Use of ventilation bag for the respiratory support during magnetic resonance imaging in Arnold-Chiari ventilated patients,a case report

Context: Magnetic Resonance Imaging (MRI) is an essential diagnostic tool for neuroimaging tissues such as the spinal cord. Unfortunately, the use of MRI may be limited in ventilated patients, who cannot maintain the supine position in spontaneous breathing for the whole duration of the exam (i.e. neuro-muscular patients with diaphragm involvement). The use of MRI-compatible ventilator during MRI could be a solution but they are not universally available. Furthermore, their performances are not up to those of the conventional ones and they are not always compatible with Non Invasive Ventilation (NIV).

Findings: This case report describes an easy and low-cost solution to ventilate a patient non-invasively during the MRI procedure. The patient in this case was a 45-yr-old man, wheelchair-dependent and chronically ventilated in NIV with a forced vital capacity in supine position of 370?ml (10% of predicted normal), affected by Arnold-Chiari Syndrome, and in need of a MRI diagnostic control.

Conclusion: The technique proposed, that does not affect the MRI images quality, consists in ventilating the patient using a simple nonmetallic Ventilation Bag, operated by a Respiratory Therapist. This has been proven a useful and economical solution for ventilatory support during MRI for a respiratory-dependent patient with Arnold-Chiari Syndrome.     

Experimental study of brackets adhesion with a novel enamel-protective material compared with conventional etching

IntroductionA reliable adhesion between fixed devices and dental surfaces is a key factor for the clinical success of any orthodontic treatment. Adhesion preparation is associated with damages related to abrasive cleaning, enamel structure defacing caused by etching, enamel loss when removing resin remnants at orthodontic treatment finishing stage or when conditioning surface for adhesive failure and fractures at bracket removal.AimThe objective of this study was to compare the shear bond strength of metallic brackets to enamel adhered with a novel non-damaging and remineralizing material for enamel versus the traditional 37% phosphoric acid etching.Material and methods75 Premolars collected from 15- to 40-years old healthy donors requiring extraction were collected. The teeth were then randomly divided into three groups (n = 25). One group was used for the experimental new method (EX), the second for the conventional phosphoric acid etching (PA) method and the third group was left without any treatment (NT). The metallic brackets were fixed with Transbond® XT adhesive and composite resin polymerized for 40 s with a halogen photocuring lamp. The shear bond strength was quantified by means of a universal testing machine at 1 mm/min crosshead speed and a load cell of 1 kN.Statistical analysis usedTests of normality, adjustment of the data to a root square, a one-way ANOVA and Tukey tests were performed.ResultsStatistically significant differences between the NT (1.4 MPa), PA (32.1 MPa) and EX (9.7 MPa) groups were observed.ConclusionsThe experimental material for conditioning human enamel induces calcium phosphates crystals on the enamel surface and improves the bond strength in comparison to the NT group.     

Coledocolitiasis en el embarazo. Reporte de caso

Lithogenesis and biliary stasis increases during pregnancy. This generates a high incidence in the production of gallstones. Cholelithiasis is not usually a surgical emergency in pregnancy, but when there are complications, which can be in up to 10% of obstetric patients, these complications can require intervention.A case report is presented on an obstetric patient with cholelithiasis, and high risk of choledocholithiasis, that required intervention using endoscopic retrograde cholangiopancreatography.     

Hotspot Analysis of Traditional Drugs in Diabetes Treatment Literature

Objective:To summarize current hotspots and predict the potential trends in traditional drugs of diabetes treatment for further research.Methods:Publications on the application of traditional drugs in diabetes treatment were searched from PubMed without language limits.Highly frequent MeSH terms were identified through Bibliographic Item Co-Occurrence Matrix Builder(BICOMB).Biclustering analysis results were visualized utilizing the gCLUTO software.Finally,a strategic diagram was generated.Results:Totally 2,386 relevant publications were obtained from PubMed on November 9th,2018,and 69 highly frequent MeSH terms were identified.Biclustering analysis revealed that these highly frequent MeSH terms were classified into 7 clusters.After calculating the density and centrality of each cluster,strategy diagram was presented.Cluster 0"Chinese medicine monomers such as antioxidant and hypoglycemic effects"was considered as the most potential research hotspot.Conclusions:In this study,we found 7 topics related to the application of traditional drugs in diabetes treatment.The molecular mechanisms of Chinese medicine monomers in diabetes could become a potential hotspot with high centricity and low density.     

Do buffered local anesthetics provide more successful anesthesia than nonbuffered solutions in patients with pulpally involved teeth requiring dental therapy?: A systematic review

Background

The authors conducted a systematic review that addresses the following population, intervention, comparison, outcome question: “In adults requiring dental therapy with pulpally involved teeth, what is the comparative efficacy of buffered local anesthetics (LAs) compared with that of nonbuffered LAs in achieving anesthetic success?”

The accuracy of diagnostic tests for adenoid hypertrophy: A systematic review

BackgroundAdenoid hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening adenoid hypertrophy.MethodsThe authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction.ResultsThe authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent).ConclusionsNo ideal tool exists for dentists to screen adenoid hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool.Practical ImplicationsAlthough lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other's weaknesses. This combined approach is the best tool available to dentists for screening adenoid hypertrophy.     

质量环在根管充填质量控制中的应用

目的探讨质量环管理模式在降低根管充填缺陷率中的应用效果。方法应用质量环管理模式控制根管充填质量,对比实施质量环前后的根管充填缺陷率。结果根管充填缺陷率（不含再治疗病例）由实施前的7．28％降低到实施后的1．83％,差异有统计学意义（P〈0．01）。结论质量环管理模式规范了根管治疗的各个环节,在根管充填质量控制中发挥了积极的作用。