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Sample records for class-iii conditions review

  1. Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

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    Meyer Ulrich

    2007-01-01

    Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

  2. Early orthodontic treatment for Class III malocclusion: A systematic review and meta-analysis.

    Science.gov (United States)

    Woon, See Choong; Thiruvenkatachari, Badri

    2017-01-01

    Class III malocclusion affects between 5% and 15% of our population. The 2 most common dilemmas surrounding Class III treatment are the timing of treatment and the type of appliance. A number of appliances have been used to correct a Class III skeletal discrepancy, but there is little evidence available on their effectiveness in the long term. Similarly, early treatment of Class III malocclusion has been practiced with increasing interest. However, there has been no solid evidence on the benefits in the long term. The aim of this systematic review was to evaluate the effectiveness of orthodontic/orthopedic methods used in the early treatment of Class III malocclusion in the short and long terms. Several sources were used to identify all relevant studies independently of language. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase (Ovid), and MEDLINE (Ovid) were searched to June 2016. The selection criteria included randomized controlled trials (RCTs) and prospective controlled clinical trials (CCTs) of children between the ages of 7 and 12 years on early treatment with any type of orthodontic/orthopedic appliance compared with another appliance to correct Class III malocclusion or with an untreated control group. The primary outcome measure was correction of reverse overjet, and the secondary outcomes included skeletal changes, soft tissue changes, quality of life, patient compliance, adverse effect, Peer Assessment Rating score, and treatment time. The search results were screened for inclusion, and the data extracted by 2 independent authors. The data were analyzed using software (version 5.1, Review Manager; The Nordic Cochrane Centre, The Cochrane Collaboration; Copenhagen, Denmark). The mean differences with 95% confidence intervals were expressed for the continuous data. Random effects were carried out with high levels of clinical or statistical heterogeneity and fixed affects when the heterogeneity was low

  3. Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study.

    Science.gov (United States)

    Tachiki, Chie; Nishii, Yasushi; Takaki, Takashi; Sueishi, Kenji

    2018-01-01

    Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (ppre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (ppre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre

  4. Pseudo Class III malocclusion

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    Fadia M. Al-Hummayani

    2016-04-01

    Full Text Available The treatment of deep anterior crossbite is technically challenging due to the difficulty of placing traditional brackets with fixed appliances. This case report represents a none traditional treatment modality to treat deep anterior crossbite in an adult pseudo class III malocclusion complicated by severely retruded, supraerupted upper and lower incisors. Treatment was carried out in 2 phases. Phase I treatment was performed by removable appliance “modified Hawley appliance with inverted labial bow,” some modifications were carried out to it to suit the presented case. Positive overbite and overjet was accomplished in one month, in this phase with minimal forces exerted on the lower incisors. Whereas, phase II treatment was performed with fixed appliances (braces to align teeth and have proper over bite and overjet and to close posterior open bite, this phase was accomplished within 11 month.

  5. Comprehensive surgical. Orthodontic treatment of class III malocclusion in cleft patient involving minimally invasive surgery Case report and literature review.

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    Stojkovic, Goran; Stojkovic, Miodrag; Stojkovic, Jasna; Nikolic, Dejan; Stajcic, Zoran

    2016-12-19

    Surgical and orthodontic treatment of a teenage cleft patient. Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16. Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention. This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery. Alveolar bone grafting, Cleft, Malocclusion.

  6. Gait and Function in Class III Obesity

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    Catherine Ling

    2012-01-01

    Full Text Available Walking, more specifically gait, is an essential component of daily living. Walking is a very different activity for individuals with a Body Mass Index (BMI of 40 or more (Class III obesity compared with those who are overweight or obese with a BMI between 26–35. Yet all obesity weight classes receive the same physical activity guidelines and recommendations. This observational study examined the components of function and disability in a group with Class III obesity and a group that is overweight or has Class I obesity. Significant differences were found between the groups in the areas of gait, body size, health condition, and activity capacity and participation. The Timed Up and Go test, gait velocity, hip circumference, and stance width appear to be most predictive of activity capacity as observed during gait assessment. The findings indicate that Class III-related gait is pathologic and not a normal adaptation.

  7. Timely management of developing class III malocclusion

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    M R Yelampalli

    2012-01-01

    Full Text Available Timing of orthodontic treatment, especially for children with developing class III malocclusions, has always been somewhat controversial, and definitive treatment tends to be delayed for severe class III cases. Developing class III patients with moderate to severe anterior crossbite and deep bite may need early intervention in some selected cases. Class III malocclusion may develop in children as a result of an inherent growth abnormality, i.e. true class III malocclusion, or as a result of premature occlusal contacts causing forward functional shift of the mandible, which is known as pseudo class III malocclusion. These cases, if not treated at the initial stage of development, interfere with normal growth of the jaw bases and may result in severe facial deformities. The treatment should be carried out as early as possible for permitting normal growth of the skeletal bases. This paper deals with the selection of an appropriate appliance from the various current options available for early intervention in developing class III malocclusion through two case reports.

  8. Gender differences in Class III malocclusion.

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    Baccetti, Tiziano; Reyes, Brian C; McNamara, James A

    2005-07-01

    This study evaluated gender differences in the cephalometric records of a large-scale cross-sectional sample of Caucasian subjects with Class III malocclusion at different developmental ages. The purpose also was to provide average age-related and sex-related data for craniofacial measures in untreated Class III subjects that are used as reference in the diagnostic appraisal of the patient with Class III disharmony. The sample examined consisted of 1094 pretreatment lateral cephalometric records (557 female subjects and 537 male subjects) of Caucasian Class III individuals. The age range for female subjects was between three years six months and 57 years seven months. The male subject group ranged from three years three months to 48 years five months. Twelve age groups were identified. Skeletal maturity at different age periods also was determined using the stage of cervical vertebral maturation. Gender differences for all cephalometric variables were analyzed using parametric statistics. The findings of the study indicated that Class III malocclusion is associated with a significant degree of sexual dimorphism in craniofacial parameters, especially from the age of 13 onward. Male subjects with Class III malocclusion present with significantly larger linear dimensions of the maxilla, mandible, and anterior facial heights when compared with female subjects during the circumpubertal and postpubertal periods.

  9. Correction of a severe Class III malocclusion.

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    Arslan, Seher Gündüz; Kama, Jalan Devecioglu; Baran, Sedat

    2004-08-01

    The success of early orthopedic treatment in patients with Class III anomalies depends on facial skeletal development and type of treatment. This case report describes the treatment of a 12.6-year-old girl who had a severe Class III malocclusion with a 6-mm anterior crossbite, a deep overbite, a narrow maxilla, and unerupted maxillary canines. The treatment plan included rapid palatal expansion to expand the maxilla, reverse headgear to correct the maxillary retrognathia, a removable anterior inclined bite plane to correct the anterior crossbite and the deep overbite, and fixed edgewise appliances to align the teeth. One canine was brought into alignment, but the other was placed in occlusion in its transposed position. Ideal overjet and overbite relationships were established, and the final esthetic result was pleasing.

  10. Contemporary solutions for managing Class III malocclusion

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    Nathamuni Rengarajan Krishnaswamy

    2015-01-01

    Full Text Available Although patients with Class III malocclusions constitute a small percentage of the average orthodontic practice, providing them with optimal treatment is a daunting task. The treatment approach is dependent upon the growth status of the individual and the severity of the skeletal dysplasia. For growing individuals, facemask therapy to protract the maxilla is ineffective because of its dependence on dental anchorage to bring forth skeletal correction. Orthodontic camouflage in nongrowing mild skeletal Class III individuals is met with limited success because of the anatomical boundaries and the conventional biomechanics. Orthognathic surgery to correct the maxillomandibular relations is time-consuming, and the facial esthetics is compromised during the orthodontic decompensation period. Contemporary solutions to overcome these limitations are now viable with the use of temporary anchorage devices and by performing surgery prior to orthodontic decompensation. The rationale for employing these contemporary approaches will be discussed in this study with illustrative cases.

  11. Evolution of Class III treatment in orthodontics.

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    Ngan, Peter; Moon, Won

    2015-07-01

    Angle, Tweed, and Moyers classified Class III malocclusions into 3 types: pseudo, dentoalveolar, and skeletal. Clinicians have been trying to identify the best timing to intercept a Class III malocclusion that develops as early as the deciduous dentition. With microimplants as skeletal anchorage, orthopedic growth modification became more effective, and it also increased the scope of camouflage orthodontic treatment for patients who were not eligible for orthognathic surgery. However, orthodontic treatment combined with orthognathic surgery remains the only option for patients with a severe skeletal Class III malocclusion or a craniofacial anomaly. Distraction osteogenesis can now be performed intraorally at an earlier age. The surgery-first approach can minimize the length of time that the malocclusion needs to worsen before orthognathic surgery. Finally, the use of computed tomography scans for 3-dimensional diagnosis and treatment planning together with advances in imaging technology can improve the accuracy of surgical movements and the esthetic outcomes for these patients. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  12. Strategies to finish orthodontic treatment with a Class III molar relationship: three patient reports.

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    Farret, Milton M B; Farret, Marcel M; Farret, Alessandro M

    2009-01-01

    The purpose of this article is to review treatment concepts for patients with congenitally missing teeth in the mandible, for patients in whom teeth in only the mandibular arch were extracted, or for patients with Class III camouflage treatment. The therapy result in these situations is a Class III molar relationship. With this type of intercuspation, esthetic and functional aspects must be observed. © 2009 BY QUINTESSENCE PUBLISHING CO, INC.

  13. 25 CFR 522.12 - Revocation of class III gaming.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Revocation of class III gaming. 522.12 Section 522.12 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR APPROVAL OF CLASS II AND CLASS III ORDINANCES AND RESOLUTIONS SUBMISSION OF GAMING ORDINANCE OR RESOLUTION § 522.12 Revocation of class III...

  14. 25 CFR 502.4 - Class III gaming.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Class III gaming. 502.4 Section 502.4 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GENERAL PROVISIONS DEFINITIONS OF THIS CHAPTER § 502.4 Class III gaming. Class III gaming means all forms of gaming that are not class I gaming or class...

  15. Management of Skeletal Class III Malocclusion with a Combined Approach of Facemask Therapy & Fixed Orthodontic Treatment - A Case Report

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    Shraddha Subhash Shetti

    2013-01-01

    Full Text Available A case report of an adolescent girl with a skeletal Class III malocclusion is presented. The associated clinical features of skeletal Class III are presented and management of such condition is discussed. The need for early identification and intervention of the skeletal Class III malocclusion is universally accepted by dentofacial orthopaedicians. Early intervention is associated with a better orthopedic response. Thus, treatment in the mixed or early permanent dentition can produce favorable results. Overcorrection of skeletal class III is recommended because treated patients grow similar to untreated Class III patients after treatment. Functional orthopaedic treatment rendered at an appropriate age ensures desired results in most cases. The intent of this article is to discuss the non-surgical treatment of a skeletal class III malocclusion along with a rationale of orthodontic management of such patients.

  16. Policy and procedures for classification of Class III groundwater at UMTRA Project sites

    International Nuclear Information System (INIS)

    1989-03-01

    The US Environmental Protection Agency (EPA) has recently proposed groundwater regulations for the US Department of Energy's )DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project. These regulations allow the application of supplemental standards at UMTRA Project sites in specific situations. The designation of groundwater as Class III permits the application of supplemental standards. This document discusses a final UMTRA Project policy and procedures for identifying Class III groundwater, including identification of a review area, definition of water quality, quantification of aquifer yield, and identification of methods reasonably employed for public water supply systems. These items, either individually or collectively, need to be investigated in order to determine if groundwaters at UMTRA Project sites are Class III. This document provides a framework for the DOE to determine Class III groundwaters

  17. Class III malocclusion with severe anteroposterior discrepancy

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    Susana Maria Deon Rizzatto

    2012-10-01

    Full Text Available This study aims at reporting the clinical case of a patient with Class III skeletal malocclusion with severe maxillary deficiency, producing a reduced midface associated with severe mandibular prognathism. The pre-surgical orthodontic preparation was composed mainly by dentoalveolar expansion and repositioning of the incisors in the lower arch. Then, a combined maxillary and mandibular orthognathic surgery was performed. The treatment objectives were achieved, with significant improvement in facial esthetics and occlusion, followed by post-treatment stability. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO, as part of the requirements for obtaining the title of Diplomate by BBO.O objetivo deste artigo é relatar o caso clínico de um paciente portador de má oclusão de Classe III esquelética com acentuada deficiência maxilar, causando redução do terço médio da face, associada a severo prognatismo mandibular. O preparo ortodôntico pré-cirúrgico foi composto, principalmente, pela expansão dentoalveolar da maxila e o reposicionamento dos incisivos na arcada inferior. Depois, foi realizada a cirurgia ortognática combinada maxilomandibular. Os objetivos do tratamento foram atingidos, com significativa melhora da oclusão e da estética facial, seguida de estabilidade pós-tratamento. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, como parte dos requisitos para obtenção do título de Diplomado pelo BBO.

  18. Class III Malocclusion Surgical-Orthodontic Treatment

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    Bruna Alves Furquim

    2014-01-01

    Full Text Available The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.

  19. Interdisciplinary orthognathic treatment of high angle class III ...

    African Journals Online (AJOL)

    For Class III adult patients, combined treatment strategy must be followed which includes either further dentoalveolar compensation or orthognathic surgery following decompensation of the teeth. This case report presents the interdisciplinary approach of a skeletal Class III malocclusion with increased vertical facial ...

  20. Expansion/Facemask Treatment of an Adult Class III Malocclusion.

    Science.gov (United States)

    Jackson, Gregory W; Kravitz, Neal D

    2014-01-01

    The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.

  1. Expansion/Facemask Treatment of an Adult Class III Malocclusion

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    Gregory W. Jackson

    2014-01-01

    Full Text Available The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.

  2. Semilongitudinal cephalometric study of craniofacial growth in untreated Class III malocclusion.

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    Alexander, Ann E Zionic; McNamara, James A; Franchi, Lorenzo; Baccetti, Tiziano

    2009-06-01

    Class III growth in white subjects is poorly characterized because of the low prevalence of the disharmony and the clinical tendency to treat this condition early. The purpose of this study was to investigate craniofacial growth changes by using longitudinal cephalometric records of white subjects with untreated Class III malocclusions to provide comparison data for studies of Class III treatment outcomes. Longitudinal records of 103 subjects were analyzed. Annual incremental growth changes in craniofacial variables from early childhood to late adolescence were examined for each sex. Inferential statistics were applied to changes in mandibular length, midfacial length, and lower anterior facial height of each sex (Wilcoxon tests) and between sexes (Mann-Whitney U tests). In the girls, the adolescent spurt in mandibular growth occurred between the ages of 10 and 12 years. In the boys, the adolescent mandibular growth spurt was between 12 and 15 years. Statistically significant growth changes in the average increments of growth of these linear measurements occurred in both sexes between 12 and 15 years. Adolescent peaks in midfacial growth were at prepubertal ages in both sexes. During childhood (5-7 years), much craniofacial growth occurred. Moreover, there was considerable mandibular growth relative to the maxilla in Class III subjects after the adolescent growth spurt. White Class III subjects showed definite worsening of the relative mandibular prognathism and sagittal skeletal discrepancy between the jaws with growth. The growth pattern of 3 fundamental cephalometric measurements (lower anterior face height, midfacial length, and mandibular length) exhibited differences between Class III male and female subjects in both the timing and the size of average growth increments in the adolescent growth spurt.

  3. DIAGNOSTIC GUIDANCE AND EARLY INTERVENTION IN CLASS III MALOCCLUSION

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    Rinandri Charea Runizar

    2015-06-01

    Full Text Available Timing of orthodontic treatment for Class III malocclusion has always been somewhat controversial. Many orthodontic pioneers like Angle, Tweed, and Graber have advocated early interception of class II malocclusion because this kind of skeletal discrepancy once established, would usually progress rapidly. What kind of early treatment would be appropriate for this malocclusion? Would this approach be effective and promises a stable result? Early orthodontic treatment is defined as a treatment that is initiated during the primary or mixed dentition stage to enhance skeletal and dental development. It is usually done in two phases. The first phase is intended to correct skeletal discrepancy by taking advantage of growth and development period. The second phase followed to improve occlusal relationship. Early treatment of Class III malocclusion is a possible alternative to improve skeletal discrepancy or at the very east may serve to prevent a worsening malocclusion. Principles of Class III early treatment depend on whether it is dental Class III, functional Class III, or skeletal Class III. Practitioners should consider positive and negative factors of a patient before initiating treatment. Likewise, they should understand factors that affect prognosis and stability of the results.

  4. Effect of Class III bone anchor treatment on airway.

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    Nguyen, Tung; De Clerck, Hugo; Wilson, Michael; Golden, Brent

    2015-07-01

    To compare airway volumes and minimum cross-section area changes of Class III patients treated with bone-anchored maxillary protraction (BAMP) versus untreated Class III controls. Twenty-eight consecutive skeletal Class III patients between the ages of 10 and 14 years (mean age, 11.9 years) were treated using Class III intermaxillary elastics and bilateral miniplates (two in the infra-zygomatic crests of the maxilla and two in the anterior mandible). The subjects had cone beam computed tomographs (CBCTs) taken before initial loading (T1) and 1 year out (T2). Twenty-eight untreated Class III patients (mean age, 12.4 years) had CBCTs taken and cephalograms generated. The airway volumes and minimum cross-sectional area measurements were performed using Dolphin Imaging 11.7 3D software. The superior border of the airway was defined by a plane that passes through the posterior nasal spine and basion, while the inferior border included the base of the epiglottis to the lower border of C3. From T1 to T2, airway volume from BAMP-treated subjects showed a statistically significant increase (1499.64 mm(3)). The area in the most constricted section of the airway (choke point) increased slightly (15.44 mm(2)). The airway volume of BAMP patients at T2 was 14136.61 mm(3), compared with 14432.98 mm(3) in untreated Class III subjects. Intraexaminer correlation coefficients values and 95% confidence interval values were all greater than .90, showing a high degree of reliability of the measurements. BAMP treatment did not hinder the development of the oropharynx.

  5. Conservative treatment of Angle Class III malocclusion with anterior crossbite

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    João Hélder Ferreira de Aguiar

    2015-08-01

    Full Text Available Angle Class III malocclusion is characterized by anteroposterior dental discrepancy which might be associated or not with skeletal changes. Class III molar relationship is associated with vertical or lingually tipped mandibular incisors and a usually concave profile. These characteristics seriously affect facial esthetics and most frequently are the reason why patients seek orthodontic treatment. This case was presented to the committee of the Brazilian Board of Orthodontics and Facial Orthopedics (BBO as part of the requisites to become a BBO Diplomate.

  6. 25 CFR 291.15 - How long do Class III gaming procedures remain in effect?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How long do Class III gaming procedures remain in effect... ENTERPRISES CLASS III GAMING PROCEDURES § 291.15 How long do Class III gaming procedures remain in effect? Class III gaming procedures remain in effect for the duration specified in the procedures or until...

  7. Non-extraction treatment of a Class III skeletal case.

    Science.gov (United States)

    Gonzalez, Bulmario

    2009-01-01

    Adult Class III Skeletal treatment options have generally included some form of surgery (Maxillary advancement in midface deficient cases and/or Mandibular set-back). This article discusses non-surgical treatment of an adult patient using the combined concepts of mandibular molar distalization enhanced with TADs and non-extraction camouflage dental correction through maxillary incisor protraction and mandibular incisor lingualization.

  8. Orthodontics-surgical combination therapy for Class III skeletal malocclusion

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    M S Ravi

    2012-01-01

    Full Text Available The correction of skeletal Class III malocclusion with severe mandibular prognathism in an adult individual requires surgical and Othodontic combination therapy. The inter disciplinary approach is the treatment of choice in most of the skeletal malocclusions. A case report of an adult individual with Class III malocclusion, having mandibular excess in sagittal and vertical plane and treated with orthodontics,, bilateral sagittal split osteotomy and Le - Forte I osteotomy for the correction of skeletal, dental and soft tissue discrepancies is herewith presented. The surgical-orthodontic combination therapy has resulted in near-normal skeletal, dental and soft tissue relationship, with marked improvement in the facial esthetics in turn, has helped the patient to improve the self-confidence level.

  9. A benefit-risk assessment of class III antiarrhythmic agents

    DEFF Research Database (Denmark)

    Brendorp, Bente; Pedersen, Oledyg; Torp-Pedersen, Christian

    2002-01-01

    , which differentiates them from the others. However, all have potential serious adverse events. Proarrhythmia, especially torsade de pointes, is a common problem making the benefit-risk ratio of these drugs a key question. Class III drugs have been evaluated in different settings: primary and secondary...... prevention of ventricular arrhythmias and in treatment of atrial fibrillation or flutter. Based on existing evidence there is no routine indication for antiarrhythmic drug therapy other than beta-blockers in patients at high risk of sudden death. Subgroup analyses of trials with amiodarone and dofetilide......-intervals or - in the future - from genetic testing. Class III drugs are effective in converting atrial fibrillation to sinus rhythm and for the maintenance of sinus rhythm after conversion. This is currently by far the most important indication for this class of drugs. As defined by recent guidelines, amiodarone...

  10. [Orthodontic treatment of Class III patients with mandibular asymmetry].

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    Duan, Yin-Zhong; Huo, Na; Chen, Lei; Chen, Xue-Peng; Lin, Yang

    2008-12-01

    To investigate the treatment outcome of Class III patients with dental, functional and mild skeletal mandibular asymmetry. Thirty-five patients (14 males and 21 females) with dental, functional and mild skeletal mandibular asymmetry were selected. The age range of the patients was 7 - 22 years with a mean age of 16.5 years. Dental mandibular asymmetry was treated with expansion of maxillary arch to help the mandible returning to normal position. Functional mandibular asymmetry was treated with activator or asymmetrical protraction and Class III elastics. Mild skeletal mandibular asymmetry was treated with camouflage treatment. Good occlusal relationships were achieved and facial esthetics was greatly improved after orthodontic treatment in patients with dental and functional mandibular asymmetry. However, patients with skeletal mandibular asymmetry should be treated with both extraction and genioplasty. Orthodontic treatment was suitable for patients with dental and functional mandibular asymmetry, while combined orthodontics and surgery could get good results in patients with skeletal mandibular asymmetry.

  11. Class III treatment using facial mask: Stability after 10 years

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    Adilson Luiz Ramos

    2014-10-01

    Full Text Available Early Class III malocclusion treatment may not have long-term stability due to mandibular growth. Although some features of this malocclusion point to a better prognosis, it is practically impossible for the orthodontist to foresee cases that require new intervention. Many patients need retreatment, whether compensatory or orthodontic-surgical. The present study reports the case of a Class III patient treated at the end of the mixed dentition with the use of a face mask followed by conventional fixed appliances. The case remains stable 10 years after treatment completion. It was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as a requirement for the title of certified by the BBO.

  12. A benefit-risk assessment of class III antiarrhythmic agents

    DEFF Research Database (Denmark)

    Elming, Hanne; Brendorp, Bente; Pehrson, Steen

    2004-01-01

    The prevalence of arrhythmia in the population is increasing as more people survive for longer with cardiovascular disease. It was once thought that antiarrhythmic therapy could save life, however, it is now evident that antiarrhythmic therapy should be administrated with the purpose of symptomat......, and reducing the need for implantable cardioverter defibrillator shock/antitachycardia therapy, since no class III antiarrhythmic agents have proven survival benefit. The risks discussed mainly focus on pro-arrhythmia as torsade de pointes ventricular tachycardia....

  13. Surgical-orthodontic correction of a Class III dentofacial deformity.

    Science.gov (United States)

    Devanna, Raghu; Kakkirala, Neelima

    2010-04-01

    This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.

  14. Surgical-orthodontic correction of a Class III dentofacial deformity

    Directory of Open Access Journals (Sweden)

    Raghu Devanna

    2010-01-01

    Full Text Available This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.

  15. [Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment].

    Science.gov (United States)

    Wu, Jia-qi; Xu, Li; Liang, Cheng; Zou, Wei; Bai, Yun-yang; Jiang, Jiu-hui

    2013-10-01

    To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment. There were 10 skeletal Class III patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group. Upper first premolars were extracted in all patients. After leveling and alignment (T2), corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment (T1) and after space closing (T3). All the casts were laser scanned, and the distances of the movement of incisors and molars were digitally measured. The distances of tooth movement in two groups were recorded and analyzed. The alignment time between two groups was not statistically significant. The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months). The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months), and the differences were significant (P 0.05). Accelerated osteogenic orthodontic treatment could accelerate space closing in Class III surgical patients and shorten preoperative orthodontic time. There were no influence on the movement pattern of anterior and posterior teeth during pre-surgical orthodontic treatment.

  16. [Cephalometric analysis in cases with Class III malocclusions].

    Science.gov (United States)

    Rak, D

    1989-01-01

    Various orthodontic class III anomalies, classified into several experimental groups, and eugnathic occlusions serving as controls were studied by roentgencephalometry. The objective of the study was to detect possible distinctions in the quantitative values of two variables chosen and to select the variables which most significantly discriminate the group of class III orthodontic anomalies. Attempts were made to ascertain whether or not there were sex-related differences. The teleroentgenograms of 269 examines, aged 10-18 years, of both sexes were analyzed. The experimental group consisted of 89 examinees class III orthodontic anomalies. The control group consisted of 180 examines with eugnathic occlusion. Latero-lateral skull roentgenograms were taken observing the rules of roentgenocephalometry. Using acetate paper, the drawings of profile teleroentgenograms were elaborated and the reference points and lines were entered. A total of 38 variables were analyzed, of which there were 10 linear, 19 angular, and 8 variables were obtained by mathematical calculation; the age variable was also analyzed. In statistical analyses an electronic computer was used. The results are presented in tables and graphs. The results obtained showed that: --compared to the findings in the control group, the subjects in the experimental group displayed significant changes in the following craniofacial characteristics a negative difference in the position of the apical base of the jaw, manifest concavity of the osseous profile and diminished convexity of the profile of soft parts, retroinclination of the lower incisors, mandibular prognathism, increased mandibular angle and increased mandibular proportion compared to maxillary and the anterior cranial base; --with regard to the sex of the examinees, only four linear variables of significantly discriminating character were selected, so that in can be concluded that there were no significant sex differences among the morphological

  17. Class III camouflage treatment: what are the limits?

    Science.gov (United States)

    Burns, Nikia R; Musich, David R; Martin, Chris; Razmus, Thomas; Gunel, Erdogan; Ngan, Peter

    2010-01-01

    The purpose of this study was to determine the skeletal, dental, and soft-tissue changes in response to camouflage Class III treatment. Thirty patients (average age, 12.4 + or - 1.0 years) with skeletal Class III malocclusions who completed comprehensive nonextraction orthodontic treatment were studied. Skeletal, dental, and soft-tissue changes were determined by using published cephalometric analyses. The quality of orthodontic treatment was standardized by registering the peer assessment rating index on the pretreatment and posttreatment study models. The change in the level of gingival attachment with treatment was determined on the study casts. The results were compared with a group of untreated subjects. Data were analyzed with repeated measures analysis and paired t tests. The average change in the Wits appraisal was greater in the treated group (1.2 + or - 0.1 mm) than in the control group (-0.5 + or - 0.3 mm). The average peer assessment rating index score improved from 33.5 to 4.1. No significant differences were found for the level of gingival attachments between the treatment and control groups. The sagittal jaw relationship (ANB angle) did not improve with camouflage treatment. A wide range of tooth movements compensated for the skeletal changes in both groups. The upper and lower limits for incisal movement to compensate for Class III skeletal changes were 120 degrees to the sella-nasion line and 80 degrees to the mandibular plane, respectively. Greater increases in the angle of convexity were found in the treated group, indicating improved facial profiles. Greater increases in length of the upper lip were found in the treated group, corresponding to the changes in the hard tissues with treatment. Significant dental and soft-tissue changes can be expected in young Class III patients treated with camouflage orthodontic tooth movement. A wide range of skeletal dysplasias can be camouflaged with tooth movement without deleterious effects to the

  18. Vertical control in the Class III compensatory treatment.

    Science.gov (United States)

    Sobral, Márcio Costa; Habib, Fernando A L; Nascimento, Ana Carla de Souza

    2013-01-01

    Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patient's treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who present with a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extraoral appliances on the lower dental arch (J-hook), until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

  19. Vertical control in the Class III compensatory treatment

    Directory of Open Access Journals (Sweden)

    Márcio Costa Sobral

    2013-04-01

    Full Text Available INTRODUCTION: Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patient's treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who carry a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. OBJECTIVE: The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extra-oral appliances on the lower dental arch (J-hook, until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse Curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

  20. Class III camouflage using skeletal anchorage and Pendex appliance.

    Science.gov (United States)

    Miguel, José Augusto M; Zanardi, Gustavo

    2011-01-01

    This case report describes the orthodontic treatment for a young female, aged 18 years 4 months, with a Class III malocclusion on the right side, with a combination of a posterior and anterior crossbite. Two rigid orthodontic mini-implants were placed in the retromolar region in order to move the entire lower arch distally with nickel-titanium coil springs. In addition, a Pendex appliance was used to create space and to improve the arch form and the transverse relationship. The active treatment period was 17 months. Normal overjet and overbite were obtained, and facial balance was improved. Although the cephalometric superimposition has demonstrated the effects of dental compensation, the final dental and facial results were satisfactory and stable after the second year in retention. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  1. Surgical-orthodontic treatment of a skeletal class III malocclusion.

    Science.gov (United States)

    Katiyar, Radha; Singh, G K; Mehrotra, Divya; Singh, Alka

    2010-07-01

    For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment option left. One indication for surgery obviously is a malocclusion too severe for orthodontics alone. It is possible now to be at least semiquantitative about the limits of orthodontic treatment, in the context of producing normal occlusion as the diagrams of the "envelope of discrepancy" indicate. In this case report we present orthognathic treatment plan of an adult female patient with skeletal class III malocclusion. Patient's malocclusion was decompensated by orthodontic treatment just before the surgery and then normal jaw relationship achieved by bilateral sagittal split osteotomy.

  2. Surgical–orthodontic treatment of a skeletal class III malocclusion

    Science.gov (United States)

    Katiyar, Radha; Singh, G. K.; Mehrotra, Divya; Singh, Alka

    2010-01-01

    For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment option left. One indication for surgery obviously is a malocclusion too severe for orthodontics alone. It is possible now to be at least semiquantitative about the limits of orthodontic treatment, in the context of producing normal occlusion as the diagrams of the “envelope of discrepancy” indicate. In this case report we present orthognathic treatment plan of an adult female patient with skeletal class III malocclusion. Patient's malocclusion was decompensated by orthodontic treatment just before the surgery and then normal jaw relationship achieved by bilateral sagittal split osteotomy. PMID:22442586

  3. [Positive inotropic and lusitropic effect of RP 62719, a new class III antiarrhythmia agent].

    Science.gov (United States)

    Beregi, J P; Escande, D; Coudray, N; Chemla, D; Mestre, M; Péry, N; Lecarpentier, Y

    1994-02-01

    Antiarrhythmic drugs, especially the Class I family, exert a negative inotropic effect on the myocardium which is particularly undesirable in patients with depressed left ventricular function. Therefore, research has been directed to the development of new, more specific molecules of the Class III family. The authors studies the mechanical effects of RP 62719 on guinea pig left ventricular papillary muscle. This new molecule is a pure Class III antiarrhythmic, known to lengthen the duration of the cardiac action potential by selectively blocking the potassium current iK1 (inward rectifier K+ current). The mechanical parameters were determined during the phases of contraction and relaxation under isotonic and isometric conditions. At 0.2 and 2 microM concentrations, RP 62719 improved cardiac contraction under both isotonic and isometric conditions with an increase of about 30% of Vmax (p delta 1 (p force normalized per cross-sectional area [AF/S (p actions could provide significant therapeutic advantages especially in patients cardiac failure.

  4. Risk of cesarean delivery among pregnant women with class III obesity.

    Science.gov (United States)

    Borghesi, Yves; Labreuche, Julien; Duhamel, Alain; Pigeyre, Marie; Deruelle, Philippe

    2017-02-01

    To identify factors associated with cesarean delivery among women with class III obesity attempting vaginal delivery. In a retrospective study, medical charts were reviewed for women aged 18 years or older with a singleton pregnancy of at least 37 weeks and a body mass index (calculated as weight in kilograms divided by the square of height in meters) of 40 or higher who were eligible to attempt vaginal delivery at a maternity hospital in Lille, France, between 1999 and 2012. Among 345 eligible women, 301 (87.2%) attempted vaginal delivery; 211 (70.1%) were successful and 90 (29.9%) delivered by cesarean. The frequency of nulliparity was higher among those undergoing cesarean after a trial of labor (64 [71.1%]) than among those who delivered vaginally (57 [27.0%]; Pcesarean (61 [67.8%] vs 96 [45.5%]; Pcesarean among women attempting vaginal delivery (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.25-4.22), whereas history of vaginal delivery was protective (OR 0.08, 95% CI 0.04-0.17). Nulliparous women with class III obesity attempting a vaginal delivery should be warned of the high risk of cesarean delivery, especially if they require induction. © 2016 International Federation of Gynecology and Obstetrics.

  5. Skeletal class III camouflage by mandibular incisor extraction: A case report

    OpenAIRE

    Janardhanan Kumaresan; Tamizharasi Senthil Kumar; Senthil Kumar

    2014-01-01

    Treatment planning in orthodontics plays a key role in determining the successful treatment of any kind of malocclusion. Skeletal class III malocclusions are generally difficult to treat because of the complex nature of the skeletal and dental manifestations they produce. Mild to moderate skeletal class III malocclusions sometimes have an acceptable facial profile where orthodontic camouflage is possible. In this case report, camouflage of a mild skeletal class III is done by the extraction o...

  6. 25 CFR 291.13 - When do Class III gaming procedures for an Indian tribe become effective?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false When do Class III gaming procedures for an Indian tribe... ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.13 When do Class III gaming procedures for an Indian tribe become effective? Upon approval of Class III gaming procedures for the Indian tribe under either...

  7. Substrate specificity determinants of class III nucleotidyl cyclases.

    Science.gov (United States)

    Bharambe, Nikhil G; Barathy, Deivanayaga V; Syed, Wajeed; Visweswariah, Sandhya S; Colaςo, Melwin; Misquith, Sandra; Suguna, Kaza

    2016-10-01

    The two second messengers in signalling, cyclic AMP and cyclic GMP, are produced by adenylyl and guanylyl cyclases respectively. Recognition and discrimination of the substrates ATP and GTP by the nucleotidyl cyclases are vital in these reactions. Various apo-, substrate- or inhibitor-bound forms of adenylyl cyclase (AC) structures from transmembrane and soluble ACs have revealed the catalytic mechanism of ATP cyclization reaction. Previously reported structures of guanylyl cyclases represent ligand-free forms and inactive open states of the enzymes and thus do not provide information regarding the exact mode of substrate binding. The structures we present here of the cyclase homology domain of a class III AC from Mycobacterium avium (Ma1120) and its mutant in complex with ATP and GTP in the presence of calcium ion, provide the structural basis for substrate selection by the nucleotidyl cyclases at the atomic level. Precise nature of the enzyme-substrate interactions, novel modes of substrate binding and the ability of the binding pocket to accommodate diverse conformations of the substrates have been revealed by the present crystallographic analysis. This is the first report to provide structures of both the nucleotide substrates bound to a nucleotidyl cyclase. Coordinates and structure factors have been deposited in the Protein Data Bank with accession numbers: 5D15 (Ma1120 CHD +ATP.Ca 2+ ), 5D0E (Ma1120 CHD +GTP.Ca 2+ ), 5D0H (Ma1120 CHD (KDA→EGY)+ATP.Ca 2+ ), 5D0G (Ma1120 CHD (KDA→EGY)+GTP.Ca 2+ ). Adenylyl cyclase (EC number: 4.6.1.1). © 2016 Federation of European Biochemical Societies.

  8. 77 FR 48167 - Approved Tribal-State Class III Gaming Compact; Indian Gaming

    Science.gov (United States)

    2012-08-13

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Approved Tribal--State Class III Gaming Compact; Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an approval of the gaming compact between...

  9. Do Class III patients have a different growth spurt than the general population?

    Science.gov (United States)

    Lee, Yun-Sik; Lee, Shin-Jae; An, Hongseok; Donatelli, Richard E; Kim, Soo-Hwan

    2012-11-01

    Understanding the timing and length of the growth spurt of Class III prognathic patients is fundamental to the strategy of interceptive orthopedic orthodontics as well as to the timing of orthognathic surgery. Consequently, this study was undertaken to determine whether there are any significant differences in the stature growth pattern of Class III subjects compared with non-Class III subjects and the general population. Twelve-year longitudinal stature growth data were collected for 402 randomly selected adolescents in the general population, 55 Class III mandibular prognathic patients, and 37 non-Class III patients. The growth data were analyzed by using the traditional linear interpolation method and nonlinear growth functions. The 6 stature growth parameters were measured: age at takeoff, stature at takeoff, velocity at takeoff, age at peak height velocity, stature at peak height velocity, and velocity at peak height velocity. Comparisons in the stature growth parameters and 15 cephalometric variables among the general population, Class III subjects, and non-Class III subjects were made with multivariate analysis. Patients with Class III prognathism did not have different growth parameters compared with Class II subjects or the general population. This study does not allow meaningful conclusions with regard to the relationship of mandibular size and stature growth pattern. The application of nonlinear growth curves vs the traditional linear interpolation method was also discussed. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Prosthetic rehabilitation of severe Siebert′s Class III defect with modified Andrews bridge system

    Directory of Open Access Journals (Sweden)

    Manu Rathee

    2015-01-01

    Full Text Available Prosthetic dentistry involves the replacement of missing and contiguous tissues with artificial substitutes to restore and maintain the oral functions, appearance, and health of the patient. The treatment of edentulous areas with ridge defects poses a challenging task for the dentist. Management of such cases involves a wide range of treatment options comprising mainly of surgical interventions and non surgical techniques such as use of removable, fixed or fixed- removable partial dentures. But each treatment plan undertaken should be customized according to patient needs. A variety of factors such as quality and quantity of existing contiguous hard and soft tissues, systemic condition and economic status of the patient play an important role in treatment planning, clinical outcome and prognosis. This case report presents the restoration of a Seibert′s Class III ridge defect by an economical modification of Andrews Bridge in a 32 Year old patient.

  11. Complex networks for data-driven medicine: the case of Class III dentoskeletal disharmony

    International Nuclear Information System (INIS)

    Scala, A; Auconi, P; Scazzocchio, M; Caldarelli, G; McNamara, JA; Franchi, L

    2014-01-01

    In the last decade, the availability of innovative algorithms derived from complexity theory has inspired the development of highly detailed models in various fields, including physics, biology, ecology, economy, and medicine. Due to the availability of novel and ever more sophisticated diagnostic procedures, all biomedical disciplines face the problem of using the increasing amount of information concerning each patient to improve diagnosis and prevention. In particular, in the discipline of orthodontics the current diagnostic approach based on clinical and radiographic data is problematic due to the complexity of craniofacial features and to the numerous interacting co-dependent skeletal and dentoalveolar components. In this study, we demonstrate the capability of computational methods such as network analysis and module detection to extract organizing principles in 70 patients with excessive mandibular skeletal protrusion with underbite, a condition known in orthodontics as Class III malocclusion. Our results could possibly constitute a template framework for organising the increasing amount of medical data available for patients’ diagnosis. (paper)

  12. Management of skeletal Class III malocclusion with unilateral crossbite on a growing patient using facemask-bonded rapid palatal expander and fixed appliances

    Directory of Open Access Journals (Sweden)

    Tinnie Effendy

    2015-01-01

    Full Text Available Facemask (FM and bonded rapid palatal expander (RPE are part of growth modification treatments for correcting skeletal Class III pattern with retrognathic maxilla. This orthopaedic treatment is usually preceded by fixed appliances to achieve aesthetic dental alignment and improve interdigitation. This case report reviews treatment of Class III malocclusion with unilateral crossbite in a 12-year-old boy using FM and bonded RPE, followed by fixed appliances. Choice of FM and bonded RPE was in line with indication which was mild Class III malocclusion with retrognathic maxilla. Execution of treatment was made considering treatment biomechanics and patient cooperation. This orthopaedic treatment was followed by orthodontic treatment specifically aimed to correct unilateral crossbite, canine relationship yet to reach Class I, lower midline shift, as well as unintended dental consequences of using bonded RPE, namely posterior open bite and deepening curve of spee. Posttreatment facial profile and smile are more esthetic. Occlusion is significantly improved both functionally and aesthetically.

  13. Craniofacial changes in Class III malocclusion as related to skeletal and dental maturation.

    Science.gov (United States)

    Baccetti, Tiziano; Reyes, Brian C; McNamara, James A

    2007-08-01

    In this large cross-sectional study, we aimed to analyze growth trends in white subjects with Class III malocclusion using both skeletal and dental maturation staging. The sample consisted of 1091 pretreatment lateral cephalometric records of Class III patients (560 female, 531 male). Cephalometric dentoskeletal measurements were compared at subsequent stages in cervical vertebral maturation and Hellman's categorization of dental development by means of ANOVA with Bonferroni post-hoc tests in both sexes separately. The findings indicated that, in Class III malocclusion, the pubertal peak in mandibular growth occurs between stages 3 and 4 of cervical vertebral maturation, with average increases in total mandibular length of about 8 and 5.5 mm in Class III boys and girls, respectively. Significant changes in total mandibular length occur until young adulthood (18 years on average), with increases between late maturation stages (4 through 6) that were twice as large as in subjects with normal occlusion for the Class III females, and 3 times as large as in subjects with normal occlusion for the Class III males. Growth trends toward accentuated Class III profile and increased vertical dimension of the face also become apparent at late developmental stages (corresponding with complete eruption of the second and third molars).

  14. The Effect of Excipients on the Permeability of BCS Class III Compounds and Implications for Biowaivers.

    Science.gov (United States)

    Parr, Alan; Hidalgo, Ismael J; Bode, Chris; Brown, William; Yazdanian, Mehran; Gonzalez, Mario A; Sagawa, Kazuko; Miller, Kevin; Jiang, Wenlei; Stippler, Erika S

    2016-01-01

    Currently, the FDA allows biowaivers for Class I (high solubility and high permeability) and Class III (high solubility and low permeability) compounds of the Biopharmaceutics Classification System (BCS). Scientific evidence should be provided to support biowaivers for BCS Class I and Class III (high solubility and low permeability) compounds. Data on the effects of excipients on drug permeability are needed to demonstrate that commonly used excipients do not affect the permeability of BCS Class III compounds, which would support the application of biowaivers to Class III compounds. This study was designed to generate such data by assessing the permeability of four BCS Class III compounds and one Class I compound in the presence and absence of five commonly used excipients. The permeability of each of the compounds was assessed, at three to five concentrations, with each excipient in two different models: Caco-2 cell monolayers, and in situ rat intestinal perfusion. No substantial increases in the permeability of any of the compounds were observed in the presence of any of the tested excipients in either of the models, with the exception of disruption of Caco-2 cell monolayer integrity by sodium lauryl sulfate at 0.1 mg/ml and higher. The results suggest that the absorption of these four BCS Class III compounds would not be greatly affected by the tested excipients. This may have implications in supporting biowaivers for BCS Class III compounds in general.

  15. The biowaiver extension for BCS class III drugs: the effect of dissolution rate on the bioequivalence of BCS class III immediate-release drugs predicted by computer simulation.

    Science.gov (United States)

    Tsume, Yasuhiro; Amidon, Gordon L

    2010-08-02

    The Biopharmaceutical Classification System (BCS) guidance issued by the FDA allows waivers for in vivo bioavailability and bioequivalence studies for immediate-release (IR) solid oral dosage forms only for BCS class I drugs. However, a number of drugs within BCS class III have been proposed to be eligible for biowaivers. The World Health Organization (WHO) has shortened the requisite dissolution time of BCS class III drugs on their Essential Medicine List (EML) from 30 to 15 min for extended biowaivers; however, the impact of the shorter dissolution time on AUC(0-inf) and C(max) is unknown. The objectives of this investigation were to assess the ability of gastrointestinal simulation software to predict the oral absorption of the BCS class I drugs propranolol and metoprolol and the BCS class III drugs cimetidine, atenolol, and amoxicillin, and to perform in silico bioequivalence studies to assess the feasibility of extending biowaivers to BCS class III drugs. The drug absorption from the gastrointestinal tract was predicted using physicochemical and pharmacokinetic properties of test drugs provided by GastroPlus (version 6.0). Virtual trials with a 200 mL dose volume at different drug release rates (T(85%) = 15 to 180 min) were performed to predict the oral absorption (C(max) and AUC(0-inf)) of the above drugs. Both BCS class I drugs satisfied bioequivalence with regard to the release rates up to 120 min. The results with BCS class III drugs demonstrated bioequivalence using the prolonged release rate, T(85%) = 45 or 60 min, indicating that the dissolution standard for bioequivalence is dependent on the intestinal membrane permeability and permeability profile throughout the gastrointestinal tract. The results of GastroPlus simulations indicate that the dissolution rate of BCS class III drugs could be prolonged to the point where dissolution, rather than permeability, would control the overall absorption. For BCS class III drugs with intestinal absorption patterns

  16. Non-surgical Management of Skeletal Class III Malocclusion with Bilateral Posterior Crossbite: A Case Report.

    Science.gov (United States)

    Kumari, Lalima; Nayan, Kamal

    2016-12-01

    A 16-year-old female patient with skeletal Class III malocclusion and bilateral posterior cross bite complaining of difficulty in chewing was treated orthodontically without surgery (camouflage treatment). The treatment comprised of fixed orthodontic treatment with MBT prescription (0.022˝×0.028˝ slot) using quad helix appliance for bilateral expansion of maxillary arch and Class III elastics for occlusal correction. Post-treatment records showed normal overbite and overjet with acceptable occlusion. So with this treatment strategy of expanding the maxillary arch using a quad helix appliance and use of Class III elastics, we achieved a good result with optimal occlusion.

  17. Skeletal class III camouflage by mandibular incisor extraction: A case report

    Directory of Open Access Journals (Sweden)

    Janardhanan Kumaresan

    2014-01-01

    Full Text Available Treatment planning in orthodontics plays a key role in determining the successful treatment of any kind of malocclusion. Skeletal class III malocclusions are generally difficult to treat because of the complex nature of the skeletal and dental manifestations they produce. Mild to moderate skeletal class III malocclusions sometimes have an acceptable facial profile where orthodontic camouflage is possible. In this case report, camouflage of a mild skeletal class III is done by the extraction of a single mandibular incisor, which helped in maintaining the profile of the patient and also in the correction of crowding in the mandibular anterior region.

  18. Early class III occlusal tendency in children and its selective management

    Directory of Open Access Journals (Sweden)

    Kapur A

    2008-09-01

    Full Text Available Class III malocclusion may develop in children as a result of an inherent growth abnormality, i.e., true class III malocclusion, or as a result of premature occlusal contacts causing forward functional shift of the mandible, which is known as pseudo class III malocclusion. These cases, if not treated at the initial stage of development, interfere with normal growth of the skeletal bases and may result in severe facial deformities. The treatment should be carried out as early as possible with the aim of permitting normal growth. This paper deals with the selection of an appropriate treatment approach from the various current options available for early intervention in children developing class III occlusal tendencies; the different clinical features are depicted in the three case reports.

  19. Má oclusão Classe III de Angle com discrepância ântero-posterior acentuada Angle Class III malocclusion with severe anteroposterior disharmony

    Directory of Open Access Journals (Sweden)

    Marcos Alan Vieira Bittencourt

    2009-02-01

    Full Text Available A má oclusão Classe III de Angle é caracterizada por uma discrepância dentária ântero-posterior, que pode ou não estar acompanhada por alterações esqueléticas. Em geral, o aspecto facial fica bastante comprometido, sendo justamente esse fator, na maioria das vezes, que motiva o paciente a procurar pelo tratamento. Este caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, representando a categoria 4, ou seja, uma má oclusão com discrepância ântero-posterior acentuada, Classe III, com ANB menor ou igual a -2º, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.Angle Class III malocclusion is characterized by an anteroposterior dental discrepancy which may or may not be accompanied by skeletal changes. In general, distressed by a significantly compromised facial aspect, patients tend to seek treatment. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO, as representative of Category 4, i.e., a malocclusion with severe anteroposterior discrepancy, Class III, and ANB Angle equal to or smaller than -2º, as part of the requirements for obtaining the BBO Diploma.

  20. 25 CFR 291.3 - When may an Indian tribe ask the Secretary to issue Class III gaming procedures?

    Science.gov (United States)

    2010-04-01

    ... III gaming procedures? 291.3 Section 291.3 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.3 When may an Indian tribe ask the Secretary to issue Class III gaming procedures? An Indian tribe may ask the Secretary to issue Class III...

  1. 25 CFR 291.12 - Who will monitor and enforce tribal compliance with the Class III gaming procedures?

    Science.gov (United States)

    2010-04-01

    ... Class III gaming procedures? 291.12 Section 291.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.12 Who will monitor and enforce tribal compliance with the Class III gaming procedures? The Indian tribe and the State may have an agreement...

  2. Combination of expansion and orthognathic surgery in a severe hyperdivergent skeletal Class III malocclusion

    Directory of Open Access Journals (Sweden)

    Anadha Gujar

    2016-01-01

    Full Text Available Class III malocclusions with a severe hyperdivergent growth pattern are very complex to plan and treat. This case report describes the treatment of an adult with a skeletal Class III malocclusion with a midface deficiency, severe bilateral posterior crossbite, and a severe hyperdivergent growth pattern by a combination of a bonded rapid maxillary expansion appliance and surgical procedure of Le Fort I osteotomy for maxillary advancement.

  3. Camouflage treatment of skeletal Class III malocclusion with conventional orthodontic therapy.

    Science.gov (United States)

    Park, Jae Hyun; Yu, Joseph; Bullen, Ryan

    2017-04-01

    Nonextraction camouflage treatment along with Class III elastics was used to treat a 39-year-old woman with a skeletal Class III pattern and a low mandibular plane angle and short lower anterior facial height. The total active treatment time was 26 months. Her occlusion, smile esthetics, and soft tissue profile were significantly improved after treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  4. Maxillary canine-first premolar bilateral transposition in a Class III patient: A case report.

    Science.gov (United States)

    Potrubacz, Maciej Iancu; Tepedino, Michele; Chimenti, Claudio

    2016-05-01

    Tooth transposition is a rare dental anomaly that often represents a challenge for the clinician. The case of a girl with skeletal Class III malocclusion and concomitant maxillary canine-first premolar bilateral transposition, followed from 7 to 17 years of age, is presented. After a first phase of treatment aimed at resolving the Class III malocclusion, the transposition was maintained and the case finalized with a multibracket appliance.

  5. Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern

    OpenAIRE

    Farret,Marcel Marchiori

    2016-01-01

    ABSTRACT This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end...

  6. Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report

    OpenAIRE

    Farret, Marcel Marchiori; Farret, Milton M. Benitez; Farret, Alessandro Marchiori

    2016-01-01

    ABSTRACT Introduction: Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. Objective: To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. Methods: The patient refused to undergo orthognathic surgery; therefore, orthodo...

  7. Management of skeletal Class III malocclusion with reverse pull headgear in a growing individual

    OpenAIRE

    Ambreen Afzal; Hasnain Sakrani; Norisha Ehsan Mahmood; Kamellia Mehershahi; Fatima Burney

    2016-01-01

    Skeletal Class III malocclusion is considered to be one of the most difficult orthodontic problems to treat. This malocclusion is associated with the retrognathic maxilla or prognathic mandible or sometimes a combination of both. The treatment of such cases requires an integrated approach and a comprehensive treatment plan including growth modification, dental camouflage, or orthognathic surgery. In a growing patient, orthopedic correction of skeletal Class III malocclusion with the help of a...

  8. A new modified tandem appliance for management of developing Class III malocclusion

    OpenAIRE

    Sukh, Ram; Singh, Gyan P; Tandon, Pradeep

    2013-01-01

    Most developing Class III patients display a retruded maxilla. Early intervention in mixed dentition is associated with better patient compliance and possibly a better orthopedic response, which can produce favorable results. The aim of this article is to present the fabrication of the new modified tandem appliance and its use in management of developing Class III malocclusion. The therapeutic results of a new modified tandem appliance are presented in an 8 year-old male patient with anterior...

  9. The Effect of Excipients on the Permeability of BCS Class III Compounds and Implications for Biowaivers

    OpenAIRE

    Parr, Alan; Hidalgo, Ismael J.; Bode, Chris; Brown, William; Yazdanian, Mehran; Gonzalez, Mario A.; Sagawa, Kazuko; Miller, Kevin; Jiang, Wenlei; Stippler, Erika S.

    2015-01-01

    Purpose Currently, the FDA allows biowaivers for Class I (high solubility and high permeability) and Class III (high solubility and low permeability) compounds of the Biopharmaceutics Classification System (BCS). Scientific evidence should be provided to support biowaivers for BCS Class I and Class III (high solubility and low permeability) compounds. Methods Data on the effects of excipients on drug permeability are needed to demonstrate that commonly used excipients do not affect the permea...

  10. Morphometric Analysis of the Mandible in Subjects with Class III Malocclusion

    Directory of Open Access Journals (Sweden)

    Jin-Yun Pan

    2006-07-01

    Full Text Available This study evaluated the deformations that contribute to Class III mandibular configuration, employing geometric morphometric analysis. Lateral cephalograms of male and female groups of 100 young adults and 70 children with Class III malocclusion were compared to those of counterparts with normal occlusion. The sample included an equal number of both genders. The cephalographs were traced, and 12 homologous landmarks were identified and digitized. Average mandibular geometries were generated by means of Procrustes analysis. Thin-plate spline analysis was then applied to mandibular configurations to determine local form differences in male and female groups of adults and children with normal occlusion and Class III malocclusion. The mandibular morphology was significantly different between these two groups of male and female adults, and children (p < 0.0001. This spline analysis revealed an anteroposterior elongation of the mandible along the condylion-gnathion axis, showing an extension in the regions of the mandibular condyle and ramus, and of the anteroinferior portion of the mandibular symphysis in Class III groups. More extension was evident in Class III adults. The deformations in subjects with Class III malocclusion may represent a developmental elongation of the mandible anteroposteriorly, which leads to the appearance of a prognathic mandibular profile.

  11. Glenoid fossa position in Class III malocclusion associated with mandibular protrusion.

    Science.gov (United States)

    Innocenti, Cristina; Giuntini, Veronica; Defraia, Efisio; Baccetti, Tiziano

    2009-04-01

    Our aim in this study was to investigate the position of the glenoid fossa in subjects with Class III malocclusion associated with mandibular protrusion to better clarify the role of this craniofacial component in Class III skeletal disharmony. A sample of 30 subjects, aged 8 years +/- 6 months, with skeletal and dental Class III malocclusion associated with mandibular protrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a control group of 33 subjects with skeletal and dental Class I relationships. The comparisons between the Class III group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed with the Mann-Whitney U test at P <0.05. Subjects with Class III malocclusion had a significantly more mesial position of the glenoid fossa, when compared with the control group as measured with 3 parameters. An anterior position of the glenoid fossa is a possible diagnostic anatomic feature of Class III malocclusion associated with mandibular protrusion. An effective measurement to evaluate glenoid fossa position in craniofacial relationships is the cephalometric distance from the glenoid fossa to the frontomaxillary-nasal suture.

  12. Duration of the pubertal peak in skeletal Class I and Class III subjects.

    Science.gov (United States)

    Kuc-Michalska, Małgorzata; Baccetti, Tiziano

    2010-01-01

    To estimate and compare the duration of the pubertal growth peak in Class I and Class III subjects. The data examined consisted of pretreatment lateral cephalometric records of 218 skeletal Class I or Class III subjects (93 female and 125 male subjects) of white ancestry. The duration of the pubertal peak was calculated from the average chronological age intervals between stages CS3 and CS4 of the cervical vertebral maturation in Class I vs Class III groups (t-test). In skeletal Class I subjects, the pubertal peak had a mean duration of 11 months, whereas in Class III subjects it lasted 16 months. The average difference (5 months) was statistically significant (P < .001). The growth interval corresponding to the pubertal growth spurt (CS3-CS4) was longer in Class III subjects than in subjects with normal skeletal relationships; the larger increases in mandibular length during the pubertal peak reported in the literature for Class III subjects may be related to the longer duration of the pubertal peak.

  13. Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children.

    Science.gov (United States)

    Watkinson, Simon; Harrison, Jayne E; Furness, Susan; Worthington, Helen V

    2013-09-30

    Prominent lower front teeth (termed reverse bite; under bite; Class III malocclusion) may be due to a combination of the jaw or tooth positions or both. The upper jaw (maxilla) can be too far back or the lower jaw (mandible) too far forward, or both. Prominent lower front teeth can also occur if the upper front teeth (incisors) are tipped back or the lower front teeth are tipped forwards, or both. Various treatment approaches have been described to correct prominent lower front teeth in children and adolescents. To assess the effects of orthodontic treatment for prominent lower front teeth in children and adolescents. We searched the following databases: Cochrane Oral Health Group's Trials Register (to 7 January 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE via OVID (1946 to 7 January 2013), and EMBASE via OVID (1980 to 7 January 2013). Randomised controlled trials (RCTs) recruiting children or adolescents or both (aged 16 years or less) receiving any type of orthodontic treatment to correct prominent lower front teeth (Class III malocclusion). Orthodontic treatments were compared with control groups who received either no treatment, delayed treatment or a different active intervention. Screening of references, identification of included and excluded studies, data extraction and assessment of the risk of bias of the included studies was performed independently and in duplicate by two review authors. The mean differences with 95% confidence intervals were calculated for continuous data. Meta-analysis was only undertaken when studies of similar comparisons reported comparable outcome measures. A fixed-effect model was used. The I2 statistic was used as a measure of statistical heterogeneity. Seven RCTs with a total of 339 participants were included in this review. One study was assessed as at low risk of bias, three studies were at high risk of bias, and in the remaining three studies risk of bias

  14. A radiographic study of temporomandibular joints in skeletal class III malocclusion

    International Nuclear Information System (INIS)

    Kim, Sung Eun; Kim, Kae Duk

    2003-01-01

    To investigate the differences between the position of the mandibular condyles in temporomandibular joints of patients presenting with normal occlusion and skeletal class III malocclusion. Forty-two subjects with normal occlusion and thirty-seven subjects exhibiting skeletal class III malocclusion prior to orthodontic treatment were included in the study. Transcranial radiographs of each subject were taken at centric occlusion and 1 inch mouth opening. The positional relationship between the mandibular condyles with articular fossae and articular eminences at two positional states were evaluated and analyzed statistically. The mandibular condyles of the skeletal class III malocclusion group were found to be located more anteriorly from the center of the articular fossae compared to the normal occlusion group in centric occlusion. The mandibular condyles of the skeletal Class III malocclusion group were located more superiorly from the middle of articular height than those of the normal occlusion group in centric occlusion. However, these differences were not statistically significant. At 1 inch mouth opening, the mandibular condyles of the skeletal class III malocclusion group were placed more posteriorly from the articular eminences than those of the normal occlusion group. The mean angle of the articular eminence posterior slope were 56.51 .deg. ± 6.29 .deg. in the normal occlusion group and 60.37 .deg. ± 6.26 .deg. in the skeletal Class III malocclusion group. The mandibular condyles of the skeletal Class III malocclusion group were placed more anteriorly at centric occlusion and more posteriorly at 1 inch mouth opening when compared with those of the normal occlusion group.

  15. A radiographic study of temporomandibular joints in skeletal class III malocclusion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Eun; Kim, Kae Duk [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    2003-06-15

    To investigate the differences between the position of the mandibular condyles in temporomandibular joints of patients presenting with normal occlusion and skeletal class III malocclusion. Forty-two subjects with normal occlusion and thirty-seven subjects exhibiting skeletal class III malocclusion prior to orthodontic treatment were included in the study. Transcranial radiographs of each subject were taken at centric occlusion and 1 inch mouth opening. The positional relationship between the mandibular condyles with articular fossae and articular eminences at two positional states were evaluated and analyzed statistically. The mandibular condyles of the skeletal class III malocclusion group were found to be located more anteriorly from the center of the articular fossae compared to the normal occlusion group in centric occlusion. The mandibular condyles of the skeletal Class III malocclusion group were located more superiorly from the middle of articular height than those of the normal occlusion group in centric occlusion. However, these differences were not statistically significant. At 1 inch mouth opening, the mandibular condyles of the skeletal class III malocclusion group were placed more posteriorly from the articular eminences than those of the normal occlusion group. The mean angle of the articular eminence posterior slope were 56.51 .deg. {+-} 6.29 .deg. in the normal occlusion group and 60.37 .deg. {+-} 6.26 .deg. in the skeletal Class III malocclusion group. The mandibular condyles of the skeletal Class III malocclusion group were placed more anteriorly at centric occlusion and more posteriorly at 1 inch mouth opening when compared with those of the normal occlusion group.

