Collagen Matrix in Decompressive Hemicraniectomy

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS176-ONS181 ◽  
Author(s):  
Jorn A. Horaczek ◽  
Jan Zierski ◽  
Alexander Graewe
Keyword(s):  
Cerebrospinal Fluid ◽  
Time Course ◽  
Treatment Time ◽  
Randomized Study ◽  
Operating Time ◽  
Collagen Matrix ◽  
Control Group ◽  
Dural Defect ◽  
Decompressive Hemicraniectomy ◽  
Total Treatment Time

Abstract Objective: Decompressive hemicraniectomy is an accepted treatment for otherwise untreatable intracranial hypertension. The aim of this prospective randomized study is to evaluate the benefit of application of collagen matrix as an onlay graft to reduce operating time during hemicraniectomy and to facilitate dural dissection during secondstage cranioplasty. Methods: Thirty-four consecutive patients were randomized to receive collagen matrix during hemicraniectomy or to undergo the conventional procedure. Specific time points were recorded during hemicraniectomy and cranioplasty. Intra- and postoperative complications, time course of Glasgow Coma Scale, Barthel's, and Early Rehabilitation Indices were monitored. The surgeon had to rate the convenience of the procedure if collagen matrix was used. Cost implications are discussed. Results: The use of collagen matrix during hemicraniectomy resulted in a reduction of combined operating time for hemicraniectomy and cranioplasty by an average of 19.7%. The rate of cerebrospinal fluid effusion during cranioplasty was 13% when collagen was used and 58% in the control group. None of the patients who received collagen developed cerebrospinal fluid effusion persisting longer than 1 week, compared with 33% of patients in the control group. A total of 85% of the surgeons rated the use of collagen matrix as being easier than usual; the rest did not see a difference. Conclusion: The use of collagen matrix to cover the dural defect during hemicraniectomy reduces operating time in hemicraniectomy and cranioplasty. The complication rate (cerebrospinal fluid effusion), total treatment time, and time on intensive care unit can be reduced, giving a potential for cost reduction. There was no difference in the rehabilitative outcome.

scholarly journals Relationship between the polymorphism in the interleukin 1-β and the treatment time of patients subjected to a modified piezocision technique

2020 ◽  
pp. 1-14
Author(s):  
Juan Fernando Aristizabal ◽  
Hector Rios ◽  
Diego Rey ◽  
Maria Antonia Alvarez ◽  
Beatriz Parra ◽  
...  
Keyword(s):  
Tooth Movement ◽  
Treatment Time ◽  
Interleukin 1 ◽  
Orthodontic Tooth Movement ◽  
Collagen Matrix ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Protein Levels ◽  
Total Treatment Time ◽  
3D Collagen

Aim: We aimed to evaluate the correlation between the polymorphism of the interleukin 1-Beta (IL1-β, +3954 C>T) and tooth movement, in a group of Colombian patients undergoing surgically accelerated orthodontic tooth movement. Methods: The study was nested to a controlled clinical trial. Blood samples were taken from 11 women and 29 healthy Colombian male volunteers between 18 and 40 years old, after 1 year of starting orthodontic treatment. The patients presented malocclusion class I, with grade II or III. To detect the genetic polymorphism of the nucleotide +3954 C to T in the IL-1β gene, we used a real-time PCR assay. Results: Eleven individuals presented the allele 2 (T) heterozygous with the allele 1 (T/C) and 19 individuals were homozygous for the allele 1 (C/C). When analyzing the presence of the SNP, no significant differences were found in any of the variables. The best treatment was reflected in Group 3 (selective upper and lower alveolar decortication and 3D collagen matrix) and Group 4 (only selective alveolar decortication in the upper arch, with 3D collagen matrix), with 27% and 35% more speed respectively than in the control group. Conclusions: Our analyses indicated that a reduction in the total treatment time can be mostly potentiated by using decortication and collagen matrices and not for the presence of the allele 2 in the IL-1β. Nevertheless, it is important that further studies investigate if the polymorphism could be associated with the speed of tooth movement and analyze the baseline protein levels.

