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Aim: To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice. Materials and Methods: Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13–23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP). Results: Ninety‐two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty‐two patients (95% CI: 42%–62%) could by treated with IIP, 58 (95% CI: 48%–67%) with EIP and 88 (95% CI: 80%–93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP. Conclusion: From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired. [ABSTRACT FROM AUTHOR]

Aim: To assess the impact of the timing of implant placement following alveolar ridge preservation (ARP) on the need for soft‐tissue augmentation (STA) and to identify the risk factors for horizontal and vertical soft‐tissue loss. Materials and Methods: Patients with a single failing tooth in the anterior maxilla (15–25) were treated at six centres. Following tooth extraction, they were randomly allocated to the test group (immediate implant placement, IIP) or control group (delayed implant placement, DIP). ARP was performed in both groups and implants were immediately restored with an implant‐supported provisional crown. Six months after tooth extraction and ARP, a panel of five blinded clinicians assessed the need for STA on the basis of anonymized clinical pictures and a digital surface model. Lack of buccal soft‐tissue convexity and/or mid‐facial recession qualified for STA. Pre‐operative and 6‐month digital surface models were superimposed to assess horizontal and vertical soft‐tissue changes. Results: Thirty patients were included per group (test: 20 females, 10 males, mean age 53.1; control: 15 females, 15 males, mean age 59.8). The panel deemed STA as necessary in 24.1% and 35.7% of the cases following IIP and DIP, respectively. The difference was not statistically significant (odds ratio [OR] = 1.77; 95% confidence interval [CI] [0.54–5.84]; p =.343). Loss of buccal soft‐tissue profile was higher following DIP (estimated mean ratio = 1.66; 95% CI [1.10–2.52]; p =.018), as was mid‐facial recession (mean difference [MD] = 0.47 mm; 95% CI [0.12–0.83]; p =.011). Besides DIP, regression analysis identified soft‐tissue thickness (−0.57; 95% CI [−1.14 to −0.01]; p =.045) and buccal bone dehiscence (0.17; 95% CI [0.01–0.34]; p =.045) as additional risk factors for mid‐facial recession. Surgeons found IIP significantly more difficult than DIP (visual analogue scale MD = −34.57; 95% CI [−48.79 to −20.36]; p <.001). Conclusions: This multi‐centre randomized controlled trial failed to demonstrate a significant difference in the need for STA between IIP and DIP when judged by a panel of blinded clinicians. Based on objective soft‐tissue changes, patients with thin buccal soft tissues, with a buccal bone dehiscence and treated with a delayed approach appeared particularly prone to soft‐tissue loss. [ABSTRACT FROM AUTHOR]

Aim: To assess the impact of the timing of soft‐tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla. Materials and Methods: Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant‐supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1‐year follow‐up. Clinical outcomes were registered at 1‐year follow‐up. Results: Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was −0.553 and −0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: −0.415 to 1.104; p = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft‐tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (p = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00–0.44; p = 0.028). Conclusion: In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss. Trial Registration: ClinicalTrials.gov identifier: NCT05537545 [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the accuracy of 3‐dimensional (3D)‐printed surgical guides for fully guided immediate implants from different manufacturers. Methods: Eighteen 3D printed fully guided surgical guides (split into 3 groups [n = 6] according to their manufacturer: Company, Desktop, or Lab), were used to place 72 implants (n = 24) in identical maxillary models. After placement, the mean global, angular, mesiodistal, buccopalatal, and vertical deviation at the platform and apex of the placed implants, relative to their preoperatively planned positions, was calculated. Results: Significant differences in global apex deviation, angular deviation, mesiodistal apex deviation, and vertical platform and apex deviation were found between the Lab and Desktop groups (p ≤ 0.007). Significant differences in mesiodistal platform and apex deviation and buccopalatal apex deviation were also found between the Company and Desktop groups (p ≤ 0.005). Finally, significant differences in buccopalatal apex deviation, and vertical platform and apex deviation were found between the Company and Lab groups (p ≤ 0.003). Mean differences between guide groups across all parameters never exceeded 0.5 mm or 1°. Conclusions: The choice of 3D printer has a significant effect on the accuracy of fully guided immediate implants. However, the clinical relevance of these differences may be considered limited. [ABSTRACT FROM AUTHOR]

Breast cancer ranks first worldwide in cancer-related deaths in women. The percentage of breast cancer in Turkey has almost doubled in the last decade. Breast cancer treatment encompasses a broad spectrum of oncological treatments, including radiotherapy, chemotherapy and oncoplastic surgical treatments. Oncoplastic reconstruction is an integral part of breast cancer treatment, providing favorable aesthetic and psychological outcomes. In our study, the breast reconstructions of 166 patients who underwent mastectomy due to tumoral pathologies, performed by our institute between 2005 and 2023, were analyzed from various aspects. Based on our 19 years of experience, the number of breast reconstruction surgeries has increased dramatically in the last ten years; however, the repair trend has shifted to immediate and also implant-based reconstruction procedures. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the impact of the COVID-19 pandemic on breast reconstruction trends in the United States, focusing on implant-based and autologous techniques, as well as the timing of reconstruction (immediate vs. delayed). Methods: A retrospective analysis of data from 2015 to 2022 from the American Society of Plastic Surgeons' National Plastic Surgery Statistics was conducted. Annual trends in breast reconstruction procedures were analyzed, comparing the pre-pandemic (2015–2019) and pandemic (2020–2022) periods. A sensitivity analysis was performed to assess the impact of missing data from 2019 and 2021. Results: The total number of breast reconstructions increased from 106,338 in 2015 to 151,641 in 2022. The proportion of implant-based reconstructions decreased from 81.41% pre-pandemic to 76.51% during the pandemic (p < 0.001), with a notable rise in direct-to-implant procedures from 10.37% to 19.12% (p < 0.001). Autologous reconstructions increased from 18.59% to 23.49% (p < 0.001). Among autologous techniques, DIEP flaps remained the most popular. Immediate reconstruction rates increased from 72.61% pre-pandemic to 75.57% during the pandemic, while delayed reconstruction rates decreased from 27.39% to 24.43% (p < 0.001). The sensitivity analysis confirmed the robustness of these trends. Conclusions: During the COVID-19 pandemic, there was a significant shift towards autologous breast reconstruction techniques, particularly DIEP flaps, and an increase in immediate reconstructions in the United States. Within implant-based reconstructions, the proportion of DTI procedures increased while the proportion of tissue expander procedures decreased. These changes likely reflect adaptations in surgical practice and decision-making processes in response to the unique challenges posed by the pandemic, rather than alterations in surgical techniques themselves. The insights gained from this study can help guide plastic surgeons and healthcare providers in preparing for future pandemics or similar disruptions. [ABSTRACT FROM AUTHOR]

Objectives: To compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient‐reported outcomes. Materials and Methods: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction. Results: Out of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta‐analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta‐analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [−0.23; 0.86], p =.260; I2 = 83%, p <.001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [−0.23; 2.07], p =.120; I2 = 89%, p <.001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p =.480; I2 = 0%, p =.980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [−0.12, 0.17], p =.700; I2 = 0%, p =.470). Insufficient data were available for meta‐analyses of other secondary outcomes. Conclusion: In low‐risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state‐of‐the‐art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient‐reported outcomes since these have been underreported. [ABSTRACT FROM AUTHOR]

