Postsurgical Condition Research Articles

Irisin levels are correlated with age and behavioural performance in Post-surgical HypoPT condition

Irisin levels are correlated with age and behavioural performance in Post-surgical HypoPT condition

Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis

ObjectiveTo identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP).Materials and methodsA systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle–Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed.ResultsThe cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005).ConclusionIn the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies.Clinical relevanceStudying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.

Pharmacotherapeutic Management of Pressure Wound in Sushma Koirala Memorial Hospital

Background: Pressure ulcers are the serious kinds of wounds that get developed within the skin tissues. They affect larger surface areas of the body resulting severe pain in the infected body parts of the patients. Pressure wound, thus has been presented as one of the major health problem worldwide. This study was aimed to find out different aspects of pressure ulcer cases and outcomes in Sushma Koirala Memorial Hospital (SKMH). Along with this, the study was targeted to study major affected body part, role of diet in healing wounds, grades of pressure ulcers and medicines used during the management and treatment of such chronic wounds.&#x0D; Methods: A descriptive, unicentric, retrospective study was conducted in 2018 at Sushma Koirala Memorial Hospital. A total of 163 patient records from October 2016 to October 2018 were reviewed. The data was entered in SPSS 16 version for analysis.&#x0D; Results: Pressure ulcers were common among people from the age group 21-40 years. The males were more vulnerable than female. Most people stayed for 41-60 days while the most affected body part in many patients was the sacral region. Third grade sacral region pressure wound was mostly found in the admitted patients. Wounds and injuries were common cause for development of pressure ulcers. The usage of third generation cephalosporin- ceftriaxone was predominantly found during surgery as well as post-surgery. During surgery, most commonly used medications include fentanyl, paracetamol, midazolam and propofol. After surgery, analgesics like ketorolac, combination of ibuprofen and paracetamol were frequently used. For post-surgical condition, ceftriaxone, ascorbic acid, ranitidine and pantoprazole were mostly used. Patients with pressure ulcers were advised to take high protein diet.&#x0D; Conclusion: This study showed sacral region was most affected body part and grade 3 pressure wound were predominant in most of the admitted patients. Ceftriaxone was mostly prescribed antibiotics and combination of paracetamol and ibuprofen was mostly prescribed for analgesic effects.

Hostile Abdomen, A Review of the Current Literature

The patient with a hostile abdomen is a challenge, where the abdominal cavity is open, with the edges retracted, healed and compacted into a single block of fibrous tissue that does not allow its adequate dissection or separation, carrying a high risk of injury to the intestinal loops. and appearance of concomitant fistulas. The term catastrophic abdomen was used for the first time in 1937 by Abell I, describing a dramatic post-surgical condition, involving the presence of intestinal leakage in an open abdomen with severe adhesions, having a high associated mortality.

Septic shock of abdominal urinary focus after renal surgery [Version 1; Peer Review - In process

Introduction: a 30 years and 12 days old female patient from the canton of La Troncal and mixed ethnicity on admission to the right lumbar fossa with the presence of a 5 cm orifice with a large amount of fetid purulent content that evolves to a diagnosis of septic shock of urinary vs. abdominal origin, acute perforated abdomen and retroperitoneal collection, for which on November 30, 2022 an exploratory laparotomy, ileostomy, right hemicolectomy, right nephrectomy, retroperitoneal collection drainage and drain placement were performed. Jackson Pratt's patient remains under sedoanalgesia with midazolam and fentanyl RASS -4. She is coupled to mechanical ventilation, afebrile with antibiotic therapy with meropenem and vancomycin, who presents elevated acute phase reactants with rising leukocytosis and neutrophilia. In addition, the culture revealed the presence of Gram-negative bacilli in the surgical wound. Case report: to present a complex clinical case where the post-surgical patient's condition was complicated, causing septic shock Conclusion: post-surgical complications are rare; however, they can be deadly and very complicated to treat, which urges health professionals to take the necessary measures to minimize this postoperative risk

Short-time effects of spa rehabilitation on pain, mood and quality of life among patients with degenerative or post-surgery musculoskeletal disorders

Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.

Successful treatment of an 82-year-old COVID-19 delta variant-infected patient with haemorrhagic stroke and active prostate cancer brain metastasis.

Successful treatment of an 82-year-old COVID-19 delta variant-infected patient with haemorrhagic stroke and active prostate cancer brain metastasis.

