scholarly journals Indications, advantages, disadvantages and effectiveness of Invisalign aligners

2021 ◽  
Author(s):  
Mohamed A. A. Hosny ◽  
Fahad S. Alasmari ◽  
Nada M. Alsaidi ◽  
Hanin M. Alsharif ◽  
Sewar A. Alshareef ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Outcomes ◽  
Periodontal Diseases ◽  
Gingival Tissue ◽  
Current Evidence ◽  
Clinical Settings ◽  
Technological Advances ◽  
Fixed Appliances ◽  
To Receive ◽  
Toxic Reactions

As a result of the increasing demands to enhance esthetics among the different community populations, many efforts have focused on innovating other substitutes to increase patients’ satisfaction and to obtain better clinical outcomes. Among the variously proposed candidates, clear aligners are now commonly reported and used within clinical settings. Additionally, technological advances are also significant in this field. In this literature review, we aim to discuss the indications, advantages, disadvantages and the effectiveness of Invisalign braces. Typically, the ideal patients that are indicated to receive Invisalign systems are adult patients with either incisor flaring, spacing, crowding, infra- or supra-positions. Although time-consuming, Invisalign systems are reported with reduced adverse events and toxic reactions with the gingival tissue, minimizing the risk of developing periodontal diseases. However, Although Invisalign modalities are associated with fewer adverse events and reduced gingival inflammation and plaque formation. Previous studies have demonstrated that the outcomes might be similar when patients with fixed appliances are educated about properly conducting oral hygienes. Besides, improved healing of the periodontal ligament was also reported with the modality. Therefore, better clinical outcomes are expected with the modality. Furthermore, studies have also demonstrated similar effectiveness between Invisalign and fixed appliances while the most accurately obtained tooth movements with Invisalign might include retrusion, rotations, fan-type expansions and protrusions. Further investigations are urgently needed for further validation of the current evidence.

scholarly journals The association between osteoarthritis and invasive treatment and clinical outcomes in 6.5 million patients presenting with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Parmar ◽  
M Mohamed ◽  
R Wilkie ◽  
M Mamas
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adverse Events ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Major Bleeding ◽  
Management Strategies ◽  
Lower Likelihood ◽  
To Receive ◽  
Invasive Management

Abstract Background People with osteoarthritis (OA) have an increased risk of cardiovascular disease, including acute myocardial infarction (AMI). Despite OA being the most common joint condition and the fastest increasing major health condition, there is limited information on the management strategies and subsequent outcomes of OA patients presenting with AMI. Purpose To describe the association between OA and invasive management strategies (including coronary angiography (CA), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG)) and clinical outcomes. Methods We analysed all hospitalisations for AMI between 2004 and 2015 recorded in the National Inpatient Sample (NIS), the largest inpatient electronic health record database in the United States. The proportion of patients receiving CA, PCI, and CABG were compared between patients with and without OA, as were the proportions of in-hospital adverse events including major acute cardiovascular and cerebrovascular events (MACCE; composite of mortality, cardiac complications and acute stroke), in-hospital mortality, stroke, and major bleeding. Multivariate logistic regression modelling with adjustment for potential confounders (demographics, medical history, and comorbidities) was performed to examine associations between OA and in-hospital clinical outcomes; results are expressed as adjusted odds ratios (AdjOR) with 95% confidence intervals (95% CI). Results A total of 6,561,940 people were hospitalised for AMI between January 2004 and September 2015, of which 444,217 (6.8%) had a concurrent diagnosis of OA. On average, those with OA were older (median: 77 vs. 67 years), more likely to be female (55.7% vs. 38.6%), and less likely to receive CA (55.3% vs. 65.2%), PCI (33.3% vs. 43.6%), and CABG (7.4% vs. 8.5%) (Figure 1A, p<0.001 for all). After adjustment for confounders, OA was associated with a lower likelihood of receiving CA (AdjOR 0.89; 95% CI 0.87, 0.90), PCI (0.85; 0.84, 0.87), and CABG (0.92; 0.90, 0.94). With reference to outcomes, OA was associated with lower likelihood of in-hospital adverse events (MACCE: AdjOR 0.71; 95% CI 0.69, 0.72; in-hospital mortality: 0.69; 0.67, 0.71; stroke: 0.81; 0.77, 0.85; and major bleeding: 0.73; 0.70, 0.75) (Figure 1B, p<0.001 for all). Conclusion In a national cohort of AMI hospitalisations, patients with OA were less likely to receive invasive management compared to those without OA. However, they were also less likely to experience adverse events. Further work is required to investigate treatment disparities in this increasingly prevalent patient group when presenting with AMI. Figure 1 Funding Acknowledgement Type of funding source: None

