A retrospective long-term comparison of early RME-facemask versus late Hybrid-Hyrax, alt-RAMEC and miniscrew-supported intraoral elastics in growing Class III patients

Abstract Background Class III malocclusion is associated with high sexual dimorphism, especially in individuals older than 13 years of age, with significant differences in growth between males and females during the pubertal and postpubertal stages, and in adulthood. The aim of this research was to examine differences between males and females in long-term stability (10 years) of treatment for skeletal Class III malocclusion. Methods Thirty patients (15 males and 15 females) with skeletal Class III malocclusion, who had been treated with rapid maxillary expansion (RME) combined with face mask protraction followed by fixed appliances, were selected sequentially. Thirty patients (15 males and 15 females) with skeletal Class I and mesofacial patterns treated only with fixed appliances for dental problems served as the control group. Differences between groups and sexes were evaluated using lateral cephalograms taken at the start of treatment (T0), immediately after the end of treatment (T1), and after 10 years (T2). The long-term treatment success rate was calculated. Results Ten years after Class III treatment, overjet and overbite relapse occurred similarly in females (− 0.68 ± 0.7 mm; − 0.38 ± 0.75 mm, respectively) and males (− 1.09 ± 1.47 mm; − 0.64 ± 0.9 mm, respectively); the ANB angle and Wits appraisal became significantly more negative in males (− 1.37 ± 1.06°; − 2.7 ± 2.53 mm) than in females (− 0.18 ± 1.26°; − 0.46 ± 1.94 mm). The success rate was 73.3% in males and 80% in females. Conclusions Significant differences in the long-term stability of Class III treatment outcomes have been found between males and females, with a larger skeletal Class III relapse and lower long-term success rates in males.

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Outcomes associated with modern treatment paradigms in connective tissue disease (CTD)-associated pulmonary arterial hypertension (PAH): a meta-analysis of randomized controlled trials (RCTs)

European Heart Journal ◽

10.1093/ehjci/ehaa946.2282 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

V McLaughlin ◽

C Zhao ◽

J.G Coghlan ◽

L.S Chung ◽

S.C Mathai ◽

...

Keyword(s):

Drug Treatment ◽

Treatment Effect ◽

Meta Analysis ◽

Response To Treatment ◽

Funding Source ◽

Class Iii ◽

Inclusion Criteria ◽

Private Company ◽

Mortality Event

Abstract Background CTD-PAH has historically represented a PAH subtype with poor prognosis. New therapies, as well as combination therapy approaches targeting multiple pathways have been approved for PAH based on RCTs. CTD-PAH patients comprise a subgroup of the RCT populations and efficacy analyses are based on subgroup analyses which can be less reliable than the overall analysis. We conducted a meta-analysis of RCTs of approved PAH therapies to evaluate outcomes of patients with CTD-PAH. Purpose To use meta-analysis to determine response to treatment in patients with CTD-PAH. Methods The PubMed and EMBASE databases were searched for English-only articles published between January 1, 2000 and November 25, 2019. Inclusion criteria were multicenter RCTs that enrolled adults with WHO group 1 pulmonary hypertension (PAH); enrollment in 2000 or later; long-term clinical morbidity and/or mortality event or 6-minute walk distance (6MWD) as an efficacy endpoint reported for ≥30 patients with CTD-PAH; and evaluation of a US Food and Drug Administration-approved PAH therapy. The primary outcomes were treatment effect as measured by the study time to first morbidity or morality event and change in 6MWD from baseline to between 3–6 months, per the data provided in each article. Results from individual studies were combined using a random-effects model for overall study population (PAH patients) and the subgroup of CTD-PAH patients. Results Ten RCTs (N=4329 PAH patients; n=1263 (29%) with CTD-PAH) met inclusion criteria and were included in the meta-analysis. At baseline, PAH patients had a mean age of 50 years, approximately 78% were female, and approximately 58% had functional class III or IV disease. These characteristics were balanced between treatment and control groups. Baseline 6MWD was 356 m for the overall population and 337 m for patients with CTD-PAH. Five RCTs (N=3172; n=941 with CTD-PAH [30%]) reported hazard ratios (HRs) for time to a morbidity or mortality event by drug treatment and PAH etiology: overall population HR=0.63 (95% confidence interval [CI], 0.56–0.72; P<0.001); CTD-PAH population HR=0.64 (95% CI, 0.51–0.80; P<0.001) (Figure). Nine RCTs reported mean change with drug treatment from baseline to 3 to 6 months in 6MWD for PAH and CTD patients: 33.9 m (95% CI, 21.9–45.9; P<0.001) in the overall population; 20.2 m (95% CI, 10.8–29.7; P<0.001) in CTD-PAH patients. Conclusions The improvement in 6MWD in patients with CTD-PAH is smaller than in those with other types of PAH, perhaps reflecting comorbidities and CTD-induced mobility constraints, independent of their cardiopulmonary capacity. Data from long term clinical morbidity/mortality endpoint studies in this large group of patients with CTD-PAH demonstrate that these patients derive significant benefit from currently available PAH therapies which, in many patients, comprised the addition of a drug targeting a second or third pathway involved in the pathophysiology of PAH. Treatment effect on morbidity/mortality Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Actelion Pharmaceuticals US, Inc.

