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At least 1,243 records · Page 69Linked to original sources
PubMed2005

Full-thickness flap/subepithelial connective tissue grafting with intramarrow penetrations: three case reports of lingual root coverage.

Three case reports are presented that demonstrate the use of full-thickness flap/subepithelial connective tissue grafting for root coverage on the lingual surfaces of the mandibular anterior teeth. This is accomplished using an envelope full-thickness flap technique with intramarrow penetrations at the recipient site. Miller Class I, II, and III gingival recession defects and gingival perforation defects were treated. Complete root coverage was achieved in two Miller Class I gingival recession defects, in one Miller Class II gingival recession defect, and in two gingival perforation defects in areas that exhibited no radiographic evidence of bone loss. Partial root coverage was achieved in two Miller Class III gingival recession defects in an area that exhibited radiographic evidence of bone loss. Although the majority of the exposed root surface was covered in these two Miller Class III defects, about 1 mm of root surface remained exposed, which seemed to closely correspond to the amount of bone loss that was noted radiographically. A grafting technique has been presented that can be used to restore the functional properties of the lingual gingiva of the mandibular anterior teeth by repairing gingival defects and re-establishing the continuity and integrity of the zone of keratinized gingiva. Our clinical impression is that this has made it easier for the three patients presented in this report to maintain the lingual surfaces of the mandibular anterior teeth with routine oral hygiene measures.

Adult↗
PubMed2006

Coronally positioned flap with subepithelial connective tissue graft for root coverage: various indications and flap designs.

Aesthetic concerns and functional abnormalities, such as dentin hypersensitivity, are often associated with gingival recession defects. Root coverage procedures aim to restore both gingival aesthetics and function in recession defects. The coronally positioned flap combined with the subepithelial connective tissue graft is one of the most widely used root coverage procedures. The present report illustrates four different indications where this procedure has been successfully employed. An isolated Miller class II recession defect associated with frenum pull, multiple adjacent Miller class I defects in the aesthetic zone, an isolated Miller class I defect associated with dentin hypersensitivity, and an isolated Miller class II defect on a retained deciduous tooth are the four diverse conditions treated by periodontal plastic surgery. Different approaches were used to create the coronally positioned flap. Treatment resulted in complete root coverage, resolution of hypersensitivity, and satisfaction of the patients' aesthetic concerns. An effective and predictable treatment modality, such as the coronally positioned flap combined with the subepithelial connective tissue graft, should be considered when treatment planning for gingival recession defects.

Adult↗
PubMed2005

[Vaccination coverage among children and adolescents in Malopolskie voivodeship in period 1999-2004].

Malopolskie voivodeship was established in 1999 from regions where alarming low vaccination coverage had place. It was necessary to introduce an improvement program of vaccination performance in this area. The vaccination coverage in Malopolska voivodeship in period 1999-2004 has been analyzed. The immunization coverage has improved during this time, but is very sensitive on any problems in organization of vaccination performance.

Adolescent↗
PubMed2006

The effect of EDTA in attachment gain and root coverage.

Root surface biomodification using low pH agents such as citric acid and tetracycline has been proposed to enhance root coverage following connective tissue grafting. The authors hypothesized that root conditioning with neutral pH edetic acid would improve vertical recession depth, root surface coverage, pocket depth, and clinical attachment levels. Twenty teeth in 10 patients with Miller class I and II recession were treated with connective tissue grafting. The experimental sites received 24% edetic acid in sterile distilled water applied to the root surface for 2 minutes before grafting. Controls were pretreated with only sterile distilled water. Measurements were evaluated before surgery and 6 months after surgery. Analysis of variance was used to determine differences between experimental and control groups. We found significant postoperative improvements in vertical recession depth, root surface coverage, and clinical attachment levels in test and control groups, compared to postoperative data. Pocket depth differences were not significant (P<.01).

Adult↗
PubMed2005

After-hours coverage: national survey of policies and guidelines for primary care physicians.

OBJECTIVE: To determine the prevalence and content of existing or developing policies and guidelines of medical associations and colleges regarding after-hours care by family physicians and general practitioners, especially legal requirements. DESIGN: Telephone survey in fall 2002, updated in fall 2004. SETTING: Canada. PARTICIPANTS: All national and provincial medical associations, Colleges of Family Physicians, Colleges of Physicians and Surgeons, local government offices for the north, and the Canadian Medical Protective Association (CMPA). MAIN OUTCOME MEASURE: RESPONSE TO THE QUESTION: "Does your agency have a policy in place regarding after-hours health care coverage by FPs/GPs, or are there active discussions regarding such a policy?" RESULTS: The College of Physicians and Surgeons of British Columbia was the first to institute a policy, in 1995, requiring physicians to make "specific arrangements" for after-hours care of their patients. The College of Physicians and Surgeons of Alberta adopted a similar policy in 1996 along with a guideline to aid implementation. In 2002, the College of Physicians and Surgeons of Nova Scotia approved a guideline on the Availability of Physicians After Hours. The Saskatchewan Medical Association and the College of Physicians and Surgeons of Saskatchewan formulated a joint policy on medical practice coverage that was released in 2003. Many agencies actively discussed the topic. Provincial and national Colleges of Family Physicians did not have any policies in place. The CMPA does not generate guidelines but released in an information letter in May 2000 a section entitled "Reducing your risk when you're not available." CONCLUSION: There is increasing interest Canada-wide in setting policy for after-hours care. While provincial Colleges of Physicians and Surgeons have traditionally led the way, a trend toward more collaboration between associations was identified. The effect of policy implementation on physicians' coverage of patients is unclear.

After-Hours Care↗
PubMed2006

Vaccination coverage among children entering school--United States, 2005-06 school year.

One of the national health objectives for 2010 is to achieve and sustain > or =95% vaccination coverage among children in kindergarten through first grade for the following vaccines: hepatitis B vaccine; diphtheria and tetanus toxoids and pertussis vaccine, diphtheria and tetanus toxoids and acellular pertussis vaccine, or diphtheria and tetanus toxoids vaccine (DTP/DTaP/DT); poliovirus (polio) vaccine; measles, mumps, and rubella vaccines; and varicella vaccine. To determine vaccination coverage among children entering kindergarten, data were analyzed from reports submitted to CDC by states and the District of Columbia (DC) for the 2005-06 school year. This report summarizes the results of that analysis, which indicated that coverage for each vaccine was reported to have exceeded 95% in more than half of the states.

Child↗
PubMed2006

Influenza vaccination coverage among children aged 6-23 months - six immunization information system sentinel sites, United States, 2005-06 influenza season.

Beginning with the 2004-05 influenza season, the Advisory Committee on Immunization Practices (ACIP) recommended that all children aged 6-23 months receive influenza vaccinations annually. Other children recommended to receive influenza vaccinations include those aged 6 months-18 years who have certain high-risk medical conditions, those on chronic aspirin therapy, those who are household contacts of persons at high risk for influenza complications, and, since 2006, all children aged 24-59 months. Previously unvaccinated children aged <9 years need 2 doses administered at least 1 month apart to be considered fully vaccinated. This report assesses influenza vaccination coverage among children aged 6-23 months during the 2005-06 influenza season by using data from six immunization information system (IIS) sentinel sites. The findings demonstrate that vaccination coverage with 1 or more doses varied widely (range: 6.6% to 60.4%) among sites, with coverage increasing from the preceding influenza season in four of the six sites. However, <23% of children in five of the sites were fully vaccinated, underscoring the need for increased measures to improve the proportion of children who are fully vaccinated.

Humans↗
PubMedDate not supplied

A study on utilization and quality of coverage of antenatal care services at the subcentre level.

