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Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male?to?female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time
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Objective:To explore the application effects of work record analysis combined with emergency plan drill on the practice teaching of nursing students in department of emergency.Methods:A total of 80 nursing students who had clinical practice in the Department of Emergency of Beijing Shijitan Hospital Affiliated to Capital Medical University between February 2018 and August 2020 were selected as research subjects. They were divided into control group and observation group according to the admission order to the department. The control group was given routine teaching, and the observation group adopted work record analysis combined with emergency plan drill teaching. The theoretical knowledge level, the success rate of emergency treatment and teaching effect evaluation were compared between the two groups of nursing students before and after learning. SPSS 19.0 was used for t test and chi-square test. Results:After learning, the scores of theoretical knowledge (pre-hospital emergency, common emergency diseases, emergency treatment plan, and complications) of the two groups were higher than those before learning, and the scores in observation group were higher than those in control group ( P<0.05). The success rates of emergency treatments (electrocardiogram, electrocardiogram monitoring, blood sample collection, thrombolytic therapy coordination, and cardiopulmonary resuscitation) and satisfaction rates of teaching effects (fully understanding emergency work, improving the ability of independent learning, enhancing the ability of flexible use of knowledge, and active classroom atmosphere) were higher in observation group than control group ( P<0.05). Conclusion:Work record analysis combined with emergency plan drill can effectively ensure the teaching effects of nursing students in department of emergency, and has the advantages of improving the theoretical knowledge and practical operation ability.
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@#AIM: To analyze the efficacy of bevel-up phaco chop versus bevel-down phaco drill in the treatment of hard nuclear cataract and the influence on corneal endothelium.<p>METHODS: Between August 2018 and April 2020, 94 patients(104 eyes)with hard(grade Ⅳ-Ⅴ)nuclear cataract treated with phacoemulsification were enrolled in this retrospective study. Among them, 50 eyes treated by bevel-up phaco chop were included in the control group, while 54 eyes treated by phaco drill technique were included in the observation group. The time of using ultrasound, ultrasonic energy and accumulated energy complex parameter in the two groups were recorded. The best corrected visual acuity(BCVA)in 7d, corneal endothelial cell count in 2mo, the proportions of normal hexagonal cells and the degree of corneal edema in 7d were compared between the two groups.<p>RESULTS: The time of using ultrasound, ultrasonic energy and accumulated energy complex parameter of the observation group were shorter and lower than those of the control group(<i>P</i><0.05). The BCVA of both groups increased after operation, and the observation group had higher BCVA than the control group at the same time(<i>P</i><0.05). In 1 and 2mo, the corneal endothelial cell counts and the proportions of normal hexagonal cells in both groups were lower than those before operation. Meanwhile, the corneal endothelial cell count and the proportions of normal hexagonal cells in the observation group were higher than those in the control group(<i>P</i><0.05). Besides, corneal edema was milder in the observation group than in the control group at 24h and 7d after operation(<i>P</i><0.05).<p>CONCLUSION: Compared with bevel-up phaco chop, phaco drill can significantly shorten the time of using ultrasound, reduce ultrasound energy, promote visual recovery, and reduce corneal endothelial cell damage.
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Objective:To explore the application effect of flipped classroom combined with simulated case teaching in internship of pediatric nursing students.Methods:In the study, 52 nursing interns having internship in our department from July 2018 to January 2020 were selected and divided into control group and experimental group according to the internship period, including 26 interns in each group. The control group adopted traditional teaching method, while the experimental group adopted flipped classroom teaching method combined with simulated case drill. Indicators such as assessment scores and satisfaction surveys were compared between the two groups.Results:Compared with the control group, the test results of nursing students in the experimental group [(77.077±5.455) points] were significantly better than those [(67.692±4.905) points] in the control group ( P<0.01). The teaching satisfaction of nursing students in the experimental group (99.78%) was significantly better than that (89.92%) in the control group ( P<0.01). Conclusion:The application of flipped classroom combined with simulated case practice teaching method in the internship teaching of pediatric nursing students has achieved good results, which is worthy of promotion in the teaching of pediatric nursing drill.
