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Alzahrani L, Denucci GC, Lippert F, Dehailan LA, Bhamidipalli SS, Hara AT. Impact of toothbrush head configuration and dentifrice abrasivity on non-carious cervical lesions in-vitro. J Dent 2024; 140:104798. [PMID: 38043721 DOI: 10.1016/j.jdent.2023.104798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE To investigate the effect of toothbrush head configuration and dentifrice slurry abrasivity on the development of simulated non-carious cervical lesions (NCCLs) in vitro. METHODS Extracted premolars were randomly allocated into 15 groups (n = 16) generated by the association between toothbrush head configuration (flat-trimmed, rippled, cross-angled/multilevel/rubbers added, cross-angled/multilevel/flex head, feathered) and dentifrice slurry abrasivity (low/medium/high). Teeth were mounted on acrylic blocks and had their roots partially covered with acrylic resin, leaving 2-mm root surfaces exposed. Toothbrushing was performed for 35,000 and 65,000 double-strokes. Specimens were analyzed using non-contact profilometry for dental volume loss (mm3) and lesion morphology. Data was analyzed using ANOVA with pairwise comparisons and Kruskal-Wallis tests. RESULTS The two-way interaction between toothbrush head configuration and slurry abrasivity was significant (p = 0.02). At 35,000 strokes, the flat-trimmed and cross-angled/multilevel/rubbers added toothbrushes caused the highest loss, when associated to the high-abrasive slurry (p<0.05); whereas cross-angled/multilevel/flex head showed the least loss, when associated to the low-abrasive (p<0.05). At 65,000, more dental loss was observed for all toothbrushes when associated to the high-abrasive slurry, with flat-trimmed causing the highest loss (p < 0.05). Lower dental loss rates were observed for cross-angled/multilevel/flex head associated to the low-abrasive slurry when compared to the other toothbrushes (p < 0.05), except to feathered (p = 0.14) and rippled (p = 0.08). Flat lesions (mean internal angle ± standard-deviation: 146.2°± 16.8) were mainly associated with low-abrasive slurry, while wedge-shaped lesions (85.8°± 18.8) were more frequent with medium- and high-abrasive slurries. CONCLUSION The development, progression and morphology of simulated NCCLs were modulated by both toothbrush head configuration and dentifrice abrasivity. CLINICAL SIGNIFICANCE Dental professionals should consider both the type of toothbrush and dentifrice abrasivity in the management plan of patients at risk of developing NCCLs.
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Affiliation(s)
- Lina Alzahrani
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA; Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia
| | - Giovanna C Denucci
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA
| | - Frank Lippert
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA
| | - Laila Al Dehailan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia
| | - Surya S Bhamidipalli
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, USA
| | - Anderson T Hara
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA.
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Gawrieh S, Lake JE, Debroy P, Sjoquist JA, Robison M, Tann M, Akisik F, Bhamidipalli SS, Saha CK, Zachary K, Robbins GK, Gupta SK, Chung RT, Chalasani N, Corey KE. Burden of fatty liver and hepatic fibrosis in persons with HIV: A diverse cross-sectional US multicenter study. Hepatology 2023; 78:578-591. [PMID: 36805976 PMCID: PMC10496090 DOI: 10.1097/hep.0000000000000313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/02/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND AIMS The current prevalence of fatty liver disease (FLD) due to alcohol-associated (AFLD) and nonalcoholic (NAFLD) origins in US persons with HIV (PWH) is not well defined. We prospectively evaluated the burden of FLD and hepatic fibrosis in a diverse cohort of PWH. APPROACH RESULTS Consenting participants in outpatient HIV clinics in 3 centers in the US underwent detailed phenotyping, including liver ultrasound and vibration-controlled transient elastography for controlled attenuation parameter and liver stiffness measurement. The prevalence of AFLD, NAFLD, and clinically significant and advanced fibrosis was determined. Univariate and multivariate logistic regression models were used to evaluate factors associated with the risk of NAFLD. Of 342 participants, 95.6% were on antiretroviral therapy, 93.9% had adequate viral suppression, 48.7% (95% CI 43%-54%) had steatosis by ultrasound, and 50.6% (95% CI 45%-56%) had steatosis by controlled attenuation parameter ≥263 dB/m. NAFLD accounted for 90% of FLD. In multivariable analysis, old age, higher body mass index, diabetes, and higher alanine aminotransferase, but not antiretroviral therapy or CD4 + cell count, were independently associated with increased NAFLD risk. In all PWH with fatty liver, the frequency of liver stiffness measurement 8-12 kPa was 13.9% (95% CI 9%-20%) and ≥12 kPa 6.4% (95% CI 3%-11%), with a similar frequency of these liver stiffness measurement cutoffs in NAFLD. CONCLUSIONS Nearly half of the virally-suppressed PWH have FLD, 90% of which is due to NAFLD. A fifth of the PWH with FLD has clinically significant fibrosis, and 6% have advanced fibrosis. These data lend support to systematic screening for high-risk NAFLD in PWH.
