Tag: nevin manimala

Mil Med. 2021 Aug 19:usab322. doi: 10.1093/milmed/usab322. Online ahead of print.

ABSTRACT

INTRODUCTION: The coronavirus-2019 (COVID-19) pandemic has significantly impacted global healthcare delivery. Brooke Army Medical Center (BAMC) is the DoD’s largest hospital and a critical platform for maintaining a ready medical force. We compare temporal trends in patient volumes and characteristics in the BAMC emergency department (ED) before versus during the pandemic.

MATERIALS AND METHODS: We abstracted data on patient visits from the BAMC ED electronic medical record system. Data included patient demographics, visit dates, emergency severity index triage level, and disposition. We visually compared the data from January 1, 2019 to November 30, 2019 versus January 1, 2020 to November 30, 2020 to assess the period with the most apparent differences. We then used descriptive statistics to characterize the pre-pandemic control period (1 March-November 30, 2019) versus the pandemic period (1 March-November 30, 2020).

RESULTS: Overall, when comparing the pre-pandemic and pandemic periods, the median number of visits per day was 232 (Interquartile Range (IQR) 214-250, range 145-293) versus 165 (144-193, range 89-308, P < .0001). Specific to pediatric visits, we found the median number of visits per day was 39 (IQR 33-46, range 15-72) versus 18 (IQR 14-22, range 5-61, P < .001). When comparing the median number of visits by month, the volumes were lower during the pandemic for all months, all of which were strongly significant (P < .001 for all).

CONCLUSIONS: The BAMC ED experienced a significant decrease in patient volume during the COVID-19 pandemic starting in March 2020. This may have significant implications for the capacity of this facility to maintain a medically ready force.

PMID:34411255 | DOI:10.1093/milmed/usab322

Int J Oral Maxillofac Implants. 2021 Jul-Aug;36(4):755-761. doi: 10.11607/jomi.8722.

ABSTRACT

PURPOSE: The study aimed to evaluate the outcomes of flapless guided surgery related to surgery, patient, operator, assistant, and advisor, comparing it with conventional surgery performed by undergraduate students who had never placed implants in patients.

MATERIALS AND METHODS: A randomized controlled split-mouth clinical trial was carried out. Ten patients with bilateral mandibular posterior tooth loss received an implant on each side with conventional flap surgery or flapless guided surgery that was performed by undergraduate students. Surgery time, pain, patient satisfaction, quantity of consumed medications, time of procedure, ease of procedure, anxiety, and stress were assessed.

RESULTS: Conventional surgery showed statistically significantly inferior results compared with flapless guided surgery in terms of procedure time (56 minutes, 36 seconds ± 8 minutes, 38 seconds vs 30 minutes, 1 second ± 6 minutes, 2 seconds), consumption of analgesic medications (49 tablets vs 15 tablets), intraoperative (1.75 ± 1.56 vs 0.65 ± 0.64) and postoperative pain (4.62 ± 2.17 vs 1.17 ± 0.72), and operator anxiety (4.76 ± 1.66 vs 3.47 ± 1.50), respectively.

CONCLUSION: Flapless guided implant surgeries performed by individuals with no previous clinical experience showed reduced surgery time and delivered better patient-reported outcomes both in the intraoperative and postoperative periods; reduced medication consumption; and showed better results in the operator and assistant perspectives.

PMID:34411217 | DOI:10.11607/jomi.8722

Int J Oral Maxillofac Implants. 2021 Jul-Aug;36(4):762-770. doi: 10.11607/jomi.8682.

ABSTRACT

PURPOSE: The aim of this study was to investigate the influence of different clinical parameters on the primary stability of a variable thread tapered implant system with a focus on surgical undersizing protocols.

MATERIALS AND METHODS: This retrospective study evaluated patients who received NobelActive implants in a single institution. The relationship between the independent variables, bone quality, implant diameter, implant length, implantation time, region of the jaw, and surgical undersizing protocol, and the dependent variable, maximum insertion torque, was investigated. Statistical analysis was conducted using analysis of variance (ANOVA) and multiple linear regression.

RESULTS: A total of 1,292 implants placed in 574 fully or partially edentulous patients were evaluated. For the total sample size, without further differentiation between bone qualities, statistically significantly higher primary stability values were shown for an 8% to 9% undersized group (50.33 ± 17.16 Ncm), compared with a 16% undersized group (41.88 ± 17.63 Ncm), a 20% undersized group (33.65 ± 15.78 Ncm), a 26% to 28% undersized group (34.53 ± 15.49 Ncm), and a 35% to 44% undersized group (32.78 ± 18.80 Ncm). No statistical differences were found for undersizing protocols in bone quality 4. Bone quality had the highest influence on primary stability (Welch-Test F(3, 65.57) = 119.48, P < .001, η² = .20). Contrary to the other investigated independent variables, no statistically significant differences in primary stability were found for the different implantation times.