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Objective:To explore the formulation of the evaluation system of nuclear emergency medical rescue drills.Methods:By using the analytic hierarchy process, theoretical analysis and expert consultation, the evaluation system was established, and online questionnaires were used to investigate student satisfaction. Excel software was used for data entry, Matlab 6.5 software was used for weight calculation, and questionnaire data were authorized to SPSSAU online platform to analyze the correlation coefficient between trainees' attitude towards drills and satisfaction of the evaluation system.Results:An evaluation system of nuclear emergency medical rescue drills composed of multiple indicators was constructed, and the weights of each indicator of the system were obtained. The corresponding weights for group comprehensive proficiency, topic theoretical oral examination, personal practice and virtual system were 0.108, 0.557, 0.280 and 0.054, respectively. Simultaneously, the evaluation of the system by the trainees was investigated, and it was found that there was a significant correlation between the trainee's attitude towards the drills and satisfaction with the system.Conclusion:The nuclear emergency medical rescue evaluation system formed in this research is expected to provide theoretical methods for comprehensive evaluation of students' knowledge and capabilities, and at the same time it's helpful to improve the nuclear emergency rescue capabilities of students.
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Dacryocystorhinostomy (DCR) is a bypass operation for tear drainage system which involves removal of bone adjacent to lacrimal sac and incorporating lacrimal sac with nasal mucosae. The operative approaches to lacrimal apparatus are external and endoscopic. In recent times advances in surgical technique and better standing of anatomy have made several changes in endoscopic DCR all aiming to improve results, reduce complications, and reduce operative time. Both costly powered and cost affective non-powered instruments are commonly used to make bone windows in endoscopic DCR. The aim of this study is to compare merits and demerits of powered instrument (Drill) and non-powered (Kerrison’s punch) DCR. METHODSA randomized comparative study of 60 patients in the age group of 21-70 yrs. who attended our outpatient department regularly and underwent endoscopic DCR procedure at our institution from June 2017 until Aug. 2019 was conducted. Patients were categorised into two groups of 30 patients each, one group which had patients who were operated conventionally by Kerrison’s punch and the group with patients who were operated by powered drill. Operative technique, surgical outcome and complications were compared between the two groups. RESULTSA total of 60 endoscopic endonasal DCRs were performed during the period. Male: female ratio; 1:5. 36 (60%) patients presented with watering of eye. Procedure success rate among Kerrison’s punch group was 93.33 % vs. 90% in powered drill group (p= 0.476). The complications rate in Kerrison’s punch group was 10% compared 20% in powered drill group (p= 0.032). The mean operating time among Kerrison punch group was 33.3 min which was significantly lower than that of powered drill group which was 78.3 min. CONCLUSIONSEndoscopic DCR is keyhole minimal invasive magic surgery. In a comparative study, Kerrison’s punch was found to be better tool for making bony window in terms of cost, operating time and complications when compared to powered drill. In terms of success rate of surgery and other factors, there was no significant difference between the two groups.
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Objective To make drilling mechanical and thermal analysis of bones with different drill bits and drilling parameters, so as to reduce the drilling force and drilling temperature in drilling process and decrease the damage to surrounding bone tissues. Methods The bone drilling model was established by finite element simulation software AdvantEdge. By comparison with the pig femur drilling experiment, the simulated and experimental results of standard twist driII and three standard multi-facet drills at different speeds and feed rates were analyzed. Results The simulation and experiment comparison showed that the influences of driII bit structure, drilling speed, feed rate on drilling force and drilling temperature were consistent, and the established simulation model was credible. Conclusions Under the same drilling conditions, the multi-facet driII for drilling rubber had lower drilling force and drilling temperature than the standard twist drill. The research findings provide theoretical basis for the application of multi-facet driII in fracture surgery.
