Polyester 5-0 Suture for Porous Implant Placement After Retinoblastoma Enucleation: Analysis of 120 Sockets

Abstract Background: Techniques used to suture the rectus muscle to the implant can influence the implant-related complications which is still a major problem following retinoblastoma enucleation. The goals of this work were to report the efficacy among patients with retinoblastoma who underwent enucleation followed by porous implant placement with the rectus muscles sutured with 5-0 polyester suture.Methods: This was a retrospective study of consecutive patients with retinoblastoma who underwent primary enucleation and porous implant placement with the rectus muscles tagged and sutured to the implant with polyester 5-0 suture. All the patients were followed up for a minimum of 2 years. The main outcome measure was implant exposure. The secondary efficacy measures were other implant-related complications.Results: A total of 120 patients (120 eyes) underwent primary enucleation and porous implant placement were included. Postoperatively, 10/120 (8.3%) eyes developed exposure and conjunctival granuloma. Exposure was the most common postoperative complication (7/10, 70.0%). There were no cases of implant extrusion, migration, or infection.Conclusions:Polyester 5-0 sutures are successful in patients with retinoblastoma who underwent enucleation followed by porous implant placement. Complications are minimal. Polyester 5-0 sutures were not associated with unacceptable complications in this pediatric population.

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Skeletal and Dental Correction and Stability Following LeFort I Advancement in Patients With Cleft Lip and Palate With Mild, Moderate, and Severe Maxillary Hypoplasia

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621996108 ◽

2021 ◽

pp. 105566562199610

Author(s):

Buddhathida Wangsrimongkol ◽

Roberto L. Flores ◽

David A. Staffenberg ◽

Eduardo D. Rodriguez ◽

Pradip. R. Shetye

Keyword(s):

Retrospective Study ◽

Outcome Measures ◽

Cleft Lip ◽

Outcome Measure ◽

Cleft Lip And Palate ◽

Inclusion Criteria ◽

Maxillary Hypoplasia ◽

Main Outcome Measure ◽

Lateral Cephalograms

Objective: This study evaluates skeletal and dental outcomes of LeFort I advancement surgery in patients with cleft lip and palate (CLP) with varying degrees of maxillary skeletal hypoplasia. Design: Retrospective study. Method: Lateral cephalograms were digitized at preoperative (T1), immediately postoperative (T2), and 1-year follow-up (T3) and compared to untreated unaffected controls. Based on the severity of cleft maxillary hypoplasia, the sample was divided into 3 groups using Wits analysis: mild: ≤0 to ≥−5 mm; moderate: <−5 to >−10 mm; and severe: ≤−10 mm. Participants: Fifty-one patients with nonsyndromic CLP with hypoplastic maxilla who met inclusion criteria. Intervention: LeFort I advancement. Main Outcome Measure: Skeletal and dental stability post-LeFort I surgery at a 1-year follow-up. Results: At T2, LeFort I surgery produced an average correction of maxillary hypoplasia by 6.4 ± 0.6, 8.1 ± 0.4, and 10.7 ± 0.8 mm in the mild, moderate, and severe groups, respectively. There was a mean relapse of 1 to 1.5 mm observed in all groups. At T3, no statistically significant differences were observed between the surgical groups and controls at angle Sella, Nasion, A point (SNA), A point, Nasion, B point (ANB), and overjet outcome measures. Conclusions: LeFort I advancement produces a stable correction in mild, moderate, and severe skeletal maxillary hypoplasia. Overcorrection is recommended in all patients with CLP to compensate for the expected postsurgical skeletal relapse.

