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Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: To study the consequences of temporomandibular joint injury and efficacy of arthrocentesis for treatment of post-traumatic internal temporoman-dibular disorders.
OBJECTIVE
The aim: To study the consequences of temporomandibular joint injury and efficacy of arthrocentesis for treatment of post-traumatic internal temporoman-dibular disorders.
PATIENTS AND METHODS
Materials and methods: 24 patients who experienced trauma history in the head without jaw fractures underwent CT, ultrasound and/or MRI. TMJ ar¬throcentesis was performed according to a modified method of D. Nitzan (1991) under local anesthesia by means of blockade of the peripheral branch of the auricular-temporal nerve on the background of intravenous sedation.
RESULTS
Results: The ages of the patients varied between 18 and 44 years, and mean was 32,58 years. The causes of trauma were diverse, as traffic accident - 3 (12,5%), assault 12 (50%), hit by materials 3 (12, 5%), and fall-down 6 (25%). According to clinical and radiological signs after traumatic temporomandibular disorders, patients were divided into two groups according to Wilkes classification (1989): 13 patients with stage II (early-middle) and 11 - with stage III (middle).The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 84.61% of patients with intra-articular disorders of the second degree, and in 72.72% of patients with internal disorders of the third degree, the position and function of the articular disc was restored.
CONCLUSION
Conclusions: Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has proven itself in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible.
Topics: Humans; Adolescent; Young Adult; Adult; Arthrocentesis; Temporomandibular Joint Disorders; Temporomandibular Joint; Fractures, Bone; Accidents, Traffic
PubMed: 36883504
DOI: 10.36740/WLek202301121 -
Journal of Stomatology, Oral and... Oct 2022YouTube has been increasingly used as a source of information by patients in the field of health, but many studies revealed poor information quality. This study...
BACKGROUND
YouTube has been increasingly used as a source of information by patients in the field of health, but many studies revealed poor information quality. This study evaluated the content and quality of YouTube videos on Temporomandibular Joint Arthrocentesis (TMJA) as an information resource for patients.
MATERIAL AND METHODS
YouTube search with the two keywords "temporomandibular joint arthrocentesis" and "temporomandibular joint lavage" was performed. The first 160 videos were listed for each term according to relevancy. Results were assessed for inclusion and categorized for source, purpose, target, arthrocentesis method described, and the narrator of the videos. An evaluation was performed independently by two oral and maxillofacial surgeons. The quality of videos was analyzed for the content and defined as poor, moderate, and excellent. DISCERN was also performed by scoring between 0 and 5.
RESULTS
A total of 43 videos were evaluated. The most upload source was individual users (46.5%) and the most video upload purpose was information for professionals (37.2%). The method with the most information about was the two-needle technic, which had a rate of 44.2 percent. The average usefulness score of the videos was 3.00 and 57.1% of the videos resulted in poor quality. A statistically significant positive high correlation was found between DISCERN and usefulness scoring (r = 0.793; p < 0.001).
CONCLUSION
The majority of YouTube videos are of poor quality and this situation affects the patients' decisions about treatment. Health professionals should be aware of the content on YouTube and produce high-quality, accurate, and up-to-date information for patient education.
Topics: Arthrocentesis; Humans; Social Media; Temporomandibular Joint; Video Recording
PubMed: 35278759
DOI: 10.1016/j.jormas.2022.03.011 -
Journal of Cranio-maxillo-facial... Jan 2023This retrospective study aimed to evaluate patient satisfaction with different temporomandibular joint (TMJ) treatments. Patients were included in the study according to...
