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1.
Am J Dent ; 33(1): 3-11, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32056408

RESUMEN

PURPOSE: To compare the effects of oscillating-rotating (O-R), sonic (side-to-side), and manual toothbrushes on plaque and gingival health after multiple uses in studies up to 3 months. METHODS: A meta-analysis was conducted on randomized clinical trials (RCTs) up to 3 months in duration to evaluate O-R electric toothbrush effectiveness regarding gingivitis reduction and plaque removal versus sonic and/or manual toothbrushes. To ensure access to subject-level data, this meta-analysis was limited to RCTs involving O-R toothbrushes from a single manufacturer conducted from 2007 to 2017 for which subject-level data were available and that satisfied criteria of duration, parallel design, examiner-graded, etc. For gingivitis studies, a one-step individual subject meta-analysis was used to assess direct and indirect treatment differences and to identify any subject-level covariates modifying treatment effects. In the two-step meta-analysis, individual participant data were first analyzed in each study independently using the last timepoint (up to 3 months), producing aggregate data for each study. Then forest plots were produced using these aggregate data with random-effects models. For plaque studies, the efficacy variables were standardized so direct comparisons could be generated using the 2-step meta-analysis. Network meta-analysis was performed to assess the indirect plaque comparisons. RESULTS: 16 parallel group RCTs with 2,145 subjects were identified assessing gingivitis via number of bleeding sites. In five and 11 gingivitis studies assessing O-R brushes versus manual and sonic brushes, respectively, a change in the average number of bleeding sites of -8.9 ( 95% CI: -15.9, -1.9) and -3.1 (95% CI: -3.8, -2.4) was observed (P ≤ 0.008). These reductions equate to a 50% and 28% bleeding benefit for O-R technology versus the respective controls. The sonic brush bleeding change versus manual was -5.9 (P = 0.062), a 34% bleeding benefit. Utilizing individual bleeding scores, subjects with localized or generalized gingivitis ( #8805; 10% bleeding sites) had 7.4 times better odds of transitioning to generally healthy (< 10% bleeding sites) after using an O-R brush versus manual. 20 parallel design RCTs with 2,551 subjects assessed plaque (TMQHI, RMNPI). In eight and 12 plaque RCTs assessing an O-R brush versus manual and sonic brushes, respectively, standardized changes in average plaque scores of -1.51 (95% CI: -2.17, -0.85) and -0.55 (95% CI: -0.82, -0.28) were observed (P< 0.001). These plaque reductions by O-R equate to a relative 20% and 4% greater benefit, respectively. The change for sonic versus manual was -0.93 ( 95% CI:-1.48, -0.38); (P < 0.001) which equates to a 12% plaque benefit. CLINICAL SIGNIFICANCE: This subject-level meta-analysis of studies up to 3 months provides sound evidence supporting recommendations for patients with various degrees of gingival bleeding to use oscillating-rotating electric toothbrushes over manual and sonic toothbrushes to improve plaque control and gingival health.


Asunto(s)
Placa Dental , Gingivitis , Índice de Placa Dental , Diseño de Equipo , Humanos , Índice Periodontal , Método Simple Ciego , Cepillado Dental
2.
J Oral Sci ; 62(1): 23-27, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31996518

RESUMEN

Laminated custom-made mouthguards tend to delaminate with use; this is a problem in clinical use. Insufficient bonding strength causes delamination, and bonding strength is strongly affected by heating temperature during lamination. The present study aimed to evaluate the influence of heating temperature on the sheet lamination process. Seven mouthguard sheet products were laminated together at different heating temperatures. To evaluate the bonding strength, a delamination test (n = 6) was performed, and the fracture patterns were inspected visually. To evaluate the shock absorption capability, a falling impact test (n = 5) was performed, and the specimen thicknesses were measured. All recorded values were analyzed using two-way analysis of variance and Tukey's Honest Significant Difference Test (P < 0.05). The present study confirmed that bonding strength was dependent on heating temperature: In ethylene-vinyl acetate copolymer products, the bonding strength was almost constant at 130°C and above, and it was constant at 110°C and above in polyolefin products. The thickness of every specimen decreased and, in some specimens, the shock absorption capability decreased with increasing heating temperature. The present study concludes that the heating temperature during the sheet lamination process when laminated custom-made mouthguards are fabricated may not be less than 120°C in ethylene-vinyl acetate copolymer products and 110°C in polyolefin products.


