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Sample records for restorative treatment art

  1. The atraumatic restorative treatment (ART) strategy in Mexico: two-years follow up of ART sealants and restorations.

    PubMed

    Luengas-Quintero, Elisa; Frencken, Jo E; Muñúzuri-Hernández, Jorge Alejandro; Mulder, Jan

    2013-09-08

    The massive use of preventive measures in Mexico has resulted in a large decline in dental caries over the past two decades. There does however remain a largely unmet need for restorative treatment. This paper describes the steps leading up to the adoption of a strategy, as part of general health policy, to use Atraumatic Restorative Treatment (ART) within the Mexican public health service as a means of addressing this. The objective was to evaluate ART restorations and sealants placed in primary and permanent teeth in schoolchildren from deprived areas over a period of 2 years. 18 Dentists from 13 municipalities in 6 states with the lowest human development index treated 304, 6- to 13-year-old schoolchildren with ART sealants and ART restorations (single-surfaces) on the school compounds. Ketac Molar Easymix was the filling material used. ART procedures were evaluated according to the ART assessment criteria after 1 and 2 years, by 7 calibrated evaluators. Survival rates were estimated, using the PHREG Model with frailty correction. The 2-year cumulative survival rates of fully and partially retained ART sealants were 73.1% (primary teeth) and 48.8% (permanent teeth). The dentine carious lesion failure rates of ART sealants in primary and permanent teeth over the 2-year period were 0% and 2.5%, respectively. The 2-year cumulative survival rates of single-surface ART restorations in primary and permanent teeth were 74% and 80.9%, respectively. Secondary carious lesion development occurred in 6 restored primary teeth (2.1%) and in one restored permanent tooth (1.3%). All restorations placed in primary teeth in one state survived, whilst those in one of the 5 remaining states failed statistically significantly more than those in the other 4. The ART procedures were of substantial quality and had prevented to a large extent the development of new dentine carious lesions in these children from socio-economically deprived areas.

  2. Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART)

    PubMed Central

    MOLINA, Gustavo Fabián; CABRAL, Ricardo Juan; MAZZOLA, Ignacio; BRAIN LASCANO, Laura; FRENCKEN, Jo. E.

    2013-01-01

    The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important. Objective: To test the null-hypotheses that no difference in diametral tensile, compressive and flexural strengths exists between: (1) The EQUIA system and (2) The Chemfil Rock (encapsulated glass-ionomers; test materials) and the Fuji 9 Gold Label and the Ketac Molar Easymix (hand-mixed conventional glass-ionomers; control materials); (3) The EQUIA system and Chemfil Rock. Material and Methods: Specimens for testing flexural (n=240) and diametral tensile (n=80) strengths were prepared according to standardized specifications; the compressive strength (n=80) was measured using a tooth-model of a class II ART restoration. ANOVA and Tukey B tests were used to test for significant differences between dependent and independent variables. Results: The EQUIA system and Chemfil Rock had significantly higher mean scores for all the three strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α=0.05). The EQUIA system had significant higher mean scores for diametral tensile and flexural strengths than the Chemfil Rock (α=0.05). Conclusion: The two encapsulated high-viscosity glass-ionomers had significantly higher test values for diametral tensile, flexural and compressive strengths than the commonly used hand-mixed high-viscosity glass-ionomers. PMID:23857657

  3. Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART).

    PubMed

    Molina, Gustavo Fabián; Cabral, Ricardo Juan; Mazzola, Ignacio; Lascano, Laura Brain; Frencken, Jo E

    2013-01-01

    The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important. To test the null-hypotheses that no difference in diametral tensile, compressive and flexural strengths exists between: (1) The EQUIA system and (2) The Chemfil Rock (encapsulated glass-ionomers; test materials) and the Fuji 9 Gold Label and the Ketac Molar Easymix (hand-mixed conventional glass-ionomers; control materials); (3) The EQUIA system and Chemfil Rock. Specimens for testing flexural (n = 240) and diametral tensile (n=80) strengths were prepared according to standardized specifications; the compressive strength (n=80) was measured using a tooth-model of a class II ART restoration. ANOVA and Tukey B tests were used to test for significant differences between dependent and independent variables. The EQUIA system and Chemfil Rock had significantly higher mean scores for all the three strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α=0.05). The EQUIA system had significant higher mean scores for diametral tensile and flexural strengths than the Chemfil Rock (α=0.05). The two encapsulated high-viscosity glass-ionomers had significantly higher test values for diametral tensile, flexural and compressive strengths than the commonly used hand-mixed high-viscosity glass-ionomers.

  4. Impact of Atraumatic Restorative Treatment (ART) on the treatment profile in pilot government dental clinics in Tanzania

    PubMed Central

    Kikwilu, Emil Namakuka; Frencken, Jo; Mulder, Jan

    2009-01-01

    Background The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics. Methods Dental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square. Results The mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives. Conclusion ART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended. PMID:19505294

  5. Paediatric dentistry education of atraumatic restorative treatment (ART) in Brazilian dental schools.

    PubMed

    Camargo, L B; Fell, C; Bonini, G C; Marquezan, M; Imparato, J C P; Mendes, F M; Raggio, D P

    2011-12-01

    To evaluate the degree of knowledge, use and teaching of atraumatic restorative treatment (ART) of paediatric dentistry lecturers in dental schools throughout Brazil. A structured questionnaire was applied, containing questions regarding the use of ART, socio-demographic characteristics and academic degree background. Descriptive analysis and Poisson's regression were conducted in order to verify the association between exploratory variables and ART teaching (α=5%). Of the 721 questionnaires sent to dental schools, approximately 40% were returned (n=285). Some 98.2% of the participants teach ART. Concerning dental lecturers who teach ART, in multiple regression model, considering ART indication (emergency versus restorative treatment) the lecturers residents of the Mid-West (PR=1.66; CI:1.13-2.45) and Northeast region (PR=1.33; CI:1.02-1.72) and lecturers who use ART regularly (PR=3.73; CI:2.11-5.59) teach ART as restorative treatment. When the question was about reason for using ART (conservative technique versus other techniques failures/fast treatment), lecturers with a longer period of TG (time elapsed since graduation) (PR=1.30; CI:1.08- 1.56) and also lecturers who use ART regularly (PR=2.87; CI:1.95-4.22), teach it as being a conservative technique. Regarding the patients' age covered by ART (versus without limitation), women (PR=1.26; CI:1.06-1.50) and lecturers who use ART regularly (PR=1.28; CI:1.06-1.54), teach that there is no age restriction. ART has been widely taught in Brazilian dental schools, is regularly used in lecturer's clinical practices and has positively influenced the appropriate teaching of this technique.

  6. Survival Rate of Atraumatic Restorative Treatment (ART) Restorations Using a Glass Ionomer Bilayer Technique with a Nanofilled Coating: A Bi-center Randomized Clinical Trial.

    PubMed

    Hesse, Daniela; Bonifácio, Clarissa Calil; Bönecker, Marcelo; Guglielmi, Camila de Almeida Brandão; da Franca, Carolina; van Amerongen, Willem Evert; Colares, Viviane; Raggio, Daniela Prócida

    2016-01-01

    The high-viscosity consistency of glass ionomer cement (GIC) contributes to its inappropriate adaptation, while the material's premature exposure to humidity decreases its mechanical properties. This study's purposes were to: (1) investigate approximal atraumatic restorative treatment (ART) restorations' survival in primary molars using two different insertion techniques and two surface protection materials; and (2) compare the results of cities where treatments were performed. A total of 389 six- to seven-year-olds were selected from two cities in Brazil and randomly assigned into four groups: (1) ART restorations plus petroleum jelly (PJ); (2) bilayer-ART restorations plus PJ; (3) ART restorations plus nanofilled coating for GIC (NC); (4) bilayer-ART restorations plus NC. Restorations were evaluated after one, six, 12, 18, and 24 months. Kaplan-Meier survival analysis, log-rank test, and Cox regression analysis were performed. Restorations' cumulative survival was 46.4 percent. There was a higher survival of bilayer-ART restorations (P=0.03). No difference was observed between surface protection materials (P=0.57). Restorations made in Barueri were almost 2.5-fold more likely to survive than those from Recife (P<0.001). The bilayer technique improves approximal ART restorations' survival in primary molars. The nanofilled coating does not influence restorations' survival rate, and the city where treatments were performed influences restoration survival.

  7. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement.

    PubMed

    Mallow, P K; Durward, C S; Klaipo, M

    1998-03-01

    Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration. To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia. Clinical field trial. One high school in rural Cambodia. 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning). 92.1% of the carious lesions required class I or class V restorations, and 85.4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86.4% and 79.5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76.3% of the restorations were judged to be successful at 1 year, and 57.9% at 3 years. Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements.

  8. The willingness of US pediatric dentists to use atraumatic restorative treatment (ART) with their patients: a conjoint analysis

    PubMed Central

    Kateeb, Elham Talib; Warren, John; Gaeth, Gary; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael J.; Weber-Gasparoni, Karin; Ansley, Timothy

    2014-01-01

    Objectives The atraumatic restorative treatment (ART) was developed as an affordable, patient-friendly dental caries management procedure that does not need extensive operator training or special skills. The aim of this study was to determine factors that influence the decision to use ART using an innovative marketing research technique known as conjoint analysis. Methods A conjoint survey was completed by 723 members of the American Academy of Pediatric Dentistry. Three factors (age of the child, level of cooperation, type of insurance) were varied across three levels to create nine patient scenarios. The weights that practitioners placed on these factors in decisions to use ART in treating carious lesions were determined by conjoint analysis. Factors such as lesion location, depth, and extension were fixed in the nine clinical scenarios. Results Seven-hundred twenty-three pediatric dentists completed the survey (32 percent). Age of the child was the most important factor in pediatric dentists’ decisions to use ART (46 percent) compared with level of cooperation (41 percent) and type of insurance coverage (11 percent). For the age factor, the age of 2 years had the greatest utility (0.55) compared with age 4 (−0.09) and age 6 (−0.46). For types of insurance coverage, having no insurance (0.124) had the greatest utility compared with having public insurance (−0.119). Conclusions Although insurance coverage was the least important among the factors, being without insurance, being very young, and being uncooperative was the scenario where pediatric dentists most favored ART when making trade offs between different factors using the conjoint design. PMID:24635596

  9. The willingness of US pediatric dentists to use atraumatic restorative treatment (ART) with their patients: a conjoint analysis.

    PubMed

    Kateeb, Elham Talib; Warren, John; Gaeth, Gary; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael J; Weber-Gasparoni, Karin; Ansley, Timothy

    2014-01-01

    The atraumatic restorative treatment (ART) was developed as an affordable, patient-friendly dental caries management procedure that does not need extensive operator training or special skills. The aim of this study was to determine factors that influence the decision to use ART using an innovative marketing research technique known as conjoint analysis. A conjoint survey was completed by 723 members of the American Academy of Pediatric Dentistry. Three factors (age of the child, level of cooperation, type of insurance) were varied across three levels to create nine patient scenarios. The weights that practitioners placed on these factors in decisions to use ART in treating carious lesions were determined by conjoint analysis. Factors such as lesion location, depth, and extension were fixed in the nine clinical scenarios. Seven-hundred twenty-three pediatric dentists completed the survey (32 percent). Age of the child was the most important factor in pediatric dentists' decisions to use ART (46 percent) compared with level of cooperation (41 percent) and type of insurance coverage (11 percent). For the age factor, the age of 2 years had the greatest utility (0.55) compared with age 4 (-0.09) and age 6 (-0.46). For types of insurance coverage, having no insurance (0.124) had the greatest utility compared with having public insurance (-0.119). Although insurance coverage was the least important among the factors, being without insurance, being very young, and being uncooperative was the scenario where pediatric dentists most favored ART when making trade offs between different factors using the conjoint design. © 2014 American Association of Public Health Dentistry.

  10. Proposal of e-learning strategy to teach Atraumatic Restorative Treatment (ART) to undergraduate and graduate students

    PubMed Central

    2014-01-01

    Background The aim of this study was to evaluate e-learning strategy in teaching Atraumatic Restorative Treatment (ART) to undergraduate and graduate students. The sample comprised 76 participants—38 dental students and 38 pediatric dentistry students—in a specialization course. To evaluate knowledge improvement, participants were subjected to a test performed before and after the course. Results A single researcher corrected the tests and intraexaminer reproducibility was calculated (CCI = 0.991; 95% IC = 0.975–0.996). All students improved their performances after the e-learning course (Paired t-tests p < 0.001). The means of undergraduate students were 4.7 (initial) and 6.4 (final) and those of graduate students were 6.8 (initial) and 8.2 (final). The comparison of the final evaluation means showed a statistically significant difference (t-tests p < 0.0001). Conclusions The e-learning strategy has the potential of improving students’ knowledge in ART. Mature students perform better in this teaching modality when it is applied exclusively via distance learning. PMID:25034167

  11. Survival of ART restorations assessed using selected FDI and modified ART restoration criteria.

    PubMed

    Farag, Abeer; van der Sanden, Wil J M; Abdelwahab, Hisran; Frencken, Jo E

    2011-06-01

    A new set of criteria for assessing the quality of restorations using modern restorative materials, named FDI criteria, was recently introduced. This study tested the null hypothesis that there is no significant difference in survival estimate percentages of ART restorations assessed using selected FDI and modified ART criteria after 1 and 5 years. One operator placed a total of 60 class I and 30 Class II high-viscosity glass-ionomer ART restorations in ninety 14- to 15-year-olds. Two calibrated and independent evaluators using both criteria evaluated restorations on diestone replicas at baseline and after 1 and 5 years. Statistical analyses were done using the Kaplan-Meier method and log-rank test. The survival results of ART restorations assessed using both sets of criteria after 1 and 5 years (p = 0.27) did not differ significantly. Three ART restorations were assessed as failures according to the ART criteria, while they were assessed as survived using the FDI criteria. We conclude that the modified ART criteria enable reliable assessment of ART restorations in permanent teeth from diestone replicas and that there was no significant difference in survival estimates of ART restorations assessed using both sets of criteria. The null hypothesis was accepted.

  12. [Evaluation of the perception of the oral health teams of the municipal health department of Curitiba, Paraná State, regarding atraumatic restorative treatment (ART)].

    PubMed

    Busato, Ivana Maria Saes; Gabardo, Marilisa Carneiro Leão; França, Beatriz Helena Sottile; Moysés, Samuel Jorge; Moysés, Simone Tetu

    2011-01-01

    An evaluation was made of the perception of oral health teams regarding Atraumatic Restorative Treatment (ART) as a primary oral healthcare strategy used by the Municipal Health Department of Curitiba, Paraná State. A study was made both of Health Units (HU) that operate using the Family Health Strategy (FHSHU) and those that do not (Basic Healthcare Units--BHU). The sample involved 191 oral health professionals proportionally (CI=95%, e=6%). A questionnaire was used to collect data. The information was analyzed using the SPSS 13.0 program. The response rate was 82%. Chi-square testing did not reveal a statistically significant difference between the FHSHU (83.1%) and the BHU (74.3%) with regard to knowledge about the technique (p>0.05). A difference was found as to training in ART among the different HU (p<0.01) and the use of the technique by the services (p<0.01). The length of training and the length of service of dental health professionals at the municipal health service were relevant in relation to knowledge of the technique and the taking of clinical decisions as to ART. The conclusion was reached that training on ART is needed at the primary healthcare level as a result of the different perceptions revealed.

  13. PERFORMANCE OF BRAZILIAN AND IMPORTED GLASS IONOMER CEMENTS USED IN ATRAUMATIC RESTORATIVE TREATMENT (ART) REGARDING MICROLEAKAGE IN PRIMARY MOLARS

    PubMed Central

    Ferreira, Fernanda de Morais; do Vale, Miriam Pimenta Parreira; Jansen, Wellington Corrêa; Paiva, Saul Martins; Pordeus, Isabela Almeida

    2006-01-01

    With the aim of assessing the performance of Brazilian and imported glass ionomer cements (GIC) with regard to microleakage, 40 primary molars received two standard class II cavity preparations with margins in enamel. Twenty cavities were filled with Brazilian materials (Vidrion® R and Vidrion® RCaps) and the other 20 cavities were filled with imported materials (Fuji® IX and Fuji® IXGPFast capsule). All fillings were performed by a single operator according to the manufacturer's instructions. Teeth were immersed in 0.5% methylene blue and half-sectioned. Three independent calibrated examiners assessed microleakage using scores (0-3). Data were submitted to the Kruskal-Wallis statistical test and Wilcoxon analysis. High microleakage indexes were verified for all ionomer cements: 59.5% of the samples restored with Vidrion® R or Vidrion® RCaps and 83.4% of the samples restored with Fuji® IX or Fuji® IXGpFast capsule obtained the maximum score (3). The Brazilian ionomer cements presented less microleakage than imported cements, although this difference was only significant (p=0.003) among the encapsulated materials. PMID:19089050

  14. One year survival of ART and conventional restorations in patients with disability.

    PubMed

    Molina, Gustavo F; Faulks, Denise; Mazzola, Ignacio; Mulder, Jan; Frencken, Jo E

    2014-05-07

    Providing restorative treatment for persons with disability may be challenging and has been related to the patient's ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry. Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period. 66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01). These short-term results indicate that ART appears to be an effective treatment protocol for treating

  15. One year survival of ART and conventional restorations in patients with disability

    PubMed Central

    2014-01-01

    Background Providing restorative treatment for persons with disability may be challenging and has been related to the patient’s ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry. Methods Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period. Results 66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01). Conclusions These short-term results indicate that ART appears to be an

  16. 5-Year survival of ART restorations with and without cavity disinfection.

    PubMed

    Farag, A; van der Sanden, W J M; Abdelwahab, H; Mulder, J; Frencken, J E

    2009-06-01

    The null-hypothesis tested was that there is no difference between the survival of ART restorations with, and without, cavity disinfection among adolescents after 5 years. Eligible students were allocated to one of the treatment groups. One operator placed a total of 90 restorations, 45 each per treatment group, in ninety 14-15 year olds. Restorations were evaluated on replica models at baseline and after 1 and 5 years, by two calibrated and independent evaluators using the ART criteria. The independent variables were gender, mean DMFT score at baseline, cavity size (small/large), cavity type (single-/multiple surfaces) and disinfected cavity (yes/no). Statistical analyses were done using the Kaplan-Meier method and log-rank test. The cumulative survival percentage and standard error for the 61 ART restorations with and without disinfection at evaluation year 5 were 85% (S.E.=6.1%) and 80% (S.E.=7.1%), respectively: not significantly different (p=0.37) from each other. The cumulative survival percentage and standard error for all ART restorations was 97% (S.E.=2.0%) at evaluation year 1 and 82% (S.E.=4.7%) at year 5, and it was 85% (S.E.=5.4%) for single- and 77% (S.E.=9%) for multiple-surface ART restorations at year 5. The cumulative survival percentage of all ART restorations at evaluation year 5 was statistically significant higher for boys than for girls (p=0.03). Disinfecting a cavity cleaned according to ART with a 2% chlorhexidine solution is unnecessary. It is useful to introduce the ART approach systematically into the healthcare system in Egypt.

  17. Art in cancer care: Exploring the role of visual art-making programs within an Energy Restoration Framework.

    PubMed

    Kirshbaum, Marilynne N; Ennis, Gretchen; Waheed, Nasreena; Carter, Fiona

    2017-08-01

    In contrast to art-therapy, little is known about the role of art-making for people who have been diagnosed with cancer, and even less is known about program-based art-making. This study explored the experience of participation in a visual art-making program for people during and after cancer treatment in the Northern Territory of Australia. A longitudinal, qualitative, single cohort study was undertaken. Eight women diagnosed with breast and/or ovarian cancer participated in weekly art-making sessions over eight weeks, facilitated by two professional artists. Data were collected before, during and after the sessions by interviews and group discussions. The Energy Restoration Framework was used to document and analyse the benefits of participation in terms of the a priori themes of: Expansive, Belonging, Nurturing and Purposeful. The four a priori themes were retained and an additional attribute of an energy restoration activity called Stimulating was added, along with sub-themes, which broadened and deepened understanding of the art-making experience within cancer care. Involvement in an activity that was expansive, new, beautiful and fascinating was highly valued in addition to the appreciation for being with and belonging to a supportive and accepting group facilitated by dynamic artists. There is much scope for continued research and promotion of art-making programs as an adjunct to cancer treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Microleakage of high-strength glass ionomer: resin composite restorations in minimally invasive treatment.

    PubMed

    Platt, J A; Rhodes, B

    Atraumatic Restorative Treatment (ART) has been investigated as an alternative caries treatment. The technique involves removal of loose tooth structure with a spoon excavator, followed by placement of an adhesive restorative material, often a high-strength glass ionomer. This study compares the microleakage of a high-strength glass ionomer/resin composite and two occlusal resin composite restoration techniques.

  19. Art Painting Diagnostic Before Restoration with Terahertz and Millimeter Waves

    NASA Astrophysics Data System (ADS)

    Guillet, Jean-Paul; Roux, M.; Wang, K.; Ma, X.; Fauquet, F.; Balacey, H.; Recur, B.; Darracq, F.; Mounaix, P.

    2017-04-01

    Art painting diagnostic is commonly performed using electromagnetic waves at wavelengths from terahertz to X-ray. These former techniques are essential in conservation and art history research, but they could be also very useful for restoring artwork. While most studies use time domain imaging technique, in this study, a painting has been investigated using both time domain imaging (TDI) and frequency-modulated continuous wave (FMCW) system in the millimeter frequency range. By applying these systems to a painting of the eighteenth century, we detect and analyze the structure of some defects. This study underlines the differences between FMCW and TDI. We present the advantages and disadvantages of each technique on a real artwork.

  20. Art Painting Diagnostic Before Restoration with Terahertz and Millimeter Waves

    NASA Astrophysics Data System (ADS)

    Guillet, Jean-Paul; Roux, M.; Wang, K.; Ma, X.; Fauquet, F.; Balacey, H.; Recur, B.; Darracq, F.; Mounaix, P.

    2017-01-01

    Art painting diagnostic is commonly performed using electromagnetic waves at wavelengths from terahertz to X-ray. These former techniques are essential in conservation and art history research, but they could be also very useful for restoring artwork. While most studies use time domain imaging technique, in this study, a painting has been investigated using both time domain imaging (TDI) and frequency-modulated continuous wave (FMCW) system in the millimeter frequency range. By applying these systems to a painting of the eighteenth century, we detect and analyze the structure of some defects. This study underlines the differences between FMCW and TDI. We present the advantages and disadvantages of each technique on a real artwork.

  1. Bilayer technique and nano-filled coating increase success of approximal ART restorations: a randomized clinical trial.

    PubMed

    Hesse, Daniela; Bonifácio, Clarissa Calil; Guglielmi, Camila de Almeida Brandão; Bönecker, Marcelo; van Amerongen, Willem Evert; Raggio, Daniela Prócida

    2016-05-01

    The high-viscosity consistency of glass ionomer cement (GIC) may lead to its incorrect adaptation into the cavity and therefore to restoration failure. To compare two different insertion techniques for GIC in approximal atraumatic restorative treatment (ART) restorations and two different surface protection materials. Approximal caries lesion in primary molars from 208 schoolchildren was randomly assigned into four groups: G1, conventional GIC insertion protected with petroleum jelly (PJ); G2, bilayer technique protected with PJ; G3 conventional GIC insertion protected with nano-filled particles coating for GIC (NPC); G4, bilayer technique protected with NPC. Restorations were evaluated after 1, 6, 12, 18, 24, and 36 months. Kaplan-Meier survival analysis and log-rank test were performed. Cox regression analysis (α = 5%) was used to verify the influence of clinical factors. Restoration survival was 52.8%. Log-rank test indicated a better survival of the bilayer technique restorations, compared to conventional restorations (P = 0.005), whereas the coated conventional restorations presented higher survival than the uncoated ones (P = 0.035). Cox regression analysis showed no influence of any clinical tested variables. The survival rate of the approximal ART restorations is positively influenced by the bilayer technique, and the application of nano-filled coating increases the longevity of the conventional approximal ART restorations. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Influence of the experience of operator and assistant on the survival rate of proximal ART restorations: two-year results.

    PubMed

    Kemoli, A M; van Amerongen, W E; Opinya, G

    2009-12-01

    The objective of the study was to determine the influence of the experience of the operator and the assistant on the survival rate of proximal ART- restorations after 2 years when placed using two methods of tooth-isolation and three glass ionomer cement-brands. A clinical intervention study. Each of 804 children aged 6-8 years received one proximal restoration in their primary molars. The restorations were placed by 'experienced/inexperienced' operators randomly paired with 'experienced/ inexperienced' assistants. The atraumatic restorative treatment (ART) approach was used with 3 brands of glass ionomer cements (GIC) and 2 tooth-isolation methods (rubber dam vs cotton rolls). Trained and calibrated evaluators evaluated the restorations, soon after placement and after 2 years. The data collected were analyzed using SPSS 14.0, to determine and relate the survival rate of the restorations to the operator and assistant with respect to the other factors such as the restorative material used and the isolation method applied. After 2 years, the survival rate of the restorations was 30.8%. In general, there were no statistical significant differences in the survival rate of the restorations made by the 'experienced' vs 'inexperienced' operators, but individually, the operator with more experience was associated with a significantly higher survival rate of the restorations. The experienced assistants were associated with significantly higher survival rates of the restorations. The most 'experienced' operator paired with any 'experienced' assistant and using rubber dam tooth-isolation method, was associated with a significantly higher survival rate of the restorations. The combination of the 'experienced' operator and assistant using rubber dam tooth-isolation method had the best chance of survival for proximal ART restorations, irrespective of the material-brand used.

  3. Two years survival rate of class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars.

    PubMed

    Topaloglu-Ak, Asli; Eden, Ece; Frencken, Jo E; Oncag, Ozant

    2009-09-01

    The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries removal gel and (2) in the survival rate of class II composite resin restorations between two treatment groups after 2 years. Three hundred twenty-seven children with 568 class II cavitated lesions were included in a parallel mouth study design. Four operators placed resin composite (Filtek Z 250) restorations bonded with a self-etch adhesive (Adper prompt L pop). Two independent examiners evaluated the restorations after 0.5, 1, and 2 years using the modified Ryge criteria. The Kaplan-Meier survival method was applied to estimate survival percentages. A high proportion of restorations were lost during the study period. Therefore, the first hypothesis could not be tested. No statistically significant difference was observed between the cumulative survival percentages of restorations produced by the two treatment approaches over the 2-year period (ART, 54.1 +/- 3.4%; ART with Carisolv, 46.0 +/- 3.4%). This hypothesis was accepted. ART with chemomechanical gel might not provide an added benefit increasing the survival percentages of ART class II composite resin restorations in primary teeth.

  4. Restorative Outcomes of a Minimally Invasive Restorative Approach Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries: A Randomised Controlled Trial.

    PubMed

    Arrow, Peter

    2016-01-01

    A pragmatic randomised controlled trial comparing a minimally invasive approach based on atraumatic restorative treatment (ART) procedures (test) was tested against the standard-care approach (control) to treat early childhood caries (ECC) in a primary-care setting in Perth, W.A., Australia. Parent/child dyads with ECC were allocated to the test or control group using stratified block randomisation. Children were examined at baseline and follow-up by two calibrated examiners blinded to group allocation status. Dental therapists trained in ART provided treatment to the test group and dentists treated the control group. Restoration quality was evaluated at follow-up using the ART criteria. Data were analysed on an intention-to-treat basis; test of proportions, Wilcoxon rank test and logistic regression, controlling for clustering of teeth, were used. Two hundred and fifty-four children were randomised (test = 127 and control = 127). There was no statistically significant difference in age, sex and baseline caries experience between the test and control groups. At follow-up (mean interval 11.4 months, SD 3.1), 220 children were examined (test = 115 and control = 105) and 597 teeth (test = 417 and control = 180) were evaluated for restoration quality, of which 16.8% (test) and 6.7% (control) were judged to have failed (required replacement; p < 0.01). Intention-to-treat, multiple logistic regression found multisurface restorations (OR = 10.4) had significantly higher odds of failure, while referral for specialist paediatric care had significantly lower odds of restoration failure (OR = 0.2). The ART-based approach enabled more children and teeth to be treated, and multisurface restoration and treatment in a primary-care setting had higher odds of restoration failure. © 2015 S. Karger AG, Basel.

  5. Application of Laser Irradiation for Restorative Treatments

    PubMed Central

    Davoudi, Amin; Sanei, Maryam; Badrian, Hamid

    2016-01-01

    Nowadays, lasers are widely used in many fields of medicine. Also, they can be applied at many branches of dental practice such as diagnosis, preventive procedures, restorative treatments, and endodontic therapies. Procedures like caries removal, re-mineralization, and vital pulp therapy are the most noticeable effects of laser irradiation which has gained much attention among clinicians. With controlled and appropriate wavelength, they can help stimulating dentinogenesis, controlling pulpal hemorrhage, sterilization, healing of collagenic proteins, formation of a fibrous matrix, and inducing hard tissue barrier. Nevertheless, there are many controversies in literatures regarding their effects on the quality of bonded restorations. It hampered a wide application of lasers in some aspects of restorative dentistry and requirements to identify the best way to use this technology. The aim of this mini review is to explain special characteristics of laser therapy and to introduce the possible applications of laser devices for dental purposes. PMID:27990188

  6. Two years survival rate of Class II ART restorations in primary molars using two ways to avoid saliva contamination.

    PubMed

    Carvalho, Thiago Saads; Sampaio, Fábio Correia; Diniz, Alexandre; Bönecker, Marcelo; Van Amerongen, Willem Evert

    2010-11-01

    To compare the survival rates of Class II Atraumatic Restorative Treatment (ART) restorations placed in primary molars using cotton rolls or rubber dam as isolation methods. A total of 232 children, 6-7 years old, both genders, were selected having one primary molar with proximal dentine lesion. The children were randomly assigned into two groups: control group with Class II ART restoration made using cotton rolls and experimental group using rubber dam. The restorations were evaluated by eight calibrated evaluators (Kappa > 0.8) after 6, 12, 18 and 24 months. A total of 48 (20.7%) children were considered dropout, after 24 months. The cumulative survival rate after 6, 12, 18 and 24 months was 61.4%, 39.0%, 29.1% and 18.0%, respectively for the control group, and 64.1%, 55.1%, 40.1% and 32.1%, respectively for the rubber dam group. The log rank test for censored data showed no statistical significant difference between the groups (P = 0.07). The univariate Cox Regression showed no statistical significant difference after adjusting for independent variables (P > 0.05). Both groups had similar survival rates, and after 2 years, the use of rubber dam does not increase the success of Class II ART restorations significantly. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

  7. Enamel hypoplasia: challenges of esthetic restorative treatment.

    PubMed

    Ruschel, Vanessa Carla; Araújo, Élito; Bernardon, Jussara Karina; Lopes, Guilherme Carpena

    2016-01-01

    Enamel defects, such as white or yellow-brown spots, usually cause problems that are more esthetic than functional. Enamel hypoplasia may be the result of hereditary, systemic, or local factors. Dental trauma is a local etiologic factor. It is relatively common in the primary dentition and can cause defects on the surface of permanent successors. Treatment for such defects can differ, depending on the depth of the spots. For deeper white-spot lesions, a composite resin restoration may be necessary. This is an excellent mode of treatment, due to both its low cost and its conservation of healthy tooth structure. The objective of this case report is to describe composite resin restoration of a maxillary central incisor affected by enamel hypoplasia.

  8. Is Atraumatic restorative treatment an option for restoring occlusoproximal caries lesions in primary teeth? A systematic review and meta-analysis.

    PubMed

    Raggio, Daniela P; Hesse, Daniela; Lenzi, Tathiane L; Guglielmi, Camila A B; Braga, Mariana M

    2013-11-01

    Atraumatic restorative treatment (ART) has demonstrated good longevity when used for single-surface restorations, but lower success rates are reported for occlusoproximal surfaces. This systematic review and meta-analysis aimed to verify the pooled success rate of occlusoproximal ART restorations in primary teeth considering the outcomes: longevity, pulp damage, or caries lesion progression. Literature searching was carried out on the studies reporting clinical trials indexed in PubMed and in English language, comprising the outcomes. A meta-analysis was undertaken considering the results from reviewed studies. An initial search resulted in 126 articles, and three of them were finally selected. The main reasons for excluding articles were the absence of control group, as amalgam, composite resin, or compomer restorations to be compared with ART (hand excavation + high-viscous GIC). The pooled estimate (odds ratio; 95% confidence interval) for ART approach success was 1.04 (0.65-1.66). Atraumatic restorative treatment restorations performed with high-viscous GIC present similar survival/success rates to conventional approach using composite resin or amalgam for occlusoproximal restorations in primary teeth and can be suggested as a good option for occlusoproximal cavities in primary molars. In addition, further randomized controlled clinical investigations concerning occlusoproximal restorations in primary teeth are still necessary. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

  9. Atraumatic restorative treatment and dental anxiety in outpatients attending public oral health clinics in South Africa.

    PubMed

    Mickenautsch, Steffen; Frencken, Jo E; van't, Hof Martin A

    2007-01-01

    This study was undertaken to test the hypotheses that using the atraumatic restorative treatment (ART) approach results in lower patient anxiety and that lower anxiety leads to higher restoration/extraction ratios. The test group of dental operators (n = 9) was trained in ART The control group (n = 11) was not, and did not apply ART The Short Form of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-SF) and Corah's Dental Anxiety Scale (DAS) were used to assess patient anxiety after ART (test group) and after traditional restorations (control group). The restoration/extraction ratio calculated for primary (children) and permanent dentitions (adults) per operator was based on 12-month treatment statistics. Dental anxiety assessments were analysed using ANOVA. Differences were compared using the t-test and corrected for confounding factors (ANCOVA). The Pearson correlation coefficient was used to measure the correlation between dental anxiety levels and restoration/extraction ratios. The mean CFSS-SF score for test-group children was statistically significantly lower than for the control-group children. The mean DAS score for test-group adults was statistically significant lower than the control. No significant correlation was observed between dental anxiety level and restoration/extraction ratio per operator for both dentitions in both groups. The first hypothesis was accepted; the second, rejected. Although dental anxiety scores were lower both in child and in adult patients treated by ART than in those who received traditional restorative treatments, this positive effect had not resulted in higher restoration/extraction ratios.

  10. Restoring Wisconsin Art Therapy Association in Art Therapy History: Implications for Professional Definition and Inclusivity

    ERIC Educational Resources Information Center

    Potash, Jordan; Burnie, Michele; Pearson, Rosemary; Ramirez, Wayne

    2016-01-01

    The Wisconsin Art Therapy Association (WATA), formally established in 1969, was the first incorporated organization of art therapists in the United States. Under the leadership of Wayne Ramirez, WATA lobbied the national association for an inclusive definition of art therapy that aimed to foster respect for psychiatric, educational, and community…

  11. Restoring Wisconsin Art Therapy Association in Art Therapy History: Implications for Professional Definition and Inclusivity

    ERIC Educational Resources Information Center

    Potash, Jordan; Burnie, Michele; Pearson, Rosemary; Ramirez, Wayne

    2016-01-01

    The Wisconsin Art Therapy Association (WATA), formally established in 1969, was the first incorporated organization of art therapists in the United States. Under the leadership of Wayne Ramirez, WATA lobbied the national association for an inclusive definition of art therapy that aimed to foster respect for psychiatric, educational, and community…

  12. Iatrogenic Damage to Periodontium by Restorative Treatment Procedures: An Overview

    PubMed Central

    Sirajuddin, Syed; Narasappa, Kumuda M; Gundapaneni, Veenadharini; Chungkham, Sachidananda; Walikar, Ambica S

    2015-01-01

    The regenerative capability found in most other tissues is not possessed by teeth. Hence, enamel or dentin once lost as a result of caries, trauma, wear, and restorative materials must be replaced to restore form and function. Teeth require preparation to receive restorations, and these preparations must be based on fundamental principles from which basic criteria can be developed to help predict the success of restorative treatment. PMID:26312091

  13. Alternative ponderosa pine restoration treatments in the western United States

    Treesearch

    James McIver; Phillip Weatherspoon; Carl Edminster

    2001-01-01

    Compared to presettlement times, many ponderosa pine forests of the United States are now more dense and have greater quantities of fuels. Widespread treatments are needed in these forests to restore ecological integrity and to reduce the risk of uncharacteristically severe fires. Among possible restorative treatments, however, the appropriate balance among cuttings,...

  14. Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders.

    PubMed

    Cruz Gonzalez, Alberto Carlos; Marín Zuluaga, Dairo Javier

    2016-05-31

    The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART), in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9%) using the conventional technique (p < 0.03). However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.

  15. The effects of ambient temperature and mixing time of glass ionomer cement material on the survival rate of proximal ART restorations in primary molars

    PubMed Central

    Kemoli, Arthur M

    2014-01-01

    Objective: Temperature fluctuations and material mixing times are likely to affect the consistency and integrity of the material mixture, and hence the restoration made out of it. The purpose of the present study was to determine the influence of the ambient temperature and the mixing time of glass ionomer cement (GIC) restorative material on the survival rate of proximal atraumatic restorative treatment (ART) restorations placed in primary molars. Materials and Methods: A total of 804 restorations were placed in the primary molars of 6-8-year-olds using the ART approach. The restorations were then followed for a period of 2 years and evaluated at given intervals. The data collected were analyzed using SPSS computer statistical program, and the results tested and compared using the Chi-square, Kaplan Meier survival analysis and Cox Proportional hazard statistical tests. Results: The cumulative survival rate of the restorations dropped from the initial 94.4% to 30.8% at the end of 2 years. The higher survival rate of the restorations was associated with the experienced operators and assistants when using the rubber dam isolation method. However, there was no statistically significant difference in the survival rate of the restorations when related to the room temperature and the mixing time of the GIC materials used in spite of the variations in the temperature recoded and the methods used in mixing the materials. Conclusion: The ambient temperature and mixing time of GIC did not have a significant effect on the survival of the proximal ART restorations. PMID:24808692

  16. Restoration of bottomland hardwood forests across a treatment intensity gradient

    Treesearch

    John A. Stanturf; Emile S. Gardiner; James P. Shepard; Callie J. Schweitzer; C. Jeffrey Portwood; Lamar C. Jr. Dorris

    2009-01-01

    Large-scale restoration of bottomland hardwood forests in the Lower Mississippi Alluvial Valley (USA) under federal incentive programs, begun in the 1990s, initially achieved mixed results. We report here on a comparison of four restoration techniques in terms of survival, accretion of vertical structure, and woody species diversity. The range of treatment intensity...

  17. Dali to Beuys: Incorporating Art History in Art Therapy Treatment Plans.

    ERIC Educational Resources Information Center

    Muri, Simone Alter

    1996-01-01

    The important role art history can play when integrated within art therapy treatment plans is explored through individual and group case studies with inpatient and elderly populations. Results illustrate the therapeutic value of art therapy sessions that incorporate museum and gallery visits, slide presentations of modern art, and anecdotal…

  18. Teaching atraumatic restorative treatment in U.S. dental schools: a survey of predoctoral pediatric dentistry program directors.

    PubMed

    Kateeb, Elham T; Warren, John J; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim

    2013-10-01

    The International Dental Federation and World Health Organization have promoted the use of Atraumatic Restorative Treatment (ART) in modern clinical settings worldwide. In the United States, the practice of ART is not believed to be widely used, which may be a result of little attention given to ART training in predoctoral pediatric dentistry curricula in U.S. dental schools. This study investigated the extent of clinical and didactic instruction on ART provided in U.S. dental schools by surveying the predoctoral pediatric dentistry programs in 2010. Of the fifty-seven directors asked to complete the survey, forty-four responded for a response rate of 77 percent. Of these forty-four programs, 66 percent reported providing clinical training on ART, though only 14 percent provide this training often or very often. The types of ART training provided often or very often included interim treatment (18 percent) and single-surface cavities (14 percent) in primary teeth. However, ART was said to be rarely taught as a definitive treatment in permanent teeth (2 percent). Attitude was a major predictor, for clinical training provided and using professional guidelines in treatment decisions were associated with a positive attitude towards ART. These predoctoral pediatric dentistry programs used ART mainly in primary, anterior, and single-surface cavities and as interim treatment. As ART increases access of children to dental care, the incorporation of the ART approach into the curricula of U.S. dental schools should be facilitated by professional organizations.

  19. Comparison of Dental School and Practicing Dentists' Restorative Treatment Recommendations.

    ERIC Educational Resources Information Center

    Bader, James D.; And Others

    1995-01-01

    Comparison and analysis of the restorative treatment recommendations made by dentists and dental school students for 63 patients found about 85% agreement on treatment plans. It is observed that the results provide some basis on which to assess how well dental school treatments reflect mainstream practice. (MSE)

  20. Pain experience after conventional, atraumatic, and ultraconservative restorative treatments in 6- to 7-yr-old children.

    PubMed

    de Menezes Abreu, Danielle M; Leal, Soraya C; Mulder, Jan; Frencken, Jo E

    2011-04-01

    The hypothesis was tested that the level of pain experienced by children during conventional restorative treatment is higher than during atraumatic restorative treatment (ART) or an ultraconservative treatment. The sample consisted of 244 children, 6- to 7 yr of age, who had at least two teeth with dentine carious lesions. Before the first treatment session (Tx-1), in which one of the carious teeth was treated using one of the treatments, the level of dental anxiety was assessed using the Facial Image Scale (FIS). The child reported the intensity of pain experienced during the procedure using the Wong-Baker FACES Pain Rating Scale. When conventional restorative treatment was used, more children needed local anaesthesia. Analyses excluding the data of children who had received local anaesthesia showed no treatment group effect on the Wong-Baker score, a FIS Tx-1 effect on the Wong-Baker score, and a statistically significant correlation between FIS Tx-1 and Wong-Baker scores. There was no significant difference in the pain levels of children treated using conventional restorative treatment, atraumatic restorative treatment or ultraconservative treatment. Local anaesthesia had to be administered more frequently to children in the conventional restorative group than to those in the other two treatment groups.

  1. CD4 Count at ART Initiation and Economic Restoration in Rural Uganda

    PubMed Central

    Venkataramani, Atheendar S.; Thirumurthy, Harsha; Haberer, Jessica E.; Boum, Yap; Siedner, Mark J.; Kembabazi, Annet; Hunt, Peter W.; Martin, Jeffrey N.; Bangsberg, David R.; Tsai, Alexander C.

    2014-01-01

    Objective To determine whether earlier initiation of antiretroviral therapy (ART) is associated with better economic outcomes. Design Prospective cohort study of HIV positive patients on ART in rural Uganda. Methods Patients initiating ART at a regional referral clinic in Uganda were enrolled in the Uganda AIDS Rural Treatment Outcomes study (UARTO) starting in 2005. Data on labor force participation and asset ownership were collected on a yearly basis and CD4 counts were collected at pre-ART baseline. We fitted multivariable regression models to assess whether economic outcomes at baseline and in the 6 years following ART initiation varied by baseline CD4 count. Results 505 individuals, followed on average for 5 years, formed the estimation sample. Participants initiating ART at CD4≥200 were 13 percentage points more likely to be working at baseline (p<0.01, 95% CI 0.06-0.21) than those initiating below this threshold. Those in the latter group achieved similar labor force participation rates within 1 year of initiating ART (p<0.01 on the time indicators). Both groups had similar asset scores at baseline and demonstrated similar increases in asset scores over the 6 years of follow up. Conclusion ART helps participants initiating therapy at CD4<200 rejoin the labor force, though the findings for participants initiating with higher CD4 counts suggests that pre-treatment declines in labor supply may be prevented altogether with earlier therapy. Baseline similarities in asset scores for those with early and advanced disease suggest that mechanisms other than morbidity may help drive the relationship between HIV infection and economic outcomes. PMID:24406678

  2. Treatment regimens in preventive and restorative dentistry.

    PubMed

    Anusavice, K J

    1995-06-01

    Due in part to a lack of appropriate training and the incentive of adequate compensation, preventive dentistry in the United States has focused on prophylaxis and fluoride application. Dentistry must shift its attention to developing standardized protocols for "preservative dentistry"--diagnosing caries, assessing and monitoring caries risk, arresting active caries and remineralizing non-cavitated lesions. This article addresses shortcomings in preventive dentistry and proposes a plan for treatment standardization that can ensure optimum treatment and, ideally, lead to adequate compensation.

  3. [Atraumatic restorative treatment in relation to pain, discomfort and dental treatment anxiety].

    PubMed

    Frencken, J E F M; Flohil, K A; de Baat, C

    2014-01-01

    Dental treatment anxiety usually develops during childhood due to a bad experience and the dental drill as well as the injection needle are the most common causes. The Atraumatic Restorative Treatment provides the opportunity to provoke little or no dental treatment anxiety because only hand instruments are used and local anaesthesia is seldom required. Several scientific studies have indicated that the Atraumatic Restorative Treatment causes less pain, discomfort and anxiety by comparison with conventional treatments. Therefore, the Atraumatic Restorative Treatment is considered to be promising for the treatment of carious lesions in anxious children and adults, and potentially also for patients suffering from dental treatment phobia. Furthermore, the Atraumatic Restorative Treatment may be indicated as the primary treatment method in children to prevent dental treatment anxiety and treatment under general anaesthesia. These conclusions must still be confirmed with responsible scientific research.

  4. Health gain from restorative dental treatment evaluated by computer simulation.

    PubMed

    Downer, M C; Moles, D R

    1998-03-01

    To simulate the influence over time of relevant factors on health gain from restorative dental treatment under varying assumptions and to compare outcomes with those resulting under a 'do nothing' scenario. A decision model was used in a computer simulation of the caries process in posterior approximal tooth surfaces. The effect of superimposing restorative treatment, based on bitewing radiology, was incorporated. Input data came from current observational studies and included caries progression rates, notional survival times of restorations, and sensitivity (Sn) and specificity (Sp) of treatment decision making by a high (A) and a low (B) performing dentist. Utility values, on a scale 0-1, for different tooth health states were obtained from questioning 92 adults of appropriate age. By assumption, the primary dental care sector. A hypothetical population, initially 14-15 years old. Class II amalgam restorations. Computed in utility based units (UBUs) as sums of the product of numbers of sound, carious and restored surfaces and their utility values. Health gain (in UBUs) was assessed relative to interim end point UBUs pertaining under 'do nothing'. One thousand approximal surfaces, designated initially as 920 sound, 51 carious and 29 filled were followed in the model over 10 years. The greatest health gain (33.16 UBUs) was from dentist A (Sn = 0.23, Sp = 0.99, 50 per cent restoration survival rate = 10 years, caries rate = 4.4% per annum). The least was from dentist B (Sn = 0.52, Sp = 0.88, 50% survival = 5 years, caries rate = 0.0% per annum) representing a loss of 17.07 UBUs compared with 'do nothing'. Results suggest that caution is advisable when making positive decisions to restore on the basis of bitewing radiographs.

  5. Does atraumatic restorative treatment reduce dental anxiety in children? A systematic review and meta-analysis

    PubMed Central

    Simon, Arun K.; Bhumika, T. V.; Nair, N. Sreekumaran

    2015-01-01

    Dental anxiety is one of the major problems affecting children, which impairs the rendering of dental care, leading to impaired quality of life. It often leads to occupational stress in dental personnel and conflict between parents/caregivers. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials done in children, to synthesize evidence of the effectiveness of atraumatic restorative treatment (ART) in reducing dental anxiety in children compared to conventional restorative treatments. The databases searched included PubMed, Google Scholar and The Cochrane Oral Health Group's Trials Register. Eligible studies reporting dental anxiety by a variety of psychometric scales were tabulated. The review was conducted and reported in accordance with the guidelines provided by the Cochrane Collaboration. Among 416 studies retrieved through literature search, six studies matched the inclusion criteria. Due to lack of data, only three studies were included for meta-analysis using RevMan software (Review Manager, Version 5.3;The Cochrane Collaboration, Copenhagen, 2014). The pooled meta-analysis data, (standardized mean difference − 2.12 [95% confidence interval: −4.52, 0.27]) failed to show any difference between ART group and the conventional treatment group. In conclusion, ART was not more beneficial in reducing dental anxiety among pediatric dental patients. The findings are relevant in the field of clinical practice in dentistry in the management of the anxious pediatric dental patient. PMID:26038668

  6. Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Drapeau, Marie-Celine; Kronish, Neomi

    2007-01-01

    This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is…

  7. Sessile drops imbibition over nano porous substrates : application for art painting restoration

    NASA Astrophysics Data System (ADS)

    Léang, Marguerite; Pauchard, Ludovic; Lee, Lay-Theng; Ott, Frédéric; Giorgiutti-Dauphiné, Frédérique

    2016-11-01

    Art painting restoration aims to restore and preserve the integrity of a painting. Most of the techniques consist of depositing solvents on the surface of the painting to dissolve the varnish layer. However the sublayers can be damaged by the penetration of the solvent, possibly resulting in swelling or cracking processes. Due to the physical and chemical complexity of the pictorial layer, we propose to study solvent penetration in model nano porous media obtained by controlled drying of aqueous dispersions of silica nanoparticles. We present the dynamics of imbibition of sessile solvent drops on porous media with different pore sizes. Three different regimes in the evolution of the drop size with time are identified. Our experimental set-up provides a precise direct quantification of the different flows outside and through the porous media. Different experimental techniques are used to characterize the porous media : neutron imaging to determine the permeability and microindentation testing to estimate the mechanical properties of the media after the imbibition process. Supported by PALM LabEx Grant.

  8. Arts-based therapies in the treatment of eating disorders.

    PubMed

    Frisch, Maria J; Franko, Debra L; Herzog, David B

    2006-01-01

    Arts-based therapies are increasingly being employed, in conjunction with empirically valid traditional therapies, in the residential treatment of eating disorders. A systematic database search of arts-based therapies in the treatment of eating disorders was conducted. In addition, program staff at 22 residential eating disorder treatment programs were contacted to provide information regarding arts-based therapy utilization rates. Of the 19 programs that participated in this study, all incorporate arts-based therapies on at least a weekly basis in the treatment of eating disorders. However, while published narrative reflections on arts-based therapies and eating disorders imply a generally positive outcome, no known, empirically valid studies exist on this experiential form of therapy within the area of eating disorders.

  9. Combination antiretroviral therapy (cART) restores HIV-1 infection-mediated impairment of JAK-STAT signaling pathway.

    PubMed

    Liu, Man-Qing; Zhao, Min; Kong, Wen-Hua; Tang, Li; Wang, Fang; Zhu, Ze-Rong; Wang, Xia; Qiu, Hong-Yan; Zhou, Dun-Jin; Wang, Xu; Ho, Wen-Zhe; Zhou, Wang

    2017-04-04

    JAK-STAT signaling pathway has a crucial role in host innate immunity against viral infections, including HIV-1. We therefore examined the impact of HIV-1 infection and combination antiretroviral therapy (cART) on JAK-STAT signaling pathway. Compared to age-matched healthy donors (n = 18), HIV-1-infected subjects (n = 18) prior to cART had significantly lower expression of toll-like receptors (TLR-1/4/6/7/8/9), the IFN regulatory factors (IRF-3/7/9), and the antiviral factors (OAS-1, MxA, A3G, PKR, and Tetherin). Three months' cART partially restores the impaired functions of JAK-STAT-mediated antiviral immunity. We also found most factors had significantly positive correlations (p < 0.05) between each two factors in JAK-STAT pathway in healthy donors (98.25%, 168/171), but such significant positive associations were only found in small part of HIV-1-infected subjects (43.86%, 75/171), and stably increased during the cART (57.31%, 98/171 after 6 months' cART). With regard to the restoration of some HIV-1 restriction factors, HIV-1-infected subjects who had CD4+ T cell counts > 350//μl responded better to cART than those with the counts < 350/μl. These findings indicate that the impairment of JAK-STAT pathway may play a role in the immunopathogenesis of HIV-1 disease.

  10. Artificial hair fiber restoration in the treatment of scalp scars.

    PubMed

    Santiago, Mariangela; Pérez-Rangel, Roberto; D'Ugo, Angelo; Griselli, Giampiero; Igitian, Garigin; Martin, Ildefonso Garcia; Nesheim, Geir B; Eddin, Usama Saad; Smith, Geoff; Brady, Gerard W; Chaker, Cherine

    2007-01-01

    There is presently no treatment for scalp scars that is fully satisfactory. The modalities of treatment currently in use are surgery, hair transplantation, and micropigmentation. Scalp implantation with artificial hair fibers is used by some physicians as an adjunctive treatment. The objective was to assess the utility of artificial hair fibers to treat scalp scars. Data were collected by the principal author from 10 hair restoration practitioners who tested polyamide hair fiber (Biofibre CE 0373/TGA by Medicap Ltd., Carpi (MO), Italy) implantation for scalp scars. Artificial hair fiber implantation occurred between June 1996 and December 2000, and observations continued until December 2004. Data from 54 scars from 44 patients treated showed: (1) no complications in 49 scars (90.7%); (2) mild adverse outcomes in 4 scars (7.4%)-temporary superficial inflammation-infection that subsided following topical cortisone and local/systemic antibiotic treatment; and (3) moderately adverse outcomes in 1 scar (1.9%)-significant inflammation and generalized infection requiring removal of artificial implant to alleviate. Occasional minor skin reactions, sebum plugs, and hyperseborrhea were successfully controlled and well accepted by patients. Fiber fall rate was 20% on average per annum. Data show that polyamide hair fiber restoration can be considered an adjunctive treatment for scalp scars in selected cases.

  11. Restoring lepidopteran diversity in a tropical dry forest: relative importance of restoration treatment, tree identity and predator pressure

    PubMed Central

    Solis-Gabriel, Lizet; Mendoza-Arroyo, Wendy

    2017-01-01

    Tropical dry forests (TDFs) have been widely transformed by human activities worldwide and the ecosystem services they provide are diminishing. There has been an urgent call for conservation and restoration of the degraded lands previously occupied by TDFs. Restoration experiences aim to recover species diversity and ecological functions. Different restoration strategies have been used to maximize plant performance including weeding, planting or using artificial mulching. In this investigation, we evaluated whether different restoration practices influence animal arrival and the reestablishment of biotic interactions. We particularly evaluated lepidopteran larvae diversity and caterpillar predation on plants established under different restoration treatments (mulching, weeding and control) in the Pacific West Coast of México. This study corroborated the importance of plant host identity for lepidopteran presence in a particular area. Lepidopteran diversity and herbivory rates were not affected by the restoration treatment but they were related to tree species. In contrast, caterpillar predation marks were affected by restoration treatment, with a greater number of predation marks in control plots, while caterpillar predation marks among plant species were not significantly different. This study highlights the importance of considering the introduction of high plant species diversity when planning TDF restoration to maximize lepidopteran diversity and ecosystem functioning. PMID:28560101

  12. Restoring lepidopteran diversity in a tropical dry forest: relative importance of restoration treatment, tree identity and predator pressure.

    PubMed

    Solis-Gabriel, Lizet; Mendoza-Arroyo, Wendy; Boege, Karina; Del-Val, Ek

    2017-01-01

    Tropical dry forests (TDFs) have been widely transformed by human activities worldwide and the ecosystem services they provide are diminishing. There has been an urgent call for conservation and restoration of the degraded lands previously occupied by TDFs. Restoration experiences aim to recover species diversity and ecological functions. Different restoration strategies have been used to maximize plant performance including weeding, planting or using artificial mulching. In this investigation, we evaluated whether different restoration practices influence animal arrival and the reestablishment of biotic interactions. We particularly evaluated lepidopteran larvae diversity and caterpillar predation on plants established under different restoration treatments (mulching, weeding and control) in the Pacific West Coast of México. This study corroborated the importance of plant host identity for lepidopteran presence in a particular area. Lepidopteran diversity and herbivory rates were not affected by the restoration treatment but they were related to tree species. In contrast, caterpillar predation marks were affected by restoration treatment, with a greater number of predation marks in control plots, while caterpillar predation marks among plant species were not significantly different. This study highlights the importance of considering the introduction of high plant species diversity when planning TDF restoration to maximize lepidopteran diversity and ecosystem functioning.

  13. Insulin treatment restores islet microvascular vasomotion function in diabetic mice.

    PubMed

    Liu, Mingming; Zhang, Xiaoyan; Li, Ailing; Zhang, Xu; Wang, Bing; Li, Bingwei; Liu, Shuying; Li, Hongwei; Xiu, Ruijuan

    2017-10-01

    The microcirculation plays an important role in the pathogenesis of diabetes and its complications. We hypothesized that pancreatic islet microvascular (PIM) vasomotion, as a parameter of pancreatic islet microcirculation function, is abnormal in diabetic mice and that insulin treatment may reverse this dysfunction. Mice were randomly assigned to non-diabetic control, untreated diabetic, and insulin-treated diabetic groups (n = 6 in each group). Separate groups of streptozotocin (STZ)-induced diabetic and high-fat diet-fed mice were used as a model of hyperglycemia. Insulin-treated diabetic mice were treated with 1-1.5 IU/day insulin for 1 week. Laser Doppler monitors were used to evaluate PIM vasomotion. Morphological and ultrastructural changes in islet endothelial cells were determined by immunohistochemistry and transmission electron microscopy. Glucagon, insulin, vascular endothelial growth factor (VEGF)-A, and platelet endothelial cell adhesion molecule (PECAM-1) expression was determined by immunohistochemistry and Western blotting. In both untreated diabetic groups, the pancreatic islet microcirculation was unable to regulate PIM vasomotion. The rhythm of vasomotion was irregular, and the average blood perfusion, amplitude, frequency, and relative velocity of vasomotion were significantly lower than in non-diabetic controls. Insulin treatment restored the functional status of PIM vasomotion. In islet endothelial cells from both untreated diabetic groups, the mitochondria were swollen with disarrangement of the cristae, and the distribution of PECAM-1 was discontinuous. Insulin treatment significantly increased the reduced expression of PECAM-1 in both untreated diabetic groups and VEGF-A expression in untreated STZ-diabetic mice. The results suggest that the functional status of PIM vasomotion is impaired in diabetic mice but can be restored by insulin. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons

  14. State of the Art: Diagnosis and Treatment.

    ERIC Educational Resources Information Center

    Kramer, Kay F., Ed.; Rosonke, Richard, Ed.

    Eight papers on the diagnosis and treatment of handicapped children comprise proceedings of a conference for Directors of Special Education, past and present Regional Resource Center Directors, and the staff of the Bureau of Education for the Handicapped. E. Martin explains the rationale of Regional Resource Centers. A systems analysis of the…

  15. Biologic Restoration: A Treatment Option for Reconstruction of Anterior Teeth

    PubMed Central

    Khanna, Priyanka; S, Shankar; Chaurasia, Vishwajit Rampratap; Masamatti, Vinaykumar S

    2014-01-01

    Several procedures are advised to manage fractured anterior tooth structure using acrylic resin, composite restoration, ceramic or metal crown with ceramic facing. Biologic restoration is a procedure to restore fractured tooth structure with natural tooth material. In this in vitro case we have made an attempt for aesthetic rehabilitation of maxillary central incisor with similar biologic crown taken form extracted maxillary central incisor. It was observed that biologic restoration is an aesthetic, economical, fast and functional procedure which can be used as an alternative method to restore fractured primary or permanent anteriors. PMID:25584332

  16. Biologic restoration: a treatment option for reconstruction of anterior teeth.

    PubMed

    Babaji, Prashant; Khanna, Priyanka; S, Shankar; Chaurasia, Vishwajit Rampratap; Masamatti, Vinaykumar S

    2014-11-01

    Several procedures are advised to manage fractured anterior tooth structure using acrylic resin, composite restoration, ceramic or metal crown with ceramic facing. Biologic restoration is a procedure to restore fractured tooth structure with natural tooth material. In this in vitro case we have made an attempt for aesthetic rehabilitation of maxillary central incisor with similar biologic crown taken form extracted maxillary central incisor. It was observed that biologic restoration is an aesthetic, economical, fast and functional procedure which can be used as an alternative method to restore fractured primary or permanent anteriors.

  17. Mesoglycan treatment restores defective fibrinolytic potential in cutaneous necrotizing venulitis.

    PubMed

    Lotti, T; Celasco, G; Tsampau, D; Teofoli, P; Benci, M; Dahm, M; Comacchi, C; Ghersetich, I; Matucci-Cerinic, M

    1993-05-01

    Cutaneous necrotizing venulitis (CNV) is a clinical disorder associated with segmental inflammation and fibrinoid necrosis of the dermal venules. It usually presents clinically as palpable purpura, even sometimes as nodules, bullae, ulcers, and urticarial lesions. This form, when showing as leukocytoclastic vasculitis is apparently characterized by the tissue deposition of circulating immune complexes and by reduced cutaneous (CFA) and plasma (PFA) fibrinolytic activity due to reduced release of plasminogen activator (PA) from the venular endotheliocytes. Reduced CFA and PFA cause large amounts of fibrin deposits in both intra- and perivascular areas, which are able to magnify and self perpetuate the inflammatory processes following immune complex deposition. We have studied both the PFA and CFA potential (the maximum amount of PA released in the skin after certain stimuli) and the deposits of immunoglobulins, C3, and fibrin related antigen, before and after intradermal injection of histamine (a substance able to provoke endothelial release of PA), in three subjects affected by CNV before and 20 days after 10 mg/kg/day I.M. treatment with the fibrinolytic agent mesoglycan. Cutaneous fibrinolytic activity and CFA potential, reduced prior to treatment, was normal after treatment, while the deposits of immunoglobulins (IgA, IgG and IgM), C3, and fibrin related antigen, detected with direct immune fluorescence (DIF) showed similar findings before and after treatment. These data suggest that reduced CFA may play a major role in the pathogenesis of the immunologically mediated injury in CNV. The intraperivascular deposition of fibrin is favored. The fibrinolytic agent mesoglycan seems effective in restoring defective fibrinolysis in patients affected by cutaneous necrotizing venulitis, suggesting that in cases with reduced cutaneous fibrinolytic activity (or potential) the use of a fibrinolytic agent should be considered.

  18. Optimizing ART Adherence: Update for HIV Treatment and Prevention

    PubMed Central

    Robbins, Reuben N.; Spector, Anya Y.; Mellins, Claude A.; Remien, Robert H.

    2014-01-01

    Optimal adherence to antiretroviral therapy (ART) is central to achieving viral suppression and positive health outcomes in HIV-infected individuals. Virally suppressed individuals can also reduce the risk of HIV transmission to uninfected partners. Hence, adherence to ART has become both an HIV treatment and an HIV prevention strategy. However, achieving optimal ART adherence can be challenging, especially over the long term. It is increasingly important for clinicians and researchers to be abreast of the most recent developments in the field as new biomedical approaches to treatment emerge, and as guidelines for the use of pre-exposure prophylaxis (PrEP) are disseminated to providers serving HIV affected populations. Several reviews have described numerous ART adherence interventions that have been developed and/or tested with the most recent review including literature up to 2012. To augment the literature, we present a review of ART adherence interventions from 2013 – present. We included peer-reviewed journals as well as abstracts from two key conferences. PMID:25304006

  19. Different Patterns of Restoration Provision Between Initial Endodontic Treatment and Retreatment: A Retrospective Clinical Study.

    PubMed

    Agrafioti, Anastasia; Giannakoulas, Dimitrios G; Kournetas, Nikos; Grigoriou, Stamatina; Kontakiotis, Evangelos G

    The aim of this study was to investigate the relationship between type of endodontic treatment and choice of definitive restoration and to show the prevalence of endodontic treatment options according to patient age and type of tooth. Data were collected from the archive system of the School of Dentistry, National and Kapodistrian University of Athens in Athens, Greece. The sample included endodontically treated teeth being restored definitively at the time of data collection. Statistically significant difference was found regarding the type of restoration between initial endodontic treatments and retreatments (P < .001). Endodontic retreatment seemed to have a significant effect on the choice of definitive restoration of the tooth.

  20. Antibody and markers of T-cell activation illuminate the pathogenesis of HCV immune restoration disease in HIV/HCV co-infected patients commencing ART.

    PubMed

    Yunihastuti, Evy; Lee, Silvia; Gani, Rino A; Saraswati, Henny; Sundaru, Heru; Lesmana, L A; Sukmana, Nanang; Price, Patricia

    2011-04-01

    Some HIV/hepatitis C virus co-infected patients beginning ART experience Immune Restoration Disease (IRD) manifested as a rise in serum alanine transaminase. This was investigated in HIV/HCV co-infected individuals (n=50) commencing ART in Jakarta (Indonesia). Samples were collected at weeks 0, 4, 8, 12, 24 and at HCV IRD. Nine patients experienced HCV IRD (incidence=9.2 per 1000 person-weeks). These resolved without changing treatment. Markers of T-cell activation (sCD26, sCD30) and immune recruitment (CXCL10) increased in many HCV IRD cases, so T-cells may mediate HCV IRD. Total anti-HCV antibody (core, NS3, NS4) remained lower in HCV IRD cases, but levels of antibody to core were not lower in HCV IRD cases. Rises in HCV RNA on ART were independent of HCV IRD, but there was a negative correlation between baseline HCV RNA and total anti-HCV antibody. High levels of antibody may protect against HCV IRD, via lower HCV antigen loads.

  1. Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial.

    PubMed

    Abdul Khalek, Amg; Elkateb, M A; Abdel Aziz, W E; El Tantawi, M

    To compare the effect of Papacarie and Atraumatic Restorative Treatment (ART) on pain and discomfort during caries removal among children. Fifty healthy, 4-8 year-old children were equally and randomly allocated to Papacarie and ART to remove caries from decayed primary teeth. A randomized, controlled, blinded, two parallel-arms clinical trial was conducted in the clinic of the Pediatric Dentistry and Dental Public Health Department, Alexandria University, Egypt in March 2014. Pain and discomfort were assessed blindly by two independent investigators watching videotaped treatment sessions using the Sound, Eye and Motor scale (SEM). Their reliability was assessed using Kappa statistics. The effect of caries removal methods, time spent to remove caries and other confounders on SEM score was assessed using regression analysis. Mean time to remove caries using Papacarie and ART was 5.8 and 4.8 minutes, P= 0.005. Median Paparie and ART scores for the S, E and M components were 1, 1, 1 and 3, 2, 3. Adjusted mean SEM score= 3.6 and 7.8, P <0.0001. Method of caries removal was the only factor significantly affecting pain and discomfort. Papacarie is associated with minimal pain during caries removal from primary teeth compared to ART, although it has longer working time.