Clinical and economic consequences of antibiotic-impregnated cerebrospinal fluid shunt catheters

2008 ◽  
Vol 1 (6) ◽  
pp. 444-450 ◽  
Author(s):  
Regina Eymann ◽  
Somar Chehab ◽  
Martin Strowitzki ◽  
Wolf-Ingo Steudel ◽  
Michael Kiefer
Keyword(s):  
Cerebrospinal Fluid ◽  
Infection Rate ◽  
Operating Time ◽  
Cost Benefit ◽  
Shunt Infection ◽  
Control Group ◽  
Shunt Insertion ◽  
Shunt Procedure ◽  
Shunt Infection Rate ◽  
The Cost

Object The authors evaluated the safety and efficacy of antibiotic-impregnated shunt catheters (AISCs) and determined the cost–benefit ratio related to the fact that AISCs increase the implant costs of a shunt procedure by ~ $400 per patient. Methods The control group comprised 98 adults with chronic hydrocephalus and 22 children, who were treated without AISCs (non-AISCs). In the treatment group, AISCs (Bactiseal, Codman, Johnson & Johnson) were implanted in 171 adults and 26 children. The minimum follow-up period was 6 months. Results Important risk factors for shunt infections (such as age, comorbidity, cause of hydrocephalus, operating time, and duration of external cerebrospinal fluid drainage prior to shunt placement) did not differ between the study and control groups. In the pediatric AISC group, the frequency of premature, shunt-treated infants and the incidence of external ventricular drainage prior to shunt insertion were actually higher than those in the non-AISC group. When using AISCs, the shunt infection rate dropped from 4 to 0.6% and from 13.6 to 3.8% in the adult and the pediatric cohort, respectively. Overall the infection rate decreased from 5.8 to 1%, which was statistically significant (p = 0.0145). The average costs of a single shunt infection were $17,300 and $13,000 in children and adults, respectively. The cost–benefit calculation assumed to have saved shunt infection–related costs of ~ $50,000 in 197 AISC–treated patients due to the reduction in shunt infection rate in this group compared with costs in the control group. Despite the incremental implant costs associated with the use of AISCs, the overall reduction in infection-related costs made the use of AISCs cost beneficial in the authors' department. Conclusions From clinical and economic perspectives, AISCs are seemingly a valuable addition in hydrocephalus therapy.

scholarly journals Effects of Varying Acupuncture Manipulations at ST36 (Zusanli) on Gastric Electrical Frequency and Amplitude in Bradygastria Rabbits

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kang Wang ◽  
Yuan Xu ◽  
Yan Niu ◽  
Yangyang Liu ◽  
Hezheng Lai ◽  
...  
Keyword(s):  
Treatment Time ◽  
Control Group ◽  
Model Group ◽  
Respective Group ◽  
Whole Process ◽  
Stimulation Parameters ◽  
Frequency Level ◽  
Total Treatment Time ◽  
Acupuncture Intervention ◽  
Total Treatment