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Background: Otosclerosis is not an uncommon condition in Telangana. Various methods such as perforator and laser are usedin performing stapedotomy during its surgical management. Stapedotomy performed with slow-speed microdrill technique forotosclerosis, and difficulties encountered during surgery, complications, and auditory gain in the post-operative period wereanalyzed in this study.Aim of the Study: The aim of this study was to use low-speed microdrill technique in stapedotomy and to analyze the difficulties,complications, and audiological evaluation in the post-operative period of 18 months.Materials and Methods: A prospective study of 62 patients undergoing stapedotomy for otosclerosis over a period of 2 yearswas reviewed. Stapedotomy with skeeter microdrill was evaluated using audiometric results (air conduction thresholds, boneconduction thresholds, air-bone gap closure, and pure tone average) and the incidence of complications during post-operativeperiod. Teflon prosthesis was used in all the patients.Observations and Results: Among the 62 patients, there were 37 females (59.67%) and 25 males (40.32%) with a male-tofemale ratio of 1:1.48. The patients belonged to the age group of 25–55 years with a mean age of 32.65 ± 4.15 years.Conclusions: Stapedotomy performed with microdrill technique for otosclerosis was a safe surgical technique to perforate thestapes footplate. The microdrill (skeeter) has low noise intensity and low torque. For duration of a few seconds, it seems to bea safe tool in creating a perforation in the footplate of the stapes, without causing acoustic trauma.
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The decision-to-delivery interval for an emergency cesarean delivery must be as rapid and safe as possible.Preventive measures befeore,during and after operation are paramount to reduce morbidity and mortality. Periodic simulation drills are valuable to improve teamwork and communication skills.
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Objective To investigate the application effect of electric drill drive in the preparation of atlanto-axial posterior screw trajectory.Methods A retrospective case-control study was conducted to analyze the clinical data of 29 patients with atlanto-axial fracture and dislocation admitted to the Lanzhou University Second Hospital from February 2016 to March 2019.There were 19 male and 10 females,aged from 10 to 72 years,with an average of 44.6 years.All patients received posterior atlantoaxial screw fixation.Electric drill drive was adopted in 14 patients to prepare the screw trajectory (electric drill group),and bare hand technique was used in 15 patients (bare hand group).In the electric drill group,28 atlantal lateral screws and 28 axial pedicle screws were implanted;in the free hand group,30 atlantal lateral screws and 30 axial pedicle screws were implanted.The trajectory preparation time and intraoperative blood loss between the two groups were compared.After the operation,the X-ray films and 3D CT were taken to observe the lateral mass of atlas as well as the position,loosening or rupture,and bone healing of axial pedicle screws,and complications.Frankel grading and visual analogue scale (VAS) at the last follow-up were compared between the two groups.Results All patients were followed up for 3 to 36 months,with an average of 21 months.The electric drill group took significantly shorter time in preparing both atlantal and axial pedicle screw trajectories than the bare hand group [(8.8 ±4.2)minutes ∶ (16.5 _±9.7)minutes;(4.1 ± 1.2)minutes∶ (6.1 ±3.2)minutes] (P＜0.05).There was no significant difference in intraoperative blood loss between the electric drill group and the bare hand group [(54.2 ± 32.0) ml ∶ (58.0 ± 28.4) ml] (P ＞ 0.05).In the electric drill group,the penetration rate of atlantal screws was 0,the complete position rate was 96％ (27/28),and the good rate of screw placement was 100％ (28/28),superior to 23％ (7/30),73％ (22/30) and 73％(22/30) in the bare hand group (P ＜ 0.05).In terms of the axial screws,in the electric drill group,the panetration rate was 4％ (1/28),the complete position rate was 82％ (23/28),and the good rate of screw placement was 96％ (27/28),superior to 10％ (3/30),70％ (21/30) and 93％ (28/30) in the bare hand group (P ＞ 0.05).There were no complications such as cerebrospinal fluid leakage,spinal cord injury,cerebellar infarction,loosening and fracture of internal fixation,and nonunion of bone.At the last follow-up,Frankel grading and VAS of the two groups were improved to different degrees (P ＜0.05),but there was no significant difference between the two groups (P ＞ 0.05).Conclusion For atlantoaxial fracture and dislocation,preparation of atlantoaxial internal fixation screw trajectories by electric power can significantly shorten the operation time and improve the accuracy of atlas screw placement.
