OBJECTIVES: We aimed to assess the extent of treatment interruption caused by efavirenz-associated ADEs.

METHODS: A case-control study of efavirenz recipients who did, versus did not (control) develop adverse drug events (ADE), and who were matched for baseline CD4 + at a ratio of 1:1.3 was conducted. Antiretroviral -naïve patients who were started on efavirenz were followed up retrospectively, and their records scrutinized every month for 2 years. Demographic and clinical predictors of treatment interruption were computed using Cox proportional hazard models. Kaplan- Meier curves were plotted to assess time to treatment interruption for the two groups. Clinical endpoints were: i) efficacy -improved CD4 + counts and/or viral load (VL) suppression, ii) safety -absence of treatment-limiting toxicities, and iii) durability - no interruption until follow-up ended.

RESULTS: Both groups had comparable CD4 + counts at baseline (p = 0.15). At t = 24-months, VL in both groups were suppressed to undetectable levels (<20 copies/mL) while median CD4 + was 353 cells/µL (IQR: 249-460). The mean time on treatment was 23 months (95% CI, 22.3 -23.4) in the control group without ADE and 20 months (95% CI, 18.9 - 21.6) in the ADE group (p = 0.001). Kaplan-Meier plots demonstrated that 59.5% of patients who experienced ≥ 1 ADE versus 81% of those who did not experience any ADE were estimated to continue treatment for up to 24 months with no interruption (p = 0.001). Most interruptions to EFV treatment occurred in the presence of opportunistic infections and these were detected within the first 5 months of treatment initiation. Independent predictors which negatively impacted the dependent variable i.e., treatment durability, were intravenous drug use (adjusted hazard ratio, aHR 2.17, 95% CI, 1.03-4.61, p = 0.043), presence of ≥ 1 opportunistic infection(s) (aHR 2.2, 95% CI, 1.13-4.21, p = 0.021), and presence of ≥ 1 serious ADE(s) (aHR 4.18, 95% CI, 1.98-8.85, p = 0.00).

CASE: A 29-year-old female at third trimester of twin pregnancy presented with massive hemoptysis. Computed tomography angiogram (CTA) showed unilateral absence of the right pulmonary artery with multiple dilated tortuous bronchial arteries supplying the right lung. Selective embolization of the bronchial artery was performed post-partum.

Setting and Design: In vitro - Comparative study.

Materials and Methods: Denture base adaptation of two different rapid heat-cured polymethyl methacrylate acrylic resins using five different cooling methods were compared. Forty maxillary edentulous stone cast were prepared to produce the denture bases with standardized thickness. The specimens were divided into five groups (n = 8) according to type of materials and cooling methods. The master stone cast and all forty denture bases were scanned with 3Shape E1 laboratory scanner. The scanned images of each of the denture bases were superimposed over the scanned image of the master cast using Materialize 3-matic software. Three dimensional differences between the two surfaces were calculated and color surface maps were generated for visual qualitative assessment.

Statistical Analysis Used: Generalized Linear Model Test, Bonferroni Post Hoc Analysis.

Results: All bench-cooled specimens showed wide green-colored area in the overall palatal surface, while the rapid cooled specimens presented with increased red color areas especially at the palate and post dam area. Generalized Linear Model test followed by Bonferroni post hoc analysis showed significant difference in the root mean square values among the specimen groups.

PURPOSE: The purpose of this in vitro and clinical study was to evaluate the effect of different build orientations on the adaptation of removable partial denture frameworks fabricated by SLM technology in vitro and to compare the adaptation of the SLM and conventional RPD frameworks clinically.

MATERIAL AND METHODS: A master model simulating a maxillary arch of Kennedy class III modification 1 was scanned and duplicated to create a virtual 3D cast and reference cast. Four groups (n=40) of Co-Cr RPD frameworks were fabricated. For the SLM groups, the Co-Cr framework was virtually designed and exported for SLM printing. The SLM printing was done in 3 different build orientations: 0-degree (n=10), 45-degree (n=10), and 90-degree (n=10) groups. Other Co-Cr frameworks were conventionally cast (n=10). All Co-Cr frameworks were scanned and virtually superimposed with the master model using a surface-matching software program. The gap under 9 selected points in the palatal major connectors was analyzed and calculated. A smaller gap indicates more surface adaptation and close contact between the palatal major connector and the master model. The data were analyzed using the Kruskal-Wallis and Dunnett T3 tests (α=.05). Three patients with a partially dentate maxillary arch were enrolled in the clinical part based on inclusion criteria. Two RPD frameworks were provided for each patient (conventional casting and SLM printing). The adaptation of each framework was assessed by measuring the gap between the palatal major connector of the framework and the palate with light-body silicone. The differences in adaptation between the conventional and SLM frameworks were compared by using independent t tests (α=.05).