1,721,128 research outputs found
STABILITY OF MAXILLARY ADVANCEMENT FOR CORRECTION OF SKELETAL CLASS III MALOCCLUSION AFTER COMBINED MAXILLARY AND MANDIBULAR PROCEDURES: PRELIMINARY RESULT OF AN ACTIVE CONTROL EQUIVALENCE TRIAL FOR SEMIRIGID AND RIGID FIXATION OF THE MAXILLA
No full textIn this paper preliminary results are presented of a prospective study designed to examine the effect of maxillary fixation methods on postoperative stability. The purpose of this study was to evaluate the stability of Le Fort I osteotomy stabilized with semirigid fixation of the maxilla (SRMF) or rigid fixation of the maxilla (RMF). All patients had skeletal Class III malocclusion and underwent bimaxillary surgery (Le Fort I maxillary advancement with or without superior repositioning and bilateral sagittal split osteotomies of the mandible). Standardized cephalometric analysis was performed on serial radiographs of 42 patients immediately before surgery, 1 week after surgery, after release of fixation, and 1 year postoperatively. The patients were randomized into 2 treatment groups: 23 patients received RMF (group A), and 19 patients received SRMF (group B). Within the groups, patients showed good stability with regard to their baseline characteristics. To show the therapeutic equivalence of the 2 treatments, analysis of the recorded data followed the approach for an equivalence trial. The mean surgical advancement was 5.34 +/- 1.50 mm for group A and 4.51 +/- 1.37 mm for group B. The mean amount of postsurgical relapse was 0.98 +/- 1.27 mm for group A and 0.30 +/- 1.04 mm for group B. Group A patients experienced 93% of their relapse (0.92 mm) during fixation, while group B patients experienced 96% of their relapse (0.29 mm) after release of fixation. RMF provided better stability than SRMF for all maxillary landmarks in the vertical plane. All considered points both in horizontal and vertical plane exhibited full equivalence for 95% confidence intervals, which seems to indicate equivalent stability between the surgical procedures
Multifrequency multicomponent tympanometry in normal and otosclerotic ears
No full textA multifrequency multicomponent admittance meter was used to evaluate 70 ears of patients affected by fenestral otosclerosis (Os ears), monolateral (16 cases) or bilateral (27 cases). The 16 contralateral ears of the patients with monolateral otosclerosis who presented a pure-tone air-bone gap less than 10 dB were evaluated separately (Cos ears). A group of 48 ears belonging to 24 otologically normal subjects (N ears), with hearing thresholds better than or equal to 10 dB HL in the frequencies between 250 and 8000 Hz served as a control group. The purpose of the study was to evaluate the acoustic admittance characteristics of the three groups of ears, with particular regard to the parameters represented by the resonance frequency (RF), the acoustic conductance value (G) at RF and the individual interaural differences in these two parameters in the N and Cos groups. The degree to which fenestral otosclerosis can influence variations of RF and the correlation between the value of RF and conductive hearing loss in patients with clinically confirmed pictures and in the controlateral ears in the cases where the disease was clinically unilateral were also investigated. The study reveals statistically significant differences between the RF means in the N group (1085 ± 244 Hz) vs the Os group (1264 ± 320 Hz) (p < 0.001) and between the G means in the N group (5.33 ± 1.72 mmhos) vs the Os group (4.46 ± 2.54 mmhos) (p = 0.04) and N group vs Cos group (3.42 ± 2.27 mmhos) (p < 0.001). No correlation was found between the value of RF and conductive hearing loss. This study also shows how prognostic value may also be attributed to conductance at middle-ear pressure balancement: extremely low values for this parameter at RF are indicative of initial otosclerotic involvement of the oval window
New tridimensional approach to the evaluation of the spine through surface measurement: The BACES system
No full textThe aim was to test a new instrument, the BACES system, an articulated arm connected to a computer, to improve non-invasive examination of the spine and to reduce X-ray examinations. To this aim, four observers performed three series of eight measurements on a dummy and two healthy volunteers. Data on the projection of the spine, any curve detectable on the frontal and sagittal plane, and any rotation at each thoracolumbar level were collected and analysed. To detect the role of the observer, of the procedure and of the object in measurement variability, a two-factor analysis of variance was performed. The results showed measurement errors for kyphosis and scoliosis generally below 3°, whereas the lordosis showed a major variability, especially in volunteers, because of the attitude role. Rotations showed a limited variability too, generally below 2°. In the clinical setting, > 2 SD may reasonably be considered a clinical change because it has not a great chance of being a measurement error. Thus, the BACES system allowed us to identify with fairly good precision kyphosis, scoliosis and trunk rotations. Even though at the moment no surface measurement method can replace X-rays, the instrument can integrate and limit the use of radiographic evaluations
Anxiety is Prevailing in Non-Cardiac Chest Pain Subjects, while Somatisation is Not A Comparative Study in the Emergency Department
Full text linkObjective:
The main purpose of this study was to verify if non-cardiac chest pain (NCCP) subjects recruited in
an Emergency Department were more anxious, depressive or burdened by somatoform symptoms as compared with
cardiac chest pain (CCP) subjects, and with subjects without chest pain (WOCP).
