Three-dimensional measurement of radiographic bone–implant contact lengths of zygomatic implants in zygomatic bone: a retrospective study of 66 implants in 28 patients

Zygomatic implant treatment is widely applied for severe maxillary atrophy to help rehabilitate the maxillary dentition. This retrospective study was performed to evaluate the actual radiographic bone–implant contact (rBIC) lengths of zygomatic implants. The records of 28 patients who underwent zygomatic implant surgery and subsequent follow-up examinations between August 2013 and September 2018 in the Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital were reviewed. The surgeries were performed by a single surgeon using the same treatment protocol. All patients had a computed tomography scan at 1 year after the surgery. Using three-dimensional imaging software, an investigator measured the rBIC lengths of 66 implants and documented their clinical status. The implant survival rate was 100%. The mean rBIC length was significantly longer in male patients than in female patients (20.80 ± 5.88 mm versus 17.79 ± 6.34 mm; P = 0.028). The mean rBIC length of double zygomatic implants was significantly longer when compared to that of single implants (21.11 ± 6.23 mm versus 17.75 ± 5.85 mm; P = 0.027). This article is novel in reporting the exact rBIC lengths of zygomatic implants in a clinical setting. The results showed that zygomatic implants are a viable treatment modality for full-mouth rehabilitation.     

Primary vaccination in adult patients after allogeneic hematopoietic stem cell transplantation – A single center retrospective efficacy analysis

Allogeneic hematopoietic stem cell transplantation (alloHSCT) results in a loss of humoral immunity and subsequent risk for severe infections. Thus, re-vaccination is required but may fail due to incomplete immune reconstitution. We retrospectively analyzed predictors of immune response to primary vaccination applied according to the EBMT (European Blood and Marrow Transplantation Group) recommendations. Serologic response to vaccination against diphtheria (D), tetanus (T), Bordetella pertussis (aP) and Haemophilus influenzae (Hib) (administrated as combined DTaP-Hib-IPV vaccination) was studied in 84 alloHSCT patients transplanted between 2008 and 2015 (age at alloHSCT: 18.6–70.6 years). All patients with a relapse-free survival of ≥9 months, at least 3 consecutive vaccinations and absence of intravenous immunoglobulin administration within 3 months before and after vaccination met the primary inclusion criteria. Additionally, immunological response to a pneumococcal conjugate vaccine was analyzed in a subgroup of 67 patients. Patients’ characteristics at the time of first vaccination were recorded. Responses were measured as vaccine-specific antibody titers. Regarding DTaP-Hib-IPV vaccination, 89.3% (n = 75) of all patients achieved protective titers to at least 3 of the 4 vaccine components and were thus considered responders. 10.7% (n = 9) of the patients were classified as non-responders with positive immune response to less than 3 components. Highest response was observed for Hib (97.4%), tetanus (95.2%) and pneumococcal vaccination (83.6%) while only 68.3% responded to vaccination against Bordetella pertussis. Significant risk factors for failure of vaccination response included low B cell counts (p < 0.001; cut-off: 0.05 B cells/nl) and low IgG levels (p = 0.026; mean IgG of responders 816 mg/dl vs. 475 mg/dl of non-responders). Further, a trend was observed that prior cGvHD impairs vaccination response as 88.9% of the non-responders but only 54.7% of the responders had prior cGvHD (p = 0.073). The results demonstrate, that the currently proposed vaccination strategy leads to seroprotection in the majority of alloHSCT patients.     

