
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rYGt7t
The aim of this study was to evaluate whether a correlation exists between temporal bone pneumatization and the morphology of the articular eminence and glenoid fossa. A sample of 100 cone beam computed tomography scans was used, for a total of 200 temporomandibular joints (TMJ). Paracoronal and parasagittal images of the TMJ were evaluated by two examiners. For all TMJ, pneumatization was classified in the mid-lateral direction using a score of 0 or 1, and in the anteroposterior direction using a score ranging from 0 to 3. (Source: International Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GKtvVn
The aim of this study was to evaluate whether a correlation exists between temporal bone pneumatization and the morphology of the articular eminence and glenoid fossa. A sample of 100 cone beam computed tomography scans was used, for a total of 200 temporomandibular joints (TMJ). Paracoronal and parasagittal images of the TMJ were evaluated by two examiners. For all TMJ, pneumatization was classified in the mid-lateral direction using a score of 0 or 1, and in the anteroposterior direction using a score ranging from 0 to 3. (Source: International Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GKtvVn
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
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In this review we describe the evidence base for postoperative analgesia after maxillofacial surgery. We discuss the implications of poorly managed pain, risk factors for the development of severe pain, and pharmacological and non-pharmacological analgesic strategies to manage it. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ENUlJk
Simulation is an important way both to optimise a trainee 's learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees' opinions of it was made in February 20 18, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ES7Okr
Introduction/Aims: Staging of Head and Neck Cancers (HNC), have moved on greatly since their first inclusion as "Buccal", "Pharynx" and "Larynx". The staging systems have evolved to incorporate Tumour Biology, Cancer Behaviour and the emergence of new stains of disease. The 8th Edition was introduced on the 1st of January 2018, with many centres including Glasgow phasing its introduction alongside TNM from October 2017. One of three new schema introduced includes HPV p16-mediated oropharyngeal carcinoma (OPC). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQqHmO
The aim of this study was to analyse and compare the biomechanical properties of 3 internal fixation techniques (2.0mm bi-cortical screws, 2.0mm miniplate and 1.7mm miniplate) in mandibular sagittal split osteotomy (SSO). A 3-D hemi-mandible model was developed from a patient's skull CT. It underwent sagittal split osteotomy (SSO) virtually and was reproduced 9 models consisting of the 3 fixation techniques with mandibular movements of 3mm setback, 3mm advancement, and 7mm advancement. Bite forces applied were 50, 75, and 100N for the incisors, and 100, 200 and 300N for the molars. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EUrlQ6
Introduction: Penetrating trauma to the head and neck presents specific diagnostic and therapeutic challenges. Aetiologies includes interpersonal violence (IPV), deliberate self-harm (DSH) and terror-related violence (TRV). Data from a Major Trauma Centre which straddles the two boroughs with the highest incidence of violent knife crime in the country will be presented, including data of victims of a major terrorist attack in 2017. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETGgei
Introduction: Radiological staging of head and neck (H&N) cancer patients is essential to direct clinical management. Extended cross-sectional imaging facilitates pre-operative planning and acts as prognostic factor. The extension of head and neck staging scan below the neck region may provide extra information. We aimed to identify the incidence of findings below the neck, in an extended field. The significance of these were to be analyzed. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERnqDG
The aesthetics industry is booming, with the increased social acceptance of having non-surgical treatments undertaken and the more affordable costs in doing so. In all branches of medicine, clinicians are being pursued to attend courses to allow them to be part of this sub-specialist area injecting neurotoxins and other materials on a non-permanent basis. Whilst, a form of regulation is being promoted via the RCS England aesthetics accreditation scheme, this remains a poorly governed area of practice, and those providing the training are also currently unregulated. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ESzN2j
Introduction: In the last decade, there has been a growing number of older patients (above 35) undergoing orthognathic surgery. Previous studies have looked at the complication rates related to orthognathic surgery in older patients and compared outcomes with a younger cohort. We aimed to look at the satisfaction of older patients undergoing orthognathic surgery at their 5-year follow-up. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETq64v
Background: King's College London (KCL) offers the only three-year dental-programme for medical graduates within Europe. It produces a significant proportion ofST3 applicants for OMFS training. Now in its tenth year, we have conducted a retrospective study looking at various parameters. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQq9NM
Introduction: The role of virtual planning in orthognathic surgery is well documented. We aim to highlight what further information is available to help optimise patient outcomes. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe63z
In this review we describe the evidence base for postoperative analgesia after maxillofacial surgery. We discuss the implications of poorly managed pain, risk factors for the development of severe pain, and pharmacological and non-pharmacological analgesic strategies to manage it. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ENUlJk
