Preparatory Treatment Research Articles

Three-Dimensional Microfluidic Capillary Device for Rapid and Multiplexed Immunoassays in Whole Blood.

In this study, we demonstrate whole blood immunoassays using a microfluidic device optimized for conducting rapid and multiplexed fluorescence-linked immunoassays. The device is capable of handling whole blood samples without any preparatory treatment. The three-dimensional channels in poly(methyl methacrylate) are designed to passively load bodily fluids and, due to their linearly tapered profile, facilitate size-dependent immobilization of biofunctionalized particles. The channel geometry is optimized to allow for the unimpeded flow of cellular constituents such as red blood cells (RBCs). Additionally, to make the device easier to operate, the biofunctionalized particles are pretrapped in a first step, and the channel is dried under vacuum, after which it can be loaded with the biological sample. This novel approach and design eliminated the need for traditionally laborious steps such as filtering, incubation, and washing steps, thereby substantially simplifying the immunoassay procedures. Moreover, by leveraging the shallow device dimensions, we show that sample loading to read-out is possible within 5 min. Our results also show that the presence of RBCs does not compromise the sensitivity of the assays when compared to those performed in a pure buffer solution. This highlights the practical adaptability of the device for simple and rapid whole-blood assays. Lastly, we demonstrate the device's multiplexing capability by pretrapping particles of different sizes, each functionalized with a different antigen, thus enabling the performance of multiplexed on-chip whole-blood immunoassays, showcasing the device's versatility and effectiveness toward low-cost, simple, and multiplexed sensing of biomarkers and pathogens directly in whole blood.

Establishment of an intragastric surgical model using C57BL/6 mice to study the vaccine efficacy of OMV-based immunogens against Helicobacter pylori.

Chronic gastritis is one of the major symptoms of gastro-duodenal disorders typically induced by Helicobacter pylori (H. pylori). To date, no suitable model is available to study pathophysiology and therapeutic measures accurately. Here, we have presented a successful surgical infection model of H. pylori-induced gastritis in C57BL/6 mice that resembles features similar to human infection. The proposed model does not require any preparatory treatment other than surgical intervention. C57BL/6 mice were injected with wild-type SS1 (Sydney strain 1, reference strain) directly into the stomach. Seven days post infection, infected animals showed alterations in cytokine responses along with inflammatory cell infiltration in the lamina propria, depicting a prominent inflammatory response due to infection. To understand the immunogenicity and protective efficacy, the mice were immunized with outer membrane vesicles (OMVs) isolated from an indigenous strain with putative virulence factors of H. pylori [A61C (1), cag+/vacA s1m1]. In contrast to the non-immunized cohort, the OMV-immunized cohort showed a gradual increase in serum immunoglobulin(s) levels on the 35th day after the first immunization. This conferred protective immunity against subsequent challenge with the reference strain (SS1). Direct inoculation of H. pylori into the stomach influenced infection in a short time and, more importantly, in a dose-dependent manner, indicating the usefulness of the developed model for pathophysiology, therapeutic and prophylactic studies.

Probiotics and NLRP3 mRNA inflammasome levels in women with endometriosis-related infertility undergoing assisted reproductive technologies.

This research was conducted at Bukovinian State Medical University and the Centre of Reproductive Medicine and included a total of 30 infertile women. The control group consisted of 10 women with tubal infertility resulting from a prior history of inflammation, who, following a comprehensive clinical and laboratory assessment, exhibited no other underlying health conditions and could be regarded as essentially healthy individuals. Participants in the control group ranged from 21 to 42 years, with an average age of 29.75 years. The control group did not receive the probiotic Femina Probiz. The main group, on the other hand, included 20 women diagnosed with external genital endometriosis who were undergoing assisted reproductive technologies. These patients were administered the probiotic Femina Probiz manufactured by Unic Biotech Ltd in India. They were instructed to take one tablet containing 10×10^9 Lactobacillus organisms twice daily for one month as part of their preparatory treatment before proceeding with assisted reproductive technologies. The levels of NLRP3 inflammasome were measured before and after this preparatory phase. The incidence of primary infertility was significantly higher in patients belonging to the main group.

