Αρχειοθήκη ιστολογίου

Κυριακή 20 Μαρτίου 2022

Endoscopic surgery for intraconal orbital tumors

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HNO. 2022 Mar 17. doi: 10.1007/s00106-022-01156-y. Online ahead of print.

ABSTRACT

Traditionally, external craniofacial approaches have been used for orbital tumor resection. Over the last 30 years, endoscopic sinonasal and skull base techniques have become widely used throughout the world. These experiences paved the way for the extension of transnasal endoscopic techniques to the intraconal orbit. Transnasal endoscopic intraconal surgery has several advantages regarding mo rbidity and outcome as compared with purely external approaches. However, the anatomical knowledge and experience of the surgeon is crucial for the success of the surgery. Endoscopic approaches for intraconal tumor removal are feasible for medial and inferior lesions as well as for lesions lateral to the optic nerve provided they remain inferior to the "plane of resectability" and no optic nerve retraction is required. As intraorbital tumors are rare, new international staging systems including CHEER (Cavernous Hemangioma Exclusively Endonasal Resection) and ORBIT (Orbital Resection by Intranasal Technique) help to standardize safety, efficacy, and outcome.

PMID:35298667 | DOI:10.1007/s00106-022-01156-y

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Evaluation of thermal plasma process for treatment disposal of solid radioactive waste

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J Environ Manage. 2022 Mar 14;311:114895. doi: 10.1016/j.jenvman.2022.114895. Online ahead of print.

ABSTRACT

The management of radioactive waste is a worldwide activity based on the guidelines of the International Atomic Energy Agency (IAEA), and all stages of management require scientifically proven methods for possible deployment. The management of radioactive waste is a huge challenge due to the high risk in the collection, gathering, transport, handling, and storage. In this s tudy, a thermal plasma treatment process was evaluated for its efficiency to process solid radioactive waste. Experiments were carried out with the application of stable isotopes of Lead, Iodine, Cobalt, and Cesium. After the thermal plasma treatments, the slag and the residual gas were analyzed to verify the influence of process time and discharge power on the efficiency of the process. The treatment for 25 min and 10 kW was sufficient to reduce the mass by 50% of the slag. When the applied power was increased to 15 kW, an expressive reduction in the treatment time (10 min) was able to promote the same mass reduction. The results indicated that the treatment of radioactive waste by thermal plasma is a promising method to manage and reduce the mass and volume for the final disposal.

PMID:35299134 | DOI:10.1016/j.jenvman.2022.114895

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Three-dimensional analysis of mandible ramus morphology and transverse stability after intraoral vertical ramus osteotomy

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Surg Radiol Anat. 2022 Mar 18. doi: 10.1007/s00276-022-02912-z. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to investigate short- and long-term postoperative changes of both morphology and transverse stability in mandibular ramus after intraoral vertical ramus osteotomy (IVRO) in patients with jaw deformity using three-dimensional (3D) orthognathic surgery planning treatment software for measurement of distances and angles.

STUDY DESIGN: T his retrospective study included consecutive patients with skeletal Class III malocclusion who had undergone intraoral vertical ramus osteotomy and computed tomography images before (T0), immediately after (T1), and 1 year after (T2) surgery. Reference points, reference lines and evaluation items were designated on the reconstructed 3D surface models to measure distances, angles and volume. The average values at T0, T1, T2 and time-dependent changes in variables were obtained.

RESULTS: After surgery, the condylar length, ramal height, mandibular body length and mandibular ramus volume were significantly decreased (P < 0.01), while clinically insignificant change was observed from T1 to T2. The angular length was increased immediately after surgery (P < 0.05), but it was decreased 1 year after surgery (P < 0.05). Lateral ramal inclination showed significant increase after surgery (P < 0.05) and maintained at T2.

CONCLUSION: Changes in the morphology of the man dibular ramus caused by IVRO do not obviously bring negative effect on facial appearance. Furthermore, despite position and angle of mandibular ramus changed after IVRO, good transverse stability was observed postoperatively. Therefore, IVRO technique can be safely used without compromising esthetic results.

PMID:35303119 | DOI:10.1007/s00276-022-02912-z

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Association Between Anxiety and Descending Pain Modulation of Thermal Stimuli in Patients with Burning Mouth Syndrome: A Cross-Sectional Study

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J Oral Facial Pain Headache. 2022 Winter;36(1):67-77. doi: 10.11607/ofph.3050.

ABSTRACT

AIMS: To investigate the predictive power of depression and anxiety for conditioned pain modulation (CPM) and to examine the relationships of CPM at 40°C and CPM at 47°C with age, disease-related pain, pain duration, and psychosocial factors in burning mouth syndrome (BMS).

METHODS: A total of 22 patients with BMS and 22 healthy female controls participated in this study. Temporal summation was used as the test stimulus for CPM, and subsequent exposure either to a nonpainful (40°C) or a painful (47°C) Peltier thermode was used as the conditioning stimulus. CPM was calculated as the difference in pain perception following the conditioning stimulus. Psychosocial factors were examined using the Profile of Mood States (POMS) and the State-Trait Anxiety Inventory (STAI).

