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Medicina (Kaunas, Lithuania) Oct 2023: Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular diseases involving the temporomandibular joint complex and the...
The Effect of Arthrocentesis Treatment for Maximum Mouth Opening and Pain in Temporomandibular Joint Diseases and the Effect of Splint, Drug, and Physical Therapy on This Treatment.
: Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular diseases involving the temporomandibular joint complex and the surrounding muscle and osseous structure. TMD can be classified as intra-articular or extra-articular. The aim of this study was to evaluate the effect of arthrocentesis in terms of maximum mouth opening (MMO) and pain in patients with TMD of intra-articular origin. In addition to this treatment, the effects of factors such as splints, medication, and physical therapy on arthrocentesis were examined. : This retrospectively designed study was conducted with 79 patients who had previously undergone arthrocentesis. These patients were divided into three groups according to the Research Diagnostic Criteria for temporomandibular disorder: disc displacement (DD) with locking (Group 1), DD without locking (Group 2), and degenerative joint diseases (Group 3) groups. The maximum mouth opening (MMO) and visual analog score (VAS) values of the groups were recorded before arthrocentesis (Baseline: T0), on the third day after arthrocentesis (T1), and at the sixth month (T2) after arthrocentesis. Information about whether the patients received concurrent medical treatment, splint treatment, and physical therapy was also recorded. These data were compared between groups. : It was observed that the VAS scores in all three groups decreased from T1 compared to T0 ( < 0.05). Likewise, the MMO value increased in all groups at T1 compared to T0. ( < 0.05). It was observed that splint treatment, pain killer and muscle relaxant treatment, and physical therapy made no additional contribution to arthrocentesis in terms of reducing pain or increasing MMO value ( > 0.05). : Arthrocentesis was observed to be effective in terms of pain and function in TMJ patients in this study. It was observed that splint therapy, physical therapy, and medical therapy made no additional contribution to arthrocentesis in terms of MMO or pain.
Topics: Humans; Arthrocentesis; Splints; Retrospective Studies; Treatment Outcome; Range of Motion, Articular; Temporomandibular Joint Disorders; Pain; Physical Therapy Modalities; Mouth
PubMed: 37893485
DOI: 10.3390/medicina59101767 -
Medicine Jun 2021Mosaicism can be observed in karyotype analyses of amniotic fluid cells. Differentiating between true mosaicism and pseudomosaicism and determining mosaic proportions... (Observational Study)
Observational Study
Mosaicism can be observed in karyotype analyses of amniotic fluid cells. Differentiating between true mosaicism and pseudomosaicism and determining mosaic proportions can help avoid misjudgments by doctors and effectively reduce mental and physical harm to pregnant women. However, the detection of mosaicism and mosaic proportions via karyotype analysis and fluorescence in situ hybridization (FISH) is extremely complex. We have developed a novel approach, "segmental duplication quantitative fluorescent PCR" (SD-QF-PCR), to detect mosaicism and mosaic proportions.In this study, twenty control samples and fourteen mosaic samples were tested by first-line karyotype analysis; by second-line karyotype analysis, SD-QF-PCR and FISH were used to reassess fetal sex chromosome mosaicism and mosaic proportions.Detection of the 20 control samples by second-line karyotype analysis via FISH and SD-QF-PCR showed normal and consistent results. Among the 14 mosaic samples, the numbers of samples showing true mosaicism and pseudomosaicism detected by the three methods were 6 and 8, respectively.Our study demonstrates that SD-QF-PCR can be used as a complementary method to traditional cytogenetic analysis of amniotic fluid mosaics and has clinical application value.
Topics: Amniocentesis; Amniotic Fluid; Cells, Cultured; Feasibility Studies; Female; Humans; In Situ Hybridization, Fluorescence; Karyotyping; Mosaicism; Polymerase Chain Reaction; Pregnancy; Prenatal Diagnosis; Primary Cell Culture; Sex Chromosome Aberrations
PubMed: 34160397
DOI: 10.1097/MD.0000000000026331 -
ESC Heart Failure Oct 2021Effusive-constrictive pericarditis (ECP) is an uncommon diagnosis, frequently missed due to its heterogeneous presentation, but a potentially reversible cause of heart...
