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Many individuals, irrespective of their age, sex and social status suffer from halitosis. There is very little evidence, however, of the disease burden in Ghana. The aim of this study was to determine the prevalence and associated factors of self-perceived halitosis in La, a suburb in Accra.
This was a cross-sectional study conducted among adults in La. The main outcome variable was self-perceived halitosis. Other variables collected included the socio-demographic characteristics (age, sex, occupation category, education), previous visit to a dentist, and previous/current consumption of alcohol. Background characteristics for all respondents were described, and summaries for variables reported. Cross-tabulations were done to explore the factors related to self-perceived halitosis.
A total of 324 participants were involved in the study. selleck chemicals This consisted of 165 males (51%) and 159 females (49%). The mean age of the entire population was 41.2±14.9 years. The prevalence of self-perceived halitosis among the study population was 18%, while halitosis was found to be significantly distributed among persons with bleeding gums (p=0.007) and those who poorly rated their oral hygiene (p<0.001).
Halitosis is a source of concern to a considerable number of inhabitants of La. Education in this regard is therefore essential in promoting awareness and better oral health practices.
Halitosis is a source of concern to a considerable number of inhabitants of La. Education in this regard is therefore essential in promoting awareness and better oral health practices.
Pneumonia contributes largely to mortality among children particularly in developing countries. In 2018, about 15% of all deaths in children aged less than 5 years were attributed to pneumonia globally. This study aimed to identify factors at presentation that determine mortality among children less than 5 years of age hospitalized with pneumonia.
This was a prospective observational study conducted at the Children emergency unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Subjects were consecutive children aged between 1-60 months with clinical and radiological pneumonia. Treatment outcome and determinants of mortality were studied.
A total of 129 subjects were studied with a male to female ratio of 1.5 1. Thirteen subjects died, giving a case fatality rate of 10.1%. Mortality was associated with age <24 months (p= 0.001), severe wasting (p< 0.001), temperature >38.30C (p= 0.001), grunting (p< 0.001), central cyanosis (p < 0.001), hypoxaemia (p < 0.001), loss of consciousness (p = 0.007), severe anaemia (p < 0.001), and leucopaenia (p = 0.001). Among the significant variables, temperature >38.30C [adjusted odds ratio (OR) 34.241, 95% confidence interval (CI) 2.496 - 469.815], grunting (OR 19.444, 95% CI 1.744 - 216.725), central cyanosis (OR 43.984, 95% CI 2.001- 966.729), hypoxaemia (OR 41.883, 95% CI 1.918 - 914.495) and severe anaemia (OR 48.201, 95% CI 3.351 - 693.432) were the independent determinants of mortality.
Children hospitalized for pneumonia with temperature >38.30C, grunting, cyanosis, hypoxaemia, and severe anaemia are more likely to die. Hence, they must be treated intensively.
38.30C, grunting, cyanosis, hypoxaemia, and severe anaemia are more likely to die. Hence, they must be treated intensively.
We assessed clinical parameters in patients confirmed to have COVID-19 in relation to arterial hypoxaemia and survival.
This was a retrospective chart review of patients who were confirmed positive for SARS-CoV-2 virus by Real Time-Polymerase Chain Reaction (RT-PCR) testing. Data extracted from patients' case files included patient demographics, presenting symptoms, provisional diagnoses, and outcomes of hospitalisation. Descriptive variables were summarized; proportions were compared using Chi-square tests, and independent predictors of mortality were assessed using multivariate regression analysis. A p-value of < 0.05 was considered as statistically significant.
There were a total of 61 patients with positive RT-PCR testing mean age ± SD (minimum - maximum) was 53.0 ± 18.5 (5 months - 90) years. Persons aged 60 years and above were the largest group (n=24, 39.3%). More than half were male (n=35, 57.4%); about 43% had one morbidity; 41.0% had at least two co-morbidities. The mean (SD) arterial oxygehe COVID-19 fight.EDITORIAL.EDITORIAL.The demand for bone grafting procedures in various fields of medicine is increasing. Existing substitutes in clinical practice do not meet all the criteria required for an ideal bone scaffold, so new materials are being sought. This study evaluated bone regeneration using a critical-size Wistar rat's calvarial defect model. 12 male and 12 female rats were evenly divided into 3 groups 1. Negative and positive (Geistlich Bio-Oss®) controls; 2. polylactic acid (PLA) and PLA/hydroxyapatite (HA); 3. PLA/HA cellularised with dental pulp stem cells (DPSC) and PLA/HA extracellular matrix (ECM) scaffolds. link2 PLA/HA filament was created using hot-melt extrusion equipment. All scaffolds were fabricated using a 3D printer. DPSC were isolated from the incisors of adult Wistar rats. The defects were evaluated by micro-computed tomography (µCT) and histology, 8 weeks after surgery. link3 µCT revealed that the Bio-Oss group generated 1.49 mm3 and PLA/HA ECM 1.495 mm3 more bone volume than the negative control. Histology showed a statistically significant difference between negative control and both (Bio-Oss and PLA/HA ECM) groups in rats of both genders. Moreover, histology showed gender-specific differences in all experimental groups and a statistically significant difference between cellularised PLA/HA and PLA/HA ECM groups in female rats. Qualitative histology showed the pronounced inflammation reaction during biodegradation in the PLA group. In conclusion, the bone-forming ability was comparable between the Bio-Oss and PLA/HA ECM scaffolds. Further research is needed to analyse the effects of ECM and PLA/HA ratio on osteoregeneration.
