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Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to use A-silicone injections to evaluate the volume of the PM. This study was conducted using 46 human cadaver heads (25 males and 21 females). A craniometric analysis was performed using the cadavers' ages, the number of silicone cartridges (carpules) used to fill the pterygomandibular space, Izard's Facial Index (FI), and the Cranial Index (CI). A Halstead mandibular block was performed by injecting 1.7 mL A-silicone cartridges (as an equivalent to standard local aesthetic carpules volume) into the PM. The cured silicone was extracted from the dissected mandibles. The volume (length, width, and thickness) of the extracted silicone and the number of silicone cartridges used to fill the space were evaluated. The results showed that there are statistically significant positive correlations between the CI and the width of the right PM, as well as the width and length of the left PM. A statistically significant correlation was found between the width of the left PM and the age of the cadaveric heads; the higher the age, the thicker the space on both sides. The volume of the PM corresponded to 1.5 cartridges on average.
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Our study aimed to clarify the anatomical features of the zygomatic, upper masseteric, lower masseteric and mandibular ligaments and their possible contribution to age-related gravitational ptosis. The study was carried out by the method of layered dissection of fresh cadavers. In several observations, the zygomatic ligament is represented by the fibers originating from the zygomaticus major muscle fibers. It is a true ligament with the fibers inserted directly into the skin. The upper and lower masseteric ligaments originate from the parotideomasseteric fascia and weave into the thickness of the SMAS. The mandibular ligament consists of two connective tissue laminae originating from the parotideomasseteric fascia at the lower edge of the mandible and from the inner surface of this fascia, along the anterior edge of the masseter muscle, skirting the facial vein sheath and the facial artery, traveling toward the platysma and the depressor anguli oris muscle, and merging with their fibers. The zygomatic ligament should be considered an osteo-musculocutaneous ligament, emphasizing the role of the associated zygomaticus major muscle in the mechanism of aging. The upper and lower masseteric and mandibular ligaments are false fascio-SMAS ligaments rather than osteo-cutaneous ones, playing the barrier role and fixing the superficial fascia and the platysma muscle.
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Cadáver , Cara , Ligamentos , Humanos , Ligamentos/anatomía & histología , Cara/anatomía & histología , Músculo Masetero/anatomía & histología , Masculino , Femenino , Mandíbula/anatomía & histología , AncianoRESUMEN
Background and Objectives: There are many surgical techniques for oroantral communication treatment, one of which is the buccal fat pad. Of particular interest is the high reparative potential of the buccal fat pad, which may be contributed to by the presence of mesenchymal stem cells. The purpose of this work is to evaluate the reparative potential of BFP cells using morphological and immunohistochemical examination. Materials and Methods: 30 BFP samples were provided by the Clinic of Maxillofacial and Plastic Surgery of the Russian University of Medicine (Moscow, Russia) from 28 patients. Morphological examination of 30 BFP samples was performed at the Institute of Clinical Morphology and Digital Pathology of Sechenov University. Hematoxylin-eosin, Masson trichrome staining and immunohistochemical examination were performed to detect MSCs using primary antibodies CD133, CD44 and CD10. Results: During staining with hematoxylin-eosin and Masson's trichrome, we detected adipocytes of white adipose tissue united into lobules separated by connective tissue layers, a large number of vessels of different calibers, as well as the general capsule of BFP. The thin connective tissue layers contained neurovascular bundles. Statistical processing of the results of the IHC examination of the samples using the Mann-Whitney criterion revealed that the total number of samples in which the expression of CD44, CD10 and CD133 antigens was confirmed was statistically significantly higher than the number of samples where the expression was not detected (p < 0.05). Conclusions: During the morphological study of the BFP samples, we revealed statistically significant signs of MSCs presence (p < 0.05), including in the brown fat tissue, which proves the high reparative potential of this type of tissue and can make the BFP a choice option among other autogenous donor materials when eliminating OAC and other surgical interventions in the maxillofacial region.
