Impact of scalpel type on operative time and acute complications in thyroidectomies

IntroductionThyroidectomy is the most common surgery in the cervical region. Currently, several techniques are available for intraoperative hemostasis.ObjectiveTo compare the performance of three techniques (monopolar and bipolar electrical and ultrasonic) on operative time and postoperative complications.MethodsPatients submitted to total thyroidectomy without prior treatment were included in this prospective series study, using a scientific design.ResultsA total of 834 patients were included; 661 women (79.3%) and 173 men (20.7%). The diagnosis was malignant neoplasia in 528 patients (63.3%) and benign disease in 306 patients (36.7%). The monopolar electric scalpel was used in 280 patients (33.6%), bipolar scalpel in 210 patients (25.2%) and ultrasonic scalpel in 344 patients (41.3%). The operative time was significantly shorter with the ultrasonic or bipolar scalpel when compared to the electric scalpel. In a linear regression model, gender, malignancy diagnosis and power energy type were significant for the procedure duration. Patients who underwent surgery with an ultrasound or bipolar scalpel had a significantly lower incidence of hypoparathyroidism.ConclusionThe use of ultrasonic or bipolar scalpel significantly reduces operative time and the incidence of transient hypoparathyroidism.     

Relationship between glycemic subsets and generalized chronic periodontitis in type 2 diabetic Brazilian subjects

ObjectiveThe aim of the present study was to evaluate the relationship between glycemic subsets and clinical periodontal conditions in type 2 diabetic Brazilians with generalized chronic periodontitis.DesignNinety-one Brazilians with type 2 DM and generalized chronic periodontitis were involved in this study. The clinical examination included full-mouth assessment of plaque index (PI), bleeding on probing (BoP), probing depth (PD), suppuration (SUP), clinical attachment level (CAL) and number of remaining teeth. Blood analyses were carried out for glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG). The relationship between the extent of periodontitis, defined as the percentage of sites with PD and CAL ≥ 5 mm, and glycemic parameters were also analysed. In addition, clinical parameters were compared amongst four (HbA1c levels ≤7.5%, 7.6–9%, 9.1–11% and >11%) and two (<9% and ≥9%) glycemic subsets.ResultsThe frequency of uncontrolled diabetic subjects (HbA1c > 7.5%) was higher than well-controlled subjects (HbA1c ≤ 7.5%). Amongst the clinical parameters evaluated, only PI was positively correlated with the levels of HbA1c and FPG (p < 0.05). The number of remaining teeth was negatively associated with the levels of HbA1c (p < 0.05). In addition, PI was significantly higher in subjects presenting HbA1c levels >11% and ≥9% than those with HbA1c levels ≤7.5% and <9%, respectively (p < 0.05).ConclusionAlthough an increased frequency of the subjects with generalized chronic periodontitis included presented type 2 uncontrolled DM, a dose–response relationship between the severity and extension of periodontitis and the glycemic control was not established in these subjects.     

Cognitive Dysfunction and Antiphospholipid Antibodies

Antiphospholipid syndrome (APS) is a multisystem prothrombotic condition, however, in recent years, its inflammatory nature has been studied extensively. Cerebral involvement is commonly observed in APS and results in different clinical manifestations. However, most of the studies include secondary APS. In this article, we review the prevalence, clinical characteristics, and physiopathology of cognitive impairment in patients with primary APS.     

Evaluation of the therapeutic effects of led (λ627 ± 10 nm) on the initial phase of ankle sprain treatment: a randomised placebo-controlled clinical trial

Various therapies for the treatment of sprains have emerged as advances occur in biomedical engineering and photobiology. Therapy with coherent and non-coherent light is a treatment modality for various musculoskeletal injuries. The main certified phototherapy benefits are the reduction of nociceptive processes and the modulation of the inflammatory process, among others. The objective of this study was to analyse the changes caused by the use of light-emitting diodes (LED) (λ627?±?10 nm) with an energy density of 10 J/cm² in 40 subjects divided into two groups (20 placebo and 20 LED). All of the volunteers had acute ankle sprains by inversion of grade II treated with the PRICE (protection, rest, ice, compression and elevation) technique and were treated for 6 days with LED therapy and LED therapy turned off (placebo). Pain assessment was performed on the 1st, 3rd and 6th days using the visual analogue scale (VAS) of pain, the McGill Pain Questionnaire and volumetry. The group treated with LED showed statistically decreased pain compared to the placebo group in both the VAS (85.79 vs 55.73%) and McGill questionnaire (83.33 vs 52.52%). The reduction of oedema in the LED group on the 3rd and 6th days after therapy was statistically superior to that in the placebo (p?<?0.0001). Based on the results of this study, treatment with LED, using the tested dose, is effective for pain and oedema in the initial phase of ankle sprains.     

Olfactory function in systemic lupus erythematosus and systemic sclerosis. A longitudinal study and review of the literature

Background/purpose

To evaluate olfactory function in systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and healthy controls over a 2-year period, and to determine the association of olfactory dysfunction with age, disease activity, disease damage, treatment, anxiety and depression symptoms and limbic structures volumes.

Impact of Smoking Cessation on Periodontal Tissues

There is cumulative evidence supporting the negative effects of smoking on periodontal tissues. Smoking cessation can be successfully accomplished through specific programs, including behaviour modification and medications, and has been suggested as a suitable way to reduce the risk of several diseases, including periodontitis. The aim of this review is to provide a concise overview of the current knowledge about the impact of smoking cessation on periodontal tissues and therapy, with data from studies published in the last 15 years. Literature was searched using Medline database from 2005 up to and including September 2020 using medical subject heading (MeSH) terms and other search terms, restricted to the English language. Studies were evaluated and summarised in a narrative review format. Results demonstrated that there is convincing evidence to support the benefits of tobacco cessation in reducing the risk of periodontitis and tooth loss. In addition, the harmful effects of smoking on periodontal tissues seem to be assuaged as the number of years since quitting increases. The existing current evidence, even limited, also shows that smoking cessation may result in additional benefits to the outcome of nonsurgical periodontal treatment. Periodontal care providers should not only check their patient's smoking habit for estimating risk of disease progression and predictability of periodontal therapy, but they should also help smokers improve their oral and systemic health by providing efficient and personalised tobacco‐cessation counselling and treatment.