Simulation is an important way both to optimise a trainee 's learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees' opinions of it was made in February 20 18, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ES7Okr
Introduction/Aims: Staging of Head and Neck Cancers (HNC), have moved on greatly since their first inclusion as "Buccal", "Pharynx" and "Larynx". The staging systems have evolved to incorporate Tumour Biology, Cancer Behaviour and the emergence of new stains of disease. The 8th Edition was introduced on the 1st of January 2018, with many centres including Glasgow phasing its introduction alongside TNM from October 2017. One of three new schema introduced includes HPV p16-mediated oropharyngeal carcinoma (OPC). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQqHmO
Introduction: Melanotic Neuroectodermal Tumours of Infancy (MNTI) are particularly rare and although predominantly benign in nature, behave in an aggressive and locally infiltrative manner. Presenting most often in the first year of life and with surgical resection the accepted management, prompt diagnosis and treatment are critical in reducing morbidity in the early stages of each child's development. Here we aim to illustrate the lessons we have learnt from managing these tumours at Great Ormond Street Hospital (GOSH). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe8bH
The aim of this study was to analyse and compare the biomechanical properties of 3 internal fixation techniques (2.0mm bi-cortical screws, 2.0mm miniplate and 1.7mm miniplate) in mandibular sagittal split osteotomy (SSO). A 3-D hemi-mandible model was developed from a patient's skull CT. It underwent sagittal split osteotomy (SSO) virtually and was reproduced 9 models consisting of the 3 fixation techniques with mandibular movements of 3mm setback, 3mm advancement, and 7mm advancement. Bite forces applied were 50, 75, and 100N for the incisors, and 100, 200 and 300N for the molars. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EUrlQ6
Introduction: Penetrating trauma to the head and neck presents specific diagnostic and therapeutic challenges. Aetiologies includes interpersonal violence (IPV), deliberate self-harm (DSH) and terror-related violence (TRV). Data from a Major Trauma Centre which straddles the two boroughs with the highest incidence of violent knife crime in the country will be presented, including data of victims of a major terrorist attack in 2017. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETGgei
Introduction: Radiological staging of head and neck (H&N) cancer patients is essential to direct clinical management. Extended cross-sectional imaging facilitates pre-operative planning and acts as prognostic factor. The extension of head and neck staging scan below the neck region may provide extra information. We aimed to identify the incidence of findings below the neck, in an extended field. The significance of these were to be analyzed. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERnqDG
Introduction: Rural and urban differences in presentation of patients with cancer have been demonstrated at our centre, but have not yet been demonstrated in orthognathic surgery patients. We hypothesised that patients from areas further from our hospital face higher costs to attend, and may not present with minor problems as often as patients who live close to the hospital. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETjSlq
(Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EOsUiO
Introduction: In January 2016, the National Institute of Health and Care Excellence (NICE) recommended that patients with cT1-T2 N0 oral cancer not requiring reconstruction should be offered sentinel node biopsy (SNB). At that time three units in the UK were routinely offering SNB. With this in mind a national training program was created to facilitate quality assured training for head and neck units nationwide. This review appraises the process and progress of training in the UK. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EVBahy
The aesthetics industry is booming, with the increased social acceptance of having non-surgical treatments undertaken and the more affordable costs in doing so. In all branches of medicine, clinicians are being pursued to attend courses to allow them to be part of this sub-specialist area injecting neurotoxins and other materials on a non-permanent basis. Whilst, a form of regulation is being promoted via the RCS England aesthetics accreditation scheme, this remains a poorly governed area of practice, and those providing the training are also currently unregulated. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ESzN2j
Introduction: In the last decade, there has been a growing number of older patients (above 35) undergoing orthognathic surgery. Previous studies have looked at the complication rates related to orthognathic surgery in older patients and compared outcomes with a younger cohort. We aimed to look at the satisfaction of older patients undergoing orthognathic surgery at their 5-year follow-up. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETq64v
Background: King's College London (KCL) offers the only three-year dental-programme for medical graduates within Europe. It produces a significant proportion ofST3 applicants for OMFS training. Now in its tenth year, we have conducted a retrospective study looking at various parameters. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQq9NM
Introduction: The role of virtual planning in orthognathic surgery is well documented. We aim to highlight what further information is available to help optimise patient outcomes. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe63z
Updated Date: Dec 26, 2018 EST (Source: DailyMed Drug Label Updates)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
Updated Date: Dec 26, 2018 EST (Source: DailyMed Drug Label Updates)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
BACKGROUND AND PURPOSE:
Anterior circulation large-vessel occlusion stroke, one of the most devastating stroke subtypes, is associated with substantial economic burden. We aimed to identify predictors of increased acute care hospitalization costs associated with anterior circulation large-vessel occlusion stroke.