Abstract 110: Disparities in TTE Surveillance of Mitral Regurgitation

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Varsha K Tanguturi ◽  
Vijeta Bhambhani ◽  
Michael Picard ◽  
Katrina Armstrong ◽  
Jason Wasfy
Keyword(s):  
Mitral Regurgitation ◽  
Clinical Outcomes ◽  
Ventricular Remodeling ◽  
Demographic Data ◽  
Income Level ◽  
Left Ventricular ◽  
Valvular Disease ◽  
Time Interval ◽  
Technological Advances ◽  
To Receive

Valvular heart disease continues to be a significant burden to the U.S. population, and is likely to increase over the next several decades. While major technological advances have been made in repairing or replacing degenerating valves, improved outcomes have not affected all segments of society equally. The source of this disparity in outcomes after treatment of valvular disease is unknown. As clinical outcomes after surgical treatment of valvular disease, and especially mitral regurgitation (MR), are worse if intervention occurs after deterioration of left ventricular (LV) size and function, trans-thoracic echocardiographic (TTE) surveillance of patients with MR is indicated to avoid adverse ventricular remodeling. We hypothesized that patients at a lower socioeconomic status were less likely to receive TTE surveillance for MR within the appropriate guideline-indicated interval. We obtained records of all TTEs from 2001-2016 ordered at a large echocardiography laboratory and linked each TTE to patient demographic data. The primary outcome was receipt of a TTE within guideline recommended intervals for MR surveillance. Intervals between TTEs were coded as appropriate or inappropriate, and logistic regression was used to assess the association of race and income level with appropriateness while controlling for demographic and clinical factors. In total 31,058 patients with MR in 106,659 TTEs were assessed in the final cohort. Hispanic patients were less likely to receive appropriate TTEs (OR 0.89; p = 0.0440) than predicted by guidelines. Black race trended towards lower odds of receiving TTEs at appropriate intervals, but was not significant (OR 0.95; p = 0.2946). As patients aged, the odds of having a TTE within the appropriate time interval decreased across all races. Income level was not significantly associated with TTE appropriateness. We conclude that there are disparities in receipt of timely TTE surveillance, especially associated with Hispanic ethnicity. This may contribute to disparities in clinical outcomes after treatment of valvular disease, and provides an opportunity for care improvement.

Surveillance of adverse events following immunisation in Australia annual report, 2017

2019 ◽  
Vol 43 ◽  
Author(s):  
Aditi Dey ◽  
Han Wang ◽  
Helen Quinn ◽  
Rona Hiam ◽  
Nicholas Wood ◽  
...  
Keyword(s):  
Adverse Events ◽  
Annual Report ◽  
Injection Site Reaction ◽  
Reporting Rate ◽  
Vaccination Programs ◽  
National Immunisation ◽  
National Immunisation Program ◽  
Conjugate Vaccination ◽  
Reporting Rates ◽  
To Receive

This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) for 2017 reported to the Therapeutic Goods Administration and describes reporting trends over the 18-year period 1 January 2000 to 31 December 2017. There were 3,878 AEFI records for vaccines administered in 2017; an annual AEFI reporting rate of 15.8 per 100,000 population. There was a 12% increase in the overall AEFI reporting rate in 2017 compared with 2016. This increase in reported adverse events in 2017 compared to the previous year was likely due to the introduction of the zoster vaccine (Zostavax®) provided free for people aged 70–79 years under the National Immunisation Program (NIP) and also the state- and territory-based meningococcal ACWY conjugate vaccination programs. AEFI reporting rates for most other individual vaccines in 2017 were similar to 2016. The most commonly reported reactions were injection site reaction (34%), pyrexia (17%), rash (15%), vomiting (8%) and pain (7%). The majority of AEFI reports (88%) described non-serious events. Two deaths were reported that were determined to have a causal relationship with vaccination; they occurred in immunocompromised people contraindicated to receive the vaccines.

