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The aim of phonosurgery is to improve voice quality and efficiency by performing precise, minimally invasive, conservative treatment. Magnified visualization of the vocal folds is mandatory to achieve optimal results; operative microscopy has been utilized so far to perform phonosurgery. In recent decades, the use of an exoscope (extracorporeal telescope) has been proposed in several fields of surgery that necessitate magnification. Further technological advancements have enabled 3-dimensional (3D) technology to be added to existing exoscopes. Recently, a motorized holding arm (the ARTip Cruise System) was developed to allow smooth precise positioning of the 3D Vitom exoscope (Karl Storz, Tuttlingen, Germany) by the surgeon without need for assistance. To evaluate the feasibility of phonosurgery by means of this innovative system, we utilized it for six consecutive procedures for benign laryngeal pathologies, including two vocal fold polyps, two cysts, one Reinke's edema and one unilateral vocal fold paralysis treated by fat augmentation. All procedures were performed without any technical difficulty and with excellent results at follow-up, as demonstrated by GRBAS, VHI-10 and maximal phonation time evaluations. selleck kinase inhibitor Main advantages of this technique were the enhanced depth of field and high definition of anatomical details. Communication with the operating room team was facilitated by the shared view of the same images on screen; furthermore, the surgeon could perform the procedures visualizing the surgical site without need to position the eyes on the microscope eyepieces and so being able to wear full face protection, which was of paramount importance in the era of the COVID-19 pandemic. In conclusion, the 4K 3D exoscope system with the ARTip Cruise System represents a promising innovation in the field of voice surgery to allow highly precise procedures optimizing safety and co-operation with the operating room team.The widespread extrapulmonary complications of coronavirus disease 2019 (COVID-19) have gained momentum; the pancreas is another major target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we take a closer look into potential pathological interactions. We provide an overview of the current knowledge and understanding of SARS-CoV-2 infection of the pancreas with a special focus on pancreatic islets and propose direct, indirect, and systemic mechanisms for pancreas injury as result of the COVID-19-diabetes fatal bidirectional relationship.
The objectives of this study were to assess the changes in right vs left nasal cavity volumes and minimum cross-sectional width, nasopharyngeal, and oropharyngeal volumes of the upper airway in response to rapid maxillary expansion (RME).
Pretreatment and posttreatment cone-beam computed tomography scans of 28 patients with a mean age of 9.86±2.43years and 20 age- and sex-matched controls were digitized and linear, angular, and volumetric measurements were obtained.
Nasopharyngeal volume, right, and left nasal cavity volumes, and minimum cross-sectional widths increased significantly 2years post RME (P<0.05). These measurements did not show any significant increase in the control group (P>0.05), whereas the oropharyngeal volume increase for both groups was comparable (P=0.92). In the experimental group, the right and left nasal cavity volumes were not significantly different at baseline or posttreatment. However, the change that occurred was significantly larger for the left nasal cavity. This change for the control group was more significant for the right nasal cavity. Maxillary right and left molar inclinations were positively correlated to the nasal cavity volume, showing that the more buccally inclined the maxillary molars were, the smaller the nasal cavity volume.
Nasopharyngeal and right and left nasal cavity volumes and minimum cross-sectional widths increase significantly after RME in young children. Expansion decreases the degree of difference in volume between the right and left nasal cavities. The buccal inclination of maxillary molars is correlated with nasal cavity volume.
Nasopharyngeal and right and left nasal cavity volumes and minimum cross-sectional widths increase significantly after RME in young children. Expansion decreases the degree of difference in volume between the right and left nasal cavities. The buccal inclination of maxillary molars is correlated with nasal cavity volume.
Control of overbite is considered essential in achieving ideal orthodontic outcomes. Questions have been raised regarding the accuracy of ClinCheck software (AlignTechnology, Santa Clara, Calif) in predicting posttreatment outcomes with Invisalign, with the paucity of well-researched literature available on this topic. This research aimed to investigate and determine the accuracy of Invisalign (Align Technology) in correcting a deep overbite by comparing the outcomes predicted by ClinCheck with achieved posttreatment outcomes.
A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcome (ClinCheck) stereolithography files of 42 adult patients consecutively treated with Invisalign from January 2014 and completed before July 2018, selected from the files of 1 experienced orthodontist. Patients included in the study were treated without extractions and with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. The pretreatment, posttreatment, and predicted outcome stereolithography files for each patient were imported into Geomagic Control X (3D Systems, Rock Hill, SC) software to measure overbite.