MATERIALS AND METHODS:Comprehensive cost-tracking software was used to calculate acute care hospitalization costs for patients with anterior circulation large-vessel occlusion stroke admitted July 2012 to October 2014. Patient demographics and stroke characteristics were analyzed, including final infarct volume on follow-up neuroimaging. Predictors of hospitalization costs were determined using multivariable linear regression including subgroup cost analyses by treatment technique (endovascular, IV tPA-only, and no reperfusion therapy) and sensitivity analyses incorporating patients initially excluded due to early withdrawal of care.
RESULTS:Three hundred forty-one patients (median age, 69 years; interquartile range, 57–80 years; median NIHSS score, 16; interquartile range, 13–21) were included in our primary analysis. Final infarct volume, parenchymal hematoma, baseline NIHSS score, ipsilateral carotid stenosis, age, and obstructive sleep apnea were significant predictors of acute care hospitalization costs. Final infarct volume alone accounted for 20.87% of the total cost variance. Additionally, final infarct volume was consistently the strongest predictor of increased cost in primary, subgroup, and sensitivity analyses.
CONCLUSIONS:Final infarct volume was the strongest predictor of increased hospitalization costs in anterior circulation large-vessel occlusion stroke. Acute stroke therapies that reduce final infarct volume may not only improve clinical outcomes but may also prove cost-effective.
BACKGROUND AND PURPOSE:
Quality of visualization of treatment devices during critical stages of endovascular interventions, can directly impact their safety and efficacy. Our aim was to compare the visualization of neurointerventional procedures and treatment devices using a 194-μm pixel flat panel detector mode and a 76-μm pixel complementary metal oxide semiconductor detector mode (high definition) of a new-generation x-ray detector system using a blinded-rater study.
MATERIALS AND METHODS:Deployment of flow-diversion devices for the treatment of internal carotid artery aneurysms was performed under flat panel detector and high-definition-mode image guidance in a neurointerventional phantom simulating patient cranium and tissue attenuation, embedded with 3D-printed intracranial vascular models, each with an aneurysm in the ICA segment. Image-sequence pairs of device deployments for each detector mode, under similar exposure and FOV conditions, were evaluated by 2 blinded experienced neurointerventionalists who independently selected their preferred image on the basis of visualization of anatomic features, image noise, and treatment device. They rated their selection as either similar, better, much better, or substantially better than the other choice. Inter- and intrarater agreement was calculated and categorized as poor, moderate, and good.
RESULTS:Both raters demonstrating good inter- and intrarater agreement selected high-definition-mode images with a frequency of at least 95% each and, on average, rated the high-definition images as much better than flat panel detector images with a frequency of 73% from a total of 60 image pairs.
CONCLUSIONS:Due to their higher resolution, high-definition-mode images are sharper and visually preferred compared with the flat panel detector images. The improved imaging provided by the high-definition mode can potentially provide an advantage during neurointerventional procedures.
BACKGROUND AND PURPOSE:
Fetal MR imaging is part of the comprehensive prenatal assessment of fetuses with open spinal dysraphism. We aimed to assess the reliability of brain stem and posterior fossa measurements; use the reliable measurements to characterize fetuses with open spinal dysraphism versus what can be observed in healthy age-matched controls; and document changes in those within 1 week after prenatal repair.
MATERIALS AND METHODS:Retrospective evaluation of 349 MR imaging examinations took place, including 274 in controls and 52 in fetuses with open spinal dysraphism, of whom 23 underwent prenatal repair and had additional early postoperative MR images. We evaluated measurements of the brain stem and the posterior fossa and the ventricular width in all populations for their reliability and differences between the groups.
RESULTS:The transverse cerebellar diameter, cerebellar herniation level, clivus-supraocciput angle, transverse diameter of the posterior fossa, posterior fossa area, and ventricular width showed an acceptable intra- and interobserver reliability (intraclass correlation coefficient > 0.5). In fetuses with open spinal dysraphism, these measurements were significantly different from those of healthy fetuses (all with P < .0001). Furthermore, they also changed significantly (P value range = .01 to < .0001) within 1 week after the fetal operation with an evolution toward normal, most evident for the clivus-supraocciput angle (65.9 ± 12.5°; 76.6 ± 10.9; P < .0001) and cerebellar herniation level (–9.9 ± 4.2 mm; –0.7 ± 5.2; P < .0001).
CONCLUSIONS:In fetuses with open spinal dysraphism, brain stem measurements varied substantially between observers. However, measurements characterizing the posterior fossa could be reliably assessed and were significantly different from normal. Following a fetal operation, these deviations from normal values changed significantly within 1 week.
BACKGROUND AND PURPOSE:
The effect of gadolinium on the estimation of myelin has not been reported. The aim of the current study was to investigate the effects of gadolinium on automatic myelin and brain tissue volumetry via quantitative synthetic MR imaging.
