consensus report

  • 文章类型: Journal Article
    目的:第4工作组的目的是解决与植入牙科相关的患者获益问题。重点关注(A)牙科患者报告结果(dPROs),(b)改善口面功能,(c)解决了在提供植入物保留/支持的假牙后,部分和完全无牙患者的口面组织的保存问题。
    方法:三个系统综述构成了讨论的基础。与会者根据系统审查的结果制定了由小组共识确定的声明和建议。随后,根据第七届国际研究与发展战略共识会议全体会议的要求,在进一步讨论和修改后,提出并接受了这些建议,2023年在里斯本举行,葡萄牙。
    结果:使用完整的种植体支撑固定假牙(CIFDP)或种植体覆盖义齿(IOD)治疗后,佩戴全口义齿(CD)的无牙患者的整体dPRO和口腔功能得到了实质性改善。关于dPRO,两个植入物保留的下颌IOD优于一个植入物保留的IOD。然而,增加植入物的数量超过两个,不会进一步改善dPRO。在完全无牙的患者中,建议使用CIFDP或IOD进行康复治疗,以保护牙槽骨和咬肌厚度。
    结论:与CD相比,当至少使用CIFDP或IOD修复下颌骨时,完全无牙的患者会受益。在完全无牙的患者中,种植体假体是更换牙齿的最佳选择。应在所有无牙社区积极推广这种治疗方式,包括那些访问和手段有限的人。
    OBJECTIVE: The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed.
    METHODS: Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal.
    RESULTS: Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness.
    CONCLUSIONS: Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.
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  • 文章类型: Consensus Development Conference
    背景:最近发表的牙周和种植体周围疾病的新分类明确了正确诊断这些疾病的不同阶段所要考虑的参数。迄今为止,然而,没有同样明确的适应症来解决这些疾病。本共识报告的目的是为种植体周围黏膜炎和种植体周围炎的非手术治疗提供指导。为了起草共识,对最新的科学文献进行了分析。
    方法:意大利技术科学协会选出了15名意大利牙科专家(AIDI,UNID和ATASIO)和,从文献综述开始,他们根据分级方法(建议分级,评估,发展,和评估,一种评估证据质量的工具,用于制定系统评价和临床指南)关于种植体周围黏膜炎的治疗,种植体周围炎和各种种植表面的管理。
    结论:根据国际文献,单独的非手术治疗可以解决种植体周围粘膜炎,但不是种植体周围炎.已经考虑了几种辅助疗法,其中一些似乎有助于控制炎症。
    The recent publication of the new classification of periodontal and peri-implant disease has given clear indications on the parameters to be taken into consideration to correctly diagnose the different phases of these diseases. To date, however, there are no equally clear indications on the treatments to be implemented to solve these diseases. The objective of this Consensus Report is to provide guidance for the non-surgical management of peri-implant mucositis and peri-implantitis. For the drafting of the consensus, the most recent scientific literature was analysed.
    A group of 15 expert Italian dental hygienists were selected by the Italian technical-scientific societies (AIDI, UNID and ATASIO) and, starting from the literature review, they formulated indications according to the GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation, a tool for rating the quality of evidence, used to draw up systematic reviews and clinical guidelines) on the treatment of peri-implant mucositis, peri-implantitis and on management of the various implanting surfaces.
    in accordance with the international literature, non-surgical therapy alone can resolve peri-implant mucositis, but not peri-implantitis. Several adjunctive therapies have been considered and some appear to be helpful in managing inflammation.
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  • 文章类型: Journal Article
    目的:系统评估文献和报告(1)种植体口腔软组织裂开(BSTD)的发生频率,(2)与BSTD发生相关的因素和(3)BSTD覆盖率重建治疗的治疗结果。
    方法:两项系统综述,涉及与植入物BSTD发生有关的重点问题,相关因素和BSTD覆盖的治疗结局是小组讨论和共识声明的基础.系统综述的主要发现,在第3组中制定了共识声明和对临床实践和未来研究的影响,并在全体会议上进行了进一步讨论并获得最终批准。
    结果:与BSTD发生风险密切相关的因素是,其次是薄组织表型。在立即植入时,发现使用结缔组织移植物(CTG)可能是BSTD的保护因素.BSTD的覆盖可以通过冠状推进皮瓣(CAF)和结缔组织移植物的组合来实现,有或没有假体修改/移除,虽然手术的可行性取决于多个局部因素和患者相关因素。软组织替代品显示BSTD覆盖率有限。
    结论:正确的植入物三维(3D)定位对于预防BSTD的发生至关重要。如果存在,BSTD可由CAF+CTG覆盖,然而,证据来自少量的观察性研究。因此,未来的研究需要制定进一步的循证临床建议.
    OBJECTIVE: To systematically assess the literature and report on (1) the frequency of occurrence of buccal soft tissue dehiscence (BSTD) at implants, (2) factors associated with the occurrence of BSTD and (3) treatment outcomes of reconstructive therapy for the coverage of BSTD.
    METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session.
    RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage.
