Methods for evaluation of masticatory efficiency in conventional complete denture wearers: a systematized review.

The objective of this study was to present a systematized review of different methods used to evaluate the masticatory efficiency in conventional complete denture wearers. A survey was conducted in the databases PubMed, Scopus, and Cochrane, seeking scientific articles according to the previously selected terms: "Masticatory performance", "Masticatory efficiency" and "Chewing ability complete denture". Moreover, complementary studies have been carried out with library manual search/databases, which included studies related to different ways to assess masticatory efficiency, specifically as it related to conventional complete denture wearers. Forty three papers were selected to be used in the present review. Despite the wide variety of methodologies in the literature, the sieves method is currently considered the gold standard method to evaluation of conventional complete denture wearers masticatory efficiency, since it is the simplest, does not depend on specific devices (beyond the set of sieves), allows for a rational assessment, and it has been widely reproduced in various types of oral rehabilitation. More, the almond, as natural test food, and the optocal (made from the molding material Optosil), as artificial test food, are the most constantly employed test foods to evaluate masticatory efficiency.

A cross-over randomised clinical trial of eccentric occlusion in complete dentures.

The objective of this study is to compare the effects of canine guidance (CG) and bilateral balanced occlusion (BBO) on denture satisfaction and kinesiographic parameters of complete denture wearers, by means of a cross-over trial. Fifty edentulous patients received new maxillary and mandibular complete dentures. After the intra-oral adjustments and adaptation period, 44 participants were enrolled in the trial and randomly received a sequence of occlusal schemes: BBO followed by CG, or CG followed by BBO. Outcomes were assessed after 30 days of each occlusal scheme. Participants answered a denture satisfaction questionnaire and a kinesiograph instrument recorded mandibular physiologic movements and pattern of maxillary denture movement during chewing. Wilcoxon test and paired sample t-test were used to compare satisfaction levels and kinesiographic data for each occlusal scheme, respectively (α=0.05). The results showed no differences between occlusal schemes on participant's satisfaction and in any of the kinesiographic parameters studied, except for the vertical intrusion of the maxillary complete denture during chewing, which was lower with CG. It can be concluded that the occlusal scheme did not influence on satisfaction and kinesiographic parameters evaluated, as long as volume and resilience of residual edentulous ridges of the participants were normal. Clinical Trial Registration Identifier: NC.T01420536.

Reliability and validation of a Brazilian version of the Oral Health Impact Profile for assessing edentulous subjects.

The aims of this study were to evaluate the reliability and to validate a Brazilian version of Oral Health Impact Profile for assessing edentulous subjects (OHIP-EDENT), an inventory for measuring oral health-related quality of life of edentulous subjects. The sample comprised 65 complete denture wearers (23 men, mean age of 69.1 +/- 10.3 years). The translated OHIP-EDENT was applied on two occasions with a washout period of 3 months. Reliability was assessed by an internal consistency analysis and a test-retest approach. A preliminary validation process was conducted by a qualitative approach/interview. Results of internal consistency showed a Cronbach's alpha of 0.86 or 0.90 for the first or second appointment respectively. Through the test-retest analysis, an intra-class correlation coefficient of 0.57 was found, and individual answers reflected a broad range of agreement. Interviewed volunteers (n = 6) comprehended most questions well. In conclusion, the Brazilian version of OHIP-EDENT is adequate for assessing the oral health-related quality of life for edentulous subjects.

Relationship between Candida and nocturnal denture wear: quantitative study.

The purpose of this study was to evaluate the relationship between Candida and denture wear during the night. Twenty-four edentulous volunteers were randomly divided into two groups. Group I (GI, n = 11) was composed of volunteers who wore their complete dentures day and night and Group II (GII, n = 13) was composed of volunteers who wore their complete dentures only during the day. Three examination periods were performed for both groups. In GI, the first examination (A) was carried out after overnight denture wearing. Subsequent examinations were conducted after one (B) and seven nights (C) without denture use during sleep. In GII, the first (A) was done without previous use during sleep, and the following were carried out after one (B) and seven nights (C) of overnight denture wearing. Total unstimulated saliva was collected in a sterile container and cultured in duplicate inside Petri dishes. The values of colony forming units (CFU mL(-1) +/- s.d.) were obtained: GI A - 10.1 x 10(3) +/- 1.2 x 10(4), B - 2.0 x 10(3) +/- 2.6 x 10(3), and C - 2.6 x 10(3) +/- 5.9 x 10(3) and GII: A - 0.4 x 10(3) +/- 0.6 x 10(3), B - 9.4 x 10(3) +/- 17.7 x 10(3) and C - 6.3 x 10(3) +/- 15.3 x 10(3). The mean counts for Candida sp. were expressed as log (CFU + 1) mL(-1) and statistical significance of differences among groups was tested by anova (alpha = 0.05). Multiple comparisons were performed according to Bonferroni test and indicated significant differences between A-B and A-C, but not between B and C for both groups. It was concluded that there is a significant relationship between continuous denture wear and Candida sp.

