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- SourceAvailable from: Gary M Ginsberg[Show abstract] [Hide abstract]
ABSTRACT: All societies have limited resources, so decisions have to be made about which public health interventions should be provided. A major tool used for prioritisation is cost-utility analysis (CUA) where the outcomes are measured in terms of Disability Adjusted Life Years (DALYs) prevented. Collecting data and building models to calculate the ratio of net costs (i.e.: intervention costs less treatment costs averted due to decreases in morbidity and mortality) to outcomes (CUR) is complex and time consuming. Therefore, there is a great appeal in using CUA calculations that have already been published in other countries. This paper points out the many limitations and inaccuracies caused by generalizing results from CUAs across different countries. However, if time constraints are pressing then first-order estimates of results could be presented after adjustments for the major drivers of the CUR, such as incidence rates, intervention costs and averted treatment costs.
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ABSTRACT: The aim of the study was to assess the alteration of alveolar ridge dimensions after decoronation procedures in children and adolescents at least 1 year after surgery. Twelve children who underwent decoronation of ankylosed maxillary anterior incisors with at least 1 year after surgery follow-up were recalled for reevaluation. All decoronations were performed when the ankylosed teeth were submerged 1-1.5 mm. During the recall appointment, impressions of the upper arch were obtained. The bucco-palatal alveolar dimensions of the decoronated teeth were measured on the cast at the mid-mesiodistal distance from the missing tooth and were compared with the distance from the contralateral healthy incisor. Overall, 12 children (9 male and 3 female) were reevaluated up to 82 months after decoronation (mean, 49.58 ± 24 months). The mean age of the patients at the time of trauma was 9.83 ± 2.8 years. The average bucco-palatal dimension of the alveolar ridge at the mid-decoronation area was 9 ± 1 mm compared with 10.17 ± 0.9 mm at the contralateral homologous tooth (difference of 1.67 ± 1.12, P = .004). The findings show a positive statistical correlation between the duration of the follow-up period and the bucco-palatal dimension of the alveolar ridge (P = .027). Although decoronation of ankylosed young permanent incisors resulted in a decrease in the bucco-palatal dimension with time, it did not prevent additional alveolar growth that occurs with age in a developing child and thus may help maintain the alveolar bone ridge width, height, and continuity and assist in future rehabilitation with less invasive ridge augmentation procedures required for implant placement.
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ABSTRACT: The common approach to rapidly growing peristernal lesions in young infants is oncologic consultation, imaging, and early tissue diagnosis. We represent 3 such cases with unique sonographic findings favoring nonaggressive lesions named self-limiting sternal tumors of childhood, in which a conservative approach of sonographic follow-up was chosen. We review the typical sonographic characteristics in this rather new and rare entity, separating it from the more aggressive group of lesions in this location and age group, and suggest that the classic appearance should imply a wait-and-see approach, with sonographic follow-up studies rather than invasive intervention.
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