| 1. |
- Bender, Nicole, et al.
(författare)
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Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility : cross-national study
- 2011
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Ingår i: Sexually Transmitted Infections. - : BMJ. - 1368-4973 .- 1472-3263. ; 87:7, s. 601-608
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To describe, using routine data in selected countries, chlamydia control activities and rates of chlamydia infection, pelvic inflammatory disease (PID), ectopic pregnancy and infertility and to compare trends in chlamydia positivity with rates of PID and ectopic pregnancy. Methods Cross-national comparison including national data from Australia, Denmark, the Netherlands, New Zealand, Sweden and Switzerland. Routine data sources about chlamydia diagnosis and testing and International Classification of Disease-10 coded diagnoses of PID, ectopic pregnancy and infertility in women aged 15-39 years from 1999 to 2008 were described. Trends over time and relevant associations were examined using Poisson regression. Results Opportunistic chlamydia testing was recommended in all countries except Switzerland, but target groups differed. Rates of chlamydia testing were highest in New Zealand. Chlamydia positivity was similar in all countries with available data (Denmark, New Zealand and Sweden) and increased over time. Increasing chlamydia positivity rates were associated with decreasing PID rates in Denmark and Sweden and with decreasing ectopic pregnancy rates in Denmark, New Zealand and Sweden. Ectopic pregnancy rates appeared to increase over time in 15-19-year-olds in several countries. Trends in infertility diagnoses were very variable. Conclusions The intensity of recommendations about chlamydia control varied between countries but was not consistently related to levels of chlamydia diagnosis or testing. Relationships between levels of chlamydia infection and complication rates between or within countries over time were not straightforward. Development and validation of indicators of chlamydia-related morbidity that can be compared across countries and over time should be pursued.
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| 2. |
- Gracis, Stefano, et al.
(författare)
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Internal vs. external connections for abutments/reconstructions : a systematic review
- 2012
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 23:Suppl 6, s. 202-216
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: The objectives of the review were (1) to evaluate the accuracy of implant-level impressions in cases with internal and external connection abutments/reconstructions, and (2) to evaluate the incidence of technical complications of internal and external connection metal- or zirconia-based abutments and single-implant reconstructions. MATERIALS AND METHODS: A MEDLINE electronic search was conducted to identify English language publications in dental journals related to each of the two topics by inserting the appropriate keywords. These electronic searches were complemented by a hand search of the January 2009 to January 2012 issues of the following journals: Clinical Oral Implants Research, The Journal of Prosthetic Dentistry, The International Journal of Prosthodontics, The International Journal of Periodontics and Restorative Dentistry, The International Journal of Oral Maxillofacial Implants, Clinical Implant Dentistry and Related Research. RESULTS: Seven in vitro studies were included in the review to evaluate the accuracy of implant-level accuracy. No clinical study was found. There was no study that directly compared the influence of internal and external implant connections for abutments/reconstructions on the accuracy of implant-level impressions. All in vitro studies reported separately on the two connection designs and they did not use same protocol and, therefore, the data could not be compared. Fourteen clinical studies on metal-based abutments/reconstructions and five clinical studies on zirconia-based abutments/reconstructions satisfied the inclusion criteria and, therefore, were included in the review to evaluate the incidence of technical complications. The most frequent mechanical complication found in both implant connection design when employing metal abutments/reconstructions was screw loosening. CONCLUSIONS: Implant-level impression accuracy may be influenced by a number of variables (implant connection type, connection design, disparallelism between multiple implants, impression material and technique employed). Implant divergence appears to affect negatively impression accuracy when using internal connection implants. Based on the sparse literature evaluating the incidence of technical complications of metal or zirconia abutments/reconstructions, it was concluded that: The incidence of fracture of metal-based and zirconia-based abutments and that of abutment screws does not seem to be influenced by the type of connection. Loosening of abutment screws was the most frequently occurring technical complication. The type of connection seems to have an influence on the incidence of the screw loosening: more loose screws were reported for externally connected implant systems for both types of materials. However, proper preload may decrease the incidence of such a complication.
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| 3. |
- Nesti, Cedric, et al.
(författare)
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Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1-2 cm in size : a retrospective, Europe-wide, pooled cohort study
- 2023
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Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 24:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAwareness of the potential global overtreatment of patients with appendiceal neuroendocrine tumours (NETs) of 1–2 cm in size by performing oncological resections is increasing, but the rarity of this tumour has impeded clear recommendations to date. We aimed to assess the malignant potential of appendiceal NETs of 1–2 cm in size in patients with or without right-sided hemicolectomy.MethodsIn this retrospective cohort study, we pooled data from 40 hospitals in 15 European countries for patients of any age and Eastern Cooperative Oncology Group performance status with a histopathologically confirmed appendiceal NET of 1–2 cm in size who had a complete resection of the primary tumour between Jan 1, 2000, and Dec 31, 2010. Patients either had an appendectomy only or an appendectomy with oncological right-sided hemicolectomy or ileocecal resection. Predefined primary outcomes were the frequency of distant metastases and tumour-related mortality. Secondary outcomes included the frequency of regional lymph node metastases, the association between regional lymph node metastases and histopathological risk factors, and overall survival with or without right-sided hemicolectomy. Cox proportional hazards regression was used to estimate the relative all-cause mortality hazard associated with right-sided hemicolectomy compared with appendectomy alone. This study is registered with ClinicalTrials.gov, NCT03852693.Findings282 patients with suspected appendiceal tumours were identified, of whom 278 with an appendiceal NET of 1–2 cm in size were included. 163 (59%) had an appendectomy and 115 (41%) had a right-sided hemicolectomy, 110 (40%) were men, 168 (60%) were women, and mean age at initial surgery was 36·0 years (SD 18·2). Median follow-up was 13·0 years (IQR 11·0–15·6). After centralised histopathological review, appendiceal NETs were classified as a possible or probable primary tumour in two (1%) of 278 patients with distant peritoneal metastases and in two (1%) 278 patients with distant metastases in the liver. All metastases were diagnosed synchronously with no tumour-related deaths during follow-up. Regional lymph node metastases were found in 22 (20%) of 112 patients with right-sided hemicolectomy with available data. On the basis of histopathological risk factors, we estimated that 12·8% (95% CI 6·5 –21·1) of patients undergoing appendectomy probably had residual regional lymph node metastases. Overall survival was similar between patients with appendectomy and right-sided hemicolectomy (adjusted hazard ratio 0·88 [95% CI 0·36–2·17]; p=0·71).InterpretationThis study provides evidence that right-sided hemicolectomy is not indicated after complete resection of an appendiceal NET of 1–2 cm in size by appendectomy, that regional lymph node metastases of appendiceal NETs are clinically irrelevant, and that an additional postoperative exclusion of metastases and histopathological evaluation of risk factors is not supported by the presented results. These findings should inform consensus best practice guidelines for this patient cohort.
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