Pérdida de proteínas en líquido peritoneal de pacientes críticos con abdomen abierto / Protein loss in peritoneal fluid of critically ill patients with open abdomen

Introducción. Los pacientes con patología abdominal quirúrgica que requieren manejo con abdomen abierto son susceptibles a la pérdida de proteínas desde la cavidad expuesta. El objetivo de este estudio fue caracterizar la pérdida proteica a través de dos tipos de cierre temporal abdominal. Métodos. Se realizó un estudio decohorte prospectivo, con pacientes críticos manejados durante el año 2021 con abdomen abierto mediante dos tipos de cierre temporal: bolsa de Bogotá y ABThera™. Se recolectaron muestras intraoperatorias seriadas de líquido peritoneal (días 1, 3 y 5). Se calcularon frecuencias y promedios, y se compararon con las pruebas de Chi cuadrado y t de Student. Resultados. Se incluyeron 25 pacientes. El promedio de pérdida de proteínas en líquido peritoneal fue mayor con el sistema ABThera™ (44,38 g/L) comparado con la bolsa de Bogotá (25,18 g/L; p=0,0185). Durante el seguimiento se observó la tendencia a la disminución del promedio de proteínas perdidas por ambos sistemas, pero con ABThera™ se perdieron en promedio 15,47 gr/L más de proteínas, independientemente del estado nutricional y del aporte proteico recibido (p=0,042). No hubo diferencias según la etiología que llevó al manejo con abdomen abierto, los procedimientos quirúrgicos realizados o el estado de infección por COVID-19. Conclusiones. El abdomen abierto representa una fuente importante de pérdida de proteínas, que es diferente según el tipo de cierre temporal usado. Estas pérdidas deberían considerarse en los cálculos de soporte nutricional en la unidad de cuidado intensivo.

Introduction. Patients with surgical abdominal pathology requiring management with an open abdomen are susceptible to protein loss from the exposed cavity. The objective of this study was to characterize protein loss through two types of temporary abdominal closure. Methods. A prospective cohort study was carried out with critically ill patients managed during 2021 with an open abdomen using two types of temporary closure: Bogota bag and ABThera™. Serial intraoperative peritoneal fluid samples were collected (days 1, 3, and 5). Frequencies and averages were calculated and compared with the Chi square and Student's t tests. Results. Twenty-five patients were included. The average protein loss in peritoneal fluid was higher with the ABThera™ system (44.38 g/L) compared to the Bogota bag (25.18 g/L; p-value=0.0185). During follow-up, a tendency to decrease the average protein lost by both systems was observed, but with ABThera™ an average of 15.47 gr/L more protein was lost, regardless of the nutritional status and protein intake received (p=0.042). There were no differences based on etiology leading to open abdomen management, surgical procedures performed, or Covid-19 infection status. Conclusions. The open abdomen represents an important source of protein loss, which is different depending on the type of temporary closure used. These losses should be considered in calculations of nutritional support in the intensive care unit.

Resistencia a la Fractura de Premolares Según el Diseño de Cavidad de Acceso Endodóntico. Estudio in vitro

La preparación de la cavidad de acceso es el primer paso y un requisito esencial, para la instrumentación y obturación de los conductos radiculares durante el tratamiento endodóntico. El objetivo del presente estudio fue comparar la resistencia a la fractura in vitro de premolares con cavidad de acceso tradicional (CAT), cavidad de acceso conservador (CAC) y cavidad de acceso ultraconservador (CAU). Esta fue una investigación transversal, prospectiva y experimental pura. Se realizó con 40 segundos premolares superiores, divididos en 4 grupos. Todas las muestras fueron desinfectadas y almacenadas en recipientes con suero fisiológico al 0,9 %. Al primer grupo se designó como el control, al segundo grupo CAT, al tercer grupo CAC y al cuarto grupo CAU. Se realizaron todos los accesos endodónticos con una pieza de mano de alta velocidad con refrigeración respetando el protocolo de cada uno de los diseños, posterior a ello se realizó el tratamiento endodóntico y restauración de los especímenes. Una vez preparadas todas las muestras, estas fueron sometidas a una prueba de fatiga en una máquina de ensayo universal y los resultados se registraron en Newtons. La prueba estadística usada fue ANOVA con un nivel de significancia de 5 %. Las CAT obtuvieron el menor valor de resistencia a la fractura en comparación con el grupo control. Sin embargo, no se observaron diferencias estadísticamente significativas entre los grupos CAT, CAC Y CAU. Entre los grupos CAC y CAU, no se encontraron diferencias estadísticamente significativas en comparación con el grupo control.