CONCLUSION: Undersizing protocols exceeding 8% to 9% do not seem to enhance primary stability values. Further studies are needed to investigate the biologic consequences of undersizing, including the impact of implant design characteristics.

PMID:34411218 | DOI:10.11607/jomi.8682

Int J Oral Maxillofac Implants. 2021 Jul-Aug;36(4):703-714. doi: 10.11607/jomi.8695.

ABSTRACT

PURPOSE: To evaluate the impact on healing of bioactivation with argon plasma of a xenogeneic graft with adequate fixation but poor adaptation to the native host bone.

MATERIALS AND METHODS: Xenogeneic grafts were either treated with argon plasma or left untreated and randomly secured with a titanium screw to both lateral aspects of the mandible angle of rabbits. A discrepancy was obtained between the xenograft and the mandible due to the convexity of the recipient site. Collagen membranes were placed on the grafts. Thirty animals were included and euthanized in groups of 10 after 2, 6, and 10 weeks, respectively. Histomorphometric evaluations were performed on ground sections. Newly formed bone was the primary outcome, while the distance between the peak of new bone inside the graft and the upper surface of the graft, the xenograft percentages, and the area of the xenograft were considered as secondary variables. The Wilcoxon test was applied for statistical analyses.

RESULTS: After 2 weeks of healing, gaps of ~0.5 mm were observed at the interface between the graft and the recipient sites, and new bone was mainly located in the interface and within the inferior regions of the grafts. New bone increased over time in all regions, including those in the upper zones of the graft, reaching proportions of 20.3% ± 6.5% and 19.3% ± 7.4% (P = .484) after 10 weeks in the plasma and control groups, respectively. The mean distance between the peak of new bone inside the graft and the upper surface of the graft decreased between 2 and 10 weeks of healing from 1.4 mm to 0.4 mm and from 1.7 mm to 0.3 mm at the plasma and control sites, respectively.

CONCLUSION: The xenogeneic grafts of both groups were incorporated into the recipient sites by newly formed bone that presented a growth close to the upper surface of the graft. The bioactivation with argon plasma did not improve healing.

PMID:34411209 | DOI:10.11607/jomi.8695

Int J Oral Maxillofac Implants. 2021 Jul-Aug;36(4):723-729. doi: 10.11607/jomi.8647.

ABSTRACT

PURPOSE: To assess the impact of abutment angulation on loosening torque, torque loss, and percentage of torque loss in the prosthesis and abutment screws after aging of the implant-supported prosthesis.

MATERIALS AND METHODS: Fifty epoxy maxillary casts with missing central, lateral, and canine teeth were used, and each cast received two implants. All casts were divided into five groups (n = 10): (1) both implants received straight abutments (0-0); (2) the central implant received a straight abutment and the canine implant received a 17.5-degree angled abutment (0-17.5); (3) the central implant received a straight abutment and the canine implant received a 35-degree angled abutment (0-35); (4) both implants received 17.5-degree angled abutments (17.5-17.5); and (5) both implants received 35-degree angled abutments (35-35). For each cast, a three-unit zirconia restoration was fabricated, and a torque meter was utilized to tighten the abutment screw (25 Ncm) and prosthesis screw (18 Ncm). The reverse torque value was recorded for each screw. All restorations were subjected to 3,500 thermal cycles between 5°C and 55°C and load cycled for 150,000 cycles with 50-N load. After the loosening torque was measured for each screw, the torque loss and percentage of torque loss were calculated.

RESULTS: There was a statistically significant difference in the torque loss of the central prosthesis screw (P < .001) and canine prosthesis screw (P < .001) between study groups. The 35-35 group showed the highest percentage of torque loss, while the 0-0 group showed the lowest value. A significant difference was found regarding the torque loss of the central abutment screw (P < .001) and canine abutment screw (P < .001). The abutment screws of the 35-35 group showed the highest percentage of torque loss, while the 0-0 groups showed the lowest percentage of torque loss.

CONCLUSION: Screw loosening of the prosthesis and abutment screws increases with increasing abutment angulation after aging. In the same fixed prosthesis, the torque loss in the prosthesis and abutment screws was higher in canine screws employing different angled abutments.

PMID:34411211 | DOI:10.11607/jomi.8647

Int Tinnitus J. 2021 Mar 1;25(1):94-99. doi: 10.5935/0946-5448.20210017.

ABSTRACT

PURPOSE: Music is an aesthetic whole consisting of sounds combined according to a certain purpose, method and understanding. Therefore, it also interacts with emotions in listeners. Music sounds are in the range of approximately 20-8000 Hz. This frequency range is within the frequency spectrum of the human cochlea. The aim of this research is to evaluate the hearing thresholds of music teachers and to determine whether they cause tinnitus.

