Correction to: Sinus augmentation analysis of the gradient of graft consolidation: a split-mouth histomorphometric study

Clinical Oral Investigations - Figure 1 was reused with permission from "Wiley", the publisher of a previous article by the same authors, DOI:10.1111/cid.12518.     

Long-term results of prolapse recurrence and functional outcome after vaginal hysterectomy

ObjectiveTo evaluate the incidence of prolapse and prolapse-related symptoms following vaginal hysterectomy.MethodsData were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long-term follow-up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination.ResultsAmong 94 women attending long-term evaluation, the mean follow-up time was 100.7 months (range 67.0–156.0 months). Before vaginal hysterectomy, urgency was noted among 23 (24.5%), urge incontinence among 11 (11.7%), and stress incontinence among 8 (8.5%) women. At follow-up, these symptoms were observed among 23 (24.5%), 13 (13.8%), and 6 (6.4%) women, respectively. De novo urge incontinence and de novo stress incontinence were observed among 3 (3.2%) and 2 (2.1%) women, respectively. Vaginal examination data were compared for 70 women, of whom 18 (25.7%) had grade 1, 40 (57.1%) had grade 2, and 6 (8.6%) had grade 3 uterine prolapsed before surgery. Postoperatively, vaginal vault prolapse occurred in 7 (10.0%) women and correlated with degree of posterior prolapse (P = 0.007), but not with severity of uterine descent (P = 0.205) or previous prolapse surgery (P = 0.573).ConclusionThe incidence of post-hysterectomy vault prolapse correlated with the degree of preoperative rectocele.     

Pregnancy-Associated Breast Cancer: A Review for the Obstetrical Care Provider

Breast cancer is uncommon in pregnancy, but obstetrical care providers should nevertheless be familiar with the presenting signs and symptoms. The incidence of breast cancer in pregnancy and the postpartum period ranges from 2.3 to 40 cases per 100 000 women. Over 90% of patients with breast cancer in pregnancy or during lactation present with a palpable mass, and most often (84%) these are self-reported by patients. Less frequently, breast cancer will present as breast erythema, breast swelling, bloody nipple discharge, or local or distant metastasis. The histology of tumours appears to be similar in women who are pregnant or recently delivered and in age-matched women who are not pregnant. However, the stage of disease at diagnosis is more advanced in women who are pregnant or recently delivered and consequently incurs a worst prognosis, likely due to a delay in diagnosis. Although the majority of palpable breast masses are benign, breast examinations should routinely be performed in pregnant women, and identified masses should be promptly evaluated.     

Increased prevalence of obstructive lung disease in patients with obstructive sleep apnea

Study purposes

This study aims to determine whether there is an increased prevalence of obstructive lung diseases (OLDs) in patients with obstructive sleep apnea (OSA). We also determined whether among the OLD patients there is a difference in the prevalences of specific chronic disease co-morbidities between patients with and without OSA.

Methods

The prevalences of COPD, asthma, and COPD combined with asthma (ICD-9 coding) were compared between 1,497 adult OSA patients and 1,489 control patients, who were matched for age, gender, geographic location, and primary care physician. The prevalences of specific co-morbidities were measured in the OLD groups between patients with OSA and the matched control group.

Results

COPD, asthma, and COPD combined with asthma were found to be more prevalent among OSA patients compared to the matched controls. Prevalences among patients with and without OSA, respectively, were COPD—7.6 and 3.7 % (P?<?0.0001), asthma—10.4 and 5.1 % (P?<?0.0001), COPD plus asthma—3.3 and 0.9 % (P?<?0.0001). The Charlson Comorbidity Index was greater for OSA patients (2.3?±?0.2) than for controls (1.9?±?1.8; P?<?0.0001). These trends held for all severity ranges of OSA. Patients with OSA and COPD were characterized by more severe hypoxia at night compared with the OSA patients without OLD.

Conclusion

OSA was associated with an increased prevalence of OLDs.     

Differences in crestal bone-to-implant contact following an under-drilling compared to an over-drilling protocol. A study in the rabbit tibia

Objectives

The objective of this study is to compare bone-to-implant contact (BIC) between implants inserted at high torque due to under-drilling of the crestal bone to those inserted at low torque due to over-drilling of the crestal bone.

Materials and methods

Forty implants with diameters of 3.75 mm (group A) or 3.55 mm (group B) were inserted in the proximal tibiae of NZW rabbits in two separate surgeries on day 0 or 21. Osteotomy of the crestal bone was finalized with a 3.65-mm drill. In group A, implants were inserted at torque ≥35 Ncm (under-drilling) and in group B with torque <10 Ncm (over-drilling). Implants and their surrounding bone were retrieved on day 42, thus creating 3- and 6-week observation periods, processed for non-decalcified histology and stained with toluidine blue. Crestal BIC (c-BIC) and total BIC (t-BIC) were measured. Wilcoxon test was used to evaluate differences between groups.

