Predicting stress-related problems in long-term breast cancer survivors

Introduction

Little is known about the early clinical and psychosocial factors associated with subsequent stress-related problems in breast cancer survivors.

Methods

We used data collected at 3, 7, 11, and 15 months post-diagnosis to predict stress-related problems in 86 breast cancer survivors at 6 years post-diagnosis. We examined two common stress-related problems: (a) emotional distress and (b) intrusion and avoidance. Hypothesized risk factors included perceived stressfulness of the cancer; fear of the future; poor perceived health; initial stress-related problems; avoidance coping; and second cancer experience. Hypothesized protective factors included active coping (seeking social support; positive problem solving); optimism; and social support.

Results

Hierarchical multiple regression analyses, controlling for age and education, indicated that positive problem-solving coping at 3 months and emotional distress at 7 months significantly predicted 6-year emotional distress (R²=.24, P<.01). Second cancer experience and 3-month intrusion and avoidance significantly predicted 6-year intrusion and avoidance (R²=.38, P<.001). In both cases, risk and/or protective factors measured at 11 and 15 months did not add significantly to the regression equations.

Discussion/Conclusion

Symptoms of intrusion and avoidance should be monitored carefully during the first 3 months following diagnosis because they signal the risk that these symptoms will persist in the long-term. Elevated emotional distress at 7-months post-diagnosis and second-cancer experiences may signal the need for psychosocial intervention. Overreliance on positive problem solving to cope early in the disease trajectory may be detrimental in the longer term.     

片段弓和种植支抗滑动关闭间隙两种方法同时压入内收上前牙的临床研究

目的：比较两种临床矫治技术：片段弓,种植支抗滑动关闭间隙压入和内收上前牙的临床效果分析。方法：临床筛选18例患者,使用片段弓技术同时压入内收上前牙。筛选19例患者使用种植支抗滑动关闭间隙技术同时压入内收上前牙。头影测量描记上前牙,上颌第一磨牙的位置变化。使用根尖片测量根尖吸收的情况。结果：两组间比较发现下列测量指标有显著性减小变化：U1-SN,覆盖,覆（牙合）,PP-U1,U1horizontal,UL-U1。相比种植支抗组,片段组的病例中如下头影测量指标有显著性增加：U6angle,MP-SN,PP-U6,U6Horizontal。压入内收上前牙的所需时间和根吸收在两组比较中没有显著性差别。结论：种植支抗滑动关闭间隙的临床治疗方法能够有效地压入内收上前牙。和传统片段弓压入内收上前牙相比,种植支抗在矢状向,垂直向都能够有效地维护上磨牙原有的位置。     

Semantic and phonological information in sentence recall: Converging psycholinguistic and neuropsychological evidence

We present one experiment and a neuropsychological case study to investigate to what extent phonological and semantic representations contribute to short-term sentence recall. We modified Potter and Lombardi's (1990) intrusion paradigm, in which retention of a list interferes with sentence recall such that on the list a semantically related lure is presented, which is expected to intrude into sentence recall. In our version, lure words are either semantically related to target words in the sentence or semantically plus phonologically related. With healthy participants, intrusions are more frequent when lure and target overlap phonologically in addition to semantically than when they solely overlap semantically. When this paradigm is applied to a patient with a phonological short-term memory impairment, both lure types induce the same amount of intrusions. These findings indicate that usually phonological information is retained in sentence recall in addition to semantic information.     

片断弓技术纠正成人安氏二类错(牙合)伴深覆(牙合)时牙颌位置的变化

目的:通过研究矫正前后牙颌位置的变化,证实片断弓技术纠正成人安氏二类错伴深覆的有效性。方法:选择16例(平均年龄25.8岁)安氏Ⅱ类伴Ⅲ度深覆病例,利用片断弓压低辅弓技术打开咬至正常约2mm。计算T1期和T2期各测量指标的平均值和标准差。采用t检验检测各测量指标之间是否具有组间显著性差异。结果:深覆纠正至2mm,平均覆减少2.9mm,P<0.01具有显著性差异。上下前牙分别被压低1.4mm,1.5mm(P<0.001)且处于相对稳定的近远中位置(L1~NPg=-0.3mm,NS)。下颌后牙未见显著性升高。平面顺时针倾斜增加2°(P<0.01)。下颌平面未见明显的改变。结论:片断压低辅弓技术很有效地实现了压低前牙,而后牙没有出现显著性的升高,深覆纠正后基本维持原有的下颌平面倾斜角度。     

Force changes associated with different intrusion strategies for deep-bite correction by clear aligners

