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Objective:To explore the effect of Z type lateral decubitus position in patients with stroke-related pneumonia.Methods:Totally 52 patients with stroke-related pneumonia admitted to the neurology care unit in Qilu Hospital of Shandong University (Qingdao) were randomly divided into the control group and the observation group with 26 cases in each group from February to December 2021.The control group adopted routine position management, and the observation group adopted the Z type lateral decubitus position to observe. The differences in sputum volume, clinical pulmonary infection score (CPIS), blood oxygen saturation change, and hospital stay between the two groups were compared.Results:The SpO 2 was 0.966 ± 0.210 in the observation group and 0.948 ± 0.223 in the control group on the 7th day after the implementation of the measures. There was a significant difference between the two groups ( t=3.07, P<0.01). The sputum aspiration volume of the observation group was (30.65 ± 10.01), (39.27 ± 11.30), (36.92 ± 12.94) ml on the 1st, 3rd, 7th day after the implementation of the measures, which were significantly higher than those of the control group (24.81 ± 9.55), (28.92 ± 9.40), (27.65 ± 7.85) ml. The differences were statistically significant ( t=2.16, 3.59, 3.12, P<0.05). On the 7th day after implementation, the CPIS score of the observation group was 4.54 ± 1.63, which was better than that of the control group 5.46±1.61 ( t=-2.06, P<0.05). The average length of stay in the observation group was (13.35 ± 2.74) d, which was significantly shorter than (15.46 ± 4.42) d in the control group ( t=-2.07, P<0.05). Conclusions:The use of Z type lateral decubitus position has a positive significance for the rehabilitation and recovery of patients with stroke-related pneumonia. This position can promote sputum drainage and improve patients pulmonary function, accelerate the dissipation of patient inflammation, and reduce the length of hospital stay.
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Background: Surgery on posterior cranial fossa (PCF) and pineal region (PR) carries the risks of intraoperative trauma to the brainstem structures, blood loss, venous air embolism (VAE), cardiovascular instability, and other complications. Success in surgery, among other factors, depends on selecting the optimal patient position. Our objective was to find associations between patient positioning, incidence of intraoperative complications, neurological recovery, and the extent of surgery. Methods: This observational study was conducted in two medical centers: The Ohio State University Wexner Medical Center (USA) and The Burdenko Neurosurgical Institute (Russian Federation). Patients were distributed in two groups based on the surgical position: sitting position (SP) or horizontal position (HP). The inclusion criteria were adult patients with space-occupying or vascular lesions requiring an open PCF or PR surgery. Perioperative variables were recorded and summarized using descriptive statistics. The post-treatment survival, functional outcome, and patient satisfaction were assessed at 3 months. Results: A total of 109 patients were included in the study: 53 in SP and 56 in HP. A higher proportion of patients in the HP patients had >300 mL intraoperative blood loss compared to the SP group (32 vs. 13%; p = 0.0250). Intraoperative VAE was diagnosed in 40% of SP patients vs. 0% in the HP group (p < 0.0001). However, trans-esophageal echocardiographic (TEE) monitoring was more common in the SP group. Intraoperative hypotension was documented in 28% of SP patients compared to 9% in HP group (p = 0.0126). A higher proportion of SP patients experienced a new neurological symptom compared to the HP group (49 vs. 29%; p = 0.0281). The extent of tumor resection, postoperative 3-months survival, functional outcome, and patient satisfaction were not different in the groups. Conclusions: The SP was associated with, less intraoperative bleeding, increased intraoperative hypotension, VAE, and postoperative neurological deficit. More HP patients experienced macroglossia and increased blood loss. At 3 months, there was no difference of parameters between the two groups. Clinical Trial Registration: ClinicalTrials.gov: registration number NCT03364283.
