How to Implant a Leadless Pacemaker With a Tine‐Based Fixation

Two major studies have shown that leadless pacemakers are safe and effective for patients requiring right ventricular rate responsive pacing therapy. This positive result recently led to FDA approval of one of the available leadless pacing devices. While this new technology is promising, it requires a different skill set for safe implantation. In this article, we review in detail the different steps required for implantation of tine‐based leadless pacemakers while providing tips and tricks to minimize complications.     

Molecular and pathological characterization of duck enteritis virus in Egypt

In winter 2016, a fatal disease outbreak suspected to be duck virus enteritis (DVE) stroke over a million ducklings in 10 white Pekin and Muscovy ducks flocks in Dakahlia and Gharbia Governorates, Egypt, causing heavy economic losses. The disease quickly killed 20%–60% of affected farms. The clinical signs were inappetence, ataxia, crowding in corners, partially closed eye lids and blue beaks. Post mortem examination revealed white necrotic foci in liver, mottled spleen and sometimes cecal core. A total of 10 intestines, livers and spleens samples were collected from diseased flocks. Each sample was pooled randomly from eight to ten ducklings. Polymerase chain reaction (PCR) and histopathological examination were utilized for DEV identification in collected samples. Nucleotides sequences of the amplified DNA polymerase gene were compared with the other DEVs available on GeneBank. Also, existence of co‐infection with Salmonella spp. was verified via PCR. DEV nucleic acid was detected by PCR in 8 of 10 collected samples (80%) with positive amplification of polymerase gene. Histopathological examination revealed eosinophilic and basophilic intranuclear inclusion bodies in enterocytes. In some infected enterocytes, intranuclear and intracytoplasmic inclusions were observed in the same cell. Respectively, eosinophilic intranuclear inclusion bodies found in hepatocytes and reticular cells of liver and spleen of diseased ducklings. Four of the 10 collected samples showed positive results for Salmonella spp. infection that may be involved in enhancing infection with DEV. The identified DEVs revealed close genetic relationship with DEVs detected previously in India and China indicating potential transmission of the virus from there that crucially needs further work for better understanding of virus origin. In conclusion, our study revealed infection of duckling farms with DEV and Salmonella that necessitate the implementation of restricted early preventive and control measures for both diseases to decrease the expected economic losses.     

A pilot study of the association between cariogenic oral bacteria and preterm birth*

Objectives: We examined the associations between preterm birth and low birth weight and maternal caries history, maternal periodontal status, and salivary levels of mutans streptococci and Lactobacilli. Design: This study was a matched case–control study in women during their pregnancy or up to 8 weeks after delivery. Subjects and methods: Thirty‐four women delivering before 37 weeks gestation were recruited along with 73 term controls matched for age and race/ethnicity. Demographic and obstetric information was collected from questionnaires and medical records and oral examinations along with commercial salivary tests were completed within the study groups. Main outcome measures: The main outcome variables were the preterm birth and low birth weight status. The independent variables measured were the salivary levels of Lactobacilli and mutans streptococci and the caries and periodontal status of the subjects. Results: The odds ratio comparing low levels of bacteria in preterm mothers and controls was statistically significant for Lactobacilli (odds ratio (OR) = 3.45, 95% confidence interval (CI) = 1.27 to 10.00) and almost significant for mutans streptococci (OR = 2.63, 95% CI = 0.95 to 8.33). Clinical caries and periodontal disease measures did not differ significantly between groups. Conclusion: Within the limitation of our study, low levels of Lactobacilli in saliva were found to be associated with preterm birth.     

Osteoarthritis of knee joint in metabolic syndrome

Clinical Rheumatology - Pathogenesis of osteoarthritis may have a systemic metabolic component. This study was undertaken to assess the prevalence of primary knee osteoarthritis (OA) in a sample of...     

Precise intraoperative location of gastrointestinal bleeding with a hand-held counter. Work in progress

The nuclear medicine bleeding scan is frequently insufficient to locate sites of bleeding precisely, in spite of its great sensitivity. A small, hand-held Geiger-Müller counter, placed directly on exposed intestine in the operating room, enables precise location of the probable bleeding site. In three patients, the technique allowed a minimal amount of intestine to be resected, distinguished between large- and small-intestinal hemorrhage, and eliminated other foci as sites of bleeding.     

Recurrent supraventricular tachycardias prevalence and pathophysiology after RF ablation: A 5-year registry

Background

The introduction of technique of radiofrequency (RF) catheter ablation in 1990, has revolutionized management of different types of paroxysmal supraventricular tachycardia (PSVT). In spite of higher success rate, there were reported recurrences among different types of SVT. The aim of this study was to report the efficacy of RF ablation, its complications, recurrence rate and its predictors.

Methods

The material of this study (our 3rd registry) included patients who underwent electrophysiological study (EPS) and radiofrequency ablation of their supraventricular tachycardia in the past 5 years, starting from January 2002 to January 2007 at The Critical Care Medicine Department, Cairo University.

Results

Out of 400 pts studied, 381 (95%) had been subjected to radiofrequency ablation (RF) ablation while the remaining 19 pts (4.7%) refused ablation for fear of possible complications. Out of the 381 pts, 366 (96%) had their target tachycardia successfully terminated, from them 26 pts (7%) experienced recurrence after having successful RF ablation. Nine pts (34.6%) of total recurrence was reported in pts with AVNRT, 7 pts (26.9%) of total recurrence was reported in pts with AVRT utilizing septal accessory pathway (Rt AS and /or Rt PS AP), 4 pts (15.4%) was reported in pts with double AP, 2 pts (7.7%) of total recurrence was reported in pts with AFl, one pt (3.8%) of total recurrence was reported in cases of AT. Redo ablation have been carried out successfully in 25 pts (96.2%), and one pt (3.8%) refused ablation for fear of possible complications.

Conclusions

Although electrophysiological study and RF ablation eliminated different types of SVT. However, there may be increased incidence of recurrence among pts with AVNRT and AVRT utilizing concealed septal AP and multiple APs secondary to the complexity of AVN physiology, the critical location of septal AP, the clinical expertise, and poor electrophysiological criteria for good procedural success.     

Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study

Purpose: The aim of this study was to compare between the effects of resilient liner and clip attachments of bar‐implant‐retained mandibular overdenture on peri‐implant tissues. Materials and methods: In a randomized‐controlled clinical trial, 30 edentulous male patients (mean age 62.5 years) were equally assigned to two groups. In each patient, two implants were inserted in the canine area of the mandible using a two‐stage surgical protocol. After 3 months, the implants were connected with resilient bars. Mandibular overdentures were retained to the bars with either clips (group I) or silicone‐resilient liners (group II). Peri‐implant tissues were evaluated clinically (with regard to plaque scores, gingival scores and probing depths) and radiographically (with regard to peri‐implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. Results: After 12 months of using bar‐implant‐retained mandibular overdenture, the resilient liner attachment had significantly decreased peri‐implant plaque score, gingival score, probing depth, vertical and horizontal bone loss when compared with the clip attachment. Conclusion: Within the limitations of this study, and in terms of peri‐implant tissue health of bar‐implant‐retained mandibular overdenture, we recommend resilient liner rather than clip attachment. To cite this article:
Elsyad MA, EL Shoukouki AH. Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study.
Clin. Oral Impl. Res. 21 , 2010; 473–480
doi: 10.1111/j.1600‐0501.2009.01879.x