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PubMed2003

Association of INOS, TRAIL, TGF-beta2, TGF-beta3, and IgL genes with response to Salmonella enteritidis in poultry.

Several candidate genes were selected, based on their critical roles in the host's response to intracellular bacteria, to study the genetic control of the chicken response to Salmonella enteritidis (SE). The candidate genes were: inducible nitric oxide synthase (INOS), tumor necrosis factor related apoptosis inducing ligand (TRAIL), transforming growth factor beta2 (TGF-beta2), transforming growth factor beta3 (TGF-beta3), and immunoglobulin G light chain (IgL). Responses to pathogenic SE colonization or to SE vaccination were measured in the Iowa Salmonella response resource population (ISRRP). Outbred broiler sires and three diverse, highly inbred dam lines produced 508 F1 progeny, which were evaluated as young chicks for either bacterial load isolated from spleen or cecum contents after pathogenic SE inoculation, or the circulating antibody level after SE vaccination. Fragments of each gene were sequenced from the founder lines of the resource population to identify genomic sequence variation. Single nucleotide polymorphisms (SNP) were identified, then PCR-RFLP techniques were developed to genotype the F1 resource population. Linear mixed models were used for statistical analyses. Because the inbred dam lines always contributed one copy of the same allele, the heterozygous sire allele effects could be assessed in the F1 generation. Association analyses revealed significant effects of the sire allele of TRAIL-StyI on the spleen (P <0.07) and cecum (P <0.0002) SE bacterial load. Significant effects (P <0.04) were found on the cecum bacterial load for TGF-beta3-BsrI. Varied and moderate association was found for SE vaccine antibody response for all genes. This is the first reported study on the association of SNP in INOS, TRAIL, TGF-beta2, TGF-beta3, and IgL with the chicken response to SE. Identification of candidate genes to improve the immune response may be useful for marker-assisted selection to enhance disease resistance.

Animals↗
PubMed2006

Deer browse resistant exotic-invasive understory: an indicator of elevated human risk of exposure to Ixodes scapularis (Acari: Ixodidae) in southern coastal Maine woodlands.

We evaluated the relationships between forest understory structure and the abundance of questing adult and nymphal blacklegged ticks, Ixodes scapularis Say (Acari: Ixodidae), in three Maine towns endemic for Lyme disease, 2001-2003. In fragmented New England woodlands, over-abundant white-tailed deer, Odocoileus virginianus Zimmerman, overbrowse palatable species, allowing browse-resistant exotic-invasive species to replace native forest understory structures. We predicted there would be more ticks in plots dominated by exotic-invasive shrubs (such as Japanese barberry, Berberis thunbergii DC) than in plots dominated by native shrubs, ferns, or open understory. We assessed canopy composition and closure, tree basal area, litter composition, percentage of coverage and stem density of understory species, litter depth, soil moisture, and abundance of small mammals and white-tailed deer pellet groups. We used generalized linear mixed model analysis of covariance to determine the effect of understory structure on tick counts, controlling for continuous habitat and host covariates and adjusting for random spatial effects. There were twice as many adults and nearly twice as many nymphs in plots dominated by exotic-invasives than in plots dominated by native shrubs. Both adult and nymphal counts were lowest in open understory with coniferous litter. Adults were positively associated with increasing litter depth, medium soil moisture, and increasing abundance of white-footed deer mice, Peromyscus leucopus Rafinesque, and deer pellet group counts. Nymphs were positively associated with increasing litter depth, moderately wet soil, and mice. We concluded that deer browse-resistant exotic-invasive understory vegetation presented an elevated risk of human exposure to the vector tick of Lyme disease.

Animals↗
PubMed2006

Larger portion sizes lead to a sustained increase in energy intake over 2 days.

