ABSTRACT
Purpose: This study aimed to assess (1) the relationship of systemic bone mineral density (BMD) and osteoporotic status with the surgeon's subjective assessment of local jawbone quality, and ...(2) whether the surgeon's subjective assessment of local jawbone quality is a predictor of implant failure.
Materials and Methods: A retrospective analysis of 2,867 dental implants placed in 645 patients was accomplished. The surgeon's assessment of bone quality at the time of dental implant placement was recorded. Of those, 208 patients with 701 implants had BMD data available within 3 years. Statistical analyses were conducted to determine relationships between BMD, osteoporotic status, and local jawbone quality and to determine the relationship between local jawbone quality and implant survival.
Results: There was no association between systemic BMD and the surgeon's assessment of bone quality (p = .52) nor between osteoporotic status and the surgeon's assessment of local jawbone quality (Spearman rank correlation coefficient = 0.08). Additional retrospective analysis revealed implants placed in moderate‐ (hazard ratio = 1.67; p = .043) or poor‐quality (HR = 3.45, p < .001) bone (surgeon's assessment) were significantly more likely to fail than implants placed in good‐quality bone.
Conclusion: Systemic BMD and osteoporotic status are not associated with local jawbone quality. Implants placed in good‐quality bone, as assessed subjectively by the surgeon at the time of implant placement, have significantly better survival characteristics than implants placed in moderate‐/poor‐quality bone.
Distraction osteogenesis is a method of forming bone through osteotomy and sequential stretching of the healing callus. This process is accomplished with the aid of a distraction device, which is ...secured with screws placed directly into bone for a predetermined length of time. This clinical report describes the use of distraction osteogenesis to treat mandibular asymmetry in a patient with Goldenhar's syndrome, a form of hemifacial microsomia. After treatment, the patient had a more rounded facial contour and corrected occlusal plane. (J Prosthet Dent 2003;89:11-4.)
Poor adherence to scheduled dialysis treatments is common and can cause adverse clinical and economic outcomes. In 2015, the Centers for Medicare and Medicaid Innovation launched the Comprehensive ...ESRD Care (CEC) Model, a novel modification of the Accountable Care Organization framework. Many model participants reported efforts to increase dialysis adherence and promptly reschedule missed treatments.
With Medicare databases covering 2014-2019, we used difference-in-differences models to compare treatment adherence among patients aligned to 1037 CEC facilities relative to those aligned to matched comparison facilities, while accounting for their differences at baseline. Using dates of service, we identified patients who typically received three weekly treatments and the days when treatments typically occurred. Skipped treatments were defined as days when the patient was not hospitalized but did not receive an expected treatment, and rescheduled treatments as days when a patient who had skipped their previous treatment received an additional treatment before their next expected treatment date.
Patients in the CEC Model had higher odds of attending as-scheduled sessions relative to the comparison group, although the effect was only marginally significant (OR, 1.02; 95% CI, 1.00 to 1.04,
=0.08). Effects were stronger among females (OR, 1.03; 95% CI, 1.00 to 1.06,
=0.06) than males (OR, 1.01; 95% CI, 0.98 to 1.04,
=0.49), and among those aged <70 years (OR, 1.02; 95% CI, 1.00 to 1.05,
=0.04) than those aged ≥70 years (OR, 1.00; 95% CI, 0.96 to 1.04,
=0.96). The CEC was associated with higher odds of rescheduled sessions (OR, 1.09; 95% CI, 1.05 to 1.14,
<0.001). Effects were significant for both sexes, but were larger among males (OR, 1.11; 95% CI, 1.05 to 1.18,
<0.001) than females (OR, 1.07; 95% CI, 1.02 to 1.13,
=0.01), and effects were significant among those <70 years (OR, 1.12; 95% CI, 1.07 to 1.17,
<0.001), but not those ≥70 years (OR, 0.99; 95% CI, 0.92 to 1.07,
=0.80).
The CEC Model is intended to incentivize strategies to prevent costly interventions. Because poor dialysis adherence may precipitate hospitalizations or other adverse events, many CEC Model participants encouraged adherence and promptly rescheduled missed treatments as strategic priorities. This study suggests these efforts were a success, although the absolute magnitudes of the effects were modest.
Abstract 3722
Despite advances in treatments for B-cell leukemias and lymphomas, many patients ultimately relapse and succumb to disease following multiple courses of therapy. Bispecific antibody ...fragments that can simultaneously engage T cells and tumor cells have been shown, in the literature, to destroy tumor cells by effectively redirecting the cytotoxic function of T cells. T-cell engaging bispecific molecules linking anti-CD19 and anti-CD3 binding domains in the context of novel SCORPION™ (multi-specific protein therapeutic) proteins were evaluated both in vitro and in vivo for function and stability.