  2. Restoration of bottomland hardwood forest across a treatment intensity gradient.

    Treesearch

    J.A Stanturf; E.S Gardiner; J.P Shepard; C.J Schweitzer; C.J Portwood; L.C Dorros

    2009-01-01

    Large-scale restoration of bottomland hardwood forests in the lower Mississippi Alluvial Valley (USA)under federal incentive programs, begun in the 1990s. initially achieved mixed results. We report here on a comparison of four restoration techniques in terms of survival. accretion of vertical structure and woody species diversity. The...

  3. Cost-effectiveness analysis of the atraumatic restorative treatment-based approach to managing early childhood caries.

    PubMed

    Tonmukayakul, Utsana; Arrow, Peter

    2016-11-14

    Paediatric dental care under general anaesthesia among preschool children in Western Australia is increasing and costly. This study assessed cost-effectiveness of the atraumatic restorative treatment-based (ART-based) approach against the standard care (SC) approach to managing early childhood caries in a primary care setting based on a 1-year pragmatic randomized controlled trial. Cost-effectiveness analysis, from the service provider perspective, was conducted. Outcomes include number of referral to specialists and dental treatments. One-way and probabilistic sensitivity analyses were undertaken to test the robustness of the cost-effectiveness estimates. Six children in the ART-based group and 62 children in the SC group (n = 127 each group) were referred for paediatric dental specialist care. Children in the ART-based group received more dental services than those allocated to the SC group (mean = 3.8, SD 2.0 and mean = 1.8, SD 1.8, respectively, Wilcoxon rank-sum test, P < 0.01). Total costs of the ART-based approach and the SC group were $137 860 and $178 217, respectively. Based on probabilistic sensitivity analysis, $654 was saved per referral to specialist avoided and $36 was saved per additional dental treatment. The probability that the ART-based approach is cost-saving was 63%. Specialist dental treatment fees had a big impact on the cost-effectiveness estimates. The ART-based approach appears to be a worthwhile intervention because it resulted in fewer referred cases and enabled more treatments to be provided with cost-savings. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. HIV Care and Treatment Beliefs among Patients Initiating Antiretroviral Treatment (ART) in Oromia, Ethiopia

    PubMed Central

    Hoffman, Susie; Kulkarni, Sarah Gorrell; Gadisa, Tsigereda; Lahuerta, Maria; Remien, Robert H.; Elul, Batya; El-Sadr, Wafaa; Melaku, Zenebe; Nash, Denis

    2015-01-01

    To better understand patient beliefs, which may influence adherence to HIV care and treatment, we examined three dimensions of beliefs among Ethiopian adults (n = 1177) initiating antiretroviral therapy (ART). Beliefs about benefits of ART/HIV clinical care were largely accurate, but few patients believed in the ability of ART to prevent sexual transmission and many thought Holy Water could cure HIV. Factors associated with lower odds of accurate beliefs included advanced HIV, lack of formal education, and Muslim religion (benefits of ART/clinical care); secondary or university education and more clinic visits (ART to prevent sexual transmission); and pregnancy and Orthodox Christian religion (Holy Water). Assessment of patient beliefs may help providers identify areas needing reinforcement. In this setting, counselors also need to stress the benefits of ART as prevention and that Holy Water should not be used to the exclusion of HIV care and ART. PMID:26346333

  5. Restoration treatments in urban park forests drive long-term changes in vegetation trajectories.

    PubMed

    Johnson, Lea R; Handel, Steven N

    2016-04-01

    Municipalities are turning to ecological restoration of urban forests as a measure to improve air quality, ameliorate urban heat island effects, improve storm water infiltration, and provide other social and ecological benefits. However, community dynamics following urban forest restoration treatments are poorly documented. This study examines the long-term effects of ecological restoration undertaken in New York City, New York, USA, to restore native forest in urban park natural areas invaded by woody non-native plants that are regional problems. In 2009 and 2010, we sampled vegetation in 30 invaded sites in three large public parks that were restored 1988-1993, and 30 sites in three large parks that were similarly invaded but had not been restored. Data from these matched plots reveal that the restoration treatment achieved its central goals. After 15-20 years, invasive species removal followed by native tree planting resulted in persistent structural and compositional shifts, significantly lower invasive species abundance, a more complex forest structure, and greater native tree recruitment. Together, these findings indicate that successional trajectories of vegetation dynamics have diverged between restored forests and invaded forests that were not restored. In addition, the data suggest that future composition of these urban forest patches will be novel assemblages. Restored and untreated sites shared a suite of shade-intolerant, quickly-growing tree species that colonize disturbed sites, indicating that restoration treatments created sites hospitable for germination and growth of species adapted to high light conditions and disturbed soils. These findings yield an urban perspective on the use of succession theory in ecological restoration. Models of ecological restoration developed in more pristine environments must be modified for use in cities. By anticipating both urban disturbances and ecological succession, management of urban forest patches can be

  6. Re-Treatment Decisions for Failed Posterior Restorations among Dentists in Kuwait

    PubMed Central

    Alomari, Qasem; Al-Kanderi, Bader; Qudeimat, Muawia; Omar, Ridwaan

    2010-01-01

    Objectives: To compare re-treatment choices for MOD amalgam or resin composite restorations with or without cusp fracture among dentists in Kuwait. Methods: A random sample of 158 dentists completed a questionnaire designed to obtain socio-demographic, educational and work-related information and their choices for re-treatment of four scenarios of failed restorations on lower first molars: 1. MOD amalgam restoration; 2. MOD composite restoration; 3. MOD amalgam restoration with cuspal fracture; 4. MOD composite restoration with cuspal fracture. Re-treatment options were: re-treating with amalgam; re-treating with composite; placing an onlay; or, placing a crown. For the purpose of analysis, responses were dichotomized into re-treatment with a direct or indirect restoration. Results: For cases 1 and 2, most participants chose to re-treat with amalgam restoration and for cases 3 and 4, most chose to place an indirect restoration. In general, an increased tendency towards the indirect option was associated with increased age, being a male and being a specialist. Tendencies to place an indirect restoration did not differ between cases 1 and 2 (P=1.0) or cases 3 and 4 (P=0.317), although the tendency to do so was significantly greater in case 3 than 1 (P=0.000) and case 4 than 2 (P=0.000). Conclusions: The variation noted among dentists regarding their stated choices for re-treating failed posterior restorations appeared to be associated with gender, education and experience factors. A tendency towards indirect restorations was seen when the restoration is associated with a fractured cusp. PMID:20046479

  7. Hormone Treatment Restores Bone Density for Young Women with Menopause-Like Condition (Primary Ovarian Insufficiency)

    MedlinePlus

    ... News Releases News Release Monday, June 9, 2014 Hormone treatment restores bone density for young women with ... and lower spine to determine the effects of hormone treatment on bone mineral density of women with ...

  8. The art and science of the direct posterior restoration: recreating form, color, and translucency.

    PubMed

    Rubinstein, Sergio; Nidetz, Alan

    2007-01-01

    In the past two decades the major advances bonding has experienced are directly related to material improvements and significant advances in adhesive technology. It is because of the superior physical properties of the posterior composite that we can provide patients with a long-lasting restoration if a meticulous bonding protocol was followed. It is possible simultaneously to preserve healthy tooth structure; reproduce its original shape, color, and translucency; and strengthen the affected tooth. Although the main focus in the past was on improving the bonding adhesive properties and the development of strength and polishability of the restorative materials, the current objective is to simplify the bonding technique and to create a shrinkage-free composite while simultaneously improving its optical properties.

  9. The Restorative and Transformative Power of the Arts in Conflict Resolution

    ERIC Educational Resources Information Center

    Bang, April Hyoeun

    2016-01-01

    The discipline of the arts has much to contribute to the field of conflict resolution. This article broadly investigates how artistic engagement facilitates transformative learning and the development of skills and capacities for more constructive engagement with conflict. Many scholar practitioners have acknowledged the widespread use of…

  10. The Restorative and Transformative Power of the Arts in Conflict Resolution

    ERIC Educational Resources Information Center

    Bang, April Hyoeun

    2016-01-01

    The discipline of the arts has much to contribute to the field of conflict resolution. This article broadly investigates how artistic engagement facilitates transformative learning and the development of skills and capacities for more constructive engagement with conflict. Many scholar practitioners have acknowledged the widespread use of…

  11. Biological restorations: an alternative esthetic treatment for restoration of severely mutilated primary anterior teeth.

    PubMed

    N, Grewal; S, Reeshu

    2008-09-01

    Early childhood caries (ECC) affects more than one out of seven preschoolers and is more prevalent in lowincome families, who generally have limited access to dental services. The seriousness and societal costs of ECC continue to be a significant health issue for children from racial/ethnic minorities and from developing countries. Hence, a biological restoration seems to be a successful cost-effective alternative approach for treating such cases.

  12. Multidisciplinary treatment of a subgingivally fractured tooth with indirect composite restoration: a case report.

    PubMed

    Ulusoy, Ayca T; Tunc, Emine Sen; Cil, Feride; Isci, Devrim; Lutfioglu, Muge

    2012-01-01

    In pediatric patients, anterior teeth with fractures that extend subgingivally require a complex treatment plan that addresses biologic, esthetic, and functional factors, such as mastication and speech. The purpose of this clinical report was to describe a technique using indirect composite restoration to restore a subgingivally fractured permanent maxillary right central incisor in a 10-year-old boy. Due to the complex nature of the treatment, a multidisciplinary approach was used to restore the tooth. The crown fragment was removed, and endodontic treatment was performed. The tooth was then extruded orthodontically. A glass fiber post was placed to improve retention, and an indirect composite restoration was placed. A clinical and radiographic evaluation at a follow-up appointment 1 year later confirmed that the technique used in this case can be a good option for restoring anterior teeth with subgingival fractures.

  13. Spatially explicit measurements of forest structure and fire behavior following restoration treatments in dry forests

    Treesearch

    Justin Paul Ziegler; Chad Hoffman; Michael Battaglia; William Mell

    2017-01-01

    Restoration treatments in dry forests of the western US often attempt silvicultural practices to restore the historical characteristics of forest structure and fire behavior. However, it is suggested that a reliance on non-spatial metrics of forest stand structure, along with the use of wildland fire behavior models that lack the ability to handle complex structures,...

  14. Fire, fuel treatments, and ecological restoration: Conference proceedings; 2002 16-18 April; Fort Collins, CO

    Treesearch

    Philip N. Omi; Linda A. Joyce

    2003-01-01

    Recent fires have spawned intense interest in fuel treatment and ecological restoration activities. Scientists and land managers have been advocating these activities for years, and the recent fires have provided incentives for federal, state, and local entities to move ahead with ambitious hazard reduction and restoration projects. Recent fires also have increased...

  15. Inositol Treatment and ART Outcomes in Women with PCOS.

    PubMed

    Garg, Deepika; Tal, Reshef

    2016-01-01

    Polycystic ovary syndrome (PCOS) affects 5-10% of women in reproductive age and is characterized by oligo/amenorrhea, androgen excess, insulin resistance, and typical polycystic ovarian morphology. It is the most common cause of infertility secondary to ovulatory dysfunction. The underlying etiology is still unknown but is believed to be multifactorial. Insulin-sensitizing compounds such as inositol, a B-complex vitamin, and its stereoisomers (myo-inositol and D-chiro-inositol) have been studied as an effective treatment of PCOS. Administration of inositol in PCOS has been shown to improve not only the metabolic and hormonal parameters but also ovarian function and the response to assisted-reproductive technology (ART). Accumulating evidence suggests that it is also capable of improving folliculogenesis and embryo quality and increasing the mature oocyte yield following ovarian stimulation for ART in women with PCOS. In the current review, we collate the evidence and summarize our current knowledge on ovarian stimulation and ART outcomes following inositol treatment in women with PCOS undergoing in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI).

  16. Inositol Treatment and ART Outcomes in Women with PCOS

    PubMed Central

    Garg, Deepika

    2016-01-01

    Polycystic ovary syndrome (PCOS) affects 5–10% of women in reproductive age and is characterized by oligo/amenorrhea, androgen excess, insulin resistance, and typical polycystic ovarian morphology. It is the most common cause of infertility secondary to ovulatory dysfunction. The underlying etiology is still unknown but is believed to be multifactorial. Insulin-sensitizing compounds such as inositol, a B-complex vitamin, and its stereoisomers (myo-inositol and D-chiro-inositol) have been studied as an effective treatment of PCOS. Administration of inositol in PCOS has been shown to improve not only the metabolic and hormonal parameters but also ovarian function and the response to assisted-reproductive technology (ART). Accumulating evidence suggests that it is also capable of improving folliculogenesis and embryo quality and increasing the mature oocyte yield following ovarian stimulation for ART in women with PCOS. In the current review, we collate the evidence and summarize our current knowledge on ovarian stimulation and ART outcomes following inositol treatment in women with PCOS undergoing in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI). PMID:27795706

  17. Periodontal and Restorative Treatment of Gingival Recession Associated with Non-Carious Cervical Lesions: Case Study.

    PubMed

    Pereira, Analice Giovani; Teixeira, Daniela Navarro Ribeiro; Soares, Michelle Pereira Costa Mundim; Gonzaga, Ramon Corrêa de Queiroz; Fernandes-Neto, Alfredo Júlio; Soares, Paulo Vinícius

    2016-01-14

    The association between the presence of gingival recession and non-carious cervical lesions is a common finding in dentistry. These diseases have multifactorial etiology and the treatment should be multidisciplinary. Although traditionally the majority of professionals treat non-carious cervical lesions only with conventional restorative procedures, in most cases a combination of periodontal and restorative treatments provides the best functional and esthetic results. Thus, the objective of this case report was to present a new option for treatment, which consists of a subepithelial connective tissue graft associated with a coronally advanced flap placed on dentin and non-carious cervical lesions restored with lithium disilicate partial veneers. A patient complaining about the esthetic aspects of her teeth and cervical dentin hypersensitivity was submitted to occlusal adjustments and daily diet analysis in order to manage etiologic factors. Experienced operators then performed restorative and surgical treatments. Periodontal clinical attachment level (probing depth + gingival margin), bleeding on probing, plaque index, and the integrity of the restorations were observed. During the monitoring period, the treatment was effective, with good functional and esthetic results. The hypersensitivity disappeared, and neither inflammatory characteristics in gingival tissue nor failures in restorations were noted. It might be concluded that treatment with a combination of techniques can be effective and predictable for patients with gingival recession and non-carious cervical lesions that may or may not require restorative procedures under controlled conditions. Copyright© by the International Academy of Periodontology.

  18. Involuntary medication treatment for competency restoration of 22 defendants with delusional disorder.

    PubMed

    Herbel, Bryon L; Stelmach, Hans

    2007-01-01

    There are no published data on the rates of competency restoration for adjudicated incompetent felony criminal defendants diagnosed with delusional disorder. A retrospective record review was conducted of all incompetent defendants with the principal diagnosis of delusional disorder who had undergone involuntary medication treatment for competency restoration during a 13-year period at a federal psychiatric prison hospital. Of the 181 defendants who were involuntarily medicated for competency restoration during this period, 22 had delusional disorder. Seventeen (77%) of the defendants with delusional disorder improved sufficiently for the forensic evaluators to opine that they had been restored to competency after involuntary treatment with antipsychotic medication. These results are similar to the published data of the relatively high rates of competency restoration for incompetent defendants with diagnosed schizophrenia.

  19. The effectiveness of art therapy in the treatment of traumatized adults: a systematic review on art therapy and trauma.

    PubMed

    Schouten, Karin Alice; de Niet, Gerrit J; Knipscheer, Jeroen W; Kleber, Rolf J; Hutschemaekers, Giel J M

    2015-04-01

    Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The aim of this systematic review is to identify and evaluate empirical evidence of the effectiveness of art therapy for trauma treatment. As a result of the systematic review, six controlled, comparative studies on art therapy for trauma in adult patients were found. In half of the included studies, a significant decrease in psychological trauma symptoms was found in the treatment groups, and one study reported a significant decrease in depression. Although there are limitations in the number of included studies, the number of participants, the heterogeneity of included studies, and their methodological quality, the results contribute to insight into the effectiveness of art therapy in trauma treatment and form an evidence base for the urgent need for further research on art therapy and trauma treatment.

  20. Functional movement impairment in dancers: An assessment and treatment approach utilizing the Biomechanical Asymmetry Corrector (BAC) to restore normal mechanics of the spine and pelvis.

    PubMed

    Keller, K; West, J C

    1995-01-01

    Musculoskeletal injuries to the spine and pelvis are common in dancers. These injuries are associated with mechanical dysfunctions that impair spinal adaptation to the movement demands of the art form. This article introduces the biomechanical asymmetry corrector (BAC), a dynamic assessment and treatment tool, designed to restore normal spinal mechanics and functional movement patterns in dancers. A discussion of lumbo-pelvic mechanics and dance injury provides a theoretical context for describing exercises on the BAC.

  1. Approximal and occlusal carious lesions: Restorative treatment decisions by California dentists.

    PubMed

    Rechmann, Peter; Doméjean, Sophie; Rechmann, Beate M T; Kinsel, Richard; Featherstone, John D B

    2016-05-01

    Investigators use questionnaire surveys to evaluate treatment philosophies in dental practices. The aim of this study was to evaluate the management strategies California dentists use for approximal and occlusal carious lesions. In May 2013, the authors e-mailed a questionnaire that addressed approximal and occlusal carious lesion management (detection and restorative threshold, preferred preparation type, and restorative materials) to 16,960 dentists in California. The authors performed a χ(2) statistical analysis to investigate the relationship between management strategies and respondent demographic characteristics. The authors received responses from 1,922 (11.3%) dentists; 42.6% of the respondents would restore approximal lesions at the dentinoenamel junction, and 33.4% would wait until the lesion reached the outer one-third of dentin. The preferred preparation type was the traditional Class II preparation. Dentists who graduated more recently (20 years or less) were more likely to delay approximal restorations (P < .0001); 49.9% of the more recent graduates would wait to restore an occlusal lesion until the outer one-third of dentin was involved, and 42.6% would restore a lesion confined to enamel. There is wide variety among California dentists regarding their restorative treatment decisions, with most dentists restoring a tooth earlier than the literature would advise. More recent dental graduates were more likely to place their restorative threshold at deeper lesions for approximal carious lesions. Clinical evidence shows that noncavitated carious lesions can be remineralized; therefore, early restorative treatment may no longer be necessary or appropriate. Noninvasive and minimally invasive measures should be taken into consideration. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  2. Art.

    ERIC Educational Resources Information Center

    Arviso, Kathern; And Others

    Designed as a helpful guide and "how-to-do-it" outline for those on the Navajo Reservation who work with children, this guide is arranged to offer quick reference and simple projects requiring the minimum of materials. The projects are designed to meet the Navajo child's art needs based on the belief that the art program of the…

  3. Assessing the potential for log sort yards to improve financial viability of forest restoration treatments

    Treesearch

    Woodam Chung; Tyron J. Venn; Dan Loeffler; Greg Jones; Han-Sup Han; Dave E. Calkin

    2012-01-01

    Forest restoration and fuel reduction treatments have been widely applied in the western United States with the purpose of reducing the size and intensity of wildfires. However, the low value of small-diameter trees produced from such treatments has partly constrained the ability to treat all the areas identified as being in need of treatments. The objective of this...

  4. Estimates of eligibility for antiretroviral treatment (ART) and projected ART impact on AIDS mortality among South African educators.

    PubMed

    Rehle, Thomas M; Shisana, Olive

    2005-11-01

    The study assessed the proportion of HIV-infected educators that need antiretroviral treatment (ART) according to current criteria, and estimated the impact of ART on AIDS mortality by modelling scenarios with and without access to ART. Specimens for HIV testing were obtained from 17 088 educators and a sub-sample of 444 venous blood specimens from HIV-positive educators was selected for a CD4 cell count analysis. The Spectrum model package was used for estimating AIDS-associated mortality and projecting the impact of ART scenarios. The results of the CD4 cell count analysis in the HIV-positive educator study population showed that 8% had fewer than 100, 22% fewer than 200, 52% fewer than 350, and 72% fewer than 500 CD4 cells/mm3. Based on the proportion of HIV-positive educators with a CD4 cell count < 200 cells/mm3 we estimated that in 2005 approximately 10 700 educators would need ART according to current SA government guidelines. For the baseline scenario without ART the number of AIDS deaths among HIV-infected educators was projected to increase from 1 992 deaths in 2000 to 5 260 in 2010. The number of projected AIDS deaths in the educator study population was estimated to be 4 414 in 2005, with almost 50% of the AIDS deaths occurring in the 35 - 44 age group. The estimates suggest that in 2005 9.1% of the HIV-infected educators, or 1.2% of the total educator population, will be dying of AIDS. By 2010, a reduction of almost 50% in AIDS deaths was estimated for the treatment scenario with 90% ART coverage, compared with the baseline scenario without treatment. The ART impact scenarios illustrate that a relatively high ART coverage would be needed to ensure a substantial impact of ART on HIV/AIDS-associated mortality.

  5. [Restorative treatment of degenerative-dystrophic diseases of large joints].

    PubMed

    Neverov, V A; Kurbanov, S Kh

    2004-01-01

    The authors performed courses of treatment with Midocalm in 110 patients according to their original method. It reduced the pain syndrome, increased the volume of movements in the joint and shortened the time of treatment.

  6. Restoration of Endodontically Treated Teeth Review and Treatment Recommendations

    PubMed Central

    Slutzky-Goldberg, Iris; Slutzky, Hagay; Gorfil, Colin; Smidt, Ami

    2009-01-01

    Coronal restorations and posts can positively influence the long-term prognosis of teeth following root canal therapy. Final sealing the canal by placing an appropriate post and core will minimize leakage of oral fluids and bacteria into the periradicular area and is recommended as soon as possible after completion of root canal filling. Glass ionomer or MTA placed over the residual root canal filling after post space preparation may be effective to prevent bacterial leakage. A ferrule of 1-2 mm of tooth tissue coronal to the finish line of the crown significantly improves the fracture resistance of the tooth and is more important than the type of the material the core and post are made of. PMID:20309408

  7. Songbird nest survival is invariant to early-successional restoration treatments in a large river floodplain

    Treesearch

    Dirk E. Burhans; Brian G. Root; Terry L. Shaffer; Daniel C. Dey

    2010-01-01

    We monitored songbird nest survival in two reforesting, ∼50-ha former cropland sites along the Missouri River in central Missouri from 2001 to 2003. Sites were partitioned into three experimental units, each receiving one of three tree planting treatments. Nest densities varied among restoration treatments for four of five species, but overall nest survival...

  8. Effects of ecological restoration alternative treatments on nonnative plant species establishment

    Treesearch

    Michael T. Stoddard; Christopher M. McGlone; Peter Z. Fule

    2008-01-01

    Disturbances generated by forest restoration treatments have the potential for enhancing the establishment of nonnative species thereby impeding long-term native plant recovery. In a ponderosa pine forest next to the Fort Valley Experimental Forest, Arizona, we examined the establishment of nonnative species after three alternative treatments with different intensities...

  9. Effects of ecological restoration alternative treatments on nonnative plant species establishment (P-53)

    Treesearch

    Michael T. Stoddard; Christopher M. McGlone; Peter Z. Fule

    2008-01-01

    Disturbances generated by forest restoration treatments have the potential for enhancing the establishment of nonnative species thereby impeding long-term native plant recovery. In a ponderosa pine forest next to the Fort Valley Experimental Forest, Arizona, we examined the establishment of nonnative species after three alternative treatments with different intensities...

  10. Ecosystem restoration treatments affect soil physical and chemical properties in Appalachian mixed oak forests

    Treesearch

    Ralph E.J. Boerner; Jennifer a. Brinkman; Daniel A. Yaussy

    2007-01-01

    This study presents an analysis of the effect of ecosystem restoration treatments on soil properties in the oak forests of southern Ohio. The treatments were (1) prescribed fire, (2) mechanical thinning, (3) fire and thinning, and (4) passive management (control). Fire and thinning resulted in increased mineral soil exposure, with the effect decreasing by the fourth...

  11. Changes in canopy fuels and fire behavior after ponderosa pine restoration treatments: A landscape perspective

    Treesearch

    J. P. Roccaforte; P. Z. Fule

    2008-01-01

    (Please note, this is an abstract only) We modeled crown fire behavior and assessed changes in canopy fuels before and after the implementation of restoration treatments in a ponderosa pine landscape at Mt. Trumbull, Arizona. We measured 117 permanent plots before (1996/1997) and after (2003) thinning and burning treatments. The plots are evenly distributed across the...

  12. Long-term effectiveness of restoration treatments on closed wilderness campsites

    Treesearch

    David N. Cole

    2013-01-01

    This study assessed long-term recovery of vegetation on six wilderness campsites in subalpine forests in Oregon that were closed to use and that received common restoration treatments (scarification, soil amendments, mulch, transplanting, and seeding). Vegetation cover was assessed every year for the first 7 years following treatment, as well as 10 and 15 years after...

  13. Fuel-reduction treatments for restoration in eastern hardwoods: impacts on multiple ecosystem components

    Treesearch

    Thomas A. Waldrop; Daniel A. Yaussy; Ralph E.J. Boerner; Cathryn H. Greenberg; Dean M. Simon

    2013-01-01

    The Southern Appalachian Mountains and Ohio Hills sites are unique within the National Fire and Fire Surrogate Study because they are in hardwood-dominated forests. The efficacy of four fuel-reduction treatments was evaluated to restore these unmanaged hardwood forests to the structure and function of open woodland habitats. Treatments included control, prescribed...

  14. Short-term ecological consequences of collaborative restoration treatments in ponderosa pine forests of Colorado

    USGS Publications Warehouse

    Briggs, Jenny S.; Fornwalt, Paula J.; Feinstein, Jonas A.

    2017-01-01

    Ecological restoration treatments are being implemented at an increasing rate in ponderosa pine and other dry conifer forests across the western United States, via the USDA Forest Service’s Collaborative Forest Landscape Restoration (CFLR) program. In this program, collaborative stakeholder groups work with National Forests (NFs) to adaptively implement and monitor ecological restoration treatments intended to offset the effects of many decades of anthropogenic stressors. We initiated a novel study to expand the scope of treatment effectiveness monitoring efforts in one of the first CFLR landscapes, Colorado’s Front Range. We used a Before/After/Control/Impact framework to evaluate the short-term consequences of treatments on numerous ecological properties. We collected pre-treatment and one year post-treatment data on NF and partner agencies’ lands, in 66 plots distributed across seven treatment units and nearby untreated areas. Our results reflected progress toward several treatment objectives: treated areas had lower tree density and basal area, greater openness, no increase in exotic understory plants, no decrease in native understory plants, and no decrease in use by tree squirrels and ungulates. However, some findings suggested the need for adaptive modification of both treatment prescriptions and monitoring protocols: treatments did not promote heterogeneity of stand structure, and monitoring methods may not have been robust enough to detect changes in surface fuels. Our study highlights both the effective aspects of these restoration treatments, and the importance of initiating and continuing collaborative science-based monitoring to improve the outcomes of broad-scale forest restoration efforts.

  15. No Child Left behind Strikes the Arts: How Can We Restore a Balance among the Studies in the Arts, Sciences, and Humanities?

    ERIC Educational Resources Information Center

    Fuller, Judith A.

    2007-01-01

    Most Americans actually understand the importance of an education rich in arts, science and humanities. But what they may not realize is that their children are not getting enough. Each day more and more of the arts and humanities are being drained from our nation's school curriculums. Studies have shown that the arts play a stimulating role in…

  16. Treatment concept with CAD/CAM-fabricated high-density polymer temporary restorations.

    PubMed

    Güth, Jan-Frederik; Almeida E Silva, Júnio S; Ramberger, Marc; Beuer, Florian; Edelhoff, Daniel

    2012-10-01

    Tooth wear in younger patients is perceived worldwide as an increasing problem. Its etiology is multifactorial (erosion, abrasion, attrition), and its treatment is challenging for the dental practitioner specifically when a great loss of the vertical dimension of occlusion has occurred. The aim of this article is to present a treatment approach for complex cases with high loss of tooth structure using computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated temporary high-density polymer restorations without any preparations. New manufacturing technologies and innovative materials such as high-density polymers offer good possibilities for restorations during the pretreatment period. This is especially important in circumstances requiring massive corrections of color, form, or position. Pretreatment periods are indispensable in refining important factors such as lip-position dynamics as well as the correct position of the smile line, which cannot be adequately assessed in the dental laboratory. In the presented case report, CAD/CAM-fabricated non-preparation restorations were adhesively placed on the worn dentition without any further loss of tooth structure. Such an approach provides the opportunity to "test-drive" the new restoration design in terms of function, phonetics, and esthetics, thus improving the predictability of the definitive restorations design. If any change in the design is required, it can be cost-effectively achieved through simple modification or replacement of the restorations.

  17. The Life Cycle of Images: Revisiting the Ethical Treatment of the Art Therapy Image

    ERIC Educational Resources Information Center

    Hinz, Lisa D.

    2013-01-01

    Using the metaphor of the human life cycle, the author of this viewpoint suggests that consideration of the birth, life, and death of images made in art therapy may promote a new perspective on their ethical treatment. A developmental view of images encourages art therapists to see art images as living entities that undergo a natural life cycle.…

  18. The Life Cycle of Images: Revisiting the Ethical Treatment of the Art Therapy Image

    ERIC Educational Resources Information Center

    Hinz, Lisa D.

    2013-01-01

    Using the metaphor of the human life cycle, the author of this viewpoint suggests that consideration of the birth, life, and death of images made in art therapy may promote a new perspective on their ethical treatment. A developmental view of images encourages art therapists to see art images as living entities that undergo a natural life cycle.…

  19. The Use of Art Therapy in Treatment Programs to Promote Spiritual Recovery from Addiction.

    ERIC Educational Resources Information Center

    Feen-Calligan, Holly

    1995-01-01

    Illustrates the relationship between art therapy, spirituality, and recovery supported by the philosophy of Alcoholic Anonymous, and offers a model in which art therapy can be used in treatment programs to facilitate spiritual recovery from addiction. Discusses personal experiences related to the use of art therapy for assisting in addiction…

  20. Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers: a case report

    PubMed Central

    Moon, Ji-Eun; Kim, Sung-Hun; Han, Jung-Suk; Yang, Jae-Ho

    2010-01-01

    If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing. PMID:21165191

  1. Impact of intracoronal dentin treatment prior to bleaching on bond strength of restorative materials.

    PubMed

    Zanconato-Carvalho, Erica Moreno; Bruniera, João Felipe; Faria, Natália Spadini de; Colucci, Vivian; Messias, Danielle Cristine

    2014-01-01

    Surface treatment of dentin before the bleaching procedure may affect its permeability and influence the bond strength of restorative materials. This study evaluated the influence of surface treatment before the bleaching on shear bond strength (SBT) of restorative materials to intracoronal dentin. Dentin slabs were subjected to surface treatment: no bleaching (control - CON), no surface treatment + bleaching (HP), 37% phosphoric acid + bleaching (PA) and Er:YAG laser + bleaching (L). After the bleaching procedure, specimens (n=10) were restored with: microhybrid composite resin (MH), flowable composite resin (F), and resin-modified glass-ionomer cement (RMGIC). The shear test was carried out. ANOVA and Tukey's test (α=0.05) showed significant difference for surface treatment and restorative materials (p<0.05). CON presented higher STB and was statistically different from HP (p<0.05). PA and L showed intermediate values and were statistically similar to CON and HP (p>0.05). STB for MH and F were higher than RMGIC (p<0.05), and did not differ from each other (p>0.05). The surface treatments with phosphoric acid and Er:YAG laser before the bleaching procedure provided shear bond strength at the same level of unbleached dentin and the composite resins presented superior bond strength to the intracoronal dentin.

  2. The effect of baking soda when applied to bleached enamel prior to restorative treatment.

    PubMed

    Tostes, Bhenya Ottoni; Mondelli, Rafael Francisco Lia; Lima-Arsati, Ynara Bosco de Oliveira; Rodrigues, Jose Augusto; Costa, Leonardo Cesar

    2013-08-01

    This in vitro study evaluated the effect of 10% baking soda solution and sodium bicarbonate powder (applied with jets) when applied to bleached enamel prior to restorative treatment. The surfaces of 40 bovine incisors were flattened and divided into 5 groups (n = 8): Group B (bleached and restored, negative control), Group W (bleached, stored in distilled water for 7 days, and restored), Group BSJ (bleached, abraded with baking soda jet for 1 min, and restored), Group BSS (bleached, application of 10% baking soda solution for 5 min, and restored), and Group R (restored, without bleaching, positive control). The samples were bleached in 1 session with 3 applications of 35% HP-based gel and activated with a LED appliance for 9 min each. Resin composite cylinders (2 mm height and 0.8 mm diameter) were made on the enamel surface after the acid etching and a conventional 1-step single vial adhesive application was performed. After storage in distilled water (37 ± 1°C, 24 hr), the microshear bond test was performed (1 mm/min). ANOVA and Tukey tests were applied to compare the results. The mean results of these tests showed that Groups W, BBS, and R were not statistically different. These groups also indicated a higher bond strength when compared with Groups B and BSJ. The application of 10% baking soda solution for 5 min may be an alternative pre-restorative treatment for bleached enamel, but further studies are needed to consider whether or not this treatment may be effectively used in clinical practice.

  3. Molar incisor hypomineralization (MIH): conservative treatment management to restore affected teeth.

    PubMed

    Fragelli, Camila Maria Bullio; Souza, Juliana Feltrin de; Jeremias, Fabiano; Cordeiro, Rita de Cássia Loiola; Santos-Pinto, Lourdes

    2015-01-01

    The purpose of this study was to evaluate the 12-month clinical performance of glass ionomer restorations in teeth with MIH. First permanent molars affected by MIH (48) were restored with glass ionomer cement (GIC) and evaluated at baseline, at 6 and at 12 months, by assessing tooth enamel breakdown, GIC breakdown and caries lesion associations. The data were analyzed using the chi-square test and actuarial survival analysis. The likelihood of a restored tooth remaining unchanged at the end of 12 months was 78%. No statistically significant difference was observed in the association between increased MIH severity and caries at baseline (p > 0.05) for a 6-month period, or between increased MIH severity and previous unsatisfactory treatment at baseline (p > 0.05) for both a 6- and 12-month period. A statistically significant difference was observed in the association between increased MIH severity and extension of the restoration, involving 2 or more surfaces (p < 0.05) at both periods, and between increased MIH severity and caries at baseline (p < 0.05) at a 12-month period. Because the likelihood of maintaining the tooth structures with GIC restorations is high, invasive treatment should be postponed until the child is sufficiently mature to cooperate with the treatment, mainly of teeth affected on just one face.

  4. Long-term trends in restoration and associated land treatments in the southwestern United States

    USGS Publications Warehouse

    Copeland, Stella M.; Munson, Seth M.; Pilliod, David S.; Welty, Justin L.; Bradford, John B.; Butterfield, Bradley J.

    2017-01-01

    Restoration treatments, such as revegetation with seeding or invasive species removal, have been applied on U.S. public lands for decades. Temporal trends in these management actions have not been extensively summarized previously, particularly in the southwestern United States where invasive plant species, drought, and fire have altered dryland ecosystems. We assessed long-term (1940–2010) trends in restoration using approximately 4,000 vegetation treatments conducted on Bureau of Land Management lands across the southwestern United States. We found that since 1940, the proportions of seeding and vegetation/soil manipulation (e.g. vegetation removal or plowing) treatments have declined, while the proportions of prescribed burn and invasive species treatments have increased. Treatments in pinyon-juniper and big sagebrush communities declined in comparison to treatments in desert scrub, creosote bush, and riparian woodland communities. Restoration-focused treatment objectives increased relative to resource extraction objectives. Species richness and proportion of native species used in seeding treatments also increased. Inflation-adjusted costs per area rose 750% for vegetation/soil manipulation, 600% for seeding, and 400% for prescribed burn treatments in the decades from 1981 to 2010. Seeding treatments were implemented in warmer and drier years when compared to the climate conditions of the entire study period and warmer and wetter years relative to several years before and after the treatment. These results suggest that treatments over a 70-year period on public lands in the southwestern United States are shifting toward restoration practices that are increasingly large, expensive, and related to fire and invasive species control.

  5. Potential fire behavior is reduced following forest restoration treatments

    Treesearch

    Peter Z. Fule; Charles McHugh; Thomas A. Heinlein; W. Wallace Covington

    2001-01-01

    Potential fire behavior was compared under dry, windy weather conditions in 12 ponderosa pine stands treated with alternative thinning prescriptions in the wildland/urban interface of Flagstaff, Arizona. Prior to thinning, stands averaged 474 trees/ acre, 158 ft2/acre basal area, crown bulk density 0.0045 lb/ft3, and crown base height 19.2 ft. Three thinning treatments...

  6. Treatment of extended anterior crown fractures using Type IIIA bonded porcelain restorations.

    PubMed

    Magne, Pascal; Magne, Michel

    2005-05-01

    Novel-design bonded porcelain restorations, the so-called Type IIIA BPRs, represent a reliable and effective procedure when restoring large parts of the coronal volume and length in the anterior dentition. While traditional treatment approaches involve the removal of large amounts of sound tooth substance (with adverse effects on the pulp, gingivae and crown biomechanics, as well as serious financial consequences), the use of adhesive technology instead can provide maximum preservation of tissues and limited costs. Considerable advantages, such as the economical and noninvasive treatment of crown-fractured teeth, are inherent to Type IIIA bonded porcelain restorations, reducing the need for preprosthetic interventions (e.g., root canal therapy and crown-lengthening) and the use of intraradicular posts. This article, illustrated with cases with up to eight and 10 years' follow-up, sets the scientific foundations of this concept, as well as important considerations about function, strength, tooth preparation, laboratory technique, and bonding optimization.

  7. Salter-Harris type II proximal humerus injuries: state-of-the-art treatment.

    PubMed

    Verdano, Michele Arcangelo; Pellegrini, Andrea; Lunini, Enricomaria; Porcellini, Giuseppe; Ceccarelli, Francesco

    2012-12-01

    Proximal epiphyseal injuries of the humerus represent a very low percentage of traumatic growth pathologies, 5 % of all fractures during childhood. In the literature, there have been only a limited number of clinical studies investigating these injuries, basically from an epidemiological point of view, focusing on the incidence of the different types of fractures. We report our experience of 6 young patients with Salter-Harris type II proximal humerus epiphyseal injuries adopting a minimally invasive surgical technique consisting of closed reduction and percutaneous fixation with Kirschner wires. At 2 years of follow-up, the results consisting in constant; disabilities of the arm, shoulder, and hand; simple shoulder test; and Visual Analogue Scale scores obtained have been excellent and all the patients come back to a normal life with sports practice and normal daily activities. The range of motion was completely restored without any deficit in abduction-adduction, flection-extension, or intra-extra rotation. No differences in anthropometric parameters were found with no case of malangulation, vascular, or neurological complications. Our data support with evidence how the close reduction internal fixation with K-wires treatment can give to the surgeons and the patients a better security about the correct fracture healing. Furthermore, with this article, we will provide a detailed review of the literature in order to define the state-of-the-art treatment to better face such a challenging skeletal injury.

  8. Restoration of northern Rocky Mountain moist forests: Integrating fuel treatments from the site to the landscape

    Treesearch

    Theresa B. Jain; Russell T. Graham; Jonathan Sandquist; Matthew Butler; Karen Brockus; Daniel Frigard; David Cobb; Han Sup-Han; Jeff Halbrook; Robert Denner; Jeffrey S. Evans

    2008-01-01

    Restoration and fuel treatments in the moist forests of the northern Rocky Mountains are complex and far different from those applicable to the dry ponderosa pine forests. In the moist forests, clearcuts are the favored method to use for growing early-seral western white pine and western larch. Nevertheless, clearcuts and their associated roads often affect wildlife...

  9. Effluent Treatment Facility: Challenged to meet environmental restoration

    SciTech Connect

    Goetsch, S. ); Day, J.E. ); Rickenbach, K.D. ); Kelly, J.W. )

    1992-11-01

    The Effluent Treatment Facility (ETF) located in the center of the Hanford Site is designed to receive liquid effluents from several of onsite sources, process them to eliminate hazardous and radioactive materials, and then discharge in compliance with applicable laws in a suitable location. The design incorporates several technologies selected as the best demonstrated available technology (BDAT) for their particular purpose in the context of the wastes to be treated. These technologies include the following: Filtration; Ultraviolet (UV) oxidation of organic materials; Staged pH adjustment; CO[sub 2] removal (degasification); Reverse osmosis; Ion exchange; Forced circulation evaporation; Thin-film drying. In addition to these process technologies, the facility design includes semi-automated waste packaging systems, and an advanced integrated monitoring and process control system.

  10. Effluent Treatment Facility: Challenged to meet environmental restoration

    SciTech Connect

    Goetsch, S.; Day, J.E.; Rickenbach, K.D.; Kelly, J.W.

    1992-11-01

    The Effluent Treatment Facility (ETF) located in the center of the Hanford Site is designed to receive liquid effluents from several of onsite sources, process them to eliminate hazardous and radioactive materials, and then discharge in compliance with applicable laws in a suitable location. The design incorporates several technologies selected as the best demonstrated available technology (BDAT) for their particular purpose in the context of the wastes to be treated. These technologies include the following: Filtration; Ultraviolet (UV) oxidation of organic materials; Staged pH adjustment; CO{sub 2} removal (degasification); Reverse osmosis; Ion exchange; Forced circulation evaporation; Thin-film drying. In addition to these process technologies, the facility design includes semi-automated waste packaging systems, and an advanced integrated monitoring and process control system.

  11. An overview of treatment considerations for esthetic restorations: a review of the literature.

    PubMed

    Sadowsky, Steven Judd

    2006-12-01

    Controversy persists regarding the treatment planning criteria for esthetic restorations. This article reviews the literature regarding the biocompatibility, marginal adaptation, color matching, patient selection, technique sensitivity, and mode and rate of failure of tooth-colored restorations. A Medline search was completed for the period from 1986 to 2006, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks. The key words used were amalgam, posterior composite resin, ceramic inlays/onlays, CEREC, porcelain laminate veneers, all-ceramic crowns, and all-ceramic fixed partial dentures.

  12. Restoring Complexity to Industrially Managed Timberlands: The Mill Creek Interim Management Recommendations and Early Restoration Thinning Treatments

    Treesearch

    Dan Porter; Valerie Gizinski; Ruskin Hartley; Sharon Hendrix Kramer

    2007-01-01

    The Mill Creek Property was a commercial timberland acquired by the State of California to protect and restore local and regional ecological values and provide opportunities for compatible recreation. Interim Management Recommendations (IMR) were developed to guide protection, restoration, and public access of the Property until the California Department of Parks and...

  13. Integrated monitoring and assessment of soil restoration treatments in the Lake Tahoe Basin.

    PubMed

    Grismer, M E; Schnurrenberger, C; Arst, R; Hogan, M P

    2009-03-01

    Revegetation and soil restoration efforts, often associated with erosion control measures on disturbed soils, are rarely monitored or otherwise evaluated in terms of improved hydrologic, much less, ecologic function and longer term sustainability. As in many watersheds, sediment is a key parameter of concern in the Tahoe Basin, particularly fine sediments less than about ten microns. Numerous erosion control measures deployed in the Basin during the past several decades have under-performed, or simply failed after a few years and new soil restoration methods of erosion control are under investigation. We outline a comprehensive, integrated field-based evaluation and assessment of the hydrologic function associated with these soil restoration methods with the hypothesis that restoration of sustainable function will result in longer term erosion control benefits than that currently achieved with more commonly used surface treatment methods (e.g. straw/mulch covers and hydroseeding). The monitoring includes cover-point and ocular assessments of plant cover, species type and diversity; soil sampling for nutrient status; rainfall simulation measurement of infiltration and runoff rates; cone penetrometer measurements of soil compaction and thickness of mulch layer depths. Through multi-year hydrologic and vegetation monitoring at ten sites and 120 plots, we illustrate the results obtained from the integrated monitoring program and describe how it might guide future restoration efforts and monitoring assessments.

  14. Influence of endodontic treatment, post insertion, and ceramic restoration on the fracture resistance of maxillary premolars.

    PubMed

    Bitter, K; Meyer-Lueckel, H; Fotiadis, N; Blunck, U; Neumann, K; Kielbassa, A M; Paris, S

    2010-06-01

    To investigate the effects of endodontic treatment, post placement and ceramic restoration type on the fracture resistance of premolars. One hundred and twenty teeth maxillary premolars were allocated to four groups (A-D; n = 30). In group A, mesio-occlusal-distal-inlays with a buccal and palatal wall of 2 mm (MOD), in group B partial onlays with palatal cusp coverage and in group C total onlays with buccal and palatal cusp coverage were prepared. Group D served as untreated controls. Groups A-C were divided into three subgroups (n = 10): (i) teeth received solely the described preparations, (ii) teeth were root filled, (iii) teeth were root filled and quartz fibre posts were placed. Teeth were restored using Computer-assisted design/computer-assisted machining-ceramic-restorations and subjected to thermo-mechanical-loading; subsequently, the buccal cusp was loaded until fracture. Group D revealed significantly higher fracture resistance [mean (standard deviation)] [738 (272) N] compared to all other groups (P < 0.05; post hoc test Dunnett). For groups A-C, fracture resistance was significantly affected by the restoration type (P = 0.043) and endodontic treatment/post placement (P = 0.039; 2-way anova). Group A [380 (146) N] showed significantly lower fracture resistance compared to group B [470 (158) N] (P = 0.048; post hoc test Tukey). Compared to non-endodontically treated teeth [487 (120) N], root filled teeth revealed significantly lower fracture resistance [389 (171) N] (P = 0.031). The restoration of cavities with a remaining wall thickness of 2 mm using ceramic MOD-inlays is inferior with respect to the fracture resistance compared to partial onlay restorations. Root filled teeth without post placement show lower fracture resistance compared to non-endodontically treated teeth.

  15. Community occupancy responses of small mammals to restoration treatments in ponderosa pine forests, northern Arizona, USA.

    PubMed

    Kalies, E L; Dickson, B G; Chambers, C L; Covington, W W

    2012-01-01

    In western North American conifer forests, wildfires are increasing in frequency and severity due to heavy fuel loads that have accumulated after a century of fire suppression. Forest restoration treatments (e.g., thinning and/or burning) are being designed and implemented at large spatial and temporal scales in an effort to reduce fire risk and restore forest structure and function. In ponderosa pine (Pinus ponderosa) forests, predominantly open forest structure and a frequent, low-severity fire regime constituted the evolutionary environment for wildlife that persisted for thousands of years. Small mammals are important in forest ecosystems as prey and in affecting primary production and decomposition. During 2006-2009, we trapped eight species of small mammals at 294 sites in northern Arizona and used occupancy modeling to determine community responses to thinning and habitat features. The most important covariates in predicting small mammal occupancy were understory vegetation cover, large snags, and treatment. Our analysis identified two generalist species found at relatively high occupancy rates across all sites, four open-forest species that responded positively to treatment, and two dense-forest species that responded negatively to treatment unless specific habitat features were retained. Our results indicate that all eight small mammal species can benefit from restoration treatments, particularly if aspects of their evolutionary environment (e.g., large trees, snags, woody debris) are restored. The occupancy modeling approach we used resulted in precise species-level estimates of occupancy in response to habitat attributes for a greater number of small mammal species than in other comparable studies. We recommend our approach for other studies faced with high variability and broad spatial and temporal scales in assessing impacts of treatments or habitat alteration on wildlife species. Moreover, since forest planning efforts are increasingly focusing on

  16. Captopril treatment temporarily restores cerebral blood flow autoregulation in spontaneously hypertensive rats after hemorrhagic stroke.

    PubMed

    Davis, Laura A; Smeda, John S

    2010-09-01

    Hemorrhagic stroke development in stroke-prone spontaneously hypertensive Kyoto Wistar rats (SHRsp) is associated with a loss of cerebral blood flow (CBF) autoregulation and death. We assessed the ability of poststroke captopril treatment to retard death and restore CBF autoregulation in SHRsp. Laser Doppler techniques were used to measure alterations in CBF with varying mean arterial pressure (MAP) in anesthetized SHRsp. Three weeks before stroke, all SHRsp autoregulated near constant CBF to an upper MAP limit of 155 +/- 4 mm Hg. CBF autoregulation was absent in half of the SHRsp at 0.5-2 weeks before stroke and nonexistent in SHRsp with stroke. Captopril treatment (50 mg kg(-1) d(-1)) initiated at the first signs of stroke (seizures) increased the lifespan of SHRsp from 10 +/- 3 to 124 +/- 18 days without lowering blood pressure and restored CBF autoregulation within 10 days. CBF autoregulation subsequently deteriorated where after 25 days of treatment, only 2 of 5 SHRsp maintained the ability to autoregulate CBF. We concluded that captopril treatment retarded death and new hemorrhage formation after stroke. The early restoration of autoregulation could prevent sudden death after stroke, but other mechanisms associated with poststroke captopril treatment act to prolong life in the presence of hypertension and absence of CBF autoregulation.

  17. High survival and treatment success sustained after two and three years of first-line ART for children in Cambodia

    PubMed Central

    2010-01-01

    Background Long-term outcomes of antiretroviral therapy (ART) in children remain poorly documented in resource-limited settings. The objective of this study was to assess two-and three-year survival, CD4 evolution and virological response among children on ART in a programmatic setting in Cambodia. Methods Children treated with first-line ART for at least 24 months were assessed with viral load testing and genotyping. We used Kaplan-Meier analysis for survival and Cox regression to identify risk factors associated with treatment failure. Results Of 1168 registered HIV-positive children, 670 (57%) started ART between January 2003 and December 2007. Survival probability was 0.93 (95% CI: 0.91-0.95) and 0.91 (95% CI: 0.88-0.93) at 24 and 36 months after ART initiation, respectively. Median CD4 gain for children aged over five years was 704 cells/mm3 at 24 months and 737 at 36 months. Median CD4 percentage gain for children under five years old was 15.2% at 24 months and 15% at 36 months. One hundred and thirty children completed at least 24 months of ART, and 138 completed 36 months: 128 out of 268 (48%) were female. Median age at ART initiation was six years. Overall, 22 children had viral loads of >1000 copies/ml (success ratio = 86% on intention-to-treat-analysis) and 21 of 21 presented mutations conferring resistance mostly to lamivudine and non-nucleoside reverse transcriptase inhibitors. Risk factors for failure after 24 and 36 months were CD4 counts below the threshold for severe immunosupression at those months respectively. Only two out of 22 children with viral loads of >1000 copies/ml met the World Health Organization immunological criteria for failure (sensitivity = 0.1). Conclusions Good survival, immunological restoration and viral suppression can be sustained after two to three years of ART among children in resource-constrained settings. Increased access to routine virological measurements is needed for timely diagnosis of treatment failure. PMID

  18. Association of assisted reproductive technology (ART) treatment and parental infertility diagnosis with autism in ART-conceived children.

    PubMed

    Kissin, D M; Zhang, Y; Boulet, S L; Fountain, C; Bearman, P; Schieve, L; Yeargin-Allsopp, M; Jamieson, D J

    2015-02-01

    Are assisted reproductive technology (ART) treatment factors or infertility diagnoses associated with autism among ART-conceived children? Our study suggests that the incidence of autism diagnosis in ART-conceived children during the first 5 years of life was higher when intracytoplasmic sperm injection (ICSI) was used compared with conventional IVF, and lower when parents had unexplained infertility (among singletons) or tubal factor infertility (among multiples) compared with other types of infertility. Some studies found an increased risk of autism among ART-conceived infants compared with spontaneously-conceived infants. However, few studies, and none in the USA, have examined the associations between types of ART procedures and parental infertility diagnoses with autism among ART-conceived children. Population-based retrospective cohort study using linkages between National ART Surveillance System (NASS) data for 1996-2006, California Birth Certificate data for 1997-2006, and California Department of Developmental Services (DDS) Autism Caseload data for 1997-2011. All live born ART-conceived infants born in California in 1997-2006 (n = 42 383) with 5-year observation period were included in the study. We assessed the annual incidence of autism diagnosis documented in DDS, which includes information on the vast majority of persons with autism in California, and the association of autism diagnosis with ART treatment factors and infertility diagnoses. Among ART-conceived singletons born in California between 1997 and 2006, the incidence of autism diagnosis remained at ∼0.8% (P for trend 0.19) and was lower with parental diagnosis of unexplained infertility (adjusted hazard risk ratio [aHRR]; 95% confidence interval: 0.38; 0.15-0.94) and higher when ICSI was used (aHRR 1.65; 1.08-2.52), when compared with cases without these patient and treatment characteristics. Among ART-conceived multiples, the incidence of autism diagnosis between 1997 and 2006 remained at

  19. Association of assisted reproductive technology (ART) treatment and parental infertility diagnosis with autism in ART-conceived children

    PubMed Central

    Kissin, D.M.; Zhang, Y.; Boulet, S.L.; Fountain, C.; Bearman, P.; Schieve, L.; Yeargin-Allsopp, M.; Jamieson, D.J.

    2015-01-01

    STUDY QUESTION Are assisted reproductive technology (ART) treatment factors or infertility diagnoses associated with autism among ART-conceived children? SUMMARY ANSWER Our study suggests that the incidence of autism diagnosis in ART-conceived children during the first 5 years of life was higher when intracytoplasmic sperm injection (ICSI) was used compared with conventional IVF, and lower when parents had unexplained infertility (among singletons) or tubal factor infertility (among multiples) compared with other types of infertility. WHAT IS KNOWN ALREADY Some studies found an increased risk of autism among ART-conceived infants compared with spontaneously-conceived infants. However, few studies, and none in the USA, have examined the associations between types of ART procedures and parental infertility diagnoses with autism among ART-conceived children. STUDY DESIGN, SIZE, DURATION Population-based retrospective cohort study using linkages between National ART Surveillance System (NASS) data for 1996–2006, California Birth Certificate data for 1997–2006, and California Department of Developmental Services (DDS) Autism Caseload data for 1997–2011. PARTICIPANTS/MATERIALS, SETTING, METHODS All live born ART-conceived infants born in California in 1997–2006 (n = 42 383) with 5-year observation period were included in the study. We assessed the annual incidence of autism diagnosis documented in DDS, which includes information on the vast majority of persons with autism in California, and the association of autism diagnosis with ART treatment factors and infertility diagnoses. MAIN RESULTS AND THE ROLE OF CHANCE Among ART-conceived singletons born in California between 1997 and 2006, the incidence of autism diagnosis remained at ∼0.8% (P for trend 0.19) and was lower with parental diagnosis of unexplained infertility (adjusted hazard risk ratio [aHRR]; 95% confidence interval: 0.38; 0.15–0.94) and higher when ICSI was used (aHRR 1.65; 1.08–2.52), when

  20. Cleidocranial dysplasia case report: remodeling of teeth as aesthetic restorative treatment.

    PubMed

    da Cunha, Leonardo Fernandes; Caetano, Isabela Maria; Dalitz, Fernando; Gonzaga, Carla Castiglia; Mondelli, José

    2014-01-01

    Cleidocranial dysplasia (CCD), is an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals. It is generally characterized by orofacial manifestations, including enamel hypoplasia, retained primary teeth, and impacted permanent and supernumerary teeth. The successful treatment involving a timing intervention (orthodontic-maxillofacial surgeons-restorative) is already described. However, the restorative treatment might improve the aesthetic final result in dentistry management for patients with cleidocranial dysplasia. Objective. Therefore, this clinical report presents a conservative restorative management (enamel microabrasion, dental bleaching, and direct composite resin) for aesthetic solution for a patient with CCD. Clinical Considerations. The cosmetic remodeling is a conservative, secure, and low cost therapy that can be associated with other procedures such as enamel microabrasion and dental bleaching to achieve optimal outcome. Additionally, the Golden Proportion can be used to guide dental remodeling to improve the harmony of the smile and the facial composition. Conclusions. Thus, dentists must know and be able to treat dental aesthetic problems in cleidocranial dysplasia patients. The intention of this paper is to describe a restorative approach with the cosmetic remodeling teeth (by grinding or addicting material) associated with enamel microabrasion and dental bleaching to reestablish the form, shape, and color of smile for patients with cleidocranial dysplasia.

  1. Posterior ventricular restoration treatment for heart failure: a review, past, present and future aspects.

    PubMed

    Isomura, Tadashi; Fukada, Yasuhisa; Miyazaki, Takuya; Yoshida, Minoru; Morisaki, Akimasa; Endo, Masahiro

    2017-03-01

    Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations. New strategies for treating CHF are needed. In addition to conventional cardiac surgery, surgical ventricular restoration was reported as a promising surgical therapy in 1990s. After the first report of partial left ventriculectomy in which posterior wall was widely resected for dilated heart, many controversial clinical and animal research studies have been reported. In this review, the principles of posterior cardiac restoration therapy will be discussed. An overview of posterior cardiac restoration, structure, and torsion are presented. By understanding the structure of cardiac muscle, shape, and torsion of left ventricle for surgical restoration, the procedure can be performed based on appropriate indication and this knowledge can be used to optimize and improve its efficacy. The use of mechanical support devices has recently become commonplace in many centers, and the use of implantable ventricular assist devices as destination therapy will increase. Surgeons will be able to select several options of the treatment for CHF by understanding the advantages and disadvantages of those surgical treatments.

  2. Innovative systems for cultural heritage conservation. Millimeter wave application for non-invasive monitoring and treatment of works of art.

    PubMed

    Bruno, Bisceglia; De Leo, Roberto; Pastore, Anna Pia; von Gratowski, Svetlana; Meriakri, Viatcheslav

    2011-01-01

    A novel non invasive technique and a suitable apparatus for disinfestation of artworks is introduced. Non destructive and non invasive techniques are often irreplaceable in order to preserve and restore cultural heritage objects in its structure and shape. Although many techniques are available for art and archaeological works the non invasive methods are preferred as they leave the object untouched after treatment. Environmental parameters, such as humidity, can damage culture heritage objects and also results in spring up variety of pests and other micro-organisms. Non-invasive monitoring of these damage and also disinfestation treatments and drying with help of electromagnetic waves are preferred as they keep the object untouched after treatment. Application of millimeter waves for solving this problem is discussed here. Millimeter waves have high spatial resolution and absorption in water as well as in bio-objects that are usually moist and at the same time minimal interaction with dry culture heritage objects by itself. Different phases of the microwaves treatment (MW) of artworks are described, some results are shown and discussed. Many biological forms don't survive over a certain temperature, called lethal temperature which, for most xylophages is about 53-55 degrees C, while for moulds and funguses is between 65 and 70 degrees C. In order to evaluate the management of disinfestation of works of art, incident power, temperature, exposure time were monitored. The monitoring of temperature is essential in order to prevent damages. A computer simulation allows to predict and monitor the heating process.

  3. Copper treatment during storage reduces Phytophthora and Halophytophthora infection of Zostera marina seeds used for restoration.

    PubMed

    Govers, Laura L; van der Zee, Els M; Meffert, Johan P; van Rijswick, Patricia C J; Man In 't Veld, Willem A; Heusinkveld, Jannes H T; van der Heide, Tjisse

    2017-02-22

    Restoration is increasingly considered an essential tool to halt and reverse the rapid decline of vital coastal ecosystems dominated by habitat-forming foundation species such as seagrasses. However, two recently discovered pathogens of marine plants, Phytophthora gemini and Halophytophthora sp. Zostera, can seriously hamper restoration efforts by dramatically reducing seed germination. Here, we report on a novel method that strongly reduces Phytophthora and Halophytophthora infection of eelgrass (Zostera marina) seeds. Seeds were stored in seawater with three different copper sulphate concentrations (0.0, 0.2, 2.0 ppm) crossed with three salinities (0.5, 10.0, 25.0 ppt). Next to reducing seed germination, infection significantly affected cotyledon colour: 90% of the germinated infected seeds displayed a brown cotyledon upon germination that did not continue development into the seedling stage, in contrast to only 13% of the germinated non-infected seeds. Copper successfully reduced infection up to 86% and the 0.2 ppm copper sulphate treatment was just as successful as the 2.0 ppm treatment. Infection was completely eliminated at low salinities, but green seed germination was also dramatically lowered by 10 times. We conclude that copper sulphate treatment is a suitable treatment for disinfecting Phytophthora or Halophytophthora infected eelgrass seeds, thereby potentially enhancing seed-based restoration success.

  4. Semi-arid aquifer responses to forest restoration treatments and climate change.

    PubMed

    Wyatt, Clinton J W; O'Donnell, Frances C; Springer, Abraham E

    2015-01-01

    The purpose of this study was to develop an interpretive groundwater-flow model to assess the impacts that planned forest restoration treatments and anticipated climate change will have on large regional, deep (>400 m), semi-arid aquifers. Simulations were conducted to examine how tree basal area reductions impact groundwater recharge from historic conditions to 2099. Novel spatial analyses were conducted to determine areas and rates of potential increases in groundwater recharge. Changes in recharge were applied to the model by identifying zones of basal area reduction from planned forest restoration treatments and applying recharge-change factors to these zones. Over a 10-year period of forest restoration treatment, a 2.8% increase in recharge to one adjacent groundwater basin (the Verde Valley sub-basin) was estimated, compared to conditions that existed from 2000 to 2005. However, this increase in recharge was assumed to quickly decline after treatment due to regrowth of vegetation and forest underbrush and their associated increased evapotranspiration. Furthermore, simulated increases in groundwater recharge were masked by decreases in water levels, stream baseflow, and groundwater storage resulting from surface water diversions and groundwater pumping. These results indicate that there is an imbalance between water supply and demand in this regional, semi-arid aquifer. Current water management practices may not be sustainable into the far future and comprehensive action should be taken to minimize this water budget imbalance.

  5. Copper treatment during storage reduces Phytophthora and Halophytophthora infection of Zostera marina seeds used for restoration

    PubMed Central

    Govers, Laura L.; van der Zee, Els M.; Meffert, Johan P.; van Rijswick, Patricia C. J.; Man in ‘t Veld, Willem A.; Heusinkveld, Jannes H. T.; van der Heide, Tjisse

    2017-01-01

    Restoration is increasingly considered an essential tool to halt and reverse the rapid decline of vital coastal ecosystems dominated by habitat-forming foundation species such as seagrasses. However, two recently discovered pathogens of marine plants, Phytophthora gemini and Halophytophthora sp. Zostera, can seriously hamper restoration efforts by dramatically reducing seed germination. Here, we report on a novel method that strongly reduces Phytophthora and Halophytophthora infection of eelgrass (Zostera marina) seeds. Seeds were stored in seawater with three different copper sulphate concentrations (0.0, 0.2, 2.0 ppm) crossed with three salinities (0.5, 10.0, 25.0 ppt). Next to reducing seed germination, infection significantly affected cotyledon colour: 90% of the germinated infected seeds displayed a brown cotyledon upon germination that did not continue development into the seedling stage, in contrast to only 13% of the germinated non-infected seeds. Copper successfully reduced infection up to 86% and the 0.2 ppm copper sulphate treatment was just as successful as the 2.0 ppm treatment. Infection was completely eliminated at low salinities, but green seed germination was also dramatically lowered by 10 times. We conclude that copper sulphate treatment is a suitable treatment for disinfecting Phytophthora or Halophytophthora infected eelgrass seeds, thereby potentially enhancing seed-based restoration success. PMID:28225072

  6. Effects of Four Different Restoration Treatments on the Natural Abundance of 15N Stable Isotopes in Plants

    PubMed Central

    Temperton, Vicky M.; Märtin, Lea L. A.; Röder, Daniela; Lücke, Andreas; Kiehl, Kathrin

    2012-01-01

    δ15N signals in plant and soil material integrate over a number of biogeochemical processes related to nitrogen (N) and therefore provide information on net effects of multiple processes on N dynamics. In general little is known in many grassland restoration projects on soil–plant N dynamics in relation to the restoration treatments. In particular, δ15N signals may be a useful tool to assess whether abiotic restoration treatments have produced the desired result. In this study we used the range of abiotic and biotic conditions provided by a restoration experiment to assess to whether the restoration treatments and/or plant functional identity and legume neighborhood affected plant δ15N signals. The restoration treatments consisted of hay transfer and topsoil removal, thus representing increasing restoration effort, from no restoration measures, through biotic manipulation to major abiotic manipulation. We measured δ15N and %N in six different plant species (two non-legumes and four legumes) across the restoration treatments. We found that restoration treatments were clearly reflected in δ15N of the non-legume species, with very depleted δ15N associated with low soil N, and our results suggest this may be linked to uptake of ammonium (rather than nitrate). The two non-legume species differed considerably in their δ15N signals, which may be related to the two species forming different kinds of mycorrhizal symbioses. Plant δ15N signals could clearly separate legumes from non-legumes, but our results did not allow for an assessment of legume neighborhood effects on non-legume δ15N signals. We discuss our results in the light of what the δ15N signals may be telling us about plant–soil N dynamics and their potential value as an indicator for N dynamics in restoration. PMID:22645597

  7. Effects of four different restoration treatments on the natural abundance of (15)n stable isotopes in plants.

    PubMed

    Temperton, Vicky M; Märtin, Lea L A; Röder, Daniela; Lücke, Andreas; Kiehl, Kathrin

    2012-01-01

    δ(15)N signals in plant and soil material integrate over a number of biogeochemical processes related to nitrogen (N) and therefore provide information on net effects of multiple processes on N dynamics. In general little is known in many grassland restoration projects on soil-plant N dynamics in relation to the restoration treatments. In particular, δ(15)N signals may be a useful tool to assess whether abiotic restoration treatments have produced the desired result. In this study we used the range of abiotic and biotic conditions provided by a restoration experiment to assess to whether the restoration treatments and/or plant functional identity and legume neighborhood affected plant δ(15)N signals. The restoration treatments consisted of hay transfer and topsoil removal, thus representing increasing restoration effort, from no restoration measures, through biotic manipulation to major abiotic manipulation. We measured δ(15)N and %N in six different plant species (two non-legumes and four legumes) across the restoration treatments. We found that restoration treatments were clearly reflected in δ(15)N of the non-legume species, with very depleted δ(15)N associated with low soil N, and our results suggest this may be linked to uptake of ammonium (rather than nitrate). The two non-legume species differed considerably in their δ(15)N signals, which may be related to the two species forming different kinds of mycorrhizal symbioses. Plant δ(15)N signals could clearly separate legumes from non-legumes, but our results did not allow for an assessment of legume neighborhood effects on non-legume δ(15)N signals. We discuss our results in the light of what the δ(15)N signals may be telling us about plant-soil N dynamics and their potential value as an indicator for N dynamics in restoration.