OBJECTIVE: We tested the effect on energy intake of increasing the portion size of all foods and beverages served over 2 consecutive days. DESIGN: The study used a randomized crossover design. SUBJECTS/SETTING: Subjects were 32 adults from a university community. INTERVENTION: For 2 consecutive days in each of 3 weeks, subjects ate their main meals in a controlled setting and were given snacks for consumption between meals. We used the same two daily menus each week, but varied the portion sizes of all foods and beverages served in a given week (either 100%, 150%, or 200% of baseline amounts). MAIN OUTCOME MEASURES: Energy intake and ratings of hunger and satiety were measured. STATISTICAL ANALYSES PERFORMED: A linear mixed model with repeated measures was used. RESULTS: There was a significant effect of portion size on energy intake in both men and women (P<0.0001). Increasing portions by 50% increased daily energy intake by 16% (women: 335 kcal/day; men: 504 kcal/day), and increasing portions by 100% increased intake by 26% (women: 530 kcal/day; men: 812 kcal/day). Energy intake did not differ between the 2 days of each week. Daily ratings of fullness were lowest in the 100% portion condition (P=0.0004), but did not differ significantly in the 150% and 200% conditions. CONCLUSIONS: Increasing the portion size of all foods resulted in a significant increase in energy intake that was sustained over 2 days. These data support suggestions that large portions are associated with excess energy intake that could contribute to increased body weight.

Adult↗
PubMed2005

Missing covariates in longitudinal data with informative dropouts: bias analysis and inference.

We consider estimation in generalized linear mixed models (GLMM) for longitudinal data with informative dropouts. At the time a unit drops out, time-varying covariates are often unobserved in addition to the missing outcome. However, existing informative dropout models typically require covariates to be completely observed. This assumption is not realistic in the presence of time-varying covariates. In this article, we first study the asymptotic bias that would result from applying existing methods, where missing time-varying covariates are handled using naive approaches, which include: (1) using only baseline values; (2) carrying forward the last observation; and (3) assuming the missing data are ignorable. Our asymptotic bias analysis shows that these naive approaches yield inconsistent estimators of model parameters. We next propose a selection/transition model that allows covariates to be missing in addition to the outcome variable at the time of dropout. The EM algorithm is used for inference in the proposed model. Data from a longitudinal study of human immunodeficiency virus (HIV)-infected women are used to illustrate the methodology.

Algorithms↗
PubMed2005

Effect of CME on primary care and OB/GYN treatment of breast masses.

INTRODUCTION: CME program planners are being asked to move beyond assessments of knowledge to assessing the impact of CME on practice and patient outcomes. METHODS: We conducted a pre-post analysis of administrative data from 107 physicians, nurse practitioners (NPs), or physician's assistants (PAs) who attended one or two continuing medical education (CME) programs (an in-person, mainly didactic session on breast complaints in women, or an individual mentorship with general surgeons) between August 2002 and March 2003. We examined associations between the number of trainings and attempted breast mass aspirations or general surgery referrals for breast masses; individual training and breast mass aspiration attempts or general surgery referrals; and provider type and attempted breast mass aspirations. Generalized linear mixed models were used to model dichotomous outcomes. RESULTS: Clinicians who participated in individual trainings performed more breast mass aspirations after training (odds ratio (OR) 3.07, [95% confidence interval 1.10-8.54]). Participants who completed two trainings performed more breast mass aspirations after training (OR 2.33, [1.19-4.57]), while those who completed just one did not (OR 1.34, [0.39, 4.58]) but the effect started after the first training and did not strengthen after the second training. NPs and PAs attempted more aspirations after training (OR 6.1, [1.54, 24.1]), whereas physicians did not (OR 0.89 [0.36, 2.22]). Training was not associated with a change in referrals to general surgery. Referral appropriateness, pre-training readiness to change, and previous training in breast mass aspiration were not assessed. DISCUSSION: Attempts to aspirate breast masses may increase after CME training. Individual training may be more effective than group training in increasing the likelihood of attempted aspirations.

Breast Diseases↗
PubMed2004

Quantification of afferent vessels shows reduced brain vascular density in subjects with leukoaraiosis.

