Renal Function in an Ageing Community

As Bland (12) points out, there is now abundant evidence that with increasing age there is a gradual decline in kidney function as indicated by a reduction in effective renal plasma flow, in glomerular filtration, in both excretory and reabsorptive tubular mass, in the ability to excrete urea, and in the ability to concentrate the urine. From this one can predict that in the aged the power to regulate the acid-base equilibrium will be compromised. In fact, the aged can hold this balance in health, but the addition of physiological stress or disease can upset the mechanism completely. (107) These old people have a narrower margin on which to regulate this balance, and the prime factor involved is the decline in renal function, principally brought about by vascular degeneration

Sir William Mackinnon, Shipowner, 1823-1893.

This thesis is a study of Sir William Mackinnon as a shipowner and as a man who played an important part in opening East Africa to British influence. By shrewdness and good fortune he took advantage of the dramatic progress in communications, which was part of the Industrial Revolution, and he built up a shipping company which became a major trading concern in the Indian Ocean. Under the influence of humanitarian ideas, and particularly those of David Livingstone, he felt a duty to use some of his wealth to improve the lot of less fortunate people and so he engaged in various commercial and philanthropic enterprises in Africa, and the company which he founded there towards the end of his life made a substantial contribution to British colonisation in East Africa. He became supreme as a shipowner, and his business acumen was undoubted, but his involvement in international affairs exposed his weakness as a politician and as an administrator. In the whirlpool of the scramble for Africa he was out of his depth beside the political giants of the time. The Mackinnon Papers, which were the most important source of information for this thesis, reveal Mackinnon as a man of rather narrow outlook, but deep religious convictions who believed that good works received their just reward. Compared with many of his contemporaries, who were involved with Africa, such as Henry Morton Stanley, Cecil Rhodes and King Leopold of Belgium, he was not very imaginative but in his desire to spread the benefits of Christian civilisation he was more sincere and humane

A socio-historical perspective of the art and material culture of the Mijikenda of Kenya.

The Mijikenda peoples inhabit the coastal hinterland of Kenya. They comprise of nine subgroups of closely related people who speak mutually intelligible dialects of the Northcoast Bantu. The nine subgroups share a common history of origins and common social, cultural, economic and political institutions. The thesis begins with an outline of the history and ethnography of the Mijikenda to the present day. This provides the basis for discussion of how the manufacture of the art and artifacts are linked to social, ritual and political institutions, and how they have been modified through the colonial and post-colonial periods. Particular attention is given to sculptures in wood and in clay that are part of ritual contexts. Problems of style, aesthetics and meaning are also discussed. Finally the present state of these arts is considered and the extent to which Mijikenda artists have begun to produce for an external patronage

Effect of propolis gel on the in vitro reduction of dentin permeability

OBJECTIVE: The aim of this study was to evaluate the capacity of potassium oxalate, fluoride gel and two kinds of propolis gel to reduce the hydraulic conductance of dentin, in vitro. MATERIAL AND METHODS: The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on a model proposed in literature. Thirty-six 1-mm-thick dentin discs, obtained from extracted human third molars were divided into 4 groups (n=9). The groups corresponded to the following experimental materials: GI-10% propolis gel, pH 4.1; GII-30% propolis gel; GIII-3% potassium oxalate gel, pH 4,1; and GIV-1.23% fluoride gel, pH 4.1, applied to the dentin under the following surface conditions: after 37% phosphoric acid and before 6% citric acid application. The occluding capacity of the dentin tubules was evaluated using scanning electron microscopy (SEM) at ×500, ×1,000 and ×2,000 magnifications. Data were analyzed statistically by two-way ANOVA and Tukey's test at 5% significance level. RESULTS: Groups I, II, III, IV did not differ significantly from the others in any conditions by reducing in hydraulic conductance. The active agents reduced dentin permeability; however they produced the smallest reduction in hydraulic conductance when compared to the presence of smear layer (P<0.05). The effectiveness in reducing dentin permeability did not differ significantly from 10% or 30% propolis gels. SEM micrographs revealed that dentin tubules were partially occluded after treatment with propolis. CONCLUSIONS: Under the conditions of this study, the application of 10% and 30% propolis gels did not seem to reduce the hydraulic conductance of dentin in vitro, but it showed capacity of partially obliterating the dentin tubules. Propolis is used in the treatment of different oral problems without causing significant great collateral effects, and can be a good option in the treatment of patients with dentin sensitivity

Evaluation of the efficacy of dentin hypersensitivity treatments - a systematic review and follow-up analysis

OBJECTIVES: To compare the treatments used to treat dentin hypersensitivity (DH), based on its efficacy and effect duration. METHODS: Medline/PubMed, Cochrane Library, EMBASE, and ClinicalTrials were searched for articles published between January 1st , 2008 and November 14th , 2018, in English, Portuguese or Spanish, reporting clinical trials, completed and with results. This systematic review protocol was registered in PROSPERO, number CRD42019121986. RESULTS: 74 randomized clinical trials were included in the systematic review, reporting patients from 16 to 65 years old, with a clinical diagnosis of DH, that evaluate the efficacy of a desensitizing product, compared to pre-treatment, used the evaporative method stimulation and the visual analogue scale. These studies evaluated 5366 patients and at least 9167 teeth. Seven follow-up periods were considered corresponding to an immediate, medium or long-time effect. 66 studies were included in the quantitative synthesis. Glutaraldehyde with HEMA, glass ionomer cements and Laser present significant immediate (until 7 days) DH reduction. Medium term (until 1 month) reduction was observed in stannous fluoride, glutaraldehyde with HEMA, hydroxyapatite, glass ionomer cements and Laser groups. Finally, long term significant reduction was seen at potassium nitrate, arginine, glutaraldehyde with HEMA, hydroxyapatite, adhesive systems, glass ionomer cements, and LASER. CONCLUSIONS: All active ingredients show efficacy in DH reduction in different follow-up times. Only in-office treatments are effective in immediate DH reduction, maintaining its efficacy over time. For long time effects, at home treatments can also be used. More standardized evaluation protocols should be implemented to increase the robustly of the results.info:eu-repo/semantics/publishedVersio

Using classification and regression tree modelling to investigate response shift patterns in dentine hypersensitivity

BACKGROUND: Dentine hypersensitivity (DH) affects people's quality of life (QoL). However changes in the internal meaning of QoL, known as Response shift (RS) may undermine longitudinal assessment of QoL. This study aimed to describe patterns of RS in people with DH using Classification and Regression Trees (CRT) and to explore the convergent validity of CRT with the then-test and ideals approaches. METHODS: Data from an 8-week clinical trial of mouthwashes for dentine hypersensitivity (n = 75) using the Dentine Hypersensitivity Experience Questionnaire (DHEQ) as the outcome measure, were analysed. CRT was used to examine 8-week changes in DHEQ total score as a dependent variable with clinical status for DH and each DHEQ subscale score (restrictions, coping, social, emotional and identity) as independent variables. Recalibration was inferred when the clinical change was not consistent with the DHEQ change score using a minimally important difference for DHEQ of 22 points. Reprioritization was inferred by changes in the relative importance of each subscale to the model over time. RESULTS: Overall, 50.7% of participants experienced a clinical improvement in their DH after treatment and 22.7% experienced an important improvement in their quality of life. Thirty-six per cent shifted their internal standards downward and 14.7% upwards, suggesting recalibration. Reprioritization occurred over time among the social and emotional impacts of DH. CONCLUSIONS: CRT was a useful method to reveal both, the types and nature of RS in people with a mild health condition and demonstrated convergent validity with design based approaches to detect RS

Dentinal hypersensitivity: a review

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Tooth sensitivity is a very common clinical presentation which can cause considerable concern for patients. This condition is frequently encountered by periodontists, dentists, hygienists and dental therapists. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments available. This review considers the aetiology, incidence and management of dentinal hypersensitivity.PM Bartol