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The effectiveness of palate-less versus complete palatal coverage dentures (a pilot study).

The aim of this pilot study was to evaluate the effectiveness of palate-less dentures as a substitute for conventional complete palatal coverage. Ten edentulous patients who had recently received maxillary and mandibular complete dentures were included in the study. The patients' maxillary conventional dentures were duplicated to construct 'U' shape palate-less dentures. A strain gauge biting fork was used to compare the maximum biting force and chewing tests using almond were performed. They failed to show significant differences. Eight patients were more comfortable with the palate-less dentures than the complete palatal coverage. It was concluded that Palate-less dentures could be as effective as dentures with complete palatal coverage.

Adult↗

[Tuberculosis screening coverage of immigrants: marked attrition in follow-up screenings].

OBJECTIVE: To estimate the coverage of bi-annual follow-up screening for tuberculosis amongst immigrants, excluding asylum seekers. DESIGN: Retrospective cohort study. METHODS: Participation in bi-annual chest X-ray screening during the first 18 months was recorded for immigrants who underwent entry screening in 1996 in the following Dutch municipal health services (MHS's): Zuid-Kennemerland (Haarlem), Flevoland (Lelystad), Midden-Brabant (Tilburg) en West-Friesland (Hoorn). The number of immigrants that had left the country before the subsequent screening was taken into account in the Zuid-Kennemerland MHS data on screening coverage. RESULTS: Of the 2147 immigrants who underwent entry screening in 1996 (48% men and 52% women; 68% aged 15-34 years), 1075 (50%; range: 29-76) returned for the first follow-up screening and 620 (29%; 21-61) returned for the second. In MHS Zuid-Kennemerland, 113 of the 777 immigrants who had a chest X-ray at entry had left the country before the first follow-up screening, and another 89 had left before the second. Of the remaining persons, who were probably still in the Netherlands, 454 (68%; 454/777 = 58%) returned for the first follow-up screening, and 166 (29%; 166/777 = 21%) returned for the second. CONCLUSION: The coverage of screening for tuberculosis in immigrants decreased after the obligatory entry screening, even when corrected for those who left the country.

Adolescent↗

Histologic evaluation of root coverage obtained with GTR in humans: a case report.

The purpose of this study was to histologically evaluate four teeth with recession defects that were treated with guided tissue regeneration (GTR). The amount of root coverage obtained ranged from 16.7% to 50.0%. In one of the defects treated, new bone was formed but none of the new bone was coronal to the original gingival margin. Additionally, in this one case new cementum and connective tissue attachment was formed. However, because the new bone, new cementum, and new connective tissue were not coronal to the original gingival margin, this result could not be classified as regeneration. The vast majority of the attachment in this defect was long junctional epithelial attachment in the portion of the recession defect covered by the root-coverage procedure. In the other three defects treated, there was a loss of bone. All of the root coverage obtained was a long junctional epithelial attachment in three of the four defects. The results of this study do not show regeneration in any of the four defects treated.

Alveolar Bone Loss↗

Salvage of limb and function in necrotizing fasciitis of the hand: role of hyperbaric oxygen treatment and free muscle flap coverage.

We report a case of necrotizing fasciitis of the hand treated by urgent debridement followed by serial debridements, hyperbaric oxygen, and delayed free muscle flap coverage. After control of the infection, a major soft-tissue defect remained on the dorsum of the wrist and hand, exposing all extensor tendons. A rectus muscle free flap was used for wound coverage and salvage of the exposed tendons; the muscle flap was covered with a delayed skin graft. The patient regained satisfactory function with ability to extend all digits. This case emphasizes the importance of aggressive debridement and hyperbaric oxygen treatment and shows the valuable role of free muscle flap wound coverage for preservation of function in cases of necrotizing fasciitis of the hand.

Adult↗

[CAD/CAM-copings for partial coverage].

