Aetiopathogenesis and Treatment Evaluation of Odontogenic Cellulitis in the Maxillofacial Region: a Retrospective Study

Dosage and duration of antipsychotic treatment in demented outpatients with agitation or psychosis.

A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients.

Objective: to evaluate the effectiveness of injections of platelet-rich plasma in the treatment of muscle injuries of the lower limb grade 2A-2B in professional soccer players. Materials and methods: a retrospective analysis of the duration and the methods of muscle damage treating in several leading professional football (soccer) clubs in Russia was carried out. Methods and duration of muscle injury treatment were analyzed during two seasons in several leading Russian clubs, whose players are included in the Russian Football Premier League, Europa League UEFA, UEFA Champions League and who represent their National Teams. The study included players with muscle injuries of the lower extremities grade 2A-2B according to the classification of the British Athletic Association (67 people, average age 27±4.8 years, height 182±5.9 cm, weight 77±5.8 kg). Football players were divided into two groups according to the type of treatment: using local injections of PRP (34 people) and without using them (33 people). 12 people received PRP once in a volume of 8-10 ml. 6 people received one injection every 5-7 days (a total of 2-3 injections of PRP in a volume of 3-5 ml). 16 people received one injection every 5-7 days (a total of 2-3 injections of PRP in a volume of 8-10 ml). During the study, information was recorded on the total duration of treatment (before the start of regular training activity) and on the development of relapses (repeated trauma in the same place within two months after entering the general group). Result: the use of local injections of PRP does not significantly affect the duration of treatment and the number of relapses, regardless of the location of the damage and its severity. The total duration of treatment was 15 days among all players. In the group using local injections of PRP the total duration of treatment was 18 days and 14 days in the group without using RTP. Relapses were seen in 10 % of cases among all players. In the group using local injections of PRP relapses were seen in 9% and in 12 % in the group without using RTP. Conclusions: during the study, the effect of local PRP injections on the duration of treatment of muscle injuries of grade 2A-2B, on the number of relapses and on the duration of treatment of muscle injuries of various localizations was not found. The absence of statistically significant changes in the duration of treatment may be due to differences in the protocol for the administration of PRP. Future work should focus on comparing the various protocols for introducing PRP.

Ventriculoperitoneal Shunt Infections in Adult Patients

Ventriculoperitoneal Shunt Infections in Adult Patients

To investigate the combined orthodontic-orthognathic treatment times at an academic hospital in the UK and to consider the level of occlusal change in delivering this treatment by the way of comparing peer assessment rating (PAR) scores pre- and post-treatment. It was a retrospective longitudinal study of orthognathic patients between 2010 and 2013 who had completed orthognathic treatment. Analysis of records of 50 patients was carried out. Age, gender malocclusion, and skeletal pattern, extraction/nonextraction of teeth, duration of active orthodontic treatment, number of appointments, transfer of patients between orthodontists mid-treatment, and PAR scores pre and post-treatment were recorded for each patient. The skeletal pattern was III in 70% of and II in 28% of patients. Mean duration of active orthodontic treatment was 27.9 months. Age, gender, malocclusion, and skeletal pattern did not seem to affect treatment times. Extraction of teeth and transfer of operators increased treatment times. The mean PAR reduction was 89% with the PAR efficiency factor (reduction in PAR scores divided by duration of treatment in months) of 1.61. Younger patients, those with class III malocclusions and patients starting with higher PAR scores, achieved greater PAR reductions. Gender, number of appointments, extractions, transfer of operators, and total duration of treatment were not shown to affect the PAR % reduction. Combined orthodontic-orthognathic treatment has been effective in treating patients with severe skeletal discrepancies. Transfer of operators and extractions protracted treatment times. Younger patients and those with class III malocclusions achieved higher PAR % reduction.

