Development and testing of a multidimensional parent reported outcome measure for common presenting complaints of infancy: the UK infant questionnaire.

Objectives: Patient reported outcome measures are recognized as important and valuable tools to monitor patient progress in healthcare. It is fundamental to clinical practice to understand whether the treated patient has improved or not. Despite the highest use of outpatient healthcare among all pediatric age groups, no age-appropriate outcome measures are available for the infant. Therefore, the objective of this study was to develop and test a new infant outcomes instrument for the most common presenting complaints of infancy. Methods: This was a multi-phase study designed to develop a questionnaire using maternal interviews and to test it for reliability and validity for use in well child clinical practice. After collecting the mother’s views, grounded theory and content analysis were used to derive themes and domains for the questionnaire. After achieving face validity, the instrument was evaluated for test-retest reliability, homogeneity and concurrent criterion validity. Subjects comprised a convenience sample of mothers who presented their infants to a university-affiliated chiropractic teaching clinic on the south coast of England. Results: Maternal interviews revealed mothers’ concerns about feeding, sleeping, crying and other aspects of infant activities of daily living resulting in construction of a 12 question instrument. The questionnaire showed excellent test-retest reliability (ICC = 0.96) and good internal consistency (Cronbach’s α = 0.8). In validity testing, ten questions showed positive correlation to a statistically significant degree against their established gold standard references. In all, 294 mother/infant dyads were involved in the research project. Conclusion: The UK Infant Questionnaire is the first parent reported outcome measure for use with the most common complaints of the infant patient based on maternal views. As such, this instrument meets the standard set by the UK National Health Service to involve the parent’s voice in their child’s care, and is therefore innovative in its field. Although further testing is indicated, and we make no claims that this instrument is comprehensive in all aspects of infant well-child care, it may be used by individual clinicians in routine daily practice to gain understanding of clinical progress of individual patients

Effect of socket preservation therapies

Uit een eerder systematische review (Van der Weijden et al. 2009) weten we dat, na extractie, de gemiddelde veranderingen van het alveolaire bot in de breedte groter zijn dan het verlies in hoogte. Specifieker, de reductie in breedte van de alveolare bot, na extractie, is klinisch gemeten gemiddeld 3.87 mm. Het mid-buccale hoogte verlies is gemiddeld 1.67 mm. De gemiddelde vulling van een extractie alveole in hoogte gemeten in relatie tot de originele alveole bodem is 2.57 mm. Dit alles na een extractie zonder aanvullende therapie

Effect of socket preservation therapies

Uit een eerder systematische review (Van der Weijden et al. 2009) weten we dat, na extractie, de gemiddelde veranderingen van het alveolaire bot in de breedte groter zijn dan het verlies in hoogte. Specifieker, de reductie in breedte van de alveolare bot, na extractie, is klinisch gemeten gemiddeld 3.87 mm. Het mid-buccale hoogte verlies is gemiddeld 1.67 mm. De gemiddelde vulling van een extractie alveole in hoogte gemeten in relatie tot de originele alveole bodem is 2.57 mm. Dit alles na een extractie zonder aanvullende therapie

De Nederlandse samenvatting: effect of socket preservation therapies following tooth extraction in non-molar regions in humans: a systematic review

Objective: To assess, based on the existing literature, the benefit of socket preservation therapies in patients with a tooth extraction in the anterior or premolar region as compared with no additional treatment with respect to bone level. Material and methods: MEDLINE-PubMed and the Cochrane Central Register of controlled trials (CENTRAL) were searched till June 2010 for appropriate studies, which reported data concerning the dimensional changes in alveolar height and width after tooth extraction with or without additional treatment like bonefillers, collagen, growth factors or membranes. Results: Independent screening of the titles and abstracts of 1918 MEDLINE-PubMed and 163 Cochrane papers resulted in nine publications that met the eligibility criteria. In natural healing after extraction, a reduction in width ranging between 2.6 and 4.6 mm and in height between 0.4 and 3.9 mm was observed. With respect to socket preservation, the freeze-dried bone allograft group performed best with a gain in height, however, concurrent with a loss in width of 1.2 mm. Conclusion: Data concerning socket preservation therapies in humans are scarce, which does not allow any firm conclusions. Socket preservation may aid in reducing the bone dimensional changes following tooth extraction. However, they do not prevent bone resorption because, depending on the technique, on the basis of the included papers one may still expect a loss in width and in height

Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy

Purpose: To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy. Methods: A computed tomography–based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from –20° to +20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes. Results: HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°. Conclusions: HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment. Clinical Relevance: Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy