Up to 20-year retrospective study of 4-unit fixed dental prostheses for the replacement of 2 missing adjacent teeth

Purpose: This study evaluated treatment outcomes of 4-unit porcelain-fused-to-gold fixed dental prostheses (FDPs) replacing 2 adjacent missing teeth. Materials and Methods: A total of 102 FDPs made in an undergraduate university clinic for 73 patients were evaluated for up to 20 years, with a mean survival follow-up time of 11.4 years. All patients were offered an oral health maintenance program. Treatment failures were divided into irreversible (loss of FDPs/finish line involved) or reversible (FDPs and finish line intact after conservative treatment) complications and into biologic and technical/patient-related failures. Results: The Kaplan-Meier overall estimated survival rate was 68.3% at year 20. There was a statistically significant difference (P = .007) between the survival rates in the maxilla for the vital group (73.8%) and those for the root canal-treated group (25.1%). Comparing the survival rate in the root canal-treated group for the restorations in the maxilla. (25.1%) versus the mandible (66.8%), a statistically significant difference (P = .011) was found. The main reason for irreversible failure was caries (32.0%). Conclusion: The estimated successful outcome of 4-unit FDPs over an up to 20-year period is considered favorable and should be compared with the survival rates of other treatment options for the replacement of 2 adjacent teeth. Occurrence of a previously reversible complication appears to be a predictive factor for an irreversible complication later on. A reversible complication within the first 2 years will lead to an early irreversible complication

Long-term results of short-span versus long-span fixed dental prostheses : an up to 20-year retrospective study

Purpose: This study of short-span fixed dental prostheses (Ss-FDPs) versus long-span FDPs (Ls-FDPs) evaluated the long-term efficacy and determined the frequencies and causes of failures. Materials and Methods: A total of 236 Ss-FDPs and 86 Ls-FDPs made in an undergraduate university clinic for 149 and 70 patients, respectively, were evaluated over a 20-year period. Kaplan-Meier analysis with a 95% confidence interval was used to estimate the survival probability. Failures of the FDPs were divided into irreversible (loss of FDPs or finish line involvement) or reversible (FDPs and abutments intact after conservative treatment) complications and into biologic and technical/patient-related failures. Results: The overall survival estimations for Ss-FDPs (70.8%; 95% CI: 63%-79%) and Ls-FDPs (52.8%; 36%-70%) at year 20, were statistically significantly different (P =.030). There was no statistically significant difference (P =.126) for the survival estimations for Ss-FDPs (60.4%; 48%-73%) versus Ls-FDPs (59.0%; 44%-74%) at year 19 in the root-canal treated (RCT) group. For the Ss-FDPs group there was a statistically significant difference (P = .009) between the vital (82.4%; 73%-92%) and RCT (60.4%; 49%-73%) groups at year 20. The reason for failure in the Ss-FDP group was of biologic origin in 55.6% to 66.7% of cases, but for the Ls-FDP group the failures were of technical origin in 56.0% to 84.0% of cases. Conclusion: The survival of Ss-FDPs and Ls-FDPs over a 20-year period was favorable. The overall survival estimation for Ss-FDPs was statistically significantly better than for Ls-FDPs at year 20. The use of an RCT abutment becomes more significant in fixed prosthetic restorations with 4 or more units. Occurrence of a previously reversible complication is a predictive factor for an irreversible complication later on. A reversible complication within the first 2 years for an Ss-FDP will lead to an irreversible complication

Cuentas de salud del pasado al presente para una aritmética política

Este informe describe el proceso de ampliación progresiva de las cuentas de salud para medir los gastos nacionales en salud, desde los primeros intentos de la Asociación Médica Estadounidense en 1926 hasta la actualidad. Se mencionan los hitos en la creación del Sistema de Cuentas de Salud , desde los antecedentes económicos y las acciones iniciales de unos cuantos países y organizaciones a la necesidad de un conjunto de normas de contabilidad para los sistemas de atención de salud y, por último, la consolidación con el Sistema de Cuentas de Salud del 2011. Varias organizaciones internacionales, como la Organización Mundial de la Salud, la Organización para la Cooperación y el Desarrollo Económicos, Eurostat, el Banco Mundial y la Agencia de los Estados Unidos para el Desarrollo Internacional, han sido fundamentales para ampliar los ejercicios nacionales de cuentas de salud y asegurar que estén normalizados, sean comparables y se institucionalicen. Las acciones nacionales para realizar un seguimiento de los gastos en salud no solo han enriquecido los resultados colectivos, sino que se han convertido en un componente importante del liderazgo mundial, al fundamentar las políticas en todo el mundo. Más de 100 países han creado cuentas de salud de conformidad con la norma mundial, y han logrado una mejor comprensión del gasto en salud y de los flujos financieros. Estos resultados son clave para vigilar los avances relativos a las iniciativas nacionales y mundiales, como los Objetivos de Desarrollo Sostenible y la cobertura universal de salud. Todavía quedan retos por delante, como la institucionalización y la calidad de los resultados. También se necesita responsabilidad social para mejorar las fuentes de datos, y aumentar la producción y eluso de las cuentas de salud

Relationship between age at gonadectomy and health problems in kittens adopted from shelters

Prepubertal gonadectomy (PPG) is promoted as a way of managing overpopulation in cats, but concerns about PPG and potential health issues still exist. The objective of the present study was to evaluate short-term and long-term health problems in cats subjected to PPG in comparison to gonadectomy at traditional age (TAG). In a prospective clinical trial, 800 shelter kittens aged between approximately 8 weeks and 12 weeks were recruited before adoption and randomly assigned to either the PPG group (gonadectomy performed immediately) or the TAG group (gonadectomy delayed until six months to eight months of age). Short-term health issues included mortality between when kittens arrived at the clinic and up to seven days after they returned to the shelter, as well as the occurrence of various other health issues arising in the first month following adoption. Kittens were followed-up until 24 months of age specifically for feline lower urinary tract disease, urethral obstruction (male cats), lameness, fractures and hypersensitivity disorders with dermatological presentation. In the short term, there were no significant differences between health problems in PPG and TAG kittens. Similarly, no significant differences were observed between treatment groups in terms of the type or number of health issues in the long term. In conclusion, there are no health-related contraindications to advocating PPG strategies in shelter cats. Ideally, PPG should be performed at the shelter facility itself as long as excellent infectious disease control and postoperative clinical observation before adoption are guaranteed

Development assistance for health in Africa: are we telling the right story?

OBJECTIVE: To describe the different types of data sets on aid flows, what they capture and the types of questions they answer, and to explore the extent of variation in levels and trends between these data sets at the regional and country levels. METHODS: Data included in the database of the World Health Organization are derived from official country documents and are published annually after review by each country. In addition to such data, the authors extracted data from publicly available web sites. The data extracted covered all aid flows from all donors specified for sub-Saharan African countries (including aid for the African region as a whole or for groups of countries in the region) as being for health. FINDINGS: The variation in levels and trends in development assistance for health across the six data sets compared in this paper was substantial. Variation was greater at the country than at the regional level, partly because the different aggregates of development assistance for health have different meanings and partly because of incomplete reporting. CONCLUSION: It is important to know what the different aggregates of development assistance for health reported in the different databases mean before deciding which ones to use to answer a particular policy question. Using the wrong source can lead to erroneous conclusions