Background: The occurrence of pregnancy in the postpartum period poses a risk to women and their infants, and it also has increased risks of adverse health outcomes if a pregnancy happens less than two years after the preceding birth. Utilization of immediate postpartum family planning is a possible and simple way to reduce these unfavourable outcomes. However, only a small proportion of mothers use the service; but the reasons appear unclear. Thus, this study aimed to determine the level and factors associated with the utilization of immediate postpartum family planning in Bole sub-city, Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was carried out from August 15 to September 15, 2022, among mothers who gave birth one year before the data collection period. A total of 425 mothers were selected with a systematic random sampling technique. A pretested and structured questionnaire was administered to collect data. Data entry and analysis were done by Statistical Package for Social Sciences 25. Chi-square, multicollinearity and Hosmer-Lemshaw model fitness tests were tested. The level of utilization was determined by descriptive statistics and the associated factors were determined by a binary logistic regression model, and presented with the adjusted odds ratios (AOR) with their respective 95% confidence intervals (95%CI). All statistical tests were conducted at a 5% level of significance. Results: Utilization of family planning method immediately after birth was 12.9% (95% CI = 11.3-14.5%), and it was statistically significantly associated with ages between 25 and 34 years (AOR = 5; 95% CI [1.38–18.41]) and 35 years and above (AOR = 6[1.47–25.70]), unfavourable attitude (AOR = 0.2[0.11–0.31]) and no counselling about immediate postpartum family planning during antenatal care visit (AOR = 0.43[0.20–0.89]). Conclusion and recommendations: The level of utilization of immediate postpartum family planning is low in the study area. To improve it, dealing with younger women, working to achieve a positive attitude amongst women towards immediate postpartum family planning, and incorporating counselling about postpartum family planning methods during antenatal care visits are all recommended. [ABSTRACT FROM AUTHOR]

Immediate drug hypersensitivity reactions (IDHRs) are a burden for patients and the health systems. This problem increases when taking into account that only a small proportion of patients initially labelled as allergic are finally confirmed after an allergological workup. The diverse nature of drugs involved will imply different interactions with the immunological system. Therefore, IDHRs can be produced by a wide array of mechanisms mediated by the drug interaction with specific antibodies or directly on effector target cells. These heterogeneous mechanisms imply an enhanced complexity for an accurate diagnosis and the identification of the phenotype and endotype at early stages of the reaction is of vital importance. Currently, several endophenotypic categories (type I IgE/non‐IgE, cytokine release, Mast‐related G‐protein coupled receptor X2 (MRGPRX2) or Cyclooxygenase‐1 (COX‐1) inhibition and their associated biomarkers have been proposed. A precise knowledge of endotypes will permit to discriminate patients within the same phenotype, which is crucial in order to personalise diagnosis, future treatment and prevention to improve the patient's quality of life. [ABSTRACT FROM AUTHOR]

This article discusses a study conducted at Necker Hospital that examined the usefulness of skin tests in children who had immediate reactions to beta-lactam antibiotics. The study found that the risk of hypersensitivity or allergy did not differ significantly based on the timing or type of reaction. The study suggests that direct drug provocation tests may be a more effective method for exploring these reactions. However, it is important to consider the small sample size and real-life clinical practice nature of the study when interpreting the results. [Extracted from the article]

Objective: To explore the differences in plaque accumulation on the fitting surface of full‐arch implant‐supported fixed prostheses with contact or noncontact pontics. Materials and Methods: Nineteen patients (20 prostheses, 7 in the maxilla, and 13 in the mandible) intending to undergo full‐arch implant‐supported immediate function prostheses were recruited. During immediate restoration and using the midline as the boundary, one side was restored as a pontic and mucosa noncontact type (the test group), and the opposite side was restored as a pontic and mucosa contact type (the control group). In a follow‐up 6 months after the surgery, the cleanliness of the fitting surface of the immediate prosthesis was evaluated by plaque staining and debris index determination. Patient satisfaction was investigated by questionnaire. Results: Twenty prostheses from 19 patients included in the randomized controlled trial were followed up. Among the 20 prostheses, the percentage of area covered with plaque was significantly lower in the test group compared with that in the control group (31.5 ± 15.8% vs. 43.7 ± 15.3%; p < 0.001). The debris index in the test group was lower than that in the control group, although the difference was not statistically significant (2.77 ± 0.73 vs. 3.15 ± 0.90; p > 0.05). In the patient satisfaction survey, most of the patients were satisfied with most aspects of the prostheses, however, nearly half of the patients were not satisfied with the cleaning. Conclusions: The pontic and mucosa noncontact prosthetic design reduces plaque accumulation on the fitting surface, which is beneficial for maintaining oral cleanliness. However, the majority of study samples were mandible and conclusions may not be fully applicable to maxilla. Trial registration: www.chictr.org.cn (ChiCTR1900028576). Clinical Significance: The noncontact design in full‐arch implant‐supported fixed prostheses may be an effective measure of improving oral hygiene promotion. There is need for more research that can further improve oral hygiene of patients with full‐arch implant‐supported prostheses. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15–25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. Material and Methods: An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). Results: Sixty‐three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow‐up ranging from 12 to 96 months. One thousand nine hundred sixty‐one implants reported survival rates of 99.2 (98.6–99.5) % at 1 year, 97.5 (95.9–98.4) % after 3 years, and 95.8 (93.3–97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8–99.5) % after 1 year, 96.8 (93.6–98.4) % after 2 years, and 94.8 (89.6–97.4) % after 5 years. Comparing baseline to 12‐month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of −0.71 (−1.25, −0.1) mm, midfacial recession change of −0.15 (−0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. Conclusions: Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years. [ABSTRACT FROM AUTHOR]

Aim: To assess the impact of mucoperiosteal flap elevation for single immediate implant placement (IIP) on buccal hard and soft tissue changes, and on clinical, aesthetic and patient‐reported outcomes. Materials and Methods: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to June 2022. Randomized controlled trials (RCTs) comparing IIP without flap elevation to IIP with flap elevation were included for a qualitative and quantitative analysis. The primary outcome was horizontal buccal bone change. Secondary outcomes were implant survival, vertical buccal bone change, pain, and clinical and aesthetic parameters. Results: Out of 1029 records, 5 RCTs were selected reporting on 140 patients who received 140 single immediate implants (flapless: 68; flap: 72). Patients had a mean age ranging from 30 to 67 years and were followed between 6 and 12 months. Four RCTs pertained to (nearly) intact alveoli. Risk of bias assessment yielded low risk for two RCTs and high risk for three RCTs. Meta‐analysis demonstrated a mean difference of 0.48 mm (95% confidence interval [CI] [0.13, 0.84], p =.007) in horizontal buccal bone change between surgical approaches, favouring flapless surgery. Meta‐analysis failed to demonstrate a significant difference in implant survival between the groups (RR 1.00, 95% CI [0.93, 1.07], p =.920). Given the scarcity of data, meta‐analyses could not be performed on other secondary outcomes. Available studies were consistent in the direction of the effect favouring flapless surgery for vertical buccal bone change as well as for pain. Clinical and aesthetic parameters were underreported. Conclusions: Based on CBCT data, flapless surgery resulted in more buccal bone preservation at immediate implants. However, the clinical relevance of this finding is unclear, since clinical and aesthetic outcomes were underreported. [ABSTRACT FROM AUTHOR]

Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (−0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients' rehabilitation and soft tissue preservation to replace a hopeless tooth. [ABSTRACT FROM AUTHOR]