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Affiliation(s)
- Samer Gawrieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Jordan E. Lake
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Paula Debroy
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Julia A. Sjoquist
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Montreca Robison
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Mark Tann
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Fatih Akisik
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Surya S. Bhamidipalli
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Chandan K. Saha
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Kimon Zachary
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gregory K. Robbins
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Samir K. Gupta
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Raymond T. Chung
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Kathleen E. Corey
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Gawrieh S, Corey KE, Lake JE, Samala N, Desai AP, Debroy P, Sjoquist JA, Robison M, Tann M, Akisik F, Bhamidipalli SS, Saha CK, Zachary K, Robbins GK, Gupta SK, Chung RT, Chalasani N. Non-alcoholic fatty liver disease is not associated with impairment in health-related quality of life in virally suppressed persons with human immune deficiency virus. PLoS One 2023; 18:e0279685. [PMID: 36763643 PMCID: PMC9916563 DOI: 10.1371/journal.pone.0279685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/12/2022] [Indexed: 02/12/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in persons with HIV (PWH) (HIV-NAFLD). It is unknown if HIV-NAFLD is associated with impairment in health-related quality of life (HRQOL). We examined HRQOL in PWH with and without NAFLD, compared HRQOL in HIV- versus primary NAFLD, and determined factors associated with HRQOL in these groups. Prospectively enrolled 200 PWH and 474 participants with primary NAFLD completed the Rand SF-36 assessment which measures 8 domains of HRQOL. Individual domain scores were used to create composite physical and mental component summary scores. Univariate and multivariate analyses determined variables associated with HRQOL in PWH and in HIV- and primary NAFLD. In PWH, 48% had HIV-NAFLD, 10.2% had clinically significant fibrosis, 99.5% were on antiretroviral therapy, and 96.5% had HIV RNA <200 copies/ml. There was no difference in HRQOL in PWH with or without NAFLD. Diabetes, non-Hispanic ethnicity, and nadir CD4 counts were independently associated with impaired HRQOL in PWH. In HIV-NAFLD, HRQOL did not differ between participants with or without clinically significant fibrosis. Participants with HIV-NAFLD compared to those with primary NAFLD were less frequently cisgender females, White, more frequently Hispanic, had lower BMI and lower frequency of obesity and diabetes. HRQOL of individuals with HIV-NAFLD was not significantly different from those with primary NAFLD. In conclusion, in virally suppressed PWH, HRQOL is not different between participants with or without HIV-NAFLD. HRQOL is not different between HIV-NAFLD and primary NAFLD.
