Αρχειοθήκη ιστολογίου

Πέμπτη 30 Ιουνίου 2022

Feasibility of robotic thyroidectomy via hairline incision using da Vinci single port system: Initial experience with 40 consecutive cases

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Abstract

Background

This study aimed to introduce our robotic technique, which can minimize dissection extent using the da Vinci SP robotic system via hairline incision.

Methods

Forty patients underwent robotic thyroidectomy using the da Vinci SP robotic system via a hairline incision between February 2020 and April 2021 at Ulsan University Hospital. All procedures were performed successfully by one surgeon using the SP robotic system.

Results

Hemithyroidectomies were performed in 32 patients and total thyroidectomies in eight patients. Central neck dissection was performed in 32 patients. The overall mean operative time was 140.2 ± 50.7 min, and the mean console time was 74.0 ± 42.7 min. All patients were discharged on the second or third day after operation without any complications.

Conclusions

Robotic thyroidectomy using the SP robotic system via hairline incision is technically feasible and safe, with a shorter incision length when compared with that of the Xi system.

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Effects of baloxavir and oseltamivir antiviral therapy on the transmission of seasonal influenza in China: a mathematical modeling analysis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

New antiviral influenza treatments can effectively alleviate illness while reducing viral shedding. However, how such effects can translate into lower population infections of seasonal influenza in China remains unknown. To shed light on the public health impacts of novel antiviral agents for influenza, we constructed a dynamic transmission model to simulate the seasonal influenza epidemics in China. Two antivirus treatments, baloxavir and oseltamivir, were evaluated by estimating their impacts on the incidences of influenza infection in a single flu season. In the base-case analysis of 10% antiviral treatment uptake rate, 2,760 and 3,420 per 10,000 persons contracted influenza under the treatment of baloxavir and oseltamivir, respectively. These incidence rates amounted to a 18.90% relative risk reduction (RRR) of infection associated with baloxavir in relation to oseltamivir. The corresponding RRR was 82.16% when the antiviral treatment uptake rate was inc reased to 35%. In addition, the peak of the prevlance of infected individuals (per 10,000 persons) under the baloxavir treatment was 177 (Range: 93 to 274) fewer than that of oseltamivir. Our analyses suggest that the baloxavir treatment strategy reduces the incidence of influenza in China compared with oseltamivir in the setting of a seasonal flu epidemic. Also, increasing the uptake rate of antiviral treatment can potentially prevent millions of infections during a single flu season.

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Morphology of Peri‐Implant Tissues around Permanent Prostheses with Various Emergence Angles Following Free Gingival Grafting

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Abstract

Purpose

To analyze the tissue morphology around implant-supported prostheses by digital technology and to evaluate the effect of prosthetic contours on the changes in tissues following free gingiva graft procedure.

Material and Methods

A total of 53 implants in 32 patients receiving free gingiva grafts were selected. These had previously presented insufficient keratinized mucosa width (KMW). At the follow-up visits (mean: 16.66 ±9.97 months), the implant position and tissue condition were documented with an oral scanner. Vertical soft tissue thickness (VT), measured from the implant-abutment connection to the marginal tissues, and horizontal soft tissue thickness (HT), at the level of the platform, were calculated. The VT, HT and emergence angle (EA) of prostheses were assessed by 3Shape analyzing software. The final KMW was measured by clinical assessment. Marginal bone loss (MBL) was calculated in the follow-up bitewing radiographs.

Results

The mean VT in the study was 2.65 ±0.75 mm at the mid-buccal sites, 3.74 ±1.22 mm at the mesial, 3.16 ±1.08 mm at the distal, and 2.53 ±0.92 at the mid-lingual aspects. The mid-buccal HT was 1.45 ±0.53 mm while the mid-lingual was 1.05 ±0.43 mm (P = 0.008). Interestingly, prostheses with mid-buccal EA>30∘ exhibited slightly lower VT, but higher HT, than the ones with EA≤30∘. Prostheses with proximal EA>30∘ displayed slightly more MBL, compared to prostheses with EA≤30∘. The mean KMW was 4.08 ±1.10 mm.

Conclusions

Free gingival grafting is a predictable treatment approach to augmenting soft tissue 3-dimensionally. Prostheses with EA≤30∘ were preferable for preserving the maximal VT and maintaining crestal bone stability.

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Association Between Inferior Turbinate Hypertrophy and Extraesophageal Reflux

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jamanetwork.com

This cohort study examines the association between inferior turbinate hypertrophy and extraesophageal reflux in patients at 3 referral centers.
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Dysphagia in a Patient With Sarcoidosis

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jamanetwork.com

This case report describes a woman in her 70s with a medical history of sarcoidosis, atrial fibrillation, asthma, gastroesophageal reflux disease, Schatzki's ring status after multiple dilations, pulmonary hypertension, and hypothyroidism who presented with a more than 10-year history of dysphagia and was found to have sarcoid involvement of the upper esophageal sphincter.
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