The preparation of the access cavity is the first step and an essential requirement for the instrumentation and obturation of the root canals during endodontic treatment. The objective of the present study was to compare the in vitro fracture resistance of premolars with traditional access cavity (CAT), conservative access cavity (CAC) and ultraconservative access cavity (CAU). This was a cross-sectional, prospective and pure experimental research. It was carried out with 40 upper second premolars, divided into 4 groups. All samples were disinfected and stored in containers with 0.9 % physiological saline. The first group was designated as the control, the second group CAT, the third group CAC and the fourth group CAU. All endodontic accesses were carried out with a high-speed handpiece with refrigeration, respecting the protocol of each of the designs, after which the endodontic treatment and restoration of the specimens was carried out. Once all the samples were prepared, they were subjected to a fatigue test in a universal testing machine and the results were recorded in Newtons. The statistical test used was ANOVA with a significance level of 5 %. The CAT obtained the lowest fracture resistance value, presenting statistically significant differences with the control group. However, no statistically significant differences were observed between the CAT, CAC, and CAU groups. Furthermore, between the CAC and CAU groups, no statistically significant differences were found compared to the control group.

Embryonal rhabdomyosarcoma of hard palate: a case report and review of literature

Rhabdomyosarcomas are the most common malignant soft tissue tumors in children and adolescents. Around 40% of cases are diagnosed in head and neck region with orbit and face being the commonly involved areas. Oral lesions account for less than 10%. We report a case of embryonal RMS in a 4-year-old boy who presented with a polypoid mass in the hard palate. Though majority of the oral lesions encountered in children are benign, a small but significant percentage may be representative of an aggressive malignant tumor. Differentiating benign and malignant oral lesions is mandatory for optimal diagnostic strategies.

Identificação de Enterococcus SPP e Enterobacteriaceae em canais radiculares com infecção primária e secundária ou persistente / Identification of Enterococcus spp and Enterobacteriaceae in root canals with primary and secondary or persistent infection

O objetivo do presente estudo foi identificar microrganismos das espécies Enterococcus spp e Enterobacteriaceae em dentes com canais radiculares infectados portadores de infecção primária e/ou secundária/persistente. Métodos: A amostra do presente estudo foi de 23 pacientes que apresentaram necessidade de tratamento ou retratamento endodôntico. Foram coletadas amostras de 28 dentes infectados usando pontas de papel absorventes estéreis, transportadas em solução salina, diluídas, plaqueadas e incubadas em estufa de cultura bacteriológica. Para o crescimento de microrganismos foram utilizados jarros com gerador de atmosfera de anaerobiose. Colônias microbianas foram isoladas, caracterizadas e identificadas. Os dados coletados foram estatisticamente analisados com a utilização do software SPSS for Windows 10.0 (SPSS Inc., USA). Resultados: Foi isolada somente uma cepa do gênero Enterococcus spp, e nenhuma espécie do gênero Enterobacteriaceae. Das coletas microbiológicas realizadas em 28 canais radiculares, todas apresentaram crescimento microbiano em anaerobiose. Dezoito dentes apresentavam necrose pulpar e lesão periapical. Os outros 10 dentes já haviam recebido tratamento endodôntico prévio e em 6 destes houve constatação de lesão periapical, sendo que nos outros 4, não. Conclusão: Nas condições experimentais do presente estudo, pode-se concluir que não houve correlação da presença de espécies microbianas das famílias Enterococcus spp e/ou Enterobacteriaceae com infecção primária ou secundária do canal radicular.

The objective of the present study was to identify microorganisms of the Enterococcus spp and Enterobacteriaceae species in teeth with infected root canals with primary and/or secondary/persistent infection. Methods: The sample of the present study consisted of 23 patients who required endodontic treatment or retreatment. Samples of 28 infected teeth were collected using sterile absorbent paper points, transported in saline solution, diluted, plated and incubated in a bacteriological culture oven. For the growth of microorganisms, jars with an anaerobic atmosphere generator were used. Microbial colonies were isolated, characterized and identified. The collected data were statistically analyzed using the SPSS for Windows 10.0 software (SPSS Inc., USA). Results: Only one strain of the genus Enterococcus spp was isolated, and no species of the genus Enterobacteriaceae. From the microbiological collections carried out in 28 root canals, all showed microbial growth in anaerobic conditions. Eighteen teeth had pulp necrosis and periapical lesion. The other 10 teeth had already received previous endodontic treatment and in 6 of them there was a periapical lesion, and in the other 4, no. Conclusion: Under the experimental conditions of the present study, it can be concluded that there was no correlation between the presence of microbial species of the Enterococcus spp and/or Enterobacteriaceae families with primary or secondary root canal infection.

