scholarly journals Osteogenesis Modulation: Induction of Mandibular Bone Growth in Adults by Electrical Field for Aesthetic Purposes

2021 ◽  
Author(s):  
Gregorio Hernandez Zendejas ◽  
Marek K. Dobke ◽  
Andrew Phelps ◽  
Gabriel Planas ◽  
Marco Sanchez
Keyword(s):  
Medical Device ◽  
Phase Ii ◽  
Bone Growth ◽  
Technology Development ◽  
Animal Experiments ◽  
Clinical Results ◽  
Full Description ◽  
Level Of Evidence ◽  
Mandibular Bone ◽  
Mandibular Hypoplasia

Abstract Background A new technique in plastic surgery termed Osteogenesis Modulation is described. This technique uses a surgically implanted, battery-operated medical device to deliver customized electrical pulses to produce mandibular bone growth. This device was designed to be a temporary, nonpermanent implant. The purpose of this study was to review both the safety and efficacy of Osteogenesis Modulation. Methods This study comprises two phases. Phase I involved experimental technology development and animal experiments. Phase II included technology development for clinical use and a clinical trial. In Phase II, four patients with a diagnosis of mandibular hypoplasia and microgenia underwent surgical implantation of the novel medical device over the chin bone. Once a satisfactory change of contour of mandibular bone was achieved, the devices were removed. In all patients, the devices were left in place for 12 months, then surgically removed under local anesthesia. Preoperative and long-term postoperative cephalometric controls were done. Results In all patients, symmetrical mandibular bone growth was observed with good-to-excellent aesthetic results. The overall follow-up period was 39 months. Cephalometric controls taken 3 to 6 months after the device removal showed an average increase in mandible length of 5.26mm (range, 2.83–7.60mm) Conclusions Preliminary clinical results suggest that Osteogenesis Modulation is a safe, minimally invasive, and effective alternative treatment for the correction of mandibular hypoplasia in selected cases. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Outcomes of a Cardiac Rehabilitation (CRH) Program after phase II: what about our patients almost 4 years later?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Borrego Rodriguez ◽  
C Palacios Echevarren ◽  
S Prieto Gonzalez ◽  
JC Echarte Morales ◽  
R Bergel Garcia ◽  
...  
Keyword(s):  
Phase Ii ◽  
Hospital Readmissions ◽  
Clinical Results ◽  
Level Of Evidence ◽  
Coronary Syndrome ◽  
Funding Sources ◽  
The Mean ◽  
Acute Cardiovascular Event ◽  
Mean Time

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION CRH in patients with ischemic heart disease is recommended by the different clinical practice guidelines with an IA level of evidence, with an important role in reducing cardiovascular mortality and hospital readmissions during follow-up. OBJECTIVE The goal of this study is to show the 4-year clinical results of a population of patients who participated in an CRH program after an Acute Coronary Syndrome (ACS). METHODS Between May/2014 and September/2017, 221 patients who had recently presented an ACS completed the 12 weeks of phase II of the CRH program at our center. In May/2020 we collected epidemiological, clinical and echocardiographic information at the time of the acute cardiovascular event; and we evaluate the current vital status of the patients and the incidence of readmissions for: angina, HF, new ACS, or arrhythmic events. RESULTS Of the 221 patients, 182 were men (82%). The mean age of our population was 58.3 ± 7.8 years. 58% (129 patients) suffered from ST-elevation ACS. The mean time of hospital stay was 6.20 ± 2.9 days. An echocardiogram was performed at discharge, which showed an average LVEF of 56 ± 6%. Eight patients (4%) developed early Ventricular Fibrilation (VF) during the acute phase of ACS. Among the classic CVRF, smoking (79%) was the most prevalent, followed by dyslipidemia (53%) and hypertension (47%). The mean time from hospital discharge to the start of phase II RHC was 42 ± 16 days. The overall incidence of events was 9%: 10 patients suffered reinfarction during follow-up, and 7 were readmitted for unstable angina, all of whom underwent PCI; no patient was admitted for HF; and none of the 8 patients with early VF had a new tachyarrhythmia, registering a single admission for VT during follow-up. None of the patients had sustained ventricular tachyarrhythmias during exercise-training. At the mean 4.5-year follow-up, 218 patients were still alive (98%). CONCLUSION The incidence of CV events in the follow-up of our cohort was low, which can be explained by the fact that it is a young population, with an LVEF at low limits of normality at discharge, which is one of the most important predictors in the prognosis after an ischemic event. As an improvement, we must shorten the time until the start of phase II of the program. CRH shows once again its clinical benefit after an ACS, in consonance with the existing evidence. Abstract Figure. Outcomes of a CRH program.

