A CAMBRA Model For High Caries Risk Indian Children: A Pragmatic Comprehensive Tailored Intervention

2016 ◽  
Vol 40 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Krishan Gauba ◽  
Ashima Goyal ◽  
Neeti Mittal
Keyword(s):  
Pediatric Dentistry ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Healthy Children ◽  
Caries Risk ◽  
Indian Children ◽  
Carious Lesions ◽  
High Caries Risk ◽  
Set Up

Objective: To evaluate a CAMBRA based therapeutic and preventive model for high caries risk children in a pediatric dentistry clinic set-up. Study design: A total of 100 systemically healthy children aged 4–8 years with dmft/DMFT ≥5 and/or ≤20% magnitude of cariogram sector ‘chance to avoid new cavities’ were enrolled. The program comprised of following components i.e. caries risk assessment, customized preventive interventions (Motivational interviewing and counseling, oral prophylaxis, fluoride varnish, fissure sealants) and restorative procedures. The recall intervals were scheduled on the basis of caries risk i.e. every 1 month (≤40% chance to avoid new cavities) and 3 months (≥41% chance to avoid new cavities). The primary outcome measure was ‘new carious lesions' at 12 months following achievement of ‘termination levels' i.e. ≥41% magnitude of ‘chance to avoid new cavities.' The secondary outcome measures were changes in cariogram parameters at termination and duration needed to achieve termination levels. Results: The program showed 97% success rate as 3/100 subjects developed new carious lesions at 12 months follow up. Highly significant (p<0.001) favorable shift was achieved in cariogram parameters at termination. Termination levels were achieved in 2.71±4.854 months. Conclusions: The present CAMBRA based program with customized intervention and recall schedules showed favorable results.

scholarly journals Salivary 1,5-Anhydroglucitol and Vitamin Levels in Relation to Caries Risk in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Sadatullah Syed ◽  
Syed M. Yassin ◽  
Ali A. Dawasaz ◽  
Mohammed Amanullah ◽  
Ibrahim Alshahrani ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Assessment Tool ◽  
Risk Groups ◽  
Pediatric Dentistry ◽  
Healthy Children ◽  
Caries Risk ◽  
Strong Negative Correlation ◽  
Caries Activity ◽  
High Caries Risk ◽  
Caries Assessment

The objective of this study was to evaluate the association between salivary 1,5-anhydroglucitol (AG), vitamins A (VA), C (VC), and E (VE), and caries risk in children. 100 healthy children aged between 6 and 13 years were divided into two equal groups of caries-free (DMFS/dmfs=0) and caries active (DMFS/dmfs>3). Unstimulated midmorning saliva was collected from all the children and the levels of salivary AG and vitamins A, C, and E were measured. Caries risk assessment was done using American Academy of Pediatric Dentistry Caries Assessment Tool. Analysis of salivary AG and vitamins was performed using a commercially available ELISA kit. Low levels of AG were present in caries active and high caries risk groups compared to caries-free and low/medium caries risk groups. This difference is statistically significant (p < 0.05). A strong negative correlation between AG and caries activity was observed in the caries active group. VA was not related to caries activity, while VC and VE displayed a statistically significant correlation (p < 0.05). Similarly, a strong negative correlation was observed between the levels of AG and high caries risk group. Salivary AG, VC, and VE together are related to caries risk in caries active children. These salivary parameters can act as indicator of caries status in children.

Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology

2021 ◽  
pp. neurintsurg-2021-017341
Author(s):  
Devin V Bageac ◽  
Blake S Gershon ◽  
Jan Vargas ◽  
Maxim Mokin ◽  
Zeguang Ren ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Anterior Circulation ◽  
Guide Catheter ◽  
Catheter Failure ◽  
Catheter Technology ◽  
Intracranial Vasculature

BackgroundMost conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.MethodsThis is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.ResultsEach study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0–2%, and 10.26% were deceased.ConclusionsTracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.

