Direct bonding of a lingual retainer is challenging because it requires a long working time on the lingual aspect of the anterior teeth. Due to no direct vision there is a risk of contamination from saliva and moisture, which can cause bond failure; and it is difficult to apply the adhesive exactly where it is needed. The indirect method described in this article shows an easy way to increase better-quality bonding of the retainer
The bio-energy released by the hydrolysis of adenosine triphosphate, which relate to plenty of life activities and is transported in a solution, and its theory of transport are first stated and built in helix protein molecule. In order to confirm and verify the correctness of the transported theory we here systematically summarized and reviewed a great number of experimental investigation and evidences obtained by us and other researchers in past 30 years, involving the real existences of the solution and its features and lifetimes. In this survey we outlined and presented concretely the features of infrared spectra of absorption, Raman spectra and specific heat of the molecular crystal-acetanilide collagen, bivine serum albumin, myoglobin proteins and E.Coli. cell as well as the lifetimes of the solution in acetanilide and myoglobin measured by using pump-probe techniques and free-electron laser experiment, in which we give not only experimental data but also their comparisons with theoretical results. These experimental data and evidences provided here are enough to verify and affirm the true existences of the new solution, which can complete itself functions of bio-energy transport in the lifetime, and the correctness of the new theory of bio-energy transport in the acetanilide and protein molecule. Thus we can affirm the correctness of theory of the bio-energy transport in helix protein molecule, which can greatly promote the development of molecular biology.
Background: An infectious disease caused by a novel coronavirus called COVID-19 has raged across the world since December 2019. The novel coronavirus first appeared in Wuhan, China, and quickly spread to Asia and now many countries around the world are affected by the epidemic. The deaths of many patients, including medical staff, caused social panic, media attention, and high attention from governments and world organizations. Today, with the joint efforts of the government, the doctors and all walks of life, the epidemic in Hubei Province has been brought under control, preventing its spread from affecting the lives of the people. Because of its rapid spread and serious consequences, this sudden novel coronary pneumonia epidemic has become an important social hot spot event. Through the analysis of the novel coronary pneumonia epidemic situation, we can also have a better understanding of sudden infectious diseases in the future, so that we can take more effective response measures, establish a truly predictable and provide reliable and sufficient information for prevention and control model.
Methods: We establish different models according to the different developments of the epidemic situation, different time points, and different response measures taken by the government. To be specific, during the period of 2020.1.23-2020.2.7, the traditional SIR model is adopted; during the period of 2020.2.8-2020.3.30, according to the scientific research results, it was considered that the novel coronary pneumonia has a latent period, so in the later phase of epidemic development, the government has effectively isolated patients, thus we adopt the SEIQR model accordingly. During the period of 2020.3.31-2020.5.16, because more asymptomatic infected people were found, we use the SEIQLR model to fit. Finally, through a SEIR simulator, considering the susceptible number, the latent number, the infected number, the cured number, death number and other factors, we simulate the change of various numbers of people from the beginning to the next 180 days of novel coronary pneumonia.
Findings: The results based on the analysis of differential equations and kinetic models show that through the prediction of the model established in the first phase, the epidemic situation of novel coronary pneumonia in Hubei Province was controlled at the end of March, which is in line with the actual situation. The rest of Hubei province, except for Wuhan, lifted control of the departure channel from 0:00 am on March 25, and Wuhan was also unblocked on April 8. Through the establishment of the second-phase model, it is found that the epidemic situation will reach its peak in mid-February. For example, the quarantine admission of the hospital declined after mid-February, which is inseparable from the measures to build square cabin hospitals in early February so that more and more patients can be admitted. The model established in the third phase shows that the epidemic had been completely controlled by the end of May, which is also in line with the reality. Because in mid-May, the Wuhan government conducted a nucleic acid test on all the citizens to screen for asymptomatic infected persons to fundamentally control the spread of novel coronary pneumonia.
Interpretation: Hubei Province, as the center of the initial outbreak of novel coronary pneumonia, people were forced to be isolated at home during the Spring Festival, the most important Chinese holiday, and the whole society was in a state of suspension of work and study. The Chinese government had taken many measures in response to the epidemic, such as shutting down the city, vigorously building square cabin hospitals, and prohibiting people from gathering. At the beginning of May this year, the epidemic in Hubei Province was finally effectively controlled. For ordinary citizens, we should not cause unnecessary panic about the unknown novel coronavirus. Instead, we should fully understand and be familiar with this virus. In addition to the relevant medical knowledge, we should also understand the spread of infectious diseases through appropriate mathematical models. By mathematical models, we can understand the degree of harm of infectious diseases, when to control it, how to stop it, and use scientific views to reveal the original face of the novel coronavirus to the public without causing social panic.