  16. Crown-root morphology of lower incisors in patients with class III malocclusion.

    Science.gov (United States)

    Wang, Bo; Shen, Guofang; Fang, Bing; Zhang, Li

    2012-07-01

    The purpose of this study was to investigate the crown-root morphology of lower incisors in patients with class III malocclusion using cone-beam computed tomography. Cone-beam computed tomography images were analyzed from 53 adult class I patients (group 1), 37 preadolescent class III patients (group 2), and 66 adult class III patients (group 3) comprising 3 divisions (divisions 1, 2, and 3 corresponded to mild, moderate, and severe class III malocclusions). The size and crown-root angulations of lower incisors in different groups and divisions were statistically appraised with group 1 used as the control group. No significant differences were found for the size of lower incisors among different groups and divisions (P > 0.05). Compared with group 1, the crown-root angulations of lower incisors in groups 2 and 3 were significantly larger (P lower incisors of division 3 rather than divisions 2 and 3 exhibited larger crown-root angulations (P lower incisors in class III patients during orthodontic and orthognathic treatment, especially in severe ones.

  17. Early treatment of Class III malocclusion with a tandem traction bow appliance

    Directory of Open Access Journals (Sweden)

    Sneha Basaveshwar Valgadde

    2016-01-01

    Full Text Available Since Class III malocclusion is progressive in nature, the facial growth of Class III malocclusion worsens with age. Class III malocclusion is associated with a deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficient maxilla, retrognathic mandible, or a combination of both. The early orthopedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows the accomplishment of successful results, providing facial balance, modifying the maxillofacial growth and development, and in many instances, preventing a future surgical treatment by increasing the stability. Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment of Class III malocclusion, including intra- and extra-oral appliances. The major problem with extraoral anchorage has been of patient compliance due to its physical appearance. The case report presents an intraoral modified tandem appliance for maxillary protraction that has been used clinically to achieve successful results without relying much on patient co-operation.

  18. Mandibular condyle dimensions in Peruvian patients with Class II and Class III skeletal patterns.

    Directory of Open Access Journals (Sweden)

    Hugo Zegarra-Baquerizo

    2017-10-01

    Full Text Available Objective: To compare condylar dimensions of young adults with Class II and Class III skeletal patterns using cone-beam computed tomography (CBCT. Materials and methods: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III were evaluated. Skeletal patterns were classified by measuring the ANB angle of each patient. The anteroposterior diameter (A and P of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior to P (posterior. The coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium to L (lateral; all distances were measured in mm. Results: In Class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in Class III these values were 8.71±1.2 and 8.84±1.42. In Class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in Class III these values were 19.16±2.75 and 19.16±2.54. Conclusion: Class III M-L dimensions showed higher values than Class II, whereas these differences were minimal in A-P.

  19. Long-term outcomes of Class III treatment with mandibular cervical headgear followed by fixed appliances.

    Science.gov (United States)

    Baccetti, Tiziano; Rey, Diego; Oberti, Giovanni; Stahl, Franka; McNamara, James A

    2009-09-01

    To evaluate the stability of the outcomes of mandibular cervical headgear (MCH) and fixed appliance-treated Class III patients at a long-term posttreatment (5 years) observation, compared with well-matched untreated Class III controls, following a previous report on the short-term outcomes of this protocol. The treated group consisted of 20 patients with dentoskeletal Class III malocclusions treated with a two-phase protocol consisting of MCH and fixed appliances, while the control group comprised 18 untreated subjects with similar dentoskeletal Class III malocclusion. Lateral cephalograms of both patients and controls were analyzed at two time points: posttreatment (PT), after two-phase treatment; and long term (LT). All patients were at a postpubertal stage of skeletal maturity at PT, and they showed CS6 at LT, thus revealing completion of pubertal craniofacial growth. In the long term, the treatment group showed significantly smaller values for mandibular length (Co-Gn), SNB angle, maxillomandibular differential, and molar relation. When compared with the controls, the treated patients exhibited also greater values for ANB angle, Wits appraisal, and overjet at LT. No significant difference between the two groups was found for the changes occurring from PT to LT. Favorable dentoskeletal outcomes induced by MCH and fixed appliances remained stable in the long term; untreated Class III malocclusion did not show any tendency toward self-improvement during the postpubertal interval.

  20. [Limiting factors in the class III camouflage treatment: a potential protocol].

    Science.gov (United States)

    Chaques Asensi, José

    2016-06-01

    The Class III skeletal malocclusion has been traditionally treated with a combined approach of orthodontics and orthognathic surgery or with a strategy of orthodontic camouflage. Some severe cases can be identified as ideal candidates for a surgical treatment whereas some others can be handled with orthodontics alone, with a reasonable expectation of an acceptable result. However, the problem remains for the borderline patient. In fact, limited information is available in the literature regarding the identification of the factors that can help in establishing the limits for one treatment modality or the other. Furthermore, the quantification of some of these factors, for practical purposes, is practically missing or very seldom suggested. Therefore, the decision making process remains a subjective reflection based on the "good clinical sense" of the orthodontist or just reduced to an "educated guess". In order to add some information, hopefully useful in deciding the most suitable treatment option for the individual patient, we propose a clinical protocol based on four different factors. Namely: the skeletal discrepancy, the occlusal discrepancy, the periodontal condition and facial aesthetics. For each one of these factors several parameters will be evaluated and, for some of them, an attempt to provide some reference numerical values will be made. Finally, clinical examples will be presented to illustrate the concepts discussed and the treatment alternatives, final treatment plan and treatment outcome will be analyzed for each one of them. © EDP Sciences, SFODF, 2016.

  1. An Assessment of the Quality of Life of Patients With Class III Deformities Treated With Orthognathic Surgery.

    Science.gov (United States)

    Kilinc, Adnan; Ertas, Umit

    2015-07-01

    To evaluate quality of life (QoL) from a broad perspective by a comparison of Turkish patients undergoing orthognathic surgery to correct Angle Class III skeletal deformity with a control group composed of participants without dentofacial deformity using general health, generic oral health, and condition-specific QoL approaches. Thirty patients who underwent orthognathic surgery to correct Class III relations (monomaxillary and bimaxillary groups) and 30 participants with Class I skeletal structure and good dentofacial harmony (control group) were evaluated. Condition-specific QoL through a 22-item Orthognathic Quality of Life Questionnaire (OQLQ), generic oral health-related QoL through a 14-item Short-Form Oral Health Impact Profile (OHIP-14), and generic health-related QoL through a 36-item Short-Form Health Survey (SF-36) were assessed. When the groups were compared, OQLQ scores showed a significant difference in the oral function domain only in the bimaxillary group (P orthognathic surgical patients appeared to be similar to that of participants without dentofacial deformities. Oral health-related QoL of orthognathic surgical patients seemed moderately similar to that of participants without dentofacial deformities. The combined use of these methods is helpful for evaluating QoL from a larger perspective. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Treatment of Class III malocclusion: the key role of the occlusal plane.

    Science.gov (United States)

    Raymond, Jean-Louis; Matern, Olivier; Grollemund, Bruno; Bacon, William

    2010-01-01

    Patients with a Class III malocclusion generally present with a counterclockwise inclination of the occlusal plane, converging with Camper's line towards the front. This slope has an effect on mandibular movement (forward posture) and on chewing mechanisms in general. As dysfunctional mastication is likely to influence facial growth and inter-arch stability negatively, early orthopedic therapy of the occlusal unbalance concurrent with Class III malocclusion is justified. The aim of this article is to present a method of Class III treatment based on a correct re-orientation of the occlusal plane in order to achieve an optimal masticatory mechanism, essential for stability of early treatment outcomes. Copyright © 2010 Società Italiana di Ortodonzia (SIDO). Published by Elsevier Srl. All rights reserved.

  3. Orthodontic clockwise rotation of maxillomandibular complex for improving facial profile in late teenagers with Class III malocclusion: A preliminary report

    OpenAIRE

    Eric JW Liou; Yu-Chi Wang

    2018-01-01

    Objective: Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc) improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and ...

  4. Load Flow and Short Circuit Analysis of the Class III Power System of HANARO

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H. K.; Jung, H. S

    2005-12-15

    The planning, design, and operation of electric power system require engineering studies to assist in the evaluation of the system performance, reliability, safety and economics. The Class III power of HANARO supplies power for not only HANARO but also RIPF and IMEF. The starting current of most ac motors is five to ten times normal full load current. The loads of the Class III power are connected in consecutive orders at an interval for 10 seconds to avoid excessive voltage drop. This technical report deals with the load flow study and motor starting study for the Class III power of HANARO using ETAP(Electrical Transient Analyzer Program) to verify the capacity of the diesel generator. Short-circuit studies are done to determine the magnitude of the prospective currents flowing throughout the power system at various time intervals after a fault occurs. Short-circuit studies can be performed at the planning stage in order to help finalize the system layout, determine voltage levels, and size cables, transformers, and conductors. From this study, we verify the short circuit current capacity of air circuit breaker(ACB) and automatic transfer switch(ATS) of the Class III power.

  5. Proteomics computational analyses suggest that baculovirus GP64 superfamily proteins are class III penetrenes

    Directory of Open Access Journals (Sweden)

    Garry Robert F

    2008-02-01

    Full Text Available Abstract Background Members of the Baculoviridae encode two types of proteins that mediate virus:cell membrane fusion and penetration into the host cell. Alignments of primary amino acid sequences indicate that baculovirus fusion proteins of group I nucleopolyhedroviruses (NPV form the GP64 superfamily. The structure of these viral penetrenes has not been determined. The GP64 superfamily includes the glycoprotein (GP encoded by members of the Thogotovirus genus of the Orthomyxoviridae. The entry proteins of other baculoviruses, group II NPV and granuloviruses, are class I penetrenes. Results Class III penetrenes encoded by members of the Rhabdoviridae and Herpesviridae have an internal fusion domain comprised of beta sheets, other beta sheet domains, an extended alpha helical domain, a membrane proximal stem domain and a carboxyl terminal anchor. Similar sequences and structural/functional motifs that characterize class III penetrenes are located collinearly in GP64 of group I baculoviruses and related glycoproteins encoded by thogotoviruses. Structural models based on a prototypic class III penetrene, vesicular stomatitis virus glycoprotein (VSV G, were established for Thogoto virus (THOV GP and Autographa california multiple NPV (AcMNPV GP64 demonstrating feasible cysteine linkages. Glycosylation sites in THOV GP and AcMNPV GP64 appear in similar model locations to the two glycosylation sites of VSV G. Conclusion These results suggest that proteins in the GP64 superfamily are class III penetrenes.

  6. Inheritance of craniofacial features in Colombian families with class III malocclusion

    Directory of Open Access Journals (Sweden)

    L Otero

    2010-02-01

    Full Text Available L Otero, L Quintero, D Champsaur, E SimancaPontificia Universidad Javeriana, Bogotá, ColombiaIntroduction: The inheritance of class III malocclusion has been well documented, but the inheritance of craniofacial structures in Colombian families with this malocclusion has been not yet reported.Patients and methods: The study sample of 25 families comprised 186 untreated orthodontic individuals from 8 to 60 years old. Pedigrees were drawn using Cyrillic software. Complete family histories for each proband were ascertained and the affection status of relatives was confirmed by lateral cephalograms and facial and dental photographs. Analysis of variance and odds ratio test for each parameter was performed to estimate inheritance from parents to offspring and to determine similar phenotypic features in relatives.Results: The analysis of the pedigrees suggests autosomal dominant inheritance. The craniofacial characteristics that showed more resemblance between parents and offspring were middle facial height, shorter anterior cranial base and mandibular prognathism. In contrast the protrusion of upper lip and maxillary retrusion were the phenotypic features that contributed to class III in the majority of families.Conclusion: Knowledge of the inheritance of craniofacial phenotypes in class III malocclusion will enable the design of new therapies to treat this malocclusion.Keywords: inheritance, craniofacial, phenotype, class III malocclusion

  7. Forecasting craniofacial growth in individuals with class III malocclusion by computational modelling.

    Science.gov (United States)

    Auconi, Pietro; Scazzocchio, Marco; Defraia, Efisio; McNamara, James A; Franchi, Lorenzo

    2014-04-01

    To develop a mathematical model that adequately represented the pattern of craniofacial growth in class III subject consistently, with the goal of using this information to make growth predictions that could be amenable to longitudinal verification and clinical use. A combination of computational techniques (i.e. Fuzzy clustering and Network analysis) was applied to cephalometric data derived from 429 untreated growing female patients with class III malocclusion to visualize craniofacial growth dynamics and correlations. Four age groups of subjects were examined individually: from 7 to 9 years of age, from 10 to 12 years, from 13 to 14 years, and from 15 to 17 years. The connections between pathway components of class III craniofacial growth can be visualized from Network profiles. Fuzzy clustering analysis was able to define further growth patterns and coherences of the traditionally reported dentoskeletal characteristics of this structural imbalance. Craniofacial growth can be visualized as a biological, space-constraint-based optimization process; the prediction of individual growth trajectories depends on the rate of membership to a specific 'winner' cluster, i.e. on a specific individual growth strategy. The reliability of the information thus gained was tested to forecast craniofacial growth of 28 untreated female class III subjects followed longitudinally. The combination of Fuzzy clustering and Network algorithms allowed the development of principles for combining multiple auxological cephalometric features into a joint global model and to predict the individual risk of the facial pattern imbalance during growth.

  8. Identification of diverse archaeal proteins with class III signal peptides cleaved by distinct archaeal prepilin peptidases

    NARCIS (Netherlands)

    Szabó, Zalán; Oliveira Stahl, Adriana; Albers, Sonja-V.; Kissinger, Jessica C.; Driessen, Arnold J.M.; Pohlschröder, Mechthild; Pohlschroder, M.

    2007-01-01

    Most secreted archaeal proteins are targeted to the membrane via a tripartite signal composed of a charged N terminus and a hydrophobic domain, followed by a signal peptidase-processing site. Signal peptides of archaeal flagellins, similar to class III signal peptides of bacterial type IV pilins,

  9. Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion.

    Science.gov (United States)

    Singh, G D; McNamara, J A; Lozanoff, S

    1997-08-01

    The role of the cranial base in the emergence of Class III malocclusion is not fully understood. This study determines deformations that contribute to a Class III cranial base morphology, employing thin-plate spline analysis on lateral cephalographs. A total of 73 children of European-American descent aged between 5 and 11 years of age with Class III malocclusion were compared with an equivalent group of subjects with a normal, untreated, Class I molar occlusion. The cephalographs were traced, checked and subdivided into seven age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized. The datasets were scaled to an equivalent size, and statistical analysis indicated significant differences between average Class I and Class III cranial base morphologies for each group. Thin-plate spline analysis indicated that both affine (uniform) and non-affine transformations contribute toward the total spline for each average cranial base morphology at each age group analysed. For non-affine transformations, Partial warps 10, 8 and 7 had high magnitudes, indicating large-scale deformations affecting Bolton point, basion, pterygo-maxillare, Ricketts' point and articulare. In contrast, high eigenvalues associated with Partial warps 1-3, indicating localized shape changes, were found at tuberculum sellae, sella, and the frontonasomaxillary suture. It is concluded that large spatial-scale deformations affect the occipital complex of the cranial base and sphenoidal region, in combination with localized distortions at the frontonasal suture. These deformations may contribute to reduced orthocephalization or deficient flattening of the cranial base antero-posteriorly that, in turn, leads to the formation of a Class III malocclusion.

  10. Guide to preemption of state-law claims against Class III PMA medical devices.

    Science.gov (United States)

    Whitney, Daniel W

    2010-01-01

    There is a perception that the express preemption holding of the Supreme Court in Riegel v. Medtronic, 552 U.S. 312(2008), immunizes medical device manufacturers from common law personal injury actions involving Class III devices that received FDA clearance under a premarket approval application (PMA). In the aftermath of Riegel, many lawsuits involving Class III PMA devices have been dismissed by district courts applying the new heightened pleading standard of Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007). Other lawsuits involving Class III PMA devices premised on fraud-on-FDA have been dismissed based on the implied preemption holding of the Supreme Court in Buckman v. Plaintiffs' Legal Comm., 531 U.S. 341 (2001). When these decisions are carefully analyzed together with Medtronic, Inc. v. Lohr, 518 U.S. 470 (1996), which found no preemption regarding a Class III device receiving FDA clearance through the 510(k) mechanism, it is apparent that the preemption defense does not apply universally to Class III PMA devices. The overall methodology for framing a non-preempted claim is to first identify conduct which violated the PMA or other specific requirements related to safety or efficacy. If such conduct can also be stated in terms of a breach of a parallel common law duty (e.g, failure to warn under strict liability or negligence, manufacturing defect or breach of warranty), then it would appear the claim is not preempted. Alternatively, regardless of a specific violation, common law remedies are not preempted by general CGMP requirements.

  11. Skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances and lower premolar extractions.

    Science.gov (United States)

    Abu Alhaija, Elham S J; Al-Khateeb, Susan N

    2011-05-01

    Mild Class III malocciusions can be treated by upper incisor proclination and lower incisor retroclination following extraction of the lower first premolars. To compare the skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances, Class III traction and lower first premolar extractions with the changes in a group of untreated Class III patients. The Treatment group consisted of 30 Class III patients (Mean age 13.69 +/- 1.48 years) who were treated by upper and lower fixed appliances, Class III intermaxillary traction and lower first premolar extractions for 2.88 +/- 1.12 years. The Control group consisted of 20 untreated Class III patients (Mean age 13.51 +/- 0.95) matched for age and gender. The T1 to T2 changes in the treated and untreated groups were compared using a paired t-test while differences between the two groups were compared with an independent t-test. During treatment, the upper incisors were proclined about 1 degree and the lower incisors were retroclined 8 degrees. Small, but statistically significant changes in SNB, Wits and the overlying soft tissues accompanied the changes in incisor inclination. At the end of treatment a positive overbite and overjet were achieved. The increase in lower facial height in the Treatment group was comparable with the change in the Control group. A range of mild to moderate Class III malocclusions can be treated by dentoalveolar compensation.

  12. A study of Class III treatment: orthodontic camouflage vs orthognathic surgery.

    Science.gov (United States)

    Georgalis, Katherine; Woods, Michael G

    2015-11-01

    To evaluate the differences in pretreatment and post-treatment characteristics of Class III patients treated with orthodontic camouflage or orthognathic surgery, and to compare the range of skeletal, dental and soft tissue changes that are likely to occur with treatment, with particular reference to the influence of extractions on the resultant incisor angulations. Pretreatment and post-treatment cephalograms of 31 Class III orthodontically-camouflaged patients and 36 Class III surgical patients (without genioplasty) were obtained from one specialist practice. From the surgical group, 26 pre-surgical lateral cephalograms were also obtained. Inclusion criteria for the two groups were at least three of the following: (1) an ANB angle of 1 degree or less, (2) a Wits appraisal less than -4 mm, (3) an incisal overjet ≤ 0 mm, and (14) a Class III molar relationship. All lateral cephalograms were traced and digitised and a number of skeletal, dental and soft tissue variables were measured. The camouflage and surgical groups were also divided into premolar extraction and non-extraction subgroups to allow for a specific analysis of extraction effects. Before treatment, the surgical group demonstrated, on average, a more severe skeletal discrepancy and increased dental compensations, compared with the orthodontically camouflaged group. After treatment, the mean SNA angle was greater, the ANB angle was more positive, the Wits appraisal was closer to ideal and the lower incisors were less retroclined in the surgery group. There was a small mean reduction in horizontal chin projection in the surgery group compared with a small increase in the camouflage group. The mentolabial fold and the lower lip curve were deeper, on average, and the lips less retrusive after surgery. There was a mean increase in upper incisor proclination during treatment in both the surgical and camouflage groups with a greater increase in the camouflage group. There was a significant reduction in upper

  13. [Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region].

    Science.gov (United States)

    Wang, Bo; Shen, Guo-fang; Fang, Bing; Sun, Liang-yan; Wu, Yong; Jiang, Ling-yong; Zhu, Min

    2012-10-01

    To investigate the changes of periodontal conditions after micro-osteotomy assisted lower incisor decompensation for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region. The sample consisted of 22 cases diagnosed as skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region, selected from consecutive patients of Department of Oral & Cranio-maxillofacial Science of Shanghai Ninth People's Hospital during 2009-2012. The samples were divided into 2 groups; G1 comprised 10 patients who accepted micro-osteotomy assisted lower incisor decompensation; G2 comprised 12 patients who chose traditional pre-surgical decomposition. The changes of periodontal conditions of both groups were evaluated with the help of cone-beam CT(CBCT). Data was processed using SAS8.02 software package. For subjects in G1, during the micro-osteotomy assisted pre-surgical orthodontics, no significant difference was found in the amount of root resorption of lower incisors.But labial and lingual vertical alveolar bone loss were 2.60 mm and 2.22 mm; alveolar bone thickness increased by 3.05 mm on the labial side and decreased by 0.88 mm on the lingual side (Ppre-surgical orthodontics was much safer than traditional orthodontics for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region.

  14. Management of severe skeletal Class III malocclusion with bimaxillary orthognathic surgery

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    Jitesh Haryani

    2016-01-01

    Full Text Available Orthognathic surgery in conjunction with fixed orthodontics is a common indication for interdisciplinary management of severe skeletal Class III malocclusion. A thorough analysis of pretreatment investigations and development of a surgical visual treatment objective is essential to plan the type of surgical technique required. Bimaxillary orthognathic surgery is the most common type of surgical procedure for severe skeletal discrepancies. The present case report is a combined ortho-surgical team management of a skeletally Class III patient. The severity of the case required bilateral upper first premolar extraction for dentoalveolar decompensation and simultaneous “Two-jaw surgery” with maxillary advancement of 4 mm and mandibular setback of 7 mm. Postsurgery, a pleasing good facial profile was achieved with Class II molar relation and positive overjet.

  15. Camouflage of moderate Class III malocclusions with extraction of lower second molars and mandibular cervical headgear.

    Science.gov (United States)

    Mora, Diego Rey; Oberti, Giovanni; Ealo, Martha; Baccetti, Tiziano

    2007-01-01

    Orthodontic camouflage in patients with slight or moderate skeletal Class III malocclusions, can be obtained through different treatment alternatives. The purpose of this paper is to present a treatment that has not been described in the literature and which consists of the extraction of lower second molars and distal movement of the posterior segments by means of mandibular cervical headgear (MCH) and fixed appliances as a camouflage alternative. The force applied by the MCH was 250 gr per side (14hr/day). The total treatment time was 1 1/2 years. the extraction of lower second molars along with the use of mandibular cervical headgear is a good treatment alternative for camouflage in moderate Class III patients in order to obtain good occlusal relationships without affecting facial esthetics or producing marked dental compensations.

  16. Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy.

    Science.gov (United States)

    Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto

    2018-04-06

    A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

  17. Management of skeletal Class III malocclusion with face mask therapy and comprehensive orthodontic treatment.

    Science.gov (United States)

    Muthukumar, Kirthika; Vijaykumar, N M; Sainath, M C

    2016-01-01

    Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.

  18. Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern.

    Science.gov (United States)

    Farret, Marcel Marchiori

    2016-06-01

    This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as one of the requirements to become diplomate by the BBO.

  19. THERAPEUTIC DIFFICULTIES IN ACHIEVEMENT OF OPTIMAL ROOT COVERAGE AND AESTHETIC IN CLASS III GINGIVAL RECESSION.

    Directory of Open Access Journals (Sweden)

    Christina Popova

    2013-07-01

    Full Text Available The width of the attached gingiva is defined as a distance between the depth of the gingival sulcus or gingival/periodontal pocket to the mucogingival junction. Authors suggest that a minimal amount of attached gingiva is necessary to ensure the gingival health. When the buccal bone plate and gingival tissues are thin and the position of the tooth is too vestibular gingival margin often displaces apically, and gingival recession develops. In the presence of gingival recession and reduced vestibular depth oral hygiene procedures are embarrassed.The definition of class III gingival recession is marginal lack of tissue extended to/or beyond the mucogingival junction with bone and soft tissue loss interdentally or malpositioning of the tooth.Prognosis for class III and IV gingival recession is that only partial coverage can be expected after root coverage procedures - FGG (free gingival graft or connective tissue graft (CTG. Adjunctive surgical techniques would be helpful to achieve better aesthetic outcomes.

  20. Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report.

    Science.gov (United States)

    Farret, Marcel Marchiori; Farret, Milton M Benitez; Farret, Alessandro Marchiori

    2016-01-01

    Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results.

  1. Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report

    Directory of Open Access Journals (Sweden)

    Marcel Marchiori Farret

    Full Text Available ABSTRACT Introduction: Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. Objective: To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. Methods: The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. Results: After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results.

  2. Management of skeletal Class III malocclusion with face mask therapy and comprehensive orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Kirthika Muthukumar

    2016-01-01

    Full Text Available Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.

  3. Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern

    Directory of Open Access Journals (Sweden)

    Marcel Marchiori Farret

    Full Text Available ABSTRACT This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as one of the requirements to become diplomate by the BBO.

  4. A new modified tandem appliance for management of developing Class III malocclusion

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    Ram Sukh

    2013-01-01

    Full Text Available Most developing Class III patients display a retruded maxilla. Early intervention in mixed dentition is associated with better patient compliance and possibly a better orthopedic response, which can produce favorable results. The aim of this article is to present the fabrication of the new modified tandem appliance and its use in management of developing Class III malocclusion. The therapeutic results of a new modified tandem appliance are presented in an 8 year-old male patient with anterior cross bite and retrognathic maxilla at the mixed dentition stage. Anterior cross bite was corrected in 3 months and the positive overjet of 4 mm after continued use of the appliance for 1 year. There was a significant improvement in profile of the patient. The use of this appliance in this type of malocclusion enabled the correction of malocclusion in a few months and encouraging favorable skeletal growth in the future.

  5. A new modified tandem appliance for management of developing Class III malocclusion.

    Science.gov (United States)

    Sukh, Ram; Singh, Gyan P; Tandon, Pradeep

    2013-10-01

    Most developing Class III patients display a retruded maxilla. Early intervention in mixed dentition is associated with better patient compliance and possibly a better orthopedic response, which can produce favorable results. The aim of this article is to present the fabrication of the new modified tandem appliance and its use in management of developing Class III malocclusion. The therapeutic results of a new modified tandem appliance are presented in an 8 year-old male patient with anterior cross bite and retrognathic maxilla at the mixed dentition stage. Anterior cross bite was corrected in 3 months and the positive overjet of 4 mm after continued use of the appliance for 1 year. There was a significant improvement in profile of the patient. The use of this appliance in this type of malocclusion enabled the correction of malocclusion in a few months and encouraging favorable skeletal growth in the future.

  6. Current and evolving approaches for improving the oral permeability of BCS Class III or analogous molecules.

    Science.gov (United States)

    Dave, Vivek S; Gupta, Deepak; Yu, Monica; Nguyen, Phuong; Varghese Gupta, Sheeba

    2017-02-01

    The Biopharmaceutics Classification System (BCS) classifies pharmaceutical compounds based on their aqueous solubility and intestinal permeability. The BCS Class III compounds are hydrophilic molecules (high aqueous solubility) with low permeability across the biological membranes. While these compounds are pharmacologically effective, poor absorption due to low permeability becomes the rate-limiting step in achieving adequate bioavailability. Several approaches have been explored and utilized for improving the permeability profiles of these compounds. The approaches include traditional methods such as prodrugs, permeation enhancers, ion-pairing, etc., as well as relatively modern approaches such as nanoencapsulation and nanosizing. The most recent approaches include a combination/hybridization of one or more traditional approaches to improve drug permeability. While some of these approaches have been extremely successful, i.e. drug products utilizing the approach have progressed through the USFDA approval for marketing; others require further investigation to be applicable. This article discusses the commonly studied approaches for improving the permeability of BCS Class III compounds.

  7. Finishing occlusion in Class II or Class III molar relation: therapeutic Class II and III.

    Science.gov (United States)

    Nangia, A; Darendeliler, M A

    2001-11-01

    The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalize the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.

  8. Combined orthodontic and surgical treatment of a severe skeletal Class III malocclusion: a case report.

    Science.gov (United States)

    Nene, Salil; Gautam, Rajaganesh; Sharif, Kanaan; Gupta, Gaurav

    2012-01-01

    This report describes a combined orthodontic and surgical treatment approach for a severe skeletal Class III malocclusion in a young Indian woman with serious esthetic concerns. The case required significant surgical correction in the anteroposterior and vertical planes, involving surgeries in both the maxilla and the mandible. The case required the use of mini-implant anchorage in the presurgical phase as well as postorthodontic prosthodontic rehabilitation to replace missing posterior teeth to restore the occlusal table.

  9. Factors influencing orthodontic treatment time for non-surgical Class III malocclusion

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    Lívia Monteiro Bichara

    Full Text Available ABSTRACT To improve orthodontic treatment efficiency, orthodontists must know which variables could interfere with orthodontic treatment time. Objective: To identify variables and their effect size on orthodontic treatment time of Class III malocclusion. Material and Methods: Forty-five Class III malocclusion cases were selected from 2008 patients’ records. Clinical charts, cephalometric radiographs, and pre and posttreatment dental casts were evaluated. Age, sex, PAR index at T1 and T2, overjet, missing teeth, extractions, number of treatment phases, missed appointments, appliance breakages, and cephalometric variables SNA, SNB, ANB, Wits, SnGoGn, CoA, CoGn, IMPA, 1.PP were investigated by multiple linear regression analysis and stepwise method at p2 (patients who missed more than 2 appointments, to detect the influence of this data on treatment time and the quality of the treatment (PAR T2. Results: Average treatment time was 30.27 months. Multiple regression analysis showed that missed appointment (R2=0.4345 and appliance breakages (R2=0.0596 are the only variables able to significantly predict treatment duration. Treatment time for patients who missed more than 2 appointments was nearly one year longer. However, no significant influence on PAR T2 was observed for those patients. Conclusion: Orthodontic treatment duration in Class III patients is mainly influenced by factors related to patient compliance. Patients who missed more appointments did not show worse orthodontic finishing, but longer treatment. No occlusal, cephalometric, or demographic variable obtained before treatment was able to give some significant prediction about treatment time in Class III patients.

  10. Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite

    OpenAIRE

    José Valladares Neto

    2014-01-01

    INTRODUCTION: This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. METHODS: The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extr...

  11. A pilot clinical study of Class III surgical patients facilitated by improved accelerated osteogenic orthodontic treatments.

    Science.gov (United States)

    Wu, JiaQi; Jiang, Jiu-Hui; Xu, Li; Liang, Cheng; Bai, YunYang; Zou, Wei

    2015-07-01

    To evaluate if the improved accelerated osteogenic orthodontics (IAOO) procedure could speed Class III surgical patients' preoperative orthodontic treatment duration and, if yes, to what extent. This study was also designed to determine whether or not an IAOO procedure affects the tooth-moving pattern during extraction space closure. The samples in this study consisted of 24 Class III surgical patients. Twelve skeletal Class III surgery patients served as an experimental group (group 1) and the others as a control group (group 2). Before treatment, the maxillary first premolars were removed. For group 1, after the maxillary dental arch was aligned and leveled (T2), IAOO procedures were performed in the maxillary alveolar bone. Except for this IAOO procedure in group 1, all 24 patients experienced similar combined orthodontic and orthognathic treatment. Study casts of the maxillary dentitions were made before orthodontic treatment (T1) and after extraction space closure (T3). All of the casts were laser scanned, and the amount of movement of the maxillary central incisor, canine, and first molar, as well as arch widths, were digitally measured and analyzed by using the three-dimensional model superimposition method. The time durations T3-T2 were significantly reduced in group 1 by 8.65 ± 2.67 months and for T3-T1 were reduced by 6.39 ± 2.00 months (P teeth movement in the sagittal, vertical, and transverse dimensions between the two groups (P > .05). The IAOO can reduce the surgical orthodontic treatment time for the skeletal Class III surgical patient by more than half a year on average. The IAOO procedures do not save anchorage.

  12. Two-Step Extraction of the Lower First Molar for Class III Treatment in Adult Patient.

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    Almeida, Kélei Cristina de Mathias; Paulin, Ricardo Fabris; Raveli, Taísa Barnabé; Raveli, Dirceu Barnabé; Santos-Pinto, Ary

    2016-01-01

    The aim of this article is to describe a case report of Class III malocclusion treatment with lower first molar extraction. The 27-year-old Caucasian male patient presented a symmetric face with a straight profile, hyperdivergent growth pattern, molar and cuspid Class III relation, and an anterior crossbite as well as a mild crowding on cuspids area, in both upper and lower arches and a tendency to posterior crossbite. The treatment was performed by the use of Haas expansion appliance followed by an initial alignment and leveling of the upper and lower arches with a fixed edgewise appliance, extraction of lower teeth aiming the correction of the incisors proclination and end the treatment with a Class I molar relationship. It resulted in a significant change in the patient's profile, dentoalveolar Class III correction, upper arch expansion, leveling and alignment of the upper and lower arches, and improvement of tipping of the upper and lowers incisors. In cases of a dentoalveolar compensation in well positioned bone bases the treatment with fixed appliances is an alternative and extraction of lower teeth is considered.

  13. Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients.

    Science.gov (United States)

    Wang, Bo; Shen, Guofang; Fang, Bing; Yu, Hongbo; Wu, Yong; Sun, Liangyan

    2014-03-01

    To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P .05). LP decreased from T0 to T1 (P lower anterior region in patients with Class III malocclusion. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery.

    Science.gov (United States)

    Rabie, A-Bakr M; Wong, Ricky W K; Min, G U

    2008-01-01

    To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5 masculine. Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people.

  15. Treatment of skeletal Class III malocclusions: orthognathic surgery or orthodontic camouflage? How to decide.

    Science.gov (United States)

    Benyahia, Hicham; Azaroual, Mohamed Faouzi; Garcia, Claude; Hamou, Edith; Abouqal, Redouane; Zaoui, Fatima

    2011-06-01

    The choice of treatment in adult skeletal Class III occlusions often poses a particularly tricky problem for the orthodontist. Faced with the option of either orthodontic camouflage or orthognathic surgery, the clinician's clinical experience is of paramount importance, especially in borderline cases. The aim of our study was to uncover a guide model enabling the practitioner to distinguish between skeletal Class III cases which can be suitably treated with orthodontics and those requiring orthognathic surgery. The lateral headfilms of 47 adult patients exhibiting skeletal Class III occlusions were analyzed. The orthodontic group comprised 22 patients and the surgical group 25. Twenty-seven linear, proportional and angular measurements were scrutinized. Stepwise discriminant analysis was used to identify the dentoskeletal and esthetic variables which most distinguished the two groups. The Holdaway angle was chosen to differentiate between patients prior to treatment. This model enables us to classify 87.2% of patients correctly. Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.

  16. Management of skeletal Class III malocclusion with reverse pull headgear in a growing individual

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    Ambreen Afzal

    2016-01-01

    Full Text Available Skeletal Class III malocclusion is considered to be one of the most difficult orthodontic problems to treat. This malocclusion is associated with the retrognathic maxilla or prognathic mandible or sometimes a combination of both. The treatment of such cases requires an integrated approach and a comprehensive treatment plan including growth modification, dental camouflage, or orthognathic surgery. In a growing patient, orthopedic correction of skeletal Class III malocclusion with the help of a reverse pull headgear is crucial as it can reduce the chances of further surgical treatment to correct the skeletal discrepancy. This case report describes the management of skeletal Class III malocclusion in a 12-year-old female child with a retrognathic maxilla. The patient did not have any other genetic abnormality or significant known comorbidity. The treatment plan involved fixed orthodontic appliance therapy in combination with a reverse pull headgear for an orthopedic effect. This treatment was continued for 3 years, and well-aligned dental arches with a positive over jet were achieved at the conclusion of treatment. Using facemask therapy in conjunction with fixed orthodontic appliances has been a successful treatment option in growing children. Treatment should be carried out as early as possible to correct the skeletal discrepancy nonsurgically and achieve better results.

  17. Treatment and posttreatment effects of mandibular cervical headgear followed by fixed appliances in Class III malocclusion.

    Science.gov (United States)

    Rey, Diego; Angel, David; Oberti, Giovanni; Baccetti, Tiziano

    2008-03-01

    In this cephalometric investigation, we compared the treatment and posttreatment effects on patients undergoing an initial phase of mandibular cervical headgear (MCH) therapy followed later by comprehensive edgewise therapy with untreated Class III controls. The treated sample consisted of 21 patients treated consecutively with MCH before the pubertal growth spurt (average age, 10 years 2 months at the beginning of treatment). At the final observation period (average age, 15 years 3 months), all patients were in decelerative growth phases as determined by the cervical vertebral maturation method. Active treatment and posttreatment effects were evaluated in the treated group with nonparametric statistical analysis for paired samples. The treated sample was compared with a nonparametric statistical test for independent samples with 20 untreated Class III subjects who were matched for malocclusion, sex, and stage of cervical vertebral maturation to the treatment group. MCH therapy followed by fixed appliances was shown to be an effective treatment for the correction of skeletal Class III malocclusion at postpubertal observation. The favorable skeletal effects consisted mainly of smaller increases in mandibular length and advancement with respect to the controls, with the final outcome of significant improvements in the sagittal skeletal (+4 mm for the Wits appraisal) and dental (+2.7 mm for overjet, -4.4 mm for molar relationship) parameters. This treatment protocol also induced significant downward rotation of the mandible (2.8 degrees ).

  18. Evaluation of temporomandibular disorders in Class III patients treated with mandibular cervical headgear and fixed appliances.

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    Rey, Diego; Oberti, Giovanni; Baccetti, Tiziano

    2008-03-01

    Our aim in this study was to evaluate the prevalence of temporomandibular disorders (TMD) in Class III patients treated with mandibular cervical headgear (MCH) and fixed appliances. The sample of 75 patients included 25 patients with no previous orthodontic treatment, 25 Class I patients who had undergone orthodontic treatment with fixed appliances and without extractions, and 25 patients with dentoskeletal Class III disharmonies treated with MCH and fixed appliances. The Helkimo index was used to test the prevalence of TMD symptoms in the 3 groups. The prevalence rates of the Helkimo index in the 3 groups were compared with the z score on proportions. No statistically significant differences in the prevalence rates of the Helkimo index scores in the 3 groups were found (P = .367). Most subjects in the 3 groups had an Helkimo index of zero (66.7%). Subjects with Class III malocclusions treated with MCH and fixed appliances do not have greater prevalence of TMD symptoms than do Class I subjects treated with fixed appliances or untreated subjects.

  19. Components of soft tissue deformations in subjects with untreated angle's Class III malocclusions: thin-plate spline analysis.

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    Singh, G D; McNamara, J A; Lozanoff, S

    1998-01-01

    While the dynamics of maxillo-mandibular allometry associated with treatment modalities available for the management of Class III malocclusions currently are under investigation, developmental aberration of the soft tissues in untreated Class III malocclusions requires specification. In this study, lateral cephalographs of 124 prepubertal European-American children (71 with untreated Class III malocclusion; 53 with Class I occlusion) were traced, and 12 soft-tissue landmarks digitized. Resultant geometries were scaled to an equivalent size and mean Class III and Class I configurations compared. Procrustes analysis established statistical difference (P thin-plate spline (TPS) analysis indicated that both affine and non-affine transformations contribute towards the deformation (total spline) of the averaged Class III soft tissue configuration. For non-affine transformations, partial warp 8 had the highest magnitude, indicating large-scale deformations visualized as a combination of columellar retrusion and lower labial protrusion. In addition, partial warp 5 also had a high magnitude, demonstrating upper labial vertical compression with antero-inferior elongation of the lower labio-mental soft tissue complex. Thus, children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the maxillary soft tissue complex in combination with antero-inferior mandibular soft tissue elongation. This pattern of deformations may represent gene-environment interactions, resulting in Class III malocclusions with characteristic phenotypes, that are amenable to orthodontic and dentofacial orthopedic manipulations.

  20. Early orthopedic correction of skeletal Class III malocclusion using combined reverse twin block and face mask therapy

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    Vinay Kumar Chugh

    2015-01-01

    Full Text Available A 6-year 8-month-old girl presented with a moderate Class III malocclusion characterized by mid-face deficiency and an anterior cross bite. In the first phase, the patient was treated with combination of reverse twin block and facemask therapy. In phase two, fixed appliances were placed in the permanent dentition. The post treatment results were good and a favorable growth tendency could be observed. The correction of the Class III malocclusion occurred by a combination of skeletal and dental improvements. This report shows successful correction of skeletal Class III malocclusion in the early transitional dentition using combination therapy.

  1. Má oclusão Classe III, com mordida cruzada posterior unilateral e assimetria facial Class III malocclusion with unilateral posterior crossbite and facial asymmetry

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    Silvio Rosan de Oliveira

    2010-10-01

    Full Text Available Este artigo relata o tratamento ortodôntico realizado em uma paciente adulta, com 36 anos de idade, portadora de um padrão esquelético e dentário de Classe III, com mordida cruzada posterior unilateral esquerda e assimetria mandibular, além de uma diferença relativamente grande entre máxima intercuspidação habitual (MIH e relação cêntrica (RC. O tratamento foi realizado com expansão dentária superior, contração dentária inferior e descruzamento anterior, eliminando a diferença entre MIH e RC. O resultado obtido foi pautado sobre um diagnóstico criterioso e um planejamento de compensação ortodôntica, sem intervenção cirúrgica nos maxilares, por solicitação da paciente. Este caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, representando a categoria 5, ou seja, má oclusão com problema transverso, apresentando pelo menos um quadrante em cruzamento, como parte dos requisitos para obtenção do título de Diplomado pelo BBO.This article reports on the orthodontic treatment performed on a 36-year-old female patient with skeletal and dental Class III pattern, presenting with a left unilateral posterior crossbite and mandibular asymmetry, and a relatively significant difference between maximum intercuspation (MIC and centric relation (CR. The treatment was performed with maxillary dental expansion, mandibular dental contraction and anterior crossbite correction, eliminating the difference between MIC and CR. Results were based on careful diagnosis and planning of orthodontic compensation without surgical intervention in the maxilla, at the request of the patient. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO as representative of Category 5, i.e., malocclusion with a transverse problem, presenting with a crossbite in at least one of the quadrants, as part of the requirements for obtaining the BBO Certificate.

  2. [Orthodontic treatment of malocclusion Class III in patients aged 6-12 by Postnikov appliance, face mask and bracket system].

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    Postnikov, M A; Trunin, D A; Pankratova, N V; Nesterov, A M; Sadykov, M I; Ostankov, S A

    2018-01-01

    The diagnostics and treatment of malocclusion Class III in patients aged 6-12 is an vital problem in orthodontics. Method of orthodontic treatment of malocclusion Class III in patients with the help of improved and patented orthodontic construction - 'Postnikov appliance' - and face mask and bracket system is analysed in the article. Orthodontic treatment of malocclusion Class III was examined in 24 patients aged 6-12 by the suggested method. All patients were examined clinically and with the help af additional diagnostic methods: head cephalometry in lateral position with further data analysis in Dolphin Imaging (USA). The use of computer technologies in Dolphin Imaging helps to controll the process of correction of dentition correlation in different stages of treatment, to reduce the period of treatment of malocclusion Class III in patients aged 6-12 and to improve face esthetics and life quality ratio.

  3. [Size of lower jaw as an early indicator of skeletal class III development].

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    Stojanović, Zdenka; Nikodijević, Angelina; Udovicić, Bozidar; Milić, Jasmina; Nikolić, Predrag

    2008-08-01

    Malocclusion of skeletal class III is a complex abnormality, with a characteristic sagital position of the lower jaw in front of the upper one. A higher level of prognatism of the lower jaw in relation to the upper one can be the consequence of its excessive length. The aim of this study was to find the differences in the length of the lower jaw in the children with skeletal class III and the children with normal sagital interjaw relation (skeletal class I) in the period of mixed dentition. After clinical and x-ray diagnostics, profile tele-x-rays of the head were analyzed in 60 examinees with mixed dentition, aged from 6 to 12 years. The examinees were divided into two groups: group 1--the children with skeletal class III and group 2--the children with skeletal class I. The length of the lower jaw, upper jaw and cranial base were measured. The proportional relations between the lengths measured within each group were established and the level of difference in the lengths measured and their proportions between the groups were estimated. No significant difference between the groups was found in the body length, ramus and the total length of the lower jaw. Proportional relation between the body length and the length of the lower jaw ramus and proportional relation between the forward cranial base and the lower jaw body were not significantly different. A significant difference was found in proportional relations of the total length of the lower jaw with the total lengths of cranial base and the upper jaw and proportional relation of the length of the lower and upper jaw body. Of all the analyzed parameters, the following were selected as the early indicators of the development of skeletal class III on the lower jaw: greater total length of the lower jaw, proportional to the total lengths of cranial base and theupper jaw, as well as greater length of the lower jaw body, proportional to the length of the upper jaw body.

  4. Management of a severe Class III malocclusion with extreme dentoalveolar compensations.

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    Nehra, Karan; Sharma, Vineet; Mitra, Rajat

    2012-01-01

    This case report describes the treatment of a 21-year-old woman with a severe Class III malocclusion, 9-mm anterior crossbite, extremely proclined maxillary anterior incisors associated with decreased buccolingual alveolar width, and a malformed supernumerary tooth. The treatment plan included fixed appliances to align and level the teeth, en masse retraction of maxillary anterior incisors after a labial and palatal corticotomy using temporary anchorage devices, high Le Fort I maxillary osteotomy for maxillary advancement, and bilateral sagittal split osteotomy for mandibular setback. Ideal overjet and overbite relationships were established, and the final esthetic result was pleasing. Occlusal stability was excellent in the 1-year follow-up.

  5. Treatment of Class III malocclusion in a young adult patient: a case report.

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    Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

    2012-01-01

    This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

  6. Skeletal Class III and anterior open bite treatment with different retention protocols: a report of three cases.

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    Farret, Milton Meri Benitez; Farret, Marcel Marchiori; Farret, Alessandro Marchiori

    2012-09-01

    The treatment of skeletal class III and anterior open bite can be unstable and orthodontists frequently observe relapse. Here, we report on the management of three patients with skeletal class III profiles and open bites treated by orthodontic camouflage. Each received a retention protocol involving the use of two separate appliances during the night and day accompanied by myofunctional therapy. Long-term follow-up revealed a stable outcome.

  7. Skeletal Class III malocclusion with thin symphyseal bone: a case report.

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    Hikida, Eriko; Tanikawa, Chihiro

    2012-11-01

    To describe the management of a severe skeletal Class III patient with thin symphyseal bone and alveolar bone covering the mandibular incisors. A 24 year-old female presented with a skeletal Class III malocclusion characterised by thin alveolar bone in a mildly crowded, mandibular incisor region. Computerised tomography (CT) assisted in the determination of possible tooth movement within the anterior mandibular alveolar bone. The finalised treatment plan aimed to align the maxillary and mandibular dental arches following the extraction of the maxillary right first premolar and the mandibular right permanent lateral incisor. The surgical repositioning of the maxilla and mandible with a LeFort I osteotomy and a bilateral sagittal split osteotomy (BSSO) would follow. After treatment, an acceptable facial profile and a solid intercuspation of the teeth were obtained. Significant root resorption was not observed. The occlusion remained stable with normal overjet and overbite after two years of retention. CT examination provided an assessment of the three-dimensional morphological characteristics of anterior alveolar bone which enabled an evaluation of possible tooth movement.

  8. Intravenous Vancomycin Associated With the Development of Nephrotoxicity in Patients With Class III Obesity.

    Science.gov (United States)

    Choi, Yookyung Christy; Saw, Stephen; Soliman, Daniel; Bingham, Angela L; Pontiggia, Laura; Hunter, Krystal; Chuang, Linda; Siemianowski, Laura A; Ereshefsky, Benjamin; Hollands, James M

    2017-11-01

    A consensus statement recommends initial intravenous (IV) vancomycin dosing of 15-20 mg/kg every 8- 24 hours, with an optional 25- to 30-mg/kg loading dose. Although some studies have shown an association between weight and the development of vancomycin-associated nephrotoxicity, results have been inconsistent. To evaluate the correlation between incidence of nephrotoxicity associated with weight-based IV vancomycin dosing strategies in nonobese and obese patients. This retrospective cohort study evaluated hospitalized adult patients admitted who received IV vancomycin. Patients were stratified into nonobese (body mass index [BMI] obesity class I and II (BMI 30-39.9kg/m 2 ), and obesity class III (BMI≥40 kg/m 2 ) groups; patients who were overweight but not obese were excluded. Incidence of nephrotoxicity and serum vancomycin trough concentrations were evaluated. Of a total of 62 documented cases of nephrotoxicity (15.1%), 13 (8.7%), 23 (14.3%), and 26 (26.3%) cases were observed in nonobese, obesity class I and II, and obesity class III groups, respectively ( P=0.002). Longer durations of therapy ( P20 mg/L ( Pobesity were 3-times as likely to develop nephrotoxicity when compared with nonobese patients (odds ratio [OR]=2.99; CI=1.12-7.94) and obesity class I and II patients (OR=3.14; CI=1.27-7.75). Obesity and other factors are associated with a higher risk of vancomycin-associated nephrotoxicity.

  9. Orthodontic camouflage in the case of a skeletal class III malocclusion.

    Science.gov (United States)

    Costa Pinho, Teresa M; Ustrell Torrent, Josep M; Correia Pinto, João G R

    2004-01-01

    To describe the clinical problem of a male patient, 15 years of age, who had a dolichofacial biotype and a Class III skeletal type at the beginning of treatment, manifesting itself at the dental level. To resolve the dental problems, orthodontic camouflage (dentoalveolar compensation) with the extraction of two mandibular premolars was performed. This procedure allowed a more harmonious occlusal relationship at the canine level and provided better occlusal stability of the final result. The procedure choice was based on the fact that some cephalometric values were favorable to attenuation of the skeletal Class III. For example, according to the analyses of Björk and Jarabak, these values are the total sum of 1, 2, 3 (sella angle, articular angle, and gonial angles) and the anterior/posterior facial height (S-Go/Na-Me). However, the same cephalometric data indicate a possible worsening of the existing open bite, which might be corrected with dental extractions and the use of intermaxillary elastics.

  10. Diagnosis and conservative treatment of skeletal Class III malocclusion with anterior crossbite and asymmetric maxillary crowding.

    Science.gov (United States)

    Tseng, Linda L Y; Chang, Chris H; Roberts, W Eugene

    2016-04-01

    A man, aged 28 years 9 months, came for an orthodontic consultation for a skeletal Class III malocclusion (ANB angle, -3°) with a modest asymmetric Class II and Class III molar relationship, complicated by an anterior crossbite, a deepbite, and 12 mm of asymmetric maxillary crowding. Despite the severity of the malocclusion (Discrepancy Index, 37), the patient desired noninvasive camouflage treatment. The 3-Ring diagnosis showed that treatment without extractions or orthognathic surgery was a viable approach. Arch length analysis indicated that differential interproximal enamel reduction could resolve the crowding and midline discrepancy, but a miniscrew in the infrazygomatic crest was needed to retract the right buccal segment. The patient accepted the complex, staged treatment plan with the understanding that it would require about 3.5 years. Fixed appliance treatment with passive self-ligating brackets, early light short elastics, bite turbos, interproximal enamel reduction, and infrazygomatic crest retraction opened the vertical dimension of the occlusion, improved the ANB angle by 2°, and achieved excellent alignment, as evidenced by a Cast Radiograph Evaluation score of 28 and a Pink and White dental esthetic score of 3. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  11. Surgical-orthodontic treatment of Class III malocclusion with agenesis of lateral incisor and unerupted canine

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    Bruno Boaventura Vieira

    2013-06-01

    Full Text Available INTRODUCTION: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch. METHODS: The pre-surgical orthodontic treatment was performed with extractions of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the post-surgical orthodontic treatment was finished. RESULTS: The Class III malocclusion was treated establishing occlusal and facial normal standards.

  12. Orthodontic decompensation in class III patients by means of distalization of upper molars.

    Science.gov (United States)

    Carlos, Villegas B; Giovanni, Oberti; Diego, Rey; Angela, Sierra; Baccetti, Tiziano

    2009-01-01

    Pre-surgical orthodontic treatments have the objective of establishing harmony between the dental arches by moving the teeth to ideal positions in relation to their bony bases, in order to achieve adequate antero-posterior occlusal and transverse relationships at the moment of surgery. Among the typical requirements in terms of dental compensations presented by Class III patients that require surgery, the inclination of anterior teeth must be changed in most cases by proclination of the lower incisors and retroclination of upper incisors. To achieve the inclination of the upper incisors, many different alternatives have been proposed, such as inter-proximal reduction, extractions, or distalization of upper molars, which has not been widely reported in the literature as a means to decompensate Class III malocclusion prior to surgery. This article describes the Bone Supported Pendulum (BSP) as an efficient therapeutic option to distalize molars through the use of an appliance stabilized to the palate by mini-implants, thus avoiding extractions and providing good interdigitation and coordination of the dental arches.

  13. Mandibular cervical headgear vs rapid maxillary expander and facemask for orthopedic treatment of Class III malocclusion.

    Science.gov (United States)

    Baccetti, Tiziano; Rey, Diego; Angel, David; Oberti, Giovanni; McNamara, James A

    2007-07-01

    To compare the effectiveness of the rapid maxillary expander and facemask (RME/ FM) and mandibular cervical headgear (MCH) protocols when followed by fixed appliances and evaluated at a postpubertal observation in patients with dentoskeletal Class III malocclusion. The sample treated with the RME/FM followed by fixed appliances included 32 patients (12 boys and 20 girls). The sample treated with the MCH followed by fixed appliances included 26 patients (eight boys and 18 girls). Cephalometric analysis was performed at T(1) (before treatment) and T(2) (after the first phase of orthopedic therapy and the second phase of fixed appliances). T(1)-T(2) changes were evaluated by means of t-tests. Midfacial length, mandibular length, and the sagittal position of the chin all showed significantly smaller increases in the MCH group than in the RME/FM group. The amount of increase in the overjet was also significantly smaller in the MCH group, whereas the amount of molar correction was greater. The upper incisors were significantly less proclined and the lower incisors were significantly less retroclined in the MCH group when compared with the RME/FM group. RME/FM therapy appears to be indicated in Class III patients with a component of maxillary retrusion, whereas MCH therapy is preferable in patients with mandibular prognathism.

  14. Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

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    Mariana Maciel Tinano

    2015-02-01

    Full Text Available OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28 attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I and individuals with cleft lip and palate (P > 0.017. The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015. Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A in comparison to the control group (P < 0.001. No significant differences were found in the mandible (Co-Gn of the control group and individuals with cleft lip and palate (P = 1.000. CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

  15. Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite.

    Science.gov (United States)

    Valladares Neto, José

    2014-01-01

    This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extraction of mandibular first premolars. For maxillary retraction, the vertical dimension was temporarily increased to avoid obstacles to orthodontic movement. At the end of the treatment, ideal overjet and overbite were achieved. Examination eight years after orthodontic treatment revealed adequate clinical stability. This case report was submitted to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements to become a BBO diplomate.

  16. Orthognathic Surgery for the Correction of Severe Skeletal Class III Malocclusion.

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    Kafle, D; Upadhayaya, C; Chaurasia, N; Agarwal, A

    2016-01-01

    Skeletal Malocclusions results from the abnormal position of maxilla and mandible in relation with cranial base. These types of malocclusion are commonly treated by orthodontic teeth movement known as camouflage orthodontics. However severe skeletal malocclusions cannot be treated by orthodontics alone. Such cases need surgical intervention to align the position of the jaw along with orthodontic correction. This procedure is commonly known as Orthognathic Surgery. Orthognathic Surgery dates back to early eighteenth century but became popular on mid twentieth century. Though the prevalence of skeletal malocclusion is more than 1% the treatment facility was not available in Nepal till 2012. Here we present a case of Skeletal Class III malocclusion treated at Dhulikhel Hospital, Kathmandu University Hospital. For this case, double jaw surgery was performed by le-Fort I osteotomy and Bilateral Sagital Split Osteotomy. Orthognathic surgery has been routinely performed at this centre since then.

  17. Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite

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    José Valladares Neto

    2014-01-01

    Full Text Available INTRODUCTION: This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. METHODS: The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extraction of mandibular first premolars. For maxillary retraction, the vertical dimension was temporarily increased to avoid obstacles to orthodontic movement. RESULTS: At the end of the treatment, ideal overjet and overbite were achieved. CONCLUSION: Examination eight years after orthodontic treatment revealed adequate clinical stability. This case report was submitted to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO as part of the requirements to become a BBO diplomate.

  18. Natural Mallow Fiber-Reinforced Epoxy Composite for Ballistic Armor Against Class III-A Ammunition

    Science.gov (United States)

    Nascimento, Lucio Fabio Cassiano; Holanda, Luane Isquerdo Ferreira; Louro, Luis Henrique Leme; Monteiro, Sergio Neves; Gomes, Alaelson Vieira; Lima, Édio Pereira

    2017-10-01

    Epoxy matrix composites reinforced with up to 30 vol pct of continuous and aligned natural mallow fibers were for the first time ballistic tested as personal armor against class III-A 9 mm FMJ ammunition. The ballistic efficiency of these composites was assessed by measuring the dissipated energy and residual velocity after the bullet perforation. The results were compared to those in similar tests of aramid fabric (Kevlar™) commonly used in vests for personal protections. Visual inspection and scanning electron microscopy analysis of impact-fractured samples revealed failure mechanisms associated with fiber pullout and rupture as well as epoxy cracking. As compared to Kevlar™, the mallow fiber composite displayed practically the same ballistic efficiency. However, there is a reduction in both weight and cost, which makes the mallow fiber composites a promising material for personal ballistic protection.

  19. Dentofacial effects of bone-anchored maxillary protraction: a controlled study of consecutively treated Class III patients.

    Science.gov (United States)

    De Clerck, Hugo; Cevidanes, Lucia; Baccetti, Tiziano

    2010-11-01

    In this cephalometric investigation, we analyzed the treatment effects of bone-anchored maxillary protraction (BAMP) with miniplates in the maxilla and mandible connected by Class III elastics in patients with Class III malocclusion. The treated sample consisted of 21 Class III patients consecutively treated with the BAMP protocol before the pubertal growth spurt (mean age, 11.10 ± 1.8 years) and reevaluated after BAMP therapy, about 1 year later. The treated group was compared with a matched control group of 18 untreated Class III subjects. Significant differences between the treated and control groups were assessed with independent-sample t tests (P <0.05). Sagittal measurements of the maxilla showed highly significant improvements during active treatment (about 4 mm more than the untreated controls), with significant protraction effects at orbitale and pterygomaxillare. Significant improvements of overjet and molar relationship were recorded, as well as in the mandibular skeletal measures at Point B and pogonion. Vertical skeletal changes and modifications in incisor inclination were negligible, except for a significant proclination of the mandibular incisors in the treated group. Significant soft-tissue changes reflected the underlying skeletal modifications. Compared with growth of the untreated Class III subjects, the BAMP protocol induced an average increment on skeletal and soft-tissue advancement of maxillary structures of about 4 mm, and favorable mandibular changes exceeded 2 mm. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  20. Camouflage treatment of skeletal class III malocclusion with asymmetry using a bone-borne rapid maxillary expander.

    Science.gov (United States)

    Seo, Yu-Jin; Chung, Kyu-Rhim; Kim, Seong-Hun; Nelson, Gerald

    2015-03-01

    This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25 months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.

  1. Kinematic analysis of mandibular motion before and after orthognathic surgery for skeletal Class III malocclusion: A pilot study.

    Science.gov (United States)

    Ugolini, Alessandro; Mapelli, Andrea; Segù, Marzia; Galante, Domenico; Sidequersky, Fernanda V; Sforza, Chiarella

    2017-03-01

    The aim of the study was to detect the changes in 3D mandibular motion after orthognathic surgery for skeletal Class III malocclusion. Using a 3D motion analyzer, free mandibular border movements were recorded in nine patients successfully treated for skeletal Class III malocclusion and in nine patients scheduled for orthognathic surgery. Data were compared using Mann-Whitney non-parametric U-test. The results showed no differences between the groups in the total amount of mouth opening, protrusion, and in lateral excursions, but the percentage of mandibular movement explained by condylar translation was significantly increased after surgery (20% vs. 23.6%). During opening, the post-surgery patients showed a more symmetrical mandibular interincisal point and condylar path than pre-surgery patients (p < 0.01). Patients treated with orthognathic surgery for skeletal Class III malocclusion recover a good and symmetric temporomandibular joint function.

