Management of peri-implant bone loss using guided bone regeneration: a clinical report

This clinical report presents a patient who developed peri-implant bone loss around 2 maxillary endosseous root-form implants after restoration with cement-retained single crowns. Significant localized bone loss occurred around 1 of the implants due to retained excess cement. Reparative treatment consisted of a guided bone regeneration technique. Following a 9-month period of submerged healing, the implants were re-exposed and restored to complete function.     

Polypoid hyperplasia of the larynx misdiagnosed as a malpositioned laryngeal mask airway

Polypoid hyperplasia of the vocal cords, associated with smoking, reflux, and vocal cord abuse, results in inflammation and edema. This condition can produce partial airway obstruction during positive pressure ventilation.     

Alpha1-antitrypsin as a risk for infant and adult respiratory outcomes in a national birth cohort

Reduced alpha1-antitrypsin (AAT) encoded by the gene SERPINA1 is a potential risk for pulmonary disease. We investigated SERPINA1 polymorphism as a risk for infant and adult pulmonary morbidity, and adult respiratory function and its change between 43 and 53 yr. We used data on a British national representative sample (n = 5,362) studied since birth in 1946 to age 53 yr (when n = 3,035), when DNA was first obtained. SERPINA1 Z and, to a lesser extent, S carriers had an increased risk of infant lower respiratory infection compared with those who were neither S nor Z carriers (Z carriers: odds ratio = 2.32, 95% confidence interval = 1.37-3.92; S but not Z carriers odds ratio = 1.58, 95% confidence interval = 1.10-2.28) after adjustment for environmental, socioeconomic, and developmental factors, and breast-feeding. There was no difference in the adult outcomes at 53 yr according to genotype, nor was there any association of genotype with change in forced expiratory volume at 1 s between 43 and 53 yr. Lower alpha1-antitrypsin, as indicated by carrier status for the Z and S alleles, was a risk for infant lower respiratory infection, but not for adult respiratory outcomes.     

Primary cultures of rat astrocytes respond to thiamine deficiency-induced swelling by downregulating aquaporin-4 levels

Imaging studies indicate that cerebral edema is an important consequence of Wernicke's encephalopathy (WE), a disorder caused by thiamine deficiency (TD). We have investigated this problem using a recently developed in vitro astrocyte model of TD. Measurement of cell volume using the 3-O-methylglucose uptake method revealed a dose-dependent swelling of astrocytes during exposure to TD conditions. Time course studies indicated a progressive volume increase up to a maximum of 93% above controls after 4 days of treatment. This swelling then partially resolved, and remained stable for up to 10 days following commencement of TD treatment. Measurement of aquaporin-4 (AQP-4) levels showed a 44% loss after 10 days and a temporal profile consistent with an important role for this water channel protein in astrocyte cell volume changes during TD. Our findings of astrocyte swelling in TD are consistent with previous reports of focal brain edema in cases of WE, and indicate that AQP-4 may be an important target for ameliorating some of the clinical problems associated with this disorder.     

Epidemiology and morbidity of Schistosoma mansoni infection in a fishing community along Lake Albert in Uganda

Schistosoma mansoni infection, associated morbidity and symptoms were studied in Piida fishing community at Butiaba, along Lake Albert, Uganda, from November 1996 to January 1997. The study revealed that S. mansoni is highly endemic with an overall prevalence of 72%, a mean intensity of 419.4 eggs per gram (epg) faeces (geometric mean for positives only), with 37.8% of males and 33.0% of females excreting over 1000 epg. Prevalence and intensity peaked in the 10-14 year old age group and decreased with increasing age. Females were less heavily infected than males. Differences were also shown between tribes. Diarrhoea and abdominal pain were commonly reported in Piida. However, no clear-cut correlation between intensity of S. mansoni infection and these conditions could be demonstrated, indicating that retrospective questionnaires concerning S. mansoni related-symptomatology are of limited value. Organomegaly, as assessed by ultrasonography, was frequent and hepatomegaly was associated with heavy S. mansoni infection. No correlation was demonstrated between splenomegaly and infection. This study emphasizes that schistosomiasis mansoni is a major public health problem in Piida fishing community and presumably also in many similar fishing communities. These observations call for immediate intervention and can help in planning long-term strategies for sustainable morbidity control.     

