scholarly journals Management of Oroantral Fistulae and Communications: Our Recommendations for Routine Practice

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mahamadou Konate ◽  
Dounia Sarfi ◽  
Mounia El Bouhairi ◽  
Ihsane Benyahya
Keyword(s):  
Maxillary Sinusitis ◽  
Correct Diagnosis ◽  
Daily Practice ◽  
Bone Substitutes ◽  
Clinical Situation ◽  
Routine Practice ◽  
Treatment Techniques ◽  
Alternative Means ◽  
Oroantral Communication

Oroantral communication (OAC) is one of the main complications of extracting antral or sinus teeth. OAC is a gap between the maxillary sinus and the oral cavity. When left untreated, it causes maxillary sinusitis and dramatically impairs the patient’s quality of life. Numerous surgical treatment techniques have been described, from mucosal techniques to using bone substitutes or very conservative alternative means. Many cases of recurrence after treatment have been reported, and the choice of the method adapted to the clinical situation remains challenging. Therefore, it is necessary to establish a correct diagnosis and choose the surgical technique best adapted to the case. This work is aimed at reviewing several techniques for the treatment of OAC and at describing our recommendations for use in daily practice for each of them through four clinical cases.

scholarly journals Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 142
Author(s):  
Oana-Mihaela Plotogea ◽  
Madalina Ilie ◽  
Simona Bungau ◽  
Alexandru Laurentiu Chiotoroiu ◽  
Ana Maria Alexandra Stanescu ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Daily Practice ◽  
Chronic Liver ◽  
Asian Countries ◽  
Chronic Liver Diseases ◽  
Comprehensive Overview ◽  
The Usa ◽  
The Impact ◽  
Reliable Methods

The impact of sleep disorders (SDs) on patients with chronic liver diseases (CLD) is tremendous. SDs are frequently encountered among these patients and interfere with their quality of life. This review aims to present the data available so far about the prevalence, phenotypes, and proposed pathophysiological mechanisms of SDs in CLD. Moreover, we proposed to search the literature regarding the most reliable methods to assess SDs and the possible therapeutic options in patients with CLD. The main results of this review show that when it comes to prevalence, the percentages reported vary widely between studies performed among populations from the USA or Europe and those coming from Asian countries. Furthermore, it has been proven that SDs may also be present in the absence of neurocognitive disorders attributable to hepatic encephalopathy (HE), which contradicts traditional suppositions where SDs were considered part of the clinical scenario of HE. Currently, there are no specific recommendations or protocols to assess SDs in CLD patients and data about the therapeutic management are limited. Taking into consideration their impact, a protocol for diagnosing and managing SDs should be developed and included in the daily practice of hepatologists.

scholarly journals Microsurgical Anatomy of the Anterior Circulation of the Brain Adjusted to the Neurosurgeon’s Daily Practice

2021 ◽  
Vol 11 (4) ◽  
pp. 519
Author(s):  
Tomas Poblete ◽  
Daniel Casanova ◽  
Miguel Soto ◽  
Alvaro Campero ◽  
Jorge Mura
Keyword(s):  
Daily Practice ◽  
Computed Tomographic Angiography ◽  
Poor Quality ◽  
Surgical Anatomy ◽  
Microsurgical Anatomy ◽  
Anterior Circulation ◽  
Computed Tomographic ◽  
Intrinsic Complexity ◽  
Tomographic Angiography

