Idrīsī. La Finlande et les autres pays baltiques orientaux

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Correlations between EMG jaw muscle activity and facial morphology in complete denture wearers

In a sample of fifteen partially edentulous subjects assigned for immediate complete denture treatment, a correlation analysis was performed between pre-extraction facial morphology determined from lateral cephalograms, and EMG activity of the anterior temporal and masseter muscles in maximal clench and tapping of teeth. Marked correlations observed between vertical and sagittal jaw relations and mean voltages of the jaw-closing muscles indicated strong biting activity in subjects with a square facial type. No significant associations were observed between biting strength and the age of the subjects. Correlations between facial morphological changes and changes in EMG biting activity after denture insertion and during 1 year of denture wear indicated that the anterior temporal muscles were extremely sensitive to sagittal changes in anterior occlusion. The masseter muscles were less sensitive, but responded in some instances to changes in vertical jaw relationship.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73816/1/j.1365-2842.1983.tb00105.x.pd

The Copper Idols from Galich

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Roentgen cephalometric analysis of ridge resorption and changes in jaw and occlusal relationships in immediate complete denture wearers

In eighteen subjects assigned for immediate complete upper and lower dentures, roentgen cephalometric recordings were made before extraction of the residual anterior dentition and 3 weeks, 3 months, 6 months and 1 year after denture insertion. The cephalometric analysis was based on electronic measurements of linear and angular morphological variables and computer head plots generated from 177 reference points (Walker, 1967), derived for each subject for each of the five observation stages. The reduction of the alveolar ridges was most rapid during the first 3 months of denture wear and particularly during the post-extraction period of 3 weeks. The reduction in anterior height of the lower ridge was on average twice as great as that of the upper ridge. The ridge resorption and the accompanying settling of the dentures on the basal seats, measured from lead shots inserted in the dentures, brought about an upward rotation of the mandible with a resulting decrease in occlusal vertical dimension and reduction in overjet of the dentures. In accordance with the amount of ridge reduction, these changes showed great individual variation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73577/1/j.1365-2842.1980.tb01466.x.pd

Yläkulmahampaan poikkeavan puhkeamisen hoitomenetelmät ja hoidon kulku

Tiivistelmä. Pysyvä yläkulmahammas on yleisin poikkeavasti puhkeava hammas viisaudenhampaiden jälkeen. Yläkulmahammas puhkeaa suuhun toisen vaihduntavaiheen loppupuolella viereisiä hampaita myöhemmin. Myöhäinen puhkeamisajankohta yhdistettynä kulmahampaan pitkään puhkeamisreittiin altistaa kulmahampaan puhkeamisen häiriöille, joiden seurauksena kulmahammas voi puhjeta väärään sijaintiin tai jäädä puhkeamatta. Poikkeavasti puhkeava yläkulmahammas sijaitsee useimmiten joko suulaen tai huulen puolella suhteessa viereisiin hampaisiin. Yläkulmahammas on hammaskaaren kulmakivi, ja on täten tärkeä niin purennallisesti kuin esteettisesti. Sen tärkeän roolin vuoksi kulmahampaan poikkeavan puhkeamisen hoito on tärkeää. Yläkulmahampaan poikkeavan puhkeamisen hoitomenetelmät voidaan jakaa varhais- ja myöhäisvaiheen hoitomenetelmiin. Poikkeavan puhkeamisen varhainen diagnostiikka on tärkeää, jotta voidaan hyödyntää varhaisvaiheen hoitomenetelmiä. Tällöin voidaan myös välttyä mahdollisilta poikkeavan puhkeamisen aiheuttamilta ongelmilta. Maitokulmahampaan poisto sekä ahtauden varhaishoito ovat varhaisvaiheen hoitomenetelmiä. Menetelmissä hyödynnetään kehittyvän kulmahampaan puhkeamiskapasiteettia. Jos poikkeava puhkeaminen diagnosoidaan myöhään, kulmahampaan puhkeamisikä on ohitettu. Myöhäisvaiheen hoitomenetelmissä yläkulmahammas paljastetaan kirurgisesti, jonka jälkeen kulmahammas vedetään hammaskaarelle kiinteäkojeiden ja oikomisvetojärjestelyiden avulla. Kulmahampaan veto kaarelle voidaan toteuttaa usealla eri tavalla. Samoin kirurgisista paljastusmenetelmistä valittavina on useita eri menetelmiä. Kulmahampaan poikkeava sijainti määrittelee ensisijaisesti valittavan menetelmän. Myöhäisvaiheen hoitomenetelmät ovat pitkäkestoisia ja monivaiheisia edellyttäen myös potilaalta hyvää yhteistyökykyä ja motivaatiota. Syventävän opintojen tutkielman tarkoituksena on tarkastella yläkulmahampaan poikkeavan puhkeamisen hoitomenetelmiä ja hoidon kulkua kirjallisuuskatsauksen muodossa. Tutkielman aineisto koostuu laajasta määrästä kansainvälisiä katsausartikkeleita, systemaattisia katsausartikkeleita, tutkimusraportteja ja tapausselostuksia

