Academic literature on the topic 'Radiographic outcomes'

Abstract Objective To determine the diagnostic value of full-mouth radiography in dogs. Sample Population Prospective series of 226 dogs referred for dental treatment without previous full-mouth radiographic views being available. Procedure In a prospective nested case-control analysis of multiple outcomes in a hospital cohort of dogs presented for dental treatment, full-mouth radiographic views were obtained prior to oral examination and charting. After treatment, clinical and radiographic findings were compared, with reference to presenting problems, main clinical findings, additional information obtained from the radiographs, and unexpected radiographic findings. The importance of the radiographic findings in therapeutic decision-making was assessed. Results The main clinical findings were radiographically confirmed in all dogs. Selected presenting problems and main clinical findings yielded significantly increased odds ratios for a variety of other conditions, either expected or unexpected. Radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 41.7 and 27.8% of dogs, respectively, and were considered of no clinical value in 30.5%. Radiographs of teeth with clinical lesions merely confirmed the findings in 24.3% of dogs, yielded additional or clinically essential information in 50.0 and 22.6%, respectively, and were considered of no value in 3.1%. Older dogs derived more benefit from full-mouth radiography than did younger dogs. Incidental findings were more common in larger dogs. Clinical Relevance Diagnostic yield of full-mouth radiography in new canine patients referred for dental treatment is high, and the routine use of such radiographs is justifiable. (Am J Vet Res 1998;59:686-691)

Background: Knee injection therapy is less effective for severe osteoarthritis (OA), specifically Kellgren-Lawrence (KL) grade 4. Patient selection for knee injection trials has historically been based on extension anteroposterior (AP) radiographic evaluation; however, emerging evidence suggests that KL grading using a flexion posteroanterior (PA) radiograph more accurately and reproducibly predicts disease severity. The impact of radiographic view on patient selection and outcome after knee injection therapy remains unknown. Hypothesis: A 45° flexion PA radiograph will reveal more advanced knee OA in certain patients. These patients will report worse pre- and postinjection outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Four raters independently graded extension AP and flexion PA radiographs from 91 patients previously enrolled in a knee injection trial. Patients determined to have KL grade 4 OA by any rater on extension AP radiographs were excluded. Among included patients, those upgraded to KL grade 4 on flexion PA radiographs by at least 2 raters constituted group 2, while all remaining patients constituted group 1. Demographic data and patient-reported outcome scores before injection and at 6 weeks, 3 months, 6 months, and 12 months postinjection were compared between groups. Results: Overall, 64 patients met the inclusion criteria, of which 19 patients (30%) constituted group 2. Compared with group 1, patients in group 2 were older (58.7 vs 52.3 years, P = .02), had worse visual analog scale pain scores before (6.6 vs 5.3, P = .03) and 6 months after injection (5.3 vs 3.5, P = .01), had less improvement in both Lysholm (8.5 vs 20.5, P = .02) and Short Form–12 physical component (–2.2 vs 1.7, P = .03) scores from preinjection to 6 months postinjection, and had less improvement in both Lysholm (1.6 vs 13.1, P = .03) and Knee injury and Osteoarthritis Outcome Score sport subscale (–2.1 vs 16, P = .01) scores from preinjection to 12 months postinjection. Conclusion: One in 3 patients considered to have mild to moderate knee OA on extension AP radiography is upgraded to severe knee OA (KL grade 4) on flexion PA radiography. These patients report worse preinjection outcomes, worse pain scores at short-term follow-up, and decreased improvement in knee function scores between 6 months and 1 year postinjection.

Abstract Objective To determine the diagnostic value of full-mouth radiography in cats. Sample Population 115 cats referred for dental treatment without a previous full-mouth radiographic series available. Procedure In a prospective nested case-control analysis of multiple outcomes in a hospital cohort of cats referred for dental treatment, full-mouth radiography was done prior to oral examination and charting. After treatment, the clinical and radiographic findings were compared, with reference to presenting problems, main clinical findings, additional information obtained from radiography and unexpected radiographic findings. Importance of the radiographic findings in therapeutic decision making was assessed. Results The main clinical findings were radiographically confirmed in all cats. Odontoclastic resorption lesions, missed on clinical examination, were diagnosed in 8.7% of cats. Analysis of selected presenting problems and main clinical findings yielded significantly increased odds ratios for a variety of other conditions, either expected or unexpected. Radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 4.8 and 41.7% of cats, respectively, and were considered of no clinical value in 53.6%. Radiographs of teeth with clinical lesions merely confirmed the findings in 13.9% of cats, but yielded additional or clinically essential information in 53.9 and 32.2%, respectively. Clinical Relevance The diagnostic yield of full-mouth radiography in new feline patients referred for dental treatment is high, and routine use of full-mouth radiography is justifiable. (Am J Vet Res 1998;59:692-695)

