Laparoscopic Nephrectomy in Patients Undergoing Hemodialysis Treatment

With an experienced laparoscopic team of surgeons, laparoscopic nephrectomy may be performed safely

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Evaluation of fasting and postprandial plasma GLP-1 concentrations in childhood obesity

Bu çalışmada besin alımı ile barsaklardan sentezi uyarılan ve pankreasta insülinotropik etki gösteren Glukagon-like peptit 1 (GLP-1) isimli peptidin obezite patogenezindeki olası rolünü ortaya çıkarmayı , obezlerde GLP-1 düzeyindeki değişiklikler ve tokluk yanıtının oluşturulmasındaki rolünü ve insülin direnci ile ilişkisini araştırmayı planladık. Gereç ve yöntem: Bu çalışmaya toplam 55 çocuk alınmıştır. Bunların 40 olgu obezite 20 insülin direnci olan, 20 si insülin direnci olmayan obez olgular, 15'i ise sağlıklı çocuklardı. Olgulara standart OGTT yapılarak 0. ve 60. ve 120.dakikalarda plazma GLP-1 düzeyi RIA yöntemiyle ölçüldü. Ayrıca eş zamanlı olarak serum glukoz ve insülin düzeyleri belirlendi. Bulgular: Obezitesi olan Grup ile kontrol grubu cinsiyet, yaş ve pubertal durum açısından benzerdi , vücut kitle indeksi 2 grupta faklıydı. Sonuç olarak obezlerde GLP-1 konsantrasyonları açlık ve glukozla uyarılmış tokluk durumunda azalmış olarak bulundu. İnsülin direnci olan obezlerde oral glukoza GLP-1 yanıtının azalmış olmasına insülün direncinin rol oynadığını düşündürmektedir.This study was designed to find out whether there is any difference in the concentrations fasting and postprandial plasma GLP-1 in obesity and normal weight children. Material and Method: The study population consisted of 40 obesity and 15 healthy control children. Whose age, sex, height, weight, BMI, and pubertal status are matched. Immediately after sampling for blood glucose,insülin and GLP-1. The subjects were administered a standard oral glucose tolerance test. Another sampling was performed for plasma glucose,insülin and GLP-1 levels at 60-120 minutes. Results: Body mass index were different in obesity anf healthy control group Children. As expected blood glucose and plasma GLP-1 levels both pre and 60,120 min after OGTT; were different between groups. Plazma GLP-1 levels were not correlated with endogenous insülin secretion, in either group. Conclusions: The concentrations fasting and postprandial plasma GLP-1 reduced in obesity after OGTT. This decreased levels of GLP-1 study results suggest a role for GLP-1 in the obesity pathogenesis and tendancy for diabetes

Cone beam computed tomography findings of ectopic tooth in the maxillary sinus associated with dentigerous cyst: A report of two cases and review of the literature

Dentigerous cysts are the most common type of benign odontogenic lesions that associated with the crown of an unerupted or impacted tooth. They constitute the second most common cystic lesion of the jaws, after radicular cysts. Dentigerous cyst surrounding impacted teeth often displace these teeth into ectopic positions. Ectopic eruption of teeth into regions other than the oral cavity is common but dentigerous cysts associated with ectopic teeth within the maxillary sinus are fairly rare. The diagnosis is usually made by panoramic radiography. Cone beam computed tomography (CBCT) is indicated when an ectopic tooth is associated with an antral mass and prior to surgery. The standard treatment for a dentigerous cyst is enucleation and extraction of the cyst-associated impacted or unerupted tooth. We report CBCT findings of two cases of dentigerous cyst associated with an ectopic tooth in the maxillary sinus and review the literature reports of this condition over the past 34 years

Guided bone regeneration simultaneous with implant placement using bovine-derived xenograft with and without liquid platelet-rich fibrin: a randomized controlled clinical trial

Objective To assess augmentation success after guided bone regeneration (GBR) carried out simultaneously with implant placement using bovine-derived xenograft alone and in combination with liquid platelet-rich fibrin (liquid-PRF). Methods This randomized controlled clinical trial was conducted on patients with horizontal bone deficiency in the posterior regions of the mandible. After implant placement, GBR procedures were randomly performed using liquid-PRF-enriched bovine-derived xenograft (for the test group) and with bovine-derived xenograft alone (for the control group). To assess the change in augmentation thickness, the primary outcome of the study, cone beam computed tomography was carried out at the implant sites on completion and 6 months after surgery. The secondary outcomes were marginal bone level and implant survival rate at prosthetic delivery and at 6 months, 1 year, and 2 years follow-up after loading. The significance level was set at pResults Twenty patients with 50 implants were analyzed for the test group and 20 patients with 48 implants for the control group. At 6 months postoperatively, the mean values of augmentation thickness were 1.63 +/- 0.21 mm, 2.59 +/- 0.34 mm, and 3.11 +/- 0.36 mm for the test group and 1.34 +/- 0.14 mm, 2.49 +/- 0.24 mm, and 2.97 +/- 0.24 mm for the control group at 2 mm, 4 mm, and 6 mm below to the implant shoulder (p 0.001, p = 0.007, and p = 0.036, respectively). The mean marginal bone loss was found to be less than 1 mm for both study groups during the 2 years of follow-up after prosthetic loading. Implant survival rate was 100% for both study groups. Conclusion Bovine-derived xenograft alone and in combination with liquid-PRF are both successful in achieving bone augmentation around the implants and produce a small change in marginal bone level and a high implant survival rate after loading