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Affiliation(s)
- Samer Gawrieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United Sates of America
| | - Kathleen E. Corey
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jordan E. Lake
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Niharika Samala
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United Sates of America
| | - Archita P. Desai
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United Sates of America
| | - Paula Debroy
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Julia A. Sjoquist
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Montreca Robison
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United Sates of America
| | - Mark Tann
- Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Fatih Akisik
- Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Surya S. Bhamidipalli
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Chandan K. Saha
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Kimon Zachary
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gregory K. Robbins
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Samir K. Gupta
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Raymond T. Chung
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United Sates of America
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Grasch JL, Rojas JC, Sharifi M, McLaughlin MM, Bhamidipalli SS, Haas DM. Impact of Enhanced Recovery After Surgery pathway for cesarean delivery on postoperative pain. AJOG Glob Rep 2023; 3:100169. [PMID: 36876160 PMCID: PMC9975314 DOI: 10.1016/j.xagr.2023.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/23/2022] [Accepted: 01/22/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Enhanced Recovery After Surgery pathways provide evidence-based recommendations to optimize perioperative care. OBJECTIVE This study aimed to holistically investigate the effect of implementing an Enhanced Recovery After Surgery pathway for all cesarean deliveries on postoperative pain experience. STUDY DESIGN This was a prepost study comparing subjective and objective measures of postoperative pain before and after the implementation of an Enhanced Recovery After Surgery pathway for cesarean delivery. The Enhanced Recovery After Surgery pathway was developed by a multidisciplinary team and included preoperative, intraoperative, and postoperative components, with emphasis on preoperative preparation, hemodynamic optimization, early mobilization, and multimodal analgesia. All individuals undergoing cesarean delivery, whether scheduled, urgent, or emergent, were included. Demographic, delivery, and inpatient pain management data were obtained through medical record review. Of note, 2 weeks after discharge, patients were surveyed about their delivery experience, analgesic usage, and complications. The primary outcome was inpatient opioid use. RESULTS The study included 128 individuals, 56 in the preimplementation cohort and 72 in the Enhanced Recovery After Surgery cohort. Baseline characteristics between the 2 groups were similar. The survey response rate was 73% (94/128). Opioid use in the first 48 hours postoperatively was significantly lower in the Enhanced Recovery After Surgery group than the preimplementation group (9.4 vs 21.4 morphine milligram equivalents 0-24 hours after delivery [P<.001]; 14.1 vs 25.4 morphine milligram equivalents 24-48 hours after delivery [P<.001]) with no increase in either average or maximum postoperative pain scores. Individuals in the Enhanced Recovery After Surgery group used fewer opioid pills after discharge (10 vs 20; P<.001). Patient satisfaction and complication rates did not change after the implementation of an Enhanced Recovery After Surgery pathway. CONCLUSION The implementation of an Enhanced Recovery After Surgery pathway for all cesarean deliveries decreased both inpatient and outpatient postpartum opioid use without increasing pain scores or decreasing patient satisfaction.
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Affiliation(s)
- Jennifer L. Grasch
- Departments of Obstetrics and Gynecology (Drs Grasch, Rojas, and Sharifi, Ms McLaughlin, and Dr Haas), Indiana University School of Medicine, Indianapolis, IN
- Corresponding author: Jennifer L. Grasch, MD.