Objective. To observe the effects of different manual acupuncture (MA) manipulation on gastric electrical amplitude and frequency for noradrenaline-induced bradygastria in rabbits. Methods. A total of 60 rabbits were randomly allocated into six groups: four MA manipulation groups; reinforcing by twisting the manipulation group (FTG), reducing by twisting the manipulation group (RTG), reinforcing by lifting and thrusting the manipulation group (FLG), and reducing by lifting and thrusting the manipulation group (RLG), a control group (CG), and a model group (MG). The total treatment time length was 45 minutes. The bradygastria was induced via administration of noradrenaline via the marginal ear vein of the rabbits at 5 minutes from baseline, and the bradygastria model was established at 12 minutes from baseline. The rabbits in the four MA manipulation groups received different stimulation parameters at ST36 (Zusanli) for a duration of 3 minutes in accordance with their respective group allocation. The needles were then retained without further manipulation for a further 25 minutes. Gastric electrical amplitude and frequency were recorded using a data acquisition system (Biopac System MP150) at five different time points: baseline (for a duration of 5 minutes), after the bradygastria model was established at 12 minutes from baseline (for a duration of 5 minutes), during MA manipulation commencing at 17 minutes from baseline (for a duration of 3 minutes), 5 minutes after MA manipulation at 25 minutes from baseline (for a duration of 5 minutes), and at 20 minutes following MA manipulation at 40 minutes from baseline (for a duration of 5 minutes). Results. After noradrenaline induction, gastric electrical frequency levels in MA and MG groups were significantly decreased compared to the CG group (P<0.05). However, there were no significant changes to gastric electrical amplitude (P>0.05). During MA manipulation, gastric electrical frequency levels in RTG, FLG, and RLG groups were higher than in the MG group (P<0.05). At 5 minutes after MA manipulation, gastric electrical frequency levels in RTG and FLG groups were higher than in the MG group (P<0.05), and gastric electrical frequency level in the RTG group was higher than in the CG group (P<0.05). At 20 minutes after MA manipulation, gastric electrical frequency levels in FTG, RTG, and FLG groups were higher than in the MG group (P<0.05). Conclusion. All four variations of MA manipulations have a recovery effect on the gastric electrical frequency of rabbits with bradygastria. In particular, results indicated that FTG, RTG, and FLG at ST36 may have a regular and significant recovery trend through the whole process of the acupuncture intervention.

scholarly journals A Comparative Study between Autologous Dural Closure versus Collagen Matrix (DuraGen) Closure in Decompressive Craniectomy for Trauma

2020 ◽  
Vol 17 (01) ◽  
pp. 46-49
Author(s):  
Rajesh Kumar Barooah ◽  
Basanta Kumar Baishya ◽  
Hriday Haloi ◽  
Mrinal Bhuyan ◽  
Asman Ali ◽  
...  
Keyword(s):  
Wound Infection ◽  
Decompressive Craniectomy ◽  
Operating Time ◽  
Collagen Matrix ◽  
Dural Defect ◽  
Temporalis Fascia ◽  
Dural Closure ◽  
Fascia Graft ◽  
Dural Graft ◽  
Csf Leakage

Abstract Introduction Neurosurgeons often deal with the problem of a complete and watertight dural closure after cerebral operative procedures. In decompressive craniectomy done for trauma, autologous grafts such as galea, temporalis fascia can be time consuming. Hence this study was undertaken to look into the outcome using collagen matrix graft for dural closure. Aims and Objectives To study the difference between autologous dural graft closure and collagen matrix graft with respect to the time taken for closure, cerebrospinal fluid (CSF) leakage, and wound infection. Methods This prospective study includes 30 patients who underwent decompressive craniectomy for trauma. Duraplasty with temporalis fascia graft and nonautologous collagen matrix dural patch was done by randomization. Specific time points during craniectomy and cranioplasty was calculated. Total time for the procedures and the time for dural repair and separation was calculated. Results The use of collagen matrix in decompressive craniectomy resulted in decrease in mean operative time during the first surgery by average 45 minutes (p< 0.5) as compared to the use of autologous graft. There is reduction in the operating time during second surgery (cranioplasty) by 35 minutes (p< 0.5). The patients using collagen matrix graft did not record any CSF leakage or wound infection. Excellent uptake of the collagen by the duramater was seen. Conclusion The use of collagen to cover the dural defect for decompressive craniectomy for trauma results in significant reduction in the operating time during the first surgery and also in cranioplasty. There is reduction in CSF leakage and hence duration of hospital stay and cost.

scholarly journals Physiological doses of iodine and carriage of antibodies thyroid peroxidase: an open, randomized trial

2004 ◽  
Vol 50 (5) ◽  
pp. 3-7
Author(s):  
V. V. Fadeev ◽  
G. A. Mel'nichenko
Keyword(s):  
Potassium Iodide ◽  
Time Course ◽  
Randomized Study ◽  
Substantial Effect ◽  
Primary Hypothyroidism ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Study Group ◽  
Normal Thyroid Function ◽  
And Function