  2. Skeletal stability of surgery-first bimaxillary orthognathic surgery for skeletal class III malocclusion, using standardized criteria.

    Science.gov (United States)

    Park, K-H; Sandor, G K; Kim, Y-D

    2016-01-01

    The purpose of this study was to compare the postoperative stability following bimaxillary surgery performed either with or without preoperative orthodontic treatment, in class III malocclusion patients. These patients were enrolled using standardized inclusion criteria. Forty patients with a class III malocclusion were included in this retrospective study. Inclusion criteria were class III malocclusion with and without premolar extraction, stability. With respect to postsurgical changes, significant differences were observed in the changes for the vertical reference plane to the posterior nasal spine, horizontal reference plane to B-point, and occlusal plane angle in both groups. No statistically significant differences in the relapse rates were observed between the two groups. No significant differences were observed between the two groups in terms of the postoperative stability. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Class III malocclusion treated with distalization of the mandibular dentition with miniscrew anchorage: A 2-year follow-up.

    Science.gov (United States)

    Chen, Kun; Cao, Yang

    2015-12-01

    This case report describes the orthodontic camouflage treatment for a 16-year-old Chinese girl with a Class III malocclusion. The treatment included extractions of the mandibular second molars, fixed appliance therapy, and miniscrew-aided mandibular arch distalization. Pretreatment, posttreatment, and 2-year follow-up records are shown. The anterior negative overjet and the Class III molar and canine relationships were corrected. The patient's facial profile was greatly improved. The mandibular third molars erupted into the second molar spaces, with acceptable intercuspation with the maxillary dentition. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  4. Long-term stability of an adult Class III open-bite malocclusion treated with multiloop edgewise archwire

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    Chien-Chun Kuo

    2009-09-01

    Full Text Available This case report describes the treatment of a 17-year-old girl with an anterior open- bite and Class III malocclusion, who had a history of thumb-sucking habit in childhood. The multiloop edgewise archwire technique was used on the mandibular arch to facilitate uprighting of the mandibular posterior teeth, change the cant of occlusal plane, close the anterior open-bite, and correct the Class III malocclusion. At the end of treatment, Class I occlusion and correction of the anterior open-bite had been achieved. An examination 8 years 8 months after treatment revealed long-term stability of the treatment results.

  5. Ribonucleotide reductase class III, an essential enzyme for the anaerobic growth of Staphylococcus aureus, is a virulence determinant in septic arthritis.

    Science.gov (United States)

    Kirdis, Ebru; Jonsson, Ing-Marie; Kubica, Malgorzata; Potempa, Jan; Josefsson, Elisabet; Masalha, Mahmud; Foster, Simon J; Tarkowski, Andrzej

    2007-01-01

    Staphylococcus aureus is the most common cause of joint infections. It also contributes to several other diseases such as pneumonia, osteomyelitis, endocarditis, and sepsis. Bearing in mind that S. aureus becomes rapidly resistant to new antibiotics, many studies survey the virulence factors, with the aim to find alternative prophylaxis/treatment regimens. One potential virulence factor is the bacterial ability to survive at different oxygen tensions. S. aureus expresses ribonucleotide reductases (RNRs), which help it to grow under both aerobic and anaerobic conditions, by reducing ribonucleotides to deoxyribonucleotides. In this study, we investigated the role of RNR class III, which is required for anaerobic growth, as a virulence determinant in the pathogenesis of staphylococcal arthritis. The wild-type S. aureus strain and its isogenic mutant nrdDG mutant were inoculated intravenously into mice. Mice inoculated with the wild-type strain displayed significantly more severe arthritis, with significantly more synovitis and destruction of the bone and cartilage versus mutant strain inoculated mice. Further, the persistence of bacteria in the kidneys was significantly more pronounced in the group inoculated with the wild-type strain. Together these results indicate that RNR class III is an important virulence factor for the establishment of septic arthritis.

  6. Professionals' and laypersons' appreciation of various options for Class III surgical correction.

    Science.gov (United States)

    Fabré, M; Mossaz, C; Christou, P; Kiliaridis, S

    2010-08-01

    The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative

  7. Positive inotropic effects of RP 62719, a new pure class III antiarrhythmic agent, on guinea pig myocardium.

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    Beregi, J P; Escande, D; Coudray, N; Mery, P; Mestre, M; Chemla, D; Lecarpentier, Y

    1992-12-01

    The mechanical effects of RP 62719 [(-)1-[-2-(3,4-dihydro-2H-1- benzopyran-4-yl)ethyl]-4-(3,4-dimethoxyphenyl)-piperidine] were tested in vitro on guinea pig left ventricular papillary muscle. RP 62719 is a novel pure class III antiarrhythmic agent known to prolong the cardiac action potential duration by selectively blocking the inward rectifying K+ current. Mechanical parameters were determined from contraction and relaxation phases under isotonic and isometric conditions. At a concentration of 0.02 microM, RP 62719 did not produce significant effects on inotropy or lusitropy. At 0.2 and 2 microM, the drug improved contraction under both heavy and low loading conditions, as evidenced by a 30% increase in maximum unloaded shortening velocity (Vmax, P delta L, P force normalized per cross-sectional area (AF/s, P force derivative per mm2 (+dF/s, P force derivative per mm2 (-dF/s, P < .001). At a higher concentration (20 microM), effects of RP 62719 on inotropy and lusitropy were less marked, thus accounting for the bell-shaped form of the dose-response curve. An increase in the extracellular Ca++ concentration from 2.5 to 3.75 mM improved inotropy to a similar extent (+30-50%) as did 2 microM RP 62719. However, lusitropy and mechanical coupling between contraction and relaxation were not modified in the same proportion under RP 62719 and under 3.75 mM Ca++.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

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    DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

    2016-03-01

    A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412 N or 34% of initial body weight reduced maximum knee compressive force by 824 N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392 N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study.

    Science.gov (United States)

    Johal, Ama; Chaggar, Amrit; Zou, Li Fong

    2018-03-01

    The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. Significant detectable differences were found in the surface facial features of developing Class III subjects.

  10. Alteration of Occlusal Plane in Orthognathic Surgery: Clinical Features to Help Treatment Planning on Class III Patients

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    Daniel Amaral Alves Marlière

    2018-01-01

    Full Text Available Dentofacial deformities (DFD presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP, and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I facial type; (II upper incisor display at rest; (III dental and gingival display on smile; (IV soft tissue support; (V chin projection; and (VI lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up.

  11. Mandibular dimensions of subjects with asymmetric skeletal class III malocclusion and normal occlusion compared with cone-beam computed tomography.

    Science.gov (United States)

    Lee, HyoYeon; Bayome, Mohamed; Kim, Seong-Hun; Kim, Ki Beom; Behrents, Rolf G; Kook, Yoon-Ah

    2012-08-01

    The purpose of this study was to use cone-beam computed tomography to compare mandibular dimensions in subjects with asymmetric skeletal Class III malocclusion and those with normal occlusion. Cone-beam computed tomography scans of 38 subjects with normal occlusion and 28 patients with facial asymmetry were evaluated and digitized with Invivo software (Anatomage, San Jose, Calif). Three midsagittal and 13 right and left measurements were taken. The paired t test was used to compare the right and left sides in each group. The Mann-Whitney U test was used to compare the midsagittal variables and the differences between the 2 sides of the group with normal occlusion with those of asymmetry patients. The posterior part of the mandibular body showed significant differences between the deviated and nondeviated sides in asymmetric Class III patients. The difference of the asymmetry group was significantly greater than that of the normal occlusion group for the mediolateral ramal and the anteroposterior condylar inclinations (P = 0.007 and P = 0.019, respectively). The asymmetric skeletal Class III group showed significant differences in condylar height, ramus height, and posterior part of the mandibular body compared with the subjects with normal occlusion. These results might be useful for diagnosis and treatment planning of asymmetric Class III patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  12. The Populus Class III HD ZIP, popREVOLUTA, influences cambium initiation and patterning of woody stems

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    Marcel Robischon; Juan Du; Eriko Miura; Andrew Groover

    2011-01-01

    The secondary growth of a woody stem requires the formation of a vascular cambium at an appropriate position and proper patterning of the vascular tissues derived from the cambium. Class III homeodomain-leucine zipper (HD ZIP) transcription factors have been implicated in polarity determination and patterning in lateral organs and primary vascular tissues and in the...

  13. Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report

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    Seyed Mohammadreza Safavi

    2013-01-01

    Full Text Available In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen due to collision with adjacent roots. This article showcases mandibular molar distalization utilizing miniscrews, inserted at the retromolar area to correct a Class-III problem. A 24-year-old girl with a mild skeletal Class-III malocclusion and dental Class-III molar and canine relationship bilaterally was referred for orthodontic treatment. The treatment plan included distalization of the lower molars bilaterally followed by full fixed appliance therapy, after third molar extractions. For the lower molar distalization, the miniscrews were inserted at the retromolar pad. At the end of 21 months, a Class-I molar and canine relationship, normal overjet and overbite were obtained. The average amount of distalization of mandibular first molar was 3.2 mm at the crown level. In conclusion, placing miniscrews at the retromolar pad area for lower molar distalization was found to be a simple and effective method for correcting anterior cross bite and mandibular anterior crowding or protrusion, without the need for patient compliance.

  14. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Mucedero, Manuela; Cozza, Paola

    2010-06-01

    The purpose of this cephalometric study was to analyse the treatment and post-treatment craniofacial effects of a facemask (FM) combined with a bite block (BB) with specific regard to the sagittal pharyngeal dimensions in subjects with a Class III malocclusion when compared with an untreated Class III control group. The FM/BB group (22 subjects, 12 females and 10 males) had a mean age pre-treatment (T1) of 8.9 +/- 1.5 years, at the end of active treatment (T2) of 10.5 +/- 1.3 years, and post-treatment (T3) of 12.6 +/- 1.9 years. The treated group was compared with a control group of 14 subjects (6 females and 8 males) with untreated Class III malocclusions that matched the FM/BB group as to age at T1, T2, and T3, observation periods and skeletal maturation. Comparisons of the T2-T1 and T3-T1 changes between the two groups were analysed with the Mann-Whitney test. Significant favourable skeletal changes in the maxilla and mandible were observed in the treated group both after Ts2 and T3. No significant short- or long-term changes in the sagittal oropharyngeal and nasopharyngeal airway dimensions were induced by maxillary protraction in subjects with a Class III malocclusion when compared with untreated controls.

  15. Expression of a cucumber class III chitinase and Nicotiana plumbaginifolia class I glucanase genes in transgenic potato plants

    NARCIS (Netherlands)

    Moravcikova, J.; Matusikova, I.; Libantova, J.; Bauer, M.; Mlynarova, L.

    2004-01-01

    The genes encoding for a cucumber class III chitinase and Nicotiana plumbaginifolia class I glucanase were co-introduced into Slovak potato (Solanum tuberosum L.) breeding line 116/86 using Agrobacterium tumefaciens. For both transgenes the number of integrated copies and level of RNA expression

  16. Proteomics computational analyses suggest that the bornavirus glycoprotein is a class III viral fusion protein (γ penetrene

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    Garry Robert F

    2009-09-01

    Full Text Available Abstract Background Borna disease virus (BDV is the type member of the Bornaviridae, a family of viruses that induce often fatal neurological diseases in horses, sheep and other animals, and have been proposed to have roles in certain psychiatric diseases of humans. The BDV glycoprotein (G is an extensively glycosylated protein that migrates with an apparent molecular mass of 84,000 to 94,000 kilodaltons (kDa. BDV G is post-translationally cleaved by the cellular subtilisin-like protease furin into two subunits, a 41 kDa amino terminal protein GP1 and a 43 kDa carboxyl terminal protein GP2. Results Class III viral fusion proteins (VFP encoded by members of the Rhabdoviridae, Herpesviridae and Baculoviridae have an internal fusion domain comprised of beta sheets, other beta sheet domains, an extended alpha helical domain, a membrane proximal stem domain and a carboxyl terminal anchor. Proteomics computational analyses suggest that the structural/functional motifs that characterize class III VFP are located collinearly in BDV G. Structural models were established for BDV G based on the post-fusion structure of a prototypic class III VFP, vesicular stomatitis virus glycoprotein (VSV G. Conclusion These results suggest that G encoded by members of the Bornavirdae are class III VFPs (gamma-penetrenes.

  17. Assessment of pterygomaxillary separation in Le Fort I Osteotomy in class III patients.

    Science.gov (United States)

    Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Okabe, Katsuhiko; Alam, Shamiul; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

    2009-04-01

    To examine the separation of the pterygomaxillary region at the posterior nasal spine level after Le Fort I osteotomy in Class III patients. The study group consisted of 37 Japanese patients with mandibular prognathism and asymmetry, with maxillary retrognathism or asymmetry. A total of 74 sides were examined. Le Fort I osteotomy was performed without a pterygoid osteotome, with an ultrasonic curette used to remove interference at the pterygomaxillary region. Postoperative computed tomography (CT) was analyzed for all patients. The separation of the pterygomaxillary region and the location of the descending palatine artery were assessed. Although acceptable separation between the maxilla and pterygoid plates was achieved in all patients, an exact separation of the pterygomaxillary junction at the posterior nasal spine level was found in only 18 of 74 sides (24%). In 29 of 74 sides (39.2%), the separation occurred anterior to the descending palatine artery. In 29 of 74 sides (39.2%), complete separation between the maxilla and lateral and/or medial pterygoid plate was not achieved, but lower level separation of the maxilla and pterygoid plate was always complete. The maxillary segments could be moved to the postoperative ideal position in all cases. Le Fort I osteotomy without an osteotome does not always induce an exact separation at the pterygomaxillary junction at the posterior nasal spine level, but the ultrasonic bone curette can remove the interference between maxillary segment and pterygoid plates more safely.

  18. Ethnicity and skeletal Class III morphology: a pubertal growth analysis using thin-plate spline analysis.

    Science.gov (United States)

    Alkhamrah, B; Terada, K; Yamaki, M; Ali, I M; Hanada, K

    2001-01-01

    A longitudinal retrospective study using thin-plate spline analysis was used to investigate skeletal Class III etiology in Japanese female adolescents. Headfilms of 40 subjects were chosen from the archives of the Orthodontic department at Niigata University Dental Hospital, and were traced at IIIB and IVA Hellman dental ages. Twenty-eight homologous landmarks, representing hard and soft tissue, were digitized. These were used to reproduce a consensus for the profilogram, craniomaxillary complex, mandible, and soft tissue for each age and skeletal group. Generalized least-square analysis revealed a significant shape difference between age-matched groups (P spline and partial warps (PW)3 and 2 showed a maxillary retrusion at stage IIIB opposite an acute cranial base at stage IVA. Mandibular total spline and PW4, 5 showed changes affecting most landmarks and their spatial interrelationship, especially a stretch along the articulare-pogonion axis. In soft tissue analysis, PW8 showed large and local changes which paralleled the underlying hard tissue components. Allometry of the mandible and anisotropy of the cranial base, the maxilla, and the mandible asserted the complexity of craniofacial growth and the difficulty of predicting its outcome.

  19. Class III orthognathic surgical cases facilitated by accelerated osteogenic orthodontics: a preliminary report.

    Science.gov (United States)

    Wu, JiaQi; Xu, Li; Liang, Cheng; Jiang, JiuHui

    2015-11-01

    To describe a multidisciplinary treatment approach that includes corticotomy, orthodontic force and orthognathic surgery for the management of skeletal Class III surgical cases. The main advantage of the combined techniques is a reduction in treatment time for young adult patients. Accelerated Osteogenic Orthodontics (AOO) was delivered to three young adult patients during their pre-surgical orthodontic treatment. After aligning and levelling the dental arches, a piezosurgical corticotomy was performed to the buccal aspect of the alveolar bone. Bone graft materials were used to cover the decorticated area and soft tissue flaps were replaced. The mean time for extraction space closure was 5.4 ± 1.3 months and the mean time for pre-surgical orthodontic treatment was 12.0 ± 0.9 months. The average total treatment time was 20.4 ± 2.4 months. A pre-existing bony fenestration in the buccal cortex adjacent to the right lateral incisor root apex of Case 1 was corrected. The facial aesthetics of three patients improved following multidisciplinary treatment. This approach may be an efficient method for the orthognathic patient who desires a reduced treatment time, but further clinical research is required.

  20. Thin-plate spline analysis of mandibular morphological changes induced by early class III treatment: a long-term evaluation.

    Science.gov (United States)

    Franchi, Lorenzo; Pavoni, Chiara; Cerroni, Silvia; Cozza, Paola

    2014-08-01

    To evaluate the long-term mandibular morphological changes induced by early treatment of class III malocclusion with rapid maxillary expansion (RME) and facial mask (FM). Twenty-five subjects [10 boys, 15 girls; mean age at T1 (start of treatment) 9.3±1.6 years] with class III disharmony were treated with RME and FM therapy followed by fixed appliances. The patients were re-evaluated at the end of growth (T2), about 8.5 years after the end of the treatment (mean age, 18.6±2.0 years). Sixteen subjects with untreated class III malocclusion comprised the control group. Mandibular shape changes were analysed on the lateral cephalograms of the subjects of both groups by means of thin-plate spline (TPS) analysis. Procrustes average mandibular configurations were subjected to TPS analysis by means of both cross-sectional between-group comparisons at T1 and at T2 and longitudinal within-group comparisons. Statistical analysis of shape differences was performed using a generalized Goodall F test. In the long term, the treated group exhibited a significant upward and forward direction of condylar growth. On the contrary, untreated class III subjects showed an upward and backward direction of condylar growth associated with a downward and forward deformation of the mandibular symphysis. Limitations are related to the small sample size of both treated and control groups and to the retrospective nature of the study. Early treatment of class III malocclusion with RME and FM is able to produce significant and favourable long-term mandibular shape changes characterized by an anterior morphogenetic rotation. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Má oclusão Classe III de Angle, subdivisão direita, tratada sem exodontias e com controle de crescimento Angle Class III malocclusion, subdivision right, treated without extractions and with growth control

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    Sérgio Henrique Casarim Fernandes

    2010-12-01

    Full Text Available A Classe III de Angle é uma má oclusão caracterizada por discrepâncias anteroposteriores dentárias e faciais, normalmente acompanhadas por alterações esqueléticas, com componente genético associado. O diagnóstico precoce e correto e o tratamento adequado são de suma importância para promover o controle do crescimento e evitar recidivas. Este artigo relata o tratamento, executado em duas fases, de uma paciente do sexo feminino de 12 anos de idade, apresentando uma má oclusão de Classe III de Angle, subdivisão direita, com mordida cruzada anterior em máxima intercuspidação habitual (MIH e topo em relação cêntrica (RC, apresentando, ainda, falta de espaço na maxila, que foi tratada sem exodontias e com controle de crescimento. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, representando a categoria 1, ou seja, uma má oclusão Classe III de Angle, tratada sem exodontias e com controle de crescimento, como parte dos requisitos para a obtenção do título de Diplomado pelo BBOAngle Class III malocclusion is characterized by anteroposterior dental and facial discrepancies usually accompanied by skeletal changes associated with a genetic component. Early, accurate diagnosis and appropriate treatment are of paramount importance to promote growth control and prevent relapse. This article reports the two-phase treatment of a female patient, aged 12 years, with an Angle Class III, subdivision right malocclusion with anterior crossbite in maximum intercuspation (MIC and end-on bite in centric relation, further presenting with lack of maxillary space. The case was treated without extractions and with growth control. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO as representative of Category 1, i.e., Angle Class III malocclusion treated without tooth extractions, as part of the requirements for obtaining the BBO Diploma

  2. Non-surgical alternative in the treatment of skeletal Class III problems.

    Science.gov (United States)

    Jefferson, Y

    1995-01-01

    The dental profession is not static, but dynamic. New research findings, along with medical and technological advances, necessitate constant re-examination of treatment philosophies and techniques. What were acceptable treatment techniques in the past may not necessarily be the most effective and best techniques for our patients today. Currently, many practitioners feel that the only treatment for the correction of a skeletal Class III abnormality is via orthognathic surgery in older patients. In some cases it may be the only treatment option. But in most cases today, there are more conservative, non-surgical treatment alternatives in correcting Class III problems in younger aged children. In treating facial-skeletal problems, it must be emphasized that the human face is a biological masterpiece of form and function. Its importance has been documented in arts and sciences since the beginning of modern civilization. It is important enough so that individuals who are blessed with attractive features are afforded greater opportunities in our society. Attractive faces are associated with intelligence, honesty and good work ethics. With the advent of orthognathic surgery, functional appliance, functional regulator, and myofunctional therapy, the dental profession has the capability of leveling out the playing field for many individuals in our society. It does so by being able to correct problems closely associated with the human psyche--the human face. The ability to change facial features brings tremendous prestige to our profession. Along with this prestige comes greater responsibility. Our ability to change facial features entails greater understanding of facial balance and harmony. Ricketts states that the face must conform to stringent proportions known as the "divine proportion" in order for it to be esthetically pleasing. Also, our ability to move facial-skeletal structures entails greater understanding of the biomechanics of the human face. Without this

  3. Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

    Science.gov (United States)

    Martinez, P; Bellot-Arcís, C; Llamas, J M; Cibrian, R; Gandia, J L; Paredes-Gallardo, V

    2017-04-01

    The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Class III peroxidases in cellulose deficient cultured maize cells during cell wall remodelling.

    Science.gov (United States)

    Martínez-Rubio, Romina; Acebes, José Luis; Encina, Antonio; Kärkönen, Anna

    2018-02-21

    Maize (Zea mays L.) suspension-cultured cells habituated to a cellulose biosynthesis inhibitor 2,6-dichlorobenzonitrile (DCB) have a modified cell wall, in which the reduction in the cellulose content is compensated by a network of highly cross-linked feruloylated arabinoxylans and the deposition of lignin-like polymers. For both arabinoxylan cross-linking and lignin polymerization, class III peroxidases (POXs) have been demonstrated to have a prominent role. For the first time, a comparative study of POX activity and isoforms in control and cellulose-impaired cells has been addressed, also taking into account their cellular distribution in different compartments. Proteins from the spent medium (SM), soluble cellular (SC), ionically (ICW) and covalently bound cell wall protein fractions were assayed for total and specific peroxidase activity by using coniferyl and sinapyl alcohol and ferulic acid as substrates. The isoPOX profile was obtained by isoelectric focusing. POX activity was higher in DCB-habituated than in non-habituated cells in all protein fractions at all cell culture stages. For all substrates assayed, SC and ICW fractions showed higher activity at the early-log growth phase than at the late-log phase. However, the highest POX activity in the spent medium was found at the late-log phase. According to the isoPOX profiles, the highest diversity of isoPOXs was detected in the ICW and SM protein fractions. The latter fraction contained isoPOXs with higher activity in DCB-habituated cells. Some of the isoPOXs detected could be involved in cross-linking of arabinoxylans and in the lignin-like polymer formation in DCB-habituated cells. This article is protected by copyright. All rights reserved.

  5. Prognostic effect of symptomatic extracranial lesions on survival of recursive partitioning analysis Class III brain metastatic patients treated with stereotactic radiotherapy

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    Xiu-Jun Chen

    2016-01-01

    Conclusion: The presence of SELs was a negative prognosis factor for the survival of RPA Class III brain metastatic patients. If RPA Class III brain metastatic patients were without SELs, SRT may be a reasonable treatment option, but if they had SELs, SRT may not be a reasonable treatment due to the short overall survival time and KDT.

  6. Correction of a Class III malocclusion with over 20 mm of space to close in the maxilla by using miniscrews for extra anchorage.

    NARCIS (Netherlands)

    Breuning, K.H.

    2008-01-01

    Unilateral closure of maxillary extraction spaces in patients with Class III malocclusion can be challenging. This case report describes the closure of first premolar and first molar extraction spaces in a patient with a Class III dental relationship. Two miniscrews were used for intraoral skeletal

  7. Abordagem clínica não-cirúrgica no tratamento da má oclusão de Classe III Non-surgical approaches to Class III malocclusions treatment

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    Eustáquio A. Araújo

    2008-12-01

    Full Text Available A abordagem clínica não-cirúrgica da Classe III coloca-se entre os grandes desafios da Ortodontia e vem, desde sempre, gerando controvérsia entre clínicos e pesquisadores. Alguns defendem a tese de que o crescimento e o desenvolvimento do complexo craniofacial são determinados geneticamente e, portanto, inalteráveis. Para esses, a correção da grande maioria de casos de Classe III passará por intervenções orto-cirúrgicas, devendo a terapia ser realizada assim que cessar o período mais ativo do crescimento. Por outro lado, há aqueles que, mesmo concordando com o peso da hereditariedade na etiologia da Classe III, acreditam ser possível modificar o padrão e a direção do crescimento e, através de uma abordagem não-cirúrgica, minimizar a má oclusão ou até mesmo tratá-la com sucesso. Em face da controvérsia, quais seriam as possibilidades ortodônticas? Inúmeros são os relatos de que uma intervenção adequada, em momento adequado, acompanhada de um estudo do padrão familiar, pode, muitas vezes, minimizar o desenvolvimento de uma Classe III. Procedimentos selecionados com critério podem reduzir a indicação de intervenções cirúrgicas e proporcionar resultados positivos e duradouros. Há evidências clínicas e científicas de que algumas decisões terapêuticas podem mudar o curso de muitos prognósticos sombrios.Orthodontic management of the Class III malocclusion has been a constant challenge to the orthodontic profession and remains a controversial issue among clinicians and researches. Some support the belief that growth and size of the craniofacial complex are genetically predetermined and cannot be changed. They assume that the great majority of Class III cases are "untreatable" and that they are due to surgical intervention after growth has been completed. Even agreeing that heredity plays a major role in this type os deviation, others support the contention that the pattern and direction of growth can be

  8. Study on Tensile Fatigue Behavior of Thermal Butt Fusion in Safety Class III High-Density Polyethylene Buried Piping in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Kim, Jong Sung; Lee, Young Ju; Oh, Young Jin

    2015-01-01

    High-density polyethylene (HDPE) piping, which has recently been applied to safety class III piping in nuclear power plants, can be butt-joined through the thermal fusion process, which heats two fused surfaces and then subject to axial pressure. The thermal fusion process generates bead shapes on the butt fusion. The stress concentrations caused by the bead shapes may reduce the fatigue lifetime. Thus, investigating the effect of the thermal butt fusion beads on fatigue behavior is necessary. This study examined the fatigue behavior of thermal butt fusion via a tensile fatigue test under stress-controlled conditions using finite element elastic stress analysis. Based on the results, the presence of thermal butt fusion beads was confirmed to reduce the fatigue lifetime in the low-cycle fatigue region while having a negligible effect in the medium- and high-cycle fatigue regions

  9. Study on Tensile Fatigue Behavior of Thermal Butt Fusion in Safety Class III High-Density Polyethylene Buried Piping in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Sung; Lee, Young Ju [Sunchon National University, Suncheon (Korea, Republic of); Oh, Young Jin [KEPCO E and C, Yongin (Korea, Republic of)

    2015-01-15

    High-density polyethylene (HDPE) piping, which has recently been applied to safety class III piping in nuclear power plants, can be butt-joined through the thermal fusion process, which heats two fused surfaces and then subject to axial pressure. The thermal fusion process generates bead shapes on the butt fusion. The stress concentrations caused by the bead shapes may reduce the fatigue lifetime. Thus, investigating the effect of the thermal butt fusion beads on fatigue behavior is necessary. This study examined the fatigue behavior of thermal butt fusion via a tensile fatigue test under stress-controlled conditions using finite element elastic stress analysis. Based on the results, the presence of thermal butt fusion beads was confirmed to reduce the fatigue lifetime in the low-cycle fatigue region while having a negligible effect in the medium- and high-cycle fatigue regions.

  10. Dental compensation for moderate Class III with vertical growth pattern by extraction of the lower second molars.

    Science.gov (United States)

    Jacobs, Collin; Jacobs-Müller, Claudia; Hoffmann, Viviana; Meila, Dan; Erbe, Christina; Krieger, Elena; Wehrbein, Heiner

    2012-01-01

    Analysis of the effects and side effects of treatment of patients with moderate skeletal Class III and vertical growth pattern by means of extraction of the second molars in the lower jaw. A total of 20 patients with a mean age of 12.9 years were examined retrospectively. Inclusion criteria consisted of a Wits value of 0 to -5, a posterior growth pattern of the mandible (Hasund analysis), an overjet of -2 to 1 mm, and an overbite of 0 to -3 mm. Treatment was performed using a straight-wire appliance. As part of the treatment, the lower second molars were extracted and Class III elastics attached. Cephalograms and orthopantomograms taken before and after treatment were used for evaluation. Treatment resulted in a significant change in the mean overjet from 0.5 mm to 2.1 mm and the attainment of a positive mean overbite of -1.0 mm to 0.9 mm. The occlusal plane rotated anteriorly from 18.8° to 13.7°. The skeletal parameters showed a change in the Wits value from -3.3 mm to -1.4 mm and an anterior mandibular rotation (ML-NSL 35.5° vs. 32.0°). The soft tissues revealed an increase in the distance between the lower lip and the "esthetic line" to the posterior (-2.0 mm vs. -3.9 mm). Dental compensation of moderate skeletal Class III with a tendency to an anterior open bite with vertical growth pattern by extracting the lower second molars, combined with Class III elastics, resulted in an anterior rotation of the occlusal plane and mandible. Eighteen of 20 patients achieved a physiological overjet and positive overbite. A prerequisite for this therapy is the presence of lower wisdom teeth; a potential side effect is elongation of the upper second molars.

  11. [The application of Edgewise technique auxillary with extra oral anchorage and class III elastic in the treatment of bimaxillary protrusion.].

    Science.gov (United States)

    Liu, H H; Weng, S E; Chen, R J

    1995-12-01

    In the treatment of growing bimaxillary protrusion patients,Edgewise technique auxillary with extra oral anchorage and class III elastic help to improve the patient's chin shape,recover his beauty of lower facial part and get a good occlusion along with the growing of mandible.The purpose of this study is:analysis the force system in the treatment and evaluate the result of the treatment with some typical cases.

  12. Orthodontic correction of Class III malocclusion in a young patient with the use of a simple fixed appliance.

    Science.gov (United States)

    Park, Jae Hyun

    2012-01-01

    Anterior crossbites are one of the most common orthodontic problems we observe in growing children. The first step in treating an anterior crossbite is to determine whether the crossbite is dental or skeletal in nature. To determine a precise diagnosis, a thorough clinical, radiographic and model analysis is required. This article shows the treatment of Class III malocclusion by correcting anterior dental crossbite with the use of a simple fixed appliance.

  13. Comparison of incisor inclination in patients with Class III malocclusion treated with orthognathic surgery or orthodontic camouflage.

    Science.gov (United States)

    Troy, Beth A; Shanker, Shiva; Fields, Henry W; Vig, Katherine; Johnston, William

    2009-02-01

    Reports comparing Class III patients treated by camouflage and those treated by orthognathic surgery are not numerous. The purpose of this study was to compare the dental and skeletal values of Class III patients treated with these methods against normative data and over the course of treatment. Thirty-three surgical and 39 camouflage Class III patients were selected from a graduate orthodontic clinic and regional private practices, and lateral cephalograms were digitized. Skeletal and dental values were obtained, and mean and efficacy evaluations referenced to ethnic norms were calculated. At pretreatment, the surgery patients had more severe skeletal discrepancies and more compensated incisors. During presurgical orthodontic treatment, most of the surgery group's mandibular incisors were significantly decompensated, although half of the maxillary incisors remained compensated. The surgical move improved 90% of these patients but to only 60% to 65% of the norm. The camouflage group was compensated at pretreatment, and they became more compensated in the end. After treatment, there were no differences between the incisor positions of the 2 groups. There was no statistical difference in incisor inclination and position between the Class III surgical and camouflage groups after treatment; there was a significant difference in the pretreatment and posttreatment incisor inclination and position compared with normative values for both the surgical and the camouflage groups; the maxillary and mandibular incisors were not adequately decompensated in the surgical group, but significant improvement in mandibular incisor position and axial inclination was achieved presurgically. The outcome of the surgical correction was limited by the inadequate presurgical orthodontic incisor decompensation, and orthodontic compensation of incisors occurred postsurgically to achieve an optimal occlusal result.

  14. Maxillary Transverse Comparison of Skeletal Class I and Class III Patient Populations Using Cone Beam Computed Tomography

    Science.gov (United States)

    2012-04-13

    dental compensations 5. Have fully erupted canines (no...expansion. Compendium 1996;17:170-178. 2. Basaran G, Hamamci N, Hamamci O. Comparison of Dental Arch Widths in Different Types of Malocclusions . World... Dental and Alveolar Arch Widths in Normal Occlusion and Class III Malocclusion . Angle Orthod 2005; 75:809- 813.   36. Vanarsdall, Transverse dimension and long-term stability, Semin Orthod 1999;5:171–180.

  15. Miniplate-Aided Mandibular Dentition Distalization as a Camouflage Treatment of a Class III Malocclusion in an Adult

    Directory of Open Access Journals (Sweden)

    Zaki Hakami

    2018-01-01

    Full Text Available This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

  16. Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report

    OpenAIRE

    Seyed Mohammadreza Safavi; Farnaz Younessian; Sarvraj Kohli

    2013-01-01

    In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen ...

  17. Miniplate-Aided Mandibular Dentition Distalization as a Camouflage Treatment of a Class III Malocclusion in an Adult.

    Science.gov (United States)

    Hakami, Zaki; Chen, Po Jung; Ahmida, Ahmad; Janakiraman, Nandakumar; Uribe, Flavio

    2018-01-01

    This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

  18. Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse.

    OpenAIRE

    Ohba, Seigo; Nakatani, Yuya; Kawasaki, Takako; Tajima, Nobutaka; Tobita, Takayoshi; Yoshida, Noriaki; Sawase, Takashi; Asahina, Izumi

    2015-01-01

    Increasing numbers of older patients are seeking orthognathic surgery to treat jaw deformity. However, orthodontic and orthognathic surgical treatment is difficult in cases without occlusal vertical stop. A 55-year-old man presented with Class III malocclusion and mandibular protrusion including esthetic problems and posterior bite collapse. He underwent dental implant treatment to reconstruct an occlusal vertical stop before orthognathic surgery. His occlusal function and esthetic problems i...

  19. Radiographic cephalometry assessment of the linear and angular parameters on cranial base in children with skeletal class III

    Directory of Open Access Journals (Sweden)

    Stojanović Zdenka M.

    2007-01-01

    Full Text Available Background/Aim. In malocclusion of skeletal class III, mandible is located in front of maxilla in sagital plain, which is manifested by a lower value of the sagital inter-jaw angle than in skeletal class I, where the jaw sagital relation is normal. Apart from the deformities on mandible and/or maxilla, in skeletal class III deformities are also frequent on the cranial base. The aim of this research was to find the differences in the parameter values on the cranial base among the children with skeletal class III and the children with skeletal class I in the period of mixed dentition. Methods. After clinical examination and orthopan-tomography, profile radiography of the head was analyzed in 60 examinees, aged from 6−12 years. The examinees were divided into two groups: group 1 - the children with skeletal class III; group 2 - the children with skeletal class I. Both linear and angular parameters on the cranial base were measured, as well as the angles of maxillary and mandible prognatism and the angle of sagital inter-jaw relation. The level of difference in the parameter values between the groups was estimated and the degree of correlation of the main angle of the cranial base with the angles of sagital position of the jaws in each of the two groups was established. Results. A significant difference between the groups was found only in the average values of the angles of maxillary prognatism and sagital interjaw relation. In the group 1, the main angle of the cranial base was in a significant correlation with the angles of sagital positions of the jaws, while in the group 2, such significance was not found. Conclusion. There were no significant differences in the parameter values on the cranial base between the groups. There was a significant correlation of the main angle of the cranial base with the angles of sagital position of the jaws in the group 1 only. .

  20. Lower lip deformity in patients with cleft and non-cleft Class III malocclusion before and after orthognathic surgery.

    Science.gov (United States)

    Park, Joo Seok; Koh, Kyung S; Choi, Jong Woo

    2015-10-01

    Orthognathic surgery does not yield the same cosmetic benefits in patients with Class III jaw deformities associated with clefts as for patients without clefts. Preoperative upper lip tightness caused by cleft lip repair may not fully explain this difference, suggesting that a lower lip deformity is present. The study compared the outcomes of orthognathic surgery in patients with cleft and non-cleft Class III malocclusion, focusing on lip relationship. The surgical records of 50 patients with Class III malocclusion, including 25 with and 25 without clefts, who had undergone orthognathic surgery, were retrospectively analyzed. Lateral cephalometric tracings, preoperatively and at 6 months postoperatively, were superimposed to analyze the soft tissue changes at seven reference points. At 6 months after surgery, there were no significant differences in skeletal location, whereas the soft tissues of the lower lip differed significantly between patients with and without cleft (p=0.002), indicating the persistence of a lower lip deformity in cleft patients. Moreover, the soft tissues of the lower lip receded in non-cleft patients and protruded in cleft patients after orthognathic surgery. Lower lip deformity and upper lip tightness may result in an unsatisfactory relationship between the upper and lower lips of patients with cleft-related jaw deformity after orthognathic surgery. Other factors were less important than the pathology of the lower lip. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Skeletal anteroposterior discrepancy and vertical type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients.

    Science.gov (United States)

    Ahn, Hyo-Won; Baek, Seung-Hak

    2011-01-01

    To determine the initial compensation, preoperative decompensation, and postoperative compensation of the lower incisors according to the skeletal anteroposterior discrepancy and vertical type in skeletal Class III patients. The samples consisted of 68 skeletal Class III patients treated with two-jaw surgery and orthodontic treatment. Lateral cephalograms were taken before preoperative orthodontic treatment (T0) and before surgery (T1) and after debonding (T2). According to skeletal anteroposterior discrepancy/vertical type (ANB, criteria  =  -4°; SN-GoMe, criteria  =  35°) at the T0 stage, the samples were allocated into group 1 (severe anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 2 (moderate anteroposterior discrepancy/hypodivergent vertical type, N  =  17), group 3 (severe anteroposterior discrepancy/hyperdivergent vertical type, N  =  17), or group 4 (moderate anteroposterior discrepancy/hyperdivergent vertical type, N  =  17). After measurement of variables, one-way analysis of variance with Duncan's multiple comparison test, crosstab analysis, and Pearson correlation analysis were performed. At T0, groups 3 and 2 exhibited the most and least compensated lower incisors. In group 2, good preoperative decompensation and considerable postoperative compensation resulted in different values for T0, T1, and T2 (IMPA, T0 lower incisors in Class III patients.

  2. Assessment of pain and discomfort during early orthodontic treatment of skeletal Class III malocclusion using the Removable Mandibular Retractor Appliance.

    Science.gov (United States)

    Saleh, M; Hajeer, M Y; Al-Jundi, A

    2013-06-01

    To determine the degree of pain and discomfort during the orthodontic treatment of skeletal Class III malocclusion using the Removable Mandibular Retractor (RMR). The sample consisted of 33 skeletal Class III patients (17 males and 16 females; average age: 7.5 ± 1.33 years) who had been assigned to the RMR treatment group in a randomised controlled trial comparing this treatment versus a control group of no treatment at the Orthodontic Department, University of Al-Baath Dental School in Syria. Pain and discomfort were assessed using standardised questionnaires at the following assessment times: 7 days (T1), 14 days (T2), 6 weeks (T3), 3 months (T4) and 6 months (T5) after appliance insertion. Levels of pain and discomfort decreased gradually by time in general. No significant changes in the levels of pain, tooth sensitivity and soft tissues tension were detected, whereas a significant decrease in the levels of pressure, impaired speech, impaired swallowing and lack of confidence in public was observed two weeks following appliance insertion. Mandibular constraint feeling required three months to decrease significantly. No difference was found between males and females with regard to acceptance. The RMR is well accepted by Class III patients in the early mixed dentition.

  3. Localisation of deformations of the midfacial complex in subjects with class III malocclusions employing thin-plate spline analysis.

    Science.gov (United States)

    Singh, G D; McNamara, J A; Lozanoff, S

    1997-11-01

    This study determines deformations of the midface that contribute to a class III appearance, employing thinplate spline analysis. A total of 135 lateral cephalographs of prepubertal children of European-American descent with either class III malocclusions or a class I molar occlusion were compared. The cephalographs were traced and checked, and 7 homologous landmarks of the midface were identified and digitised. The data sets were scaled to an equivalent size and subjected to Procrustes analysis. These statistical tests indicated significant differences (P spline analysis indicated that both affine and nonaffine transformations contribute towards the total spline for the averaged midfacial configuration. For nonaffine transformations, partial warp 3 had the highest magnitude, indicating the large scale deformations of the midfacial configuration. These deformations affected the palatal landmarks, and were associated with compression of the midfacial complex in the anteroposterior plane predominantly. Partial warp 4 produced some vertical compression of the posterior aspect of the midfacial complex whereas partial warps 1 and 2 indicated localised shape changes of the maxillary alveolus region. large spatial-scale deformations therefore affect the midfacial complex in an anteroposterior axis, in combination with vertical compression and localised distortions. These deformations may represent a developmental diminution of the palatal complex anteroposteriorly that, allied with vertical shortening of midfacial height posteriorly, results in class III malocclusions with a retrusive midfacial profile.

  4. Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyub Soo; Choi, Hang Moon; Choi, Dong Soon; Jang, Insan; Cha, Bong Kuen [College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung (Korea, Republic of)

    2013-12-15

    This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.

  5. Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study

    International Nuclear Information System (INIS)

    Lee, Hyub Soo; Choi, Hang Moon; Choi, Dong Soon; Jang, Insan; Cha, Bong Kuen

    2013-01-01

    This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.

  6. Perceived changes by peer group of social impact associated with combined orthodontic-surgical correction of class III malocclusion.

    Science.gov (United States)

    Jesani, Aliza; DiBiase, Andrew T; Cobourne, Martyn T; Newton, Timothy

    2014-09-01

    Whereas the psychosocial benefits of orthognathic treatment for the individual patient are established, there is little data relating to social perceptions in relation to changes in facial appearance as a result of combined orthodontic and orthognathic treatment. This study aimed to investigate the social impact of combined orthodontic-orthognathic surgical correction for class III malocclusion in Caucasian subjects. This cross-sectional study compared perceptions of facial appearance prior to and after orthognathic correction of class III malocclusion. Eighty undergraduate students were shown photographs of four Caucasian subjects (2 male and 2 female) pre- and post-orthognathic class III correction. Observers were asked to rate these subjects in relation to four different outcomes: (i) social competence (SC); (ii) intellectual ability (IA); (iii) psychological adjustment (PA); (iv) attractiveness. A mixed-model analysis of variance (ANOVA) was calculated to determine the effect of each variable. Statistically significant differences were found in ratings of the same face before and after treatment. After treatment, faces were rated as more psychologically adjusted, more sociable, more likely to be successful and more attractive; with the mean psychological adjustment rating being associated with the most change (before treatment=8.06 [SD 2.30]; after treatment=6.64 [SD 2.03], t=2.04, pclass III malocclusion in Caucasians, individuals are rated by young adults as being better adjusted both psychologically and socially, more likely to be successful and more attractive. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Maintenance of class III trifurcated molars versus implant placement in regenerated extraction sockets: long-term results of 2 cases.

    Science.gov (United States)

    Zafiropoulos, Gregory-George K; di Prisco, Manuela Occipite; Deli, Giorgio; Hoffmann, Oliver

    2011-03-01

    Studies to date have reached differing conclusions regarding the long-term prognosis of teeth with class III furcation involvement. Replacement of such teeth with implants could be an alternative. This report compares the treatment outcomes of 2 cases with similar disease progression: 1 treated by implant therapy and 1 maintained with nonsurgical periodontal treatment. Two patients with advanced chronic periodontitis and class III furcation involvement of all molars were treated. Case 1 received a conservative periodontal and antibiotic treatment, followed by 15 years of maintenance. In case 2, the molars were extracted and replaced with implants, and the implants were observed for 7 years. Clinical attachment level (CAL), probing attachment level (PAL), bleeding on probing, plaque index, and periodontal pathogens were recorded. Despite good compliance of case 1, periodontal pathogens were not eliminated and tissue destruction was not halted. The PAL outcomes of case 2 improved over time; mean PAL loss reached 0.35 mm/y in the first 3 years and then decreased to 0.01 mm/y. While CAL outcomes did not change in case 2, case 1 showed increased CAL loss after 8 years. Based on the limited findings of this case report, extraction of molars with class III furcation involvement and subsequent implant placement may render a better predictability of treatment outcomes than nonsurgical periodontal therapy in the cases of infection with periodontal pathogens.

  8. Orthodontic clockwise rotation of maxillomandibular complex for improving facial profile in late teenagers with Class III malocclusion: A preliminary report

    Directory of Open Access Journals (Sweden)

    Eric JW Liou

    2018-01-01

    Full Text Available Objective: Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and preliminarily evaluate their clinical effects. Patients and Methods: Six patients in late teenage with Class III malocclusion were included in this preliminary report. Bite raisers were first placed on the upper molars to open the bite and clockwise rotate the mandible. Intermaxillary elastics were then applied vertically between the upper and lower dentitions in 3 patients for bimaxillary extrusion (Technique-1 or between the upper dentition and the lower temporary anchorage devices (TADs in another 3 patients (Technique-2 for upper dentition extrusion and closure of the anterior open bite. The three-dimensional cone-beam computed tomography images taken before and after orthodontic treatment were superimposed to evaluate the treatment effects of MMc clockwise rotation for both techniques. Results: The Technique-1 extruded the upper and lower dentitions, rotated the mandible clockwise 2.01°, moved chin down 2.98 mm, and back −1.64 mm, although the mandible grew 2.47 mm during the treatment period. The Technique-2 extruded the upper dentition, rotated the mandible clockwise 0.90°, moved chin down 1.78 mm, but slightly forward 0.47 mm due to the mandible grew 2.50 mm and lower dentition was not extruded. Conclusions: The orthodontic clockwise rotation of MMc is an effective technique for orthognathic camouflage. The applications of bite raisers and bimaxillary dentition extrusion could be more effective than single dentition extrusion with TADs in the

  9. Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization.

    Science.gov (United States)

    Jing, Yan; Han, Xianglong; Guo, Yongwen; Li, Jingyu; Bai, Ding

    2013-06-01

    This article reports the successful use of miniscrews in the mandible to treat a 20-year-old Mongolian woman with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a mildly protrusive mandible, an anterior crossbite, and a deviated midline. In light of the advantages for reconstruction of the occlusal plane and distal en-masse movement of the mandibular arch, we used a multiloop edgewise archwire in the initial stage. However, the maxillary incisors were in excessive labioversion accompanied by little retraction of the mandibular incisors; these results were obviously not satisfying after 4 months of multiloop edgewise archwire treatment. Two miniscrews were subsequently implanted vertically in the external oblique ridge areas of the bilateral mandibular ramus as skeletal anchorage for en-masse distalization of the mandibular dentition. During treatment, the mandibular anterior teeth were retracted about 4.0 mm without negative lingual inclinations. The movement of the mandibular first molar was almost bodily translation. The maxillary incisors maintained good inclinations by rotating their brackets 180° along with the outstanding performance of the beta-titanium wire. The patient received a harmonious facial balance, an attractive smile, and ideal occlusal relationships. The outcome was stable after 1 year of retention. Our results suggest that the application of miniscrews in the posterior area of the mandible is an effective approach for Class III camouflage treatment. This technique requires minimal compliance and is particularly useful for correcting Class III patients with mild mandibular protrusion and minor crowding. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Retrospective 25-year follow-up of treatment outcomes in Angle Class III patients : Success versus failure.

    Science.gov (United States)

    Wendl, Brigitte; Kamenica, A; Droschl, H; Jakse, N; Weiland, F; Wendl, T; Wendl, M

    2017-03-01

    Despite recommendations for early treatment of hereditary Angle Class III syndrome, late pubertal growth may cause a relapse requiring surgical intervention. This study was performed to identify predictors of successful Class III treatment. Thirty-eight Class III patients treated with a chincup were retrospectively analyzed. Data were collected from the data archive, cephalograms, and casts, including pretreatment (T0) and posttreatment (T1) data, as well as long-term follow-up data collected approximately 25 years after treatment (T2). Each patient was assigned to a success or a failure group. Data were analyzed based on time (T0, T1, T2), deviations from normal (Class I), and prognathism types (true mandibular prognathism, maxillary retrognathism, combined pro- and retrognathism). Compared to Class I normal values, the data obtained in both groups yielded 11 significant parameters. The success group showed values closer to normal at all times (T0, T1, T2) and vertical parameters decreased from T0 to T2. The failure group showed higher values for vertical and horizontal mandibular growth, as well as dentally more protrusion of the lower anterior teeth and more negative overjet at all times. In adittion, total gonial and upper gonial angle were higher at T0 and T1. A prognostic score-yet to be evaluated in clinical practice-was developed from the results. The failure group showed greater amounts of horizontal development during the years between T1 and T2. Treatment of true mandibular prognathism achieved better outcomes in female patients. Cases of maxillary retrognathism were treated very successfully without gender difference. Failure was clearly more prevalent, again without gender difference, among the patients with combined mandibular prognathism and maxillary retrognathism. Crossbite situations were observed in 44% of cases at T0. Even though this finding had been resolved by T1, it relapsed in 16% of the cases by T2. The failure rate increased in cases of

  11. [Nursing workloads and working conditions: integrative review].

    Science.gov (United States)

    Schmoeller, Roseli; Trindade, Letícia de Lima; Neis, Márcia Binder; Gelbcke, Francine Lima; de Pires, Denise Elvira Pires

    2011-06-01

    This study reviews theoretical production concerning workloads and working conditions for nurses. For that, an integrative review was carried out using scientific articles, theses and dissertations indexed in two Brazilian databases, Virtual Health Care Library (Biblioteca Virtual de Saúde) and Digital Database of Dissertations (Banco Digital de Teses), over the last ten years. From 132 identified studies, 27 were selected. Results indicate workloads as responsible for professional weariness, affecting the occurrence of work accidents and health problems. In order to adequate workloads studies indicate some strategies, such as having an adequate numbers of employees, continuing education, and better working conditions. The challenge is to continue research that reveal more precisely the relationships between workloads, working conditions, and health of the nursing team.

  12. Orthodontic decompensation in skeletal Class III malocclusion: redefining the amount of movement assessed by Cone-Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    José Antonio Zuega Cappellozza

    2015-10-01

    Full Text Available Introduction:Cone-Beam Computed Tomography (CBCT is essential for tridimensional planning of orthognathic surgery, as it allows visualization and evaluation of bone structures and mineralized tissues. Tomographic slices allow evaluation of tooth inclination and individualization of movement performed during preoperative decompensation. The aim of this paper was to assess maxillary and mandibular incisors inclination pre and post orthodontic decompensation in skeletal Class III malocclusion.Methods:The study was conducted on six individuals with skeletal Class III malocclusion, surgically treated, who had Cone-Beam Computed Tomographic scans obtained before and after orthodontic decompensation. On multiplanar reconstruction view, tomographic slices (axial, coronal and sagittal were obtained on the long axis of each incisor. The sagittal slice was used for measurement taking, whereas the references used to assess tooth inclination were the long axis of maxillary teeth in relation to the palatal plane and the long axis of mandibular teeth in relation to the mandibular plane.Results:There was significant variation in the inclination of incisors before and after orthodontic decompensation. This change was of greater magnitude in the mandibular arch, evidencing that natural compensation is more effective in this arch, thereby requiring more intensive decompensation.Conclusion:When routinely performed, the protocols of decompensation treatment in surgical individuals often result in intensive movements, which should be reevaluated, since the extent of movement predisposes to reduction in bone attachment levels and root length.

  13. The effect of orthognathic surgery on the lip lines while smiling in skeletal class III patients with facial asymmetry.

    Science.gov (United States)

    Kang, Sang-Hoon; Kim, Moon-Key; An, Sang-In; Lee, Ji-Yeon

    2016-12-01

    The aim of this study was to examine the relationship between improvements in lip asymmetry at rest and while smiling after orthognathic surgery in patients with skeletal class III malocclusion. This study included 21 patients with skeletal class III malocclusion and facial asymmetry. We used preoperative and postoperative CT data and photographs to measure the vertical distance of the lips when smiling. The photographs were calibrated based on these distances and the CT image. We compared preoperative and postoperative results with the t test and correlations between measurements at rest and when smiling by regression analyses. There were significant correlations between the postoperative changes in canting of the mouth corners at rest, canting of the canines, canting of the first molars, the slope of the line connecting the canines, and the slope of the line connecting first molars. The magnitude of the postoperative lip line improvement while smiling was not significantly correlated with changes in the canting and slopes of the canines, molars, and lip lines at rest. It remains difficult to predict lip line changes while smiling compared with at rest after orthognathic surgery in patients with mandibular prognathism, accompanied by facial asymmetry.

  14. Changes in anteroposterior position and inclination of the maxillary incisors after surgical-orthodontic treatment of skeletal class III malocclusions.

    Science.gov (United States)

    Zou, Bingshuang; Zhou, Yang; Lowe, Alan A; Li, Huiqi; Pliska, Benjamin

    2015-12-01

    The purpose of this study was to evaluate and compare the anteroposterior (AP) position and inclination of the maxillary incisors in subjects with class I normal occlusion and a harmonious profile with patients with skeletal class III malocclusions, and to investigate the changes in maxillary incisor inclination and AP position after surgical-orthodontic treatment in class III patients. Sixty-five subjects (35 female and 30 male; mean age: 21.8 ± 3.89 years) with normal profiles and class I skeletal and dental patterns were selected as a control sample. Sixty-seven patients (38 female and 29 male; mean age: 21.3 ± 3.31 years) with skeletal and dental class III malocclusions who sought surgical-orthodontic treatment were used as the study sample. Subjects were asked to smile and profile photographs were taken with the head in a natural position and the maxillary central incisors and the forehead in full view; cephalograms were taken and superimposed on the profile pictures according to the outline of the forehead and nose. Forehead inclination, maxillary incisor facial inclination and the AP position of the maxillary central incisor relative to the forehead (FAFFA) were measured on the integrated images and statistical analyses were performed. In both groups, there were no significant male/female differences in either the maxillary central incisor inclination or AP position. Female subjects had a significantly steeper forehead inclination compared with males (P 0.05). In the control group, 84.6% had the facial axial point (FA) of their maxillary central incisors positioned between lines through the forehead facial axis (FFA) point and the glabella. In the study group, however, 79.1% had the maxillary central incisors positioned posterior to the line through the FFA point and the difference with the control group was statistically significant (P 0.05). With the integrated radiograph-photograph method, the lateral cephalogram was reoriented, which makes it possible

  15. Skeletal class III malocclusion treated using a non-surgical approach supplemented with mini-implants: a case report.

    Science.gov (United States)

    Farret, Marcel Marchiori; Benitez Farret, Milton M

    2013-09-01

    We describe a 28-year-old man who sought orthodontic treatment complaining about the esthetics of his smile and difficulties associated with masticatory function. The patient had a straight facial profile, skeletal and dental class III relationship, anterior open bite and posterior crossbite. He refused orthognathic surgery and was therefore treated with camouflage orthodontics supplemented with the placement of one mini-implant in each side of the mandible to facilitate movement of the lower dentition distally, tooth-by-tooth. At the end of treatment, a class I molar relationship was obtained, with an ideal overjet and overbite and excellent intercuspation. Furthermore, the open bite and crossbite were corrected. Analysis 2 years after treatment revealed good stability of treatment outcome.

  16. Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse.

    Science.gov (United States)

    Ohba, Seigo; Nakatani, Yuya; Kawasaki, Takako; Tajima, Nobutaka; Tobita, Takayoshi; Yoshida, Noriaki; Sawase, Takashi; Asahina, Izumi

    2015-08-01

    Increasing numbers of older patients are seeking orthognathic surgery to treat jaw deformity. However, orthodontic and orthognathic surgical treatment is difficult in cases without occlusal vertical stop. A 55-year-old man presented with Class III malocclusion and mandibular protrusion including esthetic problems and posterior bite collapse. He underwent dental implant treatment to reconstruct an occlusal vertical stop before orthognathic surgery. His occlusal function and esthetic problems improved after surgery, and his skeletal and occlusal stability has been maintained for 6 years. Dental implant placement at appropriate positions could help to determine the position of the proximal segment at orthognathic surgery and could shorten the time required to restore esthetic and occlusal function. This case demonstrates how skeletal and dental stability can be maintained long after surgery in a patient with jaw deformity and posterior bite collapse.

  17. Evaluation depth of the curve of Spee in class I, class II, and class III malocclusion: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Sanjna Nayar

    2015-01-01

    Full Text Available Occlusal plane is an essential consideration when multiple long-span posterior restorations are designed. When restorations are added to an existing tooth arrangement characterized by rotated, tipped, or extruded teeth, excursive interferences may be incorporated, resulting in detrimental squeal. The curve of Spee, which exists in the ideal natural dentition, allows harmony to exist between the anterior tooth and condylar guidance. This curve exists in the sagittal plane and is the best viewed from a lateral aspect. It permits total posterior disclusion on mandibular protrusion, given proper anterior tooth guidance. It is unclear that whether the curve of Spee is a description of the occlusal surface of each arch separately or in maximal intercuspation. The purpose of this study was to examine the differences in the depth of curve of Spee between the class I, class II, class III and to investigate the relationship of depth of curve of Spee with over jet, over-bite.

  18. Combined Orthodontic-surgical Treatment for Skeletal Class III Malocclusion with Multiple Impacted Permanent and Supernumerary Teeth: Case Report.

    Science.gov (United States)

    Xue, Dai Juan And Feng

    2014-01-01

    In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.

  19. Soft tissue thin-plate spline analysis of pre-pubertal Korean and European-Americans with untreated Angle's Class III malocclusions.

    Science.gov (United States)

    Singh, G D; McNamara, J A; Lozanoff, S

    1999-01-01

    The purpose of this study was to assess soft tissue facial matrices in subjects of diverse ethnic origins with underlying dentoskeletal malocclusions. Pre-treatment lateral cephalographs of 71 Korean and 70 European-American children aged between 5 and 11 years with Angle's Class III malocclusions were traced, and 12 homologous, soft tissue landmarks digitized. Comparing mean Korean and European-American Class III soft tissue profiles, Procrustes analysis established statistical difference (P thin-plate spline analysis indicated that both affine and non-affine transformations contribute towards the total spline (deformation) of the averaged Class III soft tissue configurations. For non-affine transformations, partial warp (PW) 8 had the highest magnitude, indicating large-scale deformations visualized as labio-mental protrusion, predominantly. In addition, PW9, PW4, and PW5 also had high magnitudes, demonstrating labio-mental vertical compression and antero-posterior compression of the lower labio-mental soft tissues. Thus, Korean children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the labio-mental soft tissue complex with respect to their European-American counterparts. Morphological heterogeneity of the soft tissue integument in subjects of diverse ethnic origin may obscure the underlying skeletal morphology, but the soft tissue integument appears to have minimal ontogenetic association with Class III malocclusions.

  20. Novel three dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism

    International Nuclear Information System (INIS)

    Kang, Sang Hoon; Kim, Yeon Ho; Won, Yu Jin; Kim, Moon Key

    2016-01-01

    To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the Mn F. The horizontal and vertical positions were examined by regression analysis. Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination (R2): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism

  1. Novel three dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sang Hoon; Kim, Yeon Ho; Won, Yu Jin; Kim, Moon Key [Dept. of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang (Korea, Republic of)

    2016-06-15

    To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the Mn F. The horizontal and vertical positions were examined by regression analysis. Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination (R2): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism.

  2. Mechanistic investigation of food effect on disintegration and dissolution of BCS class III compound solid formulations: the importance of viscosity.