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Bronchopulmonary dysplasia and postnatal growth following extremely preterm birth

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-320816 ◽

2020 ◽

pp. fetalneonatal-2020-320816

Author(s):

Theodore Dassios ◽

Emma E Williams ◽

Ann Hickey ◽

Catey Bunce ◽

Anne Greenough

Keyword(s):

Bronchopulmonary Dysplasia ◽

Head Circumference ◽

Outcome Measure ◽

Postnatal Growth ◽

Z Score ◽

Main Outcome Measure ◽

Extremely Preterm ◽

Postmenstrual Age ◽

Extremely Preterm Birth ◽

Current Incidence

ObjectivesTo report the current incidence of bronchopulmonary dysplasia (BPD) and to compare changes in weight and head circumference between infants who developed BPD and infants who did not.DesignRetrospective, whole-population study.SettingAll neonatal units in England between 2014 and 2018.PatientsAll liveborn infants born <28 completed weeks of gestation.InterventionsThe change in weight z-score (ΔWz) was calculated by subtracting the birthweight z-score from the weight z-score at 36 weeks postmenstrual age (PMA) and at discharge. The change in head circumference z-score (ΔHz) was calculated by subtracting the birth head circumference z-score from the head circumference z-score at discharge.Main outcome measureBPD was defined as the need for any respiratory support at 36 weeks PMA.Results11 806 infants were included in the analysis. The incidence of BPD was 57.5%, and 18.9% of the infants died before 36 weeks PMA. The median (IQR) ΔWz from birth to 36 weeks PMA was significantly smaller in infants who developed BPD (−0.69 (−1.28 to −0.14), n=6105) than in those who did not develop BPD (−0.89 (−1.40 to −0.33), n=2390; adjusted p<0.001). The median (IQR) ΔHz from birth to discharge was significantly smaller in infants who developed BPD (−0.33 (−1.69 to 0.71)) than in those who did not develop BPD (−0.61 (−1.85 to 0.35); adjusted p<0.001).ConclusionsPostnatal growth was better in infants diagnosed with BPD compared with infants without BPD possibly due to more aggressive nutrition strategies.

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S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures

Otolaryngology ◽

10.1016/j.otohns.2008.05.327 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P127-P128

Author(s):

Robert L Harris ◽

Grundy Alan ◽

Tunde A Odutoye

Keyword(s):

Total Laryngectomy ◽

Balloon Dilatation ◽

Malignant Disease ◽

Outcome Measure ◽

Tertiary Care ◽

Case Series ◽

Stent Insertion ◽

Care Centre ◽

Tertiary Care Centre ◽

Main Outcome Measure

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.

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Peri-Implant Behavior of Tissue Level Dental Implants with a Convergent Neck

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105232 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5232

Author(s):

Rubén Agustín-Panadero ◽

Irene Bermúdez-Mulet ◽

Lucía Fernández-Estevan ◽

María Fernanda Solá-Ruíz ◽

Rocío Marco-Pitarch ◽

...

Keyword(s):

Retrospective Study ◽

Statistical Analysis ◽

Bone Loss ◽

Tissue Level ◽

Functional Load ◽

Implant Placement ◽

Group I ◽

Bone Level ◽

Single Crowns ◽

Functional Loading

Introduction: The aim of this retrospective study was to analyze the radiographic peri-implant bone loss of bone level implants and tissue level implants with a convergent neck in screw-retained single crowns and in screw-retained fixed partial prostheses, after two years of functional loading. Materials and methods: The sample was divided into two groups according to their type: Group I: supracrestal implants with convergent transmucosal neck; Group II: crestal implants. In each group we distinguish two subgroups according to the type of prosthetic restoration: single crowns and a three-piece fixed partial prosthesis on two implants. To quantify bone loss, parallelized periapical radiographs were analyzed at the time of implant placement and after two years of functional load. Results: A total of 120 implants were placed in 53 patients. After statistical analysis it was observed that for each type of implant bone loss was 0.97 ± 0.91 mm for bone level and 0.31 ± 0.48 mm for tissue level. No significant differences were found regarding the type of prosthesis and the location (maxilla or mandible) of the implants. Conclusions: Tissue level implants with a convergent transepithelial neck exhibit less peri-implant bone loss than bone level implants regardless of the type of prosthesis.