Objective.The Outcome Measures in Rheumatology Soluble Biomarker Working Group initiated an international, multicenter, prospective study, the Rheumatoid Arthritis (RA) BIODAM cohort, to generate resources for the clinical validation of candidate biomarkers predictive of radiographic progression. This first report describes the cohort, clinical outcomes, and radiographic findings.Methods.Patients with RA from 38 sites in 10 countries starting or changing conventional synthetic disease-modifying antirheumatic drugs and/or starting tumor necrosis factor inhibitors were followed for 2 years. Participating physicians were required to adhere to a treat-to-target strategy. Biosamples (serum, urine) were acquired every 3 months, radiography of hands and feet every 6 months, and ultrasound of hands and feet every 3 months in a subset. Primary endpoint was radiographic progression by the Sharp/van der Heijde score.Results.A total of 571 patients were recruited and 439 (76.9%) completed 2-year followup. At baseline, the majority was female (76%), mean age 55.7 years, and mean disease duration 6.5 years. Patients had a mean of 8.4 swollen and 13.6 tender joints, 44-joint count Disease Activity Score (DAS44) 3.8, 77.7% rheumatoid factor–positive or anticitrullinated protein antibody–positive. Percentage of patients in DAS and American College of Rheumatology remission at 2 years was 52.2% and 27.1%, respectively. Percentage of patients with radiographic progression (> 0.5) at 1 and 2 years was 38.2% and 59.9%, respectively.Conclusion.The RA BIODAM prospective study succeeded in generating an extensive list of clinical, imaging (2343 radiographs), and biosample (4638 sera) resources that will be made available to expedite the identification and validation of biomarkers for radiographic damage endpoints. (Clinicaltrials.gov: NCT01476956, clinicaltrials.gov/ct2/show/NCT01476956)

The introduction of digital x-ray receivers which replaced conventional films was a significant radiographic development that is commonly used in daily dental practice. Dental implant therapy (DIT) is a sought after dental therapeutic intervention and dental radiography is an essential component contributing to the success of treatment. Dental radiographs taken in daily practice are generally conventional two-dimensional images and/or three-dimensional images. Ideally, the choice of radiographic technique should be determined after a thorough clinical examination and comprehensive consideration of the advantages, indications, and drawbacks. Digital three-dimensional modalities that have emerged over the last decade have been incorporated into DIT with the assumption that treatment outcomes will be improved. These modalities are constantly being reassessed and improved but there is a paucity of published information regarding the assessment of variables such as dosages and dimensional accuracy, suggesting that further research in these matters is necessary. This is crucial in order to obtain evidence-based information that may influence future radiographic practices. In this narrative, the authors present the most commonly used dental radiographic modalities currently used in DIT.

Background: Quality of reduction in distal radius fractures (DRF) is assessed using radiographic parameters, however few studies examine the association between radiographic measurements and functional outcomes. Our purpose was to evaluate the relationship between radiographic measurements and clinical outcome measures following surgery for DRF using detailed testing to demonstrate further associations between post-surgical radiographic measurements and function. Methods: Measurements were performed on postoperative radiographs of 38 patients following ORIF of DRF. Measurements included: radial inclination, radial height, ulnar variance, volar tilt, radiocarpal interval (d2/w2), and the intra-articular step-off. Clinical outcome measures included motion, grip strength, functional dexterity testing, Moberg pick-up test, specific activities of daily living, DASH score, pain scale, manual-assessment questionnaire. Results: Different radiographic parameters correlated with different specific tasks. The parameter correlated with most functional tasks was ulnar-variance. Radial inclination, radial-styloid scaphoid distance, and fracture classification correlated with some functions. Intraarticular step-off, and radial height were not associated with functional testing. Conclusions: Surgical radiographic results may affect post-operative function. Detailed task specific testing may enable a better evaluation of surgical outcomes. Further study and refinement of functional assessment may change our surgical goals in DRF.

Summary Objective: To investigate the effects of radial extracorporeal shock wave therapy (RESWT) on radiographic and scintigraphic variables in horses with clinical pain referable to the palmar heel. Methods: Eight client-owner horses with palmar heel pain were treated with RESWT for a total of three treatments. Nuclear scintigraphy and radiography were repeated at the beginning and completion of the study. Scintigram region of interest (ROI) density ratios were calculated and compared between treated limbs, untreated limbs, and a population of comparison limbs from eight horses free of lameness. Radiographs were scored for whole navicular bone appearance as well as distal border synovial fossae number and severity. Results: There was not any preversus post-treatment difference in scintigraphic navicular pool phase or delayed phase ROI density ratios in treated limbs, or between treated and untreated limbs. Delayed phase ROI density was increased in the central navicular region in treated limbs compared to comparison limbs from non-lame horses at both time points. Radiographic scores remained unchanged. Clinical significance: RESWT as applied in the present study has no effect on acute palmar heel region scintigraphic or radiographic parameters. Any acute clinical benefit may be due to analgesic effects rather than stimulation of local tissue metabolism.

Study Design: Retrospective radiographic investigation. Objective: To evaluate the long-term radiographic and functional outcomes of patients in whom there is absence of radiographic union at 2 years after single-level anterior cervical discectomy and fusion (ACDF). Methods: Thirty-one patients were evaluated at standard postoperative time intervals per index trial protocol. Plain film radiographic fusion criteria at the arthrodesis level was defined as interspinous motion (ISM) <1 mm with corresponding motion at a non-arthrodesed superjacent level ISM ≥4 mm. Radiographs and functional outcome measures were acquired at each follow-up visit. Delayed union was defined as lack of radiographic union by 24 months. Results: Nine patients demonstrated radiographic evidence of delayed radiographic union at 24 months. Of those 9 patients, 5 patients demonstrated evidence of union during the follow-up period to 72 months. Despite the absence of radiographic union based on our criteria, 3 of the 4 remaining patients reported remarkable improvements in pain scores and functional outcomes. Conclusions: The natural history of delayed union at 24 months after ACDF was still favorable despite the prolonged delay in union. The majority of patients (5 of 9) without radiographic union at 24 months did proceed to radiographic union by final follow-up. In addition, patients that did not meet our criteria for fusion maintained postoperative improvements in patient-reported outcome scores. In summary, our study patients undergoing a single-level ACDF with asymptomatic radiographic delayed union at 24 months can expect maintained improvements in postoperative patient-reported outcomes scores and can still progress to successful radiographic fusion.

