Perceptions of control, physical exercise, and psychological adjustment to breast cancer in South African women.

Psychological adjustment and locus of control were measured in 257 South African women both with and without breast cancer. Adjustment was defined as positive affect, negative affect, the balance between the two, satisfaction with various domains of life, and an overall sense of well-being. Health locus of control was measured separately for internal, external, and chance loci. The instrument's reliability was comparable to that reported for U.S. norms. The women with breast cancer reported significantly lower affect and had lower internal and higher external and chance perceptions of control. The more invasive the surgical treatment, the greater the negative impact on adjustment. Data suggested that using written instructions to stress the importance of exercise to rebuild arm strength immediately following the surgery had a long-lasting positive impact on affect. Side of intervention was also related to psychological adjustment. Significant differences across racial groups were found for both adjustment and health locus of control.

[The implant denture in the laboratory]. / La prothèse implantaire au laboratoire.

The authors analyzed the numerous devices and prosthetic kits currently available for implant prosthodontics. Existing systems can be classified into two fundamentally different categories: the gold ring cylinder (or its equivalent in resin for casting) and the prosthetic abutment core or post concept. The former is based on connection of two nearly flat, horizontal surfaces by means of a screw, which avoids problems of parallelism; the latter can be likened to insertion of one part into another, like a crown that slides along the vertical axis of an abutment, with connection being obtained by cementation and/or screwing. Prosthetic abutment core or post: Whether monoblock or multiblock, the implant core or post is very similar to a conventional metallic abutment. Construction of the implant prosthesis is generally no problem when parallelism has been respected during surgery; if problems are encountered with parallelism, options include: 1. Adjustment of the abutment core by grinding, 2. Use of a telescope to achieve parallelism, 3. Use of a bendable prosthetic abutment core, 4. Use of a prosthetic abutment core preangulated 10 degrees-20 degrees, 5. A combination of the above solutions. The implant prostheses may be screwed, cemented or clipped in position. Gold ring cylinder concept The gold ring cylinder (or its equivalent in resin for casting) theoretically eliminates problems of parallelism, but at the same time restricts the implant prosthesis to screw techniques. A special protocol is required for the impression and construction of the prosthesis. Impression with plaster is often the best method for total edentulism whereas "open" impression trays are advisable for partial prostheses. In the laboratory, use of a machined gold ring cylinder provides optimum precision, but intra-oral verification remains necessary. Implant prosthodontics unquestionably represent a new type of "know how": both the dentist and the dental lab technician must acquire the necessary training and adapt their work routines.

Effect of helium-neon laser on musculoskeletal trigger points.

Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo "stimulation" from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions.