scholarly journals Histologic and Tomographic Findings of Bone Block Allografts in a 4 Years Follow-up: A Case Series

2016 ◽  
Vol 27 (6) ◽  
pp. 775-780 ◽  
Author(s):  
Daniel Deluiz ◽  
Luciano Santos Oliveira ◽  
Paul Fletcher ◽  
Fábio Ramôa Pires ◽  
Justine Monnerat Tinoco ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Histological Evaluation ◽  
Bone Block ◽  
Mucogingival Surgery ◽  
Native Bone ◽  
Implant Placement

Abstract The aim of this paper is to report histologic and tomographic findings of fresh frozen bone block allografts bearing dental implants in functional occlusion in a long-term follow-up. Four patients with implants functionally loaded for 4 years on augmented ridges requiring additional mucogingival surgery or implant placement were included in this case series. Cone-beam tomography scans were compared volumetrically between the baseline (first implant placement) and current images. Biopsies of the grafts were retrieved and sent to histological analysis. Volumetric reduction of the grafts varied from 2.1 to 7.7%. Histological evaluation demonstrated well-incorporated grafts with different degrees of remodeling. While data presented in this report are from a small sample size and do not allow definitive conclusions, the biopsies of the grafted sites were very similar to the host's native bone. Remodeling of the cortical portion of the allografts seems to take longer than the cancellous portion. The presence of unincorporated graft remains did not impair the implant success or the health of the surrounding tissues. This is the first time histologic and tomographic long term data of bone allograft have been made available in dentistry.

Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

2020 ◽  
Vol 11 (5) ◽  
pp. 611-618
Author(s):  
Maria Rodriguez ◽  
Anahita Malvea ◽  
Dayre McNally ◽  
Vid Bijelic ◽  
Ming Guo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Aortic Root Surgery ◽  
Valve Sparing ◽  
One Year

Background: Pediatric aortic root dilatation is a life-threatening condition that lacks guidelines for surgical management. We aimed to analyze the data on aortic valve interventions during root surgery to guide decision-making. Methods: A search was performed of MEDLINE, Embase, CENTRAL, ClinicalTrials.gov , and WHO ICTRP. Citations were screened in duplicate and independently to identify randomized controlled trials, cohorts, and case series involving populations aged 0 to 18 years, who received valve-sparing and valve-replacing aortic root surgeries between 1999 and 2019. Outcomes considered included mortality (perioperative, one year, five year), reintervention rates. Results: After duplicate removal, 689 citations were screened through abstract and full text review, identifying five eligible studies. All five were observational studies evaluating valve-sparing procedures. There were 81 patients with a mean study age range of 9.9 to 13.9 years. Both reimplantation (74%) and remodeling (26%) subtypes were done. Range of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality reported until the one-year follow-up period. The long-term mortality rate was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13). Conclusions: There is limited experience on aortic valve intervention during aortic root surgery in children. Single-arm studies on valve-sparing surgeries show excellent survival up to one year. Mortality and reintervention rates increase in the longer term. The small sample size and lack of controlled studies do not allow for direct comparisons between procedure types.

scholarly journals Nicotinamide as a Skin Whitener: Evidence and Controversies

2021 ◽  
pp. 300-305
Author(s):  
Nabeel K. Al Hamzawi
Keyword(s):  
Synergistic Effects ◽  
Small Sample Size ◽  
Small Sample ◽  
Sufficient Evidence ◽  
Double Blind ◽  
Whitening Agent ◽  
Electronic Search ◽  
Long Term Follow Up

Background: Topical nicotinamide (NAM) can reduce excessive melanin deposition in cell culture, by reversibly blocking the transfer of melanosomes from melanocytes to the adjacent keratinocytes. Thus, it has been increasingly used as a whitening agent. Objective: To assess the efficacy and safety of topical nicotinamide used for the treatment of melasma and hyperpigmentation. Methods: An electronic search for topical nicotinamide was carried out on Pubmed and Medline databases to identify studies that addressed this topic as a whitening agent. And to review the primary and secondary outcomes. Results: A significant decrease in hyperpigmentation and increased skin lightness was found with the use of topical nicotinamide, compared with the vehicle In two small sample size clinical studies. Combined regimens including nicotinamide and other ingredients offer more synergistic effects than monotherapy. Conclusion: Due to the lack of sufficient evidence, the use of nicotinamide for melasma remains controversial. Extended randomized, double-blind, placebo-controlled trials with long-term follow-up periods are needed to assess the efficacy of nicotinamide as a whitening agent. 

Abstract P500: 24-Month Follow-Up of the ‘Stand and Move at Work’ Sedentary Behavior Intervention: Effects on Cardiometabolic Risk in Those With Dysglycemia

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mark A Pereira ◽  
Sarah L Mullane ◽  
Meynard J Toledo ◽  
Sarah A Rydell ◽  
Miranda Larouche ◽  
...  
Keyword(s):  
Sedentary Behavior ◽  
Cardiometabolic Risk ◽  
Small Sample Size ◽  
Small Sample ◽  
Behavior Intervention ◽  
Long Term Effects ◽  
Individual Level ◽  
Group Randomized Trial

Long-term effects of workplace sedentary behavior interventions on cardiometabolic risk are poorly understood. Stand and Move at Work was a multi-site group randomized trial in 24 worksites (N=630, 74% female, 45±11 years of age) of office-based employees in Phoenix, AZ and Minneapolis/St. Paul, MN. Worksites in the STAND+ study arm received 12 months of a multilevel (i.e., worksite policy, environmental, and individual-level strategies) intervention to increase light-intensity physical activity along with a sit-stand workstation (SSW) to increase standing time. Worksites in the MOVE+ study arm received the same multilevel intervention but were not provided the SSW until after the intervention ended at 12 months. The STAND+ arm, but not the MOVE+ arm, had significant reductions in sedentary time over the 12-month intervention. However, 12-month improvements in cardiometabolic risk factors were only observed among a subgroup with dysglycemia (prediabetes or diabetes). Here we report the long-term follow-up of these changes, 12 months after the end of the trial (24 months). Results are shown in the Table. The effects at 12 months were largely sustained at 24 months. Although limited by the small sample size in this subgroup, long-term meaningful and sustained improvement in blood glucose, triglycerides, systolic blood pressure, and weight may be observed from a multilevel workplace sedentary behavior intervention that includes sit-stand workstations.

scholarly journals Surgically accelerated orthodontic techniques and periodontal response: a systematic review

2020 ◽  
Vol 42 (6) ◽  
pp. 635-642 ◽  
Author(s):  
Umar Rekhi ◽  
Raisa Queiroz Catunda ◽  
Monica Prasad Gibson
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Sample Size ◽  
Orthodontic Treatment ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Long Term Follow Up

Summary Background Reduction in orthodontic treatment time is gaining popularity due to patient demands. Several new techniques of acceleratory orthodontic treatment have been introduced to effectively treat the malocclusion in a shorter time period with minimal adverse effects. Objective The objective of this systematic review is to critically evaluate the potential effect of accelerated surgically assisted orthodontic techniques on periodontal tissues. Materials and methods Electronic databases used to perform the search were Medline (Ovid), EMBASE, PubMed, Scopus, Cochrane, Google Scholar, and hand searching of the literature was also performed. Selection criteria Only randomized control trials (RCTs) that assessed the relationship between accelerated surgically assisted orthodontic techniques and its effects on periodontium were included. Data collection and analysis The Joanna Briggs Institute (JBI) critical appraisal checklist tool (2016) was used to assess the finally selected studies. Among these studies, five evaluated corticotomy-facilitated orthodontics, two tested accelerated tooth movement with piezocision, one compared corticotomy-facilitated orthodontics with piezocision, and one studied the effects of periodontally accelerated osteogenic orthodontics. The duration of these studies was relatively short and had moderate to high risk of bias. Results Literature search identified 225 records from 5 databases and 50 articles from the partial grey literature (Google scholar) search. Finally, nine eligible RCTs were included in the review. Limitations Most of the included studies were of a high risk of bias due to high experimental heterogeneity and small sample size. Long-term follow-up of the periodontal response to these interventions was also lacking. Conclusions There is an absence of evidence considering the lack of long-term follow-up and small sample size therefore, the results of this review should be carefully interpreted. Implications Due to the need for more studies with less risk of bias, these techniques should be implemented in dental practice with caution. With stronger evidence, the study may be confirmed to provide quicker desired results for orthodontic patients. Registration This study protocol was not registered. Funding No funding was obtained for this systematic review.

scholarly journals Percutaneous Vertebroplasty for Symptomatic Schmorl’s Nodes: 11 Cases with Long-term Follow-up and a Literature Review

2017 ◽  
Vol 2 (20;2) ◽  
pp. 69-75
Author(s):  
Gao-Jun Teng
Keyword(s):  
Physical Therapy ◽  
Percutaneous Vertebroplasty ◽  
Case Series ◽  
Small Sample ◽  
Vertebral Compression Fractures ◽  
Safe Procedure ◽  
Long Term Follow Up ◽  
Schmorl’S Nodes

Background: Percutaneous vertebroplasty (PVP) is commonly used to treat symptomatic vertebral compression fractures. However, its long-term effectiveness and safety for use in the treatment of symptomatic Schmorl’s nodes (SNs) refractory to conservative treatment is uncertain. Objectives: To present a case series with PVP for symptomatic SNs not responding to conservative therapy and assess the effectiveness and safety for such treatment with long-term follow-up. To present a review of the literature regarding SNs and treatment options. Study Design: Single center retrospective observational study. Setting: This study consists of patients from a large academic center in China. Methods: Between January 2008 and December 2013, 11 patients suffering from symptomatic SNs that were refractory to medical or physical therapy, underwent PVP procedures in our department. All patients had a definitive diagnosis of SNs by magnetic resonance imaging (MRI) and computed tomography (CT). The visual analog scale (VAS) was assessed preoperatively at 4 hours, at one month, and every 6 months postoperatively during the long-term (mean: 58.0 months) follow-up period. Results: Each of the 11 patients reported an immediate and distinct relief of their back pain. No one reported a worsening of symptoms. The VAS decreased from an average preprocedural score of 7.9 to a postprocedural score of 2.1 at 4 hours. The VAS averaged 1.8 during the mean followup period of 58.0 (range 24.1 to 98.9) months. There were no postoperative complications during the follow-up period. At the end of the follow-up period, all 11 patients were unrestricted in their activities. Limitations: This study is a retrospective study with a small sample size. Conclusions: PVP is an effective and safe procedure for the treatment of symptomatic SNs, which are refractory to medical or physical therapy. Key words: Percutaneous vertebroplasty, symptomatic Schmorl’s nodes, vertebral endplate fracture, endplate osteonecrosis, Modic changes

Erythema Induratum: Case Series Illustrating the Utility of the Interferon-γ Release Assay in Determining the Association with Tuberculosis

2013 ◽  
Vol 17 (4_suppl) ◽  
pp. S6-S11 ◽  
Author(s):  
Vimal Prajapati ◽  
McKay Steed ◽  
Parbeer Grewal ◽  
Muhammad N. Mahmood ◽  
Geetika Verma ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Case Series ◽  
Complete Response ◽  
Interferon Γ ◽  
Small Sample ◽  
Release Assay ◽  
Novel Method ◽  
Nodular Vasculitis ◽  
Lost To Follow Up

Background: The interferon-γ release assay (IGRA) is a novel method for detecting previous sensitization to tuberculosis (TB). Despite having several advantages over the tuberculin skin test (TST), including higher specificity and no influence from past bacille Calmette-Guérin (BCG) exposure, there are a limited number of reports describing its application in patients with erythema induratum (EI)/nodular vasculitis (NV), which is usually but not always related to TB. Objectives: The aim of our case series was to evaluate the usefulness of the IGRA for determining a TB association in patients with EI/NV. Methods: Retrospective chart reviews were conducted on four patients diagnosed with EI/NV at our institution in whom an IGRA had been performed. Results: All four subjects had positive TST results. The IGRA was also positive and therefore supported a link with TB in two cases. One patient responded completely to anti-TB therapy, whereas the second was lost to follow-up. Both cases unrelated to TB, by virtue of negative IGRAs, demonstrated complete response to immunosuppressive therapy (methotrexate), with one individual having failed anti-TB therapy first. Conclusion: Our case series highlights the utility of the IGRA for establishing a TB association in patients with EI/NV. Although limited by a small sample size, we propose adjunctive use of this test at the time of EI/NV diagnosis, especially in the setting of previous BCG exposure, so that management can be tailored according to whether an underlying relationship with TB exists.

scholarly journals Repeat Vaginal Natural Orifice Transluminal Endoscopic Surgery: A First Feasibility Study

