scholarly journals Comparison of Fusion Rates Based on Graft Material Following Occipitocervical and Atlantoaxial Arthrodesis in Adults and Children

2018 ◽  
Vol 15 (5) ◽  
pp. 530-537 ◽  
Author(s):  
Leslie C Robinson ◽  
Richard C E Anderson ◽  
Douglas L Brockmeyer ◽  
Michelle R Torok ◽  
Todd C Hankinson ◽  
...  
Keyword(s):  
Failure Criteria ◽  
Atlantoaxial Instability ◽  
Graft Material ◽  
Group 4 ◽  
Significant Difference ◽  
Ann Arbor ◽  
Code Group ◽  
Adults And Children ◽  
Group 2 ◽  
Atlantoaxial Arthrodesis

Abstract BACKGROUND Fusion rates following rigid internal instrumentation for occipitocervical and atlantoaxial instability approach 100% in many reports. Based on this success and the morbidity that can be associated with obtaining autograft for fusion, surgeons increasingly select alternative graft materials. OBJECTIVE To examine fusion failure using various graft materials in a retrospective observational study. METHODS Insurance claims databases (Truven Health MarketScan® [Truven Health Analytics, Ann Arbor, Michigan] and IMS Health Lifelink/PHARMetrics [IMS Health, Danbury, Connecticut]) were used to identify patients with CPT codes 22590 and 22595. Patients were divided by age (≥18 yr = adult) and arthrodesis code, establishing 4 populations. Each population was further separated by graft code: group 1 = 20938 (structural autograft); group 2 = 20931 (structural allograft); group 3 = other graft code (nonstructural); group 4 = no graft code. Fusion failure was assigned when ≥1 predetermined codes presented in the record ≥90 d following the last surgical procedure. RESULTS Of 522 patients identified, 419 were adult and 103 were pediatric. Fusion failure occurred in 10.9% (57/522) of the population. There was no statistically significant difference in fusion failure based on graft material. Fusion failure occurred in 18.9% of pediatric occipitocervical fusions, but in 9.2% to 11.1% in the other groups. CONCLUSION Administrative data regarding patients who underwent instrumented occipitocervical or atlantoaxial arthrodesis do not demonstrate differences in fusion rates based on the graft material selected. When compared to many contemporary primary datasets, fusion failure was more frequent; however, several recent studies have shown higher failure rates than previously reported. This may be influenced by broad patient selection and fusion failure criteria that were selected in order to maximize the generalizability of the findings.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

scholarly journals The Association of Pre-Existing Left Atrial Fibrosis with Clinical Variables in Patients Referred for Catheter Ablation of Atrial Fibrillation

2014 ◽  
Vol 8s1 ◽  
pp. CMC.S15036 ◽  
Author(s):  
Jane Dewire ◽  
Irfan M. Khurram ◽  
Farhad Pashakhanloo ◽  
David Spragg ◽  
Joseph E. Marine ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Af Ablation ◽  
Group 4 ◽  
Significant Difference ◽  
History Of ◽  
Group 2 ◽  
Magnetic Resonance Imaging Mri ◽  
Left Atrial Fibrosis

Introduction Atrial fibrillation (AF) recurrence after ablation is associated with left atrial (LA) fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). We sought to determine pre-ablation, clinical characteristics that associate with the extent of LA fibrosis in patients undergoing catheter ablation for AF. Methods and Results Consecutive patients presenting for catheter ablation of AF were enrolled and underwent LGE-MRI prior to initial AF ablation. The extent of fibrosis as a percentage of total LA myocardium was calculated in all patients prior to ablation. The cohort was divided into quartiles based on the percentage of fibrosis. Of 60 patients enrolled in the cohort, 13 had <5% fibrosis (Group 1), 15 had 5-7% fibrosis (Group 2), 17 had 8-13% fibrosis (Group 3), and 15 had 14-36% fibrosis (Group 4). The extent of LA fibrosis was positively associated with time in continuous AF, and the presence of persistent or longstanding persistent AF. However, no statistically significant difference was observed in the presence of comorbid conditions, age, BMI, LA volume, or family history of AF among the four groups. After adjusting for diabetes and hypertension in a multivariable linear regression model, paroxysmal AF remained independently and negatively associated with the extent of fibrosis (-4.0 ± 1.8, P = 0.034). Conclusion The extent of LA fibrosis in patients undergoing AF ablation is associated with AF type and time in continuous AF. Our results suggest that the presence and duration of AF are primary determinants of increased atrial LGE.

