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Biomedical subjects

B Linden

Publications and source records attributed to B Linden.

14 recordsLinked to original sources

Stability measurements of one-stage Brånemark implants during healing in mandibles. A clinical resonance frequency analysis study.

Using a one-stage surgical protocol, 75 implants ad modum Brånemark of three different designs were inserted in 15 edentulous mandibles of high bone density. All implants were followed with repeated stability measurements by means of resonance frequency analysis (RFA) from implant placement to connection of the fixed prostheses (3-4 months), in order to evaluate possible stability changes during healing. It was shown that the resonance frequency (RF) values slightly decreased for the majority of the implants during the study period independent of design. Consequently, the results of the present study indicated that the implants were as stable at time of placement as when measured at 3-4 months post-surgery, i.e. when the prostheses were attached. The available data support the concept of direct loading of implants when inserted between the mental interforaminal regions. One implant failed during healing and the corresponding RF measurement disclosed, at six weeks post-surgery, a value being far below the one registered at implant placement. The lowered RF value indicated the failure several weeks before the mobility was clinically diagnosed. The presence or absence of a fixture/abutment junction did not exert any influence on the marginal bone level, as determined radiographically at the end of the short investigation period.

Aged↗

Aortic arch anomalies associated with long gap esophageal atresia and tracheoesophageal fistula.

PURPOSE: The purpose of this study was to determine whether aortic arch anomalies are associated with long gap esophageal atresia and tracheoesophageal fistula (EA-TEF). METHODS: The authors performed a retrospective review of all infants who had EA-TEF from 1980 to 1996 at two pediatric surgery centers. Two hundred three infants who had EA-TEF were identified. RESULTS: Twelve infants were noted to have both long gap EA-TEF defined as a gap length greater than 3 cm and aortic arch anomalies. Of these 12, 7 had aberrant right subclavian arteries originating from the descending aorta. Four of the seven infants who had aberrant right subclavian artery (SCA) had gap lengths greater than 4 cm. All four had their fistulae divided initially through a right thoracotomy with primary repair performed at a later date. The remaining five infants who had long gap EA-TEF had right-sided aortic arch with aberrant left subclavian arteries. All five initially underwent exploration through the right chest. On discovery of the long gap EA and concurrent vascular anomaly, the thoracotomies were closed, and the infants underwent definitive repair of both their EA-TEF and their vascular anomaly through a left thoracotomy. CONCLUSIONS: The authors find that aortic arch anomalies are associated with long gap EA-TEF. Patients who have these two anomalies tend to have a long gap. Preoperative diagnosis of these anomalies may alter the timing and technique of surgical intervention. The embryogenesis of these vascular lesions may account for this more severe form of esophageal atresia.

Aorta, Thoracic↗

Evaluation of a home-based rehabilitation programme for patients recovering from acute myocardial infarction.

There is substantial evidence of the importance of rehabilitation for patients recovering from acute myocardial infarction in reducing mortality, morbidity, and psychological distress. The aim of this study was to compare a recently established home-based coronary rehabilitation programme in a coronary care unit (CCU) with the provision of a selection of information leaflets commonly provided for patients after their myocardial infarction. A comparative study was carried out between two randomly allocated groups of patients receiving either the Heart Manual rehabilitation programme (n = 17) or general advice and information booklets (n = 17), with follow-up at 1, 3 and 6 weeks after discharge for both groups. Questionnaire measurements included anxiety and depression (HAD score), general practitioner (GP) visits, and patients' perception of their confidence of recovery and progress. The findings show that patients receiving the Heart Manual had significantly higher scores in their confidence of recovery and perception of their progress than the group receiving booklets. The Heart Manual group showed improved levels of anxiety with unchanged scores in depression, while patients receiving the booklets experienced increased depression with little change in their anxiety levels. These results help to provide guidance for health care professionals on a form of rehabilitation which is effective for patients and their families in hospital and within the community.

Female↗

A double-blind comparison of naproxen gel and placebo in the treatment of soft tissue injuries.