Yosberto Cárdenas-Moreno*, Luis Ariel Espinosa, Julio Cesar Vieyto, Michael González-Durruthy, Alberto del Monte-Martinez, Gilda Guerra-Rivera and Maria Isabel Sánchez López
Laccase catalyzes oxidation of lignin and aromatic compound with similar structure to this one. Their low substrate specificity results on degradation of similar phenolic compounds. In this context, Molecular Docking was performed with different ligands suggesting potential bio-degradation. Binding active-sites prediction of fungal laccase (access number uniprotkb: A0A166P2X0), from Ganoderma weberianum was performed using machine learning algorithm based on Deep Convolutional Neural Networks (DeepSite-CNNs chemoinformatic tool). Herein, ligands like 2,4 - dichlorophenol, benzidine, sulfisoxazole, trimethoprim and tetracycline were analyzed and two additional reference controls which were 2,2 – azinobis 3 – ethylbenzothiazoline – 6 - sulfonic acid (ABTS) and 2,6 - dimetoxyphenol (2,6 DMP) were used in comparison with the other former mentioned ligands based on high laccase affinity. The five ligands were carried out because their potential biotechnological interest: the antibiotics sulfisoxazole, trimethoprim and tetracycline, and xenobiotics 2,4 - dichlorophenol and benzidine. Molecular docking experiments returned Gibbs free energy of binding (FEB or affinity) for laccase-ligand complexes. The best docking binding-interaction from each laccase-ligand conformation complexes suggest great ability of these ligands to interact with the laccase active-binding site. Herein, FEB values (kcal/mol) were obtained with higher affinity values for reference controls like 2,6 - dimethoxyphenol with -4.8 Kcal/mol and ABTS with -7.1 Kcal/mol. Furthermore, the FEB values were -4.7, -6.5, -6.8, -5.2 and -6.5 Kcal/mol, for 2,4 - dichlorophenol, benzidine, sulfisoxazole, tetracycline and trimethoprim respectively with high prevalence of hydrophobic interaction with functional laccase binding residues. Lastly, this study presents for first time at the bioinformatics field a molecular docking approach for the prediction of potential substrate of laccase from Ganoderma weberianum towards biotechnological application.
Functional appliances used in correction of class II malocclusions are shown to modify the neuromuscular environment of dentition & associated bones. There are many studies related to the skeletal, dental and neuromuscular changes which are evaluated cephalometrically, clinically as well as with the recent diagnostic aids like MRI. The aim of this short communication was to highlight and discuss the different aspects of condylar modifications and its role in its growth.
The Twin Block has higher effectiveness & comfort as compared to other removable functional appliances [1.2]. The action of Twin Block & Bionator is for 24 hours so effects are more with these appliances. Over the years, several theories have emerged attempting to shed light on condylar growth. One of the earliest theories, the genetic theory, suggests the condyle is under strong genetic control like an epiphysis that causes the entire mandible to grow downward and forward. Although this may be related more to development of the prenatal than postnatal condyle, the theory does indirectly question the effectiveness of orthopedic appliances in condylar growth as proposed by Brodie [3,4]. Several long-term investigations actually showed clinically insignificant condylar growth modification after continuous mandibular advancement with a reasonable retention period in human beings although the initial treatment results appeared encouraging. This leads to the conclusion that the general growth of the condyle appears relatively unalterable in long-term studies.
A second hypothesis based on the earliest available acute and blind EMG monitoring technique, suggests that hyperactivity of the lateral pterygoid muscles (LPM) promotes condylar growth. Rees reported that other muscles and tendons, including those of the deep masseter and temporalis, also attach to the articular disk region. Attachments of the LPM to the condylar head or articular disk may be expected to cause condylar growth, but anatomic research has not found evidence that significant attachments actually exist [5,6]. The LPM tendon is observed attaching, however, to the anterior border of the fibrous capsule that in turn attaches to the fibrocartilage of the condylar head and neck anteriorly. At the same time, it is doubtful that initial hyperactivity could occur where the LPM muscle has been shortened by continuous mandibular displacement therapy. By using LPM myectomy in rats, which may have disrupted condylar blood supply, Whetten and Johnston found little evidence that LPM traction had any pronounced effect on condylar growth. More recently, permanently implanted longitudinal muscle monitoring techniques have found that the condylar growth is actually related to decrease postural and functional LPM activity. This notion was also supported in human studies by Auf der Maur, Pancherz and Anehus- Pancherz, and Ingervall and Bitsanis that reported decreased muscle activity. The LPM hyperactivity theory brought forward by Charlier et al. Petrovic, and later espoused by McNamara however, was important in prompting further investigations in muscle-bone interactions [7,8].
A third hypothesis, the functional matrix theory, postulates the principal control of bone growth is not the bone itself, but rather the growth of soft tissues directly associated with it. Although this was supported in part by investigations testing the different growth and developmental responses between the condyle and epiphysis, there has been no explanation as to exactly how condylar growth would be stimulated. Thus, this theory’s validity has been questioned. One of the reasons was that there was little explanation of the specific mechanism by which the condyle was stimulated to grow. Endow and Hans presented an excellent overall perspective suggesting that mandibular growth is a composite of regional forces and functional agents of growth control that interact in response to specific extra-condylar activating signals [9,10].
Background: Mechanical chronic neck pain is very common musculoskeletal dysfunction among people, manifesting one or more pain-induced movements and disability impairments. Clinical guidelines suggest passive cervical mobilization and thoracic manipulation as manual therapy interventions. Mulligan concept has positive effect in patients with lumbar and thoracic spine mechanical chronic pain. Study objective was to investigate possible clinical effects of Mulligan techniques in patients with cervical pain according to pain and disability status.