Background: The purpose of this study is to compare radiographic outcomes of patients treated with dorsal spanning plates with previously reported normal values of radiographic distal radius anatomy and compare the results with prior publications for both external fixation and internal fixation with volar locked plates. Methods: Patients with complex distal radius fractures including dorsal marginal impaction pattern necessitating dorsal distraction plating at the discretion of the senior authors (M.A.T. and M.A.I.) from May 30, 2013, to December 29, 2015, were identified and included in the study. Retrospective chart and radiograph review was performed on 19 patients, 11 male and 8 female, with mean age of 47.83 years (22-82). No patients were excluded from the study. Results: All fractures united prior to plate removal. The average time the plate was in place was 80.5 days (49-129). Follow-up radiographs showed average radial inclination of 20.5° (13.2°-25.5°), radial height of 10.7 mm (7.5-14 mm), ulnar variance of −0.3 mm (−2.1 to 3.1 mm), and volar tilt of 7.9° (−3° to 15°). One patient had intra-articular step-off greater than 2 mm. Conclusions: Dorsal distraction plating of complex distal radius fractures yields good radiographic results with minimal complications. In cases of complex distal radius fractures including dorsal marginal impaction where volar plating is not considered adequate, a dorsal distraction plate should be considered as an alternative to external fixation due to reduced risk for infection and better control of volar tilt.

Purpose The correlation between the degree of developmental hip dysplasia (DDH) measured on ultrasound images compared with that measured on radiographs is not clear. Most studies have compared ultrasonography (US) and radiographic images made at different times of follow-up. In this study the correlation between US images and radiographs of the hip made on the same day was evaluated. Methods US images and radiographs of both hips of 74 infants, who were treated for stable DDH, were reviewed in a retrospective study. Only infants who had an US examination and a radiograph on the same day were included. Results The correlation between α-angle of Graf and femoral head coverage on US was strong (p ≤ 0.0001). Weak correlations were found between the acetabular index of Tönnis on radiographs and α-angle of Graf on US (p = 0.049) and between acetabular index of Tönnis on radiographs and femoral head coverage of Morin on US (p = 0.100). Conclusion This study reports on the correlation between US and radiographic imaging outcomes, both made on the same day in patients for treatment and follow-up of DDH. Level of Evidence IV

The purpose of this study was to investigate if the addition of biologic materials and/or oral steroids would affect horizontal bone gain, or the bone density of the grafted bone in horizontal alveolar ridge augmentations. A retrospective chart review was completed to assess the clinical and radiographic outcomes of 53 ridge augmentation patients. An average bone gain of 3.6mm of width was found in our study based on radiographic analysis. There were no statistically significant differences found in the linear bone gain with the addition of biologic materials and steroids. A marginally statistically significant difference was found in the bone density when biologics were added (p-value=0.0653). No statistically significant difference found in the bone density with the addition of oral steroids. The use of tenting screws and resorbable occlusive membranes and a combination of allograft and xenograft bone materials provides significant clinical and radiographic dimensional changes in alveolar ridge width.

Background: Obtura-II injectable thermoplasticised gutta-percha technique has been available for several years. However, thus far, there are no published studies that have evaluated its clinical and radiographic success in non-vital young traumatised permanent incisors in children where teeth are expected to survive for the life-span of the patient. Aim: Evaluating the clinical and radiographic success of Obtura-II system in the root canals of non-vital young traumatised permanent incisors in children; studying the effect of different demographic and prognostic factors on the success rate of the technique; and investigating the outcome for this technique when used to obturate auto-transplanted teeth in children and adolescents. Method: This study was a retrospective study evaluating the Obtura-II treatment outcomes. Clinical dental records and periapical radiographs of 667 patients who attended the trauma clinic at the Paediatric Dentistry Department at Leeds Dental Institute during the period 2003–2011 were screened. The obturated teeth were classified as either successful or failure according to criteria developed for this study. Various prognostic factors that could influence the clinical and radiographic outcome of the technique were recorded using a special data extraction proforma. The data were entered into SPSS, with simple descriptive analysis and bivariate analyses conducted subsequently. Furthermore, a logistic regression analysis was carried out with the aim of obtaining the relation between different prognostic factors and the treatment outcomes. iv Results: According to the study criteria, 235 cases with 275 non-vital young permanent incisors with various stages of root development were included, in addition to 49 auto-transplanted teeth. The mean age of patients at the time of trauma was 10.2 years. The cases considered clinically successful accounted for 92.7% whilst the cases considered radiographically successful were 85.4% over a mean follow-up period of 51 months for the traumatised teeth. In addition, the clinical and the radiographic success for the auto-transplanted teeth were 97.9% and 93.8%, respectively. The logistic regression analysis showed a significant association between some of the prognostic factors, such as the type of trauma, the duration of Ca(OH)2 dressing, and the quality of obturation and the Obtura-II technique treatment outcomes in treating traumatised teeth. However, none of the factors associated significantly with the treatment outcomes in the cases of the auto-transplanted teeth. Conclusion: Obtura-II technique in the root canal treatment of the traumatised teeth was considered clinically successful in 92.7% and radiographically in 85.4% of the cases over a long follow-up period. In addition, when treating auto-transplanted teeth, the technique was clinically successful in 97.9% and radiographically in 93.8% of cases.