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Resumen Introducción y Objetivo: La impactación de terceros molares es una situación clínica muy común en la población mundial; Pell & Gregory han sugerido una clasificación para la impactación basados en la posición horizontal y vertical. Identificar la frecuencia de posiciones de terceros molares impactados en pacientes atendidos en la clínica CES-Sabaneta entre los años 2006-2016. Materiales y métodos: De acuerdo a la base de datos del servicio de cirugía oral, dos examinadores durante 3 meses revisaron 626 historias clínicas en pacientes entre 17 a 28 años de edad que tuvieran formula dental completa, con radiografía panorámica y que fueron remitidos por motivos ortodónticos, restaurativos o quirúrgicos. Resultados: Un total de 515 terceros molares fueron evaluados, el tercer molar más impactado fue el 28 (25,6%), seguido del 18 (25,4%), el 48 con 24,6% y el 38 con 24,2%. Prevaleció el género femenino con 58,6%, el diente más impactado fue el 28 (87.8%), a nivel vertical la posición C fue la que más se impactó, mientras que en los hombres el diente más impactado es el 18 con un 79.7%, la posición B fue la más impactada y a nivel horizontal la clase II fue la más común en ambos sexos. Conclusión: A nivel vertical la posición B, fue la más frecuente en los terceros molares del género femenino, sin embargo, en el género masculino hubo una variación, en el maxilar predomino la posición C; a nivel horizontal la clase II fue las posiciones más frecuentes en ambos géneros.
Abstract Introduction and objective: The Impaction of third molars is a very common clinical situation in the world population; Pell & Gregory have suggested a classification for impaction based on horizontal and vertical position. To identify the frequency of impacted third molar positions in patients treated at the CES-Sabaneta clinic between the years 2006-2016. Materials and methods: According to the oral surgery service database, two examiners during 3 months reviewed 626 clinical histories in patients between 17 and 28 years of ages who had complete dental formula, with panoramic radiography and who were remitted for reasons orthodontic, restorative or surgical. Results: A total of 515 third molars were evaluated, the third most impacted molar was 28 (25.6%), followed by 18 (25.4%), 48 with 24.6% and 38 with 24.2%. %. The female gender prevailed with 58.6%. The most impacted tooth was 28 (87.8%). At the vertical level, position C was the most impacted, while in men the most impacted tooth is 18 with a 79.7. %, position B was the most impacted and at the horizontal level class II was the most common in both sex. Conclusions: At the vertical level, position B was the most frequent in the third molars of the female gender, however in the male gender there was a variation, in the maxillary the position C predominated; A horizontal level class II was the most frequent positions in both sex.
Sumário Introdução e Objetivo: O impacto dos terceiros molares é uma situação clínica muito comum na população mundial; Pell & Gregory sugeriram uma classificação para o impacto com base na posição horizontal e vertical. Identifique a frequência de comprometimento das posições dos terceiros molares em pacientes tratados na clínica CES-Sabaneta entre 2006-2016. Materiais e métodos: Segundo o banco de dados do serviço de cirurgia oral, dois examinadores, durante 3 meses, revisaram 626 prontuários em pacientes entre 17 e 28 anos de idade que possuíam fórmula dental completa, com radiografia panorâmica e foram encaminhados por motivos ortodôntico, restaurador ou cirúrgico. Resultados: Foram avaliados 515 terceiros molares, o terceiro molar mais impactado foi 28 (25,6%), seguido por 18 (25,4%), 48 com 24,6% e 38 com 24,2 % O sexo feminino prevaleceu com 58,6%, o dente mais impactado foi 28 (87,8%), no nível vertical a posição C foi a mais impactada, enquanto nos homens o dente mais impactado é 18 com 79,7%. %, posição B foi a mais impactada e horizontalmente a classe II foi a mais comum em ambos os sexos. Conclusão: No nível vertical, a posição B foi a mais frequente nos terceiros molares do sexo feminino, no entanto, no sexo masculino houve variação, na posição maxilar C predominou; horizontalmente, a classe II foi a posição mais frequente em ambos os sexos.
