Computer-Assisted Evaluation Confirms Spontaneous Healing of Donor Site One Year following Bone Block Harvesting from Mandibular Retromolar Region-A Cohort Study.

Bone augmentation prior to dental implant placement is a common scenario in the dental implantology field. Among the important intraoral harvesting sites to obtain bone blocks is the ramus/retromolar region that has a high success rate and long-lasting alveolar ridge augmentation. Preserving the bone volume and quality at the donor site is crucial for preventing further complications or to serve as a site for re-harvesting. Healing of the intraoral donor sites has been described in the maxillofacial field. This study aimed to evaluate the spontaneous healing of the mandibular retromolar donor site utilizing computer-assisted quantification 6 and 12 months after bone harvesting. MATERIALS AND METHODS: The study was conducted on patients who underwent an alveolar ridge augmentation using an intraoral retromolar bone graft. Three CBCT scans were performed-intraoperative, and at six months and one year after the surgical procedure. By using the Materialise Mimics Innovation Suite software 26.0 features segmentation by thresholding, Hounsfield unit averaging, and superimposition of the tomographies, we could precisely quantify the healing process utilizing spatial and characteristic measures. RESULTS: In all cases, the computer-aided quantification showed that six months following surgery, the donor site had recovered up to 64.5% ± 4.24 of its initial volume, and this recovery increased to 89.2% ± 2.6 after one year. Moreover, the Hounsfield unit averaging confirmed dynamic bone quality healing, starting at 690.3 ± 81 HU for the bone block, decreasing to 102 ± 27.8 HU at six months postoperatively, and improving to 453.9 ± 91.4 HU at the donor site after a year. CONCLUSIONS: This study demonstrates that there is no need for additional replanting at the donor site following retromolar bone block harvesting, whether autogenous or allograft, since spontaneous healing occurs 12 months following the surgery.

Cardiovascular risk factors among Jordanian patients with rheumatoid arthritis: A cohort study.

AIM: To determine the frequency of risk factors for cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) in Jordan. METHOD: During this study, 158 patients with RA were enlisted from the outpatient rheumatology clinic at King Hussein Hospital of the Jordanian Medical Services, from 1 June 2021, to 31 December 2021. Demographic data and disease duration were recorded. After 14 h of fasting, venous blood samples were drawn to determine the levels of cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein. History of smoking, diabetes mellitus, and hypertension was recorded. Body mass index and Framingham's 10-year risk score (FRS) were calculated for each patient. Disease duration was noted. RESULTS: The mean age of the male population was 49.29 years and that of the female population was 46.06 years. Most of the study population were female (78.5%) and 27.2% of the study population had one modifiable risk factor. The most frequent risk factors observed in the study were obesity (38%) and dyslipidemia (38%). Diabetes mellitus was the least frequent risk factor, with a frequency of 14.6%. The FRS differed significantly between the sexes, with the risk score of men being 9.80, whereas that of women was 5.34 (p < .00). Regression analysis revealed that age increased the odds ratio of diabetes mellitus, hypertension, obesity, and a high-to-moderate FRS by 0.7%, 10.9%, 0.33%, and 10.3%, respectively. CONCLUSION: Rheumatoid arthritis patients have increased chances of developing cardiovascular risk factors leading to cardiovascular events.

Factors Influencing the Length of Hospital Stay Among Pediatric COVID-19 Patients at Queen Rania Al Abdullah Hospital for Children: A Cross-Sectional Study.

Background COVID-19 caused by SARS-CoV-2 is a worldwide epidemic. Children are less commonly infected and have less severe symptoms than adults. However, they are at risk for COVID-19-associated severe sickness and hospitalization. The duration of stay is a major driver of effective health treatment during hospitalization; thus, it is only logical to attempt to comprehend the factors influencing the length of stay (LOS) for these patients, particularly in light of the ongoing pandemic caused by the new SARS-CoV-2 virus. As predictors of hospital LOS, several variables, including age, gender, disease severity, hospital mortality, insurance type, and hospital location, have been discovered. In our study, we focused on the severity of the patient's condition, the presence of comorbidities, and the necessary therapeutic regimen to predict the duration of stay. This study aimed to answer the following questions: If a patient has comorbidity and has COVID-19 requiring hospital treatment, will the patient's comorbidity elongate the duration of stay at the hospital for further management in the pediatric age group? What are the risk factors that play a significant role in the hospital stay duration in pediatrics? Methodology We gathered data from 100 hospitalized children aged up to 14 years who tested positive for COVID-19, which was not specific to variants of SARS-CoV-2, over 24 months (February 2020-February 2022) at Queen Rania Al Abdullah Hospital for Children, one of the Health Care Accreditation Council accredited facilities. Clinical symptoms, signs, oxygen demand, imaging study results, laboratory data, and usage of corticosteroid and antiviral medication were all taken from patients' medical records. There were no limitations in taking the sample of patients. All patients in the duration mentioned were included. Results Clinical data of 100 COVID-19-positive pediatric patients were analyzed; 52% of the patients had associated chronic illnesses, while 48% were medically free. The longest duration of LOS was 28 days, the shortest was one day, the median was eight days, and five days was the most frequent among patients owing to 21% of patients, using mean descriptive statistics. We compared LOS to having or not having comorbidities. The mean LOS of patients with the comorbid disease was 6.15 days, with a maximum of 28 days, while for patients without chronic illnesses, the mean was 4.81 days with a maximum of 14 days. The significance was 0.07. Our results also showed a significant correlation between using steroids and LOS, as it had an advantageous effect by decreasing it with a significance value of 0.04. Having abnormal findings on chest computed tomography (CT) scan was also associated with increased LOS with a significant value of 0.00. Conclusions According to our research, there was no direct association between comorbidity and hospital LOS, which is counterintuitive, as it was influenced by multiplayers of variables such as using steroids, which decreased the LOS, and abnormal findings on chest CT, which resulted in lengthening of the hospital stay. Our findings cannot be proven without further research and a larger patient sample.