Aim of the study was to evaluate the Computer Integrated Ceramic Reconstruction (CICERO)-system and the Ceramic Reconstruction (CEREC)-system for the production of all ceramic copings for partial coverage. Posterior teeth were prepared and the stone dies were made. Accuracy analyses were performed on ceramic restorations made by means of the CICERO and by means of the CEREC technique. The marginal gaps were compared to that of a control cast metal restoration. The results demonstrate that the marginal gaps of the CICERO and CEREC copings varied respectively for the premolar 58-80 microns (mean 69 microns) and 71-91 microns (mean 81 microns). For the upper molar 63-92 microns (mean 78 microns) and 68-110 microns (mean 89 microns) and for the lower molar 54-98 microns (mean 76 microns) and 73-99 microns (mean 86 microns). Control cast metal partial coverage restorations showed marginal gaps of 33, 49 and 41 microns. It is concluded that computers can produce copings for partial coverage preparations on stone dies with a mean marginal gap for CICERO copings of 74 microns and for CEREC copings of 85 microns. These values were obtained before optimizing the marginal fit by means of porcelain veneering.

Ceramics↗

Soft tissue root coverage as treatment for cervical abrasion and caries.

Root exposure caused by gingival recession may result in cervical abrasion, root caries, root sensitivity, and compromised esthetics. Although cervical root lesions can be treated with Class V restorations, there may be advantages in treating them with soft tissue grafts for root coverage since they restore the dento-gingival unit to its prerecession condition. The rationale for root coverage with soft tissue grafts is reviewed and two cases are presented of successful root coverage procedures in which gingival recession associated with cervical abrasion and caries was present.

Adult↗

Use of bone grafts for the enhancement of a GTR-based root coverage procedure: a pilot case study.

The use of guided tissue regeneration (GTR) procedures for the treatment of gingival recession has shown encouraging results and is gaining clinical acceptance. However, attaining space maintenance beneath the membrane remains a problem for clinicians. Hence, the purpose of this pilot case study was to evaluate the effect of adjunctive demineralized freeze-dried bone allograft (DFDBA) placement during collagen membrane GTR-based root coverage procedures. Five patients with Miller Class I or II defects were treated with a combination of DFDBA and collagen membrane. Clinical parameters monitored include recession depth, probing attachment level, probing depth, width of keratinized gingiva, and recession width. Measurements were taken at baseline and 6 months. A statistically significant reduction in recession depth (3.1 +/- 0.7 mm) was observed at 6 months, representing 93.4% total attainable root coverage. A significant reduction of recession width (3.5 +/- 1.2 mm) after 6 months was also noted. Clinically, a statistically significant mean gain of 3.3 +/- 0.6 mm in clinical attachment and 0.8 +/- 0.9 mm in keratinized gingiva were obtained at 6 months. No statistically significant difference was found in probing depth between baseline and 6 months postoperative. Plaque and gingival indices remained low and showed no statistically significant change throughout the study period. Results from this pilot case study indicate that use of DFDBA during collagen membrane GTR-based root coverage could be beneficial.

Adult↗

Implementing the universal health coverage: which source of information is more reliable?

The implementation of universal health coverage needs accurate data on the distribution of health benefit coverage, particularly the uninsured. The national surveys and routine reports are two important sources of information ready for use. This study shows the validation of data from two sources. The data from national household surveys on the medical welfare, the health card and the social security schemes were validated with the routine report data of the Ministry of Public Health (MOPH) and the Social Security Office (SSO) by provinces. There were considerable differences between these data sets. The national survey data gave a 1.5 times higher estimate than the report data of the MOPH and the SSO. Financial implications of using inaccurate data to implement the universal health coverage could be huge, depending on the capitation rate.

Adolescent↗

Some coverage error models for census data.

"Alternative models are presented for representing coverage error in surveys and censuses of human populations. The models are related to the capture-recapture models used in wildlife applications and to the dual-system models employed in the vital events literature. Estimation methodologies are discussed for one of the coverage error models." After a discussion of the theory underlying the methodology, "distinctions are made between two kinds of error: (a) sampling error and (b) error associated with the model. An example involving data from the 1980 U.S. census is presented. The problem of adjusting census and survey data for coverage error is also discussed."

Americas↗

House subcommittee rejects effort to remove abortion coverage.