Primary slow-coagulation transscleral cyclophotocoagulation laser treatment for medically recalcitrant neovascular glaucoma

2021 ◽  
pp. bjophthalmol-2021-319757
Author(s):  
Mohamed M Khodeiry ◽  
Alison J Lauter ◽  
Mohamed S Sayed ◽  
Ying Han ◽  
Richard K Lee
Keyword(s):  
Continuous Wave ◽  
Surgical Intervention ◽  
Neovascular Glaucoma ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Slow Coagulation ◽  
Minimum Angle ◽  
Transscleral Cyclophotocoagulation ◽  
Cumulative Probabilities

AimsTo report treatment outcomes of slow-coagulation continuous-wave transscleral cyclophotocoagulation (TSCPC) as an initial surgical intervention in patients with neovascular glaucoma (NVG).MethodsA retrospective study including 53 patients (mean age of 69.6±16.6 years and mean follow-up of 12.7±8.9 months) with a diagnosis of NVG and no previous incisional glaucoma or cyclophotocoagulation surgeries. All patients underwent slow-coagulation continuous-wave TSCPC (1250-milliwatt power and 4-second duration).Primary outcome measure was surgical success defined as an intraocular pressure (IOP) from 6 to 21 mm Hg with a reduction ≥20% from baseline, no reoperation for glaucoma and no loss of light perception vision. Secondary outcome measures include IOP, glaucoma medications, visual acuity (VA) and complications.ResultsIOP decreased from 40.7±8.6 mm Hg preoperatively to 18.4±12.2 mm Hg postoperatively (p<0.001). The preoperative number of glaucoma medications dropped from 3.3±1.1 at baseline to 2.0±1.5 at the last postoperative visit (p<0.001). The cumulative probabilities of success at 12 and 24 months were 71.7% and 64.2 %, respectively. Mean logarithm of the minimum angle of resolution VA was relatively unchanged from 2.27±0.63 to 2.25±0.66 at the last follow-up visit (p=0.618). The most common observed complications were decrease in baseline VA (13.2%) and anterior chamber inflammation (9.4%).ConclusionsSlow-coagulation TSCPC is an effective and relatively safe initial surgical intervention in medically uncontrolled NVG.

Platelet-Rich Plasma versus Corticosteroid Injections in Rotator Cuff Related Shoulder Pain: A Comparative Study with Up to 18 Months of Follow-Up

2021 ◽  
Author(s):  
Juho Annaniemi ◽  
Jüri Pere ◽  
Salvatore Giordano
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Subacromial Injection ◽  
Western Ontario Rotator Cuff ◽  
Feasible Alternative ◽  
Cuff Repair

Abstract Purpose: Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff related shoulder pain (RCRSP).Methods: We retrospectively reviewed a total of 98 patients affected by RCRSP who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at two weeks interval, and the CS group received one injection of CS. Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while secondary outcome measures were the Visual Analogue Scale (VAS), Range of Motion (ROM) and need for cuff repair surgery, which were analyzed at interval of 6, 12, and 18 months.Results: A total of 75 patients were included in the analysis (PRP n = 35, CS n = 40). Mean follow-up was (PRP 21.1 ± 8.7 months vs CS 33.6 ± 16.3 months, p <0.001). Both groups showed improvement in WORC, VAS and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes during 6, 12 and 18 months (all p > 0.05). No adverse events were detected.Conclusion: Both treatments improve RCRSP patient’s symptoms, but none of them seems to result in a significant better outcome in this series of patients. PRP can be a safe and feasible alternative to CS in treatment of RCRSP even at long follow-up, to reduce local and systemic effects involved with CS injections.

scholarly journals Incidence and immediate consequences of electrical shocks among Danish electricians: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046584
Author(s):  
Karin Biering ◽  
Anette Kærgaard ◽  
Ole Carstensen ◽  
Kent Jacob Nielsen
Keyword(s):  
Cohort Study ◽  
Participation Rate ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Exit Point ◽  
Physical Damage ◽  
Electrical Shock ◽  
Health Related ◽  
Electrical Shocks

ObjectivesThe health-related consequences of electrical shocks are mostly studied in patients from selected cohorts in hospital burn units, by making internal comparisons of subgroups, but without comparing them to unexposed individuals, or considering information regarding the preinjury health of the injured persons. Often, little is known about the details of the electrical shocks. Our purpose was to do a longitudinal study of Danish electrical workers, to monitor exposure to electrical shocks weekly over a 6-month period and to determine whether these shocks have short-term, health-related consequences.DesignProspective cohort study with weekly measurements.SettingMembers of the Danish Union of Electricians.ParticipantsOf the 22 284 invited, 6960 electricians (31%) participated in the baseline data collection, and the participation rate in the weekly follow-up ranged from 61% to 81% during the 6 month follow-up.Primary and secondary outcome measuresThe primary outcome measure was an electrical shock and secondary outcomes were the immediate health-related consequences of the shocks.ResultsA total of 2356 electrical shocks were reported by 1612 (23%) of the participants during the 26-week follow-up. Alternating current and voltage below 1000 V were the most common forms of electricity. In most cases, the fingers/hands were the entry and exit points, but many were unable to specify the exit point. The participants categorised 73% of the electrical shocks as ‘not at all severe’, and most of the shocks did not cause any immediate physical damage. However, flashbacks were more common than physical consequences. Only a few of the participants contacted health services following an electrical shock, and even fewer were absent from work.ConclusionNearly one-fourth of Danish electricians experienced one or more electrical shocks during a 26-week period, but most of the shocks are not perceived as severe, and have only limited immediate consequences.