Tumor nasal de músculo liso de comportamiento maligno incierto: informe de un caso / Nasal smooth muscle tumor of uncertain malignant potential: A case report

Los tumores de músculo liso que no pueden ser clasificados según su histología como leiomiomas o leiomiosarcomas se denominan tumores de músculo liso de comportamiento maligno incierto. La localización nasal de estos tumores es muy infrecuente y la extensión adecuada de la cirugía para tratar estas neoplasias no está bien definida. Se describe el caso clínico de una adolescente de 16 años, que consultó por padecer un tumor de aspecto vascular en la cavidad nasal derecha y que fue tratada con éxito mediante cirugía intranasal. El diagnóstico histológico fue tumor de músculo liso de comportamiento maligno incierto. Por la rareza de estas neoplasias, su infrecuente localización nasal y la falta de evidencia que soporte cuál debe ser la extensión de la cirugía, es relevante la descripción y discusión del caso clínico.

Smooth muscle tumors that cannot be histologically classified as leiomyomas or leiomyosarcomas are defined as smooth muscle tumors of uncertain malignant potential. The location of these tumors in the nose is very rare, and the appropriate surgical extent to manage these neoplasms has not been adequately defined. Here we describe the case of a 16-year-old female adolescent who consulted due to a vascular-like tumor in the right nasal cavity who was successfully treated with intranasal surgery. The histological diagnosis was smooth muscle tumor of uncertain malignant potential. Given that these neoplasms are rare, the uncommon location in the nose, and the lack of evidence indicating the extent of surgery, it is relevant to describe and discuss this clinical case.

Reconstrução mamária com TRAM: avaliação tomográfica abdominal / Breast reconstruction with TRAM: abdominal tomographic evaluation

Introdução: O retalho transverso do músculo reto abdominal (TRAM) é um método de reconstrução mamária com bons resultados estéticos e dispensa o uso de próteses de silicone para melhor contorno corporal. Foi originalmente descrito por Holmstrom em 1979, como uma elipse de pele e gordura com base em um músculo isolado no seu pedículo vascular. A reconstrução sistematizada do defeito da parede instalado após a transposição do retalho com o uso de tela de polipropileno foi descrita em estudo prévio por Cunha. O artigo tem como objetivo avaliar as alterações na parede abdominal, após a sistematização da colocação da tela de polipropileno durante a cirurgia de reconstrução com TRAM. Método: É um trabalho de coorte retrospectivo que avalia as possíveis alterações da parede abdominal de pacientes submetidos ao retalho TRAM com tomografia computadorizada de abdome pré e pós-operatórias. Resultados: Foi evidenciada uma redução do tamanho da cavidade abdominal de, em média, 14,5% e 14,2% na espessura da parede abdominal submetidas ao TRAM. A maior redução da espessura da parede abdominal foi de um paciente submetido ao retalho bipediculado, com 50,7%. As complicações apresentadas foram hérnia umbilical, seroma tardio, fibrose peritela e granuloma de fio. Conclusão: Nesse estudo, a tomografia após a cirurgia demonstrou a redução no volume da cavidade abdominal e espessura da parede abdominal, o que não influenciou estatisticamente no aparecimento de hérnia abdominal, abaulamentos, extrusão da malha ou outras deformidades.

Introduction: The transverse rectus abdominis muscle flap (TRAM) is a method of breast reconstruction with good aesthetic results and does not require the use of silicone implants for better body contouring. It was originally described by Holmstrom in 1979 as an ellipse of skin and fat based on an isolated muscle on its vascular pedicle. The systematic reconstruction of the wall defect installed after flap transposition using polypropylene mesh was described in a previous study by Cunha. The article aims to evaluate changes in the abdominal wall, after the systematization of polypropylene mesh placement during TRAM reconstruction surgery. Method: This is a retrospective cohort study that evaluates possible changes in the abdominal wall of patients undergoing the TRAM flap with preand postoperative abdominal computed tomography. Results: A reduction in the size of the abdominal cavity of, on average, 14.5% and 14.2% in the thickness of the abdominal wall subjected to TRAM was evidenced. The greatest reduction in abdominal wall thickness was in a patient who underwent a bipedicled flap, with 50.7%. The complications presented were umbilical hernia, late seroma, perithellal fibrosis, and thread granuloma. Conclusion: In this study, tomography after surgery demonstrated a reduction in the volume of the abdominal cavity and thickness of the abdominal wall, which did not statistically influence the appearance of abdominal hernia, bulging, mesh extrusion, or other deformities.