Improving reinforcement properties of CNTs in aluminium matrix composites: a case of surface modification through AlN nano-particle grafting

This paper accentuates a newer approach to modify the surfaces of pristine multiwall carbon nanotubes (CNTs) by two-phase acid treatment, followed by silanization and grafting of functionalized AlN nano-particles onto the CNT surfaces, as a preparatory treatment before reinforcing in liquid metallurgy processed aluminium matrix composites (AMCs) without disrupting their structural integrity. Besides, the surface modified CNTs will have the strong potential to improve their dispersion uniformity, wettability and matrix-reinforcement bonding strength in the AMCs. The AlN nano-particle grafted CNTs were characterized through dispersion stability test, UV-Visible spectroscopy, Fourier-transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) analysis, Raman spectroscopy and Thermogravimetric analysis (TGA). Microstructure and elemental analysis were conducted through Scanning electron microscope (SEM) embedded with Energy dispersive X-ray spectroscope (EDS), Field emission scanning electron microscope (FESEM) and Transmission electron microscope (TEM). The aforementioned characteristics of AlN nano-particle grafted CNTs were compared with those of the pristine CNTs, acid treated CNTs and silanized CNTs to demonstrate the effectiveness of AlN nano-particle grafting on the CNT surfaces. Results revealed improvement of dispersion stability, covalent attachment of AlN nano-particles onto CNT surfaces (FTIR spectroscopy), existence of AlN on the CNT sidewalls (XRD analysis) and peaks corresponding to Al and N (EDS). Evidence of AlN on the CNT surfaces was also established through SEM, FESEM, TEM and EDS. Though there was a paltry degradation of CNT surfaces after the acid treatment, it was recovered substantially during silanization, and there was no evidence of tube shortening or fragmentations in SEM of silanized and AlN grafted CNTs.

Clinician Concerns About Cognitive Processing Therapy: A Review of the Evidence

Cognitive processing therapy (CPT) is recommended for the treatment of posttraumatic stress disorder (PTSD) but is infrequently delivered. Many clinicians have concerns about CPT that impact usage. Common concerns include (a) CPT’s effectiveness in “real-world” settings, (b) whether CPT can be individualized, (c) the possibility of making clients worse, (d) CPT’s effectiveness for clients with comorbidities, (e) CPT’s effectiveness for clients with childhood trauma, (f) the appropriateness of CPT for moral injury, (g) delivering CPT to culturally diverse populations, (h) initiating CPT without first stabilizing clients with preparatory treatment, (i) the effects of CPT’s structure on rapport, (j) whether and when CPT should be stopped, and (k) whether clients will maintain their gains long term. To inform clinical decision-making, findings from the psychological literature are presented for each concern. The evidence provides support for CPT’s safety, tolerability, acceptability, and effectiveness across populations and settings, as well as for delivery of CPT without preparatory treatment and across a range of secondary outcomes. Although symptom exacerbations occur, evidence suggests they are typically temporary and occur at similar rates as in control conditions. Findings highlight the role of fidelity in symptom outcome. The evidence may aid providers in making informed decisions about training in or delivering CPT.

Evaluation of the efficacy of hematoxylin and eosin stain when xylene is completely replaced by turpentine or kerosene oil - A comparative study for oral tissues.

Microscopic examination of cells and tissues requires the preparation of very thin and good-quality sections mounted on glass slides and appropriately stained to demonstrate normal and abnormal structures. Before this step, the tissue must undergo preparatory treatment known as tissue processing. The various stages of tissue processing are dehydration, clearing, impregnation, and embedding, each with a particular duration for proper completion of the process. Xylene is the most frequently used clearing agent whose carcinogenic potential is well documented. Hence, attempts were made to substitute xylene with a biosafe clearing agent. The present study aimed to evaluate and compare the efficacy of hematoxylin and eosin stain (H and E stain) when xylene is completely replaced by turpentine or kerosene oil. A total number of 50 tissue samples were taken in the study, which included 40 study samples and 10 controls. All the samples were randomly separated into three groups and routine tissue processing and H and E staining were performed. The result was further subjected to statistical analysis by using Fisher's exact test. Group-1: Ten tissue samples were processed and H and E staining was done in xylene. Group-2: Twenty tissue samples were processed and H and E staining was done in turpentine oil. Group-3: Twenty tissue samples were processed and H and E staining was done in kerosene oil. Nuclear staining, cell morphology, and uniformity of staining were better in kerosene sections, while cytoplasmic and clarity of staining of turpentine sections were comparable with xylene sections. Turpentine and kerosene as clearing agents can be used in the future with certain modifications in their concentration and routine staining protocol.

