Sustainability and switching of biologics for psoriasis and psoriatic arthritis at Fukuoka University Psoriasis Registry

Biologics are efficacious for treating psoriasis vulgaris (PsV) and psoriatic arthritis (PsA), but sometimes must be terminated or changed for various reasons including ineffectiveness or adverse events. To find the optimal choice of biologics for treating psoriasis, we analyzed the real‐world data on drug survival and the reason for terminating or switching biologics. Medical records from patients with PsV or PsA, who visited the Department of Dermatology, Fukuoka University Hospital from 2010 to 2017, were analyzed. Two hundred and eleven patients received biologics, and 147 patients (69.7%) were treated with only one biologic, while 64 patients (30.3%) were switched to different products. Frequently used biologics in PsV were ustekinumab (UST), infliximab and adalimumab when calculated by patient‐year. Tumor necrosis factor inhibitor (TNFi) use decreased while UST and interleukin (IL)‐17 inhibitors increased in newly introduced patients. UST showed the highest survival rate as a first‐line drug, but the advantage was lost in the second reagent's group. The major reasons for terminating/switching biologics were as follows: primary ineffectiveness (26.4%), secondary loss of efficacy (36.5%), patient's preference, including referral to nearby hospital, or stopped visiting (22.6%), side‐effects (7.7%), comorbidities (3.4%) and economic burden (2.4%). In PsA patients, TNFi are more frequently employed than in PsV patients, although switching to UST or IL‐17 inhibitors showed an increasing trend. Biologic reagents were changed mostly because of primary or secondary loss of efficacy, which affected drug survival. Further research is needed to find the optimal choice of biologics with larger samples at multiple facilities.     

Determination of Ochratoxin A and Ochratoxin B in Archived Tokaj Wines (Vintage 1959–2017) Using On-Line Solid Phase Extraction Coupled to Liquid Chromatography

According to the EU legislation, ochratoxin A contamination is controlled in wines. Tokaj wine is a special type of sweet wine produced from botrytized grapes infected by “noble rot” Botrytis cinerea. Although a high contamination was reported in sweet wines and noble rot grapes could be susceptible to coinfection with other fungi, including ochratoxigenic species, no screening of Tokaj wines for mycotoxin contamination has been carried out so far. Therefore, we developed an analytical method for the determination of ochratoxin A (OTA) and ochratoxin B (OTB) involving online SPE coupled to HPLC-FD using column switching to achieve the fast and sensitive control of mycotoxin contamination. The method was validated with recoveries ranging from 91.6% to 99.1% with an RSD less than 2%. The limits of quantification were 0.1 and 0.2 µg L⁻¹ for OTA and OTB, respectively. The total analysis time of the online SPE-HPLC-FD method was a mere 6 min. This high throughput enables routine analysis. Finally, we carried out an extensive investigation of the ochratoxin contamination in 59 Slovak Tokaj wines of 1959–2017 vintage. Only a few positives were detected. The OTA content in most of the checked wines did not exceed the EU maximum tolerable limit of 2 µg L⁻¹, indicating a good quality of winegrowing and storing.     

Effect of Architecture of Thermoresponsive Copolymer Brushes on Switching of Their Adsorption Properties

Herein, the effect of architecture of stimuli‐responsive polymer brushes on the switching of colloidal particle adsorption is reported. Thermoresponsive copolymer brushes containing positively charged amino groups are used and investigated how negatively charged colloidal particles electrostatically adsorb onto them. The distribution of charged groups (block or random copolymer architecture) and the conformation of the polymer chains (extended or collapsed state) are varied. It is found that the strongest adsorption is achieved at high fractions of charged groups in the brushes, while the amount of adsorbed particles is independent of the polymer chain conformation; that is, the adsorption of particles cannot be switched. On the contrary to this, the most pronounced switching of adsorption is achieved at low fractions of charged/adhesive groups in the brushes when the adsorption of particles is weak. The lowest fraction of charged/adhesive groups (one group per few polymer chains) can be exclusively achieved by random copolymerization and not by block copolymers. An explanation of the adsorption behavior of colloidal particles on switchable brushes is proposed.     

