Trattamento ortodontico delle III classi scheletriche : obiettivi e meccanica

Lo scopo di questo studio consiste nel descrivere una biomeccanica efficiente per la preparazione ortodontico prechirurgica delle III classi dento-scheletriche. Sono state effettuate valutazioni ortodontico pre-chirurgiche riguardo alla posizione degli elementi dentali rispetto alla propria base ossea tramite l\u2019esame clinico, lo studio delle fotografie frontali e laterali del paziente, l\u2019analisi dei modelli in gesso montati in articolatore e tracciati cefalometrici. Sono stati in seguito programmati gli spostamenti ortodontici finalizzati alla posizione delle basi ossee dopo la chirurgia. La preparazione ortodontico prechirurgica, eseguita con biomeccanica prestabilita, ha permesso di effettuare correttamente i movimenti lineari e rotazionali delle basi ossee necessari per la correzione della diasarmonia dento-scheeltrica. Il trattamento ortodontico pre-chirurgico ha lo scopo di rendere ciascuna arcata dentaria competente con la propria base ossea; compito del chirurgo sar\ue0 il riposizionamento delle ossa mascellari che pu\uf2 avvenire senza alcuna interferenza dentale se la preparazione ortodontica prechirurgica \ue8 ben eseguita

Efficacy and safety analysis of once per cycle pegfilgrastim and daily lenograstim in patients with breast cancer receiving adjuvant myelosuppressive chemotherapy FEC 100: a pilot study

Luigi Rossi,1 Federica Tomao,2 Giuseppe Lo Russo,1 Anselmo Papa,1 Federica Zoratto,1 Raffaella Marzano,3 Enrico Basso,1 Erika Giordani,1 Monica Verrico,1 Fabio Ricci,4 Giulia Pasciuti,5 Edoardo Francini,6 Silverio Tomao11Oncology Unit, ICOT Hospital, 2Department of Gynecology and Obstetrics, Policlinico Umberto I Hospital, University of Rome, 3Institute of Hematology and Blood Transfusion, 4Department of Surgery, S Maria Goretti Hospital, Latina, 5Oncology Unit, Don Luigi Liegro Hospital, Gaeta, 6Oncology Unit, Policlinico Umberto I Hospital, University of Rome, ItalyBackground: Neutropenia is a common toxicity in patients receiving myelosuppressive chemotherapy. In this prospective pilot study, we compared the efficacy and safety profiles of pegfilgrastim administered subcutaneously once per cycle and lenograstim administered subcutaneously daily six times per cycle, for primary neutropenia prophylaxis in women with breast cancer receiving adjuvant anthracycline-based chemotherapy.Materials and methods: Twenty women were enrolled. All patients received epirubicin 100 mg/m2 with 5-fluorouracil 500 mg/m2 and cyclophosphamide 500 mg/m2 on day 1 and every 21 days thereafter, according to the FEC 100 chemotherapy regimen. Eight patients received a single dose of pegfilgrastim on day 2, while 12 patients were treated with daily administration of lenograstim from days five to ten. Absolute neutrophil count and duration of grade 3–4 neutropenia were monitored using seriated blood samples. The incidence of bone pain was evaluated using the visual analog scale (VAS).Results: The incidence of grade 3–4 neutropenia was 75% in patients who received pegfilgrastim, and 25% in patients who received lenograstim. One case of febrile neutropenia was shown in pegfilgrastim patients. The mean duration of grade 3–4 neutropenia was 2 days in pegfilgrastim group versus 1.4 days in the lenograstim group. Bone pain was present in 37.5% of pegfilgrastim patients versus 58.3% of lenograstim patients. The mean duration of bone pain in the pegfilgrastim group was 4 days versus 6 days in the lenograstim group.Conclusion: In our experience, a single injection of pegfilgrastim was less effective for controlling neutropenia than six daily injections of lenograstim. The safety profiles of pegfilgrastim and lenograstim were similar with a lower incidence of bone pain in patients treated with pegfilgrastim.Keywords: lenograstim, pegfilgrastim, neutropenia, bone pain, breast cancer, adjuvant anthracycline-based chemotherap