| | - Jennymar C. Rojas
- Departments of Obstetrics and Gynecology (Drs Grasch, Rojas, and Sharifi, Ms McLaughlin, and Dr Haas), Indiana University School of Medicine, Indianapolis, IN
| | - Mitra Sharifi
- Departments of Obstetrics and Gynecology (Drs Grasch, Rojas, and Sharifi, Ms McLaughlin, and Dr Haas), Indiana University School of Medicine, Indianapolis, IN
| | - Megan M. McLaughlin
- Departments of Obstetrics and Gynecology (Drs Grasch, Rojas, and Sharifi, Ms McLaughlin, and Dr Haas), Indiana University School of Medicine, Indianapolis, IN
| | - Surya S. Bhamidipalli
- Departments of Biostatistics (Ms Bhamidipalli), Indiana University School of Medicine, Indianapolis, IN
| | - David M. Haas
- Departments of Obstetrics and Gynecology (Drs Grasch, Rojas, and Sharifi, Ms McLaughlin, and Dr Haas), Indiana University School of Medicine, Indianapolis, IN
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Yang S, Edwards PC, Zahl D, John V, Bhamidipalli SS, Eckert GJ, Stewart KT. The impact of dental curriculum format on student performance on the national board dental examination. J Dent Educ 2021; 86:661-669. [DOI: 10.1002/jdd.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Sireen Yang
- Department of Orthodontics and Oral Facial Genetics Indiana University School of Dentistry Indianapolis Indiana USA
| | - Paul C. Edwards
- Department of Oral Pathology Medicine and Radiology Indiana University School of Dentistry Indianapolis Indiana USA
| | - David Zahl
- Office of Education and Academic Affairs Indiana University School of Dentistry Indianapolis Indiana USA
| | - Vanchit John
- Department of Periodontology Indiana University School of Dentistry Indianapolis Indiana USA
| | - Surya S. Bhamidipalli
- Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis Indiana USA
| | - George J. Eckert
- Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis Indiana USA
| | - Kelton T. Stewart
- Department of Orthodontics and Oral Facial Genetics Indiana University School of Dentistry Indianapolis Indiana USA
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Fisher SG, Anderson CM, Steinhardt NP, Howser LA, Bhamidipalli SS, Brown BP, Gray BW. It Is Complex: Predicting Gastroschisis Outcomes Using Prenatal Imaging. J Surg Res 2020; 258:381-388. [PMID: 33051061 DOI: 10.1016/j.jss.2020.08.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Gastroschisis occurs in one of 2000 births with survival rates partially contingent on intestinal complications and time to establishing feeding. Enhancements in prenatal imaging have given better insight into postnatal outcomes. The goal of this study was to examine the gastroschisis patient population at a single children's hospital in the modern era and to use prenatal ultrasound (US) to develop new prenatal prognostic indicators. METHODS We performed a retrospective review of gastroschisis patients at a quaternary-care referral children's hospital from 2010 through 2018. We recorded demographics, prenatal data and imaging, early postnatal data, operative data, and patient outcomes. We compared patients within our cohort born with complex gastroschisis (bowel atresia/perforation) to uncomplicated gastroschisis patients. Second trimester and third trimester prenatal US were evaluated for changes in amniotic fluid level, amount of external bowel, bowel dilatation, and bowel wall edema to identify prognostic indicators of the status of the bowel at birth. For categorical variables, chi-square tests were used to assess for significance. Univariate and multivariable analyses were used to assess significance between categorical and continuous variables using medians and interquartile ranges or means. RESULTS A total of 134 patients were included in the study: complex (n = 24), uncomplicated (n = 110). Compared with uncomplicated gastroschisis, complex patients required longer median days to feeding initiation (44 versus 10; P < 0.001), full feeding (80 versus 23; P < 0.001), length of stay (83 versus 33; P < 0.001), and total parenteral nutrition at discharge (P = 0.004). Full US data were available on 81% of patients, and partial data were identified on 19%. Prenatal US analysis showed significantly more complex patients had polyhydramnios on third trimester US (23.5%-4.3%; P = 0.018). US analysis showed these additional factors to be most associated with complex gastroschisis: large amount of external bowel on third trimester US, increase in bowel edema on third trimester US, and increase in external bowel dilation on third trimester US. Multivariable logistic regression analyses revealed amniotic fluid on third trimester US to be the most significant predictor of complex gastroschisis (P = 0.01). Polyhydramnios in combination with two-thirds of the other US factors had both sensitivity and positive predictive value for predicting complex gastroschisis of 75%. Patients with two or less of these positive US factors had high specificity (96.8%) and negative predictive value (87.5%), suggesting uncomplicated disease. There were no differences in perioperative or long-term complications in the complex group when compared with the group with uncomplicated gastroschisis. CONCLUSIONS Polyhydramnios on third trimester prenatal US on babies with gastroschisis can predict complex gastroschisis at birth, whereas the absence of markers on prenatal US can suggest uncomplicated disease. Complex gastroschisis is associated with increased time to feeds and length of stay.