RESULTS: State anxiety and tension-anxiety scores were significantly higher for patients with BMS than for control participants. Multiple regression analyses showed that CPM47°C was affected by vigor, fatigue, confusion, and trait anxiety (adjusted R2 = 0.685, F = 5.147, P = .098). The corresponding analysis for CPM40°C showed that the model was not predictive for the following variables: disease-related pain, pain duration, or components of the POMS or STAI. A significant positive correlation was found between CPM47°C and trait anxiety, suggesting that trait anxiety negativ ely affected the endogenous pain modulation system.

CONCLUSION: Increases in trait anxiety reduced the CPM effect. These findings suggest that CPM impairments and increases in trait anxiety are involved in the development of BMS.

PMID:35298577 | DOI:10.11607/ofph.3050

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Impact of Stress and Trait Anxiety on the Sensory and Jaw Motor Responses to a Tonic Orofacial Nociceptive Stimulus

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J Oral Facial Pain Headache. 2022 Winter;36(1):26-35. doi: 10.11607/ofph.3048.

ABSTRACT

AIMS: To investigate how trait anxiety and stress jointly affect the sensory and jaw motor responses to a tonic orofacial nociceptive stimulus.

METHODS: Orthodontic separators were placed between the first molars in 45 adults with low (n = 14), intermediate (n = 17), and high (n = 14) trait anxiety. Tooth pain, occlusal discomfort, tooth clenching (as a jaw motor behavior), and situ ational stress were measured three times a day for 5 days using visual analog scales. Mixed-effects regression models were used to evaluate the sensory and motor outcome measures.

RESULTS: Pain, discomfort, and frequency of tooth-clenching trajectories were affected by trait anxiety (P = .007, P < .001, and P = .055, respectively) and stress (P < .001, P < .001, and P = .044, respectively). Individuals with high anxiety reported their highest pain (17.7 ± 2.9 mm) and discomfort (35.2 ± 4.1 mm) 24 hours earlier than those with low anxiety (pain: 15.9 ± 2.6 mm, discomfort: 28.8 ± 3.7 mm). Tooth clenching decreased progressively in response to the stimulus (P < .001).

CONCLUSION: A tonic orofacial nociceptive stimulus triggers an avoidance jaw motor behavior. Both trait anxiety and situational stress heighten the sensory response to such a stimulus, but weakly affect the motor response to it.

PMID:35298573 | DOI:10.11607/ofph.3048

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A Narrative Review of Therapeutic Peripheral Nerve Blocks for Chronic Orofacial Pain Conditions

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J Oral Facial Pain Headache. 2022 Winter;36(1):49-58. doi: 10.11607/ofph.3017.

ABSTRACT

AIMS: To provide an analysis of the different therapeutic peripheral nerve blocks (PNBs), as well as their limitations and the related evidence base for their use in chronic orofacial pain (OFP) conditions, excluding migraine and other headache conditions.

METHODS/RESULTS: The evidence base for therapeutic PNBs for chronic OFP is poor and highlights the need for improved research in this area. The diagnostic criteria and interventional PNB definitions and techniques varied between studies. In addition, the placebo effect of a peripheral injection and its resultant bias was rarely considered. Most of the PNB interventions for temporomandibular disorders were for arthrogenous disorders (arthritis and disc entrapment with pain). However, there is emerging evidence for the use of onabotulinum toxin (BTX-A) in trigeminal neuralgia, with four prospective randomized controlled trials (pRCTs), and for postherpetic neuralgia. However, despite high-level evidence for BTX-A in posttraumatic neuropathic pain outside the trigeminal system, there is no evidence for its use for PTNP within the trigeminal system.

CONCLUSION: There may be emerging evidence for treating trigeminal neuralgia with BTX-A injections; however, there is a need for future clinical studies of therapeutic PNBs in orofacial pain conditions.

PMID:35298575 | DOI:10.11607/ofph.3017

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Evaluation of About Face: A Psychology and Physiotherapy Pain Management Program for Adults with Persistent Facial Pain

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J Oral Facial Pain Headache. 2022 Winter;36(1):21-25. doi: 10.11607/ofph.2924.

ABSTRACT

AIMS: To evaluate About Face, a pain management program aimed at increasing quality of life in adults living with persistent facial pain through psychology- and physiotherapy-based skill development.

METHODS: A total of 90 patients attended a six-session program with a 1-month follow-up between 2015 and 2019. Patients filled out self-reported outcome measures preprogram, postprogram , and at a 1-month follow-up visit.

RESULTS: There was a significant reduction in pain catastrophizing and a significant increase in engagement in meaningful activity, as well as a reduction in pain-related interference.

CONCLUSION: This evaluation adds to the small amount of existing literature on interventions aimed at increasing quality of life in patients living with persistent facial pain and provides suggestions for future research.

