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Andreescu C.F.,Titu Maiorescu University | Kolerman R.,Tel Aviv University | Moraru L.,Central Military Emergency Hospital Dr Carol Davila | Mortellaro C.,Health Science University | Mijiritsky E.,Tel Aviv University
Journal of Craniofacial Surgery | Year: 2016

The purpose of this manuscript was to assess mandibular ramus block grafts used for augmentation of mandibular posterior segments, followed by subsequent implant placement. Twenty-four human subjects in need of lateral ridge mandibular augmentation were included in the current patient series. Inclusion criteria: recipient site had at least 10-mm residual height, but less than 4.3-mm bucco-lingual dimension. Autogenous bone blocks were harvested from the mandibular ramus. In the first group ramus block was used in association with platelet-rich fibrin and in the second in association with pericardium membrane. Implant surgery was performed 4 months after bone graft surgery when a total number of 44 implants were placed. Abutments were placed 4 months after implant surgery followed by final restoration. Ramus bone graft was successful in 100% patients for the first group and in 91.67% patients for the second group. Measurement on cone beam computed tomography revealed an average of 5.35mm of lateral ridge augmentation for group 1 and 5.099mm for group 2, achieved 4 months after surgery. All implants placed received fixed prosthetic restorations and are in use. Ramus block grafts can be used to allow optimal implant placement, with favor long-term success. Lateral ridge augmentation using mandibular ramus bone graft in association with platelet-rich fibrin is a more predictable and successful technique. Copyright © 2016 by Mutaz B. Habal, MD.

Gheorghita V.I.,Central Military Emergency Hospital Dr Carol Davila | Gheorghita V.I.,National Institute of Infectious Diseases Prof Dr Matei Bals | Caruntu F.A.,National Institute of Infectious Diseases Prof Dr Matei Bals | Caruntu F.A.,Carol Davila University of Medicine and Pharmacy | And 7 more authors.
Journal of Gastrointestinal and Liver Diseases | Year: 2013

Background & Aims: The aim of the study was to assess the clinical utility of serum HBsAg quantification as a surrogate biomarker for the prediction of sustained virological response (SVR) in chronic hepatitis B (CHB) patients treated with Pegylated Interferon alfa-2a (Peg-IFN α-2a). Methods: We performed a prospective cohort study which included 57 patients with CHB treated 48 weeks with Peg-IFN α-2a and followed for another 24 weeks. HBsAg was quantified at the baseline, during treatment and at the end of follow-up. SVR was defined as HBV-DNA below 2,000 IU/ml at 24 weeks after the end of therapy. Results: The majority of patients had HBeAg-negative CHB (68%, n=39). Positive predictive factors for SVR at baseline were low levels of HBsAg (3.72 log10 IU/ml, p=0.032) and HBV-DNA (3.96 log10 IU/ml, p=0.035). During treatment, patients who achieved SVR showed a marked decrease in serum HBsAg in comparison with nonresponders (at week 48 mean decrease of 1.06 ± 1.3 log10 IU/ml versus 0.04 ± 0.5 log10 UI/ml, p=0.005). On therapy, HBV-DNA reduction ≥ 2 log10 IU/ml with any decrease of HBsAg level at week 12 had a positive predictive value (PPV) of 80% (95% CI: 51.91-95.43%) for SVR, while HBV-DNA decline < 2 log10 IU/ml without any decline of HBsAg had a negative predictive value (NPV) of 85.71% (95% CI: 42.23-97.63%) for SVR. Conclusions: HBsAg quantification combined with HBV-DNA assessment could become an early useful tool to optimize the management of CHB patients treated with Peg-IFN α-2a, according to response guided therapy.

Gheorghita V.,Central Military Emergency Hospital Dr Carol Davila | Caruntu F.A.,National Institute of Infectious Diseases Prof Dr Matei Bals | Caruntu F.A.,Carol Davila University of Medicine and Pharmacy | Curescu M.,Clinical Hospital of Infectious Diseases and Pneumology Dr Victor Babes | And 7 more authors.
Therapeutics, Pharmacology and Clinical Toxicology | Year: 2012

Today's major concern in chronic HBV infections is quantitative serum HBsAg. Numerous data demonstrate its usefulness in determining the evolutionary stage of disease and the predictability of response to antiviral therapy. HBsAg production originates in two distinct viral DNA structures: intranuclear and extrachromosomal cccDNA and viral DNA sequences integrated in the host cell chromosome. At present, there are two tests available for commercial use in order to asses the HBsAg quantification: Architect QT assay (Abbott Laboratories) and Elecsys HBsAg II Quant assay (Roche Diagnostic). Serum HBV DNA levels and HBsAg decrease progressively during the natural evolution of chronic HBV infection, the lowest values being recorded in inactive carriers patients. Quantitative HBsAg decline at week 12 and 24 of Peg-IFN treatment can be used as a surrogate marker for predicting sustained response in patients with HBeAg-positive chronic HBV hepatitis. In general, a poor HBsAg decline at week 12 may predict lack of response, and a significant reduction in HBsAg at week 24 may predict response to peginterferon therapy. In conclusion, quantitative HBsAg is a topical issue in chronic HBV infections because seems to be a surrogate marker for immune control of disease. Perhaps, in the next therapeutic guidelines will be introduced the quantitative HBsAg kinetics with other established markers, especially when it is required for response-guided therapy. © 2012.

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