Assessing guidelines for burn referrals in a resource-constrained setting: Demographic and clinical factors associated with inter-facility transfer.

AIM: The aim was to assess demographic and clinical factors associated with inter-facility referrals for patients with burns in a resource-constrained setting. METHODS: This was a cross-sectional case review of patients presenting with a burn at the trauma unit at the Red Cross War Memorial Children's Hospital (RXH) in Cape Town, South Africa. RESULTS: Six hundred and eleven-(71%) children were referred to the burns or the intensive care unit and 253 children were treated and discharged from the trauma unit. Of those admitted as inpatients 94% fulfilled at least one of the criteria for referral and 80% of those treated and discharged fulfilled the criteria for referral. CONCLUSIONS: Almost three out of four children evaluated at the trauma unit were referred to the burns unit for further management. However, a large number of patients were treated and discharged from the trauma unit despite being eligible for referral.

Ten years of patients' experiences with fixed implant-supported prostheses.

PURPOSE: This study investigated patients' perceptions of fixed implant-supported prostheses (ISP) in totally edentulous jaws in order to obtain a broader base for patient information. METHODS: A total of 135 patients who had received prosthetic rehabilitation treatment responded to a questionnaire on oral functions, speech, oral self-care, esthetics, lifestyle changes and self-confidence, oral comfort, and overall satisfaction with ISP. The patients also listed positive and negative experiences with the ISP. RESULTS: Most patients (97%) reported overall satisfaction. Chewing ability was rated as good or very good by all but one (99.3%). Twenty-six patients (19.6%) identified bruxing and clenching habits; there were significantly younger than those free from problems. Phonetic problems were reported by 32.8% after insertion, with 18.6% (eight patients) having remaining problems after seven to 10 years. Most of the patients (87.2%) found it easy to clean the prosthesis. Improved lifestyle after ISP insertion was reported by 75% and increased self-confidence by 82% of the patients. Improvements were especially perceptible in social situations that involved conversation or eating. None of the measured variables was related to duration of having ISP. CONCLUSIONS: The patients' experiences in this study lasted over a period of 10 years, thus their positive and negative aspects can serve as information support for dentistry to enable future ISP patients to make appropriate choices. The information could be made available to patients by including in a patient-targeted booklet.

Ten years of patients' experiences with fixed implant-supported prostheses.

PURPOSE: This study investigated patients' perceptions of fixed implant-supported prostheses (ISP) in totally edentulous jaws in order to obtain a broader base for patient information. METHODS: A total of 135 patients who had received prosthetic rehabilitation treatment responded to a questionnaire on oral functions, speech, oral self-care, esthetics, lifestyle changes and self-confidence, oral comfort, and overall satisfaction with ISP. The patients also listed positive and negative experiences with the ISP. RESULTS: Most patients (97%) reported overall satisfaction. Chewing ability was rated as good or very good by all but one (99.3%). Twenty-six patients (19.6%) identified bruxing and clenching habits, these were significantly younger than those free from problems. Phonetic problems were reported by 32.8% after insertion, with 18.6% (eight patients) having remaining problems after seven to 10 years. Most of the patients (87.2%) found it easy to clean the prosthesis. Improved lifestyle after ISP insertion was reported by 75% and increased self-confidence by 82% of the patients. Improvements were especially perceptible in social situations that involved conversation or eating. None of the measured variables was related to duration of having ISP. CONCLUSIONS: The patients' experiences in this study lasted over a period of 10 years, thus their positive and negative aspects can serve as information support for dentistry to enable future ISP patients to make appropriate choices. The information could be made available to patients by including in a patient-targeted booklet.

Three-year evaluation of Brånemark implants connected to angulated abutments.

