expansion of maxillary arches with crossbite a systematic review of rcts in the last 12 years

The aim of this study was to review recent randomized clinical trials (RCTs) dealing with the effectiveness of various modalities of orthopaedic/orthodontic expansion of maxillary arches with crossbite and the associated 6 month post retention stability. The study selection criteria included RCTs involving subjects with maxillary deficiency with crossbite, with no limits of age. The authors searched the following electronic databases from 1999 to January 2011: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS, and WEB of SCIENCE. The search strategy resulted in 12 articles meeting the inclusion criteria. Most of the studies did not meet major methodological requirements; some studies were not relevant because of small sample size, possible bias and unaccounted for confounding variables, lack of blinding in measurements, and deficient statistical methods. Treatment outcomes were different depending on the appliance used, tooth tissue-borne/tooth-borne expanders, bonded semi-rapid maxillary expansion (SRME), or rapid maxillary expansion (RME); in any case, methodological flaws prevent any sound conclusion. Stable results have been measured at the 6 month follow-up after removal of the retention plate in the treated groups in the maxillary intermolar and intercanine distances. Long-term stability results should be assessed. The Consolidated Standards of Reporting Trials (CONSORT) Statement could be helpful in improving the reporting of RCTs

A Prognostic Model for Estimating the Time to Virologic Failure in HIV-1 Infected Patients Undergoing a New Combination Antiretroviral Therapy Regimen

<p>Abstract</p> <p>Background</p> <p>HIV-1 genotypic susceptibility scores (GSSs) were proven to be significant prognostic factors of fixed time-point virologic outcomes after combination antiretroviral therapy (cART) switch/initiation. However, their relative-hazard for the time to virologic failure has not been thoroughly investigated, and an expert system that is able to predict how long a new cART regimen will remain effective has never been designed.</p> <p>Methods</p> <p>We analyzed patients of the Italian ARCA cohort starting a new cART from 1999 onwards either after virologic failure or as treatment-naïve. The time to virologic failure was the endpoint, from the 90^thday after treatment start, defined as the first HIV-1 RNA > 400 copies/ml, censoring at last available HIV-1 RNA before treatment discontinuation. We assessed the relative hazard/importance of GSSs according to distinct interpretation systems (Rega, ANRS and HIVdb) and other covariates by means of Cox regression and random survival forests (RSF). Prediction models were validated via the bootstrap and c-index measure.</p> <p>Results</p> <p>The dataset included 2337 regimens from 2182 patients, of which 733 were previously treatment-naïve. We observed 1067 virologic failures over 2820 persons-years. Multivariable analysis revealed that low GSSs of cART were independently associated with the hazard of a virologic failure, along with several other covariates. Evaluation of predictive performance yielded a modest ability of the Cox regression to predict the virologic endpoint (c-index≈0.70), while RSF showed a better performance (c-index≈0.73, p < 0.0001 vs. Cox regression). Variable importance according to RSF was concordant with the Cox hazards.</p> <p>Conclusions</p> <p>GSSs of cART and several other covariates were investigated using linear and non-linear survival analysis. RSF models are a promising approach for the development of a reliable system that predicts time to virologic failure better than Cox regression. Such models might represent a significant improvement over the current methods for monitoring and optimization of cART.</p

Multiple bilateral impactions in an adolescent girl

his article describes a patient whose permanent canines and premolars had not erupted at age 14 years, although their root formation was complete, with closed apices. Surgical and orthodontic treatment was planned to correct the multiple impactions. The orthodontic traction used 5 strategic teeth and allowed for the eruption of all 12 impacted teeth. The surgical-orthodontic treatment of many impacted teeth yielded good esthetic and periodontal results, as shown by the patient’s satisfaction and the periodontal probing 2 years after the treatment. Multiple impacted teeth are a rare eruption disturbance that requires early de- tection: no signs of a genetic syndrome or an endocrine disorder had been found, or failure to move along the eruption path, which is a characteristic of another syndrome, primary failure of eruption. (Am J Orthod Dentofacial Orthop 2010;137:S163-72

Immunohistochemical study of carbonic anhydrase isozymes in human skin

An increasing number of carbonic anhydrase (CA) isozymes have been discovered in human organs. However, there is little evidence concerning their expression in mammal skin, humans included, and the isozymes involved have not been identified yet. In this study, the distribution of three CA isozymes I, II and IX in human skin from healthy subjects was investigated using an immunohistochemical technique. Specific staining for CA I and II was detected in the basolateral plasma membrane of the epithelial cells of the spinous and basal layers of epidermis as well as in the endothelium of capillaries in the papillary dermis. A marked CA II immunoreactivity was mostly found in secretory cells of the sweat glands. No signal for CA IX was detected but on the plasma membranes and the cytoplasm of cells surrounding the hair shaft. The significance and biological role of CA isozymes expression in human skin is discussed

Immunohistochemical study of carbonic anhydrase isozymes in human skin

An increasing number of carbonic anhydrase (CA) isozymes have been discovered in human organs. However, there is little evidence concerning their expression in mammal skin, humans included, and the isozymes involved have not been identified yet. In this study, the distribution of three CA isozymes I, II and IX in human skin from healthy subjects was investigated using an immunohistochemical technique. Specific staining for CA I and II was detected in the basolateral plasma membrane of the epithelial cells of the spinous and basal layers of epidermis as well as in the endothelium of capillaries in the papillary dermis. A marked CA II immunoreactivity was mostly found in secretory cells of the sweat glands. No signal for CA IX was detected but on the plasma membranes and the cytoplasm of cells surrounding the hair shaft. The significance and biological role of CA isozymes expression in human skin is discussed