Correction of Class III Malocclusion Treated with Carriere® MotionTM

Class III malocclusion needs complex orthodontic treatment. This case report describes a 16-year-old male patient with skeletal class III malocclusion with a negative overjet and overbite. Upper incisors were proclined with the accentuated curve of Wilson. Treatment has changed the functional curve of Wilson that has improved functional dynamic occlusion. The patient was treated using a Carriere (R) Motion (TM) Class III (CM3) and SLX 3D Brackets system. After a 25-month treatment, the patient reached class I molars and canines relationships on both sides with good facial aesthetics and good functional occlusion. The result was also satisfactory for the patient. A one-year follow-up confirmed that the outcome was stable

The Correlation between Mandibular Arch Shape and Vertical Skeletal Pattern

Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman’s rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle

Curve of Spee modification in different vertical skeletal patterns after clear aligner therapy: a 3D set-up retrospective study

Abstract Objective The purpose of the present study was to evaluate: (1) changes in the curve of Spee (COS) after clear aligner therapy and (2) whether such changes correlated with the patient’s skeletal patterns. Materials and methods Three-dimensional mandibular models of 106 patients (47 males and 59 females; mean age 22.3 SD ± 3.4 years) treated with clear aligners were retrospectively analysed. The perpendicular distance between the occlusal reference plane and the buccal cusp tip of each lateral tooth was measured. Five angular cephalometric measurements (PP-MP, PP-OP, OP-MP, AFH, and PFH) were performed and correlated with the T1–T0 difference in linear distances. The patients were divided into three groups according to facial divergence. Variance analysis with Tukey post hoc correction was performed to evaluate the differences among groups. Results The one-way ANOVA test showed a statistically significant difference for all analysed variables, except for the change in the distance of the second molar from the occlusal reference plane. Tukey’s HSD test showed the following differences: In normodivergents, the T1–T0 difference in the distance of the first molar from the occlusal plane was 1 mm greater than that observed in the hyperdivergent group (p < 0.05); in the normodivergent group, the T1–T0 difference in the distance of the second premolar from the occlusal plane was 1.23 mm greater than that observed in the hyperdivergent group (p < 0.05), while in the hypodivergent group, it was 1.08 mm greater than in the hyperdivergent group (p < 0.05); finally, in normodivergents, the T1–T0 difference in the distance of the first premolar from the occlusal plane was 0.97 mm greater than that observed in the hyperdivergent group (p < 0.05). Conclusion Treatment with aligners did not lead to a clinically significant change in COS depth. However, when dividing the sample into groups based on craniofacial divergence, COS depth change differed significantly between the three groups

Quality of dementia clinical guidelines and relevance to the care of older people with comorbidity: evidence from the literature

Purpose: The aim of this paper was to explore the applicability of dementia clinical guidelines (CGs) to older patients, to patients with one or several comorbidities, and to both targets in order to evaluate if an association between the applicability and quality of the CGs exists. Materials and methods: A systematic search strategy conducted on electronic databases identified CGs on diagnosis and treatment of dementia published from 2000 to 2013. In addition, websites of organizations devoted to the treatment and awareness of dementia were searched. The quality of evidence was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Two investigators independently scored the relevance of the CGs by means of a specific tool. Descriptive and inferential analyses were performed (Mann–Whitney test, 0.05 α-level). Results: Twenty-two CGs met our inclusion criteria. On average, the quality of the CGs was higher than 70% in three of six domains measured by the AGREE tool. The domains with lower mean scores (less than 50%) were “Applicability” and “Editorial independence”. Considering applicability to older patients, 20 CGs (91%) addressed issues of treatment for older patients, five of them (23%) classified older patients by age, and 13 CGs (60%) addressed issues of comorbidity. Only seven (32%) discussed the quality of evidence for patients with multiple comorbid conditions. Thirteen CGs (60%) reported recommendations for patients with at least one comorbid condition, while seven of them (32%) reported on several comorbid conditions. No statistically significant association between CG quality and relevance to care of older people with or without comorbidity was found (P>0.05). Conclusion: This study showed that dementia CGs poorly address treatment for older patients with comorbidities, regardless of their quality. Therefore, they scarcely satisfy the need of modern clinical practice

Dementia clinical guidelines and quality of care for older patients with multiple comorbid disease. A comparison between Europe and North America