Objectives:To investigate the relationships among different intrusion patterns of clear overlay aligners and the corresponding orthodontic forces and to provide guidance for clinical treatment.Materials and Methods:Five sets of removable thermoplastic-formed aligners with the same thickness, designed for different intrusion procedures (G0 aligners as a control group, with no activation; G1 aligners for intruding canines; G2 aligners for intruding incisors; G3 aligners for intruding canines and incisors with the same activations; G4 aligners for intruding canines and incisors with different activation), were manufactured, and the corresponding intrusion forces were measured with a multiaxis force/torque transducer measurement system in real time.Results:With the same activation (0.2-mm intrusion) and rectangular attachments placed on the premolars and first molars, the canines experienced the largest intrusive force when intruded alone using G1 aligners. The canines received a larger intrusive force than incisors in G3. The incisors received similar forces in G2 and G3. First premolars endured the largest extrusive forces when all anterior teeth were intruded with G3 aligners. Extrusion forces were exerted on canines and lateral incisors when using G4 aligners.Conclusions:Aligners with different intrusion patterns exert different forces on incisors, canines, and premolars, and the forces were closely related to the designed activation, shape and position of the attachment and relative movement of the adjacent teeth.     

Multiloop edgewise archwire treatment for a patient with a severe anterior open bite and amelogenesis imperfecta

Amelogenesis imperfecta is a rare hereditary disorder that affects dental enamel and is often associated with an anterior open bite. Orthodontic treatment of a 16-year-old female patient with hypocalcified amelogenesis imperfecta and a 9-mm anterior open bite was presented. Radiographic examination revealed a steep mandibular plane angle, an increased lower face height, a Class II skeletal pattern, and a convex profile. Additionally, the patient had stainless steel crowns on all upper and lower posterior teeth and composite veneers on the upper anterior teeth. The patient was treated nonsurgically using a multiloop edgewise archwire (MEAW). MEAW mechanics allowed for successful correction of the anterior open bite, with significant reduction in the mandibular plane angle and improvement in the patient''s profile. No fixed retainers were used, and the results remained stable 78 months after removal of orthodontic appliances. MEAW mechanics should be considered for patients with large anterior open bites, although this technique requires excellent patient compliance.     

Does overbite reduction affect smile esthetics?

Objectives:To compare the effects of two common methods of overbite reduction on smile esthetics.Materials and Methods:A prospective clinical trial was conducted with 32 patients in whom overbite reduction was achieved using a maxillary incisor intrusion arch (18 patients) or flat anterior bite plate (14 patients). Clinical and cephalometric records were compared pretreatment (T1), after overbite reduction (T2), and posttreatment (T3).Results:Both treatment groups experienced a reduction in overbite and maxillary and mandibular incisor proclination during treatment (T1–T3). The center of resistance of the maxillary incisor and the incisal edge was significantly intruded in the intrusion arch group during overbite reduction (T1–T2). However, most of the intrusion of the center of resistance was lost by the end of treatment (T2–T3). Both treatment groups experienced a reduction in maxillary incisor display and flattening of the smile arc during overbite reduction.Conclusions:Both overbite reduction methods caused a decrease in incisor display and flattening of the smile arc. Smiles were improved in some patients by the end of treatment. However, reduction in incisor display persisted. Clinicians should take precautions to prevent negative effects of overbite reduction.     

Intrusion of anterior teeth to improve smile esthetics

A gummy smile is probably one of the most common causes of an unaesthetic smile. Causes include overeruption of maxillary anterior teeth and maxillary vertical excess. Intrusion of maxillary anterior teeth with Orthodontics and Le forte I superior repositioning may form a part of the solution. Of late the use of micro implants have improved the smile esthetics of borderline surgical cases by allowing the Orthodontist to intrude teeth more than what was possible with conventional Orthodontics.     

无托槽隐形矫治器各参数对尖牙压低移动治疗的影响

目的研究隐形矫器不同参数(厚度、矫治位移量及弹性模量)在下颌尖牙压低移动治疗中对尖牙位移和牙周膜应力的影响。方法通过有限元方法模拟下颌尖牙在48个不同隐形矫治器模型作用下的压低治疗。结果尖牙的初始位移和牙周膜应力均与隐形矫治器厚度、压低位移和弹性模量成正比关系,隐形矫治器包含的压低位移量是对牙齿压低移动治疗影响最大的因素。在尖牙的压低移动治疗中,牙周膜压应力是最敏感最易受参数变化影响的参数。结论增大矫治器的厚度、压低位移和弹性模量可以提高尖牙的压低位移,但是同时牙周膜应力也将增大,并且牙周膜压应力增大的幅度最大。要加速无托槽隐形矫治治疗正畸牙移动,只能辅助以诸如黏贴附件、托槽弓丝矫治治疗和辅助外加种植支抗等其他附加的设备或者措施。