Effusive-constrictive pericarditis (ECP) is an uncommon diagnosis, frequently missed due to its heterogeneous presentation, but a potentially reversible cause of heart failure. A 62-year-old Caucasian male presented with remittent right heart failure and mild-moderate pericardial effusion. Following an initial diagnosis of idiopathic pericarditis, indomethacin was started, but the patient shortly relapsed, presenting with severe pericardial effusion and signs of cardiac tamponade, requiring pericardiocentesis. ECP was diagnosed on cardiac catheterization. Cardiac computed tomography showed non-calcified, mildly thickened and inflamed parietal pericardium. Pericardiectomy was performed with symptoms remission. On histological examination of pericardium, chronic non-necrotizing granulomatous inflammation was noted. Polymerase chain reaction assay was positive for non-tuberculous mycobacteria. This case represents a rare finding of ECP with unusual presentation due to atypical mycobacteriosis in a non-immunocompromised patient and in a non-endemic area. Pericardiectomy can be an effective option in cases unresponsive to anti-inflammatory treatment, even in the absence of significant pericardial thickening or calcification.
Topics: Cardiac Tamponade; Humans; Male; Middle Aged; Pericardial Effusion; Pericardiectomy; Pericardiocentesis; Pericarditis, Constrictive
PubMed: 34173727
DOI: 10.1002/ehf2.13470 -
Taiwanese Journal of Obstetrics &... Mar 2021The objective of this study was to report the first case of prenatal diagnosis of the fetal 20p13 microdeletion syndrome in the literature.
OBJECTIVE
The objective of this study was to report the first case of prenatal diagnosis of the fetal 20p13 microdeletion syndrome in the literature.
CASE REPORT
The mother was 31 years old and had a first trimester serum screening that indicated the fetus was at low risk. The prenatal ultrasound at 23 weeks of gestation showed mild ventriculomegaly (10.2 mm) and absent septum pellucidum. She underwent amniocentesis because of the abnormal imaging results. Karyotype analysis revealed normal results. Chromosome microarray analysis (CMA) was then performed to provide genetic analysis of the fetus and parents. CMA detected 317.902 kb deletion of 20p13 in fetus. Finally, pregnancy was terminated at 32 weeks of gestation.
CONCLUSION
This study is the first to report the prenatal diagnosis of a 20p13 microdeletion syndrome. Our results further confirmed that genes in this region, including SOX12, NRSN2 are essential for normal fetal growth and TBC1D20 for normal brain development.
Topics: Abortion, Induced; Adult; Amniocentesis; Chromosome Deletion; Chromosome Disorders; Chromosomes, Human, Pair 20; Female; Humans; Karyotyping; Pregnancy; Prenatal Diagnosis
PubMed: 33678341
DOI: 10.1016/j.tjog.2021.01.015 -
Medicine Mar 2023This study aimed to evaluate the clinical efficacy of minimally invasive puncture and drainage (MIPD) versus trepanation and drainage in the treatment of chronic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study aimed to evaluate the clinical efficacy of minimally invasive puncture and drainage (MIPD) versus trepanation and drainage in the treatment of chronic subdural hematoma (CSDH).
METHODS
PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched for studies on the treatment of CSDH by MIPD and trepanation and drainage. By reading the title, abstract and full text, and screening according to the inclusion and exclusion criteria, the qualified articles were confirmed. Subsequently, the literature quality was evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions, and the data of the research subjects and the primary outcome measures were extracted for meta-analysis with RevMan 5.1 software.
