			Home About us Contact

Early Failure (early + failure)

Distribution by Scientific Domains

Medical Sciences	61%
Psychology	15%

Selected Abstracts

Increased risk of early virological failure in non-European HIV-1-infected patients in a Dutch cohort on highly active antiretroviral therapy

HIV MEDICINE, Issue 5 2005
JB Van Den Berg
Objective To compare early and late responses to highly active antiretroviral therapy (HAART) in European and non-European HIV-1 infected patients in a Dutch cohort. Methods We retrospectively analysed the response to HAART of 216 previously treatment-naive HIV-1-infected patients using the University Medical Centre Utrecht HIV database. African (n=51), Asian (n=7), and Central/South American (n=6) patients were classified as non-European, and others as European (n=152). Early failure was defined as a viral load that remained above 400 HIV-1 RNA copies/mL after 6 months of treatment with HAART. Late-phase failure was determined in patients who were successfully treated in the early phase and was defined as two consecutive viral load measurements above 400 copies/mL, a new AIDS-defining event or death. Results In the early phase, four of 152 (2.6%) European and eight of 64 (12.5%) non-European patients failed HAART. A significant increased risk of virological failure in the early phase of treatment was observed for non-Europeans as compared to Europeans (odds ratio 4.6; 95% confidence interval 1.1,20.2). Low serum drug levels in the absence of resistant virus were often seen at the time of early failure. No difference in late-phase failure was observed between the two groups (adjusted hazard ratio 0.6; 95% confidence interval 0.3,1.2). Conclusions Non-European patients had a 4.6 times higher risk of virological failure than their European counterparts in the first 6 months of treatment with HAART. This failure seemed to be associated with low serum drug levels at the time of failure. However, if HAART was successful in the early phase, response rates in the late phase were similar for Europeans and non-Europeans. [source]

Intima-media thickness of radial artery is associated with early access failure in hemodialysis patients

HEMODIALYSIS INTERNATIONAL, Issue 1 2005
Y.O. Kim
Objective:,We have reported that intimal hyperplasia, which is the pathologic change of the radial artery, is associated with early failure of arteriovenous fistula (AVF) in hemodialysis (HD) patients (Am J Kidney Dis, 41:422,428, 2003). Intima-media thickness (IMT), which represents the whole thickness of arterial wall, can be easily measured by ultrasonography, unlike intima thickness. This study was performed to investigate the impact of IMT of radial artery on early failure of AVF in HD patients. Methods:,Ninety HD patients undergoing radiocephalic AVF operation were included in this study. The AVF was constructed in an end vein,to,side artery fashion at the wrist by one vascular surgeon. During the operation, 10-mm long partial arterial walls were removed with elliptical form for microscopic analysis. Specimens were stained with trichrome and examined by a pathologist blinded to the clinical data. AVF patency was prospectively followed up for 1 year after the operation. Results:,Mean age of the patients was 56 ± 13 years and the number of females was 44 (48.9%). Mean IMT was 430 ± 132 ,m (133,760 ,m). Of the total 90 patients, 31 patients (34.4%) had AVF failure within 1 year after the operation. Mean IMT was higher in the failed group (n = 31) than in patent group (n = 59)(486 ± 130 ,m vs. 330 ± 178 ,m, p = 0.004). Using a threshold of 500 ,m of IMT, AVF patency rate was compared between these two groups using Kaplan-Meier method with log rank test. The AVF patency rate within 1 year after the operation was higher in patients with IMT , 500 ,m (n = 26) than in patients with IMT < 500 ,m (n = 64)(p < 0.001). The patients with IMT , 500 ,m were older and had higher incidence of diabetes mellitus, compared to the patients with IMT < 500 ,m. There was no difference in sex, smoking, hypertension, total cholesterol and albumin levels between the two groups. Conclusion:,Our data suggest that increased intima-media thickness of radial artery is associated with early failure of radiocephalic arteriovenous fistula in hemodialysis patients. [source]

Increased risk of early virological failure in non-European HIV-1-infected patients in a Dutch cohort on highly active antiretroviral therapy

Resistance to tearing of calf and ostrich pericardium: Influence of the type of suture material and the direction of the suture line

JOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2004
José María García Páez
Abstract The tearing of the valve leaflet of a cardiac bioprosthesis can cause early failure of this device, which is employed to replace a diseased native valve. This report involves the study of the behavior of 312 tissue samples (152 of calf pericardium and 160 of ostrich pericardium) treated with glutaraldehyde and subsequently subjected to tear testing. The samples were cut in the two principal directions: longitudinally, or root to apex, and transversely. They included a series of control samples that were left unsutured, and the remaining samples were repaired with the use of two different suture techniques: a running suture in the direction of the load and a telescoping suture perpendicular to the load. Four commercially available suture materials were employed: Pronova®, nylon, Gore-Tex®, or silk. The unsutured control samples of both types of pericardium exhibited a similar anisotropic behavior in the tear test. The mean resistance to tearing of the calf pericardium was 24.29 kN m in samples cut longitudinally and 34.78 kN m in those cut transversely (p = .03); the values were 28.08 kN m and 37.12 kN m (p = .002), respectively, in ostrich pericardium. The series repaired with the telescoping suture always exhibited greater resistance to tearing, with values that ranged between 44.34 and 64.27 kN for the samples of calf pericardium and from 41.65 to 47.65 kN for those obtained from ostrich. These assays confirm the anisotropic behavior of calf and ostrich pericardium treated with glutaraldehyde when subjected to tear testing, as well as the loss of this behavior in ostrich pericardium after suturing. Suturing techniques, such as the telescoping model, that provide a greater resistance to tearing should be studied for use in the design of the valve leaflets of cardiac bioprostheses made of biological materials. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 69B: 125,134, 2004 [source]

Sorting out successful failures: Exploratory analyses of factors associated with academic and behavioral outcomes of retained students

PSYCHOLOGY IN THE SCHOOLS, Issue 4 2001
Phillip Ferguson
This prospective longitudinal study followed a sample of 106 kindergarten students through 11th grade examining the effects of family characteristics, school readiness, socialization, and student demographics on academic achievement and behavioral adjustment outcomes. These educational outcomes were contrasted among four groups consisting of: 1) early grade retainees; 2) transitionally placed retained students; 3) students recommended for transitional placement, but promoted; and 4) regularly promoted students. While previous studies examining the efficacy of early grade retention focus exclusively on between-group comparisons, this study examines the family and individual characteristics of successful and unsuccessful retained students by including both between-group and within-group effects on academic and behavioral outcomes. The results of this study demonstrate that retained students' initial school readiness, socioeconomic status, mother's level of education, parental value of education, kindergarten personal-social functioning, and chronological age are distinctly associated with subsequent academic or behavioral outcomes. Variables associated with relative educational success following early failure are delineated and research implications are discussed. © 2001 John Wiley & Sons, Inc. [source]

Incorporation of an invasive object

THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS, Issue 6 2004
PAUL WILLIAMS
The author discusses the experience of ,being invaded' that is sometimes communicated by certain severely disturbed patients. The complaint can sometimes be couched in terms of bodily suffering and such patients may state that they have the experience of a ,foreign body' inside. It is suggested that these patients have suffered severe early failure of containment of their projections, while at the same time they have incorporated primitive characteristics of the object that have been powerfully projected into them. An object that invades in this way, it is suggested, experiences a compulsive need to expel unbearable states of mind using others as a repository. The infant incorporates these violent projections as part of his own mental representational system, and normal identifi cation processes are disrupted. There follows impairment of the development of the sense of self. Clinical examples of how the invasive experience manifests itself in the analytic setting and in the transference and countertransference are presented. It is argued that this highly complex form of early subject-object interaction (prior to the differentiation of psyche-soma) is more likely to be found in severely narcissistically disturbed individuals. Some refl ections on the origins of invasive phenomena are given. [source]

