scholarly journals Ozone used as a supportive therapy for gingival tissue repair after facial trauma: Report of two cases

2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Daniela Santos ◽  
◽  
Gustavo Lauand ◽  
Sérgio Macedo ◽  
Leticia Filice ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Tissue Repair ◽  
Supportive Therapy ◽  
Final Concentration ◽  
Gingival Tissue ◽  
Facial Trauma ◽  
Tissue Preservation ◽  
Tissue Necrosis ◽  
Bone Exposure

The application of ozone as a supportive therapy has been widely discussed. Ozone has antimicrobial, antioxidant, and healing properties. This study presents two cases of ozone application as a supportive therapy for gingival tissue repair after facial trauma. In both cases, patients suffered extensive lacerations with bone exposure. Tissues were repositioned and sutured; however, ischemia was observed during follow-up with potential tissue necrosis. Each patient received ozone gas with a concentration of 4 μg/ml. Then, the wound was irrigated with 40 mL of ozonated water at a final concentration of 8 μg/ml. The procedure was held weekly until clinical improvement. A significant improvement was observed in ischemia without evolution to necrosis or infection, allowing gingival tissue preservation. Ozone showed a beneficial effect in the recovery of gingiva and alveolar mucosa wounds after extensive trauma.

scholarly journals Gingival Melanin Depigmentation by 808 nm Diode Laser: Report of a Case

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jade Chagra ◽  
Adel Bouguezzi ◽  
Sameh Sioud ◽  
Hajer Hentati ◽  
Jamil Selmi
Keyword(s):  
Postoperative Pain ◽  
Diode Laser ◽  
Male Patient ◽  
Pulse Width ◽  
Peak Power ◽  
Gingival Tissue ◽  
Optic Fiber ◽  
Bone Exposure ◽  
Gingival Depigmentation

Gingival hyperpigmentation frequently poses an aesthetic problem, especially in patients with gingival smile. This paper presents the use of a 808 nm pulsed diode laser for gingival depigmentation in a 22-year-old male patient, with a frequency of 20,000 Hz, a peak power of 5 W, and a pulse width of 26 microseconds, using a 400 nm flexible optic fiber. The hyperpigmented gingival tissue was removed without bleeding or postoperative pain. Three weeks later, the gum resumed its normal, firm, and pink appearance. No significant recurrence was noted after a follow-up of 4 months. However, perfect control of this device is necessary to avoid certain consequences such as bone exposure or gingival fenestrations.

scholarly journals Myonecrosis in a Sickle Cell-Diseased Patient: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ali Wasel Almomen ◽  
Yaser Mansour Tawfeeq ◽  
Ahmed Khalid Almuhaisin ◽  
Abdulraheem Ayman Altalib
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Sickle Cell ◽  
Muscle Tissue ◽  
Physical Disabilities ◽  
Supportive Therapy ◽  
Foot Pain ◽  
Tissue Necrosis ◽  
Characteristic Image

Myonecrosis is a condition that results in muscle tissue necrosis, and it is rarely seen in sickle cell patients and often missed because more common manifestations of sickle cell can overlap like vaso-occlusive crises (VOC), which results in pain in the extremities or spine; also osteomyelitis is commonly seen in sickle cell patients. In this article, we present a case of myonecrosis in a sickle cell-diseased patient who presented with left acute atraumatic left foot pain and MRI with contrast showing characteristic image of muscle infarction supportive therapy initiated, and 2-year follow-up did not reveal any physical disabilities; further study and follow-up are needed to know the nature of the disease and avoid improper management of those patients.

scholarly journals Large Bowel Ischemia/Infarction: How to Recognize It and Make Differential Diagnosis? A Review

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 998
Author(s):  
Francesca Iacobellis ◽  
Donatella Narese ◽  
Daniela Berritto ◽  
Antonio Brillantino ◽  
Marco Di Serafino ◽  
...  
Keyword(s):  
Ischemic Colitis ◽  
Intestinal Ischemia ◽  
Bowel Wall ◽  
Clinical Laboratory ◽  
Supportive Therapy ◽  
Ischemic Necrosis ◽  
Diagnostic Investigation ◽  
Enhanced Ct ◽  
Common Etiology