Methods: forty participants diagnosed with mechanical chronic cervical pain, randomly assigned into experimental and control group. NAG, SNAG and self-SNAG joint mobilization in a nine-sessions protocol implemented to the study group, while SHAM-Mulligan techniques applied to control group. Self-reported questionnaires Numeric Pain Rating scale (NPRT) and Neck Disability Index (NDI) were used for the measurement of pain and disability levels respectively. Possible Interactions among Factors (TIME X GROUP) and simple effects in three-time measurements of pre, post and one-month follow-up concerning NDI and NPRS variables, were detected with Mixed-ANOVA test.
Results: Baseline scores of pain and disability resulted in no differences between groups. A significant Group and Time factors interaction founded and simple main effects analysis showed that Mulligan concept-group had significant improvement in post-intervention NPRT and NDI scores (p<.001), compared to baseline scores. Follow-up also differed compared to post-treatment score (p<.001). SHAM-Mulligan control group had no significant differences in dependent variables at any level of TIME factor (p>.001). Significant differences were found between groups according to second and third measurement phase (p<.001).
Conclusion: Our findings suggest that Mulligan concept techniques improve symptoms of pain and disability in chronic mechanical neck pain patients in short and mid-term effect level.
Summary: Mobilization techniques of SNAGs, NAGS and self-SNAGs reduces pain and improve function in patients with mechanical neck pain. Taken into consideration the safety and simplicity of application, future studies are encourage to examine the underline mechanism of action.
Background and Purpose: Transverse myelitis (TM) is a rare neurological diagnosis found in 1-4 per million people. Rehabilitation is recommended secondary to steroid treatment. There is limited clinical research on physical therapy (PT) for TM. The purpose of this case report is to present PT examination and management strategies for a patient with TM.
Case Description: A 25-year-old female patient diagnosed with TM was referred to PT. She presented foot drop causing ataxic gait, decreased sensation in bilateral lower extremities, significant fatigue, and low back pain. The patient required significant rest time between all tests and measures due to severely increased fatigue. PT plan of care was focused on therapeutic exercises per patient tolerance, passive range of motion (ROM) administered by the therapist, and gait training when activity tolerance was increased.
Outcomes: The patient was able to tolerate bouts of exercise as prescribed through home exercise program. She responded very well to passive ROM treatment during breaks between exercises to maintain ROM and decrease rigidity. Active ROM exercise was used to build activity tolerance while being mindful of limited ability due to fatigue. Upon increased activity tolerance, the patient was able to tolerate gait training with multiple breaks and maintain corrected gait when addressed during treatment.
Discussion: PT intervention was helpful for this patient with TM. Breaking down functional activities based on patient tolerance is important when treating people with TM. More experimental research is needed to support the benefits of PT for TM.
German surgeon, Vincenz Czerny, transplanted a patient’s own lipoma located in the hip to it’s breast after gland excision due to mastitis in 1895. Dr. Vincenza reported that for at least a year he didnt observe any problem on the operated breast [1]. Injection of adipose tissue to the breast has been used in breast cancer patients during breast reconstruction and lumpectomy. And in cases of revision autologous tissues are used for reconstruction. In clinical practice, many breast cancer patients apply to the clinics mostly after radiotherapy for reconstruction. Rigotti et al used purified autologous lipoaspirates in breast cancer patients with late term complications of radiation therapy and observed increase in neovascularization and wound healing [2]. Panettiere and colleagues compared aesthetic and functional features of fat grafts in radiotherapy received breast cancer patients and control group. In the fat graft group, all clinical symptoms and aesthetic scores were significantly higher than the control group [3].
In plastic surgery especially after the surgical treatment of breast cancer, prosthetic techniques, various autologous flaps or combinations of both are performed for breast reconstruction. Particularly breast reconstructions following adjuvant radiotherapy have less success rates due to adverse effects of radiotherapy [4-10]. There are reports showing reduced complications rates with use of fat grafts before and after breast reconstruction with prosthesis in patients received radiotherapy after lumpectomy or mastectomy.
With that, in patients receiving radiotherapy after fat grafting, local complications such as fat necrosis, infection can be seen more [3,11]. It was reported that adipocytes may had paracrine and endocrine interactions with tumor cells and stromal elements [12]. The fat grafts used in breast cancer were thought to cause local recurrence, distant metastasis or development of new cancers; there was no relationship in the clinical series. There is aromatase activity in the adipose tissue. Thus, fat tissue is the main source of post-menopausal estrogen hormone. Tumor cells and surrounding tissue were found to be higher in aromatase activity. Therefore, when fat tissue is injected subcutaneous or under the gland rather than into the parenchyma local recurrence risk is low [2].
When fat tissue is injected to breast, a good physical examination and mammography should be performed. After fat injection, sometimes calcifications are formed as a result of undergoing necrosis and they interfere with malignancy. Therefore before and after the procedure, mammography must be taken for comparison and existing and or newly developed calcifications should be determined.
