Effect of radiotherapy on the differentiation and osteogenic activity of mesenchymal stem cells on dental implants / Efeito da radioterapia na diferenciação e atividade osteogênica de células-tronco mesenquimais em implantes dentários

Objective: to evaluate the differentiation and gene expression of transcripts related to osteogenesis in a primary culture of Mesenchymal Stem Cells (MSCs) derived from rat femurs submitted to radiotherapy and the installation of pure titanium implants. Material and Methods: fifty-four rats received titanium implants in both femurs and were divided into three groups: Control: implant surgery (C); Implant + immediate irradiation (IrI), and Implant + late irradiation (IrL). Euthanasia occurred 3, 14, and 49 days after surgery. The bone marrow MSCs from the femurs were isolated and cultivated. The cell viability, total protein content, alkaline phosphatase (ALP) activity, and the formation of mineralization nodules and cellular genotoxicity were analyzed. The gene expression of Alkaline Phosphatase (phoA), Collagen 1 (COL1), Runt-related transcription factor 2 (RUNX2), Osterix (OSX), Osteopontin (OPN), Integrin ß1(ITGB1), Bone Sialoprotein (BSP), Osteonectin (SPARC), Osteocalcin (Bglap), Transforming Growth Factor ß-type (TGF-ß), Granulocyte Macrophage Colony Stimulating Factor (GM-CSF), Interleukin-6 (IL-6), Apolipoprotein E (APOE) and Prostaglandin E2 synthase (PGE2) were evaluated by qRT- PCR. Results: ionizing radiation suppresses the gene expression of essential transcripts for bone regeneration, as well as cellular viability, as observed in the IrI and IrL groups. Conclusion: although this can lead to the loss of osseointegration and failure of the implant, the MSCs showed more activity at 49 days than at 3 and 14 days. (AU)

Objetivo: avaliar a diferenciação e expressão gênica de transcritos relacionados à osteogênese em cultura primária de MSCs derivadas de fêmures de ratos submetidos à radioterapia e instalação de implantes de titânio puro. Material e Métodos: cinquenta e quatro ratos receberam implantes de titânio em ambos os fêmures e foram divididos em três grupos: Controle: cirurgia de implante (C); Implante + irradiação imediata (IrI) e Implante + irradiação tardia (IrL). A eutanásia ocorreu 3, 14 e 49 dias após a cirurgia. As MSCs de medula óssea dos fêmures foram isoladas e cultivadas. Foram analisadas a viabilidade celular, teor de proteína total, atividade da fosfatase alcalina (ALP), formação de nódulos de mineralização e genotoxicidade celular. A expressão gênica de Fosfatase Alcalina (phoA), Colágeno 1 (COL1), fator de transcrição relacionado a Runt 2 (RUNX2), Osterix (OSX), Osteopontina (OPN), Integrina ß1 (ITGB1), Sialoproteína Óssea (BSP), Osteonectina (SPARC), Osteocalcina (Bglap), Fator de Crescimento Transformador tipo ß (TGF-ß), Fator Estimulante de Colônia de Granulócitos-Macrófagos (GM-CSF), Interleucina-6 (IL-6), Apolipoproteína E (APOE) e Prostaglandina E2 sintase (PGE2) foram avaliados por qRT-PCR. Resultados: a radiação ionizante suprime a expressão gênica de transcritos essenciais para a regeneração óssea, bem como a viabilidade celular, como observado nos grupos IrI e IrL. Conclusão:embora isso possa levar à perda da osseointegração e falha do implante, as MSCs apresentaram maior atividade aos 49 dias do que aos 3 e 14 dias (AU)