Background: The second most popular type of contraception is an intrauterine contraceptive device (IUCD). Immediate post-placental placement of IUCD provides women with immediate, safe, effective, long-acting reversible contraception that prevents unintended pregnancies. Objective: The aim of the current work was to evaluate efficacy, safety, and complications (displacement, expulsion, perforation, and infection) of immediate post placental insertion of copper T380 IUCD during cesarean section. Patients and methods: This prospective study included a total of 164 full term pregnant women delivered through cesarean section, attending at Department of Obstetrics and Gynecology, Menoufia University Hospital and Department of Obstetrics and Gynecology, Kafr El-dawar General Hospital. Post-placental copper T380 IUCD was offered after admission and inserted during cesarean section. Rates of IUCD displacement, expulsion, removal, uterine perforation, pregnancy and infection (endometritis/PID) were estimated at 1 week, 4 weeks, 3 months and 6 months after discharge. The absence of all these complications was considered a satisfactory outcome. Results: Mean age among study population was 28.45± 5.14 years. Rates of displacement, expulsion and satisfactory outcome at the fourth week post-insertion were 2.5%, 0.6 % and 96.9% respectively. Cumulative rates of displacement and expulsion at the end of 6-months follow-up were 4.3% and 0.6% respectively. No cases complicated by perforation, infection (endometritis/PID) or pregnancy on top of post placental IUCD. Follow-up rate at the end of 6-months was 94.5%. Continuation rate with intrauterine contraception at the end of 6-months follow-up was 93.9%. Cumulative rate of intrauterine device removal was 6.1%. Conclusion: It could be concluded that immediate post placental IUCD insertion is a suitable option with high satisfactory outcome, contraceptive efficacy, safety, and convenience. Complications (displacement, expulsion, perforation and infection) are very low. [ABSTRACT FROM AUTHOR]

The IMmediate Postpartum Access to Cardiac Therapy (IMPACT) procedure is a multidisciplinary, collaborative, highly coordinated clinical service in which a planned delivery and intensive neonatal care are offered for conditions where there is a high likelihood of postnatal instability. This process includes prenatal consultation with the parent(s), involving each service engaged with the delivery, postnatal resuscitation, and procedural care. A Cesarean section delivery is planned in an operating room with immediate access to a multifunctional procedural suite where the neonate can undergo rapid cardiac evaluation and initiation of interventional treatments which can have a positive, life-saving impact. This review describes the details of this unique procedure and multidisciplinary program at one institution. [ABSTRACT FROM AUTHOR]

Objectives: to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full‐arch prostheses, supported by 4/6 implants according to prosthetic‐driven planning and guided surgery. Materials and Methods: The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all‐on‐4/15 all‐on‐6) and 164 implants. The Implants survival, prostheses success/survival, peri‐implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss. Results: Cumulative implant survival rate was 89.7% for all‐on‐four (seven failures) and 99.0% for all‐on‐six (one failure) after a mean follow‐up of 6.46 ± 2.236 years (range 1–10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all‐on‐four/ 43.8% for all‐on‐six). Prosthesis survival rate was 88.2% for all‐on‐four. No failure was registered in all‐on‐six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5‐year and 2.09 ± 0.56 mm at 10‐year follow‐up. No difference was found in the mean value of marginal bone resorption between all‐on‐four (1.56 ± 1.61 mm) and all‐on‐six (1.20 ± 0.85 mm) (p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) (p = 0.385) after 5‐year follow‐up. The incidence of biological complications was 1.0% in all‐on‐six (one mucositis) and 10.3% in all‐on‐four (two peri‐implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears. Conclusions: Based on the results and within the limitations of the present study, the implant‐supported hybrid prosthesis according to prosthetic‐driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to integrate evidence on adherence to immediate postnatal care provided to women after birth among health care professionals, and to identify gaps in the previous studies for building new knowledge for further researches. Design: A narrative literature review. Electronic database searching strategy was used, including Web of Sciences, SAGE, CINAHL, PubMed and Jordanian Database for Nursing Research databases were used to search the literature. Findings: A total of 320 articles were retrieved. After duplicates removal, 200 articles were screened for titles and abstracts. There were 80 relevant articles that underwent full-text screening, of which 32 were found eligible to be included in the review. The studies were summarized under 3 themes; adherence to immediate postpartum care among health care professionals (n=24), Adherence to IPPCGs in Arab countries (n=5), Adherence to IPNCGs among healthcare professionals in Jordan (n=3). Paper type: Literature review. [ABSTRACT FROM AUTHOR]

Aim: To assess the effect of immediate provisionalization (IP) on soft tissue changes, hard tissue changes, and clinical parameters following single immediate implant placement (IIP). Materials and Methods: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to September 2021. Randomized controlled trials (RCTs) comparing IIP with IP (test) and IIP without IP (control) were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue changes. Secondary outcomes included horizontal midfacial soft tissue changes, implant survival, mesial and distal papillary changes, Pink Esthetic Score (PES) at final follow‐up, marginal bone‐level changes, probing depth at final follow‐up, and bleeding on probing at final follow‐up. Results: Of the 8213 records, 7 RCTs reporting on 323 patients who received 323 single immediate implants (IIP + IP: 161 implants in 161 patients; IIP: 162 implants in 162 patients) were selected with a mean follow‐up ranging from 12 to 60 months. Risk of bias assessment yielded some concerns for five RCTs and high risk for two RCTs. Meta‐analysis on the cases with intact alveoli demonstrated 0.87 mm (95% confidence interval [CI] [0.57; 1.17], p <.001) less apical migration of the midfacial soft tissue level for IIP + IP when compared to IIP alone. Implant survival, papillary changes, marginal bone‐level changes, probing depth, and bleeding on probing were not significantly affected by IP. Insufficient data were available for meta‐analyses on horizontal midfacial soft tissue changes and PES. Conclusions: IP may contribute to midfacial soft tissue stability at immediate implants. However, high‐quality RCTs are needed since the strength of this conclusion is currently rated as low according to GRADE guidelines. [ABSTRACT FROM AUTHOR]

Background: There would be less need for emergency open cholecystectomy and fewer problems if cholecystectomy was performed soon following endoscopic retrograde cholangiopancreatography (ERCP). Objective: This study aimed to evaluate the advantages of immediate over delayed laparoscopic cholecystectomy among patients who had common bile duct stones post ERCP regarding outcome, safety and complications. Subjects and Methods: At General Surgery Department of Zagazig University Hospitals, 60 patients with cholecystolithiasis after doing ERCP were divided into 2 groups. Group (A) for immediate laparoscopic cholecystectomy (LC) in same sitting after ERCP and Group (B) for delayed LC (4 weeks or more) after ERCP. Conversion rate, operative time, intra- and post-operative complications were assessed. Results: The mean operative time was shorter in the immediate group (54.96 ± 14.21 min.) than in the delayed group (71.66 ± 24.72 min.), which represented a significant difference in favor of the immediate group. There was a statistically significant distinction in the incidence of complications after surgery where in delayed group five patients showed intraoperative bleeding and three patients converted to open cholecystectomy. Length of hospital stays also differed significantly between groups, 0.9 versus 1.95 for immediate LC group & delayed LC group, respectively. Conclusion: Performing immediate LC post, ERCP in comparison to delayed LC after ERCP had better outcomes. It had the lower conversion rate, less operative time, shorter hospital stay, and less intra-operative and post-operative complications. [ABSTRACT FROM AUTHOR]