MATERIALS AND METHODS:The study included 36 patients who were referred for brain metastases screening, and quantitative synthetic MR imaging data before and after gadolinium-based contrast agent administration were analyzed retrospectively. Brain metastases were detected in 17 patients. WM volume, GM volume, CSF volume, non-WM/GM/CSF volume, myelin volume, brain parenchymal volume, myelin fraction (myelin volume/brain parenchymal volume), and intracranial volume were estimated. T1 and T2 relaxation times, proton density, and myelin partial volume per voxel averaged across the brain parenchyma were also analyzed.
RESULTS:In patients with and without metastases after gadolinium-based contrast agent administration, measurements of WM and myelin volumes, and myelin fraction were significantly increased (+26.65 and +29.42 mL, +10.14 and +12.46 mL, +0.88% and +1.09%, respectively), whereas measurements of GM, CSF, brain parenchymal, and intracranial volumes were significantly decreased (–36.23 and –34.49 mL, –20.77 and –18.94 mL, –6.76 and –2.84 mL, –27.41 and –21.84 mL, respectively). Non-WM/GM/CSF volume did not show a significant change. T1, T2, and proton density were significantly decreased (–51.34 and –46.84 ms, –2.67 and –4.70 ms, –1.05%, and –1.28%, respectively) after gadolinium-based contrast agent administration, whereas measurements of myelin partial volume were significantly increased (+0.78% and +0.75%, respectively).
CONCLUSIONS:Gadolinium had a significant effect on the automatic calculation of myelin and brain tissue volumes using quantitative synthetic MR imaging, which can be explained by decreases in T1, T2, and proton density.
SUMMARY:
Clinical practice guidelines and clinical practice parameters are among the tools that clinicians and radiologists use to inform decision making in the diagnosis and treatment of patients. Radiologists have been urged to objectively establish their value and measurable contributions to patient care. Radiology's contribution to the health care value stream can be established in the development of sound clinical practice guidelines. Neuroradiologists have been quite active in developing clinical guidelines, particularly in collaboration with the American College of Radiology, but there is a need to increase the visibility and accessibility of such documents. Increasing access and visibility can contribute to improved patient outcomes and an improved overall quality of care.
BACKGROUND AND PURPOSE:
Anterior circulation large-vessel occlusion stroke, one of the most devastating stroke subtypes, is associated with substantial economic burden. We aimed to identify predictors of increased acute care hospitalization costs associated with anterior circulation large-vessel occlusion stroke.
MATERIALS AND METHODS:Comprehensive cost-tracking software was used to calculate acute care hospitalization costs for patients with anterior circulation large-vessel occlusion stroke admitted July 2012 to October 2014. Patient demographics and stroke characteristics were analyzed, including final infarct volume on follow-up neuroimaging. Predictors of hospitalization costs were determined using multivariable linear regression including subgroup cost analyses by treatment technique (endovascular, IV tPA-only, and no reperfusion therapy) and sensitivity analyses incorporating patients initially excluded due to early withdrawal of care.
RESULTS:Three hundred forty-one patients (median age, 69 years; interquartile range, 57–80 years; median NIHSS score, 16; interquartile range, 13–21) were included in our primary analysis. Final infarct volume, parenchymal hematoma, baseline NIHSS score, ipsilateral carotid stenosis, age, and obstructive sleep apnea were significant predictors of acute care hospitalization costs. Final infarct volume alone accounted for 20.87% of the total cost variance. Additionally, final infarct volume was consistently the strongest predictor of increased cost in primary, subgroup, and sensitivity analyses.
CONCLUSIONS:Final infarct volume was the strongest predictor of increased hospitalization costs in anterior circulation large-vessel occlusion stroke. Acute stroke therapies that reduce final infarct volume may not only improve clinical outcomes but may also prove cost-effective.
BACKGROUND AND PURPOSE:
Quality of visualization of treatment devices during critical stages of endovascular interventions, can directly impact their safety and efficacy. Our aim was to compare the visualization of neurointerventional procedures and treatment devices using a 194-μm pixel flat panel detector mode and a 76-μm pixel complementary metal oxide semiconductor detector mode (high definition) of a new-generation x-ray detector system using a blinded-rater study.
MATERIALS AND METHODS:Deployment of flow-diversion devices for the treatment of internal carotid artery aneurysms was performed under flat panel detector and high-definition-mode image guidance in a neurointerventional phantom simulating patient cranium and tissue attenuation, embedded with 3D-printed intracranial vascular models, each with an aneurysm in the ICA segment. Image-sequence pairs of device deployments for each detector mode, under similar exposure and FOV conditions, were evaluated by 2 blinded experienced neurointerventionalists who independently selected their preferred image on the basis of visualization of anatomic features, image noise, and treatment device. They rated their selection as either similar, better, much better, or substantially better than the other choice. Inter- and intrarater agreement was calculated and categorized as poor, moderate, and good.
RESULTS:Both raters demonstrating good inter- and intrarater agreement selected high-definition-mode images with a frequency of at least 95% each and, on average, rated the high-definition images as much better than flat panel detector images with a frequency of 73% from a total of 60 image pairs.
