Effect of abutment`s height and framework alloy on the load distribution of mandibular cantilevered implant-supported prosthesis

In cantilevered implant-supported complete prosthesis, the abutments` different heights represent different lever arms to which the abutments are subjected resulting in deformation of the components, which in turn transmit the load to the adjacent bone. The purpose of this in vitro study was to quantitatively assess the deformation of abutments of different heights in mandibular cantilevered implant-supported complete prosthesis. A circular steel master cast with five perforations containing implant replicas (O3.75 mm) was used. Two groups were formed according to the types of alloy of the framework (CoCr or PdAg). Three frameworks were made for each group to be tested with 4, 5.5 and 7 mm abutments. A 100 N load was applied at a point 15 mm distal to the center of the terminal implant. Readings of the deformations generated on the mesial and distal aspects of the abutments were obtained with the use of strain gauges. Deformation caused by tension and compression was observed in all specimens with the terminal abutment taking most of the load. An increase in deformation was observed in the terminal abutment as the height was increased. The use of an alloy of higher elastic modulus (CoCr) also caused the abutment deformation to increase. Abutment`s height and framework alloy influence the deformation of abutments of mandibular cantilevered implant-supported prosthesis. To cite this article:Suedam V, Capello SouzaEA, Moura MS, Jacques LB, Rubo JH. Effect of abutment`s height and framework alloy on the load distribution of mandibular cantilevered implant-supported prosthesis. Clin. Oral Impl. Res. 20, 2009; 196-200.doi: 10.1111/j.1600-0501.2008.01609.x.

Influence of the menstrual cycle on the pressure pain threshold of masticatory muscles in patients with masticatory myofascial pain

Objective. The aim of this study was to investigate the influence of the menstrual cycle and oral contraceptive (OC) intake on the pressure pain threshold (PPT) of masticatory muscles in patients with masticatory myofascial pain (MFP). Study design. The sample was composed of 36 women, divided into 4 groups, according to the presence of MFP and the intake of OC (15 patients had MFP [7 taking OC] and 21 were pain-free controls [8 taking OC]). The algometer-based PPT of masseter and temporalis, and the record of subjective pain by visual analog scale (VAS) were determined during 2 consecutives menstrual cycles at 4 phases (menstrual, follicular, periovulatory, and luteal). A 3-way ANOVA for repeated measurements, Kruskal-Wallis, Friedman, and Dunn tests, with a 5% significant level analyzed the data. Results. PPT was significantly lower in MFP patients when compared with controls throughout the experiment (P < .001). The menstrual phases did not influence PPT (P > .05), while the intake of OC seems to raise PPT levels for the left temporalis (P = .01) and right masseter (P = .04). VAS was, in general, higher at the menstrual phase Conclusions. Different phases of the menstrual cycle have no influence on PPT values, regardless of the presence of a previous condition, as masticatory myofascial pain, while the intake of OC is associated with decreased levels of reported pain.

Molecular and cellular biology of pre-malignancy in the gastrointestinal tract

Important pathogenic alterations within established cancers are acquired during the premalignant stage. These genetic alterations can be grouped into specific neoplastic pathways that differ within and between anatomical sites. By understanding the mechanisms that determine the initiation and progression of each pathway, it will be possible to develop novel approaches to the diagnosis, prevention and treatment of cancer. This chapter outlines the principles underlying the molecular characterization of pre-malignant lesions, taking colorectal neoplasia as the main model.

Functional polymorphisms in the promoter of the matrix metalloproteinase-9 (MMP-9) gene are not linked with significant plasma MMP-9 variations in healthy subjects

Background: Matrix metalloproteinase-9 (MMP-9) is involved in the degradation of the extracellular matrix during physiological and pathological processes. Two functional polymorphisms [C(-1562)T and microsatellite (CA)(13-25)] in the promoter region of the MMP-9 gene have been associated with several diseases. The aim of this study was to examine whether these MMP-9 polymorphisms and haplotypes are linked with plasma MMP-9 variations in healthy subjects. Methods: We studied 177 healthy male white volunteers (age range 20-55 years) who were non-smokers and not taking any medication. Genomic DNA was extracted from whole blood and genotypes for the C(-1562)T and the microsatellite (CA)(n) polymorphisms were determined. MMP-9 levels were measured in plasma samples by gelatin zymography. Results: The frequency of the alleles C and T for the C(-1562)T polymorphism were 90% and 10%, respectively. The frequency of the alleles with less than 21 CA repeats Q and with 21 repeats or higher (H) were 47% and 53%, respectively. We found no differences in plasma MMP-9 levels among the genotype groups or among different haplotypes (all p > 0.05). Conclusions: These findings suggest that functional polymorphisms in the promoter of the MMP-9 gene are not linked with significant plasma MMP-9 variations in healthy subjects.