2021 ◽  
pp. 1-6
Author(s):  
Katrien Nulens ◽  
Ilse Van Genechten ◽  
Jan Baekelandt
Keyword(s):  
Peritoneal Cavity ◽  
Endoscopic Surgery ◽  
Large Scale ◽  
Case Series ◽  
Small Sample ◽  
Invasive Technique ◽  
Natural Orifice ◽  
Adnexal Surgery

<b><i>Objectives:</i></b> Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique in benign gynaecologic surgery whereby surgical access to the peritoneal cavity is achieved through natural orifices, namely through a vaginal colpotomy. Experience in repeat vNOTES cases is limited and so far, repeat vNOTES cases have not been described in the literature. The purpose of this study was to demonstrate the feasibility of vNOTES hysterectomy in women with a history of previous vNOTES adnexal surgery. <b><i>Design:</i></b> We performed a retrospective cohort study of the first 11 repeat vNOTES cases in our centre. All vNOTES procedures, primary adnexal surgery as well as repeat vNOTES hysterectomy, were performed by one surgeon (J.B.). <b><i>Materials, Setting, Methods:</i></b> Between March 2016 and May 2020, 11 patients underwent a vNOTES hysterectomy after prior vNOTES adnexectomy or cystectomy in Imelda Hospital, Bonheiden, Belgium. Relevant patient characteristics and outcome data were collected after written informed consent. <b><i>Results:</i></b> Median age was 49 years (range 44–65) at the moment of the first vNOTES procedure. Two patients had one or more caesarean sections in history, and 2 women were nulliparous. Median interval between primary and repeat vNOTES procedure was 15 months (range 0.8–37 months). All patients underwent a vaginally assisted NOTES hysterectomy (VANH) as repeat vNOTES procedure. Performing a colpotomy and entering the peritoneal cavity after prior vNOTES was technically feasible in all cases. All VANHs were successfully performed. There were 3 minor complications after repeat vNOTES, of which one was anaesthesia-related. The 2 complications associated with the surgical procedure were both cystitis. In one of these 2 patients, there were high post-void residues, which were easily managed by bladder training. There were no conversions to laparoscopy or laparotomy, neither serious nor life-threatening complications. No ureteric, bladder, or intestinal injuries have occurred. <b><i>Limitations:</i></b> The retrospective design and small sample size are the main limitations of this study. Moreover, the follow-up period of the most recently operated patients was too short to draw conclusions on long-term outcomes, including sexual function. <b><i>Conclusions:</i></b> In all patients in this case series, vNOTES hysterectomy after prior vNOTES adnexal surgery was successfully performed. Large-scale prospective trials with long-term follow-up are needed to evaluate the safety and feasibility of multiple consecutive vNOTES procedures in 1 patient.

scholarly journals Uraemic tumoral calcinosis in patients on haemodialysis in the renal unit at Dr George Mukhari Hospital, Pretoria

2010 ◽  
Vol 14 (4) ◽  
pp. 87
Author(s):  
F E Suleman ◽  
V Mngomezulu ◽  
N Ebrahim
Keyword(s):  
Small Sample Size ◽  
Extensive Study ◽  
Small Sample ◽  
Tumoral Calcinosis ◽  
Renal Unit ◽  
True Incidence ◽  
Long Term Follow Up ◽  
Study Setting

Objective. Uraemic tumoral calcinosis refers to metastatic calcifications that occur rarely on the extensor surfaces of joints in patients undergoing long-term haemodialysis. The aim of the study was to assess the incidence of uraemic tumoral calcinosis in participants undergoing haemodialysis and to investigate any relationship that might exist between the development of uraemic tumoral calcinosis and the length of time on dialysis. Design. Twenty-four of the 25 patients on haemodialysis at the time of the study underwent radiographs of their shoulders and hips to look for calcinosis, which were then read by the researcher and two independent readers to assess for calcinosis. Study setting. Dr George Mukhari Hospital, Pretoria. Results. Eight per cent (N=2) of participants were found to have asymptomatic calcinosis of the hips. No relationship to length of time on dialysis was found. Conclusions. The study was constrained by a small sample size but the presence of calcinosis in 8% of the participants indicates that an extensive study of a larger sample could prove to be useful in determining the true incidence of uraemic tumoral calcinosis in the region. Long-term follow-up could provide more information on the development of calcinosis and length of time on dialysis.

scholarly journals Long-term outcomes of primarily metastatic juvenile pilocytic astrocytoma in children