    Science.gov (United States)

    Radwan, Asma; Amidon, Gordon L; Langguth, Peter

    2012-10-01

    A negative food effect, i.e. a decrease in bioavailability upon the co-administration of compounds together with food, has been attributed particularly with high solubility/low permeability compounds (BCS class III). Different mechanisms have been proposed including intestinal dilution leading to a lower concentration gradient across the intestinal wall as well as binding of the active pharmaceutical ingredient to food components in the intestine and thereby decreasing the fraction of the dose available for absorption. These mechanisms refer primarily to the compound and not to the dosage form. An increase in viscosity of the dissolution fluid will in particular affect the absorption of BCS type III compounds with preferential absorption in the upper small intestine if the API release is delayed from the dosage form. The present study demonstrated that the increase in viscosity of the dissolution medium, following ingestion of a solid meal, may drastically reduce disintegration and dissolution. For that purpose the viscosity of the standard FDA meal was determined and simulated by solutions of HPMC in buffer. As model formulations, three commercially available tablets containing trospium chloride, a BCS class III m-cholinoreceptor antagonist was used. Trospium chloride drug products have been described to undergo a negative food effect of more than 80% following ingestion with food. The tablets showed prolonged disintegration times and reduced dissolution rates in viscous media, which could be attributed to changes in the liquid penetration rates. The effect was particularly significant for film-coated tablets relative to uncoated dosage forms. The results show the necessity of considering media viscosity when designing in vitro models of drug release for BCS type III drug formulations. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Aesthetic and functional outcomes using a multiloop edgewise archwire for camouflage orthodontic treatment of a severe Class III open bite malocclusion.

    Science.gov (United States)

    Marañón-Vásquez, Guido Artemio; Soldevilla Galarza, Luciano Carlos; Tolentino Solis, Freddy Antonio; Wilson, Cliff; Romano, Fábio Lourenço

    2017-09-01

    Occasionally, orthodontists will be challenged to treat malocclusions and skeletal disharmonies, which by their complexity one might think that the only treatment alternative is the surgical-orthodontic approach. A male patient, aged 17 years old, was diagnosed with a skeletal Class III malocclusion, anterior open bite and negative overjet. An unpleasant profile was the patient's 'chief complaint' showing interest in facial aesthetics improvement. Nevertheless, the patient and his parents strongly preferred a non-surgical treatment approach. He was treated with a multiloop edgewise archwire to facilitate uprighting and distal en-masse movement of lower teeth, correct the Class III open bite malocclusion, change the inclination of the occlusal plane and obtain the consequent morphological-functional adaptation of the mandible. The Class III malocclusion was corrected and satisfactory changes in the patient's profile were obtained. Active treatment was completed in 2 years, and facial result remained stable at 2 years 6 months after debonding.

  4. Ehrlichia secretes Etf-1 to induce autophagy and capture nutrients for its growth through RAB5 and class III phosphatidylinositol 3-kinase.

    Science.gov (United States)

    Lin, Mingqun; Liu, Hongyan; Xiong, Qingming; Niu, Hua; Cheng, Zhihui; Yamamoto, Akitsugu; Rikihisa, Yasuko

    2016-11-01

    Ehrlichia chaffeensis is an obligatory intracellular bacterium that causes a potentially fatal emerging zoonosis, human monocytic ehrlichiosis. E. chaffeensis has a limited capacity for biosynthesis and metabolism and thus depends mostly on host-synthesized nutrients for growth. Although the host cell cytoplasm is rich with these nutrients, as E. chaffeensis is confined within the early endosome-like membrane-bound compartment, only host nutrients that enter the compartment can be used by this bacterium. How this occurs is unknown. We found that ehrlichial replication depended on autophagy induction involving class III phosphatidylinositol 3-kinase (PtdIns3K) activity, BECN1 (Beclin 1), and ATG5 (autophagy-related 5). Ehrlichia acquired host cell preincorporated amino acids in a class III PtdIns3K-dependent manner and ehrlichial growth was enhanced by treatment with rapamycin, an autophagy inducer. Moreover, ATG5 and RAB5A/B/C were routed to ehrlichial inclusions. RAB5A/B/C siRNA knockdown, or overexpression of a RAB5-specific GTPase-activating protein or dominant-negative RAB5A inhibited ehrlichial infection, indicating the critical role of GTP-bound RAB5 during infection. Both native and ectopically expressed ehrlichial type IV secretion effector protein, Etf-1, bound RAB5 and the autophagy-initiating class III PtdIns3K complex, PIK3C3/VPS34, and BECN1, and homed to ehrlichial inclusions. Ectopically expressed Etf-1 activated class III PtdIns3K as in E. chaffeensis infection and induced autophagosome formation, cleared an aggregation-prone mutant huntingtin protein in a class III PtdIns3K-dependent manner, and enhanced ehrlichial proliferation. These data support the notion that E. chaffeensis secretes Etf-1 to induce autophagy to repurpose the host cytoplasm and capture nutrients for its growth through RAB5 and class III PtdIns3K, while avoiding autolysosomal killing.

  5. TGF-β-stimulated aberrant expression of class III β-tubulin via the ERK signaling pathway in cultured retinal pigment epithelial cells

    International Nuclear Information System (INIS)

    Chung, Eun Jee; Chun, Ji Na; Jung, Sun-Ah; Cho, Jin Won; Lee, Joon H.

    2011-01-01

    Highlights: ► TGF-β induces aberrant expression of βIII in RPE cells via the ERK pathway. ► TGF-β increases O-GlcNAc modification of βIII in RPE cells. ► Mature RPE cells have the capacity to express a neuron-associated gene by TGF-β. -- Abstract: The class III β-tubulin isotype (β III ) is expressed exclusively by neurons within the normal human retina and is not present in normal retinal pigment epithelial (RPE) cells in situ or in the early phase of primary cultures. However, aberrant expression of class III β-tubulin has been observed in passaged RPE cells and RPE cells with dedifferentiated morphology in pathologic epiretinal membranes from idiopathic macular pucker, proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR). Transforming growth factor-β (TGF-β) has been implicated in dedifferentiation of RPE cells and has a critical role in the development of proliferative vitreoretinal diseases. Here, we investigated the potential effects of TGF-β on the aberrant expression of class III β-tubulin and the intracellular signaling pathway mediating these changes. TGF-β-induced aberrant expression and O-linked-β-N-acetylglucosamine (O-GlcNac) modification of class III β-tubulin in cultured RPE cells as determined using Western blotting, RT-PCR and immunocytochemistry. TGF-β also stimulated phosphorylation of ERK. TGF-β-induced aberrant expression of class III β-tubulin was significantly reduced by pretreatment with U0126, an inhibitor of ERK phosphorylation. Our findings indicate that TGF-β stimulated aberrant expression of class III β-tubulin via activation of the ERK signaling pathway. These data demonstrate that mature RPE cells have the capacity to express a neuron-associated gene in response to TGF-β stimulation and provide useful information towards understanding the pathogenesis of proliferative vitreoretinal diseases.

  6. TGF-{beta}-stimulated aberrant expression of class III {beta}-tubulin via the ERK signaling pathway in cultured retinal pigment epithelial cells

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Eun Jee [Department of Ophthalmology, National Health Insurance Corporation Ilsan Hospital, Gyeonggi-do (Korea, Republic of); Chun, Ji Na; Jung, Sun-Ah [Konyang University Myunggok Medical Research Institute, Kim' s Eye Hospital, Konyang University College of Medicine, Seoul (Korea, Republic of); Cho, Jin Won [Department of Biology, Yonsei University, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-749 (Korea, Republic of); Lee, Joon H., E-mail: joonhlee@konyang.ac.kr [Konyang University Myunggok Medical Research Institute, Kim' s Eye Hospital, Konyang University College of Medicine, Seoul (Korea, Republic of)

    2011-11-18

    Highlights: Black-Right-Pointing-Pointer TGF-{beta} induces aberrant expression of {beta}III in RPE cells via the ERK pathway. Black-Right-Pointing-Pointer TGF-{beta} increases O-GlcNAc modification of {beta}III in RPE cells. Black-Right-Pointing-Pointer Mature RPE cells have the capacity to express a neuron-associated gene by TGF-{beta}. -- Abstract: The class III {beta}-tubulin isotype ({beta}{sub III}) is expressed exclusively by neurons within the normal human retina and is not present in normal retinal pigment epithelial (RPE) cells in situ or in the early phase of primary cultures. However, aberrant expression of class III {beta}-tubulin has been observed in passaged RPE cells and RPE cells with dedifferentiated morphology in pathologic epiretinal membranes from idiopathic macular pucker, proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR). Transforming growth factor-{beta} (TGF-{beta}) has been implicated in dedifferentiation of RPE cells and has a critical role in the development of proliferative vitreoretinal diseases. Here, we investigated the potential effects of TGF-{beta} on the aberrant expression of class III {beta}-tubulin and the intracellular signaling pathway mediating these changes. TGF-{beta}-induced aberrant expression and O-linked-{beta}-N-acetylglucosamine (O-GlcNac) modification of class III {beta}-tubulin in cultured RPE cells as determined using Western blotting, RT-PCR and immunocytochemistry. TGF-{beta} also stimulated phosphorylation of ERK. TGF-{beta}-induced aberrant expression of class III {beta}-tubulin was significantly reduced by pretreatment with U0126, an inhibitor of ERK phosphorylation. Our findings indicate that TGF-{beta} stimulated aberrant expression of class III {beta}-tubulin via activation of the ERK signaling pathway. These data demonstrate that mature RPE cells have the capacity to express a neuron-associated gene in response to TGF-{beta} stimulation and provide useful information

  7. Alternative treatment for open bite Class III malocclusion in a child with Williams-Beuren syndrome

    Directory of Open Access Journals (Sweden)

    Giovanni Modesto Vieira

    2015-02-01

    Full Text Available Williams-Beuren syndrome (WBS is a rare genetic condition that affects approximately 1 in every 20,000 - 50,000 live births. WBS children have specific skeletal deformities, dental malformations and rare lingual muscle dysfunction. The need for orthodontic and orthognathic therapy has arisen and has been considered a real clinical challenge even for experienced professionals, once it requires a complex and individualized treatment plan. This study reports a case of orthopedic expansion of the maxilla, in which a modified facial mask was used for protraction of the maxillary complex associated with clockwise rotation of the maxilla. In addition, special considerations about treatment time and orthopedic outcomes are discussed.

  8. Regulation of MIR165/166 by class II and class III homeodomain leucine zipper proteins establishes leaf polarity

    DEFF Research Database (Denmark)

    Merelo, Paz; Ram, Hathi; Caggiano, Monica Pia

    2016-01-01

    A defining feature of plant leaves is their flattened shape. This shape depends on an antagonism between the genes that specify adaxial (top) and abaxial (bottom) tissue identity; however, the molecular nature of this antagonism remains poorly understood. Class III homeodomain leucine zipper (HD-...... show that class III and class II HD-ZIP proteins act together to repress MIR165/166 via a conserved cis-element in their promoters. Organ morphology and tissue patterning in plants, therefore, depend on a bidirectional repressive circuit involving a set of miRNAs and its targets....

  9. Role of Class III phosphoinositide 3-kinase in the brain development: possible involvement in specific learning disorders.

    Science.gov (United States)

    Inaguma, Yutaka; Matsumoto, Ayumi; Noda, Mariko; Tabata, Hidenori; Maeda, Akihiko; Goto, Masahide; Usui, Daisuke; Jimbo, Eriko F; Kikkawa, Kiyoshi; Ohtsuki, Mamitaro; Momoi, Mariko Y; Osaka, Hitoshi; Yamagata, Takanori; Nagata, Koh-Ichi

    2016-10-01

    Class III phosphoinositide 3-kinase (PIK3C3 or mammalian vacuolar protein sorting 34 homolog, Vps34) regulates vesicular trafficking, autophagy, and nutrient sensing. Recently, we reported that PIK3C3 is expressed in mouse cerebral cortex throughout the developmental process, especially at early embryonic stage. We thus examined the role of PIK3C3 in the development of the mouse cerebral cortex. Acute silencing of PIK3C3 with in utero electroporation method caused positional defects of excitatory neurons during corticogenesis. Time-lapse imaging revealed that the abnormal positioning was at least partially because of the reduced migration velocity. When PIK3C3 was silenced in cortical neurons in one hemisphere, axon extension to the contralateral hemisphere was also delayed. These aberrant phenotypes were rescued by RNAi-resistant PIK3C3. Notably, knockdown of PIK3C3 did not affect the cell cycle of neuronal progenitors and stem cells at the ventricular zone. Taken together, PIK3C3 was thought to play a crucial role in corticogenesis through the regulation of excitatory neuron migration and axon extension. Meanwhile, when we performed comparative genomic hybridization on a patient with specific learning disorders, a 107 Kb-deletion was identified on 18q12.3 (nt. 39554147-39661206) that encompasses exons 5-23 of PIK3C3. Notably, the above aberrant migration and axon growth phenotypes were not rescued by the disease-related truncation mutant (172 amino acids) lacking the C-terminal kinase domain. Thus, functional defects of PIK3C3 might impair corticogenesis and relate to the pathophysiology of specific learning disorders and other neurodevelopmental disorders. Acute knockdown of Class III phosphoinositide 3-kinase (PIK3C3) evokes migration defects of excitatory neurons during corticogenesis. PIK3C3-knockdown also disrupts axon outgrowth, but not progenitor proliferation in vivo. Involvement of PIK3C3 in neurodevelopmental disorders might be an interesting future

  10. Major histocompatibility complex (MHC) class III genetics in two Amerindian tribes from southern Brazil: the Kaingang and the Guarani.

    Science.gov (United States)

    Weg-Remers, S; Brenden, M; Schwarz, E; Witzel, K; Schneider, P M; Guerra, L K; Rehfeldt, I R; Lima, M T; Hartmann, D; Petzl-Erler, M L; de Messias, I J; Mauff, G

    1997-10-01

    Population genetic studies of the major histocompatibility complex (MHC) class III region, comprising C2, BF and C4 phenotypes, and molecular genetic data are rarely available for populations other than Caucasoids. We have investigated three Amerindian populations from Southern Brazil: 131 Kaingang from Ivaí (KIV), 111 Kaingang (KRC) and 100 Guarani (GRC) from Rio das Cobras. Extended MHC haplotypes were derived after standard C2, BF, C4 phenotyping and restriction fragment length polymorphism (RFLP) analysis with TaqI, together with HLA data published previously by segregation analysis. C2 and BF frequencies corresponded to other Amerindian populations. C4B*Q0 frequency was high in the GRC (0.429) but low in the Kaingang. Unusual C4 alleles were found, viz. C4A*58, A*55 and C4B*22 (presumably non-Amerindian) and aberrant C4A*3 of Amerindian origin occurring with a frequency of 0.223 in the GRC. C4A*3 bands of homo- and heterozygous individuals carrying this variant were Rodgers 1 positive and Chido 1,3 positive, showed a C4A specific lysis type and a C4A like alpha-chain. Polymerase chain reaction studies and sequencing showed that this is based on a C4A*3 duplication with a regular C4A*3 and a partially converted C4A*0304 carrying the C4B specific epitopes Ch 6 and Ch 1,3. Associations of class III haplotypes with particular RFLP patterns were similar to those reported for Caucasoids. The previously described association between combined C4A and CYP21P deletions and the 6.4 kb TaqI fragment was not seen in these Amerindians. This fragment occurred within a regular two locus gene structure in the Kaingang, representing a "short" gene at C4 locus I. C4 and CYP21 duplications were frequently observed. The distribution of extended MHC haplotypes provides evidence for a close relationship between the KIV and KRC and a larger genetic distance between the two Kaingang groups and the GRC.

  11. A class III chitinase without disulfide bonds from the fern, Pteris ryukyuensis: crystal structure and ligand-binding studies.

    Science.gov (United States)

    Kitaoku, Yoshihito; Umemoto, Naoyuki; Ohnuma, Takayuki; Numata, Tomoyuki; Taira, Toki; Sakuda, Shohei; Fukamizo, Tamo

    2015-10-01

    We first solved the crystal structure of class III catalytic domain of a chitinase from fern (PrChiA-cat), and found a structural difference between PrChiA-cat and hevamine. PrChiA-cat was found to have reduced affinities to chitin oligosaccharides and allosamidin. Plant class III chitinases are subdivided into enzymes with three disulfide bonds and those without disulfide bonds. We here referred to the former enzymes as class IIIa chitinases and the latter as class IIIb chitinases. In this study, we solved the crystal structure of the class IIIb catalytic domain of a chitinase from the fern Pteris ryukyuensis (PrChiA-cat), and compared it with that of hevamine, a class IIIa chitinase from Hevea brasiliensis. PrChiA-cat was found to adopt an (α/β)8 fold typical of GH18 chitinases in a similar manner to that of hevamine. However, PrChiA-cat also had two large loops that extruded from the catalytic site, and the corresponding loops in hevamine were markedly smaller than those of PrChiA-cat. An HPLC analysis of the enzymatic products revealed that the mode of action of PrChiA-cat toward chitin oligosaccharides, (GlcNAc) n (n = 4-6), differed from those of hevamine and the other class IIIa chitinases. The binding affinities of (GlcNAc)3 and (GlcNAc)4 toward the inactive mutant of PrChiA-cat were determined by isothermal titration calorimetry, and were markedly lower than those toward other members of the GH18 family. The affinity and the inhibitory activity of allosamidin toward PrChiA-cat were also lower than those toward the GH18 chitinases investigated to date. Several hydrogen bonds found in the crystal structure of hevamine-allosamidin complex were missing in the modeled structure of PrChiA-cat-allosamidin complex. The structural findings for PrChiA-cat successfully interpreted the functional data presented.

  12. IBO Case Report: Management of Skeletal Class III Malocclusion with Combined Rapid Maxillary Expansion: Facemask Therapy and 5-Year Follow-up

    Directory of Open Access Journals (Sweden)

    Ashok Surana

    2012-01-01

    Full Text Available This case report describes the management of skeletal Class III malocclusion with maxillary deficiency in an adolescent girl, using combined rapid maxillary expansion-facemask approach, followed by comprehensive fixed appliance mechanotherapy. Excellent long-term stability is demonstrated up to 5 years post-treatment.

  13. Preventing an identity crisis: unexpected co-expression of class III beta-tubulin and glial fibrillary acidic protein in human fetal astrocytes in culture

    Czech Academy of Sciences Publication Activity Database

    Katsetos, C.D.; Dráberová, Eduarda; Del Valle, L.; Bertrand, L.; Agamanolis, D.P.; de Chadarévian, J.-P.; Legido, A.; Dráber, Pavel

    2007-01-01

    Roč. 26, č. 11 (2007), s. 107-107 ISSN 0364-5134 R&D Projects: GA MŠk LC545; GA ČR GA204/05/2375 Institutional research plan: CEZ:AV0Z50520514 Keywords : class III beta-tubulin * fetal glia Subject RIV: EB - Genetics ; Molecular Biology

  14. Skeletal changes, dental and face of class III skeletal malocclusion treated with philosophy MEAW (Multiloop Edgewise Arch Wire: a descriptive retrospective

    Directory of Open Access Journals (Sweden)

    Ángela Anyur García Bernal

    2013-07-01

    Plano (PP increase of 114,3°a 115,4° and the occlusal plane inclination increased from 17,8°a 24,7°. The average treatment time was 19,4 months. Conclusions: MEAW philosophy is a therapeutic alternative camouflage in the treatment of skeletal Class III malocclusions.

  15. Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

    Science.gov (United States)

    de Almeida Cardoso, Mauricio; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo

    2016-01-01

    The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects. PMID:26877982

  16. Regulation of the Tumor-Suppressor Function of the Class III Phosphatidylinositol 3-Kinase Complex by Ubiquitin and SUMO

    Energy Technology Data Exchange (ETDEWEB)

    Reidick, Christina [Biochemie Intrazellulärer Transportprozesse, Ruhr-Universität Bochum, Bochum 44801 (Germany); El Magraoui, Fouzi; Meyer, Helmut E. [Biomedical Research, Human Brain Proteomics II, Leibniz-Institut für Analytische Wissenschaften-ISAS, Dortmund 44139 (Germany); Stenmark, Harald [Department of Biochemistry, Institute for Cancer Research, Oslo University Hospital, Montebello, Oslo 0310 (Norway); Platta, Harald W., E-mail: harald.platta@rub.de [Biochemie Intrazellulärer Transportprozesse, Ruhr-Universität Bochum, Bochum 44801 (Germany)

    2014-12-23

    The occurrence of cancer is often associated with a dysfunction in one of the three central membrane-involution processes—autophagy, endocytosis or cytokinesis. Interestingly, all three pathways are controlled by the same central signaling module: the class III phosphatidylinositol 3-kinase (PI3K-III) complex and its catalytic product, the phosphorylated lipid phosphatidylinositol 3-phosphate (PtdIns3P). The activity of the catalytic subunit of the PI3K-III complex, the lipid-kinase VPS34, requires the presence of the membrane-targeting factor VPS15 as well as the adaptor protein Beclin 1. Furthermore, a growing list of regulatory proteins associates with VPS34 via Beclin 1. These accessory factors define distinct subunit compositions and thereby guide the PI3K-III complex to its different cellular and physiological roles. Here we discuss the regulation of the PI3K-III complex components by ubiquitination and SUMOylation. Especially Beclin 1 has emerged as a highly regulated protein, which can be modified with Lys11-, Lys48- or Lys63-linked polyubiquitin chains catalyzed by distinct E3 ligases from the RING-, HECT-, RBR- or Cullin-type. We also point out other cross-links of these ligases with autophagy in order to discuss how these data might be merged into a general concept.

  17. Regulation of the Tumor-Suppressor Function of the Class III Phosphatidylinositol 3-Kinase Complex by Ubiquitin and SUMO

    International Nuclear Information System (INIS)

    Reidick, Christina; El Magraoui, Fouzi; Meyer, Helmut E.; Stenmark, Harald; Platta, Harald W.

    2014-01-01

    The occurrence of cancer is often associated with a dysfunction in one of the three central membrane-involution processes—autophagy, endocytosis or cytokinesis. Interestingly, all three pathways are controlled by the same central signaling module: the class III phosphatidylinositol 3-kinase (PI3K-III) complex and its catalytic product, the phosphorylated lipid phosphatidylinositol 3-phosphate (PtdIns3P). The activity of the catalytic subunit of the PI3K-III complex, the lipid-kinase VPS34, requires the presence of the membrane-targeting factor VPS15 as well as the adaptor protein Beclin 1. Furthermore, a growing list of regulatory proteins associates with VPS34 via Beclin 1. These accessory factors define distinct subunit compositions and thereby guide the PI3K-III complex to its different cellular and physiological roles. Here we discuss the regulation of the PI3K-III complex components by ubiquitination and SUMOylation. Especially Beclin 1 has emerged as a highly regulated protein, which can be modified with Lys11-, Lys48- or Lys63-linked polyubiquitin chains catalyzed by distinct E3 ligases from the RING-, HECT-, RBR- or Cullin-type. We also point out other cross-links of these ligases with autophagy in order to discuss how these data might be merged into a general concept

  18. A three-dimensional analysis of skeletal and dental characteristics in skeletal class III patients with facial asymmetry.

    Science.gov (United States)

    Yu, Jinfeng; Hu, Yun; Huang, Mingna; Chen, Jun; Ding, Xiaoqian; Zheng, Leilei

    2018-03-15

    To evaluate the skeletal and dental characteristics in skeletal class III patients with facial asymmetry and to analyse the relationships among various parts of the stomatognathic system to provide a theoretical basis for clinical practice. Asymmetric cone-beam computed tomography data acquired from 56 patients were evaluated using Mimics 10.0 and 3-Matic software. Skeletal and dental measurements were performed to assess the three-dimensional differences between two sides. Pearson correlation analysis was used to determine the correlations among measurements. Linear measurements, such as ramal height, mandible body length, ramal height above the sigmoid notch (RHASN), maxillary height, condylar height, buccal and total cancellous bone thickness, and measurements of condylar size, were significantly larger on the nondeviated side than on the deviated side (P orthodontic camouflage has limitations and potential risks. A combination of orthodontics and orthognathic surgery may be the advisable choice in patients with a menton deviation greater than 4 mm. An important association between vertical skeletal disharmony and dental compensation was also observed.

  19. PCSK1 rs6232 Is Associated with Childhood and Adult Class III Obesity in the Mexican Population

    Science.gov (United States)

    Villalobos-Comparán, Marisela; Villamil-Ramírez, Hugo; Villarreal-Molina, Teresa; Larrieta-Carrasco, Elena; León-Mimila, Paola; Romero-Hidalgo, Sandra; Jacobo-Albavera, Leonor; Liceaga-Fuentes, Adriana E.; Campos-Pérez, Francisco J.; López-Contreras, Blanca E.; Tusié-Luna, Teresa; del Río-Navarro, Blanca E.; Aguilar-Salinas, Carlos A.; Canizales-Quinteros, Samuel

    2012-01-01

    Background Common variants rs6232 and rs6235 in the PCSK1 gene have been associated with obesity in European populations. We aimed to evaluate the contribution of these variants to obesity and related traits in Mexican children and adults. Methodology/Principal Findings Rs6232 and rs6235 were genotyped in 2382 individuals, 1206 children and 1176 adults. Minor allele frequencies were 0.78% for rs6232 and 19.99% for rs6235. Rs6232 was significantly associated with childhood obesity and adult class III obesity (OR = 3.01 95%CI 1.64–5.53; P = 4×10−4 in the combined analysis). In addition, this SNP was significantly associated with lower fasting glucose levels (P = 0.01) and with increased insulin levels and HOMA-B (P = 0.05 and 0.01, respectively) only in non-obese children. In contrast, rs6235 showed no significant association with obesity or with glucose homeostasis parameters in any group. Conclusion/Significance Although rs6232 is rare in the Mexican population, it should be considered as an important risk factor for extreme forms of obesity. PMID:22737226

  20. The influence of INS VNTR class III allele on auxological parameters, glucose, insulin, lipids, and adipocytokines secretion in prepubertal children born small for gestational age.

    Science.gov (United States)

    Stawerska, Renata; Szałapska, Małgorzata; Borowiec, Maciej; Antosik, Karolina; Młynarski, Wojciech; Lewiński, Andrzej

    2016-01-01

    The insulin gene variable number of tandem repeats (INS VNTR) class III allele has been implicated in lower birth weight, obesity, and insulin resistance. We assessed its influence on birth weight in the Polish population and on the current body mass and metabolic profile in prepubertal children born small for gestational age (SGA). DNA for genotyping of INS VNTR was available for 123 subjects born SGA and 132 born appropriate for gestational age (AGA). We identified two alleles: class I and class III. Next, in 112 prepubertal (aged: 6.8 ± 1.38 years) SGA children, the auxological measurements, fasting serum C-peptide, triglycerides, cholesterol, ghrelin, leptin, adiponectin, resistin, cortisol, and insulin-like growth factor type I (IGF-I) concentrations, as well as glucose and insulin during oral glucose tolerance test (OGTT), were assessed and insulin resistance indices were calculated. The results were analysed depending on INS VNTR variants. The occurrence of individual INS VNTR variants were similar in the SGA and AGA groups. In prepubertal SGA children, we did not observe any statistical differences as regards birth weight, body mass, lipids, or adipocytokine concentrations among I/I, I/III, and III/III class groups. The concentration of insulin in 120' of OGTT was significantly higher in class III homozygous than in class I homozygous individuals. Variant INS VNTR class III was shown not to be associated in any essential way with birth weight in the Polish population. Among prepubertal SGA children, the presence of INS VNTR class III is related to higher insulin secretion during OGTT. (Endokrynol Pol 2016; 67 (6): 585-591).

  1. Application for a Permit to Operate a Class III Solid Waste Disposal Site at the Nevada Test Site Area 5 Asbestiform Low-Level Solid Waste Disposal Site

    International Nuclear Information System (INIS)

    2010-01-01

    The NTS solid waste disposal sites must be permitted by the state of Nevada Solid Waste Management Authority (SWMA). The SWMA for the NTS is the Nevada Division of Environmental Protection, Bureau of Federal Facilities (NDEP/BFF). The U.S. Department of Energy's National Nuclear Security Administration Nevada Site Office (NNSA/NSO) as land manager (owner), and National Security Technologies (NSTec), as operator, will store, collect, process, and dispose all solid waste by means that do not create a health hazard, a public nuisance, or cause impairment of the environment. NTS disposal sites will not be included in the Nye County Solid Waste Management Plan. The NTS is located approximately 105 kilometers (km) (65 miles (mi)) northwest of Las Vegas, Nevada (Figure 1). The U.S. Department of Energy (DOE) is the federal lands management authority for the NTS, and NSTec is the Management and Operations contractor. Access on and off the NTS is tightly controlled, restricted, and guarded on a 24-hour basis. The NTS has signs posted along its entire perimeter. NSTec is the operator of all solid waste disposal sites on the NTS. The Area 5 RWMS is the location of the permitted facility for the Solid Waste Disposal Site (SWDS). The Area 5 RWMS is located near the eastern edge of the NTS (Figure 2), approximately 26 km (16 mi) north of Mercury, Nevada. The Area 5 RWMS is used for the disposal of low-level waste (LLW) and mixed low-level waste. Many areas surrounding the RWMS have been used in conducting nuclear tests. A Notice of Intent to operate the disposal site as a Class III site was submitted to the state of Nevada on January 28, 1994, and was acknowledged as being received in a letter to the NNSA/NSO on August 30, 1994. Interim approval to operate a Class III SWDS for regulated asbestiform low-level waste (ALLW) was authorized on August 12, 1996 (in letter from Paul Liebendorfer to Runore Wycoff), with operations to be conducted in accordance with the ''Management Plan

  2. Nasal changes after orthognathic surgery for patients with prognathism and Class III malocclusion: analysis using three-dimensional photogrammetry.

    Science.gov (United States)

    Worasakwutiphong, Saran; Chuang, Ya-Fang; Chang, Hsin-Wen; Lin, Hsiu-Hsia; Lin, Pei-Ju; Lo, Lun-Jou

    2015-02-01

    Orthognathic surgery alters the position of maxilla and mandible, and consequently changes the nasal shape. The nasal change remains a concern to Asian patients. The aim of this study was to measure the nasal changes using a novel three-dimensional photographic imaging method. A total of 38 patients with Class III malocclusion and prognathism were enrolled. All patients underwent two-jaw surgery with the standard technique. A nasal alar cinching suture was included at the end of procedure. Facial landmarks and nasal morphology were defined and measured from pre- and postoperative three-dimensional photographic images. Intra-rater errors on landmark identification were controlled. Patient's reports of perceptual nasal changes were recorded. The average width of the alar base and subalare remained similar after surgery. Alar width was increased by 0.74 mm. Nasal height and length remained the same. Nasolabial angle increased significantly. The area of nostril show revealed a significant increase and was correlated with a decrease of columella inclination. Nasal tip projection decreased significantly, by 1.99 mm. Preoperative nasal morphology was different between patients with and without cleft lip/palate, but most nasal changes were concordant. In the self-perception, 37% of patients reported improved nasal appearance, 58% reported no change, and 5% were not satisfied with the nasal changes. After the surgery, characteristic nasal changes occurred with an increase of nasolabial angle and nostril show, but a preserved nasal width. The majority of patients did not perceive adverse nasal changes. Copyright © 2014. Published by Elsevier B.V.

  3. Accuracy of Dolphin visual treatment objective (VTO prediction software on class III patients treated with maxillary advancement and mandibular setback

    Directory of Open Access Journals (Sweden)

    Robert J. Peterman

    2016-06-01

    Full Text Available Abstract Background Dolphin® visual treatment objective (VTO prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes. Although surgical soft tissue prediction is considered to be a vital tool, its accuracy is not well understood in tow-jaw surgical procedures. The objective of this study was to quantify the accuracy of Dolphin Imaging’s VTO soft tissue prediction software on class III patients treated with maxillary advancement and mandibular setback and to validate the efficacy of the software in such complex cases. Methods This retrospective study analyzed the records of 14 patients treated with comprehensive orthodontics in conjunction with two-jaw orthognathic surgery. Pre- and post-treatment radiographs were traced and superimposed to determine the actual skeletal movements achieved in surgery. This information was then used to simulate surgery in the software and generate a final soft tissue patient profile prediction. Prediction images were then compared to the actual post-treatment profile photos to determine differences. Results Dolphin Imaging’s software was determined to be accurate within an error range of +/− 2 mm in the X-axis at most landmarks. The lower lip predictions were most inaccurate. Conclusions Clinically, the observed error suggests that the VTO may be used for demonstration and communication with a patient or consulting practitioner. However, Dolphin should not be useful for precise treatment planning of surgical movements. This program should be used with caution to prevent unrealistic patient expectations and dissatisfaction.

  4. Class III malocclusion with complex problems of lateral open bite and severe crowding successfully treated with miniscrew anchorage and lingual orthodontic brackets.

    Science.gov (United States)

    Yanagita, Takeshi; Kuroda, Shingo; Takano-Yamamoto, Teruko; Yamashiro, Takashi

    2011-05-01

    In this article, we report the successful use of miniscrews in a patient with an Angle Class III malocclusion, lateral open bite, midline deviation, and severe crowding. Simultaneously resolving such problems with conventional Class III treatment is difficult. In this case, the treatment procedure was even more challenging because the patient preferred to have lingual brackets on the maxillary teeth. As a result, miniscrews were used to facilitate significant asymmetric tooth movement in the posterior and downward directions; this contributed to the camouflage of the skeletal mandibular protrusion together with complete resolution of the severe crowding and lateral open bite. Analysis of the jaw motion showed that irregularities in chewing movement were also resolved, and a stable occlusion was achieved. Improvements in the facial profile and dental arches remained stable at the 18-month follow-up. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  5. Thin-plate spline analysis of treatment effects of rapid maxillary expansion and face mask therapy in early Class III malocclusions.

    Science.gov (United States)

    Baccetti, T; Franchi, L; McNamara, J A

    1999-06-01

    An effective morphometric method (thin-plate spline analysis) was applied to evaluate shape changes in the craniofacial configuration of a sample of 23 children with Class III malocclusions in the early mixed dentition treated with rapid maxillary expansion and face mask therapy, and compared with a sample of 17 children with untreated Class III malocclusions. Significant treatment-induced changes involved both the maxilla and the mandible. Major deformations consisted of forward displacement of the maxillary complex from the pterygoid region and of anterior morphogenetic rotation of the mandible, due to a significant upward and forward direction of growth of the mandibular condyle. Significant differences in size changes due to reduced increments in mandibular dimensions were associated with significant shape changes in the treated group.

  6. Treatment of skeletal class III malocclusion using face mask therapy with alternate rapid maxillary expansion and constriction (Alt-RAMEC protocol

    Directory of Open Access Journals (Sweden)

    Anand Ramchandra Rathi

    2015-01-01

    Full Text Available Class III malocclusion is very common malocclusion and can be due to maxillary retrusion, mandibular prognathism, or combination. Ellis and McNamara found a combination of maxillary retrusion and mandibular protrusion to be the most common skeletal relationship (30%. The treatment should be carried out as early as possible for permitting normal growth of the skeletal bases. Reverse pull head gear combined with maxillary expansion can effectively correct skeletal Class III malocclusion due to maxillary deficiency in growing patient. An eight-year-old female patient with chief complaint of prognathic mandible and anterior crossbite was successfully treated in duration of 5 months with facemask and expansion therapy based on Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC protocol.

  7. [Morphological analysis of alveolar bone of anterior mandible in high-angle skeletal class II and class III malocclusions assessed with cone-beam computed tomography].

    Science.gov (United States)

    Ma, J; Jiang, J H

    2018-02-18

    To evaluate the difference of features of alveolar bone support under lower anterior teeth between high-angle adults with skeletal class II malocclusions and high-angle adults presenting skeletal class III malocclusions by using cone-beam computed tomography (CBCT). Patients who had taken the images of CBCT were selected from the Peking University School and Hospital of Stomatology between October 2015 and August 2017. The CBCT archives from 62 high-angle adult cases without orthodontic treatment were divided into two groups based on their sagittal jaw relationships: skeletal class II and skeletal class III. vertical bone level (VBL), alveolar bone area (ABA), and the width of alveolar bone were measured respectively at the 2 mm, 4 mm, 6 mm below the cemento-enamel junction (CEJ) level and at the apical level. After that, independent samples t-tests were conducted for statistical comparisons. The ABA of the mandibular alveolar bone in the area of lower anterior teeth was significantly thinner in the patients of skeletal class III than those of skeletal class II, especially in terms of the apical ABA, total ABA on the labial and lingual sides and the ABA at 6 mm below CEJ level on the lingual side (Pclass III than those of skeletal class II, especially regarding the apical level on the labial and lingual side and at the level of 4 mm, 6 mm below CEJ level on the lingual side (Pclass III adult patients with high-angle when compared with the sample of high-angle skeletal class II adult cases. We recommend orthodontists to be more cautious in treatment of high-angle skeletal class III patients, especially pay attention to control the torque of lower anterior teeth during forward and backward movement, in case that the apical root might be absorbed or fenestration happen in the area of lower anterior teeth.

  8. 40 CFR Figure C-2 to Subpart C of... - Illustration of the Slope and Intercept Limits for Class II and Class III PM2.5 Candidate...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Illustration of the Slope and Intercept Limits for Class II and Class III PM2.5 Candidate Equivalent Methods C Figure C-2 to Subpart C of Part 53... Methods and Reference Methods Pt. 53, Subpt. C, Fig. C-2 Figure C-2 to Subpart C of Part 53—Illustration...

  9. Class III beta-tubulin is constitutively coexpressed with glial fibrillary acidic protein and nestin in midgestational human fetal astrocytes: implications for phenotypic identity

    Czech Academy of Sciences Publication Activity Database

    Dráberová, Eduarda; Del Valle, L.; Gordon, J.; Marková, Vladimíra; Šmejkalová, Barbora; Bertrand, L.; de Chadarévian, J.-P.; Agamanolis, D.P.; Legido, A.; Khalili, K.; Dráber, Pavel; Katsetos, C.D.

    2008-01-01

    Roč. 67, č. 4 (2008), s. 341-354 ISSN 0022-3069 R&D Projects: GA MŠk LC545; GA ČR GA204/05/2375 Institutional research plan: CEZ:AV0Z50520514 Keywords : astrocytes * class III beta-tubulin * fetal glia Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 5.140, year: 2008

  10. Biowaiver extension potential to BCS Class III high solubility-low permeability drugs: bridging evidence for metformin immediate-release tablet.

    Science.gov (United States)

    Cheng, Ching-Ling; Yu, Lawrence X; Lee, Hwei-Ling; Yang, Chyun-Yu; Lue, Chang-Sha; Chou, Chen-Hsi

    2004-07-01

    The biopharmaceutics classification system (BCS) allows biowaiver for rapid dissolving immediate-release (IR) products of Class I drugs (high solubility and high permeability). The possibility of extending biowaivers to Class III high solubility and low permeability drugs is currently under scrutiny. In vivo bioequivalence data of different formulations of Class III drugs would support such an extension. The objective of this work was to demonstrate the bioequivalence of two marketed IR tablet products of a Class III drug, metformin hydrochloride, that are rapidly dissolving and have similar in vitro dissolution profiles. The effect of race on the systemic exposure of metformin was also explored. A randomized, open-label, two-period crossover study was conducted in 12 healthy Chinese male volunteers. Each subject received a single-dose of 500 mg of each product after an overnight fasting. The plasma concentrations of metformin were followed for 24 h. No significant formulation effect was found for the bioequivalence metrics: areas under concentration-time curve (AUC0-t, AUC0-infinity) and maximal concentration (Cmax). The 90% confidence intervals for the ratio of means were found within the acceptance range of 80-125% for the log-transformed data. Based on these results, it was concluded that the two IR products are bioequivalent. The pharmacokinetic parameters of metformin in Chinese for both products were similar and were in good agreement with those reported for metformin IR tablets in other ethnic populations. This study serves as an example for supporting biowaiver for BCS Class III drugs.

  11. Lip line changes in Class III facial asymmetry patients after orthodontic camouflage treatment, one-jaw surgery, and two-jaw surgery: A preliminary study.

    Science.gov (United States)

    Lee, Gung-Chol; Yoo, Jo-Kwang; Kim, Seong-Hun; Moon, Cheol-Hyun

    2017-03-01

    To evaluate the effects of orthodontic camouflage treatment (OCT), one-jaw surgery, and two-jaw surgery on the correction of lip line cant (LLC) and to examine factors affecting the correction of LLC in Class III craniofacial asymmetry patients. A sample of 30 Class III craniofacial asymmetry patients was divided into OCT (n = 10), one-jaw surgery (n = 10), and two-jaw surgery (n = 10) groups such that the pretreatment LLC was similar in each group. Pretreatment and posttreatment cone-beam computed tomography scans were used to measure dental and skeletal parameters and LLC. Pretreatment and posttreatment measurements were compared within groups and between groups. Pearson's correlation tests and multiple regression analyses were performed to investigate factors affecting the amount and rate of LLC correction. The average LLC correction was 1.00° in the one-jaw surgery group, and in the two-jaw surgery group, it was 1.71°. In the OCT group it was -0.04°, which differed statistically significantly from the LLC correction in the other two groups. The amount and rate of LLC correction could be explained by settling of skeletal discrepancies or LLC at pretreatment with goodness of fit percentages of approximately 82% and 41%, respectively. Orthognathic surgery resulted in significant correction of LLC in Class III craniofacial asymmetry patients, while OCT did not.

  12. [Preliminary evaluation on 3-demension changes of facial soft tissue with structure light scanning technique before and after orthognathic surgery of Class III deformities].

    Science.gov (United States)

    Peng, Ju-xiang; Jiang, Jiu-hui; Zhao, Yi-jiao; Wang, Yong; Li, Ze; Wang, Ning-ning; Feng, Zhi-min

    2015-02-18

    To evaluate facial soft tissue 3-deminsion changes of skeletal Class III malocclusion patients after orthognathic surgery using structure light scanning technique. Eight patients [3 males and 5 females, aged (27.08 ± 4.42) years] with Class III dentoskeletal relationship who underwent a bimaxillary orthognathic surgical procedure involving advancement of the maxilla by Le Fort I osteotomy and mandibular setback by bilateral sagittal split ramus osteotomy (BSSO) and genioplasty to correct deformity were included. 3D facial images were obtained by structure light scanner for all the patients 2 weeks preoperatively and 6 months postoperatively. The facial soft tissue changes were evaluated in 3-dimension. The linear distances and angulation changes for facial soft tissue landmarks were analyzed. The soft tissue volumetric changes were assessed too. There were significant differences in the sagittal and vertical changes of soft tissue landmarks. The greatest amount of soft tissue change was close to lips. There were more volumetric changes in the chin than in the maxilla, and fewer in the forehead. After biomaxillary surgery, there were significant facial soft tissue differences mainly in the sagittal and vertical dimension for skeletal Class III patients. The structure light 3D scanning technique can be accurately used to estimate the soft tissue changes in patients who undergo orthognathic surgery.

  13. Association between class III obesity (BMI of 40-59 kg/m2 and mortality: a pooled analysis of 20 prospective studies.

    Directory of Open Access Journals (Sweden)

    Cari M Kitahara

    2014-07-01

    Full Text Available The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2 has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year and multivariable-adjusted hazard ratios for adults, aged 19-83 y at baseline, classified as obese class III (BMI 40.0-59.9 kg/m2 compared with those classified as normal weight (BMI 18.5-24.9 kg/m2. Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976-2009. Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively, followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, respectively and diabetes (rate differences = 51.2 and 29.2 in men and women, respectively. Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40-44.9, 45-49.9, 50-54.9, and 55-59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7-7.3, 8

  14. Cone-Beam Computed Tomography Assessment of Lower Facial Asymmetry in Unilateral Cleft Lip and Palate and Non-Cleft Patients with Class III Skeletal Relationship.

    Science.gov (United States)

    Lin, Yifan; Chen, Gui; Fu, Zhen; Ma, Lian; Li, Weiran

    2015-01-01

    To evaluate, using cone-beam computed tomography (CBCT), both the condylar-fossa relationships and the mandibular and condylar asymmetries between unilateral cleft lip and palate (UCLP) patients and non-cleft patients with class III skeletal relationship, and to investigate the factors of asymmetry contributing to chin deviation. The UCLP and non-cleft groups consisted of 30 and 40 subjects, respectively, in mixed dentition with class III skeletal relationships. Condylar-fossa relationships and the dimensional and positional asymmetries of the condyles and mandibles were examined using CBCT. Intra-group differences were compared between two sides in both groups using a paired t-test. Furthermore, correlations between each measurement and chin deviation were assessed. It was observed that 90% of UCLP and 67.5% of non-cleft subjects had both condyles centered, and no significant asymmetry was found. The axial angle and the condylar center distances to the midsagittal plane were significantly greater on the cleft side than on the non-cleft side (P=0.001 and P=0.028, respectively) and were positively correlated with chin deviation in the UCLP group. Except for a larger gonial angle on the cleft side, the two groups presented with consistent asymmetries showing shorter mandibular bodies and total mandibular lengths on the cleft (deviated) side. The average chin deviation was 1.63 mm to the cleft side, and the average absolute chin deviation was significantly greater in the UCLP group than in the non-cleft group (P=0.037). Compared with non-cleft subjects with similar class III skeletal relationships, the subjects with UCLP showed more severe lower facial asymmetry. The subjects with UCLP presented with more asymmetrical positions and rotations of the condyles on axial slices, which were positively correlated with chin deviation.

  15. Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment.

    Science.gov (United States)

    Song, Han-Sol; Choi, Sung-Hwan; Cha, Jung-Yul; Lee, Kee-Joon; Yu, Hyung-Seog

    2017-07-01

    To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, -1.8° ± 2.8°, p = 0.044; nondeviated side, -3.7° ± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0° ± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

  16. Anteroposterior condylar position: a comparative study between subjects with normal occlusion and patients with Class I, Class II Division 1, and Class III malocclusions.

    Science.gov (United States)

    Fraga, Marcelo Reis; Rodrigues, Andréia Fialho; Ribeiro, Luiz Claudio; Campos, Marcio José da Silva; Vitral, Robert Willer Farinazzo

    2013-10-29

    The present study aimed to determine and compare the anteroposterior position of the condyle in the mandibular fossa between groups of asymptomatic subjects with normal occlusion and asymptomatic subjects with Class I, Class II Division 1, and Class III malocclusions. Thirty persons with normal occlusion, 30 with Class I malocclusion, 30 with Class II Division 1, and 30 with Class III had computed tomography scans of their temporomandibular joints. The anterior joint space/posterior joint space (AJS/PJS) ratio was determined for the right and left joints. The paired t test was used to analyze the AJS/PJS ratio between both sides for each group. The ANOVA test was applied to verify the differences between the groups for the measurements of the right and left sides. In case the ANOVA test confirmed significance, the Dunnett's t test was performed to compare the groups of malocclusion with that of normal occlusion. The paired t test between the AJS/PJS relationships in the right and left sides showed the following p values: Class I (0.168), Class II Division 1 (0.662), Class III (0.991), and normal occlusion (0.390). The ANOVA test showed a p value of 0.445 for the comparisons of the right side and 0.040 for the left side. The Dunnett's t test demonstrated a statistically significant difference between the Class II group and the normal occlusion group (p value of 0.026) in the joints of the left side. Bilateral symmetry and lack of condyle centralization were common characteristics among all groups. The greatest condylar decentralization was observed in the Class II group, whereas the least condylar decentralization was found in the normal occlusion group.

  17. Application of Advanced Reservoir Characterization, Simulation, and Production Optimization Strategies to Maximize Recovery in Slope and Basin Clastic Reservoirs, West Texas (Delaware Basin), Class III

    Energy Technology Data Exchange (ETDEWEB)

    Dutton, Shirley P.; Flanders, William A.

    2001-11-04

    The objective of this Class III project was demonstrate that reservoir characterization and enhanced oil recovery (EOR) by CO2 flood can increase production from slope and basin clastic reservoirs in sandstones of the Delaware Mountain Group in the Delaware Basin of West Texas and New Mexico. Phase 1 of the project, reservoir characterization, focused on Geraldine Ford and East Ford fields, which are Delaware Mountain Group fields that produce from the upper Bell Canyon Formation (Ramsey sandstone). The demonstration phase of the project was a CO2 flood conducted in East Ford field, which is operated by Orla Petco, Inc., as the East Ford unit.

  18. Treatment of an adult with a normodivergent, mild skeletal Class III pattern, and a Bolton′s discrepancy using a single mandibular incisor extraction plan

    Directory of Open Access Journals (Sweden)

    Sunjay Suri

    2015-01-01

    Full Text Available A 34½-year-old pathologist with active social and professional interaction sought orthodontic solutions for severe esthetic and functional impairment. She felt due to spaced and protruding maxillary incisors, but had not got treatment previously as she did not want to wear metallic appliances. The diagnosis revealed a skeletal Class III normodivergent pattern with relative mandibular excess tooth material. Treatment with multibracket fixed appliances using ceramic brackets, extraction of a mandibular central incisor, maxillary incisor crown recontouring with interproximal reduction, and using gentle space closure mechanics ameliorated the problems and provided an esthetically pleasing, functionally adequate occlusion with good intercuspation.

  19. 42 CFR 482.30 - Condition of participation: Utilization review.

    Science.gov (United States)

    2010-10-01

    ... circumstances: (1) A Utilization and Quality Control Quality Improvement Organization (QIO) has assumed binding... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Basic Hospital Functions § 482.30 Condition of participation: Utilization review. The hospital must have in...

  20. Technology review: prototyping platforms for monitoring ambient conditions.

    Science.gov (United States)

    Afolaranmi, Samuel Olaiya; Ramis Ferrer, Borja; Martinez Lastra, Jose Luis

    2018-05-08

    The monitoring of ambient conditions in indoor spaces is very essential owing to the amount of time spent indoors. Specifically, the monitoring of air quality is significant because contaminated air affects the health, comfort and productivity of occupants. This research work presents a technology review of prototyping platforms for monitoring ambient conditions in indoor spaces. It involves the research on sensors (for CO 2 , air quality and ambient conditions), IoT platforms, and novel and commercial prototyping platforms. The ultimate objective of this review is to enable the easy identification, selection and utilisation of the technologies best suited for monitoring ambient conditions in indoor spaces. Following the review, it is recommended to use metal oxide sensors, optical sensors and electrochemical sensors for IAQ monitoring (including NDIR sensors for CO 2 monitoring), Raspberry Pi for data processing, ZigBee and Wi-Fi for data communication, and ThingSpeak IoT platform for data storage, analysis and visualisation.

  1. The Effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for Class III correction: part I--jaw-motion analysis.

    Science.gov (United States)

    Teng, Terry Te-Yi; Ko, Ellen Wen-Ching; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The aim of this prospective study was to compare the mandibular range of motion in Class III patients with and without early physiotherapy after orthognathic surgery (OGS). This study consisted of 63 Class III patients who underwent 2-jaw OGS. The experimental group comprised 31 patients who received early systematic physical rehabilitation. The control group consisted of 32 patients who did not have physical rehabilitation. Twelve variables of 3-dimensional (3D) jaw-motion analysis (JMA) were recorded before surgery (T1) and 6 weeks (T2) and 6 months (T3) after surgery. A 2-sample t test was conducted to compare the JMA results between the two groups at different time points. At T2, the JMA data were measured to be 77.5%-145.7% of presurgical values in the experimental group, and 60.3%-90.6% in the control group. At T3, the measurements were 112.2%-179.2% of presurgical values in the experimental group, and 77.6%-157.2% in the control group. The patients in the experimental group exhibited more favorable recovery than did those in the control group, from T1 to T2 and T1 to T3. However, after termination of physiotherapy, no significant difference in the extent of recovery was observed between groups up to 6 months after OGS. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Progressive changes in patients with skeletal Class III malocclusion treated by 2-jaw surgery with minimal and conventional presurgical orthodontics: A comparative study.

    Science.gov (United States)

    Zhou, Yang; Li, Zili; Wang, Xiaoxia; Zou, Bingshuang; Zhou, Yanheng

    2016-02-01

    In this study, we aimed to compare treatment efficacy and postsurgical stability between minimal presurgical orthodontics and conventional presurgical orthodontics for patients with skeletal Class III malocclusion. Forty patients received minimal presurgical orthodontics (n = 20) or conventional presurgical orthodontics (n = 20). Lateral cephalograms were obtained before treatment, before orthognathic surgery, and at 1 week, 3 months, 6 months, and 12 months after surgery. Changes of overjet and mandibular incisal angle before surgery were greater in the conventional presurgical orthodontics group than in the minimal presurgical orthodontics group. Postsurgical horizontal changes in Points A and B, overjet, and mandibular incisal angle showed significant differences among the time points. Most of the horizontal and vertical relapses in the maxilla and the mandible occurred within the first 6 months in both groups. Minimal presurgical orthodontics and conventional presurgical orthodontics showed similar extents and directions of skeletal changes in patients with Class III malocclusion. However, orthodontists and surgeons should preoperatively consider the postsurgical counterclockwise rotation of the mandible when using minimal presurgical orthodontics. Close and frequent observations are recommended in the early postsurgical stages. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Evaluation of cephalometric changes in patients with class III malocclusion in mixed dentition period following face mask therapy and slow maxillary expansion

    Directory of Open Access Journals (Sweden)

    Ahmad Akhondi MS.

    2008-11-01

    Full Text Available "nBackground and Aim: Among different treatments of patients with Class III malocclusion , orthopedic protraction of maxilla has been known as an effective method in mixed dentition period. The aim of this study was to evaluate the cephalometric changes of Cl III patients in mixed dentition period following face mask therapy and slow maxillary expansion. "nMaterials and Methods: This was a before-after study which was conducted on 10 children in mixed dentition period, who had class III malocclusion and maxillary deficiency according to the Stiener and Mc Namara's analysis. The patients were all treated by protraction face mask and slow maxillary expansion. The cephalometric changes of maxilla , mandible and dental relations during the treatment were analyzed by Paired sample T Test. P<0.05 was considered as the level of significant. "nResults: The overjet increasement was 1.7mm. Co. ANS distance improvement was 5.6mm, Ptm.ANS distance increasing was 3mm, and ultimately improvement of Gf.s distance was 1.5mm which were all statistically significant (p<0.05. "nConclusion: Based on the results of this study, face mask therapy with slow maxillary expansion is able to improve the horizotal position of maxilla, in patients with Cl III malocclusion , in mixed dentition period.

  4. Orthopedic treatment of Class III malocclusion with rapid maxillary expansion combined with a face mask: a cephalometric assessment of craniofacial growth patterns

    Directory of Open Access Journals (Sweden)

    Daniella Torres Tagawa

    2012-06-01

    Full Text Available OBJECTIVE: The aim of this prospective study was to assess potential changes in the cephalometric craniofacial growth pattern of 17 children presenting Angle Class III malocclusion treated with a Haas-type expander combined with a face mask. METHODS: Lateral cephalometric radiographs were taken at beginning (T1 and immediately after removal of the appliances (T2, average of 11 months of treatment. Linear and angular measurements were used to evaluate the cranial base, dentoskeletal changes and facial growth pattern. RESULTS: The length of the anterior cranial base experienced a reduction while the posterior cranial base assumed a more vertical position at T1. Some maxillary movement occurred, there was no rotation of the palatal plane, there was a slight clockwise rotation of the mandible, although not significant. The ANB angle increased, thereby improving the relationship between the jaws; dentoalveolar compensation was more evident in the lower incisors. Five out of 12 cases (29.41% showed the following changes: In one case the pattern became more horizontal and in four cases more vertical. CONCLUSIONS: It was concluded after a short-term assessment that treatment with rapid maxillary expansion (RME associated with a face mask was effective in the correction of Class III malocclusion despite the changes in facial growth pattern observed in a few cases.

  5. Effects of orthognathic surgery for class III malocclusion on signs and symptoms of temporomandibular disorders and on pressure pain thresholds of the jaw muscles.

    Science.gov (United States)

    Farella, M; Michelotti, A; Bocchino, T; Cimino, R; Laino, A; Steenks, M H

    2007-07-01

    The aim of this longitudinal study was to determine the effects of orthognathic surgery on signs and symptoms of temporomandibular disorders (TMD) and on pressure pain thresholds (PPTs) of the jaw muscles. Fourteen consecutive class III patients undergoing pre-surgical orthodontic treatment were treated by combined Le Fort I osteotomy and bilateral sagittal ramus osteotomy. The clinical examination included the assessment of signs and symptoms of TMD and the assessment of PPTs of the masseter and temporalis muscles. Anamnestic, clinical and algometric data were collected during five sessions over a 1-year period. Seven out of 14 patients presented with disc displacement with reduction at baseline, whereas four patients (two of them were new cases) did so at the end of follow up (p>0.05). None of the patients were diagnosed with myofascial pain of the jaw muscles at the beginning or end of follow up. PPTs of the masseter and temporalis muscles did not change significantly from baseline values throughout the whole study period. The occurrence of signs and symptoms of TMD fluctuates with an unpredictable pattern after orthognathic surgery for class III malocclusions.

  6. Root cementum modulates periodontal regeneration in Class III furcation defects treated by the guided tissue regeneration technique: a histometric study in dogs.

    Science.gov (United States)

    Gonçalves, Patricia F; Gurgel, Bruno C V; Pimentel, Suzana P; Sallum, Enilson A; Sallum, Antonio W; Casati, Márcio Z; Nociti, Francisco H

    2006-06-01

    Because the possibility of root cementum preservation as an alternative approach for the treatment of periodontal disease has been demonstrated, this study aimed to histometrically evaluate the effect of root cementum on periodontal regeneration. Bilateral Class III furcation defects were created in dogs, and each dog was randomly assigned to receive one of the following treatments: control (group A): scaling and root planing with the removal of root cementum; or test (group B): removal of soft microbial deposits by polishing the root surface with rubber cups and polishing paste, aiming at maximum cementum preservation. Guided tissue regeneration (GTR) was applied to both groups. Four months after treatment, a superior length of new cementum (3.59 +/- 1.67 mm versus 6.20 +/- 2.26 mm; P = 0.008) and new bone (1.86 +/- 1.76 mm versus 4.62 +/- 3.01 mm; P = 0.002) and less soft tissue along the root surface (2.77 +/- 0.79 mm versus 1.10 +/- 1.48 mm; P = 0.020) was observed for group B. Additionally, group B presented a larger area of new bone (P = 0.004) and a smaller area of soft tissue (P = 0.008). Within the limits of this study, root cementum may modulate the healing pattern obtained by guided tissue regeneration in Class III furcation defects.

  7. Comparison of temporomandibular joint and ramus morphology between class II and class III cases before and after bi-maxillary osteotomy.

    Science.gov (United States)

    Iguchi, Ran; Yoshizawa, Kunio; Moroi, Akinori; Tsutsui, Takamitsu; Hotta, Asami; Hiraide, Ryota; Takayama, Akihiro; Tsunoda, Tatsuya; Saito, Yuki; Sato, Momoko; Baba, Nana; Ueki, Koichiro

    2017-12-01

    The purpose of this study was to compare changes in temporomandibular joint (TMJ) and ramus morphology between class II and III cases before and after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy. The subjects were 39 patients (78 sides) who underwent bi-maxillary surgery. They consisted of 2 groups (18 class II cases and 21 class III cases), and were selected randomly from among patients who underwent surgery between 2012 and 2016. The TMJ disc tissue and joint effusion were assessed by magnetic resonance imaging (MRI) and the TMJ space, condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), pre- and post-operatively. The number of joints with anterior disc displacement in class II was significantly higher than that in class III (p bi-maxillary surgery. The findings of the numerical analysis also demonstrated that reduction of condylar volume occurred frequently in class II, although TMJ disc position classification did not change significantly, as previously reported. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

    Science.gov (United States)

    Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

    2016-01-01

    This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  9. Occlusal plane change after intrusion of maxillary posterior teeth by microimplants to avoid maxillary surgery with skeletal Class III orthognathic surgery.

    Science.gov (United States)

    Park, Hyo-Sang; Kim, Ji-Yeun; Kwon, Tae-Geon

    2010-11-01

    To increase stability and mandibular setback movement, surgical maxillary impaction is normally performed with mandibular setback surgery in treating adult skeletal Class III patients. This article demonstrates the use of microimplants for anchorage to intrude molars and the resultant rotation of the maxillary occlusal plane clockwise to increase the surgical mandibular setback and reduce the posterior vertical dimension instead of maxillary surgical impaction. A 21-year-old man with mandibular prognathism was treated with mandibular setback surgery that included orthodontic treatment for decompensation. Microimplants placed into the palatal alveolar bone between the maxillary first and second molars were used to intrude the maxillary posterior teeth and change the occlusal plane clockwise. This produced 4 mm more of distal movement of the chin during mandibular setback surgery compared with the surgical prediction with no change in the occlusal plane. These results were similar to those of 2-jaw surgery with maxillary posterior impaction. The intrusion of the maxillary posterior teeth with microimplants might prevent the need for maxillary surgery in adult skeletal Class III patients. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions.