Background: Supporting our adolescent people in realizing his/her self ability to reorganize and to establish a cross-linked paraspinal muscle control can be considered the most effective approach for muscle rehabilitation in adolescents affected by “AIS. Aim of this study was to evaluate the SEMG activity of paraspinal erector muscles by using an innovative dynamic and asymmetric spine brace called “BRIXIA” in the conservative treatment of patients affected by adolescent idiopathic scoliosis (AIS).
Methods: Five patients affected by adolescent idiopathic scoliosis were recruited for the aim of this study in line with an informed consent and simple inclusion criteria. Each patient underwent a first task-specific evaluation at time T0 and T1 and a secondary experimental course at time T2, T3 and T4. After a first postural and total spine X-ray evaluation, recruited patients began to use our innovative spine brace called BRIXIA (time T0 and T1). During the second experimental phase, a SEMG bilateral activity of the trunk large rhomboid, the latissimus dorsi and the quadratus lumborum was investigated without spine brace, by using a common Chenêau brace and afterwards the dynamic BRIXIA spine brace, with the acquisition of the so-called RMS SEMG Ratio value. The SEMG measurements were acquired in six study conditions: a. SiRP=Sitting Resting Position; b. SiRCP=Sitting Recruiting Position with a so-called pneumothorax thrust; c. StRP = Standing Resting Position; d. StRCP = Standing Recruiting Position; e. BA = Anterior Trunk Bending; f. BARC = Anterior Trunk Recruiting Bending. At the end of this SEMG evaluation, each patient received (for a daily use around 18 hours per day) the final version of the BRXIA spine brace and began an individualized educational postural rehabilitative treatment course (time T2). At time T3 and T4 a second and third SEMG assessment was made without using a spine brace and by using BRIXIA, with each patient evaluated in a resting condition and realizing a self-made cross-linked postural correction. Finally, a functional, radiographic and postural evaluation were made to define and quantify an amelioration and modification of patients’ postural attitude at the end of a combined rehabilitative and device supported treatment.
Findings: A comparative analysis of our SEMG data acquired in six study conditions showed different trends in all patients recruited proceeding from time T2 to time T5. Particularly, we observed at time T2 an homogeneous grade of paraxial muscle recruitment acquisition, expressed by the RMSsEMG ratio index, without using spine brace (53,3%) and by using Chêneau and BRIXIA brace (46,7%); specifically, a 57,14% of our patients used BRIXIA brace and a 42,86% Chêneau brace; the most homogeneous response was acquired in BA study condition; a symmetric paraxial muscle recruitment acquisition without using spine brace was observed in an 80% of our patients; the most grade of not homogeneous muscle activity response was observed in SiRP and StRCP study conditions; at time T3, an homogeneous grade of symmetric paraxial muscle recruitment activity, expressed by the RMSsEMG ratio index, was observed by using BRIXIA brace (56,7%); all patients recruited (100%) showed in SiRCP study condition the most homogeneous and symmetric paraxial muscle recruitment by using BRIXIA brace; in SiRP and StRCP study condition this trend was observed in an 80% of our patients with a reversion of this trend in StRP and BRAC conditions; at time T4, an immodification of the grade of symmetric paraxial muscle recruitment acquisition, expressed by the RMSsEMG ratio index, was observed in a 56,7% of patients who were using BRIXIA brace; all patients recruited (100%) showed in BARC study condition the most homogeneous and symmetric paraxial muscle recruitment by using BRIXIA brace, while in SiRP condition this trend was observed in an 80% of our patients. In a comparative and time-related analysis between our clinical and RMS data, Cobb angle trend showed a statistical significant correlation with RMS data, acquired at time T4 in BARC condition and without BRIXIA brace, and similarly with RMS data acquired at time T4 with BRIXIA brace. In line with the Visual Postural Analysis trend, our rehabilitative model showed a sensible capacity to modify patient’s individual sense of posturality, to increase the acquisition of cross-linked self-correction strategies and to induce a progressive rebalancing between the anterior and posterior kinetic muscle chains recruitment. These rehabilitative principles were perfectly in line with the perceptive and pro-rehabilitative value of our innovative BRIXIA brace.
Interpretation: This study will underline the professional attitude of all physiotherapists to use in a critical and task-specific way our dynamic and asymmetric spine orthesis called “BRIXIA”. This innovative brace allows to achieve: a. an individualized peripheral neuromodulation of patient’s sense of postural attitude (peripheral perceptive re-modulation of paraxial muscle recruitment); b. a neurorehabilitative re-learning device of postural self-correction strategies (peripheral neurosensitive facilitation of a dynamic process of motor corticalization device-related); c. an increase of patient’s quality of life in term of appearance and relational sense (life-impact device-related).
Socioeconomic barriers appears to be the greatest threat to dental care apart from considering the geographic location of the population. Access to need of care becomes primary consideration and through teleconsultation it is possible to overcome these barriers. As oral cavity being gateway to entry of health problems, dental treatment becomes a pivotal in health care system. Tele medicine and Tele dentistry becomes effective in treatment of health problems, reducing the chances of late stage detection of the abnormalities. It allows us to utilize our time better and screen more patients. This article aims to provide amazing technology of Tele dentistry involving all the dental specialties to reach all the populations of the society.
