Quantification of three-dimensional orthodontic force systems of T-loop archwires

Objective: To demonstrate the three-dimensional (3D) orthodontic force systems of three commercial closing T-loop archwires using a new method and to quantify the force systems of the T-loop archwires. Materials and Methods: An orthodontic force tester (OFT) and a custom-made dentoform were developed to measure force systems. The system simulated the clinical environment for an orthodontic patient requiring space closure, which included measurement of three force components along, and three moment components about, three clinically defined axes on two target teeth. The archwires were attached to the dentoform and were activated following a standard clinical procedure. The resulting force system was measured using the OFT. Results: The force systems of the T-loops on the teeth were 3D. Activation in one direction resulted in force and moment components in other directions (side effects). The six force and moment components as well as the moment-to-force ratios in the clinically defined coordinate system were quantified. Conclusions: The commercial archwires do not provide force systems for pure translation. Quantification of the force system is critical for the selection and design of optimal orthodontic appliances

Clinical Outcomes of 0.018-Inch and 0.022-Inch Bracket Slot Using the ABO Objective Grading System

Objective: To determine if there is a significant difference in the clinical outcomes of cases treated with 0.018-inch brackets vs 0.022-inch brackets according to the American Board of Orthodontics (ABO) Objective Grading System (OGS). Materials and Methods: Treatment time and the ABO-OGS standards in alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal relationships, occlusal contacts, interproximal contacts, and root angulations were used to compare clinical outcomes between a series of 828 consecutively completed orthodontic cases (2005–2008) treated in a university graduate orthodontic clinic with 0.018-inch- and 0.022-inch-slot brackets. Results: A two-sample t-test showed a significantly shorter treatment time and lower ABO-OGS score in four categories (alignment/rotations, marginal ridges, overjet, and root angulations), as well as lower total ABO-OGS total score, with the 0.018-inch brackets. The ANCOVA—adjusting for covariants of discrepancy index, age, gender, and treatment time—showed that the 0.018-inch brackets scored significantly lower than the 0.022-inch brackets in both the alignment/rotations category and total ABO-OGS score. Conclusions: There were statistically, but not clinically, significant differences in treatment times and in total ABO-OGS scores in favor of 0.018-inch brackets as compared with the 0.022-inch brackets in a university graduate orthodontic clinic (2005–2008)

Translating the Diabetes Prevention Program into the Community The DEPLOY Pilot Study

Background The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention can reduce the development of diabetes by more than half in adults with prediabetes, but there is little information about the feasibility of offering such an intervention in community settings. This study evaluated the delivery of a group-based DPP lifestyle intervention in partnership with the YMCA. Methods This pilot cluster-randomized trial was designed to compare group-based DPP lifestyle intervention delivery by the YMCA to brief counseling alone (control) in adults who attended a diabetes risk-screening event at one of two semi-urban YMCA facilities and who had a BMI ≥24 kg/m2, ≥2 diabetes risk factors, and a random capillary blood glucose of 110–199 mg/dL. Multivariate regression was used to compare between-group differences in changes in body weight, blood pressures, HbA1c, total cholesterol, and HDL-cholesterol after 6 and 12 months. Results Among 92 participants, controls were more often women (61% vs 50%) and of nonwhite race (29% vs 7%). After 6 months, body weight decreased by 6.0% (95% CI=4.7, 7.3) in intervention participants and 2.0% (95% CI=0.6, 3.3) in controls (p<0.001; difference between groups). Intervention participants also had greater changes in total cholesterol (–22 mg/dL vs +6 mg/dL controls; p<0.001). These differences were sustained after 12 months, and adjustment for differences in race and gender did not alter these findings. With only two matched YMCA sites, it was not possible to adjust for potential clustering by site. Conclusions The YMCA may be a promising channel for wide-scale dissemination of a low-cost approach to lifestyle diabetes prevention

Translating the Diabetes Prevention Program into the Community The DEPLOY Pilot Study

