Two Ways of Immediate Rehabilitation of Edentulous Mandible with Dental Implants and Prostheses – Critical View on Brånemark System® Novum

With appropriate stabilization and occlusal loading, mandibular implants can be immediately loaded in a complete- arch configuration with no apparent detrimental effect on the rates of osseointegration. Ten patients were treated with the immediate loading protocols in completely edentulous mandible either with conventional one-stage implants and a provisional denture or with the Brånemark System® Novum and a definite restoration. A total of 42 implants were placed. One Novum implant was lost 1 month after placement. The clinical success rate of the immediately loaded implants at the time of the 6–month check-up was 97.6 %. Radiographic surveys completed by panoramic radiographs 6 months after the surgery revealed good healing of bone at implant interface. After the period, mean marginal bone loss was 0.4 mm (ranged from 0 mm to 1.5 mm). The results of this short-term clinical and radiographic study indicate that the precise surgical and prosthetic protocol allows successful prosthetic rehabilitation of mandibular edentulism and that the provisional or permanent fixed reconstruction can be provided to a patient on a day of fixture surgery. Finally, authors consider critical comments on Brånemark System® Novum.

Download Full-text

Endoscopic Self-Expandable Metallic Stent Insertion without Fluoroscopic Guidance Is Feasible and Safe for Acute Colonic Obstruction Caused by Colorectal Cancer

Gastroenterology Research and Practice ◽

10.1155/2020/6810164 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Yadong Feng ◽

Qian Yu ◽

Ming Li ◽

Wei Xu ◽

Ye Zhu ◽

...

Keyword(s):

Success Rate ◽

Clinical Success ◽

Colonic Obstruction ◽

Clinical Success Rate ◽

Metallic Stent ◽

Fluoroscopic Guidance ◽

Procedure Time ◽

Technical Success ◽

Short Term ◽

Expandable Metallic Stent

Aims. Endoscopic self-expandable metallic stent (SEMS) insertion for acute colonic obstruction caused by colorectal cancer (CRC) is always performed under fluoroscopic guidance. This study evaluated the feasibility and safety of an endoscopic stenting procedure without fluoroscopic guidance. Methods. A total of 36 patients with an acute colonic obstruction caused by CRC underwent endoscopic SEMS insertion using a colonoscope without fluoroscopic guidance, followed by analyses of the technical and clinical success and short-term complications. Results. Total technical success rate and clinical success rate were 91.7% and 86.1%, respectively. The mean procedure time was 21.2±10.3 minutes. There was no stent dislodgement. One case of hematochezia and two cases of tenesmus occurred in patients with left-sided complete obstructions. No other short-term complications occurred. Procedure time, technical success, and clinical success rate were 16.3±9.4 minutes, 93.1%, and 89.6% for left-sided obstructions, respectively, and were 26.8±10.7 minutes, 85.7%, and 71.4% for right-sided obstructions, respectively. For complete obstructions, procedure time, technical success, and clinical success rate were 22.5±8.9 minutes, 90%, and 83.3%, respectively. In the incomplete cases, procedure time, technical success, and clinical success were 13.5±6.7 minutes, 100%, and 100%, respectively. Technical success, clinical success, and short-term complications were not differed between lesion locations and degrees. Conclusions. This simple technique is feasible and safe for palliation of acute colonic obstruction caused by CRC.

Download Full-text

Amplatzer occluders for refractory esophago-respiratory fistulas: a case series

Endoscopy International Open ◽

10.1055/a-1490-9001 ◽

2021 ◽

Vol 09 (09) ◽

pp. E1350-E1354

Author(s):

Arthur Belle ◽

Christine Lorut ◽

Aurélie Lefebvre ◽

Einas Abou Ali ◽

Rachel Hallit ◽

...