CONCLUSIONS:Due to their higher resolution, high-definition-mode images are sharper and visually preferred compared with the flat panel detector images. The improved imaging provided by the high-definition mode can potentially provide an advantage during neurointerventional procedures.
BACKGROUND AND PURPOSE:
Fetal MR imaging is part of the comprehensive prenatal assessment of fetuses with open spinal dysraphism. We aimed to assess the reliability of brain stem and posterior fossa measurements; use the reliable measurements to characterize fetuses with open spinal dysraphism versus what can be observed in healthy age-matched controls; and document changes in those within 1 week after prenatal repair.
MATERIALS AND METHODS:Retrospective evaluation of 349 MR imaging examinations took place, including 274 in controls and 52 in fetuses with open spinal dysraphism, of whom 23 underwent prenatal repair and had additional early postoperative MR images. We evaluated measurements of the brain stem and the posterior fossa and the ventricular width in all populations for their reliability and differences between the groups.
RESULTS:The transverse cerebellar diameter, cerebellar herniation level, clivus-supraocciput angle, transverse diameter of the posterior fossa, posterior fossa area, and ventricular width showed an acceptable intra- and interobserver reliability (intraclass correlation coefficient > 0.5). In fetuses with open spinal dysraphism, these measurements were significantly different from those of healthy fetuses (all with P < .0001). Furthermore, they also changed significantly (P value range = .01 to < .0001) within 1 week after the fetal operation with an evolution toward normal, most evident for the clivus-supraocciput angle (65.9 ± 12.5°; 76.6 ± 10.9; P < .0001) and cerebellar herniation level (–9.9 ± 4.2 mm; –0.7 ± 5.2; P < .0001).
CONCLUSIONS:In fetuses with open spinal dysraphism, brain stem measurements varied substantially between observers. However, measurements characterizing the posterior fossa could be reliably assessed and were significantly different from normal. Following a fetal operation, these deviations from normal values changed significantly within 1 week.
BACKGROUND AND PURPOSE:
The effect of gadolinium on the estimation of myelin has not been reported. The aim of the current study was to investigate the effects of gadolinium on automatic myelin and brain tissue volumetry via quantitative synthetic MR imaging.
MATERIALS AND METHODS:The study included 36 patients who were referred for brain metastases screening, and quantitative synthetic MR imaging data before and after gadolinium-based contrast agent administration were analyzed retrospectively. Brain metastases were detected in 17 patients. WM volume, GM volume, CSF volume, non-WM/GM/CSF volume, myelin volume, brain parenchymal volume, myelin fraction (myelin volume/brain parenchymal volume), and intracranial volume were estimated. T1 and T2 relaxation times, proton density, and myelin partial volume per voxel averaged across the brain parenchyma were also analyzed.
RESULTS:In patients with and without metastases after gadolinium-based contrast agent administration, measurements of WM and myelin volumes, and myelin fraction were significantly increased (+26.65 and +29.42 mL, +10.14 and +12.46 mL, +0.88% and +1.09%, respectively), whereas measurements of GM, CSF, brain parenchymal, and intracranial volumes were significantly decreased (–36.23 and –34.49 mL, –20.77 and –18.94 mL, –6.76 and –2.84 mL, –27.41 and –21.84 mL, respectively). Non-WM/GM/CSF volume did not show a significant change. T1, T2, and proton density were significantly decreased (–51.34 and –46.84 ms, –2.67 and –4.70 ms, –1.05%, and –1.28%, respectively) after gadolinium-based contrast agent administration, whereas measurements of myelin partial volume were significantly increased (+0.78% and +0.75%, respectively).
CONCLUSIONS:Gadolinium had a significant effect on the automatic calculation of myelin and brain tissue volumes using quantitative synthetic MR imaging, which can be explained by decreases in T1, T2, and proton density.
SUMMARY:
Clinical practice guidelines and clinical practice parameters are among the tools that clinicians and radiologists use to inform decision making in the diagnosis and treatment of patients. Radiologists have been urged to objectively establish their value and measurable contributions to patient care. Radiology's contribution to the health care value stream can be established in the development of sound clinical practice guidelines. Neuroradiologists have been quite active in developing clinical guidelines, particularly in collaboration with the American College of Radiology, but there is a need to increase the visibility and accessibility of such documents. Increasing access and visibility can contribute to improved patient outcomes and an improved overall quality of care.