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Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1067/mod.2003.44 ◽

2003 ◽

Vol 123 (3) ◽

pp. 306-320 ◽

Cited By ~ 162

Author(s):

Patricia Vetlesen Westwood ◽

James A. McNamara ◽

Tiziano Baccetti ◽

Lorenzo Franchi ◽

David M. Sarver

Keyword(s):

Rapid Maxillary Expansion ◽

Class Iii ◽

Long Term Effects ◽

Maxillary Expansion ◽

Fixed Appliances ◽

Class Iii Treatment

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Abstract 2068: Systematic Undersized Rigid Ring Decreases Recurrence Rate Following Repair of Ischemic Mitral Valve

Circulation ◽

10.1161/circ.116.suppl_16.ii_448-a ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Raphaël Fontaine ◽

Denis Bouchard ◽

Philippe Demers ◽

Raymond Cartier ◽

Michel Carrier ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Recurrence Rate ◽

Nyha Class ◽

High Recurrence Rate ◽

Class Iii ◽

Term Survival ◽

Rigid Ring

Introduction: Chronic ischemic mitral regurgitation (MR) has been associated with poor long-term survival. Suboptimal midterm results have been a growing concern in the surgical community. In recent years, our approach to repair those valves has evolved to a standardized technique using complete, rigid and small annuloplasty rings. This study aims to compare this systematic approach with our prior experience from 1996 –2001 where recurrent MR rate was high. Methods: 129 patients underwent repair for pure ischemic mitral valve regurgitation between 2002 and 2005 at our institution. Of these patients, 99 had clinical and echographic follow-up. These patients were compared to the 1996 –2001 cohort of 73 patients. Results: Preoperatively, 84% of patients were in NYHA class III or IV, 17% had moderate MR, 83% had moderate-severe to severe MR. Sixteen were redo operations, mostly of previous CABG. All patients except one were treated with a complete rigid ring (Annuloflo 46.5%, Physioring 34.9%, Etlogix 13.9%, others 3.8%). Ring size was: 24 (0.8%); 26 (55.8%); 28 (38%); or 30 (4.5%). Mortality was 8.5% at 30 days, 14.7% at 1 year and 17.8% at 2 years. Immediate postoperative regurgitation was absent or trace in all patients. Freedom from reoperation was 97%. Mean postoperative NYHA class was 1.15 at a mean follow-up of 28 months. Recurrent moderate mitral regurgitation (2+) was 15.34%, severe mitral regurgitation (3+ to 4+) was 13.4% at a mean follow-up of 16 months. In the 73 patients from the period 1996 –2001 at the same echo follow-up time, the moderate and severe recurrence were: 37% and 21%. The decrease in the recurrence rate was highly significant (p=0.001). Conclusion: A more standardized approach to ischemic mitral valve repair has improved the high recurrence rate previously reported by our group. Long-term follow-up is necessary to confirm these findings.

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Clinical and Histologic Evaluation of Using Block Xenograft Combined With Leukocyte-Platelet Rich Fibrin (L-PRF) Versus Intraoral Autogenous Bone Block Graft With L-PRF in Treating Localized Ridge Defects: A Randomized Clinical Trial

Perio J ◽

10.26810/perioj.2021.a2 ◽

2021 ◽

Vol 5 (1) ◽

pp. 11-21

Author(s):

Ahmed Y. Gamal ◽

Shahinaz G. Elashiry ◽

Fatma H. Eldemerdash ◽

Omar M. Elnashar

Keyword(s):

