جستجوی مقالات مرتبط با کلیدواژه « instrumentation » در نشریات گروه « پزشکی »

Introduction:

This study used different irrigation techniques to compare the levels of apical bacterial extrusion during the preparation of root canals with a reciprocating instrument widely used in endodontics, the Reciproc files 25/0.08 and 40/0.06.

The irrigation techniques employed were conventional syringe irrigation and passive ultrasonic irrigation (PUI); the latter, with one or two activation cycles. Seventy extracted mandibular human premolars were contaminated with Enterococcus faecalisfor 5 days and were distributed into 6 experimental groups (n=10), and the remaining specimens were used as positive and negative control groups (n=5). Group 1: instrumentation performed with Reciproc 25/0.08 and conventional syringe irrigation; Group 2: instrumentation performed with Reciproc 25/0.08 along with PUI for one minute after instrumentation (PUI-1) ; and Group 3: instrumentation performed with Reciproc 25/0.08 along with PUI for one minute before and after instrumentation (PUI-2). Groups 4, 5 and 6 were instrumented with Reciproc 40/0.06, and irrigation was performed similar to the previous groups, in the aforementioned order. Each root canal was irrigated with saline solution. Extruded debris was collected in microtubes. The contents of the microtubes were homogenized, diluted, and spread on Brain Heart Infusion agar. After 48 hours, the number of colony-forming units was determined for each sample. For statistical analysis, the Kruskal-Wallis test followed by the Dunn’s tests were used (α=0.05).

The CFU/mL count indicated that the instrumentation with Reciproc 25/0.08 was associated with the highest bacterial extrusion, mainly when PUI was performed (P<0.05).

All the instrumentation techniques caused bacterial extrusion through the apical foramen; however, the largest file size of the Reciproc 40/0.06 groups was associated with less apical bacterial extrusion.

Improper use of standards for measurement instruments can impact the accuracy of study results. 

This study systematically reviews the Instruments for measuring pain intensity during venous catheter insertion in preschool children.

In this systematic review, conducted from October 2023 to January 2023, an open search was carried out for articles in domestic databases, such as scientific information database (SID), MagIran, and Iran Medex, and international databases, including PubMed, CINAHL, Web of Science, and Scopus using the following keywords: Preschool period, pain intensity, cannulation, vein removal, pain scale, pain relief, pain perception, and pain sensation. The objective of this search was to examine the measurement tools utilized to assess pain intensity during venipuncture in preschool-aged children without a time restriction. Duplicate articles were excluded, and other studies meeting the inclusion criteria were reviewed. Articles were assessed by two researchers, and any discrepancies were resolved by a third author.

Among all the reviewed studies, 21 articles that were conducted between 2001 and 2023 met the inclusion criteria. The tools utilized in these studies to assess pain intensity during venous catheter insertion in preschool children included face, legs, activity, cry, and consolability (FLACC), Wong-Baker, Oucher scale, visual analog scale, and Poker Chip scale. The Wong-Baker instrument was a self-assessment, FLACC were assessed by both the researcher and a reviewer, Oucher was a self-assessment, the visual analog scale was assessed by parents and reviewers, and the Poker Chip scale was a self-assessment.

Researchers who do not adhere to tool standards often opt to utilize tools based on the methods of other studies or their requirements, which could potentially impact the outcomes of their studies

Traumatic sacral spondylosis is a sporadic injury pattern, and frequently, it is accompanied by injury to the cauda equina with perineal numbness, paralysis of sphincters, and sacral root weakness.

A 35-year-old male complained of low back pain, left-sided dropped foot, and sphincter dysfunction after 9 meters fall. On imaging, he had S1-S2 spondylosis. We operated on the patient with a single posterior approach. The L3-S3 instrumented fusion after stepwise distraction to reduce deformity concomitant with L5-S2 laminectomy and foraminotomy. After two years of follow-up, the sphincter disturbance was relieved, but the limb deficit had no change. On follow-up images, the fusion between S1 and S2 was confirmed.

We recommend surgical treatment of this injury to allow some neurological improvement and stabilize the spine on the pelvis. Also, the operation must be delayed for days to rule out any intra-pelvic life-threatening, primarily vascular injury. A stepwise intraoperative distraction on not curved rods could be helpful in the reduction of this deformity.

How people react to stressful and painful situations, such as suffering from a chronic disease like multiple sclerosis, is influenced by various factors, one of which is self-compassion. Self-compassion has a psychological nature and significant efficiency in the care and treatment of chronic patients. Existing tools have not paid attention to the characteristics of people suffering from chronic diseases such as MS in using self-compassion for managing the disease. Therefore, the present study aimed to design a questionnaire to measure self-compassion in patients with MS.