Comparison of Periodic in-Person and Remote Visits via Smartphone Applications during COVID-19 Pandemic in Clinical Follow-up of Range of Motion in Patients with Distal Radius Fracture.

Wrist function has a significant impact on quality of life, which is why restoring normal wrist movement after surgery is so important. Due to the COVID-19 pandemic, and the restrictions imposed on "face-to-face" visits, using smartphones has become more important in tracking patients. The main purpose of this study was to determine the accuracy of telemedicine in following up patients who had undergone distal radius fracture operation. From February to October 2020, 126 patients between 20 and 60 years old were randomly selected at our orthopedic trauma center. All patients were visited in person by an orthopedic surgeon in the morning (control group) and again all of them were visited online via smartphone in the evening by another orthopedic surgeon (case group). Both visits were done at regular intervals in the 2nd, 6th, and 12th weeks after surgery. Patients were evaluated for extremity function outcomes and joint range of motion. The two groups were similar in terms of mean Patient-Rated Wrist Evaluation score and Disabilities of the Arm, Shoulder, and Hand score and did not show a statistically significant difference (P < 0.05). There was no significant difference in wrist range of motion measurements between the two groups (in-person visits and smartphone visits) during the follow-ups (P > 0.05). Changes in wrist range of motion after surgery can be assessed with high accuracy using smartphone applications and this method can be considered as a proper alternative to frequent in-person visits to evaluate postsurgical wrist condition.

MON-LB63 Hypocalcemia-A Clue to Digeorge Syndrome; A Very Rare Case Diagnosed in a 41 Year Male

41-year-old male with history of anxiety, bipolar disorder, depression, cognitive developmental delay, Idiopathic Thrombocytopenic Purpura (ITP), Vit D deficiency, tinnitus, suicidal attempt, auditory hallucination, borderline intellectual functioning comes to the PCP’s office for regular follow-up. The PCP has noted that the patient was hypocalcemic on multiple visits. On exam, vitals were in normal range, height 5 feet 2 inches, BMI 31 kg/m2.Despite the patient being on calcium and Vit D2 pills for a couple of months, his Calcium level were low ranging from 5.8–7.8mg/dl (normal 8.5-10.1) with normal albumin; ionized calcium was low 0.9-0.97mmol/l (normal 1.12-1.23); Magnesium was normal 2mEq/L (normal 1.5-2.5), phosphorus slightly high 5 mg/dL (normal 2.5-4.9), PTH (ParaThyroid Hormone level) was low-normal 18.8pg/ml (normal 11.1-79.5), vitamin D 25 OH low 16ng/ml (normal 30-100); 1,25 di OH vitamin D low 8ng/ml (normal25-40).Thyroid ultrasound showed 2 benign nodules, no further work-up done. TSH and free T4 were normal. FISH (Fluorescence In Situ Hybridization) came positive for DiGeorge syndrome (deletion at 22q11.2). He was treated with calcium 600 mg 4 pills daily, calcitriol 0.25 mcg two pills daily, Vit D2 50000 IU weekly and thiazide diuretic. His labs improved.DISCUSSIONHypocalcemia can be due to low magnesium level, drugs or associated with high or low PTH. The patient had normal magnesium and he was not on any medication that causes hypocalcemia. This rules out first two casues. Hypocalcemia with high PTH (pseudohypoparathyroidism or low vit D levels) doesn’t fall in our differential because our patient had low PTH. For hypocalcemia with low PTH, differentials include post-surgical condition (no surgical history), autoimmune (history and labs not suggestive of), infiltrative diseases (eg hemochromatosis- he had normal iron study, Wilson disease- normal copper level, granulomas- contrary he had low 1,25 Di OH vit D). Hypocalcemia secondary to genetic parthyroid gland anomaly was thought to be most likely in our patient. So FISH was pursued.Conclusion: For patients with cognitive issues, persistence of chronic hypocalcemia (with low PTH) despite treatment should prompt for genetic disorders like DiGeorge. DiGeorge is usually the diagnosis of children. Perhaps this is the first case of DiGeorge diagnosed so late at age of 41.

Calcium Phosphate Ceramics Can Prevent Bisphosphonate-Related Osteonecrosis of the Jaw.