Ischemic colitis represents the most frequent form of intestinal ischemia occurring when there is an acute impairment or chronic reduction in the colonic blood supply, resulting in mucosal ulceration, inflammation, hemorrhage and ischemic necrosis of variable severity. The clinical presentation is variable and nonspecific, so it is often misdiagnosed. The most common etiology is hypoperfusion, almost always associated with generalized atherosclerotic disease. The severity ranges from localized and transient ischemia to transmural necrosis of the bowel wall, becoming a surgical emergency, with significant associated morbidity and mortality. The diagnosis is based on clinical, laboratory suspicion and radiological, endoscopic and histopathological findings. Among the radiological tests, enhanced-CT is the diagnostic investigation of choice. It allows us to make the diagnosis in an appropriate clinical setting, and to define the entity of the ischemia. MR may be adopted in the follow-up in patients with iodine allergy or renal dysfunctions, or younger patients who should avoid radiological exposure. In the majority of cases, supportive therapy is the only required treatment. In this article we review the pathophysiology and the imaging findings of ischemic colitis.

scholarly journals Comparison of treatment outcomes for native tissue repair and sacrocolpopexy as apical suspension procedures at the time of hysterectomy for uterine prolapse

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sumin Oh ◽  
E. Kyung Shin ◽  
Sowoon Hyun ◽  
Myung Jae Jeon
Keyword(s):  
Treatment Outcomes ◽  
Tissue Repair ◽  
Uterine Prolapse ◽  
Reoperation Rate ◽  
Complication Rates ◽  
Native Tissue Repair ◽  
Apical Suspension ◽  
Native Tissue ◽  
Surgical Failure

AbstractConcomitant apical suspension should be performed at the time of hysterectomy for uterine prolapse to reduce the risk of recurrent prolapse. Native tissue repair (NTR) and sacrocolpopexy (SCP) are commonly used apical suspension procedures; however, it remains unclear which one is preferred. This study aimed to compare the treatment outcomes of NTR and SCP in terms of surgical failure, complication and reoperation rates. Surgical failure was defined as the presence of vaginal bulge symptoms, any prolapse beyond the hymen, or retreatment for prolapse. This retrospective cohort study included 523 patients who had undergone NTR (n = 272) or SCP (n = 251) along with hysterectomy for uterine prolapse and who had at least 4-month follow-up visits. During the median 3-year follow-up period, the surgical failure rate was higher in the NTR group (21.3% vs 6.4%, P < 0.01), with a low rate of retreatment in both groups. Overall complication rates were similar, but complications requiring surgical correction under anesthesia were more common in the SCP group (7.2% vs 0.4%, P < 0.01). As a result, the total reoperation rate was significantly higher in the SCP group (8.0% vs 2.6%, P = 0.02). Taken together, NTR may be a preferred option for apical suspension when hysterectomy is performed for uterine prolapse.

Fatigue, mood and quality of life improve in MS patients after progressive resistance training

2010 ◽  
Vol 16 (4) ◽  
pp. 480-490 ◽  
Author(s):  
U. Dalgas ◽  
E. Stenager ◽  
J. Jakobsen ◽  
T. Petersen ◽  
HJ Hansen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Resistance Training ◽  
Beneficial Effect ◽  
Control Group ◽  
Progressive Resistance Training ◽  
Multiple Sclerosis Patients ◽  
Progressive Resistance

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.

Beneficial effect of statins on total mortality in abdominal aortic aneurysm (AAA) repair

2017 ◽  
Vol 22 (5) ◽  
pp. 406-410 ◽  
Author(s):  
Sven Ross Mathisen ◽  
Michael Abdelnoor
Keyword(s):  
Cohort Study ◽  
Beneficial Effect ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Open Surgery ◽  
Total Mortality ◽  
Abdominal Aortic ◽  
Statin Use