On May 12, (1994) a subcommittee of the House Education and Labor Committee voted 16-11 in support of retaining abortion coverage in the President's proposed health care plan. With its vote, the Labor/Management Relations subcommittee rejected an amendment by Representative Ron Klink (D-PA), which would have allowed insurers to cover abortions only in cases of forcible rape or incest, or life endangerment. Two Republican Representatives joined 14 Democrats voting against the amendment, while 3 Democratic Representatives were among the 11 people supporting the Klink amendment. The subcommittee also defeated an amendment introduced by Representative Dick Armey (R-TX), which would have prohibited any language in a health care reform bill from overruling constitutional state laws restricting abortion. 14 subcommittee members voted against the Armey amendment; 11 voted in favor. The subcommittee is not expected to act on a final health care measure before the Memorial Day recess. In related news, a Veterans' Affairs House subcommittee voted 11-8 on May 11 to prohibit the performance of abortions at Department of Veterans' Affairs Hospitals or the coverage of abortion services by VA funds. The amendment was introduced in the Hospitals and Health Care subcommittee by Representative Chris Smith (R-NJ). Neither subcommittee action represents a final decision on abortion coverage in health care reform and none of the 5 Congressional committees considering health reform is expected to finalize their proposals before the Memorial Day recess. The Senate Labor and Human Resources Committee and the House Ways and Means Committee started work on health care reform on May 18. The Senate Finance Committee has only been meeting privately thus far, while neither the full House Education and Labor Committee nor the House Energy and Commerce Committee has met.

Abortion, Induced↗

Minnesota court overturns ban on Medicaid coverage for abortion.

Hennipin County District Court Judge William Posten issued a decision on June 16 striking down Minnesota's near ban on abortion coverage for low-income women. Ruling in Women of the State of Minnesota vs. Haas-Steffen, Judge Posten found that the state Constitution's rights of privacy and equality are more protective of women's reproductive choices than the corresponding federal rights. Holding that "the state's selective funding of childbirth over abortion impinges on an indigent woman's fundamental right to decide for herself whether to continue or terminate her pregnancy," the state district court permanently enjoined enforcement of the measure. Minnesota must now cover all medically necessary abortions for women receiving Medicaid. For more than 15 years, the statutes and regulations invalidated by Judge Posten have limited abortion coverage to cases of life endangerment or reported rape or incest. State officials have indicated that they will seek a stay and expedited review of Judge Posten's decision from the Minnesota Supreme Court. Filed on March 8, 1993, the Minnesota case is one of 5 such lawsuits brought by CRLP. Last December, in a similar case, the West Virginia Supreme Court struck down that state's ban on Medicaid coverage for abortions. Similar CRLP cases are still pending in Florida, Texas, and Montana. Plaintiffs--a class of Minnesota Medicaid-eligible women seeking abortions, Dr. Jane Hodgson, Pro-Choice Resources, Women's Health Center, Midwest Health Center for Women, and Meadowbrook Women's Clinic, on behalf of themselves and the women they serve--are represented by CRLP's Simon Heller, Janet Benshoof, and Lenora Lapidus, along with Minnesota attorney Linda Ojala.

Abortion, Induced↗

[Influence of soil humidity and vegetation coverage on wind erosion].

Wind erosion is becoming a constraining factor to agriculture and animal husbandry in the arid and semiarid area of Luanhe River. In this paper, wind erosion process was studied through simulation experiments. The results showed that soil humidity and vegetation coverage were the main factors affecting wind erosion. The wind erosion rate was decreased with increasing soil humidity and vegetation coverage, and hence, wind erosion process was reduced by modulating soil humidity and vegetation coverage in human activities.

Ecology↗

[Is sufficient femoral head coverage obtained after Pemberton's pericapsular osteotomy? Evaluation by three-dimensional computed tomographic reconstruction].

OBJECTIVES: We evaluated femoral head coverage by three-dimensional computed tomographic reconstruction after Pemberton's pericapsular osteotomy with open reduction in cases with developmental dysplasia of the hip. METHODS: In a prospective design, routine radiographs of 15 consecutive patients were obtained and three-dimensional computed tomographic reconstruction was performed preoperatively and six months after surgery. The mean age at the time of surgery was 26 months (range 18 to 34 months). Twelve patients were girls and three were boys. RESULTS: The mean acetabular index was 38 degrees (range 33 degrees -52 degrees ) preoperatively, and 19 degrees (range 16 degrees -23 degrees ) postoperatively. Comparison between pre- and postoperative three-dimensional computed tomographic reconstruction images revealed increased acetabular adduction and extension, and decreased acetabular anteversion in all cases. Sufficient coverage of the femoral head was documented in all patients. CONCLUSION: Pemberton's pericapsular osteotomy provides successful results in appropriate cases, with sufficient coverage of the femoral head. However, if there is any doubt, utilization of three-dimensional computed tomographic reconstruction images may contribute to a more precise evaluation of the outcome.