Results

Three weeks post-surgery, the mean c-BIC in group A was 16.3?±?3.3 vs 31.5?±?3.4 % in group B (P?<?0.05). At 6 weeks, a similar trend was observed (group A: 28.7?±?3.6 %; group B: 38.4?±?4.9 %) (P?>?0.05). No differences in t-BIC were noted at 3 weeks and at 6 weeks between the groups.

Conclusions

Insertion of implants with an over-drilling protocol of the crestal aspect of the osteotomy resulted in increased short-term crestal bone-to-implant contact.

Clinical relevance

Insertion of implants with a high torque following an under-drilling protocol, commonly used for immediate loading, may reduce crestal bone-to-implant contact at early healing stages.

     

Swallowing before and after tonsillectomy as evaluated by surface electromyography.

OBJECTIVES: Surface electromyography (sEMG) was performed on adult patients (n = 40) following tonsillectomy to evaluate recovery by objective means. METHODS: Evaluated parameters included timing of swallowing and continuous drinking, electric amplitude and graphic patterns of masseter (MS), and measurement of infrahyoid (INF) and submental (SUB) muscles after tonsillectomy and comparison with normative database. RESULTS: The duration of drinking periods showed significant increase among patients; single-swallow durations remained normal. The electric activity of MS and INF muscles was significantly higher among the patients compared with normative database. It took one month until all the EMG data returned to normal. CONCLUSION: Tonsillectomy affects muscle activity during swallowing by involving additional muscles in deglutition. EMG is a simple reliable method for postoperative evaluation and might contribute to comparative analysis of different tonsillectomy techniques. EMG can be used during pre- and postoperative stages to monitor recovery and functional improvement of throat muscles and deglutition. SIGNIFICANCE: The reported sEMG method and obtained data might be further used: 1) As an additional tool for comparison of different methods of tonsillectomy (eg, cold vs hot dissection, laser surgery, etc); 2) For further development of objective postsurgical pain assessment; 3) As an additional tool for assessment and development of less traumatic surgical technique; and 4) For monitoring of recovery in difficult cases.     

Computed tomographic features of afferent loop syndrome: pictorial essay.

ALS, a rare condition, is often difficult to diagnose clinically but has a characteristic CT appearance as a U-shaped, fluid-filled tubular structure crossing the midline between the abdominal aorta and the superior mesenteric artery. Radiologists should be familiar with this rare entity, as awareness of its pathognomonic CT features will aid in establishing the correct diagnosis as well as in offering a tentative etiology as a guide for treatment.     

Nonrecurring transient cortical blindness after coronary angiography: A role for hypoventilation and hypercarbia?

A 73-year-old morbidly obese patient suffered cortical blindness following coronary angiography. Symptoms rapidly resolved and did not recur following a repeated procedure. Hypoventilation due to narcotics with subsequent hypercarbia and blood-brain barrier breaching may be implicated in the pathogenesis of this complication.     

Hemoptysis in Israeli CF patients — Prevalence, treatment, and clinical characteristics

OBJECTIVE: To identify the characteristics of CF patients with hemoptysis in Israel and to compare clinical features and risk factors to a control group of CF patients without hemoptysis. DESIGN: Retrospective chart review. PATIENTS: All CF patients in Israel who experienced hemoptysis between 2001 and 2005 and a control group of sex- and age-matched patients with no history of hemoptysis. RESULTS: 40/440 CF patients (9.1%) experienced hemoptysis during the study period, 50% were male. Ten patients (25%) were under 13 years old at the first hemoptysis episode. Pulmonary exacerbation was the precipitating factor in 90%. Twenty three patients showed moderate or major hemoptysis. 35/40 patients responded well to conservative therapy. Bronchial artery embolization (BAE) was performed in 5 patients with no recurrence of bleed within 24 h. However all of these patients experienced recurrent hemoptysis. One patient died during the follow-up period because of end stage lung disease. Pulmonary function tests, body-mass index, coagulation tests, pancreatic status, presence of bronchiectasis, sputum cultures and genetic mutations were similar in the two groups. A high incidence (57.5%) of associated diseases including cystic fibrosis related diabetes, cirrhosis and portal hypertension, and distal intestinal obstruction syndrome was found among hemoptysis patients, compared to only 5.2% in the control group (p<0.001). CONCLUSIONS: Hemoptysis, even major, did not seem to be a risk factor for mortality in our patients. A higher incidence of hemoptysis was found in our pediatric patients compared to other series. BAE shows a high immediate rate of success in controlling hemoptysis, but does not prevent future disease.