Doctors videos

NEW YORK (Reuters Health) - In patients with diabetic nephropathy, high doses of B vitamins accelerate kidney dysfunction and increase the rate of myocardial infarction (MI) and strokes, according to a Canadian study.

B vitamins are used to lower high plasma levels of homocysteine, which is linked to an elevated risk for diabetic nephropathy and vascular diseases, the authors explain in the April 28th Journal of the American Medical Association. But previous research has suggested either a neutral effect or even potential harm from B vitamins.

The multicenter, double-blinded DIVINe trial, conducted between 2001 and 2007, enrolled 238 patients with diabetic nephropathy. Senior author Dr. J. David Spence, from the University of Western Ontario, London, and colleagues randomly assigned patients to treatment with a single daily tablet containing 2.5 mg folic acid, 25 mg vitamin B6 and 1 mg vitamin B12, or to placebo.

A total of 118 subjects completed the 36-month follow-up, but 119 subjects in each group were included in the modified intention-to-treat analyses.

Subjects in the B-vitamin group had a “much greater” decrease in radionuclide glomerular filtration rate (GFR) than the placebo group, the authors report. At 36 months, GFR had fallen by a mean of 16.5 vs 10.7 mL/min/1.73 m2 in the vitamin vs placebo groups, respectively (p = 0.02).

Dr. Spence and associates also observed a significantly greater difference in the 36-month risk of the composite endpoint (MI, stroke, revascularization, and all-cause mortality). There were 13 events (14.4%) in the placebo group and 24 events (23.5%) in the vitamin group, for a hazard ratio of 2.0 (p = 0.04).

There was no significant difference between groups in the proportion of participants who required dialysis or in mean glycated hemoglobin, and proteinuria did not change significantly. Also, the treatment arms were similar in rates of all-cause mortality, amputation and cognitive decline.

The authors suggest that “B vitamins were in some way associated with both renal and vascular toxicity.” They note that the vitamins are metabolized in the kidneys, so vitamin toxicity may be more of a problem in patients with impaired renal function.

They conclude, “It would be prudent to discourage the use of high-dose B vitamins as a homocysteine-lowering strategy outside the framework of properly conducted clinical research.”

Reference:
JAMA 2010;303:1603-1609.

source:
http://www.thedoctorschannel.com/video/3196.html

Dentistry: Mandibular Expander (Removable)

2010-04-29T12:46:00.000+03:00

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Dentistry: Surgically Assisted Palatal Expansion [HQ]

2010-04-28T12:36:00.000+03:00

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Endoscopy :Upper GI (Gastrointestinal) Endoscopy for Gastric Ulcers (Full Version) - Medical Animation

2010-04-26T09:54:00.000+03:00

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World's first full face transplant carried out

2010-04-24T08:06:00.001+03:00

The world's first full face transplant has been hailed a success by doctors in Barcelona.....

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The world’s first full face transplant consisting in nose, skin, cheekbones,jaws, teeth and other features was recently carried out in Barcelona’s Vall d’Hebron Hospital. The patient had suffered a car accident in the past that left him with serious face trauma and deformation.

The operation was done in late March by a medical team consisting of 30 medical team personnel and it took 24 hours. The identity of the patient remained confidential, doctors stating that it is about a Spanish persons between 20 and 40 years old who is now recovering well and the operation has all the chances to be a full success.

Named by the UK Facial Transplantation Research Team “the most complex face transplantation operation there has probably been in the world to date”, the operation succeed in giving the patient a new face. Although it was a face transplant, the patient wont inherit the donor looks as some expected, because the taken bones and skin will rearrange on the new face structure resulting in a completely new face.

Until now there have been 10 partial-face transplant operations carried out but the one did in Spain is far the most complex because it involved the patient’s full face.

Dentistry: Bionator [HQ]

2010-04-23T21:06:00.001+03:00

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Dentistry: Block Bone Graft for Implant [HQ]

2010-04-23T09:08:00.000+03:00

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Dentistry: Class III Elasticwear [HQ]

2010-04-22T21:52:00.000+03:00

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Dentistry: Extraction therapy (mx & md) [HQ]

2010-04-22T20:50:00.000+03:00

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Dentistry: Dolphin Imaging 11.5 Morph Movie Feature [HQ]

2010-04-22T12:59:00.000+03:00

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Dentistry: 3D Dental Anatomy Simulation

2010-04-16T18:04:00.000+03:00

For dental students and researchers. We created this software in an
attempt to facilitate the learning curve for new people introduced to dental
anatomy. The software has been utilized by thousands of dental students at hundreds of universities and has faciliitiated learning the complicated filed of dental anatomy. Every tooth comes with descriptions on various detailed structures, thus allowing for easy access for review.
This software is an interactive 3D simulation system designed specifically

Recommended Requirements
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CPU: PIII 500Mhz or equivelent
Memory: 128MB
Graphics Card: NVIDIA TNT 2 or higher. Any card that supports T & L will work
OS: Windows 98, ME, 2000 and XP

Developers:
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Bassam A. Hassan
Programmer and dental student at Baghdad University, college of dentistry.
Wisam T. Alrawi
CG designer and dental student at Baghdad University, college of dentistry