Background and objectives: New AKI biomarkers (on the top of it NGAL biomarker) have demonstrated better performance for prediction of AKI in critically ill patients with heterogeneous illness. Renal angina index was recently reported to enhance prediction of severe AKI at the time of intensive care unit admission. This study tested the hypothesis that incorporation of uNGAL in patients with renal angina improves the prediction of severe AKI.
Design, setting, participants & measurements: In our study 53critically ill children admitted to the pediatric intensive care unit in Zagazig university hospital, Measurement of urine neutrophil gelatinase– associated lipocalin (uNGAL) was determined individually by ELISA kit and in combination with the RAI which is calculated in each critically ill child for severe AKI. Statistical analysis was done for these data.
Results: Individual uNGAL demonstrated marginal discrimination for severe AKI (area under curve [AUC]: NGAL, 0.877), little higher than prediction by RAI (AUC=0.847). Incorporation of uNGAL significantly added to the renal angina index AKI prediction (AUC=0.847, increased to 0.893).
Conclusion: This study shows that incorporation of uNGAL into the RAI improves detection ability of severe AKI in critically ill children.
Four mestranol moieties were chemically linked to Zn(II) phthalocyanine (4) by cycloaddition “Click” reaction using a tetra-azidoethoxy substituted Zn(II)-phthalocyanine (3). The alkyl-azido coupling reaction was realized between azido groups of 3 and alkyl group of mestranol. The alkylation reaction was carried out to obtain cationic Zn(II) phthalocyanine derivative (5). The new compounds were chemically characterized by the known analytical methods. The absorption and fluorescence properties were studied in comparison. The absorption maxima of phthalocyanines 3, 4 and 5 were recorded at approx. shifts of 8 - 12 nm in the far- red region (680 - 684 nm) and the fluorescence maxima (692 - 693 nm) as compared to unsubstituted ZnPc (672 nm, 680 nm) in DMSO. The studies of singlet oxygen generation of 3, 4 and 5 showed relatively high values such as 0.52 for 3; 0.51 for 4 and 0.46 for 5. The fluorescence lifetime of 3.15 ns (3), 3.25 ns (4) and 3.46 ns (5) were determined with lower than the value than for the used standard ZnPc (3.99 ns). The high photo stability was observed for compounds 3, 4 and 5. In addition, the photosensitized oxidation of cholesterol was compared for 3 and 4 with much lower values of oxidation potential than for unsubstituted ZnPc which suggests that the substitution groups influenced on the photooxidation index of the target molecule.
Background: In line with the so-called “embodiment concept”, human bodily experience is characterized by the immediate feeling that our body is localized in a certain position in space and that the self is localized within these body limits.
Aim: To verify in a cohort of patients affected by unilateral spatial neglect (NSU) secondary to cerebrovascular damage the possible correlation between a comprehensive neuromotor/neuropsychological rehabilitative treatment and the modification of body representation.
Setting: A rehabilitation institute for the treatment of neurological gait disorders and neuropsychological failures.
Methods: 12 patients (7 males, 5 females; mean age 60 ± 2yy) affected by NSU secondary to cerebral stroke and recovered in the Neurological Rehabilitation Section of the Clinical Institute Città di Brescia were recruited for the aim of this study. In accordance with our inclusion criteria we recruited 4 patients affected by ischemic stroke and 8 patients affected by haemorragic stroke; 9 patients of our study group arrived from a coma state period. Recruited patients underwent at time T0 (hospitalization day) to a functional impairment evaluation (Motricity Index = MI; Trunk Control Test = TCT; Functional Ambulation Category = FAC) and to a neuropsychological evaluation (Behavioural Inattention Test = BIT; Representional drawing; Personal Neglect evaluation scale); each evaluation was repeated in the same way at time T1 (intertime between 2 and 4 months after hospitalization) and time T2 (inter time between 5 and 6 months after hospitalization). At time T0 each patient began an individualized integrated (motor and neuropsychological) rehabilitative treatment course.
Results: In all patients recruited a statistical significant modification was observed for the MI LL left, the TCT and the FAC; no significant statistical modification was observed for the MI UL left, the MI UL and the MI LL right. The t-test showed a significant statistical modification of the personal neglect evaluation scale while no significant statistical modification was defined for the spontaneous human figure drawing test proceeding from time T0 to time T1. The spontaneous drawing of the human figure showed an individual different trend and modification in all patients recruited. A correlation analysis was made comparing the mean value of all motor scales (G1) with the mean value of all neuropsychological scales (G2) and no statistical significant correlation was observed between G1 (T0) and G1 (T1), G1 (T0) and G2 (T0), G1 (T0) and G2 (T1), G2 (T0) and G1 (T1), G2 (T0) and G2 (T1), G1 (T1) and G2 (T1). A second correlation analysis was made comparing all single motor scales with the neuropsychological scales, for the group made by 12 patients and the group made by 5 patients. For the group made by 12 patients, we observed the subsequently significant correlations: MI UL left (T0) correlates with MI LL left (T0); MI LL left (T0) correlates with MI LL left (T1); MI UL left (T1) correlates with MI LL left (T1); MI LL left (T1) correlates with FAC (T1); TCT (T1) correlates with FAC (T1). For the group made by 5 patients, we observed the subsequently significant correlation: TCT (T2) correlates with FAC (T2). In the group made by 12 patients, the mean amelioration of the time related normalized (T0-T1) motor scales is equal to 49% while to 63% was observed for the neuropsychological scales. The mean amelioration of the neuropsychological scale proceeding from time T0 to T1 is equal to 26% with an increase equal to 57% proceeding from time T1 to T2. The neurocognitive amelioration can be observed especially between the 5th and 6th month from the ischemic cerebral damage with a mean increase from 26% to 57%.