Keyword(s):

Primary Outcome ◽

Clinical Success ◽

Case Series ◽

Clinical Success Rate ◽

Endoscopic Management ◽

Vacuum Therapy ◽

Short Term ◽

Endoscopic Vacuum Therapy ◽

Endoscopic Placement ◽

Safe Treatment Option

Abstract Background and study aims Endoscopic management of esophagorespiratory fistulas (ERF) is challenging and currently available options (stents, double pigtail, endoscopic vacuum therapy) are not very effective. We report the feasibility and efficacy of endoscopic placement of Amplatzer cardiovascular occluders for this indication. Patients and methods This was a single-center, prospective study (June 2019 to September 2020) of all patients with non-malignant ERF persistent after conventional management with esophageal and/or tracheal stents. The primary outcome was the technical feasibility of Amplatzer placement. Secondary outcomes were clinical success defined by effective ERF occlusion and resolution of respiratory symptoms allowing oral food intake. Results Endoscopic placement of Amplatzer occluders was feasible in 83 % of patients (5/6), with a 50 % (3/6) clinical success rate at 9 months. The mortality rate was 33 % (2/6). Conclusions An Amplatzer cardiac or vascular occluder is a feasible and safe treatment option for refractory ERF, with a 50 % short-term clinical success.

Download Full-text

Combined therapy with bronchial artery embolization and tranexamic acid for hemoptysis

Acta Radiologica ◽

10.1177/0284185120933984 ◽

2020 ◽

pp. 028418512093398

Author(s):

Hyoung Nam Lee ◽

Hong Suk Park ◽

Dongho Hyun ◽

Sung Ki Cho ◽

Kwang Bo Park ◽

...

Keyword(s):

Risk Factor ◽

Tranexamic Acid ◽

Bronchial Artery ◽

Clinical Success ◽

Combined Therapy ◽

Significant Risk ◽

Clinical Success Rate ◽

Short Term ◽

Recurrence Rates ◽

Survival Difference

Background While most previous studies have viewed tranexamic acid as a bridging or temporary therapy, our preliminary study offers insights into the combined therapy of antifibrinolytic agent with endovascular treatment for hemoptysis. Purpose To investigate the feasibility and safety of combined therapy, to analyze factors affecting the outcomes of combined therapy, and to compare the effectiveness of combined therapy between groups with different etiologies. Material and Methods Between January 2011 and December 2014, 64 patients (33 men, mean age 64.6 years) underwent combined therapy for hemoptysis. The median follow-up time was 14.7 months (range 174–2435 days). Patients were divided into a tuberculosis group (GroupTB, n=37) and a non-tuberculosis group (Groupnon-TB, n=27). Results Embolotherapy was technically successful in 62/64 (96.9%) cases. The immediate clinical success rate was 96.8% (60/62). The short-term and long-term recurrence rates were 12.9% (n=8) and 19.4% (n=12), respectively. The one-, two-, and four-year recurrence-free survival rates were 61%, 49%, and 32%, respectively. There was no significant survival difference between the two groups. Suboptimal embolization was a significant risk factor for immediate clinical failure (odds ratio 29.624, P = 0.023). Optimal embolization (hazard ratio [HR] 0.199, P = 0.023) and older age (HR 0.956, P = 0.013) were significantly associated with lower recurrence risk. Conclusion Combined therapy is an effective and safe treatment modality for hemoptysis of various etiologies, with potential benefits for short-term recurrence vis-a-vis current literature evidence. Suboptimal embolization was the most important modifiable risk factor for treatment failure and recurrence after combined therapy.

Download Full-text

Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽

10.1055/s-0037-1622301 ◽

2010 ◽

Vol 39 (02) ◽

pp. 69-71 ◽

Cited By ~ 6

Author(s):

T. M. Proebstle ◽

Keyword(s):

Side Effects ◽

Thermal Ablation ◽

Clinical Success ◽

Clinical Success Rate ◽

Duplex Ultrasound ◽

Multicenter Trial ◽

Saphenous Veins ◽

Clinical Control ◽

Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

Download Full-text

Clinical effectiveness of high dose versus standard dose of meropenem in ventilator-associated pneumonia caused by multidrug-resistant bacteria: a randomized single-blind clinical trial

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200227102013 ◽

2020 ◽

Vol 20 ◽

Author(s):

Mahila Monajati ◽

Shahram Ala ◽

Masoud Aliyali ◽

Roya Ghasemian ◽

Fatemeh Heidari ◽

...