Aim: To study patient-related functional outcome measures, implant survival and radiographic loosening after total wrist arthroplasty (TWA) using four different implants. To evaluate a new TWA design biomechanically and clinically. Methods: The studies included two cohort studies with prospectively collected data (n=206 and n=219), an anatomic and kinematic analysis in a cadaveric model and a pilot study (n=20). Results: The Maestro TWA had a significantly greater improvement of radial/ulnar deviation than the Biax and Remotion TWAs. Summarized patientrelated functional outcome was significantly better for the Maestro than for the Remotion TWA. Cumulative implant survival after 8 years was 94% for Remotion, and 95% for Maestro implants. Radiographic loosening five years postoperatively was present in 26% of the Biax wrists, 18% of those with Remotion, and 2% of those with Maestro. Following TWA with the new implant design in a cadaveric model, there were no statistically significant changes compared to a native wrist regarding flexion, extension, radial deviation, the extension/radial deviation component of the dart-thrower’s motion, or the circumduction range of motion. Clinically, there was significant improvement of COPM, PRWE and VAS pain scores. Wrist extension and ulnar deviation improved, while grip strength remained largely unchanged. Conclusions: TWA is a surgical procedure which may offer a high level of patient satisfaction. Implant design may affect patient-related functional outcome after TWA. Implant survival as well as the frequency of radiographic loosening differed considerably between the four types of implants and might be a result of different implant design. Kinematic analysis of the new TWA design suggests that a stable and functional wrist is achievable with this design. Surgical placement of the new total wrist implant was reproducible and the implant yielded good patient-related outcome measures in the short term. Since TWA is an evolving procedure, further studies are warranted in order to refine indications and the place for TWA in modern hand surgery.

Published Article<br>This article describes a process of student learning outcomes assessment for a health sciences programme in radiography at a university in South Africa. Its purpose is to demonstrate that while the process of student learning outcomes assessment is universal, it can be used both nationally and internationally. As long as underlying premises are met, assessment needs to be considered within the context of a country's unique culture, society and history. Underlying premises include understanding the institution's mission and vision, determining that the programme's mission and vision are congruent with those of the institution, and involving faculty early in the assessment process.

Thesis (M.S.)--University of North Carolina at Chapel Hill, 2009.<br>Title from electronic title page (viewed Jun. 4, 2010). "... in partial fulfillment of the requirements for the degree of Master of Science in the Department of Endodontics, School of Dentistry." Discipline: Endodontics; Department/School: Dentistry.

Psoriatic arthritis is an inflammatory arthritis affecting a fifth of patients with skin psoriasis. Inflammation of the joints and tendons causes pain, stiffness, reduced function and disability. Work disability is increasingly recognised as an important, patient centred, functional measure of disease yet little is known about work disability in psoriatic arthritis. The overall aim of my thesis is to examine patient reported work disability in psoriatic arthritis by undertaking the following; • A systematic review of the relevant literature • Classification of a cohort of patients to study • Validation of a commonly used work outcome measure used in other rheumatic diseases • Selection of a suitable measure of structural damage to inflamed joints for investigating the associations of work disability in longitudinal observational studies. The results of the systematic review identified limited data reporting high levels of work disability associated with a wide variety of disease and non-disease related factors. The review also identified the lack of a validated outcome measure for use in psoriatic arthritis. I report the classification of a large single centre longitudinal cohort of patients with psoriatic arthritis and evidence supporting the retrospective application of a psoriatic arthritis classification criterion. Subsequently I report a preliminary validation study of the work productivity and activity impairment questionnaire to measure work disability in psoriatic arthritis and a further study comparing the existing measures of structural damage in psoriatic arthritis. Finally I developed and supervised a multicentre observational study to examine the associations of work disability in psoriatic arthritis. The study identified reduced work effectiveness to be associated with measures of disease activity, whereas unemployment was associated with recent disease onset, greater age and worse physical function. The study will provide a valuable cohort for prospective study of work disability and the effect of medical treatment and will form part of my planned post-doctoral studies.

