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Journal of Prosthodontics : Official... Jul 2023Centric relation (CR) is a universally recognized term and an acceptable reference position with a long history of success. The problem is that there is little consensus... (Review)
Review
PURPOSE
Centric relation (CR) is a universally recognized term and an acceptable reference position with a long history of success. The problem is that there is little consensus as to its definition or the method of recording it, and this has created an uprising to abolish it.
METHODS
A review of pertinent literature related to its definition, method of recording, anatomic considerations, and long-standing principles was conducted.
RESULTS
Centric relation is an established term but there are valid concerns over its definition and method of recording. There is consensus on using it as a restorative position in a patient in need of full-arch reconstruction, and there is no substantive clinical research to contradict this. If a clinician decides to use a different position, it should have a different name.
CONCLUSIONS
Centric relation is a reproducible reference position that can be utilized for diagnostic and restorative dental procedures with substantial scientific evidence to support that premise. There are numerous well-documented techniques, all of which are intermaxillary, that can replicate the position. There is little scientific evidence to support a premise as to where the exact position of the condyle should be in relation to the fossa.
Topics: Humans; Centric Relation; Consensus; Dental Occlusion, Centric; Jaw Relation Record; Mandibular Condyle
PubMed: 36074517
DOI: 10.1111/jopr.13603 -
Seminars in Musculoskeletal Radiology Oct 2023Scoliosis is a three-dimensional spinal deformity that can occur at any age. It may be idiopathic or secondary in children, idiopathic and degenerative in adults....
Scoliosis is a three-dimensional spinal deformity that can occur at any age. It may be idiopathic or secondary in children, idiopathic and degenerative in adults. Management of patients with scoliosis is multidisciplinary, involving rheumatologists, radiologists, orthopaedic surgeons, and prosthetists. Imaging plays a central role in diagnosis, including the search for secondary causes, follow-up, and preoperative work-up if surgery is required. Evaluating scoliosis involves obtaining frontal and lateral full-spine radiographs in the standing position, with analysis of coronal and sagittal alignment. For adolescent idiopathic scoliosis, imaging follow-up is often required, accomplished using low-dose stereoradiography such as EOS imaging. For adult degenerative scoliosis, the crucial characteristic is rotatory subluxation, also well detected on radiographs. Magnetic resonance imaging is usually more informative than computed tomography for visualizing associated canal and foraminal stenoses. Radiologists must also have a thorough understanding of postoperative features and complications of scoliosis surgery because aspects can be misleading.
Topics: Adult; Adolescent; Child; Humans; Scoliosis; Kyphosis; Radiography; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Spinal Fusion
PubMed: 37816361
DOI: 10.1055/s-0043-1772168 -
Soins; La Revue de Reference Infirmiere Jun 2024
Topics: Humans; Sitting Position; Standing Position
PubMed: 38880586
DOI: 10.1016/j.soin.2024.04.006 -
Vnitrni Lekarstvi 2023Orthostatic intolerance (OI) is defined as a group of diseases which symptoms are typically manifested in a standing position. These symptoms result from cerebral...
Orthostatic intolerance (OI) is defined as a group of diseases which symptoms are typically manifested in a standing position. These symptoms result from cerebral hypoperfusion and disappear in the supine position. We include postural orthostatic intolerance syndrome (POTS), orthostatic hypotension (OH) and vasovagal orthostatic syncope in this group of diseases. Each of them have similar clinical presentation (blurred vision, weakness, dizziness, nausea, headaches, fatigue). However, they vary from each other in biochemical, autonomic and hemodynamic characteristics. The aim of the work is to provide an overview of humoral and non-human markers that are involved in the etiopathogenesis of orthostatic intolerance.
Topics: Humans; Orthostatic Intolerance; Postural Orthostatic Tachycardia Syndrome; Syncope; Syncope, Vasovagal; Biomarkers
PubMed: 37827818
DOI: 10.36290/vnl.2023.066 -
Orthopadie (Heidelberg, Germany) Feb 2024To this day, patients with coccyx problems are the most frequently underestimated patient population in orthopedic practices. The clinical picture of coccygodynia was... (Review)
Review
BACKGROUND
To this day, patients with coccyx problems are the most frequently underestimated patient population in orthopedic practices. The clinical picture of coccygodynia was first described in 1859. Nevertheless, discussions about the importance of coccyx problems remain a tiresome topic. All patients have in common that they have gone through a long ordeal with many therapists, examinations and therapeutic approaches without having received a real diagnosis.
DIAGNOSTIC
The main symptom of coccygodynia is the pain directly on the lowest segment of the coccyx, which often only occurs when sitting and is intensified by the change in position, usually from a sitting to a standing position. Trauma can only be described as the trigger in 50% of cases. Women are four times more likely to be affected than men. The gold standard for imaging should be viewed from standing and seated dynamic lateral radiographs of the coccyx.
TREATMENT
After the diagnosis has been made, conservative treatment should first be started with oral NSAIDs, relief with a coccyx cushion with a recess and, if necessary, physiotherapy to strengthen or loosen the pelvic floor. Local infiltrations with a glucocorticoid and local anesthetic directly in the painful area are also often promising. If the symptoms persist for more than 6 months, surgical treatment in the sense of removing the coccyx can be discussed with the patient. The literature shows a success rate of 80-90% if the indication was correct.