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Tejido Adiposo , Compuestos Azo , Mejilla , Inmunohistoquímica , Humanos , Inmunohistoquímica/métodos , Femenino , Masculino , Antígeno AC133/análisis , Receptores de Hialuranos/análisis , Neprilisina/análisis , Células Madre Mesenquimatosas , Adulto , Eosina Amarillenta-(YS) , Hematoxilina , Verde de MetiloRESUMEN
Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. Such injuries are frequent in Siberia, which is a territory surrounded by dense forests inhabited by brown bears. In the last 4 months alone (September-December 2023), four bear attacks on humans were registered in Khakassia, Russia. This article presents a clinical case of rehabilitating a patient after a bear attack, who suffered multiple fragmentary fractures of the facial skeleton with displaced bone fragments, subcutaneous emphysema of the soft tissues of the face, damage to the parietal and right occipital regions and paranasal sinus hemorrhage on the left side. The nature of the injuries was enhanced by trauma to the upper extremity caused by the patient defending himself against the animal. In addition to the damage to his face, the bear tried to open his cranium, as evidenced by four furrows caused by its canines, including two each on the frontal and occipital bones of the skull. The patient's complex treatment included both maxillofacial and reconstructive surgeries, and outpatient treatment involved the formation of normotrophic scars using a neodymium laser and injections of a heterogeneous composition consisting of microparticles of "crosslinked" collagen of animal origin placed in a gel identical to the natural extracellular matrix.
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The toxicity of local anesthetics is a serious problem, given their widespread use. One of the main causes of the side effects of local anesthetics is their non-selectivity of action in the body. A possible way to increase the selectivity of the action of drugs is to use the photopharmacology approach. Previously, we described the light-controlled local anesthetic ethercaine, the biological effect of which can be controlled using light, thereby increasing its selectivity of action. An important limitation of ethercaine was its low solubility in water, limiting the potential of this compound. In this work, we developed a dosage form of ethercaine, which allowed us to increase its solubility from 0.6% to 2% or more. The resulting 1% solution of ethercaine hydrochloride in 4% Kolliphor ELP had high biological activity on the surface anesthesia model, while demonstrating low acute toxicity in mice with intravenous administration (4-5 times less than that of lidocaine).
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This study addresses the cervical part of the vertebral column. Clinical pictures of dystrophic diseases of the cervical part of the vertebral column do not always correspond only to the morphological changes-they may be represented by connective tissue formation and nerve and vessel compression. To find out the possible reason, this morphometric study of the cervical part of the vertebral column in 40 cadavers was performed. CT scans were performed on 17 cadaveric material specimens. A total of 12 histological samples of connective tissue structures located in intervertebral canals (IC) were studied. One such formation, an intracanal ligament (IL) located in the IC, was found. Today, there is no term "intervertebral canal", nor is there a detailed description of the intervertebral canal in the cervical part of the vertebral column. Cervical intervertebral canals make up five pairs in segments C2-C7. On cadavers, the IC lateral and medial apertures were 0.9-1.5 cm and 0.5-0.9 cm, correspondingly. According to our histological study, the connective tissue structures in the IC are ligaments-IL. According to the presence of these ligaments, ICs were classified into three types. Complete regional anatomy characterization of the IC of the cervical part of the vertebral column with a description of its constituent anatomical elements was provided. The findings demonstrate the need to include the terms "intervertebral canal" and "intervertebral ligament" in the Terminologia anatomica.
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The prevalence of periodontal diseases is increasing, tends to increase with age and is considered as one of the main causes of tooth loss. To assess the effectiveness of new methods of treatment of periodontal diseases, studies on laboratory animals can be promising. THE AIM OF THE STUDY: to develop a new method of accelerated modeling of experimental periodontitis on laboratory animals. MATERIAL AND METHODS: The study was carried out on 22 female rats. A wire ligature was applied to the cervical area of the incisors of the animals in an eight-shaped manner. Plaque obtained from a patient with periodontitis was placed under the wire, and nicotine and ethyl alcohol solutions were injected under the gingival mucosa. A complex index has been proposed to assess inflammation. At the end of the experiment the animals were euthanized, their jaws were dissected into dentoalveolar blocks and further descriptive histologic analysis was performed. RESULTS: On the second day the gingiva of the rats acquired a cyanotic-pink color, on the fourth day the consistency of the gingiva became friable, mobility appeared in the lower incisors. Complex index of inflammation in animals of the main group: before the study-9, on the 7th day-195. Gingival preparations showed signs of exudative inflammation. In alveolar processes-irreversible resorption of bone structures. The difference of indicators in animals before and after the experiment was statistically significant (p < 0.05). CONCLUSION: The new experimental model of periodontitis is reproduced in a short period of time, provides intensive development of inflammation, leads to disruption of the integrity of epithelial and connective tissue attachment, destruction of alveolar bone.