Alveolar Bone ◽

Autogenous Bone ◽

Bone Block ◽

Bone Augmentation ◽

Class Iii ◽

Platelet Rich Fibrin ◽

Oral Implants ◽

Histologic Evaluation

Background: Augmentation of vertical bone defects remains the corner stone in periodontal tissue engineering. The amount and quality of alveolar bone available in all dimensions affects the success of dental implants for restoration of edentulous areas. Adequate and healthy bone supports the degree of osseointegration which in turn affects the long-term success of oral implants. The primary aim of the study was to histologically evaluate autogenous block grafts versus synthetic block grafts for the treatment of atrophic vertical and horizontal bony defects (Siebert Class III) in the anterior esthetic zone of the mouth. The secondary aim was to clinically and radiographically evaluate the outcomes of the procedure. Methods: This was a randomized controlled clinical study with a statistically determined sample size of 10 patients per group and a total of 20 patients in both groups. Patients with vertical and horizontal bone loss were enrolled from the Department of Oral Medicine, Periodontology, and Oral Diagnosis of Ain Shams University and Misr International University. Bone augmentation procedures were performed using two techniques: autogenous bone block graft and xenograft bone block graft both with leukocyte-platelet rich fibrin (L-PRF). Results: Both autogenous and xenograft blocks in conjunction with L-PRF had a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region. Conclusion: Both autogenous and xenograft bone blocks in conjunction with L-PRF have a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region.

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Changes to the Population Status of Horned Grebes (Podiceps auritus) and Red-necked Grebes (Podiceps grisegena) in Southwestern Manitoba, Canada

The Canadian Field-Naturalist ◽

10.22621/cfn.v131i4.2069 ◽

2018 ◽

Vol 131 (4) ◽

pp. 317-324

Author(s):

Gord Hammell

Keyword(s):

Field Studies ◽

Quantitative Information ◽

Class Iii ◽

Population Status ◽

Breeding Bird ◽

Breeding Populations ◽

Trend Data ◽

Podiceps Grisegena ◽

Long Term Trend

Continental trend data for North America suggest that Horned Grebe (Podiceps auritus) breeding populations are declining and Red-necked Grebe (P. grisegena) populations are increasing. However, data reliability is low due to lack of survey routes in the northern boreal and taiga ecozones, areas encompassing much of the breeding range of both species. Locally in the southern Manitoba prairie ecozone, reliability of long-term trend data is also considered low and these data suggest that Horned Grebe populations are declining faster than the continental trend and that Red-necked Grebe populations are increasing rapidly. The lack of current quantitative information on population densities of these two species in southern Manitoba prompted me to compare 1970s historical data from two sites to recent data collected at the same locations in 2008–2016. I surveyed 42 (1970–1972) and 38 (2008–2016), and 144 (2009–2015) Class III-V wetlands at Erickson and Minnedosa, Manitoba, respectively. Historical Minnedosa data were available from previous field studies. At both locations, Horned Grebe breeding populations have fallen significantly, and Red-necked Grebe populations have risen significantly since the 1970s. The results of this study corroborate the Breeding Bird Survey’s trend data for Horned and Red-necked Grebes in southwestern Manitoba pothole habitat.

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Bariatric Surgery in Cirrhotic Patients: Is It Safe?

Obesity Surgery ◽

10.1007/s11695-019-04214-7 ◽

2019 ◽

Vol 30 (4) ◽

pp. 1241-1248 ◽

Cited By ~ 4

Author(s):

Hafsa Younus ◽

Amit Sharma ◽

Rosa Miquel ◽

Alberto Quaglia ◽

Subba Rao Kanchustambam ◽

...

Keyword(s):

Bariatric Surgery ◽

Liver Disease ◽

Postoperative Complications ◽

Length Of Stay ◽

Class Iii ◽

Alcoholic Fatty Liver ◽

Long Term Outcome ◽

Bariatric Patients ◽

Cirrhotic Patients

Abstract Introduction Ten percent of cirrhotic patients are known to have a high risk of postoperative complications. Ninety percent of bariatric patients suffer from non-alcoholic fatty liver disease (NAFLD), and 50% of them may develop non-alcoholic steatohepatitis (NASH) which can progress to cirrhosis. The aim of this study was to assess whether the presence of cirrhosis at the time of bariatric surgery is associated with an increased rate and severity of short- and long-term cirrhotic complications. Methods A cohort of 110 bariatric patients, between May 2003 and February 2018, who had undergone liver biopsy at the time of bariatric surgery were reassessed for histological outcome and divided into two groups based on the presence (C, n = 26) or absence (NC, n = 84) of cirrhosis. The NC group consisted of NASH (n = 49), NAFLD (n = 24) and non-NAFLD (n = 11) liver histology. Medical notes were retrospectively assessed for patient characteristics, development of 30-day postoperative complications, severity of complications (Clavien-Dindo (CD) classification) and length of stay. The C group was further assessed for long-term cirrhosis-related outcomes. Results The C group was older (52 years vs 43 years) and had lower BMI (46 kg/m2 vs 52 kg/m2) and weight (126 kg vs 145 kg) compared to the NC group (p < 0.05). The C group had significantly higher overall complication rate (10/26 vs 14/84, p < 0.05) and severity of complications (CD class ≥ III, 12% vs 7%, p < 0.05) when compared to the NC group. The length of stay was similar between the two groups (5 days vs 4 days). The C group had significant improvement in model end-stage liver disease scores (7 vs 6, p < 0.01) with median follow-up of 4.5 years (range 2–11 years). There were no long-term cirrhosis-related complications or mortality in our studied cohort (0/26). Conclusion Bariatric surgery in cirrhotic patients has a higher risk of immediate postoperative complications. Long-term cirrhosis-related complications or mortality was not increased in this small cohort. Preoperative identification of liver cirrhosis may be useful for risk stratification, optimisation and informed consent. Bariatric surgery in well-compensated cirrhotic patients may be used as an aid to improve long-term outcome.

