scholarly journals Clinical evaluation of growth potentiality of autogenous costochondral graft in Temporomandibular joint on New Zealand white rabbit- an experimental study

2021 ◽  
Vol 12 (1) ◽  
pp. 8-18
Author(s):  
Jachmen Sultana ◽  
Quazi Billur Rahman ◽  
Emdadul Haque Chowdhury ◽  
Nasrin Sultana Juyena ◽  
Abul Bashar
Keyword(s):  
Experimental Study ◽  
New Zealand ◽  
Temporomandibular Joint ◽  
Clinical Evaluation ◽  
Behavioral Change ◽  
Clinical Presentation ◽  
Growth Potential ◽  
Growth Center ◽  
Costochondral Graft

Background: Costochondral graft has been used as a substitute for a growth center in the damaged Temporomandibular joint (TMJ) in the growing children. But the relapse of the TMJ ankylosis along with facial deformity is the most common outcome after the surgery for the resorption or overgrowth of the graft. While an exploration of the human Temporomandibular joint seems to be unethical after reconstruction with an autogenous costochondral graft for study purposes, therefore we sought to determine the growth potential of the graft by clinical evaluation. Material and methods: An experimental study was done on 96 New Zealand white male rabbits, which were divided into batches. Each batch (total 2 batches) contained 24 experimental and 24 control rabbits of known ages and species; growing (3-4) and adult (12-18) months old. TMJ arthroplasty with a costochondral graft using either 1mm or 4 mm thickness of cartilaginous cap done in both age groups. Follow-up was done regularly in batches comparing with control up to 4th, 12th, and 24th weeks of surgery to find out any relationship of behavioral change, clinical presentation, and macroscopic growth of the graft. Results: There was a relationship among the rabbits with their behavioral change, clinical presentation, and presence of growth center in the graft. Growth was found in 60% cases, 40% was growing, and 20% in adults. Conclusions: Costochondral graft had a 60% growth potentiality. The failure rate of 40% may be due to some unknown factors. Grafts grew in a greater number of growing rabbits than adults. Long time follow-up had a strong role in the growth of the graft. In conclusion, clinical evaluation of the rabbit model provided a fair estimation of the growth process.

scholarly journals Temporomandibular joint anchorage surgery: a 5-year follow-up study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Xiuming Liu ◽  
Zhihang Zhou ◽  
Yi Mao ◽  
Xuzhuo Chen ◽  
Jisi Zheng ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Temporomandibular Joint ◽  
Clinical Evaluation ◽  
Mouth Opening ◽  
Vas Score ◽  
Disc Position ◽  
Tmj Disc ◽  
Condyle Position ◽  
Magnetic Resonance Imaging Mri

AbstractThe purpose of this study was to confirm the 5-year efficiency of temporomandibular joint (TMJ) anchorage, using clinical evaluation and magnetic resonance imaging (MRI). We also studied the influence of disc length and position on efficiency and postoperative condylar height. Sixty-one patients (76 joints) undergoing TMJ disc anchorage were followed up for >5 years. Visual analogue scale (VAS) score and maximum mouth-opening pre-and postsurgery were analysed and patient satisfaction recorded. Disc length, condyle height and disc position pre- and postsurgery were measured using MRI. Patients were ranked as A, B or C degree according to postoperative disc condyle position. Mean follow-up time was 71.34 months. Maximum mouth-opening improved by 14.34 ± 5.87 mm, and VAS score decreased by 33.44 ± 20.56 (P < 0.05). Clinical evaluation efficiency was 84.21%; patient satisfaction rate was 85.53%. On follow-up MRI, 68 joints were judged A or B degree (89.67%). Disc length was 7.96 ± 1.38 mm, 7.10 ± 1.41 mm and 5.75 ± 1.16 mm in A, B and C groups, respectively. In patients evaluated as C, condylar height decreased by 0.43 ± 1.36 mm, while increasing by 0.67 ± 1.88 mm and 0.51 ± 1.09 mm in A and B groups, respectively (all P < 0.05). We concluded that anchorage surgery improves mouth-opening and eliminates pain, longer disc length is related to better postoperative disc position, and significant condylar reconstruction occurs after disc repositioning. MRI confirmed that TMJ disc anchorage is reliable 5 years postsurgery.

Temporomandibular joint ankylosis: reconstruction with costochondral graft. Follow-up of two cases

2011 ◽  
Vol 40 (10) ◽  
pp. 1208
Author(s):  
B. Beltran-Salinas ◽  
A. Cervantes ◽  
H. Martinez ◽  
D. Perez
Keyword(s):  
Temporomandibular Joint ◽  
Temporomandibular Joint Ankylosis ◽  
Joint Ankylosis ◽  
Costochondral Graft

scholarly journals Management of pediatric Temporomandibular joint ankylosis: use of costochondral rib graft with interpositional temporalis myofacial flap

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Muhammad Usman Akhtar ◽  
Adnan Ali Shah ◽  
Iram Abbas
Keyword(s):  
Temporomandibular Joint ◽  
Low Socioeconomic Status ◽  
Mixed Dentition ◽  
Low Socioeconomic ◽  
Jaw Opening ◽  
Preoperative Ct ◽  
Growing Age ◽  
One Year ◽  
Costochondral Graft

