Life-Time Adversities,Reported Thirteen Years After a Suicide Attempt: Relationship to Recovery, 5HTTLPR Genotype,and Past and Present Morbidity

In this study, we investigated how adversities related to past and present morbidity, and genotype. Forty-two, suicide attempters and 22 matched control patients were followed-up after 13 years. Life-time adversities were explored in an interview, and the patients were reassessed psychiatrically. The serotonin-transporter-linked promotor region (5-HTTLPR) was typed. More adversities were reported by suicide attempters than controls, and by still-ill than recovered suicide attempters. Adversities reported at follow-up were related to psychiatric morbidity at follow-up, but not to morbidity 13 years earlier. The 5-HTTLPR, genotype was associated with reported adversities, but not chances of recovery. Adversities potentially affected chronic morbidity. 5-HTTLPR genotype did not affect long-term recovery.     

Network participation for unpromoted female dentists in relation to psychosocial support

Studies have shown that female unpromoted general practice (GP) dentists have a taxing work situation with many problems related to their psychosocial work environment. This study aims to describe: 1) the participation of this group in organized network activity (support groups) in a region (Scania) in Sweden, 2) the sense of support compared with another organization and with a nationwide sample of GP dentists, and 3) the covariation of network participation with support. All unpromoted female dentists within the Public Dental Health Service (PDHS) in Scania received a questionnaire and 94% responded. Those participating in network activity ≥4 times a year constituted 12% of respondents. Cooperation between colleagues was lower than in the nationwide sample. Support from the PDHS was experienced as weak. It was not possible to explain why female unpromoted GP dentists participated ≥4 times a year, while those who felt lonely in their work were to a higher degree participants in a network. Almost 9 out of 10 reported being strengthened by the network both as a person and in a professional role. The female dentist was three times more likely to participate in a network if she had a male head of clinic. The main findings are a paucity of inter‐colleague contact and a lack of association between support and network participation. The many affirmative comments indicated that network participation might be a good coping strategy for unpromoted female GP dentists.     

Bone Graft Healing in Reconstruction of Maxillary Atrophy

Purpose: Evaluate correlations between volume change for iliac crest bone grafts in maxillary reconstruction (graft volume change [GVC]) and bone mineral density (BMD), bone volume fraction (BVF), hematologic bone metabolic factors (I), and identify indicators of implant failure (II). Material and Methods: Forty‐six consecutive patients had their edentulous atrophic maxilla reconstructed with free autogenous bone grafts from anterior iliac crest. Endosteal implants were placed 6 months after graft healing. Computer tomography was performed after 3 weeks and 6 months after grafting. Bone biopsies were taken from the internal table of donor site for calculation (BVF), and blood samples were collected. Implant stability was measured at placement with resonance frequency analysis and expressed as implant stability quotient (ISQ). Implant failure was registered. Results: GVC in onlay bone graft was 37%. The BVF in iliac crest biopsies was 32%. Serum‐IGFBP3 differed with 79% of the samples over normal range. Fifteen patients had one or more implant failures prior to loading (early failures). Forty‐two patients were followed for a minimum of 3 years after implant loading and, in addition, 6/42 patients had one or more implants removed during the follow‐up (late failures). GVC correlated to decreased BMD of lumbar vertebrae L2‐L4 (Kruskal–Wallis test, p = .017). No correlation was found between GVC and hematologic factors (Pearson correlation test) or between GVC and BVF (Kruskal–Wallis test). No correlation was found between ISQ and GVC (Pearson correlation test, p = .865). The association between implant failures and the described factors were evaluated, and no significant correlations were found (unconditional logistic regression). Conclusion: Onlay bone grafts decrease 37% during initial healing period, which correlate to BMD of lumbar vertebrae L2‐L4. No other evaluated parameters could explain GVC. The evaluated factors could not explain implant failure.     

Treatment with mesenchymal stromal cells is a risk factor for pneumonia-related death after allogeneic hematopoietic stem cell transplantation

We performed a retrospective cohort study to find out whether the use of reduced‐intensity conditioning (RIC) might reduce the risk of early death from pneumonia. Pneumonia‐associated deaths were evaluated in 691 hematopoietic stem cell transplantation (HSCT) patients. The majority had a hematological malignancy (n = 504) and an HLA‐matched donor (n = 584). RIC was given to 336 patients and myeloablative conditioning (MAC) to 355. Data concerning radiology, culture and autopsy results were evaluated together with risk factors for death related to pneumonia within or after 100 d after HSCT (early and overall pneumonia). In 60 patients, pneumonia contributed to death (early n = 17). The cumulative incidence of early pneumonia‐related death was 2.8% and 2.1% in MAC and RIC patients, respectively. The cumulative incidence of overall pneumonia‐related death was 8.2% and 10.5%, respectively. In 40 patients, (67%) an etiology could be established, with 19 patients having proven or probable mold infection. In the multivariate analyses, acute graft‐versus‐host disease (GVHD) grades II–IV, cytomegalovirus (CMV) infection and having received mesenchymal stromal cells (MSCs) were factors associated with overall pneumonia‐related death. Bacteremia and a previous HSCT were associated with early pneumonia‐related death. RIC did not reduce the incidence of early death associated with pneumonia. Acute GVHD II–IV, CMV infection and MSC treatment were factors associated with pneumonia‐related death. Mold infection was the most common contributor to pneumonia‐related death in HSCT patients.