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Relapse recovery

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000653 ◽

2019 ◽

Vol 7 (2) ◽

pp. e653 ◽

Cited By ~ 4

Author(s):

Orhun H. Kantarci ◽

Burcu Zeydan ◽

Elizabeth J. Atkinson ◽

Brittani L. Conway ◽

Carmen Castrillo-Viguera ◽

...

Keyword(s):

Term Treatment ◽

Benign Disease ◽

Good Recovery ◽

Class Iii ◽

Early Recovery ◽

Double Blind ◽

Delayed Treatment ◽

Long Term Treatment ◽

Edss Score

ObjectiveTo determine whether basing the decision to initiate immediate vs delayed disease-modifying therapy (DMT) on extent of recovery after initial relapse affects long-term disability accumulation in a multiple sclerosis (MS) evidence-based setting.MethodsWe analyzed the double-blind, placebo-controlled interferon beta-1a 30 mc once a week in clinically isolated syndrome and 10-year-follow-up extension trial. Good recovery after presenting relapse was defined as (1) full early recovery within 28 days of symptom onset (Expanded Disability Status Scale [EDSS] score of 0 at enrollment maintained ≥6 months) and (2) delayed good recovery (EDSS score > 0 at enrollment and improvement from peak deficit to 6th-month or 1-year visit ≥ median). Time from recovery assignment to future disability (EDSS score ≥ 2.5 or ≥4.0) was studied on a relapse-recovery-stratified age axis and immediate vs 3-year delayed treatment initiation with Kaplan-Meier statistics and hazard ratios (HRs).ResultsOne hundred seventy-five/328 patients had good recovery (94 immediate and 81 delayed treatment); 153 did not have good recovery (77 immediate and 76 delayed treatment). HRs for EDSS score ≥2.5 outcome were: delayed treatment without good recovery as reference (HR = 1.0), delayed treatment with good recovery (HR6th-month: 0.67, p = 0.207; HR1st-year: 0.40, p = 0.027), immediate treatment without good recovery (HR6th-month: 0.56, p = 0.061; HR1st-year: 0.40, p = 0.011), and immediate treatment with good recovery (HR6th-month: 0.43, p = 0.014; HR1st-year: 0.48, p = 0.034). Placebo patients were switched to long-term treatment after 3 years, and insufficient EDSS score ≥4.0 outcome events were available to study.ConclusionsIn patients with MS presenting without good recovery after the initial relapse, immediate DMT initiation favorably influences the likelihood of more ambulatory-benign disease akin to patients with good recovery after the initial relapse.Classification of evidenceThis study provides Class III evidence that for patients with MS without good recovery after the initial relapse, immediate DMT initiation increases the likelihood of a benign disease course.

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Optimizing Anterior Implant Esthetics With a Vascularized Interpositional Periosteal Connective Tissue Graft for Ridge Augmentation: A Case Report

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00264 ◽

2018 ◽

Vol 44 (4) ◽

pp. 267-276

Author(s):

Cimara Fortes Ferreira ◽

Edival de Magalhães Barreto ◽

Barbara Zini

Keyword(s):

Connective Tissue ◽

Soft Tissues ◽

Treatment Plan ◽

Class Iii ◽

Anterior Maxilla ◽

Ridge Augmentation ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Close Cooperation

Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert Class III with malaligned implants in the esthetic zone resolved with a cost-modified treatment plan to reestablish esthetics in the anterior maxilla using a rotated palatal flap. The vascularized interpositional periosteal connective tissue graft was effective in augmenting the soft tissue in the esthetic zone and remained stable over a 2-year period. Additional long-term clinical studies are necessary to support these results.

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