[System of evaluation, application manual and cut-off score for the cube copying test]. / Sistema de evaluación, manual de aplicación y puntuación de corte para la copia del cubo.

INTRODUCTION: One of the difficulties that arises in copying figures in clinical practice and in research is that of how to evaluate performance quantitatively. AIM: To implement a system for evaluating the copying of a solid cube in adults that is sensitive, simple to apply, easily reproducible and which establishes a cut-off score that distinguishes between a well-copied cube and others with alterations. SUBJECTS AND METHODS: The system proposed here is descriptive and is based on the compulsory features a set of nine lines (three groups of three parallel horizontal, vertical and sloping lines) must have in order to form a cube that offers the visual effect of having three dimensions when put together. The elements that are taken into account are the number of faces, the relation between the sizes of the faces, the size of the copy and the characteristics of the groups of horizontal, vertical and sloping lines. The maximum possible score is 9 points (perfect). Four scorers performed a blind analysis of copies of cubes drawn by 215 subjects; copies ranged from normal to others with serious alterations. RESULTS: In all a total of 860 evaluations were obtained (215 x 4). The kappa coefficient was 0.6013 and the Cronbach's alpha coefficient was 0.991. Cubes with a score equal to or above 6 were considered to have been copied correctly. CONCLUSIONS: The system succeeded in evaluating all kinds of cubes and the data set was reliable and consistent. Taking into consideration the extent to which the copies can vary as well as the subjectivity inherent in any clinical method, we believe that the system displayed a high degree of inter-evaluator reliability. The cut-off score can help researchers and doctors with little experience in evaluating the results of the cube copying test.

Sistema de evaluación, manual de aplicación y puntuación de corte para la copia del cubo / System of evaluation, application manual and cut - off score for the cube copying test

Introducción. Una dificultad que plantea la copia de figuras en la práctica clínica y en investigación es su evaluación cuantitativa. Objetivos. Implementar un sistema de evaluación de la copia de un cubo sólido en adultos sensible, de sencilla aplicación, con buena reproducibilidad, y establecer una puntuación de corte que diferencie un cubo bien copiado de otro copiado con alteraciones. Sujetos y métodos. El sistema propuesto es descriptivo, basado en las características obligatorias que debe tener un conjunto de nueve líneas (tres grupos de tres paralelas: horizontales, verticales y oblicuas) para que, unidas, conformen un cubo con sensación visual de tridimensionalidad. Se valora el número de caras, la relación de tamaño entre las caras, el tamaño de la copia y las características de los grupos de paralelas horizontales, verticales y oblicuas. El máximo obtenido es 9 puntos (perfecto). Cuatro calificadores analizaron de manera ciega copias de cubos de 215 sujetos, que incluyeron desde copias normales hasta con graves alteraciones. Resultados. Se obtuvo un total de 860 evaluaciones (215 × 4). El coeficiente kappa fue de 0,6013, y el coeficiente alfa de Cronbach, de 0,991. Cubos con puntuación igual o mayor a 6 se calificaron como copiados correctamente. Conclusiones. El sistema logró evaluar todo tipo de cubos, y el conjunto de datos fue confiable y consistente. Considerando la variabilidad que pueden presentar las copias y la subjetividad inherente a todo método clínico, consideramos que el sistema demostró una buena fiabilidad entre evaluadores. La puntuación de corte puede asistir a investigadores y clínicos con poca experiencia en la evaluación de la copia del cubo (AU)

Introduction. One of the difficulties that arises in copying figures in clinical practice and in research is that of how to evaluate performance quantitatively. Aim. To implement a system for evaluating the copying of a solid cube in adults that is sensitive, simple to apply, easily reproducible and which establishes a cut-off score that distinguishes between a well-copied cube and others with alterations. Subjects and methods. The system proposed here is descriptive and is based on the compulsory features a set of nine lines (three groups of three parallel horizontal, vertical and sloping lines) must have in order to form a cube that offers the visual effect of having three dimensions when put together. The elements that are taken into account are the number of faces, the relation between the sizes of the faces, the size of the copy and the characteristics of the groups of horizontal, vertical and sloping lines. The maximum possible score is 9 points (perfect). Four scorers performed a blind analysis of copies of cubes drawn by 215 subjects; copies ranged from normal to others with serious alterations. Results. In all a total of 860 evaluations were obtained (215 × 4). The kappa coefficient was 0.6013 and the Cronbach’s alpha coefficient was 0.991. Cubes with a score equal to or above 6 were considered to have been copied correctly. Conclusions. The system succeeded in evaluating all kinds of cubes and the data set was reliable and consistent. Taking into consideration the extent to which the copies can vary as well as the subjectivity inherent in any clinical method, we believe that the system displayed a high degree of inter-evaluator reliability. The cut-off score can help researchers and doctors with little experience in evaluating the results of the cube copying test (AU)

[Disorder profile in the Mini-Mental State Examination in patients with mild cognitive impairment]. / Perfil de alteración en el Mini-Mental State Examination en pacientes con deterioro cognitivo leve.