Relación entre la periodontitis y la enfermedad cerebrovascular isquémica

La periodontitis es un trastorno inmunoinflamatorio de etiología microbiana causado por gérmenes únicos en la cavidad bucal que pueden diseminarse a través del torrente sanguíneo, activan la respuesta inflamatoria del huésped y favorecen la formación, maduración y exacerbación de la placa de ateroma. Varios estudios clínicos han investigado la posible relación entre la enfermedad periodontal y las enfermedades consecuentes de la aterosclerosis como la cardiopatía isquémica y la enfermedad cerebrovascular isquémica. Se realizó una revisión bibliográfica exhaustiva de artículos científicos publicados en las bases de datos: Pubmed, Medline, LILACS, Scielo, en el período comprendido entre el 2012 y el 2022, en idioma español e inglés. Se utilizaron como descriptores: periodontitis, enfermedad cerebrovascular y aterosclerosis. Los reportes incluidos indican que la enfermedad cerebrovascular y la enfermedad aterosclerótica presentan las alteraciones con mayores asociaciones con la periodontitis, sin embargo, se necesitan estudios más amplios para determinar el papel de la severidad y extensión de la periodontitis en estas enfermedades.

Periodontitis is an immunoinflammatory disorder of microbial etiology caused by unique germs in the oral cavity that can spread through the bloodstream, activate the host's inflammatory response and promote the formation, maturation and exacerbation of atheromatous plaque. Several clinical studies have investigated the possible relationship between periodontal disease and diseases resulting from atherosclerosis such as ischemic heart disease and ischemic cerebrovascular disease. An exhaustive bibliographic review of scientific articles published in the databases: Pubmed, Medline, LILACS, Scielo, in the period between 2012 and 2022, in Spanish and English was carried out. The following were used as descriptors: periodontitis, cerebrovascular disease and atherosclerosis. The included reports indicate that cerebrovascular disease and atherosclerotic disease present the alterations with the greatest associations with periodontitis, however, larger studies are needed to determine the role of the severity and extent of periodontitis in these diseases.

Quiste nasoalveolar unilateral derecho en adulto joven de 30 años / Right unilateral nasoalveolar cyst in a 30-year-old young adult

Introducción: El quiste nasolaveolar, conocido también como nasolabial o de Klestadt, se considera un raro quiste del desarrollo, epitelial y no odontogénico. Aparece en la región del ala nasal, produce asimetría facial, afecta la estética y puede conducir a alteraciones psicológicas. Objetivo: Presentar un caso clínico de quiste nasoalveolar unilateral derecho. Caso clínico: Paciente masculino de 30 años de edad, de color de piel negra, procedencia rural y con antecedentes de salud. Acudió a consulta por presentar aumento de volumen en ala nasal derecha, que producía obstrucción nasal y dificultades al respirar. El examen físico y complementarios imagenológicos revelaron diagnóstico presuntivo de quiste nasoalveolar unilateral derecho. Se procedió a la exéresis quirúrgica de la lesión bajo anestesia local sin complicaciones, el examen histopatológico confirmó el presunto diagnóstico. Conclusiones: El quiste nasoalveolar es una entidad clínica poco frecuente en Cuba y el mundo, su tratamiento es quirúrgico y es baja su recurrencia(AU)

Introduction: The nasolaveolar cyst, also known as nasolabial or Klestadt, is considered a rare developmental, epithelial and non-odontogenic cyst. It appears in the region of the nasal wing, produces facial asymmetry, affects aesthetics and can lead to psychological disorders. Objective: To present a clinical case of a right unilateral nasoalveolar cyst. Clinical case: A 30-year-old male patient, black, rural origin and with a history of health. He came to the consultation due to presenting an increase in volume in the right nasal wing, which caused nasal obstruction and difficulties in breathing. The physical and complementary imaging examinations revealed a presumptive diagnosis of a right unilateral nasoalveolar cyst. The lesion was surgically removed under local anesthesia without complications and histopathological examination confirmed the presumed diagnosis. Conclusions: The nasoalveolar cyst is a rare clinical entity in Cuba and the world, its treatment is surgical and its recurrence is low(AU)

A rare cause of dysmenorrhea-accessory cavitated uterine malformation: a case report

Accessory cavitated uterine malformation is a newly recognized mullerian anomaly where the uterine cavity is normal unlike other Mullerian anomalies and hence needs to be described more accurately. These are non-communicating ULMs that occur contiguously along the wall of the uterus. This case report is about a 31 years old female who came with complaints of acute severe dysmenorrhea with a chronic course for the past 2 years and was evaluated for a similar episode in the past where she was diagnosed as fibroid with cystic degeneration and treated with SPRM and OCP which gave no relief from symptoms. With another exacerbation of symptoms two years later, patient was evaluated with an USG suggesting hemorrhagic degeneration in rudimentary horn and gave two differentials- fibroid with cystic degeneration and adenomyoma, wherein the latter was more likely. As a part of pre-op evaluation, MRI was done. Then came the third differential-ACUM [Accessory cavitated uterine mass]. Patient was counselled about the risk of infertility and uterine rupture in subsequent pregnancy as a post-op complication underwent laparoscopic surgery. Intraoperative and postoperative period was uneventful and HPE of the same confirmed the diagnosis. ACUM is a very treatable cause of severe dysmenorrhea and adequate awareness of this new entity will enable in making the diagnosis early.