Investigations on skeletal growth zones via bone scans as base of determination of optimal time for surgery in mandibular asymmetry

2000 ◽  
Vol 39 (05) ◽  
pp. 121-126 ◽  
Author(s):  
R. Werz ◽  
P. Reuland
Keyword(s):  
Bone Growth ◽  
Region Of Interest ◽  
Tracer Uptake ◽  
Optimal Time ◽  
Mandibular Bone ◽  
The Third ◽  
Mandibular Asymmetry ◽  
Bone Scans ◽  
Epiphyseal Plates

Summary Aim of the study was to find out wether there is a common stop of growth of mandibular bone, so that no individual determination of the optimal time for surgery in patients with asymmetric mandibular bone growth is needed. As there are no epiphyseal plates in the mandibular bone, stop of growth cannot be determined on X-ray films. Methods: Bone scans of 731 patients [687 patients (324 male, 363 female) under 39 y for exact determination of end of growth and 44 (21 male, 23 female) patients over 40 y for evaluation of nongrowth dependant differences in tracer uptake] were reviewed for the study. All the patients were examined 3 hours after injection of 99mTc-DPD. Tracer uptake was measured by region of interest technique in different points of the mandibular bone and in several epiphyseal plates of extremities. Results: Tracer uptake in different epiphyseal plates of the extremities shows strong variation with age and good correlation with reported data of bone growth and closure of the epiphyseal plates. The relative maximum of bone activity is smaller in mandibular bone than in epiphyseal plates, which show well defined peaks, ending at 15-18 years in females and at 18-21 years in males. In contrast, mandibular bone shows no well defined end of growing but a gradually reduction of bone activity which remains higher than bone activity in epiphyseal plates over several years. Conclusion: No well defined end of growth of mandibular bone exists. The optimal age for surgery of asymmetric mandibular bone growth is not before the middle of the third decade of life, bone scans performed earlier for determination of bone growth can be omitted. Bone scans performed at the middle of the third decade of life help to optimize the time of surgical intervention.

Diagnosis and management of hook of hamate fractures

2017 ◽  
Vol 43 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Assaf Kadar ◽  
Allen T. Bishop ◽  
Marissa A. Suchyta ◽  
Steven L. Moran
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Clinical Findings ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Historical Case ◽  
Treatment Groups ◽  
Diagnosis And Management ◽  
Time To Diagnosis ◽  
Hook Of Hamate

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively. Level of evidence: IV

The non-operative management of bony mallet injuries

2021 ◽  
pp. 175319342199298
Author(s):  
Ryan W. Trickett ◽  
James Brock ◽  
David J. Shewring
Keyword(s):  
Fragment Size ◽  
Visual Analogue Score ◽  
Operative Management ◽  
Clinical Results ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Custom Made ◽  
Evaluation Measure ◽  
Non Operative Management ◽  
Extensor Lag