Conclusions: It would certainly make sense to treat patients with NSU from the neuropsychological point of view in the long term and from the neuro-motor point of view in the first 3-4 months after stroke; in all this, we cannot exclude that an improvement of the visuo-spatial exploration, emphasized by the neuropsychological treatment, can positively influence also patient’s motor outcome.
Introduction: The phimosis condition is characterized by the inability to retract the foreskin on the glans, making it impossible to expose them. Surgical treatment, although effective, has been questioned by the risk to which the patient is exposed. Therefore, we have opted for the use of topical corticosteroids to resolve this pathology.
Goals: To compare the effectiveness of Dexamethasone and Hyaluronidase + Betamethasone Valerate associated with preputial massage in the treatment of infantile phimosis, the degree of regression of phimosis, the time needed to achieve complete efficacy, possible adverse reactions, long-term outcome and parental adherence to treatment in children attending a specialized service in Blumenau, Santa Catarina.
Materials and methods: Controlled clinical trial, quantitative, non-blind, prospective and randomized sample analysis through the analysis of 523 patients.
Results: After 1 month of treatment, 435 patients presented some degree of regression and 63 children were referred to surgery. The success rate in this period was 45.8% in boys who were taking Hyaluronidase + Betamethasone Valerate and 49.8% in those who used Dexamethasone. In the late evaluation, 398 children reached grade 0, and 213 used Hyaluronidase + Betamethasone Valerate and 185, Dexamethasone; 39 patients were referred to the postectomy. Adherence to treatment was similar in both groups. The average time for degree 0 to be reached similar in both.
Conclusion: Both topical corticosteroids were effective in the resolution of phimosis. However, in the evaluation after the first month and in the regression, Dexamethasone proved to be more effective. The time to resolution of the condition was similar for both. The surgical procedure was taken when there was no clinical improvement. No adverse effects were reported in both groups.
Behavioral dentistry is an interdisciplinary science, which needs to be learned, practiced and reinforced in the context of clinical care and within the community oral health care system. The objective of this science is to develop in a dental practitioner an understanding of the interpersonal, intrapersonal, social forces that influence the patients’ behavior. The clinician must acquire knowledge to develop appropriate behavioral skills with an improved quality of communication and management of patients. Behavior dentistry also teaches to develop a recognition and understanding that the body and mind are not separate entities and focuses on patients’ social, emotional and physiological dental experiences.
Behavior is an observable act. It is defined as any change observed in the functioning of an organism. Learning as related to behavior is a process in which experience or practice results in relatively permanent changes in an individual’s behavior. Self-perceptions of dental-facial appearance begin with aesthetic values shared within families and based generally on social norms, but that they may be strongly influenced by peer values and specific experiences of individual children, particularly those involving social responses.
Theories incorporating concepts of social comparison and self-efficacy suggest that individuals evaluate themselves in comparison with others in their social environment. Children who perceive themselves to be attractive will reflect those perceptions in their behaviors and generally will receive confirming social responses. The comparison group may express an attractiveness norm that reflects negatively on the individual’s behavior. This, in turn, can affect the individual perceived sense of self-efficacy or adequacy within that group and lead to behaviors that reflect more negative beliefs about the self, thereby inviting still more negative social responses.
Patient cooperation is the single most important factor every dentist must contend with. Major considerations are
• Regularity in keeping appointments
• Compliance in wearing removable appliances
• Refraining from chewing hard and tenacious substances that are likely to distort or damage the teeth or crowns
• Maintenance of oral hygiene. Laxity in following these instructions may lead not only to compromised treatment but also to slow progress of treatment, loss of chair time and frustration.
What may be more interesting to the Dentist than the shaping of self-perceptions in the shaping of behavior that will ensure a successful result of treatment, that is, the patient’s adherence to prescribed routines for self-care and other regimens during Dental treatment. It is helpful in this regard to know that most patients expect improved dental-facial appearance as an outcome of treatment, but there is much more to know about factors influencing cooperation.
