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Aim: To study the influence of different force magnitudes on dental arches in cervical headgear (CHG) treatment. Material and methods: In this controlled clinical trial, patients (n = 40) were treated with CHG with light (L, 300 g, n = 22) or heavy force (H, 500 g, n = 18) magnitude. Subjects were asked to use CHG for 10 hours a day for 10 months. The outer bow of the CHG facebow was raised 10–20 degrees and the inner bow expanded 3–4 mm. Adherence to instructions and force magnitude were monitored with an electronic module (Smartgear, Swissorthodontics, Switzerland). Impressions for study models were taken before (T1) and after (T2) treatment and the study models were scanned into digital form (3Shape, R700 Scanner, Denmark). Measurements were made using the digital models (Planmeca Romexis, Model analyser, Finland). Results: During the treatment (T1–T2) the upper inter-canine distance increased by 2.83 mm (P = 0.000) and 2.60 mm (P = 0.000) in the L and H force magnitude groups, respectively. Upper inter-molar width increased by 3.16 mm (P = 0.000) and 2.50 mm (P = 0.000) in the L and H groups, respectively. Maxillary total arch perimeter increased by 6.39 mm (P = 0.001) and 6.68 mm (P = 0.001) in the L and H groups, respectively. In the amount of change over time, T1–T2, in the upper arch measurements, no significant difference was found between the groups. Lower inter-canine width increased by 0.94 mm (P = 0.005) and 1.16 mm (P = 0.000) in the L and H groups, respectively; no difference between the groups. Lower inter-molar distance increased by 2.17 mm (P = 0.000) and 1.11 mm (P = 0.008) in the L and H groups, respectively. At the end of the study, upper and lower inter-molar width was larger in the L group than in the H group (P = 0.039 and P = 0.022, respectively). Conclusions: CHG therapy is an effective method for expanding and releasing moderate crowding of the upper dental arch. The lower arch spontaneously follows the upper arch in widening effe

Aim: To study the effect of force magnitude on the maxillary first and second molars in cervical headgear (CHG) therapy. Material and methods: In this controlled clinical trial, patients (n = 40) were treated with CHG with a light (L, 300 g, n = 22) or a heavy force (H, 500 g, n = 18) magnitude. The subjects were asked to wear CHG for 10 hours a day for 10 months. The outer bow of the CHG facebow was lifted up for 10–20 degrees and the inner bow was expanded 3–4 mm. Adherence to instructions and force magnitude were monitored using an electronic module (Smartgear, Swissorthodontics, Switzerland). Panoramic and lateral radiographs before (T1) and after treatment (T2) were analysed using a Romexis Cephalometric module (Planmeca, Finland) focussing on the angular, sagittal, and vertical positions of the permanent first and second molars. Results: According to the cephalometric analysis of the maxillary first and second molars, distal tipping occurred during T1–T2 in the H group (P = 0.010 and 0.000, respectively), and the change was greater in the H group compared to the L group (P = 0.045 and 0.019, respectively). Based on the panoramic analysis, tipping occurred in the distal direction during therapy in the H group in the second molars compared to the midline or condylar line (P = 0.001 and 0.001; P = 0.008 and 0.003 on the right and left, respectively). Conclusions: With heavy force magnitude, the maxillary first and second molars can tilt more easily in the distal direction even if the CHG was used less. Distal tipping of the molar can be considered to be a side effect of CHG therapy.

Polymerase chain reaction (PCR)-based diagnostics for Mycoplasma pneumoniae (M. pneumoniae) from the respiratory tract has become widely available, but the interpretation of the results remains unclear. M. pneumoniae has been suggested to cause mainly mild and self-limiting infections or asymptomatic carriage. However, systematic analyses of the association between PCR results and clinical findings are scarce. This study aimed to clarify the clinical features of PCR-positive M. pneumoniae infections in a hospital setting. We reviewed 103 PCR-positive patients cared for in a university hospital during a 3-year period. Data on age, sex, health condition, acute symptoms, other pathogens found, laboratory and X-ray results and treatments were collected. Over 85% of the patients had a triad of typical symptoms: fever, cough and shortness of breath. Symptoms in the upper respiratory tract were rare. In 91% of the cases, M. pneumoniae was the only pathogen found. The highest incidence was found in the age group of 30–40 years, and 68% of the patients did not have any underlying diseases. Most patients were initially empirically treated with beta-lactam antibiotics and needed 2–4 changes in their treatment. Only 6% were discharged without an antibiotic effective against M. pneumoniae. This study shows that M. pneumoniae often led to hospitalisation and that patients needed appropriate antimicrobial treatment to recover. Mixed infections were rare, and situations that could be interpreted as carriage did not occur.