  8. Long-term effectiveness of restoration treatments on closed wilderness campsites.

    PubMed

    Cole, David N

    2013-03-01

    This study assessed long-term recovery of vegetation on six wilderness campsites in subalpine forests in Oregon that were closed to use and that received common restoration treatments (scarification, soil amendments, mulch, transplanting, and seeding). Vegetation cover was assessed every year for the first 7 years following treatment, as well as 10 and 15 years after treatment. This made it possible to compare long-term treatment effectiveness to short-term efficacy. Plots that were closed and not scarified had virtually no vegetation cover even after 15 years without use. If long-used campsites in these subalpine forests are simply closed and allowed to recover on their own, restoration of undisturbed conditions will require hundreds if not thousands of years. Study results show, however, that simple treatments can accelerate recovery rates substantially. Scarification and transplanting were highly effective treatments, with seeding and soil amendment with organic matter and compost also contributing to success, but to a lesser degree. The use of a mulch mat, in contrast, had no effect, either positive or negative. Assessments of success conducted within the first few years of treatment overestimate treatment efficacy, particularly the effectiveness of soil amendments and seeding.

  9. Long-Term Effectiveness of Restoration Treatments on Closed Wilderness Campsites

    NASA Astrophysics Data System (ADS)

    Cole, David N.

    2013-03-01

    This study assessed long-term recovery of vegetation on six wilderness campsites in subalpine forests in Oregon that were closed to use and that received common restoration treatments (scarification, soil amendments, mulch, transplanting, and seeding). Vegetation cover was assessed every year for the first 7 years following treatment, as well as 10 and 15 years after treatment. This made it possible to compare long-term treatment effectiveness to short-term efficacy. Plots that were closed and not scarified had virtually no vegetation cover even after 15 years without use. If long-used campsites in these subalpine forests are simply closed and allowed to recover on their own, restoration of undisturbed conditions will require hundreds if not thousands of years. Study results show, however, that simple treatments can accelerate recovery rates substantially. Scarification and transplanting were highly effective treatments, with seeding and soil amendment with organic matter and compost also contributing to success, but to a lesser degree. The use of a mulch mat, in contrast, had no effect, either positive or negative. Assessments of success conducted within the first few years of treatment overestimate treatment efficacy, particularly the effectiveness of soil amendments and seeding.

  10. Original hypothesis: Extracorporeal shockwaves as a homeostatic autoimmune restorative treatment (HART) for Type 1 diabetes mellitus.

    PubMed

    Craig, Kenneth; d'Agostino, Cristina; Poratt, Daniel; Walker, Marjorie

    2014-09-01

    Mononuclear invasion of Langerhans islet and the ensuing insulitis triggers signal-transduction for the autoimmune mediated pancreatic beta-cell (β-cell) apoptosis that severely disrupts insulin production resulting in hyperglycemia associated with Type-1 diabetes (T1DM). Today extensive global research is being conducted to eliminate the need for insulin, and even prevent or find a cure for T1DM. The multifactorial combination of autoimmune dysfunction, Langerhans islet hypoxia, and bio-chemical disruption are seen to be contributory factors for β-cell destruction and the consequential disruption to insulin production. Regeneration of β-cells back to physiological levels may restore homeostatic insulin levels, reversing T1DM. Evidence suggests that there are still functioning pancreatic β-cells even in long standing T1DM providing the potential for their regeneration. Although the exact mechanism of extracorporeal shockwaves (ESW) is yet to be fully elucidated, it is seen to influence a complex spectrum of bio-chemical, cellular and neuronal functions (i.e. suppression of pro-inflammatory immune response, improved tissue hemodynamics, anti-microbial properties, and the induction of progenitor cell expression including proangiogenic factors and nitric oxide syntheses). The rationale for the use of ESW as a therapeutic modality in this instance is attributed to its restorative properties and safety profile demonstrated in urology, cardiology, chronic wounds, osteogenesis, complex pain syndromes, and tendinopathies. ESW may restore autoimmune homeostasis creating a suitable environment for pancreatic β-cell proliferation which in-turn may significantly increase or normalize endogenous insulin secretion reducing or totally eliminating dependency of exogenous insulin. The devastating complications, morbidity and mortality associated with T1DM warrants the exploration of homeostatic autoimmune restorative treatment (HART) modalities that may partially or fully

  11. Art Therapy Outcomes in the Rehabilitation Treatment of a Stroke Patient: A Case Report

    ERIC Educational Resources Information Center

    Kim, Sun-Hyun; Kim, Min-Young; Lee, Jae-Hyuk; Chun, Sae-il

    2008-01-01

    This case report discusses the potential for art therapy to aid in the recovery of early-chronic stroke patients. The patient was diagnosed with having a subarachnoid hemorrhage from a cerebral aneurysm rupture 1 year prior to hospitalization. Therapies used as part of the patient's treatment included 10 weeks of art therapy conducted twice a…

  12. Focusing and Expressive Arts Therapy as a Complementary Treatment for Women with Breast Cancer

    ERIC Educational Resources Information Center

    Klagsbrun, Joan; Rappaport, Laury; Speiser, Vivien Marcow; Post, Pamela; Byers, Julia; Stepakoff, Shanee; Karman, Shira

    2005-01-01

    This pilot study (N = 18) explored the effectiveness of focusing and expressive arts therapies intervention on the quality of life of women with breast cancer. The format was a 2-day (7 hours per day) retreat/support group in which complementary treatments (focusing, writing, art, and movement) were provided in an intensive format. Our hypothesis…

  13. Effects of alpha-tocopherol on fracture resistance after endodontic treatment, bleaching and restoration.

    PubMed

    Jordão-Basso, Keren Cristina Fagundes; Kuga, Milton Carlos; Dantas, Andrea Abi Rached; Tonetto, Mateus Rodrigues; Lima, Suellen Nogueira Linhares; Bandéca, Matheus Coêlho

    2016-05-20

    This study evaluated the effects of 10% alphatocopherol on the fracture resistance of endodontically treated teeth subjected to tooth bleaching with hydrogen peroxide and immediately restored with composite resin. Fifty bovine incisors were selected, including 10 sound teeth that constituted the control group (G1 (C)). The remaining 40 teeth, which were endodontically treated, were divided into four groups (n = 10): G2 (CR), consisting of teeth immediately restored with composite resin; G3 (HP + CR), consisting of teeth subjected to tooth bleaching with 38% hydrogen peroxide and immediately restored with composite resin; G4 (HP + SA + CR), which received treatment similar to that used for G3, but with 10% sodium ascorbate gel applied after the bleaching protocol; and G5 (HP + AT + CR), which was similar to G4 but included 10% alphatocopherol gel as an antioxidant. After 24 h, composite restorations were performed, and teeth were subjected to a fracture resistance test at a speed of 0.5 mm/min in an electromechanical testing machine. The axial force was applied with an angle of incidence of 135° relative to the long axis of the root. Data were subjected to ANOVA and Tukey tests (p = 0.05). G1 exhibited the highest fracture resistance (p < 0.05). No significant differences among the other experimental groups were observed. The 10% sodium ascorbate and 10% alphatocopherol gels did not improve the fracture resistance of endodontically treated teeth subjected to bleaching with 38% hydrogen peroxide.

  14. Resiliency of an interior ponderosa pine forest to bark beetle infestations following fuel-reduction and forest-restoration treatments

    Treesearch

    Christopher J Fettig; Stephen R. McKelvey

    2014-01-01

    Mechanical thinning and the application of prescribed fire are commonly used to restore fire-adapted forest ecosystems in the western United States. During a 10-year period, we monitored the effects of fuel-reduction and forest-restoration treatments on levels of tree mortality in an interior ponderosa pine, Pinus ponderosa Dougl. ex Laws., forest...

  15. The effectiveness of four-cavity treatment systems in sealing amalgam restorations.

    PubMed

    Morrow, Leean A; Wilson, Nairn H F

    2002-01-01

    Amalgam does not bond to tooth tissue; therefore, restorations using such material are prone to leakage despite the deposition of corrosion products. This study evaluated the effectiveness of four cavity treatment systems placed in vivo in sealing restorations of amalgam. Four cavity treatment systems were investigated in this study: Cervitec, Gluma One Bond, Panavia 21 and Copaliner Dentin Varnish and Sealant. No cavity treatment was placed in an additional group to serve as a control. The teeth were extracted within 15 minutes of restoration placement. The specimens were thermocycled (5-55 +/- 2 degrees C, 500 cycles), immersed in a dye solution, sectioned and scored for leakage. Scanning electron microscopy also examined features of the tooth/restoration interfaces. There were statistically significant differences among the groups regarding leakage scores (p = 0.00). None of the materials tested consistently prevented leakage; however, use of Copaliner Dentin Varnish and Sealant resulted in less overall, occlusal and cervical microleakage than any other systems tested. Significantly more leakage was observed in relation to the cervical portions of the cavities (p = 0.00). No significant differences were identified between the leakage scores obtained for the buccal and palatal (lingual) cavities and the different tooth types (p = 0.52 and 0.83, respectively). A level of significance of 0.05 was selected in all cases. The benefits of the materials tested in this study need to be evaluated using robust, long-term clinical studies. Further work should continue to develop laboratory tests that predict the behavior and performance of cavity sealants in clinical service.

  16. Water Treatment Plant Sludges--An Update of the State of the Art: Part 2.

    ERIC Educational Resources Information Center

    American Water Works Association Journal, 1978

    1978-01-01

    This report outlines the state of the art with respect to nonmechanical and mechanical methods of dewatering water treatment plant sludge, ultimate solids disposal, and research and development needs. (CS)

  17. Water Treatment Plant Sludges--An Update of the State of the Art: Part 2.

    ERIC Educational Resources Information Center

    American Water Works Association Journal, 1978

    1978-01-01

    This report outlines the state of the art with respect to nonmechanical and mechanical methods of dewatering water treatment plant sludge, ultimate solids disposal, and research and development needs. (CS)

  18. Treatment and restoration of adult dentoalveolar trauma: A clinical case report.

    PubMed

    Serra-Pastor, Blanca; Penarrocha-Diago, Miguel; Penarrocha-Diago, María; Agustín-Panadero, Rubén

    2016-12-01

    Adult dentoalveolar trauma most often occurs in the context of sports activities and traffic accidents. Coronal fractures are the most common type of lesion, followed by tooth luxation. We present the case of a 25-year-old woman who suffered alveolar bone damage and coronal fractures of the upper incisors, with extrusive luxation of the right central incisor, as the result of a fall. On the first visit, manual reduction of the buccal plate was carried out under local anesthesia, with repositioning of the right central incisor and splinting to the neighboring teeth. Composites were used to restore the coronal fractures. After one month, both upper central incisors and the right lateral incisor were subjected to endodontic treatment. Internal bleaching of the right lateral incisor was also carried out, due to pigmentation secondary to pulp necrosis. At follow-up 5 months later, the alveolar bone fracture was seen to have healed. Definitive anterior restorative treatment with porcelain veneers was therefore carried out. After two years the patient remains asymptomatic and in good dental condition. Key words:Dental trauma, extrusive luxation, dento-alveolar fracture, esthetic restoration.

  19. Treatment and restoration of adult dentoalveolar trauma: A clinical case report

    PubMed Central

    Penarrocha-Diago, Miguel; Penarrocha-Diago, María; Agustín-Panadero, Rubén

    2016-01-01

    Adult dentoalveolar trauma most often occurs in the context of sports activities and traffic accidents. Coronal fractures are the most common type of lesion, followed by tooth luxation. We present the case of a 25-year-old woman who suffered alveolar bone damage and coronal fractures of the upper incisors, with extrusive luxation of the right central incisor, as the result of a fall. On the first visit, manual reduction of the buccal plate was carried out under local anesthesia, with repositioning of the right central incisor and splinting to the neighboring teeth. Composites were used to restore the coronal fractures. After one month, both upper central incisors and the right lateral incisor were subjected to endodontic treatment. Internal bleaching of the right lateral incisor was also carried out, due to pigmentation secondary to pulp necrosis. At follow-up 5 months later, the alveolar bone fracture was seen to have healed. Definitive anterior restorative treatment with porcelain veneers was therefore carried out. After two years the patient remains asymptomatic and in good dental condition. Key words:Dental trauma, extrusive luxation, dento-alveolar fracture, esthetic restoration. PMID:27957283

  20. Long-term insulin treatment restores cardioprotection induced by sufentanil postconditioning in diabetic rat heart.

    PubMed

    Zhang, Yuwen; Zhang, Lei; Gu, Erwei; Zhu, Bingqing; Zhao, Xianya; Chen, Jingjing

    2016-03-01

    Sufentanil, a commonly used opioid analgesic, could mimic ischemia postconditioning to attenuate ischemia reperfusion injury, but this effect might be hindered in diabetic animals by inhibition of glycogen synthase kinase-3β phosphorylation. Also, diabetes can abrogate the cardioprotection of sevoflurane (an inhaled anesthetic) against ischemia reperfusion injury, and short-term insulin treatment does not restore protection by sevoflurane postconditioning. We hypothesized that long-term insulin treatment might restore the cardioprotective effect of sufentanil postconditioning in diabetic rats via phosphorylation of glycogen synthase kinase-3β. Streptozotocin (55 mg/kg)-induced diabetic rats received insulin (Novolin N, 6-8 u/d) for two days or two weeks, then were exposed to 30-min ischemia and 120-min reperfusion. Sufentanil postconditioning was performed 5 min before the onset of reperfusion. Controls included non-diabetic rats, sham surgery for ischemia/reperfusion, and sufentanil vehicle. Infarct size, cardiac troponin I, and phosphorylated glycogen synthase kinase-3β were examined. Sufentanil postconditioning reduced infarct size by 46% in non-diabetic rats (P < 0.001), but diabetes prevented this protective effect. Two-day insulin treatment was not effective, but two-week treatment reduced infarct size by 45% (P < 0.001), reduced cardiac troponin I by 33% (P < 0.001), and increased phosphorylated glycogen synthase kinase-3β levels (P < 0.001) in the diabetic sufentanil postconditioning group. In conclusion, sufentanil-induced cardioprotection was restored by long-term insulin treatment. The underlying mechanism may be increased phosphorylation of glycogen synthase kinase-3β.

  1. Relationship between periodontics and restorative procedures: surgical treatment of the restorative alveolar interface (rai)--case series.

    PubMed

    Almeida, A L P F; Esper, L A; Sbrana, M C; Cunha, M J S; Greghi, S L A; Carrilho, G P B; Pegoraro, L F

    2013-12-01

    Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren't respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorative alveolar interface (RAI) technique was described as the portion of the root surface extending from the alveolar crest apically to the restorative margin coronally. RAI consists of modifying the restorative margin position into a healthier environment, respecting the biological width and therefore allowing effective plaque control. This paper describes four clinical cases with indication for the RAI technique for maintenance of periodontal health. The cases were associated with prostheses. All cases were evaluated at 90 days and exhibited a healthy periodontal tissue. Successful outcomes were observed in the different indications for the RAI technique.

  2. Treating women with perinatal mood and anxiety disorders (PMADs) with a hybrid cognitive behavioural and art therapy treatment (CB-ART).

    PubMed

    Sarid, Orly; Cwikel, Julie; Czamanski-Cohen, Johanna; Huss, Ephrat

    2017-02-01

    This paper presents an overview of a combined, evaluated protocol, cognitive behavioural and art therapy treatment (CB-ART), for the treatment of women with perinatal mood and anxiety disorders (PMADs). The protocol integrates cognitive behavioural interventions and art therapy. CB-ART focuses on changing distressing image, symptom or memory (ISM) that interferes with functioning. The method directs clients to identify compositional elements that characterize their stressful ISM and to alter the element in their imagination, in bodily sensations and on the page. Examples are provided to illustrate the therapeutic process.

  3. Restoration of MPTP-induced deficits by exercise and Milmed® co-treatment

    PubMed Central

    Archer, Trevor; Fredriksson, Anders

    2014-01-01

    1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induces permanent neurochemical and functional deficits. Following the administration of either two or four injections of the dopamine neurotoxin, MPTP, at a dose of 40 mg/kg, C57/BL6 mice were given access to running-wheels (30-min sessions, four times/week, Monday–Thursday) and treatment with the treated yeast, Milmed® (four times/week, Monday–Thursday), or simply running-wheel exercise by itself, over ten weeks. It was observed that the combination of physical exercise and Milmed® treatment, the MPTP + Exercise + Yeast (MC) group [MPTP + Exercise + Milmed® (MC)], restored spontaneous motor activity markedly by test day 10, restored completely subthreshold L-Dopa-induced activity, and dopamine concentration to 76% of control values, in the condition wherein two administrations of MPTP (2 × 40 mg/kg) were given prior to initiation of exercise and/or Milmed® treatment. Physical exercise by itself, MPTP + Exercise (MC) group, attenuated these deficits only partially. Administration of MPTP four times (i.e., 40 mg/kg, s.c., once weekly over four weeks for a total of 160 mg/kg, MPTP + Exercise + Yeast (MC) group [MPTP + Exercise + Milmed® (SC)] and MPTP + Exercise (SC), induced a lesioning effect that was far too severe for either exercise alone or the exercise + Milmed® combination to ameliorate. Nevertheless, these findings indicate a powerful effect of physical exercise reinforced by Milmed® treatment in restoring MPTP-induced deficits of motor function and dopamine neurochemistry in mice. PMID:25210657

  4. Simplified methods of determining treatment retention in Malawi: ART cohort reports vs. pharmacy stock cards.

    PubMed

    Chan, A K; Singogo, E; Changamire, R; Ratsma, Y E C; Tassie, J-M; Harries, A D

    2012-06-21

    Rapid scale-up of antiretroviral therapy (ART) has challenged the health system in Malawi to monitor large numbers of patients effectively. To compare two methods of determining retention on treatment: quarterly ART clinic data aggregation vs. pharmacy stock cards. Between October 2010 and March 2011, data on ART outcomes were extracted from monitoring tools at five facilities. Pharmacy data on ART consumption were extracted. Workload for each method was observed and timed. We used intraclass correlation and Bland-Altman plots to compare the agreeability of both methods to determine treatment retention. There is wide variability between ART clinic cohort data and pharmacy data to determine treatment retention due to divergence in data at sites with large numbers of patients. However, there is a non-significant trend towards agreeability between the two methods (intraclass correlation coefficient > 0.9; P > 0.05). Pharmacy stock card monitoring is more time-efficient than quarterly ART data aggregation (81 min vs. 573 min). In low-resource settings, pharmacy records could be used to improve drug forecasting and estimate ART retention in a more time-efficient manner than quarterly data aggregation; however, a necessary precondition would be capacity building around pharmacy data management, particularly for large-sized cohorts.

  5. Simplified methods of determining treatment retention in Malawi: ART cohort reports vs. pharmacy stock cards

    PubMed Central

    Singogo, E.; Changamire, R.; Ratsma, Y. E. C.; Tassie, J-M.; Harries, A. D.

    2012-01-01

    Setting: Rapid scale-up of antiretroviral therapy (ART) has challenged the health system in Malawi to monitor large numbers of patients effectively. Objective: To compare two methods of determining retention on treatment: quarterly ART clinic data aggregation vs. pharmacy stock cards. Design: Between October 2010 and March 2011, data on ART outcomes were extracted from monitoring tools at five facilities. Pharmacy data on ART consumption were extracted. Workload for each method was observed and timed. We used intraclass correlation and Bland-Altman plots to compare the agreeability of both methods to determine treatment retention. Results: There is wide variability between ART clinic cohort data and pharmacy data to determine treatment retention due to divergence in data at sites with large numbers of patients. However, there is a non-significant trend towards agreeability between the two methods (intraclass correlation coefficient > 0.9; P > 0.05). Pharmacy stock card monitoring is more time-efficient than quarterly ART data aggregation (81 min vs. 573 min). Conclusion: In low-resource settings, pharmacy records could be used to improve drug forecasting and estimate ART retention in a more time-efficient manner than quarterly data aggregation; however, a necessary precondition would be capacity building around pharmacy data management, particularly for large-sized cohorts. PMID:26392945

  6. L-carnitine treatment partially restores urinary bladder function of streptozotocin diabetic rats.

    PubMed

    Gur, Serap; Irat, Ali Murat

    2008-01-01

    Diabetes mellitus is associated with urinary bladder dysfunction. This study determined whether or not detrusor responses were altered and reversed by L-carnitine treatment in the urinary bladders of diabetic rats. Three groups of animals were used: streptozotocin-treated (45 mg x kg(-1) i.p., 8 weeks), parallel L-carnitine-treated (0.6 g x kg(-1) x day(-1) i.p.), and control rats. Contractile and relaxant responses were measured using isolated bath techniques. Serum glucose levels in diabetic rats were partially reversed after L-carnitine treatment. Detrusor strips from diabetic rats exhibited an increase in response to electrical field stimulation (EFS; 0.5-32 Hz). Treatment with L-carnitine restored the hyperreactivity to EFS-induced contractility. The response to direct activation of the smooth muscle with carbachol and KCl remained unaltered. In relaxation studies, the urinary bladders of diabetic rats displayed a diminished response to isoprenaline, an unchanged response to ATP, and an increased response to adenosine of the ATP metabolite. L-carnitine treatment restored the hyporesponsiveness of isoprenaline and the hyperresponsiveness of adenosine-elicited relaxation. These findings show that carnitine can be implicated in the contractile response of noradrenergic noncholinergic nerve stimulation and the relaxation response of isoprenaline and adenosine. Hence, L-carnitine deficiency can contribute to voiding deficiency in diabetic patients. 2008 S. Karger AG, Basel

  7. The Use of Art and Music Therapy in Substance Abuse Treatment Programs

    PubMed Central

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

    2014-01-01

    While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

  8. The use of art and music therapy in substance abuse treatment programs.

    PubMed

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

    2014-01-01

    Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

  9. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan

    PubMed Central

    Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam

    2012-01-01

    Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental chair with oral mirror and dental probe. The results were recorded in a special form for each patient for statistical analysis and evaluation of restorations to be successful or failed. Statistical analysis was performed by chi-square and fisher exact tests for comparison between success rates of restorations and Kendall's tau-b test for evaluating the effect of time on success rates of them (P < 0.05). Results: Stainless steel crown restorations had significantly better results vs class I and class II amalgam and class I and class II tooth color restorations. All types of posterior tooth color restorations had statistically same results with amalgam restorations. Anterior composite resin build-up represented significantly low success rates. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up (P = 0.344 and P = 0.091, respectively). Conclusion: Stainless steel crown restorations had significantly better results vs other posterior restorations. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up in comparison of other restorations. PMID:23162592

  10. Reinforced composite restoration following trauma to a mandibular tooth: technique and follow-up treatment.

    PubMed

    Smidt, Ami; Sharon, Eldad; Adler, Mordekhai Lipovetsky

    2012-10-01

    The loss of an entire tooth in the anterior region is accompanied by impairment of esthetics, function, phonetics, and self-esteem. It is common knowledge that treatment with implants during childhood or early adolescence is not an option. Splinting of adjacent teeth during growth and development may interfere with the independent process of teeth realignment and repositioning during that phase of life. Other creative solutions must be offered, such as free-standing composite buildup restorations on compromised broken teeth or single wing/cantilevered restorations adhered to one neighboring tooth during the growth period. The positive effects of reinforced composite materials were researched and presented in the literature. Their use is clearly indicated for interim and economical restorations. Long-term follow-up on a mandibular incisor that experienced trauma, losing its clinical crown and vitality when the patient was 12 years of age, is discussed with all the various aspects of material selection, future considerations, and long-term follow-up to adulthood, when a conventional crown was prepared and delivered.

  11. Intraoral treatment of veneering porcelain chipping of fixed dental restorations: a review and clinical application.

    PubMed

    Kimmich, Magdalena; Stappert, Christian F J

    2013-01-01

    Every dental ceramic system can experience failure of the veneering porcelain. However, the increasing popularity of all-ceramic crowns and fixed dental prostheses (FDPs) seems to have led to an increasing need to repair chipped veneering porcelain. The authors compared different methods to repair fractured ceramic restorations (porcelain-fused-to-metal and all-ceramic) and explain the basic principles of adhesion in these systems. They also evaluated the frequency and causes of failure in dental ceramic systems. This review is based on the results of PubMed and Google Scholar searches, as well as on a hand search of the scientific literature, resulting in 300 articles from 1977 to 2012. The authors used multiple key words (ceramic, repair, bonding, hydrofluoric acid, air abrasion, silane, phosphates, silicon dioxide) and different strategies (connecting different key words with OR, NOR and AND and truncation of the stem of words) to search the databases. Because of differences in the material composition of ceramic systems (composed of metal, alumina or zirconia, glass-ceramics and feldspathic ceramics), different treatments are required for the exposed material surfaces after chipping. Use of hydrofluoric acid etching, air abrasion, tribochemical coating, silanization and metal primers or zirconia primers seem to be the most successful conditioning methods for durable bonding and repair. Intraoral repair of a restoration offers a satisfying option for the patient when the restoration cannot be removed or replaced. Its success depends largely on the conditioning methods used for the fractured surfaces.

  12. Treatment of Childhood Depression: The State of the Art.

    ERIC Educational Resources Information Center

    Clarizio, Harvey F.

    1986-01-01

    This article reviews various aspects of seven approaches to the treatment of childhood depression--psychoanalytic, behavioral, cognitive, familial, rational-emotive, multimodal, and drug interventions. Implications for practitioners are considered in terms of target selection, choice of treatment methods, rational evaluation based on developmental…

  13. Restoration of primary anterior teeth: review of the literature.

    PubMed

    Lee, Jacob K

    2002-01-01

    This paper reviews the published data on restorations of primary anterior teeth. The discussion includes Class III restorations, Class V restorations, various forms of full coronal restorations, atraumatic restorative technique (ART) and recommendations for future research.

  14. The Application of Traditional Martial Arts Practice and Theory to the Treatment of Violent Adolescents.

    ERIC Educational Resources Information Center

    Twemlow, Stuart W.; Sacco, Frank C.

    1998-01-01

    Reviews treatment programs, the complex problems posed by youth gangs, and the use of martial arts in the treatment of violence and proposes a program for violent adolescents. The program philosophy is committed to respect and self-control; emphasis is on leadership and community service. Provides clinical examples. (Author/EMK)

  15. Development of an Art Psychotherapy Model for the Prevention and Treatment of Unresolved Grief during Midlife.

    ERIC Educational Resources Information Center

    Turetsky, Cheryl J.; Hays, Ronald E.

    2003-01-01

    Presents an integrated model as an appropriate intervention to enable mourning and creativity and thus help in the prevention and treatment of unresolved grief in midlife. Two examples of this model in art-psychotherapy group treatment are provided. (Contains 53 references, 1 table, and 2 figures.) (GCP)

  16. The Application of Traditional Martial Arts Practice and Theory to the Treatment of Violent Adolescents.

    ERIC Educational Resources Information Center

    Twemlow, Stuart W.; Sacco, Frank C.

    1998-01-01

    Reviews treatment programs, the complex problems posed by youth gangs, and the use of martial arts in the treatment of violence and proposes a program for violent adolescents. The program philosophy is committed to respect and self-control; emphasis is on leadership and community service. Provides clinical examples. (Author/EMK)

  17. Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia

    PubMed Central

    Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

    2016-01-01

    Background Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can’t control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Methods Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. Result The incidence rate of treatment failure was found 9.38 (95% CI 7.79–11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61–7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46–5.84).Bedridden [AHR = 5.02; 95% CI: (1.98–12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08–4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72–5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99–9.54]. Having other opportunistic infection during ART initiation was also

  18. Clinical value of DNA fragmentation evaluation tests under ART treatments.

    PubMed

    Tavukçuoğlu, Ilkay Şafak; Al-Azawi, Tahani; Khaki, Amir Afshin; Khaki, Arash; Khalil, Ahmed; Al-Hasani, Safaa

    2012-01-01

    Male reproductive health has been under scrutiny recently. Many studies in the literature have concluded that semen quality is declining and that the incidence of testicular cancers is increasing. The reason for this change has been attributed to damage in sperm chromatin. During in vivo reproduction, the natural selection process ensures that only a spermatozoon with normal genomic material can fertilize an oocyte. However, the assisted reproduction technique (ART) is our selection process, leading to the possibility that abnormal spermatozoa could be used to fertilize an oocyte. We could avoid this by quantifying the amount and type of genomic damage in sperm using well-accepted laboratory methods. The sperm deoxyribonucleic acid (DNA) integrity is important for success of natural or assisted fertilization as well as normal development of the embryo, fetus and child. Intra cytoplasmic sperm injection (ICSI) is bypassing natural sperm selection mechanisms, which increases the risk of transmitting damaged DNA. The significance of required investigations and multiple techniques is that they could evaluate DNA defects in human spermatozoa. The ability of these techniques to accurately estimate sperm DNA damage depends on many technical and biological aspects. The aim of this review is to evaluate the most commonly used methods.

  19. Growing season soil moisture following restoration treatments of varying intensity in semi-arid ponderosa pine forests

    NASA Astrophysics Data System (ADS)

    O'Donnell, F. C.; Springer, A. E.; Sankey, T.; Masek Lopez, S.

    2014-12-01

    Forest restoration projects are being planned for large areas of overgrown semi-arid ponderosa pine forests of the Southwestern US. Restoration involves the thinning of smaller trees and prescribed or managed fire to reduce tree density, restore a more natural fire regime, and decrease the risk of catastrophic wildfire. The stated goals of these projects generally reduced plant water stress and improvements in hydrologic function. However, little is known about how to design restoration treatments to best meet these goals. As part of a larger project on snow cover, soil moisture, and groundwater recharge, we measured soil moisture, an indicator of plant water status, in four pairs of control and restored sites near Flagstaff, Arizona. The restoration strategies used at the sites range in both amount of open space created and degree of clustering of the remaining trees. We measured soil moisture using 30 cm vertical time domain reflectometry probes installed on 100 m transects at 5 m intervals so it would be possible to analyze the spatial pattern of soil moisture. Soil moisture was higher and more spatially variable in the restored sites than the control sites with differences in spatial pattern among the restoration types. Soil moisture monitoring will continue until the first snow fall, at which point measurements of snow depth and snow water equivalent will be made at the same locations.

  20. State of the Art Treatments for Cannabis Dependence

    PubMed Central

    Danovitch, Itai; Gorelick, David A.

    2012-01-01

    Synopsis This article reviews established and emerging treatment options for cannabis dependence. Cannabis dependence poses some distinct challenges for treatment providers. The evolving sociocultural context of cannabis use for medical purposes, policy liberalization, and societal normalization has contributed to decreased perceived risk and increased acceptability of use. Simultaneously, the comparatively lower “severity” of cannabis-associated consequences makes it more difficult for some users to recognize the impact of their use and establish an enduring commitment to change. As a result, many treatment seekers are reluctant to accept traditional abstinence-based goals. Among treatment providers, consensus has not been established about the value of non-abstinence goals, such as moderation and harm reduction. Notwithstanding these challenges, the high prevalence of cannabis dependence, its strong association with co-morbid mental health problems, and the difficulty of achieving cannabis cessation ensure that many psychiatrists will face patients with cannabis dependence. While no pharmacotherapy has been approved for cannabis dependence, a number of promising approaches are in development. Psychotherapy studies are establishing a number of evidence-based models and techniques in the treatment resources for patients in need. PMID:22640758

  1. Concordance between Responses to Questionnaire Scenarios and Actual Treatment to Repair or Replace Dental Restorations in the National Dental PBRN

    PubMed Central

    Heaven, Tim J.; Gordan, Valeria V.; Litaker, Mark S.; Fellows, Jeffrey L.; Rindal, D. Brad; Gilbert, Gregg H.

    2015-01-01

    Objective To quantify the agreement between treatment recommended during hypothetical clinical scenarios and actual treatment provided in comparable clinical circumstances. Methods A total of 193 practitioners in the National Dental Practice-Based Research Network participated in both a questionnaire and a clinical study. The questionnaire included three hypothetical scenarios about treatment of existing restorations. Clinicians then participated in a clinical study about repair or replacement of existing restorations. We quantified the overall concordance between their questionnaire responses and what they did in actual clinical treatment. Results Practitioners who recommended repair (instead of replacement) of more scenario restorations also had higher repair percentages in clinical practice. Additionally, for each of the three hypothetical scenario restorations, practitioners who recommended repair had higher repair percentages in clinical practice. Conclusions The questionnaire scenarios were a valid measure of clinicians’ tendency to repair or replace restorations in actual clinical practice. Clinical implications Although there was substantial variation in practitioners’ tendency to repair or replace restorations, responses to questionnaire scenarios by individual practitioners were concordant with what they did in actual clinical practice. PMID:25998565

  2. State of the art treatments for cannabis dependence.

    PubMed

    Danovitch, Itai; Gorelick, David A

    2012-06-01

    The treatment of cannabis dependence can be viewed as a cup half empty or half full. On the one hand, few people who might benefit from treatment actually receive it. Among those who undergo treatment in randomized trials, long-term abstinence is achieved by fewer than 20%. Moderate use goals have been associated with decreases in consequences, but the differential impact of such goals on the long-term course of cannabis dependence is unknown. Optimal duration of treatment is unclear, and certain populations, particularly patients with co-occurring disorders, have not been studied adequately. Twelve-step programs are low cost, effective for other substance use disorders, and readily available in most regions of the world. However, their role and efficacy in cannabis dependence has not been examined. Finally, effective pharmacologic treatments are under development, but none have yet been firmly established. On the other hand, psychotherapeutic strategies used to treat other substance use disorders can be effective for cannabis dependence. A recent meta-analysis of psychosocial interventions for illicit substance use disorders found that treatments for cannabis dependence had comparatively larger effect sizes than treatments for other substance use disorders. Combination therapies have proven most effective, particularly those that begin with a motivational intervention, utilize incentives to enhance the commitment to change, and teach behavioral and cognitive copings skills to prevent relapse. Among adolescents, family engagement and collaboration with community stakeholders adds substantial value. Although only 9% of cannabis users develop cannabis dependence, the volume of people who smoke cannabis ensures that the total number of people in need of help is larger than the capacity of substance abuse specialty services. Thus, although efforts to refine and improve the efficacy of treatment interventions continue, innovations that increase the availability and

  3. State of the art of biogranulation technology for wastewater treatment.

    PubMed

    Liu, Yu; Tay, Joo-Hwa

    2004-09-01

    Biogranulation technology developed for wastewater treatment includes anaerobic and aerobic granulation processes. Anaerobic granulation is relatively well known, but research on aerobic granulation commenced only recently. Many full-scale anaerobic granular sludge units have been operated worldwide, but no report exists of similar units for aerobic granulation. This paper reviews the fundamentals and applications of biogranulation technology in wastewater treatment. Aspects discussed include the models of biogranulation, major factors influencing biogranulation, characteristics of biogranules, and their industrial applications. This review hopes to provide a platform for developing novel granules-based bioreactors and devising a unified interpretation of the formation of anaerobic and aerobic granules under various operation conditions.

  4. Bond strength of novel CAD/CAM restorative materials to self-adhesive resin cement: the effect of surface treatments.

    PubMed

    Elsaka, Shaymaa E

    2014-12-01

    To evaluate the effect of different surface treatments on the microtensile bond strength (μTBS) of novel CAD/CAM restorative materials to self-adhesive resin cement. Two types of CAD/CAM restorative materials (Vita Enamic [VE] and Lava Ultimate [LU]) were used. The specimens were divided into five groups in each test according to the surface treatment performed; Gr 1 (control; no treatment), Gr 2 (sandblasted [SB]), Gr 3 (SB+silane [S]), Gr 4 (hydrofluoric acid [HF]), and Gr 5 (HF+S). A dual-curing self-adhesive resin cement (Bifix SE [BF]) was applied to each group for testing the adhesion after 24 h of storage in distilled water or after 30 days using the μTBS test. Following fracture testing, specimens were examined with a stereomicroscope and SEM. Surface roughness and morphology of the CAD/CAM restorative materials were characterized after treatment. Data were analyzed using ANOVA and Tukey's test. The surface treatment, type of CAD/CAM restorative material, and water storage periods showed a significant effect on the μTBS (p<0.001). For the LU/BF system, there was no significant difference in the bond strength values between different surface treatments (p>0.05). On the other hand, for the VE/BF system, surface treatment with HF+S showed higher bond strength values compared with SB and HF surface treatments (p<0.05). Surface roughness and SEM analyses showed that the surface topography of CAD/CAM restorative materials was modified after treatments. The effect of surface treatments on the bond strength of novel CAD/CAM restorative materials to resin cement is material dependent. The VE/BF CAD/CAM material provided higher bond strength values compared with the LU/BF CAD/CAM material.

  5. Survey of subsurface treatment technologies for environmental restoration sites at Sandia National Laboratories, New Mexico.

    SciTech Connect

    McGrath, Lucas K.; Ho, Clifford Kuofei; Wright, Jerome L.

    2003-08-01

    This report provides a survey of remediation and treatment technologies for contaminants of concern at environmental restoration (ER) sites at Sandia National Laboratories, New Mexico. The sites that were evaluated include the Tijeras Arroyo Groundwater, Technical Area V, and Canyons sites. The primary contaminants of concern at these sites include trichloroethylene (TCE), tetrachloroethylene (PCE), and nitrate in groundwater. Due to the low contaminant concentrations (close to regulatory limits) and significant depths to groundwater ({approx}500 feet) at these sites, few in-situ remediation technologies are applicable. The most applicable treatment technologies include monitored natural attenuation and enhanced bioremediation/denitrification to reduce the concentrations of TCE, PCE, and nitrate in the groundwater. Stripping technologies to remove chlorinated solvents and other volatile organic compounds from the vadose zone can also be implemented, if needed.

  6. Translucency changes of direct esthetic restorative materials after curing, aging and treatment.

    PubMed

    Lee, Yong-Keun

    2016-11-01

    The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP) of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9). Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8). Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials.

  7. Translucency changes of direct esthetic restorative materials after curing, aging and treatment

    PubMed Central

    2016-01-01

    The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP) of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9). Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8). Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials. PMID:27847744

  8. [Diagnosis and treatment of polycythaemia vera: state of the art].

    PubMed

    Marton, Imelda; Simon, Zsófia; Borbényi, Zita

    2016-10-01

    Polycythaemia vera (PV), a condition characterized by blood hyperviscosity due to the expansion of the erythrocyte mass is the most common entity among all Philadelphia chromosome-negative myeloproliferative neoplasms. Arterial and venous thrombotic events are leading determinants of morbidity and mortality but impairment of quality of life due to vasomotor symptoms (erythromelalgia, pruritus) and disease-associated symptoms (tiredness, fatigue, pruritus, night sweats, vision problems, headache, concentration loss, abdominal discomfort, early satiety, fever, weight loss) are also present. The review of polycythaemia vera is actual as the updated WHO 2016 classification of myeloid neoplasms has changed the diagnostic criteria and a new second-line treatment option - JAK1/JAK2 inhibitor ruxolitinib - has been approved for patients who had an inadequate response to or are intolerant of hydroxyurea, which represents a breakthrough in the treatment of this patient population. Orv. Hetil., 2016, 157(44), 1743-1751.

  9. Poor quality evidence suggests that failure rates for atraumatic restorative treatment and conventional amalgam are similar.

    PubMed

    Hurst, Dominic

    2012-06-01

    The Medline, Cochrane CENTRAL, Biomed Central, Database of Open Access Journals (DOAJ), OpenJ-Gate, Bibliografia Brasileira de Odontologia (BBO), LILACS, IndMed, Sabinet, Scielo, Scirus (Medicine), OpenSIGLE and Google Scholar databases were searched. Hand searching was performed for journals not indexed in the databases. References of included trials were checked. Prospective clinical trials with test and control groups with a follow up of at least one year were included. Data abstraction was conducted independently and clinical and methodologically homogeneous data were pooled using a fixed-effects model. Eighteen trials were included. From these 32 individual dichotomous datasets were extracted and analysed. The majority of the results show no differences between both types of intervention. A high risk of selection-, performance-, detection- and attrition bias was identified. Existing research gaps are mainly due to lack of trials and small sample size. The current evidence indicates that the failure rate of high-viscosity GIC/ART restorations is not higher than, but similar to that of conventional amalgam fillings after periods longer than one year. These results are in line with the conclusions drawn during the original systematic review. There is a high risk that these results are affected by bias, and thus confirmation by further trials with suitably high numbers of participants is needed.

  10. Treatment of osteoporosis: current state of the art.

    PubMed

    Hamrick, Irene; Schrager, Sarina; Nye, Ann Marie

    2015-02-01

    Osteoporosis can be treated with medications and lifestyle changes, including avoiding a sedentary lifestyle, alcohol, and smoking. We will identify medications that protect against hip fractures in addition to vertebral fractures, and explore new evidence of adverse effects and risks. Bisphosphonates are used as first-line treatment. We will discuss the latest osteoporosis medications, drug interactions, potential bone protective effects of other drug classes, and the evidence of exercise and kyphoplasty.

  11. [State-of-the-art Treatment of Acute Stroke].

    PubMed

    Weber, R; Nordmeyer, H

    2015-11-01

    This article gives an overview about diagnostic imaging and treatment options of acute patients with ischemic and hemorrhagic stroke with emphasis on evidence from relevant studies published in the last 2 years. A computed tomography of the brain with CT-angiography should be the minimal standard imaging modality in acute ischemic stroke patients. Diffusion-weighted/imaging-fluid-attenuated inversion recovery (FLAIR)-mismatch magnetic resonance imaging can be useful in patients with wake-up stroke to select patients for recanalisation therapies. Systemic thrombolysis with rt-PA within 4.5 hours after symptom onset and mechanical thrombectomy with stent retrievers within 6 hours and proven occlusion of a large vessel in the anterior brain circulation are both evidence-based treatments. In contrast, there are no major therapeutic advances in patients with hemorrhagic stroke. The systolic blood pressure should be lowered < 140  mm Hg in these patients within one hour. Both acute ischemic and hemorrhagic stroke and patients with a transient ischemic attack should be monitored and treated on a stroke unit due to an improved outcome. A prophylactic antibiotic treatment and very early mobilization during the first 24 hours is not recommended in acute stroke patients.

  12. Antiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ART.

    PubMed

    Worodria, William; Massinga-Loembe, Marguerite; Mayanja-Kizza, Harriet; Namaganda, Jane; Kambugu, Andrew; Manabe, Yukari C; Kestens, Luc; Colebunders, Robert

    2011-01-01

    Commencement of antiretroviral treatment (ART) in severely immunosuppressed HIV-infected persons is associated with unmasking of subclinical disease. The subset of patients that are diagnosed with tuberculosis (TB) disease while on ART have been classified as ART-associated TB. Few studies have reported the incidence of ART-associated TB and unmasking TB-IRIS according to the International Network for the Study of HIV-Associated IRIS (INSHI) consensus definition. To determine the incidence and predictors of ART-associated TB, we screened 219 patients commencing ART at the Infectious Diseases Clinic in Kampala, Uganda for TB by symptoms, sputum microscopy, and chest X-rays and followed them for one year. Fourteen (6.4%) patients were diagnosed with TB during followup. Eight (3.8%) patients had ART-associated TB (incidence rate of 4.3 per 100 person years); of these, three patients fulfilled INSHI criteria for unmasking TB-associated IRIS (incidence rate of 1.6 per 100 person years). A body mass index of less than 18.5 kg/m(2) BMI (HR 5.85 95% CI 1.24-27.46, P = .025) and a C-reactive protein greater than 5 mg/L (HR 8.23 95% CI 1.36-38.33, P = .020) were risk factors for ART-associated TB at multivariate analysis. In conclusion, with systematic TB screening (including culture and chest X-ray), the incidence of ART-associated TB is relatively low in settings with high HIV and TB prevalence.

  13. Current state of the art brachytherapy treatment planning dosimetry algorithms

    PubMed Central

    Pantelis, E; Karaiskos, P

    2014-01-01

    Following literature contributions delineating the deficiencies introduced by the approximations of conventional brachytherapy dosimetry, different model-based dosimetry algorithms have been incorporated into commercial systems for 192Ir brachytherapy treatment planning. The calculation settings of these algorithms are pre-configured according to criteria established by their developers for optimizing computation speed vs accuracy. Their clinical use is hence straightforward. A basic understanding of these algorithms and their limitations is essential, however, for commissioning; detecting differences from conventional algorithms; explaining their origin; assessing their impact; and maintaining global uniformity of clinical practice. PMID:25027247

  14. Differentiated Thyroid Cancer—Treatment: State of the Art

    PubMed Central

    Schmidbauer, Benedikt; Menhart, Karin; Hellwig, Dirk; Grosse, Jirka

    2017-01-01

    Differentiated thyroid cancer (DTC) is a rare malignant disease, although its incidence has increased over the last few decades. It derives from follicular thyroid cells. Generally speaking, the prognosis is excellent. If treatment according to the current guidelines is given, cases of recurrence or persistence are rare. DTC requires special expertise by the treating physician. In recent years, new therapeutic options for these patients have become available. For this article we performed a systematic literature review with special focus on the guidelines of the American Thyroid Association, the European Association of Nuclear Medicine, and the German Society of Nuclear Medicine. For DTC, surgery and radioiodine therapy followed by levothyroxine substitution remain the established therapeutic procedures. Even metastasized tumors can be cured this way. However, in rare cases of radioiodine-refractory tumors, additional options are to be discussed. These include strict suppression of thyroid-stimulating hormone (also known as thyrotropin, TSH) and external local radiotherapy. Systemic cytostatic chemotherapy does not play a significant role. Recently, multikinase or tyrosine kinase inhibitors have been approved for the treatment of radioiodine-refractory DTC. Although a benefit for overall survival has not been shown yet, these new drugs can slow down tumor progression. However, they are frequently associated with severe side effects and should be reserved for patients with threatening symptoms only. PMID:28629126

  15. Understory vegetation response to thinning and burning restoration treatments in dry conifer forests of the eastern Cascades, USA

    Treesearch

    Erich Kyle Dodson; David W. Peterson; Richy J. Harrod

    2008-01-01

    Restoration/fuel reduction treatments are being widely used in fire-prone forests to modify stand structure, reduce risks of severe wildfire, and increase ecosystem resilience to natural disturbances. These treatments are designed to manipulate stand structure and fuels, but may also affect understory vegetation and biodiversity. In this study, we describe prescribed...

  16. Cheap and Cheerful Stream Restoration - An Example of System Wide Woody Addition Treatment

    NASA Astrophysics Data System (ADS)

    Wheaton, J. M.; Bennett, S. N.; Bouwes, N.; Camp, R.

    2012-12-01

    Stream restoration has been plagued with high price tags, limited spatial extents, and questionable effectiveness in light of largely absent monitoring efforts. One prominent example is the placement of large woody debris (LWD) structures and engineered log jams that are frequently employed to promote heterogeneity of instream habitat. Ironically, many of these treatments attempt to lock in place and over-engineer the woody structures as opposed to allowing them to adjust and rearrange themselves as natural LWD would have. We are in the midst of a large scale restoration experiment using LWD to recover ESA-listed steelhead trout (Oncorhynchus mykiss) populations in the Asotin Creek Watershed of Southeast Washington. The project is an Intensively Monitored Watershed (IMW) where the restoration treatment and monitoring use a hierarchal staircase design maximizing the power to detect a population level response in steelhead. We are treating over 12 km of stream with enough LWD input (> 200 pieces per km) to mimic the historic background wood loading and encourage the stream to reshape and regularly rework itself leaving. We are using hundreds of structures we call DWS (dynamic woody structures), which generally consist of a series of wooden fence posts driven into the stream bed and complex LWD anchored between them to invoke a specific hydrogeomorphic response. The real advantage of these DWS are their cost. They can be installed quickly (15-30 minutes each) and cheaply (< $100/DWS); even in remote settings with a 2-3 person crew, hydraulic post pounder, very cheap materials, and avoiding impacts associated with operating heavy equipment. This allows us to install lots of the structures at high density (every 5-15 channel widths) over an entire stream system. We call this overall approach System Wide Woody Addition Treatment (SWWAT). In the long term, we hypothesize that the SWWAT will provide an intial input LWD that will become a part of study creeks which are more

  17. Virological Blips and Predictors of Post Treatment Viral Control After Stopping ART Started in Primary HIV Infection

    PubMed Central

    Olson, Ashley D.; Bucher, Heiner C.; Fox, Julie; Thornhill, John; Morrison, Charles; Muga, Roberto; Phillips, Andrew; Frater, John; Porter, Kholoud

    2017-01-01

    Background: Few individuals commencing antiretroviral therapy (ART) in primary HIV infection (PHI) maintain undetectable viremia after treatment cessation. Associated factors remain unclear given the importance of the phenomenon to cure research. Methods: Using CASCADE data of seroconverters starting ART in PHI (≤6 months from seroconversion), we estimated proportions experiencing viral blips (>400 copies followed by <400 copies HIV-RNA/mL without alteration of regimen) while on ART. We used Cox models to examine the association between time from ART stop to loss of control (2 consecutive measurements >1000 copies per milliliter) and magnitude and frequency of blips while on ART, time from seroconversion to ART, time on ART, adjusting for mean number of HIV-RNA measurements/year while on ART, and other confounders. Results: Seven hundred seventy-eight seroconverters started ART in PHI with ≥3 HIV-RNA measurements. Median interquartile range (IQR) ART duration was 16.2 (8.0–35.9) months, within which we observed 13% with ≥1 blip. Of 228 who stopped ART, 119 rebounded; time to loss of control was associated with longer interval between seroconversion and ART initiation [hazard ratio (HR) = 1.16 per month; 1.04, 1.28], and blips while on ART (HR = 1.71 per blip; 95% confidence interval = 0.94 to 3.10). Longer time on ART (HR = 0.84 per additional month; 0.76, 0.92) was associated with lower risk of losing control. Of 228 stopping ART, 22 (10%) maintained post treatment control (PTC), ie, HIV-RNA <50 copies per milliliter ≥24 months after ART cessation. Conclusion: HIV viral blips on therapy are associated with subsequent viral rebound on stopping ART among individuals treated in PHI. Longer duration on ART is associated with a greater chance of PTC. PMID:27846036

  18. Virological Blips and Predictors of Post Treatment Viral Control After Stopping ART Started in Primary HIV Infection.

    PubMed

    Fidler, Sarah; Olson, Ashley D; Bucher, Heiner C; Fox, Julie; Thornhill, John; Morrison, Charles; Muga, Roberto; Phillips, Andrew; Frater, John; Porter, Kholoud

    2017-02-01

    Few individuals commencing antiretroviral therapy (ART) in primary HIV infection (PHI) maintain undetectable viremia after treatment cessation. Associated factors remain unclear given the importance of the phenomenon to cure research. Using CASCADE data of seroconverters starting ART in PHI (≤6 months from seroconversion), we estimated proportions experiencing viral blips (>400 copies followed by <400 copies HIV-RNA/mL without alteration of regimen) while on ART. We used Cox models to examine the association between time from ART stop to loss of control (2 consecutive measurements >1000 copies per milliliter) and magnitude and frequency of blips while on ART, time from seroconversion to ART, time on ART, adjusting for mean number of HIV-RNA measurements/year while on ART, and other confounders. Seven hundred seventy-eight seroconverters started ART in PHI with ≥3 HIV-RNA measurements. Median interquartile range (IQR) ART duration was 16.2 (8.0-35.9) months, within which we observed 13% with ≥1 blip. Of 228 who stopped ART, 119 rebounded; time to loss of control was associated with longer interval between seroconversion and ART initiation [hazard ratio (HR) = 1.16 per month; 1.04, 1.28], and blips while on ART (HR = 1.71 per blip; 95% confidence interval = 0.94 to 3.10). Longer time on ART (HR = 0.84 per additional month; 0.76, 0.92) was associated with lower risk of losing control. Of 228 stopping ART, 22 (10%) maintained post treatment control (PTC), ie, HIV-RNA <50 copies per milliliter ≥24 months after ART cessation. HIV viral blips on therapy are associated with subsequent viral rebound on stopping ART among individuals treated in PHI. Longer duration on ART is associated with a greater chance of PTC.

  19. Restorative treatment and use of local anesthesia in free and subsidized public dental services in Helsinki, Finland.

    PubMed

    Palotie, Ulla; Vehkalahti, Miira

    2003-08-01

    Our aim was to evaluate restorative treatment and the use of local anesthetics in free and subsidized public dental care in Helsinki, Finland. Public dental clinics are open to all patients under the age of 36, and to some specific groups above that age. Patients up to age 19 receive all treatment free of charge and others at highly subsidized rates. Data were collected in May 2001 during a maximum 2-week period covering all public dental clinics in Helsinki. A one-page questionnaire was sent to all dentists (n = 140) in clinical fields. The data requested included the patient's gender and year of birth, and details on restorations: which tooth and which surfaces were filled, the reason for placement or replacement, the material used, and use of local anesthetic. The response rate was 96%. Of all restorations (n = 3057) placed, 14% were in primary teeth and in permanent teeth: 17% in premolars, 17% in incisors, and 52% in molars; the restorative material most often used was composite resin (69%). Glass-ionomer/compomers dominated in the primary teeth. Local anesthetic was used least (35%) in patients under 13 years of age. Replacements of restorations accounted for 10% of all in the free service (under 20 years of age) and 46% in subsidized dental care (20 and older). The major reasons for replacement were secondary caries (41%) and fractured or lost restoration (40%).

  20. Restorative Retelling for Violent Death: An Investigation of Treatment Effectiveness, Influencing Factors, and Durability

    PubMed Central

    RHEINGOLD, ALYSSA A.; BADDELEY, JENNA L.; WILLIAMS, JOAH L.; BROWN, CLARA; WALLACE, MEGAN M.; CORREA, FANNY; RYNEARSON, EDWARD K.

    2015-01-01

    Many adults who have lost a loved one to violent death suffer from depression, posttraumatic stress disorder (PTSD), and complicated grief. Limited research has examined structured group interventions for violent death survivors or characteristics (e.g., types of loss, quality and type of relationship with the deceased) that may impact response to intervention. This records review of 91 survivors examined the effectiveness of Restorative Retelling (RR), a brief structured group intervention for violent loss survivors. Participants completed depression, PTSD, and complicated grief measures at pre- and post-treatment and at 1-year follow-up for a subset of participants. Findings revealed statistically significant changes in depression and PTSD symptoms (Cohen's d values ranged from .33–.46) at post-treatment, with significant changes observed across all domains at 1-year follow-up. Treatment response appeared to be influenced by high distress, gender, and relationship with the deceased. Results imply a large-scale randomized control trial to determine treatment efficacy. PMID:26640420

  1. Prostate cancer: state of the art imaging and focal treatment.

    PubMed

    Woodrum, D A; Kawashima, A; Gorny, K R; Mynderse, L A

    2017-08-01

    In 2016, it is estimated 180,890 men are newly diagnosed with prostate cancer and 3,306,760 men live with prostate cancer in the United States. The introduction of multiparametric (mp) magnetic resonance imaging (MRI) of the prostate, standardised interpretation guidelines such as Prostate Imaging Reporting and Data System (PI-RADS version 2), and MRI-based targeted biopsy has improved detection of clinically significant prostate cancer. Accurate risk stratification (Gleason grade/score and tumour stage) using imaging and image-guided targeted biopsy has become critical for the management of patients with prostate cancer. Recent advances in MRI-guided minimally invasive ablative treatment (MIAT) utilising cryoablation, laser ablation, high-intensity focused ultrasound ablation, have allowed accurate focal or regional delivery of optimal thermal energy to the biopsy proven, MRI-detected tumour, under real-time or near simultaneous MRI monitoring of the ablation zone. A contemporary review on prostate mpMRI, MRI-based targeted biopsy, and MRI-guided ablation techniques is presented. Copyright © 2017. Published by Elsevier Ltd.

  2. Wherefore Art Thou, O Treatment for Diabetic Neuropathy?

    PubMed

    Malik, R A

    2016-01-01

    As of March 2016, we continue to advocate the diagnosis of diabetic neuropathy using a simple foot examination or monofilament, which identifies only those with severe neuropathy and hence risk of foot ulceration. Given the fact that the 5-year mortality rate of diabetic patients with foot ulceration is worse than that of most common cancers, surely we should be identifying patients at an earlier stage of neuropathy to prevent its progression to a stage with such a high mortality? Of course, we lament that there is no licensed treatment for diabetic neuropathy. Who is to blame? As researchers and carers, we have a duty of care to our patients with diabetic neuropathy. So, we have to look forward not backwards, and move away from our firmly entrenched views on the design and conduct of clinical trials for diabetic neuropathy. Relevant organizations such as Neurodiab, the American Diabetes Association and the Peripheral Nerve Society have to acknowledge that they cannot continue to endorse a bankrupt strategy. The FDA needs an open and self-critical dialogue with these organizations, to give pharmaceutical companies at least a fighting chance to deliver effective new therapies for diabetic neuropathy.

  3. The bonded amalgam restoration--a review of the literature and report of its use in the treatment of four cases of cracked-tooth syndrome.

    PubMed

    Bearn, D R; Saunders, E M; Saunders, W P

    1994-05-01

    Recent interest in amalgam as a restorative material has been directed toward the development of the bonded amalgam restoration. The literature regarding the theoretical and clinical aspects of this technique is reviewed. Four cases of successful treatment of cracked-tooth syndrome with the bonded amalgam restoration are presented.

  4. Restoration of body image and self-esteem for women after cancer treatment: a rehabilitative strategy.

    PubMed

    Anderson, M S; Johnson, J

    1994-01-01

    Cancer treatment has the potential for limited or permanent impact on body image and self-esteem. Physical changes that impose cosmetic and appearance challenges can be psychologically immobilizing for women with cancer. Their ability to function within social roles may also be affected. This paper describes a restorative strategy as part of a comprehensive cancer rehabilitation program. Women who have had cancer are invited to an informal event that combines fashion modeling with practical suggestions for adaptive and cosmetic needs. Fashion and beauty products are displayed and informational materials provided. It incorporates components of Look Good ... Feel Better, a joint program of the American Cancer Society, the National Cosmetology Association and the Cosmetic, Toiletry, and Fragrance Association Foundation. Evaluations show this program to be helpful and enjoyable for attendees. Health professionals can utilize this strategy in a variety of settings as a component of a cancer rehabilitation program.

  5. Ceiling art in a radiation therapy department: its effect on patient treatment experience

    PubMed Central

    Bonett, Jotham

    2015-01-01

    Introduction A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art were most preferred by patients. Methods Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. Results The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. Conclusion The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department. PMID:26451241

  6. Ceiling art in a radiation therapy department: its effect on patient treatment experience

    SciTech Connect

    Bonett, Jotham

    2015-09-15

    A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art were most preferred by patients. Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department.

  7. Art Therapy for Individuals with Traumatic Brain Injury: A Comprehensive Neurorehabilitation-Informed Approach to Treatment

    ERIC Educational Resources Information Center

    Kline, Tori

    2016-01-01

    I describe an approach to art therapy treatment for survivors of traumatic brain injury developed at a rehabilitation facility for adults that serves inpatient, outpatient, and long-term residential clients. This approach is based on a review of the literature on traumatic brain injury, comprehensive neurorehabilitation, brain plasticity, and art…

  8. Structured Sensory Therapy (SITCAP-ART) for Traumatized Adjudicated Adolescents in Residential Treatment

    ERIC Educational Resources Information Center

    Raider, Melvyn C.; Steele, William; Delillo-Storey, Margaret; Jacobs, Jacqueline; Kuban, Caelan

    2008-01-01

    This randomized controlled study assessed the efficacy of a structured group therapy for traumatized, adjudicated adolescents in residential treatment. Youth were randomly assigned to a trauma intervention (SITCAP-ART) or to a waitlist/comparison group. The intervention included both sensory and cognitive/behavioral components. Standardized trauma…

  9. Art Therapy for Individuals with Traumatic Brain Injury: A Comprehensive Neurorehabilitation-Informed Approach to Treatment

    ERIC Educational Resources Information Center

    Kline, Tori

    2016-01-01

    I describe an approach to art therapy treatment for survivors of traumatic brain injury developed at a rehabilitation facility for adults that serves inpatient, outpatient, and long-term residential clients. This approach is based on a review of the literature on traumatic brain injury, comprehensive neurorehabilitation, brain plasticity, and art…

  10. Effects of eradication and restoration treatments on Italian thistle (Carduus pycnocephalus)

    USGS Publications Warehouse

    McGinnis, Thomas; Keeley, Jon

    2011-01-01

    Low elevation grasslands in California long have been dominated by Mediterranean grasses, but many areas still have large native forb populations. Alien forbs invade these grasslands, displacing both native and other alien species. Italian thistle is a noxious alien herb that has recently invaded these grasslands, including ungrazed blue oak (Quercus douglassii) and interior live oak (Quercus wislizenii) stands in Sequoia National Park. Here, Italian thistle tends to dominate under oaks and has the potential to substantially alter the foothill ecosystem by displacing native plants and acting as a ladder fuel that can carry fires into the oak canopy. We tested the effects of selectively reducing Italian thistle populations alone and in combination with restoration of native species. Two thistle eradication techniques (clipping and the application of clopyralid herbicide) and two restoration techniques (addition of native forb seeds or planting native grass plugs) were used. After two consecutive years of treatment we found: a) clipping was not effective at reducing Italian thistle populations (clipping reduced Italian thistle density in some areas, but not vegetative cover), b) herbicide reduced both Italian thistle density and vegetative cover for the first two growing seasons after application, but cover rebounded in the third growing season, c) native forb cover and species richness were not significantly affected by clipping or spot-treating with herbicide, d) the grass and forb addition treatments by themselves were not effective at reducing Italian thistle during the course of this study and e) sowing annual forb seeds after clipping resulted in greater forb cover and moderately reduced Italian thistle vegetative cover in the short term.

  11. Triangular Fixation Technique for Bicolumn Restoration in Treatment of Distal Humerus Intercondylar Fracture

    PubMed Central

    Kang, Seung-Hoon; Jeong, Min; Lim, Hae-Seong

    2016-01-01

    Background Distal humerus intercondylar fractures are intra-articular and comminuted fractures involving soft tissue injury. As distal humerus is triangle-shaped, parallel plating coupled with articular fixation would be suitable for bicolumn restoration in treatment of distal humerus intercondylar fracture. Methods This study included 38 patients (15 males and 23 females) who underwent olecranon osteotomy, open reduction and internal fixation with the triangle-shaped cannulated screw and parallel locking plates (triangular fixation technique). Functional results were assessed with the visual analog scale (VAS) scores, Mayo elbow performance (MEP) scores and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Anteroposterior and lateral elbow radiographs were assessed for reduction, alignment, fracture union, posttraumatic arthrosis, and heterotopic ossification, and computed tomography (CT) scans were used to obtain more accurate measurements of articular discrepancy. Results All fractures healed primarily with no loss of reduction. The mean VAS, MEP, and DASH scores of the affected elbow were not significantly different from those of the unaffected elbow (p = 0.140, p = 0.090, and p = 0.262, respectively). The mean degree of flexion was significantly lower in the affected elbow than in the unaffected elbow, but was still considered as functional (p = 0.001, > 100° in 33 of 38 patients). Two cases of articular step-offs (> 2 mm) were seen on follow-up CT scans, but not significantly higher in the affected elbow than in the unaffected elbow (p = 0.657). Binary logistic regression analysis revealed that only Association for Osteosynthesis (AO) type C3 fractures correlated with good/excellent functional outcome (p = 0.012). Complications occurred in 12 of the 38 patients, and the overall reoperation rate for complications was 10.5% (4 of 38 patients). Conclusions Triangular fixation technique for bicolumn restoration was an effective and reliable

  12. MissMarble, a multi-user interdisciplinary data base of marble for archaeometric, art historian and restoration use

    NASA Astrophysics Data System (ADS)

    Zöldföldi, J.; Székely, B.; Hegedüs, P.

    2009-04-01

    During a research project a lot of data are compiled by literature research, field studies, surveys, measurements. After the termination of the project these data remain in general unpublished, and are stored in the respective research institutions analogously or digitally. There exist the countless data which are stored on different media often decentralised in databases of different formats. All these data would be ready in principle for any scientific purposes on request; however, only the author has the information about the storage system of the data. This makes it difficult to verify the conclusions of the publications in the light of the gathered data; and this makes it almost impossible to prepare the data for later use in answering research-related questions. Sometimes unnecessarily repeated work is done; consequently the resources of the respective research equipment are needlessly used. To avoid duplicated research, the researchers are expected to publish the data together with the scientific contributions to provide public access to the original information. Nevertheless, it is often difficult to fulfil this demand. The standards for raw data publication are quite different from the requirements for research publications. The storage must be organised in such a way that it is conceivable for the researchers worldwide. Furthermore the data must be filed in reliable data centres where they are maintained and are put into archives for long time and remain available. The co-ordinated and clear availability of the research data serves all scientists - interdisciplinary and internationally. Via the availability of the raw data the original research results gain also importance and become valuable. Restorers, researchers working in various fields of humanities, museologists and specialists managing collections, are basically interested in the construction of data retrieval system of primary data. Thus, the storage, access and safety of scientific data can be

  13. Effect of ultrasound application during setting on the mechanical properties of high viscous glass-ionomers used for ART restorations

    PubMed Central

    Daifalla, Lamia E.; Mobarak, Enas H.