Objective: To analyse if exposure to sunitinib in the Immediate Surgery or Surgery After Sunitinib Malate in Treating Patients With Metastatic Kidney Cancer (SURTIME) trial, which investigated opposite sequences of cytoreductive nephrectomy (CN) and systemic therapy, is associated with the overall survival (OS) benefit observed in the deferred CN arm. Patients and Methods: A post hoc analysis of SURTIME trial data. Variables analysed included number of patients receiving sunitinib, time from randomisation to start sunitinib, overall response rate by Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1, and duration of drug exposure and dose in the intention‐to‐treat population of the immediate and deferred arm. Descriptive methods and 95% confidence‐intervals (CI) were used. Results: In the deferred arm, 97.7% (95% CI 89.3–99.6%; n = 48) received sunitinib vs 80% (95% CI 66.9–88.7%, n = 40) in the immediate arm. Following immediate CN, 19.6% progressed 4 weeks after CN and the median time to start sunitinib was 39.5 vs 4.5 days in the deferred arm. At week 16, 46.0% had progressed at metastatic sites in the immediate CN arm vs 32.7% in the deferred arm. Sunitinib dose reductions, escalations and interruptions were not statistically significantly different between arms. Among patients who received sunitinib in the immediate or deferred arm the median total sunitinib treatment duration was 172.5 vs 248 days. Reduction of target lesions was more profound in the deferred arm. Conclusions: In comparison to the deferred CN approach, immediate CN impairs administration, onset, and duration of sunitinib. Starting with systemic therapy leads to early and more profound disease control and identification of progression prior to planned CN, which may have contributed to the observed OS benefit. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP). Materials and Methods: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta‐analyses were performed when possible. Results: Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow‐up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta‐analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [−0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta‐analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made. Conclusion: SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: In India, COVID-19 infected more than 10 million and caused more than 148,000 fatalities during 2020. Due to "lockdown" eye banks were shuttered in March, 2020 and reopened for operations in the month of May, 2020. This study assesses the immediate impact of the pandemic on eye banking and cornea transplantation in India. Methods: Data was gathered through an online survey of the eye banks and cornea surgeons in India. The questionnaire collected information on the vital statistics of eye bank operations and cornea transplants for the period from March to June for the years 2019 and 2020. Results: 47 eye banks responded to the survey. Collectively in the March–May 2020 period, corneas collected and transplanted declined by 78.27% and 79.14%, respectively, compared to the same period of 2019. In June 2020, the first full month after operations restarted, the collection and transplants were respectively, 82.10% and 81.82%, lower than June, 2019. Long-term glycerine preservation of corneas in the period from March to June 2020 increased by 124.5% compared to same period in 2019, but overall only 5.26% of the corneas recovered were preserved in this way. 44.44% of the eye banks collected corneas only from donors with negative COVID-19 diagnosis. 36.11% of the respondents rejected all suspicious cases, such as donors with respiratory pathologies, and 2.78% of the respondents accepted donations from medico legal cases only. 19.44% of the responding eye banks did SARS-CoV-2 nasal swab test for the deceased donor. 79.5% of the eye banks reported that staff were willing to work during the pandemic, and 82.05% eye banks gave special training to staff before restarting services. Conclusion: Due to the steep decline in collections and transplants, 2020 can be termed as a lost year in Indian eye banking. Attention to Hospital Cornea Recovery Programs, continuous situation monitoring, and ongoing staff training programs are recommended. [ABSTRACT FROM AUTHOR]

Introduction: To determine which day automated refraction stabilised the first week after uneventful cataract surgery. Methods: This was a prospective, single-blinded, randomised cohort study of 148 eyes in 148 consecutive patients undergoing uneventful cataract surgery. Automated refraction was measured from days 2 to 7 after surgery and compared to automated refraction measured 6 weeks post-surgery. We compared measurements using a hierarchical mixed-effect model. Results: Our adjusted results did not show a statistically significant change in spherical equivalent between the first week after surgery and 6 weeks after surgery (p-values: day 2: 0.914, day 3: 0.922, day 4: 0.168, day 5: 0.211, day 6: 0.457, day 7: 0.621). We measured the spherical error as stable except for day 5, where a statistically significant change of 0.32 dioptre (p = 0.049) was detected. Similarly, the cylindrical error was also stable on all days of measurements except on day 6, where a significant change of 0.28 dioptre (p = 0.034) was detected. Conclusion: The adjusted spherical equivalent was stable on days 2–7 after uneventful cataract surgery in our study population. However, as we observed a statistically significant difference in spherical and cylindrical errors on days 5 and 6, respectively, we could not conclude that automated refraction stabilised the first week after uncomplicated cataract surgery. [ABSTRACT FROM AUTHOR]

Background: Immediate contraceptive initiation, including start of a method before abortion completion, is a convenient option for women seeking abortion care.Objectives: To evaluate the effect of systemic hormonal contraception initiation on medical abortion effectiveness and the safety of hormonal contraceptive methods following abortion.Data Sources: PubMed, Popline, Cochrane Library, and Clinicaltrials.gov.Study Eligibility Criteria: Studies that assessed medical abortion effectiveness after systemic hormonal contraception initiation and the safety of hormonal contraception initiation after abortion.Participants: Pregnant persons undergoing or who had recently undergone an abortion.Interventions: Initiation of systemic hormonal contraception post abortion or on the day of the first pill of the medical abortion.Study Appraisal and Synthesis Methods: We assessed study quality using the US Preventive Services Task Force evidence grading system. We created narrative summaries and calculated pooled relative risks when appropriate.Results: We identified 16 studies for inclusion, 7 randomized controlled trials, and 9 cohorts. Nine studies assessed medical abortion effectiveness with hormonal contraception initiation and generally found no decreased risk of abortion success or increased risk of additional treatment. One fair-quality study reported a small increase in ongoing pregnancy rate with immediate depot medroxyprogesterone (DMPA) compared with delayed DMPA initiation (3.6% vs 0.9%, risk difference 2.7%, 90% confidence interval 0.4-5.6). We identified no bleeding-related safety concerns following hormonal contraception initiation after medical or surgical abortion. Pooled results were too imprecise to draw firm conclusions.Limitations: Included studies were poor or fair quality and primarily in high-income or upper-middle-income settings.Conclusions: Abortion effectiveness did not differ between immediate vs delayed initiation of most systemic hormonal contraceptive methods after a first trimester medical abortion. However, immediate DMPA initiation did show increased ongoing pregnancy. Bleeding effects with hormonal contraception initiation postabortion appeared minimal.Implications: Initiating a hormonal contraceptive method after an abortion and as early as the same day as the first pill of the medical abortion is an option if contraception is desired. The slight increase in ongoing pregnancy with immediate DMPA initiation highlights the importance of information provision during contraceptive counseling. [ABSTRACT FROM AUTHOR]

Objectives: To compare overall survival between patients with metastatic renal cell carcinoma treated by cytoreductive nephrectomy and those not treated by cytoreductive nephrectomy. Methods: We retrospectively evaluated 278 patients with metastatic renal cell carcinoma treated with first‐line tyrosine kinase inhibitors between January 2008 and November 2019. Patients were divided into two groups: a cytoreductive nephrectomy group (immediate or deferred cytoreductive nephrectomy) and a group who received systemic tyrosine kinase inhibitor therapies alone without cytoreductive nephrectomy (control group). Overall survival comparisons were made in all patients in the control versus the cytoreductive nephrectomy group, the control versus the immediate cytoreductive nephrectomy group, the control versus the deferred cytoreductive nephrectomy group, and the deferred cytoreductive nephrectomy versus the immediate cytoreductive nephrectomy group. Analyses were weighted using the propensity score‐based inverse probability of treatment weighting method to adjust for group imbalances. Results: The median (range) age of the patients was 65 (59–73) years. Of the 278 patients, 132 and 146 were in the control group and the cytoreductive nephrectomy (immediate, n = 107 and deferred, n = 39) group, respectively. A significant difference was noted between the control and cytoreductive nephrectomy groups in age, clinical stage, International Metastatic Renal Cell Carcinoma Database Consortium risk factors, and the number of metastatic sites. Inverse probability of treatment weighting‐adjusted Cox regression analysis showed a significant difference in overall survival between the control and the cytoreductive nephrectomy groups and between the control and the immediate or deferred cytoreductive nephrectomy groups. However, there was no significant difference in overall survival between the immediate and the deferred cytoreductive nephrectomy groups. Conclusions: Our findings suggest that metastatic renal cell carcinoma patients undergoing cytoreductive nephrectomy are more likely to have longer overall survival than those who receive tyrosine kinase inhibitor therapy only. [ABSTRACT FROM AUTHOR]