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Objective@#To investigate the application effect of electric drill drive in the preparation of atlanto-axial posterior screw trajectory.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 29 patients with atlanto-axial fracture and dislocation admitted to the Lanzhou University Second Hospital from February 2016 to March 2019. There were 19 male and 10 females, aged from 10 to 72 years, with an average of 44.6 years. All patients received posterior atlantoaxial screw fixation. Electric drill drive was adopted in 14 patients to prepare the screw trajectory (electric drill group), and bare hand technique was used in 15 patients (bare hand group). In the electric drill group, 28 atlantal lateral screws and 28 axial pedicle screws were implanted; in the free hand group, 30 atlantal lateral screws and 30 axial pedicle screws were implanted. The trajectory preparation time and intraoperative blood loss between the two groups were compared. After the operation, the X-ray films and 3D CT were taken to observe the lateral mass of atlas as well as the position, loosening or rupture, and bone healing of axial pedicle screws, and complications. Frankel grading and visual analogue scale (VAS) at the last follow-up were compared between the two groups.@*Results@#All patients were followed up for 3 to 36 months, with an average of 21 months. The electric drill group took significantly shorter time in preparing both atlantal and axial pedicle screw trajectories than the bare hand group [(8.8±4.2)minutes ∶(16.5±9.7)minutes; (4.1±1.2)minutes∶ (6.1±3.2)minutes] (P<0.05). There was no significant difference in intraoperative blood loss between the electric drill group and the bare hand group [(54.2±32.0)ml ∶ (58.0±28.4)ml] (P>0.05). In the electric drill group, the penetration rate of atlantal screws was 0, the complete position rate was 96% (27/28), and the good rate of screw placement was 100% (28/28), superior to 23% (7/30), 73% (22/30) and 73%(22/30) in the bare hand group (P<0.05). In terms of the axial screws, in the electric drill group, the panetration rate was 4% (1/28), the complete position rate was 82% (23/28), and the good rate of screw placement was 96% (27/28), superior to 10% (3/30), 70% (21/30) and 93% (28/30) in the bare hand group (P>0.05). There were no complications such as cerebrospinal fluid leakage, spinal cord injury, cerebellar infarction, loosening and fracture of internal fixation, and nonunion of bone. At the last follow-up, Frankel grading and VAS of the two groups were improved to different degrees (P<0.05), but there was no significant difference between the two groups (P>0.05).@*Conclusion@#For atlantoaxial fracture and dislocation, preparation of atlantoaxial internal fixation screw trajectories by electric power can significantly shorten the operation time and improve the accuracy of atlas screw placement.
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OBJECTIVE: To explore an objective evaluation mode for emergency response capacity on sudden poisoning incidents. METHODS: Based on the health emergency drills and blind design,22 teams in Guangdong Province were recruited to participate in the first round of evaluation,including blind sample analysis,theoretical examination( poisoning medical rescue,detection and investigation) and skills assessment( poisoning medical care,poisoning investigation,personal protection,poisoning detection and emergency decision-making). Then,the top 10 teams in the first round of evaluation were proceeded to desktop exercise in the second round of evaluation. The evaluation results were compared with the local gross domestic product( GDP) from 2011 to 2015 by Spearman rank correlation analysis. RESULTS: The median scores of the 4 sections were as follows: blind sample analysis was 71. 0,theoretical examination was 61. 4,skills assessment was 76. 5,and the desktop exercise was 55. 0. The rates of excellent for assessment of blind sample analysis,theoretical examination and skills assessment were 22. 7%,4. 5% and 0. 0%,while the failure rates were 31. 8%,45. 5% and 4. 5%,respectively. The rates of failure in medical rescue and investigation in theoretical examination were63. 6% and 50. 0%,the rates of failure in medical rescue and investigation in skills assessment were 40. 9% and 31. 8%,respectively. The middle-grade and passing rates of the top 10 teams in the desktop exercise were 10. 0%,and the failure rate was 80. 0%. There was a moderate positive correlation between the emergency response capacity for emergent poisoning and local GDP( Spearman rank correlation coefficient > 0. 700,P < 0. 05). CONCLUSION: The evaluation mode of emergency response capability assessment combined with actual combat and desktop emergency drill is established successfully. It can objectively test the assessment of emergency response capabilities.
