Orthodontic treatment in impacted maxillary canines. A review of the literature

The prevalence of impacted maxillary canines is 1 to 3%, with approximately 50% of impacted canines causing root resorption of adjacent teeth. If the permanent canine has not acquired its correct position, evaluation by an orthodontist is necessary to determine the most adequate treatment. Surgery and orthodontic treatment are used for the treatment of impacted canines in the maxilla affecting permanent dentition. Selection of the most adequate treatment to achieve the correct position of the canine tooth depends on the position of the canine. This article summarizes the different techniques available and describes their advantages, and cost-benefit considerations. The objective of this literature review is to describe the etiology of impacted maxillary canines and provide an update of the information on orthodontic treatments available for these patients.

Incidence and risk of venous thromboembolism according to primary treatment type in women with endometrial cancer: a population-based study

Background Current prophylaxes and treatments for venous thromboembolism (VTE) in women with gynecologic cancer are mainly guided by studies on solid cancers because studies in gynecologic cancer did not provide sufficient data. Large-scale studies evaluating the incidence and risk of VTE according to therapeutic modality may guide prophylaxis and treatment of VTE in gynecologic cancer. This study was performed to determine the incidence and risk of VTE according to primary treatment type in Korean women with endometrial cancer. Methods We selected 26,256 women newly diagnosed with endometrial cancer between 2009 and 2018 from the Korean Health Insurance Review and Assessment Service database. During the total follow-up period and first six months after primary treatments initiation, the incidence and risk of VTE were evaluated according to primary treatment type, that is, no treatment, surgery, radiotherapy, chemotherapy, or hormone therapy. Results VTE occurred in 136 per 10,000 women during the total follow-up period and in 54 per 10,000 women during the first six months with the highest frequency in women that underwent chemotherapy. During the first year, the monthly incidence of VTE decreased with time among women that underwent no treatment, surgery, or hormone therapy and remained unchanged in those that received radiotherapy or chemotherapy. Compared with women that received no treatment, VTE risk, especially of PE significantly increased in women that underwent chemotherapy (VTE: hazard ratio (HR), 2.334; 95% CI, 1.38–3.949; P = 0.002) (PE: HR, 2.742; 95% CI, 1.424–5.278; P = 0.003) or hormone therapy (VTE: HR, 2.073; 95% CI, 1.356–3.17; P = 0.001) (PE: HR, 2.086; 95% CI, 1.19–3.657; P = 0.01) during the total follow-up period and women that underwent only chemotherapy during the first six months (VTE: HR, 2.532; 95% CI, 1.291–4.966; P = 0.007) (PE: HR, 3.366; 95% CI, 1.496–7.576; P = 0.003). Conclusions In this cohort study, the incidence and risk of VTE were highest in women with endometrial cancer that underwent chemotherapy as a primary treatment. Notably, the incidence of VTE decreased over time in women that received no treatment, surgery, or hormone therapy. This study can help guide therapies for prophylaxis and treatment of VTE in women with endometrial cancer.

MASSIVE MURAL AORTIC ARCH THROMBUS.

Mural aortic thrombus is a rare pathology that is more frequently seen in severe atherosclerotic aortic walls, in aneurysms and acute aortic syndrome(1). However this can be found in patients without aortic disease, and be responsible for systemic or cerebral emboli. A 54-year-old male was admitted to our institution for syncope and aphasia, he was found in the street with ethylic intoxication. After neurological examination mixed type aphasia was observed, cerebral and supra aortic arteries CT angiography were performed. Cerebral CT showed focal filling defect of left middle cerebral artery. Supra aortic arteries CT angiography was completed with toracoabdominal CT because massive ascending and arch thrombus was found. The thrombus measured 130 x 33 x 15 mm (Figures 1A and 1B and 1C), and covered from mid ascending aorta to 40 mm distal to the ostium of left subclavian artery. The patient was referred to our unit for urgent surgical treatment. Surgery was performed throw median sterntomy, cardiopulmonary bypass with moderate hypothermic arrest and anterograde cerebral perfusion via right axillary artery. Longitudinal aortotomy was made and 140 x 30 x 15 mm thrombus (Figure 2), attached to posterior mid ascending aorta, was found and resected, the aortic wall did not show any abnormality. The patient had an eventful recovery and was discharged 9 days later with oral anticoagulation and aspirin.

Work with cancer or stop working after diagnosis? Variables affecting the decision

BACKGROUND: Studies about work and cancer predominantly considered the return to work of cancer survivors. However, some studies highlighted that many patients work with cancer even immediately after the diagnosis. Little is known about the frequency, causes, and consequences of this behavior. OBJECTIVE: This study aimed to estimate how many cancer patients continue working in the month after the diagnosis in an Italian context and to determine which factors affect the decision to stop working in the same period. METHODS: One hundred seventy-six patients with breast, gastrointestinal, prostate, or female reproductive system cancer completed a survey with demographic, occupational, and psychosocial information. Clinical information was collected from medical records. We measured how many workers continued working in the month after cancer diagnosis without substantial interruptions and selected the best logistic regression model of this behavior’s predictors. RESULTS: Sixty-eight percent of the patients continued working in the month after the diagnosis. Patients were more likely to stop working with a higher level of perceived work-health incompatibility (OR = 2.64; 95%CI: 1.48–4.69), an open-ended contract (OR = 3.20; CI: 1.13–9.09), and a complex treatment (surgery+chemo-/radio-therapy, OR = 4.25; CI: 1.55–11.65) and less likely with breast cancer (OR = 0.20; CI: 0.07–0.56), and more children (OR = 0.59; CI: 0.37–0.96). CONCLUSIONS: To continue working with cancer is a common practice among the newly diagnosed. The decision to suspend work activity relates to evaluating how much work activities hamper one’s health care needs and the practical difficulties expected in handling cancer care and work.