Contemporary Australian epidemiological data on acute pulmonary embolism (PE) are lacking.
To determine the admission rates of acute PE in Australia, and to assess the temporal trends in short- and medium-term mortality following acute PE.
Retrospective population-linkage study of all New South Wales residents admitted with a primary diagnosis of PE between January 1, 2002 and December 31, 2018 using data from the Centre for Health Record Linkage databases. Main outcome measures included temporal trends in total PE admissions and all-cause mortality at prespecified time points up to 1 year, stratified by gender.
There were 61,607 total PE admissions between 2002 and 2018 (mean ± standard deviation 3,624 ± 429 admissions per annum; 50.42 ± 3.70 admissions per 100,000 persons per annum). The mean admission rate per annum was higher for females than for males (54.85 ± 3.65 vs. 44.91 ± 4.34 admissions per 100,000 persons per annum, respectively) and remained relatively stable for both genders througho follow-ups between 2002 and 2018 with greater reductions in females despite their higher admission rates over time.
Emicizumab prophylaxis improves coagulation function in congenital hemophilia A, regardless of inhibitor presence. We recently reported that emicizumab enhanced the coagulant potentials, ex vivo
in plasmas from patients with acquired hemophilia A (PwAHAs) at diagnosis. However, coagulant effects of emicizumab in PwAHAs during the clinical course remain unclear.
To assess ex vivo coagulant effects of emicizumab in PwAHAs during the clinical course.
Blood samples were obtained from 14 PwAHAs on (median) days 0 and 6 during a severe-bleeding phase, and days 27 and 59 during a reduced-bleeding phase with elevated endogenous factor VIII (FVIII) and decreased inhibitor titers. If administered a single dose of 3 or 6 mg/kg, or two doses at 6 mg/kg followed by 3 mg/kg, estimated plasma emicizumab concentrations (10/5/2.5, 20/10/5, and 30/15/7.5 µg/mL on days 0-7/30/60, respectively) could be used to represent potential changes, based on the half-life (
∼30 days). Emicizumab concentrations that covered maximum plasma concentrations of each dosage were used for spiking on day 0. Ex vivo addition of estimated emicizumab to PwAHA's plasma containing endogenous FVIII and/or inhibitor, without and with recombinant (r)FVIIa administration during immunosuppressive therapy, increased the calculated Ad|min1| values, assessed by clot waveform analysis, and their coagulant potentials were below normal levels. Rotational thromboelastometry revealed that ex vivo emicizumab addition resulted in the further improvement of coagulant potentials in whole bloods when combined with rFVIIa administration.
Based on ex vivo and in vitro data, emicizumab has the potential to be effective in clinical situations for PwAHAs.
Based on ex vivo and in vitro data, emicizumab has the potential to be effective in clinical situations for PwAHAs.
Clipping is still considered the treatment of choice for middle cerebral artery (MCA) aneurysms due to their angioarchitectural characteristics as they are often bifurcation dysplasias, needing a complex reconstruction rather than a simple exclusion. Thus, maintaining this surgical expertise is of paramount importance to train of young cerebrovascular surgeons. To balance for the increasingly limited experience due the worldwide general inclination toward the endovascular approaches, it is important to provide to the young neurosurgeons rules and operative nuances to guide this complex surgery. We describe the technical algorithm we use to teach our residents to approach ruptured and unruptured MCA aneurysms, which may help to develop a procedural memory useful to perform an effective and safe surgery.
We reviewed our last 10 years' institutional experience of about 400 cases of ruptured and unruptured MCA aneurysms clipping, analyzing our technical refinements and the difficulties in residents and young neurosurgeons teaching, to establish fundamental key-points and design a didactic algorithm that includes operative instructions and safety rules.
We recognized seven pragmatic technical key points regarding craniotomy, sylvian fissure opening, basal cisternostomy, proximal vessel control, lenticulostriate arteries preservation, aneurysm neck microdissection, and clipping to use as a didactic algorithm for teaching residents, and as operative instructions for inexperienced neurosurgeons.
In the setting of clipping MCA aneurysms, respect for surgical rules is of paramount importance to perform an effective and safe procedure, ensure the best aneurysm exclusion, and preserve the flow in collaterals and perforators.
In the setting of clipping MCA aneurysms, respect for surgical rules is of paramount importance to perform an effective and safe procedure, ensure the best aneurysm exclusion, and preserve the flow in collaterals and perforators.
Different types of skull base tumors and intracranial aneurysms may lead to compression of the optic pathways. Since most of them are biologically benign conditions, the first aim of surgery is preservation of optic nerves rather than the oncologic radicality.
Based on the progressive technical refinements coming from our institutional experience of optic nerve compression from aneurysms and extra-axial tumors, we analyzed the surgical steps to release nerves and chiasm during tumor debulking and aneurysm clipping.
We distinguished vascular and tumor lesions according to the main direction of optic nerve compression lateral to medial, medial to lateral, inferior to superior, and anterior to posterior. We also identified four fundamental sequential maneuvers to release the optic nerve, which are (1) falciform ligament (FL) section, (2) optic canal unroofing, (3) anterior clinoid process drilling, and (4) optic strut removal. The FL section is always recommended when a gentle manipulation of the optic nerve is required.
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