    2014-01-01

    This study was conducted to evaluate the effect of ultrasound application on the surface microhardness (VHN) and diametral tensile strength (DTS) of three high viscous glass-ionomer restorative materials (HVGIRMs). For each test (VHN and DTS), a total of 180 specimens were prepared from three HVGIRMs (Ketac-Molar Aplicap, Fuji IX GP Fast, and ChemFil Rock). Specimens of each material (n = 60) were further subdivided into three subgroups (n = 20) according to the setting modality whether ultrasound (20 or 40 s) was applied during setting or not (control). Specimens within each subgroup were then equally divided (n = 10) and tested at 24 h or 28 days. For the VHN measurement, five indentations, with a 200 g load and a dwell time for 20 s, were made on the top surface of each specimen. The DTS test was done using Lloyd Testing machine at a cross-head speed of 0.5 mm/min. Ultrasound application had no significant effect on the VHN. Fuji IX GP Fast revealed the highest VHN value, followed by Ketac-Molar Aplicap, and the least was recorded for ChemFil Rock. Fuji IX GP Fast and Ketac-Molar Aplicap VHN values were significantly increased by time. ChemFil Rock recorded the highest DTS value at 24 h and was the only material that showed significant improvement with both US application times. However, this improvement did not sustain till 28 days. The ultrasound did not enhance the surface microhardness, but its positive effect on the diametral tensile strength values was material and time dependent. PMID:26644916

  14. Effect of ultrasound application during setting on the mechanical properties of high viscous glass-ionomers used for ART restorations.

    PubMed

    Daifalla, Lamia E; Mobarak, Enas H

    2015-11-01

    This study was conducted to evaluate the effect of ultrasound application on the surface microhardness (VHN) and diametral tensile strength (DTS) of three high viscous glass-ionomer restorative materials (HVGIRMs). For each test (VHN and DTS), a total of 180 specimens were prepared from three HVGIRMs (Ketac-Molar Aplicap, Fuji IX GP Fast, and ChemFil Rock). Specimens of each material (n = 60) were further subdivided into three subgroups (n = 20) according to the setting modality whether ultrasound (20 or 40 s) was applied during setting or not (control). Specimens within each subgroup were then equally divided (n = 10) and tested at 24 h or 28 days. For the VHN measurement, five indentations, with a 200 g load and a dwell time for 20 s, were made on the top surface of each specimen. The DTS test was done using Lloyd Testing machine at a cross-head speed of 0.5 mm/min. Ultrasound application had no significant effect on the VHN. Fuji IX GP Fast revealed the highest VHN value, followed by Ketac-Molar Aplicap, and the least was recorded for ChemFil Rock. Fuji IX GP Fast and Ketac-Molar Aplicap VHN values were significantly increased by time. ChemFil Rock recorded the highest DTS value at 24 h and was the only material that showed significant improvement with both US application times. However, this improvement did not sustain till 28 days. The ultrasound did not enhance the surface microhardness, but its positive effect on the diametral tensile strength values was material and time dependent.

  15. Lamivudine treatment can restore T cell responsiveness in chronic hepatitis B.

    PubMed Central

    Boni, C; Bertoletti, A; Penna, A; Cavalli, A; Pilli, M; Urbani, S; Scognamiglio, P; Boehme, R; Panebianco, R; Fiaccadori, F; Ferrari, C

    1998-01-01

    High viral and/or antigen load may be an important cause of the T cell hyporesponsiveness to hepatitis B virus (HBV) antigens that is often observed in patients with chronic HBV infection. Reduction of viral and antigen load by lamivudine treatment represents an ideal model for investigating this hypothesis. HLA class II restricted T cell responses and serum levels of HBV-DNA, HBsAg, and HBeAg were studied before and during lamivudine treatment in 12 patients with hepatitis B e antigen positive chronic active hepatitis B to assess possible correlations between viral and/or antigen load and vigor of the T cell response. Cell proliferation to HBV nucleocapsid antigens and peptides and frequency of circulating HBV nucleocapsid-specific T cells were assessed to characterize CD4-mediated responses. A highly significant enhancement of the CD4-mediated response to HBV nucleocapsid antigens was already detectable in most patients 7-14 d after the start of lamivudine treatment. This effect was dramatic and persistent in 10 patients but undetectable in 2. It occurred concomitant with a rapid and marked reduction of viremia. Interestingly, lamivudine also enhanced the responses to mitogens and recall antigens, showing that its effect was not limited to HBV-specific T cells. In conclusion, an efficient antiviral T cell response can be restored by lamivudine treatment in patients with chronic hepatitis B concurrently with reduction of viremia, indicating the importance of viral load in the pathogenesis of T cell hyporesponsiveness in these patients. Since lamivudine treatment can overcome T cell hyporeactivity, combining lamivudine with treatments directed to stimulate the T cell response may represent an effective strategy to induce eradication of chronic HBV infection. PMID:9727065

  16. Frontonasal dysplasia: oral features, restorative and orthodontic dental treatment in a child.

    PubMed

    Valério, R A; Scatena, C; Santos, F R R; Romano, F L; Queiroz, A M; Paula-Silva, F W G

    2017-04-01

    Frontonasal dysplasia is a complex rare malformation, characterised by abnormalities involving the central portion of the face, especially the eyes, nose and forehead. It can manifest independently or associated with other abnormalities as part of some syndromes. The purpose of this case report was to describe a 5-year-old patient, diagnosed with frontonasal dysplasia. Among the abnormalities characterised with this disorder were ocular hypertelorism, broad nose tip with median notch, median facial cleft, bifid anterior skull, low set hairline, Poland's syndactyly and ankyloglossia. Consisted of behavioural management, oral hygiene instruction, prophylaxis, topical fluoride application, extraction of primary teeth, composite resin restorations and sealants in pits and fissures. Preformed metal crowns were also applied to the right and left primary maxillary second molars. Currently, the patient is 11 years-old in the permanent dentition and therefore was referred for corrective orthodontic and periodontal treatments due to the persistence of gingival retraction of the permanent mandibular right central incisor. The treatment in this case was directed to the promotion of oral health and orthodontic corrections, which are of fundamental importance due to medical, physical and social limitations of children affected by this syndrome, hindering healing and rehabilitative treatment. Paediatric dentists should be included in multidisciplinary teams providing care to patients with special needs, improving their quality of life.

  17. Chemistry, Color, and Art.

    ERIC Educational Resources Information Center

    Orna, Mary Virginia

    2001-01-01

    Describes pigments and artists' colors from a chronological perspective. Explains how chemical analysis can be used to distinguish the differences between artists' palettes, identify the evolution of art, and lead to restoration of an art work. (Contains 13 references.) (YDS)

  18. Chemistry, Color, and Art.

    ERIC Educational Resources Information Center

    Orna, Mary Virginia

    2001-01-01

    Describes pigments and artists' colors from a chronological perspective. Explains how chemical analysis can be used to distinguish the differences between artists' palettes, identify the evolution of art, and lead to restoration of an art work. (Contains 13 references.) (YDS)

  19. Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country.

    PubMed

    Serrano, Charlotte; Laporte, Remi; Ide, Moussa; Nouhou, Yacouba; de Truchis, Pierre; Rouveix, Elisabeth; Adamou, Adiza; Pauly, Vanessa; Mattei, Jean-François; Gastaut, Jean-Albert

    2010-01-01

    In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnutrition represents another cause of acquired immunodeficiency and premature death. This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count <200 /mm3 and/or developing a WHO stage III/IV or with body mass index <18.5 kg/m2 and receiving antiretroviral treatment. Follow-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm3 respectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mortality Ratio=0.19; p<0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm3 respectively in supported and control groups; p<0.05) and observance was improved in supported group (p<0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care.

  20. LXR agonist treatment of blastic plasmacytoid dendritic cell neoplasm restores cholesterol efflux and triggers apoptosis

    PubMed Central

    Ceroi, Adam; Masson, David; Roggy, Anne; Roumier, Christophe; Chagué, Cécile; Gauthier, Thierry; Philippe, Laure; Lamarthée, Baptiste; Angelot-Delettre, Fanny; Bonnefoy, Francis; Perruche, Sylvain; Biichle, Sabeha; Preudhomme, Claude; Macintyre, Elisabeth; Lagrost, Laurent; Garnache-Ottou, Francine

    2016-01-01

    Blastic plasmacytoid dendritic cell (PDC) neoplasm (BPDCN) is an aggressive hematological malignancy with a poor prognosis that derives from PDCs. No consensus for optimal treatment modalities is available today and the full characterization of this leukemia is still emerging. We identified here a BPDCN-specific transcriptomic profile when compared with those of acute myeloid leukemia and T-acute lymphoblastic leukemia, as well as the transcriptomic signature of primary PDCs. This BPDCN gene signature identified a dysregulation of genes involved in cholesterol homeostasis, some of them being liver X receptor (LXR) target genes. LXR agonist treatment of primary BPDCN cells and BPDCN cell lines restored LXR target gene expression and increased cholesterol efflux via the upregulation of adenosine triphosphate–binding cassette (ABC) transporters, ABCA1 and ABCG1. LXR agonist treatment was responsible for limiting BPDCN cell proliferation and inducing intrinsic apoptotic cell death. LXR activation in BPDCN cells was shown to interfere with 3 signaling pathways associated with leukemic cell survival, namely: NF-κB activation, as well as Akt and STAT5 phosphorylation in response to the BPDCN growth/survival factor interleukin-3. These effects were increased by the stimulation of cholesterol efflux through a lipid acceptor, the apolipoprotein A1. In vivo experiments using a mouse model of BPDCN cell xenograft revealed a decrease of leukemic cell infiltration and BPDCN-induced cytopenia associated with increased survival after LXR agonist treatment. This demonstrates that cholesterol homeostasis is modified in BPDCN and can be normalized by treatment with LXR agonists which can be proposed as a new therapeutic approach. PMID:27702801

  1. LXR agonist treatment of blastic plasmacytoid dendritic cell neoplasm restores cholesterol efflux and triggers apoptosis.

    PubMed

    Ceroi, Adam; Masson, David; Roggy, Anne; Roumier, Christophe; Chagué, Cécile; Gauthier, Thierry; Philippe, Laure; Lamarthée, Baptiste; Angelot-Delettre, Fanny; Bonnefoy, Francis; Perruche, Sylvain; Biichle, Sabeha; Preudhomme, Claude; Macintyre, Elisabeth; Lagrost, Laurent; Garnache-Ottou, Francine; Saas, Philippe

    2016-12-08

    Blastic plasmacytoid dendritic cell (PDC) neoplasm (BPDCN) is an aggressive hematological malignancy with a poor prognosis that derives from PDCs. No consensus for optimal treatment modalities is available today and the full characterization of this leukemia is still emerging. We identified here a BPDCN-specific transcriptomic profile when compared with those of acute myeloid leukemia and T-acute lymphoblastic leukemia, as well as the transcriptomic signature of primary PDCs. This BPDCN gene signature identified a dysregulation of genes involved in cholesterol homeostasis, some of them being liver X receptor (LXR) target genes. LXR agonist treatment of primary BPDCN cells and BPDCN cell lines restored LXR target gene expression and increased cholesterol efflux via the upregulation of adenosine triphosphate-binding cassette (ABC) transporters, ABCA1 and ABCG1. LXR agonist treatment was responsible for limiting BPDCN cell proliferation and inducing intrinsic apoptotic cell death. LXR activation in BPDCN cells was shown to interfere with 3 signaling pathways associated with leukemic cell survival, namely: NF-κB activation, as well as Akt and STAT5 phosphorylation in response to the BPDCN growth/survival factor interleukin-3. These effects were increased by the stimulation of cholesterol efflux through a lipid acceptor, the apolipoprotein A1. In vivo experiments using a mouse model of BPDCN cell xenograft revealed a decrease of leukemic cell infiltration and BPDCN-induced cytopenia associated with increased survival after LXR agonist treatment. This demonstrates that cholesterol homeostasis is modified in BPDCN and can be normalized by treatment with LXR agonists which can be proposed as a new therapeutic approach. © 2016 by The American Society of Hematology.

  2. Improved communication during treatment planning using light-curing hybrid wax for esthetic try-in restorations.

    PubMed

    Witkowski, Siegbert; Kunz, Andreas; Wagenknecht, Günther

    2006-01-01

    The chance for a successful restorative outcome is improved when the clinician, the laboratory technician, and the patient agree on the design and appearance of the planned dental prosthesis as early as possible. A try-in of a planned dental restoration in the patient's mouth provides the parties involved in treatment planning with the ability to determine treatment goals together. The following article describes the use of a novel light-curing hybrid wax, a resin-like material that allows natural-looking, fracture-proof esthetic try-in restorations. Corrections can be made chairside by adding or removing material. The material is suitable for all indications involving fixed or removable dentures. Moreover, as the material can be burned without producing residues, it can be used directly in other applications such as pressable ceramics, ceramics pressed to metal, and casting techniques. A clinical case demonstrating the use of the hybrid wax is also presented.

  3. The ART approach: clinical aspects reviewed

    PubMed Central

    MOLINA, Gustavo Fabián; CABRAL, Ricardo Juan; FRENCKEN, Jo E.

    2009-01-01

    ABSTRACT The success of ART as a caries management approach is supported by more than 20 years of scientific evidence. ART follows the contemporary concepts of modern cariology and restorative dentistry. It challenges treatment concepts such as step-wise excavation and the need for complete removal of affected dentine. The ART approach so far has mainly used high-viscosity glass-ionomer as the sealant and restorative material. Cariostatic and remineralization properties have been ascribed to this material which requires further research to establish its clinical relevance. The adhesion of high-viscosity glass-ionomer to enamel in pits and fissures is apparently strong, as its remnants, blocking the pits and fissures, have been considered a possible reason for the low prevalence of carious lesion development after the glass-ionomer has clinically disappeared from it. encapsulated high-viscosity glass-ionomers may lead to higher restoration survival results than those of the hand-mixed version and should, therefore, not be neglected when using ART. Similarly, the use of resin-modified glass-ionomer with ART should be researched. The effectiveness of ART when compared to conventional caries management approaches has been shown in numerous studies. Proper case selection is an important factor for long-lasting ART restoration survival. This is based on the caries risk situation of the individual, the size of the cavity opening, the strategic position of the cavitated tooth and the presence of adequate caries control measures. As the operator is one of the main causes for failure of ART restorations, attending a well-conducted ART training course is mandatory for successful implementation of ART. PMID:21499662

  4. The ART approach: clinical aspects reviewed.

    PubMed

    Molina, Gustavo Fabián; Cabral, Ricardo Juan; Frencken, Jo E

    2009-01-01

    The success of ART as a caries management approach is supported by more than 20 years of scientific evidence. ART follows the contemporary concepts of modern cariology and restorative dentistry. It challenges treatment concepts such as step-wise excavation and the need for complete removal of affected dentine. The ART approach so far has mainly used high-viscosity glass-ionomer as the sealant and restorative material. Cariostatic and remineralization properties have been ascribed to this material which requires further research to establish its clinical relevance. The adhesion of high-viscosity glass-ionomer to enamel in pits and fissures is apparently strong, as its remnants, blocking the pits and fissures, have been considered a possible reason for the low prevalence of carious lesion development after the glass-ionomer has clinically disappeared from it. Encapsulated high-viscosity glass-ionomers may lead to higher restoration survival results than those of the hand-mixed version and should, therefore, not be neglected when using ART. Similarly, the use of resin-modified glass-ionomer with ART should be researched. The effectiveness of ART when compared to conventional caries management approaches has been shown in numerous studies. Proper case selection is an important factor for long-lasting ART restoration survival. This is based on the caries risk situation of the individual, the size of the cavity opening, the strategic position of the cavitated tooth and the presence of adequate caries control measures. As the operator is one of the main causes for failure of ART restorations, attending a well-conducted ART training course is mandatory for successful implementation of ART.

  5. Group art therapy as an adjunctive treatment for people with schizophrenia: multicentre pragmatic randomised trial

    PubMed Central

    Killaspy, Helen; Barnes, Thomas R E; Barrett, Barbara; Byford, Sarah; Clayton, Katie; Dinsmore, John; Floyd, Siobhan; Hoadley, Angela; Johnson, Tony; Kalaitzaki, Eleftheria; King, Michael; Leurent, Baptiste; Maratos, Anna; O’Neill, Francis A; Osborn, David P; Patterson, Sue; Soteriou, Tony; Tyrer, Peter; Waller, Diane

    2012-01-01

    Objectives To evaluate the clinical effectiveness of group art therapy for people with schizophrenia and to test whether any benefits exceed those of an active control treatment. Design Three arm, rater blinded, pragmatic, randomised controlled trial. Setting Secondary care services across 15 sites in the United Kingdom. Participants 417 people aged 18 or over, who had a diagnosis of schizophrenia and provided written informed consent to take part in the study. Interventions Participants, stratified by site, were randomised to 12 months of weekly group art therapy plus standard care, 12 months of weekly activity groups plus standard care, or standard care alone. Art therapy and activity groups had up to eight members and lasted for 90 minutes. In art therapy, members were given access to a range of art materials and encouraged to use these to express themselves freely. Members of activity groups were offered various activities that did not involve use of art or craft materials and were encouraged to collectively select those they wanted to pursue. Main outcome measures The primary outcomes were global functioning, measured using the global assessment of functioning scale, and mental health symptoms, measured using the positive and negative syndrome scale, 24 months after randomisation. Main secondary outcomes were levels of group attendance, social functioning, and satisfaction with care at 12 and 24 months. Results 417 participants were assigned to either art therapy (n=140), activity groups (n=140), or standard care alone (n=137). Primary outcomes between the three study arms did not differ. The adjusted mean difference between art therapy and standard care at 24 months on the global assessment of functioning scale was −0.9 (95% confidence interval −3.8 to 2.1), and on the positive and negative syndrome scale was 0.7 (−3.1 to 4.6). Secondary outcomes did not differ between those referred to art therapy or those referred to standard care at 12 or 24 months

  6. Direct adhesive pin-retained restorations for severely worn dentition treatment: a 1.5-year follow-up report.

    PubMed

    de Andrade, Camila Lima; Gonçalves, Thais Marques Simek Vega; Santos, Ícaro Leite dos; Barros, Michel Silva; Araújo, Nubia Rafaela Ribeiro; Cury, Altair Antoninha Del Bel

    2014-01-01

    Excessive occlusal surface wear can result in occlusal disharmony, functional and esthetic impairment. As a therapeutic approach, conventional single crowns have been proposed, but this kind of treatment is complex, highly invasive and expensive. This case report describes the clinical outcomes of an alternative minimally invasive treatment based on direct adhesive-pin retained restorations. A 64-year-old woman with severely worn dentition, eating problems related to missing teeth and generalized tooth hypersensitivity was referred for treatment. Proper treatment planning based on the diagnostic wax-up simulation was used to guide the reconstruction of maxillary anterior teeth with direct composite resin over self-threading dentin pins. As the mandibular remaining teeth were extremely worn, a tooth-supported overdenture was installed. A stabilization splint was also used to protect the restorations. This treatment was a less expensive alternative to full-mouth rehabilitation with positive esthetic and functional outcomes after 1.5 years of follow-up.

  7. The correct use of the ART approach

    PubMed Central

    FRENCKEN, Jo E.; LEAL, Soraya Coelho

    2010-01-01

    Confusion exists amongst dentists and scientists about the correct use of the caries management approach termed atraumatic restorative treatment (ART). Inconsistent use of the original definition of ART and suggested modifications (mART) have led to misunderstanding, misconception and miscommunication in the dental literature over the last decade. The aim of this paper is to contribute to a uniform understanding and use of the term ART. Adherence to its original description is suggested and two major aspects were addressed: the use of hand instruments only and the use of adhesive materials and systems. PMID:20379674

  8. The correct use of the ART approach.

    PubMed

    Frencken, Jo E; Leal, Soraya Coelho

    2010-01-01

    Confusion exists amongst dentists and scientists about the correct use of the caries management approach termed atraumatic restorative treatment (ART). Inconsistent use of the original definition of ART and suggested modifications (mART) have led to misunderstanding, misconception and miscommunication in the dental literature over the last decade. The aim of this paper is to contribute to a uniform understanding and use of the term ART. Adherence to its original description is suggested and two major aspects were addressed: the use of hand instruments only and the use of adhesive materials and systems.

  9. Anti-aging treatments slow propagation of synucleinopathy by restoring lysosomal function.

    PubMed

    Kim, Dong-Kyu; Lim, Hee-Sun; Kawasaki, Ichiro; Shim, Yhong-Hee; Vaikath, Nishant N; El-Agnaf, Omar M A; Lee, He-Jin; Lee, Seung-Jae

    2016-10-02

    Aging is the major risk factor for neurodegenerative diseases that are also associated with impaired proteostasis, resulting in abnormal accumulation of protein aggregates. However, the role of aging in development and progression of disease remains elusive. Here, we used Caenorhabditis elegans models to show that aging-promoting genetic variations accelerated the rate of cell-to-cell transmission of SNCA/α-synuclein aggregates, hallmarks of Parkinson disease, and the progression of disease phenotypes, such as nerve degeneration, behavioral deficits, and reduced life span. Genetic and pharmacological anti-aging manipulations slowed the spread of aggregates and the associated phenotypes. Lysosomal degradation was significantly impaired in aging models, while anti-aging treatments reduced the impairment. Transgenic expression of hlh-30p::hlh-30, the master controller of lysosomal biogenesis, alleviated intercellular transmission of aggregates in the aging model. Our results demonstrate that the rate of aging closely correlates with the rate of aggregate propagation and that general anti-aging treatments can slow aggregate propagation and associated disease progression by restoring lysosomal function.

  10. Anti-aging treatments slow propagation of synucleinopathy by restoring lysosomal function

    PubMed Central

    Kim, Dong-Kyu; Lim, Hee-Sun; Kawasaki, Ichiro; Shim, Yhong-Hee; Vaikath, Nishant N.; El-Agnaf, Omar M. A.; Lee, He-Jin; Lee, Seung-Jae

    2016-01-01

    ABSTRACT Aging is the major risk factor for neurodegenerative diseases that are also associated with impaired proteostasis, resulting in abnormal accumulation of protein aggregates. However, the role of aging in development and progression of disease remains elusive. Here, we used Caenorhabditis elegans models to show that aging-promoting genetic variations accelerated the rate of cell-to-cell transmission of SNCA/α-synuclein aggregates, hallmarks of Parkinson disease, and the progression of disease phenotypes, such as nerve degeneration, behavioral deficits, and reduced life span. Genetic and pharmacological anti-aging manipulations slowed the spread of aggregates and the associated phenotypes. Lysosomal degradation was significantly impaired in aging models, while anti-aging treatments reduced the impairment. Transgenic expression of hlh-30p::hlh-30, the master controller of lysosomal biogenesis, alleviated intercellular transmission of aggregates in the aging model. Our results demonstrate that the rate of aging closely correlates with the rate of aggregate propagation and that general anti-aging treatments can slow aggregate propagation and associated disease progression by restoring lysosomal function. PMID:27485532

  11. Clinical Assessment of a Combination Lip Treatment to Restore Moisturization and Fullness

    PubMed Central

    Trookman, Nathan S.; Rizer, Ronald L.; Ford, Rosanne; Gotz, Vincent

    2009-01-01

    Objective. To evaluate the efficacy and tolerance of a topical lip-care treatment. Step one of the two-step treatment is a lip-renewal formulation containing human growth factors, hyaluronic acid and marine filling spheres, emollients, and a tripeptide palmitoyl-glycyl-histidyl-lysine complex. Step two is a lip-plumper formulation containing niacin, emollients, and essential fatty acids. Design. Four-week, single-center, open-label, clinical study with clinical assessments at Baseline, Week 2, and Week 4. Treatment. Subjects wore the lip products at least eight hours every day with a minimum of three applications per day. Participants. Thirty-two women ages 22 to 40 years with mild-to-moderate lip dryness and average size lips completed the study. Measurements. Visual grading of the condition of the lips, rating of subjective irritation, corneometry, digital caliper measurements of lower lip, and digital photography. A self-assessment questionnaire was also employed to assess patient satisfaction. Results. Clinical assessments showed statistically significant improvements (P<0.001) in key lip condition parameters after both two and four weeks of use. Key parameters included lip scaling, cupping, cracking/fissuring, fine lines due to dryness, lip texture/visual roughness, lip color/rosiness, lip definition/contour, and overall lip condition. Significant increases (P<0.001) were observed in both corneometer measurements, which confirm the moisturizing benefits, and in digital caliper measurements, which confirm the lip-plumping benefits. Self-assessment questionnaires showed a 97-percent overall satisfaction rating. No adverse events were reported during the course of the study. Conclusion. The results from this clinical study demonstrate that this two-part lip-care treatment product was well tolerated and effective in restoring moisture and fullness to the lips of female subjects with mild-to-moderate lip dryness. PMID:20725584

  12. Conservative restorative treatment using a single-visit, all-ceramic CAD/CAM system.

    PubMed

    Benk, Joel

    2007-01-01

    Computer-aided design/computer-aided manufacturing (CAD/CAM) continues to radically change the way in which the dental team plans, prepares, and fabricates a patient's restoration. This advancing technology offers the clinician the ability to scan the patient's failing dentition and then designs a long-lasting, reliable restoration based on this data. CAD/CAM systems also permit efficient, single-visit placement of the restoration while preserving much of the natural tooth structure. This article discusses how a chairside CAD/CAM system can be used to provide such a restoration in the posterior region in a single-visit.

  13. Habitat associations of the sagebrush lizard (Sceloporus graciosus): Potential responses of an ectotherm to ponderosa pine forest restoration treatments

    Treesearch

    Shawn C. Knox; Carol Chambers; Stephen S. Germaine

    2001-01-01

    Little is known about the response of ectotherms to ponderosa pine (Pinus ponderosa) restoration treatments. The ambient body temperature of an ectotherm affects its physiology, development, and behavior. Microhabitat availability and heterogeneity are critical factors in determining which thermoregulation choices are available to a terrestrial ectotherm (Stevenson...

  14. Early impacts of forest restoration treatments on the ectomycorrhizal fungal community and fine root biomass in a mixed conifer forest.

    Treesearch

    Jane E. Smith; Donaraye McKay; Greg Brenner; Jim McIver; Joseph W. Spatafora

    2005-01-01

    1. The obligate symbiosis formed between ectomycorrhizal fungi (EMF) and roots of tree species in the Pinaceae influences nutrient uptake and surrounding soil structure. Understanding how EMF respond to prescribed fire and thinning will assist forest managers in selecting fuel-reducing restoration treatments that maintain critical soil processes and site productivity....

  15. Comparison of simple screening criteria with the International Caries Detection and Assessment System classification in determining restorative treatment need.

    PubMed

    Kämppi, Antti; Tanner, Tarja; Päkkilä, Jari; Patinen, Pertti; Tjäderhane, Leo; Anttonen, Vuokko

    2016-04-01

    The Finnish Defence Forces' unique oral health-screening protocol (FDFsp) has been in use for decades. In FDFsp, restorative treatment need is determined based on the World Health Organization (WHO) criteria. The aim of this study was to compare the outcome of screening restorative treatment need with the outcome of using the International Caries Detection and Assessment System (ICDAS) classification at both individual and tooth levels. Our hypothesis was that the outcome of screening with FDFsp agrees with the outcome of using the ICDAS classification. In this study, a trained, calibrated examiner estimated, in a visual-tactile manner the restorative treatment need of 337 young healthy adults using the FDFsp. During the screening, 74 conscripts were selected for a thorough inspection. The inclusion criteria for those selected were: having no, having one to five, or having six or more caries lesions needing restorative treatment. In the thorough inspection, the participants were inspected in a visual-tactile manner using the ICDAS classification. The association of the outcomes achieved using the two different methods was analysed at individual and tooth levels. Sensitivity, specificity, and kappa values were calculated. Wisdom teeth were excluded. At the individual level, the agreement between the outcomes of using FDFsp and ICDAS ≥4 was excellent: sensitivity, 94.1%; specificity, 97.5%; and kappa = 0.92. When ICDAS ≥3 was used, the values were 72.7%, 96.7%, and 0.66%, respectively. Screening performed by a trained examiner using specific criteria is a reliable method for detecting individuals with restorative treatment need. The outcome of screening agrees strongly with results using the ICDAS classification. © 2015 FDI World Dental Federation.

  16. The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics.

    PubMed

    Ling, Zongxin; Liu, Xia; Chen, Weiguang; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, Karen E; Huang, Shaolei; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie

    2013-04-01

    Whether or not treatment with antibiotics or probiotics for bacterial vaginosis (BV) is associated with a change in the diversity of vaginal microbiota in women was investigated. One hundred fifteen women, consisting of 30 healthy subjects, 30 BV-positive control subjects, 30 subjects with BV treated with a 7-day metronidazole regimen, and 25 subjects with BV treated with a 10-day probiotics regimen, were analyzed to determine the efficacy and disparity of diversity and richness of vaginal microbiota using 454 pyrosequencing. Follow-up visits at days 5 and 30 showed a greater BV cure rate in the probiotics-treated subjects (88.0 and 96 %, respectively) compared to the metronidazole-treated subjects (83.3 and 70 %, respectively [p = 0.625 at day 5 and p = 0.013 at day 30]). Treatment with metronidazole reduced the taxa diversity and eradicated most of the BV-associated phylotypes, while probiotics only suppressed the overgrowth and re-established vaginal homeostasis gradually and steadily. Despite significant interindividual variation, the microbiota of the actively treated groups or participants constituted a unique profile. Along with the decrease in pathogenic bacteria, such as Gardnerella, Atopobium, Prevotella, Megasphaera, Coriobacteriaceae, Lachnospiraceae, Mycoplasma, and Sneathia, a Lactobacillus-dominated vaginal microbiota was recovered. Acting as vaginal sentinels and biomarkers, the relative abundance of Lactobacillus and pathogenic bacteria determined the consistency of the BV clinical and microbiologic cure rates, as well as recurrent BV. Both 7-day intravaginal metronidazole and 10-day intravaginal probiotics have good efficacy against BV, while probiotics maintained normal vaginal microbiota longer due to effective and steady vaginal microbiota restoration, which provide new insights into BV treatment.

  17. Celecoxib treatment restores pharmacosensitivity in a rat model of pharmacoresistant epilepsy

    PubMed Central

    Schlichtiger, J; Pekcec, A; Bartmann, H; Winter, P; Fuest, C; Soerensen, J; Potschka, H

    2010-01-01

    Background and purpose: A functional link between seizure-induced P-glycoprotein overexpression at the blood–brain barrier and therapeutic failure has been suggested by several studies using rodent epilepsy models and human epileptic tissue. Recently, we reported that interference with the mechanisms that up-regulate P-glycoprotein in response to seizure activity might provide a novel approach to control its expression in the epileptic brain. Based on these data, we hypothesized that blocking the appropriate signalling cascade by cyclooxygenase-2 inhibition should improve brain penetration of antiepileptic drugs and help to overcome drug resistance. Experimental approach: Effects of the selective cyclooxygenase-2 inhibitor celecoxib on the response to the P-glycoprotein substrate, phenobarbital, was evaluated in a chronic model of drug-resistant temporal lobe epilepsy in rats. Drug-resistant rats selected from this model exhibit a marked overexpression of P-glycoprotein in the hippocampus and other limbic brain regions. Key results: Responders and non-responders were selected from a group of rats with spontaneous recurrent seizures after prolonged treatment with phenobarbital at maximum tolerated doses. The efficacy of phenobarbital was re-evaluated following a 6 day treatment with celecoxib and the frequency of spontaneous recurrent seizures was significantly reduced in both groups of rats, phenobarbital responders or non-responders selected from the previous drug trial. Conclusions and implications: Pretreatment with the cyclooxygenase-2 inhibitor restored the anticonvulsant activity of phenobarbital in rats that failed to exhibit a relevant response before celecoxib treatment. Our data provide further support for a novel therapeutic approach to overcome transporter-mediated drug resistance in epilepsies. PMID:20590600

  18. Pioglitazone treatment restores in vivo muscle oxidative capacity in a rat model of diabetes.

    PubMed

    Wessels, B; Ciapaite, J; van den Broek, N M A; Houten, S M; Nicolay, K; Prompers, J J

    2015-01-01

    To determine the effect of pioglitazone treatment on in vivo and ex vivo muscle mitochondrial function in a rat model of diabetes. Both the lean, healthy rats and the obese, diabetic rats are Zucker Diabetic Fatty (ZDF) rats. The homozygous fa/fa ZDF rats are obese and diabetic. The heterozygous fa/+ ZDF rats are lean and healthy. Diabetic Zucker Diabetic Fatty rats were treated with either pioglitazone (30 mg/kg/day) or water as a control (n = 6 per group), for 2 weeks. In vivo ¹H and ³¹P magnetic resonance spectroscopy was performed on skeletal muscle to assess intramyocellular lipid (IMCL) content and muscle oxidative capacity, respectively. Ex vivo muscle mitochondrial respiratory capacity was evaluated using high-resolution respirometry. In addition, several markers of mitochondrial content were determined. IMCL content was 14-fold higher and in vivo muscle oxidative capacity was 26% lower in diabetic rats compared with lean rats, which was, however, not caused by impairments of ex vivo mitochondrial respiratory capacity or a lower mitochondrial content. Pioglitazone treatment restored in vivo muscle oxidative capacity in diabetic rats to the level of lean controls. This amelioration was not accompanied by an increase in mitochondrial content or ex vivo mitochondrial respiratory capacity, but rather was paralleled by an improvement in lipid homeostasis, that is lowering of plasma triglycerides and muscle lipid and long-chain acylcarnitine content. Diminished in vivo muscle oxidative capacity in diabetic rats results from mitochondrial lipid overload and can be alleviated by redirecting the lipids from the muscle into adipose tissue using pioglitazone treatment. © 2014 John Wiley & Sons Ltd.

  19. Heat Treatment Influences Monomer Conversion and Bond Strength of Indirect Composite Resin Restorations.

    PubMed

    Magne, Pascal; Malta, Daniel Alexandre Menezes Pedrosa; Enciso, Reyes; Monteiro-Junior, Sylvio

    2015-12-01

    To assess the resin microtensile bond strength (MTBS) and the degree of conversion (DC) of indirect composite resin restorations polymerized with light and heat. Two direct (Filtek Z100 and Premise) and one indirect (Premise Indirect) composite resins were polymerized with a combination of light and heat (138°C for 20 min). For MTBS, 42 cylinders were fabricated (n = 7). After the surface treatment, cylinders were bonded to each other using adhesive resin (Optibond FL). Specimens were stored in water for 24 h. Another 15 cylinders (n = 5) were fabricated for determining degree of conversion using Fourier Transform Infrared Spectrometry immediately and at 24 h. The MTBS and the DC was submitted to two-way ANOVA. The interaction with existing data was explored with univariate ANOVA and two-way ANOVA. Tukey's HSD post-hoc test was used to detect pairwise differences (α = 0.05). The MTBS to light and heat polymerized Z100 was 75.7 MPa, significantly higher than that to Premise (58.6 MPa) and Premise Indirect (63.9 MPa). The immediate DC for Z100, Premise, and Premise Indirect were 51.0%, 68.7%, and 61.8%, respectively. The DC at 24 h ranged from 53.4% (Z100) to 72.8% (Premise Indirect) and significantly increased for Premise Indirect only. Comparison with previously published data revealed that the heat treatment increased both MTBS and DC of Premise and Premise Indirect. Z100 showed better bond strength but lower DC. Heat treatment and a 24-h delay before delivery can benefit DC of Premise Indirect. The increase in DC of Premise and Premise Indirect did not affect their bond strength.

  20. A visual progression of the Fort Valley Restoration Project treatments using remotely sensed imagery (P-53)

    Treesearch

    Joseph E. Crouse; Peter Z. Fule

    2008-01-01

    The landscape surrounding the Fort Valley Experimental Forest in northern Arizona has changed dramatically in the past decade due to the Fort Valley Restoration Project, a collaboration between the Greater Flagstaff Forest Partnership, Coconino National Forest, and Rocky Mountain Research Station. Severe wildfires in 1996 sparked community concern to start restoration...

  1. Landscape variability in soil and vegetation response to 70-year-old restoration treatments

    USDA-ARS?s Scientific Manuscript database

    During the 1930’s the Civilian Conservation Corps implemented a number of landscape restoration projects, most of which were abandoned in the early 1940’s. Although many restoration projects failed, several projects had a lasting effect on the landscape and can be used to study the long term effects...

  2. Multiple treatments yield early success in a shortleaf pine woodland restoration project in the Missouri Ozarks

    Treesearch

    Matthew G. Olson; Elizabeth K. Olson

    2016-01-01

    Shortleaf pine woodland communities were more extensive in the southeastern Missouri Ozarks prior to Euro-American settlement than today. In 2000, the Missouri Department of Conservation initiated a shortleaf pine woodland restoration project on state land in the Ozarks of southeast Missouri at an area called the Midco Pine Flats Restoration Area. The purpose of this...

  3. Forest restoration treatments have subtle long-term effects on soil C and N cycling in mixed conifer forests.

    PubMed

    Ganzlin, Peter W; Gundale, Michael J; Becknell, Rachel E; Cleveland, Cory C

    2016-07-01

    Decades of fire suppression following extensive timber harvesting have left much of the forest in the intermountain western United States exceedingly dense, and forest restoration techniques (i.e., thinning and prescribed fire) are increasingly being used in an attempt to mitigate the effects of severe wildfire, to enhance tree growth and regeneration, and to stimulate soil nutrient cycling. While many of the short-term effects of forest restoration have been established, the long-term effects on soil biogeochemical and ecosystem processes are largely unknown. We assessed the effects of commonly used forest restoration treatments (thinning, burning, and thinning + burning) on nutrient cycling and other ecosystem processes 11 yr after restoration treatments were implemented in a ponderosa pine (Pinus ponderosa var. scopulorum)/Douglas fir (Pseudotsuga menziesii var. glauca) forest at the Lubrecht Fire and Fire Surrogates Study (FFS) site in western Montana, USA. Despite short-term (<3 yr) increases in soil inorganic nitrogen (N) pools and N cycling rates following prescribed fire, long-term soil N pools and N mineralization rates showed only subtle differences from untreated control plots. Similarly, despite a persistent positive correlation between fuels consumed in prescribed burns and several metrics of N cycling, variability in inorganic N pools decreased significantly since treatments were implemented, indicating a decline in N spatial heterogeneity through time. However, rates of net nitrification remain significantly higher in a thin + burn treatment relative to other treatments. Short-term declines in forest floor carbon (C) pools have persisted in the thin + burn treatment, but there were no significant long-term differences among treatments in extractable soil phosphorus (P). Finally, despite some short-term differences, long-term foliar nutrient concentrations, litter decomposition rates, and rates of free-living N fixation in the experimental plots

  4. The morphology of amputated human teeth and its relation to mechanical properties after restoration treatment

    NASA Astrophysics Data System (ADS)

    Gugger, Jonas; Krastl, Gabriel; Huser, Marius; Deyhle, Hans; Müller, Bert

    2010-09-01

    The increased susceptibility to fracture of root canal- and post-treated teeth is less affected by alterations of the dentin structure, but seems to crucially depend on the loss of coronal tooth substance. The surface, available for adhesion of the composite material in the root canal and in the coronal part of the tooth, is assumed to be of key importance for the fracture resistance. Thus, an appropriate three-dimensional method should be identified to determine the adhesive surface with necessary precision. For this purpose, severely decayed teeth were simulated decapitating clinical crowns. After root canal filling and post space preparation, impressions of the root canal and the amputation surface were obtained using silicone. Micro computed tomography scans of these impressions were acquired. For one selected specimen, an additional high-resolution scan was recorded at a synchrotron radiation source. Software of ImageLab served for the extraction of the amputation interface, the post surface and the post volume from the tomography data, which have been finally correlated with the Young's modulus and the maximal load derived from mechanical tests. The morphological parameters show a realistic relationship to the mechanical tests performed after the restoration treatments and are consequently important for improving the dental skills.

  5. Probiotic treatment restores protection against lethal fungal infection lost during amphibian captivity.

    PubMed

    Kueneman, Jordan G; Woodhams, Douglas C; Harris, Reid; Archer, Holly M; Knight, Rob; McKenzie, Valerie J

    2016-09-28

    Host-associated microbiomes perform many beneficial functions including resisting pathogens and training the immune system. Here, we show that amphibians developing in captivity lose substantial skin bacterial diversity, primarily due to reduced ongoing input from environmental sources. We combined studies of wild and captive amphibians with a database of over 1 000 strains that allows us to examine antifungal function of the skin microbiome. We tracked skin bacterial communities of 62 endangered boreal toads, Anaxyrus boreas, across 18 time points, four probiotic treatments, and two exposures to the lethal fungal pathogen Batrachochytrium dendrobatidis (Bd) in captivity, and compared these to 33 samples collected from wild populations at the same life stage. As the amphibians in captivity lost the Bd-inhibitory bacteria through time, the proportion of individuals exposed to Bd that became infected rose from 33% to 100% in subsequent exposures. Inoculations of the Bd-inhibitory probiotic Janthinobacterium lividum resulted in a 40% increase in survival during the second Bd challenge, indicating that the effect of microbiome depletion was reversible by restoring Bd-inhibitory bacteria. Taken together, this study highlights the functional role of ongoing environmental inputs of skin-associated bacteria in mitigating a devastating amphibian pathogen, and that long-term captivity decreases this defensive function.

  6. Development of NanoART for HIV Treatment: Minding the Cytochrome P450 (CYP) Enzymes

    PubMed Central

    Midde, Narasimha M.; Kumar, Santosh

    2015-01-01

    Sustained suppression of HIV viral load is the primary objective for HIV treatment, which successfully achieved by the use of a wide array of antiretroviral therapies (ART). Despite this enormous success low level of virus persists in the anatomical and cellular reservoirs of the body causing a multitude of immunological and neurocognitive deficits. Towards this, nano-formulations are gaining attention to solve these problems by delivering ART to the targeted locations such as brain, lymphoid tissues, and monocytes/macrophages. As cytochrome P450 (CYP) enzymes play a critical role in the metabolism of drugs and other xenobiotics, it is expected that the interaction of nanoparticles with CYP enzymes may result in adverse drug reactions, cellular toxicity, and alterations in CYP-mediated metabolism of other drug molecules. Considering these potential adverse outcomes it is imperative to design the nano-carriers that will have minimal impact on CYP enzymes. Therefore, developing a long-acting nanoART regimen with minimal side effects is an essential step to improve patient’s adherence to the treatment paradigm, effective treatment strategy, and to combat the HIV infection & AIDS. PMID:26635972

  7. [Functional restoration--it depends on an adequate mixture of treatment].

    PubMed

    Pfingsten, M

    2001-12-01

    In the last 50 years conventional treatments have not been able to slow down the expanding chronic low back pain problem. However, nowadays health care has changed according to a broad biopsychosocial model of health, the positive effect of activity on health and healing, emphasis on function rather than pain or impairment, and reliance upon clinical evidence. In search for new solutions "functional restoration" (FR) programs have been developed. They include multidisciplinary treatment of patients in groups, consisting of 6-8 h of treatment a day, lasting 3 to 6 weeks and usually integrating intense physical and ergonomic training, psychological (behavioral) therapy, patient education, and instruction in social- and work-related issues. FR programs have yet to demonstrate their effectiveness in several countries. Controlled studies in the USA were very positive regarding the return-to-work rate, whereas studies in Scandinavian countries did not demonstrate similar results. Possible reasons for the different results concerning back-to-work ratios might be that study design, patient population, content of the program, and other external factors are different and studies as well as effects are therefore not directly comparable. According to several well-controlled studies, the most probable reason for this different effect may be that social and security (health care) systems and cultures differ among countries and that patients with chronic low back pain respond differently to this combination. Sick absenteeism and inability to work may be influenced by many factors besides pain that cannot be addressed by intervention or prevention programs, e.g., job satisfaction, education level, and the compensation systems. It may be that the lower economic benefit during sick leave in the United States leads to favorable results from functional restoration programs. Concerning the prediction of success, several studies have shown that medical background, diagnosis and physical

  8. Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment.

    PubMed

    Merolla, Giovanni; Singh, Sanjay; Paladini, Paolo; Porcellini, Giuseppe

    2016-03-01

    Calcific tendinitis is a painful shoulder disorder characterised by either single or multiple deposits in the rotator cuff tendon. Although the disease subsides spontaneously in most cases, a subpopulation of patients continue to complain of pain and shoulder dysfunction and the deposits do not show any signs of resolution. Although several treatment options have been proposed, clinical results are controversial and often the indication for a given therapy remains a matter of clinician choice. Herein, we report on the current state of the art in the pathogenesis, diagnosis and treatment of calcific tendinitis of the rotator cuff.

  9. Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders: The construction of the Self-expression and Emotion Regulation in Art Therapy Scale (SERATS).

    PubMed

    Haeyen, Suzanne; van Hooren, Susan; van der Veld, William M; Hutschemaekers, Giel

    2017-07-21

    Despite the use of art therapy in clinical practice, its appreciation and reported beneficial results, no instruments are available to measure specific effects of art therapy among patients with personality disorders cluster B/C in multidisciplinary treatment. In the present study, we described the development and psychometric evaluation of the Self-expression and Emotion Regulation in Art Therapy Scale (SERATS). Structural validity (exploratory and confirmatory factor analysis), reliability, construct validity and sensitivity to change were examined using two independent databases (n = 335; n = 34) of patients diagnosed with personality disorders cluster B/C. This resulted in a nine-item effect scale with a single factor with a high internal reliability and high test-retest reliability; it demonstrated discriminant validity and sensitivity to change. In conclusion, the SERATS is brief and content-valid and offers objective and reliable information on self-expression and emotion regulation in art therapy among patients with personality disorders cluster B/C. Although more research on construct validity is needed, the SERATS is a promising tool to be applied as an effect scale and as a monitoring tool during art therapy treatment. © 2017 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd. © 2017 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

  10. Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO2 Lasers.

    PubMed

    Mozaffari, Hamid Reza; Ehteshami, Alireza; Zallaghi, Farshad; Chiniforush, Nasim; Moradi, Zohreh

    2016-12-30

    Aims: Glutaraldehyde, CO2 and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO2 and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO2 and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO2 laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.

  11. Esthetic treatment of a diffuse amelogenesis imperfecta using pressed lithium disilicate and feldspathic ceramic restorations: 5-year follow up.

    PubMed

    Savi, Andrea; Turillazzi, Oliviero; Crescini, Aldo; Manfredi, Maddalena

    2014-01-01

    The treatment of a diffuse and severe case of amelogenesis imperfecta represents a challenge for the dental team and in particular for the dentist who perform the prosthetic restorations. The enamel alterations, which are characteristic of the disease, determine different problems that need to be carefully planned and solved before the beginning of the treatment, with particular regard to the materials used to perform the restorations. In order to create the best conditions to perform the prosthetic restoration, the treatment plan should be multidisciplinary. In addition, the young age of the patients usually affected by the disease imposes a very conservative and cautious approach. The main goals of the therapy are represented by the need to protect the occlusal dental surfaces from the abrasion and provide a satisfactory esthetic result. In particular, dental abrasions if not treated may determine the loss of the vertical dimension as well as a diffuse and marked dentinal hypersensitivity. A correct treatment plan and the use of the new adhesive ceramic materials made it possible to obtain good results both from a functional and esthetic point of view with a much more conservative approach compared with the traditional one. This clinical report describes the prosthetic rehabilitation of an adult female patient with a diffuse amelogenesis imperfecta using feldspathic ceramics for the esthetic regions and monolithic lithium disilicate material for the posterior areas. © 2014 Wiley Periodicals, Inc.

  12. Chronic resveratrol treatment restores vascular responsiveness of cerebral arterioles in type 1 diabetic rats

    PubMed Central

    Arrick, Denise M.; Sun, Hong; Patel, Kaushik P.

    2011-01-01

    Decreased dilation of cerebral arterioles via an increase in oxidative stress may be a contributing factor in the pathogenesis of diabetes-induced complications leading to cognitive dysfunction and/or stroke. Our goal was to determine whether resveratrol, a polyphenolic compound present in red wine, has a protective effect on cerebral arterioles during type 1 diabetes (T1D). We measured the responses of cerebral arterioles in untreated and resveratrol-treated (10 mg·kg−1·day−1) nondiabetic and diabetic rats to endothelial (eNOS) and neuronal (nNOS) nitric oxide synthase (NOS)-dependent agonists and to a NOS-independent agonist. In addition, we harvested brain tissue from nondiabetic and diabetic rats to measure levels of superoxide under basal conditions. Furthermore, we used Western blot analysis to determine the protein expression of eNOS, nNOS, SOD-1, and SOD-2 in cerebral arterioles and/or brain tissue from untreated and resveratrol-treated nondiabetic and diabetic rats. We found that T1D impaired eNOS- and nNOS-dependent reactivity of cerebral arterioles but did not alter NOS-independent vasodilation. While resveratrol did not alter responses in nondiabetic rats, resveratrol prevented T1D-induced impairment in eNOS- and nNOS-dependent vasodilation. In addition, superoxide levels were higher in brain tissue from diabetic rats and resveratrol reversed this increase. Furthermore, eNOS and nNOS protein were increased in diabetic rats and resveratrol produced a further increased eNOS and nNOS proteins. SOD-1 and SOD-2 proteins were not altered by T1D, but resveratrol treatment produced a decrease in SOD-2 protein. Our findings suggest that resveratrol restores vascular function and oxidative stress in T1D. We suggest that our findings may implicate an important therapeutic potential for resveratrol in treating T1D-induced cerebrovascular dysfunction. PMID:21666113

  13. Prioritizing forest fuels treatments based on the probability of high-severity fire restores adaptive capacity in Sierran forests.

    PubMed

    Krofcheck, Daniel J; Hurteau, Matthew D; Scheller, Robert M; Loudermilk, E Louise

    2017-09-23

    In frequent fire forests of the western US a legacy of fire suppression coupled with increases in fire weather severity have altered fire regimes and vegetation dynamics. When coupled with projected climate change, these conditions have the potential to lead to vegetation type change and altered carbon (C) dynamics. In the Sierra Nevada, fuels reduction approaches that include mechanical thinning followed by regular prescribed fire are one approach to restore the ability of the ecosystem to tolerate episodic fire and still sequester C. Yet, the spatial extent of the area requiring treatment makes widespread treatment implementation unlikely. We sought to determine if a priori knowledge of where uncharacteristic wildfire is most probable could be used to optimize the placement of fuels treatments in a Sierra Nevada watershed. We developed two treatment placement strategies: the naive strategy, based on treating all operationally available area and the optimized strategy, which only treated areas where crown-killing fires were most probable. We ran forecast simulations using projected climate data through 2100 to determine how the treatments differed in terms of C sequestration, fire severity, and C emissions relative to a no-management scenario. We found that in both the short (20 years) and long (100 years) term, both management scenarios increased C stability, reduced burn severity, and consequently emitted less C as a result of wildfires than no-management. Across all metrics, both scenarios performed the same, but the optimized treatment required significantly less C removal (naive = 0.42 Tg C, optimized = 0.25 Tg C) to achieve the same treatment efficacy. Given the extent of western forests in need of fire restoration, efficiently allocating treatments is a critical task if we are going to restore adaptive capacity in frequent-fire forests. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Education-related inequality in restorative dental treatment need over 11 years in two areas of Finland.

    PubMed

    Raittio, Eero; Vehkalahti, Miira M; Helminen, Sari; Suominen, Anna L

    2017-09-11

    This study aimed to analyse education-related inequality in restorative dental treatment need among adults aged 30 years and older living in Northern and Southern Finland in 2000 and 2011. Data were taken from the Health 2000 and 2011 population-based follow-up surveys, including information gathered by interviews and clinical dental examination. Final effective sample sizes were 2423 people in 2000 and 1192 people in 2011. Restorative dental treatment need was measured with number of decayed and/or fractured teeth (DT + FrT). Education-related inequality in number of DT + FrT and factors explaining it were analysed using the Poisson regression analysis, relative index of inequality and slope index of inequality. Average number of DT + FrT decreased from 2000 to 2011. Absolute and relative education-related inequalities in them decreased approximately 50% and 25% from 2000 to 2011, respectively. Tooth brushing frequency and time since last dental visit explained approximately 30%-40% of the education-related inequality. The contribution of time since last dental visit to the education-related inequality was smaller in 2011 than in 2000. It seems that, from 2000 to 2011, the need for restorative dental treatment decreased simultaneously with the education-related inequality in it among adults aged 30 years and older living in Northern and Southern Finland. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Bonded restorations for the prevention and treatment of the cracked-tooth syndrome.

    PubMed

    Geurtsen, W; García-Godoy, F

    1999-12-01

    Several reports revealed that the cracked-tooth syndrome is a common problem in dental practice, which often results in extraction of the affected incompletely fractured teeth. Predominantly restored teeth suffer from these incomplete fractures. Therefore, it is of outstanding importance to stabilize teeth weakened due to cavity preparation. Besides full cuspal coverage by partial or full crowns, bonded restorations have been proposed for internal splinting of restored teeth. Although contradictory data have been published, there is evidence that bonded amalgam or resin-based composite restorations (RBC) do not increase fracture resistance of teeth with wide occlusal-proximal cavities to values similar to sound, unrestored controls. Indirectly fabricated RBC inlays and various ceramic inlays, however, increased fracture strength to levels as high as those of sound caries-free teeth. Therefore, it is recommended that weakened teeth with wide cavities be strengthened by full cuspal coverage with cast or ceramic restorations, by bonded ceramic inlays, or by indirectly-fabricated bonded RBC composite inlays.

  16. Psychiatric disorders among women and men in assisted reproductive technology (ART) treatment. The Danish National ART-Couple (DANAC) cohort: protocol for a longitudinal, national register-based cohort study.

    PubMed

    Schmidt, Lone; Hageman, Ida; Hougaard, Charlotte Ørsted; Sejbaek, Camilla Sandal; Assens, Maria; Ebdrup, Ninna Hinchely; Pinborg, Anja

    2013-03-21

    There are complex causal associations between mental disorders, fertility treatment, fertility treatment outcome and infertility per se. Eating disorders cause endocrine disturbances, anovulation and thereby infertility, and research has shown that infertility as well as unsuccessful assisted reproductive technology (ART) treatment are potential risk factors for developing a depression on a long-term basis. Despite the fact that worldwide more than 400 000 ART treatment cycles are performed every year, the causal associations between mental disorders, use of medication for mental disorders and ART treatment in both sexes have only been sparsely explored. The main objective of this national register-based cohort study is to assess women's and men's mental health before, during, and after ART treatment in comparison with the mental health in an age-matched population-based cohort of couples with no history of ART treatment. Furthermore, the objective is to study the reproductive outcome of ART treatment among women who have a registered diagnosis of a mental disorder or have used medication for mental disorders prior to ART treatment compared with women in ART treatment without a mental disorder. We will establish the Danish National ART-Couple (DANAC) cohort including all women registered with ART treatment in the Danish in vitro fertilisation Register during 1994-2009 (N=42 915) and their partners. An age-matched population-based comparison cohort of women without ART treatment (n=215 290) and their partners will be established. Data will be cross-linked with data from national registers on psychiatric disorders, medical prescriptions for mental disorders, births, causes of deaths and sociodemographic data. Survival analyses and other statistical analyses will be conducted on the development of mental disorders and use of medication for mental disorders for women and men both prior to and after ART treatment.

  17. Population trends and live birth rates associated with common ART treatment strategies.

    PubMed

    Chambers, Georgina M; Wand, Handan; Macaldowie, Alan; Chapman, Michael G; Farquhar, Cynthia M; Bowman, Mark; Molloy, David; Ledger, William

    2016-11-01

    Have ART live birth rates improved in Australia over the last 12 years? There were striking improvements in per-cycle live birth rates observed for frozen/thaw embryo transfers, blastocyst transfer and single embryo transfer (SET), while live birth rates following ICSI were lower than IVF for non-male factor infertility in most years. ART and associated techniques have become the predominant treatment of infertility over the past 30 years in most developed countries. However, there are differences in ART laboratory and clinical practices, and success rates worldwide. Australia has one of the highest ART utilization rates and lowest multiple birth rates in the world, thus providing a unique setting to investigate the contribution of common ART strategies in an unrestricted population of patients to ART success rates. A retrospective cohort study of 585 065 ART treatment cycles performed in Australia between 2002 and 2013 using the Australian and New Zealand Assisted Reproduction Database (ANZARD). An unrestricted population of all women who underwent autologous ART treatment between 2002 and 2013. Visual descriptive analysis was used to assess the trends in ART procedures by the calendar years. Adjusted odds ratios (aORs) of a live birth for four common ART techniques were calculated after controlling for important confounders including female age, infertility diagnosis, stage of the embryo (blastocyst versus cleavage stage), type of embryo (fresh versus thawed), fertilization method (IVF versus ICSI) and number of embryos transferred (SET versus multiple embryos). The overall live birth rate per embryo transfer increased from 19.2% in 2002 to 23.3% in 2013 (21.9-24.3% for fresh embryo transfers and 14.6-23.3% for frozen/thaw embryo transfers). This occurred concurrently with an increase in SET from 29.7% to 78.9%, and an increase in the average age of women undergoing treatment from 35.0 to 35.9 years. Individuals who had a frozen/thaw embryo transfer cycle in 2002

  18. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  19. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  20. Restoring a sludge holding tank at a wastewater treatment plant using high-performance coatings

    SciTech Connect

    O'Dea, V.

    2005-11-01

    Faced with a serious hydrogen sulfide (H{sub 2}S) corrosion problem in two sludge holding tanks in 1993, the city of Concord, New Hampshire, repaired the deteriorating substrate by using a conventional acrylic-modified cementitious resurfacer and a coal tar epoxy (CTE) coating system. CTE failure occurred within 2 years, leading to more severe coating delamination. Restoration was delayed for 10 years, which caused extensive chemical attack on the concrete substrate-upwards of 2 in. (50 mm) of concrete loss. This article explains how one of these tanks was restored and prepared for another 15+ years of service.

  1. MOP Reduction During Long-Term Methamphetamine Withdrawal was Restored by Chronic Post-Treatment with Fluoxetine.

    PubMed

    Yamamoto, H; Takamatsu, Y; Imai, K; Kamegaya, E; Hagino, Y; Watanabe, M; Yamamoto, T; Sora, I; Koga, H; Ikeda, K

    2011-03-01

    Previously, we found fluoxetine reduces methamphetamine preference in mice. However, effects of fluoxetine on developed methamphetamine preference and on methamphetamine induced gene expression changes have been largely unknown. The present study investigates effects of post-treatment with fluoxetine on methamphetamine dependence and on gene expressions after long-term withdrawal in mice. First, we examined whether chronic post-treatment with fluoxetine attenuated methamphetamine-conditioned place preference. Next, we examined the changes in gene expression levels after long-term withdrawal (with saline or fluoxetine treatment) following chronic methamphetamine treatment. Using mRNA from the pooled frontal cortices of 10 mice per group, gene expression analyses were performed using a custom-developed cDNA array and a real-time quantitative reverse transcription-PCR. Chronic post-treatments with fluoxetine abolished the conditioned place preference developed by methamphetamine administrations. Even after long-term withdrawal from repeated methamphetamine administration, µ-opioid receptor (MOP) gene expression was significantly reduced in the frontal cortex. The reduced MOP gene expression in the frontal cortex was restored by chronic administration with fluoxetine. These changes were confirmed by Western blot analyses. These findings suggest that the chronic post-treatments with fluoxetine might be effective for restoring the reduction of MOP levels in the frontal cortex following long-term abstinence from methamphetamine.

  2. Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention - a modelling study.

    PubMed

    McCreesh, Nicky; Andrianakis, Ioannis; Nsubuga, Rebecca N; Strong, Mark; Vernon, Ian; McKinley, Trevelyan J; Oakley, Jeremy E; Goldstein, Michael; Hayes, Richard; White, Richard G

    2017-08-09

    UNAIDS calls for fewer than 500,000 new HIV infections/year by 2020, with treatment-as-prevention being a key part of their strategy for achieving the target. A better understanding of the contribution to transmission of people at different stages of the care pathway can help focus intervention services at populations where they may have the greatest effect. We investigate this using Uganda as a case study. An individual-based HIV/ART model was fitted using history matching. 100 model fits were generated to account for uncertainties in sexual behaviour, HIV epidemiology, and ART coverage up to 2015 in Uganda. A number of different ART scale-up intervention scenarios were simulated between 2016 and 2030. The incidence and proportion of transmission over time from people with primary infection, post-primary ART-naïve infection, and people currently or previously on ART was calculated. In all scenarios, the proportion of transmission by ART-naïve people decreases, from 70% (61%-79%) in 2015 to between 23% (15%-40%) and 47% (35%-61%) in 2030. The proportion of transmission by people on ART increases from 7.8% (3.5%-13%) to between 14% (7.0%-24%) and 38% (21%-55%). The proportion of transmission by ART dropouts increases from 22% (15%-33%) to between 31% (23%-43%) and 56% (43%-70%). People who are currently or previously on ART are likely to play an increasingly large role in transmission as ART coverage increases in Uganda. Improving retention on ART, and ensuring that people on ART remain virally suppressed, will be key in reducing HIV incidence in Uganda.

  3. Convergence Insufficiency Treatment Trial – Attention and Reading Trial (CITT-ART): Design and Methods

    PubMed Central

    Scheiman, Mitchell; Mitchell, G. Lynn; Cotter, Susan A.; Kulp, Marjean; Chase, Christopher; Borsting, Eric; Arnold, Eugene; Denton, Carolyn; Hertle, Richard

    2016-01-01

    Objective To describe the design and methodology of the Convergence Insufficiency Treatment Trial: Attention and Reading Trial (CITT-ART), the first randomized clinical trial evaluating the effect of vision therapy on reading and attention in school-age children with symptomatic convergence insufficiency (CI). Methods CITT-ART is a multicenter, placebo-controlled, randomized clinical trial of 324 children ages 9 to 14 years in grades 3 to 8 with symptomatic CI. Participants are randomized to 16 weeks of office-based vergence/accommodative therapy (OBVAT) or placebo therapy (OBPT), both supplemented with home therapy. The primary outcome measure is the change in the Wechsler Individual Achievement Test-Version 3 (WIAT-III) reading comprehension subtest score. Secondary outcome measures are changes in attention as measured by the Strengths and Weaknesses of Attention (SWAN) as reported by parents and teachers, tests of binocular visual function, and other measures of reading and attention. The long-term effects of treatment are assessed 1 year after treatment completion. All analyses will test the null hypothesis of no difference in outcomes between the two treatment groups. The study is entering its second year of recruitment. The final results will contribute to a better understanding of the relationship between the treatment of symptomatic CI and its effect on reading and attention. Conclusion The study will provide an evidence base to help parents, eye professionals, educators, and other health care providers make informed decisions as they care for children with CI and reading and attention problems. Results may also generate additional hypothesis and guide the development of other scientific investigations of the relationships between visual disorders and other developmental disorders in children. PMID:26942226

  4. Marginal adaptation of class V restorations with current-generation dentin-bonding agents: effect of different dentin surface treatments.

    PubMed

    Cavalheiro, Jessica Patrícia; Tonetto, Mateus Rodrigues; Borges, Álvaro Henrique; Bandéca, Matheus Coelho; dos Santos, Reidson Stanley Soares; de Campos, Edson Alves; Saad, José Roberto Cury; Dantas, Andréa Abi Rached; de Andrade, Marcelo Ferrarezi

    2014-05-01

    This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with Filtek™ Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

  5. Outplanting long tubes with the expandable stinger: A new treatment for riparian restoration

    Treesearch

    David E. Steinfeld; Thomas D. Landis; Dan Culley

    2002-01-01

    Long tubes are a new stock type developed specifically for restoration of challenging sites such as disturbed riparian areas. Constructed out of polyvinyl chloride plastic pipe, long tubes have a Vexar lining to promote good root growth and easier extraction. The expandable stinger is a new invention that was developed to outplant long tubes. The stinger is attached to...

  6. Seedling response to initial oak woodland restoration treatments on the Ozark National Forest

    Treesearch

    Jamie L. Schuler; Don C. Bragg; Eric Heitzman; Jason Milks

    2013-01-01

    Over the last century, the range of oak woodland ecosystems has diminished as woodlands have become more closed-canopy forests. A century of fire suppression efforts has all but eliminated the frequent ground fires necessary to maintain the open canopy characteristics of oak woodland ecosystems. Restoration efforts are underway to return some of the closed-canopy...

  7. Stand dynamics of an oak woodland forest and effects of a restoration treatment on forest health

    Treesearch

    Stacy L. Clark; Callie J. Schweitzer

    2016-01-01

    Woodland restoration has been conducted in many countries, primarily in Mediterranean regions, but has only recently been attempted on publically and privately owned lands in the eastern United States. We reconstructed historical stand dynamics and tested the immediate effects of an oak

  8. Restoring the gingival contour by means of provisional resin crowns after single-implant treatment.

    PubMed

    Jemt, T

    1999-02-01

    A consecutive group of 55 patients was treated with 63 single-implant restorations. The soft tissue was allowed to heal to either provisional resin crowns (n = 25) that were placed at the time of second-stage surgery, or to healing abutments (n = 38) before final crown insertion. An index that assessed the size of the interproximal mucosa adjacent to the single-implant restorations was used to evaluate the volume of the papillae 2 years after crown insertion. The results indicated that the use of provisional crowns may restore soft tissue contour faster than healing abutments alone, but the papillae adjacent to single-implant restorations presented similar volume in both groups after 2 years in function. Furthermore, the mean marginal bone loss at the implants was 0.9 mm after 1 year, and no differences were observed between the 2 groups. The present data focus on the need for more scientific data to evaluate different clinical procedures for optimizing esthetic results in implant dentistry.