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Ultrasound Screening for Thyroid Carcinoma in Childhood Cancer Survivors: A Case Series

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2008-1528 ◽

2008 ◽

Vol 93 (12) ◽

pp. 4840-4843 ◽

Cited By ~ 51

Author(s):

Enrico Brignardello ◽

Andrea Corrias ◽

Giuseppe Isolato ◽

Nicola Palestini ◽

Luca Cordero di Montezemolo ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Cancer Survivors ◽

Childhood Cancer ◽

Outcome Measure ◽

Childhood Cancer Survivors ◽

Ultrasound Screening ◽

Thyroid Ultrasound ◽

Main Outcome Measure ◽

Head Neck

Context: Childhood cancer survivors need regular monitoring into young adulthood and beyond, because they are at risk for developing late-onset complications of cancer therapy, including second malignancies. Objective: This study focuses on the use of thyroid ultrasound to screen for thyroid carcinoma in a population of childhood cancer survivors. Patients: A total of 129 subjects who had received radiotherapy to the head, neck, or upper thorax for a pediatric cancer were studied in the setting of a long-term follow-up unit. Design: Thyroid ultrasound usually began 5 yr after radiotherapy and was repeated every third year, if negative. Median follow-up time since childhood cancer diagnosis was 15.8 yr (range 6.1–34.8 yr). Solid thyroid nodules were found in 35 patients. Fine-needle aspiration was performed in 19 patients, of which 14 had nodules above 1 cm. Main Outcome Measure: The main outcome measure was the finding of not palpable thyroid cancers. Results: Cytological examination of specimens diagnosed papillary carcinoma in five patients who underwent surgery. The cytological diagnosis of papillary thyroid carcinoma was confirmed in all cases by histological examination. Notably, only two of these patients had palpable nodules; the other three were smaller than 1 cm and were detected only by ultrasound. However, histological examination showed nodal metastases in two of these. Conclusions: Although ultrasound screening for thyroid cancer in the general population is not cost effective and could lead to unnecessary surgery, due to false positives, we believe that in childhood cancer survivors who received radiotherapy involving the head, neck, or upper thorax, it would be worthwhile.

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Pyelonephritis in Pediatric Uropathic Patients: Differences from Community-Acquired Ones and Therapeutic Protocol Considerations. A 10-Year Single-Center Retrospective Study

Children ◽

10.3390/children8060436 ◽

2021 ◽

Vol 8 (6) ◽

pp. 436

Author(s):

Giovanni Parente ◽

Tommaso Gargano ◽

Stefania Pavia ◽

Chiara Cordola ◽

Marzia Vastano ◽

...

Keyword(s):

Escherichia Coli ◽

Retrospective Study ◽

Success Rate ◽

Pediatric Population ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Significant Difference ◽

Klebsiella Spp

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020. We recorded 58 PNs in 33 patients affected by VUR and 112 PNs in the not VUR group. The mean age of not VUR patients at the PN episode was 1.3 ± 2.6 years (range: 20 days of life–3 years), and almost all the urine cultures, 111 (99.1%), isolated Gram-negative bacteria and rarely, 1 (0.9%), Gram-positive bacteria. The Gram-negative uropathogens isolated were Escherichia coli (97%), Proteus mirabilis (2%), and Klebsiella spp. (1%). The only Gram-positive bacteria isolated was an Enterococcus faecalis. As regards the antibiograms, 96% of not VUR PNs responded to beta-lactams, 99% to aminoglycosides, and 80% to sulfonamides. For the VUR group, mean age was 3.0 years ± 3.0 years (range: 9 days of life–11 years) and mean number of episodes per patient was 2.0 ± 1.0 (range: 1–5); 83% of PNs were by Gram-negatives bacteria vs. 17% by Gram-positive: the most important Gram-negative bacteria were Pseudomonas aeruginosa (44%), Escherichia coli (27%), and Klebsiella spp. (12%), while Enterococcus spp. determined 90% of Gram-positive UTIs. Regimen ampicillin/ceftazidime (success rate: 72.0%) was compared to ampicillin/amikacin (success rate of 83.0%): no statistically significant difference was found (p = 0.09). The pathogens of PNs in uropathic patients are different from those of community-acquired PNs, and clinicians should be aware of their peculiar antibiotic susceptibility. An empiric therapy based on the association ampicillin + ceftazidime is therefore suggested.