PMID:35298572 | DOI:10.11607/ofph.2924

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Short-term Effects of a First-Line Treatment Including Counseling and Self-Management Strategies on Chronic TMD Muscle Pain and Awake Bruxism in Women

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J Oral Facial Pain Headache. 2022 Winter;36(1):36-48. doi: 10.11607/ofph.3037.

ABSTRACT

AIMS: To evaluate the short-term effects of a standardized first-line noninvasive approach (FL-A) including counseling and self-management strategies on pain, masticatory muscle tenderness, and awake bruxism in women with chronic temporomandibular disorder myalgia (mTMD) and to test whether patients' trait anxiety predicted their response to treatment.

METHODS: FL-A was administered to 14 women with chronic mTMD (mean age ± SD = 33.8 ± 11.1 years; 8 with Graded Chronic Pain Scale [GCPS] grade I and 6 with grade II). Its effects on facial pain, masticatory muscle tenderness, and spontaneous awake bruxism episodes were evaluated using questionnaires, surface electromyography, and quantitative sensory testing. General linear models were used to test FL-A efficacy after 1 (T1) and 2 (T2) months.

RESULTS: FL-A reduced pain (from baseline [T0] to T2, P = .010), the frequency of awake bruxism episodes (T0 to T1, P = .024), and their intensity by about 30% (T0 to T1, P < .001). Pressure pain thresholds at the masticatory muscle locations increased significantly from T0 to T2 (P < .001). Patients' trait anxiety decreased significantly from T0 to T2 (P = .030). Trait anxiety measured at baseline was not correlated with relative changes in pain (T0 to T2, P = .248).

CONCLUSION: In the short term, FL-A reduces facial pain, masticatory muscle tenderness , and awake bruxism in women with chronic mTMD with low disability. A conservative management strategy should be prioritized for the initial management of these patients.

PMID:35298574 | DOI:10.11607/ofph.3037

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The effects of estrogen and hormone replacement therapy on platelet activity: a review

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Am J Blood Res. 2022 Feb 15;12(1):33-42. eCollection 2022.

ABSTRACT

Many studies have shown that an increase in cardiovascular disease in women is related to hormonal changes occurring particularly after menopause with increasing age. While the results of large clinical trials reporting no benefit of hormone replacement therapy (HRT) in cardiovascular disease have been known for some time, there is an increasing body of knowledge regarding the various mechanisms by which estrogen modulates platelet function that could in part explain the higher cardiovascular risk occurring in postmenopausal women and potential benefits of HRT on cardiovascular health. Our review summarizes our current knowledge regarding the effect of endogenous and exogenous estrogen on platelet activity, which can help researchers design future studies. We collected information from 21 peer-reviewed articles published from 1993 to 2021. Studies have indicated that p ostmenopausal women have higher platelet activity than premenopausal women, which can increase the risk of thrombo-embolic events and cardiovascular disease. Although some studies have reported pro-thrombotic effects of estrogen replacement therapy such as increased platelet activation and adhesion, other studies demonstrated decreased platelet aggregation by inhibiting GP IIb/IIIa receptor expression. This is mediated by estrogen receptors on the platelet membrane in a non-genomic manner and suggests an opportunity for the usage of estrogen replacement therapy with subtle changes in the formulation and route, particularly if started early after menopause. The effect of estrogen on platelet activity is promising as an important factor in reducing the risk of cardiovascular events, warranting further investigation.

PMID:35291255 | PMC:PMC8918702

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Oral exercises significantly improve oral functions in people with mild and moderate dementia: a randomized controlled study

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J Oral Rehabil. 2022 Mar 11. doi: 10.1111/joor.13317. Online ahead of print.

ABSTRACT

BACKGROUND: There have been no standard protocols of oral exercises for maintaining and improving oral function for people with dementia.

OBJECTIVE: This study aimed to determine the effects of home-based oral exercises on the oral function of people with mild to moderate dementia.

METHODS: Twenty-two participants at King Chulalongkorn Memorial Hospital were randomly assigned to exercis e group (n = 11) or control group (n = 11). The exercise group was instructed to do three home-based oral exercises, consisting of tongue-strengthening, oral diadochokinesis (ODK), and mouth-opening exercises, for 3 months, while the control group received advice on oral health care. The maximum tongue pressure (MTP) was the primary outcome. MTP, ODK rates of /pa/, /ta/, /ka/, modified water swallowing test (MWST), and oral moisture were measured at baseline, and after 1, 2, and 3 months of training. The generalized estimating equation analysis was used to evaluate the effects of oral exercises on the oral function.

RESULTS: The MTP and all ODK rates in the exercise group were significantly increased after 3 months of training. There were significant interaction effects between time and intervention in MTP and all ODK rates. No significant interaction effects between time and intervention in oral moisture were found. The MWST scores in both groups did not change through the en d of study and no adverse effects were reported.

CONCLUSION: Home-based oral exercises were found to be effective for improving tongue strength and tongue-lip motor function in people with mild to moderate dementia.

PMID:35274344 | DOI:10.1111/joor.13317

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