Feasibility of an evidence-based literature search service for general practitioners

Objective: To test the feasibility of an evidence-based clinical literature search service to help answer general practitioners' (GPs') clinical questions. Design: Two search services supplied GPs who submitted questions with the best available empirical evidence to answer these questions. The GPs provided feedback on the value of the service, and concordance of answers from the two search services was assessed. Setting: Two literature search services (Queensland and Victoria), operating for nine months from February 1999. Main outcome measures: Use of the service; time taken to locate answers; availability of evidence; value of the service to GPs; and consistency of answers from the two services. Results: 58 GPs asked 160 questions (29 asked one, 11 asked five or more). The questions concerned treatment (65%), aetiology (17%), prognosis (13%), and diagnosis (5%). Answering a question took a mean of 3 hours 32 minutes of personnel time (95% Cl, 2.67-3.97); nine questions took longer than 10 hours each to answer, the longest taking 23 hours 30 minutes. Evidence of suitable quality to provide a sound answer was available for 126 (79%) questions. Feedback data for 84 (53%) questions, provided by 42 GPs, showed that they appreciated the service, and asking the questions changed clinical care. There were many minor differences between the answers from the two centres, and substantial differences in the evidence found for 4/14 questions. However, conclusions reached were largely similar, with no or only minor differences for all questions. Conclusions: It is feasible to provide a literature search service, but further assessment is needed to establish its cost effectiveness.

Increasing the response rate to a mailed questionnaire by including more stamps on the return envelope: A cotwin control study

Twins taking part in two unrelated studies were sent a questionnaire together with a self-addressed envelope that either carried one or multiple (up to 5) stamps to the same value. The unprompted proportion of questionnaires returned (before commencement of telephone reminder calls) was increased from 62% to 71% in one study, and from 43% to 52% in the other study (test for common odds ratio in studies, p = 0.04).

IBD sharing around the PPARG locus is not increased in dizygotic twins or their mothers

We observe no evidence of linkage to the region around the PPARG locus in several samples of DZ twins who have been genotyped at multiple markers on chromosome 3 (Fig. 1). Among 199 Australian DZ twins ascertained for a history of wheezing2, mean identity by descent (IBD) sharing at the position of PPARG is 0.463 (99% bootstrapped confidence interval=0.412−0.516). We obtained a similar result with 232 pairs of Australian adolescent DZ twins taking part in a longitudinal study of naevus development3 (0.444, 0.390−0.499), and a set of 125 Australian adult DZ twin pairs assessed for anxiety4 (0.508, 0.435−0.580). A Dutch scan of 160 DZ twin pairs5 obtained slightly more encouraging results (0.553, 0.482−0.587, peak maximum lod score (MLS)=0.57). Pooling all these samples gives 0.477 (0.454−0.512) at the position of PPARG. The test for heterogeneity of sharing between studies was not significant (P=0.10). In the combined dataset, the peak IBD sharing (MLS=0.70) is 50 cM closer to the centromere than PPARG. Finally, in a sample of 203 Australian and New Zealand sister pairs where each had given birth to DZ twins6, sharing across the region is also not increased (0.433). We do not replicate linkage in the populations we study to survival of a twin pregnancy or polyovulation.

Colourful objects through animal eyes

To understand how bees, birds, and fish may use colour vision for food selection and mate choice, we reconstructed views of biologically important objects taking into account the receptor spectral sensitivities. Reflectance spectra a of flowers, bird plumage, and fish skin were used to calculate receptor quantum catches. The quantum catches were then coded by red, green, and blue of a computer monitor; and powers, birds, and fish were visualized in animal colours. Calculations were performed for different illumination conditions. To simulate colour constancy, we used a von Kries algorithm, i.e., the receptor quantum catches were scaled so that the colour of illumination remained invariant. We show that on land this algorithm compensates reasonably well for changes of object appearance caused by natural changes of illumination, while in water failures of von Kries colour constancy are prominent. (C) 2000 John Wiley & Sons, Inc.

Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda

This paper reports research conducted among theaged residents of a rural, Southwestern Ugandanvillage. It documents their knowledge ofHIV/AIDS, their perceptions of their own riskof infection, and the multiple impacts of thecurrent HIV/AIDS epidemic on their lives. Mostolder individuals have a sound understanding ofthe sexual transmission of HIV, and someconsider themselves to be at risk of infectionthrough having multiple sexual partners. Theyattempt to limit their children's exposure toHIV, but many of these children have left thevillage to live in urban areas of relativelyhigh HIV prevalence. The loss of adult childrendeprives the aged of any support these childrenmight have provided as their parents'capabilities declined with advancing age.Female-headed households were more affected inthis way than were male-headed households. TheAIDS epidemic has increased the number ofburials taking place in the village, and theiraccumulated costs, both in time and money, andcreated new hardships for the aged, who alsohave to cope with grief that accompaniescontinuing deaths among their children andtheir contemporaries' children.

