Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Background: Until now, only a few studies have compared the ability of different intraoral scanners (IOS) to\ncapture high-quality impressions in patients with dental implants. Hence, the aim of this study was to compare the\ntrueness and precision of four IOS in a partially edentulous model (PEM) with three implants and in a fully\nedentulous model (FEM) with six implants.\nMethods: Two gypsum models were prepared with respectively three and six implant analogues, and polyetherether-\nketone cylinders screwed on. These models were scanned with a reference scanner (ScanRider�®), and with\nfour IOS (CS3600�®, Trios3�®, Omnicam�®, TrueDefinition�®); five scans were taken for each model, using each IOS. All\nIOS datasets were loaded into reverse-engineering software, where they were superimposed on the reference\nmodel, to evaluate trueness, and superimposed on each other within groups, to determine precision. A detailed\nstatistical analysis was carried out.\nResults: In the PEM, CS3600�® had the best trueness (45.8 �± 1.6�¼m), followed by Trios3�® (50.2 �± 2.5�¼m), Omnicam�®\n(58.8 �± 1.6�¼m) and TrueDefinition�® (61.4 �± 3.0�¼m). Significant differences were found between CS3600�® and Trios3�®,\nCS3600�® and Omnicam�®, CS3600�® and TrueDefinition�®, Trios3�® and Omnicam�®, Trios3�® and TrueDefinition�®. In the\nFEM, CS3600�® had the best trueness (60.6 �± 11.7�¼m), followed by Omnicam�® (66.4 �± 3.9�¼m), Trios3�® (67.2 �± 6.9�¼m)\nand TrueDefinition�® (106.4 �± 23.1�¼m). Significant differences were found between CS3600�® and TrueDefinition�®,\nTrios3�® and TrueDefinition�®, Omnicam�® and TrueDefinition�®. For all scanners, the trueness values obtained in\nthe PEM were significantly better than those obtained in the FEM. In the PEM, TrueDefinition�® had the best\nprecision (19.5 �± 3.1�¼m), followed by Trios3�® (24.5 �± 3.7�¼m), CS3600�® (24.8 �± 4.6�¼m) and Omnicam�® (26.3 �± 1.5�¼m);\nno statistically significant differences were found among different IOS. In the FEM, Trios3�® had the best precision\n(31.5 �± 9.8�¼m), followed by Omnicam�® (57.2 �± 9.1�¼m), CS3600�® (65.5 �± 16.7�¼m) and TrueDefinition�® (75.3 �± 43.8�¼m);\nno statistically significant differences were found among different IOS. For CS3600�®, For CS3600�®, Omnicam�® and\nTrueDefinition�®, the values obtained in the PEM were significantly better than those obtained in the FEM; no\nsignificant differences were found for Trios3�®.\nConclusions: Significant differences in trueness were found among different IOS; for each scanner, the trueness\nwas higher in the PEM than in the FEM. Conversely, the IOS did not significantly differ in precision; for CS3600�®,\nOmnicam�® and TrueDefinition�®, the precision was higher in the PEM than in the FEM. These findings may have\nimportant clinical implications....
Background: The inserted cochlear implanted electrode is covered at the site of the round window or\ncochleostomy to prevent infections and leakage. In a surgically hearing preservational concept, low intracochlear\npressure changes are of high importance. The aim of this study was to observe intracochlear pressure changes due\nto different sealing techniques in a cochlear model.\nMethods: Cochlear implant electrode insertions were performed in an artifical cochlear model and the\nintracochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical\nregion of the cochlea model to follow the maximum amplitude of intracochlear pressure. Four different sealing\nconditions were compared: 1) overlay, 2) overlay with fascia pushed in, 3) donut-like fascia ring, 4) donut-like fascia\nring pushed in.\nResults: We found statistically significant differences in the occurrence of maximum amplitude of intracochlear\npressure peak changes related to sealing procedure comparing the different techniques. While the lowest\namplitude changes could be observed for the overlay technique (0.14 mmHg �± 0.06) the highest values could be\nobserved for the donut-like pushed in technique (1.79 mmHg �± 0.69).\nConclusion: Sealing the electrode inserted cochlea can lead to significant intracochlear pressure changes. Pushing\nin of the sealing tissue cannot be recommended....
Background: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem,\nmany programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients\nwith implanted mechanical circulatory support system have rarely been considered as potential lung donors. This\ncase demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory\nsupport system despite the possible difficulties of lung retrieval.\nCase presentation: Our case presents a successful procurement and bilateral lung transplantation from a donor\nsupported by a left ventricular assist device (LVAD) who experienced an intraoperatively haemodynamic complication.\nThe use of portable normothermic perfusion device let us to reduce ischemic injury and assess these marginal donor\nlungs helping us to determine the clinical suitability for transplantation. Given our extensive experience with the device\ninstrumentation and management, the EVLP process was uneventful with excellent post-transplant course.\nConclusions: This case report demonstrates the feasibility of lung transplantations from organ donors supported by a\nmechanical circulatory support system using the portable normothermic perfusion platform to assess and preserve\nthese donor lungs....
