Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes

Objectives To examine the effect of surgical approach on perioperative morbidity and mortality after partial nephrectomy. Materials and Methods Within the Nationwide Inpatient Sample, patients who underwent RAPN or LPN between October 2008 and December 2009 were identified. Propensity-based matching was performed to adjust for potential baseline differences between the two groups. The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality, stratified according to RAPN vs. LPN, were compared. Results Overall, 851 (72.5%) patients underwent RAPN and 323 (27.5%) underwent LPN. For RAPN and LPN respectively, the following rates were recorded in the propensity-score matched cohort: blood transfusions, 4.5 vs. 6.8% (p = 0.223); intraoperative complications, 5.2 vs. 2.6% (p = 0.096); postoperative complications, 10.6 vs. 13.5% (p = 0.268); prolonged length of stay, 6.8 vs. 9.4% (p = 0.238); in-hospital mortality, 0.0 vs. 0.0%. Conclusions RAPN has supplanted LPN as the predominant minimally invasive surgical approach for renal masses. Perioperative outcomes after RAPN and LPN are comparable. Interpretation of these findings needs to take into account the lack of adjustment for case complexity and surgical expertise. .

Influence of lingual bracket position on microbial and periodontal parameters in vivo

OBJECTIVE: Lingual orthodontics is becoming more popular in dental practice. The purpose of the present investigation was to compare plaque formation on teeth bonded with the same bracket onto buccal or lingual surface, with non-bonded control teeth, via an in vivo growth experiment over a 30-day period. MATERIAL AND METHODS: A randomized controlled trial with split-mouth design was set up enrolling 20 dental students. Within each subject sites with buccal and lingual brackets and control sites were followed. Clinical periodontal parameters (periodontal pocket depth: PPD; bleeding on probing: BOP) were recorded at baseline and on days 1, 7 and 30. Microbiological samples were taken from the brackets and the teeth on days 1, 7 and 30 to detect colony-forming units (CFU). Total CFU, streptococci CFU and anaerobe CFU were measured. RESULTS: No significant differences (P>0.05) were found between buccal and lingual brackets in terms of clinical periodontal parameters and microbiological values. Conclusion: Bracket position does not have significant impact on bacterial load and on periodontal parameters.

Angiotomografia computadorizada como método diagnóstico de aneurisma intracraniano: relato do primeiro caso em Caxias do Sul / The computed tomographic angiography of skull like adicional method in order to reveal intracranial aneurysms: the first case report in Caxias do Sul

O trabalho objetiva mostrar a angiotomografia computadorizada de crânio como método adicional, a fim de revelar aneurismas intracranianos, a partir da ocorrência do primeiro caso do referido exame, com finalidade diagnóstica, ter ocorrido na cidade de Caxias do Sul. Sobre esse caso clínico, descreve-se a forma como foi realizada a investigaçäo angiotomográfica, explicitando-se com atençäo as informaçöes referentes ao próprio procedimento (velocidade do aparelho, espessura dos cortes, volume de contraste, tipo de pós-processamento, entre outros), ao mesmo tempo em que säo colocadas em destaque as vantagens, desvantagens, complicaçöes, restriçöes e limitaçöes da técnica. Após atento trabalho de observaçäo, conclui-se que a angiotomografia computadorizada de crânio tem reconhecidos benefícios técnicos quanto à capacidade de demonstrar lesöes vasculares pequenas e também de apontar o quadro de vascularizaçäo tridimensional. Contudo, apesar de suas inúmeras vantagens, ainda näo se consegue superar o realismo obtido com a angiografia convencional ou excluí-la de uso para casos de exames diagnósticos. A angiotomografia apresenta deficiência na visualizaçäo de vasos adjacentes à clipes, podendo näo revelar aneurismas nessa situaçäo particular. Sendo uma técnica recente, necessita, certamente, de estudos adicionais que ampliem as suas vantagens, inclusive para outras patologias, que restrinjam as suas limitaçöes e que demonstrem outras restriçöes que contra-indiquem seu emprego.