Oral health related quality of life of edentulous patients after denture relining with a silicone-based soft liner

doi: 10.1111/j.1741‐2358.2011.00503.x Oral health related quality of life of edentulous patients after denture relining with a silicone‐based soft liner Background: Knowledge of benefits caused by a treatment on quality of life is very relevant. Despite the wide use and acceptance of soft denture liners, it is necessary to evaluate the patient’s response about the use of these materials with regard to improvement in oral health related quality of life (OHRQoL). Objectives: The aim of this study was to evaluate the influence of denture relining in the OHRQoL of edentulous patients. Materials and methods: Thirty‐two complete denture wearers had their lower dentures relined with a silicone‐based material (Mucopren soft, Kettenbach, Germany) according to chairside procedures. OHRQoL was assessed before and after 3 months of relining by means of OHIP‐EDENT, and the median scores were compared by Wilcoxon test (p ≤ 0.05). Results: After 3 months of relining, participants reported significant improvement of their OHRQoL (p ≤ 0.01). Conclusion: Denture relining with a soft liner may have a positive impact on the perceived oral health of edentulous patients.     

Oral rehabilitation of severely worn dentition using an overlay for immediate re-establishment of occlusal vertical dimension

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.     

The influence of mandibular implant-retained overdentures in masticatory efficiency

doi: 10.1111/j.1741‐2358.2011.00539.x The influence of mandibular implant‐retained overdentures in masticatory efficiency Objective: To evaluate the masticatory efficiency of patients rehabilitated with conventional dentures (CDs) or implant‐retained mandibular overdentures. Background: Despite the evident benefits of implants on mastication as assessed by subjective patient‐based outcomes, the extent of implant overdenture treatment effect on food comminution is not well established. Materials and methods: A randomised clinical trial was carried out with 29 completely edentulous patients divided into two groups. The first group was rehabilitated with a mandibular overdenture retained by two splinted implants with bar‐clip system, while the second group was rehabilitated with a mandibular CD. Both groups also were rehabilitated with maxillary CDs. Masticatory efficiency and patient satisfaction were assessed 3 months after denture insertion. Masticatory efficiency was evaluated through the colorimetric method with the beads as the artificial test‐food. Comparisons for masticatory efficiency and patient satisfaction were performed using Student’s t‐test (α = 0.05). Results: No significant statistical difference was found for masticatory efficiency (p = 0.198). Patient overall satisfaction was significantly higher for the mandibular overdenture (p < 0.001). In addition, mandibular overdenture patients were significantly more satisfied with chewing experience (p < 0.05) and retention of the lower denture (p < 0.005). Conclusion: The results of this study suggest that mandibular overdenture significantly improves chewing experience, although limited effect on masticatory efficiency has been observed.     

The systematics of right whales (Mysticeti: Balaenidae)

Balaenidae (right whales) are large, critically endangered baleen whales represented by four living species. The evolutionary relationships of balaenids are poorly known, with the number of genera, relationships to fossil taxa, and position within Mysticeti in contention. This study employs a comprehensive set of morphological characters to address aspects of balaenid phylogeny. A sister‐group relationship between neobalaenids and balaenids is strongly supported, although this conflicts with molecular evidence, which may be an artifact of long‐branch attraction (LBA). Monophyly of Balaenidae is supported, and three major clades are recognized: (1) extinct genus Balaenula, (2) extant and extinct species of the genus Eubalaena, and (3) extant and extinct species of the genus Balaena plus the extinct taxon, Balaenella. The relationships of these clades to one another, as well as to the early Miocene stem balaenid, Morenocetus parvus, remain unresolved. Pliocene taxa, Balaenula astensis and Balaenula balaenopsis, form a clade that is the sister group to the Japanese Pliocene Balaenula sp. Eubalaena glacialis and Pliocene Eubalaena belgica, are in an unresolved polytomy with a clade including E. japonica and E. australis. Extant and fossil species of Balaena form a monophyletic group that is sister group to the Dutch Pliocene Balaenella, although phylogenetic relationships within Balaena remain unresolved.     