scholarly journals Microleakage beneath Ceramic and Metal Brackets Bonded with a Conventional and an Antibacterial Adhesive System

2006 ◽  
Vol 76 (6) ◽  
pp. 1028-1034 ◽  
Author(s):  
Neslihan Arhun ◽  
Ayca Arman ◽  
Sevi Burçak Çehreli ◽  
Serdar Arıkan ◽  
Erdem Karabulut ◽  
...  
Keyword(s):  
Adhesive System ◽  
White Spot Lesions ◽  
Adhesive Interface ◽  
Group 4 ◽  
Significant Difference ◽  
Ceramic Brackets ◽  
Group 3 ◽  
Group 2 ◽  
Ceramic Bracket ◽  
Nail Varnish

Abstract Objective: To assess microleakage of a tooth-adhesive-bracket complex when metal or ceramic brackets were bonded with a conventional and an antibacterial self-etching adhesive. Materials and Methods: Forty freshly extracted human premolars were randomly assigned to four equal groups and received the following treatments: group 1 = Transbond XT + metal bracket, group 2 = Transbond XT + ceramic bracket, group 3 = Clearfil Protect Bond + ceramic bracket, and group 4 = Clearfil Protect Bond + metal bracket. After photopolymerization, the teeth were kept in distilled water for 1 month and thereafter subjected to thermal cycling (500 cycles). Specimens were further sealed with nail varnish, stained with 0.5% basic fuchsin for 24 hours, sectioned and examined under a stereomicroscope, and scored for marginal microleakage for the adhesive-tooth and bracket-adhesive interfaces from incisal and gingival margins. Statistical analysis was accomplished by Kruskal-Wallis test and Mann-Whitney U-test with Bonferroni correction. Results: All groups demonstrated microleakage between the adhesive-enamel and bracket-adhesive interfaces. A significant difference was observed among all groups (P &lt; .05) for the microleakage between the bracket-adhesive interface. Metal brackets exhibited significantly more microleakage than did ceramic brackets between the bracket-adhesive interface with either of the adhesives. Clearfil Protect Bond exhibited results similar to Transbond XT. Clearfil Protect Bond may be a choice of adhesive in bracket bonding because of its antibacterial activity and similar microleakage results with the orthodontic adhesive. Conclusions: Metal brackets cause more leakage between an adhesive-bracket interface, which may lead to lower clinical shear bond strength and white-spot lesions.

scholarly journals Comparative evaluation of postoperative pain intensity after single-visit and multiple-visit retreatment cases: a prospective randomized clinical trial

2018 ◽  
Vol 21 (1) ◽  
pp. 26 ◽  
Author(s):  
Hatice Miray Uyan ◽  
Keziban Olcay ◽  
Mutlu Özcan
Keyword(s):  
Postoperative Pain ◽  
Repeated Measures ◽  
Control Group ◽  
Periapical Lesions ◽  
Single Visit ◽  
Group 4 ◽  
Multiple Visit ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

<p><strong>Objective:</strong> This study was designed to evaluate postoperative pain after endodontic retreatment. <strong>Material and Methods:</strong> Asymptomatic, multi-rooted molar &amp; premolar teeth requiring retreatment with 2–5 mm periapical lesions were included. Seventy-eight teeth were randomly placed in four groups (n=20): single-visit (control, group 1), Ledermix (group 2), metronidazole, ciprofloxacin, minocycline mixture (group 3), calcium hydroxide (group 4). The postoperative pain was recorded using a VAS at 6, 12, 24, and 48 h after retreatment. Statistical evaluation was performed using Two-Way Repeated Measures ANOVA and Tukey test. <strong>Results:</strong> Mild pain occurred in 67.5%, moderate in 30%, and flare-ups in 2.5%, and there was a significant difference between the groups (p&lt;0.01). Significantly lower postoperative pain was observed in TAP and CaOH<sub>2 </sub>groups(p&lt;0.05). In the 6, 12, and 24 h intervals, there was a significant difference in the pain levels (p&lt;0.05). <strong>Conclusion:</strong> TAP and CaOH<sub>2</sub> are effective for reducing postoperative pain after retreatment.</p><p><strong>Keywords</strong></p><p>Intracanal medicaments; Multiple-visit; Postoperative pain; Retreatment; Single-visit.</p>

