The impact of a cancer Survivorship Care Plan on gynecological cancer patient and health care provider reported outcomes (ROGY Care): study protocol for a pragmatic cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>There is a need for improvement of information provision and post-treatment care for cancer survivors. A Survivorship Care Plan (SCP) is recommended by the American Institute of Medicine and the Dutch Health Council, which is a summary of patients' course of treatment as a formal document, and includes recommendations for subsequent cancer surveillance, management of late effects, and strategies for health promotion. Until now, evidence on the effects of implementing the SCP in clinical practice is lacking. The rationale and study design of a pragmatic cluster randomized trial, aiming to assess the impact of SCP care in routine clinical practice, is presented.</p> <p>Methods/Design</p> <p>A web-based patient registration system 'Registrationsystem Oncological GYnecology' (ROGY) is used by gynecologists in the South of the Netherlands since 2006. A personalized SCP can automatically be generated out of ROGY. In this pragmatic cluster randomized controlled trial, 12 hospitals are randomized to either 'usual care' or 'SCP care'. In patients with 'usual care', the gynecologist provides care as usual. In patients with 'SCP care', information about the tumor stage and treatment is personally discussed with the patient and a document is handed to the patient. Prospectively, all patients diagnosed with endometrial or ovarian cancer in the participating hospitals will be approached for study participation. Patients will complete questionnaires after surgery, and before additional treatment, and after 6, 12, 18 and 24 months. In addition, health care providers will be asked their opinion about implementation of SCP care. Primary outcome is defined as patient satisfaction with information provision and care. Secondary outcomes are illness perception, health-related quality of life, health care use, prevalence, course and referral rate of survivors with psychosocial distress, and health care providers' evaluation of SCP care.</p> <p>Discussion</p> <p>The ROGY Care trial will help to gain insight into the impact of SCP care on patient reported outcomes, and on the evaluation of cancer survivors and health care providers of the different elements of the SCP. Therefore, results will contribute to efforts to improve quality of care for cancer survivors.</p> <p>Trial registration</p> <p>Trial Registration: <url>http://www.ClinicalTrials.gov</url>. Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01185626">NCT01185626</a></p> <p>Medical Research Ethics Committee Reference Number: NL33429.008.10 Grant Reference Number: UVT2010-4743</p

Implication de la cigarette électronique dans la prise en charge parodontale conduite à tenir face à ce phénomène de société

L'épidémie tabagique tue 6 millions de personnes chaque année, ce qui en fait de nos jours un réel problème mondial de santé publique. Le tabac est communément reconnu comme premier facleur de risque de la maladie parodolltale et de nombreuses maladies systémiques. Depuis son invention, la cigarette électronique n'a cessé de conquérir le marché en développant un discours autour de la cigarette propre. Sa diffusion massive au sein de la population, en fail aujou rd'hui un nouveau problème de santé publique. Les chirurgiens-dentistes, quotidiennement confrontés aux méfaits du tabac s' interrogent sur l'influence de cette consommation en plein essor. L'objectif de ce travail est, dans un premier temps, de faire le point sur l'état actuel des connaissances scientifiques. Puis, nous dresserons un bilan de l'impact des composants de la cigarette électronique dans la prise en charge parodontale. Ainsi, nous définirons la conduite à tenir du chirurgien-dentiste, acteur de la santé publique, face à ce phénomène de sociélé, tant dans le sevrage labagique, que dans les thérapeutiques parodontales étiologiques, symptomatiques el implantairesMONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Odontologie (341722110) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Optimisation parodontale du sourire : adresser au bon moment pour un réel bénéfice esthétique

Introduction : De nos jours, la demande esthétique devient un des premiers motifs de consultation des patients. Soumis aux diktats de la beauté imposés par notre société, le sourire est un élément clé dans cette quête de l’esthétique parfaite. Ainsi, l’orthodontiste est souvent le premier spécialiste consulté par les adolescents, mais aussi de plus en plus par les adultes. Celui-ci doit être en mesure de réaliser, grâce à des outils simples, une analyse précise du patient comprenant son examen orthodontique, mais aussi parodontal avec un diagnostic parodontal esthétique. Objectifs : Dans cette analyse, l’orthodontiste doit pouvoir identifier le morphotype parodontal de son patient et évaluer si celui-ci est à risque de complications durant son traitement. L’une des principales complications est la récession parodontale. Impactant l’esthétique et suscitant l’inquiétude chez le patient, l’orthodontiste peut vite se retrouver démuni. En cas de doute, il est impératif d’orienter son patient vers l’omnipraticien ou le parodontiste. Matériels et méthodes : Les auteurs décriront dans cet article l’arbre décisionnel qui peut être un outil didactique aidant le praticien dans la prise en charge de son patient. Discussion : Une synergie dans la prise en charge globale des patients est gage d’un résultat optimal des traitements inscrivant le patient dans un schéma thérapeutique individuel et adapté

