ABSTRACT
Undergoing a major surgery within 14 days is considered a contraindication for intravenous alteplase. However, there is no consensus as to what qualifies as major surgery or an invasive procedure. Occasionally, determining whether a procedure is "invasive" or too risky in the setting of emergency ischemic stroke thrombolytic management can be challenging. Stroke neurologists may not be able to make such a decision on their own. Guidance or clearance from the physicians who performed the procedure is essential. We report the case of a patient who received intravenous alteplase after developing a stroke immediately following transcatheter aortic valve implantation (TAVI).
ABSTRACT
STATEMENT OF PROBLEM: In spite of a digital workflow playing an important role in the intraoral prosthetic rehabilitation of patients with head and neck cancer, information about how it has been implemented and its clinical implications is sparse. PURPOSE: The purpose of this systematic review was to evaluate the use of a digital workflow in the intraoral prosthetic rehabilitation of patients with head and neck cancer by analyzing the frequency and type of the digital procedures used. MATERIAL AND METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The following terms were applied for the search conducted in the MEDLINE-PubMed, Cochrane, and SciELO databases: (prosthesis OR dental OR rehabilitation) AND (digital OR CAD-CAM OR intraoral scanner) AND (Cancer OR head neck). Articles that specified data on intraoral prosthetic treatment and analyzed the use of a digital workflow in the different prosthetic phases such as digital scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) in patients with head and neck cancer were included. Data from the frequency and type of digital procedures were analyzed. RESULTS: Thirteen articles were included, and all had incorporated CAD-CAM techniques in at least 1 of the prosthetic treatment stages (scanning, design, and/or fabrication). Only 1 patient was rehabilitated by using a completely digital workflow. The most frequent prosthetic treatment was an obturator (82.6%). Regarding the image capture method, the most used method was cone beam computed tomography (CBCT) (60.9%). CONCLUSIONS: Most reports described the partial use of a digital workflow in the intraoral prosthetic rehabilitation of patients treated for head and neck cancer. A digital workflow is used for specific stages but not for the entire process. More studies are needed to evaluate digital systems, ideally comparing parameters with the conventional method, and to determine whether this technique has more relevant clinical implications.
Subject(s)
Dental Implants , Head and Neck Neoplasms , Computer-Aided Design , Dental Prosthesis Design/methods , Humans , WorkflowABSTRACT
Objetivo: Se valora histomorfológicamente la capacidad de regeneración ósea del plasma rico en plaquetas, a distintas concentraciones,y el extracto de médula ósea rico en plaquetas, en comparación con -fosfato tricálcico. Material y Metodo: Se realiza un trabajo experimental en 8 cerdos, a los que se les practican trepanaciones mandibulares para colocar los materiales a estudio. Las muestras obtenidas se observan mediante microscopio electrónico y se realizan fotografías sistemáticas para analizarlas mediante un sistema de histograma de grises. Resultados: Los fenómenos de osificación se aprecian en el 96% de los defectos practicados, con independencia del material empleado para rellenarlo. Se aprecia que el plasma rico en plaquetas (PRP) y la médula ósea (M) muestran un grado de osteogénesis equivalente, 12,3 y 13,4 respectivamente más potencia que el control. El plasma pobre en plaquetas (PPP) presenta una capacidad semejante a los controles (C) con una media de sustracción de 14,03 y 14,12 respectivamente. El fosfato tricálcico (FT) se muestra efectivo como elemento inductor de osificación, 3,03 veces más potente que el control. Conclusiones: La osificación se presenta en la mayor parte de los defectos practicados. El PRP y la M son los elementos con máscapacidad osteogénica y el PPP no se muestra más efectivo que el control.
Objetive: On numerous occasions after the oral surgery bone defects occur which may be difficult to repair. Objective: We assessed the histomorphologic bone regeneration capacity of platelet-rich plasma at different concentrations, and extract bone marrow platelet-rich, compared with -tricalcium phosphate. Material and Methods: We performed an experimental study in 8 pigs, who are practicing trepanaciones jaw to move the materials to study. The samples obtained were observed through electronic microscope and systematic photographs were made to analyse them through a system of gray histogram. Results: Ossification Phenomena were seen in 96% of the defaults practiced with independance of the material used to fill them. It is appreciated that the platelet-rich plasma (PRP) and bone marrow (M) show an equivalent degree of osteogenesis, 12.3 and 13.4 respectively, more power than the control. The platelet-poor plasma (PPP) provides a capability similar to controls (C) with an average of 14.03 and 14.12 abduction respectively. Tricalcium phosphate (FT) is effective as an inducer of ossification, 3.03 times more potent than the control. Conclusions: The ossification occurs in most of the charged defects. The PRP and the M are the most osteogenic capacity and the PPP is no more effective than control.
Subject(s)
Animals , Bone Marrow , Platelet-Rich Plasma , Bone RegenerationABSTRACT
A través de los tiempos se ha tratado de evitar la pérdida de los dientes afectados por diferentes problemas como caries, traumatismo o enfermedad periodontal. La regeneración tisular guiada es una de las técnicas actuales que se basa en el principio básico de posibilitar la creación de un espacio biológico que permita únicamente el crecimiento del tejido deseado, favoreciendo así la regeneración específica de la zona.