The purpose of this study was primarily to explore the conceptualization of critical thinking development in radiologic science students by radiography program directors. Seven research questions framed three overriding themes including 1) perceived definition of and skills associated with critical thinking; 2) effectiveness and utilization of teaching strategies for the development of critical thinking; and 3) appropriateness and utilization of specific assessment measures for documenting critical thinking development. The population for this study included program directors for all JRCERT accredited radiography programs in the United States. Questionnaires were distributed via Survey Monkey©, a commercial on-line survey tool to 620 programs. A forty-seven percent (n = 295) response rate was achieved and included good representation from each of the three recognized program levels (AS, BS and certificate). Statistical analyses performed on the collected data included descriptive analyses (median, mean and standard deviation) to ascertain overall perceptions of the definition of critical thinking; levels of agreement regarding the effectiveness of listed teaching strategies and assessment measures; and the degree of utilization of the same teaching strategies and assessment measures. Chi squared analyses were conducted to identify differences within each of these themes between various program levels and/or between program directors with various levels of educational preparation as defined by the highest degree earned. Results showed that program directors had a broad and somewhat ambiguous perception of the definition of critical thinking, which included many related cognitive processes that were not always classified as attributes of critical thinking according to the literature, but were consistent with definitions and attributes identified as critical thinking by other allied health professions. These common attributes included creative thinking, decision making, problem solving and clinical reasoning as well as other high-order thinking activities such as reflection, judging and reasoning deductively and inductively. Statistically significant differences were identified for some items based on program level and for one item based on program director highest degree. There was general agreement regarding the appropriateness of specific teaching strategies also supported by the literature with the exception of on-line discussions and portfolios. The most highly used teaching strategies reported were not completely congruent with the literature and included traditional lectures with in-class discussions and high-order multiple choice test items. Significant differences between program levels were identified for only two items. The most highly used assessment measures included clinical competency results, employer surveys, image critique performance, specific course assignments, student surveys and ARRT exam results. Only one variable showed significant differences between programs at various academic levels.<br>Ed.D.<br>Department of Educational and Human Sciences<br>Education<br>Education EdD