Over a 4-year period, 218 mallet fractures in 211 adult patients were treated using a custom-made thermoplastic splint. Clinical results were collected prospectively, including the visual analogue score for pain, the range of motion and extensor lag, and the Patient Evaluation Measure (PEM). The joints were congruent in 168 and subluxed in 50. There were no differences in range of movement, extensor lag or PEM associated with articular subluxation or the size of the articular fragment. Pre-existing joint degeneration did not influence outcome. Non-surgical treatment demonstrates predictably good outcomes regardless of fragment size or subluxation in most patients and should be considered when discussing treatment for patients with bony mallet fractures. Level of evidence: III

scholarly journals Application of a Proposed Multi-Positional Circumferential Arm Liposuction Method and Quantification of its Clinical Efficacy Evaluation

2021 ◽  
Author(s):  
Yunpeng Gu ◽  
Ning Kang ◽  
Qianwen Lv ◽  
Yue Qi ◽  
Zhenjun Liu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Quantitative Research ◽  
Three Dimensional ◽  
Reduction Rate ◽  
Full Description ◽  
Type I ◽  
Efficacy Evaluation ◽  
Level Of Evidence ◽  
Simple Measurement ◽  
Based Medicine

Abstract Background Upper arm liposuction mainly focuses on the posterolateral region, which may lead to a lack of harmony between the aspirated and unaspirated areas. In addition, the treatment effect of arm liposuction is often evaluated only by preoperative and postoperative photograph comparison and simple measurement; quantitative research on this topic is still lacking. Methods The multi-positional circumferential arm liposuction (MCAL) technique was proposed and applied to a total of 34 females in our hospital from 2017 to 2019. Three-dimensional data of 12 patients before the operation and after 2–3 months were collected and processed by 3D imaging, and the volume reduction rate was evaluated quantitatively. Results The MCAL method was successfully applied in the clinic, and its surgical effect was quantitatively studied. The mean follow-up time of 12 patients was (75.2 ±13.1) days, and the postoperative volume was significantly reduced. The postoperative volume of patients with type I, type II and type III decreased by (10.79 ±2.55)%, (17.25 ±3.02)% and (22.76 ±3.51)%, respectively. Conclusion Our new MCAL technique was successful, maximizing the esthetic results in upper limb contour refinements in the superficial fascial layer. The clinical efficacy of this proposed MCAL method was evaluated by CT and 3D digital technology, which provided further accuracy in demonstrating its effect on the shape of the arm. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com.

Clinical results of releasing the entire A2 pulley after flexor tendon repair in zone 2C

2016 ◽  
Vol 41 (8) ◽  
pp. 822-828 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
K. Hara ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Clinical Results ◽  
The Other ◽  
Flexor Tendon Repair ◽  
Level Of Evidence ◽  
A2 Pulley ◽  
Active Mobilization ◽  
Finger Motion

We report the results of complete release of the entire A2 pulley after zone 2C flexor tendon repair followed by early postoperative active mobilization in seven fingers and their comparisons with 33 fingers with partial A2 pulley release. In seven fingers, release of the entire A2 pulley was necessary to allow free gliding of the repairs in five fingers and complete release of both the A2 and C1 pulleys was necessary in two. No bowstringing was clinically evident in any finger. Two fingers required tenolysis. Using Tang’s criteria, the function of two digits was ranked as excellent, four good and one fair; there was no failure. The functional return in these seven fingers was similar with that in 33 fingers with partial A2 pulley release; in these patients only one finger required tenolysis. Our results support the suggestion that release of the entire A2 pulley together with the adjacent C1 pulley does not clinically affect finger motion or cause tendon bowstringing, provided that the other pulleys are left intact. Level of evidence: IV

scholarly journals Final Report, Project: Advanced Oxy-Combustion Technology Development and Scale Up for New and Existing Coal-Fired Power Plants (Phase II)

2019 ◽  
Author(s):  
Mark Fitzsimmons ◽  
Doug M. Heim ◽  
William Follett ◽  
Stevan Jovanovic ◽  
Makini Byron ◽  
...  
Keyword(s):  
Phase Ii ◽  
Power Plants ◽  
Technology Development ◽  
Scale Up ◽  
Final Report ◽  
Combustion Technology

Does Transection of the Superficial MCL During HTO Result in Progressive Valgus Instability?