Bisphosphonate-associated osteonecrosis of the jaw (BRONJ), a post-surgical non-healing wound condition, is one of the most common side effects in patients treated with nitrogen-containing bisphosphonates. Its physiopathology has been related with suppression of bone turnover, of soft tissue healing and infection. Biphasic calcium phosphates (BCP) are used as a drug delivery vehicle and as a bone substitute in surgical wounds. Due to their capacity to adsorb zoledronate, it was hypothesized these compounds might have a protective effect on the soft tissues in BRONJ wounds. To address this hypothesis, a reproducible in vivo model of BRONJ in Wistar rats was used. This model directly relates chronic bisphosphonate administration with the development of osteonecrosis of the jaw after tooth extraction. BCP granules were placed in the alveolus immediately after tooth extraction in the test group. The animals were evaluated through nuclear medicine, radiology, macroscopic observation, and histologic analysis. Encouragingly, calcium phosphate ceramics were able to limit zoledronate toxicity in vivo and to favor healing, which was evidenced by medical imaging (nuclear medicine and radiology), macroscopically, and through histology. The studied therapeutic option presented itself as a potential solution to prevent the development of maxillary osteonecrosis.

Optimization of surgical intervention outside the epileptogenic zone in the Virtual Epileptic Patient (VEP).

Studies to improve the efficacy of epilepsy surgery have focused on better refining the localization of the epileptogenic zone (EZ) with the aim of effectively resecting it. However, in a considerable number of patients, EZs are distributed across multiple brain regions and may involve eloquent areas that cannot be removed due to the risk of neurological complications. There is a clear need for developing alternative approaches to induce seizure relief, but minimal impact on normal brain functions. Here, we develop a personalized in-silico network approach, that suggests effective and safe surgical interventions for each patient. Based on the clinically identified EZ, we employ modularity analysis to identify target brain regions and fiber tracts involved in seizure propagation. We then construct and simulate a patient-specific brain network model comprising phenomenological neural mass models at the nodes, and patient-specific structural brain connectivity using the neuroinformatics platform The Virtual Brain (TVB), in order to evaluate effectiveness and safety of the target zones (TZs). In particular, we assess safety via electrical stimulation for pre- and post-surgical condition to quantify the impact on the signal transmission properties of the network. We demonstrate the existence of a large repertoire of efficient surgical interventions resulting in reduction of degree of seizure spread, but only a small subset of them proves safe. The identification of novel surgical interventions through modularity analysis and brain network simulations may provide exciting solutions to the treatment of inoperable epilepsies.

Synthetic Calcium Phosphate Ceramics as a Potential Treatment for Bisphosphonate-Related Osteonecrosis of the Jaw.

(1) Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is one of the most often seen side effects in patients treated with nitrogen-containing bisphosphonates (BPs), a post-surgical non-healing wound condition. Since calcium phosphate (CP) compounds are able to adsorb zoledronate (ZOL) when used as a drug delivery vehicle, we aimed to verify if these ceramics might have a potential protective effect for soft tissues surrounding surgical osseous wounds. (2) Methods: The chemical reaction between ZOL and CP compounds was evaluated through ultraviolet-visible spectroscopy and elemental analysis. A primary culture of human gingival fibroblasts (HGF) was established as a model to evaluate the cytotoxicity of the association of ZOL (5–500 μM) and of ZOL/biphasic calcium phosphates (BCP). Metabolic activity, cell viability, types of cell death, the cell cycle through, and the migration ability of human gingival fibroblasts were evaluated. (3) Results: ZOL was adsorbed by biphasic calcium phosphate compounds in an aqueous solution. The HGF were sensitive to ZOL toxicity; nevertheless, ZOL/BCP showed a significant protective effect regarding metabolic activity, cell viability, and cell migration. (4) Conclusions: BCP interaction with ZOL reduces or abolishes its toxicity in HGF. This finding represents a potential solution for BRONJ in the case of patients undergoing therapy with ZOL.

