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Yurchenko M, Hubálková H, Charvát J. Selected muscle tone and asymmetry of the occlusal plane in case of intracapsular temporomandibular joint disorder. Cranio 2024; 42:267-278. [PMID: 34355675 DOI: 10.1080/08869634.2021.1964052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: To discover the extent of the connection between occlusal plane asymmetry and the rest tone of the four muscle groups of the orofacial region with temporomandibular joint pathology.Methods: Eighty-seven subjects were divided into two groups. The following methods were applied: clinical examination, roentgenological examination, and electromyography. Data were evaluated and statistically analyzed.Results: The variability of occlusal plane inclination in relation to the porion plane was 0-4.6º.The tonus of masseter muscle was higher in the experimental group: 1.45 mV more than in the control group: 1.23 mV (p < 0.05).Conclusion: Asymmetry of the occlusal plane inclination was found for nearly all subjects in both groups. It can be compensated for by adaptation mechanisms and does not cause temporomandibular joint disorders. Undertaken research shows the existence of a proven correlation between TMJ disorders and the resting tonus of the masseter muscle.
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Affiliation(s)
- Maksim Yurchenko
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
| | - Hana Hubálková
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
| | - Jindřich Charvát
- Charles University in Prague, 1st Faculty of Medicine, Department Of Stomatology, Prague 2, Czech Republic
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2
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Dechong Z, He H, Jigang Z, Cunming L. Airway and anesthesia management in tracheoesophageal fistula closure implantation: a single-centre retrospective study. J Cardiothorac Surg 2024; 19:172. [PMID: 38570837 PMCID: PMC10993449 DOI: 10.1186/s13019-024-02737-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE To review and analyze the airway and anesthesia management methods for patients who underwent endoscopic closure of tracheoesophageal fistula (TEF) and to summarize the experience of intraoperative airway management. METHOD We searched the anesthesia information system of the First Affiliated Hospital of Nanjing Medical University for anesthesia cases of TEF from July 2020 to July 2023 and obtained a total of 34 anesthesia records for endoscopic TEF occlusion. The intraoperative airway management methods and vital signs were recorded, and the patients' disease course and follow-up records were analyzed and summarized. RESULTS The airway management strategies used for TEF occlusion patients included nasal catheter oxygen (NCO, n = 5), high-flow nasal cannula oxygen therapy (HFNC, n = 4) and tracheal intubation (TI, n = 25). The patients who underwent tracheal intubation with an inner diameter of 5.5 mm had stable hemodynamics and oxygenation status during surgery, while intravenous anesthesia without intubation could not effectively inhibit the stress response caused by occluder implantation, which could easily cause hemodynamic fluctuations, hypoxemia, and carbon dioxide accumulation. Compared with those in the TI group, the NCO group and the HFNC group had significantly longer surgical times, and the satisfaction score of the endoscopists was significantly lower. In addition, two patients in the NCO group experienced postoperative hypoxemia. CONCLUSION During the anesthesia process for TEF occlusions, a tracheal catheter with an inner diameter of 5.5 mm can provide a safe and effective airway management method.
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Affiliation(s)
- Zhu Dechong
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Huang He
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhang Jigang
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Liu Cunming
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Belloni E, Labiad C, Manceau G. Ileosigmoid knotting, a rare but serious cause of intestinal obstruction. J Visc Surg 2024:S1878-7886(23)00208-4. [PMID: 38555203 DOI: 10.1016/j.jviscsurg.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Elena Belloni
- Digestive and Oncological Surgery Department, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - Camélia Labiad
- Digestive and Oncological Surgery Department, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - Gilles Manceau
- Digestive and Oncological Surgery Department, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France.
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Chen L, Deng YS, Wang LY, Mao XQ, Zhang DC, Liu ZT, Yang JS. Successful endovascular thrombectomy using solitaire FR stent with intermediate catheter assisting technique for acute persistent primitive trigeminal artery and basilar artery occlusion: A case report and literature review. Surg Neurol Int 2024; 15:93. [PMID: 38628508 PMCID: PMC11021110 DOI: 10.25259/sni_997_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/01/2024] [Indexed: 04/19/2024] Open
Abstract
Background The persistent primitive trigeminal artery (PPTA) is a persistent embryological carotid-basilar connection. Endovascular thrombectomy (EVT) for hypoplastic PPTA occlusion is a challenge. This case report aims to describe the successful recanalization of simultaneous occlusions in both the PPTA and basilar artery (BA) using the Solitaire FR (RECO SR)/Stent and Intermediate Catheter Assisting (SWIM) technique in a patient with acute cardiogenic cerebral embolism. To the best of our knowledge, this is the first report of such a case. Case Description We present a case of a 70-year-old female patient who presented with acute right-sided hemiparesis and altered consciousness. Digital subtraction angiography confirmed the occlusion of both the distal portion of the PPTA and the BA. The patient underwent EVT using the SWIM technique, resulting in successful recanalization and significant improvement in the patient's condition. Conclusion This case report demonstrates the successful application of the SWIM technique in achieving recanalization and improving outcomes in a patient with simultaneous occlusion of the acute PPTA and BA. These findings support the potential use of EVT in similar cases.
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Affiliation(s)
- Li Chen
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - Yu Shi Deng
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - Lan Yu Wang
- Department of Blood Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - Xi Quan Mao
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - De Chou Zhang
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - Zu Tian Liu
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
| | - Jin Si Yang
- Department of Neurology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou City, Sichuan, China
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Zhang L, Pu T, Xu X, Raynald, Zheng S, Fu J, Yong Q, Zhang W, He W. Diagnostic feasibility of middle cerebral artery stenosis or occlusion evaluated by TCCS and CEUS: Repeatability, reproducibility, and diagnostic agreement with DSA. J Stroke Cerebrovasc Dis 2024; 33:107575. [PMID: 38232582 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/19/2024] Open
Abstract
AIM This study aimed to evaluate the feasibility of transcranial color-coded sonography (TCCS) and contrast-enhanced ultrasound (CEUS) in assessing middle cerebral artery (MCA) stem stenosis or occlusion compared to digital subtraction angiography (DSA). METHODS A total of 48 cases including 96 MCAs suspected stem stenosis or obstruction in the MCA were assessed by TCCS, CE-TCCS, and DSA. The diameters of the most severe stenosis (Ds), proximal normal artery (Dn), and diameter stenosis rate of MCA were measured using both the color doppler flow imaging (CDFI) modality of TCCS or CEUS and the CEUS imaging modality. The intraclass correlation coefficients (ICCs) and 95 % confidence intervals (CI) were evaluated, and a weighted Kappa value was used to evaluate the intra-observer agreement, inter-observer agreement, agreement between CDFI modality and DSA stenosis or occlusion, and agreement between CEUS imaging modality and DSA stenosis or occlusion. RESULTS The ICC results indicated excellent repeatability and reproducibility (all ICCs > 0.75; weighted Kappa values >0.81). Compared with DSA, the weighted Kappa values and 95 % CIs of stenosis (the first measurement was taken by two observers) of CDFI modality and CEUS imaging modality were 0.175 (0.041, 0.308) and 0.779 (0.570, 0.988) for observers A and 0.181 (0.046, 0.316) and 0.779 (0.570, 0.988) for observers B respectively. CONCLUSION This study indicates that inter- and intra-observer agreements were good for the direct method of measuring percentages of MCA stenosis by TCCS and CEUS. CEUS imaging modality is a new and reliable imaging modality approach to evaluate the MCAs stenosis and occlusion.
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Affiliation(s)
- Lei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tianning Pu
- Department of comprehensive ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaotong Xu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University
| | - Raynald
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University
| | - Shuai Zheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jingjing Fu
- Department of comprehensive ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qiang Yong
- Ultrasonic Medical Diagnosis and treatment Center, Shunyi Women's & Children's Hospital of Beijing Children's Hospital, Capital Medical University
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Suzuki K, Katano T, Numao S, Nishi Y, Kutsuna A, Kanamaru T, Saito T, Aoki J, Nishiyama Y, Kimura K. The effect of asymptomatic intracranial hemorrhage after mechanical thrombectomy on clinical outcome. J Neurol Sci 2024; 457:122868. [PMID: 38246126 DOI: 10.1016/j.jns.2024.122868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Whether asymptomatic intracranial hemorrhage (ICH) affects the clinical outcomes in patients with acute large vessel occlusion treated with mechanical thrombectomy (MT) remains unclear. This study aimed to address this uncertainty. METHODS We retrospectively analyzed patients with acute ischemic stroke and internal carotid or middle cerebral (M1 segment) artery occlusion treated with MT between April 2011 and March 2021 at a single center. All patients had a premorbid modified Rankin scale (mRS) score ≤ 2 and an anterior circulation occlusion and underwent magnetic resonance imaging at admission. Asymptomatic ICH was defined as ICH without symptomatic ICH defined by the SITS-MOST criteria. A favorable outcome was defined as an mRS score ≤ 2 at 90 days after stroke onset. RESULTS Our study included 349 patients; 62% were men, the median age was 76 [67-83] years, and the median National Institutes of Health Stroke Scale (NIHSS) score was 15 [8-21]. As determined via computed tomography, 103 (30%) patients had ICH (20 symptomatic and 83 asymptomatic). The favorable outcome rate was significantly lower for asymptomatic vs. no ICH (30% vs. 67%, p < 0.01). In a multivariate regression analysis, a high NIHSS score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02-1.10; p < 0.01) and low Alberta Stroke Program Early CT Score (OR, 0.78; 95% CI, 0.65-0.92; p < 0.01) were independent risk factors for ICH. CONCLUSIONS Asymptomatic ICH is associated with poor clinical outcome at 90 days after stroke onset.
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Affiliation(s)
- Kentaro Suzuki
- Department of Neurology, Nippon Medical School, Tokyo, Japan.
| | - Takehiro Katano
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | | | - Yuji Nishi
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Akihito Kutsuna
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Takuya Kanamaru
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Tomonari Saito
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Junya Aoki
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | | | - Kazumi Kimura
- Department of Neurology, Nippon Medical School, Tokyo, Japan
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Luo X, Tahabi FM, Rollins DM, Sawchuk AP. Predicting future occlusion or stenosis of lower extremity bypass grafts using artificial intelligence to simultaneously analyze all flow velocities collected in current and previous ultrasound examinations. JVS Vasc Sci 2024; 5:100192. [PMID: 38455094 PMCID: PMC10918260 DOI: 10.1016/j.jvssci.2024.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/26/2023] [Indexed: 03/09/2024] Open
Abstract
Objective Routine surveillance with duplex ultrasound (DUS) examination is recommended after femoral-popliteal and femoral-tibial-pedal vein bypass grafts with various intervals postoperatively. The presently used methodology to analyze bypass graft DUS examination does not use all the available data and has been shown to have a significant rate for missing impending bypass graft failure. The objective of this research is to investigate recurrent neural networks (RNNs) to predict future bypass graft occlusion or stenosis. Methods This study includes DUS examinations of 663 patients who had bypass graft operations done between January 2009 and June 2022. Only examinations without missing values were included. We developed two RNNs (a bidirectional long short-term memory unit and a bidirectional gated recurrent unit) to predict bypass graft occlusion and stenosis based on peak systolic velocities collected in the 2 to 5 previous DUS examinations. We excluded the examinations with missing values and split our data into training and test sets. Then, we applied 10-fold cross-validation on training to optimize the hyperparameters and compared models using the test data. Results The bidirectional long short-term memory unit model can gain an overall sensitivity of 0.939, specificity of 0.963, and area under the curve of 0.950 on the prediction of bypass graft occlusion, and an overall sensitivity of 0.915, specificity of 0.909, and area under the curve of 0.912 predicting the development of a future critical stenosis. The results on different bypass types show that the system performs differently on different types. The results on subcohorts based on gender, smoking status, and comorbidities show that the performance on current smokers is lower than the never smoker. Conclusions We found that RNNs can gain good sensitivity, specificity, and accuracy for the detection of impending bypass graft occlusion or the future development of a critical bypass graft stenosis using all the available peak systolic velocity data in the present and previous bypass graft DUS examinations. Integrating clinical data, including demographics, social determinants, medication, and other risk factors, together with the DUS examination may result in further improvements. Clinical Relevance Detecting bypass graft failure before it occurs is important clinically to prevent amputations, salvage limbs, and save lives. Current methods evaluating screening duplex ultrasound examinations have a significant failure rate for detecting a bypass graft at risk for failure. Artificial intelligence using recurrent neural networks has the potential to improve the detection of at-risk bypass graft before they fail. Additionally, artificial intelligence is in the news and is being applied to many fields. Vascular surgeons need to know its potential to improve vascular outcomes.