ABSTRACT: Objective: The aim of this study was to assess the periodontal status of women during pregnancy attended in a maternity hospital, as well as their oral hygiene habits. Materials and Methods: The sample was composed by 100 pregnant women, ranging from their first to ninth month of pregnancy, were examined at a maternity hospital in Goiás, Brazil. They received information about oral hygiene techniques and they were submmited a periodontal examination in a dentist's office, where the Periodontal Screening and Recording (PSR) codes were verified along with bleeding on probing and tooth loss. Results: About their pregnancy period, the most (46%) were in their third trimester at the time of this study. The gingival index showed an average of 12% and 90% of the patients presented PSR Code 2. As for dental hygiene, 55% reported brushing three times a day and 48% used dental floss daily. Conclusion: The most pregnant women in the third trimester, showed a prevalence for gingivitis. They reported brushing their teeth three times a day and using dental floss daily.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AhgL2Q
ABSTRACT: Aim: The aim of this study was to evaluate the optical behavior of tooth color using CIE L*A*B* space; the teeth were subjected to novel bleaching gels containing peroxide carbamide with potassium oxalate. Materials and Method: Three different carbamide peroxide gels were experimentally fabricated. They consisted of 10% (G10), 16% (G16) and 37% (G37) concentrations. Sixty recently extracted premolars were subjected to different bleaching protocols. Color change (ΔE) was assessed using the CIE L*a*b* system after the application of each gel. The data were analyzed using one-way ANOVA with Tukey's post hoc test (α=5%) and a t-test. Results: The G10 and G16 gels exhibited an increase in ΔE*ab parameters from T0 to T1 (T0: application day of the gels. T1: 14th day measurement); a small decrease from T1 to T2 was also noted (T2: control measurement, 28th day). However, no statistically significant differences were found (p=0,22 for G10 and p=0,10 for G16). The G37 gel also exhibited an increase in ΔE*ab parameters, with similar results after the first application of 45 min, the second application of 45 min, and the third application of 45 min (T1, T2 and T3, respectively. T4: control measurement, 14th day). No statistically significant differences were observed between the three times of application (p>0,69), and an appreciable difference was noted between times T3 and T4 (p=0,000). Conclusions: The presented formulations of peroxide carbamide at 10%, 16%, and 37% are clearly effective. The G10 and G16 gels exhibited better effectiveness than the G37 gel.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SpJLfy
RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.
RESUMEN: Objetivo: Determinar los criterios de selección más usados al elegir una marca comercial de implantes dentales según odontólogos especialistas. Material y método: Se identificaron los parámetros para escoger una marca de implantes, estos se clasificaron en técnicos y mercadológicos, ordenándose en un cuestionario de tipo cerrado, valorándose por medio de escala psicométrica Likert del 1 al 5, además se incluyó una pregunta abierta. Se tomó una muestra por conveniencia de veinte odontólogos especialistas con experiencia al menos en tres marcas de implantes. Para el análisis estadístico descriptivo se usó Microsoft Excel 2011 versión para Mac, utilizando medidas de tendencia central como la Media Aritmética y Moda. Los parámetros técnicos se clasificaron de 1a hasta 1i, mercadológicos del 2a hasta el 2f y los sugeridos de p1 a p7. Resultados: La variabilidad en pilares de retención protésica, disponibilidad adecuada de los productos ofertados por la empresa y la compatibilidad de los aditamentos entre marcas comerciales, fueron los factores más relevantes considerados por especialistas a la hora de elegir un determinado sistema de implante. Conclusión: Las razones que más influyen en la elección de un sistema de implante son la variedad y disponibilidad de productos junto a la compatibilidad entre marcas.
RESUMEN: La Poliposis Adenomatosa Familiar (PAF) es un síndrome hereditario autosómico dominante causado por la mutación del gen APC. En su forma clásica se desarrollan más de 100 pólipos adenomatosos intestinales que progresan a cáncer colorrectal en casi el 100% de los casos no tratados. Dentro de las manifestaciones extracolónicas de PAF, se encuentran las maxilofaciales, como: osteomas y alteraciones dentales, que pueden preceder por años al desarrollo de poliposis colónica. A pesar de que en Chile hay estudios de PAF y cáncer de colon, son escasos los reportes de manifestaciones maxilofaciales en estos pacientes. En la familia en estudio se encontró manifestaciones descritas previamente como: odontoma, osteomas y malformaciones de incisivos; adicionalmente tags mucosos que no se han asociado previamente al síndrome.
RESUMEN: Objetivo: El objetivo de este estudio fue establecer la prevalencia de signos y síntomas de trastornos temporomandibulares (TTM) en pacientes con maloclusión. Materiales y métodos: Estudio transversal descriptivo. Se revisaron de forma manual 951 fichas clínicas de pacientes ingresados en el Postítulo de Ortodoncia de la Facultad de Odontología de Universidad de Chile (FOUCH) entre los años 2013 y 2015. Se utilizaron los programas Excel 2013, Stata v. 12 y para la comparación entre grupos etarios se utilizó la prueba estadística de Kruskall Wallis. Resultados: Del total de pacientes con maloclusión, el 43,9% presentaron al menos un signo o síntoma de TTM, siendo la desviación mandibular el signo más prevalente con un 43,2%, seguido por el ruido articular con un 12,6%. El dolor fue el síntoma menos prevalente con un 2%. Los adultos fueron los que presentaron mayor prevalencia de signos y síntomas de TTM. No hubo diferencia estadística entre géneros. Conclusión: Debido a que los signos y síntomas de TTM son una condición tan común en pacientes con maloclusión, es necesaria la evaluación de la ATM siempre que se piense en iniciar un tratamiento ortodóncico, para así establecer un adecuado plan de tratamiento.
