Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

¿Novo sistema para tratamento de Classe III esquelética: Ortopedia Maxilomandibular com Ancoragem Óssea (BAMO) em mini-implantes de 3mm?

This case report illustrates the treatment of a skeletal Class III patient in mixed dentition, performed by means of Bone Anchored Maxillo-Mandibular Orthopedics (BAMO), using coil springs and 3-mm miniscrews which are used instead of extraoral appliance

Design and construction of a transducer for bite force registration.

This study describes the development of a system for quantification of human biting forces by (1) determining the mechanical properties of an epoxy resin reinforced with carbon fiber, (2) establishing the transducer's optimal dimensions to accommodate teeth of various widths while minimizing transducer thickness, and (3) determining the optimal location of strain gages using a series of mechanical resistance and finite element (FE) analyses. The optimal strain gage location was defined as the position that produced the least difference in strain pattern when the load was applied by teeth with two different surface areas. The result is a 7.3-mm-thick transducer with a maximum load capacity beyond any expected maximum bite force (1500N). This system includes a graphic interface that easily allows acquisition and registration of bite force by any health-sciences or engineering professional

Diseño y fabricación de un implante de cráneo a la medida.

Este artículo describe la metodología empleada para diseñar y fabricar un implante de cráneo a la medida de un paciente de trece años de edad con una lesión en la región fronto-parietal izquierda del cráneo, provocada por una caída

Desarrollo de un modelo FEM del complejo craneofacial para simular tratamientos en CLASE III esqueletica

Introducción y Objetivo: Describir el método de reconstrucción de un cráneo completo para desarrollar un modelo de elementos finitos que permita posteriormente simular la acción de diferentes dispositivos tracción cervical mandibular, máscara facia