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The Journal of Oral Implantology Feb 2013When placing dental implants, there may be a surgical flap to reposition. The flap can be sutured or held in place with a stent that protects the flap and maintains its...
When placing dental implants, there may be a surgical flap to reposition. The flap can be sutured or held in place with a stent that protects the flap and maintains its position and immobility. Use of a bis-acryl stent may be preferable to sutures or other materials in many cases. Bis-acryl is easily applied from an auto-mixing gun. Stents may be preferable to sutures in that there is no "wicking effect," where bacteria colonize the suture beneath the healing surgical wound. Additionally, many times there is no submucosa to suture to, and the sides of the wound may not allow appropriate flap positioning and immobility with sutures. In these situations an acryl stent may be placed for easy and proper flap positioning and healing.
Topics: Acrylic Resins; Dental Implantation, Endosseous; Humans; Stents; Surgical Flaps; Wound Healing
PubMed: 22804806
DOI: 10.1563/AAID-JOI-D-11-00129 -
Progres En Urologie : Journal de... Dec 2008Tubeless PCNL has been promoted by Bellman in 1997 and consists in a PCNL without placing a nephrostomy tube at the end of the procedure. Double J stent or ureteral...
Tubeless PCNL has been promoted by Bellman in 1997 and consists in a PCNL without placing a nephrostomy tube at the end of the procedure. Double J stent or ureteral stent are the most common internal drainage used but totally tubeless PCNL has been described by using no ureteral stent. Tubeless PCNL is safe and efficient. Exclusion criteria to propose a tubeless procedure are significant bleeding or purulent renal discharge. Stone size or location, shape, position or function of the kidneys are also irrelevant with regard to tubeless PCNL. A nephrostomy tube should be placed if a second look is necessary. Some hemostatic agents have been described but none has really proved its efficacy. The results of the more recent series of the literature will be presented.
Topics: Humans; Kidney Calculi; Nephrostomy, Percutaneous
PubMed: 19033051
DOI: 10.1016/j.purol.2008.09.045 -
Social Science & Medicine (1982) Dec 1998Health is affected by the places in which people live, work and interact, yet many epidemiological studies overlook the characteristics of places and instead focus...
Health is affected by the places in which people live, work and interact, yet many epidemiological studies overlook the characteristics of places and instead focus solely on the people who inhabit them. Place-based investigations of disparities in health outcomes are concerned with the healthiness of places and not merely the healthiness of the populations in these places. A place-based approach has been used within medical geography and medical sociology, typically in the study of health differentials associated with long-term, cumulative exposures to a wide range of environmental variables. This approach has rarely been extended, however, to health research that looks at the effects of extreme events (such as industrial accidents or hurricanes). The purpose of this paper is to incorporate a place-based framework into extreme event health research. The paper first discusses methodological considerations for a place-based approach and then illustrates the use of spatial analysis techniques as the first step in identifying place-based risk factors in mortality associated with heat waves. The study centers on St. Louis, Missouri, a city where heat waves are frequent and heat-related mortality is high. The results show that heat-related mortality rates during the most severe heat waves were generally higher in the warmer, less stable and more disadvantaged areas of St. Louis and lower in the cooler and more affluent parts of the city. During the milder years analyzed, there was little evidence of a relationship between place-based characteristics and the distribution of heat-related mortality. These findings about extreme event mortality risk would not have been evident from a population-based analysis. Ongoing dialog between epidemiologists and social scientists can help to bring place into the arena of extreme event research and to increase understanding of the role of place in risk.
Topics: Health Status Indicators; Hot Temperature; Humans; Missouri; Mortality; Socioeconomic Factors; Topography, Medical
PubMed: 9877350
DOI: 10.1016/s0277-9536(98)00237-8 -
Journal of Endodontics Jul 2009The purpose of this national study was to assess endodontists' opinions regarding whether endodontists should place dental implants.
INTRODUCTION
The purpose of this national study was to assess endodontists' opinions regarding whether endodontists should place dental implants.
METHODS
A written survey was developed and mailed to 1505 randomly selected practicing endodontists within the United States.
RESULTS
The response rate was 46%. Univariate, bivariate, and logistic regression analyses were performed. Fifty-seven percent of respondents supported endodontists placing implants. Currently 5.7% of respondents place implants. Regression analyses identified the following variables as being positively associated with endodontists placing implants: graduation from an endodontic training program >or=10 years ago (p = .002); interest in placing implants in the future (p = .0001); the belief that implant placement should be incorporated into the endodontic residency curriculum (p < .0001); the belief that general dentists would support endodontists placing implants (p < .0001); and the desire to continue the rapport with a referred patient by placing an implant if the patient's tooth is nonrestorable (p < .0001).
CONCLUSIONS
The majority of responding endodontists believed that dental implant placement is within the scope of endodontic practice. Governing bodies of the specialty of endodontics might consider discussing whether formal implant training should be incorporated into future curricula.