PURPOSE: To investigate vessel density changes with increasing age in three areas of the brain and to correlate these changes with leukoaraiosis (LA) on the basis of magnetic resonance (MR) images and location in deep white matter (WM). MATERIALS AND METHODS: Internal review board approval or informed consent from next of kin was not required. Brains of 21 subjects (mean age, 72.5 years; 12 men, nine women) were evaluated at autopsy with MR imaging. The presence of LA was indicated by confluent or patchy areas of hyperintensity in deep WM. Microvascular density (percentage of vessel area divided by total area) in subjects with LA was measured with computerized morphometric analysis in LA lesions, healthy-appearing WM at MR imaging, and the cortex. These measurements were compared with each other and with measurements from corresponding areas in healthy subjects. Afferent vasculature was stained with alkaline phosphatase in celloidin sections. Hypotheses were tested with computation of a series of repeated-measures linear mixed models. RESULTS: Autopsy brains from 12 subjects with LA (mean age, 72 years; six men, six women) and nine subjects without LA (mean age, 73 years; six men, three women) were studied. Afferent microvascular density +/- standard deviation in LA lesions in deep WM (2.56% +/- 1.56) was significantly lower than that in corresponding deep WM of healthy subjects (3.20% +/- 1.82) (P = .018). Subjects with LA demonstrated decreased afferent vascular density at early ages in all three areas of the brain when compared with healthy subjects of the same age. CONCLUSION: Findings of decreased afferent vascular density in the area of LA and outside the lesion indicate that LA is a generalized cerebrovascular disease process rather than one confined to deep WM.

Aged↗
PubMed2004

Goal-directed upper limb movements by children with and without DCD: a window into perceptuo-motor dysfunction?

BACKGROUND AND PURPOSE: Developmental co-ordination disorder (DCD) occurs in at least 6% of school-aged children. Researchers agree that motor co-ordination problems evident in DCD are, in part, the result of perceptual and cognitive processes, but the limited research available remains inconclusive. The present study investigated perceptual-motor abilities, with regard to vision, kinaesthesia and cross-modal judgement, in children with and without DCD. METHOD: A cross-sectional study design was used. Nine children, aged six years (+/- six months) with DCD, and nine children without DCD, matched for age and gender, participated in the study. The children were required to point with the preferred hand to a target in three different positions under four sensory conditions, either with or without vision. Three-dimensional motion analysis was used to investigate trajectory lengths, endpoint error and movement time. The results were analysed using a generalized linear mixed model to examine the systematic effects of group, target position and task. RESULTS: Compared with children without DCD, the children with DCD produced larger endpoint errors, greater movement times and longer trajectories. Children in both groups produced larger endpoint errors, greater movement times and longer trajectories in non-visually guided aiming versus visually guided aiming tasks. CONCLUSIONS: Children with DCD moved more slowly, with longer movement trajectories and were less accurate than children without DCD when aiming to all target positions under all sensory conditions. The greatest error and trajectory length occurred for both groups when aiming movements were performed in the absence of vision. As children in the DCD group had difficulties with movement executed under kinaesthetic or visual control, the results indicate that the normal advantage of vision displayed by children without DCD is not apparent, and visual and kinaesthetic problems may be present in children with DCD.

Arm↗
PubMed2003

Counseling and physical therapy as treatment for myofascial pain of the masticatory system.

