The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations. Keywords: Energy intake; Nutrition counselling; Nutrition intervention; Protein intake; SPRINTT.University of Helsinki including Helsinki University Central Hospital Innovative Medicine Initiative (IMI) Juho Vainio foundatio

DIRECT RECONSTRUCTION OF PERMANENT DENTITION OF A PATIENT WITH AMELOGENESIS IMPERFECTA

Introduction and aim: Amelogenesis imperfecta associates a clinically and genetically heterogeneous group of developmental defects affecting the appearance and structure of enamel, which more or less severely affect all dental functions. Manifestations of amelogenesis imperfecta are considered by patients to be a compromise of aesthetics and increased tooth sensitivity. The consequences of the disease have a detrimental effect on adolescents who integrate into groups and seek their place in society. However, the traditional treatment approach can be very expensive and may require a certain degree of psychological resilience of the patient due to the pain and time consuming treatment. These treatment requirements, together with the insufficient thickness of the secondary dentin layer, thus often force the physician to delay treatment, which may adversely affect the patient's psychosocial development. Self-observation: A fifteen-year-old patient was sent to the prosthetic department for complete reconstruction of permanent teeth with a diagnosis of hypoplastic amelogenesis imperfecta. Due to the nature of the disease, immediate direct reconstruction was performed. Conclusion: An unprepared approach is possible even in adolescence. Hard dental tissues are preserved, the vitality of the dental pulp is not endangered and the patient's psychological burden is reduced. Direct reconstruction can be approached provided the patient cooperates. This approach must be combined with consistent treatment of the tooth surface to reduce adhesion and plaque retention. The advantage is also that any partial failure of the reconstruction is relatively easy to repair in the case of direct reconstruction