Exodontia de supranumerário paramolar e de primeiro molar com destruição coronária em região de maxila: relato de caso / Extraction of a supernumerary paramolar and first molar with coronary destruction in the maxilla area: case report

Os dentes supranumerários são descritos como uma espécie de anomalia dentária, determinada pela formação de dentes além daqueles pertencentes à dentição convencional, que geralmente promovem complicações na cavidade oral. Diversos fatores etiológicos podem estar relacionados e de acordo com sua localização, são classificados em mesiodens, distomolar e paramolar. O presente estudo tem como objetivo apresentar e descrever a exodontia de um elemento supranumerário paramolar em região de maxila, bem como a remoção cirúrgica do primeiro molar com destruição coronária em região subjacente, através de um relato de caso. Paciente E.M.J., sexo feminino, 38 anos de idade, ASA 1, procurou atendimento odontológico devido à queixa principal de dor em região do 1° molar superior esquerdo. Ao exame físico e radiográfico, foi observada grande destruição coronária do elemento 26 associado a uma fístula intraoral, além da presença de dente supranumerário paramolar na região vestibular do dente 26. O tratamento preconizado foi a remoção cirúrgica de ambos elementos e a paciente evoluiu sem intercorrências no pós-operatório. Desta maneira, pode-se concluir que a remoção cirúrgica de dente supranumerário paramolar e de unidade dentária com grande destruição coronária por lesão cariosa, mostrou-se uma alternativa segura e eficaz no presente caso.

Supernumerary teeth are described as a kind of dental anomaly, determined by the teeth´s formation other than those belonging to the conventional dentition, which generally promote complications in the oral cavity. Several etiological factors may be related and, according to their location, they are classified into mesiodens, distomolar and paramolar. This study aims to present and describe the extraction of a paramolar supernumerary element in the maxillary region, as well as the surgical removal of the first molar with coronary destruction in the underlying region, through a case report. Patient E.M.J., female, 38 years old, ASA 1, sought dental care due to the main complaint of pain in the region of the upper left 1st molar. At the clinical and radiographic examination, a great coronal destruction of element 26 associated with a intraoral fistula was observed, in addition to the presence of a supernumerary paramolar tooth on the buccal side of tooth 26. The recommended treatment was the surgical removal of both elements and the patient evolved uneventfully in the post-operative. Thus, it can be concluded that the surgical removal of a supernumerary paramolar tooth and a dental unit with great coronary destruction due to a carious lesion proved to be a safe and effective alternative in the present case.

Experience of Medicinal Insects for Gynaecological Diseases / 中医杂志

It is believed that all kinds of gynaecological diseases are mostly related to deficiency and stagnation of qi and blood. Medicinal insects are good at running and scurrying， with the effectiveness of activating blood circulation and dispelling blood stasis， moving qi and relieving pain， searching and dredging collaterals， attacking hardness and dissipating mass， and purging foetus and resolving mass， etc. Appropriate prescriptions can enhance the effectiveness of the formula in eliminating blood stasis and eliminating stagnation. In the treatment of menstrual disorders， chronic pelvic inflammatory disease， uterine cavity disease， incomplete miscarriage， ectopic pregnancy， and other gynaecological diseases， medicinal insects including Quanxie （Scorpio）， Wugong （Scolopendra）， Tubiechong （Eupolyphaga/Steleophaga）， Jiuxiangchong （Coridius chinenses）， Shuizhi （Hirudo）， Mangchong （Tabanus）， Dilong （Pheretima） and other insects for medicinal purposes could be used， and the self-prescribed empirical formulas such as Sanhuang Decoction （三黄汤）， Hongteng Decoction （红藤汤）， Penning Decoction （盆宁方）， Shapei Decoction （杀胚方）， and Gongwaiyun Decoction （宫外孕方） and so on， were all applied medicinal insects and showed effective in clinic.