The effect of preparatory therapy with myo-inositol on the outcome of infertility treatment by ART in men with low reproductive function

Research objective: to study the effect of myo-inositol (MI), folic acid (FA) and cyanocobalamin in mono- and complex therapy on the classical fertility rates and the level of DNA fragmentation in sperm in men with low reproductive function, and on the results of the in vitro fertilization (IVF) programs performed in these patients.Materials and methods. A retrospective study of 133 patients aged 32 to 40 years was carried out for the period 2020–2021. All patients were divided into three groups: group 1 – 44 men who took MI, FA and cyanocobalamin daily as monotherapy for 3 months; group 2 – 42 patients who followed a diet to improve spermatogenesis for 3 months; group 3 – 47 men, for whom complex therapy was applied for 3 months: MI, FA, cyanocobalamin and diet.Results. The increase of sperm concentration in ejaculate, improvement of progressively motility of spermatozoa, and increase of the percent of spermatozoa with normal morphology in men with failures of reproductive function after the complex preparatory therapy are defined. The preparatory therapy for men with MI in preparation for IVF helps to improve the quality of embryos and increase the pregnancy rates in couples with male infertility due to the assisted reproductive technologies. The positive effect of preparatory complex therapy in patients with poor spermatogenesis on the blastocyst formation rates in IVF programs is shown.Conclusions. The positive effect of MI on the normal functioning of the reproductive system in men has been proven. The increase pregnancy rates in the IVF program after preparatory treatment of men with MI can be explained by its positive effect on reducing the level of DNA fragmentation of sperm.

Evaluation of the effectiveness of a proposed approach to treat infertility against the background of uterine leiomyoma, which includes treatment with a releasing hormone agonist, hysteroresectoscopy or conservative myomectomy, and pre-pregnancy treatment

There is much discussion about the effect of uterine leiomyomas on the outcomes of assisted reproductive technologies (ART). This study aimed to analyze the effectiveness of in vitro fertilization following the use of a therapy scheme we propose to treat infertility with the background of uterine leiomyoma. The therapy scheme includes the use of a releasing hormone agonist, hysteroresectoscopy or conservative myomectomy and pre-pregnancy pre-treatment. The clinical study involved 175 women of reproductive age who had been diagnosed with uterine leiomyoma, and were divided into the groups as follows. The treatment group A included 137 women with uterine leiomyoma, and was further divided into subgroups. Subgroup A1 included 55 women with uterine leiomyoma after conservative myomectomy who underwent the proposed treatment scheme (TS); A2 included 45 women with uterine leiomyoma after hysteroresectoscopy who underwent the TS; A3 included 37 women with uterine leiomyoma who underwent the TS but not the surgical removal of uterine leiomyoma. Control group B included 38 women with uterine leiomyoma after conservative myomectomy. All patients with intramural and submucosal myoma nodules underwent a hormonal preparatory treatment with a gonadotropin-releasing hormone (GnRH) agonist (Diphereline 3.75 mg intramuscularly once every 28 days for 3 months) prior to the myomectomy. After the surgery, patients were prescribed a combination therapy with a vitamin complex FT 500 plus, vitamin D3 and Pelvidol for three months before and during controlled ovarian stimulation (COS) protocol up to the follicle puncture. We determined that the incidence of pregnancy was the lowest (37.8 %) in women with infertility against the background of uterine leiomyoma, who surgically treated for the myomas, but underwent pre-pregnancy pre-treatment. The frequency of pregnancy did not differ between the A1 and A2 treatment groups, and was on average 7.0 % higher than in the control group, and 11.0 % higher than in the A3 group. The relative incidence of clinical pregnancies was the highest in A1 (45.5 %) and A2 (44.4 %) treatment groups. The frequency of live births in the A1 group was significantly higher than in A3 group (by 14.0 %), while the relative number of term live births in the A1 group exceeded that of A3 group by 26.0 %. Thus, both proposed therapy schemes to treat infertility against the background of uterine leiomyoma, which include the use of a releasing hormone agonist, either a conservative myomectomy or hysteroresectoscopy and pre-pregnancy pre-treatment in addition to the ART protocol with a multi-vitamin complex with inositol, vitamin D3, alpha-lipoic acid and magnesium, had the equivalent effects on the incidence of clinical pregnancy, however the frequency of live births was highest after conservative myomectomy (84.0 %).