Asunto(s)
Protectores Bucales , Diseño de Equipo , Temperatura Ambiental
3.
Anal Bioanal Chem ; 412(3): 621-633, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31907590

RESUMEN

We produced a prometryn-specific monoclonal antibody and propose a strategy for convenient on-site detection of prometryn residues in herbs for the first time. This strategy has perfect applicability in a complex herbal medicine matrix. The strategy combines a semiquantitative immunochromatographic strip assay with a heterologous indirect competitive ELISA. When there was no matrix interference, the ELISA had a half-maximal inhibitory concentration of 2.6 ng·mL-1 and a limit of detection of 0.2 ng·mL-1. The immunochromatographic strip assay can be completed within 5 min with a visual limit of detection of 1 ng·mL-1. Although the sample matrix had different effects on the sensitivity of the antibody, excellent repeatability and accuracy were achieved. The method was successfully applied for the screening and determination of prometryn residue in multiple complex herb samples for the first time, and the results were in good agreement with those obtained by liquid chromatography-tandem mass spectrometry. The proposed strategy is rapid, of high-throughput, and of low cost, and may be a promising choice for on-site detection of prometryn in different kinds of herbs. Graphical abstract.


Asunto(s)
Ensayo de Inmunoadsorción Enzimática/métodos , Herbicidas/análisis , Plantas Medicinales/química , Prometrina/análisis , Animales , Anticuerpos Monoclonales/química , Ensayo de Inmunoadsorción Enzimática/instrumentación , Diseño de Equipo , Femenino , Contaminación de Alimentos/análisis , Oro Coloide/química , Inmunoconjugados/química , Límite de Detección , Ratones Endogámicos BALB C , Tiras Reactivas/análisis
4.
Int J Radiat Oncol Biol Phys ; 106(2): 440-448, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31928642

RESUMEN

PURPOSE: Recent studies suggest that ultrahigh-dose-rate, "FLASH," electron radiation therapy (RT) decreases normal tissue damage while maintaining tumor response compared with conventional dose rate RT. Here, we describe a novel RT apparatus that delivers FLASH proton RT (PRT) using double scattered protons with computed tomography guidance and provide the first report of proton FLASH RT-mediated normal tissue radioprotection. METHODS AND MATERIALS: Absolute dose was measured at multiple depths in solid water and validated against an absolute integral charge measurement using a Faraday cup. Real-time dose rate was obtained using a NaI detector to measure prompt gamma rays. The effect of FLASH versus standard dose rate PRT on tumors and normal tissues was measured using pancreatic flank tumors (MH641905) derived from the KPC autochthonous PanCa model in syngeneic C57BL/6J mice with analysis of fibrosis and stem cell repopulation in small intestine after abdominal irradiation. RESULTS: The double scattering and collimation apparatus was dosimetrically validated with dose rates of 78 ± 9 Gy per second and 0.9 ± 0.08 Gy per second for the FLASH and standard PRT. Whole abdominal FLASH PRT at 15 Gy significantly reduced the loss of proliferating cells in intestinal crypts compared with standard PRT. Studies with local intestinal irradiation at 18 Gy revealed a reduction to near baseline levels of intestinal fibrosis for FLASH-PRT compared with standard PRT. Despite this difference, FLASH-PRT did not demonstrate tumor radioprotection in MH641905 pancreatic cancer flank tumors after 12 or 18 Gy irradiation. CONCLUSIONS: We have designed and dosimetrically validated a FLASH-PRT system with accurate control of beam flux on a millisecond time scale and online monitoring of the integral and dose delivery time structure. Using this system, we found that FLASH-PRT decreases acute cell loss and late fibrosis after whole-abdomen and focal intestinal RT, whereas tumor growth inhibition is preserved between the 2 modalities.