EXPRESS: Altering the rehabilitation environment to improve stroke survivor activity (AREISSA): a Phase II trial.

2021 ◽  
pp. 174749302110069
Author(s):  
Heidi Janssen ◽  
Louise Ada ◽  
Sandy Middleton ◽  
Michael Pollack ◽  
Michael Nilsson ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Outcomes ◽  
Environmental Enrichment ◽  
Brain Plasticity ◽  
Social Activity ◽  
Stroke Survivor ◽  
Group Differences ◽  
Control Group ◽  
Serious Adverse Events ◽  
Clinical Trial Registration

Background: Environmental enrichment involves organisation of the environment and provision of equipment to facilitate engagement in physical, cognitive and social activity. In animals with stroke, it promotes brain plasticity and recovery. Aims: To assess the feasibility and safety of a patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment. Methods: A non-randomised cluster trial with blinded measurement involving people with stroke (n=193) in 4 rehabilitation units was carried out. Feasibility was operationalised as activity 10 days after admission to rehabilitation and availability of environmental enrichment. Safety was measured as falls and serious adverse events. Benefit was measured as clinical outcomes at 3 months, by an assessor blinded to group. Results: The experimental group (n=91) spent 7% (95% CI -14 to 0) less time inactive, 9% (95% CI 0 to 19) more time physically, and 6% (95% CI 2 to 10) more time socially active than the control group (n=102). Communal environmental enrichment was available 100% of the time, but individual environmental enrichment was rarely within reach (24%) or sight (39%). There were no between-group differences in serious adverse events or falls at discharge or 3 months nor in clinical outcomes at 3 months. Conclusions: This patient-driven model of environmental enrichment was feasible and safe. However, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes 3 months after stroke do not provide justification for an efficacy trial. Clinical Trial Registration: ANZCTR 12613000796785 Words: 245

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

scholarly journals Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1638
Author(s):  
Hirohito Minami ◽  
Shuntaro Mukai ◽  
Atsushi Sofuni ◽  
Takayoshi Tsuchiya ◽  
Kentaro Ishii ◽  
...  
Keyword(s):  
Bile Duct ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
Significant Risk ◽  
Histopathological Analysis ◽  
Bile Duct Stones ◽  
Serious Adverse Events ◽  
Visualization System ◽  
Visual Impression ◽  
Number Of Patients

Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures (n = 93) and bile duct stones (n = 90) were analyzed retrospectively. All patients (93/93) with bile duct strictures successfully underwent visual observation, and 95.7% (89/93) of these patients successfully underwent direct biopsy. The sensitivity, specificity, and overall accuracy were 94.7%, 83.3%, and 90.3%, respectively, for visual impression; 80.9%, 100%, and 89.2%, respectively, for histopathological analysis of a direct biopsy; and 96.5%, 91.7%, and 94.6%, respectively, for visual impression combined with biopsy. Successful visualization of the stones was achieved in 98.9% (89/90) of the patients, and complete stone removal was achieved in 92.2% (83/90) of the patients, with an average of 3.3 procedures. The adverse events rate was 17.5% (32/183; cholangitis in 15 patients, fever the following day in 25, pancreatitis in 1, hemorrhage in 1, and gastrointestinal perforation in 1). No administration of antibiotics before the procedure was found to be a statistically significant risk factor for the development of fever after the procedure (p < 0.01). Spy DS-guided procedures are effective for the diagnosis and treatment of bile duct lesions and can be performed with a low risk of serious adverse events.