La salive un avenir prometteur dans le monde du diagnostic médical et parodontal

International audienceLe projet BioPARO, initié à Montpellier, a pour but de mettre en évidence de nouveaux biomarqueurs de la salive afin de faciliter la prévention, le diagnostic et le dépistage précoce des patients à risque potentiel d'une maladie parodontale

La salive un avenir prometteur dans le monde du diagnostic médical et parodontal

International audienceLe projet BioPARO, initié à Montpellier, a pour but de mettre en évidence de nouveaux biomarqueurs de la salive afin de faciliter la prévention, le diagnostic et le dépistage précoce des patients à risque potentiel d'une maladie parodontale

[Collaboration between periodontics and orthodontics: interest of alveolar corticotomies and piezocision. Review of literature]

International audienceOrthodontics in adults must adapt to certain particularities especially related to the decrease or absence of growth and the prevalence of periodontal damage in this population. This review of the literature aims to assess the effects of alveolar corticotomies on accelerating or facilitating tooth movements in different types of orthodontic movements, to compare results obtained by classical technique with those obtained by piezocision and analyze their impact on periodontal tissues in the long term. MATERIAL AND METHODS: Research was performed with Medline, Embase and Cochrane databases, beginning in January 2000. Every study, selected through its title and abstract, was then evaluated through its full content. A total of 65 studies were included. RESULTS: All studies showed that corticotomies temporarily facilitate accelerated orthodontic tooth movement, with minimal complications. No periodontal lesion, loss of pulpal vitality or severe root resorption were reported. DISCUSSION: Only a few studies have examined control groups treated with conventional orthodontics. Corticotomy allows temporary acceleration of orthodontic tooth movement. Piezocision is less invasive and performed in certain indications; it also lightens the postoperative complications. However, the fact that using alveolar corticotomies significantly decreases the treatment time remains uncertain, due to the lack of significant data. Further prospective randomized clinical studies are necessary to analyze more precisely the decrease in the overall treatment time, improved periodontal support and stability of orthodontic treatment results in the long term following the alveolar corticotomies

Benefits of mineralized bone cortical allograft for immediate implant placement in extraction sites: an in vivo study in dogs

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Assessing a multiplex-targeted proteomics approach for the clinical diagnosis of periodontitis using saliva samples

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Peri-implantitis: Summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021

OBJECTIVE: To evaluate the influence of implant and prosthetic components on peri-implant tissue health. A further aim was to evaluate peri-implant soft-tissue changes following surgical peri-implantitis treatment. MATERIALS AND METHODS: Group discussions based on two systematic reviews (SR) and one critical review (CR) addressed (i) the influence of implant material and surface characteristics on the incidence and progression of peri-implantitis, (ii) implant and restorative design elements and the associated risk for peri-implant diseases, and (iii) peri-implant soft-tissue level changes and patient-reported outcomes following peri-implantitis treatment. Consensus statements, clinical recommendations, and implications for future research were discussed within the group and approved during plenary sessions. RESULTS: Data from preclinical in vivo studies demonstrated significantly greater radiographic bone loss and increased area of inflammatory infiltrate at modified compared to non-modified surface implants. Limited clinical data did not show differences between modified and non-modified implant surfaces in incidence or progression of peri-implantitis (SR). There is some evidence that restricted accessibility for oral hygiene and an emergence angle of &gt;30 combined with a convex emergence profile of the abutment/prosthesis are associated with an increased risk for peri-implantitis (CR). Reconstructive therapy for peri-implantitis resulted in significantly less soft-tissue recession, when compared with access flap. Implantoplasty or the adjunctive use of a barrier membrane had no influence on the extent of peri-implant mucosal recession following peri-implantitis treatment (SR). CONCLUSIONS: Prosthesis overcontouring and impaired access to oral hygiene procedures increases risk for peri-implantitis. When indicated, reconstructive peri-implantitis treatment may facilitate the maintenance of post-operative peri-implant soft-tissue levels