Power cut in the countertransference

THE JOURNAL OF ANALYTICAL PSYCHOLOGY, Issue 4 2010
Alessandra Cavalli
Abstract:, This paper is an attempt to describe and understand a certain type of defence that I shall call a ,power cut' because of its crippling and anti-relational nature. I will take extracts from a baby observation to show how this type of defence can be adopted from the beginning of life, followed by vignettes from my work with a young child and an adult patient which addresses the particular kind of difficulty the analyst has to face with patients who resort to such a defence. I am arguing that while defending from another, the patient is able to destabilize not only the connection between himself and this other, the analyst, but also that between the analyst and the analyst's internal world. I understand this as the violent re-enactment of the patient's uncontained and split off primitive experience. I see recovery from ,power cuts' as the main challenge for the analyst who is helping the patient to recover from an early failure in containment which has led to defective splitting. Only when the unthinkable experience of ,power cut' can become an experience that can be lived through and converted into a deintegrate, may integration be achieved. Translations of Abstract Cet article est une tentative de décrire et de comprendre un certain type de défenses que je nommerai « courts-circuits», du fait de leur nature invalidante et anti-relationnelle. Je présenterai des extraits d'une observation de nourrisson pour montrer comment ce type de défenses peut être adopté dès le début de la vie. Je poursuivrai par des vignettes de mon travail avec un jeune enfant et un patient adulte révélatrices du type de difficultés auxquelles est confronté l'analyste avec des patients relevant de ce type de défenses. Je montre que, tandis qu'il se défend d'un autre, l'individu est capable de déstabiliser non seulement le lien qui le relie à cet autre, l'analyste en l'occurrence, mais également le lien de l'analyste avec son propre monde interne. Je comprends cela comme une violente remise en acte de l'expérience primaire de clivage et d'absence de contenant. J'envisage la guérison des « courts-circuits» comme le défi majeur de l'analyste qui aide le patient à réparer la faille précoce du contenant primaire génératrice du clivage. Ce n'est que lorsque l'expérience impensable du « court-circuit » est devenue une expérience vivable pour le patient, que celle-ci peut se transformer en un dé-intégrat et ouvrir la voie à l'intégration. Dieser Text ist ein Versuch, einen bestimmten Abwehrtypus zu beschreiben und zu verstehen, den ich wegen seiner lähmenden und antibeziehungshaften Natur ,Stromsperre' nennen werde. Ich werde Auszüge aus einer Babybeobachtung heranziehen um zu zeigen, wie dieser Abwehrmodus vom Beginn des Lebens an aufgebaut werden kann. Es folgen Vignetten aus meiner Arbeit mit einem Kleinkind und einem erwachsenen Patienten die sich auf die bestimmte Art von Schwierigkeiten beziehen, die dem Analytiker bei Patienten begegnen, die sich in solcherart Abwehr flüchten. Ich zeige auf, daß, während er sich vor dem anderen schützt, der Patient nicht nur in die Lage gerät, die Verbindung zwischen ihm selbst und diesem anderen, dem Analytiker, zu destabilisieren, sondern auch jene zwischen dem Analytiker und des Analytikers innerer Welt. Ich verstehe dies als die gewaltsame Reinszenierung einer nicht eingebundenen und abgespaltenen primitiven Erfahrung des Patienten. Ich sehe die Behebung von ,Stromsperren' als Hauptherausforderung für den Analytiker an, der dem Patienten hilft, von einem frühen Versagen des Gehaltenwerdens zu genesen, daß zur Spaltung geführt hat. Nur wenn die undenkbare Erfahrung ,Stromsperre' zu einer Erfahrung werden kann, die durchlebt und in ein Nichtintegriertes überführt werden kann, mag Integration erreicht werden. Questo lavoro è un tentativo di descrivere e comprendere un certo tipo di difesa che chiamerò,corto circuito' per via della sua natura mutilante e antirelazionale. Presenterò estratti dall'osservazione del neonato per mostrare come questo tipo di difesa può essere adottata fin dagli inizi della vita seguiti da vignette del mio lavoro con un bambino e con un paziente adulto che indicano il particolare tipo di difficoltà che l'analista deve affrontare con pazienti che si aggrappano a tale difesa. Sostengo che mentre si difende dall'altro il paziente è capace di destabilizzare non solo le connessioni tra se stesso e questo altro, ma anche tra l'analista e il mondo interno dell'analista. Intendo con ciò il violento ripresentarsi della esperienza primaria del paziente non contenuta e scissa. Considero il riprendersi dalla ,corto circuito' come la sfida principale petr l'analista che sta aiutando il paziente a guarire dal precoce fallimento del contenimento che ha portato alla scissione. L'integrazione può essere raggiunta solo quando l'esperienza impensabile della ,corto circuito' può diventare una esperienza che si può attraversare e convertire in una reintegrazione. Este trabajo es una intento por de describir y comprender un cierto tipo de defensa que llamaré un ,corte de energía' a causa de su efecto paralizador y su naturaleza anti-relacional. Tomaré extractos de una observación de un bebé para mostrar cómo este tipo de defensa puede surgir al principio de la vida, seguido por viñetas de mi trabajo con un niño y un paciente adulto para explorar el tipo de dificultad que el analista tiene que encarar con pacientes que recurren a tal defensa. Discuto que al defenderse del otro, el paciente puede desestabilizar no sólo la conexión con él mismo y este otro, el analista, sino también entre el analista y el mundo interno del analista. Entiendo esto como la reconstrucción violenta sin contención y disociadora de la experiencia primitiva del paciente. ,Considero a ,estos cortes de energía' como el principal desafío para el analista que ayuda al paciente a recuperarse de un fracaso temprano en la contención que lo ha llevado a la disociación. Sólo cuando la experiencia inconcebible de ,corte de energía' pueda ser revivida y convertida en una desintegración, se puede lograr la integración. [source]