Background: The posttraumatic ankylosis of the temporomandibular joint (TMJ) is frequently seen in children in Pakistan. The factors which favour in the development of this condition are; the children exhibit much more liability to emergency management, greater difficulty in clinical and radiological examination, state of mixed dentition, faster rate of healing, non-availability of specialists and low socioeconomic status of the patient. Different autogenous and alloplastic interpositional materials have been attempted after the resection of the ankylotic bone to achieve desirable results. Method: All patients were presented at Punjab Dental and Children Complex Hospitals Lahore. Twenty-three children (age 1 to 15years) with 28 joints underwent costochondral arthroplasty with interpositional temporalis myofacial flap, out of which 6 were of re-ankylosis after surgery at other centres. The costochondral graft was fixed by tripod screws with remaining ramus condylar unit. The surgery was planned after caref ul examination and final radiographic confirmation. The preoperative CT scan was also performed in few patients. Results: The surgical protocol is used to achieve the desirable interincisal jaw opening (>30mm) that was also the postoperative criteria for successful surgery. Five patients with bilateral ankylosis were operated and one patient with additional ipsilateral coronoidectomy. Less than 30mm interincisal opening was considered as unsatisfactory jaw opening. The overall success rate was 96% with only one patient was observed with less than 30mm opening. The lateral and protrusive jaw movements were assessed as excellent, good and poor. The immediate postoperative complications were transient. Conclusion: The ankylosis develops mainly after damage to mandibular condyles or TMJ at a growing age. Results with the procedure were encouraging without noticeable complications during an average follow up of one year.

Eine Therapie mit Everolimus und reduziertem Ciclosporin kann das Krebsrisiko von Nierentransplantierten verringern* (Sponsor: Novartis Pharma GmbH, Nürnberg)

2017 ◽  
Vol 05 (01) ◽  
pp. 22-22
Keyword(s):  
New Zealand ◽  
De Novo

ZusammenfassungDie Verknüpfung der A2309-Studie mit dem Australia and New Zealand Dialysis and Transplant (ANZDATA) Register erlaubte ein Follow up von 7 Jahren. Die Autoren bezeichnen diese Analyse als die bisher überzeugendste Evidenz, dass eine Immunsuppression mit de novo Everolimus und reduziertem Ciclosporin langfristig mit einer geringeren Krebsinzidenz nach Nierentransplantation assoziiert ist als die Standardtherapie.

The Language of New Terrorism: Differences in Psychological Dimensions of Communication in Dabiq and Inspire

2017 ◽  
Author(s):  
Matteo Vergani ◽  
Ana-Maria Bliuc
Keyword(s):  
Experimental Study ◽  
English Language ◽  
Terrorist Attacks ◽  
Al Qaeda ◽  
Positive Attitudes ◽  
Terrorist Groups ◽  
The Usa ◽  
Psychological Dimensions ◽  
New Terrorism

We investigate differences in the psychological aspects underpinning Western mobilisation of two terrorist groups by analysing their English-language propaganda. Based on a computerized analysis of the language used in two English-language online magazines circulated by ISIS and al-Qaeda (i.e., Dabiq and Inspire), we found significant differences in their language - the ISIS’ language being higher in authoritarianism and its level of religiousness. In a follow-up experimental study, we found that being high in religiousness and authoritarianism predicts more positive attitudes towards the language used by ISIS, but not towards the language used by al-Qaeda. The results suggest that ISIS’ propaganda may be more effective in mobilising individuals who are more authoritarian and more focused on religion than that of al-Qaeda. These findings are consistent with the behaviour observed in recent homegrown terrorist attacks in the USA and Europe.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Necrosis avascular

2020 ◽  
Vol 63 (2) ◽  
pp. 18-23
Author(s):  
Alejandro Jardón Gómez ◽  
Ana Cristina King ◽  
Carlos Pacheco Díaz
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Femoral Fracture ◽  
Open Fracture ◽  
Clinical Presentation ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Young Population ◽  
Steroid Use

The clinical presentation of a proximal femoral fracture is completely different between young and adult patients. Unlike closed proximal femoral fractures, the incidence of exposed fractures is found in the young population between 15 and 30 years of age. Osteonecrosis of the femoral head is one the complications we can find in this type of fractures. Avascular necrosis (AVN or osteonecrosis) is defined as the interruption of blood supply to the femoral head due to trauma, infectionalcohol or steroid use, resulting in bone necrosis, joint collapse and osteoarthrosis. The treatment will depend on the clinical presentation, age of the patient and when the diagnosis is made. This is a case report of a 16-year-old patient with a gunshot wound on the hip. Surgical cleansing and closed reduction plus internal fixation with a nail in the center of the spine were performed. A 3-year clinical and radiographic follow up was made, observing the evolution of the fracture and the subsequent avascular necrosis that the patient presented. Key words: Proximal femoral fracture; hip; avascular necrosis (AVN, osteonecrosis); open fracture; osteoarthritis.

External Investigators' Follow-Up Intentions When Whistleblowers Report Healthcare Fraud: The Effects of Report Anonymity and Previous Confrontation

2020 ◽  
Vol 32 (2) ◽  
pp. 91-101
Author(s):  
Steven E. Kaplan ◽  
Danny Lanier ◽  
Kelly R. Pope ◽  
Janet A. Samuels
Keyword(s):  
Experimental Study ◽  
Early Detection ◽  
Data Availability ◽  
Medical Provider ◽  
Perceived Credibility ◽  
The Relationship ◽  
Critical Investigation

ABSTRACT Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical, investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions. Data Availability: Data are available upon request.

scholarly journals When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

2019 ◽  
Vol 30 (1) ◽  
pp. 146-148
Author(s):  
Lara Girelli ◽  
Elena Prisciandaro ◽  
Niccolò Filippi ◽  
Lorenzo Spaggiari
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
High Morbidity ◽  
Conservative Approach ◽  
Chronic Fistula ◽  
Less Is More ◽  
Primary Surgery ◽  
History Of ◽  
Uncommon Complication

Abstract Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient’s good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

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