CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria.

OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice

Trauma Characteristics Associated with E-Scooter Accidents in Switzerland-A Case Series Study.

E-scooters have gained popularity worldwide in the last few years. Due to the increase in users, more accidents related to e-scooters can be observed. The present study aimed to analyse epidemiological data, characteristics, and severity of injuries in patients admitted to a Level I trauma centre in Switzerland (Inselspital Bern, University Hospital Bern) after accidents associated with e-scooters. This retrospective case series evaluated 23 patients who presented to the University Hospital of Bern between 1 of May 2019 and 31 of October 2021 after an e-scooter accident. Data were collected on patient demographics, time and cause of the accident, speed, alcohol consumption, helmet use, type and localisation of injury, number of injuries per patient, and outcome. Men were most frequently affected (61.9%). The mean age was 35.8 (STD 14.8) years. Slightly more than half (52.2%) of all accidents were self-inflicted. Most accidents were reported during the night (7 p.m. to 7 a.m., 60.9%) and in summer (43.5%). Alcohol consumption was reported in 43.5% of cases, with a mean blood alcohol level of 1.4 g/l. Most injuries were observed in the face (25.3%) and head/neck area (20.25%). Skin abrasions (56.5%) and traumatic brain injury (43.5%) were the most common types of traumata in terms of total number of patients. Only in one case it was reported that a protective helmet had been worn. Five patients required hospitalisation and four patients underwent surgery. Three patients underwent emergency orthopaedic surgery, and one patient underwent emergency neurosurgery. E-scooter accidents result in a significant number of facial and head/neck injuries. E-scooter riders would potentially benefit from a helmet to protect them in the event of an accident. Additionally, the results of this study indicate that a significant number of e-scooter accidents in Switzerland occurred under the influence of alcohol. Prevention campaigns to raise awareness of the risks of driving e-scooters under the influence of alcohol could help prevent future accidents

Bauen in Brasilien

Im Herbst 2014 fand die große Exkursion 2014 der Fakultät Bauingenieurwesen der HTWG Konstanz nach Brasilien unter der Leitung von Prof. Dr. Horst Werkle und Prof. Dr. Peter Hirschmann statt. Auf dem Programm stand der Besuch der Städte Sao Paulo, Rio de Janeiro und Iguacu. Der Bericht schildert den Besuch interessanter Baustellen und großer Bauprojekte wie des im Bau befindlichen futuristisch anmutenden „Museum of Tomorrow“, des Maracana-Stadions mit seiner neuen Membrandachkonstruktion sowie des zweitgrößten Wasserkraftwerks der Welt

Evaluation des complications après extraction dentaire sans prophylaxie antibiotique: hôpital de district de Mfou, Cameroun

Le but de cette étude était d'évaluer le taux de complications après avulsions dentaires et d'identifier les facteurs de risque associés aux complications dans une population de patients venus pour des soins d'urgence à l'Hôpital de District de Mfou, Cameroun. Le taux de complications post-opératoires a été de 37.7% sur l'ensemble du collectif. L'alvéolite sèche a été la complication la plus fréquente. Dans 65.5% des cas un traitement antibiotique a été nécessaire pour obtenir une guérison complète, les autres cas ont été maîtrisés par un traitement local. Sur l'ensemble des patients, 24.7% ont reçu des antibiotiques. Une régression logistique binaire a donné deux facteurs de risque significatifs pour une complication post-opératoire : la position dentaire postérieure (OR, 12.1 ; CI, 1.4-104.2) et le non-suivi des instructions pendant la phase de guérison (OR, 5.0 ; CI, 1.2-21.5) comme cesser l'usage du tabac, le maintien de l'hygiène orale

PROLINE BETAINE: A UNIQUE OSMOLYTE IN AN EXTREMELY EURYHALINE OSMOCONFORMER

Volume: 167Start Page: 495End Page: 50

Uncovering tumor−stroma inter-relationships using MALDI Mass spectrometry imaging