scholarly journals Caries risk assessment of a sample of children attending preventive specialized dental center in Al Resafa, Baghdad

2020 ◽  
Vol 32 (4) ◽  
pp. 17-24
Author(s):  
Zaid N Muhson ◽  
Shaymaa Thabit ◽  
Fatima S Al-ward ◽  
Sahar AE Al Shatari
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Pediatric Dentistry ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Caries Risk ◽  
Care Needs ◽  
Special Health Care ◽  
Carious Lesions ◽  
Special Health

Background: Young children’s oral health maintenance and outcomes are influenced by their parent’s knowledge and beliefs, which affect oral hygiene and healthy eating habits. This study aims at assessing caries risk in children aged 6 months to 6 years attending the Specialized Center of Preventive and Pediatric Dentistry Center at Al-Resafa sector in Baghdad. Materials and Methods: A cross-sectional study was conducted from 15 May – 15 June 2018, all children attended the center (80 children) were assessed by using the standard caries risk assessment tool of the American Academy of Pediatric Dentistry (AAPD). Results: The highest percentage of children was as follows: no fluoride exposure 44(55%), did not brush 46(57.5%), had no special health care needs 77(96.25%), had no missed teeth due to caries 51(63.75%), had no-visible plaque 52(65%), frequent or prolonged between-meal exposure/day 55(68.75%), their mothers had carious lesions in last 7-23 months 34(42.5%); in visual caries: had carious lesions or restorations in last 24 months 67(83.75%), while the incipient carious lesions in last 24 months were 50(62.50%). Most of risk assessment score for the participants was moderate 57(71.3%), followed by low risk 16(20%), while the participants with high risk were 7(8.8%), with a statistically significant association between the risk assessment score and fluoride exposure (p=0.043), sugary foods or drinks(p=0.038), caries experience of the mothers (p=0.001), brushing (p=0.020) visual caries (p=0.000), incipient caries (p= 0.000), missing teeth due to caries (p= 0.001), but no statistical significance with special health care needs (p=0.533) and visible plaque (p=0.259). Conclusion: Moderate-risk of developing dental caries was predominant among the participants, followed by low-risk and less high-risk categories.

scholarly journals Hybrid Polyetheretherketone (PEEK)–Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up

2020 ◽  
Vol 9 (7) ◽  
pp. 2187 ◽  
Author(s):  
Miguel de Araújo Nobre ◽  
Carlos Moura Guedes ◽  
Ricardo Almeida ◽  
António Silva ◽  
Nuno Sereno
Keyword(s):  
Bone Loss ◽  
Subjective Evaluation ◽  
Acrylic Resin ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Marginal Bone Loss ◽  
Mechanical Complications ◽  
Hybrid Prosthesis ◽  
Technical Complication

Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.

scholarly journals Prognostic value of reduction in left atrial size during a follow-up of heart failure: an observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044409
Author(s):  
Masayuki Shiba ◽  
Takao Kato ◽  
Takeshi Morimoto ◽  
Hidenori Yaku ◽  
Yasutaka Inuzuka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lower Risk ◽  
Left Atrial ◽  
Primary Outcome ◽  
Outcome Measure ◽  
No Reduction ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Group Change