This retrospective study aimed to evaluate patient satisfaction with different temporomandibular joint (TMJ) treatments. Patients were included in the study according to the following inclusion criteria: 1) arthrogenous and/or myogenous temporomandibular disorders (TMD); 2) Dimitroulis classification category between 1-4; 3) conservative treatment without any improvement at least for 3 months; 4) indication for one of the following TMD treatments: injection of botulinum toxin; arthrocentesis; arthroscopy, and open surgery without alloplastic material; and 5) age ≥16 years. An independent satisfaction questionnaire with 11 queries was applied via phone call to all patients, which included 6 questions using a 10-point Likert scale and 5 yes-or-no questions. The principal outcome was the overall satisfaction with the clinical result of the treatment, and the secondary outcomes were specific satisfaction with the following: 1) pain reduction; 2) range of mouth opening; 3) chewing ability; 4) postoperative recovery; 5) the fulfillment of expectations; 6) treatment choice; 7) treatment recommendation to a friend; and 8) the need for another intervention. Anxiety and depression were also included as variables. Data were analyzed using descriptive statistics, non-parametric Kruskal-Wallis and Spearman rank correlation coefficient tests. A total of 120 patients (mean age 41.20 ± 17.78 years) were enrolled, comprising 109 women (90%) and 11 men (10%). The overall clinical satisfaction of all patients was 8.24 ± 2.23 (mean ± SD), and 97 patients (80.8%) stated that they would repeat the treatment. Patients submitted to TMJ arthrocentesis and arthroscopy had higher overall clinical satisfaction (9.09 ± 0.971 and 9.03 ± 1.13, p = 0.021) followed by open surgery (8.38 ± 1.84). The authors observed three statistically significant correlations: 1) overall clinical satisfaction and patient expectations (r = 0.803; p < 0.0001); 2) overall clinical satisfaction and post-treatment pain (r = -0.299; p = 0.003); and (3) the presence of depression and the need for further TMJ treatment (r = 0.186; p = 0.043). Within the limitations of the study it seems that patient expectations should be addressed ad initium, and the presence of a diagnosis of depression with concomitant TMD must alert the clinical team and patient for the possible need of additional treatment.
Topics: Male; Humans; Female; Young Adult; Adult; Middle Aged; Adolescent; Retrospective Studies; Treatment Outcome; Patient Satisfaction; Range of Motion, Articular; Temporomandibular Joint; Temporomandibular Joint Disorders; Arthrocentesis; Pain; Patient Outcome Assessment
PubMed: 36739190
DOI: 10.1016/j.jcms.2023.01.006 -
JB & JS Open Access 2021The use of ultrasound guidance during knee arthrocentesis has proven to increase operator confidence and accuracy, particularly in novice healthcare providers. Realistic... (Review)
Review
BACKGROUND
The use of ultrasound guidance during knee arthrocentesis has proven to increase operator confidence and accuracy, particularly in novice healthcare providers. Realistic and practical means of teaching this procedure to medical trainees are needed. This study is intended to assess the feasibility and efficacy of using formalin-embalmed human cadavers in the instruction of ultrasound-guided knee arthrocentesis to medical trainees.
METHODS
Twenty participants received a 30-minute didactic orientation detailing the principles of ultrasound-guided knee arthrocentesis, followed by a training practicum performed on human cadavers. The practicum included a 25-minute training period, followed by a 15-minute assessment period. Participants were objectively assessed on their ability to independently aspirate synovial fluid from the suprapatellar bursa using ultrasound guidance. Digital pretraining and posttraining questionnaires were administered to evaluate each participant's confidence in their ability to independently locate the site of optimal needle placement and successfully aspirate synovial fluid with the guidance of ultrasound imaging.
RESULTS
An analysis via the Wilcoxon rank sum testing revealed that participant self-confidence increased significantly after training across all assessment items (p < 0.0001). Fifteen participants (75%) successfully aspirated 1 mL of synovial fluid on their first attempt, whereas 3 participants (15%) were successful on their second attempt. Two participants (10%) failed to perform a successful aspiration within the 15-minute time limit. The average time required to aspirate 1 mL of synovial fluid was 41 seconds.