Uvod: Povezanost dijabetesa melitusa i&nbsp; tuberkuloze je odavno primećena i bila je predmet ispitivanja mnogih studija. Dijagnoza &scaron;ećerne bolesti pre otkrića insulina značila je smrtni ishod u roku od pet godina, a najče&scaron;ći uzrok smrti su bile infekcije, uključujući tuberkulozu. Poslednjih godina incidenca tuberkuloze je u padu, ali je i dalje prisutan značajan broj obolelih od tuberkuloze u zemljama u razvoju. Sa druge strane incidenca dijabetes melitusa je u porastu, pre svega zbog tendencije porasta broja gojaznih osoba. Procenjeno je da će prevalencija obolelih od dijabetes melitusa dostići 438 miliona obolelih do 2030, a 80% svih slučajeva će biti stanovnici zemalja u razvoju gde je i dalje visoka prevalencija tuberkuloze. Kao rezultat ovakve epidemiolo&scaron;ke situacije ove dve bolesti će se sve če&scaron;će javljati uporedo, modifikujući tok jedna drugoj. Preduslov za uspe&scaron;no lečenje dijabetičara obolelih od tuberkuloze je postizanje zadovoljavajuće metaboličke regulisanosti &scaron;ećerne bolesti. smrtni ishod u roku od pet godina, a najče&scaron;ći uzrok smrti su bile infekcije, uključujući tuberkulozu. Poslednjih godina incidenca tuberkuloze je u padu, ali je i dalje prisutan značajan broj obolelih od tuberkuloze u zemljama u razvoju. Sa druge strane incidenca dijabetes melitusa je u porastu, pre svega zbog tendencije porasta broja gojaznih osoba. Procenjeno je da će prevalencija obolelih od dijabetes melitusa dostići 438 miliona obolelih do 2030, a 80% svih slučajeva će biti stanovnici zemalja u razvoju gde je i dalje visoka prevalencija tuberkuloze. Kao rezultat ovakve epidemiolo&scaron;ke situacije ove dve bolesti će se sve če&scaron;će javljati uporedo, modifikujući tok jedna drugoj. Preduslov za uspe&scaron;no lečenje dijabetičara obolelih od tuberkuloze je postizanje zadovoljavajuće metaboličke regulisanosti &scaron;ećerne bolesti. Cilj istraživanja: Cilj rada je bilo ispitivanje uticaja dijabetesa melitusa na tok plućne tuberkuloze, prvenstveno na bakteriolo&scaron;ki status, radiolo&scaron;ku prezentaciju bolesti, dužinu terapijskog režima i učestalost recidiva bolesti. Materijal i metode: Ispitivanjem su obuhvaćene dve grupe od po pedeset bolesnika koji su hospitalizovani u Institutu za plućne bolesti Vojvodine. Prvu grupu činili su bolesnici sa plućnom tuberkulozom i pridruženom &scaron;ećernom bole&scaron;ću, a drugu grupu bolesnici sa plućnom tuberkulozom bez pridružene &scaron;ećerne bolesti. Svi bolesnici su analizirani po sledećim karakteristikama: starost, pol, klinička slika, bakteriolo&scaron;ki status, radiolo&scaron;ka prezentacija, prisustvo neželjenih efekata antituberkulotika, prisustvo rezistencije M. tuberculosis na lekove, trajanje terapijskog režima, ishod lečenja, pojava recidiva i dužina hospitalizacije. Oboleli od &scaron;ećerne bolesti bili su dodatno analizirani prema: tipu bolesti, dužini trajanja bolesti, metaboličkoj regulisanosti bolesti i prisustvu komplikacija. Svi bolesnici obuhvaćeni ispitivanjem bili su podvrgnuti standardnom dijagnostičkom algoritmu koji obuhvata: anamnezu i fizikalni pregled, direktnu mikroskopiju sputuma, kultivaciju sputuma, radiogram grudnog ko&scaron;a, CT grudnog ko&scaron;a u slučaju postavljenih kliničkih indikacija. Invazivna dijagnostika će se sprovesti kod bolesnika kod kojih dijagnoza nije mogla biti postavljena prethodno sprovedenom neinvazivnom dijagnostikom. Terapijski režim će biti započet tokom hospitalizacije u Institutu za plućne bolesti Vojvodine, a nastavljen ambulantno pod kontrolom Dispanzera za plućne bolesti. Po zavr&scaron;etku terapijskog režima predviđena je kontrola u Institutu za plućne bolesti Vojvodine koja obuhvata procenu kliničke slike, bakteriolo&scaron;kog statusa, radiolo&scaron;kog nalaza i eventualnu potrebu za produženjem terapijskog režima. Rezultati: Istraživanje je pokazalo da je u grupi obolelih od tuberkuloze bez pridruženog dijabetes melitusa bio sličan broj bolesnika mu&scaron;kog i ženskog pola, a veći broj ispitanika se nalazio u starosnim kategorijama do 50 godina starosti, dok je u grupi obolelih od tuberkuloze sa dijabetes melitusom bio značajno vi&scaron;e zastupljen mu&scaron;ki pol i značajno vi&scaron;e ispitanika se nalazilo u starosnim kategorijama preko 50 godina starosti. Beleži se statistički značajno veći broj recidiva u grupi obolelih od tuberkuloze sa dijabetes melitusom (p=0,001). Između ispitvanih grupa se ne beleži statistički značajna razlika u kliničkoj prezentaciji bolesti. U grupi obolelih od tuberkuloze sa dijabetes melitusom, statistički značajno je veći broj direktno pozitivnih nalaza sputuma (p=0,046). Utvrđeno je postojanje statistički značajne razlike u prosečnoj dužini vremena potrebnoj za direktnu konverziju sputuma (p=0,000) i prosečnoj dužini vremena potrebnoj za konverziju kulture sputuma (p=0,000). U oba slučaja je grupa obolelih od tuberkuloze sa pridruženim dijabetes melitusom imala duže prosečno vreme potrebno za konverziju. U grupi obolelih od tuberkuloze sa pridruženim dijabetes melitusom bilo je statistički značajno vi&scaron;e bolesnika sa prisustvom kaverne (p=0,006) i lokalizacijom promena u sva tri režnja (p=0,000). Nije zapažena statistički značajna razlika u trajanju terapijskog režima, ispoljavanju neželjenih efekata lekova, pojavi rezistencije na lekove i ishodu lečenja između dve ispitivane grupe. Grupa obolelih od tuberkuloze sa pridruženim dijabetesom imala je statistički značajno veći broj bolničkih dana (p=0,000). Poređenjem grupa obolelih od tuberkuloze sa pridruženim zadovoljavajuće regulisanim dijabetesom i grupe obolelih od tuberkuloze sa lo&scaron;e regulisanim dijabetesom uočeno je statistički značajno duže trajanje terapijskog režima kod dijabetičara sa lo&scaron;e regulisanom bole&scaron;ću (p=0,018). Nije bilo statistički značajne razlike u zastupljenosti recidiva, kliničke prezentacije bolesti, bakteriolo&scaron;kog i radiolo&scaron;kog statusa, ispoljavanju neželjenih efekata lekova, pojavi rezistencije na lekove, ishoda lečenja i broja bolničkih dana između dve ispitivane grupe. Dodatnim poređenjem grupa (oboleli od tuberkuloze bez pridruženog dijabetesa, oboleli od tuberkuloze sa pridruženim zadovoljavajuće regulisanim dijabetesom i oboleli od tuberkuloze sa pridruženim lo&scaron;e regulisanim dijabetesom) primećeno je da je grupi bolesnika obolelih od tuberkuloze sa lo&scaron;e regulisanim dijabetesom potrebno najduže vreme za direktnu konverziju i konverziju kultura sputuma na MT i da imaju najveći broj bolničkih dana. U grupi obolelih od tuberkuloze sa pridruženim lo&scaron;e regulisanim dijabetesom je bilo statistički značajno veći broj bolesnika koji su lečeni osam meseci u odnosu na druge dve grupe (p=0,011). Poređenjem grupa obolelih od tuberkuloze sa tipom 1 dijabetesa tipom 2 dijabetesa nije uočena statističk značajna razlika između grupa po svim ispitivanim varijablama. U grupi dijabetičara sa dobro regulisanim dijabetesom nalazi se veći broj onih koji imaju tip 2 bolesti, u odnosu na grupu bolesnika sa lo&scaron;e regulisanim dijabetesom. Grupa dijabetičara sa lo&scaron;e regulisanom bolesti ima statistički značajno veći broj komplikacija &scaron;ećerne bolesti. Zaključak: Dokazano je da &scaron;ećerna bolest značajno utiče na bakteriolo&scaron;ki status, radiolo&scaron;ku prezentaciju, dužinu terapijskog režima, učestalost recidiva tuberkuloze i broj bolničkih dana obolelih od tuberkuloze,kao i da je regulisanost &scaron;ećerne bolesti imala značajan uticaj na dužinu terapijskog režima.