Background: Cefaclor, a second-generation oral cephalosporin, is widely prescribed to treat infectious diseases. Immediate hypersensitivity (HS) reactions to cefaclor have continuously been reported and are expected to increase with its greater use. This study aimed to investigate the clinical characteristics and risk factors of immediate HS to cefaclor over the most recent 5 years. Methods: This retrospective study investigated 521 adverse drug reactions (ADRs) to cefaclor at pharmacovigilance centers at two tertiary hospitals from January 2014 to December 2018. In total, 459 patients with immediate HS to cefaclor were reviewed. Results: A total of 459 cases of cefaclor immediate HS were included among 521 cefaclor ADRs, and anaphylaxis was recorded in 61.2%. Female sex (odds ratio 2.917, 95% confidence interval 2.397–3.550, P < 0.001), age under 65 years (4.225, 3.017–5.916, P < 0.001), hypertension (2.520, 1.875–3.388, P < 0.001), liver diseases (2.189, 1.208–3.967, P = 0.010), asthma (8.075, 5.301–12.302, P < 0.001), and concomitant use of nonsteroidal anti-inflammatory drugs (1.888, 1.554–2.294, P < 0.001) were significantly associated with cefaclor immediate HS. Conclusions: Cefaclor was found to elicit high proportions of immediate HS and anaphylaxis. Physicians ought to be cautious with prescribing cefaclor to females, individuals with hypertension, liver diseases, or asthma, and patients taking nonsteroidal anti-inflammatory drugs. Trial registration: This study was retrospectively registered. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of connective tissue graft (CTG) in terms of vertical mid‐facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP). Materials and methods: Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non‐randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow‐up of at least 12 months were included for a qualitative analysis. Meta‐analyses were performed on data provided by RCTs. Results: Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow‐up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta‐analysis revealed a significant difference in terms of vertical mid‐facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p <.001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid‐facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p =.002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [−35%; 1%], p =.06). Meta‐analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid‐facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. Conclusion: CTG contributes to mid‐facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid‐facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness). [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10 years (a) and to identify putative risk factors for advanced mid‐facial recession (b). Material and Methods: Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15–25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3 months due to obvious alveolar process deficiency (n = 5) or advanced mid‐facial recession (n = 2). Clinical, aesthetic and radiographical outcomes at 10 years were compared to those at 5 years and CBCTs were taken at 10 years. Results: Twenty‐two patients (10 women; mean age 50) were consecutively treated and 18 could be re‐examined. Two implants failed and two patients died. None of the parameters differed between the 5‐ and 10‐year re‐assessment (marginal bone loss: 0.31 mm; plaque score: 15%; probing depth: 3.4 mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: −0.03 mm; distal papillary recession: 0.22 mm; mid‐facial recession: 0.58 mm). Six implants (33%) demonstrated ≥1 mm mid‐facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri‐implant mucositis and another demonstrated peri‐implantitis. Conclusions: Advanced mid‐facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone. [ABSTRACT FROM AUTHOR]

Rapid start of antiretroviral therapy (ART) is quickly becoming best practice around the world. In the US, programs exist to facilitate rapid ART start, but little is known about the experiences of newly diagnosed individuals receiving these recommendations and services. Twenty participants (19 men who have sex with men and 1 transgender woman) from an early ART start program were interviewed to better understand these experiences. Interviews were analyzed for main themes in three general areas: reasons to start, reasons to delay, and factors influencing early ART adherence. Participants reported starting anywhere from right away (same visit as diagnosis) to within a few weeks (median 10.5 days). Reasons to start right away included fear of what could happen if not treated, personal health, influence of people/resources at the clinic, and study participation. Most had small delays in ART start because of structural (insurance, costs) and intentional delays (getting additional medical consultations). Adherence facilitators included desires to improve CD4/viral load and positive beliefs in benefits of suppression. Participants were largely supportive of rapid ART start and appeared to rely on CD4/viral load as "proof" of need for ART, which may be particularly helpful for asymptomatic, newly diagnosed individuals starting ART. [ABSTRACT FROM AUTHOR]

Aim: ChloraPrep™ (CHP) is a clear solution of 2% (w/v) chlorhexidine (CHG) in 70% (v/v) isopropyl alcohol (IPA) administered with a specially designed sterile single‐use applicator in which a tinting agent can be added to the CHP solution upon activation of applicator immediately prior to patient skin preparation (CHP+T). This study investigated whether the immediate and residual efficacy of CHP vs CHP+T and a stock solution of 2% CHG in 70% IPA varied, and whether CHP was compromised by the addition of the dye. Methods and Results: We compared the immediate and residual activity (in 1 min) of 70% IPA with that of 2% CHG in 70% IPA stock solution prepared in the laboratory against CHP+T and CHP, against 22 micro‐organisms (5 ATCC and 18 clinical isolates) on germ‐carriers. CHP and CHP+T demonstrated superior immediate and residual efficacy compared to the 70% IPA plus 2% CHG in 70% IPA stock solutions. Each antiseptic tested showed greater efficacy against the Gram‐positive bacteria than against the Gram‐negative bacteria. However, their antimicrobial effect on yeasts was even lower. Conclusions: CHP and CHP+T have superior immediate and residual efficacy compared to stock 70% IPA and 2% CHG in 70% IPA solutions, and CHP+T is not affected by the tinting agent. Significance and Impact of the Study: ChloraPrep is a product which can be stained just before use. We have demonstrated that the immediate and residual efficacy of the antimicrobial solution is not compromised by the dye. The efficacy of CHP is greater against bacteria than against yeasts obtained from ICU patients. Interestingly, CHP is more effective against bacteria than a formula made in the laboratory with the same basic components (2% chlorhexidine and 70% IPA). The intermittent heat sterilization process of the commercial preparation might hypothetically have improved the residual activity of the CHP solutions. [ABSTRACT FROM AUTHOR]

Recent studies point to the importance of interleukin-33 in the pathogenesis of allergic respiratory diseases. The relationship of interleukin-33 and certain allergic respiratory diseases as well as their characteristics is not fully elucidated. The basic aim of this research was to determine interleukin-33 serum levels in children with allergic asthma and allergic rhinitis, as well as to examine the relationship between obtained interleukin-33 levels and individual clinical characteristics of these patients. Material and Methods. Serum interleukin- 33 levels were measured in a total of 91 children. The study group included 39 children with both allergic asthma and allergic rhinitis, and also 22 children with allergic asthma without allergic rhinitis. The control group included 30 healthy children. Results. Serum levels of interleukin-33 in children with both allergic asthma and allergic rhinitis were significantly higher compared to those in children with allergic asthma only (χ2 = 7.01; p = 0.008; p < 0.01). Both groups of patients had significantly higher interleukin-33 serum levels compared to healthy children (χ2 = 7.01; p = 0.008; p < 0.01). The correlation between serum interleukin-33 levels and allergic asthma severity was statistically significant (rs = 0.289; p = 0.024; p < 0.05). Conclusion. Serum levels of interleukin-33 were significantly higher in children with allergic respiratory diseases compared to healthy examinees. Significantly higher levels of serum interleukin-33 levels were found in children with both allergic asthma and allergic rhinitis, compared to children with allergic asthma only. Patients with higher interleukin- 33 serum levels also had a more severe type of allergic asthma. [ABSTRACT FROM AUTHOR]

In the setting of secondary breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap, the mastectomy skin is usually deepithelialized and buried under the reconstructed breast. In this study, by virtue of tube flap technique, we hypothesize that an amount of mastectomy skin could be transferred to the apex of reconstructed breast mound for nipple reconstruction. A total of 30 female postmastectomy patients were recruited between June 2012 and August 2015. A bipedicle DIEP flap was harvested and folded upward to reconstruct the breast. An inferiorly based mastectomy flap was raised and rolled into a tube. The free end of the flap was sutured to the reconstructed breast mound to allow revascularization. After serial stages, a sufficient tissue bulk from the mastectomy flap was transferred to the apex of the breast mound and remolded into a new nipple. Reconstructed breasts and nipples survived well postoperatively. The mean nipple projection was 9.2 ± 2.7 mm at the 1-year follow-up. In total 24 patients ranked the overall nipple and breast reconstruction to be very good or good. Based on DIEP flap breast reconstruction, the staged immediate nipple reconstruction with local mastectomy tube flap could maintain a long term residual projection with aesthetically acceptable outcomes. [ABSTRACT FROM AUTHOR]

