Behavior of patients with autistic syndrome makes delivery of oral hygiene and dental treatment a problem. In this study, the oral health and needs of two groups of patients with autism were evaluated: noninstitutionalized children with a mean age of 11 and institutionalized adults with a mean age of 22. The latter group had severe periodontal problems; almost half required periodontal surgery. Many of the children also needed periodontal treatment. Adults were found to have lower decayed, missing, and filled teeth (DMFT) scores than functionally independent Israeli persons of the same age. This finding was surprising because institutionalized adults are predisposed to development of dental caries; they frequently consume sweets, have poor oral hygiene, and do not use fluoride. Noninstitutionalized children with autism had caries rates that were similar to rates of functionally independent peers.

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Exercise left ventriculography has been shown to be a sensitive and specific tool for the detection of coronary artery disease. At the present time, such studies require radionuclide-base methods. Computer-based techniques recently have been shown to provide high resolution images of the left ventricle when the levophase of an intravenous injection of radiopaque contrast medium is imaged with fluoroscopy. To evaluate the possible efficacy of using "intravenous digital subtraction left ventriculograms" in exercise ventriculography, such ventriculograms were performed at rest and during maximal supine bicycle exercise in 31 patients. Studies that could be analyzed were obtained in 29 patients. In 21 patients with coronary artery disease, ejection fraction was 58% at rest and 45% with exercise (p less than 0.001 vs. rest). In contrast, in seven patients with no coronary artery disease, ejection fraction was 65% at rest and 69% with exercise (difference not significant). In a subgroup of 8 patients with "severe" coronary obstruction, the change in ejection fraction from rest to exercise was -18%, while in the remaining 13 patients with less severe disease, it was -9% (p less than 0.001). All patients with coronary artery disease manifested new or worsening segmental wall abnormality with exercise, compared with two of seven patients without coronary disease (p less than 0.01). Sixteen patients underwent rest and exercise radionuclide cineangiography in addition to digital subtraction angiography. There was a strong correlation between the two techniques for ejection fraction at rest (r = 0.78, p less than 0.001), ejection fraction and with exercise (r = 0.83, p less than 0.001) and change in ejection fraction from rest to exercise (r = 0.88, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

In order to determine the influence of culture, individual idiosyncrasy, social and economic conditions as well as the importance of past and current dental care on oral health, the oral conditions of 610 patients in seven old age homes were evaluated in four countries: USA, Peru, Argentina and Israel. The patients included in this study were examined by clinicians who had undergone training and calibration sessions. The seven institutions surveyed have a large range of physical facilities, economic levels, and a variety of quantity and quality among medical, dental and ancillary staff. There were marked differences as to philosophy of treatment and scope for the dental care of the residents. A subjective impression by the examiners is that old age home administrators do not regard the dental needs of the residents to be among their higher priorities. Dental care is considered expensive and requires special equipment and exclusive physical space on the institutional premises. Of the 610 residents 419 were women and 191 men, with an average age of 80 years. The mean number of years of schooling was six. Sixty-two percent of the examinees were widowed, 21% were married, 1% single, 2% divorced, and 5% of unknown or undeclared status. The main orodontal characteristic of the population surveyed was partial or full eduentulousness. Of the total population (610 examinees) only three patients possessed a full complement of natural, unrestored teeth. Twelve examinees had 28 unit dentition, partly natural teeth and partly restored with plastic fillings, fixed prostheses, crowns or pontics. Three hundred and one patients (49%) of the examined population were totally edentulous, 249 (41%) wore sets of complete dentures and 52 (8%) did not wear any prosthetic restoration or replacement.

A reparative dentin bridge was induced in rat molar teeth by pulp exposure and capping with calcium hydroxide. Transmission electron-microscopic examination after 10 days revealed the presence of odontoblastic cells and collagenous matrix with focal calcifications. The calcifying fronts were composed of hydroxyapatite crystals. Numerous extracellular matrix vesicles were scattered between the forming cells and the calcifying fronts. Some of the vesicles contained electron-dense material and in others, apatite crystals were detected. Matrix vesicles could not be identified in normal, mature calcifying dentin matrix. In view of the present observations and studies on surgical manipulations in articular cartilage, it is concluded that matrix vesicle calcification may result from alterations in the metabolic state of mesenschymal tissues. These changes can be induced surgically or chemically.

The safety, efficacy and long term clinical benefits of renal artery revascularization by stenting are still a matter of debate. The aim of our study was to define the safety and efficacy of renal artery stenting with the Tsunami peripheral stent (Terumo Corporation, Tokyo, Japan). The ODORI was a prospective, multicentre registry which enrolled 251 consecutive patients, (276 renal arteries) in 36 centres across Europe. The primary endpoint was acute procedural success defined as <30% residual stenosis after stent placement. Secondary endpoints included major adverse events, blood pressure control, serum creatinine level, and target lesion revascularization (TLR) at 6 and 12 months. Patients were 70 ± 10 years old, 59% were male, 33% had diabetes, and 96% hypertension. The main indications for renal stent implantation were hypertension in 83% and renal salvage in 39%. Direct stent implantation was performed in 76% of the cases. Acute success rate was 100% with residual stenosis of 2.5 ± 5.4%. Systolic/diastolic blood pressure decreased from a mean of 171/89 at baseline to 142/78 mmHg at 6 months (p < 0.0001 vs. baseline), and 141/80 mmHg at 12 months (p < 0.0001 vs. baseline). Mean serum creatinine concentration did not change significantly in the total population. However, there was significant improvement in the highest tercile (from 283 μmol/l at baseline to 205 and 209 μmol/l at 6 and 12 months respectively). At 12-months, rates of restenosis and TLR were 6.6 and 0.8% respectively. The 12 month cumulative rate of all major clinical adverse events was 6.4% while the rate of device or procedure related events was 2.4%. In hypertensive patients with atherosclerotic renal artery stenosis Tsunami peripheral balloon-expandable stent provides a safe revascularization strategy, with a potential beneficial impact on hypertension control and renal function in the highest risk patients.

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