COVID-19 and venous thromboembolism: Known and unknown for imaging decisions

As we continue to fight against the current coronavirus disease-2019 (COVID-19) pandemic, healthcare professionals across the globe are trying to answer questions surrounding how to best help patients with the up-to-date available science while awaiting the development of new therapies and mass vaccination. Since early in the pandemic, studies indicated a heightened risk of venous thromboembolism (VTE) in COVID-19 infected patients. There have been differing expert opinions about how to assess pretest probability of VTE in this patient population. This has been partly due to the high prevalence of respiratory failure in this patient population and the use of D-dimer as a prognostic test which is also frequently elevated in patients with COVID-19 in absence of VTE. Some experts have argued for an approach similar to usual care with testing if clinical suspicion is high enough. Some have argued for more routine screening at different points of care. Others have even suggested empiric therapeutic anti-coagulation in moderate to severely ill COVID-19 patients. In the following article, we review and summarize the most current literature in hopes of assisting clinicians in decision making and guidance for when to be concerned for VTE in COVID-19 patients. We also discuss research gaps and share pathways currently being used within our institution.     

Position paper on stress cardiac MRI in chronic coronary syndrome: Endorsed by the Société Française de Radiologie (SFR) the Société Française d’Imagerie CardioVasculaire (SFICV) and the Société Française de Cardiologie (SFC)

This position paper was intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging (MRI) in chronic coronary syndrome published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, procedure with patient preparation, stress inducing drugs, acquisition protocol, interpretation and risk stratification by stress MRI.     

基于SEER数据库脊索瘤临床预测模型的建立及验证

目的构建脊索瘤患者的预测模型并进行验证。方法从SEER数据库(2004~2015年)中鉴定和收集597例脊索瘤患者。Nomogram是基于建模组420例拥有完整数据的患者建立的。C指数(C-index)和校正曲线确定Nomogram的预测精度和判别能力。结果建立了基于年龄、种族、原发部位及数量、肿瘤分期(TNM)、手术方式、是否放疗、肿瘤转移和肿瘤大小等预后因素的预测模型,C指数为0.778。确定生存概率的校准曲线表明,Nomogram预测结果与实际观测结果吻合较好。年龄>60岁(P<0.001,HR 5.723,95%CI 1.988~16.474)、M1(P<0.001,HR 4.121,95%CI 1.834~9.257)、手术方式(全切除,P<0.01,HR0.416,95%CI 0.236~0.732;根治性扩大切除,P<0.0001,HR 0.251,95%CI 0.143~0.442)是独立预后因素。结论 Nomogram为脊柱脊索瘤患者提供了更准确的预后预测。本研究结果显示,年龄>60岁肿瘤分期M1和不进行手术是显著缩短脊索瘤患者生存时间的独立危险因素。     

A guide to assessing post-operative complications following en bloc spinal resection

En-bloc resection of spinal tumours is a complex procedure with significant morbidity and mortality. The extensive resection leaves a large soft tissue and osseous defect requiring reconstruction. Following en-bloc resection, there may be complications relating to both the removal of the tumour and the subsequent reconstruction. This paper outlines the imaging appearances of the frequently encountered complications in our experience. The primary aim is to improve the confidence of the radiologist when reporting imaging following spinal en-bloc resection, however we believe this is also useful for the spinal and orthopaedic surgeons in assessing the patients following en block resection.     

液晶数字显示角度仪在全髋关节置换术中的应用价值

目的:探讨在全髋关节置换术中使用液晶数字显示角度仪控制前倾角的应用价值。方法:回顾分析自2018年1月至2019年12月83例行初次全髋关节置换术的患者,其中男28例,女55例;年龄42~81(70.4±7.9)岁。股骨颈骨折63例,股骨头缺血性坏死20例。所有患者术中使用液晶数显角度仪控制髋臼杯假体的前倾角,术后采用CT扫描,测量髋臼杯的前倾角,两者进行比较,了解使用液晶数显角度仪的准确性。结果:术后CT测量提示患者的髋臼前倾角均位于Lewinnek提倡的安全区内,术中使用液晶数显角度仪测量髋臼杯的前倾角度中位数为14.20°(12.80~15.40)°,术后CT扫描测量的髋臼杯的前倾角中位数为14.20°(13.40~15.50)°,两者比较差异无统计学意义(Z=-1.725,P=0.085)。结论:应用液晶数显角仪器对术中控制髋臼杯的前倾角是一种准确可靠的方法,具有良好的辅助参考价值。