AIMS: To prospectively evaluate the effectiveness of a treatment regimen comprising counseling and physical therapy in patients with myofascial pain of the masticatory system, and to explore whether the duration of the physical therapy offered (4 vs 6 weeks) would influence the treatment result. METHODS: Twenty-six patients were randomly distributed over 2 groups. All patients received reassuring information, advice regarding relaxation of the jaws, avoiding parafunctions, and limited use of the jaws. In addition, a physical therapy program (heat application, massage, ultrasound and muscle stretching) was initiated 2 weeks after the start of the study (group I, receiving 4 weeks of physical therapy) or immediately from the start of the study (group II, receiving 6 weeks of physical therapy). The following parameters were taken at baseline, 2, 4, and 6 weeks: visual analog scale (VAS) scores of present pain; lowest and highest pain over the past period; percentage of pain relief; jaw function assessment by the Mandibular Function Impairment Questionnaire (MFIQ); and pressure pain thresholds (PPTs) of the masseter, temporalis, and thumb muscles. Statistical analysis used a linear mixed model and corrected for multiple testing (Tukey test). RESULTS: Pain and MFIQ scores decreased while PPTs increased in both groups. Only after 4 and 6 weeks, significant differences were present for the PPT of the masseter in group I (P < .02) and the temporalis in both groups (P < .01). Also, the VAS scores of present (P < .02), minimal (P < .01), and maximal (P < .0001) pain and the MFIQ score (P < .001) improved. After 6 weeks, a mean of 60% pain decrease was reported (P < .0001). There were no significant differences between the groups receiving 4 weeks vs 6 weeks of physical therapy. CONCLUSION: A conservative approach involving counseling and physical therapy resulted in significant improvement in parameters of pain and jaw function in patients with myofascial pain. A controlled study will be necessary to elucidate the specific effectiveness of physical therapy over counseling or no treatment.

Adolescent↗
PubMed2006

Short-term effects of air pollution on heart rate variability in senior adults in Steubenville, Ohio.

OBJECTIVE: We examined the association between ambient air pollution levels and heart rate variability (HRV) in a panel study of 32 subjects. METHODS: We used linear mixed models to analyze the effects of fine particles (PM2.5), sulfate (SO4), elemental carbon (EC), and gases on log-transformed standard deviation of normal RR intervals (SDNN), mean square of differences between adjacent RR intervals (r-MSSD), and high- and low-frequency power (HF, LF). RESULTS: An interquartile range (IQR) increase of 5.1 mug/m in SO4 on the previous day was associated with a decrease of -3.3% SDNN (95% confidence = -6.0% to -0.5%), -5.6% r-MSSD (-10.7% to -0.2%), and -10.3% HF (-19.5% to -0.1%). Associations with total PM2.5 were similar. HRV was not associated with EC, NO2, SO2, or O3. CONCLUSION: In addition to traffic-related particles, elevated levels of sulfate particles may also adversely affect autonomic function.

Aged↗
PubMed1992

Correlated response in growth and body measurements accompanying selection for milk yield in Jerseys.

Growth and body measurements from a long-term selection project were analyzed to determine correlated responses to single-trait selection for milk yield. Data were from 1056 daughters (765 selection, 291 control) of 37 bulls (17 selection, 20 control) of 37 bulls (17 selection, 20 control) and included BW and measures of heart girth, chest depth, wither height, and length from withers to pins and from withers to hooks taken at 6 mo, 15 mo, first calving, end of first lactation, and maturity. Other data were birth weight, change in measurements and weights from first calving to end of first lactation, monthly rate of gain from 1 to 13 mo of age, and age reaching breeding weight (250 kg). Principal component scores were calculated from standardized measurements at each age. The first three principal components has meaning (size, length vs. girth, and height vs. girth). All analyses used linear mixed models with fixed effects of genetic group, generation within group, year-season of birth or calving, parity of dam, and birth status (multiple or single birth). Sires were assumed to be random and nested within genetic group. Mean squares for sires was used to test for group differences. Generation did not differ in any analysis and was removed from all models. Selection cows were heavier, larger in some measurements, and had greater overall size at 6 mo of age. Selection cows had greater monthly rate of gain and attained breeding weight at an earlier age. Genetic groups did not differ for any other measurement or weight. Control cows gained more weight and increased more in some measurements between first calving and end of first lactation. Selection for milk yield did not result in an undesirable correlated response in an growth or body measurement.

Animals↗
PubMed2006

Association between dietary fiber and serum C-reactive protein.