Clinical Efficacy of Chinese Medicine Combined with Indirect Moxibustion Plaster on COVID-19 Patients During Recovery Period Based on COVID-19 Diagnosis and Treatment Protocol（Tenth Edition） / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Chinese medicine combined with indirect moxibustion plaster on corona virus disease 2019 （COVID-19） patients during recovery period. MethodNinety patients of COVID-19 during the recovery period were randomly divided into a Chinese medicine group， an indirect moxibustion plaster group， and a combination group，with 30 cases in each group. According to the 10th edition of COVID-19 Diagnosis and Treatment Protocol，patients in the Chinese medicine group received oral Chinese medicine based on syndrome differentiation，one dose per day， twice a day. Patients in the indirect moxibustion plaster group were treated with indirect moxibustion plaster at Zusanli （ST 36）， Pishu （BL 20）， Dazhui （GV 14）， Feishu （BL 13）， Kongzui （LU 6）， and Tiantu （CV 22），once a day，40 min each time. Patients in the combination group were treated with Chinese medicine combined with indirect moxibustion plaster. Treatment lasted two weeks. Before and after treatment，the traditional Chinese medicine （TCM） symptom score，pulmonary computed tomography （CT） score，St. George's Respiratory Questionnaire （SGRQ） score，blood routine indexes ［white blood cell count （WBC），neutrophil count （NEUT），and lymphocyte count （LYM）］， and inflammatory indexes ［C-reactive protein （CRP），serum ferritin， and interleukin-6 （IL-6）］ were observed in the three groups. The clinical efficacy was evaluated. ResultAfter treatment，the scores of TCM symptoms，pulmonary CT， and SGRQ，CRP，IL-6，and ferritin in the three groups decreased（P<0.05），while WBC and LYM increased（P<0.05）， but there was no significant difference in NEUT. The above indexes in the combination group were better than those in the other two groups（P<0.05）. After treatment， the cured and markedly effective rate was 76.7% （23/30） in the combination group， 50.0% （15/30） in the Chinese medicine group， and 46.7% （14/30） in the indirect moxibustion plaster group. The cured and markedly effective rate of the combination group was significantly higher than that of the Chinese medicine group （χ2=4.593， P<0.05） and the indirect moxibustion plaster group （χ2=5.711， P<0.05）. The total effective rate was 96.7 % （29/30） in the combination group， 93.3% （28/30） in the Chinese medicine group， and 86.7% （26/30） in the indirect moxibustion plaster group. The total effective rate of the combination group was higher than that of the Chinese medicine group and the indirect moxibustion plaster group， but the differences were not statistically significant. ConclusionChinese medicine combined with indirect moxibustion plaster can effectively improve the clinical symptoms，promote pulmonary inflammation，blood routine indexes， and inflammatory indexes， and improve the quality of life of COVID-19 patients during the recovery period，which is more advantageous than Chinese medicine alone or indirect moxibustion plaster.

Physical activity in the treatment of depression in college students / Atividade física no tratamento da depressão em estudantes universitários / La actividad física en el tratamiento de la depresión en estudiantes universitarios

ABSTRACT Introduction: The mental health of college students is getting more and more attention from society. Physical exercise as a means of psychotherapy and mental health has become common at home and abroad. Objective: We explore the effect of prescribing physical exercise in the treatment of depression in college students. Methods: College students who had been diagnosed with depression were randomly divided into an observation group and a control group, each with 18 patients. The control group received drug treatment. The observation group received sports therapy in addition to drug therapy. Results: There was a statistically significant difference in HAMD scores between the observation and control groups in the first week (P<0.01). Conclusions: Exercise can play a role in treating depression patients rapidly, safely, and efficiently. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A saúde mental dos estudantes universitários está recebendo cada vez mais atenção da sociedade. O exercício físico como meio de psicoterapia e saúde mental tornou-se comum no país e no exterior. Objetivo: Exploramos o efeito da prescrição de exercícios físicos no tratamento da depressão em estudantes universitários. Métodos: Estudantes universitários com diagnóstico de depressão foram divididos randomicamente em grupo observação e grupo controle, cada um com 18 participantes. O grupo controle recebeu tratamento medicamentoso. O grupo observação recebeu terapia esportiva acrescida de terapia medicamentosa. Resultados: Verificou-se diferença estatisticamente significativa nos escores da HAM-D entre os grupos observação e controle na primeira semana (P < 0,01). Conclusões: Os exercícios podem ter um papel no tratamento de pacientes com depressão de forma rápida, segura e eficiente. Nível de Evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: La salud mental de los estudiantes universitarios recibe cada vez más atención por parte de la sociedad. El ejercicio físico como medio de psicoterapia y salud mental se ha convertido en algo habitual en el país y en el extranjero. Objetivo: Explorar el efecto de la prescripción de ejercicios físicos en el tratamiento de la depresión en estudiantes universitarios. Métodos: Estudiantes universitarios con diagnóstico de depresión fueron divididos aleatoriamente en un grupo de observación y un grupo de control, los cuales contaban con 18 participantes cada uno. El grupo de control recibió tratamiento farmacológico. El grupo de observación recibió terapia deportiva y terapia farmacológica. Resultados: Se comprobó una diferencia estadísticamente significativa en las puntuaciones de HAM-D entre los grupos de observación y control en la primera semana (P < 0,01). Conclusiones: La actividad física puede actuar en el tratamiento de pacientes con depresión de forma rápida, segura y eficaz. Nivel de Evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Evaluating the efficacy and safety of ultrasound-guided percutaneous microwave ablation for the treatment of adrenal metastasis