Topics: Attitude of Health Personnel; Curriculum; Dental Implantation; Dentists; Endodontics; Female; Humans; Logistic Models; Male; Middle Aged; Surveys and Questionnaires; United States; Workforce
PubMed: 19567316
DOI: 10.1016/j.joen.2009.04.021 -
Journal of Neurophysiology Jul 2010It has been suggested that the kinematics of a reach-to-grasp movement, performed within an action sequence, vary depending on the action goal and the properties of...
It has been suggested that the kinematics of a reach-to-grasp movement, performed within an action sequence, vary depending on the action goal and the properties of subsequent movement segments (action context effect). The aim of this study was to investigate whether the action context also affects action sequences that consist of several grasping movements directed toward different target objects. Twenty participants were asked to perform a sequence in which they grasped a cylinder, placed it into a target area, and subsequently grasped and displaced a target bar of a certain orientation. We specifically tested whether the orientation of the target bar being grasped in the last movement segment influenced the grip orientation adapted to grasp and place the cylinder in the preceding segments. When all movement segments within the sequence were easy to perform, results indeed showed that grip orientation chosen in the early movement segments depended on the forthcoming motor demands, suggesting a holistic planning process. In contrast, high accuracy demands in specifying a movement segment reduced the ability of the motor system to plan and organize the movement sequence into larger chunks, thus causing a shift toward sequential performance. Additionally, making the placing task more difficult resulted in prolonged reaction times and increased the movement times of all other movement segments.
Topics: Adult; Biomechanical Phenomena; Brain; Female; Hand Strength; Humans; Male; Middle Aged; Movement; Orientation; Psychomotor Performance; Reaction Time; Space Perception; Young Adult
PubMed: 20457862
DOI: 10.1152/jn.00097.2010 -
Injury Apr 2016Incorrectly placed fasciotomy incisions can lead to catastrophic complications in compartment syndrome. Two distinctly different techniques are widely practiced to... (Clinical Trial)
Clinical Trial
UNLABELLED
Incorrectly placed fasciotomy incisions can lead to catastrophic complications in compartment syndrome. Two distinctly different techniques are widely practiced to decompress the anterior and peroneal compartments. In one technique the anterior compartment is decompressed directly, and then the peroneal via the inter-muscular septum, avoiding the peroneal perforators. The second technique relies on surface anatomy landmarks to place the skin incision immediately over the inter-muscular septum, and then the respective fascial envelopes are incised separately. A study in healthy active volunteers was conducted to explore the feasibility of a new technique for the placing the incision very accurately over the inter-muscular septum and so avoiding perforator vessels. Hypothesis The inter-muscular septum can be reliably identified using hand-held ultrasound, and confirmed with MRI.
METHODS
Fourteen healthy active volunteers underwent hand-held ultrasound to identify the antero-lateral inter-muscular septum in the left lower limb, which was then marked using cod liver oil capsules. The positions of the anterior, septal and peroneal perforators were then identified using hand-held Doppler, and marked in the same way. MRI was then used to measure the relationship between the surface land marks, the septum (compared to its US position), and the relationship of the perforators themselves.
RESULTS
Hand held ultrasound was successful in identifying the position of the inter-muscular septum in healthy volunteers, as confirmed on MRI scanning. The position and number of peroneal and anterior perforators proved very variable. Direct decompression of the anterior compartment would result in the loss of all anterior perforators in all subjects. Decompression with the skin incision over the inter-muscular septum would not jeopardise any peroneal muscular perforators.
CONCLUSION
This new technique enables decompression both the anterior and peroneal compartments through an accurately placed incision, sparing the greatest number of perforators. Two brief case histories in which the technique was used are presented.
Topics: Adult; Clinical Competence; Compartment Syndromes; Decompression, Surgical; Endosonography; Fasciotomy; Feasibility Studies; Female; Healthy Volunteers; Humans; Lower Extremity; Magnetic Resonance Angiography; Male; Peroneal Nerve; Postoperative Complications; Risk Factors; Saphenous Vein
PubMed: 26948239
DOI: 10.1016/j.injury.2016.02.007 -
Seizure Dec 2020There is a harmful myth that persists in modern culture that one should place objects into a seizing person's mouth to prevent "swallowing the tongue." Despite expert... (Review)
Review
OBJECTIVE
There is a harmful myth that persists in modern culture that one should place objects into a seizing person's mouth to prevent "swallowing the tongue." Despite expert guidelines against this, the idea remains alive in popular media and public belief. We aimed to investigate the myth's origins and discredit it.
METHODS
A medical and popular literature review was conducted for the allusions to "swallowing one's tongue" and practice recommendations for and against placing objects into a seizing person's mouth. Current prevalence of these beliefs and relevant anatomy and physiology were summarised.
RESULTS
The first English language allusions to placing objects in a patient's mouth occurred in the mid-19th century, and the first allusions to swallowing one's tongue during a seizure occurred in the late 19th century. By the mid-20th century, it was clear that some were recommending against the practice of placing objects in a patient's mouth to prevent harm. Relatively recent popular literature and film continue to portray incorrect seizure first aid through at least 2013. There is ample modern literature confirming the anatomical impossibility of swallowing one's tongue and confirming the potential harm of putting objects in a patient's mouth.