Effect of nasal microflora on nasal function after endoscopic surgery in patients with chronic sinusitis and nasal polyps / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the effect of nasal microflora on nasal function after endoscopic surgery in patients with chronic sinusitis and nasal polyps.METHODS There were 88 patients with chronic sinusitis with nasal polyps who underwent elective nasal endoscopic surgery in Daxing District People's Hospital from May 2021 to May 2022.High-throughput sequencing technology was used to analyze the distribution of microflora in nasal secretions,and the patients were divided into a microbial-negative group(24 cases),a bacteria-positive group(42 cases)and a fungus-positive group(22 cases).Visual analog scale,Lund-Kennedy endoscopic score and Lund-Mackay CT were used to evaluate the nasal function of the patients before and 6 months after surgery,respectively.After surgery,nasal endoscopy was used to evaluate the degree of nasal mucosal injury and the thickness of the basement membrane of the nasal mucosal tissue was measured.RESULTS There were 64 pathogens who were detected in nasal secretions of 88 patients with chronic sinusitis and nasal polyps,accounting for 47.73%of bacteria and 25.00%of fungi.After operation,the nasal function score of the three groups was significantly lower than that before operation,and the pair-to-pair comparison between the three groups had statistical significance(P<0.05).The damage degree and basement membrane thickness of nasal mucosal epithelium in bacteria positive group and fungi positive group were higher than those in microbial negative group(P<0.05),but there was no difference between groups(P>0.05).CONCLUSION Bacteria and fungi in nasal secretions can affect the recovery of nasal function after endoscopic surgery in patients with chronic sinusitis and nasal polyps,and affect the effect of endoscopic surgery.

Experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach / 中华内分泌外科杂志

Objective:To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods:Clinical data of 138 patients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM) method and best-fit curve analysis were used to compare the differences in each index such as operative time, intraoperative bleeding, number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results:All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach, and one patient was converted to open surgery due to large intraoperative bleeding in the mass. There were 14 males and 124 females, mean age (36.07±8.49) years (20-55 years), thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal thyroidectomy, 129 cases underwent Unilateral lobectomy + lymph node dissection in the middle region, and 4 cases total thyroidectomy + central zone lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45, and the learning curve was divided into two stages: the learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The operative time, intraoperative bleeding, postoperative hospital stay, and chin numbness were all lower in the proficiency period than in the learning and training period ( P<0.05), and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) . Conclusion:The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this technique is 45.

CT and MRI findings of different types of small round cell tumor in the nasal cavity and sinuses / 实用放射学杂志

Objective To investigate the CT and MRI findings of different types of small round cell tumor(SRCT)in the nasal cavity and sinuses.Methods A retrospective analysis was conducted on the imaging data and clinical data of 35 SRCT patients confirmed by pathology.Thirty-one SRCT patients underwent CT examination,and 19 SRCT patients underwent MRI examination.Results There were 20 cases of tumors that invaded the nasal cavity and 19 cases involved the sinuses,including 11 cases of the maxillary sinus,7 cases of the ethmoid sinus,2 cases of the sphenoid sinus,and 1 case of the frontal sinus.CT findings of SRCT were all soft tissue masses.Lymphoma was relatively homogeneous with mild bone destruction,and usually involved nasal vestibular skin.Rhabdomyosarcoma(embryonic type)happened at an early age and easily caused bone destruction and metastasis.Melanoma generally occurred in the nasal septum and nasal cavity,which was prone to bleeding.Small cell neuroendocrine carcinoma was heterogeneous,with moderate to significant enhancement,bone absorption and destruction were often noticed.The MRI manifestations of SRCT were equal or long signal on T1WI,high signal on T2WI,and significant diffusion limitation on diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)except for melanoma.On contrast-enhanced images,lymphoma showed mild to moderate enhancement,rhabdomyosarcoma showed typical"grape sign",and small cell neuroendocrine carcinoma showed"sieve"and"map-like"obvious enhancement.Typical melanoma showed a high signal on T1WI and a low signal on T2WI and usually caused bleeding.The MRI findings were related to the presence of melanoma and hemorrhage within the lesion.Conclusion SRCT of the nasal cavity and sinuses have a high degree of malignancy and poor prognosis,CT and MRI have many similar manifestations.Combining clinical data,bone destruction,MRI enhancement,and DWI sequence can effectively distinguish different types of SRCT,as well as squamous cell carcinoma of the nasal cavity and sinuses and adenoid cystic carcinoma.

The application of percutaneous puncture renal fascia suspension in laparoscopic partial nephrectomy / 中华泌尿外科杂志

When partial nephrectomy is performed by posterior abdominal approach, the surgical field is poorly exposed, resulting in increased surgical difficulty and risk of injury.In this study, 28 patients with T 1a stage kidney tumors underwent retroperitoneal laparoscopic partial nephrectomy. Intraoperatively, exposure of the surgical field was achieved using the percutaneous puncture of the renal fascia suspension technique. There were no dissatisfactory exposures due to peritoneal damage during the surgery, no additional tubes were inserted, and no conversions to open surgery were needed. The operation time was (76.5±20.3) minutes, blood loss was (92.1±18.7) ml, renal artery clamping time was (19.5±4.3) minutes. Postoperatively, there were no complications such as bleeding, infection, or hematuria.