3D Printing and Virtual Surgical Planning in Oral and Maxillofacial Surgery.

Compared to traditional manufacturing methods, additive manufacturing and 3D printing stand out in their ability to rapidly fabricate complex structures and precise geometries. The growing need for products with different designs, purposes and materials led to the development of 3D printing, serving as a driving force for the 4th industrial revolution and digitization of manufacturing. 3D printing has had a global impact on healthcare, with patient-customized implants now replacing generic implantable medical devices. This revolution has had a particularly significant impact on oral and maxillofacial surgery, where surgeons rely on precision medicine in everyday practice. Trauma, orthognathic surgery and total joint replacement therapy represent several examples of treatments improved by 3D technologies. The widespread and rapid implementation of 3D technologies in clinical settings has led to the development of point-of-care treatment facilities with in-house infrastructure, enabling surgical teams to participate in the 3D design and manufacturing of devices. 3D technologies have had a tremendous impact on clinical outcomes and on the way clinicians approach treatment planning. The current review offers our perspective on the implementation of 3D-based technologies in the field of oral and maxillofacial surgery, while indicating major clinical applications. Moreover, the current report outlines the 3D printing point-of-care concept in the field of oral and maxillofacial surgery.

Cardiac Tamponade as a Rare Presentation of Adult-Onset Still's Disease.

Adult-onset Still's disease (AOSD) is a rare inflammatory disease that affects multiple organ systems. Efforts have been made to study the course of the illness and possible treatment options. Cardiac tamponade is a rare and life-threatening complication of AOSD that can be the initial presentation of the disease. We report a 34-year-old patient who presented with a picture of cardiac tamponade and underwent emergency pericardiocentesis. Upon further investigations, the diagnosis of AOSD was made based on Yamaguchi criteria. Furthermore, he showed significant improvement following treatment with prednisolone, methotrexate, and tocilizumab. Our case provides evidence that AOSD should be considered in the differential diagnosis of cardiac tamponade and how prompt treatment of AOSD can effectively prevent potentially fatal complications.

Role of glucagon-like peptide-1 agonist in patients undergoing percutaneous coronary intervention or coronary artery bypass grafting: A meta-analysis.

Importance: Glucagon-like peptide-1 (GLP-1) protects against ischemia-reperfusion injury in patients with acute myocardial infarction (AMI). Controversy exists on the effects of GLP-1 on AMI patients undergoing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. Study objective: We aimed to investigate the cardioprotective effects of GLP-1 in AMI patients after PCI and CABG. Design: We searched PubMed, Web of Science, EBSCO, Scopus, and the Cochrane Library for relevant randomized controlled trials (RCTs) up to June 2021, with no restriction on publication date. The following search terms are used: "percutaneous coronary intervention" or "coronary artery bypass grafting" or "myocardial infarction" and "glucagon-like peptide 1" or "exenatide" or "liraglutide". Study selection: Articles were independently assessed by 2 reviewers. We included RCTs only that compared GLP-1 with control in AMI patients. Data extraction and synthesis: Continuous data were pooled as mean differences (MDs), while dichotomous variables were pooled as odds ratios (ORs), with 95% confidence interval (CI), using R software (meta package) for windows. Subgroup analysis according to the intervention type and GLP-agents were conducted. We assessed the heterogeneity among RCTs using the Q statistic and I2 statistic. We also tested publication bias by funnel plot-based methods. The quality of each study was assessed with the Cochrane risk of bias tool. Main outcomes and measures: Primary outcomes were changes of left ventricular ejection fraction (LVEF), myocardial infarct characteristics, salvage index. Secondary outcomes included major adverse cardiac events (MACE), gastrointestinal events, and hypoglycemia. Results: Nine RCTs (14 reports) including 1216 patients were included in this meta-analysis. At 3 months follow up, GLP-1 was associated with improved LVEF (MD = 2.81, 95% CI [0.69, 4.94]), infarct size in grams (MD = -5.71, 95% CI [-10.24, -1.18]), and salvage index (MD = 0.09, 95% CI [0.05, 0.14]). While, GLP-1 had less MACE rate than control (RR = 0.64, 95% CI [0.41, 0.99]), and higher gastrointestinal side effects (RR = 4.21, 95% CI [2.39, 7.41]). Conclusions and relevance: This meta-analysis illustrated that GLP-1 was associated with better LVEF and reduced infarct size in patients with AMI undergoing PCI and CABG surgery, although the mechanism on how this agent provide this benefit is not clear. Key points: Question: What is the effectiveness of Glucagon-like peptide-1 (GLP-1) agonist in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery.Findings: This systematic review and meta-analysis illustrated that GLP-1 was associated with better left ventricular ejection fraction and reduced infarct size in patients with AMI undergoing PCI and CABG surgery, probably by reducing reperfusion injury.Meaning: GLP-1 could improve systolic and diastolic function, lowering the cardiovascular risk of morbidity and mortality in AMI patients.