Can exchange transfusion be replaced by double-LED phototherapy?

Phototherapy is a conventional treatment for neonatal jaundice and widely considered as a safe procedure. Recent developments in light-emitting diode (LED) phototherapy devices have made more effective treatments possible. Exchange transfusion (ET) is typically applied for cases of refractory severe hyperbilirubinemia despite its risk of various complications. Since the therapeutic effect of phototherapy is correlated with its irradiance, ET may be avoided by performing phototherapy with higher irradiation. Recently, we adopted double-LED phototherapy as a bridging treatment to ET to treat a case of severe hyperbilirubinemia. In this case, the continual increase of bilirubin levels was suppressed immediately after its administration, and ET was not required. Throughout the treatment, no complications or increase in oxidative stress was observed. In addition, neurodevelopment was appropriate for the patient’s age at the 1-year follow-up, and no findings of kernicterus, including physical and magnetic resonance imaging findings, were observed. We hypothesized that double-LED phototherapy may be a good treatment strategy to replace ET for infants with severe hyperbilirubinemia; however, further investigations regarding safety issues including acute and long-term complications are needed before clinical adaptation.

Successful Reconstruction of Bone and Soft Tissue Defect Using Artificial Dermal Matrix after Hand Injury due to Dog Bite

Here we report a successful treatment of animal bite wound involving the bone. We used an artificial dermal matrix to reconstruct the cortical defect and prevent adhesion of the tendinous structures. A 48-year-old woman visited the emergency department for a painful hand swelling due to a dog bite 2 months earlier. A physical examination revealed a firmly palpable lesion with swelling and tenderness on the dorsal aspect of her hand. Magnetic resonance imaging found lytic changes of the second metacarpal bone with cortical destruction and fluid collection. After debridement of the necrotic tissue, a cortical bone defect with inflammatory changes of the medulla was noted. Following several days of irrigation, an artificial dermal matrix was applied with skin flap coverage to restore the soft tissue and bone defect. Three months later, the patient showed good motion of her hand without any restrictions. We believe artificial dermal matrix can be a good treatment strategy for restoring bone defect and preventing tendon adhesion simultaneously.

Repeated reverse sural fasciocutaneous flap is an effective surgical strategy for repairing long segmental soft tissue defects of the tibia

Objective This study was performed to introduce our surgical strategy and experience in applying a repeated reverse sural fasciocutaneous flap (RSFF) to repair large areas of tibial exposure. Methods During a 3-year period, 10 patients with a large area of tibial exposure and intact posterior skin and soft tissue after trauma were treated in our hospital using a repeated RSFF. First, most of the area of proximal tibial exposure was covered by an RSFF. Three weeks later, another smaller RSFF was designed from the original flap and rotated to repair the remaining exposed area of the tibial wound. Results All 10 patients’ wounds were completely healed after 2 to 4 operations. The wounds had healed well after 6 months. The patients were satisfied in terms of both appearance and function. Conclusion The repeated RSFF is a good treatment strategy for patients with large areas of tibial exposure with intact posterior skin and soft tissue.

Agenesis of second premolar teeth - diagnostics and treatment

Agenesis of second premolar teeth represents a problem that dentists and orthodontists deal with on a daily basis, and which will occur with greater and greater prevalence due to a tendency for the number of teeth to decrease evolutionally. Besides being an obvious aesthetic defect, the absence of teeth may cause serious functional effects such as, for example, malocclusion. Depending on the author of a research study, agenesis prevalence rate is reported to amount to 0.3 – 36.5 per cent, which suggests that it is a problem that every orthodontist will, sooner or later, have to handle. Very delayed development of second premolars described in the literature may also cause serious problems. <b>Aim.</b> This article is an attempt to present the problem in its entirety. It will discuss patient diagnostics, treatment planning in cases where buds of second premolars are missing as well as common tooth anomalies in subjects from the sample under examination. <b>Material and methods.</b> Selected scientific articles from the years 1939-2015 have been reviewed. <b>Results and conclusions.</b> A clinician has at their disposal at least several tools allowing for separation of patients that can be found in a group being at risk of agenesis or late development of second premolar teeth. A clinician may refer to the chronological age, adjacent teeth development stage or certain phenotypic traits described. A diagnosis made correctly is the foundation of good treatment strategy, which has to take into account a large number of the abovementioned factors. The best choice in these days when full wide smiles are preferred seems to be to leave the deciduous tooth in place for as long as possible.

Enriching the diet with menhaden oil improves peripheral neuropathy in streptozotocin-induced type 1 diabetic rats

The purpose of this study was to determine the effect of supplementing the diet of type 1 diabetic rats with menhaden oil on diabetic neuropathy. Menhaden oil is a natural source for n-3 fatty acids, which have been shown to have beneficial effects in cardiovascular disease and other morbidities. Streptozotocin-induced diabetic rats were used to examine the influence of supplementing their diet with 25% menhaden oil on diabetic neuropathy. Both prevention and intervention protocols were used. Endpoints included motor and sensory nerve conduction velocity, thermal and mechanical sensitivity, and innervation and sensitivity of the cornea and hindpaw. Diabetic neuropathy as evaluated by the stated endpoints was found to be progressive. Menhaden oil did not improve elevated HbA1C levels or serum lipid levels. Diabetic rats at 16-wk duration were thermal hypoalgesic and had reduced motor and sensory nerve conduction velocities, and innervation and sensitivity of the cornea and skin were impaired. These endpoints were significantly improved with menhaden oil treatment following the prevention or intervention protocol. We found that supplementing the diet of type 1 diabetic rats with menhaden oil improved a variety of endpoints associated with diabetic neuropathy. These results suggest that enriching the diet with n-3 fatty acids may be a good treatment strategy for diabetic neuropathy.