A mean field Ising model for cortical rotation in amphibian one-cell stage embryos

We propose a new physical mechanism of cortical rotation generation in one-cell embryos of amphibians based on a phase transition in the ensemble of microtubules localized to the cortical region of the cell interior. Microtubules, protein polymers formed from tubulin heterodimers, are highly negatively charged, which results in strong electrostatic interactions over tens of nanometers, even in the presence of counterions that partially screen electrostatic interactions. A simplified model that offers a plausible representation of these effects is based on the Ising Hamiltonian, which has been robustly applied to explain a wide range of order-disorder transitions in physics, chemistry and other sciences. An Ising model phase transition, especially with the supercooperative flow alignment effect of global rotation of the cortex, provides an alternative to models of cortical rotation based on microtubule polymerization or motor molecules. Insofar as there is any reality to the concept that microtubules are involved in consciousness, we propose that cortical rotation in the one-cell embryo is a better place to look for the purported microtubule entanglement or coherence properties than the adult brain.     

Neurohormonal and cytokine fluctuations following transcatheter closure for an atrial septal defect

Introduction

Inflammation and neurohormonal activation are considered to be involved in the development of earlier and/or later complications in congenital heart disease patients, even after a successful repair of the lesion. It is not yet clarified what is the role of the therapeutic interventions in the occurrence of such a response and how it could be associated with possible postoperative complications.

Aim

We sought to assess the inflammatory and neurohormonal response to transcatheter closure of secundum type atrial septal defects (ASD) over a six-month follow-up period. We also evaluated the association between the respective markers and catheterization data as well as echocardiographic measurements.

Methods

Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), N-terminal-proatrial natriuretic peptide (NT-proANP) and N-terminal-probrain natriuretic peptide (NT-proBNP) were assessed and echocardiographic measurements were performed in twenty-eight patients with atrial septal defect prior to, and at the first, second and sixth months post transcatheter closure. Thirty-three age-matched healthy volunteers were also enrolled.

Results

IL-6 plasma levels, although higher preoperatively, [physical logarithm (ln) IL-6: 3.37 ± 0.66 vs 2.92 ± 0.44 pg/ml, p = 0.015], reached control levels postoperatively, at the end of the third month, whereas TNF-α and IL-10 were not influenced by the procedure. NT-proANP levels were elevated preoperatively compared to the control group (ln NT-proANP 3.78 ± 0.572 vs 3.48 ± 0.30, p = 0.031), with a further significant increase during the 1st month (ln NT-proANP 3.78 ± 0.572 vs 4.2 ± 0.42, p = 0.006), following the pattern of the left atrial volume enlargement, and remained high even 6 months after the procedure .On the other hand, the initially normal concentrations of NT-proBNP, after a transient significant increase during the first month postoperatively (ln NT-proBNP 3.56 ± 0.94 vs 4.58 ± 0.91, p < 0.0001) returned to the controls’ levels at the end of the third month. Preoperative concentrations of NT-proANP positively correlated with NT-proBNP concentrations and pulmonary to systemic flow ratio (Qp/Qs).

Conclusions

Transcatheter closure could improve, on a mid- term basis, the inflammatory process but natriuretic peptides’ secretion continues in parallel with left atrial volume increase. Further follow up is required to determine the long-term progress of the inflammatory and neurohormonal response to the procedure.     

老年患者就医流向及影响因素调查研究

??????? 目的 分析老年患者就医流向的原因与因素,为合理引导老年患者适宜就医、提高医疗有效利用率、缓解医疗供需矛盾提出参考建议。方法 利用SPSS20.0描述性统计和X²检验对数据进行分析。结果 老年患者在生病时首选三级医院就医的比例最高,其次为社区卫生服务中心,二级医院比例最低。就医流向的影响因素有：年龄、医疗保障情况、文化程度、家庭平均月收入。结论 应通过加强宣教、合理引导,强化社区医疗机构服务能力建设,畅通双向转诊/转查渠道,积极推进二级医院的转型发展,来吸引老年就医群,优化老年人群就医流向,提高医疗资源的有效使用效率。     

On a Romanian attempt to legislate on medically assisted human reproduction

The paper presents and briefly analyses some of the provisions of a Romanian legislative proposal which arrived at the Presidency for ratification twice, in slightly different forms, and which was rejected twice: the first time at the Presidency in October 2004, and the second at the Constitutional Court in July 2005. The proposal was finally dropped in February 2006. My intention here is to point to some of the most problematic deficiencies of the legislative document in the hope that this may assist with future debates and regulations on assisted reproduction either in Romania or elsewhere. I have isolated the features to be discussed under two headings: (1) whose are the rights to reproduce, that the document claimed to ‘acknowledge, regulate and guarantee’ and (2) what is the status of the embryo, the child and the surrogate mother?