A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms

OBJECTIVE: This study determined whether self-reported Traumatic Brain Injury (TBI), identified in a community sample and occurring up to 60 years previously, is associated with current psychiatric symptoms, suicidality, and psychologic well-being. STUDY DESIGN AND SETTING: Three age cohorts (20-24, 40-44, 60-64) were randomly sampled from the cities of Canberra and Queanbeyan, Australia, yielding a total of 7,485 participants. The samples were administered scales measuring anxiety, depression, suicidality, positive and negative affect, personality traits, and physical health status. RESULTS: Of the total sample, 5.7% reported history of TBI involving loss of consciousness for at least 15 min, occurring an average of 22 years previously. History of TBI was associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation. CONCLUSION: History of TBI is a risk factor for psychiatric morbidity. The effect is greatest in young adults, and occurs up to several decades subsequent to the occurrence of TBI.     

The treatment of postnatal depression by health visitors: impact of brief training on skills and clinical practice

BACKGROUND: Postnatal depression can be effectively treated by cognitive behavioural counselling (CBC), a simple intervention designed to be delivered by non-specialists in mental health. METHODS: Health visitors were trained in CBC and post-training changes in counselling skills, clinical practice and costs were assessed. RESULTS: Following training health visitors showed improved counselling skills, and they carried out more mental health assessments, recorded mental symptoms more often and treated more women themselves. However, their mean number of contacts with depressed women did not change; and the number of urgent contacts diminished. Referrals to general practitioners did not increase but there was an increase in referrals to mental health services. Costs to health visitor practice did not increase. LIMITATIONS: Assessment of clinical practice was based on health visitor records. The study uses a 'before and after' design rather than randomisation of subjects. CONCLUSIONS: Training health visitors in CBC leads to improved counselling skills and corresponding changes in clinical practice, without increasing the costs of health visitor practice.     

Why semantic dementia drives you to the dogs (but not to the horses): A theoretical account

This paper describes a patient (IH) with semantic dementia and severe impairment in all semantic categories except for numerical knowledge, which was preserved. IH showed a severe deficit in reading and writing non-number words (e.g., candle, juice) and nonwords, and preservation of reading and writing number words (e.g., one, forty) and numerals (e.g., 1, 40). IH's pattern of performance can be explained by the combination of a selective sparing of one semantic category--i.e., numbers--with a total deficit of nonsemantic processes for mapping letters and sounds. As number was the only spared semantic category in the presence of these other nonsemantic deficits, it follows that the semantic route is sufficient for accurate reading and spelling. Our data clarify the nature of reading and writing processes and support the functional and neuroanatomical independence of the number domain.     

Bacterial adhesion to titanium-oxy-nitride (TiNOX) coatings with different resistivities: a novel approach for the development of biomaterials

In this study the quantitative adhesion of a strain of Staphylococcus epidermidis, Streptococcus mutans and Pseudomonas aeruginosa to and the ease of removal from different TiNOX coatings was investigated by means of a parallel plate flow chamber and in situ image analysis. Quality of adhesion was determined by counting bacteria which remained attached to the surface after exposure to an air-liquid interface. S. epidermidis and S. mutans showed a bipolar adhesion pattern with highest numbers of adhesion at low and high resistivity with lowest adhesions at a resistivity of 10(4) microohms cm. P. aeruginosa was the least adherent organism. These results indicate that the affinity of these three strains under the current experimental conditions is minimal for TiNOX coatings with a specific resistivity. TiNOX coatings with pre-adsorbed fibrinogen showed different numbers of S. epidermidis adhered to the different coatings. However, the affinity of this strain for fibrinogen-coated TiNOX remains low when the resistivity is around 10(4) microohms cm. This indicates that the specific influence of the resistivities of the TiNOX coatings is transferred through the adsorbed fibrinogen film to the interface with adhering bacteria.