scholarly journals Predprotetičko liječenje kompleksnog 35-godišnjeg bolesnika lošeg oralnog zdravlja

2021 ◽  
Vol 45 (2) ◽  
pp. 161-165
Author(s):  
Marko Babić ◽  
Alessia Cerin ◽  
Nikolina Lešić ◽  
Đorđe Petrović ◽  
Sonja Vukadin ◽  
...  
Keyword(s):  
Teaching Assistants ◽  
Complete Loss ◽  
Dental Disease ◽  
Alveolar Ridge ◽  
Loss Of Function ◽  
Oral Rehabilitation ◽  
Dental Attrition ◽  
Life Improvement ◽  
Periapical Periodontitis

This is a case of a 35-year-old patient who was selected to participate in the humanitarian project of a complete oral rehabilitation and quality of life improvement. The project was carried out by the dean, professors, teaching assistants and students at the Faculty of Dental Medicine and Health in Osijek. Patient’s oral cavity status was incongruent with his age due to the extensive inflammatory disease and active caries on multiple teeth. Further progression of dental disease in this patient would have led to a complete loss of function, alveolar ridge resorption and edentulousness of the both jaws. Clinical examination revealed the following: decay of the teeth 18, 13, 12, 23, 33, 43 (FDI system), dental attrition of teeth 32, 31, 41, 42, root remnants 15, 14, 11, 24, 26, 27, 38, 37, 36, 35 and 34, periodontitis and periapical periodontitis. Extensive dental reparative work has been done in this patient and he was prepared for the upcoming prosthetic work.

Chronic Ischemic Monomelic Neuropathy after Arteriovenous Fistula Creation: A Unique Presentation of Vascular Steal

2020 ◽  
Vol 3 (2) ◽  
pp. 147-150
Author(s):  
Kaczynski RE ◽  
Asaad Y ◽  
Valentin-Capeles N ◽  
Battista J
Keyword(s):  
Arteriovenous Fistula ◽  
Complete Loss ◽  
Dialysis Access ◽  
Loss Of Function ◽  
Access Site ◽  
Surgical Ligation ◽  
Arteriovenous Access ◽  
Vascular Steal ◽  
Steal Syndrome

We discuss a case of a 58 year old male who presented for left upper extremity steal syndrome including ischemic monomelic neuropathy (IMN) 1.5 months after arteriovenous fistula creation. He presented after three surgical attempts to salvage his fistula with rest pain, complete loss of function with contracture of the 4th and 5th digits, and loss of sensation in the ulnar distribution for more than three weeks. At our institution, he underwent surgical ligation of the distal fistula and creation of a new fistula proximally, resulting in complete resolution of his vascular steal symptoms almost immediately despite the chronicity prior to surgical presentation. Our patient provides a unique perspective regarding dialysis access salvage versus patient quality of life. The patients’ functional status and pain levels should take precedence over salvage of an arteriovenous access site, and early ligation of the access should be completed prior to chronic IMN development. However, if a patient presents late along the IMN course, we recommend strong consideration of access ligation in order to attempt to regain the full neurovascular function of the extremity as we experienced in our patient.

Letter to the Editor: The Continuing Challenge of Evaluating RSD Impairment and Disability

1998 ◽  
Vol 3 (5) ◽  
pp. 8-10
Author(s):  
Robert L. Knobler ◽  
Charles N. Brooks ◽  
Leon H. Ensalada ◽  
James B. Talmage ◽  
Christopher R. Brigham
Keyword(s):  
Disability Evaluation ◽  
Body Part ◽  
Loss Of Function ◽  
Regulatory Requirements ◽  
Major Cardiac Event ◽  
Clinical Scenarios ◽  
Impairment Score ◽  
Occupational Activities ◽  
The Difference

Abstract The author of the two-part article about evaluating reflex sympathetic dystrophy (RSD) responds to criticisms that a percentage impairment score may not adequately reflect the disability of an individual with RSD. The author highlights the importance of recognizing the difference between impairment and disability in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides): impairment is the loss, loss of use, or derangement of any body part, system, or function; disability is a decrease in or the loss or absence of the capacity to meet personal, social, or occupational demands or to meet statutory or regulatory requirements because of an impairment. The disparity between impairment and disability can be encountered in diverse clinical scenarios. For example, a person's ability to resume occupational activities following a major cardiac event depends on medical, social, and psychological factors, but nonmedical factors appear to present the greatest impediment and many persons do not resume work despite significant improvements in functional capacity. A key requirement according to the AMA Guides is objective documentation, and the author agrees that when physicians consider the disability evaluation of people, more issues than those relating to the percentage loss of function should be considered. More study of the relationships among impairment, disability, and quality of life in patients with RSD are required.

