Comparison of Indicators for Achievement of Pain Control With a Personalized Pain Goal in a Comprehensive Cancer Center

Context

The achievement of a personalized pain goal (PPG) is advocated as an individualized pain relief indicator.

Long-term follow up of esophageal varices after balloon-occluded retrograde transvenous obliteration for gastric varices.

Aim: Because the procedure of balloon-occluded retrograde transvenous obliteration (B-RTO) causes extensive thrombosis of the major shunt that connects the spleen and gastric/renal venous systems, an increase in portal pressure is unavoidable. The aim of the present study was to assess the long-term outcome of B-RTO, including changes in esophageal varices. Methods: B-RTO was conducted in 22 patients with gastric varices, who were divided according to the severity of esophageal varices at baseline; there were no esophageal varices (n = 7), F(1) varices (n = 11), and F(2) varices (n = 4). The outcome measures included the development/worsening of esophageal varices after B-RTO and survival rates. Results: The cumulative bleeding-free probability for all 22 patients at 3 years after B-RTO was 100%. The overall 3-year survival was 94.4%. Seven patients who had no esophageal varices prior to B-RTO did not develop any after the procedure. Seven (63.6%) of the 11 patients with stage F(1) esophageal varices prior to B-RTO showed no changes in the varices after B-RTO, while two patients progressed to F(2) varices and two developed F(3) varices. The cumulative treatment-free probability of the esophageal varices at 24 months after B-RTO was 100% for patients without esophageal varices at baseline, 80.8% for patients with pre-existing F(1) varices, and 75% for those with pre-existing F(2) varices. Conclusion: Although the B-RTO procedure is considered useful for the treatment of gastric varices, changes in hemodynamics due to obliteration of this major shunt must be taken into account and observed closely.     

Evaluation of dimensional accuracy and degree of polymerization of stereolithography photopolymer resin under different postpolymerization conditions: An in vitro study

Statement of problemThe appropriate postpolymerization of stereolithography (SLA) resins with the least effect on dimensional accuracy and with optimal polymerization is unclear.PurposeThe purpose of this in vitro study was to investigate the dimensional accuracy and degree of polymerization of a photopolymer resin for SLA with different postpolymerizing times and temperatures.Material and methodsSixty 1.5-mm-thick specimens were made from clear photopolymer resin with a 3D printer to simulate a maxillary complete denture. They were postpolymerized for different periods (15 and 30 minutes) at 3 different temperatures (40 °C, 60 °C, and 80 °C). Both prepolymerization and postpolymerization gap sizes for each specimen were measured at 5 different locations under a stereomicroscope. The tissue surface was scanned before and after polymerization, and the images were superimposed. The deviation was analyzed by using computer-aided design (CAD) software; root mean square estimates (RMSE) and color map data were obtained. Fourier transform infrared spectrometry was used to determine the degree of conversion (DC) of all specimens. The Kruskal-Wallis and Mann-Whitney tests were used to calculate the difference value of the gap sizes (α=.05). One-way ANOVA and the Tukey test were used for RMSE and DC (α=.05).ResultsThe smallest average change in gap sizes was found at 15 minutes and 40 °C, and the largest change at 30 minutes and 80 °C. The lowest RMSE was obtained at 30 minutes and 40 °C (P<.05). On the color map, a uniform deposited layer was created at 15 minutes and 40 °C and 30 minutes and 40 °C. The highest DC was found at 30 minutes and 60 °C, which differed significantly from 15 minutes and 40 °C (P<.05). The lowest degree of polymerization was found at 30 minutes and 40 °C.ConclusionsThe polymerizing temperature exerted a greater effect than polymerizing time, with lower temperatures leading to improved fit and tissue surface accuracy. The recommended parameters for SLA polymerization are 15 minutes and 40 °C. These conditions offered high dimensional accuracy, favorable surface tissue adaptation, and satisfactory DC.