Tooth loss and implant outcomes in patients refractory to treatment in a periodontal practice

Aim: The aim of this study was to investigate the factors associated with continued significant tooth loss due to periodontal reasons during maintenance following periodontal therapy in a specialist periodontal practice in Norway.
Material and Methods: A case-control design was used. Refractory cases were patients who lost multiple teeth during a maintenance period of 13.4 (range 8-19) years following definitive periodontal treatment in a specialist practice. Controls were age- and gender-matched maintenance patients from the same practice. Characteristics and treatment outcomes were assessed, and all teeth classified as being lost due to periodontal disease during follow-up were identified. The use of implants in refractory cases and any complications relating to such a treatment were recorded.
Results: Only 27 (2.2%) patients who received periodontal treatment between 1986 and 1998 in a specialist practice met the criteria for inclusion in the refractory to treatment group. Each refractory subject lost 10.4 (range 4-16) teeth, which represented 50% of the teeth present at baseline. The rate of tooth loss in the refractory group was 0.78 teeth per year, which was 35 times greater than that in the control group. Multivariate analysis indicated that being in the refractory group was predicted by heavy smoking (p=0.026), being stressed (p=0.016) or having a family history of periodontitis (p=0.002). Implants were placed in 14 of the refractory patients and nine (64%) of these lost at least one implant. In total, 17 (25%) of the implants placed in the refractory group were lost during the study period.
Conclusions: A small number of periodontal maintenance patients are refractive to treatment and go on to experience significant tooth loss. These subjects also have a high level of implant complications and failure. Heavy smoking, stress and a family history of periodontal disease were identified as factors associated with a refractory outcome.

Attitudes to community relations in Northern Ireland: signs of optimisim in the post-cease fire period?

This article uses attitudinal data to explore Catholic and Protestant perspectives on community relations and equality since the paramilitary cease fires in 1994. Although attitudes tend to fluctuate with the‘headline grabbing'events of the day, the article argues that there are signs that some fundamental changes have taken place in the post cease fire period. Of particular importance in this regard is the positive response recorded by the Catholic community towards government measures to tackle disadvantage and inequality. Equally significant is the protestant response to many of these measures which is often one of ambivalence rather than derision. In so far as the data appear to challenge the‘zero-sum'game that traditionally underpins relations between the two communities in Northern Ireland, they provide some grounds for optimism. Yet such optimism is tempered somewhat by the seeds of discontent which are manifest within the protestant community, particularly around issues of equality in employment and cultural traditions. Despite the more positive assessment of community relations and equality in 2002, it is argued that further monitoring will be required to determine the long-term effects of policy reform on relationships between the two communit

Habit reversal training as a treatment for refractory OCD - A case study

Nearly 4 million American men and women from all geographic, ethnic, or economic backgrounds are diagnosed with obsessive-compulsive disorder (OCD). While a combination of cognitive behaviour therapy (CBT) and psycho-pharmaca seems successful for 50% to 60% of patients, for intractable cases the typical recommendation is more medication or more CBT, however there is little evidence that the intensified treatment regimen is successful. In this paper, habit reversal training, including awareness training, competing/other response training, self-monitoring, social support, and generalisation, was implemented with a long-term treatment-refractory OCD patient. Treatment gains and long-term maintenance indicate the potential of habit reversal procedures with these patients.

Radiocarbon calibration in the Anglo-Saxon period: AD 495-725

Radiocarbon dating has been rarely used for chronological problems relating to the Anglo-Saxon period. The "flatness" of the calibration curve and the resultant wide range in calendrical dates provide little advantage over traditional archaeological dating in this period. Recent advances in Bayesian methodology have, however, created the possibility of refining and checking the established chronologies, based on typology of artifacts, against 14C dates. The calibration process, within such a confined age range, however, relies heavily on the structural accuracy of the calibration curve. We have therefore re-measured, at decadal intervals, a section of the Irish oak chronology for the period AD 495–725. These measurements have been included in IntCal04.

A phase 2 study of high-activity 186Re-HEDP with autologous peripheral blood stem cell transplant in progressive hormone-refractory prostate cancer metastatic to bone

Purpose: We investigated the potential for improvement in disease control by use of autologous peripheral blood stem cell transplant (PBSCT) to permit administration of high activities of 186Re-hydroxyethylidene diphosphonate (HEDP) in patients with progressive hormone-refractory prostate cancer (HRPC).

Methods: Eligible patients had progressive HRPC metastatic to bone, good performance status and minimal soft tissue disease. Patients received 5,000 MBq of 186Re-HEDP i.v., followed 14 days later by PBSCT. Response was assessed using PSA, survival, pain scores and quality of life.

Results: Thirty-eight patients with a median age of 67 years (range 50–77) and a median PSA of 57 ng/ml (range 4–3,628) received a median activity of 4,978 MBq 186Re-HEDP (range 4,770–5,100 MBq). The most serious toxicity was short-lived grade 3 thrombocytopenia in 8 (21%) patients. The median survival of the group is 21 months (95%CI 18–24 months) with Kaplan-Meier estimated 1- and 2-year survival rates of 83% and 40% respectively. Thirty-one patients (81%, 95% CI 66–90%) had stable or reduced PSA levels 3 months post therapy while 11 (29%, 95% CI 15–49%) had PSA reductions of >50% lasting >4 weeks. Quality of life measures were stable or improved in 27 (66%) at 3 months.

Conclusion: We have shown that it is feasible and safe to deliver high-activity radioisotope therapy with PBSCT to men with metastatic HRPC. Response rates and survival data are encouraging; however, further research is needed to define optimal role of this treatment approach.

Long-period chromospheric oscillations in network bright points

The spatial variation of chromospheric oscillations in network bright points (NBPs) is studied using high-resolution observations in Ca II K3. Light curves and hence power spectra were created by isolating distinct regions of the NBP via a simple intensity thresholding technique. Using this technique, it was possible to identify peaks in the power spectra with particular spatial positions within the NBPs. In particular, long-period waves with periods of 4-15 minutes (1-4 mHz) were found in the central portions of each NBP, indicating that these waves are certainly not acoustic but possibly due to magnetoacoustic or magnetogravity wave modes. We also show that spatially averaged or low spatial resolution power spectra can lead to an inability to detect such long-period waves.