<br>Introduction: The association of diabetes mellitus and tuberculosis has long been observed and has been the subject of many studies. The diagnosis of diabetes before the discovery of insulin meant death within five years, a leading cause of death were infections, including tuberculosis. Last years the incidence of tuberculosis has declined, but there is still a significant number of TB patients in developing countries. On the other hand, the incidence of diabetes is on the rise, primarily due to the tendency of an increasing number of obese people. It is estimated that the prevalence of patients with diabetes will reach 438 million sufferers by 2030, and 80% of all cases will be people in developing countries where it is still a high prevalence of tuberculosis. As a result of the epidemiological situation, these two diseases will increasingly occur in parallel, modifying the current one another. Aim: The aim of this study was to investigate the influence of diabetes mellitus on the course of pulmonary tuberculosis, primarily in the bacteriological status, radiological presentation of disease, duration of the treatment regimen and the frequency of disease relapse. Materials and Methods: The study included two groups of fifty patients who were hospitalized at the Institute for pulmonary diseases. The first group consisted of patients with pulmonary tuberculosis and concomitant diabetes mellitus, a second group consisted of patients with pulmonary tuberculosis without associated diabetes. All patients were analyzed by the following characteristics: age, gender, clinical picture, bacteriological status, radiological presentation, the presence of side effects of antituberculosis drugs, the presence of M. tuberculosis resistant to the drugs, the duration of the therapeutic regimen, treatment outcome, recurrence and length of hospitalization. Diabetics were further analyzed with respect to: the type of disease, duration of disease, a metabolic disease and the regulation for the presence of a complication. All patients completed this study were subjected to a diagnostic algorithm comprising: history and physical examination, direct microscopy of sputum, cultivation of sputum, radiographs of the chest, chest CT scan in case positioned on clinical indications. Invasive diagnostic will be performed in patients in whom the diagnosis could not be set previously conducted noninvasive diagnostics. The treatment regimen will be started during the hospitalization in the Institute of pulmonary diseases and is set under the control of ambulatory pulmonary dispensaries. Results: The study showed that in the group of TB patients without concomitant diabetes mellitus was a similar number of patients male and female, a greater number of respondents was in the age groups up to the age of 50, while in the group of TB patients with diabetes mellitus was significantly more frequent male half and significantly more respondents were in the age groups over 50 years of age. Significantly higher number of relapses is recorded in a group of TB patients with diabetes mellitus (p = 0,001). Between the two study groups was not significant difference in the clinical presentation of the disease. In the group of TB patients with diabetes mellitus, is statistically significant higher number of smear positive findings (p = 0,046). There is a statisticaly significant difference in the average length of time required for the smear conversion (p = 0,000) and average length of time needed for the conversion of sputum cultures (p = 0,000). In both cases, the group of TB patients with associated diabetes mellitus had a longer average time needed for the conversion. In the group of patients with tuberculosis associated with diabetes mellitus was statistically significantly more patients with the presence of the cavern (p = 0,006), and the localization of the pulmonary changes in all three lobes (p = 0,000). Between the two study groups was not observed a statistically significant difference in duration of the treatment regimen, the expression of adverse drug effects, develop resistance to the drugs, and the outcome of the treatment. Group of patients with tuberculosis associated with diabetes had a statistically significantly greater number of hospital days (p = 0,000). Between the groups of patients with tuberculosis associated with satisfactory controlled diabetes and the group of TB patients with poorly controlled diabetes was statistically significantly longer duration of the therapeutic regimen in diabetic patients with poor regulation of the disease (p = 0,018). There was no significant difference in the appearance of relapses, the clinical presentation of disease, the bacteriological status, radiology, the expression of adverse drug effects, develop resistance to the drugs, outcome of the treatment, number of hospital days between the two study groups. Comparing the three groups (tuberculosis without associated diabetes mellitus, TB patients with associated satisfactorily controlled diabetes and TB patients with associated poorly controlled diabetes), it was observed that the group of patients suffering from tuberculosis with poorly controlled diabetes takes the longest time to smear conversion and conversion of sputum culture and to have the highest number of hospital days. In the group of patients with tuberculosis associated with poorly controlled diabetes was significantly greater number of patients who were treated for eight months compared to the other two groups (p = 0,011). Comparing the group of TB patients with type 1 diabetes and type 2 diabetes is not a statistically significant difference between the groups in all variables. In the group of diabetic patients with satisfactorily controlled diabetes, there are a large number of those with type 2 disease, in comparison to the group of patients with poorly controlled diabetes. Group of diabetics with poorly regulated disease has a significantly greater number of diabetes comlications. Conclusion: It has been shown that diabetes mellitus has a significant effect on the bacteriological status, radiological presentation, the length of the treatment regimen, the frequency of recurrence of tuberculosis and the number of hospital days of patients with tuberculosis, and that the adjustment of diabetes had a significant effect on the length of the treatment regimen.