The study of cerebrovascular anatomy can be difficult and may take time due to its intrinsic complexity. However, it can also be difficult for the following reasons: the excessive description of neuroanatomy making articles hard to read, the unclear clinical application of what is written, the use of simplified or intricate schematic drawings that are not always appropriate for effective teaching, the poor quality of neuroanatomy dissections and the use of unusual views of figures that are not strictly related to the most frequent neuroimages to be interpreted in daily practice. Because of this, we designed an article that incorporates original and accurate anatomical dissections in an attempt to improve its comprehensibility. Five formalin-fixed adult cadaveric heads, whose vessels were injected with a colored silicone mixture (red for arteries and blue for veins), were dissected and examined under a microscope with magnifications from 3× to 40×. Special emphasis has been placed on correlating topographic anatomy with routine neuroimaging studies from computed tomographic angiography (CTA) and digital subtraction angiography (DSA). The essential surgical anatomy in a neurosurgeon’s daily practice is also described. The cadaveric dissections included in this study contribute to the understanding of the cerebrovascular anatomy necessary for the neurosurgeon’s daily practice.

scholarly journals Implant Placement after Closure of Oroantral Communication by Sinus Bone Graft Using a Collagen Barrier Membrane in the Shape of a Pouch: A Case Report and Review of the Literature

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 626
Author(s):  
Jae-Ha Baek ◽  
Byung-Ock Kim ◽  
Won-Pyo Lee
Keyword(s):  
Bone Graft ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Collagen Membrane ◽  
Implant Placement ◽  
Barrier Membrane ◽  
Membrane Perforation ◽  
Oroantral Communication ◽  
Sinus Membrane ◽  
Posterior Area

Oro-antral communication (OAC) acts as a pathway for bacteria between the maxillary sinus and oral cavity, and is a common complication after the removal of a dental implant or extraction of a tooth from the maxillary posterior area. In the case of an untreated OAC, oro-antral fistula develops and becomes epithelialized. We aimed to introduce a treatment for OAC closure via a sinus bone grafting procedure using bone tacks and a collagen membrane with an allograft. The procedure was performed by applying an absorbable membrane made in pouch form. This membrane acted as a barrier for closing the large sinus membrane perforation. Bone tacks were used to fix the membranes. Subsequently, the maxillary sinus was filled with the allograft, and the absorbable membrane was reapplied. Primary closure was achieved by performing a periosteum-releasing incision for a tension-free suture. After 6 months, sufficient bone dimensions were gained without any occurrence of maxillary sinusitis or recurrence of OAC. Additional bone grafts and implantation could be performed to rehabilitate the maxillary posterior area. We conclude that this technique might be a useful treatment for reconstructing the maxillary posterior area with simultaneous sinus bone graft and OAC closure.

Impact of neuropsychiatry screening in neurological in-patients: comparison with routine clinical practice

2011 ◽  
Vol 23 (6) ◽  
pp. 297-301 ◽  
Author(s):  
Justin Earl ◽  
Olimpia Pop ◽  
Kate Jefferies ◽  
Niruj Agrawal
Keyword(s):  
Mental Illness ◽  
Clinical Practice ◽  
Neurological Disorders ◽  
Psychiatric Comorbidity ◽  
Screening Programme ◽  
Psychiatric Symptoms ◽  
Routine Clinical Practice ◽  
Routine Practice ◽  
Sustained Effect

Earl J, Pop O, Jefferies K, Agrawal N. Impact of neuropsychiatry screening in neurological in-patients: comparison with routine clinical practiceBackground: It is now well recognised that the rate of psychiatric comorbidity is high in patients with neurological disorders. Psychiatric comorbidity has a significant impact on quality of life and often goes undetected in routine clinical practice.Objectives: To compare the rate of detection of psychiatric illness in routine clinical practice with the prevalence of mental illness established using a dedicated screening programme at a regional neuroscience centre and to assess if the screening programme had any enduring impact on routine clinical practice after its completion.Methods: Consecutive admissions to a neurology ward in the 3-month period before (n = 160) and after (n = 158) a dedicated neuropsychiatric screening programme was carried out were identified. Case notes were then reviewed to establish if symptoms of mental illness were identified by the treating neurologists and if patients were referred for neuropsychiatric assessment. Rates of detection of neuropsychiatric problems and rates of referral for treatment were compared with those identified during the screening programme.Results: In routine clinical practice, over two 3-month study periods, psychiatric symptoms were identified in 23.7% of patients and only 10.6% received neuropsychiatric interventions. This is much lower as compared with rates identified (51.3%) and treated (51.3%) during dedicated screening. Detection of mood symptoms decreased from 14.7% pre-screening to 3.8% in the post-screening period.Conclusion: Rate of detection and treatment of neuropsychiatric problems remain low in neurology in-patients in routine clinical practice. Neuropsychiatric screening is effective but does not have sustained effect once it stops. Hence we suggest that active ongoing screening should be incorporated into routine practice.