In this single center, retrospective cohort study we wished to compare early and total mortality for all patients treated for abdominal aortic aneurysms (AAA) with open surgery who were taking statins compared to those who were not. A cohort of 640 patients with AAA was treated with open surgery between 1999 and 2012. Patients were consecutively recruited from a source population of 390,000; 21.3% were female, and the median age was 73 years. The median follow-up was 3.93 years, with an interquartile range of 1.79–6.58 years. The total follow-up was 2855 patient-years. An explanatory strategy was used. The propensity score (PS) was implemented to control for selection bias and confounders. The crude effect of statin use showed a 78% reduction of the 30-day mortality. A stratified analysis using the Mantel–Haenszel method on quintiles of the PS gave an adjusted effect of the odds ratio equal to 0.43 (95% CI: 0.18–0.96), indicating a 57% reduction of the 30-day mortality for statin users. The adjusted rate ratio was 0.62 (95% CI: 0.45–0.83), indicating a reduction of long-term mortality of 38% for statin users compared to non-users for a median follow-up of 3.93 years. This retrospective cohort study showed a significant beneficial effect of statin use on early and long-term survival for patients treated with open surgery. To be conclusive, our results need to be replicated by a randomized clinical trial.

scholarly journals Long-Term Outcomes of the Minimally Invasive Ponto Surgery vs. Linear Incision Technique With Soft Tissue Preservation for Installation of Percutaneous Bone Conduction Devices

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruben M. Strijbos ◽  
Louise V. Straatman ◽  
Tim G. A. Calon ◽  
Martin L. Johansson ◽  
Arthur J. G. de Bruijn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Soft Tissue ◽  
Bone Conduction ◽  
Tissue Preservation ◽  
Implant Stability ◽  
Implant Stability Quotient ◽  
Incision Technique

Objective: Comparing the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with the linear incision technique with soft tissue preservation (LITT-P) for bone conduction devices after a follow-up of 22 months.Methods: In this multicenter randomized controlled trial, there was the inclusion of 64 adult patients eligible for unilateral surgery. There was 1:1 randomization to the MIPS (test) or the LITT-P (control) group. The primary outcome was an (adverse) soft tissue reaction. Secondary outcomes were pain, loss of sensibility, soft tissue height/overgrowth, skin sagging, implant loss, Implant Stability Quotient measurements, cosmetic scores, and quality of life questionnaires.Results: Sixty-three subjects were analyzed in the intention-to-treat population. No differences were found in the presence of (adverse) soft tissue reactions during complete follow-up. Also, there were no differences in pain, wound dehiscence, skin level, soft tissue overgrowth, and overall quality of life. Loss of sensibility (until 3-month post-surgery), cosmetic scores, and skin sagging outcomes were better in the MIPS group. The Implant Stability Quotient was higher after the LITT-P for different abutment lengths at various points of follow-up. Implant extrusion was nonsignificantly higher after the MIPS (15.2%) compared with LITT-P (3.3%).Conclusion: The long-term results show favorable outcomes for both techniques. The MIPS is a promising technique with some benefits over the LITT-P. Concerns regarding nonsignificantly higher implant loss may be overcome with future developments and research.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02438618.

An Injectable Hydrogel Scaffold With Kartogenin-Encapsulated Nanoparticles for Porcine Cartilage Regeneration: A 12-Month Follow-up Study

2020 ◽  
Vol 48 (13) ◽  
pp. 3233-3244
Author(s):  
Wenqiang Yan ◽  
Xingquan Xu ◽  
Qian Xu ◽  
Ziying Sun ◽  
Zhongyang Lv ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Subchondral Bone ◽  
Therapeutic Efficacy ◽  
Tissue Repair ◽  
Porcine Model ◽  
Hyaline Cartilage ◽  
Plga Nanoparticles ◽  
Full Thickness ◽  
Subchondral Bone Tissue