Preliminary evidence indicates beneficial acute effects of resistance exercise on domain-specific cognitive function. Studies on dose response relationships and underlying mechanisms so far failed to deduce the impact of intensity and overall workload. To analyze the impact of different intensities and workloads on effects of full body resistance training on cognitive attention, executive function performance, and affective response. Twenty-six volunteers (9 (35%) female, age 25.9 ± 4.0 years) participated in three workload-matched (60%, 75% and 90% one repetition maximum intensity (1RM) resistance exercise interventions (RE)) and one workload reduced but intensity matched (75% 1RM, 50% overall workload) RE. Order was randomized, REs were on separate days with ≥48 h washout in between. Stroop Test performance (Attention: word and color condition; Interference control: word color interference), self-perceived levels of arousal and ability to concentrate were assessed before and after each RE. Workload-matched REs induced significant changes in attention and interference control. The workload reduced 75% 1RM RE induced changes in interference control, but no changes in attention performance. 75% 1RM exercise with full and 50% workload induced significant changes in arousal. Only 75% 1RM exercise with full workload significantly increased participants ability to concentrate. The repeated measures ANCOVA (Covariates: sex and fluid intelligence) indicated greater changes of interference control after 60% 1RM compared to 90% 1RM RE and greater changes of attention performance after 90% 1RM compared to 75% 1RM and 50% workload RE. Higher cognitive functions such as interference control seem to particularly benefit from moderate intensity RE whereas lower cognitive functions may be stimulated by higher intensity and higher workload RE. Self-perceived subjective factors did not mediate these dose response relationships. Future studies could analyze changes in cortisol levels, oxygenation, blood flow or electrophysiological signals to deduce triggers for increased stimulus-driven brain response and more controlled brain function. • The first study deducing the impact of intensity and workload. • Higher cognitive functions seem to benefit from moderate intensity resistance exercise. • Lower cognitive functions may be stimulated by higher intensity and higher workload resistance exercise. • Affective response to resistance exercise was associated with beneficial effects on cognitive function. • Affective response was not associated with workload or intensity dependent dose response relationships. [ABSTRACT FROM AUTHOR]

Aim: To compare immediate implant placement (IIP) to delayed single implant placement (DIP, ≥3 months post‐extraction) in terms of implant survival (primary outcome), surgical, clinical, aesthetic, radiographic and patient‐reported outcomes (secondary outcomes). Materials and Methods: Two reviewers independently performed an electronic search in PubMed, Web of Science, EMBASE and Cochrane and a hand search to identify eligible studies up to May 2018. Only randomized controlled trials (RCTs) and non‐randomized controlled studies (NRSs) comparing IIP to DIP with at least 1 year of follow‐up were selected for a qualitative analysis and meta‐analysis. Results: The search identified 3 RCTs and 5 NRSs out of 2,589 titles providing data on 473 single implants (IIP: 233, DIP: 240) that had been in function between 12 and 96 months. One RCT showed unclear risk of bias, whereas all other studies demonstrated high risk. Meta‐analysis showed significantly lower implant survival for IIP (94.9%) as compared to DIP (98.9%) (RR 0.96, 95% CI [0.93; 0.99], p = 0.02). All were early implant failures. A subgroup meta‐analysis demonstrated a trend towards lower implant survival for IIP when postoperative antibiotics had not been administered (RR: 0.93, 95% CI [0.86; 1.00], p = 0.07). This was not observed among studies including the administration of postoperative antibiotics (RR: 0.98, 95% CI [0.94; 1.02], p = 0.35). Meta‐analyses showed similar probing depth (WMD 0.43 mm, 95% CI [−0.47; 1.33], p = 0.35) and aesthetic outcomes as assessed by the pink aesthetic score (standardized WMD −0.03, 95% CI [−0.46; 0.39], p = 0.88) for IIP and DIP. Data on marginal bone loss were conflicting and highly biased. Soft tissue recession was underreported and available data were highly biased. Patient‐reported outcomes were underreported, yet both IIP and DIP seemed well tolerated. Conclusion: Immediate implant placement demonstrated higher risk for early implant loss than DIP. There is a need for RCTs comparing IIP to DIP with CBCT analyses at different time points and data on midfacial recession with the preoperative status as baseline. In these studies, the need for hard and soft tissue grafting should also be evaluated. [ABSTRACT FROM AUTHOR]

Background: Single implant crowns have become the preferred rehabilitation treatment option for replacing a missing tooth. Purpose: This study evaluates 5‐year clinical success of using tilted implants placed immediately after extraction followed by rehabilitation with all‐ceramic crowns. Materials and Methods: Twenty‐seven participants requiring 28 single implant crowns in the aesthetic zone of maxilla were recruited to participate in a single‐arm clinical trial. All participants were rehabilitated according to immediate implant placement using CP grade 4 titanium implants with roughened surfaces and a 12°‐angled platform. Provisional implant crowns were connected within 4 hours of implant placement and loaded according to progressive loading protocol. At 8 weeks (baseline), definitive screw‐retained crowns fabricated using densely sintered zirconia abutments with the veneering porcelain were delivered. Participants were followed up to 5 years and 16 participants with 17 single implant crowns attended Year 5 recall. Data collection included changes in marginal bone levels (MBLs), mid‐buccal mucosal levels (MBMLs), implant stability quotient (ISQ) values, and any prosthodontic maintenance issues. Results: The mean changes in MBLs at each recall was bone fill of 0.5 ± 1.18 mm (surgery—baseline), increase of 0.1 ± 0.57 mm (baseline—Year 1), and marginal bone loss of 0.1 ± 0.25 mm (Years 1‐5). A minimal change occurred with the MBMLs during the observation period. The mean ISQ value at each time point increased from 65.1 (implant placement), to 67.4 (baseline) and 69.9 (Years 1 and 5). Prosthodontic maintenance issues occurred only during the first year which included fracture of veneering ceramic and zirconia abutment as well as aesthetic concerns. Conclusions: Within the limitations of this study, the data collected would suggest that replacing a single missing tooth using titanium oral implants with 12° platform tilt and zirconia abutments can be a successful rehabilitation option in the esthetically demanding zone of anterior maxilla. [ABSTRACT FROM AUTHOR]

This article examines the origin of the concept of medium and of media theory as an area of knowledge. It claims that the concept of medium in the modern sense was first introduced in the works of German philosopher Ludwig Feuerbach. Attempting to re-read Feuerbach's texts to reveal his original methodology and to "scrub" it of prevailing (mainly Hegelian and Marxist) interpretations, the author briefly traces the impact of this method—defined as a combination of three operations: an "inversion," a determination of "material means," and a "translation"—on the development of post-Feuerbachian thought. The question of "material means" is central to Feuerbach's critical project and is directly linked to a "translation" procedure. Considered together, these two essentially coincide with the questions of medium and mediation as they are presented in media theory (particularly in Marshall McLuhan and Régis Debray). In conclusion, the author discusses the theological background of the concept of medium and introduces the concept of a "cultural Filioque." [ABSTRACT FROM AUTHOR]

