PURPOSE: This in vitro study investigated the fracture resistance of endodontically treated premolars restored using silorane- or methacrylate-based composite along with or without fiber or nano-ionomer base. MATERIALS AND METHODS: Ninety-six intact maxillary premolars were randomly divided into eight groups (n = 12). G1 (negative control) was the intact teeth. In Groups 2-8, root canal treatment with mesio-occlusodistal preparation was performed. G2 (positive control) was kept unrestored. The other groups were restored using composite resin as follows: G3, methacrylate-based composite (Z250); G4, methacrylate composite (Z250) with polyethylene fiber; G5 and G6, silorane-based composite (Filtek P90) without and with the fiber, respectively; G7 and G8, methacrylate- and silorane-based composite with nano-ionomer base, respectively. After aging period and thermocycling for 1000 cycles, fracture strength was tested and fracture patterns were inspected. The results were analyzed using ANOVA and Tukey HSD tests (alpha=0.05). RESULTS: Mean fracture resistance for the eight groups (in Newton) were G1: 1200 +/- 169a, G2: 360 +/- 93b, G3: 632 +/- 196c, G4: 692 +/- 195c, G5: 917 +/- 159d, G6: 1013 +/- 125ad, G7: 959 +/- 148d, G8: 947 +/- 105d (different superscript letters revealed significant difference among groups). Most of the fractures in all the groups were restorable, except Group 3. CONCLUSION: Silorane-based composite revealed significantly higher strength of the restored premolars compared to that of methacrylate one. Fiber insertion demonstrated no additional effect on the strength of both composite restorations; however, it increased the prevalence of restorable fracture of methacrylate-based composite restored teeth. Using nano-ionomer base under methacrylate-based composite had a positive effect on fracture resistance and pattern. Only fiber-reinforced silorane composite restoration resulted in a strength similar to that of the intact teeth.
Aging ; Bicuspid* ; Dental Pulp Cavity ; Polyethylene ; Prevalence ; Silorane Resins ; Tooth

OBJECTIVES: The risk factors for miscarriage vary across communities and countries. This study was conducted to investigate the predictors of miscarriage in the west of Iran. METHODS: This matched case-control study was conducted in Hamadan Province from April 2013 to March 2014. Cases were selected from women who had a recent spontaneous abortion and controls were selected from women who had a recent live birth. Two controls were selected for every case and matched for date of pregnancy and area of residence. Multivariate conditional logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Five hundred fifty cases were compared with 1,091 controls. The OR of miscarriage was 1.58 (95% CI=1.30-1.92) for every five-year increase in age, 0.20 (95% CI=0.14-0.28) for every live birth, and 3.43 (95% CI=2.03-5.79) for a history of previous spontaneous abortion. Compared to nulliparous women, primiparous or multiparous women had an OR of 17.85 (95% CI=6.65-47.91) for miscarriage. There was a strong association between miscarriage and abnormal amniotic status (OR, 2.46; 95% CI, 0.46-13.09) and also abnormal placenta status (OR, 10.44; 95% CI, 0.95-114.92); however, these associations were not statistically significant. No significant associations were observed between miscarriage and body mass index, previous history of stillbirth, low birth weight, congenital anomaly, ectopic pregnancy, impaired thyroid function, or high blood pressure. CONCLUSIONS: Our study suggests that miscarriage is a multifactorial outcome associated with several modifiable and non-modifiable risk factors that may vary among different communities.
Abortion, Habitual ; Abortion, Spontaneous* ; Body Mass Index ; Case-Control Studies* ; Female ; Humans ; Hypertension ; Infant, Low Birth Weight ; Infant, Newborn ; Iran ; Live Birth ; Logistic Models ; Odds Ratio ; Placenta ; Pregnancy ; Pregnancy, Ectopic ; Risk Factors ; Stillbirth ; Thyroid Gland