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Affiliation(s)
- Xiao Luo
- School of Engineering and Technology, Indiana University Purdue University at Indianapolis, Indianapolis, IN
| | - Fattah Muhammad Tahabi
- School of Engineering and Technology, Indiana University Purdue University at Indianapolis, Indianapolis, IN
| | | | - Alan P. Sawchuk
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
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Ma W, Deng X, Chen J, Guo X. Risk factor analysis of changes in blood flow in the A1 segment of the anterior cerebral artery after flow-diverter coverage of it. Neurosurg Rev 2024; 47:74. [PMID: 38315259 DOI: 10.1007/s10143-024-02306-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/14/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024]
Abstract
Few studies have explored the effect of a flow-diverter device (FD) on blood flow in the A1 segment of the anterior cerebral artery (ACA), after treatment of intracranial aneurysms in the bifurcation region of the internal carotid artery (ICA). The main objective of this article is to investigate the factors that affect A1 blood flow after FD covers the A1 artery. This is a single-center, retrospective study. Data were collected retrospectively from our center, and patients whose FDs were placed for treatment from the terminal of the ICA to the M1 segment were analyzed. A total of 42 patients were included in the study. Immediate post-procedural angiography following device placement revealed decreased blood flow in the A1 of 15 (35.7%) patients and complete occlusion of the A1 segment in 11 (26.2%) patients. During an average follow-up period of 9.8 months, the A1 segment was ultimately occluded in 25 patients (59.5%) and decreased blood flow in 4 patients (9.5%). When using FD to cover the A1 artery for the treatment of intracranial aneurysms, patients with preoperative opening of the anterior communicating artery (AcomA) are more prone to occlusion or decreased blood flow of the A1 artery, compared to patients without opening.
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Affiliation(s)
- WuLin Ma
- Department of Neurointervention, Erqi District, The First Affiliated Hospital of Zhengzhou University, No.1, East Construction Road, Zhengzhou City, 450052, Henan Province, China
| | - Xin Deng
- Department of Neurointervention, Erqi District, The First Affiliated Hospital of Zhengzhou University, No.1, East Construction Road, Zhengzhou City, 450052, Henan Province, China
| | - JunFan Chen
- Department of Neurointervention, Erqi District, The First Affiliated Hospital of Zhengzhou University, No.1, East Construction Road, Zhengzhou City, 450052, Henan Province, China
| | - XinBin Guo
- Department of Neurointervention, Erqi District, The First Affiliated Hospital of Zhengzhou University, No.1, East Construction Road, Zhengzhou City, 450052, Henan Province, China.
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Cho JH, Çakmak G, Yi Y, Yoon HI, Yilmaz B, Schimmel M. Tooth morphology, internal fit, occlusion and proximal contacts of dental crowns designed by deep learning-based dental software: A comparative study. J Dent 2024; 141:104830. [PMID: 38163455 DOI: 10.1016/j.jdent.2023.104830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES This study compared the tooth morphology, internal fit, occlusion, and proximal contacts of dental crowns automatically generated via two deep learning (DL)-based dental software systems with those manually designed by an experienced dental technician using conventional software. METHODS Thirty partial arch scans of prepared posterior teeth were used. The crowns were designed using two DL-based methods (AA and AD) and a technician-based method (NC). The crown design outcomes were three-dimensionally compared, focusing on tooth morphology, internal fit, occlusion, and proximal contacts, by calculating the geometric relationship. Statistical analysis utilized the independent t-test, Mann-Whitney test, one-way ANOVA, and Kruskal-Wallis test with post hoc pairwise comparisons (α = 0.05). RESULTS The AA and AD groups, with the NC group as a reference, exhibited no significant tooth morphology discrepancies across entire external or occlusal surfaces. The AD group exhibited higher root mean square and positive average values on the axial surface (P < .05). The AD and NC groups exhibited a better internal fit than the AA group (P < .001). The cusp angles were similar across all groups (P = .065). The NC group yielded more occlusal contact points than the AD group (P = .006). Occlusal and proximal contact intensities varied among the groups (both P < .001). CONCLUSIONS Crowns designed by using both DL-based software programs exhibited similar morphologies on the occlusal and axial surfaces; however, they differed in internal fit, occlusion, and proximal contacts. Their overall performance was clinically comparable to that of the technician-based method in terms of the internal fit and number of occlusal contact points. CLINICAL SIGNIFICANCE DL-based dental software for crown design can streamline the digital workflow in restorative dentistry, ensuring clinically-acceptable outcomes on tooth morphology, internal fit, occlusion, and proximal contacts. It can minimize the necessity of additional design optimization by dental technician.
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Affiliation(s)
- Jun-Ho Cho
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Yuseung Yi
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, USA
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Gomez MA, Snow JC. How to construct liquid-crystal spectacles to control vision of real-world objects and environments. Behav Res Methods 2024; 56:563-576. [PMID: 36737581 PMCID: PMC10424568 DOI: 10.3758/s13428-023-02059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 02/05/2023]
Abstract
A major challenge in studying naturalistic vision lies in controlling stimulus and scene viewing time. This is especially the case for studies using real-world objects as stimuli (rather than computerized images) because real objects cannot be "onset" and "offset" in the same way that images can be. Since the late 1980s, one solution to this problem has been to have the observer wear electro-optic spectacles with computer-controlled liquid-crystal lenses that switch between transparent ("open") and translucent ("closed") states. Unfortunately, the commercially available glasses (PLATO Visual Occlusion Spectacles) command a high price tag, the hardware is fragile, and the glasses cannot be customized. This led us to explore how to manufacture liquid-crystal occlusion glasses in our own laboratory. Here, we share the products of our work by providing step-by-step instructions for researchers to design, build, operate, and test liquid-crystal glasses for use in experimental contexts. The glasses can be assembled with minimal technical knowledge using readily available components, and they can be customized for different populations and applications. The glasses are robust, and they can be produced at a fraction of the cost of commercial alternatives. Tests of reliability and temporal accuracy show that the performance of our laboratory prototype was comparable to that of the PLATO glasses. We discuss the results of our work with respect to implications for promoting rigor and reproducibility, potential use cases, comparisons with other liquid-crystal shutter glasses, and how users can find information regarding future updates and developments.
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Affiliation(s)
- Michael A Gomez
- Department of Psychology, The University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV, USA.
- Psychology Department, Clovis Community College, 10309 N. Willow Ave, Fresno, CA, USA.
| | - Jacqueline C Snow
- Department of Psychology, The University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV, USA.
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Yi X, Zhang S, Han Q, Hong W, He B, Liu Y, Zheng R. Quantitative Evaluation of Hemodynamic Changes After Multiple Intracranial Aneurysms Occlusion Using Computational Fluid Dynamics. World Neurosurg 2024; 181:e918-e924. [PMID: 37949299 DOI: 10.1016/j.wneu.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Multiple intracranial aneurysms (MIA) are prevalent. This study conducted hemodynamic calculations on MIA to analyze the effects of occlusion of the internal carotid artery (ICA) and middle cerebral artery (MCA) aneurysms on the hemodynamics of other arteries, as well as the issue of the treatment order for these aneurysms. METHODS The models of 9 patients with MIA were selected for the study. A computational fluid dynamics model combining 1-dimension and 3-dimension was used to obtain the vascular flow pattern and wall pressure. RESULTS There was increased pressure at the MCA and anterior cerebral artery (ACA) after occlusion of the aneurysm at the ICA. However, the pressure at the ICA has hardly changed after the aneurysm occlusion at the MCA. Occlusion of the aneurysm of different sizes at the MCA had almost no impact on the pressure at the ICA and ACA. For small aneurysm, the pressure of the ACA and MCA increases with decreasing size of the aneurysm at the ICA. After occlusion of a large aneurysm at the ICA, the impact on the pressure of the ACA and MCA is almost the same as after occlusion of a medium-sized aneurysm. CONCLUSIONS If the treatment order of ICA and MCA aneurysms cannot be determined based on patient factors and aneurysm characteristics, the MCA aneurysm should be treated as a priority.
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Affiliation(s)
- Xu Yi
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Shuhua Zhang
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Qicheng Han
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Wenyao Hong
- Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, China; Department of Neurosurgery, Fujian Provincial Hospital, Fuzhou, China
| | - Bingwei He
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China; Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, China
| | - Yuqing Liu
- Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, China; Department of Neurosurgery, Fujian Provincial Hospital, Fuzhou, China
| | - Rongye Zheng
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China; Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, China.
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Xu Y, Pan X, Shen D, Sun Y, Liu W, Lin Y, Fu B, Zhang L. In-depth occlusion of dentine tubules via the application of (poly-L-aspartic acid)‑strontium and phosphate/fluoride to treat dentine hypersensitivity. Int J Biol Macromol 2024; 254:127780. [PMID: 37907172 DOI: 10.1016/j.ijbiomac.2023.127780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/09/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Abstract
Dentine hypersensitivity (DH) is a common oral health issue and occlusion of the exposed dentinal tubules (DTs) is regarded as the most effective therapeutic treatment nowadays. However, it is still difficult to develop easy and effective strategies for deep occlusion of DTs. In this study, we develop a strategy for occluding DTs deeply and compactly via simple application of occlusion media including (poly-L-aspartic acid)‑strontium (PAsp‑strontium) and phosphate/fluoride. The bonding of strontium ions to poly-L-aspartic acid formed a positively charged PAsp‑strontium complexes. After application of 15 min each, the PAsp‑strontium and phosphate/fluoride rapidly penetrated into the DTs in turn via the electrostatic interaction, then occluded the DTs with crystals up to a depth of 150 μm. The occlusion within DTs was resistant to abrasive and acidic challenges. The occlusion media performed better than commercial desensitizers Duraphat and Gluma. Moreover, this strategy possessed sufficient biocompatible and excellent performance in vivo. The application of occlusion media would shed light on in the management of DH.