RESUMEN: Objetivo: Determinar parámetros visuales sencillos para la evaluación de características esqueletales relacionadas con el biotipo facial en una telerradiografía lateral. Material y método: Estudio transversal descriptivo. Se confeccionó una guía visual impresa acerca de ocho características morfológicas del esqueleto facial visibles en la telerradiografía de perfil. Ésta fue entregada a un grupo de 69 estudiantes de Odontología de 5º año sin estudios previos en cefalometría, quienes la analizaron durante 10 minutos. Inmediatamente se les mostraron una serie de telerradiografías, y se les pidió que evaluaran las 8 características a través de una serie de opciones presentadas en una escala visual que se correspondía con la guía estudiada. Las respuestas fueron registradas utilizando un sistema digital de cliqueras. Los datos fueron analizados con el método Rasch para determinar la dificultad de los ítems, estableciéndose el grado de dificultad a través del Logit. Resultados: Los estudiantes lograron identificar y graduar sin dificultad 5 de las 8 características presentadas. Éstas fueron: Proyección del mentón (-2,49), Divergencia facial (-2,85), Ancho de la rama mandibular (-1,97), Escotadura sigmoidea (-0,96) y Relación de la rama con el cuerpo mandibular (-0,06). Conclusión: Se determinó que hay 5 características de la morfología ósea facial relacionadas con el biotipo que se pueden identificar y graduar sin dificultad por estudiantes de pregrado de odontología. Ésta información podría ser utilizada para construir una escala sencilla de identificación del biotipo facial.
ABSTRACT: Aim: This study aimed to report the clinical case of an immediate implant-supported rehabilitation in infected alveolar socket with buccal bone resorption and apical periodontitis in the teeth 42 and 43. Case Report: The patient was rehabilitated with implants associated with guided bone regeneration and immediate provisionalization. After 4 months, the custom molding was made in order to receive the metal-ceramic prosthesis. The follow-up lasted 24 months and there was no painful symptomatology, infection, implant mobility or marked peri-implant bone loss in this period. Conclusion: Therefore, the placement of immediate implants on fresh infected alveolar sockets is viable for the implant-supported rehabilitation.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Sogl1r
RESUMEN: Introducción: Uno de los procedimientos realizados con mayor frecuencia para el restablecimiento de la estética en la zona anterosuperior es el alargamiento de corona, el cual está indicado ante la presencia de una longitud insuficiente de la corona clínica de un diente, cuando existe caries o fracturas subgingivales y para la mejora de la estética en pacientes con margen gingival desigual. Objetivo: El objetivo de este artículo es presentar el alargamiento de corona estético realizado en una paciente que presentaba márgenes discrepantes y pérdida de las papilas en la zona anterosuperior, la cual fue remitida del área de prótesis para poder realizar posterior rehabilitación protésica. Resultados: Mediante el procedimiento quirúrgico se logró la corrección y restablecimiento de los márgenes gingivales. Conclusiones: La zona anterosuperior es el área estéticamente más comprometida, por lo que es indispensable la planeación interdisciplinaria del tratamiento para asegurar el éxito del mismo.
RESUMEN: Introducción: La relación entre terceros molares y el desarrollo o reincidencia de maloclusión y apiñamiento dental tras el tratamiento de ortodoncia, especialmente en el segmento anterior del arco dental, es un tema que ha sido discutido y presentado en la literatura, el cual aún permanece sin resolver. Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, preparamos tablas de resumen de los resultados utilizando el método GRADE. Resultados: Identificamos 7 revisiones sistemáticas que en conjunto incluyen 31 estudios primarios, de los cuales, 2 son ensayos aleatorizados. Conclusiones: El limitado desarrollo de estudios que relacionan los terceros molares con apiñamiento dental y el bajo nivel de evidencia de éstos no permiten tener claridad respecto a la posible asociación. Son necesarios nuevos estudios sobre el tema.