BACKGROUND: High sensitivity C-reactive protein (CRP) is a marker of acute inflammation recently recognized as an independent predictor of future cardiovascular disease and diabetes. The identification of modifiable factors, such as diet, that influence serum CRP concentrations may provide the means for reducing the risk of these diseases. Data on longitudinal associations between dietary fiber intake and CRP are currently lacking. OBJECTIVE: The purpose of this study was to examine longitudinal associations between dietary fiber intake and CRP. DESIGN: Data collection took place at baseline and quarterly (every 13 wk) thereafter for a total of 5 visits, each including measurements of body composition, CRP, diet, and physical activity. Relations between serum CRP and dietary fiber were assessed by using linear mixed models and logistic regression, adjusted for covariates. RESULTS: A total of 524 subjects had multiple measurements of CRP and dietary factors. The average total dietary fiber intake was 16.11 g/d. Average serum CRP was 1.78 mg/L. We observed an inverse association between intake of total dietary fiber (separately for soluble and insoluble fiber) and CRP concentrations in both cross-sectional and longitudinal analyses. The likelihood of elevated CRP concentrations was 63% lower (OR: 0.37; 95% CI: 0.16, 0.87) in participants in the highest quartile of total fiber intake than in participants in the lowest quartile. CONCLUSIONS: Our results suggest that dietary fiber is protective against high CRP, which supports current recommendations for a diet high in fiber.

Adult↗
PubMed2004

Factors affecting menstrual cycle characteristics.

This 1989-1991 study in California and Utah used daily urinary metabolites of estrogen and progesterone and computer algorithms to assess ovulatory status and day of ovulation. The authors examined the associations of risk factors with menstrual cycle characteristics for 309 working women aged 20-44 years who collected a median of five cycles each of daily urine samples. Linear mixed models were used to assess continuous menstrual outcomes. Compared with women less than age 35 years, women aged 35 years or older had a significantly decreased (-0.94 days, 95% confidence interval: -1.83, -0.05) adjusted mean cycle length. Age modified the effects of smoking, physical activity, ethnicity, and alcohol consumption on mean follicular phase length. Asian women had a significantly longer (1.65 days, 95% confidence interval: 0.54, 2.76) adjusted mean cycle length compared with Caucasian women. Compared with women who did not consume alcoholic drinks, women who did had a significantly shorter (-1.26 days, 95% confidence interval: -2.21, -0.31) adjusted mean cycle length. Mean cycle and phase lengths were significantly associated with length of the prior luteal phase. These results indicate that potentially modifiable risk factors, as well as immutable host factors, are associated with menstrual cycle characteristics that may in turn be related to subsequent disease risk.

Adult↗
PubMed2004

The evolution of phylogenetic differences in the efficiency of digestion in ruminants.

This study investigates, for the first time (to our knowledge) for any animal group, the evolution of phylogenetic differences in fibre digestibility across a wide range of feeds that differ in potential fibre digestibility (fibre to lignin ratio) in ruminants. Data, collated from the literature, were analysed using a linear mixed model that allows for different sources of random variability, covariates and fixed effects, as well as controlling for phylogenetic relatedness. This approach overcomes the problem of defining boundaries to separate different ruminant feeding styles (browsers, mixed feeders and grazers) by using two covariates that describe the browser-grazer continuum (proportion of grass and proportion of browse in the natural diet of a species). The results indicate that closely related species are more likely to have similar values of fibre digestibility than species that are more distant in the phylogenetic tree. Body mass did not have any significant effect on fibre digestibility. Fibre digestibility is estimated to increase with the proportion of grass and to decrease with the proportion of browse in the natural diet that characterizes the species. We applied an evolutionary model to infer rates of evolution and ancestral states of fibre digestibility; the model indicates that the rate of evolution of fibre digestibility accelerated across time. We suggest that this could be caused by a combination of increasing competition among ruminant species and adaptation to diets rich in fibre, both related to climatically driven environmental changes in the past few million years.

Animals↗
PubMed2006

The measurement of ground reaction force in dogs trotting on a treadmill: an investigation of habituation.

