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Huntington Disease is a chronically progressive and neurodegenerative disease, which leads to death after 10 to 30 years of suffering and worsening. When suffering Huntington Disease the patient will experience physical, cognitive and psychological issues, so that the patient won't be able to communicate or express his will in the end-of-life-phase of his disease. The problem is, after suffering a while the patient often won't be able to eat by himself, so a feeding tube must be implanted. In some cases a tracheostomy tube is needed because of the respiratory insufficiency. The cause of death in most cases is an infection like a respiratory disease. That's why it's most important when diagnosed with Huntington Disease to advance care planning to end-of-life care like life-sustaining measures that engages patients in decision-making regarding future care, while they are still able to make and express decisions by themselves.This article discusses the impact of the 'second' Vienna Medical School, hallmarked by Karl Rokitansky, Joseph Skoda and Ferdinand Hebra, on the study and practice of medicine in Hungary. Six medical doctors' lives and achievements are outlined, who formed a bridge between Vienna and Budapest through their studies and work. Four of them returned to Hungary and promoted the cause of medicine and medical education there. Lajos Arányi (1812-1877) founded in 1844 the Institute of Pathology at the University of Pest. János Balassa (1814-1868) took the Chair of the Surgical Department. Ignaz Philip Semmelweis (1818-1865), the 'Saviour of Mothers', received a position at the Department of Obstetrics and Gynaecology in Vienna in 1846. Gustav Scheuthauer (1832-1894) became Arányi's successor. Each of them continued to keep contact with their tutors in Vienna, especially with Karl Rokitansky, and followed the clinicopathological conception pioneered by the Vienna Medical School regarding diagnostics, treatment and prevention of diseases. Two physicians remained in Vienna Mór Kaposi (1837-1902), who became known worldwide posthumously due to the connection between Kaposi's sarcoma and AIDS, was the director of the Department of Dermatology of the Vienna University in 1878. Salomon Stricker (1837-1898) undertook the leadership of the Department of General and Experimental Pathology in 1872.At all times anatomists endeavored to procure scientific foundations for medicine. Tebipenem Pivoxil The anatomist dissected corpses in order to serve the living. The knowledge of anatomy is a prerequisite for the understanding of physiological and pathophysiological processes. In the "Hippocratic corpus" there is no clear reference to the performance of human autopsies. Anatomy was taught on a human corpse for the first time in Alexandria around 300 B.C. For more than 1300 years anatomy and medicine then stood under the influence of Galen of Pergamon (131-201 A.D.). The Italian Mondino dei Luzzi (1275-1326) was the first to introduce systematic anatomy lessons with a regular inclusion of teaching dissections in the teaching curriculum in Bologna. Andreas Vesalius (1514-1564) from Belgium founded the scientifically based human anatomy during the modern era and corrected many errors in the traditional views on anatomy of Galen. In the seventeenth and eighteenth centuries the Dutch universities, particularly the University of Leiden, were the leaders with respect to the clinical and practical student training.
The aim of this study was to evaluate the effects of multi-walled carbon nanotubes/hydroxyapatite (MWCNT/HA) granules with or without leukocyte- and platelet-rich fibrin (L-PRF) on bone regeneration in cancellous bone of sheep model.
Totally, 32 cylindrical holes were drilled in female sheep (n = 4) in the distal epiphysis and proximal metaphysis of right and left humerus and femur. The defects were randomly filled with (1) MWCNT/HA, (2) MWCNT/HA mixed with L-PRF, (3) L-PRF, and (4) left empty as control. After 8 weeks, defects were evaluated and compared radiographically using multi-slice computed tomographic (CT) scan and cone beam CT scans, histologically and histomorphometrically.
The results showed that there was no significant inflammation (> 10%) or foreign body reaction around the granules. The new lamellar bone was regenerated around the MWCNT/HA nanocomposite granules. Addition of L-PRF to MWCNT/HA demonstrated significantly improvement of new bone formation, about 27.40 ± 1.08%, in comparison with the L-PRF alone, about (12.16 ± 1.46%) (P < 0.01). Also, the rate of new bone formation was significantly greater with the use of MWCNT/HA granules (24.59 ± 1.54%) compared to the control (10.36 ± 1.17%) (P < 0.01).
Consequently, both biocompatibility and osteoconductivity of MWCNT/HA nanocomposite were demonstrated in the preclinical sheep model, and the use of L-PRF in combination with MWCNT/HA nanocomposite can improve bone regeneration.
Consequently, both biocompatibility and osteoconductivity of MWCNT/HA nanocomposite were demonstrated in the preclinical sheep model, and the use of L-PRF in combination with MWCNT/HA nanocomposite can improve bone regeneration.
The aim of this study is to investigate the association of oral dryness with overall survival and determine the threshold points of moisture degree for predicting 7-day survival in palliative care patients.
A total of 147 consecutive palliative care patients were included between January 2017 and November 2018. Oral dryness at the lingual and buccal mucosa was measured using an oral moisture-checking device. Overall survival was compared between patients with and without oral dryness using Kaplan-Meier curves with a log-rank test. Prediction accuracy was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC).
Median survival (95% confidence interval) in patients with oral dryness at the lingual mucosa was shorter than that in patients without oral dryness (17 [11-24] days vs. 28 [22-37] days, log-rank test, p <0.001), but not at the buccal mucosa. Time-dependent ROC revealed that the AUCs for 7-, 14-, 21-, and 28-day survival predictions were 0.72, 0.68, 0.61, and 0.