  9. Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study

    PubMed Central

    2014-01-01

    Background Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. Methods The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann–Whitney tests. Results The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. Conclusions After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders. PMID:24886223

  10. Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study.

    PubMed

    Santa-Rosa, Thalita Thyrza De Almeida; Ferreira, Raquel Conceição; Drummond, Andréia Maria Araújo; De Magalhães, Cláudia Silami; Vargas, Andréa Maria Duarte; Ferreira E Ferreira, Efigênia

    2014-05-13

    Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann-Whitney tests. The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders.

  11. Dentin surface treatment using a non-thermal argon plasma brush for interfacial bonding improvement in composite restoration

    PubMed Central

    Ritts, Andy Charles; Li, Hao; Yu, Qingsong; Xu, Changqi; Yao, Xiaomei; Hong, Liang; Wang, Yong

    2010-01-01

    The objective of this study is to investigate the treatment effects of non-thermal atmospheric gas plasmas on dentin surfaces for composite restoration. Extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. The dentin surfaces were treated by using a non-thermal atmospheric argon plasma brush for various durations. The molecular changes of the dentin surfaces were analyzed using FTIR/ATR and an increase in carbonyl groups on dentin surfaces was detected with plasma treated dentin. Adper Single Bond Plus adhesive and Filtek Z250 dental composite were applied as directed. To evaluate the dentin/composite interfacial bonding, the teeth thus prepared were sectioned into micro-bars as the specimens for tensile test. Student Newman Keuls tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment. However, the bonding strength to plasma treated inner dentin did not show any improvement. It was found that plasma treatment of peripheral dentin surface up to 100 s gave an increase in interfacial bonding strength, while a prolong plasma treatment of dentin surfaces, e.g., 5 min treatments, showed a decrease in interfacial bonding strength. PMID:20831586

  12. Post-traumatic treatment of maxillary incisors by immediate dentoalveolar restoration with long-term follow-up.

    PubMed

    Rosa, Ariádene Cristina Pértile de Oliveira; Francischone, Carlos Eduardo; Cardoso, Mauricio de Almeida; Alonso, Ana Carolina; Filho, Leopoldino Capelozza; da Rosa, José Carlos Martins

    2015-02-01

    Replacing both missing maxillary anterior teeth is particularly challenging, especially in compromised sockets. This case report describes the management of an 18-year-old female patient, who suffered avulsion of both maxillary central incisors at 7 years of age. This multidisciplinary implant technique, called Immediate Dentoalveolar Restoration (IDR), included extraction of the injured teeth and a single procedure for immediate implant placement and restoration of the compromised sockets after root fracture and periapical lesion development were detected during orthodontic treatment. Successful esthetic and functional outcomes and reestablishment of the alveolar process after bone reconstruction were observed during the 3-year follow-up period. The predictable esthetic outcomes and soft- and hard-tissue stability that can be achieved following IDR are demonstrated.

  13. Treatment with garlic restores membrane thiol content and ameliorates lead induced early death of erythrocytes in mice.

    PubMed

    Sarkar, Avik; Sengupta, Dipanwita; Mandal, Samir; Sen, Gargi; Dutta Chowdhury, Kaustav; Chandra Sadhukhan, Gobinda

    2015-04-01

    Sequelae of chronic lead (Pb(2+) ) toxicity includes anemia that is partially due to early death of erythrocytes characterized by excess accumulation of ROS and downregulation of antioxidant system causing oxidative stress and externalization of phosphatidylserine. In this study, pathophysiological based therapeutic application of garlic was evaluated against erythrocyte death. Results suggest that garlic administration prevents oxidative stress, restored the antioxidant balance in erythrocytes of Pb(2+) exposed mice. Moreover, in vitro studies revealed that activity of both scramblase and aminophospholipid translocase could be changed by modifying the critical sulfhydryl groups in presence of dithiothreitol during Pb(2+) exposure. Data also indicated that garlic treatment in Pb(2+) exposed mice exhibited sharp decline in PS exposure and increase in erythrocyte membrane thiol group followed by increase in aminophospholipid translocase activity and decline in scramblase activity. Findings indicated that garlic has the ability to restore the lifespan of erythrocytes during Pb(2+) exposure. Copyright © 2013 Wiley Periodicals, Inc.

  14. State-of-the-art surgical approaches to the treatment of medically refractory ulcerative colitis.

    PubMed

    Bordeianou, Liliana; Maguire, Lillias

    2013-11-01

    Management of medically refractory ulcerative collitis (UC) is a significant challenge to the surgeon. Operative morbidity is high and the potential for mortality remains. Medical therapies have the potential to meaningfully improve the patient, or may dangerously delay and complicate surgery. Operative planning must appropriately address the patient's acuity without losing sight of the patient's long-term need for definitive surgical care and adequate functional outcome. State-of-the-art treatment hinges on prompt recognition of patients with acute severe UC, multidisciplinary coordination of medical therapy, and mature surgical judgment. Biologic therapies and minimally invasive surgical technologies represent the vanguard in UC. However, state-of-the-art treatment of acute severe UC is not employment of the newest drug or technology, but early performance of standard of care surgery, ileal pouch anal anastomosis, for every eligible patient. As the range of therapies available for UC continues to expand, the challenge for the surgeon is incorporating these new drugs and devices without losing sight of the standard of care.

  15. Initial tree mortality, and insect and pathogen response to fire and thinning restoration treatments in an old growth, mixed-conifer forest of the Sierra Nevada, California

    Treesearch

    P. Maloney; T. Smith; C. Jensen; J. Innes; D. Rizzo; M. North

    2008-01-01

    Fire and thinning restoration treatments in fire-suppressed forests often damage or stress leave trees, altering pathogen and insect affects. We compared types of insect- and pathogen-mediated mortality on mixed-conifer trees 3years after treatment. The number of bark beetle attacked trees was greater in burn treatments compared with no-burn treatments, and in some...

  16. Socioeconomic disparities in access to ART treatment and the differential impact of a policy that increased consumer costs.

    PubMed

    Chambers, G M; Hoang, V P; Illingworth, P J

    2013-11-01

    What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. Women undertaking fertility treatment in Australia between 2007 and 2010. Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. In this study, SES was based on the average relative

  17. The State of the Art: Atrial Fibrillation Epidemiology, Prevention, and Treatment.

    PubMed

    Morin, Daniel P; Bernard, Michael L; Madias, Christopher; Rogers, Paul A; Thihalolipavan, Sudarone; Estes, N A Mark

    2016-12-01

    As the most common sustained arrhythmia in adults, atrial fibrillation (AF) is an established and growing epidemic. To provide optimal patient care, it is important for clinicians to be aware of AF's epidemiological trends, methods of risk reduction, and the various available treatment modalities. Our understanding of AF's pathophysiology has advanced, and with this new understanding has come advancements in prevention strategies as well as pharmacological and nonpharmacological treatment options. Following PubMed and MEDLINE searches for AF risk factors, epidemiology, and therapies, we reviewed relevant articles (and bibliographies of those articles) published from 2000 to 2016. This "state-of-the-art" review provides a comprehensive update on the understanding of AF in the world today, contemporary therapeutic options, and directions of ongoing and future study.

  18. State of the art of biological processes for coal gasification wastewater treatment.

    PubMed

    Zhao, Qian; Liu, Yu

    2016-01-01

    The treatment of coal gasification wastewater (CGW) poses a serious challenge on the sustainable development of the global coal industry. The CGW contains a broad spectrum of high-strength recalcitrant substances, including phenolic, monocyclic and polycyclic aromatic hydrocarbons, heterocyclic nitrogenous compounds and long chain aliphatic hydrocarbon. So far, biological treatment of CGW has been considered as an environment-friendly and cost-effective method compared to physiochemical approaches. Thus, this reviews aims to provide a comprehensive picture of state of the art of biological processes for treating CGW wastewater, while the possible biodegradation mechanisms of toxic and refractory organic substances were also elaborated together with microbial community involved. Discussion was further extended to advanced bioprocesses to tackle high-concentration ammonia and possible options towards in-plant zero liquid discharge.

  19. Microleakage in Resin Composite Restoration following Antimicrobial Pre-treatments with 2% Chlorhexidine and Clearfil Protect Bond

    PubMed Central

    Hameed, Hisham; Babu, Biju P; Sagir, V M Mohammed; Chiriyath, Kennet J; Mathias, Jones; Shaji, A P

    2015-01-01

    Aim: To evaluate microleakage in resin composite restorations after antimicrobial pre – treatments Materials and Methods: Forty freshly extracted non carious human premolars were procured. In all forty premolar specimens, class V preparation of standard dimension were prepared and were randomly divided into three experimental and one control group. In all control and experimental groups the class V preparations were restored with FILTEK Z350 composite restorative material. The experimental groups included different self etching primers and 2% Chlorhexidine gluconate. The control group included Xeno III and no antimicrobial pre-treatment was done for the control group. Thereafter these specimens were thermocycled, dried and sealed with nail varnish, leaving 1mm around the restoration and immersed in 0.5% basic fuchsin for 24 hours and then the specimens were subjected for microleakage evaluation. The results were statistically analyzed by Kruskal Wallis Test and Mann Whitney ‘U’ test. Results: Results indicate that group II (2% chlorhexidine gluconate group) had the minimum mean value (15.05) and group III(Clearfil protect Bond group) and IV(control group) had the maximum mean microleakage at the enamel margin (23.00). At the gingival margin the lowest mean microleakage values were obtained with group I (Clearfil SE bond group) and group II (2% chlorhexidine gluconate) (20.25) and highest with group III and group IV (20.85). The difference was not statistically significant both at the enamel margin and the dentin margin (p>0.05). Interpretation & Conclusions: Within the limitations of this in-vitro study, we conclude that: None of the materials tested in this study completely eliminated microleakage at the enamel and at the gingival margin.All of the tested materials provided better sealing at the enamel margin than at the gingival margin. PMID:26229374

  20. Restorative Treatment Thresholds for Occlusal Primary Caries by Dentists in “The Dental Practice-Based Research Network”

    PubMed Central

    Gordan, Valeria V; Bader, James D; Garvan, Cynthia W; Richman, Joshua S; Qvist, Vibeke; Fellows, Jeffrey L; Rindal, D. Brad; Gilbert, Gregg H

    2010-01-01

    Objectives (1) Quantify at which carious lesion depths dentists intervene surgically for cases of varying caries penetration and caries risk; (2) Identify characteristics that are associated with surgical intervention. Methods Dentists in a practice-based research network who reported doing at least some restorative dentistry were surveyed. Dentists were asked to indicate whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and a written description of a patient at a specific level of caries risk. Using logistic regression, we analyzed associations of surgical treatment with dentist and practice characteristics, and patient caries risk levels. Results 519 DPBRN practitioner-investigators responded, of whom 63% indicated that they would surgically restore lesions located on inner enamel surfaces, and 90% of lesions located in outer dentin surfaces in a low caries risk individual. Regarding individuals at high caries risk, 77% reported that they would surgically restore inner enamel lesions and 94% reported restoring lesions located on the outer dentin surface. Dentists who did not assess caries risk were more likely to intervene on dentin lesions (p=.004). Practitioner-investigators who were in private practice were significantly more likely to intervene surgically on enamel lesions, compared to dentists from large group practices (p<.001). Conclusion Most dentists chose to provide some treatment to lesions that were within the enamel surface. Decisions to intervene surgically in the caries process differ by caries lesion depth, patient caries risk, assessment of caries risk, type of practice model, and percent of patients who self-pay. PMID:20123876

  1. High-viscosity glass-ionomer cements for direct posterior tooth restorations in permanent teeth: The evidence in brief.

    PubMed

    Mickenautsch, S

    2016-12-01

    To provide a brief overview of the current evidence-base for direct posterior tooth restorations in permanent teeth placed using high-viscosity glass-ionomer cement (HVGIC). The evidence sources: laboratory trials, uncontrolled clinical trials, controlled clinical trials with HVGIC restorations placed after conventional cavity preparation by drill and controlled clinical trials with HVGIC restorations placed following the atraumatic restorative treatment (ART) approach, were assessed based on systematic reviews and meta-analyses, as well as methodological studies. The precision and validity of evidence from laboratory trials, uncontrolled clinical trials and non-ART controlled clinical trials are insufficient for clinical guidance. Clinical evidence for HVGIC restorations placed using ART, comprises of 38 controlled clinical trials including over 10 000 tooth restorations. Systematic review results of these trials indicate no statistically significant differences (p>0.05) in the failure rates between HVGIC and amalgam restorations in single- and multiple surface tooth cavities after up to six years. Although, many of these trials suffered from too low sample sizes, their results could be pooled in three meta-analyses. The bias risk in all trials was judged to be high. Controlled clinical trials with HVGIC restorations placed using ART provide the bulk of the available evidence that suggest that the failure rate of direct posterior HVGIC restorations in permanent teeth are comparable to that of dental amalgam restorations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe.

    PubMed

    Vogt, Florian; Rehman, Andrea M; Kranzer, Katharina; Nyathi, Mary; Van Griensven, Johan; Dixon, Mark; Ndebele, Wedu; Gunguwo, Hilary; Colebunders, Robert; Ndlovu, Mbongeni; Apollo, Tsitsi; Ferrand, Rashida A

    2017-04-01

    Age-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown. To assess the effect of time to ART initiation on mortality and loss to follow-up (LTFU) among treatment eligible adolescents. We conducted a retrospective cohort analysis among 1499 ART eligible adolescents aged ≥10 to <19 years registered in a public sector HIV program in Bulawayo, Zimbabwe, between 2004 and 2011. Hazard ratios (HR) for mortality and LTFU were calculated for different time to ART durations using multivariate Cox regression models. Median follow-up duration was 1.6 years. Mortality HRs of patients who initiated at 0 to ≤7 days, >14 days to ≤1 month, >1 to ≤2 months, >2 months, and before initiation were 1.59, 1.19, 1.56, 1.08, and 0.94, respectively, compared with the reference group of >7 to ≤14 days. LTFU HRs were 1.02, 1.07, 0.85, 0.97, and 3.96, respectively. Among patients not on ART, 88% of deaths and 85% of LTFU occurred during the first 3 months after becoming ART eligible, but only 37% and 29% among adolescents on ART, respectively. Neither mortality or LTFU was associated with varying time to ART. The initiation process can be tailored to the adolescents' needs and individual life situations without risking to increase poor treatment outcomes. Early mortality was high despite rapid ART initiation, calling for earlier rather than faster initiation through HIV testing scale-up.

  3. Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe

    PubMed Central

    Rehman, Andrea M.; Kranzer, Katharina; Nyathi, Mary; Van Griensven, Johan; Dixon, Mark; Ndebele, Wedu; Gunguwo, Hilary; Colebunders, Robert; Ndlovu, Mbongeni; Apollo, Tsitsi; Ferrand, Rashida A.

    2017-01-01

    Background: Age-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown. Objective: To assess the effect of time to ART initiation on mortality and loss to follow-up (LTFU) among treatment eligible adolescents. Methods: We conducted a retrospective cohort analysis among 1499 ART eligible adolescents aged ≥10 to <19 years registered in a public sector HIV program in Bulawayo, Zimbabwe, between 2004 and 2011. Hazard ratios (HR) for mortality and LTFU were calculated for different time to ART durations using multivariate Cox regression models. Results: Median follow-up duration was 1.6 years. Mortality HRs of patients who initiated at 0 to ≤7 days, >14 days to ≤1 month, >1 to ≤2 months, >2 months, and before initiation were 1.59, 1.19, 1.56, 1.08, and 0.94, respectively, compared with the reference group of >7 to ≤14 days. LTFU HRs were 1.02, 1.07, 0.85, 0.97, and 3.96, respectively. Among patients not on ART, 88% of deaths and 85% of LTFU occurred during the first 3 months after becoming ART eligible, but only 37% and 29% among adolescents on ART, respectively. Conclusions: Neither mortality or LTFU was associated with varying time to ART. The initiation process can be tailored to the adolescents' needs and individual life situations without risking to increase poor treatment outcomes. Early mortality was high despite rapid ART initiation, calling for earlier rather than faster initiation through HIV testing scale-up. PMID:28002183

  4. Various Surface Treatments to Implant Provisional Restorations and Their Effect on Epithelial Cell Adhesion: A Comparative In Vitro Study.

    PubMed

    Luchinskaya, Darya; Du, Rong; Owens, David M; Tarnow, Dennis; Bittner, Nurit

    2017-02-01

    The aim of this in vitro study was to investigate the ability of epithelial cells to attach to or proliferate on various mechanical or chemical surface treatments of an implant provisional material. Polyethyl methacrylate discs 10 mm in diameter and ∼0.2 to 0.75 mm in width were used in the study. Experimental discs were treated with either a mechanical (pumice, varnish for shine, or high polishing) or a chemical agent (alcohol, chlorhexidine, or steam) to provide cleaning and/or polishing. Using primary human epidermal keratinocytes, experiments were performed to test the adhesion or proliferation of cells on the discs with various surface treatments. Scanning electron microscope analysis, rhodamine staining, and cell counting using a hemocytometer corroborated all findings and illustrated that the highest cell adhesion was found to be in the smooth surface treatment groups and the poorest adhesion was found to be in the rough surface groups and chemical treatment group. Within the limitations of this study, the following clinical protocol is recommended for finishing, polishing, and disinfecting implant provisional restorations: coarse, medium, fine pumice → high polishing (if desired) → steam. It is recommended to avoid applying varnish in the perimucosal area near the epithelium. This study could establish the most appropriate way to handle provisional restorations in the peri-implant sulcus for improved soft tissue health, esthetics, and long-term stability.

  5. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from The National Dental PBRN

    PubMed Central

    Fellows, Jeffrey L; Gordan, Valeria V.; Gilbert, Gregg H.; Rindal, D. Brad; Qvist, Vibeke; Litaker, Mark S.; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J.; Johnson, Neil

    2014-01-01

    Purpose Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. We used actual clinical data to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods We combined data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists. Analysis of variance and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results Network dentists from 5 regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (p<0.05) by patient age and race/ethnicity, dentist use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (p<0.05) by dentist race/ethnicity, network region, and practice type. CLINICAL SIGNIFICANCE Identifying patient, dentist, and practice characteristics associated with enamel caries restorations can guide strategies to improve provider adherence to evidence-based clinical recommendations. PMID:25000667

  6. Treatment of neuromyelitis optica: state-of-the-art and emerging therapies

    PubMed Central

    Papadopoulos, Marios C.; Bennett, Jeffrey L.; Verkman, Alan S.

    2014-01-01

    Neuromyelitis optica (NMO) is an autoimmune disease of the CNS that is characterized by inflammatory demyelinating lesions in the spinal cord and optic nerve, potentially leading to paralysis and blindness. NMO can usually be distinguished from multiple sclerosis (MS) on the basis of seropositivity for IgG antibodies against the astrocytic water channel aquaporin-4 (AQP4). Differentiation from MS is crucial, because some MS treatments can exacerbate NMO. NMO pathogenesis involves AQP4-IgG antibody binding to astrocytic AQP4, which causes complement-dependent cytotoxicity and secondary inflammation with granulocyte and macrophage infiltration, blood–brain barrier disruption and oligodendrocyte injury. Current NMO treatments include general immunosuppressive agents, B-cell depletion, and plasma exchange. Therapeutic strategies targeting complement proteins, the IL-6 receptor, neutrophils, eosinophils and CD19—all initially developed for other indications—are under clinical evaluation for repurposing for NMO. Therapies in the preclinical phase include AQP4-blocking antibodies and AQP4-IgG enzymatic inactivation. Additional, albeit currently theoretical, treatment options include reduction of AQP4 expression, disruption of AQP4 orthogonal arrays, enhancement of complement inhibitor expression, restoration of the blood–brain barrier, and induction of immune tolerance. Despite the many therapeutic options in NMO, no controlled clinical trials in patients with this condition have been conducted to date. PMID:25112508

  7. Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011.

    PubMed

    Le, Nicole K; Riggi, Emilia; Marrone, Gaetano; Vu, Tam Van; Izurieta, Ricardo O; Nguyen, Chuc Kim Thi; Larsson, Mattias; Do, Cuong Duy

    2017-01-01

    We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (ARV) drugs, age, and gender on the sensitivity and specificity of the WHO criteria. We conducted a retrospective cohort study of 605 HIV-infected patients using data previously collected from a cluster randomized control trial study. We compared the sensitivity and specificity of CD4+ counts to the gold standard of virologic testing as a diagnostic test for ART failure at different time points of 12, 18, and 24 months. The sensitivity [95% confidence interval (CI)] of the WHO immunological criteria based on a viral load ≥ 1000 copies/mL was 12% (5%-23%), 14% (2%-43%), and 12.5% (2%-38%) at 12, 18, and 24 months, respectively. In the same order, the specificity was 93% (90%-96%), 98% (96%-99%), and 98% (96%-100%). The positive predictive values (PPV) at 12, 18, and 24 months were 22% (9%-40%), 20% (3%-56%), and 29% (4%-71%); the negative predictive values (NPV) at the same time points were 87% (84%-90%), 97% (95%-98%), and 96% (93%-98%). The stratified analysis revealed similar sensitivities and specificities. The sensitivity of the WHO immunological criteria is poor, but the specificity is high. Although testing costs may increase, we recommend that Vietnam and other similar settings adopt viral load testing as the principal method for determining ART failure.

  8. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis

    PubMed Central

    Gillen, Brian M.; Looney, Stephen W.; Gu, Li-Sha; Loushine, Bethany A.; Weller, Roger N.; Loushine, Robert J.; Pashley, David H.; Tay, Franklin R.

    2013-01-01

    Introduction Thorough cleaning and shaping of root canals are essential for periapical healing. Restoration of endodontically-treated teeth is also required for them to function and prevent coronal leakage. This study compared the impact of the quality of root canal treatment versus the quality of coronal restoration in treatment outcomes. Methods Literature search was conducted using the search terms “coronal restoration”, “root canal”, “periapical status” and “quality”. Articles that evaluated the effect of the quality of root filling and coronal restoration or both on the success of root canal treatment were selected. Nine articles were identified and were reviewed by three investigators. Data were collected based on pre-determined criteria. Percentages of teeth without apical periodontitis were recorded for each category: Adequate Root Canal Treatment (AE), Inadequate Root Canal Treatment (IE), Adequate Restoration (AR), Inadequate Restoration (IR). Data were analyzed using meta-analysis for odds ratios (ORs). Results After adjusting for significant covariates to reduce heterogeneity, the results were combined to obtain pooled estimates of the common OR for the comparison of AR/AE vs AR/IE (OR 2.734; 95% CI 2.61–2.88; p<0.001) and AR/AE vs IR/AE (OR 2.808; 95% CI 2.64–2.97; p<0.001). Conclusion On the basis of the current best available evidence, the odds for healing of apical periodontitis increase with both adequate root canal treatment and adequate restorative treatment. Although poorer clinical outcomes may be expected with adequate root filling-inadequate coronal restoration and inadequate root filling-adequate coronal restoration, there is no significant difference in the odds of healing between these two combinations. PMID:21689541

  9. Protective effect of resin coating on the microleakage of Class V restorations following treatment with carbamide peroxide in vitro.

    PubMed

    Yu, Hao; Li, Qing; Attin, Thomas; Wang, Yining

    2010-01-01

    This in vitro study evaluated the effects of a resin coating on the microleakage of Class V restorations due to bleaching. One-hundred and sixty Class V cavities were randomly restored with one of four different restorative materials (n = 40): a compomer (Dyract AP), a conventional glass-ionomer cement (Ketac Molar Easymix), a resin modified glass-ionomer cement (Fuji II LC) and a resin composite (Filtek Z350). For each kind of material, 40 restorations were divided into four subgroups: bleached with resin coating (group BC), bleached without resin coating (group B), immersed in artificial saliva with resin coating (group SC), immersed in artificial saliva without resin coating (group S). In groups B and BC, the specimens were bleached with 10% carbamide peroxide gel for eight hours daily, while groups SC and S were stored in artificial saliva instead. After 28-day treatment, all the samples were subjected to a dye penetration test using the multiple-sectioning technique. In addition, one more test was performed to investigate the color difference between the coated and uncoated tooth surface after bleaching. There was a statistically significant increase in cervical microleakage in the group B specimens of Fuji II LC and Ketac Molar Easymix compared to their respective control specimen (group S). These effects on microleakage were not found in the bleached specimens with resin coating (group BC). There was also no visually-detectable color difference between the coated and uncoated tooth surface. In conclusion, resin coating is an effective method for avoiding the bleaching-induced microleakage of glass-ionomer cement.

  10. [Barriers to ART initiation in HIV infected subjects and with treatment indication in Spain. Why don't they start their treatment? Bridgap Study].

    PubMed

    Viciana-Fernández, Pompeyo; Falcó, Vicenç; Castaño, Manuel; de los Santos-Gil, Ignacio; Olalla-Sierra, Julián; Hernando, Asunción; Deig, Elisabet; Clotet, Bonaventura; Knobel, Hernando; Podzamczer, Daniel; Pedrol, Pere Domingo

    2015-01-01

    In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented. A cross-sectional survey including every HIV infected patient in care in 19 hospitals across Spain in 2012, with ≥1 indication to start ART according to 2011 national treatment guidelines, who had not been scheduled for ART initiation. Reasons for deferring treatment were categorized as follows (non-exclusive categories): a) The physician thinks the indication is not absolute and prefers to defer it; b) The patient does not want to start it; c) The physician thinks ART must be started, but there is some limitation to starting it, and d) The patient has undetectable viral load in absence of ART. A total of 256 patients, out of 784 originally planned, were included. The large majority (84%) were male, median age 39 years, 57% MSM, 24% heterosexuals, and 16% IDUs. Median time since HIV diagnosis was 3 years, median CD4 count, 501 cells/mm3, median viral load 4.4 log copies/ml. Main ART indications were: CD4 count <500 cells/mm(3), 48%; having an uninfected sexual partner, 28%, and hepatitis C coinfection, 23%. Barriers due to, the physician, 55%; the patient, 28%; other limitations, 23%; and undetectable viral load, 6%. The majority of subjects with ART indication were on it. The most frequent barriers among those who did not receive it were physician-related, suggesting that the relevance of the conditions that indicate ART may need reinforcing. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  11. Cost-effectiveness of ranibizumab in treatment of diabetic macular oedema (DME) causing visual impairment: evidence from the RESTORE trial

    PubMed Central

    Annemans, Lieven; Gallagher, Meghan; Hasan, Rafiq; Thomas, Simu; Gairy, Kerry; Knudsen, Martin; Onwordi, Henrietta

    2012-01-01

    Background/aims To evaluate the cost-effectiveness of ranibizumab as either monotherapy or combined with laser therapy, compared with laser monotherapy, in the treatment of diabetic macular oedema (DME) causing visual impairment from a UK healthcare payer perspective. Methods A Markov model simulated long-term outcomes and costs of treating DME in one eye (BCVA ≤75 letters) based on data from the RESTORE Phase III trial. Outcomes measured in quality-adjusted life-years (QALYs) were simulated for a 15-year time horizon based on 12-month follow-up from RESTORE and published long-term data. Costs included treatment, disease monitoring, visual impairment and blindness (at 2010 price levels). Results Ranibizumab monotherapy resulted in a 0.17 QALY gain at an incremental cost of £4191 relative to laser monotherapy, yielding an incremental cost-effectiveness ratio (ICER) of £24 028. Probabilistic sensitivity analysis showed a 64% probability of being cost-effective at a threshold of £30 000 per QALY. Combined ranibizumab and laser therapy resulted in a 0.13 QALY gain at an incremental cost of £4695 relative to laser monotherapy (ICER £36 106; 42% probability of ICER <£30 000). Conclusions Based on RESTORE 1-year follow-up data, ranibizumab monotherapy appears to be cost-effective relative to laser monotherapy, the current standard of care. Cost-effectiveness of combination therapy is less certain. Ongoing studies will further inform on disease progression and the need for additional ranibizumab treatment. PMID:22399690

  12. [Treatment and personality development with art therapy. A description of the method].

    PubMed

    Antalfai, Márta

    2007-01-01

    Composition as a creative form of self-expression plays an important role not only in maintaining health, but also in gaining insight into the healthy personality and in the definition of this category. It seems nowadays that psychology has collected more information on the pathological personality than on the healthy one. Therefore, different workshops of art therapy are also scenes of a "spiritual alchemy" because they can give a deeper insight into the personality in addition to the primary aim of treatment. The method of the thematic art psychotherapy based on catharsis-experience is based on analytical psychology and on analytically oriented group-therapy. The aim is to generate artificial catharsis-experiences employing the impressive forces of poems, music compositions in order to raise the unconscious or the partly experienced partner-conflicts to the surface, which could manifest themselves in the process of the creative work and could be elaborated in group-activity. The creative process (specially adapted art techniques) provides good opportunities for patients to depict their traumas and complexes and also to resolve them involving the whole personality and not only at a cognitive level. The method, tuned to the workings of nature, helps the personality to develop the emotional and volitional segments, the sensitive and empathetic capabilities, as well as the recognition skills of consciousness. In the therapeutic process, the work of art that is created holds a mirror to the creator, offering to him or her the opportunity to face the real complex at the background the actual conflict. The method aims to achieve a reconstruction of psychic dynamics in two ways. The first is an emotional resonance to the changes of nature, of the year and of the feasts, in which the psychic process starts from inside to the direction of the outside world (psychic enrichment and accomodation). The second way leads from the outer world to the inner one and this psychic

  13. [Hyperbaric oxygen treatment of musculoskeletal disorders on the sports medicine. State of the art].

    PubMed

    Drobnic, Franchek; Turmo, Antonio

    2010-03-13

    Hyperbaric oxygen therapy (OHB) is a therapeutic modality based on the properties of partial pressure of oxygen, when breathing pure oxygen under hyperbaric conditions in a chamber designed for that purpose. Its indications in medicine are considered as primary, complementary or experimental depending on the evidence based effects. From different sectors of medicine, OHB has been recently proposed as a new tool for other pathologies, primarily in musculoskeletal disorders. In this paper, the state of the art of the influence from experimental studies is reviewed. Some considerations based on these studies are hypothesized as the minimum required to obtain good results when this therapy is decided to be used as co adjuvant to standard treatment.

  14. The treatment of female pattern hair loss and other applications of surgical hair restoration in women.

    PubMed

    Epstein, Jeffrey S

    2004-05-01

    In the specialty of surgical hair restoration, men comprise more than 90% of the patients treated; however, in the last few years the number of women undergoing the procedure has increased significantly. The reasons for this growth are many and include the increase in public awareness of the efficacy of hair transplantation from such sources as the media,the Internet, advertising and word of mouth. More importantly, advances in technique have significantly improved results, increasing the confidence level in women to undergo the procedure and in hair transplant specialists to offer it.

  15. Beyond Risk Compensation: Clusters of Antiretroviral Treatment (ART) Users in Sexual Networks Can Modify the Impact of ART on HIV Incidence

    PubMed Central

    Delva, Wim; Helleringer, Stéphane

    2016-01-01

    Introduction Concerns about risk compensation—increased risk behaviours in response to a perception of reduced HIV transmission risk—after the initiation of ART have largely been dispelled in empirical studies, but other changes in sexual networking patterns may still modify the effects of ART on HIV incidence. Methods We developed an exploratory mathematical model of HIV transmission that incorporates the possibility of ART clusters, i.e. subsets of the sexual network in which the density of ART patients is much higher than in the rest of the network. Such clusters may emerge as a result of ART homophily—a tendency for ART patients to preferentially form and maintain relationships with other ART patients. We assessed whether ART clusters may affect the impact of ART on HIV incidence, and how the influence of this effect-modifying variable depends on contextual variables such as HIV prevalence, HIV serosorting, coverage of HIV testing and ART, and adherence to ART. Results ART homophily can modify the impact of ART on HIV incidence in both directions. In concentrated epidemics and generalized epidemics with moderate HIV prevalence (≈ 10%), ART clusters can enhance the impact of ART on HIV incidence, especially when adherence to ART is poor. In hyperendemic settings (≈ 35% HIV prevalence), ART clusters can reduce the impact of ART on HIV incidence when adherence to ART is high but few people living with HIV (PLWH) have been diagnosed. In all contexts, the effects of ART clusters on HIV epidemic dynamics are distinct from those of HIV serosorting. Conclusions Depending on the programmatic and epidemiological context, ART clusters may enhance or reduce the impact of ART on HIV incidence, in contrast to serosorting, which always leads to a lower impact of ART on HIV incidence. ART homophily and the emergence of ART clusters should be measured empirically and incorporated into more refined models used to plan and evaluate ART programmes. PMID:27657492

  16. Pancreatic cancer: from state-of-the-art treatments to promising novel therapies.

    PubMed

    Garrido-Laguna, Ignacio; Hidalgo, Manuel

    2015-06-01

    Pancreatic cancer is expected to be the second deadliest malignancy in the USA by 2020. The survival rates for patients with other gastrointestinal malignancies have increased consistently during the past 30 years; unfortunately, however, the outcomes of patients with pancreatic cancer have not changed significantly. Although surgery remains the only curative treatment for pancreatic cancer, therapeutic strategies based on initial resection have not substantially improved the survival of patients with resectable disease over the past 25 years; presently, more than 80% of patients suffer disease relapse after resection. Preclinical evidence that pancreatic cancer is a systemic disease suggests a possible benefit for early administration of systemic therapy in these patients. In locally advanced disease, the role of chemoradiotherapy is increasingly being questioned, particularly considering the results of the LAP-07 trial. Novel biomarkers are clearly needed to identify subsets of patients likely to benefit from chemoradiotherapy. In the metastatic setting, FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin), and nab-paclitaxel plus gemcitabine have yielded only modest improvements in survival. Thus, new treatments are urgently needed for patients with pancreatic cancer. Herein, we review the state-of-the-art of pancreatic cancer treatment, and the upcoming novel therapeutics that hold promise in this disease are also discussed.

  17. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN.

    PubMed

    Fellows, Jeffrey L; Gordan, Valeria V; Gilbert, Gregg H; Rindal, D Brad; Qvist, Vibeke; Litaker, Mark S; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J; Johnson, Neil

    2014-04-01

    Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Network dentists from five regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (P < 0.05) by patient age and race/ethnicity, dentists' use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (P < 0.05) by dentist race/ethnicity, network region, and practice type.

  18. Response of phytoplankton to protective-restoration treatments enhancing water quality in a shallow urban lake.

    PubMed

    Zębek, Elżbieta; Napiórkowska-Krzebietke, Agnieszka

    2016-11-01

    Lake Jeziorak Mały is a shallow urban lake where storm water pretreatment separators and a fountain-based water aeration system were installed as protective-restoration measures to enhance water quality. We investigated the effect of these procedures on phytoplankton dynamics and physicochemical properties in the littoral and pelagial zones in 1996-2003, 2005, and 2013. A decrease in cyanobacteria proportion, abundance, and biomass has been noticed, and other phytoplankton groups increased after these procedures. Significantly elevated species diversity was recorded in the littoral zone with the exchange of cyanobacteria and diatom dominant species typically induced by alteration from hypertrophic to eutrophic status. For example, the polytrophic Limnothrix redekei was replaced by eutrophic Planktolyngbya brevicellularis. This stemmed from greater oxygenation, water visibility and diminished pH, conductivity, and orthophosphates. Our results showed that introducing these restoration measures influence on the long-term succession of phytoplankton and induced the change from a polytrophic to eutrophic state, and that such measures are vitally important in future considerations of shallow urban lake management.

  19. Gene therapies that restore dystrophin expression for the treatment of Duchenne muscular dystrophy.

    PubMed

    Robinson-Hamm, Jacqueline N; Gersbach, Charles A

    2016-09-01

    Duchenne muscular dystrophy is one of the most common inherited genetic diseases and is caused by mutations to the DMD gene that encodes the dystrophin protein. Recent advances in genome editing and gene therapy offer hope for the development of potential therapeutics. Truncated versions of the DMD gene can be delivered to the affected tissues with viral vectors and show promising results in a variety of animal models. Genome editing with the CRISPR/Cas9 system has recently been used to restore dystrophin expression by deleting one or more exons of the DMD gene in patient cells and in a mouse model that led to functional improvement of muscle strength. Exon skipping with oligonucleotides has been successful in several animal models and evaluated in multiple clinical trials. Next-generation oligonucleotide formulations offer significant promise to build on these results. All these approaches to restoring dystrophin expression are encouraging, but many hurdles remain. This review summarizes the current state of these technologies and summarizes considerations for their future development.

  20. INFLUENCE OF POST-CURE TREATMENTS ON HARDNESS AND MARGINAL ADAPTATION OF COMPOSITE RESIN INLAY RESTORATIONS: AN IN VITRO STUDY

    PubMed Central

    Poskus, Laiza Tatiana; Latempa, Antonio Marcelo Accetta; Chagas, Maurício Alves; da Silva, Eduardo Moreira; Leal, Mariana Pareira da Silva; Guimarães, José Guilherme Antunes

    2009-01-01

    Objectives: The purpose of this study was to evaluate the Vickers hardness number (VHN) and the in vitro marginal adaptation of inlay restorations of three hybrid composite resins (Filtek Z250, Opallis and Esthet-X) subjected to two post-cure treatments. Material and Methods: For the microhardness test, three different groups were prepared in accordance with the post-cure treatments: control group (only light cure for 40 s), autoclave group (light cure for 40 s + autoclave for 15 min at 130°C); and microwave group (light cure for 40 s + microwave for 3 min at 450 W). To assess the marginal adaptation, the composite resin was inserted incrementally into a mesial-occlusal-distal cavity brass mold and each increment light-cured for 40 s. A previous reading in micrometers was taken at the cervical wall, using a stereomicroscope magnifying glass equipped with a digital video camera and image-analysis software. Subsequently, the specimens were subjected to the post-cure treatments (autoclave and microwave) and a reading was taken again at the cervical wall. Data were compared using ANOVA for the hardness test, split-plot ANOVA for the adaptation assessment and Tukey's test for multiple comparisons. A significance level of 5% was adopted for all analyses. Results: The post-cure treatments increased the hardness of conventional composites (p<0.001) and the gap values of inlay restorations (p<0.01). Filtek Z250 showed higher hardness (p<0.001) and lower gap values than Opallis and Esthet-X (p<0.05). Gap values did not exceed 90 μm for any of the experimental conditions. Conclusion: The post-cure treatments increased the VHN and the gap values on the cervical floor of composite resin inlays. Moreover, Filtek Z250 showed the best results, with higher hardness and lower gap values. PMID:20027437

  1. Stress distribution in molars restored with inlays or onlays with or without endodontic treatment: a three-dimensional finite element analysis.

    PubMed

    Jiang, W; Bo, H; Yongchun, G; LongXing, Ni

    2010-01-01

    Previous research into the strength of endodontically treated or vital teeth restored with inlays or onlays has not determined which restoration method and material provide the most favorable stress distribution upon loading. The purpose of this study was to calculate the von Mises stresses in a mandibular first molar using a 3-dimensional (3-D) finite element model. Models compared endodontically treated and vital teeth, a variety of restorative materials, and the use of either inlays or onlays to restore teeth. Four 3-D models of mandibular first molars were created: (1) the IV group (inlay restored, vital pulp); (2) the OV group (onlay restored, vital pulp); (3) the IE group (inlay restored, endodontically treated); and (4) the OE group (onlay restored, endodontically treated). In each group, 3 types of restorative material were tested: (1) composite resin, (2) ceramic, and (3) gold alloy. The materials had elastic moduli of 19 GPa, 65 GPa, and 96.6 GPa, respectively. Each model was subjected to a force of 45 N directed to the occlusal surface, applied either vertically or laterally (45 degrees obliquely). The stresses occurring in dentin tissue were calculated. The stress distribution patterns and the maximum von Mises stresses were calculated and compared. The different restorative materials exhibited similar stress distribution patterns under identical loading conditions. In each group, the gold-restored tooth exhibited the highest von Mises stress, followed by ceramic and composite resin. The maximum von Mises stress in dentin was found in the IE group (16.73 MPa), which was 5 times higher than the highest value found in the OV group (2.96 MPa). The highest stresses, which occurred at the floor of the preparation and the cervical region in dentin, were in the IE group. The stress concentration area in the IE group was also larger. The results indicate that endodontic treatment caused higher stress concentration in dentin compared with vital teeth, but that

  2. Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: a randomized controlled study.

    PubMed

    Svensk, A-C; Oster, I; Thyme, K E; Magnusson, E; Sjödin, M; Eisemann, M; Aström, S; Lindh, J

    2009-01-01

    Women with breast cancer are naturally exposed to strain related to diagnosis and treatment, and this influences their experienced quality of life (QoL). The present paper reports the effect, with regard to QoL aspects, of an art therapy intervention among 41 women undergoing radiotherapy treatment for breast cancer. The women were randomized to an intervention group with individual art therapy sessions for 1 h/week (n = 20), or to a control group (n = 21). The WHOQOL-BREF and EORTC Quality of Life Questionnaire-BR23, were used for QoL assessment, and administrated on three measurement occasions, before the start of radiotherapy and 2 and 6 months later. The results indicate an overall improvement in QoL aspects among women in the intervention group. A significant increase in total health, total QoL, physical health and psychological health was observed in the art therapy group. A significant positive difference within the art therapy group was also seen, concerning future perspectives, body image and systemic therapy side effects. The present study provides strong support for the use of art therapy to improve QoL for women undergoing radiotherapy treatment for breast cancer.

  3. Using quality of life scores to help determine treatment: is restoring bowel continuity better than an ostomy?

    PubMed

    Ko, C. Y.; Rusin, L. C.; Schoetz, D. J.; Coller, J. A.; Murray, J. J.; Roberts, P. L.; Moreau, L.

    2002-01-01

    : 91 +/- 14 vs 90 +/- 17; SF: 86 +/- 23 vs 97 +/- 5; PR: 79 +/- 34 vs 83 +/- 40; ER: 86 +/- 28 vs 88 +/- 27; MH: 77 +/- 19 vs 82 +/- 14; BP: 78 +/- 24 vs 71 +/- 32; E 60 +/- 21 vs 58 +/- 18, respectively). CONCLUSION: Although the perceived quality of life for ileostomy patients is generally worse than the 'restored bowel continuity' group, the measured HRQL is the same for both groups. These results suggest that a permanent ileostomy should be included as a viable and appropriate first line treatment option for FAP patients after resection. This study also suggests that HRQL should play a greater role in the evaluation of care and treatment in colorectal surgery.

  4. Innovative manure treatments in the USA – state of the art (Tratamientos Innovadores de estiercoles en USA - estado del arte)

    USDA-ARS?s Scientific Manuscript database

    Currently, the potential impact of manure on the environment represents one of the world agriculture’s major challenges. Treatment technologies can play an important role in the management of livestock manure by providing a more flexible approach to land application and acreage limitations and by so...

  5. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART(®)).

    PubMed

    Kip, Kevin E; Elk, Carrie A; Sullivan, Kelly L; Kadel, Rajendra; Lengacher, Cecile A; Long, Christopher J; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F; Street, Jennifer D; Girling, Sue Ann; Diamond, David M

    2012-06-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART(®)) that incorporates the use of eye movements administered in a brief treatment period (1-5 one-hour sessions within three weeks). Eighty adults aged 21-60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants' mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p < 0.0001 for all pre-ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  6. Effect of different root caries treatments on the sealing ability of conventional glass ionomer cement restorations.

    PubMed

    Geraldo-Martins, Vinicius R; Lepri, Cesar P; Palma-Dibb, Regina G

    2012-01-01

    In this study we compared the microleakage of conventional glass ionomer cement (GIC) restorations following the use of different methods of root caries removal. In vitro root caries were induced in 75 human root dentin samples that were divided in five groups of 15 each according to the method used for caries removal: in group 1 spherical carbide burs at low speed were used, in group 2 a hand-held excavator was used, and in groups 3 to 5 an Er,Cr:YSGG laser was used at 2.25 W, 40.18 J/cm(2) (group 3), 2.50 W, 44.64 J/cm(2) (group 4) and 2.75 W, 49.11 J/cm(2) (group 5). The air/water cooling during irradiation was set to 55%/65% respectively. All cavities were filled with GIC. Five samples from each group were evaluated by scanning electron microscopy (SEM) and the other ten samples were thermocycled and submitted to a microleakage test. The data obtained were compared by ANOVA followed by Fisher's test (p≤0.05). Group 4 showed the lowest microleakage index (56.65 6.30; p<0.05). There were no significant differences among the other groups. On SEM images samples of groups 1 and 2 showed a more regular interface than the irradiated samples. Demineralized dentin below the restoration was observed, that was probably affected dentin. Group 4 showed the lowest microleakage values compared to the other experimental groups, so under the conditions of the present study the method that provided the lowest microleakage was the Er,Cr:YSGG laser with a power output of 2.5 W yielding an energy density of 44.64 J/cm(2).

  7. Restoring longleaf pine (Pinus palustris Mill.) in loblolly pine (Pinus taeda L.) stands: Effects of restoration treatments on natural loblolly pine regeneration

    Treesearch

    Ben Knapp; Wang Geoff; Huifeng Hu; Joan Walker; Carsyn Tennant

    2011-01-01

    Historical land use and management practices in the southeastern United States have resulted in the dominance of loblolly pine on many upland sites that historically were occupied by longleaf pine. There is currently much interest in restoring high quality longleaf pine habitats to such areas, but managers may also desire the retention of some existing canopy trees to...

  8. Limits to Understory Plant Restoration Following Fuel-Reduction Treatments in a Piñon-Juniper Woodland

    NASA Astrophysics Data System (ADS)

    Redmond, Miranda D.; Zelikova, Tamara J.; Barger, Nichole N.

    2014-11-01

    National fuel-reduction programs aim to reduce the risk of wildland fires to human communities and to restore forest and rangeland ecosystems to resemble their historical structure, function, and diversity. There are a number of factors, such as seed bank dynamics, post-treatment climate, and herbivory, which determine whether this latter goal may be achieved. Here, we examine the short-term (2 years) vegetation response to fuel-reduction treatments (mechanical mastication, broadcast burn, and pile burn) and seeding of native grasses on understory vegetation in an upland piñon-juniper woodland in southeast Utah. We also examine how wildlife herbivory affects the success of fuel-reduction treatments. Herbaceous cover increased in response to fuel-reduction treatments in all seeded treatments, with the broadcast burn and mastication having greater increases (234 and 160 %, respectively) in herbaceous cover than the pile burn (32 %). In the absence of seeding, herbaceous cover only increased in the broadcast burn (32 %). Notably, fuel-reduction treatments, but not seeding, strongly affected herbaceous plant composition. All fuel-reduction treatments increased the relative density of invasive species, especially in the broadcast burn, which shifted the plant community composition from one dominated by perennial graminoids to one dominated by annual forbs. Herbivory by wildlife reduced understory plant cover by over 40 % and altered plant community composition. If the primary management goal is to enhance understory cover while promoting native species abundance, our study suggests that mastication may be the most effective treatment strategy in these upland piñon-juniper woodlands. Seed applications and wildlife exclosures further enhanced herbaceous cover following fuel-reduction treatments.

  9. Limits to understory plant restoration following fuel-reduction treatments in a piñon-juniper woodland.

    PubMed

    Redmond, Miranda D; Zelikova, Tamara J; Barger, Nichole N

    2014-11-01

    National fuel-reduction programs aim to reduce the risk of wildland fires to human communities and to restore forest and rangeland ecosystems to resemble their historical structure, function, and diversity. There are a number of factors, such as seed bank dynamics, post-treatment climate, and herbivory, which determine whether this latter goal may be achieved. Here, we examine the short-term (2 years) vegetation response to fuel-reduction treatments (mechanical mastication, broadcast burn, and pile burn) and seeding of native grasses on understory vegetation in an upland piñon-juniper woodland in southeast Utah. We also examine how wildlife herbivory affects the success of fuel-reduction treatments. Herbaceous cover increased in response to fuel-reduction treatments in all seeded treatments, with the broadcast burn and mastication having greater increases (234 and 160 %, respectively) in herbaceous cover than the pile burn (32 %). In the absence of seeding, herbaceous cover only increased in the broadcast burn (32 %). Notably, fuel-reduction treatments, but not seeding, strongly affected herbaceous plant composition. All fuel-reduction treatments increased the relative density of invasive species, especially in the broadcast burn, which shifted the plant community composition from one dominated by perennial graminoids to one dominated by annual forbs. Herbivory by wildlife reduced understory plant cover by over 40 % and altered plant community composition. If the primary management goal is to enhance understory cover while promoting native species abundance, our study suggests that mastication may be the most effective treatment strategy in these upland piñon-juniper woodlands. Seed applications and wildlife exclosures further enhanced herbaceous cover following fuel-reduction treatments.

  10. Nanocarriers for the treatment of glioblastoma multiforme: Current state-of-the-art.

    PubMed

    Karim, Reatul; Palazzo, Claudio; Evrard, Brigitte; Piel, Geraldine

    2016-04-10

    Glioblastoma multiforme, a grade IV glioma, is the most frequently occurring and invasive primary tumor of the central nervous system, which causes about 4% of cancer-associated-deaths, making it one of the most fatal cancers. With present treatments, using state-of-the-art technologies, the median survival is about 14 months and 2 year survival rate is merely 3-5%. Hence, novel therapeutic approaches are urgently necessary. However, most drug molecules are not able to cross the blood-brain barrier, which is one of the major difficulties in glioblastoma treatment. This review describes the features of blood-brain barrier, and its anatomical changes with different stages of tumor growth. Moreover, various strategies to improve brain drug delivery i.e. tight junction opening, chemical modification of the drug, efflux transporter inhibition, convection-enhanced delivery, craniotomy-based drug delivery and drug delivery nanosystems are discussed. Nanocarriers are one of the highly potential drug transport systems that have gained huge research focus over the last few decades for site specific drug delivery, including drug delivery to the brain. Properly designed nanocolloids are capable to cross the blood-brain barrier and specifically deliver the drug in the brain tumor tissue. They can carry both hydrophilic and hydrophobic drugs, protect them from degradation, release the drug for sustained period, significantly improve the plasma circulation half-life and reduce toxic effects. Among various nanocarriers, liposomes, polymeric nanoparticles and lipid nanocapsules are the most widely studied, and are discussed in this review. For each type of nanocarrier, a general discussion describing their composition, characteristics, types and various uses is followed by their specific application to glioblastoma treatment. Moreover, some of the main challenges regarding toxicity and standardized evaluation techniques are narrated in brief. Copyright © 2016 Elsevier B.V. All

  11. HIV Treatment as Prevention: Modelling the Cost of Antiretroviral Treatment—State of the Art and Future Directions

    PubMed Central

    Meyer-Rath, Gesine; Over, Mead

    2012-01-01

    Policy discussions about the feasibility of massively scaling up antiretroviral therapy (ART) to reduce HIV transmission and incidence hinge on accurately projecting the cost of such scale-up in comparison to the benefits from reduced HIV incidence and mortality. We review the available literature on modelled estimates of the cost of providing ART to different populations around the world, and suggest alternative methods of characterising cost when modelling several decades into the future. In past economic analyses of ART provision, costs were often assumed to vary by disease stage and treatment regimen, but for treatment as prevention, in particular, most analyses assume a uniform cost per patient. This approach disregards variables that can affect unit cost, such as differences in factor prices (i.e., the prices of supplies and services) and the scale and scope of operations (i.e., the sizes and types of facilities providing ART). We discuss several of these variables, and then present a worked example of a flexible cost function used to determine the effect of scale on the cost of a proposed scale-up of treatment as prevention in South Africa. Adjusting previously estimated costs of universal testing and treatment in South Africa for diseconomies of small scale, i.e., more patients being treated in smaller facilities, adds 42% to the expected future cost of the intervention. PMID:22802731

  12. Si-jun-zi decoction treatment promotes the restoration of intestinal function after obstruction by regulating intestinal homeostasis.

    PubMed

    Yu, Xiangyang; Cui, Zhigang; Zhou, Zhenli; Shan, Tao; Li, Donghua; Cui, Naiqiang

    2014-01-01

    Intestinal obstruction is a common disease requiring abdominal surgery with significant morbidity and mortality. Currently, an effective medical treatment for obstruction, other than surgical resection or decompression, does not exist. Si-Jun-Zi Decoction is a famous Chinese medicine used to replenish qi and invigorate the functions of the spleen. Modern pharmacological studies show that this prescription can improve gastrointestinal function and strengthen immune function. In this study, we investigated the effects of a famous Chinese herbal formula, Si-Jun-Zi Decoction, on the restoration of intestinal function after the relief of obstruction in a rabbit model. We found that Si-Jun-Zi Decoction could reduce intestinal mucosal injury while promoting the recovery of the small intestine. Further, Si-Jun-Zi Decoction could regulate the intestinal immune system. Our results suggest that Si-Jun-Zi Decoction promotes the restoration of intestinal function after obstruction by regulating intestinal homeostasis. Our observations indicate that Si-Jun-Zi Decoction is potentially a therapeutic drug for intestinal obstruction.

  13. Transplantation of cryopreserved human ovarian tissue: restoration of reproductive function after two cycles of radio- and chemo-therapeutic treatments.

    PubMed

    Isachenko, Evgenia; Isachenko, Vladimir; Mallmann, Peter; Orth, Ingrid; Peters, Doris; Schmidt, Torsten; Morgenstern, Bernd; Foth, Dolores; Hanstein, Bettina; Röthlisberger, Maria; Rahimi, Gohar

    2014-01-01

    Patient S. was born in 1983, developed a Ewing-Sarcoma and obtained low dose chemotherapy in 1996. In 2007, Patient S. received high-dose chemotherapy because lung-metastases were diagnosed. The aim of the study was to investigate the health of cryopreserved ovarian tissue and also to examine whether this ovarian tissue can restore the reproductive function of patient after two cycles of radio-and chemo-therapeutic treatments. Twenty pieces of ovarian tissue (total of approximately 200 mm2) were conventionally frozen with 6% (v/v) dimethyl sulfoxide, 6% (v/v) ethylene glycol and 0.15 M sucrose and kept for five years before 8 pieces were thawed and transplanted back into the patient. Two small (1 x 2 x 1 mm) pieces of this thawed tissue were cultured in a chicken embryonic chorioallantoic membrane (CAM)-system for 5 days to assess the tissue viability. The ovarian tissue that was grafted re-established spontaneous menstrual bleeding within five months and serum 17-beta estradiol increased from 19 to 330 pg/mL. Ultrasound revealed a dominant follicle at the site of the transplanted tissue in the follicular phase after the menstrual bleed. Analysis of the CAM cultured tissue established that 88% of the primordial follicles had degenerated and there was limited growth of blood vessels. In spite of the damage caused by the cryopreservation the surviving follicles could restore ovarian function after re-transplantation.

  14. Non-thermal Atmospheric Plasma Treatment for Deactivation of Oral Bacteria and Improvement of Dental Composite Restoration

    NASA Astrophysics Data System (ADS)

    Yu, Qing Song; Li, H.; Ritts, A. C.; Yang, B.; Chen, M.; Hong, L.; Xu, C.; Yao, X.; Wang, Y.

    This paper reviews our recent research results of using non-thermal ­atmospheric plasmas for oral bacterial deactivation and for composite restoration improvement. Oral bacteria of Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) with an initial bacterial population density between 1.0 × 108 and 5.0 × 108 cfu/ml were seeded on various media and their survivability with plasma exposure was examined. The plasma exposure time for a 99.9999% cell reduction was less than 15 s for S. mutans and within 5 min for L. acidophilus. To evaluate the dentin/composite interfacial bonding, extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. After dental composite application and light curing, the teeth were then sectioned into micro-bars as the specimens for microtensile test. Student Newman Keuls (SNK) tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment of the dentin surfaces. These findings indicated that non-thermal atmospheric plasma technology is very promising for dental clinical applications.

  15. Expanding ART for Treatment and Prevention of HIV in South Africa: Estimated Cost and Cost-Effectiveness 2011-2050

    PubMed Central

    Granich, Reuben; Kahn, James G.; Bennett, Rod; Holmes, Charles B.; Garg, Navneet; Serenata, Celicia; Sabin, Miriam Lewis; Makhlouf-Obermeyer, Carla; De Filippo Mack, Christina; Williams, Phoebe; Jones, Louisa; Smyth, Caoimhe; Kutch, Kerry A.; Ying-Ru, Lo; Vitoria, Marco; Souteyrand, Yves; Crowley, Siobhan; Korenromp, Eline L.; Williams, Brian G.

    2012-01-01

    Background Antiretroviral Treatment (ART) significantly reduces HIV transmission. We conducted a cost-effectiveness analysis of the impact of expanded ART in South Africa. Methods We model a best case scenario of 90% annual HIV testing coverage in adults 15–49 years old and four ART eligibility scenarios: CD4 count <200 cells/mm3 (current practice), CD4 count <350, CD4 count <500, all CD4 levels. 2011–2050 outcomes include deaths, disability adjusted life years (DALYs), HIV infections, cost, and cost per DALY averted. Service and ART costs reflect South African data and international generic prices. ART reduces transmission by 92%. We conducted sensitivity analyses. Results Expanding ART to CD4 count <350 cells/mm3 prevents an estimated 265,000 (17%) and 1.3 million (15%) new HIV infections over 5 and 40 years, respectively. Cumulative deaths decline 15%, from 12.5 to 10.6 million; DALYs by 14% from 109 to 93 million over 40 years. Costs drop $504 million over 5 years and $3.9 billion over 40 years with breakeven by 2013. Compared with the current scenario, expanding to <500 prevents an additional 585,000 and 3 million new HIV infections over 5 and 40 years, respectively. Expanding to all CD4 levels decreases HIV infections by 3.3 million (45%) and costs by $10 billion over 40 years, with breakeven by 2023. By 2050, using higher ART and monitoring costs, all CD4 levels saves $0.6 billion versus current; other ART scenarios cost $9–194 per DALY averted. If ART reduces transmission by 99%, savings from all CD4 levels reach $17.5 billion. Sensitivity analyses suggest that poor retention and predominant acute phase transmission reduce DALYs averted by 26% and savings by 7%. Conclusion Increasing the provision of ART to <350 cells/mm3 may significantly reduce costs while reducing the HIV burden. Feasibility including HIV testing and ART uptake, retention, and adherence should be evaluated. PMID:22348000

  16. Invisalign technique in the treatment of adults with pre-restorative concerns

    PubMed Central

    2013-01-01

    The Invisalign method is gaining an increasing interest as an alternative treatment option in adult patient in multidisciplinary complex cases to simplify the treatment plan. The aim of this work is to show the importance of planning a multidisciplinary approach to respond at the esthetic requests of adult patients and to treat complex cases with high predictability. PMID:24325954

  17. The Efficacy of Noncontingent Escape for Decreasing Children's Disruptive Behavior during Restorative Dental Treatment

    ERIC Educational Resources Information Center

    O'Callaghan, Patrick M.; Allen, Keith D.; Powell, Shawn; Salama, Fouad

    2006-01-01

    We evaluated the effectiveness of a dentist-implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed-time…

  18. Invisalign technique in the treatment of adults with pre-restorative concerns.

    PubMed

    Mampieri, Gianluca; Giancotti, Aldo

    2013-10-20

    The Invisalign method is gaining an increasing interest as an alternative treatment option in adult patient in multidisciplinary complex cases to simplify the treatment plan. The aim of this work is to show the importance of planning a multidisciplinary approach to respond at the esthetic requests of adult patients and to treat complex cases with high predictability.

  19. Mental health and developmental outcomes for children born after ART: a comparative prospective study on child gender and treatment type.

    PubMed

    Punamäki, Raija-Leena; Tiitinen, Aila; Lindblom, Jallu; Unkila-Kallio, Leila; Flykt, Marjo; Vänskä, Mervi; Poikkeus, Piia; Tulppala, Maija

    2016-01-01

    Do children born after assisted reproductive techniques (ART; IVF/ICSI) display more mental health issues or social and cognitive developmental problems at 7-8 years than naturally conceived (NC) controls, and does child gender play a role? ART children do not differ with regard to mental health or social and cognitive developmental problems when compared with controls, but some gender-specific differences do exist. Systematic reviews have not found any evidence of delays in neurocognitive or sensorimotor development in ART children. However findings on the effect of the type of ART treatment (IVF versus ICSI) on the offspring's physical and mental development have not been uniform. Knowledge of the role of child gender in ART research is scarce. This prospective follow-up study compares mental health and social and cognitive developmental problems between 7-8-year-old ART and NC children, controlling for the father's age, length of the parents' partnership, mother's parity, child's gestational age, and the need of neonatal intensive care unit (NICU). Further, within the ART group, we analysed whether the treatment type (IVF versus ICSI) and the child's gender are associated with the mental health and developmental outcomes. In this study, 255 singleton ART children (IVF and ICSI) were compared with 278 NC children on parent-reported internalizing and externalizing symptoms, and social (social skills and peer relations) and cognitive development (executive functioning, perception, memory, and language). Within the ART group, 164 IVF and 76 ICSI children were compared on the same outcomes. Statistics included analyses of covariates (ANCOVA) with group main effects, group and gender interaction effects, and Bonferroni post hoc tests. ART and NC children did not differ generally in terms of their internalizing and externalizing symptoms or in the number of social and cognitive developmental problems (Group main effects, P > 0.05), but gender-specific group differences

  20. Chemical and structural characterization of glass ionomer cements indicated for atraumatic restorative treatment.

    PubMed

    Guedes, Orlando Aguirre; Borges, Álvaro Henrique; Bandeca, Matheus Coelho; Nakatani, Mariana Kyosen; de Araújo Estrela, Cyntia Rodrigues; de Alencar, Ana Helena Gonçalves; Estrela, Carlos

    2015-01-01

    Glass ionomer cements (GICs) are restorative materials, which clinical use has increased significantly during the last decade. The aim of the present study was to analyze the chemical constitution and surface morphology of four glass ionomer cements: Maxxion R, VitroFill, Vidrion R and Vitremer. Twelve polyethylene tubes with an internal diameter of 3 and 3 mm in length were prepared, filled and then transferred to a chamber with 95% relative humidity and a temperature of 37°C. The surface morphology of the tested materials was examined by scanning electron microscopy (SEM) and main components were investigated by energy-dispersive X-ray microanalysis (EDX). Scanning electron microscopy revealed irregular and rough external surface. Cracking was not observed. The main constituents were found to be aluminum, silicon, calcium, sodium and fluoride. Phosphorus, sulfur and barium were only observed in Vidrion R, while chlorine were only observed in Maxxion R. Elemental mapping of the outer surface revealed high concentration of aluminum and silicon. Significant irregularities on the surface of the tested materials were observed. The chemical constitution of all GIC was similar.

  1. Methicillin-resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes.

    PubMed

    Hall, David L

    2003-01-01

    The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20-35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: 1. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre-op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high-speed air turbine and electric "high" speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.

  2. Ron Hays: A Story of Art as Self Treatment for Alzheimer's Disease

    ERIC Educational Resources Information Center

    Jones, Robin M. N.; Hays, Nancy Scheller

    2016-01-01

    Ronald E. Hays is the former Director of the Hahnemann Creative Arts in Therapy Department at Drexel University in Philadelphia, Pennsylvania, and the cofounder of the graduate art therapy program at Eastern Virginia Medical School in Norfolk, Virginia. At the age of 62 he was diagnosed with early onset Alzheimer's disease, a form of dementia. In…

  3. Effect of Art Production on Negative Mood and Anxiety for Adults in Treatment for Substance Abuse

    ERIC Educational Resources Information Center

    Laurer, Mattye; van der Vennet, Renée

    2015-01-01

    This study investigated whether art production or viewing and sorting art reproductions would be more effective in reducing negative mood and anxiety for 28 adults with substance use disorders. Participants were randomly assigned to one of two groups and completed pre- and posttest measures of negative mood and anxiety The hypothesis that art…

  4. Effect of Art Production on Negative Mood and Anxiety for Adults in Treatment for Substance Abuse

    ERIC Educational Resources Information Center

    Laurer, Mattye; van der Vennet, Renée

    2015-01-01

    This study investigated whether art production or viewing and sorting art reproductions would be more effective in reducing negative mood and anxiety for 28 adults with substance use disorders. Participants were randomly assigned to one of two groups and completed pre- and posttest measures of negative mood and anxiety The hypothesis that art…

  5. Ron Hays: A Story of Art as Self Treatment for Alzheimer's Disease

    ERIC Educational Resources Information Center

    Jones, Robin M. N.; Hays, Nancy Scheller

    2016-01-01

    Ronald E. Hays is the former Director of the Hahnemann Creative Arts in Therapy Department at Drexel University in Philadelphia, Pennsylvania, and the cofounder of the graduate art therapy program at Eastern Virginia Medical School in Norfolk, Virginia. At the age of 62 he was diagnosed with early onset Alzheimer's disease, a form of dementia. In…

  6. Neuroprotection: the emerging concept of restorative neural stem cell biology for the treatment of neurodegenerative diseases.

    PubMed

    Carletti, Barbara; Piemonte, Fiorella; Rossi, Ferdinando

    2011-06-01

    During the past decades Neural Stem Cells have been considered as an alternative source of cells to replace lost neurons and NSC transplantation has been indicated as a promising treatment for neurodegenerative disorders. Nevertheless, the current understanding of NSC biology suggests that, far from being mere spare parts for cell replacement therapies, NSCs could play a key role in the pharmacology of neuroprotection and become protagonists of innovative treatments for neurodegenerative diseases. Here, we review this new emerging concept of NSC biology.