In vivosilymarin’s antioxidant and anti-apoptotic effects on photodynamic therapy’s responsiveness

2017 ◽  
Vol 21 (03) ◽  
pp. 189-197 ◽  
Author(s):  
Vlad Dionisie ◽  
Simona Clichici ◽  
Rodica M. Ion ◽  
Oana O. Danila ◽  
Remus Moldovan ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Reactive Oxygen Species Generation ◽  
Group 4 ◽  
Significant Difference ◽  
Anti Oxidant ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Apoptotic Effects ◽  
Oxidant Effect

Several studies have shown that some anti-oxidant natural compounds in combination with photodynamic therapy (PDT) can enhance the effectiveness of treatment. The aim of this study is to evaluate the effect of silymarin (SIL) in combination with 5,10,15,20-tetra-sulphonato-phenyl-porphyrin (TSPP) based photodynamic therapy, on experimental tumors. 30 Wistar rats with Walker carcinosarcoma, were divided into 6 groups: group 0 (control) — control, untreated group; group 1 (TSPP) — one dose of TSPP; group 2 (SIL) — silymarin; group 3 (PDT) — TSPP and irradiation 24 h after; group 4 (SIL[Formula: see text]PDT) — silymarin, TSPP and irradiation 24 h after; group 5 (SIL[Formula: see text]IR) and group 6 (IR) — irradiation and in addition, group 5 received SIL. Silymarin administered before photodynamic therapy decreased the lipid peroxidation ([Formula: see text] < 0.05) and modulated the antioxidant defense in tumor treated with PDT and silymarin suggesting that silymarin administration along with photodynamic therapy has an anti-oxidant effect. The caspase — 8 level and -3 activity increased in PDT and PDT [Formula: see text] SIL groups compared to the control; between the two groups there was a significant difference in term of apoptosis in favor to PDT. In conclusion, silymarin administration inhibited the reactive oxygen species generation and reduced the tumoral cells’ apoptosis, suggesting that natural compound administered before photodynamic therapy did not improve the therapy’s effect.

Efficacy of Double Manual Cleaning Versus Automated Cleaning for Removal of Biofilm of Hinged Surgical Instruments

