Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.

Background & Aims: The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos(t)ide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes.

Methods: Utilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment.

Strategies and Management for Psychiatric Drug Withdrawal: A Systematic Review of Case Reports and Series.

In recent years, an increasing number of case reports on psychiatric drug withdrawal have emerged, offering detailed clinical insights and valuable real-world evidence on the withdrawal process. The objective of this review was to evaluate the strategies and management for withdrawing psychiatric drugs, as detailed in case reports and series. A systematic review of case reports and series published between 2013 and 2023 was conducted to capture the latest trends in psychiatric drug withdrawal.

TMJ Concepts Patient-Fitted Temporomandibular Joint Reconstruction Prosthesis System: Results From a Food and Drug Administration Postmarket Surveillance Prospective Cohort Study.

Background: Custom-designed and patient-fitted temporomandibular joint replacement (TMJR) devices are used to manage end-stage temporomandibular joint (TMJ) pathology, distorted bony TMJ architecture, or in patients who have undergone multiple prior failed TMJ surgeries.

Purpose: This study aimed to measure the frequency of revision or replacement over time, estimate the 1-, 2-, and 3-year survival rate of implants, and determine what demographic, anatomical, or operative variables may be associated with a device adverse event (AE).

Study Design, Setting, Sample: A prospective cohort study was conducted on consenting adults who could read English, implanted with the TMJ Concepts TMJR prostheses between 2013 and 2015 by private or academic surgeons.

Changes in the pharyngeal and nasal microbiota in pediatric patients with adenotonsillar hypertrophy.

Unlabelled: The present study aimed to investigate the pharyngeal and nasal microbiota composition in children with adenotonsillar hypertrophy (AH) and assess longitudinal alterations in both microbiota after a probiotic oral spray treatment. A cohort of 57 AH patients were enrolled and randomly assigned to the probiotic and placebo groups for a 5-month treatment course. Pharyngeal and nasal swabs were collected before and after treatment and analyzed by 16S rRNA-based metataxonomics and axenic cultures for pathobiont identification.

Current Status of the Management of Idiopathic Condylar Resorption/Progressive Condylar Resorption-A Scoping Review.

The temporomandibular joint (TMJ) is a complex synovial joint shrouded in mystery, as the etiology of many TMJ disorders are unsolved. Idiopathic/progressive condylar resorption (ICR/PCR) is one such TMJ disorder characterized by a gradually deteriorating mandibular condylar mass, resulting in severe mandibular retrognathia, which often accompanied by clockwise rotation of mandible and an anterior open bite. Since the etiology of the ICR/PCR remains unclear, no definitive prevention or management options have been established.

Does surgical volume correlate with outcomes in TMJ replacement surgery?

Objective: To survey oral and maxillofacial surgeons (OMS) who perform temporomandibular joint replacement (TMJR) to determine whether length of surgery, specific TMJR protocols, or the incidence of complications are related to experience and case volume.

Study Design: An anonymous electronic survey was emailed to 407 surgeon members of the American Association of Oral and Maxillofacial Surgeons, American Society of Temporomandibular Joint Surgeons, and European Society of Temporomandibular Joint Surgeons known to have TMJR experience via publications or reputation. The descriptive survey contained multiple choice and open-ended questions.

Antibiotic prophylaxis in alloplastic temporomandibular joint replacement surgery: A multi-national survey of temporomandibular joint surgeons.

Temporomandibular disorders include a wide spectrum of extra-articular and intra-articular conditions affecting the temporomandibular joint (TMJ). In salvage cases involving intra-articular end-stage disease, alloplastic temporomandibular joint replacement (TMJR) is a management option which can be utilised to rehabilitate a disabled joint's function and form. Whilst post-TMJR infection is rare, it is one of the most serious complications.

Alloplastic TMJ replacement in the skeletally immature patient - A systematic review.

This study assessed the current evidence for the use of TMJR reconstruction in skeletally immature patients. A systematic review was conducted according to PRISMA guidelines. An electronic search in PubMed and Embase was performed.

The Contemporary Management of Temporomandibular Joint Intra-Articular Pain and Dysfunction.

The understanding of the causes of temporomandibular joint pain and dysfunction has evolved over 50 years. Historically, the term internal derangement has been used to describe the abnormal relationship between the articular disc, condyle, and glenoid fossa, which was thought to correlate with patient symptoms. It is now known that the pathophysiology of intra-articular pain and dysfunction (IPD) involves synovitis, capsular impingement, symptomatic disc displacement, or a combination of these.