  7. MicroRNA-126 contributes to Niaspan treatment induced vascular restoration after diabetic retinopathy

    PubMed Central

    Wang, Yang; Yan, Hua

    2016-01-01

    Diabetic retinopathy (DR) is a serious microvascular complication of diabetes and a major cause of blindness in the developing world. Early diabetic retinopathy is characterized by a loss of pericytes and vascular endothelial cells, a breakdown of the blood–retinal barrier, vascular dysfunction and vascular-neuroinflammation. However, optimal treatment options and related mechanisms are still unclear. MicroRNA-126 (miR-126) plays a potential role in the pathogenesis in DR, which may regulate VEGF, Ang-1 and VCAM-1 expressions. This study investigated the therapeutic effects and mechanisms of Niaspan treatment of DR in diabetes (DM) rats. DM rats exhibits significantly decreased miR-126 and tight junction Claudin-5/Occludin/ZO-1 genes expression, and increased Blood retinal-barrier (BRB) breakdown, retinal apoptosis and VEGF/VEGFR, as well as VCAM-1/CD45 expressions in the retina compared to normal control group. Niaspan treatment significantly improved clinical and histopathological outcomes; decreased the expressions of VEGF/VEGFR, VCAM-1/CD45, apoptosis and BRB breakdown, significantly increased tight junction proteins and Ang-1/Tie-2 expressions, as well as increased retinal miR-126 expression compared to non-treatment diabetic rats. These data are the first to show that Niaspan treatment ameliorates DR through its repair vascular and inhibits inflammatory effects, and also suggest that the miR-126 pathway may contribute to Niaspan treatment induced benefit effects. PMID:27225425

  8. Restoring grassland savannas from degraded pinyon-juniper woodlands: effects of mechanical overstory reduction and slash treatment alternatives.

    PubMed

    Brockway, Dale G; Gatewood, Richard G; Paris, Randi B

    2002-02-01

    Although the distribution and structure of pinyon-juiper woodlands in the southwestern United States are thought to be the result of historic fluctuations in regional climatic conditions, more recent increases in the areal extent, tree density, soil erosion rates and loss of understory plant diversity are attributed to heavy grazing by domestic livestock and interruption of the natural fire regime. Prior to 1850, many areas currently occupied by high-density pinyon-juniper woodlands, with their degraded soils and depauperate understories, were very likely savannas dominated by native grasses and forbs and containing sparse tree cover scattered across the landscape. The purpose of this study was to evaluate the effectiveness of mechanical overstory reduction and three slash treatment alternatives (removal, clustering and scattering) followed by prescribed fire as techniques for restoring grassland savannas from degraded woodlands. Plant cover, diversity, biomass and nutrient status, litter cover and soil chemistry and erosion rates were measured prior to and for two years following experimental treatment in a degraded pinyon-juniper woodland in central New Mexico. Treatment resulted in a significant increase in the cover of native grasses and, to a lesser degree, forbs and shrubs. Plant species richness and diversity increased most on sites where slash was either completely removed or scattered to serve as a mulch. Although no changes in soil chemistry or plant nutrient status were observed, understory biomass increased over 200% for all harvest treatments and was significantly greater than controls. While treatment increased litter cover and decreased soil exposure, this improvement did not significantly affect soil loss rates. Even though all slash treatment alternatives increased the cover and biomass of native grasses, scattering slash across the site to serve as a mulch appears most beneficial to improving plant species diversity and conserving site resources.

  9. An application of baseflow isolation and passive wetland treatment to watershed restoration

    SciTech Connect

    Hoover, K.L.; Rightnour, T.A.; Zug, F.R. III

    1999-07-01

    The project site, located in West Virginia, is a reclaimed wood waste disposal area situated on Pennsylvanian coal strata. Following reclamation of the disposal area, flow in the adjacent stream was observed to have elevated iron and manganese concentrations. The source of the groundwater baseflow entering this portion of the stream appeared to be hydrologically related to the landfill by its close proximity. The source of the metals contamination was not determined, but may be related to percolation from the disposal area into the underlying coal strata. The observable contamination was typical of alkaline coal mine drainage and met the criteria for passive wetland treatment. However, the contaminated baseflow entered the stream along the sides and bottom of the channel at several locations over a 100-meter section and could not be collected for accurate characterization of pollutant loading. Treatment of the entire contaminated stream flow to comply with NPDES permit requirements would have been prohibitively expensive, and insufficient space was available for a treatment facility of adequate size within the narrow stream valley. Given these constraints, it was decided to isolate the contaminated baseflow from the surface flow by construction of a lined stream relocation on top of a gravity-drained collection zone in the existing stream channel. The collection zone consists of a bed of coarse aggregate with a central collection pipe discharging to a submerged outlet, which prevents air from entering the collection zone and minimizes the formation of iron precipitates. The relocated stream channel was formed in place on top of the collection zone with compacted earth, and lined with one layer of polypropylene geomembrane covered by two layers of geotextile. Gabion baskets were then placed on top of the liner for stream stabilization and shaping of the final channel. Accurate discharge characterization at the end of the collection pipe allowed the design of a

  10. Effect of Silver Diamine Fluoride and Potassium Iodide Treatment on Secondary Caries Prevention and Tooth Discolouration in Cervical Glass Ionomer Cement Restoration

    PubMed Central

    Zhao, Irene Shuping; Mei, May Lei; Burrow, Michael F.; Lo, Edward Chin-Man; Chu, Chun-Hung

    2017-01-01

    This study investigated the effect of silver diamine fluoride (SDF) and potassium iodide (KI) treatment on secondary caries prevention and tooth discolouration in glass ionomer cement (GIC) restoration. Cervical GIC restorations were done on 30 premolars with: Group 1, SDF + KI; Group 2, SDF (positive control); Group 3, no treatment (negative control). After cariogenic biofilm challenge, the demineralisation of dentine adjacent to the restoration was evaluated using micro-computed tomography (micro-CT) and Fourier transform infrared (FTIR) spectroscopy. The colour of dentine adjacent to the restoration was assessed using CIELAB system at different time points. Total colour change (∆E) was calculated and was visible if ∆E > 3.7. Micro-CT showed the outer lesion depths for Groups 1, 2 and 3 were 91 ± 7 µm, 80 ± 7 µm and 119 ± 8 µm, respectively (p < 0.001; Group 2 < Group 1 < Group 3). FTIR found that there was a significant difference in amide I-to-hydrogen phosphate ratio among the three groups (p < 0.001; Group 2 < Group 1 < Group 3). ∆E of Groups 1, 2 and 3 after biofilm challenge were 22.5 ± 4.9, 70.2 ± 8.3 and 2.9 ± 0.9, respectively (p < 0.001; Group 3 < Group 1 < Group 2). SDF + KI treatment reduced secondary caries formation on GIC restoration, but it was not as effective as SDF treatment alone. Moreover, a perceptible staining on the restoration margin was observed, but the intensity of discolouration was less than that with solely SDF treatment. PMID:28178188

  11. Effect of Silver Diamine Fluoride and Potassium Iodide Treatment on Secondary Caries Prevention and Tooth Discolouration in Cervical Glass Ionomer Cement Restoration.

    PubMed

    Zhao, Irene Shuping; Mei, May Lei; Burrow, Michael F; Lo, Edward Chin-Man; Chu, Chun-Hung

    2017-02-06

    This study investigated the effect of silver diamine fluoride (SDF) and potassium iodide (KI) treatment on secondary caries prevention and tooth discolouration in glass ionomer cement (GIC) restoration. Cervical GIC restorations were done on 30 premolars with: Group 1, SDF + KI; Group 2, SDF (positive control); Group 3, no treatment (negative control). After cariogenic biofilm challenge, the demineralisation of dentine adjacent to the restoration was evaluated using micro-computed tomography (micro-CT) and Fourier transform infrared (FTIR) spectroscopy. The colour of dentine adjacent to the restoration was assessed using CIELAB system at different time points. Total colour change (∆E) was calculated and was visible if ∆E > 3.7. Micro-CT showed the outer lesion depths for Groups 1, 2 and 3 were 91 ± 7 µm, 80 ± 7 µm and 119 ± 8 µm, respectively (p < 0.001; Group 2 < Group 1 < Group 3). FTIR found that there was a significant difference in amide I-to-hydrogen phosphate ratio among the three groups (p < 0.001; Group 2 < Group 1 < Group 3). ∆E of Groups 1, 2 and 3 after biofilm challenge were 22.5 ± 4.9, 70.2 ± 8.3 and 2.9 ± 0.9, respectively (p < 0.001; Group 3 < Group 1 < Group 2). SDF + KI treatment reduced secondary caries formation on GIC restoration, but it was not as effective as SDF treatment alone. Moreover, a perceptible staining on the restoration margin was observed, but the intensity of discolouration was less than that with solely SDF treatment.

  12. Melatonin Treatment May Be Able to Restore Menstrual Cyclicity in Women With PCOS: A Pilot Study.

    PubMed

    Tagliaferri, Valeria; Romualdi, Daniela; Scarinci, Elisa; Cicco, Simona De; Florio, Christian Di; Immediata, Valentina; Tropea, Anna; Santarsiero, Carla Mariaflavia; Lanzone, Antonio; Apa, Rosanna

    2017-01-01

    The objective of the study was to investigate the effects of 6 months of melatonin administration on clinical, endocrine, and metabolic features of women affected by polycystic ovary syndrome (PCOS). This is a prospective cohort study including 40 normal-weight women with PCOS between January and September 2016, enrolled in an academic research environment. Ultrasonographic pelvic examinations, hirsutism score evaluation, hormonal profile assays, oral glucose tolerance test, and lipid profile at baseline and after 6 months of melatonin administration were performed. Melatonin treatment significantly decreased androgens levels (free androgen index: P < .05; testosterone: P < .01; 17 hydroxyprogesterone: P < .01). Follicle-stimulating hormone levels significantly raised ( P < .01), and anti-Mullerian hormone serum levels significantly dropped after 6 months of melatonin treatment ( P < .01). No significant changes occurred in glucoinsulinemic and lipid parameters after treatment except a significant decrease of low-density lipoprotein cholesterol. Almost 95% of participants experienced an amelioration of menstrual cycles. Until now, only few data have been published about the role of melatonin in women with PCOS. This is the first study focused on the effects of exogenous oral melatonin administration on the clinical, endocrine, and metabolic characteristics of patients with PCOS. After 6 months of treatment, melatonin seems to improve menstrual irregularities and biochemical hyperandrogenism in women with PCOS through a direct, insulin-independent effect on the ovary. Based on our results, melatonin could be considered a potential future therapeutic agent for women affected by PCOS.

  13. Evaluating forest product potential as part of planning ecological restoration treatments on forested landscapes

    Treesearch

    R. James Barbour; Ryan Singleton; Douglas A. Maguire

    2007-01-01

    As landscape-scale assessments and modeling become a more common method for evaluating alternatives in integrated resource management, new techniques are needed to display and evaluate outcomes for large numbers of stands over long periods. In this proof of concept, we evaluate the potential to provide financial support for silvicultural treatments by selling timber...

  14. Effect of water repellent preservatives and other wood treatments on restoration and durability of millwork

    Treesearch

    R. Sam Williams

    2001-01-01

    This report describes the long-term performance of painted window units that were placed outdoors near Madison, Wisconsin, in 1956. Covered in this report are the effects of the initial water repellent preservative (WRP) treatment during the first 6 years of exposure, a comparison of the water repellent effectiveness (WRE) ofthe WRP with the condition of the windows...

  15. Watershed Restoration Project

    SciTech Connect

    Julie Thompson; Betsy Macfarlan

    2007-09-27

    In 2003, the U.S. Department of Energy issued the Eastern Nevada Landscape Coalition (ENLC) funding to implement ecological restoration in Gleason Creek and Smith Valley Watersheds. This project was made possible by congressionally directed funding that was provided through the US Department of Energy, Energy Efficiency and Renewable Energy, Office of the Biomass Program. The Ely District Bureau of Land Management (Ely BLM) manages these watersheds and considers them priority areas within the Ely BLM district. These three entities collaborated to address the issues and concerns of Gleason Creek and Smith Valley and prepared a restoration plan to improve the watersheds’ ecological health and resiliency. The restoration process began with watershed-scale vegetation assessments and state and transition models to focus on restoration sites. Design and implementation of restoration treatments ensued and were completed in January 2007. This report describes the restoration process ENLC undertook from planning to implementation of two watersheds in semi-arid Eastern Nevada.

  16. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial

    PubMed Central

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-01-01

    Context: Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. Aims: To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. Settings and Design: A randomized clinical trial. Subjects and Methods: One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control — Restoration with total-etch technique and Experimental — Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). Statistical analysis used: The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. Results: After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). Conclusions: The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year. PMID:25298641

  17. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial.

    PubMed

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-09-01

    Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. A randomized clinical trial. One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control - Restoration with total-etch technique and Experimental - Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year.

  18. Effect of various treatment and glazing (coating) techniques on the roughness and wettability of ceramic dental restorative surfaces.

    PubMed

    Aksoy, G; Polat, H; Polat, M; Coskun, G

    2006-12-01

    Surface treatment procedures such as grinding and polishing are needed to provide the ceramic dental restorative materials with proper fitting and occlusion. The treated surfaces are customarily glazed to improve the strength and smoothness. Though smoothness and wetting of the dental surfaces are important to minimize bacterial plaque retention, influence of the surface treatment and glazing procedures on the final surface roughness and its correlation to wettability are overlooked. In this work, effect of various treatment (diamond fraising, stoning, sanding and aluminum oxide and rubber polishing) and glazing (auto and overglazing) techniques on the final roughness and the resulting wettability of dental ceramic surfaces were investigated using scanning electron microscopy (SEM) observations and atomic force microscopy (AFM) scans, 75 scans per sample. The surfaces were characterized and assigned an average roughness measure, R(a). The wettability of the same surfaces was evaluated using micro-contact angle measurements (25 micro-bubbles placed on a grid on each surface) to correlate the final surface roughness and wettability. The results show that overglazing prevails over surface irregularities from different treatment procedures and provides homegeneously smooth surfaces with mean R(a)<10 nm. It also produces uniformly wetted surfaces with low contact angles around 20 degrees . The autoglazed surfaces are less smooth (mean R(a) around 50 nm) and displays sporadic topographic irregularities. They display larger and less uniform contact angles ranging between 35 degrees and 50 degrees . The results suggest that overglazing should be preferred after surface treatment to obtain a smooth and well-wetted dental ceramic surface.

  19. Evidence and implications of the background phosphorus concentration of submerged aquatic vegetation wetlands in Stormwater Treatment Areas for Everglades restoration

    NASA Astrophysics Data System (ADS)

    Juston, John M.; Debusk, Thomas A.

    2011-01-01

    The limits of phosphorus (P) removal from the 18,120 ha Stormwater Treatment Areas (STAs) for Everglades restoration depend largely on the performance of submerged aquatic vegetation (SAV) wetlands, as SAV treatment cells now provide final stage treatment for 85% of the STA project. A long-term internal P profile in STA-2 cell 3 (STA2C3), one of the longest-running and best performing SAV cells, demonstrated no further net removal in the back quarter of the cell once total P (TP) levels approached 15 μg L-1. Inflow-outflow performance data from STA2C3 were analyzed at monthly and annual scales and were pooled with data from an additional eight STA SAV treatment cells. The pooled data allowed inference of background TP concentrations in SAV treatment cells using existing Bayesian methods. Results showed a central tendency of 16 μg L-1 (13-17, 90% bounds), insensitivity to P loads less than ˜1.7 g m-2 yr-1, and interannual variability outside these bounds. Internal data from the STA2C3 profile provided validation. Background P concentrations of 7 and 6 μg L-1 were identified for dissolved organic and particulate P fractions in the data pool, respectively, again similar to values in the STA2C3 gradient. Existing simulation modeling approaches for STA evaluations were identified as ineffective at or near background TP concentrations. Instead, we use an empirical and probabilistic approach based on full-scale data from STAs that produces annual risk of exceedance statistics and is easy to update. The current analysis suggests tangible risks for exceeding proposed annual discharge criteria from the STAs in the range of 16-20 μg L-1.

  20. The Efficacy of Noncontingent Escape for Decreasing Children's Disruptive Behavior During Restorative Dental Treatment

    PubMed Central

    O'Callaghan, Patrick M; Allen, Keith D; Powell, Shawn; Salama, Fouad

    2006-01-01

    We evaluated the effectiveness of a dentist-implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed-time schedule. The intervals were signaled by an electronic timer worn by the dentist. Clinically significant reductions were observed in physically disruptive behavior across all 5 children with the introduction of noncontingent escape, and verbally disruptive behavior was markedly reduced in 4 of the 5 children. In addition, the dental staff's use of physical restraint was reduced to near zero across all 5 children. The research extends the literature in both clinical dentistry and in applied behavior analysis by demonstrating that a dentist can easily and effectively implement noncontingent reinforcement to produce clinically significant and socially important changes in children's health behavior. PMID:16813038

  1. The efficacy of noncontingent escape for decreasing children's disruptive behavior during restorative dental treatment.

    PubMed

    O'Callaghan, Patrick M; Allen, Keith D; Powell, Shawn; Salama, Fouad

    2006-01-01

    We evaluated the effectiveness of a dentist-implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed-time schedule. The intervals were signaled by an electronic timer worn by the dentist. Clinically significant reductions were observed in physically disruptive behavior across all 5 children with the introduction of noncontingent escape, and verbally disruptive behavior was markedly reduced in 4 of the 5 children. In addition, the dental staff s use of physical restraint was reduced to near zero across all 5 children. The research extends the literature in both clinical dentistry and in applied behavior analysis by demonstrating that a dentist can easily and effectively implement noncontingent reinforcement to produce clinically significant and socially important changes in children's health behavior.

  2. Biologic outcome of implant-supported restorations in the treatment of partial edentulism. Part 2: a longitudinal radiographic study.

    PubMed

    Naert, Ignace; Koutsikakis, George; Quirynen, Marc; Duyck, Joke; van Steenberghe, Daniel; Jacobs, Reinhilde

    2002-08-01

    The purpose of this study was to evaluate over time the marginal bone level changes around implants installed to treat partial edentulism and to investigate the possible effect of several confounding variables. Consecutive intraoral radiographs taken with the paralleling technique were used. In all, 660 partially edentulous patients ever treated in the departments (248 males; 15-83 years of age) with 1655 implants, which were successfully integrated at abutment connection, were loaded by means of fixed partial prostheses. The observation period starting at abutment connection reached 16 years (mean 5.1). Implants were divided into three groups: 235 implants supported single-tooth crowns, 398 supported implant-tooth connected and 1022 free-standing fixed partial prostheses. Implants were placed in maxilla and mandible, both anteriorly and posteriorly. No significant difference in bone level evolution was predicted between the three groups of implants, either for posterior or for anterior sites. The estimated marginal bone loss for the first 6 months is 0.31 mm/year and after that 0.015 mm/year higher in the maxilla than in the mandible. More bone loss was predicted for the first 6 months when dehiscences existed, when a membrane or a bone graft were used, or when metal/ceramic prosthesis material was applied. Age and gender did not affect the change in bone level. The use of subsequently situated single-implant crowns to restore an edentulous space did not lead to more marginal bone loss than around splinted implants. Based on marginal bone height maintenance, the excellent prognosis of the presently used implants to support restorations in the treatment of partial edentulism was confirmed.

  3. [Use of diagnostic templates at stages of prosthetics treatment with implant-retained restorations].

    PubMed

    Gvetadze, R Sh; Abramian, S V; Ivanov, A A; Nubarian, A P

    2015-01-01

    The comparative analysis of efficiency of various types of diagnostic templates for planning orthopedic treatment of 50 patients with partial or complete absence of teeth was performed. The patients were divided in 3 groups according to template manufacturing technique. All diagnostic templates made in accordance with clinical conditions allowed transfering digital data of the scheduled prosthetic construction for virtual implantation planning. Advantages and pitfalls of each template type are discussed.

  4. Restored vision in a young dog following corticosteroid treatment of presumptive hypophysitis.

    PubMed

    Rzechorzek, Nina Marie; Liuti, Tiziana; Stalin, Catherine; Marioni-Henry, Katia

    2017-02-28

    Hypophysitis is an umbrella term for a group of disorders involving inflammation of the pituitary gland. A rare occurrence in humans, hypophysitis can produce a range of clinical signs including (but not limited to) visual deficits and diabetes insipidus. Only five cases of canine hypophysitis exist in the literature, all presenting in mature dogs with no visual deficits and a grave outcome. This case report describes the clinical and advanced imaging features of blindness-inducing presumptive hypophysitis in a dog, which rapidly resolved with medical management. A 1-year-and-seven-month-old neutered male Standard Poodle presented with subacute blindness, ataxia, and polyuria/polydipsia (PUPD). Magnetic resonance imaging (MRI) detected a contrast-enhancing pituitary mass with perilesional oedema compromising the optic chiasm. Suspecting neoplasia, anti-inflammatory corticosteroid was commenced prior to radiation therapy planning. Complete resolution of neurological and visual deficits occurred within 12 days of starting steroid treatment. Repeated advanced imaging indicated macroscopic resolution of the lesion. An extended thyroid panel with insulin-like growth factor-1 analysis supported a diagnosis of hypophysitis. Resolution of PUPD was achieved with tapering courses of prednisolone and desmopressin; the dog has since been clinically normal for 14 months and treatment-free for 11 months. To the authors' knowledge, this is the first instance in which a canine pituitary mass has demonstrated long-term resolution with palliative medical treatment alone, alongside reversal of associated blindness and presumptive diabetes insipidus. We suspect this lesion to be a form of hypophysitis, which should be included among differential diagnoses for pituitary masses, and for subacute blindness in dogs. Where possible, we advocate biopsy-confirmation of hypophysitis prior to timely intervention with anti-inflammatory treatment.

  5. Diagnosis and Treatment of Diminished Ovarian Reserve in ART Cycles of Women Up to Age 40 Years: The Role of Insurance Mandates

    PubMed Central

    Butts, Samantha F.; Ratcliffe, Sarah; Dokras, Anuja; Seifer, David B.

    2012-01-01

    Summary Objective To explore correlates of diminished ovarian reserve (DOR) and predictors of ART treatment outcome in DOR cycles using the SART-CORS database. We hypothesized that state insurance coverage for ART is associated with the prevalence of DOR diagnosis in ART cycles and with treatment outcomes in DOR cycles. Design Cross sectional study using ART cycles between 2004–2007. Setting United States ART registry data. Patients 182,779 fresh, non-donor, initial ART cycles in women up to age 40. Interventions None. Main Outcome Measures Prevalence of DOR and elevated FSH, odds ratio of DOR and elevated FSH in ART mandated vs. non-mandated states, live birth rates. Results Compared to cycles performed in states with mandated ART coverage, cycles in states with no ART mandate were more likely to have DOR (AOR 1.43 95% CI 1.37–1.5, p<0.0001) or elevated FSH (AOR 1.69 95% CI 1.56–1.85, p<0.0001) as the sole reason for treatment. A relationship between lack of mandated ART coverage and increased live birth rates in some, but not all DOR cycles. Conclusions A significant association was observed between lack of mandated insurance for ART and the proportion of cycles treating DOR or elevated FSH. The presence or absence of state mandated ART coverage could impact access to care and the mix of patients that pursue and initiate ART cycles. Additional studies are needed that consider the coalescence of insurance mandates, patient and provider factors, and state level variables on the odds of specific infertility diagnoses and treatment prognosis. PMID:23102859

  6. Transferring ART research into education in Brazil

    PubMed Central

    NAVARRO, Maria Fidela de Lima; MODENA, Karin Cristina da Silva; FREITAS, Maria Cristina Carvalho de Almendra; FAGUNDES, Ticiane Cestari

    2009-01-01

    ABSTRACT The aim of this study was to evaluate the teaching of the Atraumatic Restorative Treatment (ART) approach in Brazilian dental schools. Materials and Methods: A questionnaire on this subject was sent to Pediatric Dentistry, Operative Dentistry and Public Health Dentistry professors. The questions approached the followig subjects: the method used to teach ART, the time spent on its teaching, under which discipline it is taught, for how many years ART has been taught and its effect on the DMFT index. Results: A total of 70 out of 202 dental schools returned the questionnaire. The ART approach is taught in the majority of the Brazilian dental schools (96.3%), and in most of these schools it is taught both in theory and in clinical practice (62.9%). The majority (35.3%) of professors teach ART for 8 hours, and most often as part of the Pediatric Dentistry discipline (67.6%). It has been taught for the last 7 to 10 years in 34.3% of dental schools. Most professors did not observe a change in the DMFT index with this approach. There is a diversity in the teaching of ART in Brazil in terms of the number of hours spent, the teaching method (theory and practice), and the disciplines involved in its teaching. Conclusions: It is necessary to address the training of professors in the ART approach for the whole country. An educational model is proposed whereby a standard ART module features as part of other preventive and restorative caries care educational modules. This will facilitate and standardize the introduction and adoption of the ART approach in undergraduate education in Brazil. PMID:21499663

  7. Transferring ART research into education in Brazil.

    PubMed

    Navarro, Maria Fidela de Lima; Modena, Karin Cristina da Silva; Freitas, Maria Cristina Carvalho de Almendra; Fagundes, Ticiane Cestari

    2009-01-01

    The aim of this study was to evaluate the teaching of the Atraumatic Restorative Treatment (ART) approach in Brazilian dental schools. A questionnaire on this subject was sent to Pediatric Dentistry, Operative Dentistry and Public Health Dentistry professors. The questions approached the following subjects: the method used to teach ART, the time spent on its teaching, under which discipline it is taught, for how many years ART has been taught and its effect on the DMFT index. A total of 70 out of 202 dental schools returned the questionnaire. The ART approach is taught in the majority of the Brazilian dental schools (96.3%), and in most of these schools it is taught both in theory and in clinical practice (62.9%). The majority (35.3%) of professors teach ART for 8 hours, and most often as part of the Pediatric Dentistry discipline (67.6%). It has been taught for the last 7 to 10 years in 34.3% of dental schools. Most professors did not observe a change in the DMFT index with this approach. There is a diversity in the teaching of ART in Brazil in terms of the number of hours spent, the teaching method (theory and practice), and the disciplines involved in its teaching. It is necessary to address the training of professors in the ART approach for the whole country. An educational model is proposed whereby a standard ART module features as part of other preventive and restorative caries care educational modules. This will facilitate and standardize the introduction and adoption of the ART approach in undergraduate education in Brazil.

  8. Implementation of the ART approach in South Africa: an activity report.

    PubMed

    Mickenautsch, S; Rudolph, M J

    2001-07-01

    The Atraumatic Restorative Treatment (ART) approach has been adopted in public dental services in South Africa as an appropriate and economical means to provide basic restorative care in communities where it was not possible before. The approach also offers a less-traumatic treatment concept for fearful patients and children in the private dental practice. In 2000, the Division of Community Dentistry, University of the Witwatersrand, implemented a training, research and service programme in the ART approach. The aim of these activities was the promotion of ART at various levels within the oral health care system in the Republic of South Africa. The objectives of the programme were to initiate and provide training of oral health workers in ART, to evaluate the outcome of training and service programmes and to disseminate results. This paper describes the Division's ART activities in 2000, regarding public, private and refugee health services.

  9. Treatment with Salvianolic Acid B restores endothelial function in angiotensin II-induced hypertensive mice.

    PubMed

    Ling, Wei Chih; Liu, Jian; Lau, Chi Wai; Murugan, Dharmani Devi; Mustafa, Mohd Rais; Huang, Yu

    2017-04-07

    Salvianolic acid B (Sal B) is one of the most abundant phenolic acids derived from the root of Danshen with potent anti-oxidative properties. The present study examined the vasoprotective effect of Sal B in hypertensive mice induced by angiotensin II (Ang II). Sal B (25 mg/kg/day) was administered via oral gavage for 11 days to Ang II (1.2 mg/kg/day)-infused C57BL/6J mice (8-10 weeks old). The vascular reactivity (both endothelium-dependent relaxations and contractions) in mouse arteries was examined by wire myography. The production of reactive oxygen species (ROS), protein level and localization of angiotensin AT1 receptors and the proteins involved in ROS formation were evaluated using dihydroethidium (DHE) fluorescence, lucigenin-enhanced chemiluminescence, immunohistochemistry and Western blotting, respectively. The changes of ROS generating proteins were also assessed in vitro in human umbilical vein endothelial cells (HUVECs) exposed to Ang II with and without co-treatment with Sal B (0.1 - 10 nM). Oral administration of Sal B reversed the Ang II-induced elevation of arterial systolic blood pressure in mice, augmented the impaired endothelium-dependent relaxations and attenuated the exaggerated endothelium-dependent contractions in both aortas and renal arteries of Ang II-infused mice. In addition, Sal B treatment normalized the elevated levels of AT1 receptors, NADPH oxidase subunits (NOx-2 and NOx-4) and nitrotyrosine in arteries of Ang II-infused mice or in Ang II-treated HUVECs. In summary, the present study provided additional evidence demonstrating that Sal B treatment for 11 days reverses the impaired endothelial function and with a marked inhibition of AT1 receptor-dependent vascular oxidative stress. This vasoprotective and anti-oxidative action of Sal B most likely contributes to the anti-hypertensive action of the plant-derived compound.

  10. Restoration of axon conduction and motor deficits by therapeutic treatment with glatiramer acetate.

    PubMed

    Moore, Spencer; Khalaj, Anna J; Patel, Rhusheet; Yoon, JaeHee; Ichwan, Daniel; Hayardeny, Liat; Tiwari-Woodruff, Seema K

    2014-12-01

    Glatiramer acetate (GA; Copaxone) is an approved drug for the treatment of multiple sclerosis (MS). The underlying multifactorial anti-inflammatory, neuroprotective effect of GA is in the induction of reactive T cells that release immunomodulatory cytokines and neurotrophic factors at the injury site. These GA-induced cytokines and growth factors may have a direct effect on axon function. Building on previous findings that suggest a neuroprotective effect of GA, we assessed the therapeutic effects of GA on brain and spinal cord pathology and functional correlates using the chronic experimental autoimmune encephalomyelitis (EAE) mouse model of MS. Therapeutic regimens were utilized based on promising prophylactic efficacy. More specifically, C57BL/6 mice were treated with 2 mg/mouse/day GA for 8 days beginning at various time points after EAE post-induction day 15, yielding a thorough, clinically relevant assessment of GA efficacy within the context of severe progressive disease. Therapeutic treatment with GA significantly decreased clinical scores and improved rotorod motor performance in EAE mice. These functional improvements were supported by an increase in myelinated axons and fewer amyloid precursor protein-positive axons in the spinal cords of GA-treated EAE mice. Furthermore, therapeutic GA decreased microglia/macrophage and T cell infiltrates and increased oligodendrocyte numbers in both the spinal cord and corpus callosum of EAE mice. Finally, GA improved callosal axon conduction and nodal protein organization in EAE. Our results demonstrate that therapeutic GA treatment has significant beneficial effects in a chronic mouse model of MS, in which its positive effects on both myelinated and non-myelinated axons results in improved axon function. © 2014 Wiley Periodicals, Inc.

  11. Restoration of Axon Conduction and Motor Deficits by Therapeutic Treatment with Glatiramer Acetate

    PubMed Central

    Moore, Spencer; Khalaj, Anna J; Patel, Rhusheet; Yoon, JaeHee; Ichwan, Daniel; Hayardeny, Liat; Tiwari-Woodruff, Seema K

    2014-01-01

    Glatiramer acetate (GA; Copaxone) is an approved drug for the treatment of multiple sclerosis (MS). The underlying multifactorial anti-inflammatory, neuroprotective effect of GA is in the induction of reactive T cells that release immunomodulatory cytokines and neurotrophic factors at the injury site. These GA-induced cytokines and growth factors may have a direct effect on axon function. Building on previous findings that suggest a neuroprotective effect of GA, we assessed the therapeutic effects of GA on brain and spinal cord pathology and functional correlates using the chronic experimental autoimmune encephalomyelitis (EAE) mouse model of MS. Therapeutic regimens were utilized based on promising prophylactic efficacy. More specifically, C57BL/6 mice were treated with 2 mg/mouse/day GA for 8 days beginning at various time points after EAE post-induction day 15, yielding a thorough, clinically relevant assessment of GA efficacy within the context of severe progressive disease. Therapeutic treatment with GA significantly decreased clinical scores and improved rotorod motor performance in EAE mice. These functional improvements were supported by an increase in myelinated axons and fewer amyloid precursor protein-positive axons in the spinal cords of GA-treated EAE mice. Furthermore, therapeutic GA decreased microglia/macrophage and T cell infiltrates and increased oligodendrocyte numbers in both the spinal cord and corpus callosum of EAE mice. Finally, GA improved callosal axon conduction and nodal protein organization in EAE. Our results demonstrate that therapeutic GA treatment has significant beneficial effects in a chronic mouse model of MS, in which its positive effects on both myelinated and non-myelinated axons results in improved axon function. © 2014 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc. PMID:24989965

  12. Regulated recycling of mutant CFTR is partially restored by pharmacological treatment

    PubMed Central

    Holleran, John P.; Zeng, Jianxin; Frizzell, Raymond A.; Watkins, Simon C.

    2013-01-01

    Summary Efficient trafficking of the cystic fibrosis transmembrane conductance regulator (CFTR) to and from the cell surface is essential for maintaining channel density at the plasma membrane (PM) and ensuring proper physiological activity. The most common mutation, F508del, exhibits reduced surface expression and impaired function despite treatment with currently available pharmacological small molecules, called correctors. To gain more detailed insight into whether CFTR enters compartments that allow corrector stabilization in the cell periphery, we investigated the peripheral trafficking itineraries and kinetics of wild type (WT) and F508del in living cells using high-speed fluorescence microscopy together with fluorogen activating protein detection. We directly visualized internalization and accumulation of CFTR WT from the PM to a perinuclear compartment that colocalized with the endosomal recycling compartment (ERC) markers Rab11 and EHD1, reaching steady-state distribution by 25 minutes. Stimulation by protein kinase A (PKA) depleted this intracellular pool and redistributed CFTR channels to the cell surface, elicited by reduced endocytosis and active translocation to the PM. Corrector or temperature rescue of F508del also resulted in targeting to the ERC and exhibited subsequent PKA-stimulated trafficking to the PM. Corrector treatment (24 hours) led to persistent residence of F508del in the ERC, while thermally destabilized F508del was targeted to lysosomal compartments by 3 hours. Acute addition of individual correctors, C4 or C18, acted on peripheral trafficking steps to partially block lysosomal targeting of thermally destabilized F508del. Taken together, corrector treatment redirects F508del trafficking from a degradative pathway to a regulated recycling route, and proteins that mediate this process become potential targets for improving the efficacy of current and future correctors. PMID:23572510

  13. Restoration of cardiomyocyte function in streptozotocin-induced diabetic rats after treatment with vanadate in a tea decoction.

    PubMed

    Clark, Tod A; Maddaford, Thane G; Tappia, Paramjit S; Heyliger, Clayton E; Ganguly, Pallab K; Pierce, Grant N

    2010-12-01

    Diabetes mellitus is associated with abnormal cardiomyocyte Ca(2+) transients and contractile performance. We investigated the possibility that an alteration in inositol trisphosphate/phospholipase C (IP₃/PLC) signalling may be involved in this dysfunction. Phosphatidic acid stimulates cardiomyocyte contraction through an IP₃/PLC signaling cascade. We also tested a novel therapeutic intervention to assess its efficacy in reversing any potential defects. Diabetes was induced in Sprague-Dawley rats by streptozotocin treatment and maintained for an 8 week experimental period. Active cell shortening was significantly depressed in cardiomyocytes obtained from diabetic and insulin-treated diabetic rats in comparison to normal control animals. Perfusion of the cells with phosphatidic acid induced an increase in contraction of control rat cardiomyocytes whereas its effect was inhibitory in cells from streptozotocin-induced diabetic rats. Diabetic rats were also treated orally with vanadate administered in a black tea extract (T/V) for the 8 week period. T/V treatment resulted in a contractile response that was not different from cells of control animals. Furthermore, cardiomyocytes from T/V-treated animals exhibited significantly improved Ca(2+) transients in comparison to diabetic animals and exhibited a normalized response to phosphatidic acid perfusion. It is concluded that a T/V glycemic therapy is capable of preventing the defect in IP₃/PLC signaling that occurs in diabetes and can restore normal cardiac contractile function.

  14. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    PubMed Central

    Lanius, Ruth A.; Frewen, Paul A.; Tursich, Mischa; Jetly, Rakesh; McKinnon, Margaret C.

    2015-01-01

    Background Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD). Objective 1) To describe three main large-scale networks of the human brain; 2) to discuss the functioning of these neural networks in PTSD and related symptoms; and 3) to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method Literature relevant to this commentary was reviewed. Results Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network), increased and decreased arousal/interoception (salience network), and an altered sense of self (default mode network). Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms. PMID:25854674

  15. Conceptual Site Treatment Plan Laboratory for Energy-Related Health Research Environmental Restoration Project

    SciTech Connect

    Chapman, T.E.

    1993-10-01

    The Federal Facilities Compliance Act (the Act) of 1992 waives sovereign immunity for federal facilities for fines and penalties under the provisions of the Resource Recovery and Conservation Act, state, interstate, and local hazardous and solid waste management requirements. However, for three years the Act delays the waiver for violations involving US Department of Energy (DOE) facilities. The Act, however, requires that the DOE prepare a Conceptual Site Treatment Plan (CSTP) for each of its sites that generate or store mixed wastes (MWs). The purpose of the CSTP is to present DOE`s preliminary evaluations of the development of treatment capacities and technologies for treating a site`s MW. This CSTP presents the preliminary capacity and technology evaluation for the Laboratory for Energy-Related Health Research (LEHR). The five identified MW streams at LEHR are evaluated to the extent possible given available information. Only one MW stream is sufficiently well defined to permit a technology evaluation to be performed. Two other MW streams are in the process of being characterized so that an evaluation can be performed. The other two MW streams will be generated by the decommissioning of inactive facilities onsite within the next five years.

  16. A new separation and treatment method for soil and groundwater restoration

    SciTech Connect

    Hitchens, G.D.

    1997-10-01

    Soil and groundwater contamination by organic compounds is a widespread environmental pollution problem. In many cases, contaminated soil is excavated and transported to a landfill or is incinerated to remove contaminants. These remediation practices are expensive, environmentally disruptive, require extensive permitting, and only move contamination from one location to another. Onsite and in situ treatment techniques offer a safer, more cost-effective, and permanent solution. Many soil and groundwater contaminants are highly volatile, enabling the use of methods such as in situ vacuum extraction and air injection for their removal. However, these methods are often difficult to use because of slow volatilization rates and the lack of effective methods to treat the extracted hazardous material. This Phase I Small Business Innovation Research program focuses on developing an in situ soil and groundwater remediation technique that is effective against volatile as well as nonvolatile compounds and that will shorten treatment times. The technique forms the basis of a new catalytic process to degrade extracted contaminants onsite. Key hardware elements on which the new technique is based have been proven in preliminary research. The method has a high potential for public and regulatory acceptance because of its low environment impact.

  17. Group art therapy as an adjunctive treatment for people with schizophrenia: a randomised controlled trial (MATISSE).

    PubMed

    Crawford, M J; Killaspy, H; Barnes, T R; Barrett, B; Byford, S; Clayton, K; Dinsmore, J; Floyd, S; Hoadley, A; Johnson, T; Kalaitzaki, E; King, M; Leurent, B; Maratos, A; O'Neill, F A; Osborn, D; Patterson, S; Soteriou, T; Tyrer, P; Waller, D

    2012-01-01

    To examine the clinical effectiveness and cost-effectiveness of referral to group art therapy plus standard care, compared with referral to an activity group plus standard care and standard care alone, among people with schizophrenia. A three-arm, parallel group, single-blind, pragmatic, randomised controlled trial. Participants were randomised via an independent and remote telephone randomisation service using permuted blocks, stratified by study centre. Study participants were recruited from secondary care mental health and social services in four UK centres. Potential participants were aged 18 years or over, had a clinical diagnosis of schizophrenia, confirmed by an examination of case notes, and provided written informed consent. We excluded those who were unable to speak sufficient English to complete the baseline assessment, those with severe cognitive impairment and those already receiving arts therapy. Group art therapy was delivered by registered art therapists according to nationally agreed standards. Groups had up to eight members, lasted for 90 minutes and ran for 12 months. Members were given access to a range of art materials and encouraged to use these to express themselves freely. Activity groups were designed to control for the non-specific effects of group art therapy. Group facilitators offered various activities and encouraged participants to collectively select those they wanted to pursue. Standard care involved follow-up from secondary care mental health services and the option of referral to other services, except arts therapies, as required. Our co-primary outcomes were global functioning (measured using the Global Assessment of Functioning Scale - GAF) and mental health symptoms (measured using the Positive and Negative Syndrome Scale - PANSS) at 24 months. The main secondary outcomes were level of group attendance, social functioning, well-being, health-related quality of life, service utilisation and other costs measured 12 and 24 months

  18. Roads impact the distribution of noxious weeds more than restoration treatments in a lodgepole pine forest in Montana, U.S.A

    Treesearch

    Jennifer L. Birdsall; Ward McCaughey; Justin B. Runyon

    2012-01-01

    A century of fire suppression has created unnaturally dense stands in many western North American forests, and silviculture treatments are being increasingly used to reduce fuels to mitigate wildfire hazards and manage insect infestations. Thinning prescriptions have the potential to restore forests to a more historically sustainable state, but land managers need to be...

  19. Insulin Treatment Prevents Neuroinflammation and Neuronal Injury with Restored Neurobehavioral Function in Models of HIV/AIDS Neurodegeneration.

    PubMed

    Mamik, Manmeet K; Asahchop, Eugene L; Chan, Wing F; Zhu, Yu; Branton, William G; McKenzie, Brienne A; Cohen, Eric A; Power, Christopher

    2016-10-12

    infection in the brain with associated neuroinflammation is a potential pathogenic mechanism resulting in neuronal damage and death. We report that, in HIV-infected microglia cultures, insulin treatment led to reduced viral replication and inflammatory gene expression. In addition, intranasal insulin treatment of experimentally feline immunodeficiency virus-infected animals resulted in improved motor and memory performances. We show that insulin restored expression of the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ), which is suppressed by HIV-1 replication. Our findings indicate a unique function for insulin in improving neurological outcomes in lentiviral infections, implicating insulin as a therapeutic intervention for HAND. Copyright © 2016 the authors 0270-6474/16/3610683-13$15.00/0.

  20. Assessment of antiretroviral treatment (ART) care service provision in Tigray Region health centers, North Ethiopia.

    PubMed

    Tessema, Shewaye Belay; Adane, Mesafint Molla

    2015-09-10

    Client satisfaction is a vital component and main concern intertwined with strategic decisions in service provisions. To improve efficiency of services, eliciting the opinion of users about the available services and identifying factors associated with dissatisfaction is very critical. Thus, the main objective of this study was to assess the perceived levels of clients' satisfaction with health services at ART clinic level in health centres of Tigray Region in Ethiopia. Cross sectional study was conducted from May to June 2013 in Tigray Region ART clinics. A total of 714 ART care user were included in the study using both purposive and probability sampling technique. Data was collected by using structured questionnaire and the collected data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Crude and Adjusted logistic regression analyses were carried out to identify the associated factors underlying perceived levels of clients' overall satisfaction. Finally, the results were presented with table as well as odds ratio (OR) and 95% confidence interval (CI). A total of 714 study participants were enrolled in this study. An overall satisfaction level of 89.6% was reported by ART care service users. Higher scores of satisfaction of services provisions were reported for courtesy and respect (95.80%) followed by privacy (93.28%). On the other hand, respondents' dissatisfaction was rated 35.32% for toilet cleanliness followed by 26.19% for availability of additional drugs. As for overall satisfaction and associated factors, adjusted logistic regression analyses showed that marital status [AOR = 2.01 (95% CI: 1.11, 3.60)], educational status [AOR = 3.13 (95% CI: 1.15, 8.53)], travel distance to reach health centre [AOR = 3.59 (95% CI: 1.23, 10.50)], toilet cleanliness [AOR = 2.22 (95% CI :1.62, 6.32)], and ART drug availability [AOR = 2.60 (95% CI :1.18, 6.52)] were found to have influence on overall ART service

  1. Can ART treatment reduce long-term complications by reducing inflammation?

    PubMed Central

    Sandler, Netanya G.; Sereti, Irini

    2014-01-01

    Purpose of review Serious non-AIDS events or non-infectious complications of HIV infection far outnumber AIDS events in the current combination antiretroviral therapy (ART) era and are attributed to chronic inflammation. Thus, a better understanding of why inflammation persists on ART will assist in developing better therapeutic strategies, including optimal timing of ART initiation. Recent findings Markers of inflammation and coagulation, such as D-dimer, IL-6, C-reactive protein, soluble CD14, and soluble CD163, predict end-organ disease and mortality, whereas markers of T cell activation appear more predictive of CD4 T cell decline, AIDS events, or response to therapy. Initiating ART at high CD4 T cell counts can result in less inflammation as supported by studies in acute and early HIV infection, but antiretroviral drugs may differentially affect inflammatory pathways. Decreasing inflammation in HIV-uninfected subjects may decrease morbidity, but long-term outcomes studies in HIV-infected individuals are lacking. Summary Circulating biomarkers of inflammation are among the strongest predictors of non-AIDS outcomes in treated HIV infection. With additional investigation, they may serve in the future as specific end-organ disease surrogate endpoints and may help identify those patients at highest risk of non-AIDS events who may benefit from either early ART and/or potential adjuvant anti-inflammatory therapies. PMID:24247669

  2. River restoration

    NASA Astrophysics Data System (ADS)

    Wohl, Ellen; Angermeier, Paul L.; Bledsoe, Brian; Kondolf, G. Mathias; Macdonnell, Larry; Merritt, David M.; Palmer, Margaret A.; Poff, N. Leroy; Tarboton, David

    2005-10-01

    River restoration is at the forefront of applied hydrologic science. However, many river restoration projects are conducted with minimal scientific context. We propose two themes around which a research agenda to advance the scientific basis for river restoration can be built. First, because natural variability is an inherent feature of all river systems, we hypothesize that restoration of process is more likely to succeed than restoration aimed at a fixed end point. Second, because physical, chemical, and biological processes are interconnected in complex ways across watersheds and across timescales, we hypothesize that restoration projects are more likely to be successful in achieving goals if undertaken in the context of entire watersheds. To achieve restoration objectives, the science of river restoration must include (1) an explicit recognition of the known complexities and uncertainties, (2) continued development of a theoretical framework that enables us to identify generalities among river systems and to ask relevant questions, (3) enhancing the science and use of restoration monitoring by measuring the most effective set of variables at the correct scales of measurement, (4) linking science and implementation, and (5) developing methods of restoration that are effective within existing constraints. Key limitations to river restoration include a lack of scientific knowledge of watershed-scale process dynamics, institutional structures that are poorly suited to large-scale adaptive management, and a lack of political support to reestablish delivery of the ecosystem amenities lost through river degradation. This paper outlines an approach for addressing these shortcomings.

  3. Engineering approaches to ecosystem restoration

    SciTech Connect

    Hayes, D.F.

    1998-07-01

    This proceedings CD ROM contains 127 papers on developing and evaluating engineering approaches to wetlands and river restoration. The latest engineering developments are discussed, providing valuable insights to successful approaches for river restoration, wetlands restoration, watershed management, and constructed wetlands for stormwater and wastewater treatment. Potential solutions to a wide variety of ecosystem concerns in urban, suburban, and coastal environments are presented.

  4. "The Worst School I've Ever Been To:" Empirical Evaluations of a Restorative School and Treatment Milieu

    ERIC Educational Resources Information Center

    Mirsky, Laura; Wachtel, Ted

    2007-01-01

    While anecdotal reports have strongly supported restorative practices, there is a need to expand the evidence base through empirical studies of the efficacy of these interventions. This article highlights such emerging findings reported by Paul McCold of the Institute for Restorative Practices in collaboration with researchers from Temple…

  5. Role Development Applied to Art Therapy Treatment of an Artist Diagnosed with Schizophrenia

    ERIC Educational Resources Information Center

    Schindler, Victoria P.; Pletnick, Carol

    2006-01-01

    Role Development is a theory-based, individualized intervention developed for health care practitioners, including art therapists, to assist individuals diagnosed with schizophrenia to learn roles and their underlying task and interpersonal skills. The role of artist is particularly suited to this intervention. This paper describes the role…

  6. Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?

    PubMed

    Tobi, Patrick; George, Gavin; Schmidt, Elena; Renton, Adrian

    2008-12-01

    To investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. Exploratory interviews with health managers and senior clinical staff were used to identify locally relevant work environment indicators. A self-reported Likert scale questionnaire was administered to a randomly selected cohort of 269 health professionals at health facilities in KwaZulu Natal and Western Cape provinces of South Africa that included ART delivery sites. The cohort was disaggregated into ART and non-ART groups and differences between the two compared with Fisher's exact test and the non-parametric Mann-Whitney U-test. The ART sub-cohort reported: (i) a lighter workload (P = 0.013), (ii) higher level of staffing (P = 0.010), (iii) lower sickness absence (P = 0.032), (iv) higher overall job satisfaction (P = 0.010), (v) poorer physical state of their work premises (P = 0.003), and (vi) higher staff turnover (P = 0.036). Conclusion Scale-up affects the work environment in ways that influence workers' motivation both positively and negatively. A net negative balance is likely to drive staff out-migration, undermine the quality of care and compromise the capacity of the programme to achieve significant scale. As health workers are the most important element of the health system, a comprehensive and systematic understanding of scale-up impacts on their working conditions and motivation needs to be an integral part of any delivery strategy.

  7. The Fear-avoidance Components Scale (FACS): Responsiveness to Functional Restoration Treatment in a Chronic Musculoskeletal Pain Disorder (CMPD) Population.

    PubMed

    Neblett, Randy; Mayer, Tom G; Williams, Mark J; Asih, Sali; Cuesta-Vargas, Antonio I; Hartzell, Meredith M; Gatchel, Robert J

    2017-03-21

    To assess the clinical validity and factor structure of the Fear-Avoidance Components Scale (FACS), a new fear-avoidance (FA) measure. In this study, 426 chronic musculoskeletal pain disorder (CMPD) patients were admitted to a functional restoration program (FRP). They were categorized into five FACS severity levels, from Subclinical to Extreme, at admission, and again at discharge. Associations with objective lifting performance and other patient-reported psychosocial measures were determined at admission and discharge, and objective work outcomes for this predominantly disabled cohort, were assessed one-year later. Those patients in the Severe and Extreme FACS severity groups at admission were more likely to "drop out" of treatment than those in the lower severity groups (P=0.05). At both admission and discharge, the FACS severity groups were highly and inversely correlated with objective lifting performance and patient-reported FA-related psychosocial variables, including kinesiophobia, pain intensity, depressive symptoms, perceived disability, perceived injustice, and insomnia (Ps<0.001). All variables showed improvement at FRP discharge. Patients in the Extreme FACS severity group at discharge were less likely to return to, or retain, work one-year later (P≤0.02). The factor analysis identified a two-factor solution. Strong associations were found among FACS scores and other patient-reported psychosocial and objective lifting performance variables at both admission and discharge. High discharge FACS scores were associated with worse work outcomes one-year after discharge. The FACS appears to be a valid and clinically useful measure for predicting attendance, physical performance, distress and relevant work outcomes in FRP treatment of CMPD patients.

  8. Epigenetic alteration by DNA-demethylating treatment restores apoptotic response to glucocorticoids in dexamethasone-resistant human malignant lymphoid cells

    PubMed Central

    2014-01-01

    Background Glucocorticoids (GCs) are often included in the therapy of lymphoid malignancies because they kill several types of malignant lymphoid cells. GCs activate the glucocorticoid receptor (GR), to regulate a complex genetic network, culminating in apoptosis. Normal lymphoblasts and many lymphoid malignancies are sensitive to GC-driven apoptosis. Resistance to GCs can be a significant clinical problem, however, and correlates with resistance to several other major chemotherapeutic agents. Methods We analyzed the effect of treatment with the cytosine analogue 5 aza-2’ deoxycytidine (AZA) on GC resistance in two acute lymphoblastic leukemia (T or pre-T ALL) cell lines- CEM and Molt-4- and a (B-cell) myeloma cell line, RPMI 8226. Methods employed included tissue culture, flow cytometry, and assays for clonogenicity, cytosine extension, immunochemical identification of proteins, and gene transactivation. High throughput DNA sequencing was used to confirm DNA methylation status. Conclusions Treatment of these cells with AZA resulted in altered DNA methylation and restored GC-evoked apoptosis in all 3 cell lines. In CEM cells the altered epigenetic state resulted in site-specific phosphorylation of the GR, increased GR potency, and GC-driven induction of the GR from promoters that lie in CpG islands. In RPMI 8226 cells, expression of relevant coregulators of GR function was altered. Activation of p38 mitogen-activated protein kinase (MAPK), which is central to a feed-forward mechanism of site-specific GR phosphorylation and ultimately, apoptosis, occurred in all 3 cell lines. These data show that in certain malignant hematologic B- and T-cell types, epigenetically controlled GC resistance can be reversed by cell exposure to a compound that causes DNA demethylation. The results encourage studies of application to in vivo systems, looking towards eventual clinical applications. PMID:24795534

  9. Restoration of nerve growth factor in organs of mice injected with cobra venom followed by specific treatment and reversal period.

    PubMed

    Lipps, Binie V

    2002-05-01

    Research from this laboratory reported the decreased levels of endogenously present nerve growth factor (NGF) in organs of mice as a consequence of sub-lethal injection of Naja kaouthia venom. This research reports that the decreased levels of NGF in organs of mice were prevented by (1) specific treatment and (2) restored to normal by a prolonged period. Adult female Balb/c mice were injected intramuscularly (IM) with a sub-lethal dose of cobra venom. The injected mice were divided into five groups. Mice in group I were injected with PBS, group II with anti-cobra venom, and group III with lethal toxin neutralizing factor (LTNF). Mice in group IV were treated IM with synthetic LTNF (LT-10), and mice in group V were treated orally with LT-10. After 24 hr. mice were sacrificed and NGF levels in organ homogenates were assayed and compared with control mice not injected with venom. It was observed that the organs from group I treated with PBS showed a tremendous drop in NGF level in comparison to the organs of the control mice. It was further revealed that the decreased levels of NGF in organs of injected mice were prevented by treatment with anti-cobra venom, LTNF and LT-10 by IM, or oral routes. In the second series of experiments, mice injected with sub-lethal dose of cobra venom were sacrificed after 1, 3, 7, and 10 days, and the organs were assayed for NGF levels. It was observed that the recovery period for normal homeostasis of NGF was between 7 and 10 days in the brain, heart, liver, salivary glands, and ovaries.

  10. COMPARISON OF TWO MINIMALLY INVASIVE METHODS ON THE LONGEVITY OF GLASS IONOMER CEMENT RESTORATIONS: SHORT-TERM RESULTS OF A PILOT STUDY

    PubMed Central

    Barata, Terezinha Jesus Esteves; Bresciani, Eduardo; Mattos, Maria Cecília Ribeiro; Lauris, José Roberto Pereira; Ericson, Dan; Navarro, Maria Fidela de Lima

    2008-01-01

    The purpose of this study was to evaluate the clinical performance of glass ionomer cement (GIC) restorations comparing two minimally invasive methods in permanent teeth after 12 months. Fifty pregnant women (second trimester of pregnancy), mean age 22 ± 5.30 years, were treated by two previously trained operators. The treatment approaches tested were: chemomechanical method (CarisolvTM; MediTeam) and atraumatic restorative treatment (ART). A split-mouth study design was used in which the two treatments were randomly placed in 50 matched pairs of permanent teeth. The chemomechanical method (CM) was the test group and the ART was the control group. The treatments were performed in Public Health Centers. The tested restorative material was a high-strength GIC (Ketac Molar; 3M/ESPE). The restorations were placed according to the ART guidelines. Two calibrated independent examiners evaluated the restorations in accordance with ART criteria. The interexaminer kappa was 0.97. Data were analyzed using 95% confidence interval on the binomial distribution and Fisher's exact test at 5% significance level. In a 12-month follow-up, 86% of the restorations were evaluated. In the test group (CM), 100% (CI=93.3-100%) of the restorations were considered successful. In the control group (ART) 97.6% (CI=87.4-99.9%) of the restorations were considered successful and 2.4% unsuccessful (marginal defect >0.5 mm). There was no statistically significant difference between the 12-mounth success rate for both groups (Fisher's exact test: P=0.49) and between the two operators (Fisher's exact test: P=1.00). Both minimally invasive methods, chemomechanical method and ART, showed a similar clinical performance after 12 months of follow up. PMID:19089209

  11. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report

    PubMed Central

    Patel, Mit B; Bencharit, Sompop

    2009-01-01

    Treatment options for patients with severe attrition resulting in reduced occlusal vertical dimension are often limited to fixed prosthesis to reestablish proper occlusal vertical dimension and functional occlusion. In some cases such as when there are limited finances, minimal esthetic concerns, and medical considerations fixed prosthesis may not be the ideal treatment option. Overlay removable partial dentures (ORPDs) can be used as a provisional or interim prosthesis as well as permanent prosthesis in these cases. While ORPDs can provide a reversible and relatively inexpensive treatment for patients with a significantly compromised dental status, there is not much scientific evidence in the literature on ORPDs. Most studies published on ORPDs to date are primarily reviews and clinical reports. In this article, literatures on ORPDs are summarized and a patient treated with interim and permanent ORPDs is presented. This article reviews previously published literatures on the use of ORPDs. Indications, advantages and disadvantages are discussed. Treatment protocol with an example of the prosthodontic treatment of a patient with severely worn dentition with an interim ORPD and later a permanent ORPD are discussed in details. PMID:19915723

  12. Restricting Access to ART on the Basis of Criminal Record : An Ethical Analysis of a State-Enforced "Presumption Against Treatment" With Regard to Assisted Reproductive Technologies.

    PubMed

    Thompson, Kara; McDougall, Rosalind

    2015-09-01

    As assisted reproductive technologies (ART) become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection order, are given a "presumption against treatment." This article reviews the legislation and identifies arguments that may be used to justify restricting access to ART for various reasons. The arguments reviewed include limitations of reproductive rights, inheriting undesirable genetic traits, distributive justice, and the welfare of the future child. We show that none of these arguments justifies restricting access to ART in the context of past criminal history. We show that a "presumption against treatment" is an unjustified infringement on reproductive freedom and that it creates various inconsistencies in current social, medical, and legal policy. We argue that a state-enforced policy of restricting access to ART based on the non-medical factor of past criminal history is an example of unjust discrimination and cannot be ethically justified, with one important exception: in cases where ART treatment may be considered futile on the basis that the parents are not expected to raise the resulting child.

  13. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital.

    PubMed

    Gajić, Gordana Mandić

    2013-11-01

    The schizophrenics are frequently disinterested and resistant to standard care. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original "Synallactic collective image technique" (Vassiliou G, Vassiliou V.). The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) scales on admission with minimal improvement at discharge was rated. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  14. Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence

    PubMed Central

    Le Noury, Joanna; Nardo, John M; Healy, David; Raven, Melissa; Tufanaru, Catalin; Abi-Jaoude, Elia

    2015-01-01

    Objectives To reanalyse SmithKline Beecham’s Study 329 (published by Keller and colleagues in 2001), the primary objective of which was to compare the efficacy and safety of paroxetine and imipramine with placebo in the treatment of adolescents with unipolar major depression. The reanalysis under the restoring invisible and abandoned trials (RIAT) initiative was done to see whether access to and reanalysis of a full dataset from a randomised controlled trial would have clinically relevant implications for evidence based medicine. Design Double blind randomised placebo controlled trial. Setting 12 North American academic psychiatry centres, from 20 April 1994 to 15 February 1998. Participants 275 adolescents with major depression of at least eight weeks in duration. Exclusion criteria included a range of comorbid psychiatric and medical disorders and suicidality. Interventions Participants were randomised to eight weeks double blind treatment with paroxetine (20-40 mg), imipramine (200-300 mg), or placebo. Main outcome measures The prespecified primary efficacy variables were change from baseline to the end of the eight week acute treatment phase in total Hamilton depression scale (HAM-D) score and the proportion of responders (HAM-D score ≤8 or ≥50% reduction in baseline HAM-D) at acute endpoint. Prespecified secondary outcomes were changes from baseline to endpoint in depression items in K-SADS-L, clinical global impression, autonomous functioning checklist, self-perception profile, and sickness impact scale; predictors of response; and number of patients who relapse during the maintenance phase. Adverse experiences were to be compared primarily by using descriptive statistics. No coding dictionary was prespecified. Results The efficacy of paroxetine and imipramine was not statistically or clinically significantly different from placebo for any prespecified primary or secondary efficacy outcome. HAM-D scores decreased by 10.7 (least squares mean) (95

  15. Efficacy of chemical treatment of the Pietra cantone limestone in the restoration of historic buildings of Cagliari (southern Sardinia, Italy)

    NASA Astrophysics Data System (ADS)

    Columbu, Stefano; Lisci, Carla; Sitzia, Fabio; Buccellato, Giampaolo

    2015-04-01

    The present work aims to evaluate the efficacy of some chemical products in the restoration works of the "Pietra cantone" limestone, a calcarenitic rock belonging to the carbonatic miocenic series (lower Tortonian) of Cagliari (southern Sardinia, Italy), widely used in historic buildings. Such stone, once used in the masonry, if is not protected by plaster or in the presence of aqueous solutions circulating, frequently shows problems of chemical-physical decay, due to their petrophysical characteristics. In fact, being characterized by a highly porous (on average 35-42% vol.) carbonate matrix low-medium cemented, are easily alterable by weathering processes (i.e., dissolution, sulfation, etc.) and by cyclic mechanism of crystallization/solubilisation of salts and hydration/dehydration of hygroscopic phases belonging to the clay component of these calcarenites. These processes induce negative effects on physical-mechanical properties of stone, producing various macroscopic forms of alteration such as decohesion, disintegration, exfoliation, alveolation, etc. Where the decay of the walls is in an advanced stage, there was a strong retreat of the vertical profile of the facade of the building, resulting in critical static-structural. As a case study was taken the historic building of a tobacco manufacture, one of the first industrial establishments in Cagliari, then owned by the Italian State Monopoly. The factory dates back to the early decades of the XVIII century, the walls of which, however, belonged to the convent of the "Frati Minori" built towards the end of the XIV century along the wall that closed the east the historic district of "Marina" in front of the port of Cagliari. In addressing the structural restoration of this building, before selecting chemical products for dealing adequately of limestone, we proceeded at the outset to a thorough analysis of the structures built in "Pietra Cantone", and their physical-mechanical decay. Only thereafter the stone

  16. Energy dispersive X-ray microanalysis, fluoride release, and antimicrobial properties of glass ionomer cements indicated for atraumatic restorative treatment

    PubMed Central

    Saxena, Sudhanshu; Tiwari, Sonia

    2016-01-01

    Aim: The aim of this study was to compare constituents of glass powder, fluoride release, and antimicrobial properties of new atraumatic restorative treatment material with zirconia fillers and conventional glass ionomer cement (GIC) type IX. Materials and Methods: Thisin vitro study comparing Zirconomer and Fuji IX was executed in three parts: (1) energy dispersive X-ray microanalysis of glass powders (2) analysis of fluoride release at 1st, 3rd, 7th, 15th, and 30th day, and (3) antimicrobial activity against Streptococcus mutans, Lactobacillus casei, and Candida albicans at 48 hours. Data was analyzed using unpaired t-test and two way analysis of variance followed by least significant difference post hoc test. A P value of < 0.05 was considered statistically significant. Results: Energy dispersive X-ray microanalysis revealed that, in both Zirconomer and Fuji IX glass powders, mean atomic percentage of oxygen was more than 50%. According to the weight percentage, zirconium in Zirconomer and silica in Fuji IX were the second main elements. Calcium, zinc, and zirconium were observed only in Zirconomer. At all the time intervals, statistically significant higher amount of fluoride release was observed with Zirconomer than Fuji IX. At 48 hours, mean ± standard deviation (SD) of zone of inhibition against Streptococcus mutans was 11.14 ± 0.77 mm and 8.51 ± 0.43 mm for Zirconomer and Fuji IX, respectively. Against Lactobacillus casei, it was 14.06 ± 0.71 mm for Zirconomer and 11.70 ± 0.39 mm for Fuji IX. No antifungal activity was observed against Candida albicans by Zirconomer and Fuji IX. Conclusion: Zirconomer had higher antibacterial activity against Streptococcus mutans and Lactobacillus casei, which may be attributed to its composition and higher fluoride release. However, it failed to show antifungal effect againstCandida albicans. PMID:27583226

  17. Preservation & Restoration.

    ERIC Educational Resources Information Center

    Online-Offline, 2000

    2000-01-01

    This theme issue on preservation and restoration presents selected resources for elementary and secondary education that include Web sites, CD-ROM and software, videos, books, magazines, and professional resources as well as classroom activities. Age levels are specified for most materials. I Sidebars discuss restoring a masterpiece, a bug's life,…

  18. Toward universal access to HIV counseling and testing and antiretroviral treatment in Ethiopia: looking beyond HIV testing and ART initiation.