To evaluate the generalizability of stringent protocol-driven weaning in improving total duration of opioid treatment and length of inpatient hospital stay after treatment of neonatal abstinence syndrome (NAS). We conducted a retrospective cohort analysis of 981 infants who completed pharmacologic treatment of NAS with methadone or morphine from January 2012 through August 2014. Before July 2013, 3 of 6 neonatology provider groups (representing Ohio's 6 children's hospitals) directed NAS nursery care by using group-specific treatment protocols containing explicit weaning guidelines. In July 2013, a standardized weaning protocol was adopted by all 6 groups. Statistical analysis was performed to identify effects of adoption of the multicenter weaning protocol on total duration of opioid treatment and length of hospital stay at the protocol-adopting sites and at the sites with preexisting protocol-driven weaning. After adoption of the multicenter protocol, infants treated by the 3 groups previously without stringent weaning guidelines experienced shorter duration of opioid treatment (23.0 vs 34.0 days, P < .001) and length of inpatient hospital stay (23.7 vs 31.6 days, P < .001). Protocol-adopting sites also experienced a lower rate of adjunctive drug therapy (5% vs 21%, P = .004). Outcomes were sustained by the 3 groups who initially had specific weaning guidelines after multicenter adoption (duration of treatment = 17.0 days and length of hospital stay = 23.3 days). Adoption of a stringent weaning protocol resulted in improved NAS outcomes, demonstrating generalizability of the protocol-driven weaning approach. Opportunity remains for additional protocol refinement.

BackgroundAlthough clozapine is the most effective drug for treatment-resistant schizophrenia, its use remains restricted in clinical practice in India. The delay in initiating treatment with clozapine and its impact on...

This retrospective study aimed to determine whether acorrelation exists between the fractal dimension value and overall orthodontic treatment duration in children and young adults. The study included atotal of 643 patients (age: 10-25 years) who received orthodontic treatment between January 2015 and March 2020. Patient records and pretreatment panoramic radiographs were evaluated. The regions of interest selected for calculating fractal dimension were the bilateral mental foramen regions of the mandible. Fractal dimension was set in relation to orthodontic treatment duration using alinear regression model which was also adjusted for potential confounding variables. Total treatment duration was the outcome variable of interest used as acontinuous variable. The predictor variables of interest included age, gender, type of dental and skeletal malocclusion, vertical growth pattern, extraction type, and fractal dimension. The mean age, treatment duration, and fractal dimension were 14.56 years, 27.01 months, and 1.23 mm, respectively. Multiple linear regression analysis showed that the fractal dimension had asignificant influence on overall treatment duration (P < 0.001). From the other variables, Angle classII malocclusion significantly influenced treatment duration (P < 0.01), age showed asignificant negative correlation with treatment duration (P < 0.01), and treatment duration significantly increased for patients with tooth extractions (P < 0.001). There was anegative correlation between fractal dimensions at the mandibular mental region and total orthodontic treatment duration. Fractal dimension analysis may help to understand physiologic features of alveolar bone and predict orthodontic tooth movement.

Platelet-rich plasma (PRP) injections are extremely popular in the management of sports injuries in elite athletes. However, data on the use of various administration protocols of PRP are contradictory. The efficacy of platelet-rich plasma in the treatment of muscle injuries in professional soccer players has to be contextualized within the sport-specific rehabilitation program. Despite the questionable role of PRP, a well-structured rehabilitation program is still regarded as the gold standard. We examined the efficacy of various PRP protocols in the management of muscle injuries in professional soccer players in respect to treatment duration and injury recurrence. A retrospective cohort study. Muscle injuries in professional soccer players (n = 79, height 182.1 ± 5.9 cm, weight 76.8 ± 5.8 kg, BMI 23.1 ± 1.4 kg/m2) from three elite soccer clubs from the Russian Premier League were recorded during the 2018–2019 season. The injuries were graded based on MRI, using the British Athletic Muscle Injury Classification. Treatment protocols included the POLICE regimen, short courses of NSAID administration, and the specific rehabilitation program. The sample group of players were administered PRP injections. The average treatment duration with PRP injection was significantly longer than conventional treatment without PRP, 21.5 ± 15.7 days and 15.3 ± 11.1 days, respectively (p = 0.003). Soccer-specific rehabilitation and obtaining MRI/US before the treatment was associated with significantly reduced injury recurrence rate (p < 0.001). There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in respect of grade 2A–2B muscle injuries. The total duration of treatment of type 2A–2B injuries was 15 days among all players. In the group receiving local injections of PRP, the total duration of treatment was 18 days; in the group without PRP injections, the treatment duration was 14 days. In our study, PRP treatment was associated with longer treatment duration, regardless of which muscle was injured. This may reflect the tendency to use PRP in higher-degree injuries. Soccer-specific rehabilitation significantly reduced the injury recurrence rate when compared to the administration of PRP injections. MRI/US imaging before returning to play was also associated with a lower injury recurrence rate. There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in treatment of type 2A–2B muscle injuries.