Topics: Male; Humans; Female; Musculoskeletal Pain; Back Pain; Pelvic Pain; Pain Management; Coccyx
PubMed: 38167710
DOI: 10.1007/s00132-023-04467-2 -
Journal of Clinical Medicine Sep 2023Dysfunctions of the lumbosacral area and related pain syndromes, such as chronic low back pain (CLBP), are among the most common musculoskeletal problems in modern... (Review)
Review
Dysfunctions of the lumbosacral area and related pain syndromes, such as chronic low back pain (CLBP), are among the most common musculoskeletal problems in modern society. The purpose of this study was to evaluate the effectiveness of isolated myofascial release techniques (MFR) in the treatment of CLBP in adults. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched for studies published from 1 January 2013 to 1 March 2023. We included English-language randomized controlled trials evaluating the effect of isolated MFR performed by a specialist on adults with CLBP. Only studies with a comparison group without treatment or with sham MFR were included. A total of 373 studies were detected, of which 6 studies were finally included in this review. There was a total of 397 CLBP patients aged 18-60 in all study groups. The studies evaluated the effects of a series of MFR treatments as well as a single intervention. After applying a series of treatments, a statistically significant reduction in pain intensity, improvement in the range of motion, reduction in the level of functional disability and fear-avoidance beliefs, as well as a decrease in the activity of paraspinal muscles at maximum trunk flexion were demonstrated. A single, 40-min complex intervention involving tissues at various depths significantly reduced the level of pain, improved the range of motion, and reduced the resting activity of paraspinal muscles in the standing position, but did not affect postural stability. The use of a single 5 min MFR technique did not affect pain intensity and sensitivity and functional disability. The findings suggest that the use of a series of isolated MFR improves the condition of patients with CLBP by reducing the intensity of pain, improving functional efficiency, and reducing the activity of the paraspinal muscles in the position of maximum forward bend. The use of a single intervention containing a set of techniques covering superficial and deep tissue also reduces the intensity of pain, improves mobility, and reduces the resting activity of the paraspinal muscles in a standing position. Given the small number of eligible studies with limitations, conclusions should be interpreted with caution and avoid overgeneralizing the benefits of isolated MFR based on limited or mixed evidence.
PubMed: 37834787
DOI: 10.3390/jcm12196143 -
The Bone & Joint Journal Feb 2024The aim of this study is to evaluate whether acetabular retroversion (AR) represents a structural anatomical abnormality of the pelvis or is a functional phenomenon of...
AIMS
The aim of this study is to evaluate whether acetabular retroversion (AR) represents a structural anatomical abnormality of the pelvis or is a functional phenomenon of pelvic positioning in the sagittal plane, and to what extent the changes that result from patient-specific functional position affect the extent of AR.
METHODS
A comparative radiological study of 19 patients (38 hips) with AR were compared with a control group of 30 asymptomatic patients (60 hips). CT scans were corrected for rotation in the axial and coronal planes, and the sagittal plane was then aligned to the anterior pelvic plane. External rotation of the hemipelvis was assessed using the superior iliac wing and inferior iliac wing angles as well as quadrilateral plate angles, and correlated with cranial and central acetabular version. Sagittal anatomical parameters were also measured and correlated to version measurements. In 12 AR patients (24 hips), the axial measurements were repeated after matching sagittal pelvic rotation with standing and supine anteroposterior radiographs.
RESULTS
Acetabular version was significantly lower and measurements of external rotation of the hemipelvis were significantly increased in the AR group compared to the control group. The AR group also had increased evidence of anterior projection of the iliac wing in the sagittal plane. The acetabular orientation angles were more retroverted in the supine compared to standing position, and the change in acetabular version correlated with the change in sagittal pelvic tilt. An anterior pelvic tilt of 1° correlated with 1.02° of increased cranial retroversion and 0.76° of increased central retroversion.
CONCLUSION
This study has demonstrated that patients with symptomatic AR have both an externally rotated hemipelvis and increased anterior projection of the iliac wing compared to a control group of asymptomatic patients. Functional sagittal pelvic positioning was also found to affect AR in symptomatic patients: the acetabulum was more retroverted in the supine position compared to standing position. Changes in acetabular version correlate with the change in sagittal pelvic tilt. These findings should be taken into account by surgeons when planning acetabular correction for AR with periacetabular osteotomy.
Topics: Humans; Acetabulum; Hip Joint; Pelvis; Radiography; Tomography, X-Ray Computed; Retrospective Studies
PubMed: 38295849
DOI: 10.1302/0301-620X.106B2.BJJ-2023-0706.R1 -
Expert Opinion on Pharmacotherapy Feb 2024Postural tachycardia syndrome (POTS) is a disorder characterized by a constellation of symptoms including lightheadedness, fatigue, and palpitations when upright,... (Review)
Review
INTRODUCTION
Postural tachycardia syndrome (POTS) is a disorder characterized by a constellation of symptoms including lightheadedness, fatigue, and palpitations when upright, associated with an increase in the heart rate (HR) of > 30 beats per minute when changing from a lying down to standing position or head-up tilt position and not associated with orthostatic hypotension. The causes as well as the management of POTS are not quite fully understood.
AREAS COVERED
We performed a literature review on the diagnosis and management of POTS, and this article includes an overview of novel pharmacotherapeutic options for the treatment of (POTS), although an effective treatment has not been established.
EXPERT OPINION
POTS is a clinical syndrome characterized by a constellation of symptoms that are nonspecific. No single etiology or unified hypothesis could be identified. In fact, multiple pathophysiological mechanisms have been proposed, and none of the suggested medications have been approved by the FDA for this indication. Further understanding of the autonomic nervous system and its adjustment to standing position is needed to provide better management strategies.
Topics: Humans; Postural Orthostatic Tachycardia Syndrome; Hypotension, Orthostatic; Heart Rate; Fatigue; Dizziness
PubMed: 38465412
DOI: 10.1080/14656566.2024.2319224