Laser Therapy Versus Traditional Scaling and Root Planing: A Comparative Review.

Scaling and root planing (SRP) removes bacterial plaque, calculus, and associated microorganisms from the surface of the tooth and the surrounding soft tissue. While complete eradication of pathogenic microbes is impossible, gross removal can lower the microbial load, which in turn reduces inflammation and contributes to positive clinical outcomes. Instrumentation in limited-access anatomic areas like furcation, grooves, deep pockets, concavities, and distal molar areas is technically demanding with traditional mechanical debridement. However, emerging advanced systems such as lasers with bactericidal and detoxification effects offer the benefit of reaching limited-access areas that traditional SRP cannot reach. A digitized search was done on PubMed, Embase, Medline, and Google Scholar using the keywords "lasers", "periodontal therapy", "scaling", and "root planing". Upon screening and reviewing, the shortlisted articles comprised narrative reviews, systematic reviews, randomized controlled trials, comparative studies, split-mouth studies, case series, and reports of non-surgical laser therapy and lasers as an adjunct to SRP. This review presents a comprehensive comparative evaluation of different laser modalities utilized in non-surgical periodontal treatment in contrast to standard SRP, rather than an exhaustive article review. It delves into the history and development of lasers, highlighting key advancements made in the realm of periodontics and dental care. This review includes an elucidation of the theory behind laser operation, along with an exploration of its intrinsic characteristics and breakdown of the various types of lasers that are currently available, and an examination of existing literature in both present and historical contexts regarding the comparison of various types of lasers with traditional periodontal treatment.

Management Protocol for Uncomplicated Peritonsillar Abscess: Standardizing Care and Improving Emergency Medicine Resident Confidence.

INTRODUCTION: A peritonsillar abscess (PTA) is a frequent reason for a visit to the emergency department. As there are no current published guidelines for medical versus surgical management, attending physicians vary among management tendencies, generating uncertainty among resident physicians. This project established a standard of care for managing patients with PTA and provided clear management guidelines to the emergency department, in collaboration with the otolaryngology department, at a community academic hospital. METHODS: Pre- and post-interventional, anonymous surveys were given to assess resident physician confidence in the management of PTA. A proposed management protocol was developed based on existing literature and approved by both the emergency medicine (EM) and otolaryngology (ENT) departments. The protocol was then disseminated during in-person didactic sessions to EM residents and ENT residents for use over a four-month interventional period. RESULTS: The mean confidence level for all residents increased significantly after the implementation of the protocol (p<0.001). The increase in confidence level for "antibiotic selection for PTA" (p=0.72) and "inpatient PTA management" (p=0.20) was not statistically significant for the post-graduate year (PGY) 3 and 4 residents. The increase in confidence level was higher overall for PGY 1 and 2 residents (95% CI 2.25 ± 1.09, p<0.001) than for PGY 3 and 4 residents (95% CI 1.73 ± 1.09, p=0.003). CONCLUSION: The implementation of a standardized protocol for the management of PTA proved to be an effective tool in assisting residents and improving their confidence. This study highlights the importance of establishing guidelines in clinical practice to promote consistent and evidence-based management strategies for PTA. By providing clear guidelines, this protocol enhances communication among healthcare providers and contributes to the delivery of high-quality care to patients with PTA.

Protected Stroke Mechanical Thrombectomy Code During the Coronavirus (COVID-19) Pandemic: Southwestern Part of Saudi Arabia Stroke Unit Local Protocol.

Cerebrovascular diseases are a significant cause of mortality and morbidity worldwide, in particular those with large vessels occlusion (LVO). Coronavirus disease 2019 (COVID-19) has become a global crisis rapidly since its initial outbreak in Wuhan, China, in December, 2019. Stroke due to LVO needs rapid assessment and timely endovascular intervention which can be very challenging during the time of pandemic where you need to deliver proper, safe, and timely care to acute ischemic stroke (AIS) patients with LVO, yet, protecting healthcare workers and existing patients at the medical facility. In this article, we share our local experience in the stroke unit at Aseer Central Hospital which is the main hub of stroke patients in the southwestern part of Saudi Arabia and the primary regional COVID center to provide guidance to perform smooth, safe, and swift mechanical thrombectomy during the coronavirus (COVID-19) pandemic as well as possible similar future situations.

Identifying predictive markers of efficacy in antiepidermal growth factor receptor therapies in metastatic colorectal cancer / 肿瘤研究与临床

The antiEGFR monoclonal antibodies cetuximab and panitumumab have been proven to be efficient in MCRC. The degree of EGFR expression (as confirmed by immunohistochemical analysis) did not correhte with the clinical response. In this review, we describe the current status of markers that might identify patients who are likely to benefit from treatment with cetuximab or panitumumab. These molecular markers include KRAS mutations, EGFR copy number, EGFR ligands (EGF, epiregulin), cyclin DI, IgG FcγR (FCGR2A-HI31R and FCGR3A-V158F), and nuclear factor-κB, that are crucial to avoid anti-EGFR treatment toxicity and reduce treatment cost.

Constipação intestinal / Constipation

A constipação intestinal crônica é motivo comum de consulta em ambulatório de pediatria e de gastroenterologia pediátrica. A apresentação clínica é variável. A procura para tratamento é tardia, em geral quando surgem as complicações da doença, como a encoprese, o escape fecal e a dor abdominal. Alguns fatores são importantes na fisiopatologia como alimentação, predisposição genética, desmame precoce, dismotilidade intestinal, comportamento de retenção fecal, ocorrência de evacuação com dor ou sangue. As causas de constipação intestinal podem ser orgânicas ou funcionais. Em uma pequena parcela dos casos é necessária a solicitação de exames complementares para o diagnóstico definitivo. O tratamento é prolongado e depende da adesão dos pacientes e dos seus responsáveis. Algumas vezes, o médico deverá intervir na dinâmica familiar, modificando hábitos alimentares e de vida, motivando o uso dos medicamentos, quando prescritos, prevenindo a recorrência dos sintomas.

Constipation is a frequent complaint in pediatric and gastroin-testinal pediatric visits. Clínica I presentation may vary. Search of medical assistance for treatment is delayed, general/y occurring at the onset of complications such as soilíng, encopresis or abdominal pain. Associated factors in constipation physiopa- thology include low fiber diet, genetic predisposition, intestinal dismotility, fecal retentive behavior, ear/y weaning, painful defe- cation and presence of blood in feces. One must always investigate the cause of constipation as anatomic abnormalities and organic diseases may be present. Diagnosis is general/y based on medical history and physical examination, especial/y in chronic functional constipation. Complíance to long term treatment by patient and fami/y is necessary. The attending pediatrician must be prepared to motivate both patient and family regarding use of medication and changing diet habits. The pediatrician must identify the need and opportune timing for further diagnostic testing and interventions.