P136 Efficacy and safety of olokizumab in a phase III trial in patients with moderately to severely active RA inadequately controlled by TNF-α inhibitor therapy

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Eugen Feist ◽  
Saeed Fatenejad ◽  
Sergey Grishin ◽  
Elena Korneva ◽  
Michael Luggen ◽  
...  
Keyword(s):  
Adverse Events ◽  
Primary Endpoint ◽  
Inhibitor Therapy ◽  
Phase Iii ◽  
Major Adverse Cardiovascular Events ◽  
Research Support ◽  
Acr20 Response ◽  
Phase Iii Trial ◽  
Tnf Α ◽  
To Receive

Abstract Background/Aims  Olokizumab (OKZ) is a new humanised monoclonal antibody targeting IL-6. Here we present the results of the phase III study of OKZ in anti-TNF-IR patients. Methods  Patients with moderately to severely active RA who had previously failed TNF inhibitors (ClinicalTrials.gov Identifier NCT02760433/CREDO3) were randomized in a 2:2:1 ratio to receive subcutaneous (SC) injections of OKZ 64 mg every 2 weeks (q2w), OKZ 64 mg once every 4 weeks (q4w) or placebo (PBO), plus MTX. At week 16, all subjects in the PBO group were randomized in a 1:1 ratio to receive either of OKZ regimes. The primary endpoint was ACR20 response at week 12. Results  368 subjects were randomised according to the protocol and 320 patients (87%) completed the 24-week treatment period. Baseline characteristics were comparable across arms. Both regimens of OKZ were significantly better in primary endpoint: ACR20 were 60.9% (p = 0.0029 in comparison vs. PBO) in OKZ q2w, 59.6% in OKZ q2w (p = 0.0040 in comparison vs. PBO) and 40.6% in PBO. The key efficacy outcomes were maintained throughout the 24-week period of the study. Overall incidences of treatment-emergent adverse events (TEAE) were 65.5% in OKZ q2w, 65.0% in OKZ q4w and 50.7% in PBO. Subsequent randomization of PBO arm at week 16 did not change TEAEs incidence rate per treatment group significantly: 64.3% in any OKZ q2w and 59.7% in any OKZ q4w. The majority of TEAEs in all groups were not serious and were of mild or moderate severity. Incidence of treatment-emergent serious adverse events (TESAE) were: 12 (7.0%) subjects in any OKZ q2w; 6 subjects (3.2%) in any OKZ q4w group, all in the first 16 weeks. The most frequently reported TESAEs across all treatment groups were infections and infestations: 2 (1.2%) in OKZ q2w group, 2 (1.1%) in OKZ q4w group. No opportunistic infections including active tuberculosis, major adverse cardiovascular events, gastrointestinal perforations or deaths were reported. Conclusion  In this global Phase III trial in patients with moderately to severely active RA inadequately controlled by TNF-α inhibitor therapy, treatment with OKZ plus MTX in both regimes (OKZ 64 mg q2w and OKZ 64 mg q4w) was associated with significant improvements in the signs and symptoms of RA compared to PBO plus MTX over a 24-week period. Treatment with OKZ q2w and q4w in this difficult to treat population was well tolerated and consistent with the established safety profile of anti-IL-6 agents. Disclosure  E. Feist: Consultancies; R-Pharm, Abbvie, BMS, Celgene, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, Roche/Chugai, Sanofi. Honoraria; R-Pharm, Abbvie, BMS, Celgene, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, Roche/Chugai, Sanofi, Sobi, UCB. Member of speakers’ bureau; R-Pharm, Abbvie, AB2Bio, BMS, Celgene, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, Roche/Chugai, Sanofi, Sobi, UCB. Grants/research support; Lilly, Novartis, Pfizer, Roche/Chugai. S. Fatenejad: Consultancies; RPharm International. Shareholder/stock ownership; Pfizer. S. Grishin: Corporate appointments; Employed by R-Pharm. E. Korneva: Corporate appointments; Employed by R-Pharm. M. Luggen: Consultancies; Amgen, Sun Pharmaceuticals, R-Pharm International. Grants/research support; I havAbbvie, R-Pharm, Sun Pharmaceuticals, Pfizer, Novartis, Lilly, and GSK. E. Nasonov: Honoraria; Lilly, Abbnie, Prizer, Biocad, R-Pharm. Member of speakers’ bureau; Lilly, Abbnie, Prizer, Biocad, R-Pharm. M. Samsonov: Corporate appointments; Employed by R-Pharm.