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OBJECTIVE: To evaluate the ability of health emergency drill for sudden poisoning incidents in Guangdong Province. METHODS: A double-blinded method was used to organize 22 teams in Guangdong Province to conduct a health emergency drill which contained preliminary and repeated drill. The preliminaries contained blind sample analysis,theoretical examination and skills assessment. The repeated drills was desktop network exercise carried out for the teams ranked top 10 in the preliminaries. RESULTS: In the preliminary round,the median( M) of total score among the 22 teams was 72. 5. Among them,blind sample analysis,theoretical examination and skills assessment were 71. 0,61. 4 and 76. 5,respectively. The total score of skill assessment was higher than that of theoretical assessment( P < 0. 05). The passing rate of 22 teams was 68. 2%(15/22),and the failure rate was 31. 8%(7/22). The failing teams all came from the nonPearl River Delta region. The total preliminary scores,passing rate,the total scores of blind sample analysis and skills assessment of the teams in Pearl River Delta Region were higher than that in the non-Pearl River Delta region( P < 0. 01).In the theoretical examination,the scores of detection and investigation were both higher than that of medical rescue( P <0. 05). For the skills assessment,the scores of decision-making,personal protection and poisoning detection were in the top three,the scores of the medical rescue and investigation were relatively low( P < 0. 05). In the repeated round,the M of desktop exercise was 55. 0,passing rate was 20. 0%,and the failure rate was 80. 0%. CONCLUSION: The health emergency response capacity for sudden poisoning incidents in Guangdong Province needs to be improved. The construction of emergency response capacity for emergency poisoning in the non-Pearl River Delta region should be strengthened,especially the training on strengthening theoretical and practical knowledge of poisoning medical treatment and poisoning investigation.
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Objective@#The present study evaluated postoperative reactions in adjacent teeth after the extraction of lower-level horizontal-impacted mandibular third molars using a T-shaped splitting method. @*Methods@#A total of 101 patients with lower-level horizontal impaction of mandibular third molars were selected and randomly divided into two groups. The impacted mandibular third molar was extracted using a T-shaped splitting method in group A （56 cases）, and the traditional two-section method was used in group B （45 cases）。 Postoperative reactions, including temperature sensitivity, percussion pain and mobility in the adjacent teeth, were compared between the 2 groups at 1-week, 2-week, and 1-month follow-up visits. The SPSS 13.0 software package was used for the statistical analysis.@*Results @#The postoperative reactions of temperature sensitivity （χ21w= 11.81, χ22w = 17.43, P < 0.05）, percussion pain （χ21w = 8.70, χ22w = 4.75, P < 0.05） and mobility （χ21w = 4.50, χ22w = 7.10, P < 0.05） in adjacent teeth in group A were significantly less than those in group B at the 1-week and 2-week follow-up visits. The temperature sensitivity in adjacent teeth in group A was significantly less than that in group B at the 1-month follow-up visit （χ2 = 7.10, P < 0.05）, but percussion pain and mobility in adjacent teeth disappeared in both groups. @*Conclusion@#The T-shaped splitting method for the extraction of mandibular lower-level horizontal impacted third molars can reduce the postoperative reactions in adjacent teeth.