We studied the time necessary to obtain reliable kinetic data from healthy dogs trotting on a treadmill. Ten adult male Malinois Belgian Shepherd dogs were made to trot on an instrumented treadmill to record the ground reaction force for the entire body and to determine the vertical force variables (peak [PFz], impulse [IFz], stride time [Str], peak time [Tz] and contact time [Ct]). Data were collected from each dog, during three sequences per day, on three consecutive days. In order to determine the contribution of the sequence, day of measurement, and dog factors and the percentage of variance attributable to dogs, data were analyzed with a linear mixed model. The curve shapes were similar to those obtained with a floor-mounted force platform. Intra-dog coefficients of variation were between 1.57 and 3.46%. Inter-dog coefficients of variation were between 4.18 and 7.82%. A sequence effect was not noted. Each day had a significant effect on all of the data. All variables differed significantly from the first day compared to the other days. However there was not any difference between days 2 and 3. The percentage of the total variance attributable to dogs ranged from 37 to 88%. The coefficients of variation were lower than those obtained with common protocols. The treadmill locomotion remained consistent during a single session. Even if interday variation needs to be accounted for, reliable data can still be obtained after a single training session. The majority of the variation was attributable to the dog. An instrumented treadmill may be used for kinetic analysis.

Acceleration↗
PubMed2003

Acute effect of sulphur dioxide from a power plant on pulmonary function of children, Thailand.

BACKGROUND: Epidemiological studies have shown reversible declines of lung function in response to air pollution, but research on the independent effect of short-term exposure to ambient sulphur dioxide (SO2) on pulmonary function is limited. This study evaluated the association of short-term exposure to increased ambient SO2 and daily pulmonary function changes among children with and without asthma. METHODS: The associations of daily exposure to SO2 and particulate matter 10 microm in diameter (PM10) with pulmonary function were examined in 175 asthmatic and non-asthmatic children aged 6-14 years who resided near a coal-fired power plant in Thailand. Each child performed daily pulmonary function tests during the 61-day study period. General linear mixed models were used to estimate the association of air pollution and pulmonary function controlling for time, temperature, co-pollutants, and autocorrelation. RESULTS: In the asthmatic children, a daily increase in SO2 was associated with negligible declines in pulmonary function, but a small negative association was found between PM10 and pulmonary function. A 10-microg/m(3) increment was associated with changes in the highest forced vital capacity (FVC) (-6.3 ml, 95% CI: -9.8, -2.8), forced expiratory volume at 1 second (FEV(1)) (-6.0 ml, 95% CI: -9.2, 2.7), peak expiratory flow rate (PEFR) (-18.9 ml.sec(-1), 95% CI: -28.5, -9.3) and forced expiratory flow 25 to 75% of the FVC (FEF(25-75%)) (-3.7 ml.sec(-1), 95% CI: -10.9, 3.5). No consistent associations between air pollution and pulmonary function were found for non-asthmatic children. CONCLUSION: Declines in pulmonary function among asthmatic children were associated with increases in particulate air pollution, rather than with increases in SO2.

Adolescent↗
PubMed2000

Depression and other determinants of values placed on current health state by stroke patients: evidence from the VA Acute Stroke (VASt) study.

BACKGROUND AND PURPOSE: This prospective study examined the determinants of the utility (value) placed on health status among a sample of patients with acute ischemic and intracerebral hemorrhagic stroke. METHODS: Data were from the VA Acute Stroke (VASt) study, a nationwide prospective cohort of 1073 acute stroke patients admitted at any of 9 Department of Veterans Affairs Medical Center sites between April 1, 1995, and March 31, 1997. The primary outcome was the patient's health status utility as measured by the time-tradeoff method. Data were obtained by telephone interviews at 1, 6, and 12 months and by medical record review. General linear mixed modeling was used to assess the effects of social, psychological, and physical factors on patients' valuations of their current health state. The analysis was confined to the 327 patients who were able to provide self-reports at >/=2 time points. RESULTS: Patients' valuations of their health state status over the initial 12 months after stroke were very stable over time, with only a slight improvement at 6 months, followed by a slight decline at 12 months. In adjusted analyses, living alone, being institutionalized, decreased physical function, and depression were independently associated with lower levels of patient health status utility over time. CONCLUSIONS: Stroke patient health status utilities are relatively stable during the initial year after stroke. In addition to physical function, psychological health and social environment are important determinants of patient health status utility. These factors need to be considered when conducting stroke decision analyses if more accurate conclusions are to be drawn regarding preferred patterns of care.

