PURPOSE: The aim of this study was to determine the influence of long base lengths of a fixed partial denture (FPD) to rotational resistance with variation of vertical wall angulation. MATERIALS AND METHODS: Trigonometric calculations were done to determine the maximum wall angle needed to resist rotational displacement of an experimental-FPD model in 2-dimensional plane. The maximum wall angle calculation determines the greatest taper that resists rotation. Two different axes of rotation were used to test this model with five vertical abutment heights of 3-, 3.5-, 4-, 4.5-, and 5-mm. The two rotational axes were located on the mesial-side of the anterior abutment and the distal-side of the posterior abutment. Rotation of the FPD around the anterior axis was counter-clockwise, Posterior-Anterior (P-A) and clockwise, Anterior-Posterior (A-P) around the distal axis in the sagittal plane. RESULTS: Low levels of vertical wall taper, ≤ 10-degrees, were needed to resist rotational displacement in all wall height categories; 2–to–6–degrees is generally considered ideal, with 7–to–10–degrees as favorable to the long axis of the abutment. Rotation around both axes demonstrated that two axial walls of the FPD resisted rotational displacement in each direction. In addition, uneven abutment height combinations required the lowest wall angulations to achieve resistance in this study. CONCLUSION: The vertical height and angulation of FPD abutments, two rotational axes, and the long base lengths all play a role in FPD resistance form.
Denture, Partial* ; Denture, Partial, Fixed

OBJECTIVES: To investigate the impact of labyrinthectomy and intratympanic (IT) gentamicin injections on the contralateral labyrinth, we also assessed the response of each individual semicircular canal to each IT gentamicin application. METHODS: We performed a pilot observational study on tertiary, referral, academic settings. Thirteen patients with unilateral vestibular pathology were organized into two groups, group I (seven patients) receiving IT gentamicin and group II undergoing labyrinthectomy (six patients). All patients underwent six-canal video-head-impulse test in predetermined time intervals. Patients receiving gentamicin were additionally tested 3 to 5 days after every sequential injection, until all ipsilateral canals were ablated, to determine the order of response to gentamicin. We recorded the vestibular-ocular reflex gains and the presence of covert/overt saccades for each canal. RESULTS: The posttreatment ipsilateral gains were abnormal. No patient from the gentamicin group developed abnormal contralateral responses, while patients undergoing labyrinthectomy had abnormal contralateral responses from at least one canal, even several months posttreatment. Finally, the lateral semicircular canal was the first one to be affected by IT gentamicin followed by the posterior canal: the superior canal was ablated last. CONCLUSION: In our study, labyrinthectomy had an impact on the responses recorded from the contralateral ear, while IT gentamicin ablated the ipsilateral labyrinthine function without affecting the contralateral responses, possibly because of a milder, more gradual impact. We also show for the first time the order that IT gentamicin application affects the semicircular canals, with the lateral being the first to be affected.
Ear ; Ear, Inner ; Gentamicins ; Head Impulse Test ; Humans ; Observational Study ; Pathology ; Referral and Consultation ; Reflex ; Saccades ; Semicircular Canals

Background/Aims: Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB. Methods: We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized. Results: The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001). Conclusions A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.

Background/Aims: Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB. Methods: We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized. Results: The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001). Conclusions A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.

Background: Helicobacter pylori is acknowledged to cause chronic gastritis and peptic ulcer disease and is also implicated in gastric carcinoma and B cell mucosa-associated lymphoid tissue (MALT) lymphoma development. It has infected at least half of the world’s population. Proton Pump Inhibitors (PPIs) have been the conventional antacid of choice for H. pylori eradication triple therapy, while vonoprazan is a novel drug of its class that was recently studied but is limited to an oral form which makes it less feasible in cases of acute gastrointestinal bleeding. According to several systematic reviews and meta-analyses, the vonoprazan-based triple therapy regimen for H. pylori eradication is a non-inferior treatment to traditional PPI-based treatment when given in 1 week for patients having no active gastrointestinal bleeding. Likewise, a safety profile has been established with its use, offering an alternative treatment option. Objectives: The research aims to identify the H. pylori eradication rate among H. pylori-positive patients who received a vonoprazan-based triple therapy regimen as outpatients, describe their clinicodemographic profile, and identify potential side effects associated with the treatment. Methods: This study utilized a cross-sectional study design in a single tertiary institution from January 2018 to December 2020. Descriptive and inferential statistics were used in data analysis. Frequency and percentage were utilized to determine the success and failure rates of H. pylori eradication, describe the clinicodemographic profile of patients who underwent vonoprazan-based triple therapy, and the potential side effects with treatment. The chi-square test of independence was applied to assess the significant difference in the successful and failed eradication rates across the clinicodemographic profile. A P-value of <0.05 was considered statistically significant, and statistical analyses were conducted using SPSS version 20.0. Results: 32 (91%) had successful H. pylori eradication, with the majority of them determined by a negative 13C-UBT result (62.8%) and the rest with a negative H. pylori stool antigen test (28.6%). The majority of patients undergoing H. pylori eradication using a vonoprazan-based regimen with documented successful eradication belonged to the 19 to 39 years old group (50%), clerical support workers (40.63%), with a chief complaint of abdominal pain (46.88%), with no known co- morbid illness (75%), and with endoscopic finding limited to antral gastritis alone (46.88%). This study described only two documented side effects of treatment: diarrhea and abdominal pain (2.9%). Conclusion Vonoprazan-based triple therapy, given at 20 mg twice daily for 7 days, has shown a high H. pylori eradication rate among hemodynamically stable patients, without active bleeding, and treated on an outpatient basis. There was a significant difference in eradication success and failure across co-morbidities, with a higher success rate in those without co-morbid illness. A high success rate was also seen in patients <40 years of age, with a single chief complaint, and with antral gastritis as the sole endoscopic finding.
Helicobacter pylori