    Science.gov (United States)

    Hawk, Cheryl; Minkalis, Amy L; Khorsan, Raheleh; Daniels, Clinton J; Homack, Dennis; Gliedt, Jordan A; Hartman, Julie A; Bhalerao, Shireesh

    2017-06-01

    The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low- to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions. Copyright © 2017. Published by Elsevier Inc.

  11. Dental compensation for skeletal Class III malocclusion by isolated extraction of mandibular teeth. Part 1: Occlusal situation 12 years after completion of active treatment.

    Science.gov (United States)

    Zimmer, Bernd; Schenk-Kazan, Sarah

    2015-05-01

    The purpose of this work was to statistically evaluate the outcomes achieved by isolated extraction of mandibular teeth (second premolars or first molars) for Class III compensation. Part A of the study dealt with the quality of outcomes at the end of active treatment, using weighted Peer Assessment Rating (PAR) scores determined on the basis of casts for 25 (14 female and 11 male) consecutive patients aged 16 ± 1.7 years at the time of debonding. These results were compared to the scores in a randomly selected control group of 25 (14 female and 11 male) patients who were 14.7 ± 1.9 years old at debonding. Part B evaluated the long-term stability of the outcomes based on 12 (all of them female) patients available for examination after a mean of 11.8 years. The mean weighted PAR scores obtained in both study parts were analyzed for statistical differences using a two-tailed paired Student's t-test at a significance level of p ≤ 0.05. Mean weighted PAR scores of 4.76 ± 3.94 and 3.92 ± 3.44 were obtained in the Class III extraction group and the control group, respectively, at the end of active treatment. This difference was not significant (p = 0.49). Among the 12 longitudinal patients, the mean score increased from 4 ± 3.46 at debonding to 6.25 ± 3.67 by the end of the 11.8-year follow-up period. This difference was significant (p = 0.0008). Treatment of Class III anomalies by isolated extraction of lower premolars or molars can yield PAR scores similar to those achieved by standard therapies. These scores, while increasing significantly, remained at a clinically acceptable level over 11.8 years. Hence this treatment modality--intended for cases that border on requiring orthognathic surgery--may also be recommended from a long-term point of view.

  12. Human fear conditioning and extinction in neuroimaging: a systematic review.

    Directory of Open Access Journals (Sweden)

    Christina Sehlmeyer

    Full Text Available Fear conditioning and extinction are basic forms of associative learning that have gained considerable clinical relevance in enhancing our understanding of anxiety disorders and facilitating their treatment. Modern neuroimaging techniques have significantly aided the identification of anatomical structures and networks involved in fear conditioning. On closer inspection, there is considerable variation in methodology and results between studies. This systematic review provides an overview of the current neuroimaging literature on fear conditioning and extinction on healthy subjects, taking into account methodological issues such as the conditioning paradigm. A Pubmed search, as of December 2008, was performed and supplemented by manual searches of bibliographies of key articles. Two independent reviewers made the final study selection and data extraction. A total of 46 studies on cued fear conditioning and/or extinction on healthy volunteers using positron emission tomography or functional magnetic resonance imaging were reviewed. The influence of specific experimental factors, such as contingency and timing parameters, assessment of conditioned responses, and characteristics of conditioned and unconditioned stimuli, on cerebral activation patterns was examined. Results were summarized descriptively. A network consisting of fear-related brain areas, such as amygdala, insula, and anterior cingulate cortex, is activated independently of design parameters. However, some neuroimaging studies do not report these findings in the presence of methodological heterogeneities. Furthermore, other brain areas are differentially activated, depending on specific design parameters. These include stronger hippocampal activation in trace conditioning and tactile stimulation. Furthermore, tactile unconditioned stimuli enhance activation of pain related, motor, and somatosensory areas. Differences concerning experimental factors may partly explain the variance

  13. 77 FR 31302 - Review of Federal Permit Conditions

    Science.gov (United States)

    2012-05-25

    .... Intention To Work With Other Agencies It is the Federal Coordinator's intention to work closely with other... conditions early and either avoid a formal review process or conclude it expeditiously. B. Definitions (1..., right-of-way or other authorization. It was the Office of the Federal Coordinator's intention to include...

  14. Comparative study of postoperative stability between conventional orthognathic surgery and a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy for skeletal class III correction.

    Science.gov (United States)

    Mah, Deuk-Hyun; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Jung, Seo-Yun; Kim, Won-Gi; Yu, Kyung-Hwan

    2017-02-01

    The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO). The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding). The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was 2.23±0.92 mm ( P surgery-first orthognathic approach group from T1 to T2 was 3.49±1.71 mm ( P surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.

  15. Application for Permit to Operate a Class III Solid Waste Disposal Site at the Nevada Test Site - U10c Disposal Site

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Programs

    2010-08-05

    The NTS is located approximately 105 km (65 mi) northwest of Las Vegas, Nevada. NNSA/NSO is the federal lands management authority for the NTS and NSTec is the Management & Operations contractor. Access on and off the NTS is tightly controlled, restricted, and guarded on a 24-hour basis. The NTS is posted with signs along its entire perimeter. NSTec is the operator of all solid waste disposal sites on the NTS. The U10C Disposal Site is located in the northwest corner of Area 9 at the NTS (Figure 1) and is located in a subsidence crater created by two underground nuclear events, one in October 1962 and another in April 1964. The disposal site opened in 1971 for the disposal of rubbish, refuse, pathological waste, asbestos-containing material, and industrial solid waste. A Notice of Intent form to operate the disposal site as a Class II site was submitted to the state of Nevada on January 26, 1994, and was acknowledged in a letter to the DOE on February 8, 1994. It operated as a state of Nevada Class II Solid Waste Disposal Site (SWDS) until it closed on October 5, 1995, for retrofit as a Class III SWDS. The retrofit consisted of the installation of a minimum four-foot compacted soil layer to segregate the different waste types and function as a liner to inhibit leachate and water flow into the lower waste zone. Five neutron monitoring tubes were installed in this layer to monitor possible leachate production and water activity. Upon acceptance of the installed barrier and approval of an Operating Plan by NDEP/BFF, the site reopened in January 1996 as a Class III SWDS for the disposal of industrial solid waste and other inert waste.

  16. Floral nectar of the obligate outcrossing Canavalia gladiata (Jacq.) DC. (Fabaceae) contains only one predominant protein, a class III acidic chitinase.

    Science.gov (United States)

    Ma, X L; Milne, R I; Zhou, H X; Fang, J Y; Zha, H G

    2017-09-01

    Floral nectar can affect the fitness of insect-pollinated plants, through both attraction and manipulation of pollinators. Self-incompatible insect-pollinated plants receive more insect visits than their self-compatible relatives, and the nectar of such species might face increased risk of infestation by pathogens carried by pollinators than self-compatible plants. Proteins in nectar (nectarins) play an important role in protecting the nectar, but little is known regarding nectarins in self-incompatible species. The nectarins from a self-incompatible and insect-pollinated leguminous crop, Canavalia gladiata, were separated using two-dimensional electrophoresis and analysed using mass spectrometry. The predominant nectarin gene was cloned and the gene expression pattern investigated using quantitative real-time PCR. Chitinolytic activity in the nectar was tested with different substrates. The C. gladiata nectar proteome only has one predominant nectarin, an acidic class III chitinase (CaChi3). The full-length CaChi3 gene was cloned, coding for a protein of 298 amino acids with a predicted signal peptide. CaChi3 is very similar to members of the class III chitinase family, whose evolution is dominated by purifying selection. CaChi3 was expressed in both nectary and leaves. CaChi3 has thermostable chitinolytic activity according to glycol-chitin zymography or a fluorogenic substratem but has no lysozyme activity. Chitinase might be a critical protein component in nectar. The extremely simple nectar proteome in C. gladiata disproves the hypothesis that self-incompatible species always have more complex nectar proteomes. Accessibility of nectar might be a significant determinant of the evolutionary pressure to develop nectar defence mechanisms. © 2017 German Botanical Society and The Royal Botanical Society of the Netherlands.

  17. A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions.

    Science.gov (United States)

    Corry, Margarita; While, Alison; Neenan, Kathleen; Smith, Valerie

    2015-04-01

    To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. © 2014 John Wiley & Sons Ltd.

  18. Solar-Driven Air-Conditioning Cycles: A Review

    Directory of Open Access Journals (Sweden)

    A. M. Abu-Zour

    2007-12-01

    Full Text Available Most conventional cooling/refrigeration systems are driven by fossil fuel combustion, and therefore give rise to emission of environmentally damaging pollutants. In addition, many cooling systems employ refrigerants, which are also harmful to the environment in terms of their Global Warming Potential (GWP and Ozone Depletion Potential (ODP. Development of a passive or hybrid solar-driven air-conditioning system is therefore of interest as exploitation of such systems would reduce the demand for grid electricity particularly at times of peak load. This paper presents a review of various cooling cycles and summarises work carried out on solar-driven air-conditioning systems.

  19. Radioactive sodium waste treatment and conditioning. Review of main aspects

    International Nuclear Information System (INIS)

    2007-01-01

    This publication reviews the main aspects relating to the treatment and conditioning of radioactive sodium waste. This waste arises from the operation of liquid metal fast reactors (LMFRs). In this type of reactor, sodium (Na) or sodium-potassium alloys (NaK) are used as a low-effect neutron moderating coolant medium for extracting and transferring thermal energy from the core and they represent a significant technical and safety challenge during operation and decommissioning. This publication provides the reader with technologically oriented information on the present status of sodium waste management approaches and recent achievements related to treatment and conditioning, with the objective of facilitating planning and preparatory work for the decommissioning of LMFRs. This publication provides a comprehensive review of the hazards associated with sodium waste management. Given the large quantities of sodium waste arising during decommissioning or reactor refurbishment, as well as the challenges and varied techniques associated with removal of 100% of all sodium and NaK bulk quantities and residues during decommissioning, a hazards review and analysis is a critical component in planning the dismantling and waste management activities. Roughly half of this publication focuses on sodium waste generating, handling and treatment processes. This includes draining sodium and NaK from plant systems; in situ treatment of residual sodium; cutting techniques for pumps, valves, piping and other components; cleaning of components; potential reuse of sodium; and removal of selected radionuclides from sodium waste with the objective of reducing the waste classification or converting it to exempt waste. The focus is on proven techniques and technologies, and each discussed method includes a review of the associated principle or theory, practical applications, advantages and disadvantages, limitations, industry experience, and final waste products. A review is provided of final

  20. Biology of biomechanics: Finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion.

    Science.gov (United States)

    Roberts, W Eugene; Viecilli, Rodrigo F; Chang, Chris; Katona, Thomas R; Paydar, Nasser H

    2015-12-01

    In the absence of adequate animal or in-vitro models, the biomechanics of human malocclusion must be studied indirectly. Finite element analysis (FEA) is emerging as a clinical technology to assist in diagnosis, treatment planning, and retrospective analysis. The hypothesis tested is that instantaneous FEA can retrospectively simulate long-term mandibular arch retraction and occlusal plane rotation for the correction of a skeletal Class III malocclusion. Seventeen published case reports were selected of patients treated with statically determinate mechanics using posterior mandible or infrazygomatic crest bone screw anchorage to retract the mandibular arch. Two-dimensional measurements were made for incisor and molar movements, mandibular arch rotation, and retraction relative to the maxillary arch. A patient with cone-beam computed tomography imaging was selected for a retrospective FEA. The mean age for the sample was 23.3 ± 3.3 years; there were 7 men and 10 women. Mean incisor movements were 3.35 ± 1.55 mm of retraction and 2.18 ± 2.51 mm of extrusion. Corresponding molar movements were retractions of 4.85 ± 1.78 mm and intrusions of 0.85 ± 2.22 mm. Retraction of the mandibular arch relative to the maxillary arch was 4.88 ± 1.41 mm. Mean posterior rotation of the mandibular arch was -5.76° ± 4.77° (counterclockwise). The mean treatment time (n = 16) was 36.2 ± 15.3 months. Bone screws in the posterior mandibular region were more efficient for intruding molars and decreasing the vertical dimension of the occlusion to close an open bite. The full-cusp, skeletal Class III patient selected for FEA was treated to an American Board of Orthodontics Cast-Radiograph Evaluation score of 24 points in about 36 months by en-masse retraction and posterior rotation of the mandibular arch: the bilateral load on the mandibular segment was about 200 cN. The mandibular arch was retracted by about 5 mm, posterior rotation was about 16.5°, and molar intrusion was about 3

  1. In vitro Comparative Evaluation of Various Restorative Materials used for restoring Class III Cavities in Deciduous Anterior Teeth: A Clinical Study.

    Science.gov (United States)

    Priyank, Harsh; Verma, Ankita; Gupta, Komal; Chaudhary, Esha; Khandelwal, Deepak; Nihalani, Shweta

    2016-12-01

    Beauty standards in today's modernized world scenario are formed by well-aligned and well-designed bright white teeth. One of the major reasons behind patients reporting to dental clinics is pain. Caries in the anterior primary teeth forms one of the major concerns from a restorative point of view. Very few studies are quoted in literature which stresses on the follow-up of anterior restorations in primary teeth. Hence, we evaluated and compared the efficacy of composite resin and resin-modified glass ionomer cement (RGIC) for class III restorations in primary anterior teeth. The present study was conducted in the pediatric dental wing and included a total of 80 patients aged 3 to 5½ years who reported with the chief complaint of carious lesions in the primary anterior teeth. Patients having minimal of a pair of similar appearing small carious lesions on the same proximal surfaces of the deciduous maxillary incisors were included for the study. All the patients were randomly divided into two groups: One in which RGIC restoration was done and other in which composite restoration was done. Cavity preparation was done and filling of the cavity with the restorative materials was carried out. Assessment of the restorations was done at 4, 8, and 12 months time following criteria given by Ryge et al. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Mann-Whitney test and one-way analysis of variance (ANOVA) were used to evaluate the level of significance; p value less than 0.05 was considered as significant. For composite and RGIC restorations, the mean score for anatomic shape was 1.21 and 1.10 respectively. While comparing the clinical parameters, nonsignificant results were obtained between composite and RGIC restorative materials at 4-, 8-, and 12-month interval. On comparing the clinical parameters for individual restorative materials at different time intervals, statistically significant results were obtained only for

  2. Differences in three-dimensional soft tissue changes after upper, lower, or both jaw orthognathic surgery in skeletal class III patients.

    Science.gov (United States)

    Verdenik, M; Ihan Hren, N

    2014-11-01

    The decision is not always straightforward as to which orthognathic procedure is best for a good aesthetic result; three-dimensional imaging has brought new insight into this topic. The aim of this prospective study was to verify objectively whether postoperative changes occur within those regions not directly affected by surgical movements of the underlying jaw bones. The study included 83 young adults with skeletal class III deformities. They were classified into three groups according to the type of surgery: bilateral sagittal split osteotomy set-back of the mandible (BSSO), Le Fort I advancement of the maxilla, or a combination of both. Pre- and postoperative optical scans were registered as regional best-fits on the areas of the foreheads and both orbits. The shell to shell differences were measured and the average distances between the observed regions were calculated. As expected, changes were greatest in the regions where the underlying bones had been moved, but regardless of the operation performed, changes were found over the whole face. Changes in the nose, cheek, and upper lip regions in the BSSO group and in the lower lip and chin region in the Le Fort I group confirmed the concept of the facial soft tissue mask acting as one unit. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. [Evaluation of the correction of the skeletal class III malocclusion by distalization of the whole mandible dentition with micro-implant anchorage].

    Science.gov (United States)

    2017-06-18

    To evaluate the clinical effect of distalizing mandibular dentition with micro-implant in patients with skeletal class III malocclusion. In the study, 20 patients with skeletal class IIImalocclusion were selected. They are consist of 8 males and 12 female with an age range from 16 to 38 years old and an average age of (21.5±5.6) years.They were treated with straight wire technique and the implant were inserted into the mandibular external oblique line to distlize the lower dentition to a class I molar relationships. Cephalometrics films were taken before and after treatment. The changes of hard tissue and soft tissue were analyzed by evaluating 26 measurement measurements. Class I molar relationships were achieved, and the profile were improved after treatment. ANB increased by (0.80±1.02) °,Wits increased by (1.67±1.74) mm,after treatment (Plower dentition were significantly retracted after treatment with L1-NB distance decreased by(2.64±1.50) mm, Plower first molars were retracted by (3.26±1.95) mm and (0.79±1.27) mm respectively (Plower second molars were retracted by (3.06±1.80) mm (Plower lip to esthetic plane were decreased by (1.70±1.59) mm on average (Pclass III malocclusion, the lower teeth were retracted by controlled tipping movement.

  4. A novel TaqI polymorphism in the coding region of the ovine TNXB gene in the MHC class III region: morphostructural and physiological influences.

    Science.gov (United States)

    Ajayi, Oyeyemi O; Adefenwa, Mufliat A; Agaviezor, Brilliant O; Ikeobi, Christian O N; Wheto, Matthew; Okpeku, Moses; Amusan, Samuel A; Yakubu, Abdulmojeed; De Donato, Marcos; Peters, Sunday O; Imumorin, Ikhide G

    2014-02-01

    The tenascin-XB (TNXB) gene has antiadhesive effects, functions in matrix maturation in connective tissues, and localizes to the major histocompatibility complex class III region. We hypothesized that it may influence adaptive physiological response through an effect on blood vessel function. We identified a novel g.1324 A→G polymorphism at a TaqI recognition site in a 454 bp fragment of ovine TNXB and genotyped it in 150 Nigerian sheep using PCR-RFLP. The missense mutation changes glutamic acid (GAA) to glycine (GGA). Among SNP genotypes, significant differences (P bone length. Interaction effects of breed, SNP genotype, and geographic location had a significant effect (P < 0.05) on chest girth. The SNP genotype was significantly (P < 0.05) associated with physiological traits of pulse rate and skin temperature. The observed effect of this novel polymorphism may be mediated through its role in connective tissue biology, requiring further association and functional studies.

  5. [Alveolar bone thickness and root length changes in the treatment of skeletal Class III patients facilitated by improved corticotomy: a cone-beam CT analysis].

    Science.gov (United States)

    Wu, Jiaqi; Jiang, Jiuhui; Xu, Li; Liang, Cheng; Li, Cuiying; Xu, Xiao

    2015-04-01

    To evaluate the alveolar bone thickness and root length changes of anterior teeth with cone-beam computed tomography (CBCT). CBCT scans were taken for 12 skeletal Class III patients who accepted the improved corticotomy (IC) procedures during pre-surgical orthodontics. The CBCT data in T1 (the maxillary dental arch was aligned and leveled) and T2 (extraction space closure) were superimposed and the alveolar bone thickness at root apex level and root length measurements were done. From T1 to T2, the buccal alveolar bone thickness for the upper lateral incisors increased from (1.89±0.83) to (2.47±1.02) mm (P<0.05), and for central incisors and for canines from (2.32±0.71) to (2.68±1.48) mm and from (2.28±1.08) to (2.41±1.40) mm, respectively. According to Sharpe Grading System, the root resorption grade for 69 teeth of 72 was located in Grade 1, two teeth in Grade 2, one tooth in Grade 3. The improved corticotomy had the potential to increase the buccal alveolar bone thickness and the root resorption in most teeth was in Grade 1 according to Sharpe grading system.

  6. The Use of Invisalign® System in the Management of the Orthodontic Treatment before and after Class III Surgical Approach.

    Science.gov (United States)

    Pagani, Renato; Signorino, Fabrizio; Poli, Pier Paolo; Manzini, Pietro; Panisi, Irene

    2016-01-01

    The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time.

  7. The Use of Invisalign® System in the Management of the Orthodontic Treatment before and after Class III Surgical Approach

    Directory of Open Access Journals (Sweden)

    Renato Pagani

    2016-01-01

    Full Text Available The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time.

  8. 78 FR 68905 - Agency Information Collection (Wrist Conditions Disability Benefits Questionnaire) Under OMB Review

    Science.gov (United States)

    2013-11-15

    ... Number: 2900-NEW (Wrist Conditions Disability Benefits Questionnaire). Type of Review: New data... Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits Administration...- NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER...

  9. 78 FR 68908 - Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB Review

    Science.gov (United States)

    2013-11-15

    ...: 2900--NEW (Ankle Conditions Disability Benefits Questionnaire). Type of Review: New data collection... Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits Administration...-- NEW (Ankle Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER...

  10. A Review: The Probiotic Bacteria Viability under Different Conditions

    Directory of Open Access Journals (Sweden)

    Lavinia Florina CALINOIU

    2016-11-01

    Full Text Available This review summarized the current knowledge on probiotics and on the effects that different conditions have under this type of bacteria. The purpose of this review was to evaluate the survival rate/resistance or viability of different probiotic bacteria under several conditions, such as: processing, food composition, storage, freezing, thawing, refrigeration, temperature, oxygen, pH, gastrointestinal environment and package. Nowadays, the demand on probiotic functional foods is increasing rapidly, as the consumers became more aware about the potential health benefits, due to the fact that probiotics help in maintaining the balance and composition of intestinal flora and protect it from pathogens. A daily ingestion of 108–109 CFU ml−1 probiotic microorganisms is crucial in order to be able to demonstrate an effect in our organism, considering the dose and the effect of storage/gastrointestinal environments on the probiotic viability. Microencapsulation of probiotics in different polysaccharides was proven to be an ideal way to preserve and protect the cells from detrimental factors during processing, storage or resistance in the gastrointestinal transit, as many studies demonstrate it. There is a general interest in the improvement of the physical and mechanical stability of the polymers used in probiotics encapsulation, to ensure high population of probiotics not only in food during storage, but also after gastrointestinal digestion. Also, the carrier plays a very important role and should be carefully examined.

  11. Reliability of conditioned pain modulation: a systematic review

    Science.gov (United States)

    Kennedy, Donna L.; Kemp, Harriet I.; Ridout, Deborah; Yarnitsky, David; Rice, Andrew S.C.

    2016-01-01

    Abstract A systematic literature review was undertaken to determine if conditioned pain modulation (CPM) is reliable. Longitudinal, English language observational studies of the repeatability of a CPM test paradigm in adult humans were included. Two independent reviewers assessed the risk of bias in 6 domains; study participation; study attrition; prognostic factor measurement; outcome measurement; confounding and analysis using the Quality in Prognosis Studies (QUIPS) critical assessment tool. Intraclass correlation coefficients (ICCs) less than 0.4 were considered to be poor; 0.4 and 0.59 to be fair; 0.6 and 0.75 good and greater than 0.75 excellent. Ten studies were included in the final review. Meta-analysis was not appropriate because of differences between studies. The intersession reliability of the CPM effect was investigated in 8 studies and reported as good (ICC = 0.6-0.75) in 3 studies and excellent (ICC > 0.75) in subgroups in 2 of those 3. The assessment of risk of bias demonstrated that reporting is not comprehensive for the description of sample demographics, recruitment strategy, and study attrition. The absence of blinding, a lack of control for confounding factors, and lack of standardisation in statistical analysis are common. Conditioned pain modulation is a reliable measure; however, the degree of reliability is heavily dependent on stimulation parameters and study methodology and this warrants consideration for investigators. The validation of CPM as a robust prognostic factor in experimental and clinical pain studies may be facilitated by improvements in the reporting of CPM reliability studies. PMID:27559835

  12. Foot Conditions among Homeless Persons: A Systematic Review

    Science.gov (United States)

    To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

    2016-01-01

    Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

  13. Foot Conditions among Homeless Persons: A Systematic Review.

    Science.gov (United States)

    To, Matthew J; Brothers, Thomas D; Van Zoost, Colin

    2016-01-01

    Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. A literature search was conducted on MEDLINE (1966-2016), EMBASE (1947-2016), and CINAHL (1982-2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and addressing social factors that lead to increased risk

  14. Frontal Changes in the Lower Face After Clockwise Rotation of the Maxillomandibular Complex Without Perisurgical Orthodontic Treatment in Angle Class I and Skeletal Class III Women.

    Science.gov (United States)

    Lee, Sang Woo; Cho, Jeongmok; Kim, Kikap; Ahn, Seung Hyun

    2017-06-01

    Orthognathic surgery has become more popular to slenderize a wide lower face and to improve facial esthetics in Asian patients with normal occlusion. Clockwise rotation (CR) of the maxillomandibular complex (MMC) steepens the mandibular plane. This study performed a quantitative analysis on the influence of CR on slenderness of the lower face from the frontal view. This retrospective study included 36 female patients with Angle Class I occlusion and skeletal Class III pattern. The subjects underwent CR of the MMC without perioperative orthodontic treatment and change in the occlusion only for the purpose of esthetic improvement. Linear and angular variables were measured on a cephalogram and three-dimensional computed tomography (3D CT) obtained before and at least 6 months after surgery. Data were analyzed using paired t tests and Spearman correlations. Univariate regression analysis was used to predict the postoperative change according to the amount of posterior impaction. The mean posterior impaction was 3.81 mm. All mandibular plane angle (MPA) measurements were increased (ranged from 5.69° to 13.12°, p lower face becomes narrower and more slender as the MMC rotates in a clockwise direction. Orthognathic surgery with CR has the advantage of increasing the MPAs and obtaining natural soft tissue contouring while minimizing the amount of bone resection. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266c .

  15. The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles.

    Science.gov (United States)

    Ko, Ellen Wen-Ching; Teng, Terry Te-Yi; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The study was conducted to evaluate the effect of early physical rehabilitation by comparing the differences of surface electromyographic (sEMG) activity in the masseter and anterior temporalis muscles after surgical correction of skeletal class III malocclusion. The prospective study included 63 patients; the experimental groups contained 31 patients who received early systematic physical rehabilitation; the control group (32 patients) did not receive physiotherapy. The amplitude of sEMG in the masticatory muscles reached 72.6-121.3% and 37.5-64.6% of pre-surgical values in the experimental and control groups respectively at 6 weeks after orthognathic surgery (OGS). At 6 months after OGS, the sEMG reached 135.1-233.4% and 89.6-122.5% of pre-surgical values in the experimental and control groups respectively. Most variables in the sEMG examination indicated that recovery of the masticatory muscles in the experimental group was better than the control group as estimated in the early phase (T1 to T2) and the total phase (T1 to T3); there were no significant differences between the mean recovery percentages in the later phase (T2 to T3). Early physical rehabilitative therapy is helpful for early recovery of muscle activity in masticatory muscles after OGS. After termination of physical therapy, no significant difference in recovery was indicated in patients with or without early physiotherapy. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Expression of class III beta tubulin in cervical cancer patients administered preoperative radiochemotherapy: correlation with response to treatment and clinical outcome.

    Science.gov (United States)

    Ferrandina, Gabriella; Martinelli, Enrica; Zannoni, Gian Franco; Distefano, Mariagrazia; Paglia, Amelia; Ferlini, Cristiano; Scambia, Giovanni

    2007-02-01

    Alterations of the beta subunit of tubulin have been reported to be predictive of resistance to radiation and antitubulin agents in several solid tumors. The aim of the study was to investigate the clinical role of beta III tubulin expression as prognostic factor for survival and as a predictive parameter of response to preoperative radiochemotherapy in a single institutional series of locally advanced cervical cancer (LACC) patients. The study included 98 LACC patients admitted to the Gynecologic Oncology Unit, Catholic University of Rome and Campobasso between January 1998 and January 2005. Immunohistochemistry was performed by using the polyclonal rabbit anti-beta III tubulin antibody (Covance, Princeton, NJ, USA). The value of 10% immunostained tumor cells was arbitrarily chosen as cut-off value to distinguish cases with high versus low beta III tubulin content. In the whole series, beta III tubulin immunoreaction was detectable in 66/98 cases (67.3%), and the percentage of positively stained cells ranged from 0 to 100% (median=10%). The percentages of cases with high beta III tubulin expression were shown not to be differently distributed according to clinico-pathological characteristics. There was no statistically significant difference in the distribution of cases with high beta III tubulin expression according to clinical and pathological response to treatment. During the follow-up period, recurrence and death of disease occurred in 15 and 13 cases, respectively. There was no difference in disease-free and overall survival in cases with high versus low beta III tubulin expression. The assessment of class III beta tubulin status seems of little usefulness in order to identify LACC patients with poor chance of response to concomitant radiochemotherapy and unfavorable prognosis.

  17. Functional and structural comparison of pyrrolnitrin- and iprodione-induced modifications in the class III histidine-kinase Bos1 of Botrytis cinerea.

    Directory of Open Access Journals (Sweden)

    Sabine Fillinger

    Full Text Available Dicarboximides and phenylpyrroles are commonly used fungicides against plant pathogenic ascomycetes. Although their effect on fungal osmosensing systems has been shown in many studies, their modes-of-action still remain unclear. Laboratory- or field-mutants of fungi resistant to either or both fungicide categories generally harbour point mutations in the sensor histidine kinase of the osmotic signal transduction cascade.In the present study we compared the mechanisms of resistance to the dicarboximide iprodione and to pyrrolnitrin, a structural analogue of phenylpyrrole fungicides, in Botrytis cinerea. Pyrrolnitrin-induced mutants and iprodione-induced mutants of B. cinerea were produced in vitro. For the pyrrolnitrin-induced mutants, a high level of resistance to pyrrolnitrin was associated with a high level of resistance to iprodione. For the iprodione-induced mutants, the high level of resistance to iprodione generated variable levels of resistance to pyrrolnitrin and phenylpyrroles. All selected mutants showed hypersensitivity to high osmolarity and regardless of their resistance levels to phenylpyrroles, they showed strongly reduced fitness parameters (sporulation, mycelial growth, aggressiveness on plants compared to the parental phenotypes. Most of the mutants presented modifications in the osmosensing class III histidine kinase affecting the HAMP domains. Site directed mutagenesis of the bos1 gene was applied to validate eight of the identified mutations. Structure modelling of the HAMP domains revealed that the replacements of hydrophobic residues within the HAMP domains generally affected their helical structure, probably abolishing signal transduction. Comparing mutant phenotypes to the HAMP structures, our study suggests that mutations perturbing helical structures of HAMP2-4 abolish signal-transduction leading to loss-of-function phenotype. The mutation of residues E529, M427, and T581, without consequences on HAMP structure

  18. Foot-and-mouth disease virus induces autophagosomes during cell entry via a class III phosphatidylinositol 3-kinase-independent pathway.

    Science.gov (United States)

    Berryman, Stephen; Brooks, Elizabeth; Burman, Alison; Hawes, Philippa; Roberts, Rebecca; Netherton, Christopher; Monaghan, Paul; Whelband, Matthew; Cottam, Eleanor; Elazar, Zvulun; Jackson, Terry; Wileman, Thomas

    2012-12-01

    Autophagy is an intracellular pathway that can contribute to innate antiviral immunity by delivering viruses to lysosomes for degradation or can be beneficial for viruses by providing specialized membranes for virus replication. Here, we show that the picornavirus foot-and-mouth disease virus (FMDV) induces the formation of autophagosomes. Induction was dependent on Atg5, involved processing of LC3 to LC3II, and led to a redistribution of LC3 from the cytosol to punctate vesicles indicative of authentic autophagosomes. Furthermore, FMDV yields were reduced in cells lacking Atg5, suggesting that autophagy may facilitate FMDV infection. However, induction of autophagosomes by FMDV appeared to differ from starvation, as the generation of LC3 punctae was not inhibited by wortmannin, implying that FMDV-induced autophagosome formation does not require the class III phosphatidylinositol 3-kinase (PI3-kinase) activity of vps34. Unlike other picornaviruses, for which there is strong evidence that autophagosome formation is linked to expression of viral nonstructural proteins, FMDV induced autophagosomes very early during infection. Furthermore, autophagosomes could be triggered by either UV-inactivated virus or empty FMDV capsids, suggesting that autophagosome formation was activated during cell entry. Unlike other picornaviruses, FMDV-induced autophagosomes did not colocalize with the viral 3A or 3D protein. In contrast, ∼50% of the autophagosomes induced by FMDV colocalized with VP1. LC3 and VP1 also colocalized with the cellular adaptor protein p62, which normally targets ubiquitinated proteins to autophagosomes. These results suggest that FMDV induces autophagosomes during cell entry to facilitate infection, but not to provide membranes for replication.

  19. Surface and subsurface conditions in permafrost areas - a literature review

    International Nuclear Information System (INIS)

    Vidstrand, Patrik

    2003-02-01

    This report contains a summary of some of the information within existing technical and scientific literature on permafrost. Permafrost is viewed as one of the future climate driven process domains that may exist in Scandinavia, and that may give rise to significantly different surface and subsurface conditions than the present. Except for changes in the biosphere, permafrost may impact hydraulic, mechanical, and chemical subsurface processes and conditions. Permafrost and its influences on the subsurface conditions are thus of interest for the performance and safety assessments of deep geological waste repositories. The definition of permafrost is 'ground that stays at or below 0 deg C for at least two consecutive years'. Permafrost will effect the geological subsurface to some depth. How deep the permafrost may grow is a function of the heat balance, thermal conditions at the surface and within the ground, and the geothermal heat flux from the Earth's inner parts. The main chapters of the report summaries the knowledge on permafrost evolution, occurrence and distribution, and extracts information concerning hydrology and mechanical and chemical impacts due to permafrost related conditions. The results of a literature review are always dependent on the available literature. Concerning permafrost there is some literature available from investigations in the field of long-term repositories and some from mining industries. However, reports of these investigations are few and the bulk of permafrost literature comes from the science departments concerned with surficial processes (e.g. geomorphology, hydrology, agriculture, etc) and from engineering concerns, such as foundation of constructions and pipeline design. This focus within the permafrost research inevitably yields a biased but also an abundant amount of information on localised surficial processes and a limited amount on regional and deep permafrost characteristics. Possible conclusions are that there is

  20. Surface and subsurface conditions in permafrost areas - a literature review

    Energy Technology Data Exchange (ETDEWEB)

    Vidstrand, Patrik [Bergab, Goeteborg (Sweden)

    2003-02-01

    This report contains a summary of some of the information within existing technical and scientific literature on permafrost. Permafrost is viewed as one of the future climate driven process domains that may exist in Scandinavia, and that may give rise to significantly different surface and subsurface conditions than the present. Except for changes in the biosphere, permafrost may impact hydraulic, mechanical, and chemical subsurface processes and conditions. Permafrost and its influences on the subsurface conditions are thus of interest for the performance and safety assessments of deep geological waste repositories. The definition of permafrost is 'ground that stays at or below 0 deg C for at least two consecutive years'. Permafrost will effect the geological subsurface to some depth. How deep the permafrost may grow is a function of the heat balance, thermal conditions at the surface and within the ground, and the geothermal heat flux from the Earth's inner parts. The main chapters of the report summaries the knowledge on permafrost evolution, occurrence and distribution, and extracts information concerning hydrology and mechanical and chemical impacts due to permafrost related conditions. The results of a literature review are always dependent on the available literature. Concerning permafrost there is some literature available from investigations in the field of long-term repositories and some from mining industries. However, reports of these investigations are few and the bulk of permafrost literature comes from the science departments concerned with surficial processes (e.g. geomorphology, hydrology, agriculture, etc) and from engineering concerns, such as foundation of constructions and pipeline design. This focus within the permafrost research inevitably yields a biased but also an abundant amount of information on localised surficial processes and a limited amount on regional and deep permafrost characteristics. Possible conclusions are that

  1. Review of common conditions associated with periodontal ligament widening

    Energy Technology Data Exchange (ETDEWEB)

    Mortazavi, Hamed; Baharvand, Maryam [Dept. of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2016-12-15

    The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “periodontium”, “periodontal ligament”, “periodontal ligament space”, “widened periodontal ligament”, and “periodontal ligament widening”. Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well.

  2. Review of common conditions associated with periodontal ligament widening

    International Nuclear Information System (INIS)

    Mortazavi, Hamed; Baharvand, Maryam

    2016-01-01

    The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “periodontium”, “periodontal ligament”, “periodontal ligament space”, “widened periodontal ligament”, and “periodontal ligament widening”. Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well

  3. 40 CFR Figure C-3 to Subpart C of... - Illustration of the Slope and Intercept Limits for Class II and Class III PM10−2.5 Candidate...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Illustration of the Slope and Intercept Limits for Class II and Class III PM10â2.5 Candidate Equivalent Methods C Figure C-3 to Subpart C of Part... Candidate Methods and Reference Methods Pt. 53, Subpt. C, Fig. C-3 Figure C-3 to Subpart C of Part 53...

  4. Effect of transcutaneous electrical stimulation treatment on lower urinary tract symptoms after class III radical hysterectomy in cervical cancer patients: study protocol for a multicentre, randomized controlled trial.

    Science.gov (United States)

    Sun, Xiu-Li; Wang, Hai-Bo; Wang, Zhi-Qi; Cao, Ting-Ting; Yang, Xin; Han, Jing-Song; Wu, Yang-Feng; Reilly, Kathleen H; Wang, Jian-Liu

    2017-06-15

    Class III radical hysterectomy (RH III)_plus pelvic lymphadenectomy is the standard surgery for early stage cervical cancer (CC) patients, the 5 year survival rate is about 90%, but pelvic floor disorders especially bladder dysfunction are common due to damaged vessels and nerve fibers following surgery. Transcutaneous electrical stimulation (TENS) treatment has been used to treat bladder disorders for many years, but its effect on cervical cancer patients, the best treatment time point and stimulated protocol, had never been assessed. The aim of this study is to investigate the efficacy of TENS treatment on lower urinary tract symptoms (LUTS) after RH III in CC patients. The study will be conducted as a clinical, multicentre, randomised controlled trial with balanced randomisation (1:1). The planned sample size is 208 participants (at 1:1 ratio, 104 subjects in each group). At 5-7 days after RH III, patients are screened according to operative and pathological findings. Enrolled participants are randomised into an intervention group (TENS plus conventional clinical care) or control group (conventional clinical care), with stratification by menopausal status (menopause vs. non-menopause) and surgical modality (laparoscopic RH or abdominal RH). Participants in both groups will be followed up at 14 days, 21 days, 28 days, 3 months, 6 months, 12 months, 18 months and 24 months after surgery. The primary endpoint is improvement rate of urination function which is defined as recovery (residual urine ≤50 ml) or improvement (residual urine 50-100 ml). Secondary endpoints include urodynamic parameter, urinary incontinence, anorectal function, pelvic function, quality of life (QOL), disease-free survival and adverse events. Primary endpoint analyses will be carried out by Cochran-Mantel-Haenszel tests taking into center effect. To our knowledge this is the first trial to investigate the effect of TENS treatment on bladder function recovery after RH III among

  5. A New Class III Antiarrhythmic Drug Niferidil Prolongs Action Potentials in Guinea Pig Atrial Myocardium via Inhibition of Rapid Delayed Rectifier.

    Science.gov (United States)

    Abramochkin, Denis V; Kuzmin, Vladislav S; Rosenshtraukh, Leonid V

    2017-12-01

    A new class III antiarrhythmic drug niferidil (RG-2) has been introduced as a highly effective therapy for cases of persistent atrial fibrillation, but ionic mechanisms of its action are poorly understood. In the present study, the effects of niferidil on action potential (AP) waveform and potassium currents responsible for AP repolarization were investigated in guinea pig atrial myocardium. APs were recorded with sharp glass microelectrodes in multicellular atrial preparations. Whole-cell patch-clamp technique was used to measure K + currents in isolated myocytes. In multicellular atrial preparations, 10 -8  M niferidil effectively prolonged APs by 15.2 ± 2.8% at 90% repolarization level. However, even the highest tested concentrations, 10 -6  M and 10 -5  M failed to prolong APs more than 32.5% of control duration. The estimated concentration of niferedil for half-maximal AP prolongation was 1.13 × 10 -8  M. Among the potassium currents responsible for AP repolarization phase, I K1 was found to be almost insensitive to niferidil. However, another inward rectifier, I KACh , was effectively suppressed by micromolar concentrations of niferidil with IC 50  = 9.2 × 10 -6  M. I KATP was much less sensitive to the drug with IC 50  = 2.26 × 10 -4  M. The slow component of delayed rectifier, I Ks , also demonstrated low sensitivity to niferidil-the highest used concentration, 10 -4  M, decreased peak I Ks density to 46.2 ± 5.5% of control. Unlike I Ks , the rapid component of delayed rectifier, I Kr , appeared to be extremely sensitive to niferidil. The IC 50 was 1.26 × 10 -9  M. I Kr measured in ventricular myocytes was found to be less sensitive to niferidil with IC 50  = 3.82 × 10 -8  M. Niferidil prolongs APs in guinea pig atrial myocardium via inhibition of I Kr .

  6. Celiac Disease and Concomitant Conditions: A Case-based Review.

    Science.gov (United States)

    Lodhi, Muhammad Uzair; Stammann, Tracy; Kuzel, Aaron R; Syed, Intekhab Askari; Ishtiaq, Rizwan; Rahim, Mustafa

    2018-02-02

    Celiac disease is a chronic autoimmune disease with genetic predisposition, triggered by the ingestion of gluten. It has a wide range of clinical manifestations ranging from asymptomatic forms to classic presentation of malabsorption with diarrhea and abdominal cramps. Celiac disease can also present with several other concomitant disorders (at the time of diagnosis or during the course of celiac disease) such as: type 1 diabetes, inflammatory bowel disease, rheumatoid arthritis, thyroid disorders, nutritional deficiencies, and gram-negative sepsis. We present a 57-year-old female with past medical history of rheumatoid arthritis, who presented to the emergency department with a complaint of chronic diarrhea, complicated by gram-negative sepsis. The family history of the patient was significant for celiac disease, type 1 diabetes, and rheumatoid arthritis. The patient was closely monitored and treated appropriately. In this case-based review, we explore different associated conditions of celiac disease in the literature, as well as the patient's risk of developing malignancy.

  7. Estudo cefalométrico das alterações no perfil facial em pacientes Classe III dolicocefálicos submetidos à cirurgia ortognática bimaxilar Cephalometric study of the facial profile changes in Class III patients submitted to bimaxillary orthognathic surgery

    Directory of Open Access Journals (Sweden)

    Hewerson Santos Tavares

    2005-10-01

    Full Text Available O presente estudo avaliou as modificações no perfil facial de 15 pacientes portadores de má oclusão Classe III esquelética que foram submetidos a tratamento ortodôntico pré-cirúrgico e cirurgia ortognática bimaxilar estabilizada com fixação rígida. Oito pacientes foram submetidos à mentoplastia. Foram utilizadas telerradiografias pré-cirúrgicas (T1 e pós-cirúrgicas (T2 com um intervalo mínimo de 6 meses. Foram analisados deslocamentos horizontais e verticais em pontos do tecido ósseo e tecido mole. Foi realizada uma comparação entre os casos tratados com e sem mentoplastia (teste t mostrando não haver diferenças entre os grupos. A regressão linear múltipla evidenciou uma correlação significante no sentido horizontal para os pontos Pg e Pgm e vertical para os pontos Me e Mem. Foi encontrada baixa correlação para movimentos no sentido horizontal nos pontos Sena e A, e para os pontos Pn, Sn e Ph. No sentido vertical, os deslocamentos mais evidentes foram entre os pontos Pg, Gn e Me e Sena e A, porém com correlações de baixa intensidade.The present study evaluated the facial profile modifications in 15 skeletal Class III patients that were submitted to presurgical orthodontic treatment and orthognathic bimaxillary surgery stabilized with a rigid fixation. Eight of the patients have undergone to genioplastic surgery. Presurgical (T1 and late postsurgical (T2 radiographs taken apart with a minimum of 6 month interval had been used. The horizontal and vertical displacement of skeletal and soft tissue profile points were analyzed. The comparison of the cases submitted or not to a genioplastic surgery (t Test showed no differences for the displacement of the skeletal and soft tissue points. The multiple linear regression analysis showed a significant correlation for horizontal movements of the Pg and Pgm points and for vertical movements of the Me and Mem points. A low correlation was found for the horizontal movements of

  8. Gestational diabetes insipidus: a review of an underdiagnosed condition.

    Science.gov (United States)

    Aleksandrov, Nikolay; Audibert, François; Bedard, Marie-Josée; Mahone, Michèle; Goffinet, François; Kadoch, Isaac-Jacques

    2010-03-01

    To review the etiology, diagnosis, and management of diabetes insipidus during pregnancy. A search of the literature was performed in PubMed using key word searching and citation snowballing to identify articles published in English between January 1, 1980, and December 31, 2008, on the subject of diabetes insipidus during pregnancy. Once the articles were identified, a thorough review of all results was conducted. Results and conclusions were compiled and summarized. We reviewed 50 studies selected using the following key words: diabetes insipidus, pregnancy, arginine vasopressin, vasopressinase. Gestational diabetes insipidus is underdiagnosed because polyuria is often considered normal during pregnancy. Clinicians caring for pregnant women should consider screening for gestational diabetes insipidus, because it could be associated with serious underlying pathology.

  9. Three-Dimensional Evaluation of the Upper Airway Morphological Changes in Growing Patients with Skeletal Class III Malocclusion Treated by Protraction Headgear and Rapid Palatal Expansion: A Comparative Research.

    Directory of Open Access Journals (Sweden)

    Xueling Chen

    Full Text Available The aim of this study was to evaluate the morphological changes of upper airway after protraction headgear and rapid maxillary expansion (PE treatment in growing patients with Class III malocclusion and maxillary skeletal deficiency compared with untreated Class III patients by cone-beam computed tomography (CBCT.Thirty growing patients who have completed PE therapy were included in PE group. The control group (n = 30 was selected from the growing untreated patients with the same diagnosis. The CBCT scans of the pre-treatment (T1 and post-treatment (T2 of PE group and the control group were collected. Reconstruction and registration of the 3D models of T1 and T2 were completed. By comparing the data obtained from T1, T2 and control group, the morphological changes of the upper airway during the PE treatment were evaluated.Comparing with the data from T1 group, the subspinale (A of maxilla and the upper incisor (UI of the T2 group were moved in the anterior direction. The gnathion (Gn of mandible was moved in the posterior-inferior direction. The displacement of the hyoid bone as well as the length and width of dental arch showed significant difference. The volume and mean cross-sectional area of nasopharynx, velopharynx and glossopharynx region showed significant difference. The largest anteroposterior/the largest lateral (AP/LR ratios of the velopharynx and glossopharynx were increased, but the AP/LR ratio of the hypopharynx was decreased. In addition, the length and width of the maxillary dental arch, the displacement of the hyoid bone, the volume of nasopharynx and velopharynx, and the AP/LR ratio of the hypopharynx and velopharynx showed significant difference between the data from control and T2 group.The PE treatment of Class III malocclusion with maxillary skeletal hypoplasia leads to a significant increase in the volume of nasopharynx and velopharynx.

  10. Factors affecting working conditions in public hospitals: A literature review

    Directory of Open Access Journals (Sweden)

    Zodwa M. Manyisa

    2017-01-01

    Findings: Workload, HIV/AIDS epidemic, shift work, long working hours, poor infrastructure, inadequate resources and shortage of staff were found to be the main factors attributed to poor working conditions.

  11. A review of healthy condition for reactor operators of NPP

    International Nuclear Information System (INIS)

    Zhang Chi; Yang Di; Zhu Lixin; Zhou Limin

    2008-01-01

    Physical health is one of fundamental elements and the necessary qualification for holding operator license or senior operator license of a nuclear power plant issued by NNSA. Based upon requirements for healthy qualification of reactor operators in nuclear safety regulations and some new issued regulations, especially some involved national standard (GB), review direction, relevant contents and criteria were described, and some suggestions were provided in this paper. (authors)

  12. Efeito da expansão palatina sobre o processo pterigoide, sincondrose esfeno-occipital e sela turca em crânios com relação esquelética classe II e classe III pela análise de elementos finitos (AEF) = Effect of the palatal expansion on the pterygoid process, spheno-occipital synchondrosis and sella turcica in skulls with class II and class III skeletal relationship by finite element analysis (FEA)

    OpenAIRE

    Manuel Gustavo Chávez Sevillano

    2015-01-01

    Resumo: A Técnica de Expansão Palatina é usada frequentemente para corrigir a mordida cruzada posterior, atresia transversal maxilar e aumentar o perímetro da arcada dentária. O objetivo deste estudo foi avaliar pela análise de elementos finitos o efeito simulado da expansão palatina sobre o processo pterigoide, sincondrose esfeno-occipital e sela turca em dois crânios com relação esquelética tipo Classe II e Classe III, identificando a distribuição das tensões mecânicas nessas estruturas ana...

  13. Conditional political budget cycles: a review of recent evidence

    NARCIS (Netherlands)

    Haan, de J.; Klomp, J.G.

    2013-01-01

    Until recently, most research on political budget cycles was based on the (often implicit) presumption that these cycles do not differ across countries. However, more recent studies focus on heterogeneity. This paper surveys studies examining the factors conditioning the occurrence and strength of

  14. Conditional political budget cycles : a review of recent evidence

    NARCIS (Netherlands)

    de Haan, J.; Klomp, J.G.

    2013-01-01

    Until recently, most research on political budget cycles was based on the (often implicit) presumption that these cycles do not differ across countries. However, more recent studies focus on heterogeneity. This paper surveys studies examining the factors conditioning the occurrence and strength of

  15. "Converting a bi-jaw surgery to a single-jaw surgery:" Posterior maxillary dentoalveolar intrusion with microimplants to avoid the need of a maxillary surgery in the surgical management of skeletal Class III vertical malocclusion

    Directory of Open Access Journals (Sweden)

    Abhisek Ghosh

    2016-01-01

    Full Text Available The management of a vertical skeletal Class III malocclusion with mandibular prognathism revolves around the protocol of bi-jaw surgery (maxillary LeFort I impaction and mandibular bilateral sagittal split osteotomy with setback. The maxillary surgery not only provides increased stability to the ultimate surgical outcome but also increases the amount by which the mandibular set back can be done, therefore aiding in greater profile improvement. With the need of maxillary surgery almost inevitable in treating such situations, the complexity and the increased discomfort associated with such surgery can never be ignored. Is it at all possible to convert a bi-jaw surgery into a single-jaw surgery with the aid of microimplants? With increasing number of patients being treated with microimplants for anterior openbite and gummy smiles, our idea was to incorporate this novel protocol in treating Class III vertical situations and therefore avoid the need of a maxillary surgery in treating such a situation, together with achieving optimum treatment outcome.

  16. A review of iodine chemistry under severe accident conditions

    International Nuclear Information System (INIS)

    Clough, P.M.; Starkie, H.C.; Wren, D.J.; Paquette, J.; Wren, J.C.

    1987-01-01

    This report reviews the progress that has been made in establishing a basic understanding of the factors which will determine the behaviour of iodine during postulated accidents in water-cooled reactors. The topics considered are thermal reactions, radiolytic reactions, impurity effects, organic iodide formation, integral models and tests and volatility control. There have been substantial gains in a number of areas, most notably in the kinetics and thermodynamics databases for thermal and radiolytic reactions of inorganic iodine in solution. However, there remains a limited understanding of the mechanisms controlling the formation of organic iodides and a need for integral tests of iodine behaviour in complex, 'dirty' systems to provide data for the validation of chemical models which are undergoing development. 81 refs

  17. Associação entre doença hepática gordurosa não alcoólica e marcadores de lesão/função hepática com componentes da síndrome metabólica em indivíduos obesos classe III Association between non-alcoholic fatty liver disease and liver function/injury markers with metabolic syndrome components in class III obese individuals

    Directory of Open Access Journals (Sweden)

    Gabriela Villaça Chaves

    2012-06-01

    Full Text Available OBJETIVO: Investigar a associação entre doença hepática gordurosa não alcoólica (DHGNA e os marcadores de lesão e função hepática com os componentes da síndrome metabólica (SM em indivíduos obesos classe III. MÉTODOS: A população estudada foi constituída por 144 pacientes com obesidade classe III (IMC > a 40 kg/m². A SM foi identificada segundo o critério do NCEP ATP III, por meio da determinação do perfil lipídico, glicemia e insulina basal. Foram quantificados ainda os marcadores de função e lesão hepática. A resistência à insulina (RI foi verificada pelo índice HOMA-IR e o diagnóstico da DHGNA por ressonância magnética. Os cálculos estatísticos foram realizados pelo programa estatístico SPSS na versão 13.0. A associação foi verificada pelo teste Mann-Whitney e qui-quadrado, com nível de significância de 5%. RESULTADOS: Foi encontrada associação significativa entre o diagnóstico de SM e DHGNA (χ² = 6,84; p = 0,01. Quanto aos componentes diagnósticos para SM, constatou-se associação positiva e significativa entre HDL-c (p = 0,05, circunferência da cintura (p OBJECTIVE: To investigate the association between non-alcoholic fatty liver disease (NAFLD and liver function/injury markers with components of metabolic syndrome (MS in class III obese individuals. METHODS: The study population consisted of 144 patients with class III obesity (body mass index [BMI] > 40 kg/m². MS was diagnosed according to the National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III criteria, by determining the lipid profile, blood glucose and basal insulin. Liver function/injury markers were also quantified. Insulin resistance (IR was measured by HOMA-IR and NAFLD diagnosis was established by magnetic resonance imaging (MRI. Statistical calculations were performed by SPSS version 13.0. The association was assessed by the Mann-Whitney and Chi-square tests, with a level of significance set at 5

  18. Relação entre o estado nutricional de vitamina a e a regressão da esteatose hepática após gastroplastia em Y- de- Roux para tratamento da obesidade classe III Relationship of the nutritional status of vitamin a and the regression of hepatic steatosis after Roux-en-Y gastric bypass surgery for treatment of class III obesity

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo de Oliveira e Silva

    2012-12-01

    Full Text Available RACIONAL: A vitamina A participa de várias funções primordiais no organismo humano e as suas concentrações séricas podem estar diminuídas nas doenças crônicas não transmissíveis. OBJETIVO: Avaliar a relação entre o estado nutricional da vitamina A, e a regressão da esteatose hepática em indivíduos submetidos à gastroplastia em Y-de-Roux para tratamento da obesidade classe III. MÉTODOS: Foram estudados 30 pacientes obesos classe III, de ambos os sexos, com esteatose hepática, submetidos à gastroplastia em Y-de-Roux. Seis meses após a operação, os pacientes foram submetidos à ultrassonografia abdominal e distribuídos em dois grupos: grupo 1 - pacientes com esteatose detectada na ultrassonografia e grupo 2 - pacientes sem esteatose detectada na ultrassonografia. No pré-operatório e seis meses após a operação foram realizadas análises antropométricas e exames bioquímicos: insulina basal, glicemia, Homeostasis Model Assessment Index (HOMA IR, colesterol, HDL, LDL, triglicerídeos, AST, ALT, Gama-GT, albumina, bilirrubina total, retinol, e beta caroteno. RESULTADOS: A média de perda de peso foi de 35,05 + 10,47 (pBACKGROUND: Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases. AIM: To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity. METHODS: Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 - patients with steatosis

  19. CMS Nonpayment Policy, Quality Improvement, and Hospital-Acquired Conditions: An Integrative Review.

    Science.gov (United States)

    Bae, Sung-Heui

    This integrative review synthesized evidence on the consequences of the Centers for Medicare & Medicaid Services (CMS) nonpayment policy on quality improvement initiatives and hospital-acquired conditions. Fourteen articles were included. This review presents strong evidence that the CMS policy has spurred quality improvement initiatives; however, the relationships between the CMS policy and hospital-acquired conditions are inconclusive. In future research, a comprehensive model of implementation of the CMS nonpayment policy would help us understand the effectiveness of this policy.

  20. Class III antiarrhythmic agents in cardiac failure: lessons from clinical trials with a focus on the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA).

    Science.gov (United States)

    Doval, H C

    1999-11-04

    The results of previous clinical trials, in a variety of clinical settings, showed that class I agents may consistently increase mortality in sharp contrast to the effects of beta blockers. Attention has therefore shifted to class III compounds for potential beneficial effects on long-term mortality among patients with underlying cardiac disease. Clinical trials with d-sotalol, the dextro isomer (devoid of beta blockade) of sotalol, showed increased mortality in patients with low ejection fraction after myocardial infarction and in those with heart failure; whereas in the case of dofetilide, the impact on mortality was neutral. Because of the complex effects of its actions as an alpha-adrenergic blocker and a class III agent, the impact on mortality of amiodarone in patients with heart failure is of particular interest. A meta-analysis of 13 clinical trials revealed significant reductions in all-cause and cardiac mortality among patients with heart failure or previous myocardial infarction. Among these were 5 controlled clinical trials that investigated the effects of amiodarone on mortality among patients with heart failure. None of these trials was large relative to the beta-blocker trials in the postinfarction patients. However, the larger 2 of the 5 amiodarone trials produced discordant effects on mortality, neutral in one and significantly positive in the other. Some of the differences may be accounted for by the differences in eligibility criteria and baseline characteristics. Future trials that may be undertaken to resolve the discrepancies may need to allow for the newer findings on the effects of concomitant beta blockers, implantable devices, and possibly, spironolactone. All these modalities of treatment have been shown in controlled clinical trials to augment survival in patients with impaired ventricular function or manifest heart failure. Additional trials, some of which are currently in progress, compare amiodarone with implantable devices and other

  1. Relationship between time to clinical response and outcomes among Pneumonia Outcomes Research Team (PORT) risk class III and IV hospitalized patients with community-acquired pneumonia who received ceftriaxone and azithromycin.

    Science.gov (United States)

    Zasowski, Evan; Butterfield, Jill M; McNutt, Louise-Ann; Cohen, Jason; Cosler, Leon; Pai, Manjunath P; Gottwald, Joseph; Chen, Wen Zhen; Lodise, Thomas P

    2014-07-01

    Recent Food and Drug Administration (FDA) guidance endorses the use of an early clinical response endpoint as the primary outcome for community-acquired bacterial pneumonia (CABP) trials. While antibiotics will now be approved for CABP, in practice they will primarily be used to treat patients with community-acquired pneumonia (CAP). More importantly, it is unclear how achievement of the new FDA CABP early response endpoint translates into clinically applicable real-world outcomes for patients with CAP. To address this, a retrospective cohort study was conducted among adult patients who received ceftriaxone and azithromycin for CAP of Pneumonia Outcomes Research Team (PORT) risk class III and IV at an academic medical center. The clinical response was defined as clinical stability for 24 h with improvement in at least one pneumonia symptom and with no symptom worsening. A classification and regression tree (CART) was used to determine the delay in response time, measured in days, associated with the greatest risk of a prolonged hospital length of stay (LOS) and adverse outcomes (in-hospital mortality or 30-day CAP-related readmission). A total of 250 patients were included. On average, patients were discharged 2 days following the achievement of a clinical response. In the CART analysis, adverse clinical outcomes were higher among day 5 nonresponders than those who responded by day 5 (22.4% versus 6.9%, P = 0.001). The findings from this study indicate that time to clinical response, as defined by the recent FDA guidance, is a reasonable prognostic indicator of real-world effectiveness outcomes among hospitalized PORT risk class III and IV patients with CAP who received ceftriaxone and azithromycin. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  2. Ribonucleotide Reductases from Bifidobacteria Contain Multiple Conserved Indels Distinguishing Them from All Other Organisms: In Silico Analysis of the Possible Role of a 43 aa Bifidobacteria-Specific Insert in the Class III RNR Homolog

    Directory of Open Access Journals (Sweden)

    Seema Alnajar

    2017-07-01

    Full Text Available Bifidobacteria comprises an important group/order of bacteria whose members have widespread usage in the food and health industry due to their health-promoting activity in the human gastrointestinal tract. However, little is known about the underlying molecular properties that are responsible for the probiotic effects of these bacteria. The enzyme ribonucleotide reductase (RNR plays a key role in all organisms by reducing nucleoside di- or tri- phosphates into corresponding deoxyribose derivatives required for DNA synthesis, and RNR homologs belonging to classes I and III are present in either most or all Bifidobacteriales. Comparative analyses of these RNR homologs have identified several novel sequence features in the forms of conserved signature indels (CSIs that are exclusively found in bifidobacterial RNRs. Specifically, in the large subunit of the aerobic class Ib RNR, three CSIs have been identified that are uniquely found in the Bifidobacteriales homologs. Similarly, the large subunit of the anaerobic class III RNR contains five CSIs that are also distinctive characteristics of bifidobacteria. Phylogenetic analyses indicate that these CSIs were introduced in a common ancestor of the Bifidobacteriales and retained by all descendants, likely due to their conferring advantageous functional roles. The identified CSIs in the bifidobacterial RNR homologs provide useful tools for further exploration of the novel functional aspects of these important enzymes that are exclusive to these bacteria. We also report here the results of homology modeling studies, which indicate that most of the bifidobacteria-specific CSIs are located within the surface loops of the RNRs, and of these, a large 43 amino acid insert in the class III RNR homolog forms an extension of the allosteric regulatory site known to be essential for protein function. Preliminary docking studies suggest that this large CSI may be playing a role in enhancing the stability of the RNR

  3. Assessing the relationships between nurse working conditions and patient outcomes: systematic literature review.

    Science.gov (United States)

    Bae, Sung-Heui

    2011-09-01

    The purpose of the study was to systematically evaluate nurse working conditions and to review the literature dealing with their association with patient outcomes. Improving nurse working conditions is essential to address nursing shortages. Although general reviews of the literature support the positive link between working conditions and patient outcomes, definitive evidence has been lacking. A search of six electronic bibliographic databases was conducted for the primary research published in English, from January 2000 to October 2009. The concepts of working conditions were categorized into 10 groups of working conditions. A total of 69 relationships between working conditions and patient outcomes were examined. Increased attention has been drawn to nurse working conditions resulting from nursing shortages. The findings of this review suggested that the evidence supporting positive relationships between working conditions and patient outcomes is inconclusive. Further studies of a longitudinal and interventional nature in various settings are needed to advance knowledge of the complex contextual and multivariate influences among nurse working conditions and patient outcomes. Efforts to improve working conditions should be made in various health-care work settings to ensure patient safety and improve patient quality of outcomes. 2011 Blackwell Publishing Ltd.