Influence of methotrexate exposure on outcome in patients treated with MBVP chemotherapy for primary central nervous system lymphoma

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 3 2010
Hélène Blasco
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Although treated using the same high-dose methotrexate (HD-MTX)-based multiagent chemotherapy, patients with primary central nervous system lymphoma (PCNSL) have significant differences in outcome. However, little information has been published about factors influencing outcome in PCNSL. As it is known that the pharmacokinetics of MTX vary considerably between subjects leading to different exposure in patients receiving the same dose, it is important to evaluate its role in response to chemotherapy. WHAT THIS STUDY ADDS This study is the first to evaluate the exposure,response relationship in patients treated with MBVP chemotherapy. We found that patients who were early non-responders to MBVP chemotherapy had poor survival, whatever the salvage regimen. Tumour response at early evaluation was not associated with MTX pharmacokinetics and increasing the dose would probably not improve results. AIMS Although the standard treatment for primary central nervous system lymphoma (PCNSL) consists of three cycles of MBVP (methotrexate, BCNU, VP16, methylprednisolone) and radiotherapy, early failure of treatment may require modification of the treatment. However, our understanding of the outcome in such patients and of the factors involved in early failure of treatment is poor. In addition to known prognostic factors, we evaluated the influence of methotrexate (MTX) exposure on the response to MBVP chemotherapy in patients treated for PCNSL after the first two cycles. METHODS We retrospectively analyzed all patients with PCNSL treated with the MBVP regimen over the previous 10 years. Clinical, personal data and known prognostic factors were studied. The parameters of MTX exposure were estimated using a population pharmacokinetic approach with NONMEM. Objective response (OR), overall survival (OS) and failure-free survival (FFS) were evaluated in all patients. RESULTS Thirty-seven patients were studied. We observed lower FFS and OS (0.49 years) in patients who were not able to receive the planned treatment (group 1, n= 12) than in those who received three cycles (8.04 years) (group 2, n= 25). Known prognostic factors were comparable in both groups, but mean dose of MTX and mean AUC tended to be lower in patients who failed prematurely or showed no response after two cycles. CONCLUSIONS We found that patients who were early non-responders to MBVP chemotherapy had poor survival, without major influence of MTX exposure. It is thus probably unlikely that increasing the dose of MTX would improve outcome. [source]