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures are used to capture the impact of treating rheumatic diseases, and are influenced by both disease severity and the effectiveness of treatment. However, they are also influenced by a range of confounding factors. Demographic factors like age, gender, and ethnicity can all have crucial impacts. Deprivation is important, as poverty invariably worsens outcomes. Finally, comorbidities affect outcomes and patients with multiple comorbid conditions usually have worse quality of life with poorer outcomes for all diseases. These multiple confounding factors mean comparing outcomes across units without adjustment will invariably show major differences.

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures are used to capture the impact of treating rheumatic diseases, and are influenced by both disease severity and the effectiveness of treatment. However, they are also influenced by a range of confounding factors. Demographic factors like age, gender, and ethnicity can all have crucial impacts. Deprivation is important, as poverty invariably worsens outcomes. Finally, comorbidities affect outcomes and patients with multiple comorbid conditions usually have worse quality of life with poorer outcomes for all diseases. These multiple confounding factors mean comparing outcomes across units without adjustment will invariably show major differences.

Pulmonary sarcoidosis represents one of the most prevalent and clinically significant manifestations of this complex disease. This chapter delves into the intricate details of how sarcoidosis affects the lungs, exploring the spectrum of pulmonary manifestations from asymptomatic radiographic findings to progressive fibrosis and respiratory compromise. Central to this discussion are the patterns of granuloma formation within lung tissue, their impact on pulmonary function, and the diagnostic challenges they pose. By unraveling the nuances of pulmonary sarcoidosis—from its radiological appearance to histopathological correlates and clinical outcomes—we aim to provide a comprehensive overview that aids clinicians in optimizing patient management and improving prognostic outcomes.

Enzalutamide (ENZ), a potent androgen receptor pathway inhibitor, gained FDA approval in 2012 for metastatic castration-resistant prostate cancer (mCRPC) post-docetaxel chemotherapy. It exhibits high affinity to the androgen receptor (AR), disrupting AR signaling crucial for prostate cancer growth. Notably, ENZ’s mechanism inhibits AR nuclear translocation and exerts apoptotic effects, distinct from older antiandrogens like bicalutamide. Clinical trials demonstrate ENZ’s efficacy across various stages of prostate cancer, from metastatic hormone-sensitive disease to non-metastatic CRPC, prolonging overall and radiographic progression-free survival. ENZ’s favorable outcomes in combination therapies highlight its role in advancing prostate cancer treatment paradigms.

AbstractFracture of Mandible is the most common occurrence in comparison to any other bone of the maxillofacial region. Various classifications are put forward which are helpful in diagnosing the mandible fracture. This chapter focuses on the general and clinical examination of the maxillofacial region which helps in clinical diagnosis, different radiographic techniques, various approaches, emergency as well as surgical management and outcome with various modalities of treatment.

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures capture the impact of treating rheumatic diseases. They are influenced by disease severity and effective treatment. They also reflect many confounding factors. These include demographic factors like age, gender, and ethnicity and also deprivation, as poverty worsens outcomes. Comorbidities affect outcomes and patients with multiple comorbid conditions have worse quality of life with poorer outcomes. Patient self-assessment has grown in importance; it is simple and understandable. However, self-assessment can vary over time and does not always reflect assessors’ perspectives. Caution is needed comparing outcomes across units; the various confounding factors and measurement complexities make such comparative analyses challenging.

Abstract The Distal Radius Acute Fracture Fixation Trial (DRAFFT) is a multicenter randomized trial that compared the functional outcomes of Kirschner wire (K-wire) fixation vs. open reduction and internal fixation (ORIF) with locking plate for dorsally displaced extra-articular distal radius fractures that were reducible using a closed technique. Functional outcomes, radiographic parameters, and cost effectiveness were compared at twelve months postoperatively. Locking plates were associated with statistically significant improvement in radiographic findings of unknown clinical significance. No statistically significant difference in functional outcomes was seen at twelve-month follow-up. There was significant cost savings for K-wiring vs. ORIF.

Abstract This study is a follow-up from an original report of 191 reverse total shoulder arthroplasties (RTSAs) in 186 patients. A retrospective case-series analysis was performed with at least ten years of follow-up (mean of 150 months). Prosthesis survival, radiographic evaluation, complications, and clinical outcomes were presented. Implant survivorship analysis was performed on a total of 240 prostheses. Eighty-four patients (eighty-seven RTSAs) were available for clinical outcome evaluation, and sixty-four patients (sixty-seven RSTAs) were available for radiographic assessment at final follow-up. The ten-year overall implant survivorship was 93% (revision as endpoint). Scapular notching was evident in 73% of patients. Complications were recorded in forty-seven patients (29%), with ten cases (10%) occurring after two years. The mean absolute and relative Constant scores (± standard deviation) were 55 ±16 points and 86 ±26 points respectively, which were both significant.

Abstract The producing wells in South Burgan field, Kuwait Oil Company, have recently reported increase in water cut with simultaneous drop in oil production. Several wells have showed indications of scale formation to varying degrees at the well-heads‟ chokes and in the flowlines, that transferring the crude to the gathering centers. Scale deposits comprised mostly calcium carbonate with lesser amounts of silicon (formation fines). Inhibited acid cleaning has been carried out to remove the hard scales from the chokes‟ beans and the flowlines that having significant scale accumulations. Scale inhibition treatment have been adapt utilized. Online internal corrosion monitoring coupons have been installed on the flowlines to monitor the internal corrosion during acid cleaning and routine operation. Similarly, scale coupons have been installed to evaluate the scale inhibitor injection efficiency. Fluid sampling has been carried out during acid cleaning to check dissolved iron (Fe) content as corrosion monitoring indicator and scaling tendency. Radiography has been used to locate and quantify the scale depositions. Ultrasonic thickness scanning has been carried out to ensure the integrity of flowlines during acid cleaning activities. Appropriate recommendations have been provided to the asset owner for controlling the internal corrosion and scaling. This paper discusses the outcome of the work carried out in order to maintain the integrity of the wellheads and flowlines having scaling.