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Objetivos: avaliar o desempenho de furação de brocas. Material e métodos: três sistemas de implantes brasileiros foram testados: A (FGM, Joinville); B (Neodent, Curitiba); e C (SIN, São Paulo). A força de furação foi mantida constante e igual a 35 N. A rotação das brocas foi de 800 rpm e os corpos-de-prova foram mantidos em temperatura de 36°C ± 2°C, sendo a água destilada como fluido refrigerante. Dados sobre a temperatura e torque de furação foram adquiridos, e o desgaste das brocas foi avaliado por MEV. Os testes Anova e Tukey (α=5%) foram utilizados na análise estatística. Resultados: as brocas são eficazes, não ultrapassando a temperatura de limite biológico (47°C). Conclusão: de acordo com os ensaios realizados, a broca do grupo A reúne características que a habilitam como broca de perfuração única no preparo do leito do implante dentário. A análise em MEV mostrou que os grupos A e B mantiveram os gumes de corte bem defi nidos e sem desgaste aparente.
Objectives: to evaluate the osteotomy performance of implant drills. Material and methods: three different Brazilian dental implant systems were tested: A (FGM, Joinville), B (Neodent, Curitiba), and C (SIN, São Paulo). Drilling force was kept at 35 N. Drill rotation was set at 800 RPM and samples were kept at 36 ± 2°C under water coolant. Data regarding temperature and torque were acquired and drill wear evaluated under SEM. The Anova and Tukey tests (α=5%) were applied for statistical analyses. Results: all drills were effi cient and remained below the biologic limit level (47°C). Conclusion: according to the tests, drills of the A group had characteristics for a single osteotomy at the bone bed for implant placement. The SEM analysis demonstrated that groups A and B still had sharp, well-defi ned cutting edges with no visible wear.
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Humans , Data Interpretation, Statistical , Dental Implants , Dental Instruments , Microscopy, Electron, Scanning , Root Canal Preparation/instrumentation , TorqueABSTRACT
Antecedentes: Los hallazgos reportados en la literatura no relacionan directamente la efectividad de corte de las fresas de diamante de alta velocidad con la cantidad y calidad de diamantes en la superficie, ni su vida media después de un determinado número de usos. Objetivo: Evaluar la durabilidad de los diamantes de corte de la superficie activa de las fresas después de realizar desgastes en dientes naturales. Métodos: Este estudio ex vivo comparó 4 marcas comerciales de fresas de diamante con granos de 64-126 |zm, de forma troncocónica y punta redonda (norma ISO 850): MDT", Swisstech*, Pointech* y Jota". Se realizaron 5 cortes de 0,16 mm con cada fresa en la corona del diente. Luego se analizaron las fresas en microscopio electrónico de barrido para observar: a) adhesión de diamantes al sustrato en cabeza y cuerpo; b) estado de los diamantes en el sustrato en cabeza y cuerpo, tras los 5 cortes; y c) estadofinal de las fresas. Se realizó un análisis cualitativo y cuantitativo. Resultados: Todas las fresas de las 4 marcas presentaron similar desgaste después de los 5 usos, tanto en la cabeza como el cuerpo. Pese a que todas las muestras presentaban variaciones, en algunas fue más evidente el desalojo y fractura de los diamantes. Conclusión: El estudio sugiere que las fresas deberían cambiarse después de 5 usos clínicos para garantizar un desgaste adecuado y evitar daños pulpares ocasionados por la fricción.