RESULTS
Ten articles were included, with a total of 1000 patients. According to the meta-analysis, the 2 groups showed no statistical difference in CSDH recurrence rate (P > .05). The operation time, intraoperative blood loss, and incidence of postoperative adverse reactions were lower and the cure rate was higher in the MIPD group compared with trepanation and drainage group (all P < .05). By drawing the funnel plot of the outcome measures with heterogeneity, it can be seen that the distribution on both sides of the funnel was basically symmetrical, suggesting a low deviation possibility of the analysis results and reliable reference significance of our findings.
CONCLUSION
Compared with trepanation and drainage, MIPD has better clinical effects and higher safety in treating CSDH and can effectively reduce surgery-induced damage, which is worth popularizing in clinical practice.
Topics: Humans; Trephining; Hematoma, Subdural, Chronic; Paracentesis; Drainage; Treatment Outcome; Recurrence
PubMed: 36930074
DOI: 10.1097/MD.0000000000032860 -
Prenatal Diagnosis Jul 2022Chorioamnionitis is present in up to 70% of spontaneous preterm births. It is defined as an acute inflammation of the chorion, with or without involvement of the amnion,... (Review)
Review
Chorioamnionitis is present in up to 70% of spontaneous preterm births. It is defined as an acute inflammation of the chorion, with or without involvement of the amnion, and is evidence of a maternal immunological response to infection. A fetal inflammatory response can coexist and is diagnosed on placental histopathology postnatally. Fetal inflammatory response syndrome (FIRS) is associated with poorer fetal and neonatal outcomes. The only antenatal diagnostic test is amniocentesis which carries risks of miscarriage or preterm birth. Imaging of the fetal immune system, in particular the thymus and the spleen, and the placenta may give valuable information antenatally regarding the diagnosis of fetal inflammatory response. While ultrasound is largely limited to structural information, MRI can complement this with functional information that may provide insight into the metabolic activities of the fetal immune system and placenta. This review discusses fetal and placental imaging in pregnancies complicated by chorioamnionitis and their potential future use in achieving non-invasive antenatal diagnosis.
Topics: Amniocentesis; Chorioamnionitis; Female; Fetal Diseases; Humans; Infant, Newborn; Placenta; Pregnancy; Premature Birth; Systemic Inflammatory Response Syndrome
PubMed: 35670265
DOI: 10.1002/pd.6188 -
BMJ Case Reports Mar 2021A 23-year-old woman was diagnosed with Graves' disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She...
A 23-year-old woman was diagnosed with Graves' disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She developed progressive respiratory dyspnoea [New York Heart Association (NYHA) class III] and frequent palpitations. On emergency admission, the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats per minute), with an oxygen saturation of 94%. She also presented with cold, swollen and shaky extremities, with extended capillary filling time, and a significant reduction in heart sounds. Echocardiogram showed massive pericardial effusion compatible with cardiac tamponade. Pericardiocentesis was performed, with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of pericardial effusion secondary to Graves' disease was determined and corticotherapy, lithium carbonate, cholestyramine and phenobarbital were prescribed. An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.
Topics: Adult; Cardiac Tamponade; Female; Graves Disease; Humans; Methimazole; Pericardial Effusion; Pericardiocentesis; Young Adult
PubMed: 33685911
DOI: 10.1136/bcr-2020-239772 -
Journal of the American College of... Sep 2020
Topics: Colchicine; Drainage; Humans; Neoplasm Recurrence, Local; Pericardial Effusion; Pericardiocentesis
PubMed: 32972533
DOI: 10.1016/j.jacc.2020.08.008 -
Amniocentesis to diagnose congenital cytomegalovirus infection following maternal primary infection.American Journal of Obstetrics &... Jul 2022Congenital cytomegalovirus infection following maternal primary cytomegalovirus infection affects approximately 0.4% of newborns in the United States but may be hard to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Congenital cytomegalovirus infection following maternal primary cytomegalovirus infection affects approximately 0.4% of newborns in the United States but may be hard to diagnose prenatally.
OBJECTIVE
To evaluate the current sensitivity and specificity of amniocentesis in detecting congenital cytomegalovirus infection.