Context: Microwave ablation (MWA) has been proven as a promising method to treat solid tumors. Aims: This study aims to evaluate the efficacy and safety of ultrasound (US)-guided MWA for treating adrenal metastasis and to explore the factors affecting survival. Settings and Design: This was a retrospective study performed on patients treated at our department. Subjects and Methods: A total of 43 patients with adrenal metastasis (22 hepatocellular carcinoma, eight renal cell carcinoma, five non-small cell lung cancer, four colorectal cancer, three liposarcoma, and one malignant fibrous histiocytoma) were enrolled. All patients were treated at our department at least once. The treatment protocol for each patient, the technique used, and the survival details were recorded. Statistical Analysis Used: Statistical analyses were performed using SPSS 26.0 software. Results: Technical success was achieved in all cases. MWA was a safe technique for treating all types of metastasis. No major complications were observed. The pathology of adrenal lesions was the significant risk factor contributing to overall survival (OS) (P = 0.040). The 1-year and 3-year OS rates for all patients were 0.828 and 0.389, respectively. Conclusions: Percutaneous US-guided MWA is safe and effective in terms of local control and survival of adrenal metastasis

Efectividad del tratamiento temprano de niños con mutismo selectivo en los centros educativos / Effectiveness of early treatment of children with selective mutism in educational centers

Resumen El mutismo selectivo (MS) es un trastorno de ansiedad de baja prevalencia, lo que dificulta su investigación. Pese a su inicio temprano su diagnóstico no suele hacerse antes del acceso a la escolaridad obligatoria. El objetivo de este estudio fue valorar la eficiencia de un protocolo cognitivo-conductual para la intervención psicológica en el contexto educativo (ipmsce), siguiendo los criterios de la Task Force in Promotion and Dissemination of Psychological Procedures. Participaron 10 niños que presentaban una demora inferior a dos años entre el inicio del MS y su diagnóstico (1.00 ± 0.54). La edad media fue de 4.94 años y el 80% fueron niñas. Se utilizó un diseño de acumulación de casos, con medidas del tratamiento antes de su aplicación, al finalizar y en un seguimiento a los 12 meses, obtenidas a través de los padres, los profesores y un test situacional. Los resultados muestran la efectividad de la intervención.

Abstract Selective mutism (SM) is an anxiety disorder of low prevalence, which makes its investigation difficult. Despite its early start, its diagnosis is not usually made before access to compulsory schooling. The objective of this study was to assess the efficiency of a cognitive-behavioral protocol for psychological intervention in the educational context (ipmsce), following the criteria of the Task Force in Promotion and Dissemination of Psychological Procedures. Ten children with a delay of less than two years between the onset of SM and its diagnosis (1.00 ± 0.54) participated. The average age was 4.94 years and 80 % were girls. A case accumulation design was used, with measures of treatment before its application, at the end and in a followup at 12 months, obtained through parents, teachers and a situational test. The results show the effectiveness of the intervention.

Bundles of Treatment Protocol for Acute Brain Injury Complicated by Acute Lung Injury or Acute Respiratory Distress Syndrome / 中国医科大学学报

Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.

Treatment Modalities for Skeletal Class III Malocclusion: Early to Late Treatment.