Instrument & Methods:

The present study is methodological research that was conducted in qualitative and quantitative parts. The items were designed based on the qualitative part of the study and review of texts. The validation characteristics of the questionnaire were performed using face validity, content, and structure. The reliability was assessed by internal consistency and stability methods.

In the qualitative phase, 78 initial items were extracted. After calculating the item impact score index with values higher than 1.5, content validity ratio higher than 0.51, and content validity index higher than 0.79, 73 items were selected. Confirmatory and then exploratory factor analysis was performed. The internal consistency of the questionnaire was 0.813, and the stability of the questionnaire was 0.778.

Self-compassion scale in patients with MS is a valid and reliable tool in Iranian society. Since Neff theory was used as a guiding framework in this study, the tool can also be used for non-Iranian patients to understand their perception and experiences.

 The development of C5 root palsy is a well-known potential complication of cervical spine surgeries for the correction of cervical spondylotic myelopathy. It typically occurs unilaterally but on extremely rare occasions it might occur as a bilateral anomaly. The value of intraoperative neurophysiologic monitoring in detection of iatrogenic acute versus delayed onset C5 palsy, the rarity of bilateral C5 palsy and its optimal management requires further

Case Description: A 49-year-old woman with quadriparesis due to cervical spondylotic myelopathy is presented. She underwent circumferential 360’ degree cervical spine surgery. This operation was subsequently complicated by a delayed bilateral C5 palsy, despite normal transcranial motor evoked potentials (MEPs). With the utilization of conservative treatment options, the complete resolution of this complication took roughly eight months.

Bilateral C5 palsy is an extremely rare consequence of a multilevel cervical spine surgeries. Although, intraoperative monitoring of transcranial electrical stimulation–induced motor evoked potentials (MEPs) have high sensitivity and specificity in foreseeing acute onset C5 palsy, it cannot predict delayed onset palsy. With consideration of the current case, only 7 previously reported cases within all of medical literature. Further, conservative management in adherence to rigorous physical therapy may be an acceptable treatment

The aim of this study was to evaluate the retention of implant‑supported overdentures with different attachment systems.

In this in vitro study edentulous model with 2 Straumann implant in symphyseal region was used to make an overdenture with different attachment systems. (Dolder bar with 1 and 3 metal clips, Hader bar with 1 and 3 plastic clips, ball on bar with 2 and 4 plastic caps, Locator, Rhein plastic caps and Eleptical matrix). Retention values were recorded by universal testing machine with a cross speed of 50.8 mm/min in vertical, posteroanterior, and lateral direction. Repeated measure ANOVA and Duncan tests were used for the data analysis (α =0.05).

There was a statistically significant difference between the retention values of studied attachments in different dislodgment directions (P < 0.05).The highest and lowest retention were recorded for 4 balls on bar (56.71 N) and Rhein pink caps(27.89 N) in the vertical direction.Three metal clips (61.43 N) and Rhein pink cap (24.77 had the highest and lowest retention force in the posteroanterior direction. In the lateral direction, 4 balls on bar (62.68 N) and 1 plastic clip (32.27 N) showed the highest and lowest retention, respectively.

If the higher retention force has been considered for implant‑supported overdenture attachment selection, the clinician can use splinted bar or ball on bar superstructure.

Prevention of dentinal crack formation is of utmost importance in endodontic treatment. This study aimed to evaluate the effect of RaCe, ProTaper, and V-Taper rotary systems on dentinal crack formation in three root regions during endodontic treatment.

Seventy human mandibular first molars were selected randomly, and their distal roots were used. Ten samples were assigned to the control group, and sixty samples were assigned to three groups (n=20). Each group was prepared with RaCe, ProTaper, or V-Taper rotary files according to the manufacturers’ instructions. A stereomicroscope was used to view cracks at ×40 magnification. Friedman’s, chi-squared, and Kruskal-Wallis tests were used for statistical analysis of data (P<0.05).

A comparison of the three rotary systems did not reveal any significant differences in the number of cracks between the three root thirds evaluated (P>0.05). A comparison of the number of cracks in the coronal, middle, and apical thirds in each rotary system showed that the number of cracks in the middle third was fewer than that in the two other thirds only in the V-Taper group (P<0.05), with no significant differences in the ProTaper and RaCe groups between the different root regions (P>0.05).

The application of RaCe, ProTaper, and V-Taper rotary files resulted in a similar rate of crack formation in endodontic treatment. V-Taper files created the minimum number of cracks in the middle third.