Yam paste in glycemic preloads curbs peak glycemia of rice meals in apparent healthy subjects.

People with dental problems and dysphagia frequently consume foods in paste form. A strategy is required to mitigate the glycemic responses of these foods. The effect of yam paste ingestion on postprandial glycemic responses was assessed using a two-arm study design for yam paste ingestion: (1) as low- and medium-glycemic index food and (2) as preload and coingested food in a rice meal. In a randomized crossover trial, 18 healthy volunteers consumed (1) low-intensity-cooked yam paste; (2) medium-intensity-cooked yam paste; (3) cooked white rice; (4) coingested low-intensity-cooked yam paste with rice; (5) coingested medium-intensity-cooked yam paste with rice; (6) a preload of low-intensity-cooked yam paste before rice; (7) a preload of medium-intensity-cooked yam paste before rice. Postprandial glycemic responses and satiety assessments were conducted for each food approach. The glycemic characteristics of yam paste were manipulated with the preparatory treatment. Ingesting a preload of 10 g of yam paste before a rice meal resulted in better glycemic responses for 0-60 min in terms of peak glucose value and positive increments under the curve than co-ingesting yam paste with rice, with no adverse effect on satiety, irrespective of the glycemic index of the yam paste. Regarding isocarbohydrates, both low- and medium-glycemic index yam paste preloads curbed the glucose peak value of a rice meal and lowered the glycemic index value of mixed meals in young healthy people.

Transfer of exposure therapy effects to a threat context not considered during treatment in patients with panic disorder and agoraphobia: Implications for potential mechanisms of change

Further developments of exposure-based therapy (EBT) require more knowledge about transfer of treatment to non-trained everyday contexts. However, little is known about transfer effects of EBT.Using a standardized EBT protocol in 275 patients with panic disorder and agoraphobia we investigated the transfer of EBT to a highly standardized context during a Behavioral Avoidance Test (BAT; being entrapped in a small and dark test chamber) and not part of the exposure sessions. Patients of a treatment group underwent the BATs before treatment (t1), after a preparatory treatment phase (t2), and after an agoraphobic exposure phase (t3) and were compared with wait-list control patients, who repeated BAT assessments across the same time period.We found stronger reductions in avoidance behavior, reported fear, and autonomic arousal during the BAT from t1 to t3 in the treatment group patients who were anxious during t1 relative to the anxious but untreated patients. Fear reduction was related to treatment outcome indicating the contribution of transfer effects to successful EBT. Interestingly, reduction varied for different fear response systems suggesting different processes to may be involved in transfer effects. Importantly, final BAT assessment still evoked residual fear in the treatment group as compared to BAT non-anxious control patients, suggesting limited transfer effects – one possible reason for the return of symptoms in new situations.

Topology-free immersed boundary method for incompressible turbulence flows: An aerodynamic simulation for “dirty” CAD geometry

To design a method to solve the issues of handling “dirty” and highly complex geometries, the topology-free method combined with the immersed boundary method is presented for viscous and incompressible flows at a high Reynolds number. The method simultaneously employs a ghost-cell technique and distributed forcing technique to impose the boundary conditions. An axis-projected interpolation scheme is used to avoid searching failures during fluid and solid identification. This method yields a topology-free immersed boundary, which particularly suits flow simulations of highly complex geometries. Difficulties generally arise when generating the calculation grid for these scenarios. This method allows dirty data to be handled without any preparatory treatment work to simplify or clean-up the geometry. This method is also applicable to the coherent structural turbulence model employed in this study. The verification cases, used in conjunction with the second-order central-difference scheme, resulted in first-order accuracy at finer resolution, although the coarser resolution retained second-order accuracy. This method is fully parallelized for distributed memory platforms. In this study, the accuracy and fidelity of this method were examined by simulating the flow around the bluff body, past a flat plate, and past dirty spheres. These simulations were compared with experimental data and other established results. Finally, results from the simulation of practical applications demonstrate the ability of the method to model highly complex, non-canonical three-dimensional flows. The countermeasure based on the accurate classification of geometric features has provided a robust and reasonable solution.