The management of symptomatic giant hepatic hemangiomas (> 10 cm) varies in the literature. Multiple interventional approaches have been described including surveillance, embolization, enucleation, and resection based on tumor size, location, relationship to vascular and biliary structures, and the quality and quantity of the functional liver remnant. Resection is often performed as a last resort due to the risk of major hemorrhage. Preoperative arterial embolization is an option; however, many patients will experience severe pain, fever, transaminitis, acidosis, recanalization, and collateral inflow that limit its utility. Furthermore, patients require post-procedure inpatient observation, and there is no consensus on the appropriate time interval between procedures. We present and demonstrate a technique in the video that utilizes a hybrid operating room with on-table angiogram capabilities to perform hemangioma inflow embolization and immediate hepatic resection under the same anesthesia in a single procedure. Combining on-table embolization with immediate resection avoids many of the pitfalls of preoperative embolization, while enhancing the safety of the resection by decreasing the size of the tumor, enabling compressibility, and facilitating exposure of the vascular inflow and outflow. It is an efficient use of hospital resources and eliminates an intervening hospital admission. We have found it to be a preferred approach to enhance the safety and feasibility of resection for massive hepatic hemangiomas with minimal intraoperative blood loss and reduced risk. [ABSTRACT FROM AUTHOR]

Long-standing ischemic priapism leads to cavernosal smooth muscle necrosis and erectile dysfunction [1]. We report a 28-year-old gentleman who presented with 3-week duration of neglected idiopathic ischemic priapism. As his stretched penile length was 9 cm, he was taken up for immediate implantation of penile prosthesis. With minimal difficulty in corporal dilation due to scarring, a 3-piece inflatable penile prosthesis was placed. He developed fever with chills and generalized rash in the immediate postoperative period and it responded to change of antibiotics and antihistaminics. He has good intercourse satisfaction with antegrade ejaculation at the end of 2 years. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies showed that Whole Body Vibration (WBV) is an effective modality for strength and power. WBV has many usages in training and rehabilitation. Core muscles have the central role in the stability of the spine and our daily activity; so, strengthening core muscles is essential. This study aimed to investigate the immediate effect of WBV on strength, endurance, and performance of core muscles in young, healthy females. Materials and Methods: This study was a quasi-experimental interventional study. Twelve young, healthy females (18-28 years old) participated in this study; they received WBV in semi-squat position 5 times in 60 seconds separated by 30-second rest. The parameters of WBV included the frequency of 30Hz and an amplitude of 4mm. The tests used for the evaluation of core stability included Vertical Jump (VJ), pressure biofeedback, front abdominal power, trunk extensor endurance, and trunk flexor endurance tests. The tests were performed before, immediately after, and 30 minutes after the intervention. Results: According to the results, the trunk extensor endurance test, front abdominal power test, and pressure biofeedback had a significant effect (P<0.05). However, no change was observed in the trunk flexor endurance test and VJ test (P>0.05). Conclusion: This study indicated that WBV could be useful in core stability, specifically for trunk extensor endurance, lumbar strength, and front abdominal power. More studies are required to prove the effect of WBV on VJ and trunk flexor endurance. [ABSTRACT FROM AUTHOR]

The current study aimed to examine the effect of giving temporally framed health information regarding either the immediate or long-term health consequences of consuming high-calorie snacks, for people with high Negative Urgency (a dimension of impulsivity), and for those primed with impulsivity. We expected that for participants with high Negative Urgency, and those primed with impulsivity, information which detailed the immediate health benefits of avoiding snack consumption would be more effective than information which detailed long-term health benefits. Participants (N=110) completed a measure of Negative Urgency, reported their snacking frequency over the previous seven days, and completed either an impulsivity or neutral prime task. Following this, they read information detailing either the immediate or long-term health benefits of avoiding high-calorie snacks. High-calorie snack consumption was reported 7days later. The results showed a significant three-way interaction between Negative Urgency, prime task, and temporal frame. Participants who were primed with impulsivity and those high in Negative Urgency showed a greater reduction in snacking frequency after being given information about the immediate vs. long-term health benefits of snacking. The results suggest that the immediacy of health consequences should be considered when designing health information to reduce impulsive snacking behaviour. [ABSTRACT FROM AUTHOR]

Objective: Immediate delivery compared with expectant management in a low risk population stratified by birthweight. Methods: Retrospective cohort of births, stillbirths and neonatal deaths from 2010 through 2012 compiled by the National Center for Health Statistics. Birthweight categories were created using population derived deciles. Gestational age at birth was adjusted to account for time from death to delivery. The risk of immediate delivery was the neonatal death rate. The risk of expectant management was the sum of the conditional stillbirth risk plus the neonatal death rate for the following week. Relative risks were calculated comparing immediate delivery with expectant management by birthweight category. Results: There were 4 966 067 births, 6660 stillbirths and 6979 neonatal deaths. The gestational age at which expectant management exceeded risk of immediate delivery was consistently at or after 39 weeks for all except birthweights above the 95th centile, where the relative risk for death with immediate delivery was 1.72 (95% CI: 1.74–1.7) at 36 and 0.83 (95% CI: 0.84–0.81) by 37 weeks. Conclusions: In this low risk cohort, risk at 39 weeks favored immediate delivery, except for birthweight over the 95th centile, where expectant management did not appear to be beneficial after 37 weeks. [ABSTRACT FROM AUTHOR]

Purpose: To define and describe the processes underlying the successful neonatal transition to extrauterine life and methods to assess the transition. Method: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science, and Google Scholar were searched using a combination of the key words neonate, neonatal, newborn, transition, respiratory OR pulmonary, cardiac, metabolic, pH, umbilical cord, and assessment. Articles in English and German were reviewed. The final sample of articles consisted of one randomized controlled trial, 30 observational studies using human neonates, one observational study using rabbit pups, one secondary analysis, three systematic reviews, and 23 review articles. Major Findings: The pertinent findings in regard to normal events in the respiratory, cardiovascular, and metabolic transitions are reviewed and summarized. We address the underlying factors necessary for the transition to extrauterine life, specify the consequences of a successful transition, and review common assessment approaches. Conclusion: Available evidence indicates that the successful immediate transition to extrauterine life should be completed within 1-3 hr after birth, though some adaptive processes can fail as late as 24-48 hr after birth. Further research is necessary to identify a feasible, easily used, noninvasive method to assess the status of a neonate's transition to extrauterine life. [ABSTRACT FROM AUTHOR]

Background: Food allergen labeling is an important tool to reduce risk of exposure and prevent anaphylaxis for individuals with food allergies. Health Canada released a Canadian food allergen labeling regulation (2008) and subsequent update (2012) suggesting that research is needed to guide further iterations of the regulation to improve food allergen labeling and reduce risk of exposure. Objective: The primary objective of this study was to examine consumer preferences in food labeling for allergy avoidance and anaphylaxis prevention. A secondary objective was to identify whether different subgroups within the consumer population emerged. Methods: A discrete choice experiment using a fractional factorial design divided into ten different versions with 18 choice-sets per version was developed to examine consumer preferences for different attributes of food labeling. Results: Three distinct subgroups of Canadian consumers with different allergen considerations and food allergen labeling needs were identified. Overall, preferences for standardized precautionary and safety symbols at little or no increased cost emerged. Conclusion: While three distinct groups with different preferences were identified, in general the results revealed that the current Canadian food allergen labeling regulation can be improved by enforcing the use of standardized precautionary and safety symbols and educating the public on the use of these symbols. [ABSTRACT FROM AUTHOR]

European Network on Drug Allergy ( ENDA) has proposed an algorithm for diagnosing immediate beta-lactam ( BL) allergy. We evaluated its performance in real life. During 1994-2014, 1779 patients with suspected immediate reactions to BL were evaluated following ENDA's short diagnostic algorithm. Five hundred and nine patients (28.6%) were diagnosed of BL hypersensitivity. Of them, 457 (25.7%) were at first evaluation [403 by skin tests ( ST), 12 by positive IgE and 42 by controlled provocation tests ( CPT)]. At second evaluation ( SE), 52 additional patients (10.2% of allergic patients) were diagnosed, [50 (2.8%) by ST and 2 (0.1%) by CPT]. Time between reaction and study was significantly longer in patients diagnosed at SE (median 5 vs 42 months; IQR 34 vs 170; P < 0.0001). Anaphylaxis was significantly associated with a diagnosis at SE. European Network on Drug Allergy/ EAACI protocol was appropriate and safe when evaluating BL immediate reactions. Re-evaluation should be performed, particularly when anaphylaxis and long interval to diagnosis are present. [ABSTRACT FROM AUTHOR]