  4. Integrated care programmes for adults with chronic conditions: a meta-review.

    Science.gov (United States)

    Martínez-González, Nahara Anani; Berchtold, Peter; Ullman, Klara; Busato, André; Egger, Matthias

    2014-10-01

    To review systematic reviews and meta-analyses of integrated care programmes in chronically ill patients, with a focus on methodological quality, elements of integration assessed and effects reported. Meta-review of systematic reviews and meta-analyses identified in Medline (1946-March 2012), Embase (1980-March 2012), CINHAL (1981-March 2012) and the Cochrane Library of Systematic Reviews (issue 1, 2012). Methodological quality assessed by the 11-item Assessment of Multiple Systematic Reviews (AMSTAR) checklist; elements of integration assessed using a published list of 10 key principles of integration; effects on patient-centred outcomes, process quality, use of healthcare and costs. Twenty-seven systematic reviews were identified; conditions included chronic heart failure (CHF; 12 reviews), diabetes mellitus (DM; seven reviews), chronic obstructive pulmonary disease (COPD; seven reviews) and asthma (five reviews). The median number of AMSTAR checklist items met was five: few reviewers searched for unpublished literature or described the primary studies and interventions in detail. Most reviews covered comprehensive services across the care continuum or standardization of care through inter-professional teams, but organizational culture, governance structure or financial management were rarely assessed. A majority of reviews found beneficial effects of integration, including reduced hospital admissions and re-admissions (in CHF and DM), improved adherence to treatment guidelines (DM, COPD and asthma) or quality of life (DM). Few reviews showed reductions in costs. Systematic reviews of integrated care programmes were of mixed quality, assessed only some components of integration of care, and showed consistent benefits for some outcomes but not others. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care.

  5. Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions

    Science.gov (United States)

    2017-10-18

    terminology related to an aforementioned stressor or medical condition. Table 1 presents the identified operational stressor with the keywords extracted...USAARL Report No. 2018-02 Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions By Kathryn...Environmental Stressors and Medical Conditions N/A N/A N/A N/A N/A N/A Feltman, Kathryn A. Kelley, Amanda M. Curry, Ian P. Boudreaux, David A. Milam

  6. A review on condition-based maintenance optimization models for stochastically deteriorating system

    International Nuclear Information System (INIS)

    Alaswad, Suzan; Xiang, Yisha

    2017-01-01

    Condition-based maintenance (CBM) is a maintenance strategy that collects and assesses real-time information, and recommends maintenance decisions based on the current condition of the system. In recent decades, research on CBM has been rapidly growing due to the rapid development of computer-based monitoring technologies. Research studies have proven that CBM, if planned properly, can be effective in improving equipment reliability at reduced costs. This paper presents a review of CBM literature with emphasis on mathematical modeling and optimization approaches. We focus this review on important aspects of the CBM, such as optimization criteria, inspection frequency, maintenance degree, solution methodology, etc. Since the modeling choice for the stochastic deterioration process greatly influences CBM strategy decisions, this review classifies the literature on CBM models based on the underlying deterioration processes, namely discrete- and continuous-state deterioration, and proportional hazard model. CBM models for multi-unit systems are also reviewed in this paper. This paper provides useful references for CBM management professionals and researchers working on CBM modeling and optimization. - Highlights: • A review on Condition-based maintenance (CBM) optimization models is presented. • The CBM models are classified based on the underlying deterioration processes. • Existing CBM models for both single- and multi-unit systems are reviewed. • Future essential research directions on CBM are identified.

  7. Definitions and factors associated with subthreshold depressive conditions: a systematic review

    OpenAIRE

    Rodr?guez, Mar Rivas; Nuevo, Roberto; Chatterji, Somnath; Ayuso-Mateos, Jos? Luis

    2012-01-01

    Background: Subthreshold depressive disorders (minor and subthrehold depression) have been defined in a wide range of forms, varying on the number of symptoms and duration required. Disability associated with these conditions has also been reported. Our aim was to review the different definitions and to determine factors associated with these conditions in order to clarify the nosological implications of these disorders. Methods: A Medline search was conducted of the published lit...

  8. Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review.

    Science.gov (United States)

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Recent studies highlighting the psychological benefits of medical treatment for dermatological skin conditions have demonstrated a clear role for medical therapy in psychological health. Skin conditions, particularly those that are overtly visible, such as those located on the face, neck, and hands, often have a profound effect on the daily functioning of those affected. The literature documents significant emotional benefits using medical therapy in conditions such as acne, psoriasis, vitiligo, and rosacea, but there is little evidence documenting similar results with the use of cosmetic camouflage. Here we present a review highlighting the practical use of cosmetic camouflage makeup in patients with facial skin conditions and review its implications for psychological health. A search of the Medline and Scopus databases was performed to identify articles documenting the emotional benefit of cosmetic camouflage. Cosmetic camouflage provides a significant emotional benefit for patients with facial skin conditions, and this is substantiated by a literature review and personal experience. More clinical studies are needed to assess and validate the findings reported here. Patients with visible skin conditions have increased rates of depression, anxiety, and decreased self-esteem. It is prudent for us to consider therapies that can offer rapid and dramatic results, such as cosmetic camouflage.

  9. Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions.

    Science.gov (United States)

    Moore, R A; Derry, S; Wiffen, P J; Straube, S; Aldington, D J

    2015-10-01

    Ibuprofen and paracetamol have long been used as analgesics in a range of acute, intermittent and chronic pain conditions. Paracetamol is often the first line analgesic recommended, without consensus about which is the better analgesic. An overview review of systematic reviews and meta-analyses directly compares ibuprofen and paracetamol at standard doses in particular painful conditions, or uses indirect comparisons against placebo. Electronic searches for systematic reviews were sought published since 1995 using outcomes approximating to ≥50% pain intensity reduction. Painful conditions were acute post-operative pain, dysmenorrhoea, tension-type headache (TTH), migraine, osteoarthritis and rheumatoid arthritis, back pain, cancer and paediatric pain. There was no systematic assessment of harm. Sixteen systematic reviews and four individual patient data meta-analyses were included. Ibuprofen was consistently superior to paracetamol at conventional doses in a range of painful conditions. Two direct comparisons favoured ibuprofen (acute pain, osteoarthritis). Three of four indirect comparisons favoured ibuprofen (acute pain, migraine, osteoarthritis); one showed no difference (TTH), although there were methodological problems. In five pain conditions (dysmenorrhoea, paediatric pain, cancer pain, back pain and rheumatoid arthritis), there were limited data on paracetamol and ibuprofen. At standard doses in different painful conditions, ibuprofen was usually superior producing more patients with the degree of pain relief that patients feel worthwhile. Neither of the drugs will be effective for everyone, and both are needed. This overview questions the practice of routinely using paracetamol as a first line analgesic because there is no good evidence for efficacy of paracetamol in many pain conditions. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFICC®.

  10. 78 FR 19026 - Submission for Review: Request to Disability Annuitant for Information on Physical Condition and...

    Science.gov (United States)

    2013-03-28

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Request to Disability Annuitant for Information on Physical Condition and Employment, RI 30-1 AGENCY: U.S. Office of Personnel Management. ACTION... information collection request (ICR) 3206-0143, Request to Disability Annuitant for Information on Physical...

  11. Hospital Admissions for Physical Health Conditions for People with Intellectual Disabilities: Systematic Review

    Science.gov (United States)

    Dunn, Kirsty; Hughes-McCormack, Laura; Cooper, Sally-Ann

    2018-01-01

    Background: People with intellectual disabilities may have inequalities in hospital admissions compared with the general population. The present authors aimed to investigate admissions for physical health conditions in this population. Methods: The present authors conducted a systematic review, searching six databases using terms on intellectual…

  12. Condition Assessment of Ferrous Water Transmission and Distribution Systems State of Technology Review Report

    Science.gov (United States)

    This White Paper was developed to serve as the basis for discussion at a Technology Forum on Condition Assessment of Water Transmission and Distribution Systems that was held on September 9 and 10, 2008, at Edison, NJ. It was distributed to the Forum participants for review in a...

  13. Chiropractic manipulation in pediatric health conditions – an updated systematic review

    Directory of Open Access Journals (Sweden)

    Gotlib Allan

    2008-09-01

    Full Text Available Abstract Objective Our purpose was to review the biomedical literature from January 2004 to June 2007 inclusive to determine the extent of new evidence related to the therapeutic application of manipulation for pediatric health conditions. This updates a previous systematic review published in 2005. No critical appraisal of the evidence is undertaken. Data Sources We searched both the indexed and non-indexed biomedical manual therapy literature. This included PubMed, MANTIS, CINAHL, ICL, as well as reference tracking. Other resources included the Cochrane Library, CCOHTA, PEDro, WHO ICTRP, AMED, EMBASE and AHRQ databases, as well as research conferences and symposium proceedings. Results The search identified 1275 citations of which 57 discrete citations met the eligibility criteria determined by three reviewers who then determined by consensus, each citation's appropriate level on the strength of evidence scale. The new evidence from the relevant time period was 1 systematic review, 1 RCT, 2 observational studies, 36 descriptive case studies and 17 conference abstracts. When this additional evidence is combined with the previous systematic review undertaken up to 2003, there are now in total, 2 systematic reviews, 10 RCT's, 3 observational studies, 177 descriptive studies, and 31 conference abstracts defining this body of knowledge. Summary There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific

  14. Physicians' Psychosocial Work Conditions and Quality of Care: A Literature Review

    Directory of Open Access Journals (Sweden)

    Peter Angerer

    2015-05-01

    Full Text Available Background: Physician jobs are associated with adverse psychosocial work conditions. We summarize research on the relationship of physicians' psychosocial work conditions and quality of care. Method: A systematic literature search was conducted in MEDLINE and PsycINFO. All studies were classified into three categories of care quality outcomes: Associations between physicians' psychosocial work conditions and (1 the physician-patient-relationship, or (2 the care process and outcomes, or (3 medical errors were examined. Results: 12 publications met the inclusion criteria. Most studies relied on observational cross-sectional and controlled intervention designs. All studies provide at least partial support for physicians’ psychosocial work conditions being related to quality of care. Conclusions: This review found preliminary evidence that detrimental physicians’ psychosocial work conditions adversely influence patient care quality. Future research needs to apply strong designs to disentangle the indirect and direct effects of adverse psychosocial work conditions on physicians as well as on quality of care.Keywords: psychosocial work conditions, physicians, quality of care, physician-patient-relationship, hospital, errors, review, work stress, clinicians

  15. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S. [Ohio State Univ., Columbus (United States). Dept. of Radiology

    2000-09-01

    Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis. (orig.)

  16. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances

    International Nuclear Information System (INIS)

    Yu, J.S.

    2000-01-01

    Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis. (orig.)

  17. Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis.

    Science.gov (United States)

    Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel

    2013-06-14

    New possibilities for mHealth have arisen by means of the latest advances in mobile communications and technologies. With more than 1 billion smartphones and 100 million tablets around the world, these devices can be a valuable tool in health care management. Every aid for health care is welcome and necessary as shown by the more than 50 million estimated deaths caused by illnesses or health conditions in 2008. Some of these conditions have additional importance depending on their prevalence. To study the existing applications for mobile devices exclusively dedicated to the eight most prevalent health conditions by the latest update (2004) of the Global Burden of Disease (GBD) of the World Health Organization (WHO): iron-deficiency anemia, hearing loss, migraine, low vision, asthma, diabetes mellitus, osteoarthritis (OA), and unipolar depressive disorders. Two reviews have been carried out. The first one is a review of mobile applications in published articles retrieved from the following systems: IEEE Xplore, Scopus, ScienceDirect, Web of Knowledge, and PubMed. The second review is carried out by searching the most important commercial app stores: Google play, iTunes, BlackBerry World, Windows Phone Apps+Games, and Nokia's Ovi store. Finally, two applications for each condition, one for each review, were selected for an in-depth analysis. Search queries up to April 2013 located 247 papers and more than 3673 apps related to the most prevalent conditions. The conditions in descending order by the number of applications found in literature are diabetes, asthma, depression, hearing loss, low vision, OA, anemia, and migraine. However when ordered by the number of commercial apps found, the list is diabetes, depression, migraine, asthma, low vision, hearing loss, OA, and anemia. Excluding OA from the former list, the four most prevalent conditions have fewer apps and research than the final four. Several results are extracted from the in-depth analysis: most of the apps

  18. Ischemic Conditioning as a Hemostatic Intervention in Surgery and Cardiac Procedures: A Systematic Review

    DEFF Research Database (Denmark)

    Krag, Andreas Engel; Hvas, Anne-Mette

    2017-01-01

    did not increase operative bleeding. In conclusion, ischemic conditioning reduced platelet activity without increasing the risk of bleeding in patients undergoing surgery or cardiac procedures. Limited evidence supports the proposal that ischemic conditioning reduces the incidence of arterial......Ischemic conditioning induced by nonlethal cycles of tissue ischemia and reperfusion attenuates ischemia–reperfusion injury. The objective of this study is to systematically review the effects of local and remote ischemic conditioning on laboratory parameters of hemostasis and the clinical outcomes......, thromboembolism, and bleeding were extracted for qualitative synthesis. In total, 69 studies were included; of these, 53 were randomized controlled trials (RCTs) and 11 were meta-analyses. Local and remote ischemic conditioning reduced platelet activation in patients undergoing cardiac procedures. Local ischemic...

  19. On the use of temperature for online condition monitoring of geared systems - A review

    Science.gov (United States)

    Touret, T.; Changenet, C.; Ville, F.; Lalmi, M.; Becquerelle, S.

    2018-02-01

    Gear unit condition monitoring is a key factor for mechanical system reliability management. When they are subjected to failure, gears and bearings may generate excessive vibration, debris and heat. Vibratory, acoustic or debris analyses are proven approaches to perform condition monitoring. An alternative to those methods is to use temperature as a condition indicator to detect gearbox failure. The review focuses on condition monitoring studies which use this thermal approach. According to the failure type and the measurement method, it exists a distinction whether it is contact (e.g. thermocouple) or non-contact temperature sensor (e.g. thermography). Capabilities and limitations of this approach are discussed. It is shown that the use of temperature for condition monitoring has a clear potential as an alternative to vibratory or acoustic health monitoring.

  20. Multimedia psychoeducational interventions to support patient self-care in degenerative conditions: A realist review.

    Science.gov (United States)

    O'Halloran, Peter; Scott, David; Reid, Joanne; Porter, Sam

    2015-10-01

    Multimedia interventions are increasingly used to deliver information in order to promote self-care among patients with degenerative conditions. We carried out a realist review of the literature to investigate how the characteristics of multimedia psychoeducational interventions combine with the contexts in which they are introduced to help or hinder their effectiveness in supporting self-care for patients with degenerative conditions. Electronic databases (Medline, Science Direct, PSYCHinfo, EBSCO, and Embase) were searched in order to identify papers containing information on multimedia psychoeducational interventions. Using a realist review approach, we reviewed all relevant studies to identify theories that explained how the interventions work. Ten papers were included in the review. All interventions sought to promote self-care behaviors among participants. We examined the development and content of the multimedia interventions and the impact of patient motivation and of the organizational context of implementation. We judged seven studies to be methodologically weak. All completed studies showed small effects in favor of the intervention. Multimedia interventions may provide high-quality information in an accessible format, with the potential to promote self-care among patients with degenerative conditions, if the patient perceives the information as important and develops confidence about self-care. The evidence base is weak, so that research is needed to investigate effective modes of delivery at different resource levels. We recommend that developers consider how an intervention will reduce uncertainty and increase confidence in self-care, as well as the impact of the context in which it will be employed.

  1. Comparing the reported burn conditions for different severity burns in porcine models: a systematic review.

    Science.gov (United States)

    Andrews, Christine J; Cuttle, Leila

    2017-12-01

    There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post-burn and method for depth of injury assessment specified. Conditions causing deep dermal scald burns compared to contact burns of equivalent severity were disparate, with lower temperatures and shorter durations reported for scald burns (83°C for 14 seconds) compared to contact burns (111°C for 23 seconds). A valuable archive of the different mechanisms and materials used for porcine burn models is presented to aid design and optimisation of future models. Significantly, this review demonstrates the effect of the mechanism of injury on burn severity and that caution is recommended when burn conditions established by porcine contact burn models are used by regulators to guide scald burn prevention strategies. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  2. 241-AY-101 Tank Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Gunter, Jason R.

    2013-08-26

    This report provides the results of an extent of condition construction history review for tank 241-AY-101. The construction history of tank 241-AY-101 has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In tank 241-AY-101, the second double-shell tank constructed, similar issues as those with tank 241-AY-102 construction reoccurred. The overall extent of similary and affect on tank 241-AY-101 integrity is described herein.

  3. 241-SY Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Boomer, Kayle D.; Gunter, Jason R.; Venetz, Theodore J.

    2013-07-25

    This report provides the results of an extent of condition construction history review for tanks 241-SY-101, 241-SY-102, and 241-SY-103. The construction history of the 241-SY tank farm has been reviewed to identify issues similar to those experienced during tank 241-AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank 241-AY-102 as the comparison benchmark. In the 241-SY tank farm, the third DST farm constructed, refractory quality and stress relief were improved, while similar tank and liner fabrication issues remained.

  4. 241-AW Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

    2013-11-19

    This report provides the results of an extent of condition construction history review for the 241-AW tank farm. The construction history of the 241-AW tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AW tank farm, the fourth double-shell tank farm constructed, similar issues as those with tank 241-AY-102 construction occured. The overall extent of similary and affect on 241-AW tank farm integrity is described herein.

  5. 241-AZ Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Boomer, Kayle D.; Gunter, Jason R.; Venetz, Theodore J.

    2013-07-30

    This report provides the results of an extent of condition construction history review for tanks 241-AZ-101 and 241-AZ-102. The construction history of the 241-AZ tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AZ tank farm, the second DST farm constructed, both refractory quality and tank and liner fabrication were improved.

  6. Online tools for individuals with depression and neurologic conditions: A scoping review.

    Science.gov (United States)

    Lukmanji, Sara; Pham, Tram; Blaikie, Laura; Clark, Callie; Jetté, Nathalie; Wiebe, Samuel; Bulloch, Andrew; Holroyd-Leduc, Jayna; Macrodimitris, Sophia; Mackie, Aaron; Patten, Scott B

    2017-08-01

    Patients with neurologic conditions commonly have depression. Online tools have the potential to improve outcomes in these patients in an efficient and accessible manner. We aimed to identify evidence-informed online tools for patients with comorbid neurologic conditions and depression. A scoping review of online tools (free, publicly available, and not requiring a facilitator) for patients with depression and epilepsy, Parkinson disease (PD), multiple sclerosis (MS), traumatic brain injury (TBI), or migraine was conducted. MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL Register of Controlled Trials were searched from database inception to January 2017 for all 5 neurologic conditions. Gray literature using Google and Google Scholar as well as app stores for both Android and Apple devices were searched. Self-management or self-efficacy online tools were not included unless they were specifically targeted at depression and one of the neurologic conditions and met the other eligibility criteria. Only 4 online tools were identified. Of these 4 tools, 2 were web-based self-management programs for patients with migraine or MS and depression. The other 2 were mobile apps for patients with PD or TBI and depression. No online tools were found for epilepsy. There are limited depression tools for people with neurologic conditions that are evidence-informed, publicly available, and free. Future research should focus on the development of high-quality, evidence-based online tools targeted at neurologic patients.

  7. Online peer support interventions for chronic conditions: a scoping review protocol.

    Science.gov (United States)

    Munce, Sarah Elizabeth Patricia; Shepherd, John; Perrier, Laure; Allin, Sonya; Sweet, Shane N; Tomasone, Jennifer R; Nelson, Michelle L A; Guilcher, Sara J T; Hossain, Saima; Jaglal, Susan

    2017-09-24

    Peer support is receiving increasing attention as both an effective and cost-effective intervention method to support the self-management of chronic health conditions. Given that an increasing proportion of Canadians have internet access and the increasing implementation of web-based interventions, online peer support interventions are a promising option to address the burden of chronic diseases. Thus, the specific research question of this scoping review is the following: What is known from the existing literature about the key characteristics of online peer support interventions for adults with chronic conditions? METHODS AND ANALYSIS: We will use the methodological frameworks used by Arksey and O'Malley as well as Levac and colleagues for the current scoping review. To be eligible for inclusion, studies must report on adults (≥18 years of age) with one of the Public Health Agency of Canada chronic conditions or HIV/AIDS. We will limit our review to peer support interventions delivered through online formats. All study designs will be included. Only studies published from 2012 onwards will be included to ensure relevance to the current healthcare context and feasibility. Furthermore, only English language studies will be included. Studies will be identified by searching a variety of databases. Two reviewers will independently screen the titles and abstracts identified by the literature search for inclusion (ie, level 1 screening), the full text articles (ie, level 2 screening) and then perform data abstraction. Abstracted data will include study characteristics, participant population, key characteristics of the intervention and outcomes collected. This review will identify the key features of online peer support interventions and could assist in the future development of other online peer support programmes so that effective and sustainable programmes can be developed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  8. Mapping ergonomics application to improve SMEs working condition in industrially developing countries: a critical review.

    Science.gov (United States)

    Hermawati, Setia; Lawson, Glyn; Sutarto, Auditya Purwandini

    2014-01-01

    In industrially developing countries (IDC), small and medium enterprises (SMEs) account for the highest proprotion of employment. Unfortunately, the working conditions in SMEs are often very poor and expose employees to a potentially wide range of health and safety risks. This paper presents a comprehensive review of 161 articles related to ergonomics application in SMEs, using Indonesia as a case study. The aim of this paper is to investigate the extent of ergonomics application and identify areas that can be improved to promote effective ergonomics for SMEs in IDC. The most urgent issue found is the need for adopting participatory approach in contrast to the commonly implemented top-down approach. Some good practices in ergonomics application were also revealed from the review, e.g. a multidisciplinary approach, unsophisticated and low-cost solutions, and recognising the importance of productivity. The review also found that more work is still required to achieve appropriate cross-cultural adaptation of ergonomics application.

  9. Impact of the environmental conditions and substrate pre-treatment on whey protein hydrolysis: A review.

    Science.gov (United States)

    Cheison, Seronei Chelulei; Kulozik, Ulrich

    2017-01-22

    Proteins in solution are subject to myriad forces stemming from interactions with each other as well as with the solvent media. The role of the environmental conditions, namely pH, temperature, ionic strength remains under-estimated yet it impacts protein conformations and consequently its interaction with, and susceptibility to, the enzyme. Enzymes, being proteins are also amenable to the environmental conditions because they are either activated or denatured depending on the choice of the conditions. Furthermore, enzyme specificity is restricted to a narrow regime of optimal conditions while opportunities outside the optimum conditions remain untapped. In addition, the composition of protein substrate (whether mixed or single purified) have been underestimated in previous studies. In addition, protein pre-treatment methods like heat denaturation prior to hydrolysis is a complex phenomenon whose progression is influenced by the environmental conditions including the presence or absence of sugars like lactose, ionic strength, purity of the protein, and the molecular structure of the mixed proteins particularly presence of free thiol groups. In this review, we revisit protein hydrolysis with a focus on the impact of the hydrolysis environment and show that preference of peptide bonds and/or one protein over another during hydrolysis is driven by the environmental conditions. Likewise, heat-denaturing is a process which is dependent on not only the environment but the presence or absence of other proteins.

  10. MPPT Schemes for PV System under Normal and Partial Shading Condition: A Review

    Directory of Open Access Journals (Sweden)

    Malik Sameeullah

    2016-08-01

    Full Text Available The photovoltaic system is one of the renewable energy device, which directly converts solar radiation into electricity. The I-V characteristics of PV system are nonlinear in nature and under variable Irradiance and temperature, PV system has a single operating point where the power output is maximum, known as Maximum Power Point (MPP and the point varies on changes in atmospheric conditions and electrical load. Maximum Power Point Tracker (MPPT is used to track MPP of solar PV system for maximum efficiency operation. The various MPPT techniques together with implementation are reported in literature. In order to choose the best technique based upon the requirements, comprehensive and comparative study should be available. The aim of this paper is to present a comprehensive review of various MPPT techniques for uniform insolation and partial shading conditions. Furthermore, the comparison of practically accepted and widely used techniques has been made based on features, such as control strategy, type of circuitry, number of control variables and cost. This review work provides a quick analysis and design help for PV systems. Article History: Received March 14, 2016; Received in revised form June 26th 2016; Accepted July 1st 2016; Available online How to Cite This Article: Sameeullah, M. and Swarup, A. (2016. MPPT Schemes for PV System under Normal and Partial Shading Condition: A Review. Int. Journal of Renewable Energy Development, 5(2, 79-94. http://dx.doi.org/10.14710/ijred.5.2.79-94 

  11. Interactive media for parental education on managing children chronic condition: a systematic review of the literature.

    Science.gov (United States)

    Annaim, Ali; Lassiter, Mia; Viera, Anthony J; Ferris, Maria

    2015-12-03

    Although some research has examined the use of games for the education of pediatric patients, the use of technology for parental education seems like an appropriate application as it has been a part of the popular culture for at least 30 years. The main objective of this systematic review is to examine the literature for research evaluating the use of interactive media in the education of parents of children with chronic conditions. We searched the MEDLINE, PSYCHINFO, CINAHL, Cochrane database of systematic reviews and EMBASE databases from 1986 to 2014 seeking original investigations on the use of interactive media and video games to educate parents of children with chronic conditions. Cohort studies, randomized control trials, and observational studies were included in our search of the literature. Two investigators reviewed abstracts and full texts as necessary. The quality of the studies was assessed using the GRADE guidelines. Overall trend in the results and the degree of certainty in the results were considered when assessing the body of literature pertaining to our focused questions. Our initial search identified 4367 papers, but only 12 fulfilled the criterion established for final analysis, with the majority of the studies having flaws that reduced their quality. These papers reported mostly positive results supporting the idea that parent education is possible through interactive media. We found limited evidence of the effectiveness of using serious games and or interactive media to educate parents of children with chronic conditions.

  12. How is symptom flare defined in musculoskeletal conditions: A systematic review.

    Science.gov (United States)

    Costa, Nathalia; Ferreira, Manuela L; Cross, Marita; Makovey, Joanna; Hodges, Paul W

    2018-01-31

    To systematically review the definitions for "flare" in musculoskeletal conditions, the derivation processes, and validation of definitions for the 12 most burdensome musculoskeletal conditions. A literature search was conducted in MEDLINE, EMBASE, CINAHL, AMED, PsycInfo and Lilacs to identify studies that investigated derivation or validation of a flare definition, which we considered as a phrase or group of domains. Reports of derivation of flare definitions were identified for 9/12 musculoskeletal conditions. Validation of flare definitions was initiated for 4/12. For each condition, different derivation and validation methods have been used, with variable levels of consumer involvement, and in some cases different groups have worked on the process in parallel. Although some flare definitions began simply as "symptom worsening" or "change in treatment", most evolved into multidimensional definitions that include: pain, impact on function, joint symptoms, and emotional elements. Frequently initial attempts to create phrase to define the term flare evolved into consensus on the breadth of domains involved. Validation has compared flare definitions/domains against measures of disease activity, clinicians' diagnosis, response to drug therapy, or a combination. This review suggests that greater characterisation and definition of flares in musculoskeletal conditions are linked to the inclusion of multiple perspectives, multifaceted domains and compound comparators for their validation. Further work is required to optimise and test the derived definitions for most musculoskeletal conditions. As some elements are disease-specific, flare definitions cannot be extrapolated to other conditions. Research regarding flare in back pain (most burdensome disease) is limited. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Hanford Double-Shell Tank Extent-of-Condition Construction Review

    International Nuclear Information System (INIS)

    Venetz, Theodore J.; Johnson, Jeremy M.; Gunter, Jason R.; Barnes, Travis J.; Washenfelder, Dennis J.; Boomer, Kayle D.

    2013-01-01

    During routine visual inspections of Hanford double-shell waste tank 241-AY-102 (AY-102), anomalies were identified on the annulus floor which resulted in further evaluations. Following a formal leak assessment in October 2012, Washington River Protection Solutions, LLC (WRPS) determined that the primary tank of AY-102 was leaking. The formal leak assessment, documented in RPP-ASMT-53793,Tank 241-AY-102 Leak Assessment Report, identified first-of-a-kind construction difficulties and trial-and-error repairs as major contributing factors to tank failure. To determine if improvements in double-shell tank (DST) construction occurred after construction of tank AY-102, a detailed review and evaluation of historical construction records were performed for the first three DST tank farms constructed, which included tanks 241-AY-101, 241-AZ-101, 241-AZ-102, 241-SY-101, 241-SY-102, and 241-SY-103. The review for these six tanks involved research and review of dozens of boxes of historical project documentation. These reviews form a basis to better understand the current condition of the three oldest Hanford DST farms. They provide a basis for changes to the current tank inspection program and also provide valuable insight into future tank use decisions. If new tanks are constructed in the future, these reviews provide valuable 'lessons-learned' information about expected difficulties as well as construction practices and techniques that are likely to be successful

  14. Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.

    Science.gov (United States)

    Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan

    2017-02-01

    Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was

  15. The impact of environmental conditions on human performance: A critical review of the literature. Volume 2

    International Nuclear Information System (INIS)

    Echeverria, D.; Barnes, V.; Bittner, A.

    1994-09-01

    The Battelle Human Affairs Research Centers (HARC) conducted a comprehensive review of the technical literature regarding the impact of environmental conditions on human performance applicable to nuclear power plant workers. The environmental conditions considered were vibration, noise, heat, cold, and light. Research staff identified potential human performance deficits along a continuum of increasing occupational exposure, ranging from deficits that occur at low exposures to deficits that occur at high exposures. Specific deficits were included in the review if scientists demonstrated the exposure caused an effect, using sound methodology. The levels associated with each deficit were then compared to the protection afforded by existing occupational exposure standards. Volume 2 presents several conclusions regarding the applicability of the research literature to environmental conditions in nuclear power plants. The findings presented suggest that occupational standards for vibration, noise, and heat, which were developed to protect health, are inadequate for preventing deficits in cognitive or motor performance in tasks likely to be performed in nuclear power plants. Also, there is little information in the literature on simultaneous conditions; for example, the effects of simultaneous exposure to heat and noise on cognition require more research. As many exposures in nuclear power plants will be simultaneous, this limitation should be kept in mind when using Volume 1

  16. The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review.

    Science.gov (United States)

    Frier, Amanda; Barnett, Fiona; Devine, Sue

    2017-05-01

    This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation. A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered. Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible. Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation. Implications for Rehabilitation Social determinants of health are important to consider in the rehabilitation of neurological conditions. Understanding the interplay between the social determinants of health and neurological rehabilitation may enhance the possible outcomes for those requiring rehabilitation. Increased awareness and capacity of health care professionals involved in neurological rehabilitation may hasten momentum towards decreased health

  17. Health coaching interventions for persons with chronic conditions: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Boehmer, Kasey R; Barakat, Suzette; Ahn, Sangwoo; Prokop, Larry J; Erwin, Patricia J; Murad, M Hassan

    2016-09-01

    Chronic conditions are increasingly more common and negatively impact quality of life, disability, morbidity, and mortality. Health coaching has emerged as a possible intervention to help individuals with chronic conditions adopt health supportive behaviors that improve both quality of life and health outcomes. We planned a systematic review and meta-analysis of the contemporary health coaching literature published in the last decade to evaluate the effect of health coaching on clinically important, disease-specific, functional, and behavioral outcomes. We will include randomized controlled trials or quasi-experimental studies that compared health coaching to alternative interventions or usual care. To enable adoption of effective interventions, we aim to explore how the effect of intervention is modified by the intervention components, delivering personnel (i.e., health professionals vs trained lay or peer persons), dose, frequency, and setting. Analysis of intervention outcomes will be reported and classified using an existing theoretical framework, the Theory of Patient Capacity, to identify the areas of patients' capacity to access and use healthcare and enact self-care where coaching may be an effective intervention. This systematic review and meta-analysis will identify and synthesize evidence to inform the practice of health coaching by providing evidence on components and characteristics of the intervention essential for success in individuals with chronic health conditions. PROSPERO CRD42016039730.

  18. Review of experimental data for modelling LWR fuel cladding behaviour under loss of coolant accident conditions

    Energy Technology Data Exchange (ETDEWEB)

    Massih, Ali R. [Quantum Technologies AB, Uppsala Science Park (Sweden)

    2007-02-15

    Extensive range of experiments has been conducted in the past to quantitatively identify and understand the behaviour of fuel rod under loss-of-coolant accident (LOCA) conditions in light water reactors (LWRs). The obtained experimental data provide the basis for the current emergency core cooling system acceptance criteria under LOCA conditions for LWRs. The results of recent experiments indicate that the cladding alloy composition and high burnup effects influence LOCA acceptance criteria margins. In this report, we review some past important and recent experimental results. We first discuss the background to acceptance criteria for LOCA, namely, clad embrittlement phenomenology, clad embrittlement criteria (limitations on maximum clad oxidation and peak clad temperature) and the experimental bases for the criteria. Two broad kinds of test have been carried out under LOCA conditions: (i) Separate effect tests to study clad oxidation, clad deformation and rupture, and zirconium alloy allotropic phase transition during LOCA. (ii) Integral LOCA tests, in which the entire LOCA sequence is simulated on a single rod or a multi-rod array in a fuel bundle, in laboratory or in a tests and results are discussed and empirical correlations deduced from these tests and quantitative models are conferred. In particular, the impact of niobium in zirconium base clad and hydrogen content of the clad on allotropic phase transformation during LOCA and also the burst stress are discussed. We review some recent LOCA integral test results with emphasis on thermal shock tests. Finally, suggestions for modelling and further evaluation of certain experimental results are made.

  19. Family planning decisions for parents of children with a rare genetic condition: A scoping review.

    Science.gov (United States)

    Gee, Melanie; Piercy, Hilary; Machaczek, Katarzyna

    2017-12-01

    Expansion of newborn screening programmes increases the complexity around reproductive choices, both in terms of the increased number of parents faced with making reproductive decisions from the earliest days of their affected child's life, and the number of conditions for which such decisions have to be made. We conducted a scoping review to explore: (i) reproductive decision-making among parents of children with recessive genetic conditions; and, (ii) the involvement of healthcare services in facilitating and supporting those decisions. Systematic search processes involved seven bibliographic databases, citation, and grey literature searches. From an initial total of 311 identified articles, seven met the inclusion criteria and were included in the review. The extracted data were organised around three themes: factors influencing reproductive decisions taken by parents, how those factors changed over time, and the involvement of healthcare services in supporting and facilitating reproductive decisions. Most studies focused on attitudes towards, and uptake of, pre-natal diagnosis (PND) and termination. None of the studies considered the wider range of reproductive choices facing all parents, including those of children with conditions for whom PND and termination is not available or where good health outcomes make these options less justifiable. The literature provided little insight into the role of healthcare staff in providing family planning support for these parents. There is a need to better understand the support parents need in their decision-making, and who is best placed to provide that support. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Conditions and consequences of medical futility--from a literature review to a clinical model.

    Science.gov (United States)

    Löfmark, R; Nilstun, T

    2002-04-01

    To present an analysis of "futility" that is useful in the clinical setting. Literature review. According to Medline more than 750 articles have been published about medical futility. Three criteria (language, time period, and the authors expressed their own opinions) singled out 43 of them. The authors' opinions about futility were analysed using the scheme: "If certain conditions are satisfied, then a particular measure is futile" and "If a particular measure is futile, then certain moral consequences are implied". Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to quality of life, physiological improvement, or prolongation of life. The probability of success in reaching the goal was in most cases described in semiquantitative terms. Regarding consequences, the authors stated that health care professionals may (sometimes ought or should) withhold or withdraw a futile measure, most often after a dialogue with the patient (29 articles), but sometimes without informing the patient (nine articles), or with one-way information (four articles). Over time more and more articles recommend that the patient should be involved in joint decision making. Based on this literature review a clinical model was developed. The model, requiring that conditions and consequences should be made explicit, may, in "futility situations", facilitate both the collection of the necessary information and make the moral implications visible. It also makes communication about measures considered to be futile possible without using such ambiguous terms as "futile".

  1. Common and Uncommon Conditions of Breast Disease in Children and Adolescents: A Pictorial Review

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyoun; Kim, Kyu Soon; Kim, Da Mi [Dept. of f Radiology, Eulji University Hospital, Daejeon (Korea, Republic of); Kim, You Me [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Kim, Hak Hee [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2013-02-15

    The purpose of this study is to review various breast diseases in children and adolescents and to illustrate the sonographic findings. We reviewed the cases at our institution in order to identify breast disease in children and adolescent patients who underwent sonography and mammography. Breast disease in children and adolescents included developmental disturbance, infection, benign tumors and inherent defects. In contrast to adults, the radiologic findings of malignant breast conditions in pediatric populations have rarely been reported; however, we show ductal carcinoma in situ with juvenile fibroadenoma and rhabdomyosarcoma. During childhood and adolescence, the recognition and correct identification of physiologic breast development and specific lesions in breast entities on radiologic findings is most helpful in identifying and characterizing abnormalities and in guiding further investigation.

  2. Causal inference regarding infectious aetiology of chronic conditions: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sofia Orrskog

    Full Text Available BACKGROUND: The global burden of disease has shifted from communicable diseases in children to chronic diseases in adults. This epidemiologic shift varies greatly by region, but in Europe, chronic conditions account for 86% of all deaths, 77% of the disease burden, and up to 80% of health care expenditures. A number of risk factors have been implicated in chronic diseases, such as exposure to infectious agents. A number of associations have been well established while others remain uncertain. METHODS AND FINDINGS: We assessed the body of evidence regarding the infectious aetiology of chronic diseases in the peer-reviewed literature over the last decade. Causality was assessed with three different criteria: First, the total number of associations documented in the literature between each infectious agent and chronic condition; second, the epidemiologic study design (quality of the study; third, evidence for the number of Hill's criteria and Koch's postulates that linked the pathogen with the chronic condition. We identified 3136 publications, of which 148 were included in the analysis. There were a total of 75 different infectious agents and 122 chronic conditions. The evidence was strong for five pathogens, based on study type, strength and number of associations; they accounted for 60% of the associations documented in the literature. They were human immunodeficiency virus, hepatitis C virus, Helicobacter pylori, hepatitis B virus, and Chlamydia pneumoniae and were collectively implicated in the aetiology of 37 different chronic conditions. Other pathogens examined were only associated with very few chronic conditions (≤ 3 and when applying the three different criteria of evidence the strength of the causality was weak. CONCLUSIONS: Prevention and treatment of these five pathogens lend themselves as effective public health intervention entry points. By concentrating research efforts on these promising areas, the human, economic, and societal

  3. Fracture Strength of Indirect Resin Composite Laminates to Teeth with Existing Restorations : An Evaluation of Conditioning Protocols

    NARCIS (Netherlands)

    Mese, Ayse; Ozcan, Mutlu

    2009-01-01

    Purpose: This study evaluated the fracture strength and failure types of indirect resin-based composite laminates bonded to teeth with aged Class III composite restorations that were conditioned according to various protocols. Materials and Methods: Maxillary central incisors (N = 60) with

  4. Segmental dependent transport of low permeability compounds along the small intestine due to P-glycoprotein: the role of efflux transport in the oral absorption of BCS class III drugs.

    Science.gov (United States)

    Dahan, Arik; Amidon, Gordon L

    2009-01-01

    The purpose of this study was to investigate the role of P-gp efflux in the in vivo intestinal absorption process of BCS class III P-gp substrates, i.e. high-solubility low-permeability drugs. The in vivo permeability of two H (2)-antagonists, cimetidine and famotidine, was determined by the single-pass intestinal perfusion model in different regions of the rat small intestine, in the presence or absence of the P-gp inhibitor verapamil. The apical to basolateral (AP-BL) and the BL-AP transport of the compounds in the presence or absence of various efflux transporters inhibitors (verapamil, erythromycin, quinidine, MK-571 and fumitremorgin C) was investigated across Caco-2 cell monolayers. P-gp expression levels in the different intestinal segments were confirmed by immunoblotting. Cimetidine and famotidine exhibited segmental dependent permeability through the gut wall, with decreased P(eff) in the distal ileum in comparison to the proximal regions of the intestine. Coperfusion of verapamil with the drugs significantly increased the permeability in the ileum, while no significant change in the jejunal permeability was observed. Both drugs exhibited significantly greater BL-AP than AP-BL Caco-2 permeability, indicative of net mucosal secretion. Concentration dependent decrease of this secretion was obtained by the P-gp inhibitors verapamil, erythromycin and quinidine, while no effect was evident by the MRP2 inhibitor MK-571 and the BCRP inhibitor FTC, indicating that P-gp is the transporter mediates the intestinal efflux of cimetidine and famotidine. P-gp levels throughout the intestine were inversely related to the in vivo permeability of the drugs from the different segments. The data demonstrate that for these high-solubility low-permeability P-gp substrates, P-gp limits in vivo intestinal absorption in the distal segments of the small intestine; however P-gp plays a minimal role in the proximal intestinal segments due to significant lower P-gp expression levels

  5. Review and proposal for heat transfer predictions at supercritical water conditions using existing correlations and experiments

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, Wadim, E-mail: wadim.jaeger@kit.edu [Karlsruhe Institute of Technology, Institute for Neutron Physics and Reactor Technology, DE-76344 Eggenstein-Leopoldshafen (Germany); Sanchez Espinoza, Victor Hugo [Karlsruhe Institute of Technology, Institute for Neutron Physics and Reactor Technology, DE-76344 Eggenstein-Leopoldshafen (Germany); Hurtado, Antonio [Technical University of Dresden, Institute of Power Engineering, DE-01062 Dresden (Germany)

    2011-06-15

    Highlights: > Implementation of heat transfer correlations for supercritical water into TRACE. > Simulation of several heat transfer experiments with modified TRACE version. > Most correlations are not able to reproduce the experimental results. > Bishop, Sandberg and Tong correlation is most suitable for TRACE applications. - Abstract: This paper summarizes the activities of the TRACE code validation at the Institute for Neutron Physics and Reactor Technology related to supercritical water conditions. In particular, the providing of the thermo physical properties and its appropriate use in the wall-to-fluid heat transfer models in the frame of the TRACE code is the object of this investigation. In a first step, the thermo physical properties of the original TRACE code were modified in order to account for supercritical conditions. In a second step, existing Nusselt correlations were reviewed and implemented into TRACE and available experiments were simulated to identify the most suitable Nusselt correlation(s).

  6. Review and proposal for heat transfer predictions at supercritical water conditions using existing correlations and experiments

    International Nuclear Information System (INIS)

    Jaeger, Wadim; Sanchez Espinoza, Victor Hugo; Hurtado, Antonio

    2011-01-01

    Highlights: → Implementation of heat transfer correlations for supercritical water into TRACE. → Simulation of several heat transfer experiments with modified TRACE version. → Most correlations are not able to reproduce the experimental results. → Bishop, Sandberg and Tong correlation is most suitable for TRACE applications. - Abstract: This paper summarizes the activities of the TRACE code validation at the Institute for Neutron Physics and Reactor Technology related to supercritical water conditions. In particular, the providing of the thermo physical properties and its appropriate use in the wall-to-fluid heat transfer models in the frame of the TRACE code is the object of this investigation. In a first step, the thermo physical properties of the original TRACE code were modified in order to account for supercritical conditions. In a second step, existing Nusselt correlations were reviewed and implemented into TRACE and available experiments were simulated to identify the most suitable Nusselt correlation(s).

  7. Life cycle management, design review, and condition assessment of feedwater heaters

    Energy Technology Data Exchange (ETDEWEB)

    Gammage, D.; Idvorian, N. [Babcock & Wilcox Canada Ltd., Cambridge, Ontario (Canada)

    2012-07-01

    OPEX from both the Nuclear and Fossil Power Generation Industries shows that Feedwater Heaters (FWHs) are subject to several degradation mechanisms and that this degradation commonly leads to replacement of these vessels in order to ensure reliable, efficient operation of the plants. Loss of feedwater heating will impact plant thermal performance. In response to inspection results showing on-going degradation as well as other factors, B&W Canada completed a project in conjunction with a US PWR utility to review the design, condition, and Life Cycle Management of their FWHs. This project involved a multi-disciplinary approach in order to consider all aspects of the FWHs in order to provide insight into the Life Cycle Management Plan (LCMP) so that the FWHs can be operated reliably into the future and so that adequate inspections can be conducted in order to produce a detailed condition assessment. The utility was interested in evaluating their FWH LCMP to determine if it was adequate in its requirements to enable reliable, leak-free operation of their FWH equipment. As inputs to this evaluation, it was required that B&W Canada evaluate both confirmed and plausible degradation mechanisms. They also required that the thermal hydraulic and functional design be evaluated for their particular FWHs. It was important to also incorporate industry OPEX in order to provide proper trending information for tube plugging. Out of this evaluation there were several findings and recommendations that could be used to update the utilities’ LCMP as it was apparent that the current version may not be truly reflective of the current condition of the equipment or of current industry OPEX of such FWHs. Several recommendations came from this evaluation, the most significant were: • Performing thermal/hydraulic, FIV (flow-induced vibration), and tube/shell interaction calculations to determine how the FWHs operate and how their performance can change over time as a function of tube

  8. Life cycle management, design review, and condition assessment of feedwater heaters

    International Nuclear Information System (INIS)

    Gammage, D.; Idvorian, N.

    2012-01-01

    OPEX from both the Nuclear and Fossil Power Generation Industries shows that Feedwater Heaters (FWHs) are subject to several degradation mechanisms and that this degradation commonly leads to replacement of these vessels in order to ensure reliable, efficient operation of the plants. Loss of feedwater heating will impact plant thermal performance. In response to inspection results showing on-going degradation as well as other factors, B&W Canada completed a project in conjunction with a US PWR utility to review the design, condition, and Life Cycle Management of their FWHs. This project involved a multi-disciplinary approach in order to consider all aspects of the FWHs in order to provide insight into the Life Cycle Management Plan (LCMP) so that the FWHs can be operated reliably into the future and so that adequate inspections can be conducted in order to produce a detailed condition assessment. The utility was interested in evaluating their FWH LCMP to determine if it was adequate in its requirements to enable reliable, leak-free operation of their FWH equipment. As inputs to this evaluation, it was required that B&W Canada evaluate both confirmed and plausible degradation mechanisms. They also required that the thermal hydraulic and functional design be evaluated for their particular FWHs. It was important to also incorporate industry OPEX in order to provide proper trending information for tube plugging. Out of this evaluation there were several findings and recommendations that could be used to update the utilities’ LCMP as it was apparent that the current version may not be truly reflective of the current condition of the equipment or of current industry OPEX of such FWHs. Several recommendations came from this evaluation, the most significant were: • Performing thermal/hydraulic, FIV (flow-induced vibration), and tube/shell interaction calculations to determine how the FWHs operate and how their performance can change over time as a function of tube

  9. Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review.

    Science.gov (United States)

    Toivonen, Kirsti I; Zernicke, Kristin; Carlson, Linda E

    2017-08-31

    Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date. The objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility). Databases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes. Of 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables. Preliminary evidence suggests

  10. Achieving better energy-efficient air conditioning – A review of technologies and strategies

    International Nuclear Information System (INIS)

    Chua, K.J.; Chou, S.K.; Yang, W.M.; Yan, J.

    2013-01-01

    Air conditioning is essential for maintaining thermal comfort in indoor environments, particularly for hot and humid climates. Today, air conditioning, comprising cooling and dehumidification, has become a necessity in commercial and residential buildings and industrial processes. It accounts for a major share of the energy consumption of a building or facility. In tropical climates, the energy consumed by heating, ventilation and air-conditioning (HVAC) can exceed 50% of the total energy consumption of a building. This significant figure is primarily due to the heavy duty placed on cooling technologies to remove both sensible and latent heat loads. Therefore, there is tremendous potential to improve the overall efficiency of the air-conditioning systems in buildings. Based on today’s practical technology for cooling, the major components of a chiller plant are (1) compressors, (2) cooling towers, (3) pumps (chilled and cooling water) and (4) fans in air handling units. They all consume mainly electricity to operate. When specifying the kW/R ton of a plant, there are two levels of monitoring cooling efficiency: (1) at the efficiency of the chiller machines or the compressors which consume a major amount of electricity; and (2) at the overall efficiency of cooling plants which include the cooling towers, pumps for moving coolant (chilled and cooling water) to all air-handling units. Pragmatically, a holistic approach is necessary towards achieving a low energy input per cooling achieved such as 0.6 kW/R ton cooling or lower by considering all aspects of the cooling plant. In this paper, we present a review of recent innovative cooling technology and strategies that could potentially lower the kW/R ton of cooling systems – from the existing mean of 0.9 kW/R ton towards 0.6 kW/R ton or lower. The paper, broadly divided into three key sections (see Fig. 2), begins with a review of the recent novel devices that enhances the energy efficiency of cooling systems at

  11. Vibro-acoustic condition monitoring of Internal Combustion Engines: A critical review of existing techniques

    Science.gov (United States)

    Delvecchio, S.; Bonfiglio, P.; Pompoli, F.

    2018-01-01

    This paper deals with the state-of-the-art strategies and techniques based on vibro-acoustic signals that can monitor and diagnose malfunctions in Internal Combustion Engines (ICEs) under both test bench and vehicle operating conditions. Over recent years, several authors have summarized what is known in critical reviews mainly focused on reciprocating machines in general or on specific signal processing techniques: no attempts to deal with IC engine condition monitoring have been made. This paper first gives a brief summary of the generation of sound and vibration in ICEs in order to place further discussion on fault vibro-acoustic diagnosis in context. An overview of the monitoring and diagnostic techniques described in literature using both vibration and acoustic signals is also provided. Different faulty conditions are described which affect combustion, mechanics and the aerodynamics of ICEs. The importance of measuring acoustic signals, as opposed to vibration signals, is due since the former seem to be more suitable for implementation on on-board monitoring systems in view of their non-intrusive behaviour, capability in simultaneously capturing signatures from several mechanical components and because of the possibility of detecting faults affecting airborne transmission paths. In view of the recent needs of the industry to (-) optimize component structural durability adopting long-life cycles, (-) verify the engine final status at the end of the assembly line and (-) reduce the maintenance costs monitoring the ICE life during vehicle operations, monitoring and diagnosing system requests are continuously growing up. The present review can be considered a useful guideline for test engineers in understanding which types of fault can be diagnosed by using vibro-acoustic signals in sufficient time in both test bench and operating conditions and which transducer and signal processing technique (of which the essential background theory is here reported) could be

  12. Use of erythrocyte indicators of health and condition in vertebrate ecophysiology: a review and appraisal.

    Science.gov (United States)

    Johnstone, Christopher P; Lill, Alan; Reina, Richard D

    2017-02-01

    We review evidence for and against the use of erythrocyte indicators of health status and condition, parasite infection level and physiological stress in free-living vertebrates. The use of indicators that are measured directly from the blood, such as haemoglobin concentration, haematocrit and erythrocyte sedimentation rate, and parameters that are calculated from multiple measured metrics, such as mean cell volume, mean cell haemoglobin content or mean cell haemoglobin concentration is evaluated. The evidence for or against the use of any given metric is equivocal when the relevant research is considered in total, although there is sometimes strong support for using a particular metric in a particular taxon. Possibly the usefulness of these metrics is taxon, environment or condition specific. Alternatively, in an uncontrolled environment where multiple factors are influencing a metric, its response to environmental change will sometimes, but not always, be predictable. We suggest that (i) researchers should validate a metricfres utility before use, (ii) multiple metrics should be used to construct an overall erythrocyte profile for an individual or population, (iii) there is a need for researchers to compile reference ranges for free-living species, and (iv) some metrics which are useful under controlled, clinical conditions may not have the same utility or applicability for free-living vertebrates. Erythrocyte metrics provide useful information about health and condition that can be meaningfully interpreted in free-living vertebrates, but their use requires careful forethought about confounding factors. © 2015 Cambridge Philosophical Society.

  13. Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth.

    Science.gov (United States)

    Cheng, Ching-Yu; Li, Qing

    2008-01-01

    Postpartum mothers experience certain physical health conditions that may affect their quality of life, future health, and health of their children. Yet, the physical health of postpartum mothers is relatively neglected in both research and practice. The purpose of this review is to describe the general health status and prevalence of common physical health conditions of postpartum mothers. The review followed standard procedures for integrative literature reviews. Twenty-two articles were reviewed from searches in scientific databases, reference lists, and an up-to-date survey. Three tables were designed to answer review questions. In general, postpartum mothers self-rate their health as good. They experience certain physical conditions such as fatigue/physical exhaustion, sleep-related problems, pain, sex-related concerns, hemorrhoids/constipation, and breast problems. Despite a limited number of studies, the findings provide a glimpse of the presence of a number of physical health conditions experienced by women in the 2 years postpartum. In the articles reviewed, physical health conditions and postpartum period were poorly defined, no standard scales existed, and the administration of surveys varied widely in time. Those disparities prevented systematic comparisons of results and made it difficult to gain a coherent understanding of the physical health conditions of postpartum mothers. More longitudinal research is needed that focuses on the etiology, predictors, and management of the health conditions most prevalent among postpartum mothers. Instruments are needed that target a broader range of physical conditions in respect to type and severity.

  14. Use of telehealth for health care of Indigenous peoples with chronic conditions: a systematic review.

    Science.gov (United States)

    Fraser, Sarah; Mackean, Tamara; Grant, Julian; Hunter, Kate; Towers, Kurt; Ivers, Rebecca

    2017-01-01

    Telehealth may be a cost effective modality in healthcare delivery, but how well used or how appropriate it is for the care of Indigenous peoples is unclear. This review examines the evidence for telehealth in facilitating chronic conditions management with Indigenous peoples. Databases were systematically searched for qualitative or quantitative primary research studies that investigated telehealth use for chronic conditions management with Indigenous peoples worldwide. Evidence of effectiveness was by consumer health outcomes, evidence of acceptability was through consumer and user perception, and health service feasibility was evident by service impact. Data were assessed for quality and data extracted using pre-defined tools. Articles (n=32) examined effectiveness (n=11), critiqued telehealth from the perspectives of the client (n=10) and healthcare professionals (n=8), and examined feasibility (n=12). Studies reported Indigenous people tend to be satisfied with telehealth, but are sceptical about its cultural safety. Evidence for the effectiveness of telehealth from a western biomedical perspective was found. Telehealth is promising; however, a lack of robust studies in this review make tangible conclusions difficult. A better overall understanding of telehealth use with Indigenous peoples, including delivery of culturally competent health care, true consultation and cultural competency of the professionals involved, would be helpful. Telehealth may have the potential to improve health care for Indigenous people, however the modality needs to be culturally competent and the care received must be culturally safe.

  15. Review at Bikini Atoll. Assessing radiological conditions at Bikini Atoll and the prospects for resettlement

    International Nuclear Information System (INIS)

    Stegnar, P.

    1998-01-01

    Some testing during the development of the atomic bomb was done in countries that do not have the infrastructure and expertise for evaluating any associated radiation risks. In such cases, outside expertise is needed to obtain independent advice about the radiological situation caused by residual radioactive material from nuclear testing. The IAEA has been requested by the governments of a number of its Member States to provide assistance in this context. Among the former nuclear test sites which the IAEA has reviewed is the Bikini Atoll of the Marshall Islands. Based on its review, the IAEA Advisory Group determined that no further corroboration of the measurements and assessments of the radiological conditions at Bikini Atoll is necessary. The data that have been collected are of sufficient quality to allow an appropriate evaluation to be performed. The limited IAEA monitoring of the area provided a good quality assurance verification of the previously collected data. It was recommended that Bikini Island should not be permanently resettled under the present radiological conditions. This recommendation was based on the assumption that persons resettling on the island would consume a diet of entirely locally produced food. The radiological data support that if a diet of this type were permitted, it could lead to an annual effective dose of about 15 mSv. This level was judged to require intervention of some type for radiation protection purposes

  16. A systematic review of thrust manipulation for non-surgical shoulder conditions.

    Science.gov (United States)

    Minkalis, Amy L; Vining, Robert D; Long, Cynthia R; Hawk, Cheryl; de Luca, Katie

    2017-01-01

    Although many conservative management options are available for patients with non-surgical shoulder conditions, there is little evidence of their effectiveness. This review investigated one manual therapy approach, thrust manipulation, as a treatment option. A systematic search was conducted of the electronic databases from inception to March 2016: PubMed, PEDro, ICL, CINAHL, and AMED. Two independent reviewers conducted the screening process to determine article eligibility. Inclusion criteria were manuscripts published in peer-reviewed journals with human participants of any age. The intervention included was thrust, or high-velocity low-amplitude, manipulative therapy directed to the shoulder and/or the regions of the cervical or thoracic spine. Studies investigating secondary shoulder pain or lacking diagnostic confirmation procedures were excluded. Methodological quality was assessed using the PEDro scale and the Cochrane risk-of-bias tool. The initial search rendered 5041 articles. After screening titles and abstracts, 36 articles remained for full-text review. Six articles studying subacromial impingement syndrome met inclusion criteria. Four studies were randomized controlled trials (RCTs) and 2 were uncontrolled clinical studies. Five studies included 1 application of a thoracic spine thrust manipulation and 1 applied 8 treatments incorporating a shoulder joint thrust manipulation. Statistically significant improvements in pain scores were reported in all studies. Three of 4 RCTs compared a thrust manipulation to a sham, and statistical significance in pain reduction was found within the groups but not between them. Clinically meaningful changes in pain were inconsistent; 3 studies reported that scores met minimum clinically important difference, 1 reported scores did not, and 2 were unclear. Four studies found statistically significant improvements in disability; however, 2 were RCTs and did not find statistical significance between the active and sham

  17. Heat transfer augmentation in a tube using nanofluids under constant heat flux boundary condition: A review

    International Nuclear Information System (INIS)

    Singh, Vinay; Gupta, Munish

    2016-01-01

    Highlights: • Reviews heat transfer augmentation of nanofluids in a tube with constant heat flux. • Recent advances in hybrid nanofluids are reviewed. • Identifies and compares significant results. • Scope of future research in this area is discussed. - Abstract: In the last few decades, research on nanofluids has increased rapidly. Traditional heat transfer fluids with order of nanometer sized particles (1–100 nm) suspended in them are termed as nanofluids. Nanofluids have been proved as better heat transfer fluids despite of various contradictions in results by different research groups. The aim of this article is to review and summarize the recent experimental and theoretical studies on convective heat transfer in heat exchangers using constant heat flux boundary condition. The use of different types of nanoparticles with different base fluids by different research groups has been presented and compared. Further an overview of experimental results about heat transfer abilities of hybrid nanofluids from available literature sources is also presented. Finally, the challenges and future directions in which research can be further progress are discussed.

  18. A Review of Critical Conditions for the Onset of Nonlinear Fluid Flow in Rock Fractures

    Directory of Open Access Journals (Sweden)

    Liyuan Yu

    2017-01-01

    Full Text Available Selecting appropriate governing equations for fluid flow in fractured rock masses is of special importance for estimating the permeability of rock fracture networks. When the flow velocity is small, the flow is in the linear regime and obeys the cubic law, whereas when the flow velocity is large, the flow is in the nonlinear regime and should be simulated by solving the complex Navier-Stokes equations. The critical conditions such as critical Reynolds number and critical hydraulic gradient are commonly defined in the previous works to quantify the onset of nonlinear fluid flow. This study reviews the simplifications of governing equations from the Navier-Stokes equations, Stokes equation, and Reynold equation to the cubic law and reviews the evolutions of critical Reynolds number and critical hydraulic gradient for fluid flow in rock fractures and fracture networks, considering the influences of shear displacement, normal stress and/or confining pressure, fracture surface roughness, aperture, and number of intersections. This review provides a reference for the engineers and hydrogeologists especially the beginners to thoroughly understand the nonlinear flow regimes/mechanisms within complex fractured rock masses.