Effect of platform switching on peri-implant bone levels: a randomized clinical trial

Objective: The concept of platform switching has been introduced to implant dentistry based on observations of reduced peri‐implant bone loss. However, randomized clinical trials are still lacking. This study aimed to test the hypothesis that platform switching has a positive impact on crestal bone‐level changes. Material and methods: Two implants with diameters of 4 mm were inserted epicrestally into one side of the posterior mandibles of 25 subjects. After 3 months of submerged healing, the reentry surgery was performed. On the randomly placed test implant, an abutment 3.3 mm in diameter was mounted, resulting in a horizontal circular step of 0.35 mm (platform switching). The control implant was straight, with an abutment 4 mm in diameter. Single‐tooth crowns were cemented provisionally. All patients were monitored at short intervals over the course of 1 year. Standardized radiographs and microbiological samples from the implants' inner spaces were obtained at baseline (implant surgery), and after 3, 4, and 12 months. Results: After 1 year, the mean radiographic vertical bone loss at the test implants was 0.53±0.35 mm and at the control implants, it was 0.58±0.55 mm. The mean intraindividual difference was 0.05±0.56 mm, which is significantly <0.35 mm (P=0.0093, post hoc power 79.9%). The crestal bone‐level changes depended on time (P<0.001), but not on platform switching (P=0.4). The implants' internal spaces were contaminated by bacteria, with no significant differences in the total counts between the test and the control at any time point (P=0.98). Conclusions: The present randomized clinical trial could not confirm the hypothesis of a reduced peri‐implant bone loss at implants restored according to the concept of platform switching. To cite this article:
Enkling N, Jöhren P, Klimberg V, Bayer S, Mericske‐Stern R, Jepsen S. Effect of platform switching on peri‐implant bone levels: a randomized clinical trial.
Clin. Oral Impl. Res. 22 , 2011; 1185–1192.
doi: 10.1111/j.1600‐0501.2010.02090.x     

WEGO种植系统的临床观察

背景：随着种植义齿愈来愈多的应用于口腔修复领域,全球约近千种品牌不同表面处理及平台设计的种植体问世,然而国内已应用于临床的种植系统极少。目的：通过临床试验,观察和评价WEGO种植系统临床应用的安全性和有效性。方法：募集志愿者并经过严格的病例筛选,排除全身及局部禁忌症（血常规、血凝长规、肝肾糖查体等）,根据个体条件不同,分别采用埋入式、非埋入式方案,选择60例牙列缺损患者植入喷砂和酸蚀（SLA）表面处理的WEGO种植体60枚,2-4个月行种植修复,三个月血液指标检查,通过临床检查及影像学分析对临床效果进行评价。结果和结论：60例患者植入前后血液指标差异无统计学意义（P＆lt;0.05）,此种植系统临床安全性可靠。依照Albrektsson等的口腔种植评价标准60枚种植体骨结合良好,留存率100%,成功率100%,宿主无不良反应。种植术后即刻、修复后即刻、植入后1年种植体近中边缘骨高度分别为（0.33±0.45）、（0.14±0.43）、（0.16±0.37） mm;远中边缘骨高度分别为（0.17±0.43）、（0.04±0.49）、（0.11±0.40） mm,种植体植人后第1年颈部骨吸收量近中为（0.16±0.37） mm,远中为（0.04±0.35） mm。结果表明喷砂和酸蚀（SLA）表面处理的WEGO种植系统临床应用安全,修复效果有效。     

不同连接方式种植体对周围组织影响的临床比较

目的比较平台转换种植体和传统基台连接种植体对上颌美学区单牙种植周围组织的影响。方法随机选择95例（110枚）上颌美学区单牙种植修复患者,其中Ankylos系统（平台转换）47例（54枚种植体）,Nobel Replace系统（传统基台连接）48例（56枚种植体）。在患者最终修复后36～62个月进行随访,拍摄X线片及临床检查来记录种植体周围骨组织和牙龈组织的状况,比较两组种植体边缘骨吸收量和周围软组织红色美学指数。利用统计学方法分析所得数据。结果不同连接方式种植修复后种植体周围边缘骨吸收量与红色美学指数具有显著差异,平台转换种植体的骨吸收量明显少于传统基台连接组,红色美学指数也高于传统基台连接。结论平台转换种植体在上颌美学区单牙种植修复相较于传统基台连接种植体能更有效的保留周围骨组织且美学效果较佳。