Acute Disease↗
PubMed2005

Reinstatement of serum pregnanolone isomers and progesterone during alcohol detoxification therapy in premenopausal women.

BACKGROUND: Alcohol abuse is associated with menstrual irregularities related to the inhibition of progesterone secretion involved in regulation of the menstrual cycle. Reduced progesterone metabolites, including pregnanolone isomers (PIs), are efficient neuromodulators. The authors attempted to evaluate whether levels of PIs reflect impairment in progesterone biosynthesis in premenopausal women treated for alcohol addiction and whether alcohol detoxification therapy contributes to the restoration of their reproductive functions and psychosomatic stability by influencing steroid biosynthesis. METHODS: Serum allopregnanolone (3alpha-hydroxy-5alpha-pregnan-20-one; P3alpha5alpha), pregnanolone (P3alpha5beta), isopregnanolone (P3beta5alpha), epipregnanolone (P3beta5beta), progesterone, pregnanolone sulfate (PregS), pregnanolone, and estradiol were measured in 20 women during therapy (at start, three days, 14 days, one month, and four months) by gas chromatography-mass spectrometry or radioimmunoassay. The results were evaluated by a linear mixed model for longitudinal data, with stage of the treatment and subject as categorical factors, phase of the menstrual cycle as a time-varying covariate, and age of the subject as a covariate and by regression in individual stages of the menstrual cycle. RESULTS: During detoxification treatment, progesterone increased in the luteal phase. P3alpha5alpha, P3beta5alpha, and P3beta5beta rose in both phases of the menstrual cycle. DISCUSSION: Given the similar mechanism in the effects of alcohol and steroids in activating gamma-aminobutyric acid A receptors, the restoration of progesterone and PIs during therapy could be explained by an adaptation to increasing requests for gamma-aminobutyric acid A-receptor activating substances owing to the cessation of alcohol intake or by the regeneration of progesterone formation. In conclusion, the reinstatement of progesterone, P3alpha5alpha, and P3beta5beta serum levels demonstrates the favorable effect of detoxification therapy on both reproductive functions and the psychosomatic stability of premenopausal women treated for alcohol addiction.

Adult↗
PubMedDate not supplied

Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study.

PURPOSE: This study aimed to compare the prosthetic aspects and patient satisfaction with prosthetic care in two-implant-retained mandibular overdentures, whether implants were splinted with a bar or left with magnets or ball attachments. MATERIALS AND METHODS: Thirty-six completely edentulous patients had two Brånemark implants placed in the mandibular canine area. A randomized procedure allocated patients into three groups of equal size, each with a different attachment system: bars, magnets, or balls. Prosthesis retention and mechanical as well as soft tissue complications were recorded in addition to patient satisfaction. A linear mixed model was fitted with attachment type and time as classification variables and adjusted by Turkey's multiple range test. RESULTS: Ball-retained overdentures showed at year 10 the greatest vertical retention force (1,327 g), followed by bars (1,067 g) and magnets (219 g). In the ball group, need for tightening of abutment screws was the most common mechanical complication; in the magnet and bar groups, respectively, the most common complications were wear and corrosion, and the need for clip activation. Prosthesis stability and chewing comfort for the overdenture were rated significantly lower for the magnet group compared to the ball and bar groups. Prosthesis stability of the maxillary denture was rated significantly lower in the bar group compared to ball and magnet groups. CONCLUSION: The ball group scored best in relation to retention of the overdenture, soft tissue complications, and patient satisfaction at year 10. The bar group scored lower for comfort and stability of the maxillary denture. Magnets offered patients the least comfort.

Adult↗