Asunto(s)
Órganos en Riesgo/efectos de la radiación , Terapia de Protones/instrumentación , Traumatismos Experimentales por Radiación/prevención & control , Protección Radiológica/instrumentación , Radioterapia Guiada por Imagen/instrumentación , Abdomen/efectos de la radiación , Animales , Proliferación Celular/efectos de la radiación , Diseño de Equipo/métodos , Estudios de Factibilidad , Femenino , Fibrosis , Rayos gamma , Intestino Delgado/patología , Intestino Delgado/efectos de la radiación , Ratones , Ratones Endogámicos C57BL , Tratamientos Conservadores del Órgano/instrumentación , Tratamientos Conservadores del Órgano/métodos , Órganos en Riesgo/patología , Neoplasias Pancreáticas/radioterapia , Terapia de Protones/métodos , Protección Radiológica/métodos , Radiometría/métodos , Radioterapia Guiada por Imagen/métodos , Dispersión de Radiación , Células Madre/efectos de la radiación , Tomografía Computarizada por Rayos X
5.
Bone Joint J ; 102-B(1): 5-10, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31888369

RESUMEN

AIMS: Intraoperative 3D navigation (ION) allows high accuracy to be achieved in spinal surgery, but poor workflow has prevented its widespread uptake. The technical demands on ION when used in patients with adolescent idiopathic scoliosis (AIS) are higher than for other more established indications. Lean principles have been applied to industry and to health care with good effects. While ensuring optimal accuracy of instrumentation and safety, the implementation of ION and its associated productivity was evaluated in this study for AIS surgery in order to enhance the workflow of this technique. The aim was to optimize the use of ION by the application of lean principles in AIS surgery. METHODS: A total of 20 consecutive patients with AIS were treated with ION corrective spinal surgery. Both qualitative and quantitative analysis was performed with real-time modifications. Operating time, scan time, dose length product (measure of CT radiation exposure), use of fluoroscopy, the influence of the reference frame, blood loss, and neuromonitoring were assessed. RESULTS: The greatest gains in productivity were in avoiding repeat intraoperative scans (a mean of 248 minutes for patients who had two scans, and a mean 180 minutes for those who had a single scan). Optimizing accuracy was the biggest factor influencing this, which was reliant on incremental changes to the operating setup and technique. CONCLUSION: The application of lean principles to the introduction of ION for AIS surgery helps assimilate this method into the environment of the operating theatre. Data and stakeholder analysis identified a reproducible technique for using ION for AIS surgery, reducing operating time, and radiation exposure. Cite this article: Bone Joint J. 2020;102-B(1):5-10.


Asunto(s)
Neuronavegación/métodos , Escoliosis/cirugía , Adolescente , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Tornillos Óseos/estadística & datos numéricos , Diseño de Equipo , Femenino , Fluoroscopía/estadística & datos numéricos , Humanos , Cuidados Intraoperatorios/métodos , Masculino , Bloqueantes Neuromusculares/administración & dosificación , Neuronavegación/instrumentación , Tempo Operativo , Posicionamiento del Paciente , Dosis de Radiación , Resultado del Tratamiento
7.
Int J Dent Hyg ; 18(1): 17-26, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31050195

RESUMEN

OBJECTIVES: In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal? METHODS: MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible. RESULTS: Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was -0.14 (P < 0.001; 95%CI [-0.19; -0.09]) for the Q&HPI and -0.10 (P < 0.001; 95%CI [-0.14; -0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM -0.16 (P < 0.001; 95%CI [-0.22, -0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed -0.10 (P < 0.001; 95%CI [-0.15; -0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of -0.15 (P < 0.001; 95%CI [-0.22; -0.08]) and the Colgate SS for RMNPI showed a DiffM of -0.15 (P < 0.001; 95%CI [-0.18; -0.12]). CONCLUSION: There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.