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Affiliation(s)
- Sarah G Fisher
- Section of Pediatric Surgery, Riley Hospital for Children, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Cassandra M Anderson
- Section of Pediatric Surgery, Riley Hospital for Children, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nicole P Steinhardt
- Section of Pediatric Radiology, Riley Hospital for Children, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lauren A Howser
- Section of Pediatric Surgery, Riley Hospital for Children, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Surya S Bhamidipalli
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brandon P Brown
- Section of Pediatric Radiology, Riley Hospital for Children, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brian W Gray
- Section of Pediatric Surgery, Riley Hospital for Children, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
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Dos Santos LF, Albright DA, Dutra V, Bhamidipalli SS, Stewart KT, Polido WD. Is There a Correlation Between Airway Volume and Maximum Constriction Area Location in Different Dentofacial Deformities? J Oral Maxillofac Surg 2020; 78:1415.e1-1415.e10. [PMID: 32330431 DOI: 10.1016/j.joms.2020.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of the present study was to correlate the airway volume and maximum constriction area (MCA) with the type of dentofacial deformity in patients who required orthognathic surgery. MATERIALS AND METHODS The present retrospective cohort study included orthognathic surgery patients selected from the private practice of one of us. The selected cases were stratified into 5 different groups according to the clinical and cephalometric diagnosis of their dentofacial deformity. The preoperative airway volume and anatomic location of the MCA were calculated using the airway tool of the Dolphin Imaging software module (Dolphin Imaging and Management Solutions, Chatsworth, CA) and correlated with the diagnosed dentofacial deformity. Differences in the pretreatment airway volumes and MCA location were compared among the deformities. RESULTS The MCA location was more often the nasopharynx for maxillary deficiency and the oropharynx for mandibular deficiency deformities. The nasopharynx volume was significantly smaller statistically (P < .005) for maxillary deficiency plus mandibular excess compared with mandibular deficiency. The hypopharynx volume was significantly smaller statistically (P < .005) for vertical maxillary excess plus mandibular deficiency than for both maxillary deficiency and maxillary deficiency plus mandibular excess. No statistically significant difference was found among the different deformity groups in relation to the mean airway volume (P > .005). CONCLUSIONS The location of the airway MCA seems to have a strong correlation with the horizontal position of the maxilla and mandible. The MCA in maxillary deficiencies (isolated or combined) was in the nasopharynx, and the MCA in mandibular deficiencies (isolated or combined) was in the oropharynx. Clinicians should consider these anatomic findings when planning the location and magnitude of orthognathic surgery movements to optimize the outcomes.
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Affiliation(s)
- Liseane F Dos Santos
- Orthodontics Resident, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN
| | - David A Albright
- Visiting Clinical Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN
| | - Vinicius Dutra
- Clinical Associate Professor, Department of Radiology, Indiana University School of Dentistry, Indianapolis, IN
| | | | - Kelton T Stewart
- Professor and Chairman, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN
| | - Waldemar D Polido
- Clinical Professor and Acting Chairman, Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, IN.
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Nicholas LD, Fischbein RL, Bhamidipalli SS. Twin anemia-polycythemia sequence and routine monitoring practices amongst maternal-fetal medicine specialists in the United States: an initial investigation. J Perinat Med 2019; 47:388-392. [PMID: 30763267 DOI: 10.1515/jpm-2018-0240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 12/30/2018] [Indexed: 01/08/2023]
Abstract
Background The purpose of this initial investigation was to begin to understand the routine twin anemia-polycythemia sequence (TAPS) monitoring practices of maternal-fetal medicine specialists (MFM specialists) in the United States in the absence of a formal guideline. Methods This study used an anonymous, online survey of 90 MFM specialists who were practicing in the United States. A $5 gift card to an online store was used to incentivize participants. Descriptive statistics were calculated. Results All MFM specialists reported at least some familiarity (100.00%) with TAPS. Most participants (92.94%) were familiar with methods for monitoring patients for TAPS and nearly all (97.50%) responded that they use 'Doppler MCA-PSV' to make a prenatal TAPS diagnosis. Nearly two-thirds of MFM specialists surveyed (65.06%) reported performing regular TAPS monitoring for patients with monochorionic-diamniotic (MCDA) pregnancies. Conclusion Despite no formal guidelines, the majority of American MFM specialists surveyed are using routine TAPS screening in their management of MCDA twin pregnancies, suggesting that the MFM specialists included in this study consider it a valuable diagnostic tool. Future research should further explore this possible trend toward routine TAPS monitoring amongst MFM specialists in the United States, as well as the potential value of routine TAPS monitoring in MCDA pregnancy.