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The value of domiciliary medication reviews: a thematic analysis of patient views

International Journal of Clinical Pharmacy ◽

10.1007/s11096-021-01288-1 ◽

2021 ◽

Author(s):

Patricia McCormick ◽

Bridget Coleman ◽

Ian Bates

Keyword(s):

Thematic Analysis ◽

Outcome Measure ◽

Service Users ◽

Structured Interviews ◽

Main Outcome Measure ◽

Healthcare Settings ◽

Medication Reviews ◽

Informal Carers ◽

The Individual ◽

Patient Centric

AbstractBackground Medication reviews are recognised as essential to tackling problematic polypharmacy. Domiciliary medication reviews (DMRs) have become more prevalent in recent years. They are proclaimed as being patient-centric but published literature mainly focuses on clinical outcomes. However, it is not known where the value of DMRs lies for patients who participate in them. Objective To determine the value of domiciliary medication reviews to service users. Setting Interviews took place with recipients of domiciliary medication reviews residing in the London boroughs of Islington and Haringey. Method Semi-structured interviews analysed using thematic analysis. Main outcome measure Themes and sub-themes identified from interview transcripts. Results Five themes were identified: advantages over traditional settings, attributes of the professional, adherence, levels of engagement and knowledge. Conclusion For many patients, the domiciliary setting is preferred to traditional healthcare settings. Patients appreciated the time spent with them during a DMR and felt listened to. Informal carers felt reassured that the individual medication needs of their relative had been reviewed by an expert.

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Immediate implant placement after dental extraction with loss of the buccal plate. A retrospective study

Clinical Oral Implants Research ◽

10.1111/clr.405_13042 ◽

2017 ◽

Vol 28 ◽

pp. 408-408

Keyword(s):

Retrospective Study ◽

Dental Extraction ◽

Implant Placement ◽

Immediate Implant

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Association of Cryptorchidism with a Specific Haplotype of the Estrogen Receptor α Gene: Implication for the Susceptibility to Estrogenic Environmental Endocrine Disruptors

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2005-0211 ◽

2005 ◽

Vol 90 (8) ◽

pp. 4716-4721 ◽

Cited By ~ 51

Author(s):

Rie Yoshida ◽

Maki Fukami ◽

Isoji Sasagawa ◽

Tomonobu Hasegawa ◽

Naoyuki Kamatani ◽

...

Keyword(s):

Estrogen Receptor ◽

Endocrine Disruptors ◽

Outcome Measure ◽

Estrogen Receptor Α ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Main Outcome Measure ◽

Environmental Endocrine Disruptors ◽

Estrogenic Effects ◽

Specific Haplotype

Context: The prevalence of cryptorchidism (CO) has increased during the past few decades in several countries, and this event has primarily been ascribed to the estrogenic effects of environmental endocrine disruptors (EEDs). Little is known, however, about the role of genetic susceptibility to EEDs in this phenomenon. Objective: The objective of this study was to determine whether CO is associated with a specific haplotype of the gene for estrogen receptor α (ESR1) that mediates the estrogenic effects of EEDs. Design: This was a case-control study. Setting: The study was performed at the National Research Institute and University Hospitals. Subjects: Sixty-three cryptorchid males, aged 1–13 yr, and 47 control males, aged 4–12 yr, were studied. Intervention: After genotyping 15 single nucleotide polymorphisms widely distributed in the greater than 300-kb genomic sequences of ESR1, haplotype analysis was performed. Main Outcome Measure: Identification of a specific ESR1 haplotype associated with CO was the main outcome measure. Results: A haplotype block was identified for an approximately 50-kb region encompassing single nucleotide polymorphisms 10–14 in the 3′ region of ESR1 in both groups. The frequency of the estimated AGATA haplotype within the block was higher in the patients than in the control males (34.0% vs. 21.3%; P = 0.037), and the association of this haplotype with CO phenotype was significant in a recessive mode (P = 0.0060). The homozygosity for this haplotype was identified only in the patients, and the frequency of the homozygotes was significantly different between the two groups (10 of 63 vs. zero of 47; P = 0.0042). Conclusions: The association of CO with homozygosity for the specific ESR1 haplotype suggests the relevance of genetic susceptibility to EEDs in the development of CO.

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