STUDY DESIGN
Secondary analysis of a multicenter randomized placebo-controlled trial designed to evaluate whether cytomegalovirus hyperimmune globulin reduces congenital cytomegalovirus infection in neonates of individuals diagnosed with primary cytomegalovirus infection before 24 weeks of gestation. At randomization, subjects had no clinical evidence of fetal infection. Eligible subjects were randomized to monthly infusions of cytomegalovirus hyperimmune globulin or placebo until delivery. Although not required by the trial protocol, amniocentesis following randomization was permitted. The fetuses and neonates were tested for the presence of cytomegalovirus at delivery. Comparisons were made between those with and without amniocentesis and between those with cytomegalovirus-positive and negative results, using chi-square or Fisher exact test for categorical variables and the Wilcoxon rank sum test or t test for continuous variables. A P value of <.05 was considered significant.
RESULTS
From 2012 to 2018, 397 subjects were included, of whom 55 (14%) underwent amniocentesis. Cytomegalovirus results were available for 53 fetuses and neonates. Fourteen amniocenteses were positive (25%). Gestational age at amniocentesis was similar between those with and without cytomegalovirus present, as was the interval between maternal diagnosis and amniocentesis. The prevalence of fetal or neonatal infection was 26% (14/53). The neonates of all 12 subjects with a positive amniocentesis and available results had cytomegalovirus infection confirmed at delivery, as did 2 neonates from the group of 41 subjects with a negative amniocentesis, with a sensitivity of 86% (95% confidence interval, 57-98), specificity of 100% (95% confidence interval, 91-100), positive predictive value of 100% (95% confidence interval, 74-100), and negative predictive value of 95% (95% confidence interval, 83-99). Amniocentesis-positive pregnancies were delivered at an earlier gestational age (37.4 vs 39.6 weeks; P<.001) and had lower birthweights (2583±749 vs 3428±608 g, P=.004) than amniocentesis-negative pregnancies.
CONCLUSION
Amniocentesis results are an accurate predictor of congenital cytomegalovirus infection.
Topics: Amniocentesis; Cytomegalovirus; Cytomegalovirus Infections; Female; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious
PubMed: 35526782
DOI: 10.1016/j.ajogmf.2022.100641 -
Journal of Perinatal Medicine Jul 2023Early diagnosis and treatment of intra-amniotic infection is crucial. Rapid pathogen identification allows for a definite diagnosis and enables proper management. We...
OBJECTIVES
Early diagnosis and treatment of intra-amniotic infection is crucial. Rapid pathogen identification allows for a definite diagnosis and enables proper management. We determined whether the 16S amplicon sequencing performed by a nanopore sequencing technique make possible rapid bacterial identification at the species level in intra-amniotic infection.
METHODS
Five cases of confirmed intra-amniotic infection, determined by either cultivation or 16S rDNA polymerase chain reaction (PCR) Sanger sequencing, and 10 cases of women who underwent mid-trimester genetic amniocentesis were included. DNA was extracted from amniotic fluid and PCR was performed on the full-length 16S rDNA. Nanopore sequencing was performed. The results derived from nanopore sequencing were compared with those derived from cultivation and Sanger sequencing methods.
RESULTS
Bacteria were successfully detected from amniotic fluid using nanopore sequencing in all cases of intra-amniotic infection. Nanopore sequencing identified additional bacterial species and polymicrobial infections. All patients who underwent a mid-trimester amniocentesis had negative cultures, negative 16S PCR Sanger sequencing and nanopore sequencing. Identification of the microorganisms using nanopore sequencing technique at the bacterial species level was achieved within 5-9 h from DNA extraction.
CONCLUSIONS
This is the first study demonstrating that the nanopore sequencing technique is capable of rapid diagnosis of intra-amniotic infection using fresh amniotic fluid samples.
Topics: Pregnancy; Humans; Female; Chorioamnionitis; Nanopore Sequencing; Nanopores; Amniotic Fluid; Amniocentesis; Bacteria
PubMed: 36503654
DOI: 10.1515/jpm-2022-0504