Acetabulum↗

[A Survey About Immunization Coverage In A Sample Of Children Born In The First Semester 1999]

In compliance with the WHO recommendations, the Livorno ASL n degrees 6 (Local Health Unit - Tuscany, Italy) has carried out a survey about immunization coverage so as to improve its knowledge of the local situation. The study concerned immunization coverage and breastfeeding of resident children between 24 and 30 months of age. The authors used a questionnaire that was filled in by the children's parents. The immunization coverage turned out to be similar to the ICONA study as regards mandatory vaccinations (over 95% at the 24th month of age), and better than the ICONA study as regards recommended vaccinations. Breastfeeding was better than previous Italian studies (87.9% at discharge). The authors consider this study a good method for recognizing local situations and organizing specific educational strategies.

Journal Article↗

[The monitor method of immunization coverage].

A comprehensive monitor method of immunization coverage is suggested to be applied to the expanded program on immunization. The routine coverage reporting system should be set up combined with surveys in selected townships. The criteria for doing survey is expressed in the flow chart. Two sampling methods are presented based on the principle of lot quality assurance sampling (LQAS) and coverage rate could be estimated after the surveys.

Child↗

Measles epidemic attributed to inadequate vaccination coverage--Campania, Italy, 2002.

In Italy, measles has been a mandatory reportable disease for >100 years. During the prevaccination era, approximately 25,000-90,000 cases were reported annually. During the late 1980s and 1990s, incidence declined with increasing measles vaccination coverage, but measles epidemics continued to occur periodically, most recently during 1995-1997. In early 2002, measles incidence increased sharply; the area most affected was Campania (2001 population: approximately 5,782,000, including 1,100,000 children aged <15 years), a large region in southern Italy. In 2001, estimated measles vaccination coverage for the 1998 Campania birth cohort was 65%. Regional health authorities and the National Institute of Health investigated the measles outbreak in Campania. This report summarizes the preliminary results of the investigation, which attributed the epidemic to inadequate vaccination coverage. A coordinated effort is needed to interrupt measles transmission in Italy.

Adolescent↗

Coverage of oncology drug indication concepts and compositional semantics by SNOMED-CT.

OBJECTIVE: To evaluate SNOMED-CT 's ability to represent simple and compositional concepts in FDA approved oncology drug indications. METHODS: Oncology drug indications were decomposed into single and compositional concepts. SNOMED-CT's coverage of single concepts and the semantics needed to create compositional concepts were evaluated using automated and manual techniques. RESULTS: SNOMED-CT covered 86.3% of single concepts present in oncology drug indications; 11.3% of indications were covered completely. Coverage was best for concepts describing diseases, anatomy, and patient characteristics. Medications accounted for 50.5% of missing concepts. Excluding drug names, 45.2% of indications were completely represented. SNOMED-CT's semantics completely represented 60.1% of compositional expressions. CONCLUSIONS: SNOMED-CT's overall coverage of the concepts in oncology drug indications was good. Improvements or alternatives are needed for medications and semantics.

Antineoplastic Agents↗

Effect of connective tissue graft orientation on root coverage and gingival augmentation.

The present study was undertaken to assess the width of keratinized tissue and root coverage achieved when orienting the superficial surface of a connective tissue graft toward either the gingival flap or the root surface. Sixteen pairs of bilateral gingival recessions (Miller Class I and II) in 13 subjects were divided into two groups. In each subject, one side received a connective tissue graft with its superficial surface facing the gingival flap, while the contralateral side received a connective tissue graft with its superficial surface facing the root surface. Plaque Index, Gingival Index, probing depth, gingival recession, and relative clinical attachment level were recorded at baseline and 3 months postoperative. Root length was measured on periapical radiographs to calculate the percentage of actual root coverage. ANOVA was used to detect significant differences between the two treatment groups. The results indicated that surface orientation of a connective tissue graft has no significant effect on the clinical outcome of either root coverage or gingival augmentation.

Adult↗