RESUMEN: Objetivo: Describir la efectividad del uso de los distintos agentes desensibilizantes contenidos en dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos. Método: Se realizó una búsqueda electrónica de la evidencia científica en las bases de datos PubMed, Epistemónikos, EBSCO, BEIC y Cochrane Library; utilizando una estrategia de búsqueda que incluye las palabras clave. Para cada artículo encontrado se analizó el nivel y calidad de evidencia, riesgo de sesgo y ética. Resultados: En total 36 artículos fueron incluidos, 29 ensayos clínicos controlados aleatorizados y 7 revisiones sistemáticas. De los ensayos clínicos encontrados, cinco probaron la eficacia de colutorios, dos realizaron una comparación con dentífricos y colutorios y 22 evaluaron sólo el uso de dentífricos. Los agentes desensibilizantes testeados principalmente encontrados fueron sales de potasio, arginina, nano-hidroxiapatita, fosfosilicato de calcio y sodio (CSFS) y sales de estroncio. Sólo los primeros dos agentes fueron evaluados en presentación dentífrico y colutorio. Todos los ensayos clínicos demostraron reducir la hipersensibilidad dentinaria con alguno de los agentes utilizados en comparación a la medición inicial. Conclusión: Se podría recomendar el uso de nitrato y citrato de potasio, arginina, fosfosilicato de calcio y sodio y nano-hidroxiapatita en dentífricos para el tratamiento de la hipersensibilidad.
RESUMEN: El desarrollo de la Odontología Basada en Evidencia ha generado la necesidad constante de actualización e información por parte de los profesionales(1). Ante esto, los artículos actualizados que sintetizan información y poseen altos estándares, son las mejores fuentes de evidencia, siendo para ello las revisiones sistemáticas las mejores herramientas(2). Éstas, corresponden a resúmenes claros y estructurados de la información disponible orientada a responder una pregunta clínica específica(3). Poseen un proceso de elaboración estructurado que comienza con el planteamiento de una pregunta clínica específica, con los cuales se realizará la búsqueda en las bases de datos. Una vez obtenida la información se deben seleccionar los artículos y, a partir de los seleccionados, se obtendrán los datos y se realizarán los análisis críticos y estadísticos de la información, finalmente exponiendo los resultados del trabajo.
RESUMEN: El presente artículo realiza una breve revisión y síntesis sobre las Garantías Explícitas en Salud Bucal vigentes en Chile y las Guías de Práctica Clínica asociadas a su ejercicio. Se muestra una breve cronología de la reforma de salud de la cual se originan, describiendo sus principales pilares de desarrollo. Esta actualización tiene como objetivo orientar a los profesionales odontólogos de los Servicios de Salud, Sociedades Científicas, Universidades y entidades públicas y privadas que desarrollan la práctica odontológica en Chile, en el conocimiento del material existente, validado y disponible a la fecha.
ABSTRACT: Objective: The aim of this study was to assess the periodontal status of women during pregnancy attended in a maternity hospital, as well as their oral hygiene habits. Materials and Methods: The sample was composed by 100 pregnant women, ranging from their first to ninth month of pregnancy, were examined at a maternity hospital in Goiás, Brazil. They received information about oral hygiene techniques and they were submmited a periodontal examination in a dentist's office, where the Periodontal Screening and Recording (PSR) codes were verified along with bleeding on probing and tooth loss. Results: About their pregnancy period, the most (46%) were in their third trimester at the time of this study. The gingival index showed an average of 12% and 90% of the patients presented PSR Code 2. As for dental hygiene, 55% reported brushing three times a day and 48% used dental floss daily. Conclusion: The most pregnant women in the third trimester, showed a prevalence for gingivitis. They reported brushing their teeth three times a day and using dental floss daily.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AhgL2Q
ABSTRACT: Aim: The aim of this study was to evaluate the optical behavior of tooth color using CIE L*A*B* space; the teeth were subjected to novel bleaching gels containing peroxide carbamide with potassium oxalate. Materials and Method: Three different carbamide peroxide gels were experimentally fabricated. They consisted of 10% (G10), 16% (G16) and 37% (G37) concentrations. Sixty recently extracted premolars were subjected to different bleaching protocols. Color change (ΔE) was assessed using the CIE L*a*b* system after the application of each gel. The data were analyzed using one-way ANOVA with Tukey's post hoc test (α=5%) and a t-test. Results: The G10 and G16 gels exhibited an increase in ΔE*ab parameters from T0 to T1 (T0: application day of the gels. T1: 14th day measurement); a small decrease from T1 to T2 was also noted (T2: control measurement, 28th day). However, no statistically significant differences were found (p=0,22 for G10 and p=0,10 for G16). The G37 gel also exhibited an increase in ΔE*ab parameters, with similar results after the first application of 45 min, the second application of 45 min, and the third application of 45 min (T1, T2 and T3, respectively. T4: control measurement, 14th day). No statistically significant differences were observed between the three times of application (p>0,69), and an appreciable difference was noted between times T3 and T4 (p=0,000). Conclusions: The presented formulations of peroxide carbamide at 10%, 16%, and 37% are clearly effective. The G10 and G16 gels exhibited better effectiveness than the G37 gel.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SpJLfy
RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.