  19. A review of health utilities across conditions common in paediatric and adult populations

    Directory of Open Access Journals (Sweden)

    Hopkins Robert B

    2010-01-01

    Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

  20. Review of the Effects of Normal Conditions of Transport on Spent Fuel Integrity in Transportation Casks

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Junggoo; Yoo, Youngik; Lee, Seongki; Lim, Chaejoon [Korea Nuclear Fuel Co., Daejeon (Korea, Republic of)

    2014-10-15

    Spent fuel(SF) storage capacity of each domestic nuclear power plant will reach a saturated state in the near future. Although there are several methods of SF disposal, interim storage is suggested as the most realistic and promising alternative. SF integrity evaluation is a regulatory requirement that is described in Part 71 of Code of Federal Regulations, Title 10 of the U..S. NRC licensing requirement. In this paper, the report is reviewed written by EPRI in US and it is helpful to a development of domestic SF integrity evaluation technology. EPRI report about integrity evaluation method on normal conditions of high burn-up spent fuel transport is reviewed. First, dynamic forces occurred in one-foot side drop are calculated. And deformation patterns and fuel rods responses by dynamic forces calculated from spent fuel and cask model are analyzed. It is shown that the damage of fuel rods is not occurred by the dynamic forces on normal conditions. Assembly distortion is not predicted, by virtue of the facts that the spacer grids do not experience significant permanent deformation. Axial forces, bending moments and pinch forces of fuel rods are calculated and compared with the results under the hypothetical accident conditions. No occurrence of transverse tearing mode that is the most serious damage mode in side drop case is predicted. Till now, in Korea, regulatory requirements related with structural integrity of spent fuel are not specified such as 10CFR71. To establish own regulation standards, producing and analyzing sufficient experimental data must be performed preferentially. Based on this, failure analysis and criteria establishment are necessary through modeling and analyzing of spent fuel.

  1. Historical Review of Uncommanded Lateral-Directional Motions at Transonic Conditions

    Science.gov (United States)

    Chambers, Joseph R.; Hall, Robert M.

    2003-01-01

    This paper presents the results of a survey of past experiences with uncommanded lateral-directional motions at transonic speeds during specific military aircraft programs. The effort was undertaken to provide qualitative and quantitative information on past airplane programs that might be of use to the participants in the joint NASA/Navy/Air Force Abrupt Wing Stall (AWS) Program. The AWS Program was initiated because of the experiences of the F/A-l8E/F development program, during which unexpected, severe wing-drop motions were encountered by preproduction aircraft at transonic conditions. These motions were judged to be significantly degrading to the primary mission requirements of the aircraft. Although the problem was subsequently solved for the production version of the F/A-l8E/F, a high-level review panel emphasized the poor understanding of such phenomena and issued a strong recommendation to: "Initiate a national research effort to thoroughly and systematically study the wing drop phenomena." A comprehensive, cooperative NASA/Navy/Air Force AWS Program was designed to respond to provide the required technology requirements. As part of the AWS Program, a work element was directed at a historical review of wing-drop experiences in past aircraft development programs at high subsonic and transonic speeds. In particular, information was requested regarding: specific aircraft configurations that exhibited uncommanded motions and the nature of the motions; geometric characteristics of the air- planes; flight conditions involved in occurrences; relevant data, including wind-tunnel, computational, and flight sources; figures of merit used for analyses; and approaches used to alleviate the problem. An attempt was also made to summarize some of the more important lessons learned from past experiences, and to recommend specific research efforts. In addition to providing technical information to assist the AWS research objectives, the study produced fundamental

  2. Historical Review of Uncommanded Lateral-Directional Motions At Transonic Conditions (Invited)

    Science.gov (United States)

    Chambers, Joseph R.; Hall, Robert M.

    2003-01-01

    This paper presents the results of a survey of past experiences with uncommanded lateral-directional motions at transonic speeds during specific military aircraft programs. The effort was undertaken to provide qualitative and quantitative information on past airplane programs that might be of use to the participants in the joint NASA/Navy/Air Force Abrupt Wing Stall (AWS) Program. The AWS Program was initiated because of the experiences of the F/A-18E/F development program, during which unexpected, severe wing-drop motions were encountered by preproduction aircraft at transonic conditions. These motions were judged to be significantly degrading to the primary mission requirements of the aircraft. Although the problem was subsequently solved for the production version of the F/A-l8E/F, a high-level review panel emphasized the poor understanding of such phenomena and issued a strong recommendation to: Initiate a national research effort to thoroughly and systematically study the wing drop phenomena. A comprehensive, cooperative NASA/Navy/Air Force AWS Program was designed to respond to provide the required technology requirements. As part of the AWS Program, a work element was directed at a historical review of wing-drop experiences in past aircraft development programs at high subsonic and transonic speeds. In particular, information was requested regarding: specific aircraft configurations that exhibited uncommanded motions and the nature of the motions; geometric characteristics of the air- planes; flight conditions involved in occurrences; relevant data, including wind-tunnel, computational, and flight sources; figures of merit used for analyses; and approaches used to alleviate the problem. An attempt was also made to summarize some of the more important lessons learned from past experiences, and to recommend specific research efforts. In addition to providing technical information to assist the AWS research objectives, the study produced fundamental information

  3. Fuel performance under normal PWR conditions: A review of relevant experimental results and models

    Science.gov (United States)

    Charles, M.; Lemaignan, C.

    1992-06-01

    Experiments conducted at Grenoble (CEA/DRN) over the past 20 years in the field of nuclear fuel behaviour are reviewed. Of particular concern is the need to achieve a comprehensive understanding of and subsequently overcome the limitations associated with high burnup and load-following conditions (pellet-cladding interaction (PCI), fission gas release (FGR), water-side corrosion). A general view is given of the organization of research work as well as some experimental details (irradiation, postirradiation examination — PIE). Based on various experimental programmes (Cyrano, Medicis, Anemone, Furet, Tango, Contact, Cansar, Hatac, Flog, Decor), the main contributions of the thermomechanical behaviour of a PWR fuel rod are described: thermal conductivity, in-pile densification, swelling, fission gas release in steady state and moderate transient conditions, gap thermal conductance, formation of primary and secondary ridges under PCI conditions. Specific programmes (Gdgrif, Thermox, Grimox) are devoted to the behaviour of particular fuels (gadolinia-bearing fuel, MOX fuel). Moreover, microstructure-based studies have been undertaken on fission gas release (fine analysis of the bubble population inside irradiated fuel samples), and on cladding behaviour (PCI related studies on stress-corrosion cracking (SCO, irradiation effects on zircaloy microstructure).

  4. Clostridium Bacteria and Autism Spectrum Conditions: A Systematic Review and Hypothetical Contribution of Environmental Glyphosate Levels

    Directory of Open Access Journals (Sweden)

    Isadora Argou-Cardozo

    2018-04-01

    Full Text Available Nowadays, there seems to be a consensus about the multifactorial nature of autism spectrum disorders (ASD. The literature provides hypotheses dealing with numerous environmental factors and genes accounting for the apparently higher prevalence of this condition. Researchers have shown evidence regarding the impact of gut bacteria on neurological outcomes, altering behavior and potentially affecting the onset and/or severity of psychiatric disorders. Pesticides and agrotoxics are also included among this long list of ASD-related environmental stressors. Of note, ingestion of glyphosate (GLY, a broad-spectrum systemic herbicide, can reduce beneficial bacteria in the gastrointestinal tract microbiota without exerting any effects on the Clostridium population, which is highly resistant to this herbicide. In the present study, (i we performed a systematic review to evaluate the relationship between Clostridium bacteria and the probability of developing and/or aggravating autism among children. For that purpose, electronic searches were performed on Medline/PubMed and Scielo databases for identification of relevant studies published in English up to December 2017. Two independent researches selected the studies and analyzed the data. The results of the present systematic review demonstrate an interrelation between Clostridium bacteria colonization of the intestinal tract and autism. Finally, (ii we also hypothesize about how environmental GLY levels may deleteriously influence the gut–brain axis by boosting the growth of Clostridium bacteria in autistic toddlers.

  5. Patient-level costs of major cardiovascular conditions: a review of the international literature.

    Science.gov (United States)

    Nicholson, Gina; Gandra, Shravanthi R; Halbert, Ronald J; Richhariya, Akshara; Nordyke, Robert J

    2016-01-01

    Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events. MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values. Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union. This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.

  6. The Impact of Different Environmental Conditions on Cognitive Function: A Focused Review

    Science.gov (United States)

    Taylor, Lee; Watkins, Samuel L.; Marshall, Hannah; Dascombe, Ben J.; Foster, Josh

    2016-01-01

    Cognitive function defines performance in objective tasks that require conscious mental effort. Extreme environments, namely heat, hypoxia, and cold can all alter human cognitive function due to a variety of psychological and/or biological processes. The aims of this Focused Review were to discuss; (1) the current state of knowledge on the effects of heat, hypoxic and cold stress on cognitive function, (2) the potential mechanisms underpinning these alterations, and (3) plausible interventions that may maintain cognitive function upon exposure to each of these environmental stressors. The available evidence suggests that the effects of heat, hypoxia, and cold stress on cognitive function are both task and severity dependent. Complex tasks are particularly vulnerable to extreme heat stress, whereas both simple and complex task performance appear to be vulnerable at even at moderate altitudes. Cold stress also appears to negatively impact both simple and complex task performance, however, the research in this area is sparse in comparison to heat and hypoxia. In summary, this focused review provides updated knowledge regarding the effects of extreme environmental stressors on cognitive function and their biological underpinnings. Tyrosine supplementation may help individuals maintain cognitive function in very hot, hypoxic, and/or cold conditions. However, more research is needed to clarify these and other postulated interventions. PMID:26779029

  7. A Review on the Assessment of Stress conditions for Simultaneous Production of Microalgal Lipids and Carotenoids

    Directory of Open Access Journals (Sweden)

    Amritpreet kaur Minhas

    2016-05-01

    Full Text Available Microalgal species are potential resource of both biofuels and high-value metabolites, and their production is growth dependent. Growth parameters can be screened for the selection of novel microalgal species that produce molecules of interest. In this context our review confirms that, autotrophic and heterotrophic organisms have demonstrated a dual potential, namely the ability to produce lipids as well as value-added products (particularly carotenoids under influence of various physico-chemical stresses on microalgae. Some species of microalgae can synthesize, besides some pigments, very-long-chain polyunsaturated fatty acids (VL-PUFA,>20C such as docosahexaenoic acid and eicosapentaenoic acid, those have significant applications in food and health. Producing value-added by-products in addition to biofuels, fatty acid methyl esters (FAME, and lipids has the potential to improve microalgae-based biorefineries by employing either the autotrophic or the heterotrophic mode, which could be an offshoot of biotechnology. The review considers the potential of microalgae to produce a range of products and indicates future directions for developing suitable criteria for choosing novel isolates through bioprospecting large gene pool of microalga obtained from various habitats and climatic conditions.

  8. A Review on the Assessment of Stress Conditions for Simultaneous Production of Microalgal Lipids and Carotenoids

    Science.gov (United States)

    Minhas, Amritpreet K.; Hodgson, Peter; Barrow, Colin J.; Adholeya, Alok

    2016-01-01

    Microalgal species are potential resource of both biofuels and high-value metabolites, and their production is growth dependent. Growth parameters can be screened for the selection of novel microalgal species that produce molecules of interest. In this context our review confirms that, autotrophic and heterotrophic organisms have demonstrated a dual potential, namely the ability to produce lipids as well as value-added products (particularly carotenoids) under influence of various physico-chemical stresses on microalgae. Some species of microalgae can synthesize, besides some pigments, very-long-chain polyunsaturated fatty acids (VL-PUFA,>20C) such as docosahexaenoic acid and eicosapentaenoic acid, those have significant applications in food and health. Producing value-added by-products in addition to biofuels, fatty acid methyl esters (FAME), and lipids has the potential to improve microalgae-based biorefineries by employing either the autotrophic or the heterotrophic mode, which could be an offshoot of biotechnology. The review considers the potential of microalgae to produce a range of products and indicates future directions for developing suitable criteria for choosing novel isolates through bioprospecting large gene pool of microalga obtained from various habitats and climatic conditions. PMID:27199903

  9. Bullous impetigo and pregnancy: Case report and review of blistering conditions in pregnancy.

    Science.gov (United States)

    Cohen, Philip R

    2016-04-18

     Bullous impetigo results from Staphylococcus aureus (S. aureus) release of exfoliative toxins type A and type B thatresults in flaccid, easily ruptured, bullae in the upper layers of the epidermis.  Physiologic, gestation-associated, and incidental skin changes can occur in pregnancy.  Blisters in pregnant women can occur secondary to either common skin disorders orspecific dermatoses of pregnancy.  To describe a pregnant woman with bullous impetigo and review bullous conditions in pregnant women.  PubMed was used to search the following terms, separately and in combination:  blister, blistering, bullous, gestationis, herpes, herpetiformis, impetigo, pemphigoid, pregnancy, pregnant, psoriasis, pustular, virus. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.  Flaccid, easily rupturing, pustules, which developed into superficial annular erosions with peripheral scale and central healing appeared in a woman of 7-weeks gestation and allergy to penicillin on her lower abdomen, suprapubic region, perineum, buttocks, and proximal legs.  A bacterial culture subsequently isolated methicillin-susceptible S. aureus.  All of the lesions resolved after treatment with clindamycin.  Bullous impetigo should be considered in the differential diagnosis of common skin diseases presenting as blistersin pregnant women.

  10. Clostridium Bacteria and Autism Spectrum Conditions: A Systematic Review and Hypothetical Contribution of Environmental Glyphosate Levels.

    Science.gov (United States)

    Argou-Cardozo, Isadora; Zeidán-Chuliá, Fares

    2018-04-04

    Nowadays, there seems to be a consensus about the multifactorial nature of autism spectrum disorders (ASD). The literature provides hypotheses dealing with numerous environmental factors and genes accounting for the apparently higher prevalence of this condition. Researchers have shown evidence regarding the impact of gut bacteria on neurological outcomes, altering behavior and potentially affecting the onset and/or severity of psychiatric disorders. Pesticides and agrotoxics are also included among this long list of ASD-related environmental stressors. Of note, ingestion of glyphosate (GLY), a broad-spectrum systemic herbicide, can reduce beneficial bacteria in the gastrointestinal tract microbiota without exerting any effects on the Clostridium population, which is highly resistant to this herbicide. In the present study, (i) we performed a systematic review to evaluate the relationship between Clostridium bacteria and the probability of developing and/or aggravating autism among children. For that purpose, electronic searches were performed on Medline/PubMed and Scielo databases for identification of relevant studies published in English up to December 2017. Two independent researches selected the studies and analyzed the data. The results of the present systematic review demonstrate an interrelation between Clostridium bacteria colonization of the intestinal tract and autism. Finally, (ii) we also hypothesize about how environmental GLY levels may deleteriously influence the gut-brain axis by boosting the growth of Clostridium bacteria in autistic toddlers.

  11. Veterinary homeopathy: systematic review of medical conditions studied by randomised trials controlled by other than placebo.

    Science.gov (United States)

    Mathie, Robert T; Clausen, Jürgen

    2015-09-15

    No systematic review has previously been carried out on randomised controlled trials (RCTs) of veterinary homeopathy in which the control group was an intervention other than placebo (OTP). For eligible peer-reviewed RCTs, the objectives of this study were to assess the risk of bias (RoB) and to quantify the effect size of homeopathic intervention compared with an active comparator or with no treatment. Our systematic review approach complied fully with the PRISMA 2009 Checklist. Cochrane methods were applied to assess RoB and to derive effect size using standard meta-analysis methods. Based on a thorough and systematic literature search, the following key attributes of the published research were distinguished: individualised homeopathy (n = 1 RCT)/non-individualised homeopathy (n = 19); treatment (n = 14)/prophylaxis (n = 6); active controls (n = 18)/untreated controls (n = 2). The trials were highly diverse, representing 12 different medical conditions in 6 different species. No trial had sufficiently low RoB to be judged as reliable evidence: 16 of the 20 RCTs had high RoB; the remaining four had uncertain RoB in several domains of assessment. For three trials with uncertain RoB and without overt vested interest, it was inconclusive whether homeopathy combined with conventional intervention was more or was less effective than conventional intervention alone for modulation of immune response in calves, or in the prophylaxis of cattle tick or of diarrhoea in piglets. Due to the poor reliability of their data, OTP-controlled trials do not currently provide useful insight into the effectiveness of homeopathy in animals.

  12. Wind Turbine Condition Monitoring: State-of-the-Art Review, New Trends, and Future Challenges

    Directory of Open Access Journals (Sweden)

    Pierre Tchakoua

    2014-04-01

    Full Text Available As the demand for wind energy continues to grow at exponential rates, reducing operation and maintenance (OM costs and improving reliability have become top priorities in wind turbine (WT maintenance strategies. In addition to the development of more highly evolved WT designs intended to improve availability, the application of reliable and cost-effective condition-monitoring (CM techniques offers an efficient approach to achieve this goal. This paper provides a general review and classification of wind turbine condition monitoring (WTCM methods and techniques with a focus on trends and future challenges. After highlighting the relevant CM, diagnosis, and maintenance analysis, this work outlines the relationship between these concepts and related theories, and examines new trends and future challenges in the WTCM industry. Interesting insights from this research are used to point out strengths and weaknesses in today’s WTCM industry and define research priorities needed for the industry to meet the challenges in wind industry technological evolution and market growth.

  13. Natural healers: a review of animal assisted therapy and activities as complementary treatment for chronic conditions.

    Science.gov (United States)

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

    The primary objective of this review is to synthesize the existing literature on the use of animal-assisted therapy and activity (AAT/A) as complementary treatment among people living with chronic disease and to discuss the possible application of this practice among children living with HIV. Relevant databases were searched between March 10 and April 11, 2011, using the words: animal assisted therapy or treatment and chronic conditions or diseases. Thirty-one articles were found and 18 followed the inclusion and exclusion criteria. Research suggests that AAT/A is effective for different patient profiles, particularly children. Interaction with dogs has been found to increase positive behaviors, such as sensitivity and focus, in children with social disabilities. Decreased levels of pain have also been reported among child patients as a result of AAT/A. More research should be done in the area of children living with chronic diseases that require strict adherence to treatment, such as HIV, and on AAT/A's prospective use as an educational tool to teach children about the importance of self-care for their medical conditions.

  14. Critical review: Copper runoff from outdoor copper surfaces at atmospheric conditions.

    Science.gov (United States)

    Hedberg, Yolanda S; Hedberg, Jonas F; Herting, Gunilla; Goidanich, Sara; Odnevall Wallinder, Inger

    2014-01-01

    This review on copper runoff dispersed from unsheltered naturally patinated copper used for roofing and facades summarizes and discusses influencing factors, available literature, and predictive models, and the importance of fate and speciation for environmental risk assessment. Copper runoff from outdoor surfaces is predominantly governed by electrochemical and chemical reactions and is highly dependent on given exposure conditions (size, inclination, geometry, degree of sheltering, and orientation), surface parameters (age, patina composition, and thickness), and site-specific environmental conditions (gaseous pollutants, chlorides, rainfall characteristics (amount, intensity, pH), wind direction, temperature, time of wetness, season). The corrosion rate cannot be used to assess the runoff rate. The extent of released copper varies largely between different rain events and is related to dry and wet periods, dry deposition prior to the rain event and prevailing rain and patina characteristics. Interpretation and use of copper runoff data for environmental risk assessment and management need therefore to consider site-specific factors and focus on average data of long-term studies (several years). Risk assessments require furthermore that changes in copper speciation, bioavailability aspects, and potential irreversible retention on solid surfaces are considered, factors that determine the environmental fate of copper runoff from outdoor surfaces.

  15. Application of water footprint in a fertirrigated melon crop under semiarid conditions: A review.

    Science.gov (United States)

    Castellanos Serrano, María Teresa; Requejo Mariscal, María Isabel; Villena Gordo, Raquel; Cartagena Causapé, María Carmen; Arce Martínez, Augusto; Ribas Elcorobarrutia, Francisco; Jesús Cabello Cabello, María; María Tarquis Alfonso, Ana

    2015-04-01

    In recent times, there has been a major increase in the use of water and fertilizers in order to increase agricultural production, while at the same time there has increased evidence that aquifers are reducing their water level, enriched by nutrient and degraded as a result of pollution. So best management practices are needed for much of cropped, irrigated and fertirrigated land, to avoid contamination of fresh water and groundwater. The concept of "water footprint" (WF) was introduced as an indicator for the total volume of direct and indirect freshwater used, consumed and/or polluted [1]. The WF distinguishes between blue water (volume of surface and groundwater consumed), green water (rain-water consumed), and grey water (volume of freshwater that is required to assimilate the load of pollutants based on existing ambient water quality standards). This study is focused in calculating the crops WF using a real case of study in a fertirrigated melon crop under semiarid conditions which is principally cultivated in the centre of Spain declared vulnerable zone to nitrate pollution by applying the Directive 91/676/CEE. During successive years, a melon crop (Cucumis melo L.) was grown under field conditions applying mineral and organic fertilizers. Different doses of ammonium nitrate were used as well as compost derived from the wine-distillery industry which is relevant in this area. This application help us to review the different concepts in which is based WF. Acknowledgements: This project has been supported by INIA-RTA04-111-C3 and INIA-RTA2010-00110-C03-01. Keywords: Water footprint, nitrogen, fertirrigation, inorganic fertilizers, organic amendments, winery waste, semiarid conditions. [1] Hoekstra, A.Y. 2003. Virtual water trade. Proceedings of the International Expert Meeting on Virtual Water Trade, Delft, The Netherlands, 12-13 December 2002. Value of Water Research Report Series No. 12, UNESCO-IHE, Delft, The Netherlands.

  16. Self-administered foot reflexology for the management of chronic health conditions: a systematic review.

    Science.gov (United States)

    Song, Hyun Jin; Choi, Sun Mi; Seo, Hyun-Ju; Lee, Heeyoung; Son, Heejeong; Lee, Sanghun

    2015-02-01

    To systematically review the effect of self-administered foot reflexology in patients with chronic health conditions. Electronic databases were searched for literature published from 1948 to January 2014. The databases included MEDLINE, EMBASE, the Cochrane Library, CINAHL, CNKI, J-STAGE, Koreamed, Kmbase, KISS, NDSL, KISTI, and OASIS. Key search terms were "exp/relaxation therapy," "foot," "reflexology," "zone therapy," and "self." All study designs were included. Two raters independently extracted data and assessed study quality by using the Cochrane risk of bias tool (for randomized controlled trials) and the risk of bias assessment tool for nonrandomized studies (for nonrandomized and before-and-after studies). A qualitative and descriptive analysis was performed because of the clinical diversity associated with chronic health conditions. Of the 224 records assessed, 4 trials met the inclusion criteria: 3 nonrandomized controlled trials and 1 before-and-after study without comparison. Self-administered foot reflexology might have a positive effect in type 2 diabetes, but the low quality of the included study and the lack of adequately reported clinical outcomes obscure the results. Two studies of hypertensive patients and 1 study of patients with urinary incontinence showed that self-performed foot reflexology may exert a beneficial effect on lowering blood pressure and urinary incontinence; however, given the small sample size and the lack of any description of medications and other cointerventions, there was insufficient evidence to conclusively determine whether foot reflexology had any effect. The included studies on self-administered foot reflexology in patients with type 2 diabetes, hypertension, or urinary incontinence provided insufficient evidence to determine a treatment effect. Therefore, a well-designed, large-scale, and randomized controlled trial is needed to confirm the effect of self-administered foot reflexology for chronic conditions.

  17. Critical review of creep FRAPCON-3 model under dry storage conditions

    Energy Technology Data Exchange (ETDEWEB)

    Feria, F.; Herranz, L.E. [Unit of Nuclear Safety Research, CIEMAT, Avda. Complutense 22, Madrid, Madrid 28040 (Spain)

    2009-06-15

    There is a general agreement that cladding creep rupture is the most likely and limiting failure mechanism of spent fuel in dry storage compared to other potential mechanisms, like stress corrosion cracking and/or delayed hydride cracking. Nevertheless, occurrence of creep rupture is very improbable since both decay heat and hoop stress tend to decrease throughout dry storage. In spite of this, the current trend to higher burn up levels needs further attention that ensures safe storage of spent fuel irradiated over 45 GWd/MTU. An extensive work has been carried out during the last four decades in the area of in-reactor creep modelling. Unfortunately, the in-reactor conditions are so different from those prevailing under dry storage, that all the experience gained cannot be extrapolated in a straightforward manner. On the other side, as creep tests simulating conditions throughout a 20-40 year dry storage are impractical, post-irradiation cladding creep behaviour has been modelled by means of time-temperature dependent laws developed on the basis of currently available zirconium alloys data. Additionally, some tests have been exploring the effect of irradiation, hydrogen distribution and material composition on the materials creep behaviour. Adaptation of fuel performance codes initially developed for normal and off-normal reactor operation is not an easy task either. Creep modelling is usually dependent of host codes because a good part of its validation and update has been carried out in an integral way, and as a consequence its independent performance assessment is not an easy task. This work examines the current capability of FRAPCON-3 to model creep behaviour under dry storage conditions. To do so, a review of its major fundamentals has been done and its range of applicability discussed. Once its main approximations and drawbacks have been identified, an attempt to overcome some of them has been intended by implementing an alternative expression for creep under

  18. Patient-level costs of major cardiovascular conditions: a review of the international literature

    Directory of Open Access Journals (Sweden)

    Nicholson G

    2016-09-01

    Full Text Available Gina Nicholson,1 Shravanthi R Gandra,2 Ronald J Halbert,1 Akshara Richhariya,2 Robert J Nordyke1 1ICON, El Segundo, 2Amgen Inc., Thousand Oaks, CA, USA Objective: Robust cost estimates of cardiovascular (CV events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events.Methods: MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest – unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values.Results: Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union.Conclusion: This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed. Keywords: cardiovascular diseases, health care costs, hospitalization economics, follow-up studies

  19. Obesity and gynaecological and obstetric conditions: umbrella review of the literature.

    Science.gov (United States)

    Kalliala, Ilkka; Markozannes, Georgios; Gunter, Marc J; Paraskevaidis, Evangelos; Gabra, Hani; Mitra, Anita; Terzidou, Vasso; Bennett, Phillip; Martin-Hirsch, Pierre; Tsilidis, Konstantinos K; Kyrgiou, Maria

    2017-10-26

    Objective  To study the strength and validity of associations between adiposity and risk of any type of obstetric or gynaecological conditions. Design  An umbrella review of meta-analyses. Data sources  PubMed, Cochrane database of systematic reviews, manual screening of references for systematic reviews or meta-analyses of observational and interventional studies evaluating the association between adiposity and risk of any obstetrical or gynaecological outcome. Main outcomes  Meta-analyses of cohort studies on associations between indices of adiposity and obstetric and gynaecological outcomes. Data synthesis  Evidence from observational studies was graded into strong, highly suggestive, suggestive, or weak based on the significance of the random effects summary estimate and the largest study in the included meta-analysis, the number of cases, heterogeneity between studies, 95% prediction intervals, small study effects, excess significance bias, and sensitivity analysis with credibility ceilings. Interventional meta-analyses were assessed separately. Results  156 meta-analyses of observational studies were included, investigating associations between adiposity and risk of 84 obstetric or gynaecological outcomes. Of the 144 meta-analyses that included cohort studies, only 11 (8%) had strong evidence for eight outcomes: adiposity was associated with a higher risk of endometrial cancer, ovarian cancer, antenatal depression, total and emergency caesarean section, pre-eclampsia, fetal macrosomia, and low Apgar score. The summary effect estimates ranged from 1.21 (95% confidence interval 1.13 to 1.29) for an association between a 0.1 unit increase in waist to hip ratio and risk endometrial cancer up to 4.14 (3.61 to 4.75) for risk of pre-eclampsia for BMI >35 compared with <25. Only three out of these eight outcomes were also assessed in meta-analyses of trials evaluating weight loss interventions. These interventions significantly reduced the risk of caesarean

  20. Effect size and statistical power in the rodent fear conditioning literature - A systematic review.

    Science.gov (United States)

    Carneiro, Clarissa F D; Moulin, Thiago C; Macleod, Malcolm R; Amaral, Olavo B

    2018-01-01

    Proposals to increase research reproducibility frequently call for focusing on effect sizes instead of p values, as well as for increasing the statistical power of experiments. However, it is unclear to what extent these two concepts are indeed taken into account in basic biomedical science. To study this in a real-case scenario, we performed a systematic review of effect sizes and statistical power in studies on learning of rodent fear conditioning, a widely used behavioral task to evaluate memory. Our search criteria yielded 410 experiments comparing control and treated groups in 122 articles. Interventions had a mean effect size of 29.5%, and amnesia caused by memory-impairing interventions was nearly always partial. Mean statistical power to detect the average effect size observed in well-powered experiments with significant differences (37.2%) was 65%, and was lower among studies with non-significant results. Only one article reported a sample size calculation, and our estimated sample size to achieve 80% power considering typical effect sizes and variances (15 animals per group) was reached in only 12.2% of experiments. Actual effect sizes correlated with effect size inferences made by readers on the basis of textual descriptions of results only when findings were non-significant, and neither effect size nor power correlated with study quality indicators, number of citations or impact factor of the publishing journal. In summary, effect sizes and statistical power have a wide distribution in the rodent fear conditioning literature, but do not seem to have a large influence on how results are described or cited. Failure to take these concepts into consideration might limit attempts to improve reproducibility in this field of science.

  1. Effect size and statistical power in the rodent fear conditioning literature – A systematic review

    Science.gov (United States)

    Macleod, Malcolm R.

    2018-01-01

    Proposals to increase research reproducibility frequently call for focusing on effect sizes instead of p values, as well as for increasing the statistical power of experiments. However, it is unclear to what extent these two concepts are indeed taken into account in basic biomedical science. To study this in a real-case scenario, we performed a systematic review of effect sizes and statistical power in studies on learning of rodent fear conditioning, a widely used behavioral task to evaluate memory. Our search criteria yielded 410 experiments comparing control and treated groups in 122 articles. Interventions had a mean effect size of 29.5%, and amnesia caused by memory-impairing interventions was nearly always partial. Mean statistical power to detect the average effect size observed in well-powered experiments with significant differences (37.2%) was 65%, and was lower among studies with non-significant results. Only one article reported a sample size calculation, and our estimated sample size to achieve 80% power considering typical effect sizes and variances (15 animals per group) was reached in only 12.2% of experiments. Actual effect sizes correlated with effect size inferences made by readers on the basis of textual descriptions of results only when findings were non-significant, and neither effect size nor power correlated with study quality indicators, number of citations or impact factor of the publishing journal. In summary, effect sizes and statistical power have a wide distribution in the rodent fear conditioning literature, but do not seem to have a large influence on how results are described or cited. Failure to take these concepts into consideration might limit attempts to improve reproducibility in this field of science. PMID:29698451

  2. Factors that condition the spontaneous reporting of adverse drug reactions among nurses: an integrative review.

    Science.gov (United States)

    De Angelis, Alessia; Colaceci, Sofia; Giusti, Angela; Vellone, Ercole; Alvaro, Rosaria

    2016-03-01

    To describe and synthesise previous research on factors conditioning the spontaneous reporting of adverse drug reactions among nurses. Spontaneous reports of adverse drug reactions by health-care providers, are a main instrument for the continuous evaluation of the risk-benefit ratio of every drug. Under-reporting of adverse drug reactions by all health-care providers, in particular by nurses, is a major limitation to this system. An integrated review of the literature was conducted using MEDLINE, CINAHL, Embase, Scopus databases and Google Scholar. After evaluation for appropriateness related to inclusion/exclusion criteria, 16 studies were included in the final analysis and synthesis. Two factors emerged from the study: (1) intrinsic factors related to nurses' knowledge and attitudes; (2) extrinsic factors related to nurses' interaction with health-care organisations and to the relationship between nurses and physicians. Nurses' attitudes that hinder reporting include ignorance, insecurity, fear and lethargy. Nurses are not fully aware of their role in adverse drug reaction reporting. Nurses must acquire greater knowledge to implement specific skills into their daily clinical practice. To improve nurses' reporting of adverse drug reactions, it is necessary to develop management approaches that modify both intrinsic and extrinsic factors. © 2015 John Wiley & Sons Ltd.

  3. Review on plasmas in extraordinary media: plasmas in cryogenic conditions and plasmas in supercritical fluids

    Science.gov (United States)

    Stauss, Sven; Muneoka, Hitoshi; Terashima, Kazuo

    2018-02-01

    Plasma science and technology has enabled advances in very diverse fields: micro- and nanotechnology, chemical synthesis, materials fabrication and, more recently, biotechnology and medicine. While many of the currently employed plasma tools and technologies are very advanced, the types of plasmas used in micro- and nanofabrication pose certain limits, for example, in treating heat-sensitive materials in plasma biotechnology and plasma medicine. Moreover, many physical properties of plasmas encountered in nature, and especially outer space, i.e. very-low-temperature plasmas or plasmas that occur in high-density media, are not very well understood. The present review gives a short account of laboratory plasmas generated under ’extreme’ conditions: at cryogenic temperatures and in supercritical fluids. The fundamental characteristics of these cryogenic plasmas and cryoplasmas, and plasmas in supercritical fluids, especially supercritical fluid plasmas, are presented with their main applications. The research on such exotic plasmas is expected to lead to further understanding of plasma physics and, at the same time, enable new applications in various technological fields.

  4. Corrosion of titanium and titanium alloys in spent fuel repository conditions - literature review

    International Nuclear Information System (INIS)

    Aho-Mantila, I.; Haenninen, H.; Aaltonen, P.; Taehtinen, S.

    1985-03-01

    The spent nuclear fuel is planned to be disposed in Finnish bedrock. The canister of spent fuel in waste repository is one barrier to the release of radionuclides. It is possible to choose a canister material with a known, measurable corrosion rate and to make it with thickness allowing corrosion to occur. The other possibility is to use a material which is nearly immune to general corrosion. In this second category there are titanium and titanium alloys which exhibit a very high degree of resistance to general corrosion. In this literature study the corrosion properties of unalloyed titanium, titanium alloyed with palladium and titanium alloyed with molybdenum and nickel are reviewed. The two titanium alloys own in addition to the excellent general corrosion properties outstanding properties against localized corrosion like pitting or crevice corrosion. Stress corrosion cracking and corrosion fatique of titanium seem not to be a problem in the repository conditions, but the possibilities of delayed cracking caused by hydrogen should be carefully appreciated. (author)

  5. Radon dosimetry: a review of radon and radon daughter exposure conditions in dwellings and other structures

    International Nuclear Information System (INIS)

    Ryan, M.T.; Goldsmith, W.A.; Poston, J.W.; Haywood, F.F.; Witherspoon, J.P.

    1983-07-01

    Within the past few years several situations have been brought to light which indicate an increased radiation exposure of certain segments of the general population caused by human activities. The most widely publicized activities are those associated with the mining and milling of uranium in the western United States, the phosphate industry in Florida, and those potential problems represented by former Manhattan Engineer District sites. One of the primary problems involves exposure to radon and radon daughters which are released from large waste piles or, in some cases, evolve from backfill and construction materials used in homes, schools, and other buildings. This report presents a review of the available data on radon and radon daughter concentrations in dwellings and other structures. The primary objectives were to compile and tabulate pertinent radon exposure data and to prepare a statistical summary of the data which will be useful in the prediction of normal levels of radon and radon daughter concentrations in these structures. In addition, other parameters associated with radon exposure conditions are presented and discussed

  6. Halitosis: a review of the etiologic factors and association with systemic conditions and its management.

    Science.gov (United States)

    Mokeem, Sameer A

    2014-11-01

    Halitosis is a general term defined as an unpleasant or offensive odor emanating from the breath, arising from either oral or nonoral sources. Extraoral factors, such as ear-nose-throat conditions or gastrointestinal, respiratory, and systemic diseases, may also contribute to oral malodor. Although, halitosis has a multifactorial etiology, local factors play an important role in the majority of cases. Halitosis may lead to significant personal discomfort and social embarrassment. Assessment of halitosis can be performed using organoleptic measurements, sulfide monitoring, gas chromatography, microbial testing and chemical test strips. Management approaches are based on masking oral malodor, reducing the levels of volatile organic compounds (VOCs) and volatile sulfur compounds (VSCs), and mechanical and/or chemical treatment. This review aims to identify the etiology of oral halitosis, describe the methods available for assessment and differential diagnosis and introduce a variety of management strategies. The importance of a multidisciplinary approach for the improvement of overall health and for the management and prevention of halitosis is highlighted.

  7. Web Use for Symptom Appraisal of Physical Health Conditions: A Systematic Review.

    Science.gov (United States)

    Mueller, Julia; Jay, Caroline; Harper, Simon; Davies, Alan; Vega, Julio; Todd, Chris

    2017-06-13

    The Web has become an important information source for appraising symptoms. We need to understand the role it currently plays in help seeking and symptom evaluation to leverage its potential to support health care delivery. The aim was to systematically review the literature currently available on Web use for symptom appraisal. We searched PubMed, EMBASE, PsycINFO, ACM Digital Library, SCOPUS, and Web of Science for any empirical studies that addressed the use of the Web by lay people to evaluate symptoms for physical conditions. Articles were excluded if they did not meet minimum quality criteria. Study findings were synthesized using a thematic approach. A total of 32 studies were included. Study designs included cross-sectional surveys, qualitative studies, experimental studies, and studies involving website/search engine usage data. Approximately 35% of adults engage in Web use for symptom appraisal, but this proportion varies between 23% and 75% depending on sociodemographic and disease-related factors. Most searches were symptom-based rather than condition-based. Users viewed only the top search results and interacted more with results that mentioned serious conditions. Web use for symptom appraisal appears to impact on the decision to present to health services, communication with health professionals, and anxiety. Web use for symptom appraisal has the potential to influence the timing of help seeking for symptoms and the communication between patients and health care professionals during consultations. However, studies lack suitable comparison groups as well as follow-up of participants over time to determine whether Web use results in health care utilization and diagnosis. Future research should involve longitudinal follow-up so that we can weigh the benefits of Web use for symptom appraisal (eg, reductions in delays to diagnosis) against the disadvantages (eg, unnecessary anxiety and health care use) and relate these to health care costs. ©Julia Mueller

  8. Condition monitoring using empirical models: technical review and prospects for nuclear applications

    International Nuclear Information System (INIS)

    Heo, Gyun Young

    2008-01-01

    The purpose of this paper is to extensively review the Condition Monitoring (CM) techniques using empirical models in an effort to reduce or eliminate unexpected downtimes in general industry, and to illustrate the feasibility of applying them to the nuclear industry. CM provides on-time warnings of system states to enable the optimal scheduling of maintenance and, ultimately, plant uptime is maximized. Currently, most maintenance processes tend to be either reactive, or part of scheduled, or preventive maintenance. Such maintenance is being increasingly reported as a poor practice for two reasons: first, the component does not necessarily require maintenance, thus the maintenance cost is wasted, and secondly, failure catalysts are introduced into properly working components, which is worse. This paper first summarizes the technical aspects of CM including state estimation and state monitoring. The mathematical background of CM is mature enough even for commercial use in the nuclear industry. Considering the current computational capabilities of CM, its application is not limited by technical difficulties, but by a lack of desire on the part of industry to implement it. For practical applications in the nuclear industry, it may be more important to clarify and quantify the negative impact of unexpected outcomes or failures in CM than it is to investigate its advantages. In other words, while issues regarding accuracy have been targeted to date, the concerns regarding robustness should now be concentrated on. Standardizing the anticipated failures and the possibly harsh operating conditions, and then evaluating the impact of the proposed CM under those conditions may be necessary. In order to make the CM techniques practical for the nuclear industry in the future, it is recommended that a prototype CM system be applied to a secondary system in which most of the components are non-safety grade. Recently, many activities to enhance the safety and efficiency of the

  9. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies.

    Science.gov (United States)

    Dereka, X; Calciolari, E; Donos, N; Mardas, N

    2018-05-30

    Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed

  10. Review of the expected behaviour of alpha titanium alloys under Yucca Mountain conditions

    International Nuclear Information System (INIS)

    Shoesmith, D.W.

    2000-03-01

    The use of titanium alloys in two different waste package designs has been reviewed under the, conditions anticipated in the Yucca Mountain nuclear waste repository. In the first design. they are considered as one of three barrier materials incorporated into the waste package design and potentially in galvanic contact with the other two waste package materials, 316L stainless steel and Alloy-22. In the second design the Ti alloy is considered as a drip shield placed over, and not in contact with, a dual wall waste package fabricated from the other two materials. The possible failure processes, crevice corrosion, pitting and hydrogen-induced cracking (HIC) have been reviewed for the candidate titanium alloys (Ti-12, Ti-16 and Ti-7). Both pitting and crevice corrosion are very remote possibilities under these conditions. For Ti-12, a limited amount of crevice corrosion is possible but repassivation will occur before substantial damage is sustained. When Ti is considered as part of the triple wall waste package, hydrogen absorption leading to HIC, within an acidified but passive crevice, is the most likely failure mechanism. When the Ti alloy is utilized in the form of a drip shield then hydrogen absorption under potentially alkaline conditions is the major fear. Both Ti-12 and Ti-16 have been shown capable of tolerating substantial amounts of hydrogen (∼400 μ g·g -1 for Ti-12, and > 1000 μg.g -1 for Ti-16) before any effect on the materials fracture toughness is observed. The rate of absorption to a hydrogen content which exceeds these values will be the key feature determining if, or when, the material becomes susceptible to cracking. Once this condition is achieved, whether or not failure occurs will depend on the strength and location of stresses within the structure. For Ti to absorb hydrogen it is inevitably necessary to subject the material to cathodic polarization, either by coupling to a more active material or by the application of galvanic protection

  11. Review of the expected behaviour of alpha titanium alloys under Yucca Mountain conditions

    Energy Technology Data Exchange (ETDEWEB)

    Shoesmith, D.W

    2000-03-01

    The use of titanium alloys in two different waste package designs has been reviewed under the, conditions anticipated in the Yucca Mountain nuclear waste repository. In the first design. they are considered as one of three barrier materials incorporated into the waste package design and potentially in galvanic contact with the other two waste package materials, 316L stainless steel and Alloy-22. In the second design the Ti alloy is considered as a drip shield placed over, and not in contact with, a dual wall waste package fabricated from the other two materials. The possible failure processes, crevice corrosion, pitting and hydrogen-induced cracking (HIC) have been reviewed for the candidate titanium alloys (Ti-12, Ti-16 and Ti-7). Both pitting and crevice corrosion are very remote possibilities under these conditions. For Ti-12, a limited amount of crevice corrosion is possible but repassivation will occur before substantial damage is sustained. When Ti is considered as part of the triple wall waste package, hydrogen absorption leading to HIC, within an acidified but passive crevice, is the most likely failure mechanism. When the Ti alloy is utilized in the form of a drip shield then hydrogen absorption under potentially alkaline conditions is the major fear. Both Ti-12 and Ti-16 have been shown capable of tolerating substantial amounts of hydrogen ({approx}400 {mu} g{center_dot}g{sup -1} for Ti-12, and > 1000 {mu}g.g{sup -1} for Ti-16) before any effect on the materials fracture toughness is observed. The rate of absorption to a hydrogen content which exceeds these values will be the key feature determining if, or when, the material becomes susceptible to cracking. Once this condition is achieved, whether or not failure occurs will depend on the strength and location of stresses within the structure. For Ti to absorb hydrogen it is inevitably necessary to subject the material to cathodic polarization, either by coupling to a more active material or by the

  12. Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Kong, Ling Jun; Lauche, Romy; Klose, Petra; Bu, Jiang Hui; Yang, Xiao Cun; Guo, Chao Qing; Dobos, Gustav; Cheng, Ying Wu

    2016-04-29

    Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], -0.54; 95% confidence intervals [CI], -0.77 to -0.30; P chronic pain from low back pain (SMD, -0.81; 95% CI, -1.11 to -0.52; P complementary and alternative medicine for chronic pain conditions.

  13. Fermentation conditions that affect clavulanic acid production in Streptomyces clavuligerus: a systematic review

    Directory of Open Access Journals (Sweden)

    Hooi-Leng eSer

    2016-04-01

    Full Text Available The β-lactamase inhibitor, clavulanic acid is frequently used in combination with β-lactam antibiotics to treat a wide spectrum of infectious diseases. Clavulanic acid prevents drug resistance by pathogens against these β-lactam antibiotics by preventing the degradation of the β-lactam ring, thus ensuring eradication of these harmful microorganisms from the host. This systematic review provides an overview on the fermentation conditions that affect the production of clavulanic acid in the firstly described producer, Streptomyces clavuligerus. A thorough search was conducted using predefined terms in several electronic databases (PubMed, Medline, ScienceDirect, EBSCO, from database inception to June 30th 2015. Studies must involve wild-type Streptomyces clavuligerus, and full texts needed to be available. A total of 29 eligible articles were identified. Based on the literature, several factors were identified that could affect the production of clavulanic acid in S. clavuligerus. The addition of glycerol or other vegetable oils (e.g. olive oil, corn oil could potentially affect clavulanic acid production. Furthermore, some amino acids such as arginine and ornithine, could serve as potential precursors to increase clavulanic acid yield. The comparison of different fermentation systems revealed that fed-batch fermentation yields higher amounts of clavulanic acid as compared to batch fermentation, probably due to the maintenance of substrates and constant monitoring of certain entities (such as pH, oxygen availability, etc.. Overall, these findings provide vital knowledge and insight that could assist media optimization and fermentation design for clavulanic acid production in S. clavuligerus.

  14. Determinants for swine mycoplasmal pneumonia reproduction under experimental conditions: A systematic review and recursive partitioning analysis

    Science.gov (United States)

    Garcia-Morante, Beatriz; Segalés, Joaquim; Serrano, Emmanuel

    2017-01-01

    One of the main Mycoplasma hyopneumoniae (M. hyopneumoniae) swine experimental model objectives is to reproduce mycoplasmal pneumonia (MP). Unfortunately, experimental validated protocols to maximize the chance to successfully achieve lung lesions induced by M. hyopneumoniae are not available at the moment. Thus, the objective of this work was to identify those factors that might have a major influence on the effective development of MP, measured as macroscopic lung lesions, under experimental conditions. Data from 85 studies describing M. hyopneumoniae inoculation experiments were compiled by means of a systematic review and analyzed thereafter. Several variables were considered in the analyses such as the number of pigs in the experiment, serological status against M. hyopneumoniae, source of the animals, age at inoculation, type of inoculum, strain of M. hyopneumoniae, route, dose and times of inoculation, study duration and co-infection with other swine pathogens. Descriptive statistics were used to depict M. hyopneumoniae experimental model main characteristics whereas a recursive partitioning approach, using regression trees, assessed the importance of the abovementioned experimental variables as MP triggering factors. A strong link between the time period between challenge and necropsies and lung lesion severity was observed. Results indicated that the most important factors to explain the observed lung lesion score variability were: (1) study duration, (2) M. hyopneumoniae strain, (3) age at inoculation, (4) co-infection with other swine pathogens and (5) animal source. All other studied variables were not relevant to explain the variability on M. hyopneumoniae lung lesions. The results provided in the present work may serve as a basis for debate in the search for a universally accepted M. hyopneumoniae challenge model. PMID:28742802

  15. Determinants for swine mycoplasmal pneumonia reproduction under experimental conditions: A systematic review and recursive partitioning analysis.

    Directory of Open Access Journals (Sweden)

    Beatriz Garcia-Morante

    Full Text Available One of the main Mycoplasma hyopneumoniae (M. hyopneumoniae swine experimental model objectives is to reproduce mycoplasmal pneumonia (MP. Unfortunately, experimental validated protocols to maximize the chance to successfully achieve lung lesions induced by M. hyopneumoniae are not available at the moment. Thus, the objective of this work was to identify those factors that might have a major influence on the effective development of MP, measured as macroscopic lung lesions, under experimental conditions. Data from 85 studies describing M. hyopneumoniae inoculation experiments were compiled by means of a systematic review and analyzed thereafter. Several variables were considered in the analyses such as the number of pigs in the experiment, serological status against M. hyopneumoniae, source of the animals, age at inoculation, type of inoculum, strain of M. hyopneumoniae, route, dose and times of inoculation, study duration and co-infection with other swine pathogens. Descriptive statistics were used to depict M. hyopneumoniae experimental model main characteristics whereas a recursive partitioning approach, using regression trees, assessed the importance of the abovementioned experimental variables as MP triggering factors. A strong link between the time period between challenge and necropsies and lung lesion severity was observed. Results indicated that the most important factors to explain the observed lung lesion score variability were: (1 study duration, (2 M. hyopneumoniae strain, (3 age at inoculation, (4 co-infection with other swine pathogens and (5 animal source. All other studied variables were not relevant to explain the variability on M. hyopneumoniae lung lesions. The results provided in the present work may serve as a basis for debate in the search for a universally accepted M. hyopneumoniae challenge model.

  16. The Facilitators, Obstacles and Needs of Individuals with Autism Spectrum Conditions Accessing Further and Higher Education: A Systematic Review

    Science.gov (United States)

    Toor, Nicky; Hanley, Terry; Hebron, Judith

    2016-01-01

    Many young adults diagnosed with autism spectrum conditions (ASC) intend to go to college and/or university, yet research suggests that these individuals find aspects of college and university life challenging. To explore the views of individuals directly affected by these challenges, a systematic review of the existing qualitative literature in…

  17. Evidence of the efficacy for occupational therapy in different conditions: an overview of systematic reviews.

    NARCIS (Netherlands)

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Leemrijse, C.J.; Ende, C.H.M. van den

    2005-01-01

    OBJECTIVE: To summarize the research evidence available from systematic reviews of the efficacy of occupational therapy (OT) for practitioners, researchers, purchasing organizations and policy-makers. DATA SOURCE: The search for systematic reviews was conducted in PubMed and the Cochrane Library

  18. Does transcutaneous electrical nerve stimulation (TENS have a clinically relevant analgesic effect on different pain conditions? A literature review

    Directory of Open Access Journals (Sweden)

    Asami Naka

    2013-07-01

    Full Text Available Transcutaneous electric nerve stimulation (TENS is a standard therapy used in different painful conditions such as low back pain, diabetic polyneuropathy or arthrosis. However, literature reviews focusing on the effects and the clinical implication of this method in various painful conditions are yet scarce. The purpose of this literature research was to determine, whether TENS provides an analgesic effect on common painful conditions in clinical practice. Literature research was performed using three data bases (Pubmed, Embase, Cochrane Database, focusing on papers published in the space of time from 2007 to 2012. Papers were evaluated from two reviewers independently concerning the clinical outcome, taking account for the level of external evidence according to the German Cochrane levels of evidence (Ia – IV. 133 papers of varying methodological quality dealing with different painful conditions were selected in total. A clinically relevant analgesic effect was described in 90 painful conditions (67%. In 30 painful states (22%, the outcome was inconclusive due to the study design. No significant analgesic effect of TENS was observed in 15 painful conditions (11%. The vast majority of the papers were classified as Cochrane evidence level Ib (n = 64; 48%, followed by level Ia (n = 23; 17%, level III (n = 18; 14%, level IV (n = 15; 11%, level IIb (n = 10; 8% and level IIa (n = 3; 2%. Most of the studies revealed an analgesic effect in various painful conditions, confirming the usefulness of TENS in clinical practice.

  19. Using mobile phones and short message service to deliver self-management interventions for chronic conditions: a meta-review.

    Science.gov (United States)

    Jones, Katherine R; Lekhak, Nirmala; Kaewluang, Napatsawan

    2014-04-01

    The worldwide burden of chronic disease is widespread and growing. This shift from acute to chronic care requires rethinking how resources are invested in managing these conditions. One response has been to create programs and interventions that have the goal of helping patients better manage their own conditions. Over time, these self-management interventions and strategies have increasingly relied on various technologies for their implementation, with the newest technology being mobile phones and short message service (SMS). The objective of this meta-review was to evaluate the current evidence on the use of mobile phones and SMS to deliver self-management interventions for chronic conditions. A meta-review was conducted of the 11 systematic reviews (SRs) that were identified and retrieved after an extensive search of electronic databases covering the years 2000-2012. Relevant information was abstracted from each systematic review and a quality assessment carried out using the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") criteria. The number and types of included studies and total number of subjects varied significantly across the systematic reviews. Mobile phone text messaging was reported to significantly improve adherence to appointments and antiretroviral therapy, short-term smoking quit rates, and selected clinical and behavioral outcomes. AMSTAR scores ranged from 11 to 3, reflecting substantial variation in SR quality. Mobile phones and SMS show promise as a technology to deliver self-management interventions to improve outcomes of chronic care management. However, the quality of future studies and systematic reviews needs to be improved. There also are unresolved issues about the technology itself. © 2014 Sigma Theta Tau International.

  20. A Systematic Review Exploring the Social Cognitive Theory of Self-Regulation as a Framework for Chronic Health Condition Interventions.

    Science.gov (United States)

    Tougas, Michelle E; Hayden, Jill A; McGrath, Patrick J; Huguet, Anna; Rozario, Sharlene

    2015-01-01

    Theory is often recommended as a framework for guiding hypothesized mechanisms of treatment effect. However, there is limited guidance about how to use theory in intervention development. We conducted a systematic review to provide an exemplar review evaluating the extent to which use of theory is identified and incorporated within existing interventions. We searched electronic databases PubMed, PsycINFO, CENTRAL, and EMBASE from inception to May 2014. We searched clinicaltrials.gov for registered protocols, reference lists of relevant systematic reviews and included studies, and conducted a citation search in Web of Science. We included peer-reviewed publications of interventions that referenced the social cognitive theory of self-regulation as a framework for interventions to manage chronic health conditions. Two reviewers independently assessed articles for eligibility. We contacted all authors of included studies for information detailing intervention content. We describe how often theory mechanisms were addressed by interventions, and report intervention characteristics used to address theory. Of 202 articles that reported using the social cognitive theory of self-regulation, 52% failed to incorporate self-monitoring, a main theory component, and were therefore excluded. We included 35 interventions that adequately used the theory framework. Intervention characteristics were often poorly reported in peer-reviewed publications, 21 of 35 interventions incorporated characteristics that addressed each of the main theory components. Each intervention addressed, on average, six of eight self-monitoring mechanisms, two of five self-judgement mechanisms, and one of three self-evaluation mechanisms. The self-monitoring mechanisms 'Feedback' and 'Consistency' were addressed by all interventions, whereas the self-evaluation mechanisms 'Self-incentives' and 'External rewards' were addressed by six and four interventions, respectively. The present review establishes that

  1. Review of Physicochemical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

    Directory of Open Access Journals (Sweden)

    Janvier Sylvestre N’cho

    2016-05-01

    Full Text Available A power transformer outage has a dramatic financial consequence not only for electric power systems utilities but also for interconnected customers. The service reliability of this important asset largely depends upon the condition of the oil-paper insulation. Therefore, by keeping the qualities of oil-paper insulation system in pristine condition, the maintenance planners can reduce the decline rate of internal faults. Accurate diagnostic methods for analyzing the condition of transformers are therefore essential. Currently, there are various electrical and physicochemical diagnostic techniques available for insulation condition monitoring of power transformers. This paper is aimed at the description, analysis and interpretation of modern physicochemical diagnostics techniques for assessing insulation condition in aged transformers. Since fields and laboratory experiences have shown that transformer oil contains about 70% of diagnostic information, the physicochemical analyses of oil samples can therefore be extremely useful in monitoring the condition of power transformers.

  2. Self-management programs for Aboriginal and Torres Strait Islander Peoples with chronic conditions: A rapid review.

    Science.gov (United States)

    Moore, Ellie; Lawn, Sharon; Oster, Candice; Morello, Andrea

    2017-01-01

    Objectives Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. Methods A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Results Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured individual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Discussion Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.

  3. Remote Ischemic Conditioning to Protect against Ischemia-Reperfusion Injury: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Brevoord, Daniel; Kranke, Peter; Kuijpers, Marijn; Weber, Nina; Hollmann, Markus; Preckel, Benedikt

    2012-01-01

    Background Remote ischemic conditioning is gaining interest as potential method to induce resistance against ischemia reperfusion injury in a variety of clinical settings. We performed a systematic review and meta-analysis to investigate whether remote ischemic conditioning reduces mortality, major adverse cardiovascular events, length of stay in hospital and in the intensive care unit and biomarker release in patients who suffer from or are at risk for ischemia reperfusion injury. Methods and Results Medline, EMBASE and Cochrane databases were searched for randomized clinical trials comparing remote ischemic conditioning, regardless of timing, with no conditioning. Two investigators independently selected suitable trials, assessed trial quality and extracted data. 23 studies in patients undergoing cardiac surgery (15 studies), percutaneous coronary intervention (four studies) and vascular surgery (four studies), comprising in total 1878 patients, were included in this review. Compared to no conditioning, remote ischemic conditioning did not reduce mortality (odds ratio 1.22 [95% confidence interval 0.48, 3.07]) or major adverse cardiovascular events (0.65 [0.38, 1.14]). However, the incidence of myocardial infarction was reduced with remote ischemic conditioning (0.50 [0.31, 0.82]), as was peak troponin release (standardized mean difference −0.28 [−0.47, −0.09]). Conclusion There is no evidence that remote ischemic conditioning reduces mortality associated with ischemic events; nor does it reduce major adverse cardiovascular events. However, remote ischemic conditioning did reduce the incidence of peri-procedural myocardial infarctions, as well as the release of troponin. PMID:22860077

  4. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    International Nuclear Information System (INIS)

    Farid, Nikdokht; Bruce, Dean; Chung, Christine B.

    2008-01-01

    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis

  5. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Farid, Nikdokht [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); Bruce, Dean [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); University of Alberta, Edmonton, Alberta (Canada); Chung, Christine B. [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)], E-mail: cbchung@ucsd.edu

    2008-10-15

    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis.

  6. Words do matter: a systematic review on how different terminology for the same condition influences management preferences.

    Science.gov (United States)

    Nickel, Brooke; Barratt, Alexandra; Copp, Tessa; Moynihan, Ray; McCaffery, Kirsten

    2017-07-10

    Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making. Systematic review. Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices. Studies were identified via database searches from inception to April 2017, and from reference lists. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias of included studies. Of the 1399 titles identified, seven studies, all of which included hypothetical scenarios, met the inclusion criteria. Six studies were quantitative and one was qualitative. Six of the studies were of high quality. Studies covered a diverse range of conditions: ductal carcinoma in situ (3), gastro-oesophageal reflux disease (1), conjunctivitis (1), polycystic ovary syndrome (1) and a bony fracture (1). The terminologies compared in each study varied based on the condition assessed. Based on a narrative synthesis of the data, when a more medicalised or precise term was used to describe the condition, it generally resulted in a shift in preference towards more invasive managements, and/or higher ratings of anxiety and perceived severity of the condition. Different terminology given for the same condition influenced management preferences and psychological outcomes in a consistent pattern in these studies. Changing the terminology may be one strategy to reduce patient preferences for aggressive management responses to low-risk conditions. PROSPERO: CRD42016035643. © Article author(s) (or their employer(s) unless

  7. The U.S. Nuclear Regulatory Commission's antitrust review of nuclear power plants: the conditioning of licenses

    International Nuclear Information System (INIS)

    Penn, D.W.; Delaney, J.B.; Honeycutt, T.C.

    1976-04-01

    The 1970 amendments to Section 105 of the Atomic Energy Act require the Nuclear Regulatory Commission to conduct a prelicensing antitrust review of applications for licenses to construct and operate nuclear power plants. The Commission must make a finding as to whether the granting of a license 'would create or maintain a situation inconsistent with the antitrust laws,' and it has the authority to issue or continue a license, to refuse to issue a license, to rescind or amend a license, and to issue a license with conditions that it deems appropriate. This report provides information about the antitrust license conditions that have resulted from the NRC's antitrust review process. The process itself is described and a catalog of the applications requiring antitrust license conditions is presented. For each application, the license conditions are put into the general categories of unit access, transmission services, coordination, and contractual provisions. For completeness, the report also catalogs applications requiring no antitrust license conditions, and lists applications that were exempted from the 1970 amendments, are the subject of litigation, or have been withdrawn

  8. Review on the Pavement-repairing Measures as a Condition for the Choice of Road-Maintenance Strategy

    Directory of Open Access Journals (Sweden)

    Nedevska Ivana

    2017-01-01

    Full Text Available The road-maintenance strategies vary from one country to another, and even between the road management authorities within a one single country. It is not surprising, as there is not best maintenance method, nor a universal set of strategies that can be applied equally everywhere. Generally, there are strategies acceptable in certain conditions, but the factors influencing the selection process are diverse and very complex. This paper will present a review of the various measures that can be applied on the roads, which is certainly the basic condition of selection of an appropriate maintenance strategy.

