Evaluation of the use of freeze-dried skin allografts in the treatment of human mucogingival problems.

The purpose of this investigation was to evaluate the clinical responses to freeze-dried skin allografts when used to correct mucogingival problems in humans. FDS was obtained by the NMRI Tissue Bank after processing by standard procedures. The recipient sites were prepared using the standard partial thickness dissection with apical periosteal separation. Rehydrated FDS was sutured into place to completely cover the recipient sites. Routine postoperative procedures were performed. Evaluations were made by means of calibrated periodontal probe measurements, Kodachromes, and radiographs preoperatively and up to 12 months postoperatively. Fourteen patients received 24 FDS allografts over a total of 56 tooth sites. All treated teeth showed a substantial increase (greater than 2 mm) in the width of the zone of keratinized gingiva at all postoperative time periods (2.88 +/- 1.57 mm at 12 months). Other findings included a mean gain of attachment of 0.40 +/- 1.08 mm, a mean decrease in recession of 0.12 +/- 0.91 mm, and mean decrease in pocket depth of 0.33 +/- 0.53 mm. Patient comfort was good, and there were no untoward sequelae, even in patients receiving multiple grafts. This study indicates that FDS allografts are an acceptable and beneficial material for treatment of mucogingival problems in humans.     

Dietary influences on the formation of dental calculus in rats

Eleven diets were evaluated for their ability to produce dental calculus in albino rats. A diet containing 50 % cornstarch, 32 % nonfat dry milk, 3 % liver powder, 5 % celluflour, 1 % cottonseed oil, 5 % powdered sucrose, 1 % calcium chloride dihydrate, 2.7 % sodium dihydrogen phosphate monohydrate, and 0.3 % magnesium sulfate (Francis and Briner 1969) was remarkably effective. On the basis of a 0–3 calculus scoring system, an average score of 2.36 (S.D. = 0.65) resulted after 4 weeks' exposure to the above diet and, after 8 weeks, the average score was 2.59 (S.D. = 0.56).
While it was found that, in general, high cornstarch and milk powder diets were associated with higher calculus scores, no other diet remotely approached the above diet in calculogenicity.     

Facial fractures--the results of a prospective four-year-study

A prospective four-year-study of 945 fractures of the facial skeleton is presented. Details of facial trauma were collected in patients referred from the Bradford and Airedale Districts of West Yorkshire, England, an area with a population slightly in excess of half a million. Statistical analysis shows variations from previously published papers, the male to female ratio being under 2.6:1, with an average of 1.15 fractures per patient. A relatively high incidence of sports fractures is reported but the number of industrial accidents is surprisingly low. The majority of patients seen were in their third decade, the mean age being just over 25 years. The analysis also reveals that a high percentage of fractures were treated conservatively.     

Effects of Pontine Lesions on REM Sleep

Chiasmal dysfunction produces a characteristic clinical picture, regardless of the mechanism. In most cases a compressive lesion is the cause. In occasional cases, however, no such extrinsic mass is found and other possible etiologies must be explored. In some of these cases, the pathologic process is identifiable with appropriate neuroimaging. For example, inflammation, infiltrative tumors, and radiation necrosis produce intrinsic chiasmal enhancement. Chiasmal ischemia may require specialized magnetic resonance (MR) sequences for diagnosis. Chiasmal hemorrhage, trauma and chiasmal herniation typically produce distinctive changes on noncontrasted imaging. In cases of metabolic insult, either toxic or hereditary, radiographic changes are typically absent. In each of these, the correct diagnosis can usually be made with a combination of clinical and radiographic features.     

Evidence for the cardioprotective effects of omega-3 Fatty acids

OBJECTIVE: To review available literature regarding the cardiovascular effects of marine-derived Omega-3 fatty acids and evaluate the benefit of these fatty acids in the prevention of coronary heart disease. DATA SOURCES: Biomedical literature accessed through a MEDLINE search (1966-April 2002). Search terms included fish oil, omega-3 fatty acid, sudden death, hypertriglyceridemia, myocardial infarction, and mortality. DATA SYNTHESIS: Following an early 1970's observational investigation that Omega-3 fatty acids may reduce the occurrence of myocardial infarction-related deaths in Greenland Eskimos, additional trials have been conducted that support this finding. Epidemiologic and clinical trial data suggest that Omega-3 fatty acids may reduce the risk of cardiovascular-related death by 29-52%. In addition, the risk of sudden cardiac death was found to be reduced by 45-81%. Possible mechanisms for these beneficial effects include antiarrhythmic properties, improved endothelial function, antiinflammatory action, and reductions in serum triglyceride concentrations. Omega-3 Fatty acids are fairly well tolerated; potential adverse effects include bloating and gastrointestinal distress, "fishy taste" in the mouth, hyperglycemia, increased risk of bleeding, and a slight increase in low-density-lipoprotein cholesterol. CONCLUSIONS: Omega-3 Fatty acids may be beneficial and should be considered in patients with documented coronary heart disease. They may be particularly beneficial for patients with risk factors for sudden cardiac death.     

Conscientiousness and Medication Adherence: A Meta-analysis

Background

Approximately a quarter to a half of all people fail to take their medication regimen as prescribed (i.e. non-adherence). Conscientiousness, from the five-factor model of personality, has been positively linked to adherence to medications in several recent studies.

Purpose

This study aimed to systematically estimate the strength and variability of this association across multiple published articles and to identify moderators of this relationship.

Method

A literature search identified 16 studies (N?=?3,476) that met the study eligibility criteria. Estimates of effect sizes (r) obtained in these studies were meta-analysed.

Results

Overall, a higher level of conscientiousness was associated with better medication adherence (r?=?0.15; 95 % CI, 0.09, 0.21). Associations were significantly stronger in younger samples (r?=?0.26, 95 % CI, 0.17, 0.34; k?=?7).

Conclusion

The small association between conscientiousness and medication adherence may have clinical significance in contexts where small differences in adherence result in clinically important effects.     

Conceptualising Loneliness in Adolescents: Development and Validation of a Self-report Instrument

This paper reports the development and psychometric evaluations of a multidimensional model of loneliness in Australian adolescents. In the first study a new instrument was designed and administered to 1,074 adolescents (ages 10–18 years, M = 13.01). An exploratory factor analysis from data supplied by 694 of these participants yielded a 4-factor structure (friendship, isolation, negative attitude to solitude, and positive attitude to solitude). Competing measurement models were then evaluated using confirmatory factor analysis with data from the remaining 380 participants; strong support was demonstrated for the conceptual model. Significant main effects were evident for geographical location (rural remote/urban), age and sex. In a second study, involving 235 Australian adolescents (ages 10.0–16 years, M = 13.8) the superiority of the first-order model represented by four correlated factors was confirmed. The findings have clinical and practical implications for professional groups represented by child and adolescent psychiatry, pediatric and clinical psychology services, researchers, and educators. Specifically, the new self-report instrument identifies adolescents who are at risk of loneliness and its associated adverse outcomes and in doing has the potential to offer new insights into prevention and intervention.