MATERIAL AND METHODS: This research was conducted in Turgut Özal University Medical Faculty Hospital Audiology and Speech Disorders clinic. A total of 35 people (17 music teachers, 18 control groups) participated in the research. In this research, 17 music teachers (11 females, 6 males) aged 24-39, and 18 volunteers (12 females, 6 males) participated in the control group. After the otoscopic examination of all participants, pure tone audiometry (in the range of 125-16,000 Hz), immitansmetric examination and Distortion Product Otoacoustic Emission (DPOAE) tests were performed. Tinnitus Handicap Inventory (THI) was used in the evaluation of tinnitus.

RESULTS: There was no statistically significant difference between the music teachers and the control group in all pure tone hearing threshold averages of 125-16,000 Hz (p>0.05). The Uncomfortable Level (UCL) average of music teachers was 104.12 ± 3.83 dB for the right ear, 108.33 ± 3.83 dB for the control group, 107.78 ± 4.28 dB for the left ear, and 103.53 ± 4.28 for the control group. DPOAE results were found statistically significant at 3000 Hz only for the right and left ears (p=0.036; p=0.015, respectively). Also, for DPOAE test, the control group’s OAE values were higher than the music teachers. According to the Tinnitus Handicap Inventory in music teachers, 1st degree tinnitus has emerged.

CONCLUSION: According to the findings obtained, the low UCL value in music teachers compared to the control group suggests the tolerance problem. Continuous exposure to the sound was thought to create a noise effect on the cochlea, and as a result, tinnitus susceptibility appeared in music teaching.

PMID:34410086 | DOI:10.5935/0946-5448.20210017

Int Tinnitus J. 2021 Mar 1;25(1):118-123. doi: 10.5935/0946-5448.20210021.

ABSTRACT

PURPOSE: Auditory processing is the analysis of sounds’ attributions such as localization, lateralization, temporality, frequency, loudness, phase, auditory memory and auditory attention through primer and secondar central auditory paths. This study aims to show that music contributes on auditory processing by applying central auditory tests on two groups who are musicians and nonmusicians.

MATERIALS AND METHODS: The participants in this study are aged between 20 and 40. The mean age of the musician participants is 24.40±3.811, when the mean age of non-musician participants is 26.07±4.525. Each group has 30 participants. All participants got examined for otorhinolaryngology and they were tested for pure tone audiometry and immitansmetric measurement. For musician participants, this study included people who have professional music career for at least 5 years and for non-musician participants, it has been included those who are capable of normal hearing. All participants tested for Frequency Patterns Test (FPT), Duration Patterns Test (DPT), Random Gap Detection Test (RGDT) and Staggered Spondaic Word Test (SSWT).

RESULTS: The results of the FPT, DPT, RGDT and SSWT tests applied to musician and non-musician participants indicate that there is a statistical significance on auditory processing between these two groups (p<0.05). It is founded that there is a considerable difference as a result of statistical significance between the tests from right to left and from left to right (p<0.05). In addition, it is founded that musician participants have much more comprehension ability in the tests from left to right than the tests from right to lefts.

CONCLUSION: This study indicates that people who are interested in music professionally have developed auditory processing skills and senses than people who does not show any professional interest in music.

PMID:34410090 | DOI:10.5935/0946-5448.20210021

Int Tinnitus J. 2021 Mar 1;25(1):34-38. doi: 10.5935/0946-5448.2021008.

ABSTRACT

INTRODUCTION: Tinnitus- the perception of sound without external stimulation can also lead to disruption in the quality of life and has been over the years been benefitted by tinnitus masking. Hence this study to understand the effectiveness of tinnitus masking using the Auditory Brainstem Response (ABR) Test.

OBJECTIVES: The intention of this experimental research design is to determine whether tinnitus masking as treatment for tinnitus makes a significant difference in auditory evoked brainstem responses before and after masking for understanding the effectiveness of the treatment objectively and possible quantification of benefit measurement through ABR.

DESIGN: 30 subjects with normal hearing and unilateral tinnitus were assessed using ABR before and after tinnitus masking. Data was collected and compared to evaluate pre-masking and post-masking values of Latency-Intensity function and Interpeak Latency differences. Data was analyzed using descriptive statistics, test of homogeneity of variances and Two-way ANOVA.

RESULTS: Both latency-intensity functions and interpeak latency differences showed significant differences before and after tinnitus masking with significance values of Two-way ANOVA as .001, (Calculated at p < .05).

CONCLUSIONS: Despite the patient’s subjective feedback, objective proof of the patient’s benefit is a necessity. Therefore, this study shows that ABR shows significant differences in patients treated with tinnitus masking. Further suggesting benefit quantification of tinnitus masking as a treatment to tinnitus suffering individuals and for further understanding the intricacies of changes in the central auditory pathway due to masking.

