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Alison G. Loewenstein Avinash S. Bidra Thomas J. Balshi 《Journal of prosthodontics》2020,29(5):369-373
Late cluster implant failures can be one of the most devasting outcomes of implant therapy for patients. It can have anatomic, functional, psychological and financial consequences for patients, and sometimes the loss of residual bone can preclude subsequent implant placement. Fortunately, management of cluster implant failures in the maxilla can be mitigated by using implant anchorage from remote sites like zygomatic and pterygoid regions. Few reports exist in the literature that have described the management of cluster implant failure using extra‐maxillary implants such as zygomatic and pterygoid implants. This case report describes the management of a female patient with bruxism who experienced late cluster implant failure in the maxilla after 9 years of function with an overdenture. Due to the loss of residual bone, subsequent implant therapy involved the use of bilateral zygomatic, pterygoid and anterior maxillary implants, which were immediately loaded and thereafter used to support a complete arch fixed implant‐supported zirconia prosthesis. 相似文献
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Effect of total knee arthroplasty on type II diabetes mellitus and hypertension: A prospective study
Context:
Advanced osteoarthritis of knee joint if bilateral, severely restricts patient mobility. This acts as an aggravating factor for pre existing comorbid elements of metabolical syndrome (MS) like Type II diabetes mellitus and hypertension as patients are unable to carry out therapeutic walks. Successfully implanted total knee arthroplasty (TKA) increases physical activity and enables to carry out therapeutic walks thus may help in better control of type II diabetes mellitus and hypertension. The objective of this prospective study was to find whether TKA for osteoarthritis knee had any effect to improve blood glucose levels and reduce blood pressure.Materials and Methods:
A prospective study was done in which patients operated for tricompartmental osteoarthritis of knee with associated comorbidities like Type II diabetes mellitus or hypertension during a period of 2008 and 2009 were studied. One hundred and twenty patients were enrolled (55 diabetics, 65 hypertensives) who met our inclusion criteria. Preoperative knee society score, lower extremity activity scale fasting blood glucose level and systolic and diastolic blood pressure were compared with one year followup values. The KSS and LEAS scores were analysed by the Wilcoxon signed ranked test, while the fasting blood glucose (FBG) levels and systolic and diastolic blood pressure levels were analysed by paired ‘t’ test.Results:
The reduction of systolic blood pressure by 8 mmHg (t = 5.6, P value < 0.05) and diastolic blood pressure by 6 mmHg (t = 7.6, P value < 0.05) was recorded which was statistically significant. However, no statistically significant effect on fasting blood glucose levels was observed (t = -0.77, P value = 0.442). KSS improved in DM from preoperative 29 to 86 and LEAS improved from 6.7 to 11.3.Conclusions:
Authors are of the opinion that successful total knee replacement results in increased physical activity and reduces blood pressure (systolic and diastolic) in hypertensives. However, the same is not seen in blood glucose level. Increased physical activity and reduced dependence on NSAIDS postoperatively, may be contributing in reduction of systolic and diastolic blood pressure. Further studies in this aspect are necessary. 相似文献28.
A fifty-year-old male had an echocardiogram for an abnormal electrocardiogram; it revealed a left ventricular mass. A cardiac catheterization revealed normal coronary arteries and a fine tumor blush of the cardiac tumor with feeding arteries from the circumflex as well as the second diagonal coronary vessels. Due to increased risk of embolization, he underwent surgery via a transatrial approach and a 1.5 cm cavernous-capillary hemangioma was removed from the base of the posteromedial papillary muscle. Primary tumors of the heart are rare, and the symptoms and signs depend on the location and size of the tumor. Coronary angiography remains an integral part in the evaluation of cardiac tumors and often can reveal a characteristic 'tumor blush.' The natural history of the tumor is unpredictable and excision of the tumor remains the treatment of choice. We present a rare case of characteristic angiographic tumor blush of a left ventricular cardiac hemangioma with feeding arteries from both the left anterior descending as well as the circumflex arteries. This rare two-system supply was due to the intracavitary location of the hemangioma, and fortunately did not pose any excessive difficulty in mobilization and excision during surgery. 相似文献
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Purpose:National Accreditation Board for Hospitals and Healthcare Providers operates the health-care accreditation program in India. Research on impact of accreditation on eye-care centers is scarce. This article was conceptualized to scientifically evaluate the changes in documentation brought about by accreditation and its effects on staff in the Ophthalmology Department of an Indian Medical College.Methods:This was conducted as a quasi-experimental study in four steps. First, a point-based evaluation of case sheets in both pre-accreditation and postaccreditation phase, along with statistical analysis of the results, was done. Step two involved analysis of quality indicators and patient safety indices in successive years from inception of data to post-accreditation phase. Step three comprised a survey of staff employing a validated tool, and finally, face-to-face semistructured interviews with designated authorities, including finance departmental head, completed the study.Results:A statistically significant difference was seen in scores achieved by the pre and postaccreditation case sheets, with the postphase case sheets achieving 15% increased scores over the prephase case sheets. Quality indicator indices displayed improvements post-accreditation. There was an accompanying increase in quantity of documentation. Financial data analysis showed increased expenditure for accreditation under multiple heads. Staff believed that accreditation led to increased workload but did not express decreased satisfaction and felt that accreditation was eventually beneficial. However, staff believed rewards for improving quality can be enhanced.Conclusion:Accreditation increases quality and quantity of documentation, and staff workload. Increased financial costs also ensue.Staff believe that accreditation improves quality, is beneficial, but desire enhanced rewards. 相似文献
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Bartosz Wojewnik Alexander J. Ghanayem Parmenion P. Tsitsopoulos Leonard I. Voronov Tejaswy Potluri Robert M. Havey Julia Zelenakova Alpesh A. Patel Gerard Carandang Avinash G. Patwardhan 《European spine journal》2013,22(1):135-141