Peer Assessment Rating (PAR) scoring of cleft patients treated within a regional cleft centre in the United Kingdom

2021 ◽  
pp. 146531252110367
Author(s):  
Claire Furness ◽  
Helen Veeroo ◽  
Giles Kidner ◽  
Martyn T Cobourne
Keyword(s):  
Cleft Lip ◽  
Peer Assessment ◽  
Post Treatment ◽  
Percentage Change ◽  
Lower Percentage ◽  
Median Percentage ◽  
Hospital Units ◽  
Before And After ◽  
Pre Treatment ◽  
Peer Assessment Rating

Objective: To assess static occlusal outcomes for patients with cleft lip and/or palate (CLP) and cleft palate (CP) managed within a UK Regional Cleft Service and to compare with previously published Peer Assessment Rating (PAR) scores from a non-cleft population of patients treated within a UK consultant-led hospital service. Design: Retrospective multicentre study. Setting: Eight orthodontic hospital units within the Spires Cleft Service, UK. Participants: Patients born with CLP or CP between 1985 and 1995 treated within the service. Methods: Patients were assigned to groups by cleft type and whether they were treated by orthodontics only or a combination of orthodontics and orthognathic surgery. PAR was recorded before and after treatment from study models. Results: Data were collected for 171 patients included in the study. Median pre-treatment PAR was 42 and post-treatment 11. Median percentage change in PAR for all patients was 73%, although 12% of cleft patients had a PAR improvement that was worse or no different. Median change in PAR score was 71% for those treated with orthodontics only and 83% for those who had an osteotomy. Median PAR improvement for those treated with orthodontics only was 73% in the cleft lip group, 77% in the CP group, 66% in the unilateral CLP group and 53% in the bilateral CLP group. Median pre- and post-treatment PAR for the cleft group was higher and PAR reduction lower than those published for non-cleft patients. Conclusion: These data demonstrate high severity of malocclusion, complexity of orthodontic treatment and difficulty in achieving an ideal static occlusion for cleft patients. If PAR is to be used to assess orthodontic outcomes in cleft patients the findings of this study should be considered. A higher proportion of cases are likely to be classed as ‘worse or no different’, and a lower percentage change will be expected.

An Overview of the Peer Assessment Rating (Par) Index for Primary Dental Care Practitioners

2016 ◽  
Vol 5 (4) ◽  
pp. 28-37
Author(s):  
James Ij Green
Keyword(s):  
Dental Care ◽  
Peer Assessment ◽  
Post Treatment ◽  
Posterior Teeth ◽  
Contact Points ◽  
Par Index ◽  
Treatment Models ◽  
The Difference ◽  
Pre Treatment ◽  
Peer Assessment Rating

The Peer Assessment Rating (PAR) index is a valid and reliable measure of orthodontic treatment outcome and is the most widely accepted such index. Assessing outcomes with the PAR index requires the examination of pre-treatment and post-treatment orthodontic study models. Beginning with the pre-treatment models, a score is given to each feature that deviates from an ideal occlusion (all anatomical contact points adjacent, good interdigitation between posterior teeth and non-excessive overjet/overbite), the scores are then added together to give a total that represents the severity of the malocclusion. The process is then repeated with the post-treatment models. The difference between the pre-treatment and the post-treatment scores reflects the improvement that has taken place during treatment. A score of zero represents an ideal occlusion and in general the higher the score, the more extensive the malocclusion. It is currently a condition of the NHS orthodontic contract for providers to monitor a proportion of their cases using the PAR index. This paper aims to provide primary dental care practitioners with an overview of the PAR index and should provide a useful guide for those wishing to seek calibration in the use of the index.

