Evidence‐Based Guidelines for the Care and Maintenance of Complete Dentures: A Publication of the American College of Prosthodontists

The current rates of edentulism have been estimated to be between 7% and 69% of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence‐based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence‐based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, American Dental Association (ADA) Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories, and representatives from GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence‐based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and were published in February 2011 issue of The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force.     

The effect of polymorphism in gene of insulin-like growth factor-I on the serum periparturient concentration in Holstein dairy cows

Objective

To investigate the relationship between polymorphism within the 5′-untranslated region (5′-UTR) of IGF-I gene and its periparturient concentration in Iranian Holstein dairy cows.

Methods

Blood samples (5 mL, n = 37) were collected by caudal venipuncture from each animal into sample tubes containing the EDTA and DNA was extracted from blood. In order to measure IGF-I concentration the collection of blood samples (n = 111) was also done at 14 d before calving (prepartum), 25 and 45 d postpartum.

Results

We found evidence for a significant effect of C to T mutation in position 512 of IGF-I gene on its serum concentration in dairy cows in Iran. Cows with CC genotype had significantly higher concentration (Mean±SD) of IGF-I at 14 d prepartum (91.8±18.1) µg/L compared to those with TT genotype (73.3±14.4) µg/L (P=0.04). A significant trend (quadratic) was found for IGF-I concentration, as higher in CC cows compared to ones with TT genotype, during the 14 d before calving to 45 d postpartum (P=0.01).

Conclusions

We concluded that C/T transition in the promoter region of IGF-I gene can influence the serum concentration of IGF-I in periparturient dairy cows.     

Defining predictors for long progression-free survival after radioembolisation of hepatic metastases of neuroendocrine origin

Objectives

To define predictive parameters of long progression-free survival (PFS) in patients undergoing radioembolisation of neuroendocrine liver metastases.

Methods

The following clinical and magnetic resonance imaging (MRI) parameters of 45 radioembolised patients (median age, 62 years; range, 43–75) were reviewed: age, gender, levels of chromogranin A and neuron-specific enolase (NSE), primary tumour site, Ki-67 proliferation index, hepatic tumour load, number of metastases, signal intensity characteristics, vascularisation, haemorrhagic and necrotic transformation and fluid–fluid levels. PFS was assessed according to RECIST 1.0. Statistical analysis included univariate Cox regression, Kaplan–Meier and multivariate regression.

Results

Median PFS was 727 days (95 % CI, 378–964). In the univariate regression analysis, hypovascular metastases progressed earlier (111 vs 727 days; P?<?0.05). A Ki-67 ≤2 % was associated with a longer PFS than a Ki-67 of 3–20 % or >20 % (911 vs 727 vs 210 days, respectively; P?<?0.05). Low NSE predicted longer PFS (911 vs 378 days; P?<?0.05). In the adjusted multivariate analysis, vascularisation (hypervascularisation vs. no hypervascularisation; P?=?0.0009) and NSE level (low vs high; P?=?0.0119) had the strongest influence on PFS.

Conclusion

Response to radioembolisation in patients with neuroendocrine liver metastases can be predicted by the metastatic vascularisation pattern, the NSE level and the Ki-67.

Key Points

? Radioembolisation is an effective treatment in hepatic metastases of neuroendocrine origin. ? Pre-therapeutic vascularisation patterns of metastases on MRI can predict long progression-free survival. ? Assessment of pre-therapeutic markers provides better therapy planning.     

Association between left ventricular mechanical dyssynchrony with myocardial perfusion and functional parameters in patients with left bundle branch block

Objective

To identify predictors of left ventricular mechanical dyssynchrony (LVMD) in patients with known left bundle branch block (LBBB) using gated single-photon emission computed tomography (SPECT) phase analysis.

Methods

81 patients (74% male, 70 ± 10 years) with LBBB and suspected or known coronary artery disease underwent ECG-gated myocardial perfusion SPECT. LV perfusion and functional parameters were measured, and phase analysis was performed to quantify LV-dyssynchrony.

Results

35/81 patients (42%) had prior myocardial infarction (MI), and the mean left ventricular ejection fraction (LVEF) was 49% ± 16%. LVMD was present in 58/81 (72%) patients. The summed thickening score (STS) (P < .001; odds ratio 1.22) emerged as independent predictor for the presence of LVMD in a multivariate regression model. In addition, prior MI, low LVEF, summed stress score, summed rest score, summed motion score, and LAD rest extent were identified as predictors of LVMD in a univariate model. Clinical baseline characteristics, cardiac risk factors, and QRS duration (P = .051) had no influence on the presence of LVMD.

Conclusion

In patients with LBBB, the occurrence of LVMD as assessed by gated SPECT phase analysis is mainly influenced by reduced myocardial contractility as expressed by the STS. Proper discrimination between LVMD arising from known electrical conduction delay as opposed to areas of MI causing reduced regional contractility seems to be mandatory for therapy planning in patients with LVMD.     

Near‐vision impairment and unresolved vision problems in Indigenous Australian adults

Background: To describe near‐vision impairment, self‐reported unresolved vision problems and barriers to having near‐vision correction in Indigenous Australians. Design: A nationwide population‐based study designed to determine the causes and prevalence of vision loss and utilization of eye care services. Participants: Indigenous Australians aged ≥40 years. Methods: Using a multistage random cluster sampling methodology, 30 geographical areas stratified by remoteness were selected to obtain a representation of Indigenous Australians. Visual acuity was conducted using a standard E chart. A questionnaire collected data on eye health, eye care service utilization and vision‐related quality of life. Main Outcome Measures: Near‐vision impairment defined as presenting binocular near visual acuity <N8. Self‐reported unresolved vision problems defined as anything considered an eye/vision problem by the participant, including distance and/or near‐vision impairments, not resolved after seeking care and quality‐of‐life scores. Results: Being aged 50–59 years (reference group 40–49 years), speaking a language other than English at home and vision loss (distance vision impairment and blindness) increased the odds of near‐vision impairment. Of those with near‐vision impairment, 37% (175/468) reported not having near‐vision correction. Being aged 60–69 years, speaking a language other than English at home and having vision loss decreased the odds of having near‐vision correction. Longer time since last consultation was associated with unresolved vision problems and worse quality‐of‐life scores. Conclusion: There remains a large unmet need in regard to near‐vision correction. Many Indigenous adults have unresolved vision problems that could be resolved with regular consultations with eye care services.