Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment

The treatment of craniofacial anomalies has been challenging as a result of technological shortcomings that could not provide a consistent protocol to perfectly restore patient-specific anatomy. In the past, wax-up and impression-based maneuvers were implemented to achieve this clinical end. However, with the advent of computer-aided design and computer-aided manufacturing (CAD/CAM) technology, a rapid and cost-effective workflow in prosthetic rehabilitation has taken the place of the outdated procedures. Because the use of implants is so profound in different facets of restorative dentistry, their placement for craniofacial prosthesis retention has also been widely popular and advantageous in a variety of clinical settings. This review aims to effectively describe the well-rounded and interdisciplinary practice of craniofacial prosthesis fabrication and retention by outlining fabrication, osseointegrated implant placement for prosthesis retention, a myriad of clinical examples in the craniofacial complex, and a glimpse of the future of bioengineering principles to restore bioactivity and physiology to the previously defected tissue.

Accuracy of the dose delivery in prostate cancer patients-using an electronic portal imaging device [EPID]

Background: To correct patient positioning errors [setup errors] during prostate cancer treatment using EPID and fiducial gold markers, to improve the accuracy of the dose delivery in these patients

Materials and Methods: Fifteen patients with localized prostate carcinoma after implantation of fiducial gold markers in their prostate gland underwent the five-field IMRT planning technique. The plan was prepared in accordance with ICRU 50 guidance [PTV to receive 95-107% dose]. The software program reconstructed the three-dimensional position of the markers from the different Beams Eye Views [BEV]. The discrepancies of the seeds' positions [prostate surrogate] between plan and daily images were calculated three dimensionally. Then, necessary corrections were applied to match the prostate fiducial markers in the portal image with the BEV image in the planned one by moving the couch in the X, Y and Z directions

Results: Data from 15 patients and 469 fractions of radiotherapy were analyzed in this study. Two sets of data were available from EPID software before and after 3D set-up corrections. The mean of the population displacement in Left /Right [L/R], Anterior/Posterior [A/P] and Crania/Caudal [C/C] directions were 0.5, -1.0 and 2.4mm before, and -0.1, -0.5 and 0.9mm after corrections, respectively. The systematic and random errors for the measured populations in the three mentioned directions were 2.4, 2.7 and 2mm and 6.4, 5.9 and 6.1mm before corrections, and 1.1, 2.4 and 1.4mm and 3.8, 3.9 and 3.6mm after corrections, correspondingly

Conclusion: This study provides further evidence that using gold markers in the prostate improves dose delivery to the prostate. Also, it has been demonstrated that the EPID can be a powerful tool in the reduction of treatment setup errors and the quality assurance and verification of complex treatments

[Comparison of bleeding and transfusion in patients who undergo coronary artery bypass grafting with and without cardiopulmonary bypass]

Excessive Bleeding continues to play a key role and an important cause of morbidity and mortality after cardiopulmonary bypass [CPB]. The goal of this study was to determine the differences in bleeding and transfusion between OPCAB and on -pump CABG patients. In a randomized, double blinded prospective study 300 patient's undergoing coronary revascularization surgery were enrolled, 150 CABG patients were compared with 150 OPCAB patients. The patients were assessed during the first 72 hours to determine the postoperative side effects. The 2 groups were compared using the chi-square test or fisher's exact test and the rank sum test. CABG patients received more intraoperative red blood cells [P<0.0001], more albumin and more fresh- frozen plasma [P<0.0001]. Postoperatively, CABG patients were more likely to receive more platelets [29.3% ? 70.7%, P<0.007]. During the operative and the initial 4-hour postoperative period OPCAB patients exhibited greater blood loss [P<0.0001]; however, at 12,24and 72 hours postoperatively, CABG patients exhibited greater blood loss. There were4 death in CABG patients [P<0.05]. Despite not reversing the heparin at the end of the OPCAB surgery, OPCAB surgery was associated with an overall reduction in platelets, fresh- frozen plasma, Albumin and transfusion requirements

[ risk factors affecting blood transfusion in patients undergoing coronary artery bypass graft procedure related to gender]

Females were reported to have significantly lower hematocrit [Hct], which might be the cause of increased need for blood transfusion. The goal of this study is to determine risk factors affecting blood transfusion in patients undergoing coronary artery bypass graft procedure related to gender A cross sectional review of 500 [306 males and 194 females] ASA physical status I or Il patients undergoing bypass procedures with saphenous vein graft performed over a one year period were included in this study. The conducting of anesthesia was standardized. For each patient, we recorded the gender, age, body weight, height, body surface area [BSA], and duration of surgery. Hematocrit levels prior to surgery and the end of surgery were recorded. Packed red blood cell [PRBC] administration and use of fresh frozen plasma [FFP] and platelets were noted. Differences between the data for female and male patients were evaluated using Student's t-test, Chi-square test and using regression analysis. Approximately 57.2% [111] female and only 39.9% [121] male patients received PRBCs. On average, females received 1. 6 units of PRBCs intraoperatively and 2. 6 units of PRBCs during the entire hospital stay, while the males received 1.1 units and 1.8 units for similar periods [P=0.0001]. When females and males were compared within the same subgroups for age, body surface area [BSA], duration of surgery, and preoperative Hct, etc. ...had a significant correlation with age, postoperative Hct and BSA in females but had a significant correlation with preoperative Hct, preoperative PRBC and duration of surgery in males [P<0.05]. Multiple logistic regression analysis showed that the probability of a patient receiving or not receiving PRBC transfusion is significantly influenced by preoperative Hct, postoperative Hct, duration of surgery, preoperative PRBC mass, and gender. Gender is an independent essential determinant of blood transfusion in CABG patients, and may interact with BSA, preoperative Hct, duration of surgery and other factors in determining the probability of transfusion

study of densitometry comparison among three radiographic processing solutions

The radiographic image accuracy depends on the X-ray film information visibility. Good visibility is found by good contrast. Radiation exposure parameters [kVp, mAs] and film processing conditions have impact on contrast. In dentistry radiography machines, exposure time and processing procedure are set by radiographer. No optimized exposure time and processing conditions may lead to incorrect diagnosis and re-exposure of the patient. Therefore, we studied the performance of the three different available processing solutions with dental X-ray film. Dental intraoral E-speed films, size 2 [Kodak company, USA] were used in this study. These films were developed in a manual processor using three different brands of processing solution: 1] Taifsaz [Iran], 2] Darutasvir [Iran] and 3] Agfa [Germany] for temperatures of 25°C, 28°C and 30°C at the three different exposure times, 0.2 s, 0.25 s and 0.35 s. Performance was evaluated with respect to base plus fog, relative contrast and relative speed. Darutasvir processing solution as the cheapest one showed higher base plus fog density at 25°C and 30°C than that of Taifsaz and Agfa solutions. Also, Darutasvir solution was found to have better relative contrast than that of the others, except for 30°C at 0.25 s. Relative speed was higher in Darutsavir solution than Agfa for 25oC at three exposure times used in this study, for 28oC at 0.2 s and for 30°C at 0.35 s. Taifsaz Processing solution was in the second order with respect to tested conditions. Comparison among available X-ray film processing solutions for different temperatures at different exposure times can help to maintain image quality while patient exposure and film cost are kept considerably low