Treatment choice among veterans with PTSD symptoms and substance-related problems: Examining the role of preparatory treatments in trauma-focused therapy.

Although common practice in Veterans Affairs (VA) PTSD clinics, it is unclear whether preparatory treatment improves trauma-focused treatment (TFT) completion and outcomes. Furthermore, little is known about whether treatment-seeking veterans in naturalistic settings would chose to prioritize preparatory treatment if given the option of a phase-based approach or direct access to TFT, and how substance-related problems (SRPs) influence this treatment choice. The first aim of this study was to explore how co-occurring SRPs (ranging from none to moderate/severe) influence PTSD treatment choices in a naturalistic setting where veterans were offered a choice between a phase-based approach (i.e., preparatory treatment) or direct access to TFT. The study also examined whether initial treatment choice and severity of co-occurring SRPs influenced TFT completion and outcomes. The second aim was to investigate whether preparatory treatment led to superior TFT completion or outcomes, irrespective of co-occurring SRPs. Analyses were conducted using archival data from 737 United States veterans referred for outpatient VA PTSD treatment. SRPs did not predict initial treatment choice or the length of preparatory group participation. Neither SRPs nor preparatory group participation predicted TFT completion or outcomes (measured as change in PTSD and depression symptoms from pre- to post-TFT). Preparatory group participation did not predict improved TFT completion or outcomes, irrespective of co-occurring SRPs. These findings suggest that veterans with PTSD symptoms and co-occurring SRPs may make similar treatment choices and benefit from either a phase-based approach or direct TFT initiation, and preparatory treatments may not increase patient readiness for veterans seeking TFT. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Exogenous methylglyoxal enhances the reactive aldehyde detoxification capability and frost-hardiness of wheat

Cold-acclimation is essential for the development of adequate frost-hardiness in cereals and therefore sudden freezes can cause considerable damage to the canopy. However, timely adding of an appropriate signal in the absence of cold acclimation may also harden wheat for the upcoming freeze. The feasibility of the promising signal molecule methylglyoxal was tested here for such applications and the signal mechanism was studied in bread wheat (Triticum aestivum L.) and durum wheat (Triticum turgidum L. ssp. durum). Spraying with 10 mM methylglyoxal did not decrease the fresh weight and photosynthetic parameters in most wheat varieties at growth temperature (21 °C). Photosynthetic parameters even improved and chlorophyll content increased in some cases. Increased transcript level of glutathione-S-transferases and omega-3 fatty acid desaturases was detected by qPCR 6 h after the last methylglyoxal spray. Aldo-keto reductase and glyoxalase enzyme activities, as well as sorbitol content of wheat plants increased 24 h after the last 10 mM methylglyoxal spray in most of the cultivars. These mechanisms may explain the increased freezing survival of methylglyoxal pretreated wheat plants from less than 10% to over 30%. Our results demonstrate that exogenous methylglyoxal treatment can be safely added to wheat plants as preparatory treatment without detrimental effects but inducing some of the stress-protective mechanisms, which contribute to frost-hardiness.