Cytoprotective Effect of Tocotrienol-Rich Fraction and α-Tocopherol Vitamin E Isoforms Against Glutamate-Induced Cell Death in Neuronal Cells

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0140-0151 ◽  
Author(s):  
Thilaga Rati Selvaraju ◽  
Huzwah Khaza’ai ◽  
Sharmili Vidyadaran ◽  
Mohd Sokhini Abd Mutalib ◽  
Vasudevan Ramachandran ◽  
...  
Keyword(s):  
Vitamin E ◽  
Cell Viability ◽  
Neuronal Cells ◽  
Positive Control ◽  
Post Treatment ◽  
Mitochondrial Activity ◽  
Before And After ◽  
Pre Treatment ◽  
Tocotrienol Rich Fraction ◽  
Major Mediator

Glutamate is the major mediator of excitatory signals in the mammalian central nervous system. Extreme amounts of glutamate in the extracellular spaces can lead to numerous neurodegenerative diseases. We aimed to clarify the potential of the following vitamin E isomers, tocotrienol-rich fraction (TRF) and α-tocopherol (α-TCP), as potent neuroprotective agents against glutamate-induced injury in neuronal SK-N-SH cells. Cells were treated before and after glutamate injury (pre- and post-treatment, respectively) with 100 - 300 ng/ml TRF/α-TCP. Exposure to 120 mM glutamate significantly reduced cell viability to 76 % and 79 % in the pre- and post-treatment studies, respectively; however, pre- and post-treatment with TRF/α-TCP attenuated the cytotoxic effect of glutamate. Compared to the positive control (glutamate-injured cells not treated with TRF/α-TCP), pre-treatment with 100, 200, and 300 ng/ml TRF significantly improved cell viability following glutamate injury to 95.2 %, 95.0 %, and 95.6 %, respectively (p < 0.05).The isomers not only conferred neuroprotection by enhancing mitochondrial activity and depleting free radical production, but also increased cell viability and recovery upon glutamate insult. Our results suggest that vitamin E has potent antioxidant potential for protecting against glutamate injury and recovering glutamate-injured neuronal cells. Our findings also indicate that both TRF and α-TCP could play key roles as anti-apoptotic agents with neuroprotective properties.

scholarly journals Low frequency of pre-treatment and post-treatment haematological abnormalities in dogs with non-infectious meningoencephalitis treated with cytosine arabinoside and prednisolone

2019 ◽  
Vol 6 (1) ◽  
pp. e000315 ◽  
Author(s):  
Sarah Keegan ◽  
Jeremy H Rose ◽  
Zohra Khan ◽  
Francois-Xavier Liebel
Keyword(s):  
Cytosine Arabinoside ◽  
Standard Dose ◽  
Low Frequency ◽  
Post Treatment ◽  
Inclusion Criteria ◽  
Presumptive Diagnosis ◽  
Prednisolone Treatment ◽  
Before And After ◽  
Pre Treatment ◽  
The Uk

BackgroundCytosine arabinoside (CA) and prednisolone are drugs commonly used together in the management of canine non-infectious meningoencephalitis (NIME). The aim of this study was to report the haematological findings before and after CA and prednisolone treatment and identify any adverse haematological events in this clinical setting, following the veterinary cooperative oncology group established common terminology criteria for recording adverse events following administration of chemotherapy or biological antineoplastic therapy.ResultsWhile 48 patients with a presumptive diagnosis of NIME had pretreatment haematology results, only 12 patients met the inclusion criteria of also having post-treatment haematology results available for review after being treated with prednisolone and CA at a standard dose (200 mg/m2) in a single referral hospital in the UK. Forty-nine post-treatment haematology results were available for these 12 patients.ConclusionsFour adverse haematological events were identified in four patients. None of these events were convincingly attributable to CA administration.

OCT-Angiography as a reliable prognostic tool in laser-treated proliferative diabetic retinopathy: The RENOCTA Study

2020 ◽  
pp. 112067212096345
Author(s):  
Marco Lupidi ◽  
Ramkailash Gujar ◽  
Alessio Cerquaglia ◽  
Jay Chhablani ◽  
Daniela Fruttini ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Additional Treatment ◽  
Post Treatment ◽  
Vascular Perfusion ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Pre Treatment ◽  
Induced Changes