Background: Outcomes reported in the literature do not relate cutting effectiveness of high-speed diamond drills directly to the diamond surface amount and quality, not either their average life after a specific number of uses. Objective: To evaluate the durability of diamond burrs in the drill active surface after doing removal in natural teeth. Methods: This ex vivo study compared dental drills of four different brand names with 64-126 pm, round tip, conical-trunk diamond grit (ISO 850): MDT", Swisstech", Pointech* and Jota". Five 0.16 mm cuts were carried out using each dental drill on a tooth crown. The dental drills were then analyzed under the scanning electron microscope in order to observe: a) any adhesion of diamond to substrate in the head and body; b) condition of the diamonds in the substrate, in head and body, after 5 cuts; and c) final condition of the dental drills. Then a qualitative and quantitative analysis was carried out. ResuJts: The four different dental drills showed a similar worn condition after five uses, both in the head and body. Despite all the samples showed variations, some of them had greater evidence of diamond fracture and displacement. Conclusion: This study suggests that the dental drills should be changed over after 5 clinical uses in order to ensure a desirable worn condition and prevent pulpal damage due to the friction.
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Microscopy, Electron, Scanning , Dental Cavity Preparation , Dental Instruments/classification , Dental Instruments/statistics & numerical dataABSTRACT
OBJECTIVE: To analyze the effects of hand-transmitted vibration exposure on the finger vibratory and pain perception thresholds among drill workers in a gold mine. METHODS: By the judgement sampling method,134 male drill workers from a gold mine in the northern area of China were selected as the hand-transmitted vibration exposure group and102 fit-up workers without vibration exposure in the same mine were chosen as the control group. The finger vibratory perception thresholds,the pain perception thresholds and the occupational health examination were conducted and analyzed in these two groups. Based on the self-report with vibration-induced white finger( VWF),the workers of hand-transmitted vibration exposure group were divided into non-VWF subgroup( 105 workers) and VWF subgroup( 29 workers). RESULTS: The incidence of finger numbness,pain and self-reported white finger in the exposure group were significantly higher than those in the control group( P < 0. 05). Compared with the control group,the vibratory perception thresholds of the index finger,middle finger and ring finger of the right hand among the vibration exposure group workers were significantly higher( P < 0. 05),but there was no significant difference in the vibratory perception thresholds of the left ring finger between the two groups( P > 0. 05). The vibratory perception thresholds of both ring fingers,right index finger and right middle-finger in VWF subgroup were higher than those in control group( P < 0. 05). But no significant differences was found in the above 4 indexes in these two groups after compared to those of control group,respectively( P > 0. 05). The vibratory perception thresholds of left ring finger,right ring finger and right index finger in VWF subgroup were all higher than those in non-VWF subgroup( P < 0. 05),but the vibratory perception thresholds of right middle finger in these two groups showed no significant difference( P > 0. 05). The pain perception thresholds of index finger,middle finger and ring finger in both hands of the vibration exposure group workers were all higher than those in control group( P < 0. 05). The pain perception thresholds of middle finger and ring finger in both hands of the VWF subgroup and non-VWF subgroup were higher than those of control group( P < 0. 05). CONCLUSION: The hand-transmitted vibration can increase the thresholds of finger vibratory and pain perception in drill workers. The finger sensory perception examination could be used to assist the early detection of peripheral nerve damage induced by hand-transmitted vibration.
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OBJECTIVE: Although twist-drill craniostomy (TDC) has a number of procedural advantages and an equivalent outcome compared to burr hole craniostomy (BHC) for the treatment of chronic subdural hematomas (CSDHs), the latter technique remains the preferred method. We analyzed symptomatic CSDHs in whom TDC at the pre-coronal suture entry point (PCSEP) was the primary method for hematoma drainage and BHC on the parietal was the secondary option. METHODS: CSDHs in 86 consecutive patients were included. TDC at the PCSEP, which is 1 cm anterior to coronal suture at the level of the superior temporal line, was the primary operational technique when the hematoma thickness was suitable, and BHC was performed via the parietal when TDC was unreasonable or failed. The clinical feasibility and outcomes of these approaches were analyzed. RESULTS: Of the 86 patients, 68 (79.1%) were treated by TDC, and 18 (20.9%) by BHC. All patients showed improvements in their symptoms after hematoma drainage. Neither morbidity nor mortality was associated with either technique, and there were no differences in drainage days between the groups. Ten patients had bilateral hematomas and were treated using TDC. Two patients were not sufficiently treated by TDC and, as a result, BHC was applied. Only six hematomas (7% of 86 hematomas) exhibited insufficient thickness on the computed tomography to perform TDC. CONCLUSION: When the hematoma was thick enough, a majority of the CSDHs were drained using TDC at the PCSEP as the first procedure, which was especially useful for bilateral hematomas and in elderly patients.
