Notes

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The aim of this study was to analyze risk factors for failure of subclavian vein catheterization.

A retrospective analysis of 1562 patients who underwent subclavian vein puncture performed by the same experienced operator at Peking University Cancer Hospital from January 1, 2016 to January 1, 2019 was conducted. The success or failure of subclavian vein catheterization was registered in all cases. Various patient characteristics, including age, gender, body mass index (BMI), preoperative hemoglobin, preoperative hematocrit, preoperative mean corpuscular hemoglobin concentration (MCHC), preoperative albumin, preoperative serum creatinine, puncture needles from different manufacturers and previous history of subclavian vein catheterization were assessed via univariate and multivariate analyses.

For the included patients, landmark-guided subclavian vein puncture was successful in 1476 cases and unsuccessful in 86 cases (success rate of 94.5%). Successful subclavian vein catheterization was achieved via right and left subclavian vein puncture in 1392 and 84 cases, respectively. In univariate analyses, age and preoperative hemoglobin were associated with failure of subclavian vein catheterization. In a multivariate analysis, aged more than 60 years was a risk factor while the central venous access with Certofix® was associated with an increased rate of success (p-values of 0.001 and 0.015, respectively).

This study has demonstrated that patient aged more than 60 years was a risk factor for failure of subclavian vein catheterization while the central venous access with Certofix® was associated with an increased rate of success.
This study has demonstrated that patient aged more than 60 years was a risk factor for failure of subclavian vein catheterization while the central venous access with Certofix® was associated with an increased rate of success.Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by raised intracranial pressure of unknown etiology with normal cerebrospinal fluid (CSF) composition and no brain lesions. It occurs in pregnant patients at approximately the same frequency as in general population, but obstetric and anesthetic management of the pregnancy and labor remains controversial. In this article we provide a multidisciplinary review of the main aspects of IIH in pregnancy including treatment options, mode of delivery and anesthetic techniques. Additionally, we report three cases of pregnant women diagnosed with IIH between 2012 and 2019 in our institution.
Contemporary literature suggests a similar transverse stability of a surgical-assisted rapid palatal expansion and a segmented Le Fort I osteotomy. The aim of this study was to compare postoperative complications of 1-stage (segmental maxillary osteotomy) and 2-stage (surgical-assisted rapid palatal expansion followed by Le Fort I osteotomy) treated patients to determine the preferred treatment strategy.

This retrospective study included 74 consecutive patients (age range 14 - 57years; 36 males, 38 females) with a moderate transverse maxillary hypoplasia 32 patients were treated in a 1-stage protocol and 42 in a 2-stage protocol with a postoperative follow-up of at least 1year. Dental complications such as loss of teeth, gingival dehiscence, periodontal bone loss, apical root resorption, and surgical complications such as pain, hemorrhage, altered neurosensitivity, wound infection, aseptic necrosis were analyzed. Univariate analysis consisted of a generalized linear model with logit link or Fisher exact test.

No significant difference was found for group characteristics except for longer orthodontic treatment time in the 2-stage group. Incidence and severity of complications were comparable for the 1-stage and 2-stage patients. Only overall pain was significantly greater in the 2-stage patient group (P=.038).

Considering a similar complication rate and transversal stability, the choice between 1-stage and 2-stage approach for patients with a moderate transverse maxillary hypoplasia should be patient specific.
Considering a similar complication rate and transversal stability, the choice between 1-stage and 2-stage approach for patients with a moderate transverse maxillary hypoplasia should be patient specific.
This study was conducted to ascertain the efficacy of buccal injection of articaine compared to lidocaine in inducing palatal anesthesia in different maxillary regions.

This double-blinded, randomized clinical trial included 300 patients who referred for extraction of 1 maxillary tooth. Bozitinib The patients were categorized into 3 strata according to the extraction area (anterior, premolar, molar), and then randomly assigned to 2 groups based on the administered medication. The first group received buccal infiltration by 0.6mL of 2% lidocaine, whereas the second group was buccally administered using 0.6mL of 4% articaine. After a waiting period of 2minutes, the failure or success in achieving palatal anesthesia was assessed by the instrumentation technique. In cases of failed anesthesia, an additional 0.6mL of the same anesthetic was given, and the procedure was repeated if palatal anesthesia was not attained after a 2-minute delay. If pain remained 2minutes after the third injection, a supplemental palatal infiltration was administered and the extraction was attempted.

The success rate of buccal infiltration in achieving palatal anesthesia was 82.7% in the articaine group and 1.3% in the lidocaine group. There was a significant difference in the success rate and drug volume required to induce palatal anesthesia between the 2 groups (P<.001), but no significant difference was found between different maxillary regions, using either of the medications (P>.05).

Articaine can be considered as a suitable alternative to lidocaine for eliminating painful palatal infiltration in the extraction of maxillary teeth.
Articaine can be considered as a suitable alternative to lidocaine for eliminating painful palatal infiltration in the extraction of maxillary teeth.
This article describes the induced membrane technique (IMT) and presents 10 cases in which the technique was applied for segmental mandibular reconstruction.

Ten patients requiring segmental mandibular resection were reconstructed using the staged IMT. Mandibular resection, placement of a reconstruction plate and polymethylmethacrylate spacer, was performed. At the second procedure, the spacer was removed through a small incision and particulate autograft from the ilium was placed, in some cases with bone morphogenic protein.

Nine of the 10 patients achieved bony continuity with the IMT. Spacers were designed to optimize mandibular form and future implant-based restoration. All patients have either had implants placed or have adequate bone for implant placement. The average hospital length of stay for both surgeries combined was 3.1 nights.

The IMT can be successfully used to reconstruct segmental mandibular defects, allowing surgeons to create a neomandible with optimal form both for facial contour and for dental implant-based reconstruction.
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