Patient based method of assessing adverse events in clinical trials in rheumatology: the revised Stanford Toxicity Index

We describe the progress towards developing a patient rated toxicity index that meets all of the patient-important attributes defined by the OMERACT Drug Safety Working Party, These attributes are frequency, severity. importance to patient, importance to the clinician, impact on economics, impact on activities, and integration of adverse effects with benefits. The Stanford Toxicity Index (STI) has been revised to collect all attributes with the exception of impact on activities. However, since the STI is a part of the Health Assessment Questionnaire (HAQ). impact on activities is collected by the HAQ. In particular, a new question asks patients to rate overall satisfaction, taking into consideration both benefits and adverse effects. The nest step in the development of this tool is to ensure that the STI meets the OMERACT filter of truth, discrimination, and feasibility. Although truth and feasibility have been confirmed by comparisons within the ARAMIS database, discrimination needs to be assessed in clinical trials.

Clinically significant drug interactions with agents specific for migraine attacks

The drugs which provide specific relief from migraine attacks, the ergopeptides (ergotamine and dihydroergotamine) and the various 'triptans' (notably sumatriptan), are often prescribed for persons already taking various migraine preventative agents, and sometimes drugs for other indications. As a result, migraine-specific drugs may become involved in drug-drug interactions. The migraine-specific drugs all act as agonists at certain subclasses of serotonin (5-hydroxytryptamine; 5-MT) receptor, particularly those of the 5-HT1D subtype, and produce vasoconstriction through these receptor-mediated mechanisms. The oral bioavailabilities of these drugs, particularly those of the ergopeptides, are often incomplete, due to extensive presystemic metabolism. As a result, if migraine-specific agents are coadministered with drugs with vasoconstrictive properties, or with drugs which inhibit the metabolism of the migraine-specific agents, there is a risk of interactions occurring which produce manifestations of excessive vasoconstriction. This can also occur through pharmacodynamic mechanisms, as when ergopeptides or triptans are coadministered with methysergide or propranolol (although a pharmacokinetic element may apply in relation to the latter interaction), or if one migraine-specific agent is used shortly after another. When egopeptide metabolism is inhibited by the presence of macrolide antibacterials, particularly troleandomycin and erythromycin, the resultant interaction can produce ergotism, sometimes leading to gangrene. Similar pharmacokinetic mechanisms, with their vasoconstrictive consequences, probably apply to combination of the ergopeptides with HIV protease inhibitors (indinavir and ritonavir), heparin, cyclosporin or tacrolimus. Inhibition of triptan metabolism by monoamine oxidase A inhibitors, e.g. moclobemide, may raise circulating triptan concentrations, although this does not yet seem to have led to reported clinical problems. Caffeine may cause increased plasma ergotamine concentrations through an as yet inadequately defined pharmacokinetic interaction. However, a direct antimigraine effect of caffeine may contribute to the claimed increased efficacy of ergotamine-caffeine combinations in relieving migraine attacks. Serotonin syndromes have been reported as probable pharmacodynamic consequences of the use of ergots or triptans in persons taking serotonin reuptake inhibitors. There have been two reports of involuntary movement disorders when sumatriptan has been used by patients already taking loxapine. Nearly all the clinically important interactions between the ergopeptide antimigraine agents and currently marketed drugs are likely to have already come to notice. In contrast, new interactions involving the triptans are likely to be recognised as additional members of this family of drugs, with their different patterns of metabolism and pharmacokinetics, are marketed.

CD40 and CD86 upregulation with divergent CMRF44 expression on blood dendritic cells in inflammatory bowel diseases