Methods:
We included patients with chest pain not attributable to a gastro-oesophageal reflux disorder. NCCP
subjects were negative at ECG examination and at troponin test at baseline and after three months. A number of
instruments were administered, measuring anxiety and depression (HADS), somatisation (somatisation scale of SCL-
90, TAS-20), and the health-related QoL (SF-12), along with other scales measuring the social and experiential profile.
Results:
We recruited 435 subjects (of which NCCP were 44.8%) in the Emergency Department, while other 147
subjects were recruited in a primary care clinic. The logistic regression showed that the levels of HADS anxiety in
the three groups were dissimilar, even when adjusted for confounding variables: taking NCCP as reference category,
adjusted ORs were 0.64 for CCP (IC95% 0.42 – 0.96) and 0.23 for WOCP (IC95% 0.13 – 0.40). When considering the
somatisation construct, CCP and NCCP subjects reported similar somatic symptom complaints, higher than WOCP
subjects. Moreover, even if NCCP subjects showed higher TAS-20 scores than WOCP subjects, these scores were
below the range of a possible alexithymia. As for the physical health-related QoL (SF-12, subscale PCS-12), regression
analyses showed that the PCS-12 mean score of NCCP was higher than that of CCP (ß -2.31; IC95% -4.14 to -0.48)
and lower than that of WOCP (ß 2.24; IC95% 0.12 – 4.37).
Conclusion
: NCCP subjects are characterised from an elevated anxiety, together with a better physical well-being,
when compared with subjects who have a cardiac failure. The somatisation construct seems less useful to distinguish
NCCP from CCP subjects. Consequently, anxiety should be the major target of our mental-health intervention when
treating subjects with chest pain
Accuracy of custom-fitted temporomandibular joint alloplastic reconstruction and virtual surgical planning
No full textThe purpose of this study was to evaluate the accuracy of temporomandibular joint (TMJ) custom-made replacements by means of virtual surgical planning. The authors review 11 TMJ custom-made prostheses made of both mandibular and fossa components. Surgeries were virtually planned and patient-specific devices were designed together with surgical cutting and positional guides. Three-dimensional models for both preoperative planning and postoperative computed tomography scans were generated and overlapped in order to evaluate differences in measurements. Correlation between virtual preoperative and real postoperative prosthesis positioning was described by Lin's coefficient. Results of statistical analysis showed an almost perfect concordance. Wilcoxon's matched-pairs test showed no statistically significant deviation between preoperative virtual surgical planning and postoperative results. Colour map analysis confirmed the correspondence between virtually planned positioning of the devices and postoperative results. All the prostheses were placed with great accuracy. In conclusion, virtual surgical planning, surgical guides and patient-specific devices provide accuracy and precision in surgery for custom-made TMJ replacement
Retrospective analysis of the usefulness of a protocol with high-dose methotrexate in polymyalgia rheumatica: Results of a single-center cohort of 100 patients
No full textThe aim of the present study was to define subsets of patients suffering from polymyalgia rheumatica, where methotrexate (MTX) up to 20 mg/week might be more effective
ULTRASTRUCTURAL EVIDENCE OF A VESICLE-MEDIATED MODE OF CELL DEGRANULATION IN CHICKEN CHROMAFFIN CELLS DURING THE LATE PHASE OF EMBRYONIC DEVELOPMENT
No full textIn the present investigation, we attempted to determine whether ultrastructural features indicative of a vesicle-mediated mode of cell secretion were detectable in chick chromaffin cells during embryo development. The adrenal anlagen of domestic fowls were examined at embryonic days (E) 12, 15, 19 and 21 by electron microscopy quantitative analysis. Morphometric evaluation revealed a series of granule and cytoplasmic changes highly specific for piecemeal degranulation (PMD), a secretory process based on vesicular transport of cargoes from within granules for extracellular release. At E19 and E21 we found a significant peak in the percentage of granules exhibiting changes indicative of progressive release of secretory materials, i.e. granules with lucent areas in their cores, reduced electron density, disassembled matrices, residual cores and membrane empty containers. A dramatic raise in the density of 30-80-nm-diameter, membrane-bound, electron-dense and electron-lucent vesicles - which were located either next to granules or close to the plasma membrane - was recognizable at E19, that is, during the prehatching phase. The cytoplasmic burst of dense and clear vesicles was paralleled by the appearance of chromaffin granules showing outpouches or protrusions of their profiles ('budding features'). These ultrastructural data are indicative of an augmented vesicle-mediated transport of chromaffin granule products for extracellular release in chick embryo chromaffin cells during the prehatching stage. In conclusion, this study provides new data on the fine structure of chromaffin cell organelles during organ development and suggests that PMD may be part of an adrenomedullary secretory response that occurs towards the end of chicken embryogenesis. From an evolutionary point of view, this study lends support to the concept that PMD is a secretory mechanism highly conserved throughout vertebrate classes
Correlation of local interleukin-1beta levels with specific IgA response against Gardnerella vaginalis cytolysin in women with bacterial vaginosis
No full textPsychoeducation in Binge Eating Disorder and EDNOS: a pilot study on the efficacy of a 10-week and a 1-year continuation treatment.