2021 ◽  
pp. 036354652110591
Author(s):  
Joo-Hwan Kim ◽  
Dong Jin Ryu ◽  
Sung-Sahn Lee ◽  
Seung Pil Jang ◽  
Jae Sung Park ◽  
...  
Keyword(s):  
Case Series ◽  
Preoperative Assessment ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Valgus Instability

Background: During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon’s preference. However, it is still unclear whether transection of sMCL increases valgus laxity. Purpose: We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability. Study Design: Case series; Level of evidence, 4. Methods: Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs. Results: All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment ( P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, –3.5°± 2.0°; 6 months, –3.2°± 2.3°; 1 year, –3.1°± 2.3°; 2 years, –2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, –0.1°± 2.1°; 3 months, –0.2°± 2.4°; 6 months, –0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm). Conclusion: Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

scholarly journals Development and Usability of a Virtual Reality-Based Filler Injection Training System

2020 ◽  
Vol 44 (5) ◽  
pp. 1833-1842 ◽  
Author(s):  
Seung Min Oh ◽  
Ju Young Kim ◽  
Seungho Han ◽  
Won Lee ◽  
Il Kim ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Aesthetic Experience ◽  
Training System ◽  
Full Description ◽  
Training Methods ◽  
Level Of Evidence ◽  
Filler Injection ◽  
System Usability Scale ◽  
Injection Techniques ◽  
Cadaver Studies

Abstract Purpose As filler procedures have increased in popularity, serious injection-related complications (e.g., blindness and stroke) have also increased in number. Proper and effective training is important for filler procedure safety; however, limitations exist in traditional training methods (i.e. anatomical illustrations and cadaver studies). We aimed to describe the development process and evaluate the usability of a virtual reality (VR)-based aesthetic filler injection training system. Materials and Methods We developed the virtual reality hardware for the training system and a short guide, with a lecture regarding safe filler injection techniques. One hundred clinicians who attended a conference tested the training system. Participants completed system usability scale (SUS) and satisfaction questionnaires. Results Nearly half of the participants were aged 35–50 years, and 38% had more than 5 years of aesthetic experience. The mean SUS score was 59.8 (standard deviation, 12.23), with no significant differences among the evaluated subgroups. Approximately 76% of participants provided SUS scores of more than 51, indicating acceptable usability. Participants aged 35–50 years were more likely to rate the system as having poor usability than were those aged < 35 years (odds ratio = 5.20, 95% confidence interval: 1.35–20.08). Conclusions This study was the first to develop and explore the usability of a VR-based filler training system. Nearly three-fourths of participants indicated that the training system has an acceptable level of usability. However, assessments in precise target audiences and more detailed usability information are necessary to further refine the training system. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Demographic analysis: an update of randomized controlled studies in prostatic oncology

2013 ◽  
Vol 5 (4) ◽  
pp. 248
Author(s):  
Elias Wehbi ◽  
Karen Hersey ◽  
Tony Finelli ◽  
Neil E. Fleshner
Keyword(s):  
Nous Avons ◽  
Phase Ii ◽  
Randomized Trials ◽  
The United States ◽  
Prostate Neoplasms ◽  
Published Data ◽  
Demographic Analysis ◽  
Level Of Evidence ◽  
Randomized Controlled Studies ◽  
Base De Données