EPLERENONE PREVENTS ADVERSE CARDIAC REMODELLING INDUCED BY PRESSURE OVERLOAD IN ATRIAL NATRIURETIC PEPTIDE-NULL MICE

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006
Veronica Franco
SUMMARY 1Atrial natriuretic peptide (ANP)-null mice (Nppa -/- ) exhibit cardiac hypertrophy at baseline and adverse cardiac remodelling in response to transverse aortic constriction (TAC)-induced pressure overload stress. Previous studies have suggested that natriuretic peptides could potentially oppose mineralocorticoid signalling at several levels, including suppression of adrenal aldosterone production, inhibition of mineralocorticoid receptor (MR) activation or suppression of MR-mediated production of pro-inflammatory factors. Thus, we hypothesized that the MR blocker eplerenone would prevent the exaggerated left ventricular (LV) remodelling/fibrosis and dysfunction after TAC in Nppa -/- . 2In the present study, Nppa -/- and wild-type Nppa+/+ mice fed eplerenone- or vehicle (oatmeal)-supplemented chow since weaning were subjected to TAC or sham operation. The daily dose of eplerenone administered was approximately 200 mg/kg. At 1 week after TAC, LV size and function were evaluated by echocardiogram and LV cross-sections were stained with picrosirius red for collagen volume measurement. Total RNA was extracted from the LV for real-time polymerase chain reaction analysis of osteopontin. 3Eplerenone had no effect on baseline hypertrophy observed in sham-operated Nppa -/- compared with Nppa+/+ mice. Eplerenone attenuated the TAC-induced increase in LV weight in both genotypes and completely prevented LV dilation, systolic dysfunction and interstitial collagen deposition seen in Nppa -/- mice after TAC. However, serum aldosterone levels were lower in Nppa -/- compared with Nppa+/+ wild types. No interaction between eplerenone and genotype in osteopontin mRNA levels was observed. 4Eplerenone prevents adverse cardiac remodelling related to pressure overload in ANP-deficient mice, mainly due to an antifibrotic effect. The mechanism whereby ANP deficiency leads to excess hypertrophy, fibrosis and early failure following TAC is increased profibrotic signals resulting from excess or unopposed MR activation, rather than increased levels of aldosterone. [source]

Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patients

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006
Constantin Alexander Landes
Abstract Objective: To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life. Patients and methods: One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up. Results: At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9±0.9; 1.4±0.9; 0.4±0.5 mM; P<0.01); Periotest® score (,2.7±2.7; ,2.4±2.2; ,3.1±3.3; P<0.2); gingival recession (0.6±0.7 mM; 0.8±0.9 mM; 0.4±0.5 mM, P<0.02); and peri-implant probing depths (3±1.2; 2.6±0.6; 3.4±1.7 mM; P<0.002). Conclusion: The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up. [source]

Short-term clinical and quality-of-life outcomes in women treated by the TVT-Secur procedure

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
Jeanette L. LIM
Background:, The TVT-Secur (Ethicon, Somerville, NJ, USA) is a minimally invasive suburethral synthetic sling used in the treatment of female stress urinary incontinence. It claims to cause less postoperative pain and to enable performing in an office setting. However, this may be at the expense of a significant learning curve and a higher early failure rate. Aims:, To assess objectively the success rate of the TVT-Secur procedure in the ,U' configuration at six months. Secondary outcomes focussed on subjective success rates, complications, patient satisfaction and quality-of-life (QOL). Methods:, A prospective observational study was undertaken at two tertiary referral urogynaecology centres. A cohort of 42 consecutive patients with urodynamic stress incontinence who underwent the TVT-Secur procedure in the ,U' configuration between November 2006 and August 2007 were followed up for six months. Three standardised QOL questionnaires were completed preoperatively and at six months. A urogenital history, visual analogue score (VAS) for patient satisfaction, uroflow and urinary stress test were performed at six months. Results:, Recruitment was ceased prematurely because of a high number of early failures. Objective and subjective success rates at six months were 58.3% and 51.3% respectively. Complications included urinary tract infections, voiding difficulty, groin discomfort, haematoma, vaginal pain, tape erosion and intra-operative dislodgement of tape. Prevalence of de novo urge incontinence was 10.3%. Only symptom-specific QOL scores improved and only 48.6% indicated a high level satisfaction (VAS , 80%) with TVT-Secur. Conclusion:, On the basis of this limited study, we are hesitant to recommend the ,U' configuration of the TVT-Secur over its more established counterparts, the TVT and TVT-O. [source]

Antibodies and Genetically Engineered Related Molecules: Production and Purification