Background: Treatment of cartilage lesions is clinically challenging. A previous study demonstrated that a hyaluronic acid hydrogel ( m-HA) with kartogenin (KGN)-loaded PLGA nanoparticles ( m-HA+KGN treatment) achieved superior cartilage repair in a rabbit model. However, large animals serve as a bridge to translate animal outcomes into the clinic. Hypotheses: (1) m-HA+KGN treatment could facilitate hyaline cartilage and subchondral bone tissue repair in a porcine model. (2) Defect size and type (full-thickness chondral vs osteochondral) influence the therapeutic efficacy of m-HA+KGN treatment. Study Design: Controlled laboratory study. Methods: 48 minipigs were randomized into 3 treatment groups: m-HA hydrogel with KGN-loaded PLGA nanoparticles ( m-HA+KGN treatment), m-HA hydrogel ( m-HA treatment), and untreated (blank treatment). Full-thickness chondral (6.5 mm or 8.5 mm in diameter) or osteochondral (6.5 mm or 8.5 mm in diameter; 5-mm depth) defects were prepared in the medial femoral condyle. At 6 and 12 months postoperatively, defect repair was assessed by macroscopic appearance, magnetic resonance imaging (MRI), micro–computed tomography (µCT), and histologic and biomechanical tests. Results: The m-HA+KGN group exhibited superior gross and histological healing after evaluation at 6 and 12 months postoperatively. Improved quality of the repaired cartilage demonstrated by MRI and better subchondral bone reconstruction assessed by µCT were observed in the m-HA+KGN group. The m-HA+KGN group showed more hyaline-like cartilage exhibited by histological staining in terms of extracellular matrix, cartilage lacuna, and type II collagen. The biomechanical properties were improved in the m-HA+KGN group. With m-HA+KGN treatment, defects with a diameter of 6.5 mm or full-thickness chondral-type defects possessed significantly higher ICRS macroscopic and histological scores compared with diameter 8.5 mm or osteochondral-type defects. Conclusion: (1) m-HA+KGN treatment facilitated hyaline cartilage and subchondral bone tissue repair in a porcine model at the 12-month follow-up. (2) m-HA+KGN treatment demonstrated better therapeutic efficacy in defects with a diameter of 6.5 mm or full-thickness chondral-type defects. Clinical Relevance: This study verified the efficacy of this innovative KGN release system on cartilage repair. The KGN release system can be injected into defect sites arthroscopically. This convenient and minimally invasive operation holds important prospects for clinical application.

scholarly journals Combat Facial Fractures Sustained During Operation Resolute Support and Operation Freedom’s Sentinel in Afghanistan

2020 ◽  
Vol 185 (9-10) ◽  
pp. 414-416
Author(s):  
John Breeze ◽  
William Gensheimer ◽  
Joseph J DuBose
Keyword(s):  
Motor Vehicle ◽  
Bacterial Load ◽  
Trauma System ◽  
Gunshot Wounds ◽  
High Energy ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Mandible Fractures ◽  
Explosive Devices

Abstract Introduction Facial fractures sustained in combat are generally unrepresentative of those commonly experienced in civilian practice. In the US military, acute trauma patient care is guided by the Joint Trauma System Clinical Practice Guidelines but currently none exists for facial trauma. Materials and methods All casualties that underwent surgery to facial fractures between January 01, 2016 and September 15, 2019 at a US deployed Military Treatment Facility in Afghanistan were identified using the operating room database. Surgical operative records and outpatient records for local Afghan nationals returning for follow-up were reviewed to determine outcomes. Results 55 casualties underwent treatment of facial fractures; these were predominantly from explosive devices (27/55, 49%). About 46/55 (84%) were local nationals, of which 32 (70%) were followed up. Length of follow-up ranged between 1 and 25 months. About 36/93 (39%) of all planned procedures developed complications, with the highest being from ORIF mandible (18/23, 78%). About 8/23 (35%) casualties undergoing ORIF mandible developed osteomyelitis, of which 5 developed nonunion. Complications were equally likely to occur in those procedures for “battlefield type” events such as explosive devices and gunshot wounds (31/68, 46%) as those from “civilian type” events such as falls or motor vehicle collisions (5/11, 45%). Conclusions Complications Rates from facial fractures were higher than that reported in civilian trauma. This likely reflects factors such as energy deposition, bacterial load, and time to treatment. Load sharing osteosynthesis should be the default modality for fracture fixation. External fixation should be considered in particular for complex high-energy or infected mandible fractures where follow-up is possible.

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