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

<p>Abstract</p> <p>Background</p> <p>Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.</p> <p>In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008).</p> <p>Methods</p> <p>Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation.</p> <p>Results</p> <p>There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy.</p> <p>Conclusion</p> <p>A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.</p

Validation of Novel Biomarkers for Prostate Cancer Progression by the Combination of Bioinformatics, Clinical and Functional Studies

The identification and validation of biomarkers for clinical applications remains an important issue for improving diagnostics and therapy in many diseases, including prostate cancer. Gene expression profiles are routinely applied to identify diagnostic and predictive biomarkers or novel targets for cancer. However, only few predictive markers identified in silico have also been validated for clinical, functional or mechanistic relevance in disease progression. In this study, we have used a broad, bioinformatics-based approach to identify such biomarkers across a spectrum of progression stages, including normal and tumor-adjacent, premalignant, primary and late stage lesions. Bioinformatics data mining combined with clinical validation of biomarkers by sensitive, quantitative reverse-transcription PCR (qRT-PCR), followed by functional evaluation of candidate genes in disease-relevant processes, such as cancer cell proliferation, motility and invasion. From 300 initial candidates, eight genes were selected for validation by several layers of data mining and filtering. For clinical validation, differential mRNA expression of selected genes was measured by qRT-PCR in 197 clinical prostate tissue samples including normal prostate, compared against histologically benign and cancerous tissues. Based on the qRT-PCR results, significantly different mRNA expression was confirmed in normal prostate versus malignant PCa samples (for all eight genes), but also in cancer-adjacent tissues, even in the absence of detectable cancer cells, thus pointing to the possibility of pronounced field effects in prostate lesions. For the validation of the functional properties of these genes, and to demonstrate their putative relevance for disease-relevant processes, siRNA knock-down studies were performed in both 2D and 3D organotypic cell culture models. Silencing of three genes (DLX1, PLA2G7 and RHOU) in the prostate cancer cell lines PC3 and VCaP by siRNA resulted in marked growth arrest and cytotoxicity, particularly in 3D organotypic cell culture conditions. In addition, silencing of PLA2G7, RHOU, ACSM1, LAMB1 and CACNA1D also resulted in reduced tumor cell invasion in PC3 organoid cultures. For PLA2G7 and RHOU, the effects of siRNA silencing on proliferation and cell-motility could also be confirmed in 2D monolayer cultures. In conclusion, DLX1 and RHOU showed the strongest potential as useful clinical biomarkers for PCa diagnosis, further validated by their functional roles in PCa progression. These candidates may be useful for more reliable identification of relapses or therapy failures prior to the recurrence local or distant metastases

Implants in the severely resorbed mandibles: whether or not to augment? What is the clinician’s preference?

Contains fulltext : 96000.pdf (publisher's version ) (Open Access)INTRODUCTION: The aim of this study is to inventory in the Netherlands which therapy is the clinician's first choice when restoring the edentulous mandible. MATERIAL AND METHODS: A questionnaire was sent to all Dutch Oral and Maxillofacial surgeons. As part of this, the surgeons were invited to treat five virtual edentulous patients, differing only in mandibular residual height. RESULTS: In cases of a sufficient residual height of 15 mm, all surgeons were in favour to insert solely two implants to anchor an overdenture. In case of a residual height of 12 mm, 10% of the surgeons choose for an augmentation procedure. If a patient was presented with a mandibular height of 10 mm, already 40% of the OMF surgeons executed an augmentation procedure. Most (80%) surgeons prefer the (anterior) iliac crest as donor site. The choice of 'whether or not to augment' was not influenced by the surgeon's age; however, the hospital, where he was trained, did. Surgeons trained in Groningen were more in favour of installing short implants in mandibles with reduced vertical height. DISCUSSION: As the option overdenture supported on two interforaminal implants is reimbursed by the Dutch health assurance, this treatment modality is very popular in the Netherlands. From a point of costs and to minimize bypass comorbidity, surgeons should be more reluctant in executing augmentation procedures to restore the resorbed edentulous mandible as it is dated in literature that also in mandibles with a residual height of 10 mm or less, solely placing implants, thus without an augmentation procedure in advance, is a reliable treatment option

Family members’ experiences of “wait and see” as a communication strategy in end-of-life decisions

The aim of this study is to examine family members’ experiences of end-of-life decision-making processes in Norwegian intensive care units (ICUs) to ascertain the degree to which they felt included in the decision-making process and whether they received necessary information. Were they asked about the patient’s preferences, and how did they view their role as family members in the decision-making process? A constructivist interpretive approach to the grounded theory method of qualitative research was employed with interviews of 27 bereaved family members of former ICU patients 3–12 months after the patient’s death. The core finding is that relatives want a more active role in end-of-life decision-making in order to communicate the patient’s wishes. However, many consider their role to be unclear, and few study participants experienced shared decision-making. The clinician’s expression “wait and see” hides and delays the communication of honest and clear information. When physicians finally address their decision, there is no time for family participation. Our results also indicate that nurses should be more involved in family–physician communication. Families are uncertain whether or how they can participate in the decision-making process. They need unambiguous communication and honest information to be able to take part in the decision-making process. We suggest that clinicians in Norwegian ICUs need more training in the knowledge and skills of effective communication with families of dying patients