Purpose: To quantitatively assess retinal neovascularizations (RNVs) in proliferative diabetic retinopathy (PDR) before and after photocoagulative laser treatment (PLT) using Optical Coherence Tomography Angiography (OCT-A). Methods: Consecutive patients with PDR were examined with fluorescein angiography (FA) and OCT-A before and after PLT. Baseline and after-treatment FA images were quantitatively analyzed to assess both the RNVs area and leakage area. On OCT-A RNVs area, vascular perfusion density (VPD), vessel length density (VLD) and fractal dimension were computed. VPD of the full-retina OCT-A underneath the RNV was determined to evaluate potential laser-induced changes in vascular perfusion. Results: Fifteen eyes of 13 patients with PDR were enrolled. The mean area of the RNVs was 0.47 ± 0.50 mm2 in the baseline OCT-A and 0.32 ± 0.40 mm2 in the post-treatment assessment ( p = 0.0002). The mean RNV VPD of RNV was 2% ± 4% in pre-treatment and 1% ± 1% for the post-treatment ( p = 0.0001). The mean VLD of RNV was 7.26 ± 1.53 at baseline and 6.64 ± 1.65 in the post treatment ( p = 0.0002). A significant difference in terms of mean RNVs area and VPD reduction between eyes that needed additional treatment and those that did not (~40% vs ~20%; p < 0.05), was observed. Mean VPD of full-retinal thickness OCT-angiogram was 55% ± 10% for the pre-treatment and 53% ± 8% for the post treatment scan ( p = 0.02). Conclusion: The quantitative OCT-A assessment of laser-induced changes of RNVs can be a useful non-invasive approach for determining treatment efficacy. A reduction of RNVs area or VPD ⩾ 40% might reveal those eyes that won’t require additional treatment. Retinal perfusion impairment seemed to progress independently from the treatment.

Association of CD133 expression levels with the k-ras mutation status in rectal cancers before and after preoperative radiochemotherapy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 400-400
Author(s):  
Thilo Sprenger ◽  
Jochen Gaedcke ◽  
Lena-Christin Conradi ◽  
Peter Jo ◽  
Klaus Jung ◽  
...  
Keyword(s):  
Stem Cells ◽  
Rectal Cancer ◽  
Prognostic Marker ◽  
Tumor Regression ◽  
Post Treatment ◽  
Preoperative Radiochemotherapy ◽  
Cd133 Expression ◽  
Before And After ◽  
Rectal Cancers ◽  
Pre Treatment

400 Background: The role of the potential stem cell marker CD133 as a predictive or prognostic marker in multimodal rectal cancer treatment is currently under debate. While CD133 has been identified as a prognostic marker in rectal cancers after preoperative radiochemotherapy (RCT) it was recently characterized as a very unspecific feature for colorectal cancer stem cells. We therefore analyzed the association between CD133 expression and mutations in the proto-oncogenes K-Ras and PI3K in rectal cancer patients receiving neoadjuvant RCT. Methods: CD133 expression was evaluated immunhistochemically in pre-treatment biopsies and surgical specimens of 128 patients with locally advanced rectal cancers (cUICC II/III) treated with preoperative RCT within the phase-III German Rectal Cancer Trials. K-Ras mutations were analyzed by sequencing of exons 1, 2, and 3. PI3K mutations were detected by sequencing the p110α subunit (PIK3CA) and correlated with histopathologic parameters, tumor regression and survival. Results: CD133 expression was significantly associated with mutations in the K-Ras gene in both pre-treatment biopsies and post-treatment tumor specimens in uni- and multivariate analyses. However, no significant correlation was observed between CD133 and PI3K mutations. Post-treatment CD133 levels were correlated with neoadjuvant RCT (50.4 Gy/5-FU vs. 50.4 Gy/5-FU+Ox) and tumor regression grading. Anyway, there was no significant association between pre- and post-treatment CD133 expression and disease-free survival. Conclusions: CD133 expression levels are strongly associated with mutations in the K-Ras proto-oncogene in rectal cancers before and after preoperative RCT. Our results strengthen the hypothesis that CD133 is not a specific marker for colorectal stem cells but might be integrated in proliferation pathways like the ras-raf axis.

scholarly journals Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 473
Author(s):  
Maria Francesca Sfondrini ◽  
Paolo Zampetti ◽  
Giulia Luscher ◽  
Paola Gandini ◽  
José Luís Gandía-Franco ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Orthodontic Treatment ◽  
Peer Assessment ◽  
High Standard ◽  
Treatment Method ◽  
Treatment Quality ◽  
Par Index ◽  
Pre Treatment ◽  
High Treatment ◽  
Peer Assessment Rating

Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. Methods: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. Results: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53–20.95), while the percentage reduction was 94.8% (CI 95% 91.91–97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. Conclusions: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes.