Career advancement or teacher development? Teachers’ perceptions of writing publications in China

2014 ◽  
Vol 28 (3) ◽  
pp. 306-318
Author(s):  
Jocelyn L.N. Wong
Keyword(s):  
Teacher Development ◽  
Career Advancement ◽  
Teacher Educators ◽  
Daily Practice ◽  
Teaching Profession ◽  
Contributing Factors ◽  
Content Type ◽  
Teachers Perceptions ◽  
Systematic Training

Purpose – Studies in teacher research have seldom discussed the effects of writing publications and teachers’ views on it. This paper aims to examine how teachers in China regard the purpose of writing up research papers and its impact on their professional practice. It also investigates facilitating factors in preparing and writing publications. Design/methodology/approach – This is a qualitative study which mainly analyses interview data gathered from 14 teachers, who have experience in writing publications, from three schools in Shanghai, China. Documentary analysis includes selected published journal papers and book chapters of the interviewees. Findings – Findings show that teachers perceive producing publications as serving both an instrumental purpose of career advancement and a developmental purpose of enhancing their individual professional competency which in turn improves the quality of the teaching profession through knowledge transfer and knowledge transportation. Research limitations/implications – Contributing factors to help teachers to write include the provision of systematic training courses for teachers and the development of network and research partners. Originality/value – Findings of this study help school leaders and teacher educators better their understanding of improving the quality of practice of teachers through equipping them with a “stance of inquiry”. Findings suggest ways to provide relevant support to enhance the writing capacity of teachers. More importantly, a revision of the existing teacher promotion system may make the practice of writing publications of more direct value to teachers’ daily practice.

scholarly journals Consumer Satisfaction with the Services of Prosthetics and Orthotics Facilities

2009 ◽  
Vol 33 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Joline Bosmans ◽  
Jan Geertzen ◽  
Pieter U. Dijkstra
Keyword(s):  
The Netherlands ◽  
Consumer Satisfaction ◽  
Daily Practice ◽  
Delivery Time ◽  
Satisfactory Quality

Consumer satisfaction with the services provided in a prosthetics and orthotics (P&O) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 P&O facilities in The Netherlands. Consumers ( n = 1,364) of these P&O facilities who were fitted with a prosthesis, orthopaedic shoes, an orthosis, or another device, were asked to rate the overall services provided and whether they were satisfied with the device provided and its delivery time. Additionally, they filled in a modified SERVQUAL questionnaire (see Appendix). Consumers gave the service provided by P&O facilities a mean overall rating of 8.1. The highest ratings were given by consumers fitted with a prosthesis (mean overall rating of services: 8.4). In total, 78% of the consumers were satisfied with the device provided and 93% with the delivery time. The results of our study showed that, on the SERVQUAL, 50% of the statements fulfilled the criteria for a satisfactory quality of the services. The overall consumer rating of the service provided by P&O facilities is high and depends on the device provided. The outcomes on the SERVQUAL were moderate. In future, it is important to study consumer satisfaction more extensively in order to improve the quality of P&O services in daily practice. Additionally, specific questionnaires need to be developed to measure all aspects of prosthetic and orthotic care, with the aim to improve the services.