Duration of treatment and occlusal outcome using Damon3 self-ligated and conventional orthodontic bracket systems in extraction patients: A prospective randomized clinical trial

Objective:The aim of this study was to assess the effect of possible influential factors on duration of fixed orthodontic treatment. Methods:This cross-sectional retrospective study included 505 female and 183 male orthodontic patients (a total of 688 persons) referring to a university department of orthodontics during 2016-2020. The study population included only those who had undergone fixed orthodontic treatment of both maxillary and mandibular arches. Information including age, gender, total treatment duration, number of missed treatment sessions, incidences of bracket debonding, and type of treatment plan were collected from patient records. Data were analyzed using SPSS software version 21 at 0.05 significance level. Results:The mean duration of orthodontic treatment was significantly longer in men than women (19.09±5.6 versus 18.22±4.56 months, respectively; P=0.040). The treatment duration was also longer in patients with a treatment plan including teeth extraction compared to non-extraction treatment plans (19.85±4.30 versus 17.56±5.02 months, respectively; P<0.001). Duration of treatment in patients with more than one missed treatment appointment was significantly longer than those who had . one missed session (P<0.001). Duration of treatment in patients with bracket debonding was significantly longer (P=0.030). Also, the duration of treatment had a significant correlation with the frequency of both missed sessions (r=0.365, P<0.001) and bracket debonding (r=0.098, P=0.01). Conclusion:Based on the results of the present study, missed sessions, treatment plan, and bracket debonding have the greatest effect on the duration of fixed orthodontic treatment.

THU0252 A Retrospective Analysis of Pacients with Spondylodiscitis Treated in Rheumatology Department

The CARI guidelines. Evidence for peritonitis treatment and prophylaxis: peritoneal dialysis-associated peritonitis in children.

IntroductionThe greater predisposition to infections, as well as the possibility of a worse response to treatment, can lead to the excessive use of antimicrobials among cancer patients. C-reactive protein (CRP) has gained prominence as a tool for monitoring therapeutic responses and reducing the duration of antibiotic therapy; however, few studies have analyzed this protein in cancer patient populations. We hypothesize that cancer patients with a good response to antibiotic therapy show a faster decline in serum CRP levels, which would allow us to identify candidates for short-course treatments.ObjectiveTo evaluate the behavior of serum CRP levels among adult cancer patients using antibiotic therapy, and its association with the duration of this treatment, therapeutic response, and clinical recurrence.MethodsThis work consisted of a retrospective study with cancer patients admitted to a university hospital between September 2018 and December 2019. Adults (age ≥ 18 years) who underwent at least one course of antibiotic therapy were included. CRP behavior over the first 7 days of treatment was classified as: i) good response: when the CRP value on the fifth day of therapy reached 50% or less of the peak value detected in the first 48 h of treatment, and ii) poor response: Maintenance, within the same interval, of a CRP value > 50% of the peak value in the first 48 h. The duration of antibiotic therapy was categorized as up to seven full days or more. Outcomes were assessed by events that occurred during the 30 days of hospitalization or until hospital discharge. Primary outcome: Clinical recurrence of the index infection. Secondary outcomes: i) Death from any cause; ii) microbiological recurrence; iii) therapeutic response; iv) colitis associated with Clostridioides difficile; and v) isolation of multi-resistant bacteria, whether in clinical or surveillance samples.ResultsThe final analysis consisted of 212 patients, with a median age (IQ) of 59.2 (48 – 67) years old and a predominance of females (65%), who were hypertensive (35%), smokers (21%), and diabetics (17.8%). There was no difference in clinical recurrence between the two groups (8.1% vs. 12.2%; p = 0.364), with a lower 30-day mortality in the good CRP response group (32.2% vs. 14.5%; p = 0.002). Despite the tendency towards a lower occurrence of other secondary outcomes in the good response group, these differences were not statistically significant. In the poor CRP response group, outcomes like clinical recurrence, mortality, and therapeutic response were significantly worse, regardless of the duration of antibiotic treatment.ConclusionIn this study, cancer patients with a good CRP response during antibiotic therapy presented lower mortality and a higher proportion of satisfactory therapeutic responses. CRP can be a useful tool when combined with other clinical information in optimizing the duration of antimicrobial treatment in a hospitalized cancer population.