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Aged , Humans , Drainage , Hematoma , Hematoma, Subdural, Chronic , Methods , Mortality , Rabeprazole , SuturesABSTRACT
Na exploração do petróleo, o uso de fluidos de perfuração é essencial para o equilíbrio da pressão entre as formações e o interior do poço, além de impedir o refluxo do reservatório de petróleo ao poço. Os fluidos também são responsáveis pela elevação dos cascalhos de perfuração à superfície. Entretanto, estes podem ser potenciais contaminantes do ambiente, uma vez que chegam à superfície impregnados de fluidos. O trabalho objetivou avaliar o pH e os teores de Na+, K+, Ca2+, Mg2+e Al3+em um Latossolo e um Planossolo submetidos a doses de fluido de perfuração, após sofrerem dois ensaios de lixiviação. Os resultados mostraram que a adição dos fluidos ao Planossolo e Latossolo nas concentrações de 4%, 8% e 16% (m/m) reduziu o alumínio tóxico a zero e promoveu aumento do pH do solo, Na+, K+e Ca2+em comparação ao controle.
In petroleum exploration, the use of drilling fluids is critical to the balance of pressure between the formations and the interior of the shaft, and preventing the backflow of oil from the reservoir to the oill well. Fluids are also responsible for raising the drill cuttings to the surface. However, these may potentially contaminate the environment once they arrive at the fluid-impregnated surface. This study aimed to check the pH and Na+, K+, Ca2+, Mg2+ and Al3+ in an Oxisol and Planosol subjected to doses of drilling fluid, after suffering two leaching tests. The results showed that the addition of fluids to Planosoland Oxisol at concentrations of 4%, 8% and 16% (w / w) reduced toxic aluminum to zero and promoted an increase of the soil pH, Na+, K+ and Ca2+ compared to control.
ABSTRACT
BACKGROUND: This study aimed to assess the whole-body vibration (WBV) exposure among large blast hole drill machine operators with regard to the International Organization for Standardization (ISO) recommended threshold values and its association with machine- and rock-related factors and workers' individual characteristics. METHODS: The study population included 28 drill machine operators who had worked in four opencast iron ore mines in eastern India. The study protocol comprised the following: measurements of WBV exposure [frequency weighted root mean square (RMS) acceleration (m/s2)], machine-related data (manufacturer of machine, age of machine, seat height, thickness, and rest height) collected from mine management offices, measurements of rock hardness, uniaxial compressive strength and density, and workers' characteristics via face-to-face interviews. RESULTS: More than 90% of the operators were exposed to a higher level WBV than the ISO upper limit and only 3.6% between the lower and upper limits, mainly in the vertical axis. Bivariate correlations revealed that potential predictors of total WBV exposure were: machine manufacturer (r = 0.453, p = 0.015), age of drill (r = 0.533, p = 0.003), and hardness of rock (r = 0.561, p = 0.002). The stepwise multiple regression model revealed that the potential predictors are age of operator (regression coefficient beta = -0.052, standard error SE = 0.023), manufacturer (beta = 1.093, SE = 0.227), rock hardness (beta = 0.045, SE = 0.018), uniaxial compressive strength (beta = 0.027, SE = 0.009), and density (beta = e1.135, SE = 0.235). CONCLUSION: Prevention should include using appropriate machines to handle rock hardness, rock uniaxial compressive strength and density, and seat improvement using ergonomic approaches such as including a suspension system.