2020 ◽  
Vol 41 (S1) ◽  
pp. s518-s519
Author(s):  
Dayane Costa ◽  
Roel Castillo ◽  
Lillian Kelly Lopes ◽  
Anaclara Tipple ◽  
Honghua Hu ◽  
...  
Keyword(s):  
Protein Level ◽  
Positive Control ◽  
Surgical Instruments ◽  
Microbial Load ◽  
Positive Control Group ◽  
Control Group ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: To evaluate the efficacy of double manual cleaning (DMC) with enzymatic followed by alkaline detergent for removing biofilm on hinged surgical instruments compared to automated cleaning by the washer-disinfector. Methods: Biofilm of Staphylococcus aureus (ATCC 25923) was formed in vitro on hemostatic forceps (Fig. 1). Biofilm-covered forceps were rinsed in distilled water and subjected to one of the following cleaning regimes (n = 5 forceps each): Group 1 forceps were soaked in sterile water for 5 minutes. Group 2-DMC forceps were soaked in enzymatic detergent, brushed 5 times on each face, rinsed with filtrated water (0.2 µm), soaked in alkaline detergent, brushed 5 times each face, rinsed with filtrated water (0.2 µm), and dried with sterile cloth. For group 3-DMC plus hinge inner brushing (n = 5), the forceps were soaked in detergents and brushed as in group 2, including hinge inner brushing (2-mm lumen brush) (Fig. 1). In group 4 (automated cleaning in a washer/disinfector), forceps were prewashed, washed once, washed again, rinsed, thermally rinsed, and dried. After the treatments, forceps were evaluated for microbial load (counting of colony-forming units), residual protein (BCA protein assay kit), and biofilm (scanning electron microscopy). Results: There was no statistically significant differences between the microbial load and protein level contaminating the forceps subjected to DMC (group 2) and the positive control group. The DMC with hinge inner brushing group (group 3) and the automated cleaning group (group 4) demonstrated a significantly reduced microbial load: reduction averages of 2.8 log 10 (P = .038) and 7.6 log10 (P ≤ .001), respectively. The protein level remaining on the forceps also significantly decreased: 2.563 μg (P = .016) and 1,453 μg (P = .001), respectively, compared to the positive control group. There was no statistically significant difference between DMC with hinge inner brushing and automated cleaning (groups 3 and 4) for all of the tests performed. None of the cleaning methods completely removed biofilm and/or soil from the forceps hinge internal region (Fig. 1). Conclusions: Automated cleaning had the best efficacy for removing biofilm. However, DMC with hinge inner brushing was an acceptable alternative cleaning method for sterilizing service units with only manual cleaning available, as is the case in most low- and middle-income countries. Neither automated nor any manual cleaning regimes were able to completely remove biofilm and soil from the forceps hinged area, and the amount of protein left after automated and DMC plus hinge brushing was higher than the recommended. Cleaning is the most important step for the reprocessing of reusable medical devices; thus, efforts must be undertaken to improve cleaning in different social and economic realities and scenarios.Funding: This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES.Disclosures: None

scholarly journals Effect of Different Finishing and Polishing Methods for Color Stability of the E-Max Dental Ceramics: In vitro Study

2021 ◽  
Vol 14 (4) ◽  
pp. 1508-1513
Author(s):  
Ibraheem F Alshiddi
Keyword(s):  
Surface Brightness ◽  
Color Stability ◽  
Color Measurement ◽  
Control Group ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In order to assess the influence of finishing and polishing on the surface brightness and color stability of the ceramic veneer, fifty specimens were fabricated with 10 mm diameter and 2 mm thickness using IPS E-Max Ceramic. After glazing, 10 specimens were untouched as control group, and the other 40 specimens were abraded using 125µm diamond bur to create surface roughness. Forty specimens were divided into four groups (n=10), in group 1: specimens were finished using diamond point, in group 2 specimens’ surface was polished with a polishing kit, Group 3: Each specimen surface was polished with the polishing kit as in protocol 2 and was polished a polishing past and group 4 Each specimen was glazed by heating at 621℃ for 3 minutes followed by a temperature increase of 83℃/min up to 918℃ for 30 seconds. Color measurement was performed using spectrophotometer. Color stability data were analyzed using two-way ANOVA and Tukey’s HSD test (α=0.05). For Ra values, paired-samples t-tests were used to analyze the data and compare groups. The change in L and E showed a significant difference among the study groups; (group 1, group 2, group 3 and group 4) with respect to three variables L, a and b. A significant difference was noted when compared each group with the control; however, only group 2 showed a significant difference from group 4; the remaining groups demonstrated similar findings for all three variables. The study displayed a significant impact of the finishing and polishing technique on the surface brightness and color stability of ceramic restoration. However, it was evident that combination of two or three polishing techniques which includes polish kit and glaze enhances the surface finish and adds color stability by alternating the yellow – blue axis (increase in b) and red- green axis (decrease in a).

scholarly journals Çekirdeklik Kabak (Cucurbita pepo L.) Artıkları Silajının Besin Değerlerinin Belirlenmesi