INTRODUCTION: Mild cognitive impairment (MCI) is a condition that can act as a risk factor for the development of dementia. AIMS: Our objective was to determine the profile of performance in the MMSE (Mini-Mental State Examination) in patients with MCI. PATIENTS AND METHODS: We studied the performance in the MMSE of 117 patients who satisfied the diagnostic criteria for MCI. The means and standard deviations (SD) were calculated and the sample was stratified according to the total score obtained in the MMSE; performance in each area of the MMSE was analysed for each group. RESULTS: Mean performance in the MMSE was 27.87, with a range of 23 to 30, and a SD of 1.75. The most compromised areas were memory and attention; there were mild alterations in temporal orientation. The ability to copy figures was seen to be affected in the groups with the best performances and this was maintained and increased slightly in the most affected levels. CONCLUSIONS: The mean value obtained is very similar to that of the most recent studies and is above the cut score for the MMSE for schooled populations (25/26). Our study reaffirms the idea that the MMSE is not sensitive to the early stages of impairment. The most strongly involved areas are memory and attention. We discuss the visual-praxis disorder that was found, and assigned to the structure of the MMSE and the bias inherent in the sample, with no confirmable incidence of schooling.

Bone quality and implant design-related outcomes through stage II surgical uncovering of Spectra-System root form implants.

Failure rates at second-stage surgery were reported for the ongoing Dental Implant Clinical Research Group studies of the Spectra-System (Core-Vent Corporation, Las Vegas, NV) implants. As of May 1995, 69 implants failed out of 2,633 placed and uncovered. The overall failure rate was 2.6%, with 3.6% in bone quality 1 (BQ-1), 2.4% in BQ-2, 2.5% in BQ-3, and 3.1% in BQ-4. HA-coated cylinders had the lowest number of failures and titanium alloy baskets the highest. The basket design failed more often in the posterior jaw areas; 9 of 32 clinical centers (28%) accounted for 72% of these failures.

Histological evaluation of periodontal probe penetration in untreated facial molar furcations.

The purpose of this investigation was to histologically determine the position of the periodontal probe tip when probing the deepest interradicular pocket depth in grade II and III facial molar furcation sites. Facial furcation pockets (5.8 mm +/- 1.3) were probed with a pressure-sensitive probe set at 50 g pressure. The probe tip was attached to the tooth with an acid etched composite resin. Surgical block biopsies were removed, fixed, decalcified and processed for histological sectioning. Buccolingual serial sections (6 mu) were cut from 9 biopsies and apicocoronal serial sections were cut from 3 biopsies. The sections were histometrically analyzed. The probe tip penetrated the inflamed furcation connective tissue an average depth of 2.1 mm (+/- 0.6). The probe tip was located 0.4 mm (+/- 1.4) apical to the crest of the interradicular bone. The % of inflammatory cell infiltrate in the connective tissue (ICT) around the probe tip was 56% (+/- 15%). There was no correlation between the % of ICT and the depth of probe penetration. This investigation demonstrated that probing of untreated facial molar furcation sites does not measure the attachment level of the interradicular root surfaces, but rather records the depth of probe penetration into the inflamed furcation connective tissue.

Hematologic and surgical management of the dental patient with plasminogen activator deficiency.

Anticoagulation therapy is used to treat patients with a variety of hemostatic disorders in an attempt to prevent thrombus formation. A thorough understanding of the patient's medical history is essential before dental treatment that may require alteration of this anticoagulation therapy. Alteration of anticoagulation therapy should be undertaken only after consultation with the patient's physician because some patients are at greater risk than others for thrombus formation or hemorrhage. This case of a 29-year-old man with plasminogen activator deficiency illustrates how consultation can result in a coordinated treatment plan for medical and dental management formulated to help ensure safe surgical treatment for these medically compromised patients.

Inter-examiner reproducibility of probing pocket depths in molar furcation sites.

This investigation was designed to determine the reproducibility of probing pocket depths in maxillary facial and mandibular facial and lingual grade II and III molar furcation sites. 80 untreated molar teeth with 102 furcation invasions due to periodontitis were probed with a pressure-sensitive periodontal probe by 3 examiners. 8 sites per furcation were measured by each examiner at a single examination. The sequence of examiner probing was rotated in order to evaluate the effect of sequential probing. Tracings were made from radiographs of the inter-root separations in order to classify the interradicular space and to determine the effect of root separation on reproducibility. Data was analyzed by regression analysis. Pearson correlations, intraclass correlations, and the Student-Newman-Keuls test. Analysis indicated a high reproducibility of the maxillary facial and mandibular facial and lingual furcation sites in this untreated adult sample. No effect was due to probing sequence. The mid-root prominences, the line angles, and the internal surface sites of the furcation roots were recordable and reproducible, while the horizontal measurements were not consistently recordable. The reproducibility of the facial and lingual furcation sites that were probed decreased with an increase in probing pocket depth and an increased degree of root separation.