Asunto(s)
Placa Dental , Cepillado Dental , Adolescente , Adulto , Índice de Placa Dental , Diseño de Equipo , Humanos , Índice Periodontal , Ensayos Clínicos Controlados Aleatorios como Asunto , Método Simple Ciego
8.
Biomed Chromatogr ; 34(1): e4725, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31755114

RESUMEN

For the analysis of methylhippuric acids (MHAs) in human urine samples, in this study, a new method based on the metal-organic framework (MOF) of MIL-53-NH2 (Al) in microextraction by packed sorbent (MEPS) was developed. The synthesis of MIL-53-NH2 (Al) was characterized by Fourier transform infrared spectra, field emission-scanning electron microscopy and X-ray diffraction. Response surface methodology was used to investigate the influences of several parameters including type and volume of elution, type of conditional solvent, sample volume and extraction cycle on MEPS efficiency. The results showed good recoveries (>94%) and excellent extraction efficiencies (>96%) at three different concentrations of 50, 500 and 1500 µg ml-1 (as low, mid and high concentrations, respectively) of MHA isomers. Calibration curves of MHAs were linear over the concentration range of 1-1500 µg ml-1 , with high correlation coefficients (r ≥ 0.998). The reproducibility of the proposed MIL-53-MEPS for determination of three isomers of MHA was found to be in the range of 3.5-11.1%. After optimization of the proposed technique, it was used to analyze MHAs in urine samples of workers exposed to xylenes in a petrochemical plant in Asalouyah, Iran. The results indicated that the MOF-MEPS method was selective, sensitive, rapid and efficient for the extraction of urinary MHAs. The technique is also environmentally friendly and inexpensive, and the MOF sorbent is reusable.


Asunto(s)
Cromatografía Líquida de Alta Presión/métodos , Hipuratos/orina , Estructuras Metalorgánicas/química , Microextracción en Fase Sólida/métodos , Diseño de Equipo , Humanos , Límite de Detección , Modelos Lineales , Exposición Profesional/análisis , Reproducibilidad de los Resultados , Microextracción en Fase Sólida/instrumentación
9.
J Endod ; 46(1): 103-109, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31761330

RESUMEN

INTRODUCTION: This in vitro study compared the performance of the XP-endo Shaper (XP; FKG, La Chaux-de-Fonds, Switzerland) in curved canals when used with a higher speed (3000 rpm) without a glide path with the manufacturer's protocol. METHODS: Twenty extracted mandibular molars with separate mesial curved canals were matched to obtain 2 standardized groups (n = 20). For the XP 1000 group, a glide path up to a size 15 hand file was performed followed by rotary instrumentation with the XP shaper at 1000 rpm, following the manufacturer's recommendations. For the canals in the XP 3000 group, the file was rotated at 3000 rpm after only negotiation the canal with a size 8 hand file (patency file). The operating time and the number of strokes taken to reach the working length (WL) and fit a 30/.04 gutta-percha cone to the WL were recorded. The shaping abilities were evaluated by micro-computed tomographic imaging and file deformation by scanning electron microscopy. Data were analyzed using analysis of variance and chi-square tests at a 5% significance level. RESULTS: The XP 3000 group required less time and strokes to reach the WL (P < .05) and resulted in a higher percentage of adequate cone fit (P < .05). No difference was found between groups regarding the micro-CT parameters, except for the taper, which was larger in the XP 3000 group in the apical and middle thirds (P < .05). No difference was found regarding file deformation between the 2 groups. CONCLUSIONS: The suggested protocol for the use of the XP (3000 rpm without a glide path) appears to be more efficient than the manufacturer's recommended protocol to prepare curved canals in vitro.