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BACKGROUND: The complex traditional treatment of inflammation diseases in oral cavity includes the prescription of antibiotic and antiseptic therapy. This systematic review aims to evaluate the effect of photodynamic therapy as a part of management of inflammatory diseases in oral cavity; Methods: The study is presented in accordance with the preferred reporting points for systematic reviews and meta-analyses (PRISMA). This systematic review was conducted using electronic databases such as Medline PubMed, Scopus and the Cochrane Central Register of Controlled Trials. All the studies in this systematic review, were randomized, the risk of bias 2 (ROB 2) were assessed; Results: Considering the inclusion and exclusion criteria, we included 10 randomized clinical trials, published up to 2023 investigating the application of photodynamic therapy as a part of management of inflammatory diseases in oral cavity. The diode laser was used in the oral cavity in the zone of inflammatory process (gingivitis, mucositis, periimplantitis, marginal periodontitis, abscess, periostitis, osteomyelitis etc.) in nine studies or in the zone before surgical procedures in one study; Conclusion: Based on the results of clinical studies, it can be stated that photodynamic therapy shows good results for operations performed in the oral cavity and pharynx.
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The development of sulfur-containing pharmaceutical compounds is important in the advancement of medicinal chemistry. Photosensitizers (PS) that acquire new properties upon incorporation of sulfur-containing groups or individual sulfur atoms into their structure are not neglected, either. In this work, a synthesis of sulfur-containing derivatives of natural chlorophyll a using Lawesson's reagent was optimized. Thiocarbonyl chlorins were shown to have a significant bathochromic shift in the absorption and fluorescence bands. The feasibility of functionalizing the thiocarbonyl group at the macrocycle periphery by formation of a Pt(II) metal complex in the chemotherapeutic agent cisplatin was shown. The chemical stability of the resulting conjugate in aqueous solution was studied, and it was found to possess a high cytotoxic activity against sarcoma S37 tumor cells that results from the combined photodynamic and chemotherapeutic effect on these cells.
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Compuestos Organotiofosforados , Clorofila A , Compuestos Organotiofosforados/química , AzufreRESUMEN
During the last few years, in the territory of the Russian Federation, the number of cases of toxic phosphoric osteonecrosis of the jaws has increased against the background of taking drugs of "artisanal" production (pervitin, desomorphin). The aim of our study was to increase the effectiveness of surgical treatment of patients with a diagnosis of toxic phosphorus necrosis of the maxilla. We performed a comprehensive treatment of patients with a history of drug addiction and the above diagnosis. Surgical intervention in the volume of complete resection of pathologically altered tissues and reconstructive techniques using local tissues and a replaced flap made it possible to achieve good aesthetic and functional results in the early and late postoperative period. Thus, our proposed method of surgical treatment can be used in similar clinical situations.
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In surgical dentistry, suture material is the only foreign body that remains in the tissues after surgery, and it can lead to several negative reactions, for example, infection of the wound. The purpose of this study was to compare the mechanical properties and microbiological resistance of mono- and polyfilament suture materials used in tooth extraction operations. The study of elongation and knot force was carried out on an Instron 5969 Dual Column Testing System device. The capillarity of the materials was studied on a setup assembled by the authors manually by immersing the ends of the filaments in a colored manganese solution. A microbiological study was carried out on the threads taken for the experiment immediately after wound suturing, and on day 7, at which time they were removed. The comparison was made according to Rothia mucilaginosa, Streptococcus sanguinis, Staphylococcus epidermidis. Results: monofilament suture materials (Prolene and Glycolon), after calculating the Kruskal-Wallis and Mann-Whitney indices, showed better performance in all experiments compared to polyfilament sutures (Vicryl and PGA). In capillarity comparison, there was a significant difference between groups (p = 0.00018). According to the sum of the results of three microbiological studies on day 7, monofilament suture materials absorbed less of the studied bacteria on their surface compared to the polyfilament ones (p < 0.05). Conclusions: Of the studied suture materials, Prolene had the best microbiological resistance and good mechanical properties.