Keyword(s):

Success Rate ◽

Sofa Score ◽

Dose Group ◽

Clinical Success ◽

Standard Dose ◽

Clinical Success Rate ◽

High Dose Group ◽

Resistant Bacteria ◽

High Dose ◽

Ventilator Associated Pneumonia

Background: Meropenem standard doses are based on the minimum inhibitory concentration of sensitive pathogens and the pharmacokinetic parameter of not critically ill patients. We compared the efficacy of high versus standard dose of meropenem in ventilator-associated pneumonia (VAP). Methods: 24 out of 34 eligible patients were randomized to receive meropenem 3 g q8h (high dose group, 11 patients) or 2 g q8h (standard dose group, 13 patients) as a 3h infusion. Primary outcome was considered as clinical success that was defined as stable hemodynamic, improved sequential organ failure assessment (SOFA) score, stable or improved PaO2/FiO2 after 7 days. A sputum culture was taken before intervention. Results: Clinical success rate was not significantly different between the high and standard dose group (54.5% vs. 38.5%, P= 0.431). There was a significant difference in reduction of clinical pulmonary infection score (CPIS) compared to high dose with standard group (P=0.038). SOFA score declined significantly in high dose group through the study (P=0.006). A shorter duration of VAP treatment was recorded in high dose group (P=0.061). We did not observe any significant adverse event related to meropenem. Acinetobacter spp. (34.8%), Klebsiella spp. (32.6%) and, Pseudomonas aeruginosa (19.5%) isolated more frequently from sputum cultures. Conclusion: Treatment with high dose of meropenem seems to be safe. However, it did not provide significantly higher clinical success rate in comparison with the standard dose, but could be considered as an appropriate empirical treatment in patients with severe infection due to reducing in SOFA and CPIS.

Download Full-text

Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.24.4.d7u6405nw1132705 ◽

2000 ◽

Vol 24 (4) ◽

pp. 269-272 ◽

Cited By ~ 28

Author(s):

Hamijeta Ibricevic ◽

Qumasha Al-Jame

Keyword(s):

Success Rate ◽

Primary Teeth ◽

Root Resorption ◽

Clinical Success ◽

Clinical Success Rate ◽

Ferric Sulfate ◽

Primary Molar ◽

Molar Teeth ◽

The Moment

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.

Download Full-text

1306. Comparison of the Use of Extended and Intermittent Infusion Cefepime and Piperacillin/tazobactam in Non-critically Ill, Obese Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1489 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S667-S667

Author(s):

Carolyn Marg ◽

Zach DeLanoit ◽

Kimberly D Boeser

Keyword(s):

Clinical Success ◽

Small Sample Size ◽

Clinical Success Rate ◽

Intermittent Infusion ◽

Volume Of Distribution ◽

Small Sample ◽

Hospital Length Of Stay ◽

Obese Patients ◽

Target Time ◽

All Cause Mortality

Abstract Background Obesity rates have dramatically increased over the last several decades, however, there is limited data to guide how antibiotics should be adjusted in obese patients. Physiologic differences including an increased volume of distribution and increased renal clearance may alter their pharmacokinetics and pharmacodynamics and subsequently, their efficacy. For beta-lactams like piperacillin/tazobactam (pip/tazo) and cefepime, extended infusion (EI) maximizes the time above the minimum inhibitory concentration (MIC) for optimal bactericidal activity. This dosing strategy may help decrease variability in achieving the target time above MIC in this patient population and lead to more favorable outcomes. Methods This single-center, retrospective, pre-/post- analysis included patients with a body mass index (BMI) > 30 that received EI (infused over 4 hours) or intermittent infusion (II) (infused over 30 minutes) pip/tazo or cefepime between 2/1/2020-4/30/2020 and 2/1/2019-4/30/2019, respectively. The primary outcome was in-hospital, all-cause mortality. Secondary outcomes included clinical success rate and hospital length of stay (LOS). Results During the evaluation periods, 98 patients met inclusion criteria (EI, N=53; II, N=45). Mean BMI was not statistically different between groups (EI, 36.0 kg/m2 [30.1-46.3]; II, 36.5 kg/m2 [30-48]). There were no cases of mortality in either group. The mean LOS in the II group was 13 days compared to 11.5 days in the EI group [95% CI -4.14-7.04; p=0.606]. After excluding one outlier of 104 days in the EI group, the average LOS was 9.5 days [95% CI: -0.87-7.33; p=0.121]. Markers of clinical success including time to resolution of fever (II: 47 hours; EI: 34 hours; p=0.216) and time to resolution of leukocytosis (II: 2 days; EI: 3.8 days; p=0.089) were not significantly different between groups. Conclusion The use of EI pip/tazo and cefepime was not associated with any differences in in-hospital, all-cause mortality, hospital LOS, or clinical success when compared to the use of II pip/tazo and cefepime. The lack of significant differences between groups may be attributable to the small sample size limiting the ability to detect a difference, especially regarding hospital LOS. Disclosures All Authors: No reported disclosures

Download Full-text

Clinical outcome of endoscopic therapy in patients with symptomatic pancreas divisum: a Dutch cohort study

Endoscopy International Open ◽

10.1055/a-1460-7899 ◽

2021 ◽

Vol 09 (07) ◽

pp. E1164-E1170

Author(s):

David M. de Jong ◽

Pauline M. Stassen ◽

Jan Werner Poley ◽

Paul Fockens ◽

Robin Timmer ◽

...