Effect of metal-supported multi-sided foramen ultrafine drainage tube on the formation of thoracic residual cavity after uniportal video-assisted thoracoscopic upper lobectomy: A retrospective study in a single center / 中国胸心血管外科临床杂志

@#Objective To investigate the effect of multi-sided foramen ultrafine drainage tube with metal support on the formation of thoracic residual cavity after uniportal video-assisted thoracoscopic (VATS) upper lobectomy. Methods The clinical data of the patients who underwent uniportal VATS upper lobectomy for lung cancer in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from January 2021 to April 2022 were retrospectively analyzed. According to the type of ultrafine drainage tube used in the surgery, the patients were divided into a test group (using metal-supported multi-sided foramen ultrafine drainage tube) and a control group (using ordinary 12F ultrafine drainage tube). The incidence of postoperative thoracic residual cavity and operation-related data were compared between the two groups. Results A total of 200 patients were enrolled, including 126 males and 74 females, with a mean age of 57.52 years. There were 90 patients in the test group, and 110 patients in the control group. The incidence of postoperative thoracic residual cavity in the test group was lower than that in the control group (P=0.045). The differences in the postoperative bedtime, postoperative visual analogue scale, postoperative analgesic pump using time, postoperative hospitalization time, times of postoperative thoracentration and drainage, postoperative drainage time and hospitalization cost between the two groups were statistically significant (P<0.05). The incidences of postoperative lung infection, pleural effusion and atelectasis complications were lower in the test group than those in the control group (P<0.05). The differences in the preoperative anesthesia time, operation time, intraoperative bleeding and postoperative lung leakage were not statistically significant (P>0.05). Conclusion The use of multi-sided foramen ultrafine drainage tube with metal support can reduce the incidence of thoracic residual cavity after uniportal VATS upper lobectomy, and can reduce pain and economical burdens and the incidence of operation-related complications, accelerating the recovery of patients after surgery. The application of multi-sided foramen ultrafine drainage tube with metal support in uniportal VATS upper lobectomy can be widely used in the clinic.

Effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients / 局解手术学杂志

Objective To explore the effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients.Methods A total of 86 patients with lung cancer were selected and divided into the high concentration group(43 cases)and low concentration group(43 cases)by random number table method.Patients in the high concentration group received injection of 2.0%lidocaine hydrochloride in pleural cavity through the epidural catheter 1st day after surgery,and patients in the low concentration group received injection of 1.5%lidocaine hydrochloride in pleural cavity.In addition,patients in the two groups were treated with patient-controlled intravenous analgesia after surgery.The first time of getting out of bed,first time of exhaustion,first time of defecation and hospital stay after surgery of the two groups were compared.The visual analogue scale(VAS)scores 6 hours,12 hours,24 hours and 48 hours after surgery,the occurrence of agitation during the postoperative awakening period,and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery were compared.The incidence of adverse drug reactions 24 hours after surgery were recorded and the quality of recovery of patients 24 hours after surgery was evaluated by 40-item quality of recovery score(QoR-40).Results The first time of getting out of bed,first time of exhaustion,first time of defecation and hospital stay after operation of patients in the high concentration group were shorter than those in the low concentration group(P<0.05).The VAS scores of the two groups 12 hours and 24 hours after surgery were higher than those 6 hours after surgery(P<0.05),the VAS scores 24 hours and 48 hours after surgery were lower than those 12 hours after surgery(P<0.05),and the VAS scores 48 hours after surgery were lower than those 24 hours after surgery(P<0.05).The VAS scores 6 hours,12 hours,24 hours,and 48 hours after surgery of patients in the high concentration group were lower than those in the low concentration group(P<0.05).The occurrence of agitation during the postoperative awakening period,and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery for patients in the high concentration group were lower/less than those in the low concentration group(P<0.05).There was no significant difference in the total incidence of adverse drug reactions between the two groups(P>0.05).The total QoR-40 score of patients in the high concentration group were higher than those in the low concentration group(P<0.05).Conclusion The use of 2.0%lidocaine infiltration and analgesia in pleural cavity for patients after lung cancer surgery can reduce the agitation during the awakening period,alleviate the postoperative pain,improve the quality of postoperative recovery,and promote the postoperative recovery of the patients,with certain safety.

