Group 3 ITI Consensus Report: Patient-reported outcome measures associated with implant dentistry

Objectives: The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant-supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant-retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health-related quality of life (QHRQoL), as well as other indicators, that is, pain, general health-related quality of life (e.g., SF-36). Materials and methods: The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved. Results: Patients were very satisfied with the aesthetics of implant-supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients’ ratings. Edentulous patients highly rate both removable and fixed implant-supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient-reported outcomes. Conclusions: Patient-reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients’ satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success

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.

Coronavirus disease 2019 in Latin American patients with multiple sclerosis

Patients with multiple sclerosis (MS) who present coronavirus disease 2019 (COVID-19) are of particular interest to neurologists. These patients have a neuroimmune disease and receive immunomodulatory or immunosuppressive therapies in the long-term. We present here data from 73 patients with MS and a confirmed diagnosis of COVID-19 from five Latin American countries. Fifteen patients (20.5%) were hospitalized and two patients died. The use of anti-CD20 therapies was the only risk factor associated to hospitalization and death. Despite the small sample size, this study highlights the awareness regarding therapeutic options for MS during the pandemic

In the Artaud's Land of Tarahumaras : "One walks from the equinox to the solstice accomplishing one's own humanity"

A partir d’une analyse détaillée de « La danse du Peyolt » et « La Montagne des signes », textes formant l’ensemble D’Un Voyage au pays des Tarahumaras, initialement publiés dans des revues mexicaines et françaises entre 1936 et 1937, cet article s’attache à démontrer comment les nerfs d’Artaud ont enregistré les grands mythes en même temps que les grands moments de l’histoire universelle. La révolution au Mexique, les feux de l’Allemagne, de l’Italie, de l’Espagne, de l’Ethiopie, de la Chine sont autant de moments, où Artaud a pu faire prévaloir une conception matérialiste de l’esprit, qu’il rapporte à travers une vision du corps désagrégé dans la Sierra mexicaine. En parcourant les versants de la montagne, il trouve un appui dans la figure mythique du Jikuri indien et parvient à une régénération physique et spirituelle par l’écriture. Grâce au lien Jikuri, dans le rite de purification du Peyotl, Artaud transcende, par la langue, un « faire-corps » en un « faire-peuple » (Raymonde Carasco : 2009) via les images d’un paysage halluciné. Cet article parut dans une version anglaise en 2016, dans la revue indépendante finlandaise Rab-Rab Press, supportée par Frame visual art Finland. En synthétisant les résultats de l'analyse textuelle avec ceux de la recherche, l’auteur tente de démontrer, qu’au Mexique, Artaud bascule dans le délire conjointement au monde, et que sa poésie prend des intonations prophétiques en "adhérant à l’Histoire". La contamination sémantique entre les termes des Tarahumaras et le lexique de l’homme européen oblitère le sens du mot pour lui redonner immédiatement toute sa force d’énonciation, sa dimension matérielle et son souffle. Tandis qu’Hitler "adjoint la race à l’agent pathogène", Artaud, témoin du discours hygiéniste, en retour, s’y oppose par la "ruse formelle" (Florence de Mèredieu : 2014). Dans le Voyage, il résiste à toutes les formes qui pourraient contrecarrer le "nettoyage de son esprit". En déclarant le retour d’antiques « rapports perdus », il invente un rapport entre l’esprit et le corps qui interrompt l’errance de ce délire historique. Artaud Antonin, Messages révolutionnaires ; D’un voyage au pays des Tarahumaras Œuvres, édition établie, annotée et présentée par Évelyne Grossman, Paris, Gallimard, 2004, (Quarto) ; Carasco Raymonde, « Approche de la pensée tarahumaras » dans Antonin Artaud, Frau Guillaume, Bibliothèque nationale de France- Gallimard, Paris, 2007, p. 134-141 ; de Mèredieu Florence, Antonin Artaud dans la guerre, de Verdun à Hitler, L’Hygiène mentale, Paris, Blusson, 2014, p. 163-202. ; Virmaux Odette et Alain (éd.), Artaud vivant, Paris, NEO, 1980 (Lumière sur, 1) ; Chaliel André, « Antonin Artaud et la confrontation initiatique », dans Virmaux Odette et Alain (éd.), Artaud vivant, op. cit., p.138 ; Dequeker Jean« Antonin Artaud ou « l’Extermination des propriétés » », p.153-164 ; Virmaux Alain, Antonin Artaud et le théâtre, Paris, UGE, 1977 (10/18), p. 84 ; Charbonnier Georges, Antonin Artaud¸ 2e éd., Paris, Seghers, 1970, (Poètes d’aujourd’hui), p. 198-199 ; Thévenin Paule, Antonin Artaud : fin de l’ère chrétienne, Paris, Lignes, 2006, p. 40 ; Art en théorie 1900-1990.Une anthologie par Charles Harrison et Paul Wood¸ Bertrand Anne et Michel Anne (éd.), Paris, Éditions Hazan, 1997, p. 486 ; Nietzsche Friedrich, Poésies, traduction et préface de Georges Ribemont-Dessaignes, Éditions Gérard Lebovici, Paris, 1984, p. 18