BIOTECHNOLOGY PROGRESS, Issue 3 2004
A. Cecília A. Roque
Antibodies and antibody derivatives constitute 20 % of biopharmaceutical products currently in development, and despite early failures of murine products, chimeric and humanized monoclonal antibodies are now viable therapeutics. A number of genetically engineered antibody constructions have emerged, including molecular hybrids or chimeras that can deliver a powerful toxin to a target such as a tumor cell. However, the general use in clinical practice of antibody therapeutics is dependent not only on the availability of products with required efficacy but also on the costs of therapy. As a rule, a significant percentage (50,80%) of the total manufacturing cost of a therapeutic antibody is incurred during downstream processing. The critical challenges posed by the production of novel antibody therapeutics include improving process economics and efficiency, to reduce costs, and fulfilling increasingly demanding quality criteria for Food and Drug Administration (FDA) approval. It is anticipated that novel affinity-based separations will emerge from the development of synthetic ligands tailored to specific biotechnological needs. These synthetic affinity ligands include peptides obtained by synthesis and screening of peptide combinatorial libraries and artificial non-peptidic ligands generated by a de novo process design and synthesis. The exceptional stability, improved selectivity, and low cost of these ligands can lead to more efficient, less expensive, and safer procedures for antibody purification at manufacturing scales. This review aims to highlight the current trends in the design and construction of genetically engineered antibodies and related molecules, the recombinant systems used for their production, and the development of novel affinity-based strategies for antibody recovery and purification. [source]