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OBJECTIVE: To familiarize new criteria to access vertical position of mental foramen in panoramic radiographs. Furthermore, to determine and compare the position and symmetry of mental foramen in horizontal as well as in vertical plane in Indian population and to compare the results with those reported for other populations in the literature. Further gender differences in mental foramen position were also accessed to comment on the reliability of panoramic radiographs for sex determination. Methods and Material : Six hundred digital panoramic radiographs were selected and studied regarding the location and symmetry of mental foramen. They were also compared with the other studies in the literature. The method employed is similar to that described by Al Jasser and Nwoku for horizontal position and Fishal et al. for vertical position of mental foramen. Certain modifications were carried out in Fishal's criteria for vertical position assessment. Results : The commonest position of the mental foramen in horizontal plane was in line with the longitudinal axis of the second premolar (61.0%) while in vertical plane it was found to be located inferior to the apex of second premolar (72.2%). Conclusion : Mental foramen exists in different locations and possesses many variations. Hence, Individual, gender, age, race and assessing technique largely influence these variations. It suggests that the clinicians should carefully identify these anatomical landmarks, by analyzing all influencing factors, prior to their diagnostic or the other dental, surgical and implant operation.
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PURPOSE: To compare the accuracy and reliability of intraocular pressure (IOP) measurements in enucleated porcine eyes using the Icare PRO in the upright and horizontal positions. METHODS: We designed an enucleated porcine eye model whose anterior chamber was cannulated with a 30-gauge needle, connected in parallel to a pneumatic pressure device. The reference pressure was manipulated by changing the air pressure from 70 to 10 mm Hg at 10 mm Hg intervals, and the IOP of porcine eyes was measured with the Icare PRO at each pressure. Correlation analysis, comparison using the Bland-Altman plot and Wilcoxon signed rank test, was performed to assess the accuracy of IOP measurements. Intraclass correlation coefficients were calculated to assess the intra-observer variability in the upright and horizontal positions, respectively. RESULTS: The IOP value in both upright and horizontal positions was well correlated with the reference pressure (r = 0.992 and 0.985, respectively). The Bland-Altman plot showed good agreement between the two positions. However, all IOP values in both positions were lower than the reference pressures. The IOP values in the horizontal position were significantly lower than those in the upright position at the a reference pressure of 50 mm Hg or greater. Values of intraclass correlation coefficient ranged from 0.911 to 0.984 when measured in the upright position and from 0.707 to 0.914 in the horizontal position. CONCLUSIONS: IOP measurements of Icare PRO in porcine eyes were remarkably lower than reference pressures controlled by the pneumatic method even though they showed a good correlation with reference values. The higher was the reference pressure, the greater was the degree of underestimation of IOP measurement in both positions. This trend was more pronounced in the horizontal position, and the reliability of IOP measurements was also lower than that in the upright position.
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Pressão do Ar , Câmara Anterior , Pressão Intraocular , Complexo Ferro-Dextran , Agulhas , Variações Dependentes do Observador , Valores de ReferênciaRESUMO
One of the most common operations which have been performed on young adults may be the extraction of third molars. And then, we can meet many reports on third molars which were studied by lots of specialists. Many domestic reports which dealt with pathologic condition, impaction, eruption and angulation state of third molars have already been reported. The author reported the statistical survey on mandibular third molars of Korean through dental radiography in 1963. Until now, the extraction of third molars may be one of the most common operation which were done at the department of oral & maxillofacial surgery in dental hospital. But, the more we can see certain diseases easily, the more we can neglect to study on it. So now, it's true that we cannot meet the reports about the third molars. The author performed the clinical study on the eruption state of mandibular third molars of Korean and compared with the results in 34 years ago. Following results were obtained 1. It was found that the largest number was ClassI(483 cases) among the total 1004 cases in the relation of the tooth to the ramus of the mandible and second molar. 2. In ClassI, the number of cases was increased in more than 17-year-old age. In ClassII, the number of the cases was decreased as it grows older. 3. It was found that sex distributions were equal in the classification of Gregory. And the largest case number was ClassI in both of male and female. 4. The mesio-angular position in all cases was the largest number. Among Class I,II, and III, ClassIII was the only group that disto-angular position was found. Horizontal positions were found in ClassII,III more than in ClassI. Vertical positions were found in Class I more than in Class II. 5. In Winter`s classification, the largest case number was the meio-angular position in both of male and female and sex distributions were equal in all positions. 6. In Winter`s classification, the largest case number was the mesio-angular position in all ages.
