Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system.

INTRODUCTION: This treatment-outcome assessment objectively compares Invisalign (Align Technology, Santa Clara, Calif) treatment with braces. METHODS: This study, a retrospective cohort analysis, was conducted in New York, NY, in 2004. Records from 2 groups of 48 patients (Invisalign and braces groups) were evaluated by using methods from the American Board of Orthodontics Phase III examination. The discrepancy index was used to analyze pretreatment records to control for initial severity of malocclusion. The objective grading system (OGS) was used to systematically grade posttreatment records. Statistical analyses evaluated treatment outcome, duration, and strengths and weaknesses of Invisalign compared with braces. RESULTS: The Invisalign group lost 13 OGS points more than the braces group on average, and the OGS passing rate for Invisalign was 27% lower than that for braces. Invisalign scores were consistently lower than braces scores for buccolingual inclination, occlusal contacts, occlusal relationships, and overjet. Invisalign's OGS scores were negatively correlated to initial overjet, occlusion, and buccal posterior crossibite. Invisalign patients finished 4 months sooner than those with fixed appliances on average. P < .05 was used to determine statistically significant differences. CONCLUSIONS: According to the OGS, Invisalign did not treat malocclusions as well as braces in this sample. Invisalign was especially deficient in its ability to correct large anteroposterior discrepancies and occlusal contacts. The strengths of Invisalign were its ability to close spaces and correct anterior rotations and marginal ridge heights. This study might help clinicians to determine which patients are best suited for Invisalign treatment.     

Patterns of Cocaine Use Among Cocaine-Dependent Outpatients

The authors systematically evaluated the frequency patterns of cocaine use in 85 cocaine-dependent outpatients and found four patterns of use: continuous (27%), intermittent patterned (35%), intermittent nonpatterned (25%), and occasional (13%). Few subjects reported consistent cycling between binges and crashes. There were no significant differences in patterns of use associated with gender, race, educational level, route of administration, or recency of heroin use. Continuous users and occasional users were older than intermittent users. Because different contingencies may control patterned vs. nonpatterned cocaine use, pattern of use may have implications for treatment, even in individuals reporting similar amounts of cocaine use.     

Retroviruses and schizophrenia in Jamaica

Reports of an 18-fold higher incidence of schizophrenia among second-generation Afro-Caribbeans, and especially Jamaican migrants in the United Kingdom were soon called “an epidemic of schizophrenia,” with the inference that a novel virus, likely to be perinatally transmitted, was a possible etiological agent. This intriguing observation led us to explore a possible link with human T-cell lymphotropic virus type one (HTLV-I), because it is a virus that is endemic in the Caribbean Islands, is perinatally transmitted, known to be neuropathogenic, and the cause of a chronic myelopathy (tropical spastic paraparesis/ HTLV-I associated myelopathy). We therefore examined inpatients at the Bellevue Mental Hospital, Kingston, Jamaica and did standard serological tests for retroviruses HTLV-I and HTLV-II and HIV-I and HIV-II on 201 inpatients who fulfilled ICD-9 and DSM III-R criteria for schizophrenia. Our results produced important negative data, since the seropositivity rates for HTLV-I, the most likely pathogen, were no greater than the seropositivity range for HTLV-I carriers in this island population, indicating that HTLV-I and the other retroviruses tested do not play a primary etiological role in Jamaican schizophrenics.     

Fine structure of nuclear division and microgametogony ofEimeria nieschulzi Dieben, 1924

Nuclear division and microgametogony ofEimeria nieschulzi were studied by transmission electron microscopy. All nuclear divisions occurred in close proximity to the gamont surface with four centrioles situated between the nuclear envelope and the gamont plasmalemma. During early nuclear divisions, each nucleus had a rod or hourglass-shaped nucleolus, indicating that the nucleolus probably pinched in two during nuclear division. Nuclear divisions occurred by nearly centrally located intranuclear spindles. Two centrioles were associated with each centrocone. Spindle microtubules, which originated from each centrocone, either traversed to the other centrocone or terminated at kinetochores. Four to 6 chromosome-like structures were present in each dividing nucleus. The formation of 50 to 100 biflagellate microgametes occurred at the margin of the microgamont by a process similar to that described for other coccidian species. Microgametes were limited by a single membrane with a prominent glycocalyx, 13 nm thick.Based on a thesis submitted by G.J. Sibert to the Graduate School of the University of Montana in partial fulfillment of the requirements for the Master of Science degree     

The empirical validity of straight-line responses on a clinical evaluation form.

PURPOSE: Many preceptors fill out students' clerkship-performance forms with all items marked with the maximum value. Because items are usually designed to measure somewhat specific behaviors, the authors questioned the validity of straight-line five (SL5) responses, and conducted an empirical validity study to investigate the measurement properties of these SL5 forms. METHOD: In 1999-00 the authors undertook a correlation study and a generalizability study to assess the measurement characteristics of the SL5 forms. For the correlation study, they calculated mean scores for each of 168 students across forms, excluding the SL5 forms, then correlated this mean with the proportion of straight-line forms the student received. They conducted a generalizability analysis with and without the straight-line forms to determine the impact on score reliability. RESULTS: The proportion of SL5 forms was significantly correlated (r =.48, p <.0001) with the mean student score. Inclusion of the SL5 forms did not negatively affect the reliability of the mean score. CONCLUSION: The SL5 forms appear to be valid ratings of students' performances. An informal comparison of the comments on SL5 forms and those not displaying this format supported this conclusion.     

HLA-DR expression in macaque neuroendothelial cells in vitro and during SIV encephalitis

HLA-DR expression in neuroendothelial cells (NEC) was studied during the course of SIV encephalitis in rhesus monkeys. HLA-DR determinants were detected on NEC in monkeys with SIV encephalitis, but not in control animals. In situ hybridization with an SIV probe indicated that HLA-DR expression was not a consequence of SIV replication within NEC. Cultured rhesus NEC stimulated with gamma interferon expressed HLA-DR to a higher degree than cultured brain fibroblasts or astrocytes. These data support the contention that NEC participate in retrovirus-induced inflammation and autoimmunity within the central nervous system.