Implant-supported fixed prostheses in the edentulous maxilla

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2004
A 2-year clinical, radiological follow-up of treatment with non-submerged ITI implants
Abstract Objectives: To evaluate the survival rate of non-submerged solid-screw ITI dental implants with a rough (titanium plasma sprayed, TPS) surface in the edentulous maxilla after 1 and 2 years of loading. Material and method:, Twenty-five patients (mean age 64 years) with edentulous upper jaws received five,seven implants and, after a mean healing time of 6.9 months, screw-retained implant-supported fixed prostheses. A total of 146 ITI solid screw TPS implants were inserted. The diameter of 56% of the implants was smaller (3.3 mm) than the standard (4.1 mm) and the diameter of the rest (44%) was standard. The bone quantity of the majority of the patients was low and the bone quality poor. Clinical parameters were registered at baseline and at two annual follow-ups. Radiological examinations and assessments were also made at these times. Results: Mean marginal bone level at baseline was measured at a point 4.52 mm (range 1.45,7.70, SD 1.2) apical of the reference point. Mean bone loss from baseline to 1 year of loading was 0.24 mm (SD 0.9, P=0.002) and from 1 year to 2 years of loading 0.15 mm (SD 0.4, P<0.001). Five implants failed, four of which were early failures prior to loading. One implant failed shortly after bridge installation. The cumulative survival rate was 96.6% after 1 and 2 years. Conclusion: ITI TPS solid-screw implants in combination with fixed prostheses had successful survival rates and were found to be a viable treatment alternative in the edentulous maxilla. Résumé Le but de cette étude a été d'évaluer le taux de survie d'implants dentaires ITI vis solides non-enfouis avec une surface TPS (titane plasma-spray) au niveau du maxillaire édenté après une ou deux années de mise en charge. Vingt-cinq patients d'un âge moyen de 64 ans avec des mâchoires supérieures édentées ont reçu de cinq à sept implants et, après un temps de guérison moyen de 6,9 mois, des prothèses fixées vissées à ces implants (ISFP). Un total de 146 implants TPS ITI vis pleines ont été insérés. Le diamètre de 56% des implants étaient plus petits (3,3 mm) que le reste des implants qui avaient un diamètre standard (4,1 mm). La longueur des implants variait de 6 à 16 mm. La quantité osseuse de la majorité des patients était faible et la qualité osseuse pauvre. Des paramètres cliniques ont été enregistrés lors de l'examen initial et après deux années. Des examens radiographiques ont également été effectués à ces moments. Le niveau osseux marginal moyen lors de l'examen initial a été mesuréà un point 4,52 mm (de 1,45 à 7,70 mm : SD 1,2 mm) en apical du point de référence. La perte osseuse moyenne entre l'examen de départ et un an après la mise en charge était de 0,24 mm (SD 0,9; p=0,0002) et entre la première et la deuxième année de 0,15 mm (SD 0,4; p<0,001). Cinq implants ont échoué, dont quatre avant la mise en charge. Un implant a échoué peu de temps après le placement du bridge. Le taux de survie cumulatif après une ou deux années était de 96,6%. Les implants ITI TPS vis pleines avec des prothèses fixées avaient des taux de survie excellents et représentaient un traitement alternatif de qualité pour les patients édentés du maxillaire supérieur. Zusammenfassung Ziele: Die Ueberlebensrate von transmukosalen dentalen ITI-Vollschraubenimplantaten mit einer rauen Oberfläche (titanplasmabeschichtet, TPS) im zahnlosen Oberkiefer nach 1 und 2 Jahren Belastung auszuwerten. Material und Methoden: Fünfundzwanzig Patienten (mittleres Alter 64 Jahre) mit zahnlosen Oberkiefern erhielten 5,7 Implantate und nach einer mittleren Einheilzeit von 6.9 Monaten wurden verschraubte festsitzende implantatgetragene Rekonstruktionen (ISFPs) eingesetzt. Insgesamt wurden 146 ITI-Vollschraubenimplantate eingesetzt. Der Durchmesser von 56% dieser Implantate war kleiner (3.3 mm) als der Standard (4.1 mm) und der Durchmesser der restlichen 44% war Standard. Bei der Mehrzahl der Patienten war die Knochenmenge gering und die Knochenqualität schlecht. Die klinischen Parameter wurden bei der Ausgangsuntersuchung und bei den zwei Nachuntersuchungen in jährlichen Abständen aufgenommen. Bei diesen Untersuchungen wurden auch radiologische Auswertungen durchgeführt. Resultate: Das marginale Knochenniveau zum Zeitpunkt der Ausgangsuntersuchung wurde an einem Punkt 4.52 mm (Bandbreite 1.45,7.70, SD 1.2) apikal des Referenzpunktes gemessen. Der mittlere Knochenverlust von der Ausgangsuntersuchung bis 1 Jahr nach Belastung betrug 0.24 mm (SD 0.9, P=0.002) und zwischen 1 und 2 Jahren nach Belastung betrug er 0.15 mm (SD 0.4, P>0.001). Fünf Implantate zeigten Misserfolge, vier davon waren Frühmisserfolge vor Belastung. Ein Implantat versagte kurz nach der Eingliederung der Brücke. Die kummulative Ueberlebensrate nach 1 und 2 Jahren betrug 96.6%. Schlussfolgerung: ITI TPS Vollschraubenimplantate in Kombination mit festsitzenden Rekonstruktion zeigten erfolgreiche Ueberlebensraten und scheinen eine überlebensfähige Behandlungsalternative im zahnlosen Oberkiefer darzustellen. Resumen Objetivos: Evaluar el índice de supervivencia de implantes ITI roscados macizos no sumergidos con una superficie rugosa (pulverizada con plasma de titanio, TPS) en el maxilar edéntulo tras 1 o 2 años de carga. Material y Métodos: Veinticinco pacientes (edad media 64 años) con maxilares superiores edéntulos recibieron 5,7 implantes y, tras un periodo de cicatrización medio de 6.9 meses, una prótesis fija atornillada implantosoportada (ISFPs). Se insertaron un total de 146 implantes ITI roscados macizos. El diámetro del 56% de los implantes fue menor (3.3 mm) que el estándar (4.1 mm) y el diámetro del resto (44%) fue estándar. La cantidad de hueso de la mayoría de los pacientes fue baja y la calidad de hueso baja. Los parámetros clínicos se registraron al inicio y en los exámenes anuales de seguimiento. También se realizaron exámenes radiológicos y valoraciones en estos momentos. Resultados: El nivel medio de hueso marginal al inicio se midió en un punto 4.52 (rango 1.45,7.70, SD 1.2) apical al punto de referencia. La pérdida de hueso desde el inicio hasta 1 año de carga fue de 0.24 mm (SD 0.9, P=0.002) y de 1 año a 2 años de carga fue de 0.15 mm (SD 0.4, P<0.001). Cinco implantes fracasaron al poco de instalar los puentes. El índice acumulativo de supervivencia fue del 95%. Conclusión: Los implantes roscados macizos ITI TPS en combinación con prótesis fijas tuvieron unos índices de supervivencia exitosos y se encontró que eran una alternativa de tratamiento viable en el maxilar edéntulo. [source]