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Affiliation(s)
- Lauren D Nicholas
- Department of Liberal Arts, Social Sciences Program, D'Youville College, 591 Niagara Street, Buffalo, New York, NY 14201, USA
| | - Rebecca L Fischbein
- Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
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Abstract
OBJECTIVES To evaluate the precision of the virtual occlusal record using the Carestream CS3600 Intraoral Scanner (Carestream Dental, Atlanta, Ga). MATERIALS AND METHODS A total of 20 participants were recruited for this prospective study using preestablished inclusion/exclusion criteria. A complete intraoral scan and two bite registrations were obtained. The participants were instructed to bite with normal pressure when bite registrations were acquired. Contact locations, size (circumference), and intensity were identified on the maxillary first molars and canines. Agreement between contact size and intensity was assessed with intraclass correlation coefficients. Kappa statistics evaluated agreement in contact locations. Statistical significance was set at P < .05. RESULTS All participant data were included for statistical analysis. Between the two bite registrations, nonstatistically significant differences were observed in the proportion of locations with contacts (P = .7681). A nonstatistically significant difference (-0.25 mm, P = .8416) in mean contact circumference size was observed. A statistically significant difference in mean contact intensity was observed (P = .0448). When evaluating agreement between the bite registrations, a weak correlation for size (intraclass correlation coefficient = 0.35) and intensity (intraclass correlation coefficient = 0.32) was observed as well as a moderate agreement for contact location (κ coefficient = 0.67). CONCLUSIONS The findings suggest that the Carestream intraoral scanner software possesses adequate precision when acquiring the location and size of the contacts in bite registrations. The scanner failed to demonstrate adequate precision when acquiring contact intensities in bite registrations. Additional research is warranted to further investigate the precision of virtual occlusal records with currently available software systems.
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Grillo AC, Ghoneima AAM, Garetto LP, Bhamidipalli SS, Stewart KT. Predictors of orthodontic residency performance: An assessment of scholastic and demographic selection parameters. Angle Orthod 2019; 89:488-494. [PMID: 30605016 DOI: 10.2319/062518-477.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the association between resident selection criteria, including Graduate Record Examination (GRE) scores, and student performance in an orthodontic residency program. MATERIALS AND METHODS This retrospective study evaluated the academic records of 70 orthodontic residency graduates from the Indiana University School of Dentistry. The following demographic and scholastic data were extracted from the student academic records: applicant age, gender, ethnicity, race, country of origin, dental school graduation year, GRE score, and graduate orthodontic grade point average (GPA). In addition, student American Board of Orthodontics (ABO) written examination quintiles were obtained from the ABO. Scatterplots, analysis of variance, and correlation coefficients were used to analyze the data. Statistical significance was established at .05 for the study. RESULTS No associations were found with any component of the GRE, except with the quantitative GRE section, which displayed a weak association with ABO module 2 scores. Dental school GPA demonstrated weak correlations with all ABO modules and moderate correlations with overall and didactic orthodontic GPAs. When assessing demographic factors, significant differences (P < .05) were observed, with the following groups demonstrating higher performance on certain ABO modules: age (younger), race (whites), and country of origin (US citizens). CONCLUSIONS Findings suggest the GRE has no association with student performance in an orthodontic residency. However, dental school GPA and/or class rank appear to be the strongest scholastic predictors of residency performance.
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