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ring phonation, suggesting a better phonatory efficiency.Secondary alveolar bone grafting (SABG) using autologous iliac crest cancellous bone is a standard procedure for patients with cleft lip and palate (CLP). The aim of this study was to evaluate patient satisfaction after bone grafting of the alveolar cleft. Patients who underwent SABG between 2000 and 2010 in one surgical centre were included in this cross-sectional study. Three questionnaires were used, one addressing functional and aesthetic outcomes (nine items), the second being the 14-item Oral Health Impact Profile (OHIP-G14), and the third addressing donor site morbidity. A total of 103 patients fulfilled the inclusion criteria, of whom 71 could be contacted, and 52 completed the questionnaires. The majority of the patients (98%) were satisfied with the aesthetic and functional results and reported low donor site morbidity. A significant correlation was found between scores from the patient satisfaction questionnaire and the OHIP-G14. Regarding overall patient satisfaction, the manifestation of the cleft had no significant influence. The questionnaires used allowed the assessment of subjective outcome parameters, but might not be absolutely specific and exclusive for the SABG procedure in the framework of comprehensive CLP therapy. Nevertheless, SABG using autologous iliac crest cancellous bone can be considered a highly satisfactory procedure.The aim of this study was to analyse the impact of postoperative positron emission tomography-computed tomography (PET-CT) before adjuvant treatment in oral squamous cell carcinoma (OSCC) patients. Patients with OSCC requiring adjuvant treatment following surgery were divided retrospectively into two groups based on the implementation of PET-CT. The study endpoints were disease-specific survival (DSS) and overall survival (OS). A total of 123 patients underwent PET-CT examination; 28 had abnormal images, but only seven were confirmed to be pathologically positive. A total of 145 patients underwent computed tomography/magnetic resonance imaging (CT/MRI) examination; 20 had abnormal images, but only one was confirmed to be pathologically positive. The median OS time was 5.4 years in the PET-CT group and 4.3 years in the CT/MRI group, demonstrating a significant difference (P = 0.024). Findings were similar for the median DSS time. In patients with positive PET-CT results, the median DSS was 4.3 years and median OS was 3.5 years, and in those with negative PET-CT results, the median survival time could not be calculated as fewer than 50% of patients reached these endpoints; both differences were significant (P = 0.007 and P less then 0.001). Although the false-positive rate of postoperative PET-CT is high, it improves the chance of survival through early and more frequent detection of recurrence.The aim of this study was to evaluate the safety of carbohydrate intake 2 hours before surgery in elderly patients undergoing free flap surgery for oral cancer. Elderly patients undergoing free flap surgery between September 2019 and January 2021 were randomly divided into control (n = 43) and intervention (n = 43) groups. Control group patients fasted for 6 hours and were forbidden from drinking water for 4 hours before surgery. Intervention group patients fasted for 6 hours and were forbidden from drinking after the oral administration of 5 ml/kg carbohydrate (≤400 ml) 2 hours before surgery. The main outcome measures were aspiration, fasting blood glucose level, insulin concentration, insulin resistance index (fasting at admission, prior to anaesthesia induction, immediately after surgery, and at 6 a.m. on postoperative days 1 and 2), and comfort before and after surgery. No aspiration occurred in any of the patients during anaesthesia. There were significant differences in fasting blood glucose, insulin concentration, and insulin resistance index between the control and intervention groups prior to anaesthesia induction, immediately after surgery, and on day 1 after surgery (P less then 0.01). Thirst (P = 0.001) and hunger (P = 0.003) differed significantly between the two groups prior to anaesthesia induction. The intake of oral carbohydrate 2 hours before surgery was both safe and effective for elderly patients with oral cancer undergoing free flap surgery and could relieve the physiological stress response.
During the COVID-19 pandemic, adolescent carers in the UK may have experienced psychological distress owing to increased caring burden and loss of a break from their caring role. This study investigated longitudinal association between adolescents' caring status and mental health outcomes from 2018/2019 to February-March2021.
The participants (n= 3,927) answered mental health questions in both the Millennium Cohort Study sweep 7 survey (age 17years in 2018/2019) and at least one of three waves of the COVID-19 survey from May 2020 to February-March 2021. Caring status at the age of 17years was assessed using a single question regarding whether the participant regularly looked after anyone who needed care, without being paid. Outcome measures were psychological symptoms, measured using the Kessler Distress Scale, and mental well-being, measured using the Warwick-Edinburgh Mental Well-being Scale.
Compared with 3,616 noncarers, 311 (7.9%) adolescent carers reported significantly higher Kessler Distress Scale and lower Warwick-Edinburgh Mental Well-being Scale scores during the pandemic. These associations were largely explained by psychosocial risk factors. Worse outcomes were associated with poor sleep quality, attempted suicide at baseline, low social support, and a strong feeling of loneliness during the pandemic. These factors were significantly more likely to be observed among adolescent carers than noncarers.