Item does not contain fulltext, BACKGROUND: An increasing number of NFKB1 variants are being identified in patients with heterogeneous immunologic phenotypes. OBJECTIVE: To characterize the clinical and cellular phenotype as well as the management of patients with heterozygous NFKB1 mutations. METHODS: In a worldwide collaborative effort, we evaluated 231 individuals harboring 105 distinct heterozygous NFKB1 variants. To provide evidence for pathogenicity, each variant was assessed in silico; in addition, 32 variants were assessed by functional in vitro testing of nuclear factor of kappa light polypeptide gene enhancer in B cells (NF-κB) signaling. RESULTS: We classified 56 of the 105 distinct NFKB1 variants in 157 individuals from 68 unrelated families as pathogenic. Incomplete clinical penetrance (70%) and age-dependent severity of NFKB1-related phenotypes were observed. The phenotype included hypogammaglobulinemia (88.9%), reduced switched memory B cells (60.3%), and respiratory (83%) and gastrointestinal (28.6%) infections, thus characterizing the disorder as primary immunodeficiency. However, the high frequency of autoimmunity (57.4%), lymphoproliferation (52.4%), noninfectious enteropathy (23.1%), opportunistic infections (15.7%), autoinflammation (29.6%), and malignancy (16.8%) identified NF-κB1-related disease as an inborn error of immunity with immune dysregulation, rather than a mere primary immunodeficiency. Current treatment includes immunoglobulin replacement and immunosuppressive agents. CONCLUSIONS: We present a comprehensive clinical overview of the NF-κB1-related phenotype, which includes immunodeficiency, autoimmunity, autoinflammation, and cancer. Because of its multisystem involvement, clinicians from each and every medical discipline need to be made aware of this autosomal-dominant disease. Hematopoietic stem cell transplantation and NF-κB1 pathway-targeted therapeutic strategies should be considered in the future.

Objectives: The aim of this study was to assess the interaction of a bioactive glass scaffold with cells derived from dental pulp, dental follicle and periodontal ligament. Material and methods: Impacted third molars were surgically removed from three young donors. Cells from the dental pulp, follicle and periodontal ligament tissues were isolated and expanded. Different cell populations were characterised using specific CD markers. Expanded pulp, follicle and periodontal cells were then seeded onto bioactive glass scaffolds and cultured in osteogenic medium or basic medium. Cell attachment, viability, proliferation and alkaline phosphatase activity were assessed. Results: This study revealed good biocompatibility of the specific bioactive glass configuration tested and the osteogenic induction of cells derived from dental pulp, dental follicle and periodontal ligament. Osteogenic medium seemed to increase the differentiation pattern and dental pulp stem cells showed the most positive results compared to periodontal ligament and dental follicle stem cells. Conclusions: Dental pulp stem cells combined with a bioactive glass scaffold and exposed to osteogenic medium in vitro represent a promising combination for future study of hard tissue regeneration in the cranio-maxillofacial skeleton.

In line with the increasing significance of the acceleration of information technology (IT) advancement and also of harnessing the vigor of emerging economies, IT outsourcing to emerging economies has become global concerns. This enables global companies to enjoy a critical competitive edge by choosing the best option in outsourcing strategy and supplier selection. Consequently, supplier selection criteria have become critical issues for both suppliers and customers. This paper attempts to provide insightful suggestions to these issues. An empirical analysis was conducted taking supplier selection criteria evolvement in global IT outsourcing project focusing on action research in a multinational company. Noteworthy findings include impacts of manager's change, identification of creative moment and weighing of supplier selection criteria.

Efficient early identification of primary immunodeficiency disease (PID) is important for prognosis, but is not an easy task for non-immunologists. The Clinical Working Party of the European Society for Immunodeficiencies (ESID) has composed a multi-stage diagnostic protocol that is based on expert opinion, in order to increase the awareness of PID among doctors working in different fields. The protocol starts from the clinical presentation of the patient; immunological skills are not needed for its use. The multi-stage design allows cost-effective screening for PID within the large pool of potential cases in all hospitals in the early phases, while more expensive tests are reserved for definitive classification in collaboration with an immunologist at a later stage. Although many PIDs present in childhood, others may present at any age. The protocols presented here are therefore aimed at both adult physicians and paediatricians. While designed for use throughout Europe, there will be national differences which may make modification of this generic algorithm necessary., Journal Article, FLWIN, info:eu-repo/semantics/published