Tumorigenesis involves a complex interplay between genetically modified cancer cells and their adjacent normal tissue, the stroma. We used an established a breast cancer mouse model to investigate this interrelationship. Conditional activation of Rho-associated protein kinase (ROCK) in a model of mammary tumorigenesis enhances tumor growth and progression by educating the stroma and enhancing the production and remodeling of the extracellular matrix. We used peptide matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) to quantify the proteomic changes occurring within tu-mors and their stroma in their regular spatial context. Peptides were ranked according to their ability to discriminate between the two groups, using a receiver operating characteristic (ROC) tool. Peptides were identified by LC-MS/MS and protein expression was validated by quantitative immunofluorescence using an independent set of tumor samples. We have identified and validated four key proteins upregulated in ROCK-activated mammary tumors relative to those expressing kinase-dead ROCK, namely collagen I, α-SMA, Rab14 and tubulin-β4. Rab14 and tubulin-β4 are expressed within tumor cells, whereas collagen I is localized within the stroma. α-SMA is predominantly localized within the stroma but is also expressed at higher levels in the epithelia of ROCK-activated tumors. High expression of COL1A, the gene encoding the pro-α 1 chain of collagen, corre-lates with cancer progression in two human breast cancer genomic datasets, and high expression of COL1A and ACTA2, (the gene encoding α-SMA) are associated with a low survival probability (COLIA p=0.00013, ACTA2 p=0.0076) in estrogen receptor negative breast cancer patients. To investigate whether ROCK-activated tumor cells cause stromal cancer-associated fibroblasts (CAFs) to upregulate expression of collagen I and α-SMA, we treated cancer-associated fibroblasts with medium conditioned by primary mammary tumor cells in which ROCK had been activated. This led to abundant production of both proteins in CAFs, clearly highlighting the inter-relationship between tumor cells and CAFs and identifying CAFs as the potential source of high levels of collagen 1 and α-SMA and associated enhancement of tissue stiffness. Our research emphasizes the capacity of MALDI MSI to quantitatively assess tumor-stroma inter-relationships and to identify potential prognostic factors for cancer progression in human patients, using sophisticated mouse cancer models.Sarah T. Boyle, Parul Mittal, Gurjeet Kaur, Peter Hoffmann, Michael S. Samuel, and Manuela Klingler-Hoffman

Radical nephrectomy performed by open, laparoscopy with or without hand-assistance or robotic methods by the same surgeon produces comparable perioperative results

PURPOSE: Radical nephrectomy can be performed using open or laparoscopic (with or without hand assistance) methods, and most recently using the da Vinci Surgical Robotic System. We evaluated the perioperative outcomes using a contemporary cohort of patients undergoing radical nephrectomy by one of the above 4 methods performed by the same surgeon. MATERIALS AND METHODS: The relevant clinical information on 57 consecutive patients undergoing radical nephrectomy from September 2000 until July 2004 by a single surgeon was entered in a Microsoft Access DatabaseTM and queried. Following appropriate statistical analysis, p values < 0.05 were considered significant. RESULTS: Of 57 patients, the open, robotic, laparoscopy with or without hand assistance radical nephrectomy were performed in 18, 6, 21, and 12 patients, respectively. The age, sex, body mass index (BMI), incidence of malignancy, specimen and tumor size, tumor stage, Fuhrman grade, hospital stay, change in postoperative creatinine, drop in hemoglobin, and perioperative complications were not significantly different between the methods. While the estimated median blood loss, postoperative narcotic use for pain control, and hospital stay were significantly higher in the open surgery method (p < 0.05), the median operative time was significantly shorter compared to the robotic method (p = 0.02). Operating room costs were significantly higher in the robotic and laparoscopic groups; however, there was no significant difference in total hospital costs between the 4 groups. CONCLUSIONS: The study demonstrates that radical nephrectomy can be safely performed either by open, robotic, or laparoscopic with or without hand assistance methods without significant difference in perioperative complication rates. A larger cohort and longer follow up are needed to validate our findings and establish oncological outcomes

Patient Perceptions of Physical and Emotional Discomfort Related to Urodynamic Testing: A Questionnaire-based Study in Men and Women With and Without Neurologic Conditions

OBJECTIVES: To determine predictors of physical and emotional discomfort associated with urodynamic testing in men and women both with and without neurologic conditions. METHODS: An anonymous questionnaire-based study completed by patients immediately after undergoing fluoroscopic urodynamic testing. Participants were asked questions pertaining to their perceptions of physical and emotional discomfort related to the study, their urologic and general health history, and demographics. Logistic regression was performed to determine predictors of physical and emotional discomfort. RESULTS: A total of 314 patients completed the questionnaire representing a response rate of 60%. Half of the respondents (50.7%) felt that the exam was neither physically nor emotionally uncomfortable, while 29.0% and 12.4% of respondents felt that the physical and emotional components of the exam were most uncomfortable, respectively. Placement of the urethral catheter was the most commonly reported component of physical discomfort (42.9%), while anxiety (27.7%) was the most commonly reported component of emotional discomfort. Having a neurologic problem (OR 0.273; 95% CI 0.121, 0.617) and older age (OR 0.585; 95% CI 0.405, 0.847) were factors associated with less physical discomfort. There were no significant predictors of emotional discomfort based on our model. CONCLUSIONS: Urodynamic studies were well tolerated regardless of gender. Having a neurologic condition and older age were predictors of less physical discomfort. These findings are useful in counseling patients regarding what to expect when having urodynamic procedures