MULTIPLE VERTEBRAL FRACTURES AT THE “DR. MANUEL DUFOO” SPINE CLINIC

ABSTRACT Objective: To establish the frequency of presentation of multiple vertebral fractures and evaluate the relationship between the postsurgical condition and the initial neurological lesion, as well as to report the associated injuries in this group of patients. Methods: We conducted a review of patients with spinal trauma and a diagnosis of multiple vertebral fractures who were admitted to the “Dr. Manuel Dufoo Olvera” Spine Clinic of the Secretary of Health of Mexico City from January 1,2014 to June 30, 2017. The multiple fractures were classified as either contiguous or non-contiguous, according to the number of vertebral bodies and levels affected. The statistical analysis was conducted using formulas of descriptive statistics and the information was then tabulated and graphed to assess the relationship between the anatomical classification and the degree of neurological injury. Results: We observed 530 patients, of whom 47 met the criteria. Thirty-one (65.95%) of the cases corresponded to contiguous fractures and 16 cases (34.05%) to non-contiguous fractures. Fourteen patients (29.78%) with neurological integrity were classified as ASIA D, 20 patients (42.58%) with complete lesion as ASIA A, 7 seven patients (14.89%) as ASIA B, and 6 patients (12.76%) with partial injury as ASIA C. Conclusions: The correlation between the classification of vertebral injuries and the presence of neurological lesion did not show significant differences between contiguous and non-contiguous fractures. Level of Evidence II; Retrospective.

Morphometric Study of Lumbar Vertebrae Pedicle through Tomographic Exams of Outpatients from a Brazilian University Hospital Center

Introduction The knowledge of the pedicle size in the lumbar vertebrae is important for safe and effective placement of screws in cases of instrumentation in this region. This importance is even more relevant when it is about fixing through a minimally invasive way. Most of the minimally invasive techniques for lumbar spine instrumentation is described recommending parameters for introduction of pedicle screws (25mm) based on measurement of the pedicle length in model populations (North American / European mostly). It is our purpose in this work to establish the morphometric parameters of the lumbar vertebrae pedicles in the Brazilian population, which has no such parameters well studied yet. Material and Methods Cross-sectional study of 100 adult patients (between 26 and 90 years old), 50 males and 50 females (all without trauma, tumor, inflammatory / infectious diseases or post-surgical condition) who underwent simple tomography of the lumbar spine from January to December 2012 at the Institute of Radiology of the Hospital of São Paulo in Brazil, 1000 pedicles of lumbar vertebrae were evaluated. And Literature Review conducted by PUBMED by Keyword: Lumbar Spine pedicles Results We describe for each lumbar level (L1 through L5) two measure: (Measurements made for both sides (left / right) of each pedicle): Measure A (length of the longitudinal axis of the pedicle base to the intersection of 90 ° with the imaginary line that goes from the anterior border of the spinal foramen) / Measure B (length of the longest longitudinal axis of the pedicle, the base to the junction with the anterior cortex of the vertebral body, line tangential to the spinal foramen and without crossing the midline). Measurements were obtained by electronic measurement system in iSITE Radiology in the axial plane of the major axis of each pedicle on CT scans without contrast cut standard 0.5mm Based on this assessment, we noticed that the average measure (to measure A) of the pedicles in the studied population was 17,12mm to L1, L2 to 16,22mm, 15,40mm to L3, 14,83mm to L4, L5 to 14,64mm Conclusion Thus the measure advocated for introduction of pedicle screws in minimally invasive techniques is appropriate for this population

Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment.

The present work aims at showing how dyspareunia linked to endometriosis can affect the life of fertile age women and how surgical treatment of endometriosis can relieve painful symptoms and consequently improve sex and social life. From a cohort of 320 women with a clinical and instrumental diagnosis of pelvic endometriosis, 67 patients were selected. These patients had deep dyspareunia that underwent laparoscopic surgical treatment. All the patients had filled out a pre- and post-surgery questionnaire. Six months after laparoscopic treatment, a significant reduction of dyspareunia was recorded, per VAS scores. A statistically significant improvement in sex life was observed between the pre- and post-surgical condition: in particular, an increased number of coituses and of non-difficult coituses, a higher number of patients who declared that pain did not negatively affect sexual pleasure and of patients achieving orgasm. The quality of the sex life in patients with endometriosis and dyspareunia showed significant improvement 6 months after laparoscopic treatment. In view of the diagnostic delay characterizing this disease and confirmed by our results, it is essential to involve a multidisciplinary team to assess all the signs and symptoms of endometriosis that may appear in a women of fertile age. This clinical approach is able to ensure a treatment that is as personalized as possible and an appropriate follow-up also with the objective of preserving reproductive performance.