A 3-year multicenter study on 63 maxillary and 10 mandibular fixed prostheses in 71 patients is reported. Angulated abutments or a combination of angulated and standard abutments were used to support prostheses; all components were from the Brånemark System. Of 425 implants initially placed, 4 were lost before abutment connection. Of the remaining 421 implants, 209 angulated (test) abutments and 212 standard (control) abutments were placed to support fixed prostheses. The prosthesis success rates were 96.8% for maxillae and 100% for mandibles. A total of 5.3% of the loaded test implants and 7.5% of the loaded control implants failed. The survival rates after 3 years were 91.3% for maxillary control implants, 94.8% for maxillary test implants, 97.4% for mandibular control implants, and 94.1% for mandibular test implants. The findings in this study pointed out that angulated abutments will not necessarily promote peri-implant mucosal problems. The study indicated that angulated abutments on Brånemark System implants have exhibited good preliminary results and should be comparable to the standard abutment as a predictable modality in prosthetic rehabilitation.

The distribution in mice of radioactive cobalt administered by two different methods.

The short time distribution of 58Co in mice that received a 58CoCl2 solution intravenously or intraperitoneally was examined by means of scintillation measurements. The serum, kidney, pancreas, spleen, liver, and heart were analyzed. Statistically significant differences in the distribution pattern after intraperitoneal and intravenous administration were noted for serum, kidney, liver, and heart 1 h after injection and for kidney, liver, and heart 5 h after injection. Only the heart showed a significant difference between the two administration methods 24 h after injection. Intravenous injections gave less variation between animals of the 58Co distribution pattern than intraperitoneal injections.

Release and uptake of cobalt from cobalt-chromium alloy implants.

Cobalt-chromium alloy implants were placed subcutaneously in the neck region of mice, and the animals were killed after 8 weeks. The cobalt concentration was high in the connective tissue of the capsule formed around 5 out of 10 cobalt-chromium implants. In nine other tissues analyzed no statistically significant increases in the cobalt concentration were detected. The surgical procedure and the carrying of an implant did not influence the weight increase of the animals during the period of the experiment.

Distribution of 58Co from the oral cavity of mice.

Whole body retention and tissue distribution of 58Co in mice having had an oral cavity depot of 58CoCl2 was studied at 1, 5 and 24 h after administration by means of gamma scintillation measurements and autoradiography. The whole body 58Co retention at 5 h after administration was 93.3% of the whole body 58Co content at 1 h. Corresponding 58Co-retention at 24 h after administration was 9.2%. Tissues analyzed by gamma scintillation measurements at 1, 5 and 24 h post administration were: serum, kidney, pancreas, spleen, liver, heart, lung, tongue and palatal mucosa. At all survival times after administration palatal mucosa showed the highest 58Co median content followed by tongue. The very high 58Co median content of palatal mucosa and tongue at 1 h after administration showed a strongly decrease at 5 and 24 h after administration. For the other tissues the highest 58Co median content was found in the liver and the lowest in the spleen with the highest 58Co median value for each tissue at 5 h after administration. The autoradiograms revealed a high 58Co uptake in oral, nasal, pharyngeal and esophageal mucosa, intestines and stomach. In liver, pancreas and kidney no uptake was observed at 1 h and a weak uptake was detected at 5 and 24 h.

Release of cobalt from cobalt chromium alloy constructions in the oral cavity of man.

The release of cobalt from a cobalt chromium alloy construction with a major palatal connector (palatal strap) in the maxilla was determined for 10 test subjects. The concentration of cobalt in unstimulated whole saliva and tongue scrapings was estimated 21, 14 and 7 d respectively before and 1, 2, 3, 10, 20 and 30 d after insertion of the cobalt chromium alloy construction. The method used to quantify the cobalt content was flameless atomic absorption spectrophotometry (AAS). The results showed that the median cobalt concentration in saliva and tongue scrapings increased after the insertion of the cobalt chromium alloy construction, with the highest values occurring in the first 2 d after insertion. The tongue scrapings, in general, showed higher cobalt median values than saliva did at all times of estimation. The sampling method described in the present study seems to be useful in long-term investigations in man, where numerous sample collections in the oral cavity are required in order to determine metal content. The risk of negative biologic effects on the human organism caused by the cobalt release from the alloy is discussed.

Anaerobic bacterial coxitis and pseudocystic tumour in rheumatoid arthritis. A case report.

When patients with rheumatoid arthritis develop rapidly growing tumours around the hip or elbow joint, the possibility should be considered that this condition could be pseudocystic with a low virulent infection. The present report describes such a case of anaerobic bacterial coxitis with rapidly growing tumour.