The objective of this study was to assess pre-treatment quality of life and the relevant clinical variables in adult patients with malocclusion in order to improve orthodontic treatment strategies.
...The study was conducted in 240 consecutive adult patients with malocclusions divided into two groups: patients for whom an orthodontic treatment plan was considered, and patients for whom an orthognathic treatment plan was selected. Patients were examined between December 2015 and February 2017, at the School of Dental Medicine, University of Belgrade. Malocclusion severity was recorded using the Peer Assessment Rating index pre-treatment score. Skeletal malocclusion parameters were measured using lateral cephalometric radiographs. Quality of life was assessed by means of a generic questionnaire (Medical Outcomes Study Short Form-36 (SF-36)), and the disease-specific Orthognathic Quality of Life Questionnaire (OQLQ).
There were significant differences in the mean values of the OQLQ domain scores between orthodontic and orthognathic patients. Patients for whom orthodontic treatment was planned had statistically significantly lower scores in comparison to those for whom orthognathic treatment was planned. This was the case in all OQLQ domains except for "Awareness of facial deformity". Statistically significant correlations (p<0.05) were presented between OQLQ scores and following demographic and clinical variables: gender, age, malocclusion severity, maxillary and mandibular sagittal, maxillary vertical, and lower incisor positions, intermaxillary angle, and the Beck Depression Inventory and Beck Anxiety Inventory levels. The independent predictors for the planning of orthodontic and orthognathic treatment in patients with malocclusion were two OQLQ domains, "Facial aesthetics" and "Awareness of facial deformity", as well as total OQLQ score, after adjustment for demographic characteristics, skeletal parameters, anxiety and depression.
Our findings suggest that patients for whom orthodontic treatment was planned demonstrated better quality of life according to the OQLQ scores in comparison to those for whom orthognathic therapy was planned.
Every three seconds, a new case of dementia emerges in the world, and by 2050 there will be at least 150 million persons with dementia. The World Health Organization declared dementia for a public ...health priority of the 21st century before the emergence of the SARS-CoV-2/COVID 19, which affected the elderly population the most. Dementia is a disease that affects the individual, caregivers and wider society. Due to increasing dependence from others, dementia causes a health, economic, emotional, psychological and physical burden for the person with dementia and his caregivers. There is still a great stigma associated with dementia. Less than half of people with dementia are diagnosed and treated, although we have drugs available that can slow the course of the disease. In the multi-author's monograph Monitoring of Dementia in Slovenia: Epidemiological and other aspects, we addressed the problem of dementia, especially in relation to COVID-19. The publication also highlights the estimates on the prevalence of dementia in Slovenia, which were made on Slovenian data and the population of Slovenia. The publication is distinguished by a multidisciplinary treatment of the topics and is intended for both the lay and the professional public.
The voice represents a basic working tool for carrying out certain occupations. Hoarseness, as a consequence of vocal fold lesions, presents an important cause of work-related absences for voice ...professionals.
Our study was designed as a retrospective cohort one. Data on gender, workplace, vocal load and exposure to risk factors for voice disorders of the patients who had surgery in the 2014-2015 period at the tertiary centre due to benign vocal fold lesions were collected from their clinical records. We compared professional voice users (PVU) to subjects with no vocal load at work (NPVU). The SPSS programme, version 22.0, was used for statistical analysis.
From 2014 to 2015, 103 PVU and 132 NPVU were surgically treated for benign vocal fold lesions. In comparison to the second group, loud speech use was reported significantly more often by PVU (40.8% vs. 14.4%), as was a fast speaking rate (22.3% vs. 9.8%) and additional vocal load outside of the workplace (23.3% vs. 12.9%). The time that had passed between the occurrence of the hoarseness and the surgical treatment did not differ between the groups. The majority of patients were satisfied with the outcome of the operation.
Nearly a half of the operated patients had a considerable vocal load at work. An ENT assessment prior to starting a job as well as priority phoniatric treatment of voice disorders for PVU would significantly reduce the costs of work absences and contribute to a speedier recovery and return to the workplace.
Evidence on long-term effectiveness and cost effectiveness of treatment sequences for multiple myeloma (MM) is sparse. We used published data and country-specific data to assess the cost ...effectiveness of four-line treatment sequences for elderly transplant-ineligible patients with MM in Serbia.
We developed a Markov cohort model to compare long-term effectiveness and cost effectiveness of five sequential MM treatment alternatives from the perspective of the national healthcare provider. Effectiveness parameters on progression, mortality and adverse events were extracted from published clinical trials. Costs were based on price lists of the National Health Insurance Fund. We compared life expectancy, costs, and incremental cost-effectiveness ratios among alternative courses of action. The model was analyzed over a lifelong time horizon applying a 3% annual discount rate for effectiveness outcomes and costs. Robustness of the model was tested in multiple deterministic sensitivity analyses.
The sequences were defined by the frontline treatment: MPT (melphalan-prednisone-thalidomide), MPV (melphalanprednisone-bortezomib), CTD (cyclophosphamide-thalidomide-dexamethasone), VCD (bortezomib-cyclophosphamidedexamethasone) and BP (bendamustine-prednisone). MPV sequence resulted in the highest remaining life expectancy (4.76 life years). Cost-effectiveness analysis resulted in three non-dominated strategies: MPT, VCD, and MPV sequences, with an incremental cost-effectiveness ratio of EUR 35,300 per life-year gained (LYG) for VCD and EUR 47,200/LYG for MPV relative to MPT.
MPV sequence was the most effective in terms of life expectancy for elderly transplant-ineligible MM patients in Serbia. Bortezomib-based strategies would be recommended for the frontline treatment of patients with MM in Serbia if the willingness-to-pay threshold is around EUR 35,000-60,000/LYG.
The clinical profile of acute myocardial infarction (AMI) patients reflects the burden of risk factors in the general population. Differences between incident (first) and recurrent (repeated) events ...and their impact on treatment are poorly described. We studied potential differences in the clinical profile and in-hospital treatment between patients hospitalised with an incident and recurrent AMI.
A total of 324 patients admitted in the Coronary Care Unit of 'Mother Teresa' hospital, Tirana, Albania (2013-2014), were included in the study. Information on AMI type, complications and risk factors was obtained from patient's medical file. Logistic regression analyses were used to explore differences between the incident and recurrent AMIs regarding clinical profile and in-hospital treatment.
Of all patients, 50 (15.4%) had a prior AMI. Compared to incident cases, recurrent cases were older (P=0.01), more often women (P=0.01), less educated (P=0.01), and smoked less (P=0.03). Recurrent cases experienced more often heart failure (HF) (OR=2.48; 95% CI: 1.31-4.70), impaired left ventricular ejection fraction (OR=1.97; 95% CI:1.05-3.71), and multivessel disease (OR=6.32; 95% CI: 1.43-28.03) than incident cases. In-hospital use of beta-blockers was less frequent among recurrent compared to incident cases (OR=0.45; 95% CI: 0.24-0.85), while no statistically significant differences between groups were observed regarding angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, statin, aspirin or invasive procedures.
A more severe clinical expression of the disease and underutilisation of treatment among recurrent AMIs are likely to explain their poorer prognosis compared to incident AMIs.
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