This prospective open randomized study explored the effects of the physiological doses of iodine on the structure and function of the thyroid in persons who were carriers of thyroid peroxidase antibodies (TPOAb). The study included 44 females with normal thyroid function and levels of TPOAb of more than 100 mU/l. By employing open block randomization using a random number tables, the patients were divided into 2 groups: 1) 22 females who received potassium iodide in a daily dose of 100 pg for 6 months (a study group) and 2) 22 patients who did not take any therapy or placebo throughout the study (a control group). Three patients (they all from the study group) were excluded from the study due to their incompliance. Following 6 months, two patients were diagnosed as having primary hypothyroidism : 1 patient from the study group had subclinical hypothyroidism with an increase in the level of TSH up to 7.2 mU/l; the other patient from the control group had obvious hypothyroidism (TSH, 67 mU/l). Evaluation of the time course of changes in the level of TSH and the volume of the thyroid revealed no difference between the study and control groups throughout and by the end of the study. A statistically significant decrease in the volume of the thyroid was found in a group of patients with the initially enlarged thyroid treated with potassium iodide. It is concluded that the physiological doses of iodine do not produce any substantial effect on the function and volume of the thyroid in ATOAb carriers.

scholarly journals Evaluation of the Histomorphometric and Micromorphometric Performance of a Serum Albumin-Coated Bone Allograft Combined with A-PRF for Early and Conventional Healing Protocols after Maxillary Sinus Augmentation: A Randomized Clinical Trial

Materials ◽  
2021 ◽  
Vol 14 (7) ◽  
pp. 1810
Author(s):  
Bálint Trimmel ◽  
Szabolcs Gyulai-Gaál ◽  
Márton Kivovics ◽  
Noémi Piroska Jákob ◽  
Csaba Hegedűs ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Maxillary Sinus ◽  
Treatment Time ◽  
Test Group ◽  
Bone Allograft ◽  
Control Group ◽  
Two Stage ◽  
Sinus Augmentation ◽  
Maxillary Sinus Augmentation ◽  
Total Treatment Time

The aim of this study was to compare the microarchitecture of augmented bone following maxillary sinus augmentation (MSA) after healing periods of 3 (test) and 6 (control) months using the combination of advanced platelet-rich fibrin (A-PRF) and a serum albumin-coated bone allograft (SACBA). Twenty-six patients with 30 surgical sites who required two-stage MSA were enrolled and grafted with the combination of A-PRF and SACBAs. The surgical sites were randomly allocated to the test or control group. During implant site preparation, 17 bone core biopsy samples were collected from each study group for histological, histomorphometric and micromorphometric analysis. Resonance frequency analysis was performed at the time of implant placement and 6, 8, 10, and 12 weeks postoperatively. The percentage of newly formed bone was 44.89 ± 9.49% in the test group and 39.75 ± 8.15% in the control group (p = 0.100). The results of the µCT analysis showed no significant differences in morphometric parameters between the study groups. The implant stability quotient was not significantly different between the two groups at 10 and 12 weeks postoperatively. Based on these findings, the total treatment time may be reduced by 3 months with the use of A-PRF and SACBAs for two-stage MSA.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

2020 ◽  
pp. 97-105
Author(s):  
E. N. Simakova ◽  
O. V. Stenkova
Keyword(s):  
Intraocular Pressure ◽  
Drug Therapy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Main Group ◽  
Control Group ◽  
Open Angle ◽  
Complex Treatment ◽  
Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

Vital Tooth Whitening Techniques. A literature Review

2020 ◽  
Vol 02 ◽  
Author(s):  
Pia Chatterjee Kirk
Keyword(s):  
Soft Tissues ◽  
Treatment Time ◽  
Tooth Bleaching ◽  
Tooth Whitening ◽  
Easy Method ◽  
Tooth Structure ◽  
Dental Esthetics ◽  
Total Treatment Time ◽  
Restorative Materials ◽  
Total Treatment