Alloplastic temporomandibular joint replacement - past, present, and future: "Learn from the past, prepare for the future, live in the present." Thomas S. Monson.

Based on evidence from the orthopaedic, biomedical engineering, and oral and maxillofacial surgical literature, this paper discusses reported successes and failures of past alloplastic temporomandibular joint (TMJ) devices that have led to the development of present total temporomandibular joint replacement (TMJR) devices. The paper concludes with discussion of the ongoing research that will lead to future embodiment (materials, designs, and manufacture) advances in TMJR management of severe and debilitating end-stage TMJ disease, further improving patients' mandibular function, form, and overall quality of life.

Current strategies for tapering psychiatric drugs: Differing recommendations, impractical doses, and other barriers.

While effective ways to prevent withdrawal symptoms from psychiatric drugs remain unclear, a highly accepted clinical approach for treatment discontinuation is to gradually reduce doses over time. The objective of this review is to gather the current strategies for tapering of psychiatric drugs described in the literature and guidelines in an attempt to identify the most promising one. Literature review and search for practice guidelines provided by government agencies and medical organizations were performed.

Peri-articular bone formation involving the temporomandibular joint: a narrative summary and Delphi consensus of a new classification system.

Heterotopic ossification (HO) is defined as 'bone where it does not belong'. Given the historical variety of nomenclature and eponyms, there is significant confusion about the etiology, pathogenesis, classification, and treatment of HO related to the temporomandibular joint (TMJ). The existing classifications for TMJ HO have shortcomings: they relate to specific populations, use differing imaging studies and demographic data, do not universally include alloplastic/autologous replacements, are based variously on radiological and/or clinical presentations that cannot always be combined, and were largely developed to assist oral and maxillofacial surgeons in surgical management.

The impact of atypical intrahospital transfers on patient outcomes: a mixed methods study.

The architectural design of hospitals worldwide is centred around individual departments, which require the movement of patients between wards. However, patients do not always take the simplest route from admission to discharge, but can experience convoluted movement patterns, particularly when bed availability is low. Few studies have explored the impact of these rarer, atypical trajectories.

Recommendations on the Use of Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders: Current Evidence and Clinical Practice.

Background: 'Temporomandibular joint disorders (TMDs)' denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. The indications for the available 'oral splints' or 'oral orthotic occlusal devices' remain ambiguous.

Does Emotional State Improve Following Temporomandibular Joint Total Joint Replacement?

Background: Temporomandibular joint total joint replacement (TMJTJR) offers patients the opportunity for improved function and reduced pain. TMJTJR also has the potential to affect a patient's emotions in a positive or negative manner.

Purpose: The purpose of this study was to evaluate changes in emotional state for subjects undergoing TMJTJR.

Utilization of extended temporomandibular joint replacements in patients with hemifacial microsomia.

Hemifacial microsomia (HFM) patients may benefit from extended temporomandibular joint replacements (eTMJR) to improve function and quality of life. A cross-sectional survey was sent to surgeons who place alloplastic temporomandibular joints regarding their experience with and complications encountered when placing eTMJR in patients with HFM. Fifty-nine responded to the survey.

Is the risk of chronic pain after total temporomandibular joint replacement independent of its indications? A prospective cohort study.

Chronic pain is a possible long-term complication after alloplastic temporomandibular joint reconstruction (TMJR). This study was developed to evaluate various subjective and objective measurements to determine the presence and degree of TMJ pain in patients treated with TMJR regardless of the indication for the operation. A prospective, single-centre study was performed.

Increase in hypoglycaemia and hyperglycaemia in people with diabetes admitted to hospital during COVID-19 pandemic.

Background: We used detailed information on patients with diabetes admitted to hospital to determine differences in clinical outcomes before and during the COVID-19 pandemic in the UK.

Methods: The study used electronic patient record data from Imperial College Healthcare NHS Trust. Hospital admission data for patients coded for diabetes was analysed over three time periods: pre-pandemic (31st January 2019-31st January 2020), Wave 1 (1st February 2020-30th June 2020), and Wave 2 (1st September 2020-30th April 2021).

Temporomandibular Joint Facts and Foibles.

The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader must be an "out of the box thinker" which requires openness to new ways of seeing the world and a willingness to accept new concepts based on evolving evidence.