Redirected T-cell cytotoxicity (RTCC) was measured by combining CD19 positive or negative cell lines with SCORPION proteins in the presence of human T cells. In a similar assay context, CFSE-labeled T cells were monitored for activation and proliferation. Functional RTCC assays were also used to analyze serum stability of SCORPION molecules in vitro and to complete an in vivo pharmacokinetic analysis. In vivo efficacy was assessed by monitoring the rate of tumor outgrowth of Ramos xenografts co-implanted with human peripheral blood mononuclear cells (PBMC) in NOD/SCID mice after treatment with SCORPION molecules.
SCORPION molecules potently mediate target-specific T-cell cytotoxicity toward tumor cell lines presenting cell surface CD19, with EC50 values for cytotoxicity at low pM concentrations. These molecules also demonstrate induction of T-cell activation and proliferation in the presence of target-bearing tumor cells but not in the absence of target expression. SCORPION molecules retain stable function following incubation at 37°C in mouse serum for up to a week in vitro, and pharmacokinetic analysis of SCORPION protein function in BALB/c mouse serum following intravenous administration resulted in half-life estimates of 69–84 hours. In efficacy studies conducted in NOD/SCID mice, SCORPION proteins significantly inhibited the outgrowth of Ramos tumor xenografts in the presence of human effector cells.
SCORPION molecules targeting CD19 and CD3 effectively harness the cytotoxic activity of T cells to kill CD19 positive tumor cells both in vitro and in vivo and show potential for further investigation as possible therapeutic agents for B-cell malignancies.
Chenault:Emergent BioSolutions: Employment. Gottschalk:Emergent BioSolutions: Employment. Hernandez-Hoyos:Emergent BioSolutions: Employment. Wiens:Emergent BioSolutions: Employment. Gordon:Emergent BioSolutions: Employment. Klee:Emergent BioSolutions: Employment, Equity Ownership. Bienvenue:Emergent BioSolutions: Employment. Dasovich:Emergent BioSolutions: Employment. Kumer:Emergent BioSolutions: Employment. Aguilar:Emergent BioSolutions: Employment. Bannink:Emergent BioSolutions: Employment, Equity Ownership. McMahan:Emergent BioSolutions: Employment, Equity Ownership. Natarajan:Emergent BioSolutions: Employment, Equity Ownership. Algate:Emergent BioSolutions: Employment, Equity Ownership. Blankenship:Emergent BioSolutions: Employment, Equity Ownership, Patents & Royalties.
Female circumcision is curbed in Egypt Wiens, Jennifer
BMJ. British medical journal (International ed.),
08/1996, Letnik:
313, Številka:
7052
Journal Article
Recenzirano
The Egyptian government has once again changed its policy on female genital mutilation, banning any government affiliated medical staff from performing female circumsion. The country's health policy ...has shifted from government regulation to outright condemnation.
Aim. To assess whether patients who have recently had a hip fracture have a different “Decayed Missing Filled” (DMFT) status in comparison to those who have never had an osteoporotic fracture. ...Methods. A total of 50 patients 50+ years of age with a recent osteoporosis-related fracture were identified (“cases”). For comparison, 50 patients 50+ years of age with a T-score ≤ -1.5 without a previous fracture were identified (“controls”). Osteoporotic status was defined based on a patient’s bone mineral density (BMD) T-score. All patients underwent an oral evaluation of their DMFT status and participated in an interview to ascertain risk factor information. For each risk factor, the association between case/control status and the risk factor was examined by fitting a separate logistic regression model, with adjustment for age. Results. The majority of the patients were female (80% of cases and 74% of controls) and the median age was significantly higher for cases compared to controls (82 vs. 71.5 years, p<0.001). A higher DMFT score was significantly associated with case status, even after adjusting for age. For every 5-tooth increase in the DMFT score, the odds of being a case increased by 56% (odds ratio=1.56, 95% CI, 1.05-2.32, p=0.029). Likewise there was a tendency for the number of missing teeth to be associated with case status (odds ratio=1.26 per 5-tooth increase, 95% CI 1.00-1.59, p=0.055). Conclusions. Among patients 50+ years of age who are osteopenic or osteoporotic, increasing DMFT score is significantly associated with osteoporosis-related fracture. Oral evaluations by medical providers should be considered as an integral part of the general physical examination in patients at risk for osteoporotic fracture.
Weight‐length data were compiled from 139 populations of spotted bass Micropterus punctulatus (N = 26,289 fish) from 16 states within the geographic range of the species. The ...regression‐line‐percentile technique was applied to these data to develop a new 75th‐percentile standard weight (Ws) equation. The revised Ws. equation is log10Ws = –5.392 + 3.215 log10TL, where Ws is the standard weight in grams and TL is the total length in millimeters and is valid for fish 100–640 mm. The English‐unit equivalent is log10Ws = –3.533 + 3.215 log10TL, where Ws. is the standard weight in pounds and TL is in inches and is valid for fish 4–25 in. We found the current Ws equation to be length biased, but no such bias was apparent in the new equation.
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