    PubMed

    Assefa, Yibeltal; Van Damme, Wim; Mariam, Damen Haile; Kloos, Helmut

    2010-08-01

    Expanding access to HIV counseling and testing (HCT) and antiretroviral treatment (ART) has reduced morbidity and mortality in people living with HIV/AIDS. As a result, many countries are scaling up HIV/AIDS services. In this paper we discuss challenges experienced during the move toward universal access to HCT and ART services in Ethiopia. We reviewed routine reports from the Ministry of Health and implementing partners. We also had interviews, about linkage to and retention in care of patients, with 10 HIV/AIDS program managers, as well as 2 to 7 health care providers and 5 to 15 patients in each of 23 health centers and 32 hospitals in all regions of the country. We found that the number of people tested for HIV increased 10-fold from 435,854 in 2005 to 4,559,954 in 2008. Only 61% of the HIV-positive patients were linked to chronic care immediately after tested for HIV. The number of patients initiated on ART annually increased from 26,021 in 2005 to 53,696 in 2008. Attrition of patients increased from 18% in 2005 to 26% in 2008. Our interviews indicated that fear of stigma, transport cost, feeling healthy and opting for traditional medicines were the main reasons for poor linkage to and retention in care. Lack of nutrition and feeling better were also reasons for poor retention. In conclusion, in spite of the rapid scale-up of HCT and ART services in Ethiopia, linkage and retention were not adequate. Therefore, strategies should be developed and implemented to improve linkage and retention.

  19. Restorative treatment thresholds for interproximal primary caries based on radiographic images: findings from the Dental Practice-Based Research Network.

    PubMed

    Gordan, Valeria V; Garvan, Cynthia W; Heft, Marc W; Fellows, Jeffrey L; Qvist, Vibeke; Rindal, D Brad; Gilbert, Gregg H

    2009-01-01

    This study sought to quantify the depths of proximal caries lesions that lead dentists in regular clinical practice to intervene restoratively, based on hypothetical scenarios that present radiographic images and patient background information, and to identify characteristics associated with restorative intervention in lesions that have penetrated only the enamel surface. This study surveyed dentists from the Dental Practice-Based Research Network (DPBRN) who had reported doing at least some restorative dentistry (n = 901). Dentists were asked to indicate the depth at which they would restore a lesion, based on a series of radiographic images depicting interproximal caries at increasing lesion depths in a mandibular premolar; in addition, the dentists were questioned regarding two caries risk scenarios: one involving a patient with low caries risk and another involving a patient at higher risk. Logistic regression was used to analyze associations between the decision to intervene restoratively and specific dentist, practice, and patient characteristics. Of the 901 DPBRN practitioner-investigators, 500 (56%) completed the survey. For a high caries risk patient, 66% of respondents indicated that they would restore a proximal enamel lesion, while 24% would do so once the lesion had reached into the outer third of the dentin. For a low caries risk patient, 39% of respondents reported that they would restore an enamel lesion, and 54% would do so once the lesion had reached into the outer third of the dentin. In multivariate analyses that accounted for dentist and practice characteristics, dentists in large group practices were less likely to intervene surgically for enamel caries, regardless of patient's caries risk.

  20. Restoring the smile: Inexpensive biologic restorations

    PubMed Central

    Mittal, Neeti P.

    2014-01-01

    Extensive breakdown of primary teeth to the cervical level and their loss in very young children is not uncommon. Owing to increasing concerns over self-appearance, due considerations to esthetic aspects in addition to restoring function are necessary aspects of rehabilitation of mutilated teeth to help children grow into a psychologically balanced personality. The present article describes rehabilitation of grossly decayed teeth with biologic restorations such as dentine posts, dentine post and core and biologic shell crown. This treatment modality provided a cost-effective esthetic solution. PMID:25097656

  1. L-DOPA treatment selectively restores spine density in dopamine receptor D2-expressing projection neurons in dyskinetic mice.

    PubMed

    Suárez, Luz M; Solís, Oscar; Caramés, Jose M; Taravini, Irene R; Solís, Jose M; Murer, Mario G; Moratalla, Rosario

    2014-05-01

    L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesia is an incapacitating complication of L-DOPA therapy that affects most patients with Parkinson's disease. Previous work indicating that molecular sensitization to dopamine receptor D1 (D1R) stimulation is involved in dyskinesias prompted us to perform electrophysiological recordings of striatal projection "medium spiny neurons" (MSN). Moreover, because enhanced D1R signaling in drug abuse induces changes in spine density in striatum, we investigated whether the dyskinesia is related to morphological changes in MSNs. Wild-type and bacterial artificial chromosome transgenic mice (D1R-tomato and D2R-green fluorescent protein) mice were lesioned with 6-hydroxydopamine and subsequently treated with L-DOPA to induce dyskinesia. Functional, molecular, and structural changes were assessed in corticostriatal slices. Individual MSNs injected with Lucifer-Yellow were detected by immunohistochemistry for three-dimensional reconstructions with Neurolucida software. Intracellular current-clamp recordings with high-resistance micropipettes were used to characterize electrophysiological parameters. Both D1R-MSNs and D2R-MSNs showed diminished spine density in totally denervated striatal regions in parkinsonian mice. Chronic L-DOPA treatment, which induced dyskinesia and aberrant FosB expression, restored spine density in D2R-MSNs but not in D1R-MSNs. In basal conditions, MSNs are more excitable in parkinsonian than in sham mice, and excitability decreases toward normal values after L-DOPA treatment. Despite this normalization of basal excitability, in dyskinetic mice, the selective D1R agonist SKF38393 increased the number of evoked action potentials in MSNs, compared with sham animals. Chronic L-DOPA induces abnormal spine re-growth exclusively in D2R-MSNs and robust supersensitization to D1R-activated excitability in denervated striatal MSNs. These changes might constitute the anatomical and electrophysiological substrates

  2. Cervical curve restoration and forward head posture reduction for the treatment of mechanical thoracic pain using the pettibon corrective and rehabilitative procedures

    PubMed Central

    Morningstar, Mark

    2002-01-01

    Abstract Objective To demonstrate the benefits of reducing forward head posture and restoring the cervical lordosis as a novel approach to treating a patient with mechanical thoracic pain. Clinical Features The patient had thoracolumbar junction pain bilaterally that failed to respond to previous sessions of spinal manipulative therapy. Treatment included both manipulative and rehabilitative procedures designed to correct the forward head posture and cervical kyphosis. Treatment progress was quantified on pre and post lateral cervical radio-graphs. Intervention and Outcome The treatment plan was 30 sessions over an 8-week period that included spinal manipulative therapy, used in concert with a new headweight device applied immediately after the manipulation was performed at each session. The patient was also instructed on the performance of certain rehabilitative procedures to be performed in the home setting. The patient experienced significant symptomatic relief after the 3rd week of care. The cervical lordosis was restored by 144% and the forward head posture was decreased by 56% at the end of the trial period. Conclusion Restoration of the cervical curve and reduction of forward head posture appears to have beneficial effects beyond the cervical spine. The addition of active rehabilitative procedures seems to enhance the effectiveness of spinal manipulative therapy in the correction of forward head posture and cervical kyphosis. PMID:19674570

  3. New insights for pelvic radiation disease treatment: Multipotent stromal cell is a promise mainstay treatment for the restoration of abdominopelvic severe chronic damages induced by radiotherapy

    PubMed Central

    Chapel, Alain; Francois, Sabine; Douay, Luc; Benderitter, Marc; Voswinkel, Jan

    2013-01-01

    Radiotherapy may induce irreversible damage on healthy tissues surrounding the tumor. It has been reported that the majority of patients receiving pelvic radiation therapy show early or late tissue reactions of graded severity as radiotherapy affects not only the targeted tumor cells but also the surrounding healthy tissues. The late adverse effects of pelvic radiotherapy concern 5% to 10% of them, which could be life threatening. However, a clear medical consensus concerning the clinical management of such healthy tissue sequelae does not exist. Although no pharmacologic interventions have yet been proven to efficiently mitigate radiotherapy severe side effects, few preclinical researches show the potential of combined and sequential pharmacological treatments to prevent the onset of tissue damage. Our group has demonstrated in preclinical animal models that systemic mesenchymal stromal cell (MSC) injection is a promising approach for the medical management of gastrointestinal disorder after irradiation. We have shown that MSCs migrate to damaged tissues and restore gut functions after irradiation. We carefully studied side effects of stem cell injection for further application in patients. We have shown that clinical status of four patients suffering from severe pelvic side effects resulting from an over-dosage was improved following MSC injection in a compationnal situation. PMID:24179599

  4. Endo-restorative treatment of a severly discolored upper incisor: resolution of the “aesthetic” problem through Componeer veneering System

    PubMed Central

    Migliau, Guido; Besharat, Laith Konstantinos; Sofan, Afrah Ali Abdullah; Sofan, Eshrak Ali Abdullah; Romeo, Umberto

    2015-01-01

    Summary Aim Re-establishing a patient’s lost dental aesthetic appearance is one of the most important topics for contemporary dentistry. New treatment materials and methods have been coming on the scene, day by day, in order to achieve such an aim. Most dentists prefer more conservative and aesthetic approaches, such as direct or indirect veneer restorations, instead of full-ceramic crowns for anteriors where aesthetics is really important. The aim of the study is to evaluate clinically the effectiveness of a direct composite veneering system in resolving aesthetic problem of an upper incisor with a multidisciplinary treatment approach. Methods Patient with a severe discolored upper incisor came to our attention; at the X-ray exam there was an evidence of a past not good root canal treatment and also old and incongruent composite obturation. After removing all the material inside the root canal was performed a new correct endodontic filling, then Authors tried to bleach the tooth trough “walking-bleach” technique with a hydrogen peroxide (30 volumes) and sodium perborate solution without excellent results. So it was decided to insert a glass-fiber post and than to perform a direct composite veneer with Componeer System (Coltene). Componeer System is a system of prefabricated composite veneers that are abled to be applied directly in the first appointment: after a conservative preparation of the tooth, it must be used an adhesive agent (for example a “three steps”) and then with composite stratification it’s possible to apply the componeer veneer (choosing the right measure, modified as necessary) as the last covering aesthetic layer. Result The evaluation of result of this multidisciplinary treatment was essentially clinical and radiological; in fact it’s possible to observe, from a clinical point of view, the good aesthetic aspect of the direct composite restoration with componeer veneer that offers also some advantages: conservative preparation with

  5. Evaluation and art therapy treatment of the burnout syndrome in oncology units.

    PubMed

    Italia, Simona; Favara-Scacco, Cinzia; Di Cataldo, Andrea; Russo, Giovanna

    2008-07-01

    We undertook a pilot study to evaluate and potentially reduce the level of burnout in the operators of two oncology centers. The study included 65 doctors and nurses of an adult (Group A) and a pediatric oncology unit (Group B). We used the Maslach Burnout Inventory to estimate the level of burnout obtained in three dimensions: emotional exhaustion, distancing (cognitive and emotional) and reduced personal achievement. Data showed a medium-high level of burnout in Group A and a medium-low level in Group B. In the second part of the study, Group B underwent a program of art therapy interventions with the aim of reducing the level of burnout. Comparing the responses from Group B participants before and after the intervention indicated a statistically significant decreased level of burnout. In conclusion, burnout syndrome exists among oncology unit personnel and can be effectively treated with art therapies. Attention devoted to this aspect is required in order to improve the workers' well-being, thus enhancing attention and dedication to patients. (c) 2007 John Wiley & Sons, Ltd.

  6. Art, archetypes and alchemy: images of self following treatment for breast cancer.

    PubMed

    Thibeault, Catherine; Sabo, Brenda M

    2012-04-01

    The loss or alteration of a breast poses a threat to a woman's selfhood, particularly those aspects that embrace feminine identity such as sexuality and caring. The use of art as a vehicle for recreating a sense of self after breast cancer surgery framed the study that generated the stories reported here. A team of nurse-researchers and professional artists entered into a collaborative partnership aimed at creating life-like prototypes of the torsos of two breast cancer survivors. The authors sought to understand participants' experiences of healing through the narratives of their breast cancer journeys and their experiences of creating art through the use of their bodies. The participants consented to having interviews and casting sessions audio-taped. The authors used thematic analysis to explore the narratives. The authors present excerpts of stories and comment on how participants articulated the feminine archetype in the form of the Greek goddesses Hestia, Artemis, and Aphrodite. The authors explore the transformative nature of participants' experiences. The emergence of the goddess archetypes in participants' narratives was an unanticipated result of the study. The authors invite readers to contemplate these anecdotes and embark on their own quest for deeper knowledge of breast cancer experiences. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: A qualitative Brazilian study.

    PubMed

    Dornelles, L M N; MacCallum, F; Lopes, R C S; Piccinini, C A; Passos, E P

    2016-04-01

    Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology, and exploring whether this experience is affected by previous failed infertility treatments. This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through Assisted Reproductive Technology treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analysed using thematic analysis, and the sample was divided into two groups according to whether it was the participant's first treatment or not. Themes identified include: tolerance of the demands of treatment and pregnancy, consideration of the mechanics of treatment and pregnancy, and emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first Assisted Reproductive Technology treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant Assisted Reproductive Technology mothers. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  8. Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?

    PubMed Central

    Cluver, L. D.; Toska, E.; Orkin, F. M.; Meinck, F.; Hodes, R.; Yakubovich, A. R.; Sherr, L.

    2016-01-01

    ABSTRACT Low ART-adherence amongst adolescents is associated with morbidity, mortality and onward HIV transmission. Reviews find no effective adolescent adherence-promoting interventions. Social protection has demonstrated benefits for adolescents, and could potentially improve ART-adherence. This study examines associations of 10 social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10–19-year-olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa’s Eastern Cape were traced and interviewed in 2014–2015 (n = 1175 eligible). About 90% of the eligible sample was included (n = 1059). Social protection provisions were “cash/cash in kind”: government cash transfers, food security, school fees/materials, school feeding, clothing; and “care”: HIV support group, sports groups, choir/art groups, positive parenting and parental supervision/monitoring. Analyses used multivariate regression, interaction and marginal effects models in SPSS and STATA, controlling for socio-demographic, HIV and healthcare-related covariates. Findings showed 36% self-reported past-week ART non-adherence (<95%). Non-adherence was associated with increased opportunistic infections (p = .005, B .269, SD .09), and increased likelihood of detectable viral load at last test (>75 copies/ml) (aOR 1.98, CI 1.1–3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR .57, CI .42–.76, p < .001); HIV support group attendance (aOR .60, CI .40–.91, p < .02), and high parental/caregiver supervision (aOR .56, CI .43–.73, p < .001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection 39–41%, with any two social protections, 27–28% and with all three social protections, 18%. These results demonstrate that social protection provisions

  9. Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?

    PubMed

    Cluver, L D; Toska, E; Orkin, F M; Meinck, F; Hodes, R; Yakubovich, A R; Sherr, L

    2016-03-01

    Low ART-adherence amongst adolescents is associated with morbidity, mortality and onward HIV transmission. Reviews find no effective adolescent adherence-promoting interventions. Social protection has demonstrated benefits for adolescents, and could potentially improve ART-adherence. This study examines associations of 10 social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10-19-year-olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa's Eastern Cape were traced and interviewed in 2014-2015 (n = 1175 eligible). About 90% of the eligible sample was included (n = 1059). Social protection provisions were "cash/cash in kind": government cash transfers, food security, school fees/materials, school feeding, clothing; and "care": HIV support group, sports groups, choir/art groups, positive parenting and parental supervision/monitoring. Analyses used multivariate regression, interaction and marginal effects models in SPSS and STATA, controlling for socio-demographic, HIV and healthcare-related covariates. Findings showed 36% self-reported past-week ART non-adherence (<95%). Non-adherence was associated with increased opportunistic infections (p = .005, B .269, SD .09), and increased likelihood of detectable viral load at last test (>75 copies/ml) (aOR 1.98, CI 1.1-3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR .57, CI .42-.76, p < .001); HIV support group attendance (aOR .60, CI .40-.91, p < .02), and high parental/caregiver supervision (aOR .56, CI .43-.73, p < .001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection 39-41%, with any two social protections, 27-28% and with all three social protections, 18%. These results demonstrate that social protection provisions, particularly combinations of "cash

  10. A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients.

    PubMed

    Dewan, K; Kelly, R D; Bardsley, P

    2014-06-01

    To investigate the approach of restorative dentists towards the assessment and treatment planning of oral cancer patients in the UK. The survey was conducted at the annual meeting of the Association of Consultants in Restorative Dentistry (ACSRD) and Specialist Registrar in Restorative Dentistry group (SRRDG) in September 2011. Delegates were requested to fill in a two-section questionnaire; the first section included 16 questions, evaluating cancer service provision in their units, and the second included five questions based on a clinical scenario evaluating dental management of a patient undergoing pre-radiotherapy treatment. Ninety-four questionnaires were distributed; 65 (69.1%) were returned. Thirty (46.1%) respondents were consultants, 27 (41.5%) were specialist registrars and the remaining 8 (12.3%) were either specialist practitioners or trust grade dentists working in the speciality of restorative dentistry. Forty-eight (73%) of the respondents worked in NHS posts and the remaining 17 (27%) worked in academic posts. A total of 50 (77%) respondents carried out clinical work which regularly included the dental assessment or treatment of head and neck (H&N) oncology patients, before or post radiotherapy. Among the respondents who were involved in the dental assessment of oncology patients, 32% of them did not have a protocol for review appointments in their units. Ninety-one percent of respondents said that they used dental implants for rehabilitation post cancer surgery and 80% also used implants either always or sometimes in irradiated bone. Answers to scenario questions highlighted that all the respondents would extract very poorly prognostic tooth (that is, root stumps) before radiotherapy, irrespective of it being at the side of the planned radiotherapy field. Fifty-eight percent of respondents preferred to extract a non-functional, heavily restored, non-carious, distal maxillary molar tooth which was not in the area of radiotherapy beam and the

  11. Chemistry and Art.

    ERIC Educational Resources Information Center

    Berry, Martyn

    1999-01-01

    Describes a Chemistry and Art project developed for secondary students and teachers sponsored by the National Gallery and The Royal Society of Chemistry in the United Kingdom. Discusses aspects of the techniques used in creating five paintings as well as the chemistry involved in their making, deterioration, conservation, and restoration.…

  12. Chemistry and Art.

    ERIC Educational Resources Information Center

    Berry, Martyn

    1999-01-01

    Describes a Chemistry and Art project developed for secondary students and teachers sponsored by the National Gallery and The Royal Society of Chemistry in the United Kingdom. Discusses aspects of the techniques used in creating five paintings as well as the chemistry involved in their making, deterioration, conservation, and restoration.…

  13. Children with Generalised Joint Hypermobility and Musculoskeletal Complaints: State of the Art on Diagnostics, Clinical Characteristics, and Treatment

    PubMed Central

    Scheper, M. C.; Engelbert, R. H. H.; Rameckers, E. A. A.; Verbunt, J.; Remvig, L.; Juul-Kristensen, B.

    2013-01-01

    Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH) and joint hypermobility syndrome (JHS). Method. A narrative review was performed regarding diagnostics and clinical characteristics. Effectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases). Results. In the last decade, scientific research has accumulated on all domains of the ICF. GJH/JHS can be considered as a clinical entity, which can have serious effects during all stages of life. However research regarding the pathological mechanism has resulted in new potential opportunities for treatment. When regarding the effectiveness of current treatments, the search identified 1318 studies, from which three were included (JHS: n = 2, Osteogenesis Imperfecta: n = 1). According to the best evidence synthesis, there was strong evidence that enhancing physical fitness is an effective treatment for children with JHS. However this was based on only two studies. Conclusion. Based on the sparsely available knowledge on intervention studies, future longitudinal studies should focus on the effect of physical activity, fitness, and joint stabilisation. In JHS and chronic pain, the effectiveness of a multidisciplinary approach should be investigated. PMID:23971021

  14. Treatment with anti-programmed cell death 1 (PD-1) antibody restored postoperative CD8+ T cell dysfunction by surgical stress.

    PubMed

    Sun, Zhirong; Mao, Anrong; Wang, Yun; Zhao, Yanjun; Chen, Jiawei; Xu, Pingbo; Miao, Changhong

    2017-03-15

    Millions of patients benefit from surgery and are exposed to surgical stress. However, ample studies suggest that surgical stress contributes to tumor recurrence or distant metastases. Surgical stress suppresses CD8+ T cells (CTL) function which is vital for eliminating the malignant cells. Anti-programmed cell death 1 (PD-1) therapy is an effective and safe treatment that increases survival rate of patients with multiple cancers, however, whether anti-PD-1 therapy is able to reverse the immunosuppression following surgery remains largely unknown. Using a surgical stress mice model, we found that surgical stress reduced CD8+ T cell total numbers in the spleen and impaired CTLs function. Surgical induced CD8+ T cells had impaired anti-tumor effects in a tumor bearing models. Blockade of PD-1 with specific antibody restored CD8+ T cell numbers and secretion ability. PGE2 expression was dramatically upregulated in the postoperative serum, and anti-PD-1 together with PGE2 inhibitor restored CTLs dysfunction induced by surgery. Collectively, blockade of PD-1 with monoclonal antibody may be an effective treatment during the postoperative period for restoring surgery-induced immunosuppression.

  15. Effects of Different Treatments of Pasture Restoration on Soil Trace Gas Emissions in the Cerrados of Central Brazil

    EPA Science Inventory

    Planted pastures ( mainly Brachiaria spp) are the most extensive land use in the cerrado (savannas of central Brazil) with an area of approximately 50 x 10(6) ha. The objective of the study was to assess the effects of pasture restoration on the N dynamics ( net N mineralization/...

  16. Engaging communities in post-fire restoration: forest treatments and community-agency relations after the Cerro Grande fire

    Treesearch

    Robert L. Ryan; Elisabeth M. Hamin

    2006-01-01

    Our research provides advice to managers in their work in post-fire forest rehabilitation based on focus groups and interviews in the Los Alamos, New Mexico, community after the Cerro Grande fire of 2000. We address two key issues: how different restoration efforts compare to natural revegetation from the public?s perspective, and how to effectively communicate with...

  17. Effects of Different Treatments of Pasture Restoration on Soil Trace Gas Emissions in the Cerrados of Central Brazil

    EPA Science Inventory

    Planted pastures ( mainly Brachiaria spp) are the most extensive land use in the cerrado (savannas of central Brazil) with an area of approximately 50 x 10(6) ha. The objective of the study was to assess the effects of pasture restoration on the N dynamics ( net N mineralization/...

  18. A practical method for the restoration of clogged rural vertical subsurface flow constructed wetlands for domestic wastewater treatment using earthworm.

    PubMed

    Li, Huaizheng Z; Wang, Sheng; Ye, Jianfeng F; Xu, Zuxin X; Jin, Wei

    2011-01-01

    This paper presents a simple method for the restoration of clogged vertical subsurface flow constructed wetland by earthworm. Since clogging always takes place at the top layer, epigeic earthworm is suitable for restoration of the clogged wetland. Earthworm can not only loosen the substrate, but also transform 80∼90% of undissolved organic particles into dissolved matters. Accordingly, the accumulated solids in substrate with earthworm are 50% less than the one without earthworm. The wetland with earthworm removed 2∼5 percentage points more nitrogen and 12 percentage points more phosphorous for its better ventilation conditions, while 2 percentage points less COD because the generation of dissolved organic matter from undissolved organic particles by earthworm. In general, the influence of earthworm on the effluent quality of the wetland could be ignored. Hydrology of six full-scale clogged wetlands was restored by Eisenia foetida. The optimal strength of earthworm addition is 0.5 kg/m2, which spend RMB six yuan/m2, less than € 0.75/m2. No specific training is required for the staffs on this method; it takes 10 days to restore the clogged wetland.

  19. Current state of the art installation techniques for in-situ reactive wall groundwater treatment systems

    SciTech Connect

    Andromalos, K.B.; Jasperse, B.H.; Schindler, R.M.

    1999-07-01

    The consideration and use of in-situ reactive wall groundwater treatment systems on remediation projects continues to gain acceptance. Such systems are attractive due to their low initial capital costs and their minimal operation and maintenance costs compared to traditional pump and treat systems. These systems often are used as a polishing step to groundwater treatment in conjunction with source removal and natural attenuation. In constructing reactive wall groundwater treatment systems, various specialty construction techniques have been utilized. These techniques have included: deep soil mixing, bio-polymer trenching and slurry walls to successfully build funnel and gate systems with replaceable treatment cartridges as well as permeable treatment walls containing iron filings. Such systems have been installed in full-scale and pilot scale applications for various private companies, the Department of Energy and the United States Air Force and others. Several case histories are presented to illustrate these various installation techniques and their applications.

  20. Two decades of ART: improving on success through further research

    PubMed Central

    HOLMGREN, Christopher J.; FIGUEREDO, Márcia Cançado

    2009-01-01

    ABSTRACT Since the introduction of the Atraumatic Restorative Treatment (ART) approach over twenty years ago, more than 190 research publications have appeared. The last research agenda defining research priorities for ART was published in 1999. The objective of the present work was to review existing research in the context of future research priorities for ART. Material and Methods: An internet survey was conducted amongst those who had published on ART or were known to be working on the ART approach, to solicit their views as to areas of future ART research. Three broad categories were defined, namely: 1. Basic and laboratory research; 2. Clinical research, and, 3. Community, Public Health, Health Services Research. Results: A 31% response rate was achieved. The study identified a number of new areas of research as well as areas where additional research is required. These are expressed as recommendations for future ART research. Conclusions: The ART approach is based on a robust, reliable and ever-growing evidence base concerning its clinical applications which indicates that it is a reliable and quality treatment approach. In common with all other oral health care procedures, targeted applied research is required to improve the oral health care offered. PMID:21499666

  1. Anticoagulant Treatment of Deep Vein Thrombosis and Pulmonary Embolism: The Present State of the Art

    PubMed Central

    Thaler, Johannes; Pabinger, Ingrid; Ay, Cihan

    2015-01-01

    Venous thromboembolism (VTE), a disease entity comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years, the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH) or fondaparinux, followed by a vitamin K antagonist (VKA). The so-called direct oral anticoagulants (DOAC) were introduced rather recently in clinical practice for the treatment of VTE. DOAC seem to have a favorable risk-benefit profile compared to VKA. Moreover, DOAC significantly simplify VTE treatment because they are administered in fixed doses and no routine monitoring is needed. Patients with objectively diagnosed DVT or PE should receive therapeutic anticoagulation for a minimum of 3 months. Whether a patient ought to receive extended treatment needs to be evaluated on an individual basis, depending mainly on risk factors determined by characteristics of the thrombotic event and patient-related factors. In specific patient groups (e.g., pregnant women, cancer patients, and elderly patients), treatment of VTE is more challenging than that in the general population and additional issues need to be considered in those patients. The aim of this review is to give an overview of the currently available treatment modalities of acute VTE and secondary prophylaxis. In particular, specific aspects regarding the initiation of VTE treatment, duration of anticoagulation, and specific patient groups will be discussed. PMID:26664901

  2. Anticoagulant Treatment of Deep Vein Thrombosis and Pulmonary Embolism: The Present State of the Art.

    PubMed

    Thaler, Johannes; Pabinger, Ingrid; Ay, Cihan

    2015-01-01

    Venous thromboembolism (VTE), a disease entity comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years, the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH) or fondaparinux, followed by a vitamin K antagonist (VKA). The so-called direct oral anticoagulants (DOAC) were introduced rather recently in clinical practice for the treatment of VTE. DOAC seem to have a favorable risk-benefit profile compared to VKA. Moreover, DOAC significantly simplify VTE treatment because they are administered in fixed doses and no routine monitoring is needed. Patients with objectively diagnosed DVT or PE should receive therapeutic anticoagulation for a minimum of 3 months. Whether a patient ought to receive extended treatment needs to be evaluated on an individual basis, depending mainly on risk factors determined by characteristics of the thrombotic event and patient-related factors. In specific patient groups (e.g., pregnant women, cancer patients, and elderly patients), treatment of VTE is more challenging than that in the general population and additional issues need to be considered in those patients. The aim of this review is to give an overview of the currently available treatment modalities of acute VTE and secondary prophylaxis. In particular, specific aspects regarding the initiation of VTE treatment, duration of anticoagulation, and specific patient groups will be discussed.

  3. Gene therapy for Parkinson's disease: state-of-the-art treatments for neurodegenerative disease.

    PubMed

    Douglas, Michael R

    2013-06-01

    Pharmacological and surgical treatments offer symptomatic benefits to patients with Parkinson's disease; however, as the condition progresses, patients experience gradual worsening in symptom control, with the development of a range of disabling complications. In addition, none of the currently available therapies have convincingly shown disease-modifying effects - either in slowing or reversing the disease. These problems have led to extensive research into the possible use of gene therapy as a treatment for Parkinson's disease. Several treatments have reached human clinical trial stages, providing important information on the risks and benefits of this novel therapeutic approach, and the tantalizing promise of improved control of this currently incurable neurodegenerative disorder.

  4. Critical Evaluation of State-of-the-Art In Situ Thermal Treatment Technologies for DNAPL Source Zone Treatment

    DTIC Science & Technology

    2010-01-01

    source zones; however, their field-scale application has not been well -documented in the technical literature. In this project, the performance of...thermal treatment sites. The range of concentration and mass flux reductions ranged from about ᝺X to 1000X, and was strongly linked to how well the...21 Table 8. Range of Permanent Monitoring Well Pre- and Post-Treatment Concentration Data (ug/L

  5. Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art

    PubMed Central

    Iezzi, Roberto; Pompili, Maurizio; Posa, Alessandro; Coppola, Giuseppe; Gasbarrini, Antonio; Bonomo, Lorenzo

    2016-01-01

    In recent years, a combination of intervention therapies has been widely applied in the treatment of hepatocellular carcinoma (HCC). One such combined strategy is based on the combination of the percutaneous approach, such as radiofrequency ablation (RFA), and the intra-arterial locoregional approach, such as trans-arterial chemoembolization (TACE). Several types of evidence have supported the feasibility and benefit of combined therapy, despite some studies reporting conflicting results and outcomes. The aim of this review was to explain the technical aspects of different combined treatments and to comprehensively analyze and compare the clinical efficacy and safety of this combined treatment option and monotherapy, either as TACE or RFA alone, in order to provide clinicians with an unbiased opinion and valuable information. Based on a literature review and our experience, combined treatment seems to be a safe and effective option in the treatment of patients with early/intermediate HCC when surgical resection is not feasible; furthermore, this approach provides better results than RFA and TACE alone for the treatment of large HCC, defined as those exceeding 3 cm in size. It can also expand the indication for RFA to previously contraindicated “complex cases”, with increased risk of thermal ablation related complications due to tumor location, or to “complex patients” with high bleeding risk. PMID:26877601

  6. Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art.

    PubMed

    Iezzi, Roberto; Pompili, Maurizio; Posa, Alessandro; Coppola, Giuseppe; Gasbarrini, Antonio; Bonomo, Lorenzo

    2016-02-14

    In recent years, a combination of intervention therapies has been widely applied in the treatment of hepatocellular carcinoma (HCC). One such combined strategy is based on the combination of the percutaneous approach, such as radiofrequency ablation (RFA), and the intra-arterial locoregional approach, such as trans-arterial chemoembolization (TACE). Several types of evidence have supported the feasibility and benefit of combined therapy, despite some studies reporting conflicting results and outcomes. The aim of this review was to explain the technical aspects of different combined treatments and to comprehensively analyze and compare the clinical efficacy and safety of this combined treatment option and monotherapy, either as TACE or RFA alone, in order to provide clinicians with an unbiased opinion and valuable information. Based on a literature review and our experience, combined treatment seems to be a safe and effective option in the treatment of patients with early/intermediate HCC when surgical resection is not feasible; furthermore, this approach provides better results than RFA and TACE alone for the treatment of large HCC, defined as those exceeding 3 cm in size. It can also expand the indication for RFA to previously contraindicated "complex cases", with increased risk of thermal ablation related complications due to tumor location, or to "complex patients" with high bleeding risk.

  7. State of the art psychopharmacological treatment options in seasonal affective disorder.

    PubMed

    Yildiz, Mesut; Batmaz, Sedat; Songur, Emrah; Oral, Esat Timuçin

    2016-03-01

    Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is characterized by a seasonal onset. SAD is proposed to be related to the seasonal changes in naturally occurring light, and the use of bright light therapy for depressive symptoms has been shown to reduce them in placebo controlled trials. Cognitive behavioral therapy has also been demonstrated to be effective in SAD. This review article aims to focus on the psychopharmacological treatment options for SAD. According to clinical trial results, first line treatment options seem to be sertraline and fluoxetine, and are well tolerated by the patients. There is some evidence that other antidepressants (e.g. bupropion) might be effective as well. Although clinical trials have shown that some of these antidepressants may be of benefit, a recent review has concluded that there is not enough evidence to support the use of any of these agents for the treatment of SAD yet. Moreover, more studies are still needed to evaluate the effectiveness of other treatment options, e.g., propranolol, melatonin, hypericum, etc. In addition to the above proposed treatments, patients with seasonal depressive symptoms should thoroughly be evaluated for any cues of bipolarity, and their treatment should be planned accordingly.

  8. Glaucoma –state of the art and perspectives on treatment

    PubMed Central

    Wójcik-Gryciuk, Anna; Skup, Małgorzata; Waleszczyk, Wioletta J.

    2015-01-01

    Glaucoma is a chronic optic neuropathy characterized by progressive damage to the optic nerve, death of retinal ganglion cells and ultimately visual field loss. It is one of the leading causes of irreversible loss of vision worldwide. The most important trigger of glaucomatous damage is elevated eye pressure, and the current standard approach in glaucoma therapy is reduction of intraocular pressure (IOP). However, despite the use of effective medications or surgical treatment leading to lowering of IOP, progression of glaucomatous changes and loss of vision among patients with glaucoma is common. Therefore, it is critical to prevent vision loss through additional treatment. To implement such treatment(s), it is imperative to identify pathophysiological changes in glaucoma and develop therapeutic methods taking into account neuroprotection. Currently, there is no method of neuroprotection with long-term proven effectiveness in the treatment of glaucoma. Among the most promising molecules shown to protect the retina and optic nerve are neurotrophic factors. Thus, the current focus is on the development of safe and non-invasive methods for the long-term elevation of the intraocular level of neurotrophins through advanced gene therapy and topical eye treatment and on the search for selective agonists of neurotrophin receptors affording more efficient neuroprotection. PMID:26684267

  9. Towards energy neutral wastewater treatment: methodology and state of the art.

    PubMed

    Gao, Han; Scherson, Yaniv D; Wells, George F

    2014-05-01

    Conventional biological wastewater treatment processes are energy-intensive endeavors that yield little or no recovered resources and often require significant external chemical inputs. However, with embedded energy in both organic carbon and nutrients (N, P), wastewater has the potential for substantial energy recovery from a low-value (or no-value) feedstock. A paradigm shift is thus now underway that is transforming our understanding of necessary energy inputs, and potential energy or resource outputs, from wastewater treatment, and energy neutral or even energy positive treatment is increasingly emphasized in practice. As two energy sources in domestic wastewater, we argue that the most suitable way to maximize energy recovery from wastewater treatment is to separate carbon and nutrient (particularly N) removal processes. Innovative anaerobic treatment technologies and bioelectrochemical processes are now being developed as high efficiency methods for energy recovery from waste COD. Recently, energy savings or even generation from N removal has become a hotspot of research and development activity, and nitritation-anammox, the newly developed CANDO process, and microalgae cultivation are considered promising techniques. In this paper, we critically review these five emerging low energy or energy positive bioprocesses for sustainable wastewater treatment, with a particular focus on energy optimization in management of nitrogenous oxygen demand. Taken together, these technologies are now charting a path towards to a new paradigm of resource and energy recovery from wastewater.

  10. Restoration of R117H CFTR folding and function in human airway cells through combination treatment with VX-809 and VX-770

    PubMed Central

    Gentzsch, Martina; Ren, Hong Y.; Houck, Scott A.; Quinney, Nancy L.; Cholon, Deborah M.; Sopha, Pattarawut; Chaudhry, Imron G.; Das, Jhuma; Dokholyan, Nikolay V.; Randell, Scott H.

    2016-01-01

    Cystic fibrosis (CF) is a lethal recessive genetic disease caused primarily by the F508del mutation in the CF transmembrane conductance regulator (CFTR). The potentiator VX-770 was the first CFTR modulator approved by the FDA for treatment of CF patients with the gating mutation G551D. Orkambi is a drug containing VX-770 and corrector VX809 and is approved for treatment of CF patients homozygous for F508del, which has folding and gating defects. At least 30% of CF patients are heterozygous for the F508del mutation with the other allele encoding for one of many different rare CFTR mutations. Treatment of heterozygous F508del patients with VX-809 and VX-770 has had limited success, so it is important to identify heterozygous patients that respond to CFTR modulator therapy. R117H is a more prevalent rare mutation found in over 2,000 CF patients. In this study we investigated the effectiveness of VX-809/VX-770 therapy on restoring CFTR function in human bronchial epithelial (HBE) cells from R117H/F508del CF patients. We found that VX-809 stimulated more CFTR activity in R117H/F508del HBEs than in F508del/F508del HBEs. R117H expressed exclusively in immortalized HBEs exhibited a folding defect, was retained in the ER, and degraded prematurely. VX-809 corrected the R117H folding defect and restored channel function. Because R117 is involved in ion conductance, VX-770 acted additively with VX-809 to restore CFTR function in chronically treated R117H/F508del cells. Although treatment of R117H patients with VX-770 has been approved, our studies indicate that Orkambi may be more beneficial for rescue of CFTR function in these patients. PMID:27402691

  11. A comparative study of shear bond strength between metal and ceramic brackets and artificially aged composite restorations using different surface treatments.

    PubMed

    Eslamian, Ladan; Borzabadi-Farahani, Ali; Mousavi, Nasim; Ghasemi, Amir

    2012-10-01

    This in vitro study evaluated the shear bond strength (SBS) between ceramic brackets (CBs) and resin composite restorations (RCRs) prepared using different surface treatments. The findings were also compared with a similar study that used stainless steel brackets (SSBs). Forty-five premolars were restored with a nano-hybrid composite resin (Tetric EvoCeram) and randomly assigned to three surface treatment groups: group 1, 5 per cent hydrofluoric acid (HF); group 2, air abrasion (50 μm alumina particles); and group 3, diamond bur. Specimens were bonded with CBs (Fascination) and exposed to thermo-cycling (500 cycles). The shear force at a crosshead speed of 1 mm/minute was transmitted to brackets. The adhesive remnant index (ARIs) scores were recorded after bracket failure. The analysis of SBS variance (P < 0.01) and chi-square test of ARIs scores (P < 0.01) revealed significant differences among three groups tested. The SBS in group 3 (mean: 26.34 ± 4.76 MPa) and group 2 (mean: 26.68 ± 5.93 MPa) was significantly higher than group 1 (mean: 16.25 ± 5.42 MPa). The SBS was significantly higher in CBs (mean: 23.09 ± 7.19 MPa) compared to SSBs (mean: 15.56 ± 5.13 MPa). High ARIs (100 per cent) occurred in SSBs treated with a diamond bur, whereas CBs primarily failed at the resin-adhesive interface (P < 0.01). In two-thirds of the specimens (SSBs or CBs), no adhesive was left on the restoration after HF conditioning. The ARIs profile of CBs and SSBs that received surface treatments with air abrasion were similar (P > 0.05) and bond failure occurred mainly in adhesive-bracket base and resin-adhesive interfaces. The diamond bur surface treatment is recommended as a safe and cost-effective method of bonding CBs to RCRs.

  12. Restoration of R117H CFTR folding and function in human airway cells through combination treatment with VX-809 and VX-770.

    PubMed

    Gentzsch, Martina; Ren, Hong Y; Houck, Scott A; Quinney, Nancy L; Cholon, Deborah M; Sopha, Pattarawut; Chaudhry, Imron G; Das, Jhuma; Dokholyan, Nikolay V; Randell, Scott H; Cyr, Douglas M

    2016-09-01

    Cystic fibrosis (CF) is a lethal recessive genetic disease caused primarily by the F508del mutation in the CF transmembrane conductance regulator (CFTR). The potentiator VX-770 was the first CFTR modulator approved by the FDA for treatment of CF patients with the gating mutation G551D. Orkambi is a drug containing VX-770 and corrector VX809 and is approved for treatment of CF patients homozygous for F508del, which has folding and gating defects. At least 30% of CF patients are heterozygous for the F508del mutation with the other allele encoding for one of many different rare CFTR mutations. Treatment of heterozygous F508del patients with VX-809 and VX-770 has had limited success, so it is important to identify heterozygous patients that respond to CFTR modulator therapy. R117H is a more prevalent rare mutation found in over 2,000 CF patients. In this study we investigated the effectiveness of VX-809/VX-770 therapy on restoring CFTR function in human bronchial epithelial (HBE) cells from R117H/F508del CF patients. We found that VX-809 stimulated more CFTR activity in R117H/F508del HBEs than in F508del/F508del HBEs. R117H expressed exclusively in immortalized HBEs exhibited a folding defect, was retained in the ER, and degraded prematurely. VX-809 corrected the R117H folding defect and restored channel function. Because R117 is involved in ion conductance, VX-770 acted additively with VX-809 to restore CFTR function in chronically treated R117H/F508del cells. Although treatment of R117H patients with VX-770 has been approved, our studies indicate that Orkambi may be more beneficial for rescue of CFTR function in these patients.

  13. In vitro evaluation of marginal and internal adaptation of class II CAD/CAM ceramic restorations with different resinous bases and interface treatments.

    PubMed

    Sandoval, María José; Rocca, Giovanni Tommaso; Krejci, Ivo; Mandikos, Michael; Dietschi, Didier

    2015-12-01

    This in vitro study evaluated the influence of different composite bases and surface treatments on marginal and internal adaptation of class II CEREC CAD/CAM ceramic inlays, before and after simulated occlusal loading. Thirty-two IPS Empress CAD class II inlays (MO or OD) (n = 8/group) were placed on third molars, with margins 1 mm below the cementum-enamel junction (CEJ), following different cavity treatments. These treatments were non-liner (control group), a flowable composite liner (Premise flow) sandblasted or treated with soft air abrasion and a restorative composite liner (Premise) sandblasted. The restorations were then luted with Premise. All specimens were submitted to 1,000,000 cycles with a 100-N eccentric load. The tooth restoration margins were analysed semi-quantitatively by SEM pre- and post-loading. The internal adaptation was also evaluated after test completion. The percentage of satisfactory marginal adaptation varied from 75 to 87 % pre-loading and 62 to 72 % post-loading in occlusal enamel, from 71 to 83 % pre-loading and 52 to 63 % post-loading in proximal enamel, and from 68 to 88 % pre-loading and 43 to 66 % post-loading in cervical dentin. There were no significant differences among groups. The percentages of satisfactory tooth-composite internal adaptation varied from 81 to 98 % in occlusal dentin, from 63 to 90 % in axial dentin, and from 71 to 84 % in cervical dentin without any statistical difference. The results of the present study support the use of flowable or restorative composites as a liner underneath ceramic CAD/CAM inlays, producing marginal and internal adaptation which is not different from restorations placed directly on dentin. Soft air abrasion proved not to be different from sandblasting for treating cavities before cementation. The results of this in vitro test validate the increasing use of a flowable base/liner underneath CAD/CAM ceramic inlays to optimise tissue conservation and clinical procedures; in this case

  14. [Adjuvant treatment of breast cancer by concomitant hormonotherapy and radiotherapy: state of the art].

    PubMed

    Azria, D; Lemanski, C; Zouhair, A; Gutowski, M; Belkacémi, Y; Dubois, J B; Romieu, G; Ozsahin, M

    2004-06-01

    Combining radiation and hormone therapy has become common clinical practice in recent years for locally advanced prostate cancer. The use of such concomitant therapy in the treatment of breast disease has been very infrequently reported in the literature, but such an application seems justified given the common hormonal dependence of breast cancer and the potential synergetic effect of these two treatment modalities. As adjuvant therapy, tamoxifen is the key drug in the hormonal treatment arsenal, providing a significant improvement in both local control and global survival rates. Aromatase inhibitors are currently being evaluated in this setting, and initial results are promising. In vitro, tamoxifen does not seem to offer a protective effect against radiation. In clinical use, the few available published studies confirm the superiority of the association of radiation with tamoxifen as opposed to radiation therapy alone in decreasing local recurrences of surgically removed breast tumors. Toxicity associated with such concomitant therapy includes mainly subcutaneous and pulmonary fibroses. However, subcutaneous fibrosis and its cosmetic impact on the treated breast are frequently described side effects of radiation therapy, and their incidence may actually be reduced when tamoxifen is associated. The evidence is less controversial for pulmonary fibrosis, which is more common with the concomitant therapy. The association of radiation and aromatase inhibitors has as of yet rarely been reported. Letrozole (Femara) has a radiosensitizing effect on breast-cancer cell lines transfected with the aromatase gene. Clinical data assessing this effect in vivo are not available. The FEMTABIG study (letrozole vs. tamoxifen vs. sequential treatment) did not specify the sequence of radiation and hormonal therapy. The ATAC study comparing the adjuvant use of anastrozole (Arimidex) and tamoxifen does not provide any information on the number of patients receiving radiation

  15. State of the Art in the Treatment of Gastrointestinal Stromal Tumors

    PubMed Central

    Garlipp, Benjamin; Bruns, Christiane J.

    2014-01-01

    Background Gastrointestinal stromal tumors (GISTs) are the most frequently diagnosed mesenchymal neoplasms of the gastrointestinal tract. Despite their biological and clinical heterogeneity, the majority of these tumors are positive for the receptor tyrosine kinase KIT and are driven by KIT- or platelet-derived growth factor receptor alpha (PDGFRA)-activating mutations. There are still uncertainties regarding their clinical and molecular characterization and the optimal treatment regimens, making it difficult to establish a universal treatment algorithm for these tumors. Summary From a clinical perspective, the main difference between GISTs and other gastrointestinal neoplasms is that the benign or malignant behavior of GISTs cannot be predicted from histopathology, but instead relies on empirically established scoring systems. Clinical data suggest that malignant potential may be an inherent quality of some GISTs rather than a feature acquired by the tumor during disease progression. Thus, some patients may require prolonged anti-tumor treatment even after complete surgical removal of the tumor. Key Message Although GISTs are the most frequently occurring mesenchymal neoplasms in the gastrointestinal tract, no universal treatment algorithms exist. This paper reviews the current evidence that guides the management of GISTs. Practical Implications The management of localized GISTs involves the use of surgical resection, with the inclusion of preoperative tyrosine kinase inhibitor treatment for locally advanced, primarily unresectable tumors and for resectable cases requiring extensive surgery. Imatinib is also indicated as adjuvant therapy after complete surgical removal of GISTs with a high estimated risk of recurrence unless specific mutations conferring imatinib resistance are present. The optimal duration of adjuvant treatment is still controversial. For patients with metastatic imatinib-sensitive GISTs, imatinib constitutes the first-line standard treatment

  16. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients

    PubMed Central

    2012-01-01

    Background Around 70% of those living with HIV in need of treatment accessed antiretroviral therapy (ART) in Zambia by 2009. However, sustaining high levels of adherence to ART is a challenge. This study aimed to identify the predictive factors associated with ART adherence during the early months of treatment in rural Zambia. Methods This is a field based observational longitudinal study in Mumbwa district, which is located 150 km west of Lusaka, the capital of Zambia. Treatment naive patients aged over 15 years, who initiated treatment during September-November 2010, were enrolled. Patients were interviewed at the initiation and six weeks later. The treatment adherence was measured according to self-reporting by the patients. Multiple logistic regression analysis was performed to identify the predictive factors associated with the adherence. Results Of 157 patients, 59.9% were fully adherent to the treatment six weeks after starting ART. According to the multivariable analysis, full adherence was associated with being female [Adjusted Odds Ratio (AOR), 3.3; 95% Confidence interval (CI), 1.2-8.9], having a spouse who were also on ART (AOR, 4.4; 95% CI, 1.5-13.1), and experience of food insufficiency in the previous 30 days (AOR, 5.0; 95% CI, 1.8-13.8). Some of the most common reasons for missed doses were long distance to health facilities (n = 21, 53.8%), food insufficiency (n = 20, 51.3%), and being busy with other activities such as work (n = 15, 38.5%). Conclusions The treatment adherence continues to be a significant challenge in rural Zambia. Social supports from spouses and people on ART could facilitate their treatment adherence. This is likely to require attention by ART services in the future, focusing on different social influences on male and female in rural Zambia. In addition, poverty reduction strategies may help to reinforce adherence to ART and could mitigate the influence of HIV infection for poor patients and those who fall into poverty after

  17. Pharmacological treatments in alcohol use disorders: state of art and new perspectives.

    PubMed

    Guglielmo, R; Ioime, L; Solaroli, S; Janiri, L

    2015-01-01

    The main focus of this narrative review is to present and discuss the most relevant clinical data about the pharmacological therapy for alcohol use disorders. By using PubMed we conducted a review of the clinical literature on drugs related to alcohol use disorders. All data are presented following the three phases of treatment: a) from withdrawal to abstinence; b) abstinence and relapse prevention; c) reduction of alcohol consumption. Historical evidence shows that in addition to the drugs already approved for the treatment of alcoholism, there are some off-label medications as effective as the approved ones which deserve therefore further study. The treatment of the alcoholic patient always requires a multidimensional and multidisciplinary approach, directed to the specific needs of each subject in order to achieve a correct care personalization. The study of the cognitive effects of each drug and pharmacogenetics will allow us to increasingly customize therapy for each individual patient.

  18. State-of-the-art treatment of metastatic hormone-refractory prostate cancer.

    PubMed

    Goodin, Susan; Rao, Kamakshi V; DiPaola, Robert S

    2002-01-01

    Initial therapy for advanced prostate cancer includes androgen ablation by surgical or medical castration. Still, nearly all men with metastases will progress to hormone-refractory prostate cancer (HRPC). Current U.S. Food and Drug Administration-approved agents for the treatment of HRPC include mitoxantrone and estramustine, although the vinca alkaloids and the taxanes have shown promising activity in single-agent phase II trials. Combinations of these agents induce a biochemical response in greater than 50% of patients, but the median duration of response is approximately 6 months. Overall survival of patients treated with these combinations is approximately 18-24 months. Studies are ongoing to develop novel therapies that target specific molecular pathways or mechanisms of chemotherapy resistance. Novel agents under development include growth factor receptor inhibitors, antisense oligonucleotides, bisphosphonates, and cell differentiating agents. Evaluation and incorporation of these agents into existing treatment regimens will guide us in the development of more active regimens in the treatment of HRPC.

  19. [Treatment-resistant depression: state of the art. Part I. Nosography and clinic].

    PubMed

    Luchini, Federica; Cosentino, Luca; Pensabene, Laura; Mauri, Mauro; Lattanzi, Lorenzo

    2014-01-01

    This work would give an overall vision of the actual knowledge about nosography and clinic of treatment-resistant depression. A PubMed, PsychInfo, Google Scolar search was done using the key words "resistant depression", "STAR*D", "bipolar depression", "staging". Have been selected exclusively works in English, French and Italian languages. Treatment-resistant depression is one of the most important problem in public health. Nevertheless a general consensus about its definition and staging does not exist at now. Principal risk factors and associated comorbidities are well known including the association with bipolar spectrum; anyway the disease particularly common among depressed outpatients is still very disabling, responsible of an often chronic course, with numerous relapses and high risk of suicide. The future investigations, once improved procedures for differential diagnosis and subtyping of clinical depression, should be directed to the search of a shared definition of treatment resistance and the development of specific therapeutic protocols.

  20. Effect of mixing process on microleakage of glass ionomer cements used in atraumatic restorative treatment on primary molars.

    PubMed

    Ferreira, Fernanda de Morais; do Vale, Miriam Pimenta Parreira; Jansen, Wellington Corrêa; Paiva, Saul Martins; Pordeus, Isabela Almeida

    2007-01-01

    Aiming to assess the effect of mixing process on microleakage, 40 primary molars were filled with encapsulated glass ionomer cements (GICs) (Vidrion, RCaps and Fuji, IXGPFAST) or with GICs stored in bottles (Vidrion, R and Fuji, IX). Dye penetration was assessed using scores. Encapsulation and mechanical mixing have reduced significantly marginal microleakage levels in class II restorations performed with conventional GICs if compared to the values obtained by their bottled correspondents (p=0.000).

  1. Neuromodulation for treatment resistant depression: state of the art and recommendations for clinical and scientific conduct.

    PubMed

    Schlaepfer, Thomas E; Bewernick, Bettina H

    2014-01-01

    Research of Deep Brain Stimulation as a putative treatment for resistant psychiatric disorders might very well lead to the most significant development in clinical psychiatry of the last 40 years-possibly offering a rise of hope for patients to whom medicine had hitherto little to offer. Furthermore, translational research on neuromodulation will allow us to glean something about the underlying cause of patient's illnesses before figuring out a treatment that addresses the source of the problem. Major depression offers perhaps the best example of the rapid progress being made in understanding the biology of mental illness. Studies on the underlying neurobiology of major depression have typically focused on the description of biological differences between patients and healthy subjects such as alterations of monoaminergic or endocrine systems. Psychotropic drugs work by altering neurochemistry to a large extent in widespread regions of the brain, many of which may be unrelated to depression. We believe that more focused, targeted treatment approaches that modulate specific networks in the brain will prove a more effective approach to help treatment-resistant patients. In other words, whereas existing depression treatments approach this disease as a general brain dysfunction, a more complete and appropriate treatment will arise from thinking of depression as a dysfunction of specific brain networks that mediate mood and reward signals (Berton and Nestler, Nat Rev Neurosci 7 (2):137-151, 2006; Krishnan and Nestler, Nature 455(7215):894-902, 2008). A better understanding of defined dysfunctions in these networks will invariably lead to a better understanding of patients afflicted with depression and perhaps contribute to a de-stigmatization of psychiatric patients and the medical specialty treating them.

  2. Strategies for addressing restorative challenges in HIV-infected children.

    PubMed

    Abdelnur, Juliana Pires; Cerqueira, Daniella Ferraz; Castro, Gloria Fernanda; Maia, Lucianne Cople; de Souza, Ivete Pomarico Ribeiro

    2008-01-01

    The complete caries removal of deep/extensive dentin carious lesions with conventional procedures (high- and low-speed bur) may increase the risk of pulp exposure. In children with systemic diseases, such as HIV-infected children, the dental treatment proposed for the primary dentition with pulp involvement is tooth extraction once endodontic therapies cannot be guaranteed successfully. Therefore, the objective of this study was to describe 3 cases of alternative techniques for caries removal in extensive and/or deep dentin carious lesions in the primary dentition of HIV-infected children: (1) atraumatic restorative treatment (ART); (2) Carisolv; and (3) Papacarie.

  3. Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

    PubMed

    Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

    2014-01-01

    Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

  4. Restoring primary anterior teeth.

    PubMed

    Waggoner, William F

    2002-01-01

    A variety of esthetic restorative materials are available for restoring primary incisors. Knowledge of the specific strengths, weakness, and properties of each material will enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Each has distinct advantages and disadvantages and the clinical conditions of placement may be a strong determining factor as to which material is utilized. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and those crowns that are luted onto the tooth and are some type of stainless steel crown. However, due to lack of supporting clinical data, none of the crowns can be said to be superior to the others under all circumstances. Though caries in the mandibular region is rare, restorative solutions for mandibular incisors are needed. Neither stainless steel crowns nor celluloid crown forms are made specifically for mandibular incisors. Many options exist to repair carious primary incisors, but there is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. This does not discount the fact that dentists have been using many of these crowns for years with much success. Operator preferences, esthetic demands by parents, the child's behavior, and moisture and hemorrhage control are all variables which affect the decision and ultimate outcome of whatever restorative treatment is chosen.

  5. Methods Dentists Use to Diagnose Primary Caries Lesions Prior to Restorative Treatment: Findings from The Dental PBRN

    PubMed Central

    Rindal, D. Brad; Gordan, Valeria V.; Litaker, Mark S.; Bader, James D.; Fellows, Jeffrey L.; Qvist, Vibeke; Wallace-Dawson, Martha C.; Anderson, Mary L.; Gilbert, Gregg H.

    2012-01-01

    Objective To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. Methods A total of 228 DPBRN dentists recorded information on 5,676 consecutive restorations inserted due to primary caries lesions on 3,751 patients. Practitioner-investigators placed a mean of 24.9 (SD=12.4) restorations. Lesions were categorized as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorized as clinical assessment, radiographs, and/or optical. Statistical analysis utilized generalized mixed-model ANOVA to account for the hierarchical structure of the data. Results By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p<0.0001). Conclusion These results — obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios — quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics. PMID:20884316

  6. Evaluation of scraping treatments to restore initial infiltration capacity of three artificial recharge projects in central Iran

    NASA Astrophysics Data System (ADS)

    Mousavi, Sayed-Farhad; Rezai, Vafa

    A limiting factor in developing artificial recharge of groundwater is clogging of the soil surface and consequent reduction of infiltration rates. In order to evaluate the degree of improving infiltration rates by scraping away various amounts of the upper soil materials, a study was conducted at three artificial recharge sites (Kohrouyeh, Bagh-Sorkh, and Kachak) in Isfahan Province, central Iran. Five treatments (T1-T5) were considered. Infiltration was measured: T1, on deposited sediment layer; T2, after removing the sediments; T3, scraping of sediments and 5cm of soil; T4, scraping of sediments and 10cm of soil; and T5, removing sediments and 15cm of soil. Initial soil-moisture content of the sites ranged from 1.0-2.87% for Kohrouyeh, 1.18-3.47% for Bagh-Sorkh, and 1.89-3.93% for Kachak. The main texture of the soils was sandy loam. Clay particles have penetrated to a depth of more than 40cm in some of the recharge basins. A significant increase in final infiltration rate of T5 as compared to T1 treatment was observed for all recharge sites. The final infiltration rates of T1 and T5 treatments for Kohrouyeh, Bagh-Sorkh, and Kachak sites were 0.35, 7.9; 1.22, 12.3; and 0.93, 6.2cm/h, respectively. The differences between infiltration rates of T2, T3, and T4 treatments were not statistically significant. It is concluded that on average, the infiltration capacity of the untreated recharge facilities have reached 20.3% of the original values, and that scraping the top sediment layer and 15cm of topsoil could restore 68.3% of the initial infiltration capacity. Résumé Un facteur limitant lorsqu'on développe la recharge artificielle d'une nappe est le colmatage de la surface du sol et la réduction concomitante des taux d'infiltration. Afin d'évaluer le degré d'amélioration de l'infiltration en grattant de différentes manières la surface du sol, une étude a été conduite sur trois sites de recharge artificielle (Kohrouyeh, Bagh-Sorkh et Kachak) dans la

  7. Remediation of textile effluents by membrane based treatment techniques: a state of the art review.

    PubMed

    Dasgupta, Jhilly; Sikder, Jaya; Chakraborty, Sudip; Curcio, Stefano; Drioli, Enrico

    2015-01-01

    The textile industries hold an important position in the global industrial arena because of their undeniable contributions to basic human needs satisfaction and to the world economy. These industries are however major consumers of water, dyes and other toxic chemicals. The effluents generated from each processing step comprise substantial quantities of unutilized resources. The effluents if discharged without prior treatment become potential sources of pollution due to their several deleterious effects on the environment. The treatment of heterogeneous textile effluents therefore demands the application of environmentally benign technology with appreciable quality water reclamation potential. These features can be observed in various innovative membrane based techniques. The present review paper thus elucidates the contributions of membrane technology towards textile effluent treatment and unexhausted raw materials recovery. The reuse possibilities of water recovered through membrane based techniques, such as ultrafiltration and nanofiltration in primary dye houses or auxiliary rinse vats have also been explored. Advantages and bottlenecks, such as membrane fouling associated with each of these techniques have also been highlighted. Additionally, several pragmatic models simulating transport mechanism across membranes have been documented. Finally, various accounts dealing with techno-economic evaluation of these membrane based textile wastewater treatment processes have been provided.

  8. Moving Towards Gray: Art Therapy and Ambivalence in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Horay, Brian J.

    2006-01-01

    Although some consider the 12-step method of Alcoholics Anonymous to be the treatment of choice for people struggling with substance abuse, differing approaches have been developed within the area of addictions. Motivational interviewing (Miller & Rollnick, 2002), enacted within a stages-of change model (DiClemente & Velasquez, 2002), seeks to…

  9. STATE OF THE ART IN TREATMENT AND SURVIVAL OF PATHOGENS IN BIOSOLIDS

    EPA Science Inventory

    This paper discusses the pathogen/stability concerns for municipal residuals and the applicability of current sludge treatment processes to control health risks potentially associated with the use or disposal of these residuals. In recent years, there has been a rise in public co...

  10. STATE OF THE ART IN TREATMENT AND SURVIVAL OF PATHOGENS IN BIOSOLIDS

    EPA Science Inventory

    This paper discusses the pathogen/stability concerns for municipal residuals and the applicability of current sludge treatment processes to control health risks potentially associated with the use or disposal of these residuals. In recent years, there has been a rise in public co...

  11. State-of-the-art report on low-level radioactive waste treatment

    NASA Astrophysics Data System (ADS)

    Kibbey, A. H.; Godbee, H. W.

    1980-09-01

    An attempt is made to identify the main sources of low-level radioactive wastes that are generated in the United States. To place the waste problem in perspective, rough estimates are given of the annual amounts of each generic type of waste that is generated. Most of the wet solid wastes arise from the cleanup of gaseous and liquid radioactive streams prior to discharge or recycle. The treatment of the process streams and the secondary wet solid wastes thus generated is described for each type of government or fuel cycle installation. Similarly, the institutional wet wastes are also described. The dry wastes from all sources have similar physical and chemical characteristics in that they can be classified as compactible, noncompactible, combustible, noncombustible, or combinations thereof. The various treatment options for concentrated or solid wet wastes and for dry wastes are discussed. The treatment of radioactive medical and bioresearch wastes is described. Recovery of waste metals and treatment of hazardous contaminated wastes are discussed briefly.

  12. State-of-the-art report on low-level radioactive waste treatment

    SciTech Connect

    Kibbey, A.H.; Godbee, H.W.

    1980-09-01

    An attempt is made to identify the main sources of low-level radioactive wastes that are generated in the United States. To place the waste problem in perspective, rough estimates are given of the annual amounts of each generic type of waste that is generated. Most of the wet solid wastes arise from the cleanup of gaseous and liquid radioactive streams prior to discharge or recycle. The treatment of the process streams and the secondary wet solid wastes thus generated is described for each type of government or fuel cycle installation. Similarly, the institutional wet wastes are also described. The dry wastes from all sources have smilar physical and chemical characteristics in that they can be classified as compactible, noncompactible, combustible, noncombustible, or combinations thereof. The various treatment options for concentrated or solid wet wastes and for dry wastes are discussed. Among the dry-waste treatment methods are compaction, baling, and incineration, as well as chopping, cutting, and shredding. Organic materials can usually be incinerated or, in some cases, biodegraded. The filter sludges, spent resins, incinerator ashes, and concentrated liquids are usually solidified in cement, urea-formaldehyde, or unsaturated polyester resins prior to burial. Asphalt has not yet been used as a solidificaton agent in the United States, but it probably will be used in the near future. The treatment of radioactive medical and bioresearch wastes is described, but the waste from radiochenmical, pharmaceutical, and other industries is not well defined at the present time. Recovery of waste metals and treatment of hazardous contaminated wastes are discussed briefly. Some areas appearing to need more research, development, and demonstration are specifically pointed out.

  13. Sulfatide--a new candidate for ART treatment in HIV-1 infection.

    PubMed

    Sundell, I Birgitta; Cortado, Ruth V; Koka, Prasad S

    2012-01-01

    New combination drug treatment(s) now available to patients with HIV-1 infection allows them to live longer lives with good quality of life although they suffer from the incurable HIV-1 infection. In a previous study we found that sulfatide was efficient in lowering HIV-1 viral loads in SCID mice engrafted with human fetal liver/thymus tissues (SCID-hu). Current antiviral treatments carry an increased risk of other complications like cardiovascular disease and diabetes after long-term use. There is a need for new potent safe pharmaceutical agents. Endogenous sulfatide is a mixture of -isoforms, i.e. sulfatide molecules with different long-chain bases and fatty acid chain lengths and saturation. Sulfatide isoforms may have different physicochemical properties i.e, they are of different potency at different target cells. Other investigators have shown that incubation of cultured cells with sulfatide incorporated into the plasma membrane inhibited HIV-1 entry into the cells thereby inhibiting intracellular HIV-1 replication. We have shown that CD1d dependent stimulation by sulfatide may activate pDC antigen expressing cells that produce type I inteferons. Type I inteferons are known to reduce HIV-1 replication. This could provide a second likely explanation (after the inhibition of virus entry) for the more efficient lowering of HIV-1 viral loads in sulfatide versus AZT treated mice. This review aims to show the efficiency of sulfatide in reducing HIV-1 viral loads as compared to conventional HAART treatment. We also discuss the risks of HAART treatment and propose a clinical alternative of sulfatide in HIV-1 infection.

  14. Naringin treatment induces neuroprotective effects in a mouse model of Parkinson's disease in vivo, but not enough to restore the lesioned dopaminergic system.

    PubMed

    Kim, Heung Deok; Jeong, Kyoung Hoon; Jung, Un Ju; Kim, Sang Ryong

    2016-02-01

    We recently reported that treatment with naringin, a major flavonoid found in grapefruit and citrus fruits, attenuated neurodegeneration in a rat model of Parkinson's disease (PD) in vivo. In order to investigate whether its effects are universally applied to a different model of PD and whether its treatment induces restorative effects on the lesioned nigrostriatal dopaminergic (DA) projection, we observed the effects of pre-treatment or post-treatment with naringin in a mouse model of PD. For neuroprotective effects, 6-hydroxydopamine (6-OHDA) was unilaterally injected into the striatum of mouse brains for a neurotoxin model of PD in the presence or absence of naringin by daily intraperitoneal injection. Our results showed that naringin protected the nigrostriatal DA projection from 6-OHDA-induced neurotoxicity. Moreover, similar to the effects in rat brains, this treatment induced the activation of mammalian target of rapamycin complex 1 (mTORC1), which is well known as an important survival factor for DA neurons, and inhibited microglial activation in the substantia nigra (SN) of mouse brains treated with 6-OHDA. However, there was no significant change of DA phenotypes in the SN and striatum post-treated with naringin compared with 6-OHDA-lesioned mice, despite the treatment being continued for 12 weeks. These results suggest that post-treatment with naringin alone may not be enough to restore the nigrostriatal DA projection in a mouse model of PD. However, our results apparently suggest that naringin is a beneficial natural product to prevent DA degeneration, which is involved in PD.