Aim There is a paucity of long-term data on soft tissue aesthetics of single immediate implants. The objective of this study was to evaluate the 5-year clinical and aesthetic outcome of this treatment concept. Materials and methods Twenty-two periodontally healthy patients (12 men, 10 women; mean age 50) with low risk for aesthetic complications (thick gingival biotype, intact buccal bone wall, both neighbouring teeth present) were consecutively treated with a single immediate implant in the aesthetic zone (15-25). Flapless surgery was performed and the gap between the implant and buccal bone wall was systematically filled with bovine bone particles. Implants were immediately non-functionally loaded with a screw-retained provisional crown. Cases demonstrating major alveolar process changes and/or advanced mid-facial recession (>1 mm) at 3 months were additionally treated with a connective tissue graft ( CTG). Permanent crowns were installed at 6 months. The clinical and aesthetic results at 5 years were compared to those obtained at 1 year. Results Seventeen patients attended the 5-year re-assessment, of whom five had been treated with a CTG for early aesthetic complications. There was one early implant failure and one complication after 1 year (porcelain chipping). Mean marginal bone loss was 0.12 mm at 1 year and 0.19 mm at 5 years ( p = 0.595) with the moment of implant installation as baseline. Papilla height increased between 1 and 5 years ( p ≤ 0.007), whereas mid-facial contour ( p = 0.005) and alveolar process deficiency ( p = 0.008) deteriorated. Mean mid-facial recession was on average 0.28 mm ( SD 0.48) at 1 year and 0.53 mm ( SD 0.53) at 5 years ( p = 0.072) with the preoperative status as baseline. Three implants demonstrated advanced mid-facial recession (>1 mm) at 5 years. All three were in a central incisor position and none had been treated with a CTG. Thus, 8/17 implants showed aesthetic complications (five early and three late aesthetic complications). Implants in a lateral incisor position showed stable soft tissue levels. The pink aesthetic score was on average 12.15 at 1 year and 11.18 at 5 years ( p = 0.030). Conclusion Single immediate implants showed high implant survival and limited marginal bone loss in the long term. However, mid-facial recession, mid-facial contour and alveolar process deficiency deteriorated after 1 year. With an aesthetic complication rate of 8/17 in well-selected patients who had been treated by experienced clinicians, type I placement may not be recommended for daily practice. [ABSTRACT FROM AUTHOR]

Pine caterpillar, Thaumetopoea pityocampa, is a phyto-lepidopteran, responsible for the delay in the growth or the death of various types of pine trees. Besides nature damage, pine caterpillar causes dermatological reactions in humans by contact with the irritating hairs of the larvae. Although dermatitis occurs among outdoor professionals, it is primarily non-professional. Means of contamination comprise direct contact with the nest or the processional caterpillar and indirect contact with air dispersed hairs. Dermatitis is generally observed in late spring and particularly from March to June, among campers and tourers. The eruption has its onset 1-12 hours after contact with the hairs and presents with intense and continuous itching. Apart from the skin, T. pityocampa can involve the eyes and rarely the airways. Despite the considerable damages to humans and nature, pine caterpillar infestation is an underestimated problem; medical literature lists few studies and, often, relevant information is referred to local media and popular wisdom. [ABSTRACT FROM AUTHOR]

Background/Aim. Bronchiolitis in early childhood caused by respiratory syncytial virus (RSV) is considered to be important risk factor of the recurrent wheezing and asthma development. The aim of this study was to examine the frequency of RSV infection and atopy in children up to two years of age and to determine their correlation with bronchial hyperreactivity. Methods. The study included 175 children aged 5–24 months. The presence of RSV infection was identified by serum levels of IgA and IgG determined by ELISA. Bronchial hyperreactivity (BHR) has been defined as the existence of chronic bronchial disease and/or three or more previous suspected diagnosis of acute bronchial disease. Atopy was confirmed by detection of the specific serum IgE using quantitative multitest Phadiatop infant (cut off ≥ 0.35 kUA/L). Results. The children with atopy were more frequently infected with RSV (43.3%) than those without atopy (22.8%; p = 0.02). The higher frequency of RSV infection was found in children with BHR in comparison with those without it but only in the group who also had atopy (77.8% vs 28.6%, p = 0.018). In the female children, BHR and RSV infection were associated in 62.5% of cases, regardless the atopy. In the male children with atopy, RSV infection was associated with BHR in 83.3% of the cases, while in those without atopy, RSV infection with BHR was found in only 17.4% of the cases. Conclusion. Children up to two years of age with atopy are more frequently infected with RSV (43.3%) than non-atopic children. Every third child with atopy develops BHR and 77.8% of them also have RSV infection. Atopic children are at higher risk for development of BHR when infected with RSV also. [ABSTRACT FROM AUTHOR]

Allergic reaction to insulin is uncommon since the introduction of human recombinant insulin preparations and is more rare in pregnant than non-pregnant females due to altered immune reaction during pregnancy. Herein, we report two cases of allergic reaction to insulin in gestational diabetes that were successfully managed. One case was a 33-year-old female using isophane-neutral protamine Hagedom human insulin and insulin lispro. She experienced dyspnea, cough, urticaria and itching sensation at the sites of insulin injection immediately after insulin administration. We discontinued insulin therapy and started oral hypoglycemic agents with metformin and glibenclamide. The other case was a 32-year-old female using insulin lispro and insulin detemer. She experienced pruritus and burning sensation and multiple nodules at the sites of insulin injection. We changed the insulin from insulin lispro to insulin aspart. Assessments including immunoglobulin E (IgE), IgG, eosinophil, insulin antibody level and skin biopsy were performed. In the two cases, the symptoms were resolved after changing the insulin to oral agents or other insulin preparations. We report two cases of allergic reaction to human insulin in gestational diabetes due to its rarity. [ABSTRACT FROM AUTHOR]

Background/Aim. The "hygiene hypothesis" addresses the correlation between the occurrence of atopy and the frequency of infections in the earliest age, explaining an increase in the incidence of atopic diseases by living in good, infection-free, hygienic conditions. The aim of our study was to determine the conection between atopy and Campylobacter infection, and to analyze the association between serum concentrations of total IgE and Campylobacter infection in relation to atopy in children up to two years. Methods. A case control study was conducted with the sample of 98 infants of the average age of 8 months. Total serum IgE and Phadiatop infant multi-test were determined on Immunocap-100 (Phadia AB, Uppsala, Sweden). The presence of atopy was determined by detection of serumspecific IgE ≥ 0.35 kUA/L (Phadiatop infant positive) and serum IgM, IgA, IgG levels against C. jejuni were determined by a quantitative immuno-enzyme test - SERION ELISA classic. Results. Total IgE cut-off values ≥ 15 kU/L point to atopy in infants, and tIgE cut-off values ≥ 8.1 kU/L pointed to a C. jejuni infection in infants. Within the group of atopic children, tIgE levels ≥ 29.8 kU/L point to C. jejuni infection, and within the group of non-atopic children, tIgE levels ≥ 5.9 kU/L point to infection. Enteritis is not a predictor of C. jejuni infection, because of a high frequency of asymptomatic cases of infection. The risk factors for C. jejuni infection are age and tIgE, and the protective factors are breastfeeding and atopy. Conclusion. C. jejuni infection increases the total serum IgE level, which is predictive of infection, regardless of the presence of atopy. The presence of symptomatic C. jejuni infection reduces the risk of atopy in a child of the age of 5-24 months by the factor of 10. [ABSTRACT FROM AUTHOR]