Asunto(s)
Cavidad Pulpar , Preparación del Conducto Radicular , Diseño de Equipo , Gutapercha , Técnicas In Vitro , Diente Molar
10.
J Sports Sci ; 38(2): 206-213, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31722621

RESUMEN

A novel 3D motion capture analysis assessed the efficacy of insoles in maintaining the foot position on the midsole platform inside the shoe during rapid change of direction manoeuvres used in team sports. An insole (TI) with increased static (35%) and dynamic (49%) coefficient of friction compared to a regular insole (SI) was tested. Change of direction performance was faster (p < .001) and perceived to be faster (p < .001) in TI compared to SI. Participants utilised greater coefficient of friction in TI compared to SI during a complete turn, but not during a 20 degree side-cut. In-shoe foot sliding reduced across the forefoot and midfoot during the braking phase of the turn and in the rearfoot during the side-cut in TI. Greater in-shoe foot sliding occurred in the turn than the side-cut across all foot regions. Results provide guidance for athletic footwear design to help limit in-shoe foot sliding and improve change of direction performance.


Asunto(s)
Rendimiento Atlético/fisiología , Diseño de Equipo , Destreza Motora/fisiología , Zapatos , Adulto , Rendimiento Atlético/psicología , Fenómenos Biomecánicos , Femenino , Fricción , Humanos , Masculino , Percepción , Estudios de Tiempo y Movimiento , Adulto Joven
11.
Vasc Endovascular Surg ; 54(2): 118-125, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31690248

RESUMEN

BACKGROUND: Expanded applications and increasing volumes of complex endovascular procedures have increased the risk of unintended intraoperative fragmentation and retention of catheters and sheaths. We describe a series of retained or fragmented endovascular devices, a quality improvement program to address this unmet need for improved detection of catheter fragmentation, and the results of this program. METHODS: Cases utilizing endovascular devices that resulted in a retained catheter fragment were identified and analyzed during divisional quality improvement review. One consistent area of concern was operating room (OR) staff unfamiliarity with verifying the integrity of an endovascular device. In response, a slide-based training protocol of focused, endovascular nursing education was implemented. Following perceived lack of improvement after this approach, we developed a handheld visual reference display of the tips of common catheters and sheaths. Staff was surveyed before and after intervention to assess the educational value of the display and the impact on staff device familiarity. RESULTS: All 4 described cases resulted in an unplanned return to the OR for retrieval of the fragmented catheter or sheath. No thromboembolic complications were observed, although associated intra-arterial thrombus was noted in 2 cases. Thirty-four OR nurses were polled to trial the visual reference display initiative, with 70% of those reporting primary surgical assignments outside of cardiovascular ORs. Introduction of the new visual reference display improved staff confidence in their ability to identify a broken device (2.4-3.7, P < .001). This improvement was most significant in OR staff with primary assignments in noncardiovascular services. CONCLUSION: Current OR standard operating procedures fail to address the potential for unintentionally retained catheters and wires during endovascular procedures. Our novel visual reference display of common endovascular items rather than conventional in-service training improved the ability of staff to identify device fragmentation at the time of the index procedure.


Asunto(s)
Remoción de Dispositivos , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Falla de Equipo , Cuerpos Extraños/cirugía , Dispositivos de Acceso Vascular , Adulto , Anciano , Actitud del Personal de Salud , Competencia Clínica , Diseño de Equipo , Femenino , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/etiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital , Enfermería de Quirófano , Reoperación , Resultado del Tratamiento
12.
J Endod ; 46(1): 110-115, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31740067

RESUMEN

INTRODUCTION: The aim of this study was to compare a reduction in working length and area of canal enlargement resulting from instrumentation with Hedström (Kerr Dental, Orange, CA), K (Kerr Dental), ProTaper Next (Dentsply Sirona, York, PA), and TF Adaptive (Kerr Dental) files. The effect of the canal curvature on the working length and area of canal enlargement was also assessed. METHODS: A total of 80 plastic canal models were used, 40 with a canal curvature of 10° and another 40 with a canal curvature of 30°. Instrumentation of 10 models with a 10° canal curvature and 10 models with a 30° canal curvature was performed using each of the file systems up to size 25. Working length measurements were taken before and after instrumentation with each file type and size. Twenty composite images were made from superimposition of pre- and postpreparation photographs, and the difference in area was calculated using ImageJ software (National Institutes of Health, Bethesda, MD). RESULTS: ProTaper Next rotary files and TF Adaptive files produced the smallest reduction in the working length and the least canal enlargement followed by Hedström files and K files, respectively. The degree of canal curvature increased the working length reduction by a significant amount when K files and ProTaper Next rotary files were used, and the degree of curvature increased canal enlargement by a significant amount when K files were used. CONCLUSIONS: Nickel-titanium rotary files produced more favorable results than stainless steel hand files in terms of maintaining a consistent working length and producing minimal canal enlargement. Hedström files performed significantly better than K files in terms of working length reduction and canal enlargement.


