Effectiveness and Safety of Minimally Invasive Orthodontic Tooth Movement Acceleration: A Systematic Review and Meta-analysis

Doctors and patients attempt to accelerate orthodontic tooth movement with a minimally invasive surgery approach. The purpose of this systematic review was to evaluate the evidence of accelerated tooth movement in minimally invasive surgery and the adverse effects from it. A systematic search of the literature was performed in the electronic databases of PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Embase, Scopus, Web of Science, Science Direct, and Medline and was complemented by a manual search until February 2019. The inclusion criteria were prospective clinical studies of patients treated with a fixed appliance, and the intervention was accelerated orthodontic treatment with minimally invasive surgery. Nineteen articles (538 participants) were included in the review: 9 studies assessed the rate of upper canine movement; 5 considered the treatment time; 1 evaluated the en masse retraction time; and 4 studied adverse effects. We performed a meta-analysis for the rate of canine movement and treatment time and described the results for the adverse effects in a systematic review. The results of the subgroup analysis according to micro-osteoperforation and piezocision were included in the study. No accelerated tooth movement was found in the micro-osteoperforation group. After flapless corticotomy procedures, increased tooth movement rates were identified by weighted mean differences of 0.63 (95%CI = 0.22, 1.03, P = 0.003) and 0.64 (95% CI, −25 to 1.53; P = 0.16) for 1 and 2 mo, respectively. The mean treatment time was 68.42 d (95% CI, −113.19 to −23.65; P = 0.003) less that than for minimally invasive surgery. Moreover, no significant adverse effect was found. Because of the high heterogeneity of the meta-analysis, the results must be validated by additional large-sample multicenter clinical trials. There is not sufficient evidence to support that the single use of micro-osteoperforation could accelerate tooth movement, and there is only low-quality evidence to prove that flapless corticotomy could accelerate tooth movement.

P3390Relationship of thrombus healing to underlying plaque characteristics in ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Acute ST-segment elevation myocardial infarction (STEMI) is typically characterized by an occlusive coronary thrombus propagation on a disrupted or eroded atherosclerotic plaque. A variable period of plaque instability and thrombus formation occur days or weeks old in approximately 50% of patients with STEMI. Presence of late stage (older) thrombi in aspirated coronary material is an independent predictor of 1-year and long-term mortality in STEMI patients. However, the relationship between coronary thrombus healing to underlying plaque morphology and characteristics in vivo still remains largely unknown.

Purpose

Our objective was to assess differences in thrombus healing between ruptured and eroded plaques in vivo and evaluate the impact of underlying plaque characteristics on thrombus healing using optical coherence tomography (OCT).

Methods

Analyzable coronary material was obtained during primary percutaneous coronary intervention (PCI) from 135 patients with STEMI within 12h of symptom onset. Thrombi were morphologically classified as either early or late stage (lytic changes or organization). Of the 135 patients, 110 were eligible for culprit lesion evaluation using OCT. Quantitative and qualitative underlying plaque characteristics were assessed by OCT.

Results

Late-stage thrombi were found in 49 of 110 (44.5%) culprit plaques. Patients with eroded plaques more frequently had late-stage thrombi compared with ruptured plaques (59.0% vs. 36.6%, p<0.001). Subgroup analysis was performed between plaque rupture, identified in 71 patients (64.5%) and plaque erosion in 39 patients (35.5%). In plaque ruptures, patients with late-stage thrombi had larger lipid core length (12.4±3.3 vs. 14.5±3.8, p=0.020), larger rupture cavity length [1.5 (1.0, 2.0) vs. 1.9 (1.5, 2.8), p=0.034] and increased residual thrombus length [7.8 (6.3, 11.2) vs. 10.3 (7.8, 13.8), p=0.021] assessed by OCT compared with early thrombus group. However, in plaque erosions, late stage thrombi were associated with decreased residual thrombus burden compared with patients with early thrombus group [16.8 (12.8, 20.4) vs. 13.4 (10.7, 14.8), p=0.012]. No significant difference was found between thrombus healing with peak creatine kinase concentration or maximum NT-pro BNP in subgroup analysis.