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Affiliation(s)
- Yuedan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Xinni Pan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Dongni Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yi Sun
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Wei Liu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Ye Lin
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Baiping Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
| | - Ling Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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13
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Karaduran K, Aydogdu A, Gelisin O, Gunpinar S. Investigating the potential clinical impact of periodontitis on the progression of Alzheimer's disease: a prospective cohort study. Clin Oral Investig 2023; 28:67. [PMID: 38159159 DOI: 10.1007/s00784-023-05445-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES This study aimed to investigate the effect of periodontitis and current occlusal relationship on the progression rate of Alzheimer's disease (AD). METHODS Ninety Alzheimer's patients, who were divided into three groups as Stage I (n=42), Stage II (n=29), and Stage III (n=19), based on the Clinical Dementia Rating Scale, were included in the study. Cognitive status of the patients was evaluated with Standardized Mini-Mental Test (SMMT) at baseline and repeated 6 months later. Clinical periodontal examinations were recorded and occlusal relationship status was classified according to the Eichner Index. RESULTS Of 90 Alzheimer's patients, 65 were toothed individuals with periodontitis and 25 were edentulous individuals without active periodontal disease. Stage II and Stage III toothed Alzheimer's patients had higher percentage of bleeding on probing (BOP%) and clinical attachment level (CAL) values than Stage I patients (p<0.05). Stage III Alzheimer's patients had significantly higher probing pocket depth (PPD) values than Stage I individuals (p<0.05). ΔSMMT values showed positive correlation with BOP% (r=0.308, p=0.013) and PPD (r=0.275, p=0.027). Among the evaluated parameters, being in the AD Stage II-Stage III, having periodontitis and age variable had significant effects on ΔSMMT levels (p<0.05). CONCLUSIONS Within the limits of our study, it can be concluded that periodontitis may increase the severity and also accelerate the progression rate of AD. CLINICAL RELEVANCE These results are precious to show the necessity of proper oral hygiene activities and regular dental visits in patients with toothed AD. CLINICAL TRIAL REGISTRATION This study was registered and approved by clinical trials (NCT05807100).
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Affiliation(s)
- Kubra Karaduran
- Faculty of Dentistry, Department of Periodontology, Bezmialem Vakif University, Istanbul, Turkey.
| | - Ahmet Aydogdu
- Faculty of Dentistry, Department of Periodontology, Istanbul Galata University, Istanbul, Turkey
| | - Ozlem Gelisin
- Department of Neurology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Sadiye Gunpinar
- Faculty of Dentistry, Department of Periodontology, Bezmialem Vakif University, Istanbul, Turkey
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14
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Meara DJ. Applications of Maxillomandibular Fixation, Occlusal Guidance, and Jaw Physiotherapy in the Management of Fractures of the Mandible. Otolaryngol Clin North Am 2023; 56:1113-1123. [PMID: 37659861 DOI: 10.1016/j.otc.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2023]
Abstract
The goal of mandibular fracture management is to restore form and function. Maxillomandibular fixation, elastic occlusal guidance, and postoperative physiotherapy are essential elements to optimizing outcomes. Restoration of premorbid occlusion is paramount. Thus, an expert understanding of occlusion, coupled with the application of maxillomandibular techniques to achieve bony reduction with idealized dental occlusion, is required in the proper management of mandible fractures. Postoperatively, complete recovery initially requires elastic occlusal guidance followed by jaw range of motion physiotherapy. Bone healing, an idealized occlusion, and normal jaw range of motion signal success via the restoration of form and function.
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Affiliation(s)
- Daniel J Meara
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery & Hospital Dentistry, Christiana Care Health System, Wilmington, DE, USA; Affiliate Faculty, Department of Physical Therapy, University of Delaware, Newark, DE, USA.
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15
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Guy EF, Clifton JA, Knopp JL, Holder-Pearson LR, Chase JG. Respiratory pressure and split flow data collection device with rapid occlusion attachment. HardwareX 2023; 16:e00489. [PMID: 38058767 PMCID: PMC10696101 DOI: 10.1016/j.ohx.2023.e00489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
Respiratory model-based methods require datasets containing enough dynamics to ensure model identifiability for development and validation. Rapid expiratory occlusion has been used to identify elastance and resistance within a single breath. Currently accepted practice for rapid expiratory occlusion involves a 100 ms occlusion of the expiratory pathway. This article presents a low-cost modular rapid shutter attachment to enable identification of passive respiratory mechanics. Shuttering faster than 100 ms creates rapid expiratory occlusion without the added dynamics of muscular response to shutter closure, by eliminating perceived expiratory blockage via high shutter speed. The shutter attachment fits onto a non-invasive venturi-based flow meter with separated inspiratory and expiratory pathways, established using one-way valves. Overall, these elements allow comprehensive collection of respiratory pressure and flow datasets with relatively very rapid expiratory occlusion.
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Affiliation(s)
- Ella F.S. Guy
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Jaimey A. Clifton
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Jennifer L. Knopp
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Lui R. Holder-Pearson
- Department of Electrical Engineering, University of Canterbury, Christchurch, New Zealand
| | - J. Geoffrey Chase
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
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16
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Yoshizawa R, Sasaki H, Urushikubo T, Sawa Y, Owada S. Occlusion and catheter ablation using a large-size cryoballoon for various pulmonary veins: a case series. Eur Heart J Case Rep 2023; 7:ytad593. [PMID: 38099074 PMCID: PMC10720691 DOI: 10.1093/ehjcr/ytad593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023]
Abstract
Background It is established that pulmonary vein isolation using the POLARx™ (Boston Scientific, Marlborough, MA, USA) cryoballoon is a rapid, safe, and effective approach. The new POLARx™ FIT (Boston Scientific), which is expandable from 28 to 31 mm in diameter, is currently available. However, there is limited evidence available regarding the treatment of atrial fibrillation in this setting. In this article, we report a case series of cryoballoon ablation in patients with atrial fibrillation using POLARx™ FIT. Case summary This case series describes a comparison of obstruction in three patients with pulmonary veins of different shapes and diameters undergoing cryoballoon ablation and pulmonary vein isolation with a 31 mm diameter balloon. Discussion Cryoballoon ablation using the 31 mm mode of POLARx™ FIT has the potential to provide safe and stable pulmonary vein isolation with good occlusion for a variety of pulmonary vein geometries. In this case series, the 31 mm mode of the POLARx™ FIT resulted in better pulmonary vein occlusion than the 28 mm mode in patients with large left atria and large pulmonary veins, including the left common pulmonary vein. This approach may be considered a first-line therapy option of cryoballoon ablation in patients with atrial fibrillation.
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Affiliation(s)
- Reisuke Yoshizawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa, Japan
| | - Hiroki Sasaki
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa, Japan
| | - Takashi Urushikubo
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa, Japan
| | - Yohei Sawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa, Japan
| | - Shingen Owada
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa, Japan
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17
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Bueno S, Hammad Y, Schlieve T. Does the type of planning in orthognathic surgery influence patient satisfaction? Oral Maxillofac Surg 2023; 27:685-692. [PMID: 36121522 DOI: 10.1007/s10006-022-01114-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To determine if the method of orthognathic surgery planning used-computer aided surgical simulation (CASS) versus analog model surgery-influenced patients' post-operative satisfaction. The authors hypothesized that there was no difference in patient satisfaction based on the type of planning in orthognathic surgery. METHODS This was a single-site, observational, retrospective cohort study consisting of a standardized survey aimed to be given to all patients who had orthognathic surgery at the authors' institution over a 6-year period. Patients were asked to complete a survey questionnaire that consisted of eight questions, each utilizing a five-point Likert scale. RESULTS There were 643 patients initially identified with 401 potential subjects meeting the inclusion criteria. Of these 401 patients, the survey was successfully administered to 161. Patients whose orthognathic surgery was planned virtually were not only significantly more likely to be satisfied with their appearance post-operatively, but also more likely to go through with surgery again if they could choose to (p < 0.05). CASS patients were also more likely to identify that their surgery was planned virtually. When stratified by age, younger patients were more likely to have read about CASS. When each survey question was stratified based on the type of surgery that was performed, there were no significant differences. CONCLUSION Patients whose surgeries were virtually planes were significantly more likely than model surgery patients to be satisfied with their post-operative appearance as well as with their decision to have orthognathic surgery. CASS has proven to be an accurate, time-saving, and potentially cost-saving tool for surgeons. Based on the results of this study, the type of surgical planning method matters for post-operative patient satisfaction with their appearance.
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Affiliation(s)
- Scott Bueno
- University of Texas Southwestern/ Parkland Memorial Hospital Oral & Maxillofacial Surgery, 5323 Harry Hines Blvd, CS3.104, Dallas, TX, 75390, USA.
| | - Yousef Hammad
- University of Texas Southwestern/ Parkland Memorial Hospital Oral & Maxillofacial Surgery, 5323 Harry Hines Blvd, CS3.104, Dallas, TX, 75390, USA
| | - Thomas Schlieve
- University of Texas Southwestern/ Parkland Memorial Hospital Oral & Maxillofacial Surgery, 5323 Harry Hines Blvd, CS3.104, Dallas, TX, 75390, USA
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18
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Jurczyk D, Macherey-Meyer S, Rawish E, Stiermaier T, Eitel I, Frerker C, Schmidt T. New-onset atrial fibrillation after percutaneous patent foramen ovale closure: a meta-analysis. Clin Res Cardiol 2023; 112:1824-1834. [PMID: 37515604 PMCID: PMC10697880 DOI: 10.1007/s00392-023-02263-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/29/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The exact incidence and predictors of new-onset atrial fibrillation (AF) after percutaneous closure of patent foramen ovale (PFO) are unknown. OBJECTIVE We sought to find post-procedural AF incidence rates and differences due to different screening strategies and devices. METHODS A systematic search was conducted in Cochrane, MEDLINE and EMBASE. Controlled trials fulfilling the inclusion criteria were included into this meta-analysis. The incidence of new-onset AF was the primary outcome. Further parameters were surveillance strategy, device type, AF treatment and neurological events. New AF was determined as early onset within one month after implantation and late thereafter. RESULTS 8 controlled trials and 16 cohort studies were eligible for quantitative analysis. 7643 patients received percutaneous PFO closure after cryptogenic stroke or transient ischaemic attack, 117 with other indications, whereas 1792 patients formed the control group. Meta-analysis of controlled trials showed an AF incidence of 5.1% in the interventional and 1.6% in the conservative arm, respectively (OR 3.17, 95% CI 1.46-6.86, P = 0.03, I2 = 55%). 4.7% received high-quality surveillance strategy with Holter-ECG or Loop recorder whereby AF incidence was overall higher compared to the low-quality group with 12-lead ECG only (3.3-15% vs. 0.2-4.3%). Heterogeneous results on time of AF onset were found, limited by different follow-up strategies. CardioSEAL and Starflex seemed to have higher AF incidences in early and late onset with 4.5% and 4.2%, respectively. CONCLUSION Percutaneous PFO closure led to higher AF post-procedural incidence compared to the conservative strategy. Heterogeneity in surveillance and follow-up strategy limited the generalizability. TRIAL REGISTRATION Registered on PROSPERO (CRD42022359945).