Asunto(s)
Cavidad Pulpar , Preparación del Conducto Radicular , Aleaciones Dentales , Instrumentos Dentales , Diseño de Equipo , Preparación del Conducto Radicular/instrumentación , Titanio
13.
World Neurosurg ; 133: e97-e104, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31505279

RESUMEN

BACKGROUND: Intraspinal tumors are 10 to 15 times less common than brain tumors. The midline approach with extensive laminectomies represents the current gold-standard for resection, causing instability, muscle damage, and kyphosis among other well-known complications. Minimally invasive series reported their results using retractor-based systems. We analyzed a patient series treated with a non-expansile tubular approach, describing the technique, grade of resection, and clinical outcomes. METHODS: A series of consecutive cases operated between 2016 and October 2018 were analyzed retrospectively. The database included age, sex, clinical presentation, intraspinal location (intra/extradural), number of laminotomies, grade of resection, surgical time, bleeding, and follow-up. The initial and follow-up clinical condition was analyzed using the Frankel scale. RESULTS: A total of 13 patients underwent surgery: 3 intraspinal/extradural (23%), 8 intradural/extramedullary (61.5%), and 2 intramedullary tumors (15.3%); these were classified as 5 meningiomas (38.4%), 4 neurofibromas (30.7%), 2 schwannomas (15.3%), 1 hemangioblastoma (7.6%), and 1 astrocytoma (7.6%). Eleven (84.61%) patients had complete motor improvement, 1 patient had partial improvement, and 1 patient had no improvement (7.6% each). An 18-mm working channel tube was used for extramedullary lesions and 20-mm tubes for intramedullary injuries. Total tumor resection was achieved in 11 patients (84.6%) and subtotal in 2 patients (15.38%) corresponding to intramedullary tumors. CONCLUSIONS: Although this study consisted of a small series, we have shown the possibility of resecting intraspinal tumors (some intradural-intramedullary) with non-expansile tubes in a safe and effective way with no complications. Most of the patients had complete neurological improvement at the end of follow-up.


Asunto(s)
Descompresión Quirúrgica/métodos , Fijadores Internos , Microcirugia/métodos , Neoplasias de la Médula Espinal/cirugía , Neoplasias de la Columna Vertebral/cirugía , Adulto , Anciano , Descompresión Quirúrgica/instrumentación , Diseño de Equipo , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/cirugía , Meningioma/diagnóstico por imagen , Meningioma/cirugía , Microcirugia/instrumentación , Persona de Mediana Edad , Neurilemoma/diagnóstico por imagen , Neurilemoma/cirugía , Neurofibroma/diagnóstico por imagen , Neurofibroma/cirugía , Estudios Retrospectivos , Neoplasias de la Médula Espinal/diagnóstico por imagen , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Adulto Joven
14.
Vasa ; 49(1): 72-76, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31414968

RESUMEN

Chronic total occlusion remains one of the most challenging lesions to treat despite continuing developments in medical devices and increasing operator experience. Guidewire perforation complications are being increasingly observed. Early recognition and timely institution of appropriate treatment are essential to prevent potentially devastating sequelae.


