ABSTRACT
CONTEXT: Variability of the soft-tissue drape in humans has complicated the accuracy of evaluating soft tissue profiles in diagnosis and treatment planning. AIMS: The objective of the present study is to establish soft-tissue cephalometric norms for South Indian population using Arnett Bergman Soft tissue analysis. SETTINGS AND DESIGN: This study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics. SUBJECTS AND METHODS: Lateral cephalograms of 60 individuals (30 males and 30 females), age ranging between 18 and 25 years, with orthognathic facial profiles were obtained in natural head position. True vertical line was drawn through subnasale parallel to the vertical reference plane. Measurements were done according to soft-tissue cephalometric analysis. STATISTICAL ANALYSIS USED: Student's t-test was used to compare the means between two groups. RESULTS: The results of the study showed significant gender dimorphism, with men having thicker soft-tissue structures, larger vertical dimensions, deep-set midface structures, more upright incisors, and deeper inferior labial sulci than women. When compared with the standard norms, the South Indian population had significantly protruded dentition, thinner soft-tissue drape, shorter vertical face heights, prominent forehead and midface with retusive lower facial thirds and convex profiles as compared to Caucasians. CONCLUSIONS: Significant gender dimorphism was evident in the local population suggesting the need for separate set of norms for males and females. Distinct ethnic differences were found between Caucasians and the Indian population that were statistically significant, highlighting the importance of defining separate set of norms for ethnic groups. The norms obtained should be used as reference when planning treatment of a specific ethnic group.
ABSTRACT
Objective. The present systematic review of RA registry data was undertaken to analyse the time on treatment of licensed TNF inhibitors in patients with RA in Europe. Methods. English language European registry studies comparing TNF inhibitors were searched using MEDLINE, Embase, Cochrane, and WHO: ICTRP up to 16 April 2012 and proceedings of three selected conferences held between 2010 and 2012. Pooled analysis was performed to determine drug survival rates for each TNF inhibitor. Results. Sixteen studies met the inclusion criteria, of which 11 studies assessed biologic-naive patients and five studies included a mixed population of biologic-naive and biologic pretreated patients. The overall effectiveness of TNF inhibitors diminished with time, leading to decreased drug survival rates. Pooled drug survival rates after 60 months follow-up were 37% (infliximab), 48% (adalimumab), and 52% (etanercept). Further, in an observational study, when TNF inhibitors were used in combination with methotrexate, a longer drug survival was observed compared to TNF inhibitors alone. Conclusion. The findings of this systematic review indicated numerically lower drug discontinuation rates with etanercept than adalimumab, whereas infliximab had the highest rate. Further research is needed to understand the underlying mechanisms of treatment discontinuation with TNF inhibitors.
ABSTRACT
OBJECTIVES: To assess the impact of reduced frequency of oral therapies from multiple-dosing schedules to a once-daily (OD) dosing schedule on adherence, compliance, persistence, and associated economic impact. METHODS: A meta-analysis was performed based on relevant articles identified from a comprehensive literature review using MEDLINE® and Embase®. The review included studies assessing adherence with OD, twice-daily (BID), thrice-daily (TID), and four-times daily (QID) dosing schedules and costs associated with optimal/suboptimal adherence among patients with acute and chronic diseases. Effect estimates across studies were pooled and analyzed using the DerSimonian and Laird random-effect model. RESULTS: Forty-three studies met inclusion criteria, and meta-analyzable data were available from 13 studies. The overall results indicated that OD schedules were associated with higher adherence rates (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.80-5.23; P < 0.001 for OD versus > OD dosing) and compliance rates (OR 3.50, 95% CI 1.73-7.08; P < 0.001 for OD versus > OD dosing); persistence rates showed the same direction but were not statistically significant (OR 1.43, 95% CI 0.62-3.29; P = 0.405 for OD versus BID dosing). Results for each of the conditions were consistent with those observed overall with respect to showing the benefits of less frequent dosing. From a health economic perspective, higher adherence rates with OD relative to multiple dosing in a number of conditions were consistently associated with corresponding lower costs of health care resources utilization. CONCLUSION: Current meta-analyses suggested that across acute and chronic disease states, reducing dosage frequency from multiple dosing to OD dosing may improve adherence to therapies among patients. Improving adherence may result in subsequent decreases in health care costs.