Santé bucco-dentaire des enfants diabétiques: aspects épidémiologiques et cliniques au centre hospitalier universitaire Donka / Oral health of children with diabetes: epidemiological and clinical aspects at Donka University hospital

Le diabète sucré est l'une des pathologies chroniques les plus rependues chez l'enfant à cause de son apparition dans la tranche d'âge pédiatrique. Les lésions gingivales liées à la micro-angiopathie et la présence du tartre sont exceptionnelles chez l'enfant. La parodontopathie peut rendre plus difficile le contrôle de la glycémie. Les données actuelles de la littérature ont révélé qu'un enfant diabétique est plus susceptible de développer une pathologie bucco-dentaire qu'un enfant non diabétique. L'objectif de cette étude était d'évaluer l'état de santé bucco-dentaire des enfants diabétiques suivis dans le service d'Endocrinologie à l'hôpital National Donka. Il s'agissait d'une étude transversale de type descriptif et analytique, portant sur les affections orales et métaboliques des enfants diabétiques suivis ou hospitalisés dans le service d'Endocrinologie par un recrutement exhaustif sur une période de 6 mois. La population cible était composée de 72 enfants âgés de 6 à 18 ans au moment de l'étude. Un questionnaire a été utilisé pour obtenir des données sur le niveau socio-économique, le niveau sociodémographique, le niveau comportemental, les habitudes d'hygiène bucco-dentaire et les antécédents familiaux associés à un examen oral. Les paramètres diabétiques sont contenus dans le dossier médical. L'impact du diabète sur l'état oral des jeunes patients a été étudié par des variables qualitative et quantitative. Une corrélation entre l'ancienneté du diabète et l'indice d'hygiène orale simplifiée (p<0,05) a été observée avec p=0,03. IC95% [0,00 ; 0,06]. Mais aucun lien statistique n'a été enregistré entre la tranche d'âge et l'IHOS, d'autre part entre et aussi l'IHOS et la présence de variable clinique (p>0,05). La plupart des bouches présentaient des lésions carieuses avec un taux de 91,98% et un indice C.A.O moyen de 2,94 ± 2,82. Une gencive inflammatoire était présente chez 84,73% des patients et presque tous (95,83%) avaient une affection buccale au moins. La maladie bucco-dentaire est un marqueur social, les enfants diabétiques issus de milieux défavorisés doivent donc être ciblés plus particulièrement par les programmes de prévention

Diabetes mellitus is one of the most common chronic pathologies in children because of its appearance in the pediatric age group. Gingival lesions linked to microangiopathy and the presence of tartar are exceptional in children. Periodontal disease can make it more difficult to control blood sugar. Current data from the literature has revealed that a diabetic child is more likely to develop an oral pathology than a non-diabetic child. The objective of this study was to assess the oral health status of diabetic children followed in the endocrinology department at the national donka hospital. This was a descriptive and analytical cross-sectional study on the oral and metabolic disorders of diabetic children followed or hospitalized in the endocrinology department by exhaustive recruitment over a period of 6 months. The target population consisted of 72 children aged 6 to 18 at the time of the study. A questionnaire was used to obtain data on socioeconomic level, sociodemographic level, behavioral level, oral hygiene habits and family history associated with an oral examination. The diabetic parameters are contained in the medical file. The impact of diabetes on the oral status of young patients was studied by qualitative and quantitative variables. A correlation between the duration of diabetes and the simplified oral hygiene index (p0.05). Most of the mouths presented carious lesions with a rate of 91.98% and an average c.a.o index of 2.94 ± 2.82. Inflammatory gingiva was present in 84.73% of patients and almost all (95.83%) had at least one oral condition. Oral disease is a social marker, diabetic children from disadvantaged backgrounds must therefore be targeted more specifically by prevention programs.

Oral health of an indigenous population in northeastern Brazil: a cross-sectional Study of the Fulni-ô ethnic group

ABSTRACT BACKGROUND: There is a lack of studies evaluating the oral health of traditional indigenous communities in Brazil. OBJECTIVES: Thus, the objective of this study was to describe the oral health characteristics of the indigenous Fulni-ô ethnic group in Northeast Brazil. DESIGN AND SETTING: A cross-sectional observational investigation was conducted within the Project on Atherosclerosis among Indigenous Populations. METHODS: This study included participants of both sexes from the Fulni-ô ethnic group. The participants included in this investigation underwent a comprehensive oral health evaluation by a registered and experienced dentist to assess oral health and identify potentially malignant oral lesions. Participants with suspicious lesions were referred for biopsy. Shapiro-Wilk, Mann-Whitney, and Student's t-tests were used, and measures of central tendency and dispersion were described. Statistical significance was 5%. RESULTS: A total of 104 individuals were included in this study. The prevalence of the use of tobacco derivatives was 94.0%, with similarities between sexes. The prevalence of oral changes in this study population was 84.4%. Fifty-one individuals who underwent oral reassessment were referred for oral lesion biopsy. CONCLUSIONS: This study demonstrated a high prevalence of oral alterations in the Fulni-ô population. Histopathological analyses indicated the presence of mild oral epithelial dysplasia in five cases.

Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies

Abstract Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.