PURPOSE: Spine injury is one of the leading causes of death and mortality worldwide. The objective of this study was to determine the incidence, pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years. METHODS: This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran. The data collection form included the age, sex, injury location (cervical, thoracic, and lumbar), cause of injury (traffic accidents, falls, and assaults), length of hospital stay, injured segment of spine injury, severity of injury, and outcome. Statistical analyzes were performed using SPSS software version 24. RESULTS: Totally 776 cases of spine injury were identified. The spine injury rate was 17.0%, and the mortality rate was 15.5%. Cervical spine injury (20.4%) more often occulted in motorcycle accident, and thoracic spine injury (20.1%) occulted in falls. The highest and lowest rates of spine injurys were related to lumbar spine injury (30.2%) and cervical spine injury (21.5%), respectively. There was a statistically significant relationship between the mechanism of injury and the location of spine injury (p < 0.001). And patients with lumbar spine injury had the highest mortality rate (16.7%). Injury severity score (OR= 1.041, p < 0.001) and length of stay (OR = 1.018, p < 0.001) were strong predictors of mortality in trauma patients with spine injury. CONCLUSION The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0% in southern of Iran. Road traffic injury and falls are the common mechanism of injury to spine. It is important to improve the safety of roads, and passengers, as well as work environment, and improve the quality of cars. Also, paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.
Humans ; Incidence ; Trauma Centers ; Iran/epidemiology* ; Cross-Sectional Studies ; Spinal Injuries/etiology* ; Neck Injuries ; Accidents, Traffic

PURPOSE: The triage and initial care of injured patients and a subsequent right level of care is paramount for an overall outcome after traumatic injury. Early recognition of patients is an important case of such decision-making with risk of worse prognosis. This article is to answer if clinical and paraclinical signs can predict the critical conditions of injured patients after traumatic injury resuscitation. METHODS: The study included 1107 trauma patients, 16 years and older. The patients were trauma victims of Levels I and II triage and admitted to the Rajaee (Emtiaz) Trauma Hospital, Shiraz, in 2014-2015. The cross-industry process for data mining methodology and modeling was used for assessing the best early clinical and paraclinical variables to predict the patients' prognosis. Five modeling methods including the support vector machine, K-nearest neighbor algorithms, Bagging and Adaboost, and the neural network were compared by some evaluation criteria. RESULTS: Learning algorithms can predict the deterioration of injured patients by monitoring the Bagging and SVM models with 99% accuracy. The most-fitted variables were Glasgow Coma Scale score, base deficit, and diastolic blood pressure especially after initial resuscitation in the algorithms for overall outcome predictions. CONCLUSION Data mining could help in triage, initial treatment, and further decision-making for outcome measures in trauma patients. Clinical and paraclinical variables after resuscitation could predict short-term outcomes much better than variables on arrival. With artificial intelligence modeling system, diastolic blood pressure after resuscitation has a greater association with predicting early mortality rather than systolic blood pressure after resuscitation. Artificial intelligence monitoring may have a role in trauma care and should be further investigated.

PURPOSE: Traumatic hemorrhagic shock is a life-threatening event worldwide. Severe brain trauma accompanying femoral fractures can trigger inflammatory responses in the body and increase pre-inflammatory cytokines such as TNF-α, IL-1. The primary treatment in these cases is hydration with crystalloids, which has both benefits and complications. The purpose of this study was to investigate the effects of fluid therapy on the hemodynamics, coagulation profiles, and blood gases in such patients. METHODS: In this cross-sectional study, patients were divided into two groups: femoral fracture group and non-femoral group. The hemodynamic status, coagulation profile, and blood gases of patients in both groups were evaluated upon arrival at the hospital and again 2 h later. Data were analyzed by t-test and ANOVA with repeated data and paired samples t-test. RESULTS: A total of 681 trauma patients (605 men and 76 women) participated in this study, including 69 (86.3%) men and 11 (13.8%) women in femoral fracture group and 536 men (89.2%) and 65 women (10.8%) in non-femoral group. The laboratory parameters were evaluated in response to the equal amount of crystalloid fluid given upon arrival and 2 h later. Blood gases decreased in the fracture group despite fluid therapy (p < 0.003), and the coagulation profile worsened although the change was not statistically significant. CONCLUSION The treatment of multiple-trauma patients with femoral bone fractures should be more concerned with the need for the infusion of vasopressors such as norepinephrine. If there is evidence of clinical shock, excessive crystalloid infusion (limited to 1 L) should be avoided, and blood and blood products should be started as soon as possible.