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Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n = 40) and Pirogov (n = 40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.
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Anatomía , Educación de Pregrado en Medicina , Estudiantes de Medicina , Masculino , Humanos , Anatomía/educación , Universidades , Curriculum , Educación de Pregrado en Medicina/métodos , Satisfacción Personal , Encuestas y CuestionariosRESUMEN
INTRODUCTION: the world studies showed the interest in measurement of the buccal or anterior cortical plate thickness. Data indicate a significant superiority of the spongy substance over the compact one in the distal part of the jaw, which makes it possible to think about a higher effectiveness of transcortical injections. The empirical "rule of 10â³ provides for the choice of a method of anesthesia in children for primary teeth but demonstrates difficulties with high-quality anesthesia accompanied for permanent teeth. Therefore, the importance of clinical examination and anatomical investigation of the jaw cortical plate in children for competent planning of transcortical interventions has been determined. AIM: To study the features of the clinical and X-ray anatomy of the cortical layer in distal alveolar part of the mandible in children. MATERIAL AND METHODS: The assessment of the X-ray anatomical characteristics of the mandible was carried out according to 150 anonymized cone-beam computed tomograms of patients aged 6-12 years, performed for the treatment of major diseases. Qualitative assessment and examination of the cortical plate of the distal alveolar part of the mandible were carried out on the skeletonized certified preparations of aged 6-12 in the amount of 50. RESULTS: The age characteristics of the cortical plate in the area of the chewing group of teeth in the mandible were determined according to macro anatomical studies, which confirms with the X-ray results. Therefore, the obtained images serve as actual confirmation of X-ray studies, which are ranked by age. The thickness of the cortical plate in the second primary molar of the mandible in subgroups 6, 7 and 8 years has a proportional increase from the cervical region to the apical projection. The average thickness of the cortical plate is 1.57 mm at 6 years, 1.52 mm at 7 years, 1.6 mm at 8 years and 1.84 at 9 years. The cortical plate thickness in the first primary molar of the mandible in subgroups 6 and 7 years has a proportional decrease from the cervical region to the apical projection as well as an inverse proportion to age. The average thickness of the cortical plate is 1.33 mm. In the first molar of the mandible at the age limit of 6-12 years the attention is drawn to the linear increase in tissue volume from the cervical region to the apical projection up to 8 years. At 6-8 years the average thickness of the cortical plate in this age group is 1.74 ± 0.2 mm, at 9 years - 2.03 mm, at 10 - average value in the cervical region it is 1.53 ± 0.23 mm, in the root middle it is 2.19 ± 0.13 mm and in the apical projection it is 1.98 ± 0.16 mm, at 11-2.22 mm and at 12-2.35 mm. For the second primary molar the average thickness of the buccal cortical plate of the second primary molar is 1.4 mm in cervical part, 1.68 mm in the root middle and 1.81 mm in the apical projection. Finally, thickness of the buccal cortical plate in the cervical region of the first permanent molar is 2 mm in groups. CONCLUSION: The study makes it possible to determinate with noninvasive way the age limit for the least pronounced zone of the buccal cortical plate.
