The study aimed to evaluate the quality of the hybridlayer form by three different adhesive systems. Class Vcavities were prepared on the buccal surface of fourtyextracted human premolars. The prepared teeth wererandomly assigned into four groups according to theadhesive system and application mode. The systemswere: Optibond S (OS, total-etch); Optibond Versa (OV,two-bottles, self-etch); Single Bond Universal (SBU,one-bottle, self-etch) and Single Bond Universal withetchant (SBU + etchant). All cavities were restored withcomposite (Filtek Z350XT). The samples were sectioned,polished and pretreated to remove minerals, proteinand water prior to SEM evaluation. From the images,thickness of the hybrid layers was measured. Present ofresin tags and adaptation failure were also recorded. Thedata obtained were analyzed using ANOVA, Dunnett’sT3, Kruskal-Wallis and Mann-Whitney tests. OS groupshowed the highest average hybrid layer thickness (4.34µm), followed by SBU + etchant (3.06 µm), OV (1.91 µm)and SBU (0.95 µm). Both adhesive and cohesive failureswere observed in SBU group. Present of prominent resintags were seen in both OS and OV groups. In conclusion,all the investigated adhesive systems were able to performdistinguishable actions as shown in micro-morphologicalalteration and hybrid layer thickness. Two-bottles, selfetchadhesive (OV) was proven to produce negligibleadaptation failure compared to other adhesive systems inthe present study. Combined all-in-one adhesive (SBU)was found to render a superior bonding performance intotal-etch mode comparing to self-etch mode.

INTRODUCTIONNew-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre.

MATERIALS AND METHODSWe retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT.

RESULTSAmong 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival.

CONCLUSIONOur study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.

Adult ; Blood Glucose ; analysis ; Diabetes Mellitus ; etiology ; genetics ; Female ; Graft Rejection ; complications ; HLA-B Antigens ; analysis ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Risk Factors

INTRODUCTIONFamily caregivers of cancer patients often suffer from impaired quality of life (QOL) due to stress arising from the responsibility of caregiving. Most research on such QOL impairments was conducted in Western populations. Thus, this exploratory study sought to (a) examine the QOL levels of family caregivers of cancer patients in an Asian population in Singapore, in relation to caregivers from other countries within and outside of Asia; and (b) investigate the association between sociodemographic factors and QOL impairments in family caregivers in Singapore.

METHODSA total of 258 family caregivers of cancer patients who were receiving outpatient treatment completed the Caregiver Quality of Life Index-Cancer (CQOLC) and a sociodemographic survey. We compared the published CQOLC total scores from Turkey, Iran, Taiwan, South Korea, the United Kingdom, the United States and Canada with the Singapore dataset and examined the demographic relationships.

RESULTSCaregivers in Singapore and Asia had lower CQOLC total scores than their Western counterparts. Caregivers who were male, of Chinese ethnicity, had parental relationships with their care recipient, or cared for advanced-stage cancer patients were found to have impaired QOL.

CONCLUSIONThe findings of this study highlight possible areas in which support can be provided for family caregivers of cancer patients, and underscore the need to reconcile cultural diversity, values, societal expectations and demographic characteristics in Singapore.