OBJECTIVE: Dendritic cells (DC) are the only antigen-presenting cells that can activate naive T lymphocytes and initiate a primary immune response. They are also thought to have a role in immune tolerance. DC traffic from the blood to peripheral tissue where they become activated. They then present antigen and the costimulating signals necessary to initiate an immune response. In this study, we investigated the number, subsets, and activation pattern of circulating and intestinal DC from patients with clinically mild ulcerative colitis (UC) or Crohn's disease. METHODS: Patients were recruited, if they were not taking immunosuppressive therapy, and were assessed for clinical severity of their disease using for UC, the Clinical Activity Index, and for Crohn's disease, the Crohn's Disease Activity Index. Blood CD11c(+) and CD11c(-) DC subsets, expression of costimulatory antigens, CD86 and CD40, and the early differentiation/activation antigen, CMRF44, were enumerated by multicolor flow cytometry of lineage negative (lin(-) = CD3(-), CD19(-), CD14(-), CD16(-)) HLA-DR+ DC. These data were compared with age-matched healthy and the disease control groups of chronic noninflammatory GI diseases (cGI), acute noninflammatory GI diseases (aGI), and chronic non-GI inflammation (non-GI). In addition, cryostat sections of colonoscopic biopsies from healthy control patients and inflamed versus noninflamed gut mucosa of inflammatory bowel disease (IBD) patients were examined for CD86(+) and CD40(+)lin(-) cells. RESULTS: Twenty-one Crohn's disease and 25 UC patients, with mean Crohn's Disease Activity Index of 98 and Clinical Activity Index of 3.1, and 56 healthy controls, five cGI, five aGI, and six non-GI were studied. CD11c(+) and CD11c(-) DC subsets did not differ significantly between Crohn's, UC, and healthy control groups. Expression of CD86 and CD40 on freshly isolated blood DC from Crohn's patients appeared higher (16.6%, 31%) and was significantly higher in UC (26.6%, 46.3%) versus healthy controls (5.5%, 25%) (p = 0.004, p = 0.012) and non-GI controls (10.2%, 22.8%) (p = 0.012, p = 0.008), but not versus cGI or aGI controls. CD86(+) and CD40(+) DC were also present in inflamed colonic and ileal mucosa from UC and Crohn's patients but not in noninflamed IBD mucosa or normal mucosa. Expression of the CMRF44 antigen was low on freshly isolated DC, but it was upregulated after 24-h culture on DC from all groups, although significantly less so on DC from UC versus Crohn's or healthy controls (p = 0.024). The CMRF44(+) antigen was mainly associated with CD11c(+) DC, and in UC was inversely related to the Clinical Activity Index (r = -0.69, p = 0.0002). CONCLUSIONS: There is upregulation of costimulatory molecules on blood DC even in very mild IBD but surprisingly, there is divergent expression of the differentiation/activation CMRF44 antigen. Upregulation of costimulatory molecules and divergent expression of CMRF44 in blood DC was also apparent in cGI and aGI but not in non-GI or healthy controls, whereas intestinal CD86(+) and CD40(+) DC were found only in inflamed mucosa from IBD patients. Persistent or distorted activation of blood DC or divergent regulation of costimulatory and activation antigens may have important implications for gut mucosal immunity and inflammation. (Am J Gastroenterol 2001;96:2946-2956. (C) 2001 by Am. Coll. of Gastroenterology).

Skeletal effects of low-intensity pulsed ultrasound on the ovariectomized rodent

Growing evidence supports low-intensity pulsed ultrasound (US) as an osteogenic mechanical stimulus. Its effects on isolated bone cells and on fractured bone are established. However, its effects on osteoporosis are not clear. This study examined US effects on ovariectomy (OVX) induced bone changes within the rodent hindlimb (distal femur and proximal tibia), and on normal bone in animals following sham-OVX. Animals were exposed to daily unilateral active-US and contralateral inactive-US for 12 weeks. Bone status was assessed using dual energy X-ray absorptiometry and histomorphometry. Ovariectomy resulted in significant bone changes. Low-intensity pulsed US did not influence these changes. These results suggest that the US dose introduced may not be a beneficial treatment for osteoporosis, and that intact bone may be less sensitive to US than fractured bone and isolated bone cells. This may relate to the biophysical mechanisms of action of US, US-bone interactions and tissue level processes taking place.

Organizational actions in response to threats and opportunities

In this study, we tested a model in which threats and opportunities lead directly to different organizational actions and compared it to a model in which organizational characteristics moderate organizational actions taken in response to threats and opportunities. To better understand these effects, we differentiated the dimensions of threat and opportunity associated with the threat-rigidity hypothesis from the dimensions associated with prospect theory. In this study, threats had the main and moderated effects predicted from the literature, but opportunities did not.

Rate and timing of vegetative growth, flowering and fruit development of Persoonia virgata (Proteaceae)

Persoonia virgata R. Br. is harvested from the wild in both its vegetative and flowering stages. There has been no systematic study published on the annual growth cycle and anecdotal reports are conflicting. The growth pattern, flowering and fruit development of P. virgata in its natural habitat was recorded monthly for two consecutive years. The main growth period occurred in late spring-mid-autumn (November-May) when the shrubs were producing little or no fruit. Very few open flowers were observed at the site over the 2 years, with only 6.7 and 12.7% of stems bearing open flowers in January and February 1996, respectively. A second study of flowering on container-grown shrubs showed that individual flowers were open for only 2-5 days, with individual stems taking 3-8.5 weeks to complete flowering. The main fruit growth period occurred from May to September, and in June and July 1996 the total fruit set per stem was 41.6 and 36.1%, respectively. The fruit took at least 6 months to develop during which vegetative growth was minimal. The harvesting of plants in the flowering or fruiting stages removes the annual seed crop, which may reduce regeneration of this obligate seed regenerator and threaten its survival after fire.