Asunto(s)
Angioplastia , Síndromes Compartimentales , Extremidad Inferior/cirugía , Cateterismo , Diseño de Equipo , Humanos , Extremidad Inferior/irrigación sanguínea , Resultado del Tratamiento
15.
Int Endod J ; 53(2): 250-264, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31489641

RESUMEN

AIM: To compare the mechanical properties and metallurgic features of new and used Reciproc Blue and Reciproc instruments. METHODOLOGY: A total of 120 R25 Reciproc Blue and R25 Reciproc instruments were used. The morphological, chemical, mechanical, thermal and phase composition characteristics of new and ex vivo used files were investigated by scanning electron microscopy (FEG-SEM) with energy dispersive X-ray spectroscopy (EDS), focused ion beam analysis (FIB), micro-Raman spectroscopy, FEG-SEM metallography, X-ray diffraction (XRD), differential scanning calorimetry (DSC) and indentation tests. Usage-induce degradation was evaluated. Ten new and ten used instruments per type were run until fracture occurred in a stainless steel artificial canal (60° angle of curvature, 4-mm radius). Time to fracture and the length of the fractured fragment were recorded. Torque and angle of rotation at failure of ten new and ten used instruments for each type were measured according to ISO 3630-1. The fracture surface of each fragment was examined. Two-way analyses of variance was used to analyse the data statistically (α-level 0.05). RESULTS: SEM analysis revealed microcracks near the tip on both files after ex vivo usage tests. FIB imaging and micro-Raman spectroscopy confirmed the presence of an oxide layer on the Reciproc Blue surface. There was no thinning of the coating after use. XRD revealed a reduction of martensite and R-phase in Reciproc Blue after use. DSC analysis revealed different transformation temperatures for the instruments analysed. Reciproc Blue was significantly more flexible than Reciproc for both new and used samples (P < 0.05), and they were significantly more resistant to cyclic fatigue than Reciproc (P < 0.05). Ex vivo usage reduced the fatigue resistance of both files. Torsional resistance of Reciproc and Reciproc Blue was not reduced by simulated use (P > 0.05). CONCLUSIONS: The thermal treatment of Reciproc Blue was associated with a finer structure with smaller grains than Reciproc, which increased its fracture resistance and was also responsible for its reduced hardness and lower elastic modulus. Both files were safe during ex vivo usage in severely curved canals.


Asunto(s)
Metalurgia , Preparación del Conducto Radicular , Diseño de Equipo , Falla de Equipo , Dureza , Ensayo de Materiales , Estrés Mecánico , Propiedades de Superficie , Titanio , Torque
16.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 94-97, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30606750

RESUMEN

Neonatal intubation is an essential but difficult skill to learn. Videolaryngoscopy allows the airway view to be shared by the intubator and supervisor and improves intubation success. Ideally, a videolaryngoscope (VL) should be usable as a conventional laryngoscope (CL). The aims of this report were to describe differences in the shape of currently available CL and VL blades and to compare the direct airway view obtainable on a neonatal manikin with different laryngoscope blades.Three main differences were observed; compared with CL, the VL blades have a reduced vertical height, a curved tip and curved body. The direct airway view obtained by the VL is narrower than that obtained with the CL, although the corresponding view on the VL screen is maintained.Minor adaptation of intubation technique may be required when using a VL. Modifying VL blades to reduce these differences may improve their usefulness as an intubation training tool.


Asunto(s)
Laringoscopios , Laringoscopía/instrumentación , Grabación en Video , Diseño de Equipo , Humanos , Recién Nacido , Intubación Intratraqueal , Laringoscopía/educación , Maniquíes
17.
Gen Dent ; 68(1): 36-39, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859660