[Hematopoietic allogeneic transplantation with attenuated conditioning regimen on an outpatient basis. First experience in Spain]. / Trasplante alogénico de progenitores hematopoyéticos con acondicionamiento no mieloablativo en régimen ambulatorio. Primera experiencia en España.

BACKGROUND: Allogeneic hematopoietic transplantation using attenuated conditioning regimens seems promising. This procedure associates to relatively low morbidity and mortality. In consequence, an outpatient management of this transplantation modality may be considered, even in elderly patients. CLINICAL REPORT AND RESULTS: This approach was considered in a 62 years-old female suffering from chronic myeloid leukemia in chronic phase. The conditioning regimen included fludarabine and 200 cGy of total body irradiation. Cyclosporine A and mycophenolate mofetil were used as immunosuppression. Conditioning, peripheral-blood stem-cell infusion, and postransplant follow-up was managed in the outpatient setting. Two short admissions were required. Eight months after transplant, the patient remains in sustained haematological remission with complete donor chimerism,has a 100% Karnofsky score and continues being managed on an outpatient basis. CONCLUSIONS: Allogeneic stem-cell transplantation can be performed safely on an outpatient basis,even in elderly patients.

Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery.

BACKGROUND: Clinical and pharmacokinetic data suggest that very low doses of subcutaneous recombinant human erythropoietin (rHuEPO) may be effective in a preoperative autologous blood deposit program. STUDY DESIGN AND METHODS: Fifty-two patients, scheduled for orthopedic surgery, were enrolled in a double-blind and placebo-controlled study. Patients were randomly assigned to the placebo group or to receive 30, 60, or 100 IU per kg of rHuEPO subcutaneously twice a week for 2 weeks before surgery. The dose of rHuEPO that was effective in facilitating the collection of 4 units of blood in the 2 weeks before surgery and that prevented a sharp decrease in hematocrit was determined. RESULTS: Only in patients receiving 100 IU per kg of rHuEPO did the outcome measurements differ significantly from those in the placebo group. With a higher (p < 0.01) cumulative increase in red cell volume during the study period (297 +/- 127 vs. 121 +/- 44 mL), 64 percent of those receiving 100 IU per kg of rHuEPO were able to donate 4 units of blood for autologous use, as compared with 23 percent of the placebo group (p < 0.05). Allogeneic transfusion was avoided, and the preoperative hematocrit and reticulocyte count were significantly higher in the patients receiving 100 IU per kg of rHuEPO (p < 0.05 and p < 0.01, respectively). CONCLUSION: Subcutaneously administered rHuEPO at a dose of 100 IU per kg twice a week for 2 weeks is effective in facilitating the collection of blood for autologous use and may improve the cost-benefit ratio of blood conservation interventions. Doses < or = 60 IU per kg are ineffective in facilitating such collections in this surgical setting.

[Organizational models for the hematology areas of the district hospitals of Catalonia]. / Modelos de organización en las áreas de hematología de los hospitales comarcales de Catalunya.

PURPOSE: The haematological assistance in Catalonia is based upon the district hospitals, in the first step, and the stage III hospitals located usually in higher population nuclei, in the second step. The purpose of this work was to analyse the resources of the "primary haematological assistance" network provided by the district hospitals, to evaluate them and to propose a model for their organisation. MATERIAL AND METHODS: An enquiry was carried out to all members of the Grup de Treball d'Hospitals Comarcals de Catalunya (Catalonia's District Hospitals Task Force). The evaluable data included demographic figures of the population assisted, personnel of each haematological area, organising structure, clinical activity, cytomorphology, blood banks, laboratories and continuous formation activities. RESULTS: The enquiry was answered by 15 of the 21 district hospitals (71.4%) with haematologists in Catalonia. The population assisted in those hospitals is 2,100,000 (ranging between 55,000 an 450,000). All centres are integrated in the National Health network. Eleven of the hospitals analysed have only one haematologist (73.3%). If his dedication is 100% of the time, this would represent a doctor for 105,000 people. The time devoted to work is 690 hours a week for all the population, with a mean of 3,043. Four patients assisted per hour. The total number of hospital beds is 3,353 (50-450), with a mean number of 1 haematologist for every 167.6 beds. The number of patients hospitalized due to blood diseases ranges between 3 and 13 per month. Six of the 15 centres are adjunct to the outpatient clinic. Two centres have a blood bank and 7 have developed an autotransfusion programme. All the centres but one perform oral anticoagulant treatment follow-up, the number of patients assisted ranging from 20 to 210 per week. None of the hospitals has a separate Haematology Service; in most of them haematology is structurally and functionally dependent from Laboratories and in some there is a mixed Laboratory/Internal Medicine functional organisation, depending of the Medical Direction. No haematologist is ever on call specifically for his specialty. Continuous formation activities are carried out in 9 of the 15 centres (60%). COMMENT: Several measures are proposed to improve the haematological assistance, acting on different levels: continuous formation, patient flows and circuits, resident doctors training, anticoagulant treatment network, organisation models, credit cards from the Spanish Association of Haematology.