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At least 1,315 records · Page 73Linked to original sources
PubMed1991

[Osteopathy and therapeutic effect of 1 alpha-OH-D3 in severely handicapped children].

A total of 152 severely mentally and physically handicapped children were studied with regard to severity of bone atrophy assessed by microdensitometry (MD) and serum levels of calcium (Ca), phosphorus (P), alkaline-phosphatase (Al-P) and Vitamin D metabolites in an intra-group comparative manner. They were divided into four groups; MA: mobile and anticonvulsant-receiving (58 cases), MN: mobile and anticonvulsant-non-receiving (48 cases), NA: immobile and anticonvulsant-receiving (27 cases), and NN: immobile and anticonvulsant-non-receiving (17 cases). Microdensitometric (MD) abnormalities were noted in about 80% of patients. MD parameters were worse in the immobile groups than in the mobile groups. Serum levels of Ca were significantly lower, and those of Al-P were significantly higher in the anticonvulsant-receiving groups than the anticonvulsant non-receiving groups. The serum level of 25-hydroxyvitamin D (25-OH-D) was low in all groups. Fifty-eight children with MD abnormalities were treated with 1 alpha-OH-D3 and MD and hematological findings were improved specially in the mobile groups. This means that mobility plays an important role in the progress of osteopathy and treatment of severely mentally and physically handicapped children.

Adolescent↗
PubMedDate not supplied

[Evaluation of a prevention and prophylaxis program for the handicapped].

The growing interest regarding the importance of oral health in subjects affected with physical and psychological handicaps has led the Authors to prepare a programme of oral hygiene aiming at the prevention of dental and periodontal diseases and demanding the participation of the other members of the families, the educators and the specialized staff put at the head of their assistance. Fifty-three subjects presenting different pathologies, who have undergone elementary operations of oral hygiene, have been examined. In order to value the efficacy of these systems, DI (Debris Index), CI (Calculus Index) and OHI (Oral Hygiene Index) of Greene and Vermillion have been periodically calculated. The results obtained have been encouraging and have emphasized the importance of the behaviour of family and institutions towards people with physical and psychological handicaps, in order to let a project of primary prevention succeed.

Adolescent↗
PubMed1991

Dental health and dental care requirements for young handicapped adults in Wessex.

The dental health status and treatment requirements of 195 young handicapped adults living in the Wessex Health Region are reported. These young adults, aged 25-34 years, attended adult training centres on a daily basis in each of the districts in Wessex Region. The amount of untreated caries was higher and the periodontal status worse for this group than would normally be expected in young adults in this age range. The dental care received was related to the ability of the subject to comprehend and co-operate with the operator. Nearly half the subjects could receive routine treatment in a normal surgery and about a quarter were likely to require hospitalisation and general anaesthesia to achieve any treatment. The community dental service should play an important role in organising and supervising preventive strategies, with the aim of improving oral hygiene for these young handicapped adults, which should materially improve their periodontal health.

Adult↗
PubMedDate not supplied

Long-term oral effects of manual or electric toothbrushes used by mentally handicapped adults.

This study investigated the long-term oral hygiene effects in mentally handicapped patients using an electric toothbrush as compared to manual brushing. Twenty-three moderately handicapped patients were selected and sampled into two study and two control groups. The two study groups used electric toothbrushes, while the control groups used manual toothbrushes. One of each study and control groups were aided by parent or staff in brushing. Plaque and gingival indexes were scored at day 0, after 3 months and after 16 months. Instruction in toothbrushing procedures and information about oral hygiene was given. When the study was completed, no significant changes were found in or between the groups regarding plaque scores. The gingival score of the unaided electric toothbrush group was significantly reduced after 16 months. This improvement was probably attributed to frequent recalls and a well-designed prophylactic program. The main conclusion of this study is that an electric toothbrush is not superior to a manual toothbrush.

Adult↗
PubMedDate not supplied

Oral ketamine for deep sedation of difficult-to-manage children who are mentally handicapped: case report.