PURPOSE: Correct use of inhaler devices is fundamental to effective asthma management but represents an important challenge for patients. The correct inhalation manoeuvre differs markedly for different inhaler types. The objective of this study was to compare outcomes for patients prescribed the same inhaler device versus mixed device types for asthma controller and reliever therapy. METHODS: This retrospective observational study identified patients with asthma (ages 4-80 years) in a large primary care database who were prescribed an inhaled corticosteroid (ICS) for the first time. We compared outcomes for patients prescribed the same breath-actuated inhaler (BAI) for ICS controller and salbutamol reliever versus mixed devices (BAI for controller and pressurised metered-dose inhaler [pMDI] for reliever). The 2-year study included 1 baseline year before the ICS prescription (to identify and correct for confounding factors) and 1 outcome year. Endpoints were asthma control (defined as no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory tract infection) and severe exacerbations (hospitalisation or oral corticosteroids for asthma). RESULTS: Patients prescribed the same device (n=3,428) were significantly more likely to achieve asthma control (adjusted odds ratio, 1.15; 95% confidence interval [CI], 1.02-1.28) and recorded significantly lower severe exacerbation rates (adjusted rate ratio, 0.79; 95% CI, 0.68-0.93) than those prescribed mixed devices (n=5,452). CONCLUSIONS: These findings suggest that, when possible, the same device should be prescribed for both ICS and reliever therapy when patients are initiating ICS.
Adrenal Cortex Hormones ; Albuterol ; Anti-Bacterial Agents ; Asthma ; Humans ; Inhalation ; Nebulizers and Vaporizers ; Odds Ratio ; Prescriptions ; Primary Health Care ; Respiratory System ; Retrospective Studies

Lack of investment for magnetic resonance (MR) fusion systems is an obstacle to deliver targeted prostate biopsies within the prostate cancer diagnostic pathway. We developed a coordinate-based method to support cognitive targeted prostate biopsies and then performed an audit on cancer detection and the location of lesions. In each patient, the prostate is considered as two separate hemiprostates, and each hemiprostate is divided into 4 × 4 × 4 units. Each unit is therefore defined by a three-dimensional coordinate. We prospectively applied our coordinates approach to target 106 prostatic lesions in 93 men. Among 45 (of 106; 42.5%) lesions positive for cancer, 27 lesions (60.0%) harbored clinically significant disease. PSA density was significantly higher in patients with proven cancer (median: 0.264 ng ml

BACKGROUND: We aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA). METHODS: Using the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction (MI) was diagnosed by central adjudication. RESULTS: The C-statistic with 95% confidence intervals (CI) for diagnosing MI by using a common population (n=241) was 0.95 (0.91-0.99), 0.95 (0.91-0.99), and 0.93 (0.89-0.97) for the Triage, Singulex, and PathFast assays, respectively. Of samples with detectable troponin, the absolute values had high Pearson (R(P)) and Spearman (R(S)) correlations and were R(P)=0.94 and R(S)=0.94 for Triage vs Singulex, R(P)=0.93 and R(S)=0.85 for Triage vs PathFast, and R(P)=0.89 and R(S)=0.73 for PathFast vs Singulex. CONCLUSIONS: In a single comparative population of ED patients with suspected ACS, the Triage Cardio3 TnI, PathFast, and Singulex TnI assays provided similar diagnostic performance for MI.
Acute Coronary Syndrome/*diagnosis ; Biomarkers/analysis ; Emergency Service, Hospital ; Humans ; Laboratories/standards ; Myocardial Infarction/diagnosis ; *Point-of-Care Systems ; Prospective Studies ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Troponin I/*analysis

OBJECTIVE: This paper aims to provide concise background information regarding the state of noncommunicable diseases (NCDs) and their risk factors as well as the existing efforts to address them in the Philippines in the last 25 years.

METHODS: A desk review of documents and literature review as well as analyses of available statistical data and several consultations with involved government agencies have been made to come up with summary figures and tables.

RESULTS: NCDs as well as metabolic conditions that can potentially lead to NCDs are on the rise in the last score of years. The Philippines, through the Department of Health, has been visionary in leading various projects and activities to fight NCDs over the last two decades, and its efforts are slowly paying off: the prevalence of tobacco use and that of hypertension have decreased over the last 5 years. NCD mortality (including premature deaths) and prevalence of behavioral risk factors, however, generally remain high, and the Philippines needs to accelerate whole-of-society and whole-of-government actions to sustain the gains and attain its NCD targets in the next 10 years or so.

CONCLUSION: The need to strengthen health system interventions and promote accountability of various sectors in addressing NCDs and its risk factors in the country arises. The development of a multisectoral action plan on NCD prevention and control is needed to halt the rise of NCDs in the country.