Skeletal Class III malocclusion has always been characterized by an unpredictable growth pattern with doubtful prognosis though treated at a very young age. Treatment protocols may include growth modification, orthodontic camouflage, or orthognathic surgery, depending on the degree of the skeletal discrepancy and the age of the patient. The orthopedic approach for growth modification is limited to the children in a growth phase. In a patient with underdeveloped maxilla, the face mask may be the treatment of choice, whereas in a Class III patient with over developed mandible a chin cap is needed. Camouflage orthodontic treatment is performed in patients with a mild skeletal Class III discrepancy and no remaining growth. However, adult patients with severe skeletal Class III discrepancy might need orthognathic surgery to correct the malocclusion.

The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review / 中国结合医学杂志

<p><b>OBJECTIVE</b>To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia.</p><p><b>METHODS</b>A literature search was carried out up to November 10, 2012 in the databases PubMed/MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China.</p><p><b>RESULTS</b>Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear.</p><p><b>CONCLUSION</b>There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.</p>

Patrón de tratamiento en pacientes adultos mayores con fractura de húmero proximal en tres o cuatro fragmentos en un centro de referencia de una economía emergente / Treatment protocol in elderly patients with three- or four-fragment proximal humerus facture at a referral center located in an emerging economy

Antecedentes: Las fracturas proximales de húmero corresponden 4 y 5% de las fracturas en adultos mayores, ocupando 45% de las fracturas humerales, siendo 13 al 16% fracturas en tres y cuatro fragmentos. Métodos: Estudio retrospectivo, observacional y transversal de fuentes secundarias, se estudiaron registros de pacientes con diagnóstico de fractura proximal de húmero en tres o cuatro fragmentos en pacientes adultos mayores de 60 años. Técnica de muestreo no probabilístico de casos consecutivos, considerándose de cada uno: el sexo, edad, número de fragmentos, extremidad afectada y extremidad dominante, el patrón de tratamiento. Resultados: Se incluyeron 118 pacientes, siendo el sexo predominante el femenino (83.9%), con rango de edad de 60 a 93 años y una mediana de 73 años. Las fracturas en tres fragmentos representó 63% y de cuatro fragmentos 36%. La extremidad izquierda fue la mayormente afectada siendo 57%, la extremidad dominante fue la derecha ocupando 82%. El patrón quirúrgico predominó, representado 57% y el tratamiento conservador representó 43%. Se realizó en 39 casos reducción abierta y fijación interna (RAFI) con banda a tensión, en 22 pacientes con hemiartroplastía, en cinco pacientes RAFI con placa en T 4.5 y en uno RAFI con placa LCP LISS. Conclusiones: Los pacientes femeninos mayores de 72 años, mostraron mayor frecuencia de manejo quirúrgico. El patrón de tratamiento quirúrgico fue de 57%, a diferencia de lo reportado en la literatura mundial (20%).

Background: Proximal humerus fractures account for 4-5% of the fractures that occur among elderly people; they represent 45% of humerus fractures, and 13-16% of them are three- or four-fragment fractures. Methods: Retrospective, observational, cross-sectional study of secondary data sources. The records of patients over 60 years of age with a diagnosis of three- or four-fragment proximal humerus fractures were analyzed. A non-probabilistic sampling technique of consecutive cases was used. The following variables were analyzed: age, sex, fragment number, limb involved and dominant limb, and treatment protocol. Results: 118 patients were included, most of them females (83.9%), age range was 60-93 years, with a mean age of 73 years. Three-fragment fractures represented 63%, and four-fragment fractures 36%. The left limb was more frequently affected, accounting for 57%; 43% of cases were treated conservatively. Open reduction and internal fixation (ORIF) was performed in 39 cases with a tension band, in 22 patients with hemiarthroplasty, ORIF with a 4.5 T-plate in 5 patients, and ORIF with a LCP LISS plate in one patient. Conclusions: Female patients over 72 years of age underwent this kind of treatment more frequently. Surgical treatment accounted for 57%, unlike what the literature reports (20%).

