Clinical Indications to Germectomy in Pediatric Dentistry: A Systematic Review

Germectomy is a procedure often required in patients at developmental age. It is defined as the surgical removal of the third molar at a very specific stage of development. The aim of this study was to systematically analyze the literature in terms of clinical indications for germectomy in patients at developmental age. Literature searches were performed using PubMed, Google Scholar, Cochrane Library and Scopus from 1952 to 30 June 2021. The study protocol was registered after the screening stage (PROSPERO CRD42021262949). The search strategy identified 3829 articles: 167 from PubMed, 2860 from Google Scholar, 799 from Cochrane Library and 3 from Scopus. Finally, eight full-text papers were included into the qualitative analysis. Based on the included studies, clinical indications for germectomy were mainly related to orthodontic causes, infectious and cariogenic causes and prophylaxis. Based on these results, it is not possible to present evidence-based clinical indications for germectomy in patients at developmental age. Clinical trials on this subject focused specifically on patients at developmental age are awaited.

The Lateral Tarsal Strip Procedure: Reflections by a Specialist With 20 Years of Experience in a Tertiary Medical Center (Cross-sectional Study)

Introduction: Lateral tarsal strip (LTS) is a simple surgical technique that can correct eyelid malposition. Clinical indications vary from involutional entropion and ectropion, lower lid laxity, and lower lid retraction to punctal and paralytic ectropion. LTS mainly treats eyelid malposition by correcting horizontal laxity. Herein, we report the clinical indications for and effects of LTS.Methods: We retrospectively reviewed medical records of patients who underwent LTS by a single oculoplastic surgeon with eight years of experience performing the procedure at Korea University Guro Hospital.Results: We included 247 patients with 325 treated eyelids in the study. Involutional entropion was the most common indication, accounting for 69 patients (27.94%) and 88 eyelids (27.08%). The second most common indication was lower lid laxity (n=44 patients (17.81%) and 68 eyelids (20.92%)). Simultaneous surgery in addition to LTS was performed in 167 patients (67.6%) and 219 eyelids (67.4%); the most common was endoscopic dacryocystorhinostomy (DCR), which was performed in 50 patients (29.94%) and 80 eyelids (36.53%). Conclusion: LTS can be performed alone or simultaneously with oculoplastic procedures for various indications. Overcorrection with fixation above the canthal angle is useful to reduce recurrence. This study aims to explain the clinical importance of the LTS procedure.

Therapeutic possibilities of coriaria myrtifolia L. in high dilutions

Background: Homeopathy literature shows references about Coriaria myrtifolia L. at some important Homeopathic Materia Medica: Allen,TF [1], Voisin H [2] and Vijnovsky B [3]. Those reports are unsatisfactory to fulfill a contemporary standardized study basis on: origin and description, preparation, medicine general action, sensations and modalities; demanding a broader investigation. Aims: Identify therapeutic possibilities on Coriaria myrtifolia L. from ratifying and broadening the homeopathic materia medica knowledge. Methodology: Literature review on botanical, biochemical and pharmacological data [4-12]. The use of plant in various fields since XVIII century and analyzes of clinical-toxicological reports described in medical reviews published. Results: Coriaria myrtifolia L. is a toxic shrub, growing wild in western Mediterranean region. The entire plant contains a sesquiterpene-lactone called coriamyrtin, a potent convulsivant neurotoxin. Clinical manifestations of acute intoxication includes: Central Nervous System – generalized tonic-clonic seizures, recurrent, which may evolve to status epilepticus, coma, apnea and death. Respiratory Tract – respiratory depression due to anoxia, respiratory arrhythmia alternating with apnea, respiratory muscles tetanization evolving to respiratory arrest. Cardiovascular System – central excitatory action which may initially promote increased blood pressure followed by heart failure, as a result of the seizures, due to anoxia and acidosis, leading to cardiac arrest. Gastrointestinal Tract – nausea, vomiting and stomach pains that precede seizures; since there is no evidence of toxin direct action on mucosa, those symptoms may relate to Central Nervous System action (attributed to impairment of cranial nerve VIII). Knowledge of these aspects gave us possibility to build a Coriaria myrtifolia L. materia medica with broader clinical indications. Conclusion: Coriaria myrtifolia L. is a valuable source to be used in high dilutions as medicine indicated for epileptic syndromes treatment, characterized by tonic-clonic seizures, mainly presenting a malignant tendency, with recurrent seizures, which may evolve to status epilepticus and potential mortality risk. Among the clinical indications proposed stand out etiologies of great incidence at emergency rooms such as metabolic or vascular primary disorders, or resulting from systemic diseases (diabetes, hepatopathy, nephropathy), encephalitis and meningitis with or without Acquired Immunodeficiency Syndrome, withdrawal syndrome from alcohol or drugs, exogenous poisoning, poisoning or overdose of alcohol or drugs, traumatic brain injury and intracranial expanding lesions.