Conclusions

Coronary thrombi in STEMI patients exhibited diverse phases of healing, depending on the etiology of the underlying culprit plaque in vivo. These observations indicate entirely distinct mechanisms of thrombus propagation, maturation and healing between plaque rupture and erosion, illustrating an opportunity for more tailored treatment in patients with different plaque type.

[A study on the association between the infant anemia and the utilization of maternal and child health services in ethnic minorities gathering in poverty-stricken rural areas of two provinces in Western China]

In this study, 1 065 infants and young children aged 24 months below in ethnic minorities gathering in poor rural areas in poor rural areas of Liangshan Yi Autonomous Prefecture of Sichuan Province and Gannan Tibetan Autonomous Prefecture of Gansu Province were investigated for their anemia status from October to November 2014, and the association between anemia and the utilization of maternal and child health services was analyzed. The prevalence of anemia in this area was 52.68%(561/1 065). After the adjustment of socio-demographic characteristics of mothers and infants, compared with infants aged 2-5 months, Han ethnic group, and infants whose mother was not anemic, the OR(95%CI) values of infant anemia for infants aged 6-12 months, 13-8 months, 19-24 months, ethnic minorities group, and infants whose mother was anemic were 11.65 (7.09-19.14), 9.91 (5.99-16.38), 5.87 (3.39-10.16), 1.55 (1.10-2.18) and 1.52 (1.14-2.04), respectively; Compared with infants whose child examination times not up to standard, and who were not only non-hospital delivered but also received inadequate number of inoculation, the OR (95%CI) values of infant anemia for infants whose child examination times up to standard, and who were not only hospital delivered but also received adequate number of inoculation were 0.60 (0.38-0.94) and 0.71 (0.52-0.98), respectively. The infants anemia is associated with the utilization of maternal and child health services.

Efficacy of Nd-YAG laser for treatment of pyogenic granuloma on the fingers and toes

Pyogenic granuloma (PG) is a common benign vascular proliferation which often occurs on the head, neck, hands, and feet. Among the various treatment options for PG, surgical excision is the most effective treatment which offers the lowest overall recurrence rates and also provides the exact diagnosis. However, it could have difficulties to do the surgery when lesions are located on the fingers and toes, especially very near to the nails, so laser may be a very good alternative choice. In this article, we evaluated the clinical efficacy and safety of neodymium-yttrium aluminum garnet (Nd:YAG) laser for treatment of PG located on the fingers and toes. Twenty-one patients with 21 PGs located on the fingers and toes were treated by multispot Nd-YAG laser. We chose monopulse (pulse width 10.5-13.5 ms; energy 100-125 J/cm²); treatment interval was 3-4 weeks. All lesions disappeared after one or two treatments. There was no apparent scar formation, no impact on the function of the fingers and toes, no damage to nail growth, and no recurrence in more than 12-month follow-up. Nd-YAG is an effective and safety treatment option for treatment of PG located on the fingers and toes.

Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: A multicenter prospective cohort study

Infection of hepatitis B virus (HBV) occurs in ~10% of infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg) after immunoprophylaxis. We aimed to evaluate the safety and efficacy of telbivudine used during late pregnancy for preventing mother-to-child transmission of HBV. We conducted a multicenter prospective cohort study in 5 hospitals from 2012 to 2014, which enrolled HBV-infected singleton pregnant women with positive HBeAg. By their choice, women were divided into therapy (telbivudine 600 mg/day, from gestation 28-32 weeks to 3-4 weeks postpartum) and control (no antiviral agent) groups. Infants received passive-active immunoprophylaxis and follow-up at the age of 7-14 months. Totally, 328 pregnant women were included: 149 in the telbivudine group and 179 in the control group. Baseline HBV DNA levels were similar in the 2 groups (7.43 vs 7.37 log₁₀ IU/mL, P = .711). At delivery, HBV DNA levels in the telbivudine and control groups were 3.80 and 7.26 log₁₀ IU/mL, respectively (P < .0001). Of the infants, 128 (85.9%) in the telbivudine group and 156 (87.2%) in the control group were followed up. No infant in the telbivudine group had chronic infection, while 2 (1.28%) infants in the control group did (P = .503). Three (2.34%) infants in the telbivudine group, but none in the control group, had severe congenital or developmental abnormalities (P = .090). The data indicate that telbivudine may block perinatal HBV transmission. However, larger studies are required to clarify whether anti-HBV therapy in pregnancy is associated with severe adverse effects in the foetuses and infants.