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Affiliation(s)
- Dominik Jurczyk
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | - Sascha Macherey-Meyer
- Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, University of Cologne, Cologne, Germany
| | - Elias Rawish
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Thomas Stiermaier
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Ingo Eitel
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Christian Frerker
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Tobias Schmidt
- Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
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Privitera D, Bassi E, Airoldi C, Capsoni N, Innocenti G, Santomauro I, Molin AD. Effectiveness of short peripheral intravenous catheter educational programmes to improve clinical outcomes protocol for a systematic review. MethodsX 2023; 11:102352. [PMID: 37705570 PMCID: PMC10495618 DOI: 10.1016/j.mex.2023.102352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023] Open
Abstract
The placement of a short peripheral intravenous catheter (sPIVC) is the most common invasive clinical procedure for patients requiring fluid infusion and multiple blood draws. Phlebitis and infiltration represent the most common catheter-related complications. Occlusions, dislocations, and infections are less frequent. Insufficient knowledge and skills may increase the risk of these complications. This review aims to evaluate the effectiveness of training programmes to reduce sPIVC failure amongst hospitalised patients. We will search PubMed, Embase, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Vascular Specialized Register through the Cochrane Register of Studies, and Google Scholar. We defined the search query using the PICO framework (Participants: health professionals; Intervention: training programme; Comparison: No training programme; Outcomes: all-cause catheter failure). We will include experimental studies evaluating an educational programme to reduce early sPIVC failure amongst hospitalised patients. Two reviewers will independently screen studies for inclusion, extract data, and perform the risk of bias assessment using the Cochrane Effective Practice and Organisation of Care Risk of Bias tool for randomised controlled trials. This review will highlight important perspectives for future studies on the effectiveness of educational programmes focused on reducing the rate of sPIVC complications.
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Affiliation(s)
- Daniele Privitera
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Erika Bassi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Chiara Airoldi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Nicolò Capsoni
- Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gloria Innocenti
- Centro Documentazione Biomedica, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Isabella Santomauro
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
- Health Professions’ Direction, Maggiore della Carità Hospital, Novara, Italy
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20
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Lowe TW, Tenan MS, Shah K, Griffin L. Low-load blood flow restriction reduces time-to-minimum single motor unit discharge rate. Exp Brain Res 2023; 241:2795-2805. [PMID: 37874365 DOI: 10.1007/s00221-023-06720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
Resistance training with low loads in combination with blood flow restriction (BFR) facilitates increases in muscle size and strength comparable with high-intensity exercise. We investigated the effects of BFR on single motor unit discharge behavior throughout a sustained low-intensity isometric contraction. Ten healthy individuals attended two experimental sessions: one with, the other without, BFR. Motor unit discharge rates from the tibialis anterior (TA) were recorded with intramuscular fine-wire electrodes throughout the duration of a sustained fatigue task. Three 5-s dorsiflexion maximal voluntary contractions (MVC) were performed before and after the fatigue task. Each participant held a target force of 20% MVC until endurance limit. A significant decrease in motor unit discharge rate was observed in both the non-BFR condition (from 13.13 ± 0.87 Hz to 11.95 ± 0.43 Hz, P = 0.03) and the BFR condition (from 12.95 ± 0.71 Hz to 10.9 ± 0.75 Hz, P = 0.03). BFR resulted in significantly shorter endurance time and time-to-minimum discharge rates and greater end-stage motor unit variability. Thus, low-load BFR causes an immediate steep decline in motor unit discharge rate that is greater than during contractions performed without BFR. This shortened neuromuscular response of time-to-minimum discharge rate likely contributes to the rapid rate of neuromuscular fatigue observed during BFR.
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Affiliation(s)
- Timothy W Lowe
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Matthew S Tenan
- The Blanchette Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Kena Shah
- Select Physical Therapy, Spring, TX, USA
| | - Lisa Griffin
- Department of Kinesiology and Health Education, The University of Texas at Austin, 1University Station, D3700, Austin, TX, 78712, USA.
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21
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Benyahia H, Abdelkoui A, Yadfout A, Merzouk N, Berrada S. [Maxillomandibular relationship recording in removable partial petal dentures (RPMD)]. Swiss Dent J 2023; 133:737-743. [PMID: 37927040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The recording of the maxillo-mandibular relationship (MMR) is an essential and unavoidable step that occurs at different stages of treatment during a prosthetic rehabilitation. Tissue duality is a major problem in metal partial dentures (MPD), especially in complete and large edentulisms, and is responsible for occlusal inaccuracies resulting in restorations that are not integrated with the patient’s manducatory system. In order to perform this step, the practitioner must choose the right material, make the appropriate support, and adopt a reliable and reproducible technique that is adapted to the clinical situation and the prosthetic step. The objective of this work is to suggest a simple and codified approach, which guarantees a reliable recording of the maxillo-mandibular relationship, adapted to the particularities of the supporting structures and taking into consideration the clinical sequence for an optimal occlusal-functional integration of the future metallic partial denture.
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Affiliation(s)
- Hassnae Benyahia
- Université Mohamed V, Faculté de médecine dentaire, Rabat-Instituts, Maroc
| | - Anissa Abdelkoui
- Université Mohamed V, Faculté de médecine dentaire, Rabat-Instituts, Maroc
| | - Asmae Yadfout
- Université Mohamed V, Faculté de médecine dentaire, Rabat-Instituts, Maroc
| | - Nadia Merzouk
- Université Mohamed V, Faculté de médecine dentaire, Rabat-Instituts, Maroc
| | - Salwa Berrada
- Université Mohamed V, Faculté de médecine dentaire, Rabat-Instituts, Maroc
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22
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Zhou W, Liu R, Ni J, Li Y. Transthoracic minimally invasive occlusion of a large patent ductus arteriosus with irreversible thrombocytopenia: A case report. Asian J Surg 2023; 46:4940-4941. [PMID: 37336702 DOI: 10.1016/j.asjsur.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- Wenjun Zhou
- Department of Cardiovascular Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, 730000, Gansu, China
| | - Ruisheng Liu
- Department of Cardiovascular Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, 730000, Gansu, China
| | - Jinrong Ni
- Department of Cardiovascular Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, 730000, Gansu, China
| | - Yuanmin Li
- Department of Cardiovascular Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, 730000, Gansu, China.
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Eberspacher C, Arcieri S, Lauro A, Palma R, Coletta E, Arcieri FL, Mascagni D, Pontone S. Sizzling Fat-Curative Endoscopic Resection of a Giant Lipoma Causing Colo-Colic Intussusception. Dig Dis Sci 2023; 68:4123-4126. [PMID: 37733131 DOI: 10.1007/s10620-023-08087-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023]
Abstract
Giant colonic lipomas, tumors that infrequently occur in the gastrointestinal tract, can manifest as bleeding, abdominal pain and, in few cases, obstruction with intussusception. Surgery is usually the treatment of choice. We report the case of a 78 years-old woman with abdominal pain, constipation, and bleeding due to a giant lipoma of the sigmoid colon causing intussusception. After an initial diagnostic colonoscopy, the patient underwent an endoscopic mucosal resection (EMR) without complications. Even if surgery is traditionally the primary therapeutic approach for giant colonic lipomas, selected cases can be successfully treated with EMR.
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Affiliation(s)
- Chiara Eberspacher
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Stefano Arcieri
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Augusto Lauro
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy.
| | - Rossella Palma
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Enrico Coletta
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Francesco Leone Arcieri
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Domenico Mascagni
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Stefano Pontone
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
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Gomi K, Moroi A, Yoshizawa K, Iguchi R, Ueki K. Evaluation of tongue pressure and lip closing force in bimaxillary orthognathic surgery: A retrospective study. J Craniomaxillofac Surg 2023; 51:696-701. [PMID: 37652849 DOI: 10.1016/j.jcms.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/27/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023] Open
Abstract
The purpose of this study was to quantitatively compare changes in tongue pressure and lip closing force among skeletal Class II and Class III patients, who had undergone orthognathic surgery, and a control group. Maximum tongue pressure and lip closing forces were measured preoperatively and at 6 and 12 months postoperatively. Time-course changes were analyzed and compared among the groups. The control group involved 40 skeletal Class I occlusion volunteers (20 male and 20 female), the Class II group involved 20 female patients, and the skeletal Class III group involved 40 patients, who were subdivided by sex into two groups comprising 20 males and 20 females, respectively. Time-course changes in tongue pressure were not significantly different between and within groups. However, postoperative lip closing forces became gradually higher in the Class III group female and male subjects compared with the control group, although this was not observed in the Class II group. There were significant correlations between tongue pressure and lip closing force before and after surgery (p = 0.001), and these correlations increased over time. Although there was no significant increase in maximum tongue pressure after orthognathic surgery, there was an associated increase in perioral muscle strength. This suggests that an increase in perioral muscle strength may contribute more to the stability of postoperative jaw morphology.
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Affiliation(s)
- Karen Gomi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Ran Iguchi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Koichiro Ueki
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
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Zhang Y, Xiang H, Zhang Y, Tang L. Recanalization of Xen45 gel stent implant occlusion using 10 - 0 nylon suture in refractory glaucoma: a case report. BMC Ophthalmol 2023; 23:418. [PMID: 37858210 PMCID: PMC10585744 DOI: 10.1186/s12886-023-03109-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Xen Gel Stent implant is a new minimally invasive surgical treatment for glaucoma that has been proven effectiveness and safety profile. However, it may also lead to some complications. Xen Gel Stent occlusion is a relatively rare complication reported less frequently and has limited treatment experience. In our case report, we proposed a novel surgical treatment using a 10 - 0 nylon suture to successfully recanalize the occluded Xen45 Gel Stent. CASE PRESENTATION A 16-year-old female patient had bilateral juvenile glaucoma for the past 5 years. Her right eye had undergone three glaucoma surgeries but failed. At a presentation to our hospital, the right eye's intraocular pressure (IOP) was 30 mmHg despite applying four different active principles. Xen45 Gel Stent implant was chosen for treatment, but six days after implantation, the IOP rose to 40 mmHg as a result of an anterior chamber tip occlusion of the Xen45 Gel Stent. Nd: YAG laser shockwave therapy was attempted but failed. The patient eventually had to return to the operating room for a revision procedure. The Xen45 Gel Stent was recanalized from the ab externo by making an L-shaped conjunctival incision at the fornix base and threading a 10 - 0 nylon suture through it. The IOP was successfully controlled in the 11-month follow-up without medication. CONCLUSION If postoperative occlusion arises after Xen45 Gel Stent implantation, surgery using 10 - 0 nylon suture to recanalize Xen45 Gel Stent should be considered as a relatively safe, effective that does not require removal of Xen45 Gel Stent.
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Affiliation(s)
- Yao Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Haotian Xiang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Yangyang Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Li Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China.
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Zhao Y, Zhu H, Chen X, Luo F, Li M, Zhou J, Chen S, Pan Y. Pose-invariant and occlusion-robust neonatal facial pain assessment. Comput Biol Med 2023; 165:107462. [PMID: 37716244 DOI: 10.1016/j.compbiomed.2023.107462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/12/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
Neonatal Facial Pain Assessment (NFPA) is essential to improve neonatal pain management. Pose variation and occlusion, which can significantly alter the facial appearance, are two major and still unstudied barriers to NFPA. We bridge this gap in terms of method and dataset. Techniques to tackle both challenges in other tasks either expect pose/occlusion-invariant deep learning methods or first generate a normal version of the input image before feature extraction, combining these we argue that it is more effective to jointly perform adversarial learning and end-to-end classification for their mutual benefit. To this end, we propose a Pose-invariant Occlusion-robust Pain Assessment (POPA) framework, with two novelties. We incorporate adversarial learning-based disturbance mitigation for end-to-end pain-level classification and propose a novel composite loss function for facial representation learning; compared to the vanilla discriminator that implicitly determines occlusion and pose conditions, we propose a multi-scale discriminator that determines explicitly, while incorporating local discriminators to enhance the discrimination of key regions. For a comprehensive evaluation, we built the first neonatal pain dataset with disturbance annotation involving 1091 neonates and also applied the proposed POPA to the facial expression recognition task. Extensive qualitative and quantitative experiments prove the superiority of the POPA.