CONCLUSIONS
Ultrasound images of the formalin-embalmed suprapatellar bursa are of sufficient quality to use in the instruction of arthrocentesis to medical trainees. Brief instruction using formalin-embalmed cadaver models significantly increases trainee confidence and prepares first-year medical students to successfully and independently perform ultrasound-guided knee arthrocentesis.
PubMed: 34522834
DOI: 10.2106/JBJS.OA.20.00071 -
American Journal of Physical Medicine &... May 2023
Topics: Humans; Arthrocentesis; Treatment Outcome; Temporomandibular Joint
PubMed: 36228201
DOI: 10.1097/PHM.0000000000002118 -
Case Reports in Critical Care 2023As the incidence of bacterial myositis and pyomyositis in the United States is rising, we aim to highlight the presentation of bacterial myositis which is known as a...
As the incidence of bacterial myositis and pyomyositis in the United States is rising, we aim to highlight the presentation of bacterial myositis which is known as a great imitator in tropical regions. This is a case report of a 61-year-old female patient with poorly controlled diabetes who presented initially with lateral hip pain and tenderness. This was initially believed to be septic arthritis and warranted arthrocentesis. What makes this case interesting is that what was believed to be a primary community-acquired MRSA myositis, which progressed to a life-threatening septic shock, happened in a nontropical area (Northeastern USA) and in a patient with no underlying recent muscle injury. This case serves to remind clinicians that infectious myositis is gaining more incidence in nontropical regions and can masquerade as septic arthritis, requiring a high index of suspicion. Normal muscle enzymes like CK and aldolase do not rule out myositis.
PubMed: 36895204
DOI: 10.1155/2023/5623876 -
International Journal of Environmental... Feb 2022Learning modifications particularly increased due to the SARS-CoV-2 pandemic, which made it necessary to offer distance health education for many months. Social media... (Review)
Review
Learning modifications particularly increased due to the SARS-CoV-2 pandemic, which made it necessary to offer distance health education for many months. Social media allows students to have interactive activities such as discussing specific subjects or sharing data with each other, and also to have interactions with their teachers and tutors. So, we aimed to compare the effects of the use of social media on knowledge, skills and perceptions in health students compared to other methods. We performed a systematic review on PubMed, ScienceDirect and Embase about comparative learning methods using social media. The search followed PRISMA guidelines, and the quality assessment of the studies was performed using the Medical Education Research Quality instrument (MERSQI). Eight studies were analyzed including 1014 participants. Mean age ranged from 19.9 to 23.4 years, and 70% were females. About 54.4% of the participants were medical students and 20.9% were dental students. The mean MERSQI was 11.7 ± 2.6. Various subjects were included-anatomy, cultural competences, sterile surgical techniques, radiology, arthrocentesis, medical pathologies and cariology. As far as knowledge evaluation was concerned, we found that the use of social media may have had a positive effect from a short-term point of view but results concerning skills were less consistent across studies. Students usually had a positive perception of the use of social media as a complementary method but not as a complete alternative so it is not excluded that this effect might result from an increase in working time. The impact on patient care should also be assessed in future studies.
Topics: Adult; COVID-19; Education, Medical; Female; Humans; SARS-CoV-2; Social Media; Students, Medical; Young Adult
PubMed: 35206401
DOI: 10.3390/ijerph19042205 -
JBJS Reviews Jan 2020» Septic arthritis of the knee is the most common type of septic arthritis in children, and it may result in irreversible joint damage. » Staphylococcus aureus is the... (Review)
Review
» Septic arthritis of the knee is the most common type of septic arthritis in children, and it may result in irreversible joint damage. » Staphylococcus aureus is the most common pathogen associated with septic arthritis, but other causative pathogens are possible in children with certain risk factors. » The diagnosis of septic arthritis of the knee is based on history and physical examination, blood tests, and arthrocentesis. » Empiric treatment with anti-staphylococcal penicillin or a first-generation cephalosporin is usually recommended but may be tailored according to local resistance patterns and clinical culture data. » Open or arthroscopic surgical debridement including extensive lavage is effective in eradicating infection, and most patients do not require additional surgical intervention.
