Clinical application of magnets in orthodontics and biological implications: a review

Over the last decade magnets have been used in orthodontic and dentofacial orthopaedics and attempts have been made to evaluate the biological implications of magnets and magnetic fields during clinical application. This review aims to indicate the advantages and disadvantages of magnets in orthodontics and dentofacial orthopaedics over traditional techniques, and update related clinical experiences. The treatment of impacted teeth and Class II malocclusions by means of magnetic force is favoured and the correction of Class III and open bite malocclusions involving the use of magnets also appears promising. The advantages of magnets over traditional force delivery systems are: frictionless mechanics, when the magnets are in attractive configuration; predictable force levels, no force decay over time and less patient co-operation. However, the size of the magnets can increase the bulk of the appliance and three-dimensional control is limited when the magnets are in a repulsive configuration. In addition magnets used in vivo require a coating to prevent corrosion and the possible side effects of corrosive product

Smoker's paradox in ST-elevation myocardial infarction: Role of inflammation and platelets.

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Time Course of Ischemic and Bleeding Burden in Elderly Patients With Acute Coronary Syndromes Randomized to Low-Dose Prasugrel or Clopidogrel

Background Elderly patients have high ischemic and bleeding rates after acute coronary syndrome; however, the occurrence of these complications over time has never been studied. This study sought to characterize average daily ischemic rates ( ADIRs ) and average daily bleeding rates ( ADBRs ) over 1\ua0year in patients aged >74\ua0years with acute coronary syndrome undergoing percutaneous coronary intervention who were randomized in the Elderly ACS 2 trial, comparing low-dose prasugrel (5\ua0mg daily) with clopidogrel (75\ua0mg daily). Methods and Results ADIRs and ADBRs were calculated as the total number of events, including recurrent events, divided by the number of patient-days of follow-up and assessed within different clinical phases: acute (0-3\ua0days), subacute (4-30\ua0days), and late (31-365\ua0days). Generalized estimating equations were used to test the least squares mean differences for the pairwise comparisons of ADIRs and ADBRs and the pairwise comparison of clopidogrel versus prasugrel effects. Globally, ADIRs were 2.6 times (95% CI, 2.4-2.9) higher than ADBRs . ADIRs were significantly higher in the clopidogrel arm than in the low-dose prasugrel arm in the subacute phase ( Padj<0.001) without a difference in ADBRs ( Padj=0.35). In the late phase, ADIRs remained significantly higher with clopidogrel ( Padj<0.001), whereas ADBRs were significantly higher with low-dose prasugrel ( Padj<0.001). Conclusions Ischemic burden was greater than bleeding burden in all clinical phases of 1-year follow-up of elderly patients with acute coronary syndrome treated with percutaneous coronary intervention. Low-dose prasugrel reduced ischemic events in the subacute and chronic phases compared with clopidogrel, whereas bleeding burden was lower with clopidogrel in the late phase. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01777503

LINEE GUIDA PER LA TERAPIA ORTOPEDICA ED ORTODONTICA

Questo testo illustra in maniera dettagliata le Linee Guida per una terapia ortopedia delle malocclusioni scheletriche; sono inoltre descritte le modalità di trattamento mediante trattamento ortodontico fisso da eseguirsi preferibilmente dopo la terapia ortopedica

Linee guida per la terapia ortopedica ed ortodontica

Questo testo illustra in maniera dettagliata le Linee Guida per una terapia ortopedia delle malocclusioni scheletriche; sono inoltre descritte le modalità di trattamento mediante trattamento ortodontico fisso da eseguirsi preferibilmente dopo la terapia ortopedica

P997First experience in 19 months attain stability lv-lead extraction

Background: Two main issues in CRT are:1) obtain constant LV capture without PNS or lead dislodgment and 2) managing CIED infections. Active fixation LV lead Medtronic 20066 Attain Stability allows lead fixation in the target CS vein but there are no long term extraction success data. We report our experience in extraction of this lead, 19 months after implantation. Clinical Case: 84 y.o. man affected by chronic ischemic cardiopaty with severe left ventricular dysfunction (LVEF 25%) and left bundle branch block (native QRS: 180 msec). Implanted with CRT-D (2012) and undergone to malfunctioning LV-lead extraction and reimplantation with a Medtronic 20066 Attain Stability active fixation LV lead (February 2015), he was admitted in our facility in September 2016 diagnosed with pocket infection after complete laboratory and imaging assessment. Patient underwent to CRT-D explant and lead extraction procedure. We performed manual technique using 10-11F mechanical dilator sheats for passive fixation atrial lead and ventricular dual coil active fixation lead. LV lead was armed with non-autolocking stylet, disanchored with just 4 counterclockwise rotations and simply retrieved with manual traction. Procedure was well tolerated without any complication. After 21 days of targeted anthibiotic therapy, patient was right-sided reimplanted with CRT-D and a new Attain Stability Lead in the same PL branch of CS of former one. Conclusions: in our experience, Medtronic Attain Stability active fixation LV lead showed to be safely and effectively extracted, aven 19 months after implantation, as never reported before in literature

Serum osteoprotegerin and carotid intima-media thickness in acute/chronic coronary artery diseases.

AIMS: Osteoprotegerin (OPG) plays a key role in atherosclerosis progression and plaque destabilization. We investigated the relationship between intima-media thickness of the common carotid artery (CCA-IMT; an early marker of atherosclerosis) and OPG levels in patients with acute coronary syndrome (ACS) and chronic coronary artery disease (CAD). METHODS: We studied 133 consecutive patients, mean age 65 ± 9 years, referred to our department for coronary angiography. They were evaluated for cardiovascular risk factors, OPG levels and CCA-IMT and accordingly divided in two subgroups: ACS and chronic CAD. RESULTS: Except for age, the two groups were similar according to conventional cardiovascular risk factors. The chronic CAD group showed a CCA-IMT lower than the ACS group (0.86 ± 0.15 vs. 0.94 ± 0.22 mm, P = 0.027); there were no differences regarding the extension of coronary atherosclerosis on angiograms. The OPG levels were higher in chronic CAD patients than in ACS patients (5.36 ± 3.06 vs. 3.85 ± 2.96 pmol/l, P = 0.004). Moreover, the CCA-IMT was significantly correlated with the age of the patients (r = 0.5; P &lt; 0.001). OPG values were not related either to age or to the CCA-IMT. At analysis of covariance, when adjusting the groups for age, the comparison of the two groups lost statistical significance for CCA-IMT (P = 0.41), whereas the OPG values remained significant after the correction (P = 0.001). CONCLUSION: OPG levels are higher in chronic CAD patients. CCA-IMT confirmed its importance in predicting CAD, showing significantly higher values in the patients in the ACS group as compared with those in the chronic CAD group