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Affiliation(s)
- Yisheng Zhao
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Huaiyu Zhu
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Xiaofei Chen
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Feixiang Luo
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Mengting Li
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Jinyan Zhou
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Shuohui Chen
- Hospital Infection-Control Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Yun Pan
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China.
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Fernández-Gómez M, Zitan-Saidi L, Gallo-Pineda F, Hidalgo-Barranco C, Castro-Luna G. Single vs. Multiphase Computed Tomography angiography in acute internal carotid artery occlusion: An accuracy and interobserver agreement study. Clin Imaging 2023; 102:60-64. [PMID: 37595353 DOI: 10.1016/j.clinimag.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE Accurate differentiation between the intracranial and extracranial location of the acute internal carotid artery (ICA) occlusion is essential for guiding treatment decisions and mechanical thrombectomy planning. Multiphase Computed Tomography angiography (mCTA) appears to be superior to Single-phase Computed Tomography angiography (sCTA) in the evaluation of acute ICA occlusions. The main objective of our research is to study the accuracy of mCTA compared to sCTA in distinguishing isolated acute intracranial ICA occlusion from extracranial or tandem occlusion. METHODS Two observers independently analyzed sCTA and mCTA of patients with acute ICA occlusion at two different time points. The location of the occlusion was categorized as intracranial or extracranial for both imaging techniques and then compared with digital subtraction angiography (gold standard). Sensitivity and specificity rates for isolated intracranial ICA occlusion on sCTA and mCTA were calculated. Kappa statistics were used to assess interobserver agreement. RESULTS The sensitivity of sCTA and mCTA was 48.28% (28.36%-68.19%) and 79.31% (62.84%-95.78%) respectively for the diagnosis of isolated intracranial ICA occlusion, with an almost perfect interobserver agreement between both observers (p < 0.001). CONCLUSIONS Our research suggests that mCTA is more accurate than sCTA in distinguishing isolated intracranial occlusions from extracranial or tandem occlusions.
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Affiliation(s)
- Miriam Fernández-Gómez
- Interventional Neuroradiology, Radiology Department, Torrecardenas University Hospital, Almería, Spain
| | - Laila Zitan-Saidi
- Radiology Department, Torrecardenas University Hospital, Almería, Spain
| | - Félix Gallo-Pineda
- Interventional Neuroradiology, Radiology Department, Torrecardenas University Hospital, Almería, Spain.
| | - Carlos Hidalgo-Barranco
- Interventional Neuroradiology, Radiology Department, Torrecardenas University Hospital, Almería, Spain
| | - Gracia Castro-Luna
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Spain
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Salem MM, Khorasanizadeh M, Nwajei F, Gomez-Paz S, Akamatsu Y, Jordan N, Maroufi SF, Thomas AJ, Ogilvy CS, Moore JM. Predictors of aneurysmal occlusion following intracranial aneurysms treatment with pipeline embolization device. Acta Neurochir (Wien) 2023; 165:2801-2809. [PMID: 37615726 DOI: 10.1007/s00701-023-05740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE Pipeline embolization device (PED) is thought to induce aneurysmal occlusion through diversion of flow away from the aneurysmal sac with subsequent thrombosis and endothelialization. The impact of different factors especially hypertension (HTN)-a known predisposing factor to hypercoagulability and altered endothelial function-on aneurysmal occlusion after flow diversion has not been studied. We sought to determine predictors of aneurysmal occlusion following PED treatment focusing on impact of blood pressure. METHODS Database of patients with cerebral aneurysms treated with PED from 2013 to 2019 at our institution was retrospectively reviewed. Patients were defined as hypertensive if (1) they had a documented history of HTN requiring anti-HTN medications or (2) average systolic blood pressure on three measurements was > 130 mmHg. The primary outcome was aneurysm occlusion status at the last imaging follow-up. Multivariable logistic regression model was constructed to assess the effect of HTN on occlusion, controlling for age, smoking, aneurysmal size, fusiform morphology, posterior circulation location, and incorporated branches. RESULTS A total of 331 aneurysms in 294 patients were identified for this analysis. The mean age was 59 years (79.9% female). Fifty-five percent of the cohort were classified as hypertensive. When controlling for other potential confounders, hypertensive patients trended toward higher odds of achieving complete occlusion compared to non-hypertensive patients (OR = 2.05; 95% CI = 0.99-4.25; p = 0.052). Meanwhile, age (OR = 0.91; 95% CI = 0.88-0.95; p < 0.001) and an incorporated branch into an aneurysm (OR = 0.22; 95% CI = 0.08-0.58; p < 0.002) were associated with decreased odds for complete aneurysmal occlusion. CONCLUSION Hypertensive patients show a trend toward higher odds of achieving complete occlusion when controlling for potential confounders. The HTN-induced hypercoagulable state, enhanced endothelial activation, and altered extracellular matrix regulation might be the contributing factors. Further research is warranted to explore clinical implications of these findings.
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Affiliation(s)
- Mohamed M Salem
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - MirHojjat Khorasanizadeh
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Felix Nwajei
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Santiago Gomez-Paz
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Yosuke Akamatsu
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Noah Jordan
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Ajith J Thomas
- Department of Neurosurgery, Cooper University Hospital, Camden, NJ, USA
| | - Christopher S Ogilvy
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Justin M Moore
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Held S, Rappelt L, Rein R, Wiedenmann T, Donath L. Low-intensity climbing with blood flow restriction over 5 weeks increases grip and elbow flexor endurance in advanced climbers: A randomized controlled trial. Eur J Sport Sci 2023; 23:2031-2037. [PMID: 37167343 DOI: 10.1080/17461391.2023.2207079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Grip and elbow flexor strength and endurance are crucial performance surrogates in competitive climbing. Thus, we examined the effects of blood flow restricted (BFR) climbing on grip and elbow flexor performance. Fifteen trained climbers (8 females; 20.8 ± 7.0 yrs; 1.72 ± 0.08 m; 63.0 ± 9.7 kg; 21.7 ± 2.7 IRCRCA grade) were either assigned to the intervention (BFR) or control (noBFR) group, using the minimization method (Strata: age, height, body mass, gender, and IRCRA grade). While BFR was used during low-intensity climbing training (2-times 10 min/session; 3-times/week), noBFR followed identical training protocols without BFR over 5 weeks. BFR of the upper limb was applied via customized pneumatic cuffs (occlusion pressure: 120 ± 23 mmHg, 75%; occlusion pressure). Endurance and strength performances were assessed via one-handed rung pulling (GripSTRENGTH), one-handed bent arm lock off at 90° (ArmSTRENGTH), static-intermitted finger hang (GripENDURANCE), and bent arm hang (ArmENDURANCE). Bayesian credible intervals revealed increased GripENDURANCE (+21 s (95% credible interval: -2 to 43 s)) and ArmENDURANCE +11 s (-5 to 27 s); adaptations via BFR. In contrast, GripSTRENGTH +4 N (-40 to 48 N) and ArmSTRENGTH +4 N (-68 to 75 N) were not affected by the BFR intervention. Fifteen cumulative sessions of BFR application with a cumulative total BFR load of 5 h over a 5 weeks macrocycle remarkably increased grip and elbow flexor endurance. Thus, BFR might serve as a promising means to improve relevant performance surrogates in trained climbers.
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Affiliation(s)
- Steffen Held
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
- Department of Sport and Management, IST University of Applied Sciences, Duesseldorf, Germany
| | - Ludwig Rappelt
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - Robert Rein
- Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany
| | - Tim Wiedenmann
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
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Tan JH, Tan HCL. Coincidental presence of arterial occlusive disease rather than direct association of SARS-CoV-2 infection. Malays Fam Physician 2023; 18:51. [PMID: 37814668 PMCID: PMC10560468 DOI: 10.51866/lte.452r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Jih Huei Tan
- MBBS (Manipal), Dr Surg (UKM), Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
| | - Henry Chor Lip Tan
- MD (UCSI), Dr Surg (UKM), Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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Sghaier A, Jarrar MS, Ben Abdelkader A, Harroum M, Hamila F, Youssef S. Acute intestinal obstruction: What if it is instead colonic tuberculosis? What diagnostic and management dilemmas are there? Int J Surg Case Rep 2023; 110:108721. [PMID: 37647758 PMCID: PMC10509830 DOI: 10.1016/j.ijscr.2023.108721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Colonic tuberculosis is rare. Clinical, biologic endoscopic and radiological features are not unequivocal. A multitude of differential diagnoses interfere, including Crohn's disease and cancer. CASE PRESENTATION we present a case of a 48-year-old Tunisian female who complained from occlusive syndrome. For whom none of the various elements of the medical record, the clinical, endoscopic and radiological investigations had enabled a decision to be reached in favor of one diagnosis over the other. Several diagnoses were suggested, including Crohn's disease, neoplastic diseases and, ultimately, colonic tuberculosis, since our country was endemic for this pathology. The collegial decision of the medical staff involved in the management was to operate on the patient. Surgery was required with the intention to treat and mainly to provide histological proof of the disease. A right colectomy allowed histological examination and a diagnosis of colonic tuberculosis. DISCUSSION The diagnosis should be discussed in patient from endemic countries, who complain chronic abdominal pain, vesperal fever and weight loss for who endoscopy shows the presence of nodules or ulcers. The diagnosis is retained on the basis of pathological findings. CONCLUSIONS Because of a nonspecific clinical and endoscopic presentations, multiples biopsies even surgical resection are mandatory to rule out differential diagnosis and to confirm the diagnoses of colonic tuberculosis.
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Affiliation(s)
- Asma Sghaier
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty Of Medicine Of Sousse, University of Sousse, Tunisia; Department of General Surgery, Tunisia.
| | - Mohamed Salah Jarrar
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty Of Medicine Of Sousse, University of Sousse, Tunisia; Department of Anatomy, Tunisia
| | - Atef Ben Abdelkader
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty Of Medicine Of Sousse, University of Sousse, Tunisia; Department of Anatomopathology, Tunisia
| | - Mariem Harroum
- Hospital of Farhat Hached of Sousse, Tunisia; Department of General Surgery, Tunisia
| | - Fehmi Hamila
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty Of Medicine Of Sousse, University of Sousse, Tunisia; Department of General Surgery, Tunisia
| | - Sabri Youssef
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty Of Medicine Of Sousse, University of Sousse, Tunisia; Department of General Surgery, Tunisia
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Blasco-Turrión S, Gómez-López A, Morales-Ponce FJ, Casquero-Domínguez S, del Pozo-Contreras R. What eyes do not see the heart does not grieve over? The role of intracoronary imaging in acute myocardial infarction: a case report. Eur Heart J Case Rep 2023; 7:ytad444. [PMID: 37719005 PMCID: PMC10504859 DOI: 10.1093/ehjcr/ytad444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
Background The evaluation of a three-dimensional structure with a two-dimensional imaging technique makes intracoronary diagnostic techniques essential, especially in the setting of acute myocardial infarction (AMI) when no apparent coronary lesions are detected. Expert consensus recommend their use in certain scenarios such as angiographically ambiguous disease and identification of the culprit lesion. Although both intravascular ultrasound and optical coherence tomography (OCT) allow the characterization of the atherosclerotic plaque and assess the immediate and long-term results of stent implantation, they have their own benefits and limitations that make them ideal for different types of coronary lesions. Case summary We present the case of a lateral ST-elevation myocardial infarction with no evident coronary lesions in angiography, in which OCT not only allowed us to confirm a diagonal branch occlusion, but it also became crucial to locate the occlusion point and to guide the procedure, allowing complete revascularization of the culprit lesion that otherwise could have been missed. Discussion To know the actual limitations of conventional coronary angiography to adequately assess coronary disease, intracoronary diagnostic techniques are key to evaluate the underlying mechanisms of the event, especially in the setting of AMI when no clear culprit lesion has been identified. They can be of great value to locate and revascularize acute occlusions that could go unnoticed on the angiogram, guiding the revascularization and stent implantation and, therefore, preventing myocardial injury that could become irreversible when coronary disease is not treated promptly.