  9. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review

    Science.gov (United States)

    McGinty, Emma E.; Baller, Julia; Azrin, Susan T.; Juliano-Bult, Denise; Daumit, Gail L.

    2016-01-01

    People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings. PMID:26221050

  10. Tutorial review of spent-fuel degradation mechanisms under dry-storage conditions

    International Nuclear Information System (INIS)

    Einziger, R.E.

    1983-02-01

    This tutorial reviews our present understanding of fuel-rod degradation over a range of possible dry-storage environments. Three areas are covered: (1) why study fuel-rod degradation; (2) cladding-degradation mechanisms; and (3) the status of fuel-oxidation studies

  11. Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies.

    Science.gov (United States)

    Anderson, James W; Nunnelley, Paige A

    2016-09-01

    To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, prayer in four studies (P value, P prayer (P prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

  12. Asthma and lung cancer, after accounting for co-occurring respiratory diseases and allergic conditions: a systematic review protocol.

    Science.gov (United States)

    Denholm, Rachel; Crellin, Elizabeth; Arvind, Ashwini; Quint, Jennifer

    2017-01-16

    Asthma is one of the most frequently diagnosed respiratory diseases in the UK, and commonly co-occurs with other respiratory and allergic diseases, such as chronic obstructive pulmonary disease (COPD) and atopic dermatitis. Previous studies have shown an increased risk of lung cancer related to asthma, but the evidence is mixed when accounting for co-occurring respiratory diseases and allergic conditions. A systematic review of published data that investigate the relationship between asthma and lung cancer, accounting for co-occurring respiratory and allergic diseases, will be conducted to investigate the independent association of asthma with lung cancer. A systematic review will be conducted, and include original reports of cohort, cross-sectional and case-control studies of the association of asthma with lung cancer after accounting for co-occurring respiratory diseases. Articles published up to June 2016 will be included, and their selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A standardised data extraction form will be developed and pretested, and descriptive analyses will be used to summarise the available literature. If appropriate, pooled effect estimates of the association between asthma and lung cancer, given adjustment for a specific co-occurring condition will be estimated using random effects models. Potential sources of heterogeneity and between study heterogeneity will also be investigated. The study will be a review of published data and does not require ethical approval. Results will be disseminated through a peer-reviewed publication. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016043341. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Parents' learning needs and preferences when sharing management of their child's long-term/chronic condition: A systematic review.

    Science.gov (United States)

    Nightingale, Ruth; Friedl, Simone; Swallow, Veronica

    2015-11-01

    This review aimed to (1) identify parents' learning needs and preferences when sharing the management of their child's long-term/chronic (long-term) condition and (2) inform healthcare professional support provided to parents across the trajectory. We conducted a literature search in seven health databases from 1990 to 2013. The quality of included studies was assessed using a critical appraisal tool developed for reviewing the strengths and weaknesses of qualitative, quantitative and mixed methods studies. Twenty-three studies met our criteria and were included in the review. Three themes emerged from synthesis of the included studies: (1) parents' learning needs and preferences (2) facilitators to parents' learning, and (3) barriers to parents' learning. Asking parents directly about their learning needs and preferences may be the most reliable way for healthcare professionals to ascertain how to support and promote individual parents' learning when sharing management of their child's long-term condition. With the current emphasis on parent-healthcare professional shared management of childhood long-term conditions, it is recommended that professionals base their assessment of parents' learning needs and preferences on identified barriers and facilitators to parental learning. This should optimise delivery of home-based care, thereby contributing to improved clinical outcomes for the child. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Parents' experiences of living with a child with a long-term condition: a rapid structured review of the literature.

    Science.gov (United States)

    Smith, Joanna; Cheater, Francine; Bekker, Hilary

    2015-08-01

    Living with a child with a long-term condition can result in challenges above usual parenting because of illness-specific demands. A critical evaluation of research exploring parents' experiences of living with a child with a long-term condition is timely because international health policy advocates that patients with long-term conditions become active collaborators in care decisions. A rapid structured review was undertaken (January 1999-December 2009) in accordance with the United Kingdom Centre for Reviews and Dissemination guidance. Three data bases (MEDLINE, CINAHL, PSYCINFO) were searched and also hand searching of the Journal of Advanced Nursing and Child: Care, Health and Development. Primary research studies written in English language describing parents' experiences of living with a child with a long-term condition were included. Thematic analysis underpinned data synthesis. Quality appraisal involved assessing each study against predetermined criteria. Thirty-four studies met the inclusion criteria. The impact of living with a child with a long-term condition related to dealing with immediate concerns following the child's diagnosis and responding to the challenges of integrating the child's needs into family life. Parents' perceived they are not always supported in their quest for information and forming effective relationships with health-care professionals can be stressful. Although having ultimate responsibility for their child's health can be overwhelming, parents developed considerable expertise in managing their child's condition. Parents' accounts suggest they not always supported in their role as manager for their child's long-term condition and their expertise, and contribution to care is not always valued. © 2013 John Wiley & Sons Ltd.

  15. The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review.

    Science.gov (United States)

    Whitehead, Lisa; Jacob, Elisabeth; Towell, Amanda; Abu-Qamar, Ma'en; Cole-Heath, Amanda

    2018-01-01

    To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members. The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention. A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews. Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception-2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings. Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition. Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging. Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting. © 2017 John

  16. The Utrecht approach to exercise in chronic childhood conditions: the decade in review.

    Science.gov (United States)

    van Brussel, Marco; van der Net, Janjaap; Hulzebos, Erik; Helders, Paul J M; Takken, Tim

    2011-01-01

    To summarize and discuss current evidence and understanding of clinical pediatric exercise physiology focusing on the work the research group at Utrecht and others have performed in the last decade in a variety of chronic childhood conditions as a continuation of the legacy of Dr Bar-Or. The report discusses current research findings on the cardiopulmonary exercise performance of children (and adolescents) with juvenile idiopathic arthritis, osteogenesis imperfecta, achondroplasia, hemophilia, cerebral palsy, spina bifida, cystic fibrosis, and childhood cancer. Exercise recommendations and contraindications are provided for each condition. Implications for clinical practice and future research in this area are discussed for each of the chronic conditions presented. The authors provide a basic framework for developing an individual and/or disease-specific training program, introduce the physical activity pyramid, and recommend a core set of clinical measures to be used in clinical research.

  17. Rare medical conditions and suggestive past-life memories: a case report and literature review.

    Science.gov (United States)

    Lucchetti, Giancarlo; dos Santos Camargo, Luizete; Lucchetti, Alessandra L G; Schwartz, Gary E; Nasri, Fabio

    2013-01-01

    We aim to report the case of a 38-year-old male with suggestive past-life memories during a regression session and to show how these memories were related to unusual medical conditions: (1) isolated obstruction of the right coronary artery in a young patient, (2) omental infarction, and (3) right aortic arch with isolation of the left subclavian artery. These conditions were related to the following suggestive past-life memories: (1) a priest who committed suicide with a crucifix nailed to his chest and (2) a medieval weapon (skull flail) hitting his cervical and left back region. There was an intriguing relation between the patient's suggestive past-life memories and rare medical conditions. In this article, the authors highlight possible explanations, rarity of findings, and similarities/differences from previous cases and potential pitfalls in this area. © 2013 Elsevier Inc. All rights reserved.

  18. A Review of the Condition Monitoring of Capacitors in Power Electronic Converters

    DEFF Research Database (Denmark)

    Soliman, Hammam Abdelaal Hammam; Wang, Huai; Blaabjerg, Frede

    2015-01-01

    Capacitor is one of the reliability critical components in power electronic systems. In the last two decades, many efforts in the academic research have been devoted to the condition monitoring of capacitors to estimate their health status. Industry applications demand more reliable power...... electronics products with preventive maintenance. Nevertheless, most of the developed capacitor condition monitoring technologies are rarely adopted by industry due to the complexity, increased cost and other relevant issues. An overview of the prior-art research in this area is therefore needed to justify....... Therefore, this paper firstly classifies the capacitor condition monitoring methods into three categories, then the respective technology evolution from 1993 to 2015 is summarized. Remarks on the state-of-the-art research and the future opportunities targeting for practical industry applications are given....

  19. A Review of the Condition Monitoring of Capacitors in Power Electronic Converters

    DEFF Research Database (Denmark)

    Soliman, Hammam Abdelaal Hammam; Wang, Huai; Blaabjerg, Frede

    2016-01-01

    Capacitors are one type of reliability-critical components in power electronic systems. In the last two decades, many efforts in academic research have been devoted to the condition monitoring of capacitors to estimate their health status. Industry applications are demanding more reliable power...... electronics products with preventive maintenance. Nevertheless, most of the developed capacitor condition monitoring technologies are rarely adopted by industry due to the complexity, increased cost, and other relevant issues. An overview of the prior-art research in this area is therefore needed to justify......, this paper first classifies the capacitor condition monitoring methods into three categories, then the respective technology evolution in the last two decades is summarized. Finally, the state-of-the-art research and the future opportunities targeting for industry applications are given....

  20. Review Article: Atmospheric conditions inducing extreme precipitation over the eastern and western Mediterranean

    OpenAIRE

    Dayan, U.; Nissen, K.; Ulbrich, U.

    2015-01-01

    This review discusses published studies of heavy rainfall events over the Mediterranean Basin, combining them in a more general picture of the dynamic and thermodynamic factors and processes that produce heavy rain storms. It distinguishes the western and eastern Mediterranean in order to point out specific regional peculiarities. The crucial moisture for developing intensive convection over these regions can be originated not only from the adjacent Mediterranean Sea but als...

  1. Review Article: Atmospheric conditions inducing extreme precipitation over the Eastern and Western Mediterranean

    OpenAIRE

    U. Dayan; K. M. Nissen; U. Ulbrich

    2015-01-01

    This review discusses published studies of heavy rainfall events over the Mediterranean Basin, combining them in a more general picture of the dynamic and thermodynamic factors and processes producing heavy rain storms. It distinguishes the Western and Eastern Mediterranean in order to point at specific regional peculiarities. The crucial moisture for developing intensive convection over these regions can be originated not only from the ad...

  2. Strategies to translate knowledge related to common musculoskeletal conditions into physiotherapy practice: a systematic review.

    Science.gov (United States)

    Bérubé, Marie-Ève; Poitras, Stéphane; Bastien, Marc; Laliberté, Lydie-Anne; Lacharité, Anyck; Gross, Douglas P

    2018-03-01

    Many physiotherapists underuse evidence-based practice guidelines or recommendations when treating patients with musculoskeletal disorders, yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines. To evaluate the effectiveness of various knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues. A computerized literature search of MEDLINE, CINHAL and ProQuest of systematic reviews (from inception until May 2016) and primary research studies (from January 2010 until June 2016). Eligibility criteria specified articles evaluating interventions for translating knowledge into physiotherapy practice. Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. Of a total of 13014 articles located and titles and abstracts screened, 34 studies met the inclusion criteria, including three overlapping publications, resulting in 31 individual studies. Knowledge translation interventions appear to have resulted in a positive change in physiotherapist beliefs, attitudes, skills and guideline awareness. However, no consistent improvement in clinical practice, patient and economic outcomes were observed. The studies included had small sample sizes and low methodological quality. The heterogeneity of the studies was not conducive to pooling the data. The intensity and type of knowledge translation intervention seem to have an effect on practice change. More research targeting financial, organizational and regulatory knowledge translation interventions is needed. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  3. Uptake of pharmaceuticals by plants grown under hydroponic conditions and natural occurring plant species: A review.

    Science.gov (United States)

    Madikizela, Lawrence Mzukisi; Ncube, Somandla; Chimuka, Luke

    2018-04-27

    Sizeable amount of research has been conducted on the possible uptake of pharmaceuticals by plants from contaminated soil and water used for irrigation of crops. In most cases, pharmaceuticals are taken by roots and translocated into various tissues by transpiration and diffusion. Due to the plant uptake, the occurrence of pharmaceuticals in food sources such as vegetables is a public concern. Few review papers focusing on the uptake of pharmaceuticals, in particular antibiotics, and their translocation in plant tissues have been published. In the current review paper, the work conducted on the uptake of pharmaceuticals belonging to different therapeutic groups such as antibiotics, non-steroidal anti-inflammatory drugs, β-blockers and antiepileptics is reviewed. Such work includes the occurrence of pharmaceuticals in plants, translocation once taken by plants, toxicity studies as well as implications and future studies. Furthermore, the advantages and drawbacks associated with the detection and uptake of these pharmaceuticals by plants are discussed. In addition, the physico-chemical properties that could influence the plant uptake of pharmaceuticals are deliberated. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. A review on the recent development of solar absorption and vapour compression based hybrid air conditioning with low temperature storage

    Directory of Open Access Journals (Sweden)

    Noor D. N.

    2016-01-01

    Full Text Available Conventional air conditioners or vapour compression systems are main contributors to energy consumption in modern buildings. There are common environmental issues emanating from vapour compression system such as greenhouse gas emission and heat wastage. These problems can be reduced by adaptation of solar energy components to vapour compression system. However, intermittence input of daily solar radiation was the main issue of solar energy system. This paper presents the recent studies on hybrid air conditioning system. In addition, the basic vapour compression system and components involved in the solar air conditioning system are discussed. Introduction of low temperature storage can be an interactive solution and improved economically which portray different modes of operating strategies. Yet, very few studies have examined on optimal operating strategies of the hybrid system. Finally, the findings of this review will help suggest optimization of solar absorption and vapour compression based hybrid air conditioning system for future work while considering both economic and environmental factors.

  5. A Systematic Review Exploring the Social Cognitive Theory of Self-Regulation as a Framework for Chronic Health Condition Interventions.

    Directory of Open Access Journals (Sweden)

    Michelle E Tougas

    Full Text Available Theory is often recommended as a framework for guiding hypothesized mechanisms of treatment effect. However, there is limited guidance about how to use theory in intervention development.We conducted a systematic review to provide an exemplar review evaluating the extent to which use of theory is identified and incorporated within existing interventions. We searched electronic databases PubMed, PsycINFO, CENTRAL, and EMBASE from inception to May 2014. We searched clinicaltrials.gov for registered protocols, reference lists of relevant systematic reviews and included studies, and conducted a citation search in Web of Science. We included peer-reviewed publications of interventions that referenced the social cognitive theory of self-regulation as a framework for interventions to manage chronic health conditions. Two reviewers independently assessed articles for eligibility. We contacted all authors of included studies for information detailing intervention content. We describe how often theory mechanisms were addressed by interventions, and report intervention characteristics used to address theory.Of 202 articles that reported using the social cognitive theory of self-regulation, 52% failed to incorporate self-monitoring, a main theory component, and were therefore excluded. We included 35 interventions that adequately used the theory framework. Intervention characteristics were often poorly reported in peer-reviewed publications, 21 of 35 interventions incorporated characteristics that addressed each of the main theory components. Each intervention addressed, on average, six of eight self-monitoring mechanisms, two of five self-judgement mechanisms, and one of three self-evaluation mechanisms. The self-monitoring mechanisms 'Feedback' and 'Consistency' were addressed by all interventions, whereas the self-evaluation mechanisms 'Self-incentives' and 'External rewards' were addressed by six and four interventions, respectively. The present review

  6. Barriers to Physical Activity for People with Long-Term Neurological Conditions: A Review Study

    Science.gov (United States)

    Mulligan, Hilda F.; Hale, Leigh A.; Whitehead, Lisa; Baxter, G. David

    2012-01-01

    People with disability are insufficiently physically active for health. This study identified the volume, quality, and findings of research that exposes environmental and personal barriers of physical activity participation for people with neurological conditions. CINAHL, Sport Discus, EMBASE, Medline, and AMED were systematically searched between…

  7. Legal and Psychological Fundamentals of Extreme Communication in the Conditions of Hostages Detention (Bibliography Review

    Directory of Open Access Journals (Sweden)

    Zverev V. O.

    2014-01-01

    Full Text Available An attempt is made to generalize and analyze some accumulated scientific knowledge in the sphere of psychological nuances arising in the process of negotiations with criminals in the conditions of hostages detention, the experience shared by Soviet and Russian scientists

  8. A review on self-healing in reinforced concrete structures in view of serving conditions.

    NARCIS (Netherlands)

    Huang, H.; Ye, G.

    2014-01-01

    In this paper, different mechanisms of self-healing, i.e. self-healing based on adhesive agents, self-healing based on bacteria, self-healing based on autogenous self-healing were described. Their required conditions were summarized. The previous investigations showed that all mechanisms of

  9. Health, work and working conditions: a review of the European economic literature.

    Science.gov (United States)

    Barnay, Thomas

    2016-07-01

    Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29 %) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific "flexicurity" (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health.

  10. The therapeutic use of botulinum toxin in cervical and maxillofacial conditions: an evidence-based review.

    Science.gov (United States)

    Ihde, Stefan K A; Konstantinovic, Vitomir S

    2007-08-01

    The role of botulinum toxin as a therapeutic agent for several conditions is expanding. We sought to determine if botulinum toxin is safe and effective in treating patients with cervical dystonia and maxillofacial conditions. Our purpose was to establish a safety and efficacy profile to determine whether or not this treatment may be used prophylactically in patients undergoing dental implant therapy. We performed a systematic search of the literature to identify randomized clinical trials evaluating patients treated with botulinum toxin as an adjunct to dental implant therapy, maxillofacial conditions including temporomandibular disorders (TMD), and cervical dystonia. Four randomized controlled trials (RCTs) met our search criteria in the area of cervical dystonia and chronic facial pain. No RCTs were identified evaluating dental implant therapy. Patients with cervical dystonia exhibited significant improvements in baseline functional, pain, and global assessments compared to placebo. Adverse events were mild and transient with numbers needed to harm (NNH) ranging from 12 to 17. Patients with chronic facial pain improved significantly from baseline in terms of pain compared to placebo. Rates of adverse events were less than 1%. Botulinum toxin appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity. No literature exists evaluating its use in dental implantology. Randomized clinical trials are warranted to determine its safety and efficacy in dental implantology and other maxillofacial conditions such as bruxism.

  11. Kinetics of Natural Attenuation: Review of the Critical Chemical Conditions and Measurements at Bore Scale

    Directory of Open Access Journals (Sweden)

    O. Atteia

    2002-01-01

    Full Text Available This paper describes the chemical conditions that should favour the biodegradation of organic pollutants. Thermodynamic considerations help to define the reaction that can occur under defined chemical conditions. The BTEX (benzene, toluene, ethylbenzene, and xylene degradation is focused on benzene, as it is the most toxic oil component and also because it has the slowest degradation rate under most field conditions. Several studies on benzene degradation allow the understanding of the basic degradation mechanisms and their importance in field conditions. The use of models is needed to interpret field data when transport, retardation, and degradation occur. A detailed comparison of two existing models shows that the limits imposed by oxygen transport must be simulated precisely to reach correct plumes shapes and dimensions, and that first-order kinetic approaches may be misleading. This analysis led us to develop a technique to measure directly biodegradation in the field. The technique to recirculate water at the borehole scale and the CO2 analysis are depicted. First results of biodegradation show that this technique is able to easily detect the degradation of 1 mg/l of hydrocarbons and that, in oxic media, a fast degradation rate of mixed fuel is observed.

  12. The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties

    NARCIS (Netherlands)

    Bart Bartels; Janke de Groot; Caroline Terwee

    2013-01-01

    Background The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use. Purpose The purpose of this study was to systematically

  13. The six-minute walk test in chronic pediatric conditions: a systematic review of measurement properties.

    NARCIS (Netherlands)

    Bartels, B.; Groot, J.F. de; Terwee, C.B.

    2013-01-01

    Background: The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use. Purpose: The purpose of this study was to

  14. Nonmyeloablative and reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation: a clinical review.

    Science.gov (United States)

    Pollack, Seth M; O'Connor, Thomas P; Hashash, Jana; Tabbara, Imad A

    2009-12-01

    Allogeneic hematopoietic stem cell transplantation provides many patients, with hematological and malignant diseases, hope of remission and in some cases cure. Because the toxicities of this approach are severe, its use has been limited to younger healthier patients. Nonmyeloablative and reduced intensity conditioning regimens depend more on donor cellular immune effects and less on the cytotoxic effects of the conditioning regimen to eradicate the underlying disease. This approach is based on the induction of host tolerance to donor cells followed by the administration of scheduled donor T-lymphocytes infusions. Accumulated clinical data have been encouraging, and prospective studies are underway to compare this approach to conventional myeloablative allogeneic stem cell transplantation with regard to outcome, durability of responses, effects on the immune system, and the consequences of late complications such as chronic graft-versus-host disease.

  15. Assessment of Smolt Condition for Travel Time Analysis Project, 1987-1997 Project Review.

    Energy Technology Data Exchange (ETDEWEB)

    Schrock, Robin M.; Hans, Karen M.; Beeman, John W. [US Geological Survey, Western Fisheries Research Center, Columbia River Research Laboratory, Cook, WA

    1997-12-01

    The assessment of Smolt Condition for Travel Time Analysis Project (Bonneville Power Administration Project 87-401) monitored attributes of salmonid smolt physiology in the Columbia and Snake River basins from 1987 to 1997, under the Northwest Power Planning Council Fish and Wildlife Program, in cooperation with the Smolt Monitoring Program of the Fish Passage Center. The primary goal of the project was to investigate the physiological development of juvenile salmonids related to migration rates. The assumption was made that the level of smolt development, interacting with environmental factos such as flow, would be reflected in travel times. The Fish Passage Center applied the physiological measurements of smolt condition to Water Budget management, to regulate flows so as to decrease travel time and increase survival.

  16. Review of parameters influencing the structural response of a submerged body under cavitation conditions

    International Nuclear Information System (INIS)

    Escaler, X; De La Torre, O; Farhat, M

    2015-01-01

    Submerged structures that operate under extreme flows are prone to suffer large scale cavitation attached to their surfaces. Under such conditions the added mass effects differ from the expected ones in pure liquids. Moreover, the existence of small gaps between the structure and surrounding bodies filled with fluid also influence the dynamic response. A series of experiments and numerical simulations have been carried out with a truncated NACA0009 hydrofoil mounted as a cantilever beam at the LMH-EPFL cavitation tunnel. The three first modes of vibration have been determined and analysed under various hydrodynamic conditions ranging from air and still water to partial cavitation and supercavitation. A remote nonintrusive excitation system with piezoelectric patches has been used for the experiments. The effects of the cavity properties and the lateral gap size on the natural frequencies and mode shapes have been determined. As a result, the significance of several parameters in the design of such structures is discussed. (paper)

  17. Review of parameters influencing the structural response of a submerged body under cavitation conditions

    Science.gov (United States)

    Escaler, X.; De La Torre, O.; Farhat, M.

    2015-12-01

    Submerged structures that operate under extreme flows are prone to suffer large scale cavitation attached to their surfaces. Under such conditions the added mass effects differ from the expected ones in pure liquids. Moreover, the existence of small gaps between the structure and surrounding bodies filled with fluid also influence the dynamic response. A series of experiments and numerical simulations have been carried out with a truncated NACA0009 hydrofoil mounted as a cantilever beam at the LMH-EPFL cavitation tunnel. The three first modes of vibration have been determined and analysed under various hydrodynamic conditions ranging from air and still water to partial cavitation and supercavitation. A remote nonintrusive excitation system with piezoelectric patches has been used for the experiments. The effects of the cavity properties and the lateral gap size on the natural frequencies and mode shapes have been determined. As a result, the significance of several parameters in the design of such structures is discussed.

  18. Book Review: Critical Condition: Replacing Critical Thinking with Creativity by Patrick Finn

    OpenAIRE

    Matthews, Jodie

    2016-01-01

    In Critical Condition: Replacing Critical Thinking with Creativity, Patrick Finn expands upon his 2011 TEDx Talk, ‘Loving Communication’, to suggest that critical thinking implies disapproval and unnecessary judgement originating from a particular mode of Classical thought. Jodie Matthews argues that Finn’s discussion is dependent upon a crudely drawn straw man and neglects to consider thinking critically as a necessary corollary, rather than antithesis, to thinking creatively.

  19. The role of conditioning, learning and dopamine in sexual behavior: a narrative review of animal and human studies.

    Science.gov (United States)

    Brom, Mirte; Both, Stephanie; Laan, Ellen; Everaerd, Walter; Spinhoven, Philip

    2014-01-01

    Many theories of human sexual behavior assume that sexual stimuli obtain arousing properties through associative learning processes. It is widely accepted that classical conditioning contributes to the etiology of both normal and maladaptive human behaviors. Despite the hypothesized importance of basic learning processes in sexual behavior, research on classical conditioning of the sexual response in humans is scarce. In the present paper, animal studies and studies in humans on the role of pavlovian conditioning on sexual responses are reviewed. Animal research shows robust, direct effects of conditioning processes on partner- and place preference. On the contrast, the empirical research with humans in this area is limited and earlier studies within this field are plagued by methodological confounds. Although recent experimental demonstrations of human sexual conditioning are neither numerous nor robust, sexual arousal showed to be conditionable in both men and women. The present paper serves to highlight the major empirical findings and to renew the insight in how stimuli can acquire sexually arousing value. Hereby also related neurobiological processes in reward learning are discussed. Finally, the connections between animal and human research on the conditionability of sexual responses are discussed, and suggestions for future directions in human research are given. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Low back injuries related to nursing professionals working conditions: a systematic review.

    Science.gov (United States)

    Schlossmacher, Roberta; Amaral, Fernando Gonçalves

    2012-01-01

    Identify the prevalence of low back disorders and associated risks, as well as the characteristics and ergonomic factors present in the work of nursing professionals. Systematic review based on the search of terms such as low back pain, professionals, hospital ergonomics, work organization, nursing found in national and international databases. The prevalence of low back pain symptoms was between 14.7% and 72% and the main cause, that is, the transference of the patient from bed to chair, leaded to the profession abandonment as a main consequence. it was possible to conclude that the prevalence of low back injury is high among nursing professionals and its causes are related to occupational factors - physical or psychological, which are in many cases permanent and disabling.

  1. Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ping Yin

    2014-01-01

    Full Text Available Pain-related massage, important in traditional Eastern medicine, is increasingly used in the Western world. So the widening acceptance demands continual safety assessment. This review is an evaluation of the frequency and severity of adverse events (AEs reported mainly for pain-related massage between 2003 and 2013. Relevant all-languages reports in 6 databases were identified and assessed by two coauthors. During the 11-year period, 40 reports of 138 AEs were associated with massage. Author, year of publication, country of occurrence, participant related (age, sex or number of patients affected, the details of manual therapy, and clinician type were extracted. Disc herniation, soft tissue trauma, neurologic compromise, spinal cord injury, dissection of the vertebral arteries, and others were the main complications of massage. Spinal manipulation in massage has repeatedly been associated with serious AEs especially. Clearly, massage therapies are not totally devoid of risks. But the incidence of such events is low.

  2. Music-induced analgesia in chronic pain conditions: a systematic review and meta- analysis

    DEFF Research Database (Denmark)

    Garza-Villarreal, Eduardo A.; Pando, Victor; Vuust, Peter

    2017-01-01

    Background: Music is increasingly used as an adjuvant for chronic pain management as it is non-invasive, inexpensive, and patients usually report positive experiences with it. However, little is known about its clinical efficacy in chronic pain patients. Objectives: We aimed to determine the effect...... of music as an adjuvant for chronic pain, as well as to identify characteristics of music interventions associated wit positive clinical outcomes. Study Design: In this systematic review and meta-analysis, we investigated randomized controlled trials (RCTs) of adult patients that reported any type of music...... 14 RTCs that fulfilled our criteria. The sample size of the studies varied between 25 and 200 participants. Results: We found that music reduced self-reported chronic pain and depressive symptoms. We also found music had a greater effect when the participant chose the music compared to when...

  3. Radiation Boundary Conditions for Maxwell’s Equations: A Review of Accurate Time-Domain Formulations

    Science.gov (United States)

    2007-01-01

    conditions have only been constructed for the case ne = 0. Lastly we note that exact reflection formulas have recently been derived by Diaz and Joly [20, 21...SIAM J. Numer. Anal. 41 (2003), 287–305. 6. E. Bécache and P. Joly , On the analysis of Bérenger’s perfectly matched layers for Maxwell’s equations...Computational Wave Propagation (M. Ainsworth, P. Davies, D. Duncan, P. Martin , and B. Rynne, eds.), Springer-Verlag, 2003, pp. 43–82. 13. O. Bruno and D. Hoch

  4. Bariatric surgery complications. Internal hernia: A potentially fatal condition. A case report and literature review

    International Nuclear Information System (INIS)

    Canadas, Raul; Lombana, Luis Jorge; Hernandez, Javier; Solano, Claudia; Suarez, Yanette; Torres, Diana; Alvarado, Jaime; Valencia, William; Garcia, Jairo; Hani, Albis

    2007-01-01

    In recent years, Obesity (defined as Body Mass Index > 30 kg/m2) has increased its prevalence reaching epidemic levels in countries such as The United States where it has became a national health issue. In Colombia the Obesity prevalence is figured around 14%. Treatment options for Obesity include life style modifications, pharmacologist management and surgical approach (Bariatric Surgery). This article describes a patient with previous bariatric surgery, who presents abdominal pain and melena owed to isquemic process of the alimentary limb caused by an internal hernia which is a potentially lethal condition if it is not highly suspected allowing its early diagnosis and treatment

  5. Genetics of body condition score as an indicator of dairy cattle fertility. A review

    OpenAIRE

    Bastin, C.; Gengler, N.

    2013-01-01

    Body condition score (BCS) is a subjective measure of the amount of metabolizable energy stored in a live animal. Change in BCS of dairy cows is considered to be an indicator of the extent and the duration of postpartum negative energy balance. Although change in BCS over lactation is lowly heritable, heritability estimates of level of BCS range from 0.20 to 0.50. Also, BCS tends to be more heritable in mid-lactation indicating that genetic differences are more related to how well cows recove...

  6. Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review.

    Science.gov (United States)

    Woodman, J P; Moore, N R

    2012-01-01

    Complementary medicine and alternative approaches to chronic and intractable health conditions are increasingly being used, and require critical evaluation. The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions. PUBMED, EMBASE, PSYCHINFO, ISI Web-of-Knowledge, AMED, CINHAL-plus, Cochrane library and Evidence-based Medicine Reviews were searched to July 2011. Inclusion criteria were prospective studies evaluating Alexander Technique instruction (individual lessons or group delivery) as an intervention for any medical indication/health-related condition. Studies were categorised and data extracted on study population, randomisation method, nature of intervention and control, practitioner characteristics, validity and reliability of outcome measures, completeness of follow-up and statistical analyses.   Of 271 publications identified, 18 were selected: three randomised, controlled trials (RCTs), two controlled non-randomised studies, eight non-controlled studies, four qualitative analyses and one health economic analysis. One well-designed, well-conducted RCT demonstrated that, compared with usual GP care, Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. The results were broadly supported by a smaller, earlier RCT in chronic back pain. The third RCT, a small, well-designed, well-conducted study in individuals with Parkinson's disease, showed a sustained increased ability to carry out everyday activities following Alexander lessons, compared with usual care. The 15 non-RCT studies are also reviewed. Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson's-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the

  7. Tumorous Conditions of the Hand: A Retrospective Review of 402 Cases

    Directory of Open Access Journals (Sweden)

    Ali CAVİT

    2018-01-01

    Full Text Available Objective: Knowledge concerning treatment and care of hand lesions is often based on small case series, case reports and a few large general case series. The aim of this study is to present our experience with hand tumors’ and tumor-like lesions’ incidence, age range and localizations. Material and Method: Between 2006-2016, 402 patients operated and histopathologically diagnosed with bone and soft tissue tumorous conditions of the hand were evaluated retrospectively. Results: Three hundred sixty one out of 402 cases (89.8% were soft tissue tumors and 41 cases (10.2% were osseous tumors of the hand. A total of 10 malignant tumors (2.5% were encountered in the hand. The average age of the patients was 41.9 years (ranged from 1 to 83 years. Among 361 soft tissue tumors, only 6 cases (1.6% were malignant and they were squamous cell tumors (n=5 and synovial sarcoma (n=1. The most common soft tissue pathology was ganglion cyst (n=125. The most common bone tumor was enchondroma, diagnosed in 26 patients (6.4% of all patients. Primary malignant bone tumors were extremely rare in the hand; one osteosarcoma and one chondrosarcoma were reported. Metastatic tumors to the hand were seen in two patients; and they were lung carcinoma and chondrosarcoma metastasis. Conclusion: Up-date knowledge and a thorough understanding of the nature and demographic characteristics of the tumorous conditions of the hand are crucial for accurate diagnosis and appropriate treatment.

  8. Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Garza-Villarreal, Eduardo A; Pando, Victor; Vuust, Peter; Parsons, Christine

    2017-11-01

    Music is increasingly used as an adjuvant for the management of chronic pain (CP), as it is non-invasive, inexpensive, and patients usually report positive experiences with it. However, little is known about its clinical efficacy in chronic pain patients. We aimed to determine the effect of music as an adjuvant for chronic pain, as well as to identify characteristics of music interventions associated with positive clinical outcomes. In this systematic review and meta-analysis, we investigated randomized controlled trials (RCTs) of adult patients that reported any type of music intervention for chronic pain, chosen by the researcher or patient, lasting for any duration. Searches were performed using PsycINFO, Scopus, and PubMed for RCTs published until the end of May 2016. The primary outcome was reduction in self-reported pain using a standardized pain measurement instrument, reported post-intervention. The secondary outcomes were: quality of life measures, depression, anxiety, and related measures. The study was pre-registered with PROSPERO (CRD42016039837), and the meta-analysis was performed using RevMan 5.3 (The Nordic Cochrane Centre for The Cochrane Collaboration, Copenhagen, Denmark). We identified 768 titles and abstracts, and we included 14 RTCs that fulfilled our criteria. The sample size of the studies varied between 25 and 200 patients. We found that music reduced self-reported chronic pain and depressive symptoms. We also found that music had a greater effect when the patient chose the music, compared to when the researcher chose it. The sample size of RCTs was small and sometimes with different outcome measures. There was high heterogeneity associated with pooled estimates. Our analysis suggests that music may be beneficial as an adjuvant for chronic pain patients, as it reduces self-reported pain and its common comorbidities. Importantly, the analgesic effect of music appears higher with self-chosen over researcher-chosen music. Pain, music

  9. Microalgae for high-value compounds and biofuels production: a review with focus on cultivation under stress conditions.

    Science.gov (United States)

    Markou, Giorgos; Nerantzis, Elias

    2013-12-01

    Microalgal biomass as feedstock for biofuel production is an attracting alternative to terrestrial plant utilization for biofuels production. However, today the microalgal cultivation systems for energy production purposes seem not yet to be economically feasible. Microalgae, though cultivated under stress conditions, such as nutrient starvation, high salinity, high temperature etc. accumulate considerable amounts (up to 60-65% of dry weight) of lipids or carbohydrates along with several secondary metabolites. Especially some of the latter are valuable compounds with an enormous range of industrial applications. The simultaneous production of lipids or carbohydrates for biofuel production and of secondary metabolites in a biorefinery concept might allow the microalgal production to be economically feasible. This paper aims to provide a review on the available literature about the cultivation of microalgae for the accumulation of high-value compounds along with lipids or carbohydrates focusing on stress cultivation conditions. © 2013.

  10. Hospital and Pre-Hospital Triage Systems in Disaster and Normal Conditions; a Review Article

    Directory of Open Access Journals (Sweden)

    Saeed Safari

    2015-02-01

    Full Text Available Triage is a priority classification system based on the severity of problem to do the best therapeutic proceedings for patients in the less time. A triage system should be performed in a way which can make a decision with high accuracy and in the least time for each patient. Simplicity and reliability of the performance are the most important features of a standard triage system. An appropriate triage causes to increase the quality of health care services and patients’ satisfaction rate, decrease the waiting time as well as mortality rate, and increase the yield and efficiency of emergency wards along with reducing the related expenses. Considering to the above statements, in the present study the history of triage formation was evaluated and categorizing of all triage systems regarding prehospital and hospital as well as triage in normal and critical conditions were assessed, too.

  11. Understanding factors that influence participation in physical activity among people with a neuromusculoskeletal condition: a review of qualitative studies.

    Science.gov (United States)

    Newitt, Rosemarie; Barnett, Fiona; Crowe, Melissa

    2016-01-01

    This review aims to describe the factors that influence participation in physical activity (PA) in people with neuromusculoskeletal (NMS) conditions. A systematic search of six databases was conducted. Articles were included if the study qualitatively explored factors that influence participation in PA by individuals with a NMS condition. Fifteen peer-reviewed articles published between 2003 and 2013 were analysed for common themes and critically appraised. Results were categorised using the International Classification of Functioning, Disability and Health framework. The most common demotivators reported for the three areas of functioning, body function and structures, activities and participation were lack of walking balance, muscle weakness, pain, stiffness, bladder and blower problems, depression, thermoregulation and fear of injury. Fluctuating symptoms and fatigue were mentioned as demotivators in all of the progressive conditions. Maintaining independence, function and weight, and the prevention of secondary conditions were the leading motivators reported in this domain. Most common environmental barriers include accessibility, costs, transport and insufficient information and knowledge from health professionals. Social support is a consistent determinate of PA and is reported as a facilitator in every study. The most common personal demotivators include lack of motivation, feelings of self-consciousness and embarrassment in public, anxiety, frustration and anger. Personal motivators include goal setting and achieving, enjoyment, feeling good, feeling "normal", motivation and optimism, redefining self and escapism from everyday boundaries. Individuals with NMS conditions report complex common barriers, facilitators, demotivators and motivators to participation in PA. The way these factors influence participation in PA is unique to the individual; therefore, it is necessary to adopt an individually tailored approach when designing interventions. Individuals

  12. Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review.

    Science.gov (United States)

    de Bruin, Simone R; Versnel, Nathalie; Lemmens, Lidwien C; Molema, Claudia C M; Schellevis, François G; Nijpels, Giel; Baan, Caroline A

    2012-10-01

    To provide insight into the characteristics of comprehensive care programs for patients with multiple chronic conditions and their impact on patients, informal caregivers, and professional caregivers. Systematic literature search in multiple electronic databases for English language papers published between January 1995 and January 2011, supplemented by reference tracking and a manual search on the internet. Wagner's chronic care model (CCM) was used to define comprehensive care. After inclusion, the methodological quality of each study was assessed. A best-evidence synthesis was applied to draw conclusions. Forty-two publications were selected describing thirty-three studies evaluating twenty-eight comprehensive care programs for multimorbid patients. Programs varied in the target patient groups, implementation settings, number of included interventions, and number of CCM components to which these interventions related. Moderate evidence was found for a beneficial effect of comprehensive care on inpatient healthcare utilization and healthcare costs, health behavior of patients, perceived quality of care, and satisfaction of patients and caregivers. Insufficient evidence was found for a beneficial effect of comprehensive care on health-related quality of life in terms of mental functioning, medication use, and outpatient healthcare utilization and healthcare costs. No evidence was found for a beneficial effect of comprehensive care on cognitive functioning, depressive symptoms, functional status, mortality, quality of life in terms of physical functioning, and caregiver burden. Because of the heterogeneity of comprehensive care programs, it is as yet too early to draw firm conclusions regarding their effectiveness. More rigorous evaluation studies are necessary to determine what constitutes best care for the increasing number of people with multiple chronic conditions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Neurobiological and psychosocial conditionings of rationality of criminal behaviour – review

    Directory of Open Access Journals (Sweden)

    Przemysław Piotrowski

    2011-12-01

    Full Text Available The term “rationality” has been mentioned for ages in philosophical discourse, and later in science. No wonder that considerations regarding the reasons behind committing crimes involve the question of rationality of culprits. The article comprises a review of contemporary research on factors which, on a neurobiological, psychological or social level, modify the level of rationality of criminals. In case of the juveniles, factors such as not fully developed brain structures, the influence of hormonal changes resulting in emotional instability and peer pressure, should also be taken into account. Adult criminals often manifest a deficit of activity in the prefrontal cortex of the brain, combined with increased activity in the subcortex, resulting in an increased propensity for violence. Neurophysiologic disorders may be accompanied by factors reducing the rationality, such as: errors in thinking, habitual use of neutralisation techniques or being lead by the, typical for street culture, perception of justice. All of the above should be taken into account as a part of a multi-aspect analyses of the causes of crime.

  14. Review Article: Atmospheric conditions inducing extreme precipitation over the eastern and western Mediterranean

    Science.gov (United States)

    Dayan, U.; Nissen, K.; Ulbrich, U.

    2015-11-01

    This review discusses published studies of heavy rainfall events over the Mediterranean Basin, combining them in a more general picture of the dynamic and thermodynamic factors and processes that produce heavy rain storms. It distinguishes the western and eastern Mediterranean in order to point out specific regional peculiarities. The crucial moisture for developing intensive convection over these regions can be originated not only from the adjacent Mediterranean Sea but also from distant upwind sources. Transport from remote sources is usually in the mid-tropospheric layers and associated with specific features and patterns of the larger-scale circulations. The synoptic systems (tropical and extratropical) that account for most of the major extreme precipitation events and the coupling of circulation and extreme rainfall patterns are presented. Heavy rainfall over the Mediterranean Basin is caused at times in concert by several atmospheric processes working at different atmospheric scales, such as local convection, upper synoptic-scale-level troughs, and mesoscale convective systems. Under tropical air-mass intrusions, convection generated by static instability seems to play a more important role than synoptic-scale vertical motions. Locally, the occurrence of torrential rains and their intensity is dependent on factors such as temperature profiles and implied instability, atmospheric moisture, and lower-level convergence.

  15. Oral conditions in renal disorders and treatment considerations – A review for pediatric dentist

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    Megha Gupta

    2015-07-01

    Full Text Available This article reviews the current understanding of the oral and dental aspects of chronic renal disease (CRD. A PubMed literature search was performed and all relevant studies were assessed. As the number of people suffering from CRD increases worldwide, dentists are expected to encounter more patients with CRD who need oral care. In children, CRD can elicit a wide spectrum of oral manifestations in the hard and soft tissues. Bleeding, altered drug metabolism, impaired immune function, and an increased risk of dentally induced bacterial endocarditis are some important features that require attention. Dental management of patients with CRD requires that clinicians appreciate that multiple systems can be affected by the disease. Dentists should consult with nephrologists regarding the specific precautions required for each patient. Medical treatments in these patients may need to be postponed due to an unfavorable oral health status or potential risk of life-threatening infection after surgery. Improving oral hygiene and performing necessary dental and oral treatment before hemodialysis or transplantation may prevent endocarditis and septicemia in these patients. Hence, treatment plans should be formulated to restore the patient’s dentition and protect them from potentially severe infections of dental origin.

  16. Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review

    Science.gov (United States)

    2013-01-01

    Introduction Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010. Methods A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes. Results Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did. Conclusions This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth. PMID:23915121

  17. Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review.

    Science.gov (United States)

    Campos-Serna, Javier; Ronda-Pérez, Elena; Artazcoz, Lucia; Moen, Bente E; Benavides, Fernando G

    2013-08-05

    Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010. A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes. Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did. This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

  18. Cyber-Victimization of People With Chronic Conditions and Disabilities: A Systematic Review of Scope and Impact.

    Science.gov (United States)

    Alhaboby, Zhraa A; Barnes, James; Evans, Hala; Short, Emma

    2017-01-01

    The victimization of individuals with chronic conditions or disabilities is prevalent with severe impact at psychological and physiological levels. With the increasing use of technology these experiences were further reshaped. This systematic review aimed at scoping the experiences of cyber-victimization of people living with chronic conditions or disabilities and examine the documented impact on them. Following a four-stage search strategy in several databases including MEDLINE, Embase, PsychINFO, CINAHL, Cochrane and snowballing of references, a total of 2,922 studies were scanned and 10 studies were eventually included. Quality assessment was done in two phases using tools specific to observational studies and cyber-victimization research. A narrative synthesis of reported results covered a total of 3,070 people. Sample size ranged between 42 and 823 participants, and the age range was 6-71 years with a majority of White ethnic backgrounds. Most studies (n=9) were cross sectional. The prevalence range of cyber-victimization was 2%-41.7% based on variable definitions, duration and methods. Targeted conditions included physical impairments, intellectual disabilities and specific chronic diseases. The most common documented impact was psychological/psychiatric, mainly depression followed by anxiety and distress. Somatic health complaints and self-harm were also reported. We concluded that people with chronic conditions and disabilities were consistently at higher risk of victimization with devastating health complications. Research gaps were identified such as the need to address more conditions and acknowledge differences between heterogeneous health conditions. Other recommendations include allowing flexibility and accountability to patients/victims in research design, education on victimization and health consequences, and improving primary care.

  19. Review of the Factors that Influence the Condition of Wax Deposition in Subsea Pipelines

    Directory of Open Access Journals (Sweden)

    Koh Junyi

    2018-03-01

    Full Text Available When crude oil is transported via sub-sea pipeline, the temperature of the pipeline decreases at a deep depth which causes a difference in temperature with the crude oil inside. This causes the crude oil to dissipate its heat to the surrounding until thermal equilibrium is achieved. This is also known as the cloud point where wax begins to precipitate and solidifies at the walls of the pipeline which obstruct the flow of fluid. The main objective of this review is to quantify the factors that influence wax deposition such as temperature difference between the wall of the pipeline and the fluid flowing within, the flow rate of the fluid in the pipeline and residence time of the fluid in the pipeline. It is found the main factor that causes wax deposition in the pipeline is the difference in temperature between the petroleum pipeline and the fluid flowing within. Most Literature deduces that decreasing temperature difference results in lower wax content deposited on the wall of the pipeline. The wax content increases with rising flow rate. As for the residence time, the amount of deposited wax initially increases when residence time increases until it reaches a peak value and gradually decreases. Flow-loop system and cold finger apparatus were used in literature investigations to determine the trends above. Three new models are generated through a regression analysis based on the results from other authors. These new models form a relationship between temperature difference, flow rate, residence time and Reynolds number with wax deposition. These models have high values of R-square and adjusted R-square which demonstrate the reliability of these models.

  20. Zika puzzle in Brazil: peculiar conditions of viral introduction and dissemination - A Review

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    Cristina Possas

    Full Text Available This article discusses the peculiar conditions that favoured the unexpected introduction of Zika virus into the poorest northeastern region of Brazil in 2015, its speed of transmission to other Brazilian states, other Latin American countries and other regions, and the severity of related neurological disorders in newborns and adults. Contrasting with evidence that Zika had so far caused only mild cases in humans in the last six decades, the epidemiological scenario of this outbreak in Brazil indicates dramatic health effects: in 2015, an increase of 20-fold in notified cases of microcephaly and/or central nervous system (CNS alterations suggestive of Zika congenital infection, followed by an exponential increase in 2016, with 2366 cumulative cases confirmed in the country by the end of December 2016. A significant increase in Guillain-Barré syndrome in adults has also been reported. Factors involved in viral dissemination, neural pathogenesis and routes of transmission in Brazil are examined, such as the role of social and environmental factors and the controversies involved in the hypothesis of antibody-dependent enhancement, to explain the incidence of congenital Zika syndrome in Brazil. Responses to the Zika outbreak and the development of new products are also discussed.

  1. Genetics of body condition score as an indicator of dairy cattle fertility. A review

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    Bastin, C.

    2013-01-01

    Full Text Available Body condition score (BCS is a subjective measure of the amount of metabolizable energy stored in a live animal. Change in BCS of dairy cows is considered to be an indicator of the extent and the duration of postpartum negative energy balance. Although change in BCS over lactation is lowly heritable, heritability estimates of level of BCS range from 0.20 to 0.50. Also, BCS tends to be more heritable in mid-lactation indicating that genetic differences are more related to how well cows recover from the negative energy balance state. BCS measurements are generally highly correlated within and between lactations. Genetic correlations with BCS are unfavorable for milk, fat, and protein yield, suggesting that genetically superior producers tend to have lower BCS, especially during the lactation. Genetic correlations are generally moderate and favorable with fertility indicating that cows with higher levels of BCS would have a greater chance to conceive after insemination and fewer number of days when not pregnant. Because direct selection to improve fertility might be complicated by several factors, selection for higher levels of BCS, especially in mid-lactation, appears to be a good option to indirectly improve fertility in dairy cows.

  2. Performance Analysis Review of Thorium TRISO Coated Particles during Manufacture, Irradiation and Accident Condition Heating Tests

    International Nuclear Information System (INIS)

    2015-03-01

    Thorium, in combination with high enriched uranium, was used in all early high temperature reactors (HTRs). Initially, the fuel was contained in a kernel of coated particles. However, particle quality was low in the 1960s and early 1970s. Modern, high quality, tristructural isotropic (TRISO) fuel particles with thorium oxide and uranium dioxide (UO 2 ) had been manufactured since 1978 and were successfully demonstrated in irradiation and accident tests. In 1980, HTR fuels changed to low enriched uranium UO 2 TRISO fuels. The wide ranging development and demonstration programme was successful, and it established a worldwide standard that is still valid today. During the process, results of the thorium work with high quality TRISO fuel particles had not been fully evaluated or documented. This publication collects and presents the information and demonstrates the performance of thorium TRISO fuels.This publication is an outcome of the technical contract awarded under the IAEA Coordinated Research Project on Near Term and Promising Long Term Options for Deployment of Thorium Based Nuclear Energy, initiated in 2012. It is based on the compilation and analysis of available results on thorium TRISO coated particle performance in manufacturing and during irradiation and accident condition heating tests

  3. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

    Science.gov (United States)

    CALDAS, Waleska; CONTI, Ana Cláudia de Castro Ferreira; JANSON, Guilherme; Paulo César Rodrigues, CONTI

    2016-01-01

    ABSTRACT The relationship between Temporomandibular Disorders (TMD) and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. Objectives The aim of this article is to present the most commonly occlusal changes secondary to TMD. Methods The clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented. Conclusions All plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy. PMID:27556214

  4. Review of Lepidoptera with trophic relationships to Picea abies (L. in the conditions of Czechia

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    Modlinger Roman

    2016-12-01

    Full Text Available Trophic relationships of Lepidoptera (Insecta occurring in the territory of Czechia to the Norway spruce (Picea abies L. was evaluated on the basis of the excerption and critical evaluation of literature. Each species was classified into the following categories – spruce as the host plant, regular development on spruce, narrow trophic relationship, indirect relationship and episodical occurrence. The particular taxa were also characterized according to their distribution and the form of larval life was specified. The development on spruce was documented in 96 species of Lepidoptera, which represented less than 3% of taxa belonging to this group and being reported from Czechia. Of that, spruce was a common host plant for 67 species, 23 species were polyphagous and might develop on spruce, and 6 species belonged to soil species damaging spruce roots, mainly in forest nurseries. Among the species of Lepidoptera, which regularly develop on spruce in the Czech conditions, 55 species were classified. As narrow specialists with special trophic relationship to spruce, 33 taxa could be considered. There were 15 spruce species with forestry importance, which were able to outbreak their populations regularly or irregularly. Among spruce species it was possible to classify 16 taxa as rare. The provided information on Lepidoptera with trophic relationship to spruce is applicable also for other Central European areas. Besides the species with importance for forest pest management, also rare taxa, which can become endangered by climate change or by forest management, were indicated.

  5. Zika puzzle in Brazil: peculiar conditions of viral introduction and dissemination - A Review

    Science.gov (United States)

    Possas, Cristina; Brasil, Patricia; Marzochi, Mauro CA; Tanuri, Amilcar; Martins, Reinaldo M; Marques, Ernesto TA; Bonaldo, Myrna C; Ferreira, Antonio GP; Lourenço-de-Oliveira, Ricardo; Nogueira, Rita Maria R; Sequeira, Patricia C; Marzochi, Keyla BF; Homma, Akira

    2017-01-01

    This article discusses the peculiar conditions that favoured the unexpected introduction of Zika virus into the poorest northeastern region of Brazil in 2015, its speed of transmission to other Brazilian states, other Latin American countries and other regions, and the severity of related neurological disorders in newborns and adults. Contrasting with evidence that Zika had so far caused only mild cases in humans in the last six decades, the epidemiological scenario of this outbreak in Brazil indicates dramatic health effects: in 2015, an increase of 20-fold in notified cases of microcephaly and/or central nervous system (CNS) alterations suggestive of Zika congenital infection, followed by an exponential increase in 2016, with 2366 cumulative cases confirmed in the country by the end of December 2016. A significant increase in Guillain-Barré syndrome in adults has also been reported. Factors involved in viral dissemination, neural pathogenesis and routes of transmission in Brazil are examined, such as the role of social and environmental factors and the controversies involved in the hypothesis of antibody-dependent enhancement, to explain the incidence of congenital Zika syndrome in Brazil. Responses to the Zika outbreak and the development of new products are also discussed. PMID:28443985

  6. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

    Science.gov (United States)

    Persaud, Ricardo; Garas, George; Silva, Sanjeev; Stamatoglou, Constantine; Chatrath, Paul; Patel, Kalpesh

    2013-01-01

    Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, ‘first bite syndrome’, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’. PMID:23476731

  7. Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review

    Directory of Open Access Journals (Sweden)

    Kara K. Patterson

    2018-03-01

    Full Text Available Purpose: To conduct a systematic review that examined the effect of dance interventions on balance, gait and functional mobility outcomes in adults with neurological conditions other than Parkinson's disease. Methods: A systematic search of relevant databases was conducted. Data extraction and methodological appraisal were performed by two independent authors. Results: Nine studies were included (4 pre-post studies with no control group, 3 case reports, and 2 controlled studies and results of the methodological quality assessment ranged from poor to good. Study groups included stroke, multiple sclerosis, spinal cord injury, and Huntington's disease. Dance interventions varied in frequency, type and duration, and only 1 study reported intensity. Study dropout rates ranged from 20–44%, and 88–100% of dance classes were attended. Only 3 studies mentioned adverse events, of which there were none. A summary of results revealed significant changes in spatiotemporal gait parameters, Berg Balance Scale scores, Timed Up and Go test and six-minute walk test that were similar to or greater than those previously reported in a review of dance for individuals with Parkinson's disease. Conclusions: There is emerging evidence to support the use of dance as a feasible intervention for adults with neurological conditions. Further investigation of the effects of dance with randomized controlled trials using larger sample sizes and better reporting of the intervention, participant tolerance, and adverse events is warranted. Keyword: Rehabilitation

  8. The role of information in supporting self-care in vascular conditions: a conceptual and empirical review.

    Science.gov (United States)

    Blickem, Christian; Bower, Peter; Protheroe, Joanne; Kennedy, Anne; Vassilev, Ivaylo; Sanders, Caroline; Kirk, Sue; Chew-Graham, Carolyn; Rogers, Anne

    2011-09-01

    Self-care has the potential to make a significant contribution to vascular conditions, but engagement with self-care support has been limited. Lack of relevant information is highlighted by patients and policy-makers as an important barrier to effective self-care, and information provides a potentially efficient platform for changing behaviour. However, work within the social sciences has generally seen information as a necessary but insufficient driver of health behaviours. Furthermore, some groups (such as the socially disadvantaged) are expected to be less amenable to information interventions. We conducted an integrated conceptual and empirical review on information-based interventions for people with vascular disease (diabetes, heart disease and kidney disease). We reviewed conceptual and empirical work concerning the role and impact of information in self-care support to generate an explanatory framework to determine why information was effective or ineffective in encouraging self-care in patients with vascular conditions. This involved mapping relevant theories and models linking information and self-care. We also explored published systematic reviews of educational interventions in diabetes, coronary heart disease and chronic kidney disease to examine the role of information and evidence concerning its effectiveness and impact in different patient populations. The conceptual review identified variation among information interventions in terms of type, function, and their relationship to behaviour change techniques and psychological mediators of behaviour change. Key moderators of the effect of information included types of disorder, and patient capacity and resources. A wealth of educational interventions exists for diabetes and heart conditions, but the precise components of these interventions that are effective are difficult to identify. There is little evidence concerning optimal ways of tailoring interventions for socially disadvantaged groups other

  9. Cupping therapy versus acupuncture for pain-related conditions: a systematic review of randomized controlled trials and trial sequential analysis.

    Science.gov (United States)

    Zhang, Ya-Jing; Cao, Hui-Juan; Li, Xin-Lin; Yang, Xiao-Ying; Lai, Bao-Yong; Yang, Guo-Yang; Liu, Jian-Ping

    2017-01-01

    Both cupping therapy and acupuncture have been used in China for a long time, and their target indications are pain-related conditions. There is no systematic review comparing the effectiveness of these two therapies. To compare the beneficial effectiveness and safety between cupping therapy and acupuncture for pain-related conditions to provide evidence for clinical practice. Protocol of this review was registered in PROSPERO (CRD42016050986). We conducted literature search from six electronic databases until 31st March 2017. We included randomized trials comparing cupping therapy with acupuncture on pain-related conditions. Methodological quality of the included studies was evaluated by risk of bias tool. Mean difference, risk ratio, risk difference and their 95% confidence interval were used to report the estimate effect of the pooled results through meta-analysis or the results from each individual study. Trial sequential analysis (TSA) was applied to adjust random errors and calculate the sample size. Twenty-three randomized trials with 2845 participants were included covering 12 pain-related conditions. All included studies were of poor methodological quality. Three meta-analyses were conducted, which showed similar clinical beneficial effects of cupping therapy and acupuncture for the rate of symptom improvement in cervical spondylosis (RR 1.13, 95% CI 1.01 to 1.26; n = 646), lateral femoral cutaneous neuritis (RR 1.10, 95% CI 1.00 to 1.22; n = 102) and scapulohumeral periarthritis (RR 1.31, 95% CI 1.15 to 1.51; n = 208). Results from other outcomes (such as visual analogue and numerical rating scale) in each study also showed no statistical significant difference between these two therapies for all included pain-related conditions. The results of TSA for cervical spondylosis demonstrated that the current available data have not reached a powerful conclusion. No serious adverse events related to cupping therapy or acupuncture was found in included

  10. Body condition and suckling as factors influencing the duration of postpartum anestrus in cattle: a review.

    Science.gov (United States)

    Montiel, F; Ahuja, C

    2005-01-01

    Prolonged postpartum anestrus is a main factor limiting reproductive efficiency in cattle, particularly in Bos indicus and Bos taurus/Bos indicus cows from tropical regions, because it prevents achievement of a 12 month calving interval. During anestrus, ovulation does not occur despite ovarian follicular development, because growing follicles do not mature. Although many factors affect postpartum anestrus, nutrition and suckling are the major factors influencing the resumption of postpartum ovarian cycles, as they affect hypothalamic, pituitary and ovarian activity and thus inhibit follicular development. Under-nutrition contributes to prolonged postpartum anestrus, particularly among cows dependent upon forages to meet their feed requirements and it apparently interacts with genetic, environmental or management factors to influence the duration of anestrus. The nutritional status or balance of an animal is evaluated through body condition score (BCS), as it reflects the body energy reserves available for metabolism, growth, lactation and activity. There is a converse relationship between energy balance and time to resumption of postpartum ovarian activity; inadequate nutrient intake results in loss of weight and BCS and finally cessation of estrous cycles. Suckling interferes with hypothalamic release of GnRH, provoking a marked suppression in pulsatile LH release, resulting in extended postpartum anestrus. The effects of suckling on regulation of tonic LH release are determined by the ability of the cow to identify a calf as her own or as unrelated. Vision and olfaction play critical roles in the development of the maternal-offspring bond, allowing the cow to identify her own calf, and abolition of both senses attenuates the negative effects of suckling on LH secretion. Thus, the maternal-offspring bond is essential for prolonged postpartum suckling-induced anovulation, and the suppressive influence of suckling is independent of neurosensory pathways within the

  11. Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

    Science.gov (United States)

    Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

    2017-11-01

    Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

  12. Annual Research Review: The role of the environment in the developmental psychopathology of autism spectrum condition.

    Science.gov (United States)

    Mandy, William; Lai, Meng-Chuan

    2016-03-01

    Although autism spectrum condition (ASC) is strongly genetic in origin, accumulating evidence points to the critical roles of various environmental influences on its emergence and subsequent developmental course. A devel