Prospective study on titanium bar-retained overdentures: 2-year results

Within a monometallic concept 29 patients received titanium bar‐retained mandibular overdentures on 2 IMZ implants. The study had a prospective design with 3 months recall intervals. One of 58 implants failed after 11 months. There were no significant differences of the mean plaque scores (Silness, Löe) and the mean sulcus bleeding scores (Mühlemann, Son) at the abutments between baseline, 12 months and 24 months. Less than 40% of the subjects showed plaque score zero at 24 months. However, 89% exhibited sulcus bleeding score zero indicating health of the peri‐implant soft tissues in most cases. Plaque at the basal site of the bar was scored separately at additional measuring points located at the central area and the contact areas between bar and abutments. Bar plaque scores nearly doubled between baseline and 12 months and remained high at 24 months. Median maximal vertical bone loss around the implants was 1.7 mm after 2 years. Bone loss did not exceed one quarter of the implant length in 79%. The monometallic concept in bar‐retained overdentures on 2 implants proved its clinical suitability except for the applicability of pure titanium for bar clips. Plaque formation beneath the bar seems to be one of the major clinical problems.     

Congenital high myopia and central macular atrophy: a report of 3 families

Aims

To report the clinical phenotype in a series of four children from three families with the rare association of high myopia, central macular atrophy, and normal full-field electroretinography (ERG).

Methods

Four male patients were ascertained with reduced vision, nystagmus, and atrophy of the macula from early childhood. Patients underwent full ophthalmic examination, electrophysiological testing, and retinal imaging.

Results

Minimum duration of follow-up was 8 years. At last review, visual acuity ranged from 0.22 to 1.20 logMAR (6/9.5–6/95 Snellen) at a mean age of 10.5 years (median 9.5 years, range 9–14 years). Refractive error ranged from a spherical equivalent of −7.40 D to −24.00 D. Three had convergent squint. Fundus examination and imaging demonstrated bilateral macular atrophy in all patients that varied from mild atrophy of the retinal pigment epithelium (RPE) to well-demarcated, punched-out atrophic lesions of retina, RPE, and choroid. Flash ERG was normal under photopic and scotopic conditions in all patients. Pattern ERG, performed in three patients, was consistent with mild to severe macular dysfunction. Progression of the area of atrophy was evident in one patient and of the myopia in two patients but all patients had stable visual acuity.

Conclusions

Patients with congenital high myopia and macular atrophy present in infancy with reduced visual acuity and nystagmus. The macular atrophic lesions vary in size and severity but electrophysiological testing is consistent with dysfunction confined to the macula. There was no deterioration in visual acuity over 8–10 years of monitoring.     

Novel strategies for Alzheimer's disease treatment

Considerable progress has been made in recent years towards better understanding the pathogenesis of Alzheimer's disease (AD), a dementing neurodegenerative disorder that affects > 10 million individuals in the US and Europe combined. Recent studies suggest that alterations in the processing of amyloid precursor protein (APP), resulting in the accumulation of amyloid-beta protein (Abeta) and the formation of oligomers leads to synaptic damage and neurodegeneration. Therefore, strategies for treatment development have been focused on reducing Abeta accumulation using, among other approaches, antiaggregation molecules, regulators of the APP proteolysis and processing, reducing APP production (e.g., small-interfering RNA), and increasing Abeta clearance with antibodies, apolipoprotein E and Abeta-degrading enzymes (e.g., neprilysin). The main focus of this review is on novel treatments for AD with a special emphasis on delivering neuroprotective and antiamyloidogenic molecules by gene therapy and by promoting neurogenesis.     

Jugular Venous Flow Quantification Using Doppler Sonography

A consensus on venous flow quantification using echo spectral Doppler sonography is lacking. Doppler sonography data from 83 healthy individuals were examined using manually traced transverse cross-sectional area and diameter-derived cross-sectional area obtained in longitudinal view measurements of the internal jugular vein. Time-averaged velocity over a 4-s interval was obtained in the longitudinal plane using manual tracing of the waveform. Manual and computer-generated blood flow volume calculations were also obtained for the common carotid artery, for accuracy purposes. No differences were detected between semi-automated and manual blood flow volume calculations for the common carotid artery. The manual calculation method resulted in almost twofold larger venous internal jugular vein flow measurements compared with the semi-automated method. Doppler sonography equipment does not provide accurate automated calculation of venous size and blood flow. Until further technological development occurs, manual calculation of venous blood flow is warranted.