UK adolescent carers exhibited worsened mental health outcomes one year after the first national lockdown. This increased distress may be attributable to psychosocial risk factors during the pre-COVID-19 and current COVID-19 periods, and they require psychosocial support.
UK adolescent carers exhibited worsened mental health outcomes one year after the first national lockdown. This increased distress may be attributable to psychosocial risk factors during the pre-COVID-19 and current COVID-19 periods, and they require psychosocial support.Recently, Bikorimana et al. presented a new vaccine formulation, AccumTM, capable of eliciting efficient T cell-mediated immune responses and controlling tumour growth. AccumTM is designed to facilitate cross-presentation by breaking through endo/lysosomal membranes and enhancing delivery of antigens into the cytosol of dendritic cells (DCs).Women and men each represent about half the population, but people think of the concept person more as a man. Wardle et al. recently found that people also see face-like objects more as men than as women. This finding generates further questions on whether bias about concepts and faces might differ.Acromegaly is a rare disease characterized by changes in the bone and soft tissue systems, induced by excess growth hormone and insulin-like growth factor type 1. Among the skin lesions associated with acromegaly is cutis verticis gyrata, an hypertrophic, and coarse folding of the skin of the scalp, an association of uncommon incidence and unknown prevalence. This case report describes the case of a patient diagnosed with acromegaly at age 60 with previously unidentified cutis verticis gyrata. This report aims to review the literature on cutis verticis gyrata and its unusual association with acromegaly.
Patients with acute coronary syndrome complicated with cardiogenic shock (ACS-CS) frequently require mechanical circulatory support. In addition to veno-arterial extracorporeal membrane oxygenation (VA-ECMO), use of the Impella® (ECpella) (Abiomed Inc., Danvers, MA, USA) heart pump may improve the prognosis of such patients. In this study, we compared the efficacy of VA-ECMO plus intra-aortic balloon pumping (ECMO-IABP) with that of the ECpella for add-on circulatory support of VA-ECMO.
Clinical outcomes of 64 patients with ACS-CS treated with ECMO-IABP (n = 41) or ECpella (n = 23) between January 2013 and April 2021 were retrospectively analyzed. The primary outcomes were 30-day and 365-day mortality. In addition, patients resuscitated after cardiopulmonary arrest (CPA) were evaluated separately.
The ECpella group showed significantly lower mid-term mortality than the ECMO-IABP group [30-day mortality (39.1% vs 56.1%, respectively; p = 0.193) and 365-day mortality (43.5% vs 75.6%, respectively; p = 0.010)], with significantly higher rates of new hemodialysis and bleeding at the vascular access site. MALT1 MALT inhibitor Also, among the limited number of patients resuscitated from CPA, mortality was significantly lower in the ECpella group than the ECMO-IABP group [30-day mortality (28.6% vs 65.4%, respectively; p = 0.026) and 365-day mortality (28.6% vs 84.6%, respectively; p < 0.001)]. Among the resuscitated patients, ECMO weaning period and the incidence of neurological complications were related to 30-day mortality; The incidence of neurological complications was related to 365-day mortality. The use of ECpella was strongly associated with both 30-day and 365-day survival.
The ECpella heart pump may provide a survival advantage over ECMO-IABP in patients with ACS-CS.
The ECpella heart pump may provide a survival advantage over ECMO-IABP in patients with ACS-CS.
The distal radial approach (DRA) has been proposed as an alternative approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI). However, its outcomes in hemodialysis (HD) patients have not been well studied in detail. We aimed to determine the feasibility and safety of coronary intervention with the DRA for HD patients.
We performed CAG or PCI with the DRA in 2500 consecutive patients between October 2018 and February 2020. The patients included 98 HD patients (HD group) and 2402 non-HD patients (non-HD group). The primary endpoints were the rates of procedural success and puncture site-related complications. The secondary endpoints were puncture site-related complications one year after the procedure. As a subanalysis, we also compared the outcomes on the basis of CAG and PCI.
The procedural success rates were similar in the HD and non-HD groups (80.6% vs. 82.6%, p = 0.61 for the entire cohort; 78.3% vs. 80.9%, p = 0.58 for CAG; and 86.2% vs. 88.0%, p = 0.78 for PCI). The bleeding complications rates were low and there was no difference between groups (6.1% vs. 4.1%, p = 0.33 for the entire cohort; 0% vs. 2.2%, p = 0.21 for CAG; and 20.7% vs. 10.3%, p = 0.079 for PCI). Radial artery occlusion occurred in only one patient in the HD group after the procedure.
Although modified hemostasis methods could be necessary for HD patients undergoing PCI, coronary intervention with the DRA is feasible and safe for both HD and non-HD patients.
Although modified hemostasis methods could be necessary for HD patients undergoing PCI, coronary intervention with the DRA is feasible and safe for both HD and non-HD patients.
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