A 3D Radiographic Evaluation of Crestal Bone Changes Around Immediately Loaded Endosseous Implants

The purpose of this clinical investigation is to evaluate and compare the 3-dimensional radiographic crestal bone changes around 4 immediately placed and loaded implants supporting full arch fixed mandibular prosthesis in 2 groups of patients. The Test group comprises of patients with failing mandibular teeth needing extraction. ( due to caries, periodontal disease, fractures or prosthetic reasons).The Control group comprises of patients with a fully edentulous mandible presenting for fixed implant supported prosthesis with at least 6 months after the last extraction or bone grafting procedure. Stereolithographic bone model obtained from the patient’s DICOM files was used to fabricate the bone reduction guide and surgical guide. This was a prospective non-randomized controlled clinical study in which the subjects were recruited by strict inclusion and exclusion criteria. Seventeen subjects were recruited for the study. 9 patients for the test group and 8 patients for the control group were treated. Four parallel implants were placed and a fixed provisional was placed within 24 hours after surgery. CBCT and periapical radiographs were taken at baseline, 3, 6 and 12 months and were compared between the 2 group. No clinically significant difference was found in the 3D crestal bone levels between the 2 groups for the different time intervals evaluated at a significance level P \u3c 0.05. The study yielded important guidelines for implants placed in sites where extraction s were combined with alveoloplasty and immediately loaded. Crestal bone changes are minimal when these implants are placed greater than 2mm below the bone crest and when the buccal bone is greater than 3mm wide

Gathering Global Perspectives to Establish the Research Priorities and Minimum Data Sets for Degenerative Cervical Myelopathy:Sampling Strategy of the First Round Consensus Surveys of AO Spine RECODE-DCM

STUDY DESIGN: Survey.INTRODUCTION: AO Spine Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy (AO Spine RECODE-DCM) is an international initiative that aims to accelerate knowledge discovery and improve outcomes by developing a consensus framework for research. This includes defining the top research priorities, an index term and a minimum data set (core outcome set and core data elements set - core outcome set (COS)/core data elements (CDE)).OBJECTIVE: To describe how perspectives were gathered and report the detailed sampling characteristics.METHODS: A two-stage, electronic survey was used to gather and seek initial consensus. Perspectives were sought from spinal surgeons, other healthcare professionals and people with degenerative cervical myelopathy (DCM). Participants were allocated to one of two parallel streams: (1) priority setting or (2) minimum dataset. An email campaign was developed to advertise the survey to relevant global stakeholder individuals and organisations. People with DCM were recruited using the international DCM charity Myelopathy.org and its social media channels. A network of global partners was recruited to act as project ambassadors. Data from Google Analytics, MailChimp and Calibrum helped optimise survey dissemination.RESULTS: Survey engagement was high amongst the three stakeholder groups: 208 people with DCM, 389 spinal surgeons and 157 other healthcare professionals. Individuals from 76 different countries participated; the United States, United Kingdom and Canada were the most common countries of participants.CONCLUSION: AO Spine RECODE-DCM recruited a diverse and sufficient number of participants for an international PSP and COS/CDE process. Whilst PSP and COS/CDE have been undertaken in other fields, to our knowledge, this is the first time they have been combined in one process.</p

Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma

Purpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ≥5 and ≤21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure. Results: Preoperatively, the median (interquartile range: IQR) age was 18 (13.5–30) years. IOP was 16 (14–22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of −12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29–76%) at 3 months and was 21% (8 − 50%) at 1 year and 3 years. The qualified success probability was 93% (82–100%) at 1 year, which reduced to 79% (60–100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success. Conclusion: One-third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery

Hemophagocytic lymphohistiocytosis in 2 patients with multiple sclerosis treated with alemtuzumab.

Alemtuzumab is a highly effective treatment of relapsing-remitting multiple sclerosis (RRMS) with a complex safety profile, including secondary autoimmunity in 40% of patients [1]. We report two cases of hemophagocytic lymphohistiocytosis (HLH) in patients after alemtuzumab treatment of RRMS. This hyperinflammatory syndrome consists of fever, lymphadenopathy, pancytopenia, liver abnormalities, hyperferritinemia, raised soluble interleukin 2 (IL2) receptor and hemophagocytosis; it may be secondary to malignancies, autoimmune diseases, or infections [2]. Table 1 summarizes the diagnostic criteria for secondary HLH

Simulating Potential Impacts of Future Climate Change on <i>Post-Rainy</i> Season Sorghum Yields in India

Given the wide use of the multi-climate model mean (MMM) for impact assessment studies, this work examines the fidelity of Coupled Model Intercomparison Project Phase 5 (CMIP5) in simulating the features of Indian summer monsoons as well as the post-rainy seasons for assessing the possible impacts of climate change on post-rainy season sorghum crop yields across India. The MMM simulations captured the spatial patterns and annual cycles of rainfall and surface air temperatures. However, bias was observed in the precipitation amounts and daily rainfall intensity. The trends in the simulations of MMM for both precipitation and temperatures were less satisfactory than the observed climate means. The Crop Environment Resource Synthesis (CERES)-sorghum model was used to estimate the potential impacts of future climate change on post-rainy season sorghum yield values. On average, post-rainy season sorghum yields are projected to vary between −4% and +40% as well as +10% and +59% in the near future (2040–2069) for RCP 4.5 and RCP 8.5, respectively, and between +20% and +70% (RCP 4.5) as well as +38% and +89% (RCP 8.5) in the far future (2070–2099). Even though surface air temperatures are increasing in future climate change projections, the findings suggest that an increase in the post-rainy season sorghum yields was due to an increase in the rainfall amounts up to 23% and an increase in the atmospheric CO2 levels by the end of the 21st century. The results suggest that the projected climate change during the post-rainy season over India is an opportunity for smallholders to capitalize on the increase in rainfall amounts and further increase sorghum yields with appropriate crop management strategies

Simulating Potential Impacts of Future Climate Change on Post-Rainy Season Sorghum Yields in India

Given the wide use of the multi-climate model mean (MMM) for impact assessment studies, this work examines the fidelity of Coupled Model Intercomparison Project Phase 5 (CMIP5) in simulating the features of Indian summer monsoons as well as the post-rainy seasons for assessing the possible impacts of climate change on post-rainy season sorghum crop yields across India. The MMM simulations captured the spatial patterns and annual cycles of rainfall and surface air temperatures. However, bias was observed in the precipitation amounts and daily rainfall intensity. The trends in the simulations of MMM for both precipitation and temperatures were less satisfactory than the observed climate means. The Crop Environment Resource Synthesis (CERES)-sorghum model was used to estimate the potential impacts of future climate change on post-rainy season sorghum yield values. On average, post-rainy season sorghum yields are projected to vary between &minus;4% and +40% as well as +10% and +59% in the near future (2040&ndash;2069) for RCP 4.5 and RCP 8.5, respectively, and between +20% and +70% (RCP 4.5) as well as +38% and +89% (RCP 8.5) in the far future (2070&ndash;2099). Even though surface air temperatures are increasing in future climate change projections, the findings suggest that an increase in the post-rainy season sorghum yields was due to an increase in the rainfall amounts up to 23% and an increase in the atmospheric CO2 levels by the end of the 21st century. The results suggest that the projected climate change during the post-rainy season over India is an opportunity for smallholders to capitalize on the increase in rainfall amounts and further increase sorghum yields with appropriate crop management strategies