Introduction: Results from randomized trials are least prone tosystematic bias and represent the highest level of evidence in medicalpractice. We carried out a demographic analysis examiningrandomized controlled trials (RCTs) in prostate cancer. Particularemphasis was placed on newly conducted phase II/III RCTsbetween January 1997 and March 2006.Methods: We searched the MEDLINE database using the heading“prostate neoplasms” between January 1997 and March 2006. Theresults were then crossed with the MeSHs “Clinical trial.mp. ORclinical trial.pt. OR random:.mp. OR tu.xs;” this cross-checkingis considered an optimal search strategy for detecting RCTs inMEDLINE® literature. The search yielded 7831 articles in totalfor the defined period. Of this total number, 7314 articles weremanually analyzed and excluded as they did not represent RCTs.The qualifying 517 articles were then analyzed with emphasis onmodality of therapy, cohort size, principal author, participatingcountry and journal type.Results: Among the 517 randomized trials, most trials investigatedmedical therapies (42.7%). This was followed by diagnostic studies(13.2%), while the remaining categories made up 44.1%. A trendtowards more completed RCTs is noted in the later years of thecohort. Cohort sizes were generally greater than 100 participants(63.1%). Urologists were the lead investigators in 48.2% of thetrials. Trials were largely conducted in Europe and the United States(43.1% and 38.3%, respectively). About 7% of studies were basedin Canada. Articles were generally published in surgical journals(48.4%), followed by medical journals (36.9%).Conclusions: Given that initial searches yielded nearly 8000 articleslisted as RCTs in prostatic oncology, only a small percentage(5.4% to 8.6%) of these were actually RCTs which reported novelresults. Most of the published data were either review articles orcommentaries. It is abundantly clear that new recruitment strategiesneed to be developed to encourage patients to enrol in RCTs andthat such studies need to be undertaken in urologic oncology toprovide definitive answers to the abundant and unanswered questionsin urologic oncology.Introduction : Les résultats d’essais randomisés sont les moinssujets à une partialité d’emblée et représentent le plus haut niveaude données probantes en médecine. Nous avons mené une analysedémographique des essais contrôlés et randomisés (ECR) sur lecancer de la prostate, en portant attention plus particulièrementaux plus récents essais de phase II/III, menés entre janvier 1997et mars 2006.Méthodologie : Nous avons interrogé la base de données MEDLINEavec le titre « prostate neoplasms » pour la période entre janvier1997 et mars 2006. Les résultats ont ensuite été recoupés avec unerecherche dans la base de données MeSH avec les clés « Clinicaltrial.mp. OU clinical trial.pt. OU random:.mp. OU tu.xs »; cerecoupement est vu comme une stratégie optimale de recherchepour cerner les ECR dans les articles classés dans MEDLINE. Larecherche a produit un total de 7 831 articles pour la périodedéfinie. De ce nombre, 7 314 articles ont été analysés manuellementet exclus puisqu’ils ne traitaient pas d’ECR. Les 517 articlesadmissibles ont ensuite été analysés, avec une attention particulièreaux modalités de traitement, à la taille de la cohorte, à l’auteurprincipal, au pays participant et au type de périodique.Résultats : Sur les 517 essais randomisés, la plupart examinaient destraitements médicamenteux (42,7 %). Venaient ensuite les étudesdiagnostiques (13,2 %), alors que le reste (44,1 %) entrait dansles autres catégories. On a noté une tendance vers une complétudeplus élevée des ECR dans les dernières années de la période.Les cohortes comptaient habituellement plus de 100 participants(63,1 %). Les chercheurs principaux étaient des urologues dans48,2 % des essais. La grande majorité des essais ont été menésen Europe et aux États-Unis (43,1 % et 38,3 %, respectivement).Environ 7 % des études étaient menées au Canada. Règle générale,les articles étaient publiés dans des revues en chirurgie (48,4 %),suivies des revues médicales (36,9 %).Conclusions : Comme les recherches initiales ont généré près de8 000 articles classés comme des ECR en oncologie prostatique,seul un petit pourcentage (5,4 % à 8,6 %) de ces articles était enfait des ECR signalant des résultats inédits. La majorité des donnéesétaient publiées sous forme d’articles de synthèse ou de commentaires.Il est très clair que de nouvelles stratégies de recrutement doivent être établies pour encourager les patients à s’inscrire aux ECR et que de tels essais doivent être entrepris en oncologie urologique afin de fournir des réponses claires aux nombreusesquestions qui restent à élucider dans le domaine.

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