Motivational interviewing prior to cognitive behavioural treatment for social anxiety disorder: A randomised controlled trial

BackgroundWe examined whether providing three sessions of treatment based on motivational interviewing (MI) prior to Cognitive Behavioral Therapy (CBT) for Social Anxiety Disorder (SAD) improved outcomes. MethodsParticipants diagnosed with SAD (N = 186) were randomly allocated to receive three sessions of MI (MI+CBT; n = 85) or supportive counselling (SC+CBT; n = 101) prior to a 12-week group CBT program. Assessments occurred at baseline, after preparatory treatment, after CBT, and at 6-months follow-up. Outcomes were expectations for change, number of CBT sessions attended, self- and clinician-rated CBT homework completion, and self- and clinician-rated social anxiety severity. ResultsConditions did not differ significantly on expectations for change, number of CBT sessions attended, or clinician-rated homework completion. Self-rated homework completion was greater in MI+CBT than in SC+CBT. Change over time in social anxiety severity did not differ between conditions overall, however, this outcome was significantly moderated by two variables; those in MI+CBT, as compared to SC+CBT, showed significantly poorer outcomes on self-reported social anxiety severity if they were higher in change readiness and significantly better outcomes on clinician-rated social anxiety severity if they were higher in functional impairment. LimitationsAlthough therapists in MI sessions were rated as behaving more consistently with MI than therapists in SC sessions, some MI consistent behaviors occurred in the SC sessions. ConclusionsAddition of a MI-based discussion prior to evidence-based CBT appears to benefit people with SAD who have high functional impairment but may interfere with outcomes for those higher in readiness for change.

What is the Responsibility of Australian Medical Professionals Whose Patients Travel Abroad for Assisted Reproduction?

Australian medical professionals whose patients undertake assisted reproductive treatment abroad face a conflict: to try to provide optimal and on-going care for their patient at the same time as ensuring compliance with Australian legal, ethical, and professional rules which proscribe as unsafe or unethical key aspects of such treatment. A major suggestion from literature on medical travel is that risks to the patient can be mitigated through the involvement of the local professional. However, the force of legal regulation and ethical guidance in Australia strenuously directs clinicians away from involvement in overseas reproductive treatment. This article reports on 37 interviews with Australians travelling abroad for surrogacy, egg donation, and embryo donation, reflecting on patients' experiences with Australian medical professionals both before and after they travelled. Patient reports demonstrate a fragmented and bewildering medical landscape in Australia, in which the ability to access domestic care and expertise varied markedly depending upon the kind of treatment patients were seeking abroad, and the mode of practice of the Australian doctor. Doctors practicing within licensed IVF clinics were notably more constrained than those outside such a setting. Patients seeking egg donation were offered information and received a wide range of diagnostic and preparatory treatments, while those seeking surrogacy were shunned, chided and offered limited (and sometimes covert) assistance. While recent changes to national ethical guidance improve clarity on information giving, the ethical and legal propriety of Australian medical professionals providing diagnostic or preparatory treatment for cross border reproduction remains uncertain.

Systematic Transfemoral Transarterial Transcatheter Aortic Valve Replacement in Hostile Vascular Access

ABSTRACT Background: Traditionally, hostile peripheral access patients undergo TAVR via alternative access. We describe the “transfemoral-first” (TF-1) approach in patients with hostile peripheral access. Methods: Clinical and procedural data were obtained for all TAVR cases performed from August 2016 to July 2017. Computed tomography was used to assess iliofemoral arteries. Patients were divided into three femoral access groups: routine, hostile, and prohibitive. We attempted TF access in all patients with routine and hostile access. Hostile access was defined as: (1) arterial segments with diameter <5.0 mm; or (2) <5.5 mm with severe calcification (270–360° arc of calcification) or severe tortuosity; or (3) severe tortuosity along with severe calcification. Outcomes of the hostile access group patients who underwent TF-1 are described. The primary endpoint was successful completion of the procedure without major complications by the intended route. The secondary endpoints were procedural complications as defined by the VARC-2 criteria. Results: Of 377 consecutive patients, 99.5% underwent TF-1 TAVR; two patients (0.4%) had prohibitive access. Twenty-eight (7.4%) patients had hostile access with access side mean minimal lumen diameter of 4.7 mm (range 3.8–5.4 mm). Twenty-six (92.8%) were successfully treated with TF-1 strategy. Twelve (42.8%) of the 26 patients underwent preparatory endovascular treatment prior to TAVR during the same operating room visit. There was 1 (3.5%) major or life-threatening bleeding complication and 2 (7.1%) major vascular complications. There were no deaths or strokes. Conclusion: Using the safe and effective endovascular approach, TF-1 TAVR is feasible for all-comers—including those with hostile access—with low complication rate. Larger studies are warranted to validate this approach.