 Use of rotary files in root canal preparation is inevitable due to their high speed and reduced duration of treatment. However, microcracks and even root fracture may sometimes occur in teeth where canal(s) is/are prepared using these devices. The purpose of the current study was to compare NeoNiti single-file with RaCe multi-file rotary systems. 

 An accurate scanner designed detailed three-dimensional file models, and a simulated model was developed using canal-specific features; including dentin thickness, root canal length, taper rate and root canal curvature. Cleaning and shaping conditions were simulated with appropriate speed and crack conditions for both types of files on the computer. Strain accumulation sites in the root dentin wall where microcracks was likely to occur were simulated and investigated. Abaqus and ANSYS software were used to perform finite element simulations. 

 RaCe files with 0.04 taper caused the lowest level of stress (34.33 MPa) to the simulated canal. Conversely, the highest level of stress (62.35 MPa) was applied by 8% NeoNiti file to the simulated canal. 

 Based on the present experimental study, it can be concluded that RaCe multi-file rotary system may better be used in endodontic therapy, and the risk of microcracks in the tooth wall is less than that of NeoNiti single-file rotary system.

Frailty syndrome involves a complex combination of the natural process of getting old with different medical problems. Different indexes have been designed for each physical, mental, and social dimensions of frailty. Fried’s five-item index of frailty syndrome checklist is one of the most applicable scales to screen frailty. This study aimed to determine a psychometric index of frailty and the cut-off points for the Iranian elderly population.

In a cross-sectional and psychpmetric study, 249 frail elderly people were selected among members of two Iranian Army Retirees Clubs in 2019. This was a cross-sectional-psychometric study which aimed at  determining the psychometric index and cut-off points of a brief checklist of 5-item FSC among Iranian adults older than 60 years old and comparing this to prior results in different countries.

The data were analyzed by ANOVA, multi-variable regression, confirmatory, and exploratory factor analysis, and ROC analysis via SPSS 25 and AMOS 24. The validity of the study findings was determined by internal validity, high correlation of 5 questions, confirmatory and exploratory factor analysis of 3 subdomains with a clarity value of 0.87, and high goodness of fit index (GFI).

The determined cut-off points were compatible with those of Fried’s prior study. The designed tools used in this study evaluated frailty syndrome of the Iranian elderly in elderly rehabilitation studies with high confidence. The application of the tool would provide caregivers and policymakers with additional information as to caring for this population.

 We aim to evaluate the cyclic and torsional fatigue resistance of two rotary instruments, Hyflex CM 25/0.06 (HCM) (Coletene-Whaledent, Allstetten, Switzerland) and Aurum Blue (AB) 25/0.06 (Meta-Biomed, Republic of Korea). 

Methods and Materials:

 Forty rotary instruments, HCM 25/0.06 and AB 25/0.06 (n=20 each) were used. The instruments were rotated in an artificial stainless steel canal with a 60° angle and a 5-mm radius of curvature (n=10) at body temperature (35°±1°C). The torsional test evaluated the torque and angle of rotation at failure of new instruments (n=10) in the portion 3 mm from the tip according to ISO 3630-1. The fractured surface of each fragment was observed by scanning electron microscopy. The data were analyzed using unpaired student’s t- test, and the level of significance was set at 5%. 

AB 25/0.06 had significantly greater number of cycles to failure than HCM 25/0.06 (P<0.05). The torsional test showed there were no significant differences in the torsional strength and angular rotation to fracture between the groups (P>0.05). 

 Based on this in vitro study, AB 25/0.06 instrument was more resistant to cyclic fatigue than the HCM 25/0.06 instrument, suggested that these instruments are safer than HCM 25/0.06 for the preparation of severely curved canals. However; there was no significant difference in the torsional properties of the two instruments then appear to have similar performance during constricted canal preparation.

Abstract Background. The aim of this in vitro study was to compare the effectiveness of WaveOne and ProTaper Gold system in removing the Enterococcus faecalis biofilm. Methods. 38 mandibular premolars were selected. The canals were assigned to standard control groups (canals serially enlarged with ProTaper Gold S1-S2-F1-F2, n=15) and experimental (canals enlarged with Primary WaveOne file, n=15). Canals were sampled after the instrumentation procedures, and the colony forming units (CFU) count was evaluated. Samples were also visualized under a fluorescent microscope to count viable bacteria. Data were statistically analyzed using Independent Sample T-test and Paired Sample T-test. Results. Results showed that in comparison with the ProTaper group, WaveOne group displayed the least viable bacteria (P=0.004), Conclusions. Therefore, we concluded that the WaveOne reciprocating file is more successful in reducing intratubular viable bacteria compared with the ProTaper Gold rotary system.