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Affiliation(s)
- Sara Blasco-Turrión
- Interventional Cardiology Unit, Puerto Real University Hospital, Calle Romería, 7, Puerto Real, Cádiz 11510, Spain
| | - Andrea Gómez-López
- Interventional Cardiology Unit, Puerto Real University Hospital, Calle Romería, 7, Puerto Real, Cádiz 11510, Spain
| | - Francisco J Morales-Ponce
- Interventional Cardiology Unit, Puerto Real University Hospital, Calle Romería, 7, Puerto Real, Cádiz 11510, Spain
| | - Sara Casquero-Domínguez
- Interventional Cardiology Unit, Puerto Real University Hospital, Calle Romería, 7, Puerto Real, Cádiz 11510, Spain
| | - Rocío del Pozo-Contreras
- Interventional Cardiology Unit, Puerto Real University Hospital, Calle Romería, 7, Puerto Real, Cádiz 11510, Spain
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Calleja R, Mielke N, Lee R, Johnson S, Bahl A. Hemolyzed Laboratory Specimens in the Emergency Department: An Underappreciated, but Frequent Problem. J Emerg Nurs 2023; 49:744-754. [PMID: 37389514 DOI: 10.1016/j.jen.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Hemolysis of blood samples from emergency department (ED) patients leads to delays in treatment and disposition. The aim of this study is to determine the frequency of hemolysis and variables predictive of hemolysis. METHODS This observational cohort study was conducted among three institutions: academic tertiary care center and two suburban community EDs, with an annual census of over 270,000 ED visits. Data were obtained from the electronic health record. Adults requiring laboratory analysis with at least one peripheral intravenous catheter (PIVC) inserted within the ED were eligible. Primary outcome was hemolysis of lab samples and secondary outcomes included variables related to PIVC failure. RESULTS Between January 8, 2021 and May 9, 2022, 141,609 patient encounters met inclusion criteria. The average age was 55.5 and 57.5% of patients were female. Hemolysis occurred in 24,359 (17.2%) samples. In a multivariate analysis, when compared to 20-gauge catheters, smaller 22-gauge catheters had an increased odds of hemolysis (OR 1.78, 95% confidence interval (CI) 1.65-1.91; P < .001), while larger 18-gauge catheters had a lower odds of hemolysis (OR 0.94; 95% CI 0.90-0.98; P = .0046). Additionally, when compared to antecubital placement, hand/wrist placement demonstrated increased odds of hemolysis (OR 2.06; 95% CI 1.97-2.15; P < .001). Finally, hemolysis was associated with a higher rate of PIVC failure (OR 1.06; 95%CI 1.00-1.13; P = 0.043). DISCUSSION This large observational analysis demonstrates that lab hemolysis of is a frequent occurrence among ED patients. Given the added risk of hemolysis with certain placement variables, clinicians should consider catheter gauge/placement location to avoid hemolysis that may result in patient care delays and prolonged hospital stays.
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Rajan DK, Kitrou PM. Prospective, Multicenter, Observational Study to Evaluate a Cell-Impermeable Endoprosthesis for Treatment of Stenosis or Occlusion within the Dialysis Outflow Circuit of an Arteriovenous (AV) Fistula or AV Graft (The WRAP Registry). Cardiovasc Intervent Radiol 2023; 46:1285-1291. [PMID: 37592020 PMCID: PMC10533592 DOI: 10.1007/s00270-023-03531-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/29/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Dysfunctional vascular access due to stenosis/occlusion within the arteriovenous fistula or graft (AVF/AVG) negatively affects the clinical management of patients undergoing hemodialysis. Results from the feasibility study of the WRAPSODY™ Cell-Impermeable Endoprosthesis demonstrated that the device can achieve high patency rates and maintain integrity of the dialysis outflow circuit. This study was designed to assess real-world evidence of safety and efficacy outcomes following device placement. MATERIALS AND METHODS This is a prospective, multicenter, non-investigational, post-market observational study of 500 patients at up to 50 centers worldwide with a mature AVF/AVG dialysis access (≥ 1 hemodialysis session) who experience stenosis/occlusion of the outflow circuit prior to placement of WRAPSODY. Patients will be divided into the following two cohorts: peripheral or central thoracic. Primary outcome measures include target lesion primary patency (TLPP) at 6 months and procedure and/or device-related events through 30 days post-procedure. Secondary outcome measures include TLPP, safety events, and the number of interventions needed to maintain patency through the 24 month study period. Exploratory endpoints include time to access abandonment, resumption of successful dialysis, functional patency, and pending available imaging data, any incidence of stent fractures, migration, or edge stenosis. Study enrollment began in June 2022, the last patient visit is expected in 2026. DISCUSSION It is expected that this study will provide real-world evidence regarding the performance of the WRAPSODY device in a diverse population of patients, which may encourage its use in the continuum of hemodialysis access management. TRIAL REGISTRATION NCT05062291.
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Affiliation(s)
- Dheeraj K Rajan
- Department of Medical Imaging, University Medical Imaging Toronto/University of Toronto, University Health Network, 585 University Avenue, 1-PMB-287, Toronto, ON, M5G 2N2, Canada.
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Sghaier A, Mraidha MH, Jarrar MS, Gaddour M, Elghali MA, Youssef S. An unusual etiology of acute intestinal occlusion: The swallowed missing dentures a case reports and literature review. Int J Surg Case Rep 2023; 110:108770. [PMID: 37660490 PMCID: PMC10510072 DOI: 10.1016/j.ijscr.2023.108770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Denture swallowing is an uncommon incident. However, it should be suspected in edentulous elderly patients who wear removable dentures which are poorly cared for and maintain. The existence of neuro-psychiatric disorders may contribute to the occurrence of this adverse event. CASE PRESENTATION We report the case of an 85-years-old woman admitted to emergency with acute intestinal occlusion. The investigations concluded that the bowel was obstructed by a foreign body blocked in the terminal ileum. There was a high suspicion that his dental prosthesis had been swallowed. Removal of the dental prosthesis was achieved surgically after laparotomy. DISCUSSION Foreign bodies in the esophagus could be responsible of a variety of symptoms, including dysphagia, airway obstruction and even perforation. In the gastrointestinal tract foreign bodies may be responsible of fewer specific symptoms, including abdominal pain, melena or perforation. The blockage will occur in anatomical strictures. At the most appropriate situations, removal should be performed through endoscopy, although in case of failure of procedure or complication, surgery will be unavoidable. CONCLUSION Ingestion of a dental or other foreign object is a clinical condition that is more common in pediatric populations, but is very rare in healthy individuals. Denture swallowing is insidious in itself and may lead to a complicated course, if not properly managed. Although most of these can be conservative, careful monitoring is necessary to avoid such adverse event.
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Affiliation(s)
- Asma Sghaier
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty of Medicine of Sousse, University of Sousse, Tunisia; Department of general surgery, Tunisia.
| | - Mohamed Hédi Mraidha
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty of Medicine of Sousse, University of Sousse, Tunisia; Department of general surgery, Tunisia
| | - Mohamed Salah Jarrar
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty of Medicine of Sousse, University of Sousse, Tunisia; Departement of anatomy, Tunisia
| | - Mariem Gaddour
- Faculty of Medicine of Sousse, University of Sousse, Tunisia; Hospital of Sahloul, Tunisia; Departement of physical medicine and functional rehabilitation, Tunisia
| | - Mohamed Amine Elghali
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty of Medicine of Sousse, University of Sousse, Tunisia; Department of general surgery, Tunisia
| | - Sabri Youssef
- Hospital of Farhat Hached of Sousse, Tunisia; Faculty of Medicine of Sousse, University of Sousse, Tunisia; Department of general surgery, Tunisia
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Gerasimidou O, Millar BJ, Watson TF. Changes in Tooth Mobility and Position in an Established Dentition Following Placement of a New Restoration. Eur J Prosthodont Restor Dent 2023; 31:239-247. [PMID: 37382357 DOI: 10.1922/ejprd_2420gerasimidou09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 03/02/2023] [Indexed: 06/30/2023]
Abstract
The aim of this study is to examine and evaluate physiologic tooth mobility and movement in different groups of patients. Four groups of patients were examined and recordings were taken. Group A1 consisted of 12 undergraduate students under the age of 30, A2 consisted of 11 members of staff over the age of 30 and A3 consisted of 9 patients with periodontal disease between the ages of 40-65 years old. The fourth Group B, 14 patients between 30-70 years old, received single-tooth restorations and recordings were taken immediately after, a month and four months following the cementation of the restoration. Patients in the first 3 groups showed no significant change in tooth mobility and movement between appointments. The fourth group demonstrated a non-statistically significant increase in tooth mobility following the cementation of the restoration due to the force applied on the occlusal surface of the tooth during the cementation process, while tooth movement was not observed beyond that of physiological tooth migration. Regardless of the age or the restorations a patient receives over the years, with careful occlusal consideration, no significant changes in tooth mobility and movement should be observed.
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Affiliation(s)
- O Gerasimidou
- Operative Dentistry, Aristotle University of Thessaloniki, School of Health Sciences, School of Dentistry, Thessaloniki, Greece
| | - B J Millar
- Restorative Dentistry, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - T F Watson
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Hoa TQ, Cuong NN, Hoan L, Hoang N, Long H, Luu DT, Hoan NC. Occlusion of thoracic duct stent resulting in recurrent chyluria: role of renal-lymphatic fistula embolization. CVIR Endovasc 2023; 6:39. [PMID: 37548780 PMCID: PMC10406733 DOI: 10.1186/s42155-023-00387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Thoracic duct (TD) stenting is considered a treatment option for certain pathological conditions caused by TD obstruction, such as chyluria. Several studies have reported on the efficacy of TD stent treatment for both obstructive and leakage condition of TD, but few have evaluated the stent patency. This report aims to describe the patency of TD stent and the effectiveness of renal-lymphatic fistula embolization in the treatment of chyluria. CASE PRESENTATION We report a case of chyluria treated by TD stent previously, stent was placed at the TD venous junction four months before the symptoms recurred. At the second intervention we found the stent was obstructed by debris. We recanalized the stent and successfully catheterised the microcatheter through the stent retrograde into the TD then into the renal-lymphatic fistula branch. After embolization of that abnormal branch, the recurrent chyluria was treated and no further episode of chyluria was occurred during 12 months follow up. CONCLUSION Stent in the TD may be occluded by debris. Embolization of renal-lymphatic fistula might be the most important treatment for spontaneous chyluria.