Changes in the Oral Health-Related Quality of Life in Infants With Cleft Lip and/or Palate Before and After Surgical Treatment

2021 ◽  
pp. 105566562199328
Author(s):  
Roxana Patricia López Ramos ◽  
Daniel José Blanco Victorio ◽  
Gilmer Torres Ramos ◽  
Mónica J. Pajuelo ◽  
Jenny Abanto
Keyword(s):  
Surgical Treatment ◽  
Oral Health ◽  
Cleft Lip ◽  
Post Treatment ◽  
Health Related Quality ◽  
Before And After ◽  
Related Quality ◽  
Health Related

Objective: To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P). Design: Quasi-experimental study. Methods: A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed. Results: Improvements in infant’s OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores ( P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL ( P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment ( P < .0001). Conclusions: Primary surgical post-treatment resulted in significant improvement of the infant’s OHRQoL with CL/P.

scholarly journals Changes in headache characteristics with oral appliance treatment for obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji Woon Park ◽  
Sujay Mehta ◽  
Sandra Fastlicht ◽  
Alan A. Lowe ◽  
Fernanda R. Almeida
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Oral Appliance ◽  
Post Treatment ◽  
Mandibular Advancement ◽  
Headache Intensity ◽  
Obstructive Sleep ◽  
Before And After ◽  
Pre Treatment

AbstractChanges in headache characteristics in obstructive sleep apnea (OSA) patients following oral appliance treatment was investigated for the first time. Thirteen OSA patients with headaches treated with a mandibular advancement device were investigated. Level I polysomnography and Migraine Disability Assessment Questionnaire were completed before and after treatment. Various headache characteristics and concomitant conditions were analyzed. The patient was considered a headache responder when ≥ 30% reduction in headache frequency following treatment. Differences in headache and polysomnographic parameters were compared between headache responder groups. Eight patients (62%) were headache responders. Eleven patients (85%) before and 7 (54%) after treatment reported morning headaches. Significantly more patients had bilateral headache in the responder group before treatment (P = 0.035). The severest headache intensity (P = 0.018) at baseline showed a significant decrease in the headache responder group after treatment. The time spent in N2 (r = − 0.663, P = 0.014), REM sleep (r = 0.704, P = 0.007) and mean oxygen saturation (r = 0.566, P = 0.044) showed a significant correlation with post-treatment average headache intensity. Pre-treatment lower PLM index (r = − 0.632, P = 0.027) and higher mean oxygen saturation levels (r = 0.592, P = 0.043) were significantly correlated with higher post-treatment severest headache intensity. Treatment with an oral appliance is beneficial for many OSA patients with headaches. It should be considered as an alternative treatment in headache patients with mild to moderate OSA.

scholarly journals Post-azacitidine clone size predicts long-term clinical outcome of patients with myelodysplastic syndromes and related myeloid neoplasms

2021 ◽  
Author(s):  
Seishi Ogawa ◽  
Magnus Tobiasson ◽  
Shinya Sato ◽  
Elsa Bernard ◽  
Shigeki Ohtake ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Outcome ◽  
Clinical Response ◽  
Post Treatment ◽  
Clone Size ◽  
Myeloid Neoplasms ◽  
Mutational Profiling ◽  
Before And After ◽  
Pre Treatment ◽  
Next Generation Sequencing Ngs

Abstract Azacitidine is a mainstay of therapy for high-risk MDS and other myeloid neoplasms. A significant correlation between azacitidine response and clinical outcome suggests a potential role of mutational profiling based on next-generation sequencing (NGS) before and after therapy in evaluating response and predicting overall survival (OS), which however has not fully elucidated. Here through NGS-based mutational profiling of large cohorts (n=451) of azacitidine-treated patients with high-risk MDS and other myeloid neoplasms, we show significant roles of multi-hit TP53 and germline DDX41 mutations in pre-treatment samples and post-treatment clone size in the evaluation/prediction of azacitidine response and OS after azacitidine therapy, which outperformed the prediction based only on clinical response and IPSS-R score. Post-treatment clone size strongly correlated with clinical response with exception of large persistent mutations frequently affecting TET2 after achieving complete remission and those with DDX41 mutations, which poorly correlated with clinical response. Our results highlight the importance of evaluating mutations in both pre- and post-treatment samples in the assessment of response and the prediction of OS after azacitidine therapy.

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