Poor motivation can also contribute to non-compliance. The regulatory loop requires a motivational system to adjust behavior to coincide with the recommended regimen. A patient may recognize that the regimen is not being followed and yet simply not be motivated to correct the discrepancy. Poor motivation can also result from a lack of concern over the long-term health consequences of one’s behavior and/or a lack of belief in the treatment. Cognitive approaches that emphasize the personal relevance of the regimen or address misconceptions about the treatment may enhance motivation. Several approaches may be useful in treating poor compliance. Providing incentives or rewards for compliant behavior might be a useful strategy to enhance motivation. The cause of noncompliance is multifactorial and strategies to improve compliance must be tailored to fit each situation. Current Dental research focuses on a critical aspect of the feedback; specifically, the input received by the comparator that quantifies the actual amount of adherent behavior. Likewise, Patients, parents, and clinicians need a way to ascertain this information.
Ginseng extracts are often used as adaptogen to improve mental performances and well being, helping to overcome stress. Thus, in our times a lot of ginseng extracts are continuously produced and sold into commercial channels. Both Asian and Korean red ginseng (Panax ginseng) and American ginseng (Panax quinquefolius) are the most extensively used and researched. Both Panax ginseng and Panax quinquefolium contain different types of saponins, also known as ginsenosides, which are the substances that give ginseng medicinal properties. Human and animal studies showed that ginseng extracts can also have hypoglycemic effects. The mechanisms by which ginseng reduces blood glucose levels are unclear; some mechanisms have been proposed to explain its hypoglycemic effect, especially modulating effects on insulin sensitization and/or insulin secretion and regulating actions on digestion and intestinal absorption. We describe a case of hypoglycemia by ginseng in type 2 diabetic patient treated with oral hypoglycemic agents. Although, in order to provide better assessments of a sure anti-diabetic efficacy of ginseng, larger and longer randomized controlled clinical trials will be required, in our case we think that we have enough evidence to believe that the cause of hypoglycemia was ginseng. Obviously, this report should not be taken as a proof of the hypoglycemic effect of ginseng, nor it wants to be a suggestion to use ginseng in the treatment of diabetes; instead, it wants to be an alert for patients and clinicians to avoid hypoglycemia in daily clinical practice.
Calcium is the most common element in the tooth’s structure. In addition, calcium is one of the elements that are effective in maintaining dental health. As a result of calcium deficiency, the tooth becomes brittle and begins to rot. Calcium deficiency usually occurs in acidic beverage consumption and during canal treatment. A study was conducted to determine the degree of calcium removal in the root canal dentin after 17% EDTA, 17% EGTA, 15% EDTAC and 1% tetracycline-HCl treatment; later with or without 2.5% NaOCl [1]. Extracted single-rooted human teeth were bisected longitudinally and the root halves (n = 100) were isolated with nail varnish, leaving the root canal exposed. The samples were immersed in the test solutions for 1 and 5 minutes, after which the amount of calcium ion (Ca2+) release into the solutions was determined by flame photometry.
The calcium ions (Ca2+) present in hydroxyapatite crystals are one of the main inorganic elements of dentin [2]. It has been reported that some chemicals used for endodontic irrigation are capable of causing alterations in the chemical composition of dentin [3-6].
MethodsDetermination of calcium in the tooth’s structure is very important. Calcium determination, Flame Emission Spectrofometry and inductively coupled plasma optical emission spectrometry (ICP-OES) methods can be performed. These methods can be analyzed in a short time without interference effects. In both methods, the calcium in the tooth is stimulated and the emission intensity it emits is measured as it becomes basic. These emission intensities are directly proportional to the calcium concentration. Also, in these methods, calibration graph or standard addition method is used for calcium determination.
The roots were then bisected longitudinally, and the pulp tissue was removed with a toothbrush. All root halves (n = 100) were dehydrated in a sterilizer at 120 °C until they reached a fixed weight, as verified by consistent readings using a precision scale (Sartorius, Gotingen, Germany; precision = 0.0001 g). Thereafter, the specimens were covered with two consecutive layers of nail varnish, leaving the root canal surface exposed.
The samples were randomly distributed into the following treatment.
Groups:
Group 1: 2.5% NaOCl
Group 2: 17% EDTA
Group 3: 17% EGTA
Group 4: 15% EDTAC
Group 5: 1% Tetracycline-HCl
Group 6: 17% EDTA _ 2.5% NaOCl
Group 7: 17% EGTA _ 2.5% NaOCl
Group 8: 15% EDTAC _ 2.5% NaOCl
Group 9: 1% Tetracycline-HCl _ 2.5% NaOCl
Group 10: Distilled water (negative control)
In each group, the specimens were immersed in a magnetic stirrer bath containing 10 ml of test solution for 1 and 5 minutes. In groups 1 and 10, the same samples (n = 10) were used for 1- and 5-minute treatments.
Calcium is measured between 10 and 1000 ppm (mg/L) with Flame emission intensity. Calcium at a lower concentration cannot be measured.
Inductively coupled plasma optical emission spectrometry (ICP-OES) is a widely used method recently. ICP-OES is an advanced high-end method of flame emission spectrophotometer. In this method, the energy source required for excitation is provided by plasma and its temperature is between 4000 and 10000 ⁰C. There is a certain wavelength of light to which each element is stimulated. The wavelength of the light used for calcium is 455,531 nm. At this wavelength, a calibration graph is prepared from standard solutions of calcium. Calcium in the tooth is measured using the calibration chart.