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Affiliation(s)
- Tran Quoc Hoa
- Surgery Urology, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Nguyen Ngoc Cuong
- Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam.
- Diagnostic Imaging and Interventional Center, Hanoi Medical University Hospital, No1, Ton That Tung, Dong Da, Hanoi, Vietnam.
| | - Le Hoan
- Respiratory Department, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Hoang
- Surgery Department, Hanoi Medical University, Hanoi, Vietnam
| | - Hoang Long
- Surgery Urology, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Doan Tien Luu
- Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Nguyen Cong Hoan
- Outpatient Department, Hanoi Medical University Hospital, Hanoi, Vietnam
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Salih M, Ibrahim R, Eljack A, Sayfo S. Successful Revascularization of Critical Limb Ischemia: A Challenging Case of a Unilateral Tibial-to-Tibial Intervention. Cardiovasc Revasc Med 2023; 53S:S194-S198. [PMID: 36804304 DOI: 10.1016/j.carrev.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/05/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
Critical limb ischemia requires urgent diagnosis and intervention. Limitations to percutaneous revascularization therapy stem from multilevel diseased vasculature. Retrograde revascularization utilizing anterior tibial artery access in complex and proximal lesions is an alternative route for intervention that can lead to limb salvage and symptom resolution.
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Affiliation(s)
- Mohammed Salih
- Baylor University Medical Center, The Heart Hospital, 1100 Allied Drive, Plano, TX 75093, United States of America.
| | - Ramzi Ibrahim
- Department of Medicine, Banner University Medical Center-University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, United States of America
| | - Ammar Eljack
- Baylor University Medical Center, The Heart Hospital, 1100 Allied Drive, Plano, TX 75093, United States of America
| | - Sameh Sayfo
- Baylor University Medical Center, The Heart Hospital, 1100 Allied Drive, Plano, TX 75093, United States of America
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Cmejla R, Novotny M, Rusz J, Tykalova T, Vimr J, Hlavnicka J. The automated screening of speech motor development in children based on the sequential motion rate. Comput Biol Med 2023; 162:107086. [PMID: 37290387 DOI: 10.1016/j.compbiomed.2023.107086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/28/2023] [Accepted: 05/27/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Motor skills in children have traditionally been examined via challenging speech tasks such as syllable repetition, and calculating the syllabic rate using a stopwatch or by inspecting the oscillogram followed by a laborious comparison of the scores on a look-up table representing the typical performances of children of the given age and sex. As the commonly used performance tables are over-simplified to allow for manual scoring, we raise the question of whether a computational model of motor skills development could be more informative, and could allow for the automated screening of children to detect underdeveloped motor skills. METHODS We recruited a total of 275 children aged four to 15 years. All the participants were native Czech speakers with no history of hearing or neurological impairments. We recorded each child's performance of/pa/-/ta/-/ka/syllable repetition. Various parameters of diadochokinesis (DDK; DDK rate, DDK regularity, voice onset time [VOT] ratio, syllable, vowel and VOT duration) were investigated in the acoustic signals using supervised reference labels. Female and male participants were analyzed separately by comparing younger, middle, and older age groups of children via ANOVA. Finally, we implemented a fully automated model that estimated the developmental age of a child based on the acoustic signal, and evaluated its accuracy using Pearson's correlation coefficient and normalized root-mean-squared errors (RMSEs). RESULTS The DDK rate reflected the ages of the children proportionally (p < 0.001). Other DDK parameters also showed strong sensitivity to age (p < 0.001), with the exception of VOT duration, which had a smaller effect (p = 0.091). The effect of age was found to be sex specific for the syllable length (p < 0.001) and DDK rate (p = 0.003). We observed that females spoke more slowly and had a longer VOT at preschool age (p < 0.001). The DDK rate obtained via the automated algorithm was strongly correlated with the reference (p < 0.001, Pearson's correlation coefficient of 0.97), with a low normalized RMSE of 3.77%. CONCLUSIONS As children develop their motor skills, they are capable of shortening the vowels to increase the rate of syllabic repetitions. The nonlinear development in childhood and adolescence, with a steady state in adulthood, follows a logistic function for the DDK rate. This study demonstrates that the development of motor skills can be examined sensitively and more appropriately by a fully automated noninvasive procedure that also accounts for the dispersion of values within age brackets.
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Affiliation(s)
- Roman Cmejla
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
| | - Michal Novotny
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Vimr
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Hlavnicka
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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Semerci R, Bingöl H, Bay Büyükkapu S, Kudubes AA, Bektaş M, Kebudi R. Comparison of Heparin and Saline for Prevention of Central Venous Catheter Occlusion in Pediatric Oncology: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151426. [PMID: 37147152 DOI: 10.1016/j.soncn.2023.151426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The management of central venous catheter (CVC) occlusion remains an area without clear evidence-based guidelines. Studies have been conducted that compare the use of heparin and normal saline for reducing thrombosis, but the evidence is not strong enough to suggest a significant advantage of one over the other. Therefore, the study aimed to assess the effectiveness of heparin and normal saline flushing in preventing CVC occlusion in pediatric patients with cancer. DATA SOURCES A comprehensive search was conducted in PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Embase, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov platform using specific keywords. The search was conducted until March 2022. Five randomized controlled trials are included in this study. CONCLUSION Five studies with a total of 316 pediatric cancer patients met the inclusion criteria. The studies were found to be heterogeneous due to variations in the types of cancer, heparin concentration, flushing frequency of CVCs, and methods used to measure occlusion. Despite these differences, there was no significant difference in the effect of flushing with heparin and normal saline in preventing CVC occlusion. The analysis revealed that normal saline is as effective as heparin in preventing CVC occlusion among pediatric cancer patients. IMPLICATIONS FOR NURSING PRACTICE This systematic review and meta-analysis demonstrated that there is no significant difference between the use of heparin and normal saline flushing in preventing CVC occlusion among pediatric cancer patients. Considering the potential risks of heparin, the use of normal saline flushing may be recommended to prevent CVC obstruction.
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Affiliation(s)
| | - Hülya Bingöl
- Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, İstanbul, Turkey
| | - Sema Bay Büyükkapu
- Pediatric Hematology-Oncology, Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Aslı Akdeniz Kudubes
- Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Murat Bektaş
- Pediatric Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey
| | - Rejin Kebudi
- Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, İstanbul, Turkey
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Lüke JN, Reinking N, Dietlein TS, Haendel A, Enders P, Lappas A. Intraoperative primary partial occlusion of the PreserFlo MicroShunt to prevent initial postoperative hypotony. Int Ophthalmol 2023; 43:2643-2651. [PMID: 36905460 PMCID: PMC10371896 DOI: 10.1007/s10792-023-02664-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE The aim of the underlying study was to present a new surgical method in PreserFlo MicroShunt surgery for glaucoma. A removable polyamide suture was placed into the lumen of the MicroShunt during implantation to prevent early postoperative hypotony. METHODS Thirty-one patients undergoing stand-alone glaucoma surgery with implantation of a PreserFlo MicroShunt and an intraluminal occlusion were retrospectively reviewed and compared to a control group without occlusion. Inclusion criteria were diagnosis of primary open-angle glaucoma or secondary open-angle glaucoma due to pseudoexfoliation or pigment dispersion. Patients with a history of filtrating glaucoma surgery were excluded. RESULTS IOP decreased from 26.9 ± 6.6 to 18.0 ± 9.5 mmHg at the first postoperative day after PreserFlo MicroShunt implantation. Postoperative removal of the occluding suture resulted in a mean IOP reduction in 11.1 ± 7.6 mmHg. Mean visual acuity was 0.43 ± 0.24 logMAR during the first postoperative examination. The interval with the occluding intraluminal suture in place varied from days to 2-3 weeks. Patients were followed up to 1 year. CONCLUSION Implantation of a PreserFlo MicroShunt combined with an intraluminal suture prevented postoperative hypotony in all patients. Mean postoperative pressure was reduced despite the occluding suture in place.
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Affiliation(s)
- Jan Niklas Lüke
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Niklas Reinking
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Thomas S Dietlein
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Alexander Haendel
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Philip Enders
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Alexandra Lappas
- Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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De Simone A, La Rocca V, Agresta A, Maiorino M, Malacrida M, Ricciolino R. Pressure guided pulmonary vein isolation by means of a novel cryoballoon technology for the management of complex anatomy: A case report. HeartRhythm Case Rep 2023; 9:569-572. [PMID: 37614383 PMCID: PMC10444553 DOI: 10.1016/j.hrcr.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
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Attanasi ML, Bou Daher H, Rockey DC. Natural History and Outcomes of Cavernous Transformation of the Portal Vein in Cirrhosis. Dig Dis Sci 2023; 68:3458-3466. [PMID: 37349605 DOI: 10.1007/s10620-023-07993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND AIMS Cavernous transformation of the portal vein can occur after portal vein thrombosis (PVT). In this study, we investigated clinical complications associated with cavernous transformation in the context of cirrhosis and PVT. METHODS In this retrospective cohort analysis, 204 patients with cirrhosis and PVT with or without cavernous transformation were identified using MUSC's Clinical Data Warehouse between January 1, 2013, through December 31, 2019. Complete demographic data, clinical history, and laboratory tests were abstracted from the electronic medical record. RESULTS Of 204 patients, 41 (20%) had cavernous transformation. MELD, Child-Pugh, and Charlson Comorbidity Index scores were similar among groups. There were no significant differences in the prevalence of esophageal varices (with or without bleeding), splenomegaly, or hepatic encephalopathy in patients with and without cavernous transformation, although ascites tended to be lower in patients with cavernous transformation (31/41 (76%) vs 142/163 (87%), p = 0.06). Patients with cavernous transformation were significantly less likely to have hepatocellular carcinoma (HCC) (13/41 (32%) vs 81/163 (50%), p < 0.05) and had significantly lower APRI (1.4 vs 2.0, p < 0.05) and Fib-4 (4.7 vs 6.5, p < 0.05). Patients with cavernous transformation had lower 5-year mortality (12/41 (29%) vs 81/163 (49%) died, p = 0.06). The 10-year mortality of patients with cavernous transformation without HCC was significantly lower than in those without cavernous transformation (8/28 (29%) vs 46/82 (56%), respectively, p < 0.05). CONCLUSIONS Patients with cavernous transformation appeared to have better outcomes than those without cavernous transformation.
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Affiliation(s)
- Michael L Attanasi
- Digestive Disease Research Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Clinical Sciences Building, Suite 908, Charleston, SC, 29425, USA
| | - Halim Bou Daher
- Digestive Disease Research Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Clinical Sciences Building, Suite 908, Charleston, SC, 29425, USA
| | - Don C Rockey
- Digestive Disease Research Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Clinical Sciences Building, Suite 908, Charleston, SC, 29425, USA.