A double-blind study was carried out in 120 patients who had received soft tissue injuries within the preceding 48 hours to compare the effectiveness of naproxen gel (10%) with placebo gel (base alone). The injuries were predominantly synovitis and tendinitis. Standard clinical evaluations of the patients' condition were made by physicians and patients on entry and after 3 and 7 days of treatment. Both treatments resulted in a significant improvement in symptoms, but naproxen gel was significantly superior to placebo gel (p less than 0.05). The response produced by naproxen was more rapid; all symptoms were significantly improved by Day 3 (p less than 0.05). The greater efficacy of naproxen was reflected in a lower usage of active drug compared with placebo which was consistent throughout the study. While the physicians' global assessments of the two gels did not differ significantly, the patients showed a preference in favour of naproxen (p less than 0.05) Naproxen gel was well tolerated; only 1 adverse event of itching occurred. It is suggested that naproxen gel offers an effective and convenient alternative to systemic non-steroidal anti-inflammatory drugs for patients where side-effects are to be avoided or when oral administration is undesirable.

Adolescent↗

Oral function in patients treated with prostheses on Branemark osseointegrated implants in partially edentulous jaws: a pilot study.

To study the oral function of partially edentulous patients treated with fixed prostheses on osseointegrated implants, recordings of the masticatory efficiency and occlusal perception of thickness were performed. The retrievable fixed partial prostheses were used to study the immediate impact of reduced fixed occlusal support on masticatory efficiency. The masticatory efficiency was subjectively satisfactory but objectively lower when compared to naturally complete dentate persons. Furthermore, the immediate impact of reduced fixed occlusal support was compromised masticatory efficiency, which was more pronounced when the occlusal support was removed on either side.

Aged↗

Laser-welded titanium frameworks supported by implants in the edentulous maxilla: a 2-year prospective multicenter study.

PURPOSE: The aim of this study was to evaluate the clinical and radiographic performance of patients who received implants and fixed prostheses with laser-welded titanium frameworks. MATERIALS AND METHODS: Fifty-eight consecutive patients were treated with 349 osseointegrated implants ad modum Brånemark in the edentulous maxilla at 6 implant centers. The patients were randomly arranged into 2 groups at the time of final impression. Twenty-eight patients received laser-welded titanium frameworks and 30 patients received conventional cast frameworks. Clinical and radiographic data were collected for 2 years in function. RESULTS: The 2 groups of patients showed similar results. The 2-year overall cumulative implant survival rate from the time of implant placement and prosthesis insertion was 93.7% and 96.2%, respectively. The corresponding cumulative survival rate for prostheses was 96.6%. Two patients, 1 from each group, failed completely and resumed using conventional complete dentures. The only obvious factor that could possibly be related to the 2 complete failures was a smoking habit. However, it was not possible to significantly correlate implant failures to smoking habits in this study. No fractures were observed in the frameworks or implant components, and both groups experienced the same frequency of resin veneering material fractures. The overall average marginal bone loss was 0.4 mm (SD 0.8 mm). CONCLUSION: Patients treated with implant-supported prostheses fabricated with laser-welded titanium frameworks in the edentulous maxilla presented comparable results to patients with conventional cast frameworks after 2 years in function.

Adult↗

Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study.

PURPOSE: The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. MATERIALS AND METHODS: On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. RESULTS: All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (< 1%). CONCLUSION: Even though the cast frameworks had a higher success rate, the overall titanium framework treatment result was well in accordance with the result of the control group. The test groups performed better after clinicians had gained some experience with the technique, and laser-welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

Adult↗

Severe heart failure: a focus on the quality of care.

Heart failure usually originates from conditions such as coronary heart disease, valvular disease, hypertension or cardiomyopathy. Heart failure may develop after several heart attacks as a result of extensive myocardial damage. Despite many advances in treatment for heart disease, chronic heart failure is a terminal condition with a death rate as high as that for many malignant tumours.

Chronic Disease↗