The deeper the patient's initial overbite and the greater the amount of programmed reduction in overbite according to ClinCheck, the greater the discrepancy in overbite expression posttreatment. ClinCheck over-predicted overbite reduction in 95.3% of patients in which, on average, only 39.2% of the prescribed overbite reduction was expressed.
Overbite reduction may result in suboptimal outcomes when using the Invisalign appliance unless remedial measures are employed. The deeper the initial overbite, the more challenging it is to achieve the prescribed posttreatment overbite.
Overbite reduction may result in suboptimal outcomes when using the Invisalign appliance unless remedial measures are employed. The deeper the initial overbite, the more challenging it is to achieve the prescribed posttreatment overbite.
Torque in orthodontics is the activation of the archwire for the third-order movement of teeth. During this force transfer mechanism from the twisted archwire, the bracket is prone to deformation. This study aimed to compare the deformation in tie wings and the slot region of the bracket during torque using finite element analysis.
Three-dimensionally modeled 0.017×0.025-in and 0.019×0.025-in stainless steel (SS) and titanium molybdenum alloy archwires were assembled in 0.018-in and 0.022-in solid modeled SS edgewise brackets, respectively. The finite element model of the bracket-archwire combinations was developed with contact boundary conditions. The deformation between tie wings and the slot was analyzed for various angles of twist.
For SS archwires at 30° angle of twist, the tie wings deformation in 0.018-in and 0.022-in brackets were 48.67μm and 34.87μm, respectively. The slot deformations of 0.018-in and 0.022-in brackets were 66.33μm and 45.69μm, respectively. Similarly, the amount of deformation in the bracket-titanium molybdenum alloy archwire combinations were also presented.
The slot deformation was more than the tie wings deformation as the slot walls bear the immediate torque force. Thus, orthodontic researchers should know that the torque-relevant bracket deformation should ideally be evaluated in the slot region rather than the tie wings.
The slot deformation was more than the tie wings deformation as the slot walls bear the immediate torque force. Thus, orthodontic researchers should know that the torque-relevant bracket deformation should ideally be evaluated in the slot region rather than the tie wings.
This cross-sectional study sought to assess clinical features and 3-dimensional distribution of unilateral impacted maxillary central incisors and identify factors associated with the root morphology.
Cone-beam computed tomography (CBCT) images from 94 subjects exhibiting unilateral impacted maxillary incisors were selected and evaluated. Original CBCT data were reconstructed using Mimics software (version 17.0; Materialise, Belgium). Clinical features and 3-dimensional distribution of impacted maxillary central incisors and factors associated with the root morphology were observed and analyzed by 2 orthodontists.
This patient cohort included 52 male patients and 42 female patients. Thirty-three incisors (35.11%) with dilacerated roots, 17 incisors (18.09%) with retained deciduous teeth, 15 incisors (15.96%) with supernumerary teeth, and 15 incisors (15.96%) with a history of trauma were identified in the study. Of the 94 impacted incisors, the most common were labially impacted (n=65; 69.15%), followed for diagnosing impacted maxillary central incisors and for making appropriate treatment plans for patients.Somatic mutations have traditionally been associated with cancer, yet more recently, it was realized that they also appear in nontransformed cells beginning in early life. Remarkably, some of these mutations, commonly viewed as cancer driver mutations, are widely spread among cells of noncancerous tissues, sometimes affecting the majority of the tissue cells. This spreading process intensifies upon aging or exposure to extrinsic insults, such as UV irradiation, inhaling smoke, and inflammatory cues. Whereas classic driver mutations in normal cells are mostly viewed as a first step in the carcinogenesis process, here, we speculate that in certain states, they can play beneficial homeostatic roles while confronting stress and aging tissue repair.
Intensive care unit diaries are often used to support patients during their psychological recovery. The intensive care unit stay can be upsetting, disturbing and traumatic for both patients and their families especially when the patient does not survive.
To investigate the connection between intensive care unit diaries and the grieving process experienced by family members of adult patients deceased in the intensive care unit.
Systematic literature review according to PRISMA guidelines PubMed, CINAHL and Cochrane Library were consulted. The Caldwell's framework was used for the quality appraisal.
Only six studies examine this topic. The potential benefits of intensive care unit diaries in family members' bereavement process may be an aid to realise how extremely ill their loved one was, may provide comfort and may help relatives to cope with their loss.
The use of intensive care unit diaries to help family members' bereavement process may be a useful tool but further research is necessary to better understand their role and benefits.
The use of intensive care unit diaries to help family members' bereavement process may be a useful tool but further research is necessary to better understand their role and benefits.