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Serafin M, Fastuca R, Zecca PA, Lagravère M, Caprioglio A. 3D occlusal changes of upper first molars after rapid maxillary expansion on permanent versus deciduous teeth: a retrospective multicenter CBCT study. Prog Orthod 2023; 24:24. [PMID: 37518579 PMCID: PMC10387462 DOI: 10.1186/s40510-023-00476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 05/19/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the three-dimensional dental changes for the maxillary first molars and the overall skeletal effects achieved after expansion between the rapid maxillary expansion (RME) appliance attached to two different anchor units, the maxillary deciduous molars and the maxillary permanent first molars. METHODS Patients were retrospectively selected according to the anchorage unit used for RME: deciduous upper second molars (RME-E group; 10 M, 10 F; mean age 8.4 ± 1.1 years) and first upper permanent molars (RME-6 group; 10 M, 10 F; mean age 12.6 ± 1.8 years). CBCT scans were obtained before treatment start (T1) and after retention and removal of the expander (T2). Images were analyzed using a new three-dimensional intra-hemi-maxillary reference system. 3D landmarks were marked to calculate all changes on maxillary first permanent molars; mesio-distal and buccal-lingual inclination and rotation, as well as intermolar and interforaminal distances were calculated. The Wilcoxon test was used to compare within-group changes, whereas the Mann-Whitney test was used to compare between-group differences, with the significance level set at 0.05. RESULTS In the RME-E group, significant distorotation and lingual inclination of the first permanent molars at T2 were observed (p < 0.01); in the RME-6 group, only the buccolingual inclination of the crossbite side after RME was resulted statistically significant (p < 0.01). In both groups, intermolar and interforaminal values increased significantly (p < 0.01). Intergroup analysis showed a significantly higher distorotation and reduced buccal inclination of maxillary first permanent molars in the RME-E group after RME (p < 0.01). CONCLUSIONS RME is effective in treating maxillary transverse hypoplasia; RME anchored too deciduous teeth spontaneously reduces buccal inclination and increases distorotation of maxillary first permanent molars, whereas anchorage to permanent molars is associated with increased buccal inclination, albeit with little clinical significance.
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Affiliation(s)
- Marco Serafin
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | - Piero Antonio Zecca
- Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy
| | - Manuel Lagravère
- Orthodontics Department, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Alberto Caprioglio
- Department of Biomedical, Surgical and Dental Sciences, Section of Orthodontics, University of Milan, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Kakali L, Halazonetis DJ. A novel method for testing accuracy of bite registration using intraoral scanners. Korean J Orthod 2023; 53:254-263. [PMID: 37497582 PMCID: PMC10387426 DOI: 10.4041/kjod22.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/20/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
Objective The evidence on the accuracy of bite registration using intraoral scanners is sparse. This study aimed to develop a new method for evaluating bite registration accuracy using intraoral scanners. Methods Two different types of models were used; 10 stone models and 10 with acrylic resin teeth. A triangular frame with cylindrical posts at each apex (one anterior and two posteriors) was digitally designed and manufactured using three-dimensional (3D) printing. Such a structure was fitted in the lingual space of each maxillary and mandibular model so that, in occlusion, the posts would contact their opposing counterparts, enforcing a small interocclusal gap between the two arches. This ensured no tooth interference and full contact between opposing posts. Bite registration accuracy was evaluated by measuring the distance between opposing posts, with small values indicating high-accuracy. Three intraoral scanners were used: Medit i500, Primescan, and Trios 4. Viewbox software was used to measure the distance between opposing posts and compute roll and pitch. Results The average maximum error in interocclusal registration exceeded 50 μm. Roll and pitch orientation errors ranged above 0.1 degrees, implying an additional interocclusal error of around 40 μm or more. The models with acrylic teeth exhibited higher errors. Conclusions A method that avoids the need for reference hardware and the imprecision of locating reference points on tooth surfaces, and offers simplicity in the assessment of bite registration with an intraoral scanner, was developed. These results suggest that intraoral scanners may exhibit clinically significant errors in reproducing the interocclusal relationships.
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Affiliation(s)
- Lydia Kakali
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Demetrios J Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Jha S, Singhal R, Goel N, Namdev R. Modified Cap Splint: A Novel Approach to Treating Delayed Mandibular Fracture in Pediatric Patients. Int J Clin Pediatr Dent 2023; 16:645-648. [PMID: 37731795 PMCID: PMC10507306 DOI: 10.5005/jp-journals-10005-2643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Mandibular fractures in children, when compared to adults are quite less common. The treatment approaches for mandibular fractures differ in children due to their growth and developing dentition. Minimal manipulation of bony architecture is done to achieve a stable position. Thus a closed reduction is preferred in children. This article presents a case of an 8-year-old boy, mandibular left parasymphysis fracture with displacement of the left dentoalveolar segment which was managed by a novel treatment approach using a unilateral cap splint with interelastic traction. How to cite this article Jha S, Singhal R, Goel N, et al. Modified Cap Splint: A Novel Approach to Treating Delayed Mandibular Fracture in Pediatric Patients. Int J Clin Pediatr Dent 2023;16(4):645-648.
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Affiliation(s)
- Shruti Jha
- Department of Pediatric and Preventive Dentistry, Subharti Dental College & Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Ruchi Singhal
- Department of Pedodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Nancy Goel
- Department of Pedodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Ritu Namdev
- Department of Pedodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
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Thang LM, Cuong TC, Huy NDN, Giang NL, Hung NQ, Dang NH, Diem TNT, Tinh NT, Duc NM. Successful thrombectomy of top-of-the-basilar artery occlusion - difficult to detect in clinical practice: A case report. Radiol Case Rep 2023; 18:2427-2433. [PMID: 37214326 PMCID: PMC10196757 DOI: 10.1016/j.radcr.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/18/2023] [Accepted: 04/05/2023] [Indexed: 05/24/2023] Open
Abstract
Top-of-the-basilar artery occlusion frequently causes infarction of the midbrain, thalamus, and portions of the temporal and occipital lobes as the vascular supply of these regions comes from the posterior communicating and posterior cerebral arterial tributaries of the basilar artery. Clinical signs include an array of visual, oculomotor, and behavioral abnormalities, usually without prominent motor dysfunction, which makes diagnosis challenging for those inexperienced with these sign. We describe a 59-year-old male presenting with acute ischemic stroke due to top-of-the-basilar artery occlusion. Despite attempting several paraclinical examinations relating the sudden coma with Glasgow Coma Scale of 6 points, the neuroimaging detected the large vessel occlusion that was difficult to recognize. After confirming top-of-the-basilar artery occlusion, the recanalization was realized immediately. The patient was discharged with good clinical recovery.
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Affiliation(s)
- Le Minh Thang
- Digital Subtraction Angiography Unit, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Tran Chi Cuong
- Digital Subtraction Angiography Unit, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Dao Nhat Huy
- Digital Subtraction Angiography Unit, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Luu Giang
- Digital Subtraction Angiography Unit, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Quang Hung
- Department of Surgery, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Hai Dang
- Department of Surgery, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Ton Nu Thi Diem
- Department of Surgery, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Trung Tinh
- Department of Surgery, Can Tho S.I.S General Hospital, Can Tho, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Ward 12 District 10, Ho Chi Minh City, Vietnam
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Bardellini E, Amadori F, Garo ML, Majorana A, Conti G. Is there any correlation between otitis media and dental mal occlusion in children? A systematic review. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00807-0. [PMID: 37338742 PMCID: PMC10382365 DOI: 10.1007/s40368-023-00807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/15/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aims to evaluate whether there is a correlation between otitis and dental malocclusions. METHODS Electronic databases were searched for observational studies published until July 2021 without language or time restrictions. PROSPERO CRD42021270760. Observational studies on children with and without OM and/or malocclusion were included. After removing duplicates and excluding not-eligible articles, two reviewers screened relevant articles independently. Two reviewers independently extracted data and assessed data quality and validity through the Newcastle-Ottawa Scale (NOS) quality assessment tool for non-randomized studies. RESULTS Five studies met the selection inclusion criteria and were included in the studies for a total of 499 patients. Three studies investigated the relationship between malocclusion and otitis media, while the remaining two studies analyzed the inverse relationship and one of them considered eustachian tube dysfunction as a proxy of OM. An association between malocclusion and otitis media and vice versa emerged, although with relevant limitations. CONCLUSION There is some evidence that there is an association between otitis and malocclusion; however, it is not yet possible to establish a definitive correlation.
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Affiliation(s)
- E Bardellini
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy.
| | - F Amadori
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - M L Garo
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - A Majorana
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - G Conti
- University of Insubria, Varese, Italy
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Grieb D, Meila D, Sommer CM, Schulz K, Abu-Fares O, Donnerstag F, Schlunz-Hendann M, Lanfermann H, Boxberg F. Feasibility and safety of ADAPT in acute distal posterior cerebral artery occlusions. Eur J Radiol 2023; 165:110936. [PMID: 37354767 DOI: 10.1016/j.ejrad.2023.110936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE The direct aspiration first pass technique (ADAPT) is an effective and safe endovascular treatment for distal medium vessel occlusions (DMVO) of the anterior circulation. Clinical experience with ADAPT in the distal posterior circulation, however, is still limited and published data is scarce. In this original work, feasibility, safety and efficacy of ADAPT with distal access catheters (DAC) for treatment of acute distal posterior cerebral artery occlusions (DPCAOs) is evaluated. METHOD All acute ischemic stroke patients between 2017 and 2022 with primary or secondary DPCAOs in the P2 or P3 segment, that underwent thrombectomy of the DPACO using ADAPT with DACs as frontline therapy, were identified. Demographic data, recanalization rates, procedural safety, and clinical outcome were assessed. RESULTS Twenty-four patients with primary (n = 6) or secondary (n = 18) DPCAOs (P2: 21/24; P3: 3/24) were included. Median NIHSS score at admission was 14.5 (IQR 9.5). In all cases, the DPCAO could be reached with the DAC. Successful revascularization (DMVO-p-TICI ≥ 2b) with ADAPT was achieved in 79.2% (19/24), including a first pass effect of 62.5% (15/24), leading to complete recanalization (DMVO-p-TICI 3). Median number of passes was 1 (range 1-2). No complications related to distal PCA aspiration thrombectomy occurred. Median NIHSS and mRS scores at discharge were 4 (IQR 8) and 3 (IQR 2), respectively. CONCLUSIONS ADAPT appears to be feasible, safe and effective for the treatment of acute DPCAOs in the setting of different occlusion patterns. High revascularization rates without procedural complications can be achieved. Further studies are needed to consolidate these results.
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Affiliation(s)
- Dominik Grieb
- Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany; Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany.
| | - Dan Meila
- Department of Interventional Neuroradiology, Johanna-Étienne-Hospital, Neuss, Germany; Department of Diagnostic and Interventional Radiology, Helios Klinikum Krefeld, Krefeld, Germany
| | - Christof-Matthias Sommer
- Clinic of Neuroradiology, Stuttgart Clinics, Stuttgart, Germany; Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Schulz
- Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany
| | - Omar Abu-Fares
- Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany
| | - Frank Donnerstag
- Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany
| | | | - Heinrich Lanfermann
- Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany
| | - Frederik Boxberg
- Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany
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50
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Ding WY, Lip GYH, Gupta D. Left Atrial Appendage Occlusion-A Choice or a Last Resort? How to Approach the Patient. Card Electrophysiol Clin 2023; 15:133-140. [PMID: 37076225 DOI: 10.1016/j.ccep.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Left atrial appendage (LAA) occlusion is emerging as a viable alternative to oral anticoagulation in high-risk patients with atrial fibrillation. However, there remains limited evidence for this approach, especially in certain subgroups, and therefore patient selection is an important aspect of treatment. Here, the authors present arguments for LAA occlusion as either a last resort versus patient choice by evaluating contemporary studies on this topic and discuss practical steps in the approach of patients who may be suitable for LAA occlusion. Overall, an individualized and multidisciplinary team approach should be adopted in patients who are being considered for LAA occlusion.
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Affiliation(s)
- Wern Yew Ding
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dhiraj Gupta
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
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