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Tomografía Computarizada de Haz Cónico , Mandíbula , Niño , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Rayos X , Mandíbula/diagnóstico por imagen , Mandíbula/anatomía & histología , Diente Molar/diagnóstico por imagen , Diente Molar/anatomía & histología , Raíz del Diente/anatomía & histologíaRESUMEN
Photodynamic therapy (PDT) is currently regarded as a promising method for the treatment of oncological diseases. However, it involves a number of limitations related to the specific features of the method and the specific characteristics of photosensitizer molecules, including tumor hypoxia, small depth of light penetration into the tumor tissue, and low accumulation sensitivity. These drawbacks can be overcome by combining PDT with other treatment methods, for example, chemotherapy. In this work, we were the first to obtain agents that contain bacteriopurpurinimide as a photodynamic subunit and complexes of gold(I) that implement the chemotherapy effect. To bind the latter agents, N-heterocyclic carbenes (NHC) based on histidine and histamine were obtained. We considered alternative techniques for synthesizing the target conjugates and selected an optimal one that enabled the production of preparative amounts for biological assays. In vitro studies showed that all the compounds obtained exhibited high photoinduced activity. The C-donor Au(I) complexes exhibited the maximum specific activity at longer incubation times compared to the other derivatives, both under exposure to light and without irradiation. In in vivo studies, the presence of histamine in the NHC-derivative of dipropoxy-BPI (7b) had no significant effect on its antitumor action, whereas the Au(I) metal complex of histamine NHC-derivative with BPI (8b) resulted in enhanced antitumor activity and in an increased number of remissions after photodynamic treatment.
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Complejos de Coordinación , Neoplasias , Fotoquimioterapia , Humanos , Complejos de Coordinación/farmacología , Histidina , Histamina , Fármacos Fotosensibilizantes/farmacología , Fármacos Fotosensibilizantes/uso terapéutico , Neoplasias/tratamiento farmacológico , Oro/farmacología , Línea Celular TumoralRESUMEN
Background: The role of preventive measures increases significantly in the absence of effective specific COVID-19 treatment. Mass population immunization and the achievement of collective immunity are of particular importance. The future development of public attitudes towards SARS-CoV-2 immunization depends significantly on medical students, as future physicians. Therefore, it seemed relevant to determine the percentage of COVID-19-vaccinated medical students and to identify the factors significantly affecting this indicator. Methods: A total of 2890 medical students from years one to six, studying at nine leading Russian medical universities, participated in an anonymous sociological survey. The study was performed in accordance with the STROBE guidelines. Results: It was found that the percentage of vaccinated Russian medical students at the beginning of the academic year 2021 was 58.8 ± 7.69%, which did not significantly differ from the vaccination coverage of the general population in the corresponding regions (54.19 ± 4.83%). Student vaccination rate was largely determined by the region-specific epidemiological situation. The level of student vaccination coverage did not depend on the gender or student residence (in a family or in a university dormitory). The group of senior students had a higher number of COVID-19 vaccine completers than the group of junior students. The lack of reliable information about COVID-19 vaccines had a pronounced negative impact on the SARS-CoV-2 immunization process. Significant information sources influencing student attitudes toward vaccination included medical professionals, medical universities, academic conferences, and manuscripts, which at that time provided the least information. Conclusion: The obtained results make it possible to develop recommendations to promote SARS-CoV-2 immunoprophylaxis among students and the general population and to increase collective immunity.
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Tratamiento Farmacológico de COVID-19 , COVID-19 , Estudiantes de Medicina , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , SARS-CoV-2 , Universidades , VacunaciónRESUMEN
BACKGROUND: Providing regional anesthesia skills shaping remains relevant nowadays. A number of studies show that dentists have difficulties with these working independently. The study aim is the comparative analysis of the results of mandibular anesthesia (IANB) manual-skills shaping among dentists on plastic models and cadavers. METHODS: In total, 999 participants were training in the skills of mandibular anesthesia from 2017 to 2021. The participants were divided in a random way into two groups: 700 participants were trained on plastic models, and 299 were trained on the cadaver material. After a lecture on the clinical and anatomical guidelines for IANB, a demonstration of the technique was provided, with subsequent testing of the injection technique. Satisfaction with the aspects of the training was assessed using the Likert scale. RESULTS: the analysis of average values showed that participants from the group in which the manual skills were practiced on cadavers were more satisfied with the main aspects of the training, according to the sum of the main criteria of the modified scale. CONCLUSIONS: The important advantages of cadaver educational technology are that the sensations of tissue resistance are identical to natural ones, the individuality of each object, and the possibility of the visual study of the anesthesia technique, by dissection of the needle course and the location of the anesthetic depot.