For a small subset of mentally handicapped individuals, the medical and dental setting can be so threatening that they react violently to health care providers. Deep sedation can be administered enterally using oral ketamine, 6-8 mg/kg, combined with glycopyrrolate mixed in simple syrup and preceded by a dose of an oral benzodiazepine and sodium citrate. A case utilizing this technique to sedate an extremely combative mentally handicapped female requiring dental treatment planning in an ambulatory surgical center is described. A review of this use of ketamine and caveats concerning its use are covered.

Adolescent↗
PubMed1991

[Revaccination against hepatitis B in non-responders and in under-responders in a group of mentally handicapped patients].

At 's Koonings Jaght, a community for the mentally handicapped, 330 inhabitants who were seronegative for hepatitis B markers, were vaccinated with a DNA recombinant vaccine. Following primary vaccination, 87% of the inhabitants had an anti-HBs titer of greater than or equal to 10 IU/l while 68% had a titer of greater than or equal to 100 IU/l. It appears from the literature that a certain percentage of the non-responders and hyporesponders still develop sufficient protective antibodies after revaccination, directly following primary vaccination. Besides, it is known from the literature that a titer greater than or equal to 100 IU/l provides prolonged protection. For these reasons, 105 inhabitants whose anti-HBs titers were lower than 100 IU/l following primary vaccination, received one to three additional boosters, depending of the level of the titer. After this revaccination, 92% of the inhabitants had titers greater than or equal to 10 IU/l while 81% had titers greater than or equal to IU/l. From the results of the study it appears that following direct revaccination of non-responders and hyporesponders an additional percentage still reach the protective level of greater than 10 IU/l and that a not inconsiderable percentage achieve a titer providing prolonged protection. The conclusion therefore is that it is useful to revaccinate mentally handicapped persons with no or with low seroconversions following primary vaccination.

Adult↗
PubMed1991

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps.

The provision of the wide variety of support services necessary for patients with multiple handicaps is often poorly coordinated. In this study a group of 108 adults, aged from 19 to 90 years, who suffered from multiple physical handicaps and attended a rehabilitation day care centre, had their visual functions and requirements assessed by a multidisciplinary team. The programme consisted of five stages. Each patient was initially screened and subsequently referred for more detailed optometric, ophthalmological, low vision or rehabilitation assessments, where appropriate. Results indicated that many of the patients had not been receiving regular ocular assessments and would benefit from the provision of an optical appliance or ophthalmological treatment. The survey provided staff at the rehabilitation centre with information on the visual status of individual patients and enhanced general eye-care awareness.

Adult↗
PubMedDate not supplied

[Handicap and normality: needs and interventions].

The purpose of this paper is to restore the concept of "handicap" to its original etymologic meaning as a term that identifies a relationship rather than a property concerning only one subject. If the handicap is not considered only in terms of a single person but of the relationship between him and his environmental context, it is possible to avoid the dual ideological constraint whereby people are condemned to no-way-out disability or society is stigmatized as the receptacle for all ills. The wellbeing of the disabled and society alike can become feasible as a result of the flexible rediscovery of this relationship and the formulation of original new creative approaches to normality.

Persons with Disabilities↗
PubMed1990

[Dental care for a handicapped person].

The dental care of handicapped person is often neglected and many reasons can explain this situation. The purpose of this article is to show factors causing dental deterioration of this particular group and to highlight the special role of the dentist. A new approach to dental care for the handicapped person is proposed.

Architectural Accessibility↗
PubMed1990

[Effect of a sanguinarine mouthwash on children with and without upper extremity motor handicap].

A survey was done at the Center of Child Readaptation at Flavigny (Meurthe-et-Moselle) to determine the effect of a mouth rinse containing 0.03% sanguinaria extract, on the plaque accumulation and gingivitis of 30 children 8 to 17 years old. 13 children had a motricity handicap of their superior members and 17 did not. All subjects rinsed their mouths twice with 15 ml of solution each time. The mouth rinses were performed in the morning and in the evening during three weeks. The children were photographed and examined using the P1I and GI indices on days 0, 7, 14, 21 and 35. No statistical significant difference was observed at any moment between children with or without handicapped upper limbs. After 3 weeks of treatment the Plaque Index had decreased 47.3% and Gingival Index 55.6%.

Adolescent↗
PubMed1990

[Handicapped patients. General anesthesia or sedation?].