Síndrome de ativação macrofágica em paciente com artrite idiopática juvenil sistêmica / Macrophage activation syndrome in a patient with systemic juvenile idiopathic arthritis

A síndrome de ativação macrofágica (SAM) é uma doença rara e potencialmente fatal, normalmente associada às doenças reumáticas crônicas, em especial a artrite idiopática juvenil. É incluída no grupo das formas secundárias de síndrome hemofagocítica, cujas outras causas podem ser as doenças linfoproliferativas e infecções. As manifestações clínicas e laboratoriais mais importantes são a febre não remitente, esplenomegalia, hemorragias, disfunção hepática, citopenias, hipoalbuminemia, hipertrigliceridemia e hiperferritinemia. O tratamento deve ser iniciado rapidamente, e a maioria dos casos responde bem aos corticosteroides e à ciclosporina (CSA). O vírus Epstein-Barr (EBV) é descrito como possível gatilho para muitos casos de SAM, especialmente naqueles em tratamento com bloqueadores do fator de necrose tumoral (TNF). Nos casos refratários ao tratamento convencional, etoposide (VP16) deve ser administrado, em associação com corticosteroides e CSA. Nosso objetivo foi descrever um caso raro de síndrome hematofagocítica provavelmente secundária à infecção pelo vírus Epstein-Barr (EBV), em paciente com artrite idiopática juvenil sistêmica, confirmada pelas manifestações clínicas e laboratoriais típicas, mielograma e sorologia positiva contra o EBV, que atingiu remissão completa após inclusão no protocolo de tratamento HLH-04.

Machrophage activation syndrome (MAS) is a rare and potentially fatal disease, commonly associated with chronic rheumatic diseases, mainly juvenile idiopathic arthritis. It is included in the group of secondary forms of haemophagocytic syndrome, and other causes are lymphoproliferative diseases and infections. Its most important clinical and laboratorial manifestations are non-remitting fever, splenomegaly, bleeding, impairment of liver function, cytopenias, hypoalbuminemia, hypertriglyceridemia, hypofibrinogenemia and hyperferritinemia. The treatment needs to be started quickly, and the majority of cases have a good response with corticosteroids and cyclosporine. The Epstein–Barr virus is described as a possible trigger for many cases of MAS, especially in these patients in treatment with tumor necrosis factor (TNF) blockers. In these refractory cases, etoposide (VP16) should be administered, associated with corticosteroids and cyclosporine. Our objective is to describe a rare case of MAS probably due to EBV infection in a subject with systemiconset juvenile idiopathic arthritis, which achieved complete remission of the disease after therapy guided by 2004-HLH protocol.

Discrete Breast Masses in Female Children and Adolescents: Is there a Place for Non-operative Management by Pediatric Surgeons.

Background: The treatment of breast masses in female children and adolescents is controversial. While some advocate for early surgical removal others prefer the conservative non operative approach. The aim of this study is ascertain the evidence for the current protocol of early surgical removal in our centre. Materials and Methods: Retrospective observational study to highlight the epidemiology of discrete breast masses in female children and adolescents <18years seen at the Lagos University Teaching Hospital, Nigeria. Main outcome measure was to find out if there is a malignancy in excised tissue specimens. Results: Fifty three girls with 76 breast masses were evaluated. Median age at presentation was 16years (4 –17 years). Mean size of lumps was 3.6 cm (±2.1). All the breast masses had benign clinical characteristics and were confirmed histologically to be benign. There was no case of primary or secondary malignancy in any of the histological specimens. Family history, nipple discharge or ingestion of oral contraceptives did not affect presentation, diagnosis and outcome (p>0.05). Conclusion: This series show that breast masses in children and adolescents are almost always benign. It is advocated that conservative non-operative management (with close follow up with imaging such as breast ultrasound and/or MRI) should be adopted by paediatric surgeons in cases of breast masses in children except when surgery is specifically indicated. These indications which should be individualized include: cosmesis, bloody nipple discharge, persistent history of pain in the mass, rapid growth of the mass and malignancies with predilection for the breasts.