Keyword(s):

Acute Pancreatitis ◽

Cohort Study ◽

Endoscopic Therapy ◽

Clinical Success ◽

Pancreas Divisum ◽

Univariate Analysis ◽

Clinical Success Rate ◽

Recurrent Acute Pancreatitis ◽

Pancréas Divisum

Abstract Background and study aims Although the majority of patients with pancreas divisum (PDiv) are asymptomatic, a subgroup present with recurrent pancreatitis or pain for which endoscopic therapy may be indicated. The aim of this study was to evaluate success rates and long-term outcomes of endoscopic treatment in patients with symptomatic PDiv. Patients and methods A multicenter, retrospective cohort study was performed. Patients with symptomatic PDiv presenting with recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), or chronic abdominal pancreatic-type pain (CAP) who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2000 and December 2019 were included. The primary outcome was clinical success, defined as either no recurrent episode of acute pancreatitis (AP) for RAP patients, no flares for CP patients, or absence of abdominal pain for patients with CAP after technically successful ERCP. Results In 60 of 81 patients (74.1 %) a technically successful papilla minor intervention was performed. Adverse events were reported in 30 patients (37 %), with post-ERCP pancreatitis in 18 patients. The clinical success rate for patients with at least 3 months of follow-up was 42.6 %, with higher rates of success among patients presenting with RAP (44.4 %) as compared to those with CP (33.3 %) or CAP (33.3 %). Long-term sustained response was present in 40.9 % of patients with a technically successful intervention. In patients with RAP who did not completely respond to treatment, the mean number of AP episodes after treatment decreased significantly from 3.5 to 1.1 per year, and subsequently the interval between AP episodes increased from 278 to 690 days (P = 0.0006). A potential predictive factor of failure of clinical success after technically successful ERCP, at univariate analysis, was male sex (OR = 0.25, P = 0.02). Conclusions Endoscopic therapy in patients with symptomatic PDiv is moderately effective, with its highest yield in patients presenting with RAP. Future studies are needed to assess factors predictive for success of endoscopic therapy and potential risk factors for relapse after ERCP.

Download Full-text

A new treatment paradigm for phlegmasia cerulea dolen: Single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520977276 ◽

2020 ◽

pp. 026835552097727

Author(s):

GuangMing Tan ◽

Bryan PY Yan

Keyword(s):

Clinical Success ◽

Treatment Algorithm ◽

Clinical Success Rate ◽

Iliac Vein ◽

Single Stage ◽

Bleeding Complications ◽

Common Iliac Vein ◽

Period 2 ◽

Treatment Paradigm ◽

Iliac Vein Compression

Background Phlegmasia Cerulae Dolen (PCD) is potentially a lethal disease but there is currently no established treatment algorithm for it. The aim of this study was to assess the safety and effectiveness of single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting in the treatment of PCD. Method This was a retrospective single centre observational study of consecutive patients who underwent endovascular intervention for the treatment of PCD between June 2016 and March 2020. Clinical and procedural details were recorded. Procedural and clinical success rate, procedural complications, and 30 days mortality were reported. Result 11 patients were treated during the study period. 2 (18.2%) had active malignancy. 63.6% were uncomplicated PCD on presentation. Common iliac vein compression or stenosis were demonstrated in all patients. Venous stents were implanted in all cases and procedures were successful in all cases. All patients had symptoms improvement at 72 hours post procedure. Other than 2 major bleeding complications, there was no other adverse event. The 30 days mortality was 18.2%. Active malignancy and the presence of anaemia were significantly associated with major complications. Conclusion Single stage endovascular thrombectomy and stenting was effective and safe in the treatment of patients with PCD. Common Iliac vein compression was a common underlying cause of PCD.

Download Full-text