PMID:34410077 | DOI:10.5935/0946-5448.2021008

Int Tinnitus J. 2021 Mar 1;25(1):76-86. doi: 10.5935/0946-5448.20210015.

ABSTRACT

INTRODUCTION: Prevalence of tinnitus range from 7.1% to 14.6% (National Center for Health Statistics, 2016), but the mechanisms responsible for the development of this abnormal sensory state remain poorly understood.

OBJECTIVES: To determine the evidence for different etiologies and pathophysiology of tinnitus identified by clinical diagnostic tests in the adult population.

STUDY DESIGN: Systematic literature review.

METHODS: Review of data base using PRISMA guidelines: Google Scholar, Medline, Springer Link, Pubmed. In addition, manual reference search of identified papers. Randomized controlled trials, case control study, prospective cohort studies, and retrospective reviews of consecutive patients in which clear data were reported with respect to etiology and pathophysiology of tinnitus.

RESULTS: Sixty seven articles met the inclusion criteria. The papers searched recent studies from 2004 to 2018 for different etiologies such as noise exposure, age, ototoxic drugs, hearing loss among patients with tinnitus. Multiple pathophysiology were identified, including inner ear pathology, auditory nerve synchronisation, central nervous system anomalies and limbic and autonomous nervous system problems. The group of papers evaluated tinnitus patients with specific diagnostic tests such as pure tone audiometry, Immitance audiometry, otoacoustic emission, Auditory brainstem response and diagnostic imaging of fMRI, MRI and PET study.

CONCLUSIONS: The results indicate a high level of heterogeneity between the studies for all the assessed areas. These results support the need for greater stratification of the tinnitus population and the importance of a standardized Puretone audiometry with extended high frequency, OAE, ABR and diagnostic imaging (fMRI, MRI & PET) method to make comparisons between studies possible. Diagnostic imaging is an important useful method for identification of intracranial pathology that can present with tinnitus as a primary symptom. Establishment of a direct causal link between tinnitus and these etiologies and pathophysiology remains elusive.

PMID:34410084 | DOI:10.5935/0946-5448.20210015

Quintessence Int. 2021 Aug 19;0(0):0. doi: 10.3290/j.qi.b1901343. Online ahead of print.

ABSTRACT

OBJECTIVE: The opacity of the zirconia ceramic restoration may influence the degree of conversion (%DC) of dual-cured resin cements. The aim of this study was to evaluate the degree of conversion of resin luting agents photocured under different high translucency zirconia shades. The opacity of each ceramic shade was evaluated.

METHOD AND MATERIALS: The opacity percentage of Lava Frame and three Lava Plus High Translucency Zirconia ceramic shades (W1, A2, and B4) was determined. A spectrophotometer MiniScan was used to measure the opacity percentage of each specimen (0.7 mm thick) and then the opacity was calculated. Specimens from three different resin cements (Panavia F2.0, RelyX Unicem 2 Automix Self-Adhesive, and PermaFlo DC) were prepared with 100-µm thickness. The specimens were photocured according to the manufacturers’ instructions under a ceramic block (0.7 mm thick). Specimens photocured without the ceramic block were used as control. Fifteen groups (n = 3) were evaluated. Micro-ATR/FTIR (micro-attenuated total reflectance/Fourier-transformed infrared spectroscopy) spectrometry was used to evaluate the extent of polymerization of all specimens after 24 hours. The %DC was determined using experimentally polymerized versus maximally polymerized composite.

RESULTS: The opacity percentages (mean ± SD) of W1, Lava Frame, A2, and B4 ceramics were 72.41% ± 0.04%, 74.24% ± 0.09%, 77.63% ± 0.11%, and 78.17% ± 0.12%, respectively. There was a statistically significant difference in %DC among the different cements investigated (P = .003) and a statistical difference in %DC was also found among the different ceramic shades studied (P = .030). For the Lava Frame and A2 ceramic blocks, the resin cements tested presented the lowest %DC except for the RelyX Unicem resin cement.

CONCLUSIONS: The %DC of RelyX Unicem 2 cement under low zirconia opacities (W1 and Lava Frame) was greater compared to high zirconia opacities (A2 and B4). For the Panavia F2.0 cement, no effect on the %DC under different high translucency shades was observed. The highest %DC of PermaFlo cement was exhibited when the ceramic shade W1 was used.

CLINICAL IMPLICATIONS: Dual-cured resin cements exhibited different degrees of conversion depending on the opacity of the zirconia restoration. However, different brands demonstrated higher or lower dependency of the light transmittance on their degree of conversion.

PMID:34410074 | DOI:10.3290/j.qi.b1901343