Comparison of Autogenous Block Bone Graft and Screw Tent-Pole Techniques for Vertical Bone Augmentation in the Posterior Mandible: A Split-Mouth Randomized Controlled Study

uyanikgil, Yigit/0000-0002-4016-0522; KISAOGLU, Huseyin/0000-0002-3999-8846; isik, gozde/0000-0001-9572-3049; , meltem/0000-0002-7088-9701WOS:000623691700020Aim: To evaluate the effect on vertical bone augmentation of the screw tent-pole technique using particulate allograft in combination with injectable platelet-rich fibrin, and to compare this with autogenous block bone graft. Materials and Methods: This split-mouth randomized controlled study involved patients with bilateral partial edentulism and vertical bone loss in the posterior mandible. in each patient, the control side was treated with autogenous block bone graft harvested from the mandibular ramus and, on the test side, the screw tent-pole technique was employed, using particulate allograft in combination with injectable platelet-rich fibrin. All augmented sites were covered by leukocyte and platelet-rich fibrin membrane. The primary outcome variable of this study was the radiographic changes to bone height 6 months after augmentation. The secondary outcome variables were the percentage of newly formed bone and the implant survival rate. The data were analyzed with a significance level of alpha = 0.05. Results: of the 13 patients included, a total of 11 patients (7 females, 4 males; mean age 50.92) completed the study. The mean values of vertical bone gain were 1.72 0.78 mm for the test group and 2.83 +/- 0.89 mm for the control group, which constitutes a significant difference (P = .008). The percentage of newly formed bone was 18.08% +/- 2.17% for the test group and 14.26% +/- 1.76% for the control group. The difference between the groups was statistically significant (P < .001). The implant survival rates were 100% for both study groups. Conclusions: Based on the study results, screw tent-pole can be considered a feasible technique for bone augmentation. Further randomized studies will be necessary to fully evaluate vertical bone augmentation using the screw tent-pole technique, with different graft materials and with larger samples.Scientific Research Committee of the University [16-DIS-026]The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Scientific Research Committee of the University (16-DIS-026)

Trombosit konsantrelerinin yumuşak doku iyileşmesi üzerine etkisinin değerlendirilmesi: Retrospektif çalışma

Amaç: Bu retrospektifçalışmanınamacı, lökosit ve trombositten zengin fibrin (L-TZF) ile konsantre büyüme faktörünün (KBF) yumuşak doku iyileşmesi üzerine etkisinikarşılaştırmaktır.Yöntem: Çalışmada, cerrahi işlemlerinde L-TZF ve KBF kullanılan 120 hastanın verileri incelenmiştir. Hastalar, yönlendirilmiş kemik rejenerasyonu (YKR),diş çekimi (DÇ) ve yumuşak doku cerrahileri (YDC) olmak üzere üç çalışma grubuna ayrılmıştır. Her bir grup,kullanılantrombosit konsantresi, yarakenarlarındaaçılma ve enflamasyon yönünden değerlendirilmiştir.Bulgular: Toplamda 104 hasta değerlendirmeye alınmıştır. Çalışma gruplarında, yara kenarlarında açılma ve enflamasyon bulguları düşük oranda gözlenmiştir ve L-TZF ile KBF kullanımı arasında istatistiksel olarak anlamlı bir farklılık bulunmamıştır. Çalışma gruplarında yara kenarlarında açılma değerlendirildiğinde, DÇ grubundaki değişim, her iki trombosit konsantresi için istatistiksel olarak anlamlıdır (L-TZF: x2 (2)= 12; p=0,002; KBF: x2 (2)= 6; p=0,05).Sonuç:Çalışmamızda, KBF fibrin materyalininyumuşak doku iyileşmesi üzerinde L-TZF kadar etkiliolduğugözlenmiştir. Cerrahi işlemi gerçekleştiren hekimin deneyimi ve hastanın ağız hijyeni konusunda yeterliliği klinik sonuçları etkileyen faktörlerdir. Bu nedenle, farklı trombosit konsantrelerinin yumuşak doku iyileşmesi üzerine etkisini değerlendirecek kontrollü klinik çalışmalara ihtiyaç vardır