RESUMO
Background: The term "navigation" describes a device that can pinpoint critical anatomical features, the most direct path to the target, and the optimal surgical orientation. This study aimed to conduct a comprehensive literature search on computer-assisted navigation for use in oral and maxillofacial surgery. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, relevant studies were retrieved from five electronic databases: Medline, Web of Science, PubMed, Google Scholar, and Saudi Digital Library (SDL). The central question was, "Does the computer-assisted navigation system improve the outcome of surgical procedures in the oral and maxillofacial region?" The Cochrane Risk of Bias 2 was used to determine the various types of bias. Results: Post-traumatic midfacial reconstruction is one of the many fields that have benefited from the use of computer-assisted navigation because of its reliability. It can also be used to extricate difficult foreign entities from the operative zone. Locating critical anatomical components, communicating the surgical plan to the patient, and verifying surgical success can improve the function and appearance of patients with dentofacial abnormalities. In addition, it decreases the surgical error margin and duration. Conclusion: Computer-assisted navigation is promising in surgical practice. The accuracy of surgery can be significantly enhanced by first planning the process in a virtual environment and then performing it under close supervision in real time. In addition, the time required for preoperative planning and surgery can be reduced by creating and improving software programs.
RESUMO
BACKGROUND: Refractoriness to platelet transfusion is an understudied phenomenon in critically ill patients. Our objective was to evaluate the prevalence, risk factors, and clinical outcomes of platelet refractoriness among patients in a tertiary-care intensive care unit (ICU). METHODS: A retrospective cohort study included all patients (age >14 years) who were admitted to a tertiary-care medical-surgical ICU between 2011 and 2016 and received ≥2 platelet transfusions during their ICU stay. We calculated platelet increment (PI) and corrected count increment (CCI). RESULTS: A total of 267 patients were enrolled in the study, collectively receiving 1357 transfusions with a median of 4.0 (interquartile range: 2.0, 6.0) transfusions per patient. The median pretransfusion platelet count was 31000.0 × 106/L (interquartile range: 16000.0, 50000.0). The median PI was 6000 × 106/L. The prevalence of platelet transfusion refractoriness was 54.8% based on PI < 10000 × 106/L and 57.0% based on CCI <5000. Patients admitted under hepatology/liver transplant had the highest rates of platelet refractoriness (69.6%), while those under general surgery had the lowest rate (43.2%). Younger age, nontrauma admission, and larger spleen size were associated with platelet refractoriness. Finally, refractoriness was associated with increased length of stay in the ICU (p = 0.02), but not with mortality. CONCLUSIONS: Platelet transfusion refractoriness was highly (>50%) prevalent in ICU patients. However, it was not associated with increased mortality.
RESUMO
INTRODUCTION: Although the first metatarsophalangeal (MTP) joint is frequently injured, Complete dislocation of the first MTP joint represents a relatively rare traumatic injury. PRESENTATION OF CASE: A 46-year-old gentleman presented with a traumatic first MTP joint dislocation resulting from an automobile accident. Due to coronavirus outbreak in the hospital at that time, patient was referred to another hospital. Six months later, reduction was achieved surgically and fixation of the MTP with K-wires was done. DISCUSSION: Only few case reports have described the injury, and the ideal treatment along with the long-term result of the injury has yet to be further studied because reports are rare in this regard. CONCLUSION: Functional range of motion may result even after 6 months of delayed treatment with ORIF and osteopenia may result.