ObjectiveThe association between sequential changes in left atrial diameter (LAD) and prognosis in heart failure (HF) remains to be elucidated. The present study aimed to investigate the link between reduction in LAD and clinical outcomes in patients with HF.DesignA multicentre prospective cohort study.SettingThis study was nested from the Kyoto Congestive Heart Failure registry including consecutive patients admitted for acute decompensated heart failure (ADHF) in 19 hospitals throughout Japan.ParticipantsThe current study population included 673 patients with HF who underwent both baseline and 6-month follow-up echocardiography with available paired LAD data. We divided them into two groups: the reduction in the LAD group (change <0 mm) (n=398) and the no-reduction in the LAD group (change ≥0 mm) (n=275).Primary and secondary outcomesThe primary outcome measure was a composite of all-cause death or hospitalisation for HF during 180 days after 6-month follow-up echocardiography. The secondary outcome measures were defined as the individual components of the primary composite outcome measure and a composite of cardiovascular death or hospitalisation for HF.ResultsThe cumulative 180-day incidence of the primary outcome measure was significantly lower in the reduction in the LAD group than in the no-reduction in the LAD group (13.3% vs 22.2%, p=0.002). Even after adjusting 15 confounders, the lower risk of reduction in LAD relative to no-reduction in LAD for the primary outcome measure remained significant (HR 0.59, 95% CI 0.36 to 0.97 p=0.04).ConclusionPatients with reduction in LAD during follow-up after ADHF hospitalisation had a lower risk for a composite endpoint of all-cause death or HF hospitalisation, suggesting that the change of LAD might be a simple and useful echocardiographic marker during follow-up.

scholarly journals A Clinical Report of Functional and Esthetic Oral Rehabilitation in a High-caries-risk Child: One-year follow-up

2016 ◽  
Vol 19 (1) ◽  
pp. 125 ◽  
Author(s):  
Kamila Rosamilia Kantovitz ◽  
Anna Maria Cia Papa ◽  
Patrícia Almada Sacramento ◽  
Maria Beatriz Duarte Gavião ◽  
Regina Maria Puppin-Rontani ◽  
...  
Keyword(s):  
Dental Caries ◽  
Dietary Habits ◽  
Open Bite ◽  
Clinical Report ◽  
Caries Risk ◽  
Oral Rehabilitation ◽  
Facial Esthetics ◽  
High Caries Risk ◽  
Risk Child

<p>This case discusses a multi-disciplinary approach to oral functional and esthetic rehabilitation on a high-caries-risk child with prematurely lost primary teeth due to endodontic complications associated with wide-spread dental caries. The patient was diagnosed with an anterior open bite and atypical swallowing. He exhibited anxiety and low self-esteem due to esthetic impairment. A combination of targeted clinical procedures, a focus on oral home care and active parental involvement was integral to the treatment process. The patient was examined monthly by a pediatric dentist regarding dietary habits, fluoride exposure, biofilm presence, caries prevalence, and malocclusion. Improvement was evident in patient’s masticatory function, facial esthetics, and psychological behavior at a 12-month follow-up evaluation.</p><p><strong>Keywords</strong></p><p>Deciduous; Dental Caries; Mouth Rehabilitation; Tooth.</p>

scholarly journals Multicentric caries prevention program: Mechanical control of dental plaque through periodic professional oral prophylaxis. A 10 years follow up

2014 ◽  
Vol 2 (3) ◽  
pp. 215
Author(s):  
José Eduardo De Oliveira Lima ◽  
Cristiane Almeida Baldini Cardoso ◽  
Gladis Benjamina Grazziotin ◽  
Heitor Marques Honório ◽  
Ronize Fátima Pigosso Mocelini ◽  
...  
Keyword(s):  
Dental Caries ◽  
Prevention Program ◽  
Dental Plaque ◽  
Pediatric Dentistry ◽  
Preventive Strategy ◽  
Mechanical Control ◽  
Carious Lesions ◽  
Absence Rate ◽  
Biological Equilibrium

AIM: To verify the incidence of dental caries in a multicentric prevention program applied in pediatric dentistry clinics from different regions of Brazil for 10 years, and compare with results obtained by previous studies. MATERIAL AND METHODS: 697 children of both genders, ranging from 30 months to 15 years, were included in a primary preventive strategy program for mechanical control of dental plaque through professional prophylaxis (sodium bicarbonate jet on a monthly schedule). Diagnosis of carious lesions was assessed by monthly clinical examinations and annual radiographs. This procedure aimed to provide a biological equilibrium without producing undesirable side effects.  RESULTS: The average age of children at beginning of the program was 81.71 months. Before entering the program the children presented an average of 2.66 lesions/surface, while during the program the average was 0.20 lesions/surface; the incidence rate of caries per year before starting the program was on average 0.62 lesions/surface while during the program it was 0.05 lesions/surface; the time of permanence in the program was on average 44.15 months and the absence rate was 0.14 per year. CONCLUSION: The results confirm the effectiveness of the program, even when applied by different professionals and in different groups of children, turning it into an indispensible method for the control of dental caries.

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