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

scholarly journals On the Role of Bilateral Brain Hypofunction and Abnormal Lateralization of Cortical Information Flow as Neural Underpinnings of Conventional Metaphor Processing Impairment in Schizophrenia: An fMRI and EEG Study

2021 ◽  
Author(s):  
Przemysław Adamczyk ◽  
Martin Jáni ◽  
Tomasz S. Ligeza ◽  
Olga Płonka ◽  
Piotr Błądziński ◽  
...  
Keyword(s):  
Information Flow ◽  
Language Processing ◽  
Time Course ◽  
Figurative Language ◽  
Neural Circuits ◽  
Effective Connectivity ◽  
Brain Regions ◽  
Blood Oxygenation ◽  
Control Group ◽  
Metaphor Processing

AbstractFigurative language processing (e.g. metaphors) is commonly impaired in schizophrenia. In the present study, we investigated the neural activity and propagation of information within neural circuits related to the figurative speech, as a neural substrate of impaired conventional metaphor processing in schizophrenia. The study included 30 schizophrenia outpatients and 30 healthy controls, all of whom were assessed with a functional Magnetic Resonance Imaging (fMRI) and electroencephalography (EEG) punchline-based metaphor comprehension task including literal (neutral), figurative (metaphorical) and nonsense (absurd) endings. The blood oxygenation level-dependent signal was recorded with 3T MRI scanner and direction and strength of cortical information flow in the time course of task processing was estimated with a 64-channel EEG input for directed transfer function. The presented results revealed that the behavioral manifestation of impaired figurative language in schizophrenia is related to the hypofunction in the bilateral fronto-temporo-parietal brain regions (fMRI) and various differences in effective connectivity in the fronto-temporo-parietal circuit (EEG). Schizophrenia outpatients showed an abnormal pattern of connectivity during metaphor processing which was related to bilateral (but more pronounced at the left hemisphere) hypoactivation of the brain. Moreover, we found reversed lateralization patterns, i.e. a rightward-shifted pattern during metaphor processing in schizophrenia compared to the control group. In conclusion, the presented findings revealed that the impairment of the conventional metaphor processing in schizophrenia is related to the bilateral brain hypofunction, which supports the evidence on reversed lateralization of the language neural network and the existence of compensatory recruitment of alternative neural circuits in schizophrenia.

scholarly journals The Relationships between HIV-1 Infection, History of Methamphetamine Use Disorder, and Soluble Biomarkers in Blood and Cerebrospinal Fluid

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1287
Author(s):  
T. Walter ◽  
Jennifer Iudicello ◽  
Debra Cookson ◽  
Donald Franklin ◽  
Bin Tang ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Immune System ◽  
Public Health Problem ◽  
Control Group ◽  
Csf Biomarkers ◽  
Immune System Dysfunction ◽  
Immune Biomarkers ◽  
Plasma Factor ◽  
History Of ◽  
Hiv 1

Methamphetamine (METH) use disorder is highly prevalent among people with HIV (PWH) and is a significant public health problem. HIV and METH use are each associated with immune system dysfunction; however, the combined effects on the immune system are poorly understood. This cross-sectional project measured soluble immune biomarkers in plasma and cerebrospinal fluid (CSF) collected from a control group, people with a history of a METH use disorder (METH+), PWH with no history of METH use disorder (HIV+), and PWH with a history of METH use disorder (HIV+/METH+). HIV, METH, and immune dysfunction can also be associated with affective and cognitive deficits, so we characterized mood and cognition in our participants. Two factor analyses were performed for the plasma and CSF biomarkers. Plasma IL-8, Ccl2, VEGF, and 8-isoprostane loaded onto one factor that was highest in the HIV+/METH+ group (p < 0.047) reflecting worse inflammation, vascular injury, and oxidative stress. This plasma factor was also negatively correlated with delayed recall (R = −0.49, p = 0.010), which was worst in the HIV+/METH+ group (p = 0.030 compared to the control group). Overall, these data implicate that combined HIV-1 infection and METH use may exacerbate inflammation, leading to worse cognition.

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