RESUMEN

The aim of this study was to compare, in pairs, the cyclic fatigue resistance, scanning electron microscopic (SEM) appearance, and energy-dispersive X-ray (EDX) profiles of 6 rotary files: ProTaper Gold vs EdgeTaper Platinum; ProTaper Universal vs EdgeTaper; and Vortex Blue vs EdgeSequel Sapphire. Six types of rotary file were tested in 2 sizes of each type. A 3-point cyclic fatigue apparatus imparting a 60-degree angle of curvature and a 3-mm radius of curvature was used to evaluate 30 files of each type and size. The cyclic fatigue testing results from similar file types and sizes were paired for statistical analysis. After fatigue testing was completed, 36 files (3 of each type and size) were randomly selected for SEM imaging and EDX analysis. When similar file types and sizes were paired in independent-samples t tests, statistically significant differences (P < 0.0001) in cyclic fatigue resistance were established. For both tested sizes, EdgeTaper Platinum exhibited significantly greater fatigue resistance than ProTaper Gold. ProTaper Universal and EdgeTaper each demonstrated significantly greater fatigue resistance than the other system in 1 size pairing. Vortex Blue exhibited significantly greater fatigue resistance than EdgeSequel Sapphire in both size pairings. In general, the heat-treated files demonstrated greater cyclic fatigue resistance than the non-heat-treated files. The SEM images verified that fracture patterns were consistent with cyclic fatigue failure. Differences in file design between the matched pairs were noted, particularly at the tips. The EDX comparisons showed that nickel and titanium were present in similar percentages (1:1 atomic ratio) for all file types. The disparities in cyclic fatigue results and tip design indicate that clinicians should not expect identical clinical performance from different files.


Asunto(s)
Instrumentos Dentales , Falla de Equipo , Microscopía Electrónica de Rastreo/métodos , Preparación del Conducto Radicular , Aleaciones Dentales , Diseño de Equipo , Humanos , Ensayo de Materiales , Níquel , Estrés Mecánico , Titanio
18.
Water Res ; 168: 115163, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31614239

RESUMEN

Respiratory infections from opportunistic bacterial pathogens (OBPs) have heightened research interests in drinking water distribution systems, premise plumbing, and point-of-use technologies. In particular, biofilm growth in showerheads increases OBP content, and inhalation of shower aerosols is a major exposure route for Legionellae and Mycobacteria infections. Incorporation of UVC LEDs into showerheads has thus been proposed as a point-of-use option for healthcare facilities. Herein we have examined incongruities between the nature of OBP contamination in shower water and the hypothetical application of conventional UV disinfection engineering concepts. Effective UV dosing within showerheads must overcome significant shielding effects imparted by the biological matrices in which common OBPs reside, including biofilm particles and protozoan hosts. Furthermore, prevention of biofilm growth in showerhead interiors requires a different UV irradiation approach and is lacking in established design parameters. Development of showerhead devices is also likely to face a trade-off between bathing functionality and simpler form factors that are more conducive to internal UV irradiation.


Asunto(s)
Legionella , Bacterias , Biopelículas , Desinfección , Diseño de Equipo , Ingeniería Sanitaria , Microbiología del Agua
19.
Int J Prosthodont ; 33(1): 99-104, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31860919

RESUMEN

PURPOSE: To establish a complete digital workflow for the design and manufacture of sports mouthguards and to observe preliminary clinical effects. MATERIALS AND METHODS: Eighteen healthy participants were included in this study. The self-controlled method was applied, and all participants were provided with two types of mouthguards. Digital mouthguards were designed and milled using CAD/CAM with polyetheretherketone, and conventional mouthguards were fabricated using the vacuum pressure-forming method with ethylene vinyl acetate. The order of wearing was determined using a random number table, and the washout period between was set as 1 month. Degrees of satisfaction in terms of retention, appearance, occlusal comfort, and labial comfort were evaluated. Distribution of occlusal force was tested using the T-scan analysis system. Participants were also asked to choose one mouthguard for future use. RESULTS: The complete workflow of digitally designed and manufactured sports mouthguards was successfully established. No significant difference was noted in retention between the types of mouthguard. The appearance score (P = .025), occlusal comfort score (P = .030), and labial side comfort score (P = .003) of the digital mouthguard group were significantly higher compared to the conventional mouthguard group. T-scan analysis results showed that in centric occlusion, participants exhibited occlusal contact in the second molar alone while wearing conventional mouthguards, while the occlusal force was uniformly distributed with digital mouthguards. Sixteen participants selected the digital mouthguard for future use. CONCLUSION: Digital design and manufacture of sports mouthguards improved the occlusal design and greatly simplified and optimized the conventional fabrication process.


Asunto(s)
Protectores Bucales , Deportes , Diseño de Equipo , Vacio , Flujo de Trabajo
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