Preparing for the 2019‐2020 influenza season

Although the 2017‐2018 influenza season had very high rates of influenza‐associated illness, the 2018‐2019 influenza season was comparable to previous seasons. Influenza A was the most commonly identified type worldwide, although variations in influenza A subtype prevalence existed. Influenza vaccination remains the single most effective way to prevent influenza‐associated illness. A novel influenza antiviral, baloxavir, has demonstrated promising results; however, concerns about development of resistance exist.     

Persistent neuropathic pain after inguinal herniorrhaphy depending on the procedure (open mesh v. laparoscopy): a propensity-matched analysis

Background

A greater incidence of persistent pain after inguinal herniorrhaphy is suspected with the open mesh procedure than with laparoscopy (transabdominal preperitoneal), but the involvement of neuropathy needs to be clarified.

Methods

We examined the cumulative incidence of neuropathic persistent pain, defined as self-report of pain at the surgical site with neuropathic aspects, within 6 months after surgery in 2 prospective subcohorts of a multicentre study. We compared open mesh with laparoscopy using different analysis, including a propensity-matched analysis with the propensity score built from a multivariable analysis using a generalized linear model.

Results

Considering the full patient sample (242 open mesh v. 126 laparoscopy), the raw odds ratio for neuropathic persistent pain after inguinal herniorrhaphy was 4.3. It reached 6.8 with the propensity-matched analysis conducted on pooled subgroups of 194 patients undergoing open mesh and 125 undergoing laparoscopy (95% confidence interval 1.5–30.4, p = 0.012). A risk factor analysis of these pooled subgroups revealed that history of peripheral neuropathy was an independent risk factor for persistent neuropathic pain, while older age was protective.

Conclusion

We found a greater risk of persistent pain with open mesh than with laparoscopy that may be explained by direct or indirect lesion of nerve terminations. Strategies to identify and preserve nerve terminations with the open mesh procedure are needed.     

Dental magnetic resonance imaging for periodontal indication – a new approach of imaging residual periodontal bone support

Objective: The standard imaging techniques used in dentistry consist of two-dimensional radiographic techniques like intraoral periapical (PA) radiographs, bitewings or extraoral panoramic X-rays. Three-dimensional methods, such as cone beam computed tomography (CBCT), are not standard procedures. In several fields of dentistry, such as oral surgery or implantology, dental magnetic resonance imaging (DMRI), a technique without radiation exposure, has already been introduced as a new promising diagnostic tool. The aim of this study was to compare the agreement of DMRI and PA radiographs in measuring residual periodontal bone support.

Material and methods: In this study, the residual periodontal bone support of 21 teeth was investigated and compared with DMRI and PA radiographs by two independent raters. Intra-class correlation coefficients (ICCs) were calculated using the software R to identify the intra-rater and inter-rater agreement of the two modalities. Bland–Altman plots were created to directly compare the two methods.

Results: Overall, all calculated ICC values showed an excellent intra-rater and inter-rater agreement (>0.9) for DMRI, as well as PA radiographs. Bland–Altman analysis also showed a strong agreement between both diagnostic methods in this study.

Conclusions: In conclusion, there was a strong agreement between DMRI and PA. Thus, DMRI proved to be a comparable method to PA radiographs for evaluating the proportion of residual periodontal bone support.     

Determining replacement teeth position for the implant-retained prosthesis in the edentulous patient

A pleasing final appearance is vitally important for patients who undergo extensive oral rehabilitation. This applies equally to the fields of orthodontics, restorative, prosthetic, and implant dentistry. In the field of removable prostheses there are biometric guides that aid in the replacement of teeth especially when the anatomical ridges are severely resorbed. These guides should be considered when planning the appearance and function of prostheses. This paper suggests that in view of the fact that unfavourable placement of implant fixtures is not easily rectified, knowledge of biometric guides can be critical in the treatment planning of the implant supported prosthesis especially when there are large resorbed edentulous spans.     

Evolution of Mobility Function in Chinese Elders during the 6 Months of Nutritional Supplementation and Age-adapted Physical Activities: A Feasibility Study

Knee pain and discomfort appear at the early stages of normal aging, which lead to impaired mobility and reduced quality of life (QOL). Among age-related conditions, osteoarthritis (OA) is considered the most significant cause of disability. The acceleration of the aging process in China has troubled the middle-aged and elderly with a relatively high prevalence of OA, as recently reported in a meta-analysis pooling and analyzing epidemiological publications on OA in the middle-aged and elderly Chinese published from 2000 to 2018[1].     

The use of a wax bite wafer and a double computed tomography scan procedure to obtain a three-dimensional augmented virtual skull model

A detailed visualization of the interocclusal relationship is essential in a three-dimensional virtual planning setup for orthognathic and facial orthomorphic surgery. The purpose of this study was to introduce and evaluate the use of a wax bite wafer in combination with a double computed tomography (CT) scan procedure to augment the three-dimensional virtual model of the skull with a detailed dental surface. A total of 10 orthognathic patients were scanned after a standardized multislice CT scanning protocol with dose reduction with their wax bite wafer in place. Afterward, the impressions of the upper and lower arches and the wax bite wafer were scanned for each patient separately using a high-resolution standardized multislice CT scanning protocol. Accurate fitting of the virtual impressions on the wax bite wafer was done with surface matching using iterative closest points. Consecutively, automatic rigid point-based registration of the wax bite wafer on the patient scan was performed to implement the digital virtual dental arches into the patient's skull model (Maxilim, version 2.0; Medicim NV, St-Niklaas, Belgium). Probability error histograms showed errors of < or =0.16 mm (25% percentile), < or =0.31 mm (50% percentile), and < or =0.92 (90% percentile) for iterative closest point surface matching. The mean registration error for automatic point-based registration was 0.17 +/- 0.07 mm (range, 0.12-0.22 mm). The combination of the wax bite wafer with the double CT scan procedure allowed for the setup of an accurate three-dimensional virtual augmented model of the skull with detailed dental surface. However, from a clinical workload, data handling, and computational point of view, this method is too time-consuming to be introduced in the clinical routine.