A community based cross-sectional study was done by interviewing a sample of 360 women of Anchuri Block in the district of Bankura, West Bengal to know the determinants of utilization and coverage quality of antenatal care services of subcentres using an appropriate scoring system for analysis. The study revealed underutilization of subcentres by the women and also sub-optimal performance of subcentres with regard to coverage quality of ANC services The main reason for under utilization of subcentres was found to be better service provision and easy accessibility of B.S. Medical College Hospital. Multiparous mothers were seen to be at a disadvantage both in terms of utilization of the source of choice as well as in terms of coverage of ANC services by subcentre ANMs.

Adolescent↗
PubMed1991

Health insurance coverage of the immigrant elderly.

In this paper, I examine and contrast factors that contribute to whether individuals are covered by public health insurance (Medicare, Parts A and B, with and without Medicaid benefits) or private insurance. The study, based on data from a sample of foreign- and native-born elderly, employs descriptive analysis and a multivariate investigation involving logistic regression models. The results show that the immigrant population is less likely than native-born elderly to be covered by public insurance or to have private insurance. Medicare coverage for the immigrant elderly is strongly influenced by their length of stay in the United States, employment status, and country of origin, while their having private insurance coverage is affected by race, income, and employment status. For native-born elderly, race, income, and employment status are contributing factors to the type of insurance coverage retained. Policy implications are discussed.

Black or African American↗
PubMedDate not supplied

[Vaccination coverage of school children].

The results of an immunization coverage survey among first grade schoolchildren (six-year old) in public and subsidized schools of the Sant Martí district of Barcelona (Spain) are shown. Vaccination coverage is assessed by immunization cards or other valid documents and through the computerized immunization register of the City. Estimated vaccination coverage is 76% for measles, 65.9% for rubella and 65.9% for mumps. Up to 74.7% of the children have received five doses of polio vaccine, and 83.5% at least four doses, while 72.5% have received five doses of D.T.P. or D.T. and 83.4% four doses. Slight differences among the four neighborhoods in the district are seen, probably related to socioeconomic level and to the pattern of use of health services.

Child↗
PubMed1991

Measles epidemic in Harare, Zimbabwe, despite high measles immunization coverage rates.

Despite rapidly increasing measles immunization coverage in Harare city, measles remains endemic, and regular outbreaks occur. The most recent occurred in 1988, when the measles immunization coverage was 83%. We have carried out a retrospective study of the clinical and epidemiological features of this outbreak to assess whether the present immunization policy needs to be changed. Of 4357 cases of measles seen at primary health care centres and hospitals in Harare during the outbreak, 1399 (32%) were severe or involved complications that required hospital admission. The peak incidence occurred among under-2-year-olds, followed by that among 5-7-year-olds. Poor nutritional status was significantly more frequent among children who were hospitalized and among those who died. A total of 59% of all cases aged 9-59 months had documented evidence of measles immunization. The most frequent complications, which occurred most often among under-5-year-olds, were diarrhoea with dehydration, pneumonia, laryngotracheobronchitis, and convulsions, which together affected 56% of hospitalized cases. The hospital case fatality rate was low (1.43%). In Harare, measles transmission remains a problem, despite high measles immunization coverage rates; the failure rate for the standard Schwarz measles vaccine also appears to be high. There is a need to reduce the number of measles cases among under-9-month-olds and young children. Further studies into alternative measles vaccines and schedules are required.

Adolescent↗
PubMed1991

The timing of flap coverage, bone-grafting, and intramedullary nailing in patients who have a fracture of the tibial shaft with extensive soft-tissue injury.

The cases of forty-three patients who had a Type-IIIB open fracture of the tibial shaft were reviewed to determine the effect of treatment of the soft-tissue injury on the rate of major complications. An infection developed in two of the eleven patients who had had early muscle-flap coverage compared with ten of the nineteen who had been managed by open care of the wound and nine of the thirteen who had had later flap coverage. Patients who had had bone-grafting after complete re-epithelialization of the wound, regardless of the method of closure, had a lower rate of early infection (none of sixteen compared with four of fifteen) and an earlier average time to union (fifty-four compared with sixty-three weeks) than those in whom the wound was not completely closed or was draining at the time of bone-grafting. Delayed intramedullary nailing with reaming was associated with a high rate of infection (nine of nineteen patients), regardless of the condition of the soft tissue at the time of nailing. In our opinion, adequate débridement and early assessment of the soft-tissue defect are necessary so that appropriate soft-tissue coverage can be provided within the first one to two weeks. When the soft-tissue portion of the injury is addressed promptly and definitively and then allowed to heal completely, secondary osseous reconstruction may proceed with fewer complications.

