Prevalence of Maxillary Sinus Pathology in Patients Considered for Sinus Augmentation Procedures for Dental Implants.

Prevalence of Maxillary Sinus Pathology in Patients Considered for Sinus Augmentation Procedures for Dental Implants.

Implant Dent. 2013 Jul 8;
Manji A, Faucher J, Resnik RR, Suzuki JB

To determine the prevalence of maxillary sinus pathology in patients presenting for implant rehabilitation involving sinus augmentation procedures.Three-dimensional images of 275 patients were evaluated. Age and gender were recorded to see if they had any relationship to the prevalence of pathology. Scans were classified into 1 of the 5 categories based on the type of sinus pathology detected: healthy, mucosal thickening > 5mm, polypoidal mucosal thickening, partial opacification and/or air fluid level, and complete opacification.Overall, 54.9% scans were classified as healthy, and 45.1% scans were classified as exhibiting sinus pathology. Men were more likely to exhibit pathology compared with females (P < 0.01). However, age did not seem to have any relation on the prevalence of sinus pathology. Of the patients who presented with evidence of sinus pathology, 56.5% had mucosal thickening (?5mm), 28.2% with polypoidal thickening, 8.9% partial opacification and/or air/fluid level, and 6.5% complete opacification.It is proposed that, based on the findings of this study, 45.1% patients would require further consultation before proceeding with maxillary sinus augmentation surgery. HubMed – rehab

The Effect of Personality Dimensions on Functional Outcomes in Mood Disorders.

Adv Ther. 2013 Jul 10;
Leen J, Soczynska JK, Gallaugher LA, Woldeyohannes HO, Alsuwaidan MT, Cha DS, Dale RM, Muzina DJ, Kennedy SH, McIntyre RS

Functional impairment associated with mood disorders may be related to a characteristic “profile” of normative personality dimensions.Individuals (age ? 18 years) with MDD (n = 400) or BD (n = 317), as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), were enrolled in the IMDCP. Personality was evaluated with the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI), and functionality with the Sheehan Disability Scale and Endicott Work Productivity Scale. Path analysis using linear multiple regressions was performed to identify direct and indirect effects of personality on functional impairment.Lower conscientiousness exerted a significant direct effect on global (p = 0.017) and family life dysfunction in individuals with MDD (p = 0.002), as well as lower work productivity in both MDD (p = 0.020) and BD (p = 0.018). Lower extraversion exerted a significant direct effect on social impairment in individuals with BD (p = 0.017). Higher neuroticism and agreeableness as well as lower extraversion exerted indirect effects on global and social dysfunction in individuals with MDD via their effects on depression severity. In BD, higher neuroticism and openness indirectly affected global dysfunction. Family dysfunction was indirectly affected by higher neuroticism and openness as well as lower extraversion in MDD and BD.The results suggest that discrete personality dimensions may exert direct and indirect effects on functional outcomes in individuals with mood disorders. Personalizing disease management approaches in mood disorders with emphasis on vocational rehabilitation may benefit from measurement and intervention targeting personality. HubMed – rehab

Safe and Effective Outcome of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Aged 90 Years or Older.

Eur Neurol. 2013 Jul 2; 70(1-2): 84-87
Balestrino M, Carlino V, Bruno C, Finocchi C, Mancardi GL, Del Sette M, Gandolfo C

Concerning intravenous thrombolysis, only inconclusive data are available for patients older than 90. We retrospectively evaluated 11 such patients whom we treated with thrombolysis from June 2007 through April 2012, comparing them to 41 patients of the same age whom we treated conventionally in the same period. Baseline clinical data were superimposable, except for shorter onset-to-hospital time for thrombolyzed patients. Mortality and hemorrhagic transformation did not differ. Functional status (modified Rankin scale) 3 months after was better in treated patients, even when compared to controls who arrived early in the hospital. Treated patients were more often discharged home or to intensive rehabilitation, less often to a nursing home. We conclude that safety and effectiveness of intravenous thrombolysis in eligible nonagenarians are evident in a setting of everyday practice, and that patients 90 years or older should not be denied thrombolysis solely on the basis of their age. HubMed – rehab

Spinal Stenosis: Factors That Influence Patients’ Decision to Undergo Surgery.

J Spinal Disord Tech. 2013 Jul 8;
Roszell K, Sandella D, Haig AJ, Yamakawa KS

Prospective non-interventional observation.To examine factors that influence a patient’s real decision to accept the offer of surgery for lumbar spinal stenosis in a relatively controlled situation.A patient’s decision to undergo spine surgery might be influenced by factors other than pathology. However there is limited research exploring the decision.A study performed for other purposes recruited persons aged 55-90 with medical record evidence of an offer of surgery for spinal stenosis by a university faculty surgeon. Inclusion criteria included neurogenic claudication, subjectively positive imaging, difficulty walking 200 yards. Potential subjects with additional disabling conditions (e.g. lower limb amputation), conditions that might mimic stenosis (e.g. polyneuropathy) or some contraindications to invasive treatment (e.g. anticoagulation) were excluded. Subjects filled out questionnaires on function, quality of life, pain, and health, and were examined by a spine surgeon masked to diagnostic category. (Other recruits had back pain or no symptoms) Telephone follow-up 6-12 months later determined whether surgery was done.Of 39 qualifying subjects, 20 followed through with surgery. A binary logistic regression revealed that significant factors that influence patient decision-making included SF-36 measures of “Comparative Health” and “Role Limit Emotional” as well as the subject’s overall perception of their quality of life. The combination of all three factors yielded a predictive model (P=0.031). Individually, however, only “Comparative Health” was significant and able to predict a decision to proceed with surgery (P=0.036).In this population with significant disability, uncomplicated medical history and a relatively clear diagnosis, the decision to accept surgical intervention was influenced by issues of perceived overall health and quality of life. Interventions to change real or perceived overall health may impact patient acceptance of surgery. HubMed – rehab