Topics: Arthritis, Infectious; Child; Humans; Knee Joint
PubMed: 32105243
DOI: 10.2106/JBJS.RVW.19.00069 -
Journal of Clinical Medicine May 2023The aim of this review was to systematically map the research on the intra-articular administration of injectable platelet-rich fibrin (I-PRF) to the temporomandibular... (Review)
Review
The aim of this review was to systematically map the research on the intra-articular administration of injectable platelet-rich fibrin (I-PRF) to the temporomandibular joints (TMJs). Medical databases covered by the ACM, BASE, Google, NLM, and ResearchGate were searched on 23 February 2023. The assessment of the level of evidence was based on the Oxford Center for Evidence-Based Medicine 2011 scale. The risk of bias was assessed for randomized controlled trials with the RoB2 tool. Extracted data were tabulated, and the changes in effect values were calculated. A total of eight studies qualified, of which five trials on 213 patients were randomized and controlled (RCTs). In each of the RTC study groups, arthrocentesis was performed, and 1-2 mL per joint of I-PRF (700 rpm/3 min/60 g centrifugation) was administered. Articular pain in three months decreased to 0-25% of the initial pre-interventional values in the study and 38-50% in the control groups. Mandible mobility increased to 121-153% and 115-120% in the I-PRF groups and controls, respectively. The main limitations of the evidence were the small number of RCTs and the lack of any RCT study groups receiving I-PRF without prior arthrocentesis. In conclusion, supplementing the temporomandibular joint rinsing with I-PRF administration further relieves pain and improves mandible mobility. The lack of RCTs on the intra-articular administration of I-PRF as a stand-alone procedure encourages further research. This research received no external funding. The review protocol has not been previously published.
PubMed: 37176766
DOI: 10.3390/jcm12093326 -
Medicina (Kaunas, Lithuania) May 2023Emergency department (ED) overcrowding is a public health crisis that affects patient care quality. Space management in the ED can affect patient flow dynamics and...
Emergency department (ED) overcrowding is a public health crisis that affects patient care quality. Space management in the ED can affect patient flow dynamics and clinical practice. We proposed a novel design of the "emergency procedure zone" (EPZ). The purpose of the EPZ was to provide an isolated area for clinical practice and procedure teaching, to ensure a secure area with adequate equipment and monitors, and safeguard patient privacy and safety. This study aimed to analyze the impact of the EPZ on procedural practice and patient flow dynamics. This study was conducted at the ED of a tertiary teaching hospital in Taiwan. Data were collected from 1 March 2019 to 31 August 2020 (pre-EPZ period) and from 1 November 2020 to 30 April 2022 (post-EPZ period). Statistical analyses were performed using IBM SPSS Statistics software. This study focused on the number of procedures and length of stay in the emergency department (LOS-ED). Variables were analyzed using the chi-square test and Mann-Whitney U test. Statistical significance was defined as < 0.05. There were 137,141 (pre-EPZ period) and 118,386 (post-EPZ period) ED visits recorded during this period. The post-EPZ period showed a significant increase in central venous catheter insertion, chest tube or pigtail placement, arthrocentesis, lumbar puncture, and incision and drainage procedures ( < 0.001). For patients who were directly discharged from the ED, the post-EPZ period also had a higher percentage of ultrasound studies performed in the ED and a shorter LOS-ED for patients who were directly discharged from the ED ( < 0.001). The establishment of an EPZ in the ED has a positive impact on procedural efficiency. The EPZ improved diagnosis and disposition efficiency, shortened the length of stay, and provided benefits such as improved management, patient privacy, and teaching opportunities.
Topics: Humans; Retrospective Studies; Length of Stay; Emergency Service, Hospital; Time Factors; Hospitals, Teaching
PubMed: 37241133
DOI: 10.3390/medicina59050901