    CONCLUSIONS: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    SARS-CoV-2(COVID-19)大流行是全球范围内的公共卫生紧急情况,对医疗保健服务产生广泛影响。在这些不寻常的COVID-19中,在常规血液学护理的管理过程中已经注意到不可预见的挑战。医疗服务已经过度紧张,一线卫生工作者首当其冲地受到了新冠肺炎大流行的冲击。封锁期间的行动限制阻止了大部分人口获得医疗保健,持有血液驱动器的血库,以及诊断血液学服务的中断。与其他亚专科相比,印度因COVID-19大流行而导致的血液学护理中断比例更高,因为印度的血液学实践仍然仅限于主要城市。在这篇综述中,我们记录了在印度COVID-19大流行期间在护理血液学患者方面遇到的挑战,并提出了建议,以尽量减少其对提供血液学护理的影响,特别强调中低收入国家(LMICs)的血液学实践。
    The SARS-CoV-2 (COVID-19) pandemic is a worldwide public health emergency with widespread impact on health care delivery. Unforeseen challenges have been noted during administration of usual haematology care in these unusual COVID-19 times. Medical services have been overstretched and frontline health workers have borne the brunt of COVID-19 pandemic. Movement restrictions during lockdown prevented large sections of population from accessing health care, blood banks from holding blood drives, and disrupted delivery of diagnostic hematology services. The disruption in hematology care due to COVID-19 pandemic in India has been disproportionately higher compared to other subspecialities as hematology practice in India remains restricted to major cities. In this review we chronicle the challenges encountered in caring for hematology patients during the COVID-19 pandemic in India and put forth recommendations for minimizing their impact on provision of hematology care with special emphasis on hematology practice in lower and middle income countries (LMICs).
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  • 文章类型: Journal Article
    Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects.
    Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior.
    There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases.
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  • 文章类型: Journal Article
    这篇评论描述了在2019年9月18日星期三在欧洲糖尿病研究协会(EASD)第55届年会上举行的题为“SUs治疗T2DM:新的面貌和新的见解”的研讨会上的演讲。在巴塞罗那,西班牙。它研究了磺酰脲类(SU)在2型糖尿病(T2DM)管理中的当前作用,并给出了作者个人对该治疗类别在本地和国际指南中的表现的看法。强调了SU在当前准则中的位置,并对给出的准则之间差异的原因进行了批判性评估。最后,讨论了循证指南和共识报告的比较。
    This review describes a presentation at a recent symposium entitled \"SUs in the treatment of T2DM: a fresh look and new insights\" on Wednesday September 18, 2019 at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain. It examines the current role of sulfonylureas (SUs) in the management of type 2 diabetes mellitus (T2DM) and gives the author\'s personal perspective of how this therapeutic class has performed in both local and international guidelines. The place of SUs within current guidelines is highlighted, and a critical appraisal of the reasons for the differences between guidelines given. Finally, comparison of evidence-based guidelines and consensus reports is discussed.
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  • 文章类型: Journal Article
    Cow\'s milk protein allergy (CMPA) is the most common type of food-allergy in younger children. Prognosis is usually good, with most children developing tolerance before school age. Children may present with a wide spectrum of symptoms that range from mild to severe; skin reactions such as angioedema and urticaria and gastrointestinal symptoms are the most common presentations of CMPA. Approximately one-third of CMPA patients suffer from multiple food-allergies; severe conditions such as anaphylactic shock (9%), eosinophilic esophagitis (4.7%), and food-protein induced enterocolitis (1%) may also develop in some children. Timely and accurate diagnosis and management is essential for proper growth and development of children with CMPA. In this expert consensus report, we aimed to adapt current understandings in the CMPA field to the specific conditions in Turkey and health system to help physicians with their day-to-day decision making.
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  • 文章类型: Journal Article
    受孕前以及怀孕和婴儿期的营养状况似乎对成年期的疾病风险有影响(早期营养/发育计划)。我们旨在回顾有关微量营养素在早期营养计划中的作用及其对医疗保健的影响的最新知识。
    在全球范围内,甚至在高收入国家,均衡饮食通常是可以获得的,母亲微量营养素不足的情况很常见.这可能会在母亲和胎儿/新生儿中立即和以后的生活中引起健康问题。孕妇和可能怀孕的人应该通过均衡的饮食达到令人满意的微量营养素状态,并在必要时从额外的补充。关键信息:我们强调需要呼吁医疗保健提供者和政策制定者采取行动,更好地教育育龄妇女,了解适当的微量营养素状态的短期和长期益处。需要更多地强调微量营养素状况在早期营养规划中的作用,以解决对怀孕期间微量营养素供应欠佳的潜在长期健康影响的认识仍然有限的问题。
    Nutrition status prior to conception and during pregnancy and infancy seems to have an influence on the disease risk in adulthood (early nutrition/developmental programming). We aimed to review the current knowledge on the role of micronutrients in early nutrition programming and its implications for healthcare.
    Globally and even in high-income countries where a balanced diet is generally accessible, an inadequate maternal micronutrient status is common. This may induce health problems in the mother and foetus/newborn both immediately and in later life. Pregnant women and those who may become pregnant should aim to achieve a satisfactory micronutrient status from a well-balanced diet, and where necessary from additional supplements. Key Messages: We emphasise the need for a call to action for healthcare providers and policymakers to better educate women of child-bearing age regarding the short- and long-term benefits of an appropriate micronutrient status. The role of micronutrient status in early nutrition programming needs to be emphasized more to address the still limited awareness of the potential long-term health repercussions of suboptimal micronutrient supply during pregnancy.
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  • 文章类型: Consensus Development Conference
    In September 2011, the Korean Society of Hematology Lymphoma Working Party held a nationwide conference to establish a consensus for assessing bone marrow (BM) involvement in patients with lymphoma. At this conference, many clinicians, hematopathologists, and diagnostic hematologists discussed various topics for a uniform consensus in the evaluation process to determine whether the BM is involved. Now that the discussion has matured sufficiently to be published, we herein describe the consensus reached and limitations in current methods for assessing BM involvement in patients with lymphoma.
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