Background Dementia affects 5.4% of the over 65s and its prevalence further increases with age, expecially without effective preven- tion and treatment. Clinical Guidelines (CG) could be used as a tool to improve the quality of care. There is evidence suggesting that CG should be modified for the patient with comorbidities. The aim of this study was to evaluate the applicability of CG for Dementia to the care of older individuals with several comorbid diseases between different international contexts. Methods CG on diagnosis and treatment of dementia published between 2005 and 2012 in Europe (EU) and North America (NA) were identified through searches in the electronic databases. Additionally, dementia organizational websites were searched. Quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Two investi- gators independently assessed the relevance of the CG on the care of older people with comorbidity by means of a specific instrument developed by Boyd et al. Descriptive and inferential analyses were performed (chi-square test at the 0.05 signifi- cance level). Results Twenty-one CG were included in the study. Quality of the evaluated CG was on average higher than 70% in three out of the six domains measured by AGREE instrument. The domains with lower mean scores (less than 50%) were Applicability and Editorial Indipendence. The 8 (38.10%) of the selected CG were published in EU, while 13 (61.90%) were from NA (23.81% from Canada, 38.10% from USA). Quality of evidence for older patients with comorbid conditions was considered in 9 (57.14%)CG. In 12 to 22 CG there are specific recommendations for patients with one comorbid condition, while only 6 to 22 considering several comorbid condition. No differences between NA and EU were found on the analysis of quality of evidence for older patient. While the quality of evidence is discussed for older patients with comorbid conditions more in Europe than in North America (p < 0.02). Also the attention to specific recommendations for patients with at least one comorbid condition is higher in EU (p < 0.04). Conclusion Our findings show that the attention to comorbidity in diagnosis and treatment of dementia is a matter to delve more deeply at the international level

SUCCESSFULLY AGING. CHOICE OF LIFE OR LIFE THAT CHOICES?

Introduction: Doing regular physical activity offers a great deal of positive physiological and psychological effects, such as a decrease in cardiovascular diseases, osteoporosis and hypertension. Today, more than ever, physical activity is particularly relevant in people’s life, as it can be seen by the great number of people who registers in gyms, and by the growing importance given to wellness/ fitness and the striving to physical “perfection”. It is known that a good perception of his own body allows the individual to positively influence his self-esteem, his self-efficacy and his mood. There are not age limitations to enroll in sport clubs and in the last twenty years many seniors have begun to enroll in sport clubs and to frequent them assiduously. Materials and methods: In the present research, we asked ourselves if for a sample of seniors, going regularly to a sport club is linked to a concept of health or to different variables We went to a prestigious Sicilian gym and we documented ourselves about the age of the people enrolled in the structure; we examined a sample of seniors frequenting the structure both on personality and self-perception variables, and on the natural predi- sposition to confront emergencies (digit radio). Results: The Big Five -10 items show that the female group is more open to experience while the male sample shows higher values for consciousness and extroversion. 44% of the female sample and 52% of the male sample obtained mean self-efficacy values.Values obtained from the sample show a statistically relevant difference (P&lt;&lt;0,0001) between real figure and ideal figure; these values reveal that the sample is not satisfied of his body. Results obtained from the entire sample show a slight level of overwei- ght with a BMI of 25,91 (±3,5). While the ratio 2D: 4D is correlated for both groups conscientiously. Conclusion: Results leads us to observe, firstly, the growing number of seniors enrolled at the gym, secondary, that the choice to frequent a sport club is mostly linked to an aesthetic canon imposed by modern society and not to a concept of health. To the que- stion “Choice of life or life that choices?” that we asked ourselves at the beginning of this work we can answer with slight bitterness that often is the life that choices. In any age, mediatic conditioning is very strong; we should continue to make physical activity with the awareness that it represents life and health for our body, becoming sometimes a true elixir of life

Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study

Introduction: Cefiderocol is a siderophore cephalosporin showing activity against various carbapenem-resistant Gram-negative bacteria (CR-GNB). No data currently exist about real-world use of cefiderocol in terms of types of therapy (e.g., empirical or targeted, monotherapy or combined regimens), indications, and patient characteristics. Methods: In this multicenter, prospective study, we aimed at describing the use of cefiderocol in terms of types of therapy, indications, and patient characteristics. Results: Cefiderocol was administered as empirical and targeted therapy in 27.5% (55/200) and 72.5% (145/200) of cases, respectively. Overall, it was administered as monotherapy in 101/200 cases (50.5%) and as part of a combined regimen for CR-GNB infections in the remaining 99/200 cases (49.5%). In multivariable analysis, previous isolation of carbapenem-resistant Acinetobacter baumannii odds ratio (OR) 2.56, with 95% confidence interval (95% CI) 1.01-6.46, p&nbsp;=&nbsp;0.047] and previous hematopoietic stem cell transplantation (OR 8.73, 95% CI 1.05-72.54, p&nbsp;=&nbsp;0.045) were associated with administration of cefiderocol as part of a combined regimen, whereas chronic kidney disease was associated with cefiderocol monotherapy (OR 0.38 for combined regimen, 95% CI 0.16-0.91, p&nbsp;=&nbsp;0.029). Cumulative 30-day mortality was 19.8%, 45.0%, 20.7%, and 22.7% in patients receiving targeted cefiderocol for infections by Enterobacterales, A. baumannii, Pseudomonas aeruginosa, and any metallo-β-lactamase producers, respectively. Conclusions: Cefiderocol is mainly used for targeted treatment, although empirical therapies account for more than 25% of prescriptions, thus requiring dedicated standardization and guidance. The almost equal distribution of cefiderocol monotherapy and cefiderocol-based combination therapies underlines the need for further study to ascertain possible differences in efficacy between the two approaches