Adult↗
PubMedDate not supplied

Evaluation of acetabular coverage: three-dimensional CT imaging and modified pelvic inlet view.

The anterior and posterior coverages of the acetabula were evaluated by comparison of anterior edge-center-posterior edge (ACP) angle by modified inlet view and three-dimensional computed tomographic (3-D CT) images of the hip. Acetabular coverage in 3-D CT images was classified into three grades of front and rear views. The close relationship of this grading and the ACP angle was confirmed. Conventional radiographs with a modified inlet view are usually significant to evaluate the acetabular coverage, however, in the future, 3-D CT images will be routinely used in complicated hip surgery because they provide more detailed information to aid preoperative planning.

Acetabulum↗
PubMed1991

Differences in hospital resource allocation among sick newborns according to insurance coverage.

OBJECTIVE: To assess whether newborns' insurance coverage was associated with differences in the allocation of hospital services. DESIGN: Retrospective analysis of computerized hospital discharge data, comparing resource allocation among newborns according to insurance status, controlling for race/ethnicity, diagnoses, hospital characteristics (ownership, teaching status, nursery level), and disposition. SETTING: All California civilian acute-care hospitals. PATIENTS: Population-based sample, excluding out-of-hospital and military hospital births. Resource allocation was studied among all newborns discharged in 1987 with evidence of serious problems (N = 29,751). MAIN OUTCOME MEASURES: Length of stay, total charges, and charges per day. RESULTS: Sick newborns without insurance received fewer inpatient services than comparable privately insured newborns with either indemnity or prepaid coverage. This pattern was observed across all hospital ownership types. Mean stay was 15.7 days for all privately insured newborns (15.6 days for those with indemnity and 15.7 days for those with prepaid coverage), 14.8 days for Medicaid-covered newborns, and 13.2 days for uninsured newborns (P less than .001). Length of stay, total charges, and charges per day were 16%, 28%, and 10% less, respectively, for the uninsured than for all privately insured newborns (P less than .001). Resources for newborns covered by Medicaid were generally greater than for the uninsured and less than for the privately insured. Both uninsured and Medicaid-covered newborns were found to have more severe medical problems than the privately insured. CONCLUSIONS: The findings cannot be explained by differences in medical need or by differences in non-medically indicated services; they constitute prima facie evidence of inequities that need to be addressed by policy changes.

California↗
PubMed1991

Morphogenesis and territorial coverage by isolated mammalian retinal ganglion cells.

Identified retinal ganglion cells were isolated from postnatal cat retinas and their dendrites were removed by trituration and centrifugation. The denuded cells were placed in a cell culture system and allowed to reexpress dendritic arbors in the absence of afferent input, target tissue, and interactions with neighboring ganglion cells. The retinal ganglion cells were grown above a feeder layer of astrocytes on glass coverslips equipped with paraffin pedestals. The spatial patterns of the reexpressed neurites were quantitatively analyzed using a number of measures, including an estimate of the Hausdorff dimension, H, which was used as a scale-independent metric for how well the neurite patterns filled in a restricted spatial domain. As assessed by the estimation of the Hausdorff dimensions, the neurites from a single cell achieve uniform coverage of a restricted territory independent of the total neurite length or the total number of inter-branch-point segments. A comparison with H values of ganglion cells from the intact retina revealed a similar trend. These results suggest that these cultured ganglion cells can express an intrinsic growth strategy for the uniform coverage of a restricted territory. The arbors expressed in the culture system displayed a limited range of diameters and exhibited morphology similar to the alpha-, beta-, and gamma-ganglion cells of the intact retina in the absence of afferent input or the influences of neighboring cells and target tissue. Time-lapse video data revealed that individual cultured cells showed extensive dendritic remodeling during their growth; however, after about 3 d in culture, this remodeling did not appreciably affect the territorial coverage of a cell. In the intact retina, the existence of dendritic sheets that independently and uniformly sample visual space may result from this intrinsic ability to elaborate dendrites that uniformly cover or fill in a restricted territory.