Background: Prosthesisââ?¬â??patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic\nvalve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the\nfactors contributing to PPM in China.\nMethods: We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital\nbetween January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ââ?°Â¤ 0.\n85 cm2/m2. The baseline, echocardiographic, operative, and outcome data of all patients were collected from the\nnational database.\nResults: A total of 869 patients were included in the study. PPM was detected in 15.9% (138/869) of the patients. Four\npatients (0.5%) met the criteria for severe PPM. Patients with PPM were older and had a higher prevalence of diabetes,\ncoronary heart disease, aortic stenosis (AS), and preoperative left ventricular dysfunction but a lower incidence of smoking\nhistory and aortic regurgitation. Logistic regression analysis showed that female gender (P < 0.001), AS (P= 0.014), higher\nbody mass index (BMI) (P < 0.001), and bioprosthesis (P < 0.001) were independent predictors of PPM. We also found that\nPPM (P = 0.005) was associated with 30-day all-cause mortality, along with smoking history (P= 0.001) and low\npreoperative left ventricular ejection fraction (LVEF) (P= 0.004).\nConclusions: PPM is associated with high short-term mortality after AVR in China. Female gender, aortic stenosis,\nbioprosthesis, and high BMI are risk factors for the incidence of PPM....
Background: Urinary tract infection is the most common complication after kidney transplantation. It can cause\nsevere sepsis and transplant loss. Emergence of drug resistance among gram-negative urinary pathogens is the\ncurrent challenge for urinary tract infection treatment after kidney transplantation.\nMethods: This study analyzes the antimicrobial susceptibility of gram-negative urinary pathogens after kidney\ntransplantation from 2009 to 2012 at the Transplant Outpatient Clinic of the University Hospital Essen, Germany.\nKidney transplant patients at the University Hospital Essen receive regular follow up examinations after transplantation.\nMidstream urines were examined for bacteriuria at each follow up visit.\nResults: From 2009 to 2012 15.741 urine samples were obtained from 859 patients. In 2985 (19%) samples bacterial\ngrowth was detected. The most frequently detected gram-negative bacteria were E.coli 1109 (37%), Klebsiella spp.\n242 (8%) and Pseudomonas aeruginosa 136 (4.5%). Klebsiella spp. showed a significant increase of resistance to\ntrimethoprim-sulfamethoxazole by 19% (p = 0.02), ciprofloxacin by 15% (p = 0.01) and ceftazidime by 17% (p = 0.004).\nE.coli and P. aeruginosa isolates presented no significant differences of antimicrobial susceptibility to the analyzed\nantibiotics.\nConclusions: Antimicrobial resistance of Klebsiella spp. increased significant to trimethoprim-sulfamethoxazole,\nciprofloxacin and ceftazidime from 2009 to 2012....
Background: The cases of donation after brain death followed by circulatory death (DBCD) and donation after\ncardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the\noutcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its\npotential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD\nand DCD transplant and the main risk factors for DGF in DBCD.\nMethods: Retrospective analysis of the clinical data of 367donations after citizens� death kidney transplant procedures\n(donors and recipients) between July 2012 and August 2015 at our center.\nResults: During the study period, the donation success rate was 25.3%. 164 cases of DBCD and 35 cases of\nDCD had been implemented and 367 kidneys were transplanted. The incidence of DGF in DBCD group\nwere significantly lower than that of DCD group (12.0% vs. 27.0%, p = 0.002). The 1-year percent freedom\nfrom acute rejection (AR) was significantly higher in DBCD group compared with it of DCD group (94% vs.\n82%, p = 0.036). Multivariate logistic regression analysis of the kidney transplants revealed that the high risk\nfactors for DGF after renal transplantation in DBCD were history of hypertension (Odds Ratio [OR] = 5.88,\n95% CI: 1.90 to 18.2, p = 0.002), low blood pressure (BP < 80 mmHg) (OR = 4.86, 95% CI: 1.58 to 14.9, p = 0.\n006) and serum creatinine of donor (OR = 1.09, 95% CI: 1.03 to 1.16, p = 0.003) before donation.\nConclusions: The outcomes of DBCD could be better than DCD in DGF and AR. The main risk factors for\nDGF in DBCD kidney transplants are donors with a history of hypertension, low blood pressure, and serum\ncreatinine of donor before donation....
Background. Calcineurin inhibitors (CNI) have significantly improved patient and graft survival in pediatric liver transplantation\n(pLT). However, CNI toxicity leads to significant morbidity. Moreover, CNIs cannot prevent long-term allograft injury.\nMesenchymal stem (stromal) cells (MSC) have potent immunomodulatory properties, which may promote allograft tolerance\nand ameliorate toxicity of high-dose CNI. The MYSTEP1 trial aims to investigate safety and feasibility of donor-derived\nMSCs in pLT. Methods/Design. 7 to 10 children undergoing living-donor pLT will be included in this open-label,\nprospective pilot trial. A dose of 1 Ã?â?? 106 MSCs/kg body weight will be given at two time points: first by intraportal\ninfusion intraoperatively and second by intravenous infusion on postoperative day 2. In addition, participants will receive\nstandard immunosuppressive treatment. Our primary objective is to assess the safety of intraportal and intravenous MSC\ninfusion in pLT recipients. Our secondary objective is to evaluate efficacy of MSC treatment as measured by the\nindividual need for immunosuppression and the incidence of biopsy-proven acute rejection. We will perform detailed\nimmune monitoring to investigate immunomodulatory effects. Discussion. Our study will provide information on the\nsafety of donor-derived MSCs in pediatric living-donor liver transplantation and their effect on immunomodulation and\ngraft survival....
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