No full textObjective: The goals of the present study were (a) to analyse the efficacy of short-term (10 weeks) psychoeducation group treatment in patients with binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS), and (b) to analyse the determinants of the success of psychoeducation on single outcome measures. Methods: The sample included all patients seeking help for their binge behaviour at the Psychiatric Clinic of the Teaching Hospital of Udine. They all met the inclusion DSM-IV TR criteria for a diagnosis of EDNOS or BED. Eating attitudes were measured with the Eating Disorder Inventory (EDI-2), which includes three scales: bulimia (EDI-BU), body dissatisfaction (EDI-BD) and drive to thinness (EDI-DT). Other psychometric instruments were the Hospital Anxiety and Depression Scale and the Toronto Alexithymia Scale (TAS-20). Psychoeducation group treatment was carried out in an outpatient setting. It consisted in 10 weekly sessions of group therapy. At the end of this period, patients who maintained an eating disorder (ED) were asked to participate to an extension protocol, which included two fortnightly sessions followed by further monthly sessions for a period of 8 months. Results: 98 patients were originally included in the protocol. Of these, 54 met the criteria for BED and 44 for EDNOS. At the end of the treatment, 30 patients (30.6 %) no longer suffered from an ED. All patients showed significant improvements on several other outcome measures (frequency of binges, BMI, bulimic traits, body dissatisfaction, anxiety, depression and alexithymia). The probability to recover from an ED was greater in subjects with higher scores of both BMI (p = 0.009) and EDI-BU (p = 0.002), together with lower TAS-20 scores at t0 (p = 0.003); the probability to reduce the frequency of binges was greater in subjects with higher frequency of binges at t0 (p < 0.0001); the improvement in the EDI-BD scores was negatively associated (p = 0.005) with BMI at t0, and positively associated with scores at t0 of EDI-BD (p < 0.0001); the improvement in the EDI-BU scores at t1 was associated with the EDI-BU scores at t0 (p < 0.0001). 53 patients accepted to participate to the continuation phase; of these, 32 were assessed at the end of the period. About 41 % of the latter obtained a recovery from an ED, with a further reduction of the episodes of binges and an improvement of BMI scores. Conclusion: This study may demonstrate the efficacy of psychoeducation group treatment for BED and EDNOS patient
BLyS upregulation in Sjogren's syndrome associated with lymphoproliferative disorders, higher ESSDAI score and B-cell clonal expansion in the salivary glands
No full textObjective: Primary SS is characterized by an increased risk of lymphoma in patients with prelymphomatous manifestations (i.e. myoepithelial sialadenitis or mixed cryoglobulinaemia). Serum B-lymphocyte stimulator (s-BLyS) levels in SS-related B-cell lymphoproliferative disorders were studied by integrating the results with the disease activity score and with molecular analyses of B-cell expansion in the salivary glands. Methods: Seventy-six primary SS patients (with or without lymphoma or prelymphomatous manifestations), 56 HCV-related cryoglobulinaemic vasculitis patients and 55 controls were studied. s-BLyS and molecular analyses of B-cell expansion in the salivary gland tissues were performed. Patients with SS and persistent parotid swelling underwent parotid biopsy. Results: S-BLyS differed between SS subgroups, higher levels being documented in patients with lymphoma or prelymphomatous manifestations vs SS without [1.85 (0.45-4.12) ng/ml vs 1.12 (0.56-1.98) ng/ml; P<0.0001]. s-BLyS levels significantly correlated with the European League Against Rheumatism (EULAR) SS disease activity index (r = 0.62, P<0.0001, Spearman's test). Clonal B-cell expansion in the salivary glands, but not polyclonal B-cell expansion, was associated with higher s-BLyS levels [1.98 (0.45-4.12) ng/ml vs 1.15 (0.56-3.25) ng/ml; P = 0.013)]. Conclusion: Higher s-BLyS levels and tissue clonal B-cell expansion characterize SS with B-cell lymphoproliferative disorders, even at prelymphomatous stages. This subgroup of SS patients showed the highest EULAR SS disease activity index scores. This represents a biologic rationale for targeting both clonal B-cell expansion and s-BLyS overproduction in SS. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved
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