2018 ◽  
Vol 21 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Derek Yecies ◽  
Paul Graham Fisher ◽  
Samuel Cheshier ◽  
Michael Edwards ◽  
Gerald Grant
Keyword(s):  
Stable Disease ◽  
Pilocytic Astrocytoma ◽  
Radiation Treatment ◽  
Small Sample Size ◽  
Case Series ◽  
Disease Process ◽  
Small Sample ◽  
Long Term Outcomes ◽  
Juvenile Pilocytic Astrocytoma

OBJECTIVEPrimarily metastatic juvenile pilocytic astrocytoma (JPA) is rare, likely representing 2%–3% of all cases of JPA. Due to the rarity of primarily metastatic JPA, there is currently no standard treatment paradigm and the long-term outcomes are not fully known. The goal of this case series was to add to the current understanding of this disease process.METHODSThe authors searched a comprehensive database of pediatric patients with brain and spinal cord tumors treated at Lucile Packard Children’s Hospital from 1997 to 2016 and identified 5 patients with primarily metastatic JPA. A retrospective chart review was performed and details of the patients’ treatment and clinical course were recorded for further analysis.RESULTSFor the 5 patients with primarily metastatic JPA, the mean follow-up period was 12.3 years. All patients in our series had biopsies or subtotal resections and upfront treatment. Three patients were treated with chemotherapy alone, one was treated with chemotherapy and radiotherapy, and one was treated with radiotherapy alone. Four patients had stable disease after initial treatment, and one patient had multiple episodes of progressive disease but underwent successful salvage therapy and has had stable disease for 19 years. One patient died of an intracerebral hemorrhage 10 years following initial radiation treatment believed to be secondary to radiation vasculopathy.CONCLUSIONSEvaluation of the entire neuraxis should be performed in all instances of initial JPA diagnosis to properly assess for primarily metastatic disease. Many patients with primarily metastatic JPA will have stable disease after upfront treatment, although the higher rate of stable disease found in this series relative to other reports is likely secondary to the small sample size.

scholarly journals Resultados de supervivencia del cáncer colorrectal metastásico (CCRm) en una cohorte de una práctica en Medellín, Colombia

2021 ◽  
Vol 8 (1) ◽  
pp. 18-28
Author(s):  
Mauricio Lema ◽  
Beatriz Elena Preciado Franco ◽  
Camila Lema ◽  
Ana María Romero Millán ◽  
Sara Paulina Mora Vélez ◽  
...  
Keyword(s):  
Systemic Therapy ◽  
Randomized Clinical Trials ◽  
Small Sample Size ◽  
Case Series ◽  
Biologic Agents ◽  
Small Sample ◽  
Phase Iii ◽  
Survival Outcomes ◽  
The Impact

Therapy for mCRC is based on surgery, cytotoxic chemotherapy, and biologic agents. In randomized clinical trials, median progression-free survival (PFS) and overall survival (OS) hover around 10mo and 29mo, respectively. There are no published results on survival outcomes of patients with mCRC in Colombia. Objective: Describe the survival outcomes of patients with mCRC treated by Mauricio Lema in Medellín, Colombia. Methods: This is a retrospective, case series (2008-2020) of mCRC, ≥18 years old, treated with systemic therapy for metastatic disease, and ≥3-month follow-up.  Stratification factors included: use of biologic (anti-VEGF or anti-EGFR) plus chemotherapy in 1st-Line (yes/no) and metastasectomy (yes/no). Survival analyses were evaluated using Kaplan- Meier curves. Results from the general population are described, and they are also discriminated against by the use of a biological agent in the first-line of systemic therapy. Results: 89 patients with mCRC were included. The Median follow-up was 35 months (IQR: 21-57). Median PFS and OS were 12.1mo (95%CI: 10.4-13.8) and 29.3mo (95%CI: 23.2-34.4), respectively. Median OS in patients receiving biologics was 28.8mo (95%CI: 22.1 – 35.6) vs 33.7mo (95%CI: 16.4 – 51.0) in the chemo-only group (p=0.01). Median OS in the metastasectomy and non-metastasectomy groups were 36.1 (95% CI: 26.5 - 45.7) and 25.0 months (95% CI: 15.4 - 34.5), respectively (NS). Conclusion: In this case series of patients’ survival outcomes were similar to thosereported in large phase III trials. A small sample size precludes any conclusion as to the impact of biologic agents on survival in this study.

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