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Background In recent years thread lift has become widespread; however, existing methods need to improve their long-term outcome, which requires considering topographic anatomy of face and neck, especially the ligamentous apparatus. This study aims to assess the effectiveness and safety of an innovative method of one-time three-step thread facelift, which provides an additional support to the ligamentous structures of the upper, middle, and lower thirds of the face and neck. Methods The study included 357 patients aged 32 to 67 years with various morphotypes of aging. The original method of thread lift was applied, and its effectiveness was followed up for to 2 years. The Wrinkle Severity Rating Score (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores were used for assessment by investigators, independent observers, and patients. Statistical significance was determined using paired t -test and chi-square test. Results The mean WSRS score was 3.88 ± 0.88 before the thread lift, 1.93 ± 0.81 one month after the procedure, and 2.36 ± 0.85 after 2 years of follow-up. The mean GAIS was 4.80 ± 0.04 one month after thread lift, and 4.01 ± 0.04 after 2 years, while in the patients' assessment Global Satisfaction Scale was 4.86 ± 0.02 and 4.10 ± 0.02, respectively. There were no clinically significant complications throughout the observation period. Conclusion The new method of one-time three-step thread fixation of the soft tissues of the face and neck demonstrated a high degree of satisfaction by both experts and patients after 2 years of follow-up. It showed high efficacy and safety, including in the group of patients with pronounced age-related changes of the skin of face and neck.
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Pain is a common symptom that impairs the quality of life for people around the world. Local anesthetics widely used for pain relief have a number of side effects, which makes the development of both new drugs and new ways to control their activity particularly important. Photopharmacology makes it possible to reduce the side effects of an anesthetic and control its biological activity in the body. The purpose of this work was to create a new light-controlled local anesthetic and study its biological activity in animals. A compound with a simple scheme of synthesis was chosen to shift the UV-Vis absorption band towards the visible range of the spectrum and was synthesized for the first time. Some computer calculations were performed to make sure that the aforementioned changes would not lead to loss of biological activity. The micellar form of the new compound was prepared, and in vivo biological studies were carried out in rabbits. The existence of a local anesthetic effect, which disappeared almost completely on irradiation with light (λ = 395 nm), was shown using the surface anesthesia model. Moreover, the possibility of multiple reversible changes in the biological activity of ethercaine under the action of light was demonstrated. The latter compound manifests no local irritating effect, either. The data obtained indicate the prospects for the development of new compounds based on azobenzene for light-controlled local anesthesia.
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Anestesia Local , Anestésicos Locales , Anestésicos Locales/farmacología , Animales , Compuestos Azo , Humanos , Dolor , Calidad de Vida , ConejosRESUMEN
Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals' ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.
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Agotamiento Profesional , COVID-19 , Médicos , Agotamiento Profesional/epidemiología , Estudios Transversales , Hospitales , Humanos , Unidades de Cuidados Intensivos , SARS-CoV-2 , Encuestas y CuestionariosRESUMEN
Orthodontic implants have been developed for the implementation of skeletal anchorage and are effectively used in the design of individual orthodontic devices. However, despite a significant amount of clinical research, the biomechanical aspects of the use of skeletal anchorage have not been adequately studied. The aim of this work was to numerically investigate the stress-strain state of the developed palatal orthodontic device supported by mini-implants. Four possible options for the placement of mini-implants in the bone were analyzed. The effect of a chewing load of 100 N on the bite plane was investigated. The study was carried out using biomechanical modeling based on the finite element method. The installation of the palatal orthodontic device fixed on mini-implants with an individual bite plane positioned on was simulated. The dependence of equivalent stresses and deformation changes on the number and location of the supporting mini-implants of the palatal orthodontic device was investigated. Two materials (titanium alloy and stainless steel) of the palatal orthodontic device were also investigated. The choice of a successful treatment option was based on the developed biomechanical criteria for assessing the surgical treatment success. Application of the criteria made it possible to estimate the stability and strength of fixation of each of the considered mini-implants installation options. As a result, options for the mini-implants optimal placement were identified (the first and the fourth which provide distributed front and side support of the device), as well as the preferred material (titanium alloy) for the manufacture of the palatal orthodontic device.