Surgical Management of Multiple Oropharynx Hemangioma: A review literature with a new case report (Preprint)

UNSTRUCTURED Hemangioma is an extremely uncommon benign tumor of blood vessels, which occurs mostly during childhood, particularly in the head and neck regions, it remains unusual in the oral cavity and exceedingly rare in the tongue, and larynx. This report recorded a patient's case of cavernous tongue hemangioma and explained how this case was treated. Here we report a case of a 49-year-old female patient was referred to our clinic at Rania Medical City Private-Hospital, Kurdistan-Region Iraq country with the complaint of slowly enlarging mass and bleeding. The patient was diagnosed with multiple cavernous hemangioma of the lounge, larynx, pharynx, epiglottis, and lip. The patient was diagnosed by CT-angiography. Treatment consisted of surgical resection. Healing have occurred after 1 month of surgery. From 18 articles we obtained after searching (Google scholar and PubMed), we selected those papers focused on oral cavity, most of the cases were from India between 1961 and 2021, the average age range was 40 yrs. Females constituted the major gender. Dyspnea and swelling accounted for many complaints, especially from varied sides of the tongue and pharynx. Almost all cases have cavernous hemangioma regarding the histological types. Concerning treatment, surgery especially under general anaesthesia were the major. Nevertheless, bleeding was the major recorded complications, otherwise not any other significant complication were seen. Overall, the majority of cases had nearly 1 year of follow-up according to the year of the procedure. Recovering after the procedures were concluded the majority of recorded results. The author declares that cavernous hemangioma is extremely rare in adults, particularly in oro-pharynx, it needs to be included in the differential diagnosis of oral lesions, and there are many complications post operatively such as hemorrhage, it needs to be followed up to control complications.

Hair restoration

Hair restoration focuses on replacing hair where it has been lost, although there is also a demand for hair to be placed where it is desired, but lacking, for a perceived aesthetic gain. For both men and women, hair loss can be devastating and lead to loss of confidence and self-esteem. Hair restoration can be beneficial but treatment should be tailored to the individual’s needs and the correct diagnosis for the hair loss needs to be determined through a detailed history, thorough examination, and appropriate investigations. The average human has over 5 million hair follicles of which only about 100,000 are located on the scalp. While it is loss of scalp hair that is often most noticeable and distressing, eyebrow and eyelash hair loss is also very obvious in both sexes, as is loss of beard and moustache hair in men. Hair loss may be localized or generalized, part of a medical condition, a side effect of medications, the result of a dermatological condition, or genetically predetermined. Hair restoration can be achieved through medical treatment, surgery, and non-surgical alternatives.

Overactive bladder

Urinary incontinence is a problem among both older and young women. The most common symptoms of this condition include urinary incontinence and an unpleasant odour. In order to conceal the ailments related to this problem, women change their lifestyle by limiting the amount of fluid consumed and not moving too far from home or places where toilets are located. The main source of information on this disease in women aged over 45 is books, magazines and websites. Medical personnel are only ranked behind them. In order to make a correct diagnosis of this disease and to start treatment, urodynamic examination, urinalysis, cystoscopy and imaging examinations should be performed. Urodynamic examination can be divided into two groups: invasive and non-invasive. The micturition diary is considered to be the basic urodynamic test. It allows for performing differential diagnosis of functional micturition disorders. It is characterized by high repeatability and correlation with clinical symptoms. Treatment options are dependent on the type of urinary incontinence. They may include conservative treatment, surgery and pharmacotherapy. Combining conservative methods with pharmacological or surgical methods brings the most beneficial results. Invasive methods are the last-line therapy.

Literature Analysis of Artificial Intelligence in Biomedicine

Artificial Intelligence (AI) refers to the simulation of human intelligence in machines, using machine learning, deep learning and neural networks. AI enables machines to learn from experience and perform human-like tasks. The field of AI research has been developing fast over the past five to ten years, due to the rise of ‘big data’ and increasing computing power. In the medical area, AI can be used to improve diagnosis, prognosis, treatment, surgery, drug discovery, or for other applications. Therefore, both academia and industry are investing a lot in AI. This review investigates the biomedical literature (in the PubMed and Embase databases) by looking at bibliographical data, observing trends over time and occurrences of keywords. Some observations are made: AI has been growing exponentially over the past few years; it is used mostly for diagnosis; COVID-19 is already in the top-5 of diseases studied using AI; the United States, China, United Kingdom, South Korea and Canada are publishing the most articles in AI research; MIT is the world’s leading university in AI research; and convolutional neural networks are by far the most popular deep learning algorithms at this moment. These trends could be studied in more detail, by studying more literature databases or by including patent databases. More advanced analyses could be used to predict in which direction AI will develop over the coming years. The expectation is that AI will keep on growing, in spite of stricter privacy laws, more need for standardization, bias in the data, and the need for building trust.

Lipiodol lymphangiography as a treatment for refractory postoperative chylothorax: a case report

Postoperative chylothorax is the most frequent cause of traumatic thoracic chyle leakage. Conservative treatment is primarily used to treat low flow rate chylothoraces and should be initiated as soon as the diagnosis has been made. In case of high flow rate chylothorax or failure of initial treatment, surgery and radiological treatment are indicated. Despite this fact, there is a lack of consensus regarding the best therapeutic option to choose. In the case reported herein, a postoperative chylothorax with a low flow chyle leakage which didn’t respond to conservative treatment is demonstrated. We used lipiodol lymphangiography to determine the site of chyle leakage and to successfully treat our patient. Risk factors for non-response to conservative treatment are also discussed.