Patient satisfaction and comfort after a full-arch immediate loaded prosthesis

2020 ◽  
Author(s):  
Elena Dellepiane ◽  
Francesco Pera ◽  
Paola Zunino ◽  
Maria Grazia Mugno ◽  
Paolo Pesce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Intermediate Phase ◽  
Critical Issue ◽  
Health Impact ◽  
Immediate Loading ◽  
Oral Rehabilitation ◽  
Masticatory Ability ◽  
Chewing Ability

The aim of this study was to assess oral health related quality of life (OHRQoL) of patients before, during and after completion of implant-supported full-arch immediate loading rehabilitation according to the Columbus Bridge Protocol (CBP). 25 patients with compromised dentition were rehabilitated according to the CBP and were assessed for OHRQoL using 4 questionnaires specifically realized for this study and inspired to the OHIP (Oral Health Impact Profile) questionnaire. Patients assessed themselves before surgery, during the healing period (1 week and 2 months after surgery) and after definitive prosthodontic treatment (4 months after surgery). The questionnaires specifically investigated patients’ pain, confort, home oral hygiene habits, satisfaction related to esthetics, masticatory ability, phonetics and general satisfaction toward the treatment.Patients reported an improvement of OHRQoL after full-arch immediate loading rehabilitation. A statistically significant improvement in aesthetic and chewing ability was found. After 4 months 92% of the patients did not feel tense with their smile, 96% did not show problems to relate with other people or smiling, 92% did not show difficulty to eat some foods. Phonetics was found to be a critical issue, especially in the intermediate phase of healing. One week after surgery the percentage of patients who was very satisfied with phonetics slightly decreased from 48% to 36%. The assessment of patients' OHRQoL related to full-arch immediate loading implant therapy exhibited a significant improvement of their quality of life. The questionnaires herein presented could be an effective tool to evaluate patients' reaction to oral rehabilitation.

scholarly journals The Use of Autogenous Teeth for Alveolar Ridge Preservation: A Literature Review

2021 ◽  
Vol 11 (4) ◽  
pp. 1853
Author(s):  
João Cenicante ◽  
João Botelho ◽  
Vanessa Machado ◽  
José João Mendes ◽  
Paulo Mascarenhas ◽  
...  
Keyword(s):  
Ridge Preservation ◽  
Graft Material ◽  
Alveolar Ridge ◽  
Natural Consequence ◽  
Oral Rehabilitation ◽  
Future Directions ◽  
The Past ◽  
Alveolar Ridge Preservation ◽  
Functional Consequences ◽  
Teeth Extraction

Alveolar ridge resorption is a natural consequence of teeth extraction, with unpleasant aesthetic and functional consequences that might compromise a future oral rehabilitation. To minimize the biological consequences of alveolar ridge resorption, several surgical procedures have been designed, the so-called alveolar ridge preservation (ARP) techniques. One important characteristic is the concomitant use of biomaterial in ARP. In the past decade, autogenous teeth as a bone graft material in post-extraction sockets have been proposed with very interesting outcomes, yet with different protocols of preparation. Here we summarize the available evidence on autogenous teeth as a biomaterial in ARP, its different protocols and future directions.

scholarly journals Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

2021 ◽  
pp. 1-10
Author(s):  
Stephanie Paula Elisabeth Guillery ◽  
Rainer Hellweg ◽  
Golo Kronenberg ◽  
Ulrich Bohr ◽  
Hagen Kunte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Replacement Therapy ◽  
Psychological Functioning ◽  
Treatment Options ◽  
Chronically Ill ◽  
Cross Sectional ◽  
Life Improvement ◽  
Methadone Patients ◽  
Opioid Replacement Therapy

<b><i>Background:</i></b> Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. <b><i>Objectives:</i></b> Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (<i>n</i> = 126), diamorphine (<i>n</i> = 85), or buprenorphine (<i>n</i> = 37) were recruited in 6 German therapy centers. <b><i>Methods:</i></b> Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the <i>Profile of the Quality of Life in the Chronically Ill</i> (PLC) questionnaire. <b><i>Results:</i></b> Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (<i>p</i> &#x3c; 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (<i>p</i> &#x3c; 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.141). Diamorphine patients reported a higher psychological functioning (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.078) and overall life improvement (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.060) compared to methadone, but not compared to buprenorphine patients (both <i>p</i> &#x3e; 0.25). <b><i>Conclusion:</i></b> Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

scholarly journals Molecular characterisation of rare loss-of-function NPAS3 and NPAS4 variants identified in individuals with neurodevelopmental disorders

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joseph J. Rossi ◽  
Jill A. Rosenfeld ◽  
Katie M. Chan ◽  
Haley Streff ◽  
Victoria Nankivell ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Protein Function ◽  
Transcriptional Activity ◽  
Neurodevelopmental Disorder ◽  
Complete Loss ◽  
Loss Of Function ◽  
Targeted Disruption ◽  
Clinical Exome Sequencing ◽  
Partner Protein ◽  
The Brain

AbstractAberrations in the excitatory/inhibitory balance within the brain have been associated with both intellectual disability (ID) and schizophrenia (SZ). The bHLH-PAS transcription factors NPAS3 and NPAS4 have been implicated in controlling the excitatory/inhibitory balance, and targeted disruption of either gene in mice results in a phenotype resembling ID and SZ. However, there are few human variants in NPAS3 and none in NPAS4 that have been associated with schizophrenia or neurodevelopmental disorders. From a clinical exome sequencing database we identified three NPAS3 variants and four NPAS4 variants that could potentially disrupt protein function in individuals with either developmental delay or ID. The transcriptional activity of the variants when partnered with either ARNT or ARNT2 was assessed by reporter gene activity and it was found that variants which truncated the NPAS3/4 protein resulted in a complete loss of transcriptional activity. The ability of loss-of-function variants to heterodimerise with neuronally enriched partner protein ARNT2 was then determined by co-immunoprecipitation experiments. It was determined that the mechanism for the observed loss of function was the inability of the truncated NPAS3/4 protein to heterodimerise with ARNT2. This further establishes NPAS3 and NPAS4 as candidate neurodevelopmental disorder genes.

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