CONCLUSION
One cannot swallow their tongue during a seizure. Foreign objects should not be placed into a seizing person's mouth. We must continue to disseminate these ideas to our patients and colleagues. As neurologists, we have an obligation to champion safe practices for our patients, especially when popular media and culture continue to propagate dangerous ones.
Topics: Deglutition; First Aid; Humans; Mouth; Public Health; Seizures; Tongue
PubMed: 33080482
DOI: 10.1016/j.seizure.2020.09.023 -
The Pan African Medical Journal 2022Medical research in the United States remains a global reference, endowed with unrivalled financing, a source of endless advancements, and recognized with many...
Medical research in the United States remains a global reference, endowed with unrivalled financing, a source of endless advancements, and recognized with many accolades; with 45 per cent of the winners, the United States outrageously dominates the Nobel Prize for Medicine. The volume of health spending in the United States is far more than any other country; however, the health outcomes are far below expectation. An American child Born in 2016 will live on average 78.6 years, which places the country around the thirty-fifth place in the world, somewhere between Cuba and Qatar; the United States has other modest results, as evidenced by the ranking of countries in terms of infant mortality in 2015, which placed the country 33 out of 35 member countries, ahead of only Turkey and Mexico. Although the United States ranks 35th out of 190 countries based on infant mortality in 2015, it is still far behind Cuba, which was 30 and the first "non-high" income country. In 2016, US health expenditures/gross domestic product (GDP) exceeded 16%, with an average of 10,000 USD/inhabitants, while Cuban health expenditures/GDP did not exceed 11% during the same period. We aim through the present work to show that the state of health doesn't improve by spending more. However, it improves by spending more on programs that we know from the evidence can improve health outcomes.
Topics: Delivery of Health Care; Gross Domestic Product; Health Expenditures; Health Facilities; Humans; Income; United States
PubMed: 36034037
DOI: 10.11604/pamj.2022.42.95.35133 -
Journal of Endourology Sep 2012To assess the necessity of placing a ureteral stent after transperitoneal laparoscopic ureterolithotomy (TPLU). (Clinical Trial)
Clinical Trial
PURPOSE
To assess the necessity of placing a ureteral stent after transperitoneal laparoscopic ureterolithotomy (TPLU).
PATIENTS AND METHODS
In the period from May 2006 to November 2010, 46 patients underwent TPLU. There were 13 females and 33 males. All patients had an impacted stone larger than 1.5 cm in the upper and middle parts of the ureter. TPLU was performed as either a primary therapy or as a salvage therapy in patients in whom another treatment had failed. The exclusion criteria were pregnancy, a body mass index more than 35, and patients with abnormal results on coagulative tests. In all cases, after removing the stone, the ureter was sutured. In the first 23 patients, no ureteral catheter was placed, but in the second 23 patients, a Double J catheter was inserted through the ureter.
RESULTS
In one case, the stone was pushed back. The stone-free rate was 97.8%. There were four cases of prolonged urinary leakage after the surgery. All of them were in the group in whose members the Double J catheter had not been placed. The problem was resolved in one patient spontaneously after 4 days, but for the other three patients, a Double J catheter was placed and the leakage was stopped in 24 hours. There was no case of urinary leakage in the second group of patients with a placed Double J catheter.
CONCLUSION
Placing a Double J catheter during surgery does not increase the time of operation and may play a role in prevention of urinary extravasation after laparoscopic ureterolithotomy.
Topics: Adult; Demography; Female; Humans; Intraoperative Care; Laparoscopy; Male; Postoperative Care; Ureteral Calculi; Urinary Catheters; Urologic Surgical Procedures
PubMed: 22540150
DOI: 10.1089/end.2012.0082 -
Annales Pharmaceutiques Francaises Nov 2022As the healthcare system changes, the pharmacist's place does. In this context the health institutions are looking for improving prevention and so realize how well... (Review)
Review
INTRODUCTION
As the healthcare system changes, the pharmacist's place does. In this context the health institutions are looking for improving prevention and so realize how well placed pharmacists were. For their competences as well as the trust patients are giving, they are serious actors in the implementation of prevention.
METHODS
We sought to understand which place pharmacists take in prevention policies. Thus, we have proceeded with an analysis of bibliography of the past ten years about articles registered in Medline talking about pharmacist's places in French prevention.
RESULTS
We have selected 47 articles classified according to San Marco's 3 levels of prevention: universal, oriented or targeted prevention. The pharmacist is involved in universal prevention, cancer screening or the proper use of antibiotics. In targeted prevention, they are specifically interested in the proper use of medicines and their correct prescription to patients. Finally, for targeted prevention, they offer patients therapeutic education adapted to their needs.
CONCLUSIONS
We can highlight that pharmacists improve consequently the patient's quality of life. They also enhance connections between health care professionals. Thanks to pharmacists, patients can find easy access and reliable health advice and government, trustworthy support for prevention.
Topics: Humans; Pharmacists; Quality of Life; Public Health; France; Anti-Bacterial Agents; Hospitals; Professional Role
PubMed: 35151625
DOI: 10.1016/j.pharma.2022.02.004