Direct Oral Anticoagulants and Vitamin K Antagonists: Role in Thrombotic Damage, Safety, and Indications

This chapter is intended to discuss the available oral anticoagulants, including vitamin K antagonists and the Direct Oral Anticoagulants such as dabigatran, apixaban, rivaroxaban, and edoxaban. It will review their basic pharmacology, pharmacokinetics, pharmacodynamics, dosage forms, clinical indications, and place in therapy. Finally, this chapter will also discuss the currently available reversal agents.

Liquid Embolics: A Guide to Currently Available and Pipeline Products

Over the last decade, several publications have reported the safety and efficacy of liquid embolics in a wide range of clinical indications. The expansion of clinical scenarios in which liquid embolics are utilized has been in part driven by some of the advantages these materials hold over other embolic agents. For instance, liquid embolics do not rely on the patient's ability to form clot and can be delivered more distally then coils at times. While several liquid embolics are commercially available, and in some cases have been for decades, there are limitations to these materials as well. The potential benefits of liquid embolics combined with the limitations of available materials have led to the ongoing development of several new agents. This review aims to familiarize the reader with both available liquid embolics and those that are relatively new or in development.

Telerehabilitation: An Overview

Rehabilitation is a major component of health sciences, and is the process of restoring an incapacitated individual to a normal life through training and therapy. Globally, 2.4 billion people may currently require rehabilitation. In 60 to 70% of countries, existing rehabilitation services have been disrupted due to the coronavirus disease 2019 (COVID-19) pandemic. Even after lockdowns and with vaccinations, some form of physical distancing is likely to be part of the new normal. Concurrently, there is an exponential growth of telehealth. This global overview will demonstrate that telerehabilitation (TR) is likely to be a distinct stand-alone sub-specialty of telehealth. Details of setting up TR, methods, and components are discussed, and clinical indications, limitations, advantages, disadvantages, challenges, and barriers to implementation and technological advances in TR are highlighted followed by an in-depth study of the literature from India.

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry

Ob jectives The European Society of Radiology identified 10 common indications for computed tomography (CT) as part of the European Study on Clinical Diagnostic Reference Levels (DRLs, EUCLID), to help standardize radiation doses. The objective of this study is to generate DRLs and median doses for these indications using data from the UCSF CT International Dose Registry. Methods Standardized data on 3.7 million CTs in adults were collected between 2016 and 2019 from 161 institutions across seven countries (United States of America (US), Switzerland, Netherlands, Germany, UK, Israel, Japan). DRLs (75th percentile) and median doses for volumetric CT-dose index (CTDIvol) and dose-length product (DLP) were assessed for each EUCLID category (chronic sinusitis, stroke, cervical spine trauma, coronary calcium scoring, lung cancer, pulmonary embolism, coronary CT angiography, hepatocellular carcinoma (HCC), colic/abdominal pain, appendicitis), and US radiation doses were compared with European. Results The number of CT scans within EUCLID categories ranged from 8,933 (HCC) to over 1.2 million (stroke). There was greater variation in dose between categories than within categories (p < .001), and doses were significantly different between categories within anatomic areas. DRLs and median doses were assessed for all categories. DRLs were higher in the US for 9 of the 10 indications (except chronic sinusitis) than in Europe but with a significantly higher sample size in the US. Conclusions DRLs for CTDIvol and DLP for EUCLID clinical indications from diverse organizations were established and can contribute to dose optimization. These values were usually significantly higher in the US than in Europe. Key Points • Registry data were used to create benchmarks for 10 common indications for CT identified by the European Society of Radiology. • Observed US radiation doses were higher than European for 9 of 10 indications (except chronic sinusitis). • The presented diagnostic reference levels and median doses highlight potentially unnecessary variation in radiation dose.