scholarly journals Tensile Strength and Failure Types of Direct and Indirect Resin Composite Copings for Perio-Overdentures Luted Using Different Adhesive Cementation Modalities

Materials ◽  
2020 ◽  
Vol 13 (16) ◽  
pp. 3517
Author(s):  
Raffaele Cesca ◽  
Vera Colombo ◽  
Bruna Ernst ◽  
Luigi Maria Gallo ◽  
Mutlu Özcan
Keyword(s):  
Resin Composite ◽  
Periodontal Diseases ◽  
Tensile Load ◽  
Resin Cement ◽  
Tensile Failure ◽  
Human Teeth ◽  
Abutment Teeth ◽  
Adhesive Cementation ◽  
To Receive ◽  
Two Parameter

Perio-overdenture design helps to reduce periodontal diseases and secondary caries on abutment teeth. Composite copings can be cemented adhesively to the abutment teeth with different techniques. In this study, direct/indirect resin composite copings for perio-overdentures, luted using different adhesive cementation modalities were compared. Human teeth (N = 40) were prepared to receive spherical attachment copings and randomly divided into four groups: (1) resin-composite copings bonded directly (DC), (2) composite copings made indirectly, luted with dual-polymerized resin cement (ICV), (3) composite copings made indirectly, bonded with resin composite (ICT), (4) composite copings made indirectly, bonded with resin composite after the immediate dentin sealing method (IDS). Specimens were tested for tensile failure and one-way ANOVA (alpha = 0.05) was performed and the two-parameter Weibull modulus, scale (m) and shape (0) were calculated. Mean tensile load (N) was significantly higher for Group IDS (238 ± 81) than for the other groups (144 ± 53–184 ± 46) (p < 0.05). Group IDS (0.54 ± 0.25 mm) showed significantly higher deformation (mm) than other groups (0.2 ± 0.1–0.32 ± 0.15) (p < 0.05). Weibull distribution presented lower shape (0) for DC (3.33) compared to other groups (3.57–4.99). Cohesive coping failures were more frequent in Group IDS (60%) and mixed failures in other groups (40–60%). In conclusion, IDS copings could be preferred over other fabrication and adhesion modalities.

scholarly journals The occurrence of Entamoeba gingivalis among patients with periodontal disease

2016 ◽  
Vol 29 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Joanna Luszczak ◽  
Michal Bartosik ◽  
Jolanta Rzymowska ◽  
Agnieszka Sochaczewska-Dolecka ◽  
Ewa Tomaszek ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Periodontal Disease ◽  
Periodontal Diseases ◽  
Age Groups ◽  
Healthy People ◽  
Gingival Tissue ◽  
Pathological Changes ◽  
Oral Diseases

AbstractAccording to some studies, the Entamoeba gingivalis colonizing the gingival tissue is an important agent in bringing about periodontitis. Other studies, however, deem it an opportunist that is able to survive in the medium induced by periodontal disease. The aim of this study was to investigate the prevalence of Entamoeba gingivalis infection in patients from the Department of Periodontology, and compare this population with that of healthy people, so as to analyze the relationships between infection and patient sex and age. The result of this work is that in both groups, a correlation (p = 0,19) has been noted between the occurrence of amoebae and other diseases in the oral cavity. Indeed, 81,4% of all patients with some periodontal disease showed the presence of amoeba. Among those who are not afflicted with oral diseases, the presence of amoeba was indicated in 62,5% of the total. In addition, a correlation between the person's age and the presence of protozoa (p = 0,15) was strongly marked among women (p = 0,19). In the three age groups of women in this study (40-49, 60-69, and above 80 years), we observed a 100% presence of protozoa.Our study leads us to the conclusion that infections with Entamoeba gingivalis should be regarded as an factor that is associated with the pathological changes occurring in patients with periodontal diseases.

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