Animals↗
PubMed1990

Organ transplantation costs, insurance coverage, and reimbursement.

With few exceptions, most organ transplantation procedures are expensive, although there is considerable variability in costs across transplantation programs. Because of their high cost, many public and private insurers are in the process of carefully evaluating their transplantation coverage and reimbursement policies. Some public insurers have decided to discontinue paying for some procedures on grounds that the resources expended on transplantation could be used to benefit a larger number of people without catastrophic disease. Thus, transplantation is being pitted against health promotion and disease prevention initiatives. Some insurers have also been reluctant to pay for selected transplants, arguing that they are "experimental" or "investigational." Pancreas, lung, and heart-lung transplants are often classified as such. While these decisions have a reasonable basis, concerns related purely to cost, not benefit, have made insurers hesitant to extend coverage to procedures they view as inefficacious. Transplantation programs performing pancreas, heart-lung, and lung transplantation, therefore, do so at some risk. They may not be reimbursed for the procedures they perform, or, more likely, the level of payment received is likely to be substantially below actual hospital costs. To control costs, insurers have also begun to designate transplantation centers. In doing so they limit coverage and reimbursement to programs they regard as "centers of excellence." To become a designated center, a transplantation program must meet preestablished volume and outcome requirements, which insurers believe will assure quality and minimize costs. Thus, designated centers are expected to provide cost-effective transplantation services. If insurers choose to regionalize transplantation programs, controlling both their number and distribution, it is quite possible that patient access to transplantation, as well as their choice of provider, will be severely constrained. In conclusion, concerns related to transplantation costs undoubtedly will have enormous implications for the delivery of transplantation services throughout the foreseeable future. Most significantly, the number of "qualified" centers, using insurer criteria, may be restricted to a small subset of currently active programs. This could have a dramatic affect on the start-up of new programs and the continuation of others.

Costs and Cost Analysis↗
PubMedDate not supplied

Coverage evaluation surveys amongst children in some blocks of West Bengal.

Immunisation coverage evaluation was carried out in 9 Blocks of West Bengal amongst 12-23 months old children. Fully immunised status of 5 blocks were under 16%. Poor measles vaccine coverage thought to be the reason. Other vaccine coverage was more than 60%, in most of the blocks excepting Hilly Balurghat and Tamluk. "Child ill-not brought" was the important reason for immunisation failure in most of the blocks.

Cluster Analysis↗
PubMed1990

Measles vaccination coverage and its determinants in a rapidly growing peri-urban area.

A study was undertaken to ascertain the vaccination coverage of children aged 12-23 months living in Khayelitsha, a peri-urban township outside Cape Town, and to identify factors associated with measles vaccination coverage. A stratified proportional cluster sampling technique was used to select 46 clusters of 10 children each. Three strata were defined according to area of residence. The vaccination status of each child was determined from the preschool card. Usable information was obtained for 432 children; in 75.4% of cases the respondent was the child's mother, and 69.4% of children possessed a preschool card. Measles vaccination coverage was 63.5% (95% confidence interval 58-67%). Three factors had a significant association with incomplete measles vaccination: less than 6 months' residence in the area (odds ratio (OR) 3.1), having been born outside Cape Town (OR 2.5), and home delivery (OR 2.0). The mothers' level of education and children's age were not associated with measles vaccination status. Children in the New Shanty area were identified as a high-risk group. Carers of children in the New Shanty area were the least likely to know of the need for measles vaccination and to be visited by a community health worker. Greater efforts are required to identify high-risk children and areas.

Black or African American↗