A large number of nursing students work while studying to gain clinical experience, but there is not a standard tool to evaluate the clinical competence areas affected by working while studying.

The current study aimed at explaining the role of clinical work while studying in the clinical competence of novice nurses and the development of a valid and reliable instrument to measure it.

The current study employed an exploratory sequential mixed method design in two steps. First, qualitative research was conducted using conventional content analysis on 45 participants. The semi-structured, in-depth interviews (nurses, head nurses, and nurse managers) were performed, and data were analyzed using the eight steps of Elo and Kyngas. Second, based on the categories extracted from the first phase of the study and review of literature, 215 items were designed and analyzed in a methodological process.

The results of the first phase consisted of three themes, including task rearing role, personality rearing role, and knowledge rearing role. Exploratory factor analysis leads to the formation of three factors: professional abilities with 18 items, individual abilities with seven items, and scientific and educational abilities with six items. Calculating Cronbach’s alpha coefficient confirmed high internal consistency in the scale (0.94).

This tool could be used in teaching hospitals to evaluate the situation of working while studying in hospitals at different levels. With this tool, nursing managers can optimize educational environments and plan the workshops and training courses for nurses working in the departments in order to strengthen the qualifications of nursing students while working and graduating.

Considering the increasing prevalence rate of smoking among Iranian adolescents, and recent evidence on the relationship between obscenity of smoking and tendency of adolescents towards the behavior, there is a need for an appropriate measurement tool to measure the level of obscenity on cigarette smoking among adolescents. This study was conducted to develop a valid and reliable questionnaire for measuring the obscenity of cigarette smoking in adolescents.

This study was conducted in Tabriz, Iran, using an exploratory sequential mixed methods design. To explain the concept of obscenity and develop the questionnaire’s items, 18 students attended semi-structured individual interviews and 13 others took part in focus group discussions (FGDs) in three groups of 4-5. Extracting and summarizing the codes derived from the interviews, an item pool was developed, from which the initial draft of the scale was provided. Next, the psychometric properties of the scale were assessed using face, content, construct, and predictive validity, as well as internal consistency, and reliability in a sample of 1013 high school students.

The 22-item Cigarette Smoking Obscenity Scale (CSOS) was developed based on the codes derived from qualitative data. Explanatory factor analysis revealed five-factor structure (Negative Attitude; Negative Consequence; Negative Valuation; Inappropriate Relationship; A gateway to addiction). In confirmatory factor analysis, the χ2 /df ratio was 3.911 for the CSOS five-factor structure. Suitable values were obtained for the goodness of fit indices (GFI=0.88, AGFI=0.85, NFI=0.87, IFI=0.90, CFI=0.90, RFI=0.85, and RMSEA=0.072). The Cronbach’s alpha and intraclass correlation (ICC) coefficients for the constructs ranged between 0.77 to 0.90 and 0.80 to 0.91, respectively.

The validity and reliability of the CSOS was appropriate; therefore, it can be used in future studies as a suitable tool for measuring the obscenity of cigarette smoking in adolescents.

The complications of unwanted surface roughness of composite restorations are highly common due to the increasing use of this restorative material. Therefore, the present study was designed to compare the effect of four finishing and polishing (F&P) tools on surface roughness of microhybrid resin composites.

This experimental study was performed on 42 samples of CLEARFIL™ AP-X ​​microhybrid composite, which were divided into four groups of different F&P methods and one control group as follows: control (n=2), Flexi-D discs (n=10), Flexi-D + diamond polishing paste (n=10), Intensive twisted rubber polisher (n=10), and Rubber Polisher Teco (n=10). The samples were examined by profilometry. Surface roughness (Ra) of each specimen was measured at three points, and the mean value was considered as surface roughness. The results were analyzed by analysis of variance (ANOVA) and post hoc statistical tests.

The surface roughness of composite discs in an ascending order was as follows: control (0.048±0.014 µm), Flexi-D disc (0.179±0.132 µm), Intensive twisted rubber polisher (0.233±0.105 µm), Flexi-D disc with diamond polishing paste (0.232±0.141 µm), and Rubber Polisher Teco (0.251±0.087 µm; P=0.001). The difference between the two groups of Flexi-D disc with diamond polishing paste and Rubber Polisher Teco was not statistically significant (P=0.742). The level of surface roughness in Flexi-D samples was significantly lower than that of the other samples (P<0.05).

It seems that the Flexi-D disc is the best F&P tool for microhybrid resin composites.