prior to hypotensive episodes rather than rising or remaining stable) was no greater than chance. RBV and rate of change in RBV slopes did not predict hypotension as a dichotomous outcome, and were not correlated with MAP or SBP whether autocorrelation was corrected for or neglected. Substituting rate of change in RBV (RBV slopes) for absolute RBV values did not improve predictive power. CONCLUSIONS: These results suggest that strategies based on online RBV monitoring are unlikely to reduce hypotension in intermittent hemodialysis for ARF that is delivered through central venous catheters.

Acute Kidney Injury↗

PubMed2002

Platelet transfusions in children: results of a randomized, prospective, crossover trial of plasma removal and a prospective audit of WBC reduction.

BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) complicate 2 to 37 percent of platelet transfusions in adults, but the incidence of such reactions in children is not known. The effectiveness of plasma reduction after storage and WBC reduction of platelet concentrates before storage was studied in pediatric recipients of platelet transfusions. STUDY DESIGN AND METHODS: In the first study, a prospective randomized crossover design was used in which patients received either unmodified whole-blood-derived or apheresis platelets or platelets from which most of the plasma supernatant had been removed just before transfusion. The second study was a prospective audit of recipients of prestorage WBC-reduced platelets. Children between 3 months and 17 years of age were eligible for both studies. Patients were assessed for signs and symptoms that are characteristic of a reaction during, immediately after, and 2 hours following transfusion. RESULTS: There were 226 platelet transfusions administered to 66 children. One hundred and sixty transfusions were given to 35 children enrolled in the randomized study, and 66 transfusions were given to 33 children during the audit. In the randomized study, nine of the 75 transfusions of unmodified platelets (12%) and six of 85 transfusions of poststorage plasma-removed platelets (7%) were associated with an FNHTR (p=0.42). In the audit, three of 66 transfusions of prestorage WBC-reduced platelets (5%) were associated with an FNHTR. Allergic reactions occurred with 5 percent (4 of 75), 6 percent (5 of 85), and 6 percent (4 of 66) of platelet transfusions, respectively. CONCLUSION: FNHTRs appear to be less common among pediatric recipients of platelet transfusions than in adults. In our two studies, there was a trend toward a lower frequency of FNHTRs with poststorage plasma removal and prestorage WBC reduction than with standard platelets, but this was not significant.

Adolescent↗

PubMed2002

Effect of light source and specimen thickness on the surface hardness of resin composite.

PURPOSE: To compare the Knoop hardness of different thicknesses of resin composite irradiated using either a plasma arc curing (PAC) light, or a quartz tungsten halogen (QTH) light. MATERIALS AND METHODS: A 2.5-mm diameter hole was drilled through the center of 2, 3, 4, and 5-mm thick discs of enamel and dentin. This hole was filled with either Filtek P60 or Prodigy Condensable composite and irradiated in bulk using: (a) a PAC light with an 8-mm, 470 nm light guide for 3 seconds, (b) a QTH light with an 8-mm standard light guide for 40 seconds (QTH+S), or (c) a QTH light with a 13/8-mm Turbo light guide for 40 seconds (QTH+T). Immediately after irradiating the composite, the surface hardness was measured at the bottom and then the top. Hardness values were remeasured after 24-hour and 7-day storage in water at 37 degrees C. The hardness values were compared using the Analysis of Variance for Repeated Measures and Least Squares Means test for multiple comparisons (LSM test) at P< 0.05. RESULTS: The power density delivered by each light was: PAC over 1999 mW/cm2, QTH+S 588 mW/cm2, and QTH+T 844 mW/cm2. Both the thickness of the composite and the light source had a significant effect on the hardness. Overall, using the QTH+T produced the highest hardness values and the PAC light the lowest values. For all 2-mm thick specimens, irrespective of the light source, the hardness values at the bottom were not significantly different from their top hardness values measured at the same time. For the 3-mm thick specimens using the QTH+T, the hardness values at the bottom of both composites were not significantly different from their top hardness values at all time intervals. For the 3-mm thick specimens using the QTH+S, the bottom hardness values were not significantly different from those at the top for P60 only, and only at 24 hours and 7 days, but not when measured immediately. For all the 4 and 5-mm thick specimens, the hardness values at the bottom were all significantly different from those at the top measured at the same time interval.

Analysis of Variance↗