The Authors consider the problems involved in dental treatment of the handicapped patients. Accuracy in diagnosis of the handicap factor, knowledge about its consequences on pathophysiological status and about chronically assumed drugs are the first step: in fact these patients may be affected by a wide variety of physiopathologic and mental diseases. Failure of cooperation requires general anesthesia or sedation techniques. General anesthesia can be dangerous (malignant hyperthermia in myopathies, difficult intubation in facial anomalies, pharmacological interactions); furthermore, its frequent application even in order to perform minimal treatment is often unsuitable. Sedation techniques offer a more convenient possibility, but must be practised by trained operators. Nitrous oxide alone rarely produces in fact a sufficient degree of sedation and is suitable only in patients affected by very slight mental insufficiency. In the other cases, association with various drugs (as benzodiazepines, barbiturates etc) is needed. In such a situation, the active and continuous presence of the anesthesiologist becomes mandatory.

Anesthesia, Dental↗
PubMedDate not supplied

[Handicapped situations in dentistry].

Moving from the general definition of "handicap" "the Authors suggest a classification system based upon the most important altered function of a patient. A handicap situation happens when a patient needs special care in a dental office, both for particular oral changes due to his primary pathology or related therapy and for increased operatory risks.

Dental Care for Persons with Disabilities↗
PubMed1990

The organisation of dental care for groups of mentally handicapped persons.

One hundred and eighty-nine mentally handicapped persons attending both residential and non-residential institutions were examined during 1984/85. All were assessed for treatment need for caries; periodontal need was also assessed in 43 of the older patients. At base-line examination it was found that a high proportion of the dental caries remained untreated and most of the treatment that was provided consisted of extractions. Treatment was subsequently provided by a health board dental officer, junior hospital staff, final year undergraduate students or a consultant in paediatric dentistry. Most treatment requirements were met by the non-consultant personnel. A follow-up examination completed during 1987 showed a considerable improvement in the treatment of caries; periodontal treatment need remained unchanged. It can concluded from this study that it is feasible to set up an effective dental service for mentally handicapped groups, that improvements in the treatment of dental caries can be achieved in a relatively short period of time and that most treatment requirements can be met by non-consultant staff. Continuing care, particularly for periodontal disease, remains a problem.

Adolescent↗
PubMedDate not supplied

[Use of conscious sedation in dental care for the handicapped].

The Authors illustrate the treatment of partially co-operating handicapped patients with relative analgesia. This treatment is widespread in foreign countries: in Italy the general anaesthesia is often used. A group of 12 patients with various kinds of handicap (from 7 to 46 years old) have been treated with relative analgesia. A very good result has been obtained in three cases, good in six, sufficient in one, insufficient in two for whom the general anaesthesia has been used.

Adolescent↗
PubMed1990

[Oral findings of institutionalized handicapped children].

In this study, we investigated the oral conditions of 77 handicapped children (57 boys and 20 girls) and backgrounds of living in an institution. The results were as follows. Among 73 children having permanent dentition, the percentage of subjects with one or more DMF teeth was 94.52%, while DMFT was 7.45. The percentage of teeth treated for dental caries was 57.35%. GI (Gingival Index) was 1.7, and OHI-S was 3.50. The other features observed were attrition of posterior teeth in 25 subjects and crowding in 39. According to the degree of mental retardation, severely retarded children had a lower percentage of teeth treated for dental caries than moderately and mildly retarded children. Additionally, the severely retarded handicapped children who were long-time institutionalized and taking antispastic drugs, had the higher incidence of gingivitis and poor oral hygiene. This study indicated the necessity of a scheduled and active practice in order to improve oral hygiene status and gingival condition, and raise the percentage of teeth treated for dental caries of severely retarded children in an institution.

Child↗
PubMed1990

"The measurement of hearing handicap" revisited: a 20-year perspective.

Interest in the development of self-assessment instruments to measure the handicapping effect of hearing difficulty has grown in the last 20 years. Numerous paper and pencil instruments are now available which vary in purpose, design, and psychometric underpinings. This paper discusses the status of the self-assessment approach in clinical audiology, presents a point of view regarding some of the factors contributing to this status and proposes some frontiers still open to self-assessment instruments in the assessment of hearing handicap.

Attitude of Health Personnel↗