  15. On the design and operation of primary settling tanks in state of the art wastewater treatment and water resources recovery.

    PubMed

    Patziger, Miklos; Günthert, Frank Wolfgang; Jardin, Norbert; Kainz, Harald; Londong, Jörg

    2016-11-01

    In state of the art wastewater treatment, primary settling tanks (PSTs) are considered as an integral part of the biological wastewater and sludge treatment process, as well as of the biogas and electric energy production. Consequently they strongly influence the efficiency of the entire wastewater treatment plant. However, in the last decades the inner physical processes of PSTs, largely determining their efficiency, have been poorly addressed. In common practice PSTs are still solely designed and operated based on the surface overflow rate and the hydraulic retention time (HRT) as a black box. The paper shows the results of a comprehensive investigation programme, including 16 PSTs. Their removal efficiency and inner physical processes (like the settling process of primary sludge), internal flow structures within PSTs and their impact on performance were investigated. The results show that: (1) the removal rates of PSTs are generally often underestimated in current design guidelines, (2) the removal rate of different PSTs shows a strongly fluctuating pattern even in the same range of the HRT, and (3) inlet design of PSTs becomes highly relevant in the removal efficiency at rather high surface overflow rates, above 5 m/h, which is the upper design limit of PSTs for dry weather load.

  16. Atomic Oxygen Used to Restore Artworks

    NASA Technical Reports Server (NTRS)

    Banks, Bruce A.; Miller, Sharon K.

    2004-01-01

    Techniques developed at the NASA Glenn Research Center to produce atomic oxygen in order to simulate the low-Earth-orbit environment for spacecraft materials testing can also be applied in the field of art restoration. Defaced or fire-damaged artwork can be treated with atomic oxygen to remove the damage and enable restoration that could not be accomplished with conventional methods. The process has been patented (U.S. Patents 5,560,781 and 5,693,241) and has been used to restore several works of art.

  17. Renal denervation for treatment of cardiac arrhythmias: state of the art and future directions.

    PubMed

    Kosiuk, Jedrzej; Hilbert, Sebastian; Pokushalov, Evgeny; Hindricks, Gerhard; Steinberg, Jonathan S; Bollmann, Andreas

    2015-02-01

    It has now been more than a quarter of a century since modulation of the sympathetic nervous system was proposed for the treatment of cardiac arrhythmias of different origins. But it has also been some time since some of the early surgical attempts have been abandoned. With the development of ablation techniques, however, new approaches and targets have been recently introduced that have revolutionized our way of thinking about sympathetic modulation. Renal nerve ablation technology is now being successfully used for the treatment of resistant hypertension, but the indication spectrum might broaden and new therapeutic options might arise in the near future. This review focuses on the possible impact of renal sympathetic system modulation on cardiac arrhythmias, the current evidence supporting this approach, and the ongoing trials of this method in electrophysiological laboratories. We will discuss the potential roles that sympathetic modulation may play in the future.

  18. Applications of molecular diagnostics for personalized treatment of head and neck cancer: state of the art.

    PubMed

    Mes, Steven W; Leemans, C René; Brakenhoff, Ruud H

    2016-01-01

    Squamous cell carcinomas of the head and neck are the sixth most frequent tumors worldwide. Risk factors are carcinogenic exposure, infection with the human papillomavirus (HPV) and genetic predisposition. Lymph node metastasis in the neck and HPV status are major prognostic factors. There are several important clinical challenges that determine the research agenda in head and neck cancer. The first is more accurate staging, particularly of occult metastatic lymph nodes in the neck. A second challenge is the lack of biomarkers for personalized therapy. There are a number of treatment modalities that can be employed both single and in combination, but at present only site and stage of the tumor are used for treatment planning. Provided here is an overview of the successes and failures of molecular diagnostic approaches that have been and are being evaluated to address these clinical challenges.

  19. State of the art and review on the treatment technologies of water reverse osmosis concentrates.

    PubMed

    Pérez-González, A; Urtiaga, A M; Ibáñez, R; Ortiz, I

    2012-02-01

    The growing demand for fresh water is partially satisfied by desalination plants that increasingly use membrane technologies and among them reverse osmosis to produce purified water. Operating with water recoveries from 35% to 85% RO plants generate huge volumes of concentrates containing all the retained compounds that are commonly discharged to water bodies and constitute a potentially serious threat to marine ecosystems; therefore there is an urgent need for environmentally friendly management options of RO brines. This paper gives an overview on the potential treatments to overcome the environmental problems associated to the direct discharge of RO concentrates. The treatment options have been classified according to the source of RO concentrates and the maturity of the technologies. For the sake of clarity three different sources of RO concentrates are differentiated i) desalination plants, ii) tertiary processes in WWTP, and iii) mining industries. Starting with traditional treatments such as evaporation and crystallization other technologies that have emerged in last years to reduce the volume of the concentrate before disposal and with the objective of achieving zero liquid discharge and recovery of valuable compounds from these effluents are also reviewed. Most of these emerging technologies have been developed at laboratory or pilot plant scale (see Table 1). With regard to RO concentrates from WWTP, the manuscript addresses recent studies that are mainly focused on reducing the organic pollutant load through the application of innovative advanced oxidation technologies. Finally, works that report the treatment of RO concentrates from industrial sources are analyzed as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Oxybutynin for the Treatment of Primary Hyperhidrosis: Current State of the Art

    PubMed Central

    Campanati, Anna; Gregoriou, Stamatis; Kontochristopoulos, George; Offidani, Annamaria

    2015-01-01

    Oxybutynin is an anticholinergic drug with an emerging role in the treatment of hyperhidrosis. Several recent studies have documented that it is effective both in focal and generalized hyperhidrosis and shows universally good response among different groups of patients regardless of age, gender, and weight. The most common adverse event is dry mouth reported by almost all patients treated. The way this might affect long-term compliance and tolerability should be better investigated in the future. PMID:27172124

  1. Health literacy in HIV treatment: accurate understanding of key biological treatment principles is not required for good ART adherence.

    PubMed

    Laws, M Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B

    2015-04-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors' instructions, without the need for deep understanding.

  2. State-of-the-art of external photon beam radiation treatment planning. Photon Treatment Planning Collaborative Working Group.

    PubMed

    1991-05-15

    A virtual revolution in computer capability has occurred in the last few years, largely based on rapidly decreasing costs and increasing reliability of digital memory and mass-storage capability. These developments have now made it possible to consider the application of both computer and display technologies to a much broader range of problems in radiation therapy, including planning of treatment, dose computation, and treatment verification. Several methods of three-dimensional dose computations in heterogeneous media capable of 3% accuracy are likely to be available, but significant work still remains, particularly for high energy x-rays where electron transport, and possibly pair production, need to be considered. Innovative display and planning techniques, as well as plan evaluation schemes, are emerging and show great promise for the future. No doubt these advances will lead to substantially improved treatment planning systems in the next few years. However, it must be emphasized that for many of these applications a tremendous software and hardware development effort is required.

  3. Health Literacy in HIV Treatment: Accurate Understanding of Key Biological Treatment Principles is Not Required for Good ART Adherence

    PubMed Central

    Laws, M. Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B.

    2016-01-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors’ instructions, without the need for deep understanding. PMID:25354736

  4. Nanomedicine applications in the treatment of breast cancer: current state of the art.

    PubMed

    Wu, Di; Si, Mengjie; Xue, Hui-Yi; Wong, Ho-Lun

    2017-01-01

    Breast cancer is the most common malignant disease in women worldwide, but the current drug therapy is far from optimal as indicated by the high death rate of breast cancer patients. Nanomedicine is a promising alternative for breast cancer treatment. Nanomedicine products such as Doxil(®) and Abraxane(®) have already been extensively used for breast cancer adjuvant therapy with favorable clinical outcomes. However, these products were originally designed for generic anticancer purpose and not specifically for breast cancer treatment. With better understanding of the molecular biology of breast cancer, a number of novel promising nanotherapeutic strategies and devices have been developed in recent years. In this review, we will first give an overview of the current breast cancer treatment and the updated status of nanomedicine use in clinical setting, then discuss the latest important trends in designing breast cancer nanomedicine, including passive and active cancer cell targeting, breast cancer stem cell targeting, tumor microenvironment-based nanotherapy and combination nanotherapy of drug-resistant breast cancer. Researchers may get insight from these strategies to design and develop nanomedicine that is more tailored for breast cancer to achieve further improvements in cancer specificity, antitumorigenic effect, antimetastasis effect and drug resistance reversal effect.

  5. Aeration of large-scale municipal wastewater treatment plants: state of the art.

    PubMed

    Rosso, Diego; Stenstrom, Michael K; Larson, Lory E

    2008-01-01

    Aeration is the most energy-intensive operation in wastewater treatment, amounting to 45-75% of plant energy costs. Fine-pore diffusers are today almost ubiquitous in municipal wastewater aeration, due to their advantageous aeration efficiency (mass of oxygen transferred per unit energy required). Nevertheless, older municipal treatment facilities and many industrial treatment plants are still equipped with coarse-bubble or surface aerators. Fine-pore diffusers are subject to two major disadvantages: a) fouling, if not cleaned periodically; b) decrease in oxygen transfer efficiency caused by dissolved surfactants. Coarse-bubble and surface aerators are typically not subject to the traditional problems affecting fine-pore diffusers. Nonetheless, they achieve oxygen transfer at the expense of increased energy intensity. The increased biomass concentration associated with high mean cell retention time (MCRT) operations has a beneficial effect on aeration. Nutrient-removing selectors are able to further increase aeration efficiency, as they sorb and utilize the readily available substrate which otherwise would accumulate at bubble surfaces and dramatically decrease aeration efficiency. We summarise here our 30-year long experience in aeration research, and results obtained with clean- and process-water tests are used to show the beneficial effects of high MCRT operations, the beneficial effect of selectors, and the decline of aeration efficiency due to dissolved surfactants. Copyright IWA Publishing 2008.

  6. Arts Education: Teaching What Technology Cannot

    ERIC Educational Resources Information Center

    Taylor, Bruce

    2012-01-01

    Recently, Paul Sznewajs and Nick Rabkin made an introductory case for restoring the arts into Chicago Public Schools. They noted that past research has shown the positive benefits of arts instruction, especially for low-income students. Over the last several decades, research has validated the role of the arts, while in the same time span people…

  7. Photodynamic therapy in colorectal cancer treatment--The state of the art in preclinical research.

    PubMed

    Kawczyk-Krupka, Aleksandra; Bugaj, Andrzej M; Latos, Wojciech; Zaremba, Katarzyna; Wawrzyniec, Katarzyna; Kucharzewski, Marek; Sieroń, Aleksander

    2016-03-01

    Photodynamic therapy (PDT) is used in many different oncologic fields. Also in gastroenterology, where have been a few attempts to treat both the premalignant lesion and advanced colorectal cancer (CRC). This review aims to give a general overview of preclinical photodynamic studies related to CRC cells and animal studies of photodynamic effects related to CRC treatment to emphasize their potential in study of PDT mechanism, safety and efficiency to translate these results into clinical benefit in CRC treatment. Literature on in vitro preclinical photodynamic studies related to CRC cells and animal studies of photodynamic effects related to CRC treatment with the fallowing medical subject headings search terms: colorectal cancer, photodynamic therapy, photosensitizer(s), in vitro, cell culture(s), in vivo, animal experiment(s). The articles were selected by their relevance to the topic. The majority of preclinical studies concerning possibility of PDT application in colon and rectal cancer is focused on phototoxic action of photosensitizers toward cultured colorectal tumor cells in vitro. The purposes of animal experiments are usually elucidation of mechanisms of observed photodynamic effects in scale of organism, estimation of PDT safety and efficiency and translation of these results into clinical benefit. In vitro photodynamic studies and animal experiments can be useful for studies of mechanisms and efficiency of photodynamic method as a start point on PDT clinical research. The primary disadvantage of in vitro experiments is a risk of over-interpretation of their results during extrapolation to the entire CRC. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Natural restoration

    SciTech Connect

    Kamlet, K.S.

    1993-02-01

    After a company pays millions of dollars to clean up contaminated site, its liability may not be over. It may have to spend tens of millions more to restore damaged natural resources under an oft-overlooked Superfund program. Examples of liability are cited in this report from the Exxon Valdez oil spill and a pcb leak which contaminated a harbor.

  9. Ecological restoration

    Treesearch

    Christopher D. Barton; John I. Blake; Donald W. Imm

    2005-01-01

    The long history of human settlement, agriculture, and industry at the Savannah River Site (SRS) has created extensive opportunities for ecological restoration. Two hundred years of farming, drainage, dam construction, stream channeling, fire protection, subsistence hunting and fishing, exotic animal and plant introduction, and selective timber harvesting have caused...

  10. Chronic Vortioxetine Treatment Reduces Exaggerated Expression of Conditioned Fear Memory and Restores Active Coping Behavior in Chronically Stressed Rats

    PubMed Central

    Sánchez, Connie

    2017-01-01

    Abstract Background: Stress is a risk factor for depression and anxiety disorders, disrupting neuronal processes leading to exaggerated fear and compromised coping behaviors. Current antidepressants are only partially effective. Vortioxetine, a novel multimodal antidepressant, is a serotonin transporter inhibitor; 5-HT3, 5-HT7, and 5-HT1D receptor antagonist; 5-HT1B partial agonist; and 5-HT1A agonist. We have shown that chronic dietary vortioxetine administration reversed stress-induced deficits in cognitive flexibility. In the present studies, we investigated the generality of vortioxetine’s effects on other stress-related behavioral changes after different types of chronic stress. Methods: In experiment 1, rats were fear-conditioned by pairing a tone with footshock, then exposed to chronic plus acute prolonged stress. In experiment 2, rats were exposed to chronic unpredictable stress. In both experiments, beginning on day 4 of chronic stress, vortioxetine was given in the diet (24 mg/kg/d). In experiment 1, effects of vortioxetine were tested on stress-induced changes in retention and extinction of cue-conditioned fear, and in experiment 2, on coping behavior on the shock probe defensive burying test after chronic stress. Results: Chronic stress exaggerated the expression of conditioned fear memory. Vortioxetine restored fear memory to control levels and rendered extinction in stressed rats comparable with that in controls. In experiment 2, chronic unpredictable stress caused a shift from active to passive coping behavior, and vortioxetine restored active coping. Conclusions: Vortioxetine reduced exaggerated expression of conditioned fear and restored adaptive coping behavior following 2 different types of chronic stress, adding to the evidence of its therapeutic potential in the management of depression and anxiety disorders. PMID:27927740

  11. Chronic Vortioxetine Treatment Reduces Exaggerated Expression of Conditioned Fear Memory and Restores Active Coping Behavior in Chronically Stressed Rats.

    PubMed

    Hatherall, Lauren; Sánchez, Connie; Morilak, David A

    2016-12-29

    Stress is a risk factor for depression and anxiety disorders, disrupting neuronal processes leading to exaggerated fear and compromised coping behaviors. Current antidepressants are only partially effective. Vortioxetine, a novel multimodal antidepressant, is a serotonin transporter inhibitor; 5-HT3, 5-HT7, and 5-HT1D receptor antagonist; 5-HT1B partial agonist; and 5-HT1A agonist. We have shown that chronic dietary vortioxetine administration reversed stress-induced deficits in cognitive flexibility. In the present studies, we investigated the generality of vortioxetine's effects on other stress-related behavioral changes after different types of chronic stress. In experiment 1, rats were fear-conditioned by pairing a tone with footshock, then exposed to chronic plus acute prolonged stress. In experiment 2, rats were exposed to chronic unpredictable stress. In both experiments, beginning on day 4 of chronic stress, vortioxetine was given in the diet (24 mg/kg/d). In experiment 1, effects of vortioxetine were tested on stress-induced changes in retention and extinction of cue-conditioned fear, and in experiment 2, on coping behavior on the shock probe defensive burying test after chronic stress. Chronic stress exaggerated the expression of conditioned fear memory. Vortioxetine restored fear memory to control levels and rendered extinction in stressed rats comparable with that in controls. In experiment 2, chronic unpredictable stress caused a shift from active to passive coping behavior, and vortioxetine restored active coping. Vortioxetine reduced exaggerated expression of conditioned fear and restored adaptive coping behavior following 2 different types of chronic stress, adding to the evidence of its therapeutic potential in the management of depression and anxiety disorders. © The Author 2016. Published by Oxford University Press on behalf of CINP.

  12. Medical treatment and patient decisional power: the Italian state of the art.

    PubMed

    Molinelli, A; Bonsignore, A; Rocca, G; Ciliberti, R

    2009-10-01

    Therapy dissent and refusal are the situations most debated in the medical profession, that lead to various interpretations with regards to life and health, and even more in case of death risk. In the last decades, the medical treatment consent matter has become such an interesting and central issue that it has considerably modified the doctor-patient relationship. In particular, thanks to a fecund discussion on doctrine and case law, the informed consent became an autonomy act through which the patient exercises his/her personal health right. There are two international provisions that deserve to be mentioned for the matter: article no. 3 of the Charter of Fundamental Rights of the European Union, adopted in Nice on December 7, 2000, and the Oviedo Convention of April 4, 1997, which Italy passed under article no. 145, March 28, 2001. Both laws are symptomatic for the growing attention toward the person's self-determination, and for the impossibility to perform treatment in absence of personal, informed, recent and at any time revocable consent of the person concerned. Actually, these different and opposite ways of thinking correspond to a variable attitude of the case law that, in absence of a clear legislation regarding this matter, induces a deep insecurity in the physician's act on the one hand, and, does not allow the patient to totally avail him/herself of the self-determination principle on the other hand, particularly regarding the will and choices on health care.

  13. On-treatment platelet reactivity: State of the art and perspectives.

    PubMed

    Marcucci, Rossella; Grifoni, Elisa; Giusti, Betti

    2016-02-01

    High on-clopidogrel platelet reactivity (HcPR) during dual-antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis, in patients with acute coronary syndromes (ACS). Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HcPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulated platelets in patients' blood, that characterize the acute phase of acute coronary syndromes, are associated with HcPR. To overcome the limitation of clopidogrel, new antiplatelet agents (prasugrel and ticagrelor) were developed and the demonstration of their superiority over clopidogrel was obtained in the two randomized trials, TRITON TIMI 38 and PLATO. Emerging evidence is accumulating on the role of high-on aspirin platelet reactivity (HaPR), especially in the clinical context of diabetes. Finally, the presence of new, potent antiplatelet drugs has shifted the focus from thrombotic to bleeding risk. Recent data document that low on-treatment platelet reactivity (LPR) is associated with a significantly higher bleeding risk. Due to the current possibility to choose between multiple antiplatelet strategies, the future perspective is to include in the management of ACS, in addition to clinical data and classical risk factors, the definition of platelet function during treatment in order to set a tailored therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Essential Oils for Complementary Treatment of Surgical Patients: State of the Art

    PubMed Central

    Stea, Susanna; Beraudi, Alina; De Pasquale, Dalila

    2014-01-01

    Aromatherapy is the controlled use of plant essences for therapeutic purposes. Its applications are numerous (i.e., wellbeing, labour, infections, dementia, and anxiety treatment) but often they have not been scientifically validated. The aim of the present study is to review the available literature to determine if there is evidence for effectiveness of aromatherapy in surgical patients to treat anxiety and insomnia, to control pain and nausea, and to dress wound. Efficacy studies of lavender or orange and peppermint essential oils, to treat anxiety and nausea, respectively, have shown positive results. For other aspects, such as pain control, essential oils therapy has shown uncertain results. Finally, there are encouraging data for the treatment of infections, especially for tea tree oil, although current results are still inconclusive. It should also be considered that although they are, allergic reactions and toxicity can occur after oral ingestion. Therefore, while rigorous studies are being carried out, it is important that the therapeutic use of essential oils be performed in compliance with clinical safety standards. PMID:24707312

  15. Essential oils for complementary treatment of surgical patients: state of the art.

    PubMed

    Stea, Susanna; Beraudi, Alina; De Pasquale, Dalila

    2014-01-01

    Aromatherapy is the controlled use of plant essences for therapeutic purposes. Its applications are numerous (i.e., wellbeing, labour, infections, dementia, and anxiety treatment) but often they have not been scientifically validated. The aim of the present study is to review the available literature to determine if there is evidence for effectiveness of aromatherapy in surgical patients to treat anxiety and insomnia, to control pain and nausea, and to dress wound. Efficacy studies of lavender or orange and peppermint essential oils, to treat anxiety and nausea, respectively, have shown positive results. For other aspects, such as pain control, essential oils therapy has shown uncertain results. Finally, there are encouraging data for the treatment of infections, especially for tea tree oil, although current results are still inconclusive. It should also be considered that although they are, allergic reactions and toxicity can occur after oral ingestion. Therefore, while rigorous studies are being carried out, it is important that the therapeutic use of essential oils be performed in compliance with clinical safety standards.

  16. Experience Art.

    ERIC Educational Resources Information Center

    Turner, Brenda

    This Arkansas art education curriculum guide for grades 1 to 6 covers basic concepts, vocabulary, activities, and evaluation for each grade. The basic concepts to be taught throughout these grades include line, shape, color, space, drawing, painting, printing, art history, and art careers. Specific art techniques and types of arts are introduced…

  17. [How useful is restorative care in the primary dentition?

    PubMed

    Frencken, J E

    2017-04-01

    Too many children develop carious lesions and many such lesions progress into a dentine carious lesion. In 2010, the percentage of dentine carious lesions in the primary dentition of 6-year-old Dutch children that were restored was less than 50 per cent. Owing to research, the necessity to restore dentine carious lesions routinely has been called into question. Current understanding of cariologic principles point in the direction of a causal treatment that is based on cleaning accessible dentine carious cavities and those that can be made accessible, possibly supported by the application of silver diamine fluoride. The ultimate goal of a restoration in the primary dentition is to make it possible to remove biofilm from the tooth surface and to prevent infection of the pulp. If restoration in primary teeth is necessary, dental practitioners will, in order to prevent the development of dental anxiety, first have to consider whether it is feasible to place restorations in an atraumatic manner, for example by means of the ART method or the Hall technique.

  18. Nanotechnology-based inhalation treatments for lung cancer: state of the art

    PubMed Central

    Ahmad, Javed; Akhter, Sohail; Rizwanullah, Md; Amin, Saima; Rahman, Mahfoozur; Ahmad, Mohammad Zaki; Rizvi, Moshahid Alam; Kamal, Mohammad A; Ahmad, Farhan Jalees

    2015-01-01

    Considering the challenges associated with conventional chemotherapy, targeted and local delivery of chemotherapeutics via nanoparticle (NP) carriers to the lungs is an emerging area of interest. Recent studies and growing clinical application in cancer nanotechnology showed the huge potential of NPs as drug carriers in cancer therapy, including in lung carcinoma for diagnosis, imaging, and theranostics. Researchers have confirmed that nanotechnology-based inhalation chemotherapy is viable and more effective than conventional chemotherapy, with lesser side effects. Recently, many nanocarriers have been investigated, including liposomes, polymeric micelles, polymeric NPs, solid lipid NPs, and inorganic NPs for inhalation treatments of lung cancer. Yet, the toxicity of such nanomaterials to the lungs tissues and further distribution to other organs due to systemic absorption on inhalation delivery is a debatable concern. Here, prospect of NPs-based local lung cancer targeting through inhalation route as well as its associated challenges are discussed. PMID:26640374

  19. [Osteosynthesis in the Surgical Treatment of Prognathism: State of The Art].

    PubMed

    Durão, Nuno; Amarante, José

    2017-03-31

    Prognathism is a common skeletal facial abnormality, associated with class III malocclusion, often with repercussions in quality of life. In addition to orthodontic treatment, sagittal split ramus osteotomy is the most common technique for its correction, and segment osteosynthesis is an important element of the post-surgical outcome. A search for relevant literature was conducted in the PubMed/MEDLINE database and in other relevant sources. The stability of different fixation methods, their repercussions on inferior alveolar nerve lesions, and the type of material are among the most researched subjects. Recent research about the type of osteosynthesis applied in the sagittal split ramus osteotomy for mandibular setback is discussed. Miniplates appear to be the better option for fixation of sagittal split osteotomy for mandibular setback. Bioabsorbable osteosynthesis may be an acceptable alternative to titanium.

  20. In-ear medical devices for acoustic therapies in tinnitus treatments, state of the art.

    PubMed

    Ibarra, David; Tavira-Sanchez, Francisco; Recuero-Lopez, Manuel; Anthony, Brian W

    2017-04-21

    Cochrane reviews indicate there is very limited support for all forms of sound therapy and cognitive behavioral therapy has the strongest support. American Academy of Otolaryngology (AAO) recently published some guidelines which recommends Cognitive Behavioral Therapy (CBT) for tinnitus intervention, and only indicates that sound therapy should be considered an "option" for intervention. Nevertheless, acoustic therapy could lead to cause changes in the tinnitus perception and has been appreciated by the affected people for years. In the last decades, the use of sound or sound enrichment has become a central part of many tinnitus management programs used by audiologists, whether the intention was to mask tinnitus, suppress tinnitus, or interrupt the tinnitus generating neural activity. Several acoustic therapies have been developed and implemented in the last 40 years, but how can we determine which one is the most effective? We can determine the effects based on the results reported in many research studies, but in those studies are many factors that differ from one study to another, like in-ear medical devices used to apply acoustic therapy for tinnitus treatment. In this article, we review and analyze the different types of in-ear medical devices used in the most recently acoustic therapies in treatments against tinnitus, allowing us to identify the pros and cons. By our analysis, an optimal medical device could be characterized to enhance the application of acoustic therapies and in consequence the global results of the sound therapies that already exist. In this review, it was considered acoustic therapies, the technology implemented in medical devices and the clinical needs. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. State-of-the-art monitoring in treatment of dengue shock syndrome: a case series.

    PubMed

    Moulton, Steven L; Mulligan, Jane; Srikiatkhachorn, Anon; Kalayanarooj, Siripen; Grudic, Greg Z; Green, Sharone; Gibbons, Robert V; Muniz, Gary W; Hinojosa-Laborde, Carmen; Rothman, Alan L; Thomas, Stephen J; Convertino, Victor A

    2016-08-24

    Early recognition and treatment of circulatory volume loss is essential in the clinical management of dengue viral infection. We hypothesized that a novel computational algorithm, originally developed for noninvasive monitoring of blood loss in combat casualties, could: (1) indicate the central volume status of children with dengue during the early stages of "shock"; and (2) track fluid resuscitation status. Continuous noninvasive photoplethysmographic waveforms were collected over a 5-month period from three children of Thai ethnicity with clinical suspicion of dengue. Waveform data were processed by the algorithm to calculate each child's Compensatory Reserve Index, where 1 represents supine normovolemia and 0 represents the circulatory volume at which hemodynamic decompensation occurs. Values between 1 and 0 indicate the proportion of reserve remaining before hemodynamic decompensation. This case report describes a 7-year-old Thai boy, another 7-year-old Thai boy, and a 9-year-old Thai boy who exhibited signs and symptoms of dengue shock syndrome; all the children had secondary dengue virus infections, documented by serology and reverse transcriptase polymerase chain reaction. The three boys experienced substantial plasma leakage demonstrated by pleural effusion index >25, ascites, and >20 % hemoconcentration. They received fluid administered intravenously; one received a blood transfusion. All three boys showed a significantly low initial Compensatory Reserve Index (≥0.20), indicating a clinical diagnosis of "near shock". Following 5 days with fluid resuscitation treatment, their Compensatory Reserve Index increased towards "normovolemia" (that is, Compensatory Reserve Index >0.75). The results from these cases demonstrate a new variation in the diagnostic capability to manage patients with dengue shock syndrome. The findings shed new light on a method that can avoid possible adverse effects of shock by noninvasive measurement of a patient's compensatory

  2. The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

    PubMed Central

    Ashok, A H; Marques, T R; Jauhar, S; Nour, M M; Goodwin, G M; Young, A H; Howes, O D

    2017-01-01

    Bipolar affective disorder is a common neuropsychiatric disorder. Although its neurobiological underpinnings are incompletely understood, the dopamine hypothesis has been a key theory of the pathophysiology of both manic and depressive phases of the illness for over four decades. The increased use of antidopaminergics in the treatment of this disorder and new in vivo neuroimaging and post-mortem studies makes it timely to review this theory. To do this, we conducted a systematic search for post-mortem, pharmacological, functional magnetic resonance and molecular imaging studies of dopamine function in bipolar disorder. Converging findings from pharmacological and imaging studies support the hypothesis that a state of hyperdopaminergia, specifically elevations in D2/3 receptor availability and a hyperactive reward processing network, underlies mania. In bipolar depression imaging studies show increased dopamine transporter levels, but changes in other aspects of dopaminergic function are inconsistent. Puzzlingly, pharmacological evidence shows that both dopamine agonists and antidopaminergics can improve bipolar depressive symptoms and perhaps actions at other receptors may reconcile these findings. Tentatively, this evidence suggests a model where an elevation in striatal D2/3 receptor availability would lead to increased dopaminergic neurotransmission and mania, whilst increased striatal dopamine transporter (DAT) levels would lead to reduced dopaminergic function and depression. Thus, it can be speculated that a failure of dopamine receptor and transporter homoeostasis might underlie the pathophysiology of this disorder. The limitations of this model include its reliance on pharmacological evidence, as these studies could potentially affect other monoamines, and the scarcity of imaging evidence on dopaminergic function. This model, if confirmed, has implications for developing new treatment strategies such as reducing the dopamine synthesis and/or release in

  3. The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment.

    PubMed

    Ashok, A H; Marques, T R; Jauhar, S; Nour, M M; Goodwin, G M; Young, A H; Howes, O D

    2017-05-01

    Bipolar affective disorder is a common neuropsychiatric disorder. Although its neurobiological underpinnings are incompletely understood, the dopamine hypothesis has been a key theory of the pathophysiology of both manic and depressive phases of the illness for over four decades. The increased use of antidopaminergics in the treatment of this disorder and new in vivo neuroimaging and post-mortem studies makes it timely to review this theory. To do this, we conducted a systematic search for post-mortem, pharmacological, functional magnetic resonance and molecular imaging studies of dopamine function in bipolar disorder. Converging findings from pharmacological and imaging studies support the hypothesis that a state of hyperdopaminergia, specifically elevations in D2/3 receptor availability and a hyperactive reward processing network, underlies mania. In bipolar depression imaging studies show increased dopamine transporter levels, but changes in other aspects of dopaminergic function are inconsistent. Puzzlingly, pharmacological evidence shows that both dopamine agonists and antidopaminergics can improve bipolar depressive symptoms and perhaps actions at other receptors may reconcile these findings. Tentatively, this evidence suggests a model where an elevation in striatal D2/3 receptor availability would lead to increased dopaminergic neurotransmission and mania, whilst increased striatal dopamine transporter (DAT) levels would lead to reduced dopaminergic function and depression. Thus, it can be speculated that a failure of dopamine receptor and transporter homoeostasis might underlie the pathophysiology of this disorder. The limitations of this model include its reliance on pharmacological evidence, as these studies could potentially affect other monoamines, and the scarcity of imaging evidence on dopaminergic function. This model, if confirmed, has implications for developing new treatment strategies such as reducing the dopamine synthesis and/or release in

  4. [Evaluation in the interest in arts psychotherapy treatment of alcoholics hospitalized for a weaning process--presentation of two clinical examples].

    PubMed

    Ricci-Boyer, L; Schiltz, L; Spitz, E

    2010-01-01

    The aim of our study is to show the relevance of art therapeutic treatment with an alcoholic population met in the weaning department of a general hospital. A current tendency of research in psychology consists in using an integrated quantitative and qualitative methodology. This approach is especially suited to the study of the therapeutic intervention. In arts therapeutic research the investigation of the artistic production and the application of a projective test (Rotter) may complete the psychometric tools: SVF 78 Stressverarbeitungsfragebogen by Janke W., Erdmann G., Kallus W.; MDBF Mehrdimensionalen Befindlichkeitsfragebogens by Steyer R., Schwenkmezger P., Notz P., Eid M.. The results of the study show the relevance of our art therapeutic treatment. We are going to illustrate the multidimensional reality of the therapeutic process by two clinical examples.

  5. Chronic 5-HT4 receptor agonist treatment restores learning and memory deficits in a neuroendocrine mouse model of anxiety/depression.

    PubMed

    Darcet, Flavie; Gardier, Alain M; David, Denis J; Guilloux, Jean-Philippe

    2016-03-11

    Cognitive disturbances are often reported as serious invalidating symptoms in patients suffering from major depression disorders (MDD) and are not fully corrected by classical monoaminergic antidepressant drugs. If the role of 5-HT4 receptor agonists as cognitive enhancers is well established in naïve animals or in animal models of cognitive impairment, their cognitive effects in the context of stress need to be examined. Using a mouse model of anxiety/depression (CORT model), we reported that a chronic 5-HT4 agonist treatment (RS67333, 1.5mg/kg/day) restored chronic corticosterone-induced cognitive deficits, including episodic-like, associative and spatial learning and memory impairments. On the contrary, a chronic monoaminergic antidepressant drug treatment with fluoxetine (18mg/kg/day) only partially restored spatial learning and memory deficits and had no effect in the associative/contextual task. These results suggest differential mechanisms underlying cognitive effects of these drugs. Finally, the present study highlights 5-HT4 receptor stimulation as a promising therapeutic mechanism to alleviate cognitive symptoms related to MDD.

  6. Group 2 Innate Lymphoid Cell Proportions Are Diminished in Young Helminth Infected Children and Restored by Curative Anti-helminthic Treatment

    PubMed Central

    Nausch, Norman; Appleby, Laura J.; Sparks, Alexandra M.; Midzi, Nicholas; Mduluza, Takafira; Mutapi, Francisca

    2015-01-01

    Background Group 2 Innate lymphoid cells (ILC2s) are innate cells that produce the TH2 cytokines IL-5 and IL-13. The importance of these cells has recently been demonstrated in experimental models of parasitic diseases but there is a paucity of data on ILC2s in the context of human parasitic infections and in particular of the blood dwelling parasite Schistosoma haematobium. Methodology/Principal Findings In this case-control study human peripheral blood ILC2s were analysed in relation to infection with the helminth parasite Schistosoma haematobium. Peripheral blood mononuclear cells of 36 S. haematobium infected and 36 age and sex matched uninfected children were analysed for frequencies of ILC2s identified as Lin-CD45+CD127+CD294+CD161+. ILC2s were significantly lower particularly in infected children aged 6–9 years compared to healthy participants. Curative anti-helminthic treatment resulted in an increase in levels of the activating factor TSLP and restoration of ILC2 levels. Conclusion This study demonstrates that ILC2s are diminished in young helminth infected children and restored by removal of the parasites by treatment, indicating a previously undescribed association between a human parasitic infection and ILC2s and suggesting a role of ILC2s before the establishment of protective acquired immunity in human schistosomiasis. PMID:25799270

  7. Value of Antiquity in the Restoration Process of the Art Nouveau Villa Duelfer in Barlinek/ Wartość Dawności W Procesie Renowacji Secesyjnej Willi Architekta W Barlinku

    NASA Astrophysics Data System (ADS)

    Rutyna, Halina

    2015-06-01

    The value assigned to time-worn objects and buildings seems crucial to a conservator's theoretical beliefs. The notion of antiquity is almost imprinted in the structure of the building itself, as well as in the concept of the time that has lapsed since the erection of the building. The head of the restoration project of the 1908 art nouveau Villa Duelfer, in Barlinek, which gradually fell into ruin after the war, presents how, in practice, this idea of antiquity was respected in that project. On the hundredth anniversary of the construction of the villa, the building, commonly referred to as the `Pałacyk Cebulowy`, has lived to see its revival by sustaining its primary residential function, its architectural form and its historic values, in an urban context. Kluczowa dla poglądów konserwatora zabytków architektury jawi się idea wartości dawności. Jest ona niejako odciśnięta w strukturze budowli i w wyobrażeniu o czasie, jaki upłynął od chwili powstania. Dobrym przykładem ilustrującym zagadnienie dawności zabytku jest ostatnia renowacja Willi Duelfera w Barlinku, wzniesionej w 1908 roku i potocznie zwanej "Pałacykiem Cebulowym". Po wojnie popadającej w ruinę, W 2008 roku w wyniku konsultacji z konserwatorem zabytków właściciel postanowił przywrócić jej symetrię i dobudować z lewej strony dodatkowe pomieszczenie. Podjęto także rozbudowę wilii od strony zachodniej poprzez dostawienie klatki schodowej i dodanie balkonu opartego na kolumnach na wzór elewacji wschodniej. Dokonano również renowacji zdobień elewacji i odtworzono brakujące elementy od frontu i z tyłu obiektu. Prace przebiegały w szybkim tempie i trwały zaledwie dwa lata, choć budynek był bardzo zniszczony.

  8. Life cycle assessment applied to wastewater treatment: state of the art.

    PubMed

    Corominas, Ll; Foley, J; Guest, J S; Hospido, A; Larsen, H F; Morera, S; Shaw, A

    2013-10-01

    Life cycle assessment (LCA) is a technique to quantify the impacts associated with a product, service or process from cradle-to-grave perspective. Within the field of wastewater treatment (WWT) LCA was first applied in the 1990s. In the pursuit of more environmentally sustainable WWT, it is clear that LCA is a valuable tool to elucidate the broader environmental impacts of design and operation decisions. With growing interest from utilities, practitioners, and researchers in the use of LCA in WWT systems, it is important to make a review of what has been achieved and describe the challenges for the forthcoming years. This work presents a comprehensive review of 45 papers dealing with WWT and LCA. The analysis of the papers showed that within the constraints of the ISO standards, there is variability in the definition of the functional unit and the system boundaries, the selection of the impact assessment methodology and the procedure followed for interpreting the results. The need for stricter adherence to ISO methodological standards to ensure quality and transparency is made clear and emerging challenges for LCA applications in WWT are discussed, including: a paradigm shift from pollutant removal to resource recovery, the adaptation of LCA methodologies to new target compounds, the development of regional factors, the improvement of the data quality and the reduction of uncertainty. Finally, the need for better integration and communication with decision-makers is highlighted.

  9. Sustained-release nanoART formulation for the treatment of neuroAIDS

    PubMed Central

    Jayant, Rahul Dev; Atluri, Venkata SR; Agudelo, Marisela; Sagar, Vidya; Kaushik, Ajeet; Nair, Madhavan

    2015-01-01

    A novel approach was developed for the coencapsulation of an anti-HIV drug (tenofovir) and a latency-breaking agent (vorinostat), using magnetically guided layer-by-layer (LbL) assembled nanocarriers for the treatment of neuroAIDS. Ultrasmall iron oxide (Fe3O4) nanoparticles (10±3 nm) were synthesized and characterized. The LbL technique was used to achieve a sustained release profile, and application of 2 bilayers ([tenofovir+dextran sulphate]2+vorinostat) to magnetic nanoparticles resulted in a 2.8 times increase in drug (tenofovir) loading and also resulted in an increase in the drug release period by 30-fold, with 100% drug release in sustained manner over a period of 5 days with the simultaneous stimulation of latent HIV expression. Nanoformulation showed a good blood–brain barrier transmigration ability (37.95%±1.5%) with good in vitro antiviral efficacy (~33% reduction of p24 level) over a period of 5 days after HIV infection in primary human astrocytes, with good cell viability (>90%). Hence, LbL arrangements of drugs on magnetic nanoparticles provides sustained release and, therefore, may improve the patient’s adherence to therapy and lead to better compliance. PMID:25709433

  10. Sustained-release nanoART formulation for the treatment of neuroAIDS.

    PubMed

    Jayant, Rahul Dev; Atluri, Venkata S R; Agudelo, Marisela; Sagar, Vidya; Kaushik, Ajeet; Nair, Madhavan

    2015-01-01

    A novel approach was developed for the coencapsulation of an anti-HIV drug (tenofovir) and a latency-breaking agent (vorinostat), using magnetically guided layer-by-layer (LbL) assembled nanocarriers for the treatment of neuroAIDS. Ultrasmall iron oxide (Fe3O4) nanoparticles (10±3 nm) were synthesized and characterized. The LbL technique was used to achieve a sustained release profile, and application of 2 bilayers ([tenofovir+dextran sulphate]2+vorinostat) to magnetic nanoparticles resulted in a 2.8 times increase in drug (tenofovir) loading and also resulted in an increase in the drug release period by 30-fold, with 100% drug release in sustained manner over a period of 5 days with the simultaneous stimulation of latent HIV expression. Nanoformulation showed a good blood-brain barrier transmigration ability (37.95%±1.5%) with good in vitro antiviral efficacy (~33% reduction of p24 level) over a period of 5 days after HIV infection in primary human astrocytes, with good cell viability (>90%). Hence, LbL arrangements of drugs on magnetic nanoparticles provides sustained release and, therefore, may improve the patient's adherence to therapy and lead to better compliance.

  11. Treatment of congestive heart failure--state of the art and future trends.

    PubMed

    Parmley, W W

    1989-01-01

    1. Cardiac failure is a clinical syndrome of symptoms and signs, which can be confirmed by imaging or invasive haemodynamic techniques. It may be caused by systolic or diastolic dysfunction, but systolic dysfunction rarely occurs alone. It is important to ascertain the degree to which each contributes, and the precise aetiology of the condition, particularly in relation to surgically correctable lesions. 2. Non-pharmacological approaches including weight loss, salt restriction and lifestyle changes may be beneficial in some patients, and diuretics, which reduce the load on the heart, are the traditional baseline therapy. 3. Digitalis has been used where problems with contractility predominate, but its beneficial effect has been disputed, and expectations of improvement in patients in sinus rhythm should not be too high. 4. Vasodilators have been considered as the next line of treatment. Arteriolar dilators tend to increase cardiac output, but have little effect on pulmonary artery wedge pressure, and venodilators tend to have the opposite effect. Probably both actions are necessary and angiotensin converting enzyme (ACE) inhibitors, which have both, have proved effective in terms of symptoms and survival. 5. Various other inotropic agents have been tried. Phosphodiesterase inhibitors improve exercise tolerance, but may increase the probability of serious arrhythmias, already a significant cause of sudden death. beta 1-partial adrenoceptor agonists such as xamoterol have shown some promise, and anti-arrhythmic therapy has also been considered. 6. Drugs which prevent progression of myocardial damage would prove a great advance, and beta-adrenoceptor antagonists and calcium channel blockers appear to have considerable potential in this area.

  12. Restoration Process

    NASA Technical Reports Server (NTRS)

    1979-01-01

    In the accompanying photos, a laboratory technician is restoring the once-obliterated serial number of a revolver. The four-photo sequence shows the gradual progression from total invisibility to clear readability. The technician is using a new process developed in an applications engineering project conducted by NASA's Lewis Research Center in conjunction with Chicago State University. Serial numbers and other markings are frequently eliminated from metal objects to prevent tracing ownership of guns, motor vehicles, bicycles, cameras, appliances and jewelry. To restore obliterated numbers, crime laboratory investigators most often employ a chemical etching technique. It is effective, but it may cause metal corrosion and it requires extensive preparatory grinding and polishing. The NASA-Chicago State process is advantageous because it can be applied without variation to any kind of metal, it needs no preparatory work and number recovery can be accomplished without corrosive chemicals; the liquid used is water.

  13. Microhardness of glass ionomer cements indicated for the ART technique according to surface protection treatment and storage time.

    PubMed

    Shintome, Luciana Keiko; Nagayassu, Marcos Paulo; Di Nicoló, Rebeca; Myaki, Silvio Issáo

    2009-01-01

    The aim of this study was to assess the microhardness of 5 glass ionomer cements (GIC) - Vidrion R (V, SS White), Fuji IX (F, GC Corp.), Magic Glass ART (MG, Vigodent), Maxxion R (MR, FGM) and ChemFlex (CF, Dentsply) - in the presence or absence of a surface protection treatment, and after different storage periods. For each GIC, 36 test specimens were made, divided into 3 groups according to the surface protection treatment applied - no protection, varnish or nail varnish. The specimens were stored in distilled water for 24 h, 7 and 30 days and the microhardness tests were performed at these times. The data obtained were submitted to the ANOVA for repeated measures and Tukey tests (alpha = 5%). The results revealed that the mean microhardness values of the GICs were, in decreasing order, as follows: F > CF = MR > MG > V; that surface protection was significant for MR, at 24 h, without protection (64.2 + or - 3.6a), protected with GIC varnish (59.6 + or - 3.4b) and protected with nail varnish (62.7 + or - 2.8ab); for F, at 7 days, without protection (97.8 + or - 3.7ab), protected with varnish (95.9 + or - 3.2b) and protected with nail varnish (100.8 + or - 3.4a); and at 30 days, for F, without protection (98.8 + or - 2.6b), protected with varnish (103.3 + or - 4.4a) and protected with nail varnish (101 + or - 4.1ab) and, for V, without protection (46 + or - 1.3b), protected with varnish (49.6 + or - 1.7ab) and protected with nail varnish (51.1 + or - 2.6a). The increase in storage time produced an increase in microhardness. It was concluded that the different GICs, surface protection treatments and storage times could alter the microhardness values.

  14. Effects of a Treatment Package to Facilitate English/Language Arts Learning for Middle School Students with Moderate to Severe Disabilities

    ERIC Educational Resources Information Center

    Mims, Pamela J.; Lee, Angel; Browder, Diane M.; Zakas, Tracie-Lynn; Flynn, Susan

    2012-01-01

    This pilot study sought to develop and evaluate the use of a treatment package that included systematic and direct instruction on acquisition of literacy skills aligned with middle school English/Language Arts standards for students with moderate to severe disabilities, including autism. Participants included five teachers and 15 middle school…

  15. Treatment with an SSRI antidepressant restores hippocampo-hypothalamic corticosteroid feedback and reverses insulin resistance in low-birth-weight rats.

    PubMed

    Buhl, Esben S; Jensen, Thomas Korgaard; Jessen, Niels; Elfving, Betina; Buhl, Christian S; Kristiansen, Steen B; Pold, Rasmus; Solskov, Lasse; Schmitz, Ole; Wegener, Gregers; Lund, Sten; Petersen, Kitt Falck

    2010-05-01

    Low birth weight (LBW) is associated with type 2 diabetes and depression, which may be related to prenatal stress and insulin resistance as a result of chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity. We examined whether treatment with a selective serotonin reuptake inhibitor [escitalopram (ESC)] could downregulate HPA axis activity and restore insulin sensitivity in LBW rats. After 4-5 wk of treatment, ESC-exposed LBW (SSRI-LBW) and saline-treated control and LBW rats (Cx and LBW) underwent an oral glucose tolerance test or a hyperinsulinemic euglycemic clamp to assess whole body insulin sensitivity. Hepatic phosphoenolpyruvate carboxykinase (PEPCK) mRNA expression and red skeletal muscle PKB Ser(473) phosphorylation were used to assess tissue-specific insulin sensitivity. mRNA expression of the hypothalamic mineralocorticoid receptor was fivefold upregulated in LBW (P < 0.05 vs. Cx), accompanied by increased corticosterone release during restraint stress and total 24-h urinary excretion (P < 0.05 vs. Cx), whole body insulin resistance (P < 0.001 vs. Cx), and impaired insulin suppression of hepatic PEPCK mRNA expression (P < 0.05 vs. Cx). Additionally, there was a tendency for reduced red muscle PKB Ser(473) phosphorylation. The ESC treatment normalized corticosterone secretion (P < 0.05 vs. LBW), whole body insulin sensitivity (P < 0.01) as well as postprandial suppression of hepatic mRNA PEPCK expression (P < 0.05), and red muscle PKB Ser(473) phosphorylation (P < 0.01 vs. LBW). We conclude that these data suggest that the insulin resistance and chronic HPA axis hyperactivity in LBW rats can be reversed by treatment with an ESC, which downregulates HPA axis activity, lowers glucocorticoid exposure, and restores insulin sensitivity in LBW rats.

  16. Treatment with an SSRI antidepressant restores hippocampo-hypothalamic corticosteroid feedback and reverses insulin resistance in low-birth-weight rats

    PubMed Central

    Jensen, Thomas Korgaard; Jessen, Niels; Elfving, Betina; Buhl, Christian S.; Kristiansen, Steen B.; Pold, Rasmus; Solskov, Lasse; Schmitz, Ole; Wegener, Gregers; Lund, Sten; Petersen, Kitt Falck

    2010-01-01

    Low birth weight (LBW) is associated with type 2 diabetes and depression, which may be related to prenatal stress and insulin resistance as a result of chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity. We examined whether treatment with a selective serotonin reuptake inhibitor [escitalopram (ESC)] could downregulate HPA axis activity and restore insulin sensitivity in LBW rats. After 4–5 wk of treatment, ESC-exposed LBW (SSRI-LBW) and saline-treated control and LBW rats (Cx and LBW) underwent an oral glucose tolerance test or a hyperinsulinemic euglycemic clamp to assess whole body insulin sensitivity. Hepatic phosphoenolpyruvate carboxykinase (PEPCK) mRNA expression and red skeletal muscle PKB Ser473 phosphorylation were used to assess tissue-specific insulin sensitivity. mRNA expression of the hypothalamic mineralocorticoid receptor was fivefold upregulated in LBW (P < 0.05 vs. Cx), accompanied by increased corticosterone release during restraint stress and total 24-h urinary excretion (P < 0.05 vs. Cx), whole body insulin resistance (P < 0.001 vs. Cx), and impaired insulin suppression of hepatic PEPCK mRNA expression (P < 0.05 vs. Cx). Additionally, there was a tendency for reduced red muscle PKB Ser473 phosphorylation. The ESC treatment normalized corticosterone secretion (P < 0.05 vs. LBW), whole body insulin sensitivity (P < 0.01) as well as postprandial suppression of hepatic mRNA PEPCK expression (P < 0.05), and red muscle PKB Ser473 phosphorylation (P < 0.01 vs. LBW). We conclude that these data suggest that the insulin resistance and chronic HPA axis hyperactivity in LBW rats can be reversed by treatment with an ESC, which downregulates HPA axis activity, lowers glucocorticoid exposure, and restores insulin sensitivity in LBW rats. PMID:20103738

  17. Chemistry, Color, and Art

    NASA Astrophysics Data System (ADS)

    Orna, Mary Virginia

    2001-10-01

    Artists' colors have been intertwined with chemistry from antiquity, both in the extraction of them from raw materials and their production by the 'manufacturing chemists' of their day. In our own time, not only has chemistry made possible the enormous expension of the artist's palette, but also has provided methods to study it scientifically with a view to restoration, preservation, authentication, and understanding of works of art.

  18. Effects of various chair-side surface treatment methods on dental restorative materials with respect to contact angles and surface roughness.

    PubMed

    Sturz, Candida R C; Faber, Franz-Josef; Scheer, Martin; Rothamel, Daniel; Neugebauer, Jörg

    2015-01-01

    Available chair-side surface treatment methods may adversely affect prosthetic materials and promote plaque accumulation. This study investigated the effects of treatment procedures on three resin restorative materials, zirconium-dioxide and polyetheretherketone in terms of surface roughness and hydrophobicity. Treatments were grinding with silicon carbide paper or white Arkansas stone, blasting with prophylaxis powder and polishing with diamond paste. Surface roughness was assessed using confocal laser scanning. Hydrophobicity as measured by water contact angle was determined by computerized image analysis using the sessile drop technique. All of the specific surface treatments performed led to significant changes in contact angle values and surface roughness (Ra) values. Median contact angle values ranged from 51.6° to 114°. Ra values ranged from 0.008 µm to 2.917 µm. Air-polishing as well as other polishing procedures increased surface roughness values in all materials except zirconium dioxide. Polyetheretherketone displayed greatest change in contact angle values after air-polishing treatment.

  19. The martial arts.

    PubMed

    Terry, Charles M

    2006-08-01

    Given the increasing popularity of the martial arts, it is likely that physicians in all specialties encounter patients who participate. From pediatric patients, to geriatric patients, to those living with various disabilities, the martial arts may offer physical, psychologic, and therapeutic benefits. An appreciation of the physical demands of the martial arts is crucial to understanding the pathogenesis of injury as well as to planning treatment and prevention strategies and to determining safe return to participation after injury.

  20. Effects of prescribed fire and other plant community restoration treatments on tree mortality, bark beetles, and other saproxylic coleoptera of longleaf pine, Pinus palustris Mill., on the coastal plain of Alabama

    Treesearch

    Joshua W. Campbell; James L. Hanula; Kenneth W. Outcalt

    2008-01-01

    Treatments to restore understory plant communities of mature (50-80-year old) longleaf pine (Pinus palustris Mill.) and reduce risks of wildfire were applied to 10 ha plots that had a substantial shrub layer due to lack of fire. Plots were located in the Coastal Plain of Alabama and treatments consisted of: (1) untreated control, (2) growing season...

  1. [Consequences of dental restorative treatment (and of the dental materials used in its execution) on pulp tissue].

    PubMed

    Bogaerts, P

    2000-01-01

    Pulp tissue may suffer from carious invasion, direct or indirect trauma and last but not least from dental treatment. As the general population grows older and retains longer its dentition, teeth will inevitably experience a complex history of multiple episodes of aggressions. It is therefore not surprising that the dental practitioner is confronted more and more with teeth reacting acutely or chronically (in other words, painfully or not) after proper dental treatment. This paper describes the common pathologic and iatrogenic events that may have an effect on the pulpal health status. Preventive endodontic treatment is to be considered in cases of extensive dental treatment.

  2. Gourdeous Art

    ERIC Educational Resources Information Center

    Coy, Mary

    2007-01-01

    In this article, the author describes a gourd art project for her art club. Prior to students actually working on the gourds, the author and her art volunteer did a joint demonstration on the process students would go through to create their project. The volunteer brought in and explained her gourd art and shared information about the drying and…

  3. Gourdeous Art

    ERIC Educational Resources Information Center

    Coy, Mary

    2007-01-01

    In this article, the author describes a gourd art project for her art club. Prior to students actually working on the gourds, the author and her art volunteer did a joint demonstration on the process students would go through to create their project. The volunteer brought in and explained her gourd art and shared information about the drying and…

  4. Down-regulation of NR4A1 in follicular thyroid carcinomas is restored following lithium treatment

    PubMed Central

    Camacho, Cléber P.; Latini, Flavia R. M.; Oler, Gisele; Hojaij, Flavio C.; Maciel, Rui M. B.; Riggins, Gregory J.; Cerutti, Janete M.

    2009-01-01

    SUMMARY Introduction The identification of follicular thyroid adenoma-associated transcripts will lead to a better understanding of the events involved in pathogenesis and progression of follicular tumors. Using Serial Analysis of Gene Expression, we identified five genes that are absent in a malignant follicular thyroid carcinoma (FTC) library, but expressed in follicular adenoma (FTA) and normal thyroid libraries. Methods NR4A1, one of the five genes, was validated in a set of 27 normal thyroid tissues, 10 FTAs and 14 FTCs and three thyroid carcinoma cell lines by real time PCR. NR4A1 can be transiently increased by a variety of stimuli, including lithium, which is used as adjuvant therapy of thyroid carcinoma with 131I. We tested if lithium could restore NR4A1 expression. The expression of other genes potentially involved in the same signaling pathway was tested. To this end, lithium was used at different concentration (10mM or 20mM) and time (2h and 24 h) and the level of expression was tested by quantitative PCR. We next tested if Lithium could affect cell growth and apoptosis. Results We observed that NR4A1 expression was under-expressed in most of the FTCs investigated, compared to expression in normal thyroid tissues and FTAs. We also found a positive correlation between NR4A1 and FOSB gene expression. Lithium induced NR4A1 and FOSB expression, reduced CCDN1 expression, inhibited cell growth and triggered apoptosis in a FTC cell line. Conclusions NR4A1 is under-expressed in most of FTCs. The loss of expression of both NR4A1 and the Wnt pathway gene FOSB was correlated with malignancy. This is consistent with the hypothesis that its loss of expression is part of the transformation process of FTCs, either as a direct or indirect consequence of Wnt pathway alterations. Lithium restores NR4A1 expression, induces apoptosis and reduces cell growth. These findings may explain a possible molecular mechanism of lithium’s therapeutic action. PMID:18727708

  5. Ceftriaxone Treatment after Traumatic Brain Injury Restores Expression of the Glutamate Transporter, GLT-1, Reduces Regional Gliosis, and Reduces Post-Traumatic Seizures in the Rat

    PubMed Central

    Goodrich, Grant S.; Kabakov, Anatoli Y.; Hameed, Mustafa Q.; Dhamne, Sameer C.; Rosenberg, Paul A.

    2013-01-01

    Abstract Excessive extracellular glutamate after traumatic brain injury (TBI) contributes to excitotoxic cell death and likely to post-traumatic epilepsy. Glutamate transport is the only known mechanism of extracellular glutamate clearance, and glutamate transporter 1 (GLT-1) is the major glutamate transporter of the mammalian brain. We tested, by immunoblot, in the rat lateral fluid percussion injury TBI model whether GLT-1 expression is depressed in the cortex after TBI, and whether GLT-1 expression after TBI is restored after treatment with ceftriaxone, a well-tolerated β-lactam antibiotic previously shown to enhance GLT-1 expression in noninjured animals. We then tested whether treatment with ceftriaxone mitigates the associated regional astrogliosis, as reflected by glial fibrillary acid protein (GFAP) expression, and also whether ceftriaxone treatment mitigates the severity of post-traumatic epilepsy. We found that 7 days after TBI, GLT-1 expression in the ipsilesional cortex was reduced by 29% (n=7/group; p<0.01), relative to the contralesional cortex. However, the loss of GLT-1 expression was reversed by treatment with ceftriaxone (200 mg/kg, daily, intraperitoneally). We found that ceftriaxone treatment also decreased the level of regional GFAP expression by 43% in the lesioned cortex, relative to control treatment with saline (n=7 per group; p<0.05), and, 12 weeks after injury, reduced cumulative post-traumatic seizure duration (n=6 rats in the ceftriaxone treatment group and n=5 rats in the saline control group; p<0.001). We cautiously conclude that our data suggest a potential role for ceftriaxone in treatment of epileptogenic TBI. PMID:23510201

  6. Forest restoration paradigms

    Treesearch

    John Stanturf; Brian J. Palik; Mary I. Williams; R. Kasten Dumroese

    2014-01-01

    An estimated 2 billion ha of forests are degraded globally and global change suggests even greater need for forest restoration. Four forest restoration paradigms are identified and discussed: revegetation, ecological restoration, functional restoration, and forest landscape restoration. Restoration is examined in terms of a degraded starting point and an ending point...

  7. A synopsis of short-term response to alternative restoration treatments in Sagebrush-Steppe: The SageSTEP Project

    Treesearch

    James McIver; Mark Brunson; Steve Bunting; Jeanne Chambers; Paul Doescher; James Grace; April Hulet; Dale Johnson; Steve Knick; Richard Miller; Mike Pellant; Fred Pierson; David Pyke; Benjamin Rau; Kim Rollins; Bruce Roundy; Eugene Schupp; Robin Tausch; Jason Williams

    2014-01-01

    The Sagebrush Steppe Treatment Evaluation Project (SageSTEP) is an integrated long-term study that evaluates ecological effects of alternative treatments designed to reduce woody fuels and to stimulate the herbaceous understory of sagebrush steppe communities of the Intermountain West. This synopsis summarizes results through 3 yr posttreatment. Woody vegetation...

  8. How have ART treatment programmes changed the patterns of excess mortality in people living with HIV? Estimates from four countries in East and Southern Africa

    PubMed Central

    Slaymaker, Emma; Todd, Jim; Marston, Milly; Calvert, Clara; Michael, Denna; Nakiyingi-Miiro, Jessica; Crampin, Amelia; Lutalo, Tom; Herbst, Kobus; Zaba, Basia

    2014-01-01

    Background Substantial falls in the mortality of people living with HIV (PLWH) have been observed since the introduction of antiretroviral therapy (ART) in sub-Saharan Africa. However, access and uptake of ART have been variable in many countries. We report the excess deaths observed in PLWH before and after the introduction of ART. We use data from five longitudinal studies in Malawi, South Africa, Tanzania, and Uganda, members of the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA). Methods Individual data from five demographic surveillance sites that conduct HIV testing were used to estimate mortality attributable to HIV, calculated as the difference between the mortality rates in PLWH and HIV-negative people. Excess deaths in PLWH were standardized for age and sex differences and summarized over periods before and after ART became generally available. An exponential regression model was used to explore differences in the impact of ART over the different sites. Results 127,585 adults across the five sites contributed a total of 487,242 person years. Before the introduction of ART, HIV-attributable mortality ranged from 45 to 88 deaths per 1,000 person years. Following ART availability, this reduced to 14–46 deaths per 1,000 person years. Exponential regression modeling showed a reduction of more than 50% (HR =0.43, 95% CI: 0.32–0.58), compared to the period before ART was available, in mortality at ages 15–54 across all five sites. Discussion Excess mortality in adults living with HIV has reduced by over 50% in five communities in sub-Saharan Africa since the advent of ART. However, mortality rates in adults living with HIV are still 10 times higher than in HIV-negative people, indicating that substantial improvements can be made to reduce mortality further. This analysis shows differences in the impact across the sites, and contrasts with developed countries where mortality among PLWH on ART can be similar to that of the

  9. [Effects of interdisciplinary functional restoration treatment with cognitive behavior therapy in patients with chronic back pain: healthcare research in the context of selective contracts].

    PubMed

    Hafenbrack, K; Heinrich, M; Müller, G; Marnitz, U; Mallwitz, J; Klinger, R

    2013-12-01

    The efficacy of functional restoration programs for the treatment of chronic back pain is well documented. Nevertheless, there are only a few such centres in Germany and few trials have been conducted in German-speaking regions to demonstrate that implementing such programs in everyday clinical settings with large numbers of patients is just as effective as in a research setting. The present study examined whether the positive effects of such programs can also be observed in the clinically relevant context of a standardized day clinic treatment regimen. A total of 681 back pain patients in 2 German cities were examined at 4 measurement points (before and immediately after the program, as well as 6 and 12 months after treatment) using a comprehensive questionnaire on perceived pain and symptoms of anxiety and depression, as well as the work situation. In both cities significant and long-term improvements in back pain, pain-related impairment and degree of chronification were observed, as well as a high return-to-work rate after treatment. Hence, the quality of such programs was also confirmed for a large patient population.

  10. Metal stain on monolithic zirconia restoration: A case report

    PubMed Central

    2017-01-01

    In restorative treatment using fixed dental prostheses, dentists should select appropriate restoration material among various types of dental materials. The strength, marginal fit, esthetics, wear resistance, biocompatibility, and cost are important factors in the choice of restoration materials. The present case showed a surface stain on a monolithic zirconia restoration that was due to wear between the monolithic zirconia restoration and the base metal alloy restoration. This phenomenon was confirmed by surface roughness measurement and electron probe micro-analysis. PMID:28435624

  11. Metal stain on monolithic zirconia restoration: A case report.

    PubMed

    Cha, Min-Sang; Lee, Sang-Woon; Huh, Yoon-Hyuk; Cho, Lee-Ra; Park, Chan-Jin

    2017-04-01

    In restorative treatment using fixed dental prostheses, dentists should select appropriate restoration material among various types of dental materials. The strength, marginal fit, esthetics, wear resistance, biocompatibility, and cost are important factors in the choice of restoration materials. The present case showed a surface stain on a monolithic zirconia restoration that was due to wear between the monolithic zirconia restoration and the base metal alloy restoration. This phenomenon was confirmed by surface roughness measurement and electron probe micro-analysis.

  12. Art Education/Art Therapy.

    ERIC Educational Resources Information Center

    Rogers, John R., Ed.

    1978-01-01

    The special issue presents 13 articles dealing with art education and art therapy for special groups. Included are the following titles and authors: "Art Education for Special Groups: The Emotionally Disturbed" (E. Ulman); "You Are The Early Warning System" (C. Stember); "School Art Therapist Rationale for DPI Certification" (V. Minar); "Art…

  13. The implementation and preliminary evaluation of an ART strategy in Mexico - a country example

    PubMed Central

    HERMOSILLO, Vera Heriberto; QUINTERO, Luengas Elisa; GUERRERO, Namihira Delia; SUÁREZ, Díaz Dante Sergio; HERNÁNDEZ, Muñúzuri Jorge Alejandro; HOLMGREN, Christopher J.

    2009-01-01

    ABSTRACT The massive use of preventive measures in Mexico including fluoride toothpaste, a national program of salt fluoridation and education on prevention has resulted in a large decline in dental caries over the past two decades. There does however remain a largely unmet need for restorative treatment. This paper describes the steps leading up to the adoption of a strategy, as part of general health policy, to use Atraumatic Restorative Treatment (ART) within the Mexican public health service as a means to address this. This included the development of training materials, the organization of training courses for existing dentists and the incorporation of ART into the undergraduate curriculum. Results: Six years after the introduction of ART in the year 2000, it was estimated that over 2 million ART procedures had been provided. As part of the planning cycle, an evaluation was undertaken in 2008 to determine amongst Mexican dentists what were the perceived problems when implementing the ART approach. Such research identified that the scarcity of appropriate dental materials and the lack of suitable instruments were the major problems. In addition, a preliminary evaluation of ART restorations and sealants placed as part of this National Oral Health Program w