In Support of Initial Parenteral Medical Management of Intrathecal Baclofen Withdrawal in Spasticity Patients

2021 ◽  
pp. 875512252110392
Author(s):  
Brian L. LaRowe ◽  
Vicki M. Nussbaum
Keyword(s):  
Case Reports ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Treatment Protocol ◽  
Patient Characteristics ◽  
Clinical Problem ◽  
Clinical Situation ◽  
Intrathecal Baclofen ◽  
Wide Range ◽  
Baclofen Withdrawal

Background: Spasticity may present as a wide range of symptoms and conditions. With this protean presentation, a consensus regarding the best course of treatment does not exist. Those patients most severely affected may receive significant benefit from intrathecal baclofen delivery. However, this therapy may itself lead to patient injury in the event of withdrawal. Objective: Withdrawal from intrathecal baclofen may devolve rapidly into a situation in which the patient may incur significant morbidity and even death. A focused, prompt treatment plan would afford the patient the best possible outcome. Methods: The medical literature was reviewed for reports of plans of treatment of baclofen withdrawal and the results obtained. The nature of this problem does not lend itself to a typical study design, depending on case reports and basic pharmacological science application. The paucity of such reports severely limits categorical comparison of patient characteristics and clinical circumstances. Clinical situations, patient characteristics, and therapies were considered and compared. Outcomes of the varied treatments were evaluated for efficacy. Results: Inaccurate diagnoses, delayed correct diagnoses, and the absence of a consistent, treatment plan contributed to widely disparate outcomes. Prompt, correct diagnosis and intensive care unit–based continuous benzodiazepine infusion with titration led to a controlled clinical situation and maximized patient outcomes. Conclusions: Patients going through withdrawal from intrathecal baclofen achieved best outcomes when treated with a continuous infusion and titration of an intravenous benzodiazepine. A well-defined treatment protocol employing this management, reporting serial outcomes, would enable further refinement of the treatment of this clinical problem.

scholarly journals Discrepancies in interpretation of night-time emergency computed tomography scans by radiology residents

2018 ◽  
Vol 7 (10) ◽  
pp. 205846011880723
Author(s):  
Elias Vaattovaara ◽  
Marko Nikki ◽  
Mika Nevalainen ◽  
Mervi Ilmarinen ◽  
Osmo Tervonen
Keyword(s):  
Computed Tomography ◽  
Emergency Radiology ◽  
Correct Diagnosis ◽  
Anatomical Variations ◽  
Night Time ◽  
Radiology Resident ◽  
Computed Tomography Scans ◽  
Time Work ◽  
Radiology Residents

Background In many emergency radiology units, most of the night-time work is performed by radiology residents. Residents’ preliminary reports are typically reviewed by an attending radiologist. Accordingly, it is known that discrepancies in these preliminary reports exist. Purpose To evaluate the quality of night-time computed tomography (CT) interpretations made by radiology residents in the emergency department. Material and Methods Retrospectively, 1463 initial night-time CT interpretations given by a radiology resident were compared to the subspecialist’s re-interpretation given the following weekday. All discrepancies were recorded and classified into different groups regarding their possible adverse effect for the emergency treatment. The rate of discrepancies was compared between more and less experienced residents and between different anatomical regions. Results The overall rate of misinterpretations was low. In 2.3% (33/1463) of all night-time CT interpretations, an important and clinically relevant diagnosis was missed. No fatalities occurred due to CT misinterpretations during the study. The total rate of discrepancies including clinically irrelevant findings such as anatomical variations was 12.2% (179/1463). Less experienced residents were more likely to miss the correct diagnosis than more experienced residents (18.3% vs. 10.9%, odds ratio [OR] = 1.82, P = 0.001). Discrepancies were more common in body CT interpretations than in neurological CTs (18.1% vs. 9.1%, OR = 2.30, P < 0.0001). Conclusion The rate of clinically important misinterpretations in CT examinations by radiology residents was found to be low. Experience helps in lowering the rate of misinterpretations.

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

Sign in / Sign up

Export Citation Format

Share Document