Non-invasive acquisition of fetal ECG from the maternal xyphoid process: a feasibility study in pregnant sheep and a call for open data sets

OBJECTIVE

The utility of fetal heart rate (FHR) monitoring can only be achieved with an acquisition sampling rate that preserves the underlying physiological information on the millisecond time scale (1000 Hz rather than 4 Hz). For such acquisition, fetal ECG (fECG) is required, rather than the ultrasound to derive FHR. We tested one recently developed algorithm, SAVER, and two widely applied algorithms to extract fECG from a single-channel maternal ECG signal recorded over the xyphoid process rather than the routine abdominal signal.

APPROACH

At 126dG, ECG was attached to near-term ewe and fetal shoulders, manubrium and xyphoid processes (n  =  12). fECG served as the ground-truth to which the fetal ECG signal extracted from the simultaneously-acquired maternal ECG was compared. All fetuses were in good health during surgery (pH 7.29  ±  0.03, pO₂ 33.2  ±  8.4, pCO₂ 56.0  ±  7.8, O₂Sat 78.3  ±  7.6, lactate 2.8  ±  0.6, BE  -0.3  ±  2.4).

MAIN RESULT

In all animals, single lead fECG extraction algorithm could not extract fECG from the maternal ECG signal over the xyphoid process with the F1 less than 50%.

SIGNIFICANCE

The applied fECG extraction algorithms might be unsuitable for the maternal ECG signal over the xyphoid process, or the latter does not contain strong enough fECG signal, although the lead is near the mother's abdomen. Fetal sheep model is widely used to mimic various fetal conditions, yet ECG recordings in a public data set form are not available to test the predictive ability of fECG and FHR. We are making this data set openly available to other researchers to foster non-invasive fECG acquisition in this animal model.

Magnetic field application or mechanical stimulation via magnetic microparticles does not enhance chondrogenesis in mesenchymal stem cell sheets

Using a novel magnetic field bioreactor, this work evaluated the chondrogenesis of scaffold-free human mesenchymal stem cell sheets in response to static and variable magnetic fields, as well as mechanical stimulation via 4.4 μm magnetic particles. Neither static nor variable magnetic fields generated by 1.44-1.45 T permanent magnets affected cartilage formation. Notably, magnetic field-induced mechanical stimulation by magnetic particles, which applied forces to the cells and ECM statically (4.39 pN) or cyclically (1.06-63.6 pN; 16.7 mHz), also did not affect cartilage formation.

No effect of AR polyG polymorphism on spinal and bulbar muscular atrophy phenotype

BACKGROUND AND PURPOSE

Disease severity varies considerably among patients with Spinal and Bulbar Muscular Atrophy (SBMA). Our aim was to investigate the role of androgen receptor (AR) polymorphic repeats in SBMA phenotype.

METHODS

We analyzed the length of AR polyQ and polyG tracts in 159 SBMA patients.

RESULTS

No relationship between polyG size or polyG/polyQ haplotypes and clinical phenotype was found. An independent negative correlation between polyQ-length and onset of weakness was confirmed (P < 0.001).

CONCLUSIONS

The negative results of our study prompt to continue the search for potential disease modifiers in SBMA outside the AR gene.