The sensitivity of this method is high. Calcium analysis in ppm (mg/L) and ppb (µg/L) concentration can be analyzed with ICP-OES. In this method, the analysis takes minutes. Therefore, it is used in routine analysis.
ConclusionUsing these methods, you can easily analyze the calcium found in the structure of the tooth. Also, disinfectant like hypochlorite used during canal treatment increases the calcium release of the tooth. Therefore, the released calcium can also be analyzed using these methods. Here, each sample takes at least 5 measurements and gives the results in accordance with the scientific representation.
Background: Various studies examined the effect of birth order. First born children show usually better cognitive performance than their later born siblings. Studies on emotional aspects yield heterogeneous results, sometimes in favour of first born, sometimes in favour of later born children. Studies comparing only-children with children with siblings are rare.
Method: An internet survey was performed in 508 Polish and 500 German subjects. Only-children, first born, middle born and latest born children were compared regarding body mass index, depression, anxiety and partnership.
Results: No differences among first born, middle born and latest born children were detected. Only-children reported significantly less symptoms of social phobia than first born children (z=0.50, p< 0.01).
Conclusions: Except for suicidality, the results of this study question the sense of further investment in studying effects of birth order. In contrast, examining differences between only-children vs. children having siblings seems to have the potential to yield interesting and new results. Optimally, such research would combine self-report measures with reports from others, such as parents, teachers or clinicians.
The patient with an oncological disease presents a series of discomforts related to the psychological sphere such as depression, pain, sense of usefulness, anger, but also inconveniences related to food sphere. Neoplastic disease interferes with eating behaviour for several reasons. The communication of the diagnosis can create a state of anorexia as a result of the shock; certain tumours of the gastrointestinal tract-gold (mouth, esophagus, stomach, colon and rectum, but also pancreas and liver) are directly responsible for the possible alteration of food intake; alteration in eating behaviour may be secondary to the main therapeutic treatments. The link between food and cancer is not only evident in case of disease, but also in case of prevention, in fact a growing number of studies indicates more an more clearly the close correlation between a healthy diet and prevention of oncological diseases although at present time it is not still possible to give definitive results. The diagnosis of a person is like a melody in which some notes are repeated but their combination is almost infinite, because each person has different eating needs, as well as different psychological needs, and the starting point for a good professional must necessarily be a ‘customized’ diagnosis. This ‘diagnosis of well-being’, tailor-made for each person, involves professionals in both the food and psychological and behavioural sectors, since the individual needs have to be evaluated globally.
Finally, the professionals of human behaviour in food consumption, and the chemical and science processing experts, have the duty not to limit themselves to a single refusal against the use of certain foods, but framing the phenomenon in a wider perspective and, as experts of human health, to propose alternatives.
Background: A structured multidisciplinary team is very important during every phase of the amputation process and a good communicative team guarantees a greater tranquility for the patient, thanks to more homogenous information, that is already discussed between the clinicians.
Aim: The aim of this study was to define the efficacy and outcome value of an innovative procedure tool (TRIA-MF protocol) in the treatment of lower limb amputees before and after prosthesis use with the purpose to quantify the quality of the procedure and its economic impact on the clinical patients’ recovery.
Setting: A rehabilitation institute for the treatment of neurological and orthopaedic gait disorders.
Methods: 12 patients (4 women and 8 males) subjected to lower limb amputation and admitted according to the principles of inclusion criteria of the TRIA-MF protocol at the Rehabilitation Department of the Clinical Institute Città di Brescia were recruited in this study. All patients were included in an integrated and task-specific management protocol of the amputee, which allowed to follow the rehabilitation process from amputation to the final restoration, for a period of 6 months for each patient. Patients were evaluated 5 times during the study, collecting their degree of pain (VAS), their independence profile (Barthel Index) and the cirtometry of their amputation stump. Data on the duration of their admission to the rehabilitation unit, the inter-time between the amputation and acquisition of the temporary prosthesis, and between temporary prosthesis acquisition and the final prosthesis acquisition were also reported.
Results: Patients of our sample, at the end of their hospitalization, highlight a significant modification of the temporal data at 1 month and 6 months from their hospital discharge. A statistical significant increase of the Barthel Index value was observed in all patients recruited in this study proceeding from time T0 to time T4; in the same way, a statistical significant decrease of the VAS scale was observed in all patients recruited proceeding from time T0 to time T4; the cirtometry of the amputation stump (expressed in cm) showed a statistical significant decrease in all patients recruited proceeding from time T0 to time T4. We haven’t observed a statistical significant correlation between the duration of the rehabilitative hospitalization and our clinical data; no statistical significant correlation was observed between the amputation stump cirtometry time-related modification and our intertime data.
Conclusions: The protocol was found to be a clear and relevant tool with the definition of the operational profile for each single professional figure involved; it could also be considered as an optimal tool for coding the management and evaluation of the effectiveness of amputee treatment, with a related high reproducibility, sensitivity and specificity profile. In line with the literature, the TRIA-MF protocol has allowed us not to exceed a period of hospitalization in rehabilitation units of more than 23 days, thus showing that it is an excellent tool for optimizing the management costs of the amputee over time.
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