Efficacy of arterial occlusion pressure estimation-based tourniquet pressure settings in upper limb surgery.

BACKGROUND: The use of a minimal individualized effective pneumatic tourniquet pressure is recommended to avoid pressure related complications in extremity surgery. The aim of this study was to investigate the efficacy of arterial occlusion pressure estimation-based tourniquet pressure settings in upper limb surgery. METHODS: Hundred and fifteen patients undergoing upper limb surgeries were enrolled in the present study. Arterial occlusion pressure estimation formula was used and a safety margin of 20 mmHg was added to arterial occlusion pressure in the tourniquet pressure setting. Primary and secondary endpoints were the amount of tourniquet pressure and its effectiveness respectively. Other outcome measures included the tourniquet pressure setting time and tourniquet related complications. Surgical team unaware of the tourniquet pressure assessed the bloodless surgical field. RESULTS: The mean initial and maximal tourniquet pressures were 171.5 ± 13.7 and 175.5 ± 13.2 mmHg, respectively. The effectiveness of the tourniquet was rated as "excellent" and "good" in the initial and middle stages, and at the end of the surgery of the procedure in 97.3%, 99.1%, and 100% of cases respectively. The mean tourniquet pressure setting time was 29.0 ± 3.7 s. No tourniquet related complications were observed. CONCLUSIONS: Arterial occlusion pressure estimation-based tourniquet pressure setting is a practical and effective method, which allows using lower tourniquet pressures than previously used in the literature for upper extremity surgery.

Future perspectives of anatomy in dental education: quo vadis? / Perspectivas futuras de la anatomía en la educación dental: ¿quo vadis?

Anatomists have become familiar with an ongoing debate about the integration of basic sciences into the clinical context or vice versa. Although various educational modalities in dental school curricula and changes in curricular strategies challenge anatomists, the priorities in teaching anatomy and the emergency of presenting fundamental concepts in order to integrate students' basic science skills into the clinic led educators to develop new teaching methods. A search for improved efficiency and impact of the presentation of knowledge to the students in order to foster positive feedback should be one of the major responsibilities of the educators in basic sciences. New gold standards, such as computer-based learning tools and computer-assisted instruction laboratories, may provide trigger points for the perception of the audience in dental faculties. In the light of these considerations, Anatomy Society should rapidly communicate future perspectives.

Los anatomistas comenzaron a familiarizarse con un debate sobre la integración de las ciencias básicas en el contexto clínico, o viceversa. Aunque diversas modalidades educativas en los programas de la escuela de odontología y estrategias del plan de estudios anatómicos han cambiado, las prioridades en la enseñanza de la anatomía y la emergencia de presentar los conceptos fundamentales para integrar los conocimientos de ciencias básicas de los estudiantes en la clínica de llevar a los educadores a desarrollar nuevos métodos de enseñanza. La búsqueda en la mejora de la eficiencia y el impacto de la presentación de los conocimientos a los estudiantes con el fin de originar en la evaluación una retroalimentación positiva debe ser una de las principales responsabilidades de los educadores en ciencias básicas. Los nuevos gold standarts, como herramientas informáticas de aprendizaje y laboratorios de instrucción asistida por computadora pueden ser los puntos gatillo para la percepción de la audiencia en las facultades de odontología. A la luz de estas consideraciones, la Sociedad Anatómica debe designar urgentemente perspectivas futuras.

Length of the styloid process and anatomical implications for Eagle's syndrome.

The styloid process is a bony projection, located just anterior to the stylomastoid foramen, the normal length of which is approximately 20-25 mm. Elongation of the process may cause various clinical symptoms such as neck and cervicofacial pain, described as Eagle's syndrome. The present study aimed to determine the mean length of the styloid process on cadavers, panoramic radiographs, and dry skulls, and to investigate the incidence of the elongated styloid process, while assessing the elongation in relation to Eagle's syndrome. When the measurements from the panoramic radiographs were assessed, the mean length of the styloid processes in males and females on the right and left sides were found to be the following: 25.78 + or - 5.68 mm; 22.69 + or - 3.68 mm, 25.80 + or - 5.75 mm; and 22.75 + or - 3.65 mm, respectively. The males had greater styloid process lengths than the females, and the differences in length on both the right and left sides were statistically significant. Descriptive statistics and comparison results according to age groups were determined. There was no statistically significant difference between right or left styloid process lengths according to age groups. The mean length of the styloid process of the cadavers and dry bones was 22.54 + or - 4.24, and there was no significant difference between the right and left sides of the cadavers and dry bones. The incidence of the elongated styloid process was determined as 3.3%, and the elongations revealed a female dominance. The average length of the elongated styloid process was 36.06 + or - 6.12 mm, while the mean length of the styloid processes of the subjects reporting Eagle's syndrome was 40 + or - 4.72 mm. The results of this morphological study will assist clinicians in the diagnosis of Eagle's syndrome.

A morphometric consideration of nasal septal deviations by people with paranasal complaints; a computed tomography study.

The purpose of our study was to examine the localizations and the value of septal deviation by examining the coronal computed tomography of 143 persons with paranasal complaints which 72 of them were female and 71 of them were male, without taking into consideration if a deviation existed or not. The localization of the deviations of the septum nasi was investigated and the relationship between the genders were compared. The septum nasi was examined in the anterior, media, posterior regions for the left and the right directions in each person and was also examined at the superior, media and inferior levels except for the caudal end area. The value and the direction of the deviation was established. A deviation was found in one region in at least 76.2% of the 143 persons (70% female and 81% male). The maximum average deviations were found to be 1.43 +/- 2.1 mm in mediomedia "MM" (the vertically and sagittaly middle region of the septum nasi) region with a percentage of 34.7% towards the right-hand side in the female group, and 1.0 +/- 1.7 mm in the MM region with a percentage of 31.9% also towards the right-hand side in the male group. The maximum deviation in the female group was found to be 7.8 mm in the MM region and 7.9 mm in the AT region in the male group. No statistically significant difference was found for the averages of the deviations (0.298 +/- 0.345 mm in the female group and 0.295 +/- 0.269 mm in the male group) in different regions (p > 0.05). No statistically significant difference was found for the averages of the deviations towards the right-hand and left-hand sides between the male (right 0.302 +/- 0.292 mm; left 0.287 +/- 0.261 mm) and the female (right 0.350 +/- 0.438 mm; left 0.247 +/- 0.235 mm) group (p > 0.05). Separation of the nasal septum into 10 segments will constitute a new basically aspect for an objective, simple and practical consideration and classification.