How do implant patients experience complications? A cross-sectional multicentre pilot study.

BACKGROUND: This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes. MATERIALS AND METHODS: Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data. RESULTS: The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2 = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2 = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2 = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2 = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73). CONCLUSIONS: Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.

Changes in Dendritic Spine Density and Inhibitory Perisomatic Connectivity onto Medium Spiny Neurons in L-Dopa-Induced Dyskinesia.

Using bacterial artificial chromosome-double transgenic mice expressing tdTomato in D1 receptor-medium spiny neurons (MSNs) and enhanced green fluorescent protein in D2 receptor-MSNs, we have studied changes in spine density and perisomatic GABAergic boutons density in MSNs of both the D1R and D2R pathways, in an experimental model of parkinsonism (mouse injected with 6-hydroxydopamine in the medial forebrain bundle), both in the parkinsonian and dyskinetic condition induced by L-DOPA treatment. To assess changes in perisomatic GABAergic connectivity onto MSNs, we measured the number of contacts originated from parvalbumin (PV)-containing striatal "fast-spiking" interneurons (FSIs), the major component of a feed-forward inhibition mechanism that regulates spike timing in MSNs, in both cell types as well as the number of vesicular GABA transporter (VGAT) contacts. Furthermore, we determined changes in PV-immunoreactive cell density by PV immunolabeling combined with Wisteria floribunda agglutinin (WFA) labeling to detect FSI in a PV-independent manner. We also explored the differential expression of striatal activity-regulated cytoskeleton-associated protein (Arc) and c-Fos in both types of MSNs as a measure of neuronal activation. Our results confirm previous findings of major structural changes in dendritic spine density after nigrostriatal denervation, which are further modified in the dyskinetic condition. Moreover, the finding of differential modifications in perisomatic GABAergic connectivity and neuronal activation in MSNs suggests an attempt by the system to regain homeostasis after denervation and an imbalance between excitation and inhibition leading to the development of dyskinesia after exposure to L-DOPA.

Role of maternal adrenal glands on the developing serotoninergic and aminoacidergic systems of the postnatal rat brain.

Serotonin, gamma-aminobutyric acid and glutamate, which are regulated by glucocorticoids in the central nervous system, are involved in neuroendocrine functions and the development of the brain. The present study investigates the effect of maternal adrenalectomy on the developing serotoninergic, GABAergic and glutamatergic systems. Neurotransmitter levels were measured in four brain areas of both male and female offspring on postnatal days 1, 8, 12 and 22. At postnatal day 1 and 8, the pups of adrenalectomized dams showed higher concentrations of serotonin than controls in all the brain areas studied. Serotonin levels decreased significantly in males at postnatal day 22 in the hippocampus and cortex. During the first 2 weeks of postnatal life, the lack of maternal corticosterone produced an increase in glutamate and a reduction in gamma-aminobutyric acid concentrations, mainly in males. Further, on postnatal day 1, increased serotonin and glutamate levels and lower levels of gamma-aminobutyric were observed in the hypothalamus of male pups born to adrenalectomized dams. The absence of maternal corticosterone affects the pattern of development of the serotoninergic system, especially in the hippocampus and cortex, and particularly in males. A delay in the maturation of the aminoacidergic systems, mainly of the GABAergic system and in males, was also seen. A sexually dimorphic response to the removal of maternal glucocorticoids was seen in terms of neurotransmitter levels, mainly in the hippocampus and hypothalamus.

Maternal adrenalectomy affects development of adrenal medulla.

This work investigates the effects of maternal adrenalectomy (ADX) on the development of the adrenal medulla. Adrenal catecholamines (AC) were measured at postnatal day (PN) 1, 8, 12 and 22 in rat offspring of ADX dams and in pups of control dams. The pups of ADX rats showed a reduction in AC concentrations in the adrenal medulla at PN 1, 12 and 22, although these were higher than in the pups of sham dams at PN 8. Further, in the pups of control mothers, there was an increase in ACs during the first two weeks of life whereas pups of ADX mothers only showed increases in noradrenaline, dopamine and adrenaline levels at day 8. These results suggest that maternal absence of corticosterone affects the medulla catecholamine content during development. These data support the idea that a maternal glucocorticoids are involved in the differentiation or/and maturation of the adrenal medulla.