Psicoterapia de grupo para dor crônica: um protocolo / Group psychotherapy for chronic pain: a protocol

Este artigo trata da psicoterapêutica para dor crônica. Apresenta um protocolo para tratamento psicológico em grupo. É resultado de uma experiência que buscou integrar práticas clínicas que interrompem os processos psicológicos e psicossociais mantenedores do ciclo da dor. Neste protocolo, o treino de habilidades, intervenções psicoeducativas e estratégias mais recentes da terapia comportamental contemporânea são privilegiados. O procedimento de grupo amplia o leque de problemas que podem ser trabalhados ao vivo quando ocorrem durante a sessão. Diversas estratégias que abordam o problema de diferentes ângulos são integradas numa plataforma unificada de tratamento que pode ser aplicado a diversos ambientes (settings). Assim, o protocolo pode contribuir para a acessibilidade ao tratamento psicológico para a dor crônica. A proposta pretende servir aos profissionais no campo e à pesquisa sobre os efeitos de intervenções psicológicas em dor crônica.

This article is about psychotherapy for chronic pain. A protocol for group treatment is provided, as a result of efforts to integrate clinical practices that address several psychological and psychosocial mechanisms that maintain chronic pain. Contemporary behavioral strategies are assimilated, together with skills training and psycho-education. The group format makes it easier to target a range of problems while they occur in vivo during the sessions. The protocol integrates different strategies that target social, interpersonal, and experiential changes into a portable set that can be applied to a variety of medical and community settings. This can improve access to effective multidimensional treatment for people with chronic pain. The protocol is intended for professionals in the field, but also lends itself to efficacy research in psychological intervention for chronic pain.

Orthodontics In Cleft Palate Therapy - A Clinical Review.

There are certain protocols to be followed in treating the Cleft palate and Lip patients. There should be perfect timing, Judgement and understanding between the different members of the team treating the patient.This is particular true with the case of rapport between the Oro- Maxillofacial surgeon and Orthodontist. This review provides few guidelines in treating the cleft palate and lip patients

Orthdodontic Management of Medically Compromised Patients.

The nature of the orthodontic patient base seeking treatment continues to grow. Some of these patients may have potentially medical compromises or conditions. As such there is no absolute contraindication of orthodontic treatment in most of these conditions but may require a slightly modified protocol. This article reviews the orthodontic treatment Protocol for some common medical conditions.

Reconsideration of treatment protocol on the reduction of Enterococcus faecalis associated with failed root canal treatment / 대한치과보존학회지

Microorganism survived in the root canal after root canal cleaning and shaping procedure is a main cause of root canal treatment failure. There are several mechanisms for the bacteria to survive in the root canal after chemomechanical preparation and root canal irrigation. Bacteria organized as biofilm has been suggested as an etiology of persistent periapical lesion. Recent studies were focus on removal of Enterococcus faecalis biofilm due to the report that the persistence of this bacteria after root canal treatment may be associated with its ability to form biofilm. Several investigations demonstrated that current root canal treatment protocol including use of NaOCl, EDTA and Chlorhexidine as irrigants is quite effective in eliminating E. faecalis biofilm. However, this microorganism still can survive in inaccessible areas of root canal system and evade host immune response, suppress immune activity and produce biofilm. Up to date, there is no possible clinical method to completely get rid of bacteria from the root canal. Once the root canal treatment failure occurred, and conventional treatment incorporating current therapeutic protocol has failed, periapical surgery or extraction should be considered rather than prolong the ineffected retreatment procedure.

Multidisciplinary Treatment Protocol of Stroke Patients with Hemiplegia / 中国康复理论与实践

@# The individual and multidisciplinary treatment is decided by the complexities of befalling-mechanism and clinical symbolization in hemiplegia resulting from stroke. So we enactmented the multidisciplinary treatment protocol, which includes traditional Chinese medical differentiation treatment, acupuncture and rehabilitation-treatment-technique by stages. The result of clinical treatment showed that the multidisciplinary treatment protocol is suitable to living qualities of hemiplegia and embodies the superiority of unity and individual integrated.

Poisoning surveillance and creation of protocol for the treatment of rare poisons in a private corporate hospital.

A survey on the incidence of poisoning was conducted at Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu. The retrospective study by the Drug/Poison Information Center on incidence of poisoning in the department of Accident and Emergency Medicine indicated the requirement of treatment protocols for some rare poisons. Hence, the Drug/Poison Information Center developed and introduced the “Protocol for the Treatment of Rare Poisons” to the physicians of various departments and their response to the protocol was collected in the feedback form. Analysis of the feedback data revealed that the protocol was well appreciated by the physicians involved in the study.