2020 ◽  
Vol 8 (3) ◽  
pp. 768
Author(s):  
Abdurrahman Pirinç ◽  
Abdullah Özbilgin ◽  
Oğuzhan Kahraman ◽  
Esad Sami Polat
Keyword(s):  
Protein Ratio ◽  
Feed Material ◽  
Group 4 ◽  
Ethanol Content ◽  
Significant Difference ◽  
Group 3 ◽  
Silage Production ◽  
Group 2 ◽  
Nutrient Analyses ◽  
Group 1

In this study, nutritional values of silages made from seed pumpkin residues were investigated. Pumpkin residues collected from Konya region were put into silo in vacuum sacks with various additives. As additives, straw, inoculant containing lactic acid bacteria or a mixture of both in certain proportions were used. After the silos were opened, their pH was determined and then samples were taken to determine the essential fatty acid compositions and nutrient analyses were done. Natural pumpkin (Group 1), natural pumpkin + inoculant (100ppm) (Group 2), withered pumpkin + 15% straw (Group 3), withered pumpkin + 15% straw + inoculant (100ppm) (Group 4) such that the fourth group is formed. Dry matter values of pumpkin groups are Group 1 7.89%, Group 2 6.62%, Group 3 12.22% and Group 4 12.25% respectively. Their pH is 3.78 in Group 1, 3.71 in Group 2, 3.86 in Group 3 and 3.82 in Group 4. The crude protein ratio in the experimental groups was determined in the highest Group 2 (14.97%) and the lowest in Group 3 (10.56%). NDF rate was determined in the highest group 4 (49.74%) and the lowest in Group 2 (28.51%). In addition, the highest ADF rate was determined in Group 4 (37.91%) and the lowest in Group 2 (24.90%). There was a statistically significant difference between the research groups in terms of ethanol content. Acetic acid and propionic acid content was found statistically significant between groups. As a result, when the pumpkin residues are silaged, it can be used as feed material in animal feeding. In addition, it can be said that pumpkin residues can be evaluated in different areas in the high amount of Ethanol content resulting from silage production.

scholarly journals Effects of eliminating tension by means of epineural stitches: a comparative electrophysiological and histomorphometrical study using different suture techniques in an animal model

2011 ◽  
Vol 69 (2b) ◽  
pp. 365-370 ◽  
Author(s):  
J Bustamante ◽  
M Socolovsky ◽  
R S Martins ◽  
J Emmerich ◽  
M G Pennini ◽  
...  
Keyword(s):  
Test Results ◽  
Motor Action ◽  
Nerve Suture ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Human Nerve ◽  
Group 1

Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. METHOD: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. RESULTS: The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). CONCLUSION: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.

scholarly journals THE EFFECT OF TRACHEAL DIVERTICULUM AND CHRONIC OSTRUCTIVE LUNG DISEASE ON CHEST ANTHROPOMETRY

2021 ◽  
Author(s):  
Mine ARGALI DENIZ ◽  
Hilal ER ULUBABA ◽  
M. Furkan ARPACI ◽  
Fatih CAVUS ◽  
Gokhan DEMIRTAS ◽  
...  
Keyword(s):  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Group 4 ◽  
Tracheal Diverticulum ◽  
Copd Patients ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: In this study, the effect of tracheal diverticula (TD) on chest anthropometry and its relation with chronic obstructive pulmonary disease (COPD) was evaluated. Method: Between January 2019 and March 2020, 995 patients who underwent chest CT were retrospectively analyzed and TD was detected in 31 cases. Group 1 is only TD, Group 2 is TD + COPD, Group 3 is only COPD, Group 4 is defined as control group. We measured the localization, size, the distance to carina and vocal cord of TDs. In all groups chest diameters at T4 and T9 levels were measured as transverse and vertical plans. Results: TDs detected mostly at the T2 and T3 levels. In Group 1 and Group 2, there was a statistically significant difference the distance to TD of vocal chords. A statistically significant difference was found between Group 1 and Group 3 only in the vertical diameter at the T4 and T9 levels. Conclusion: We observed that COPD effect TD location and also TD had opposite effect on anteroposteriorly increasing chest parameters in COPD. Precence of TD is essential on COPD patients about thorax anthropometry. Keywords: Tracheal diverticulum; antropometry; radiology; COPD; chest diameter

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