Background The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention can reduce the development of diabetes by more than half in adults with prediabetes, but there is little information about the feasibility of offering such an intervention in community settings. This study evaluated the delivery of a group-based DPP lifestyle intervention in partnership with the YMCA. Methods This pilot cluster-randomized trial was designed to compare group-based DPP lifestyle intervention delivery by the YMCA to brief counseling alone (control) in adults who attended a diabetes risk-screening event at one of two semi-urban YMCA facilities and who had a BMI ≥24 kg/m2, ≥2 diabetes risk factors, and a random capillary blood glucose of 110–199 mg/dL. Multivariate regression was used to compare between-group differences in changes in body weight, blood pressures, HbA1c, total cholesterol, and HDL-cholesterol after 6 and 12 months. Results Among 92 participants, controls were more often women (61% vs 50%) and of nonwhite race (29% vs 7%). After 6 months, body weight decreased by 6.0% (95% CI=4.7, 7.3) in intervention participants and 2.0% (95% CI=0.6, 3.3) in controls (p<0.001; difference between groups). Intervention participants also had greater changes in total cholesterol (–22 mg/dL vs +6 mg/dL controls; p<0.001). These differences were sustained after 12 months, and adjustment for differences in race and gender did not alter these findings. With only two matched YMCA sites, it was not possible to adjust for potential clustering by site. Conclusions The YMCA may be a promising channel for wide-scale dissemination of a low-cost approach to lifestyle diabetes prevention

Effect of tension-free vaginal tape procedure on urodynamic continence indices.

OBJECTIVE: To assess the difference in measured urethral function before and after tension-free vaginal tape procedure (TVT). METHODS: Women who underwent TVT for genuine stress incontinence with or without intrinsic sphincter deficiency completed this study. Multichannel urodynamic testing was performed preoperatively and 6 weeks postoperatively. Maximum urethral closure pressure and pressure transmission ratio were recorded. Valsalva leak point pressures were determined at 150 mL and at full bladder capacity. Resting and straining urethral angles were measured using the cotton swab technique. Subjects completed both the Incontinence Impact Questionnaire and Urodynamic Distress Inventory preoperatively and postoperatively. RESULTS: Thirty-five consecutive women were studied. Twenty-three (65.7%) had a preoperative diagnosis of intrinsic sphincter deficiency as defined by maximum urethral closure pressure less than 20 cm H(2)O and/or Valsalva leak point pressure less than 60 cm H(2)O. Subjective and objective success rates were 91% and 83%, respectively. Subjects showed an 86.8% (95% CI 71.9%, 100.0%) improvement in their Incontinence Impact Questionnaire score and a 72.9% (95% CI 62.6%, 83.1%) improvement in their Urodynamic Distress Inventory score. The mean change in maximum urethral closure pressure was -1.3 cm H(2)O (95% CI -5.9, 3.3), whereas the pressure transmission ratio increased 15.7% (95% CI 5.0%, 26.3%). The mean decrease in straining urethral angle was 16.3 degrees (95% CI -23.9 degrees, -8.7 degrees ). Cured subjects demonstrating hypermobility preoperatively continued to do so postoperatively. CONCLUSION: There was a significant increase in pressure transmission ratio, but not maximum urethral closure pressure, after TVT. These changes are similar to those reported after retropubic urethropexy and traditional sling procedures. The effectiveness of the TVT sling does not appear to depend on a clinically significant change in the straining urethral angle

Antigen Clearance during Treatment of Disseminated Histoplasmosis with Itraconazole versus Fluconazole in Patients with AIDS

Antifungal treatment reduces the concentration of Histoplasma antigen in blood and urine, supporting a hypothesis that antigen clearance could be used to compare the activity of new agents for treating histoplasmosis. In separate trials in patients with AIDS, clinical response was similar with itraconazole (85%) and fluconazole (74%). Fungal blood cultures at week 4, however, were negative in a significantly higher proportion of patients treated with itraconazole (92.3%) than in those treated with fluconazole (61.9%) (P = 0.017). Baseline antigen concentrations were similar in the two groups: serum, P = 0.7235; and urine, P = 0.1360. After 4 weeks of treatment, the decline in antigen from baseline in serum was similar in the two treatment groups (P = 0.5237), as it was in urine (P = 0.4679). At week 12, the decline in antigen from baseline in serum also was similar in the two groups (P = 0.4911) and in urine (P = 0.2786). More rapid clearance of fungemia suggests that itraconazole is more effective than fluconazole in treating histoplasmosis. This study demonstrates that clearance of fungemia is a better measure of antifungal effect than clearance of antigen