Interdyscyplinary treatment of the patient with inflamatory papillary hyperplasia stomatitis – case report

Prosthetic treatment of the edentulous patients is often a big challenge for a clinician. In many cases, it must be preceded by preparatory treatment before prosthetic treatment, becoming interdisciplinary. It should be remembered that the healing process does not end at the moment of hand over final prosthetic restorations. Equally important is patient education about the use of prostheses, the time of their use, hygienization and control visits. Lack of any elements or failure to folow medical recommendations may be associated with far-reaching adverse changes within the masticatory system and health. The article presents a description of prosthodontic treatment edentulous patient with third degree denture stomatitis according to the Newton’s classification. The rehabilitation process was preceded by surgical treatment of the prosthetic base. The publication describes not only the stages of clinical management, postoperative care but also highlights the special role of the prosthetics physician in oncological prevention.

I233] Automated treatment planning and quality assurance

In radiotherapy, there is a strong development striving at improving the quality of the treatment plans. Consequently, there is a great need for quality assurance procedures focusing on the treatment plan quality. The most fundamental aspect is perhaps the quality of a treatment plan for an individual patient (treatment plan optimization), which in turn is dependent on the quality of the underlying protocols and prioritization strategies (guidelines). However, there are also other important aspects, such as quality assurance of treatment planning algorithms and their application to specific diagnoses or treatment techniques (benchmarking), preparatory treatment planning for multi-centre clinical studies (dummy runs), and treatment planner achievements (training and competencies). The quality of a treatment plan may also encompass its deliverability at treatment (QC pass rate and plan robustness). To approach these issues in a quantitative fashion, there must be an unambiguous understanding of the concept of treatment plan quality, that can be applied in a continuous quality assurance program. While the plan quality in its fundamental sense is related to the degree of prescription fulfilment, it is also influenced by various limitations and uncertainties. In this respect, it is of foremost importance to use optimization objectives that are specific and measurable. Many of these issues can be addressed using automatically generated treatment plans, either data-base driven or protocol based, and extended to sets of multiple Pareto-optimal plans. In this presentation, we will review some of the possibilities for treatment plan quality assurance that becomes available with automated treatment planning techniques. The influence of short-cuts and limitations will be discussed.

Effects of Scheduled Waiting for Psychotherapy in Patients With Major Depression.

The role of nonspecific factors in the outcome of psychotherapy is poorly understood. To study the effects of pretreatment expectancy of scheduled psychotherapy, we examined the effects of an agreed waiting time on the outcome of psychodynamic psychotherapy. Thirty-three treatment-naive outpatients with major depressive disorder were randomly selected to start psychotherapy either directly (DG; n = 17) or after waiting for 6 months (WG; n = 16). In WG, 18% to 60% of the total decline in symptoms took place during the waiting time. After 1 year of active psychotherapy, the anxiety score declined significantly only in WG, and the total length of treatment needed was shorter in WG. No other outcome differences between WG and DG were found. We conclude that scheduled waiting associates with a significant decline in depressive symptoms. Scheduled waiting should be regarded as a preparatory treatment and not as an inert nontreatment control.

Comparative analysis of the effectiveness of indirect restorations of anterior

A comparative analysis of the effectiveness of indirect restorations of anterior in 35 patients. Studied the objective criteria of the quality of dental treatment and quality of life Oral Health Impact Profile-OHIP-14RU in the period up to 1 year. It is established that indirect restorations are highly resistant according to the criteria of form, color, roughness. In addition, at a high level in the medium term, retain the integrity and conformance of the design. Among the indications for indirect restorations metal-ceramic crowns-dimensional structure or texture of the tooth were observed in 31% ofpatients, multiple fillings, defects of shape, and disposition - 41, 17 and 11% respectively. When using metal crowns, on the stage of the preparatory treatment shows deponirovanie 41,1% of the teeth. In patients who underwent restorations in the front group were made metal-ceramic crowns, at the dispositions ofpulpless 80% of the teeth, just the restoration of the 11th, 21st, 31st and 41st teeth was performed in 58,8%.