Change of biochemical parameters in cows with abomasal displacement after omentopexy

The aim of the research is to evaluate the postsurgical health condition of cows with left abomasal displacement (LDA) based on the blood serum biochemical indices. The research has been performed at a Lithuanian cattle farm having 600 dairy cows in 2007–2014. The research included in total 30 cows diagnosed with LDA during the clinical trial. For the purpose of control, 25 clinically healthy cows were selected based on the analogy principle. All the cows with LDA have undergone surgical treatment according to omentopexia. For the ketosis prevention, cows were given 0.300 kg of monopropylenglycol for 14 days after surgical correction. For the purpose of biochemical testing, blood samples were collected from v. coccigea right before the surgery (Day 0), and subsequently seven days (Day 7), fourteen days (Day 14), and twenty-one days (Day 21) after the surgery. Blood serum was tested for the following parameters: calcium (Ca), phosphorus (P), magnesium (Mg), aspartataminotranspherase (AST), albumines (Alb), beta-hydroxybutyrates (BHB), glucose concentration. Cows with LDA were observed to develop ketosis and hepatic lesions after surgical correction. Cows with LDA demonstrated reliably (p < 0.001) higher BHB concentration than clinically healthy cows (average BHB of cows with LDA amounted to 1.16 mmol/l, whereas that of healthy cows was 0.8 mmol/l). The average AST concentration in cows with LDA amounted to 158 (IU/l), whereas that in control cows was 86.9 IU/l (p < 0.001). The average blood glucose level in cows with LDA amounted to 2.27 mmol/l, whereas that in control cows was 2.62 mmol/l (p < 0.05). Hypocalcemia is characteristic of cows with LDA. The average calcium concentration in the blood serum of cows with LDA amounted to 2.09 mmol/l, whereas that of healthy cows was 2.73 mmol/l (p < 0.05). Calcium concentration remained low for the entire period of the trial (until Day 21 after the surgical correction). Risks of ketosis and hepatic lesions decreased after 21 days following the treatment (when BHB AST levels decreased and blood glucose level increased).

The impact of a total hip replacement on jaw position, upper body posture and body sway

Objectives:The purpose of this study was to examine whether, and to what extent, a total hip replacement can influence the position and the movement of the jaw, the upper body posture and body sway.Methods:Twenty test subjects (6 females, 14 males) participated in this study pre- and post-total hip replacement, in addition to a healthy control group of 20 subjects (5 females, 15 males). The measurements were conducted by means of an ultrasound system to measure jaw condyle position and movement of the lower jaw, a three-dimensional back scan to analyze upper back posture, and a static and dynamic force plate to measure body sway. For statistical analysis the Wilcoxon-Matched-Pairs-Test or Man–Whitney-U-Test, including a Bonferroni–Holm correction, respectively, was used.Results:After surgery, the mean values of the left and right jaw condyles of the test group moved posterior, and the left condyle position was located more caudally. There were no significant differences concerning the jaw position between the two groups. There was little change in upper body posture in both groups. The test group had a more anteriorly inclined thoracic spine and a less pronounced lumbar lordosis. During static body sway measurements, increased fluctuations in the test group after surgery could be seen.Conclusion:Differences between both groups in the pre- and post-surgical condition could be detected. These differences were more prominent when the measured body segments were more distally located with respect to the hip region.

Bacterial culture after three sterilization methods for cataract surgery

To compare bacterial cultures from three sterilization methods immediately before and after cataract surgery. A prospective randomized open-label group-comparison study. We investigated 75 eyes in 73 consecutive patients undergoing cataract surgery. After swabbing the eyelid and surrounding area, patients were randomly assigned to one of 3 eye-washing methods: patients administered one drop of 5 % povidone-iodine (Group A); patients whose conjunctival sac was washed with 0.02 % chlorhexidine while everting the eyelid (Group B); or 0.02 % chlorhexidine as above but without eyelid eversion (Group C). In each group, specimens were collected from the conjunctival sac immediately before and after eye washing and again at completion of surgery, along with aqueous humor. The post-surgical condition of the corneal epithelium and the severity of anterior chamber inflammation were assessed by use of a slit-lamp microscope. In Groups A and C, the percentage of eyes with conjunctival bacteria decreased significantly from immediately before to immediately after washing (Group A, p = 0.008; Group C, p = 0.016), but there was no significant decrease in Group B (p = 0.125). Slit-lamp microscopy showed that inflammation of the anterior chamber 1 day after surgery was significantly milder in Group C than in Group B (p = 0.032). Eye-washing methods without eyelid eversion are more effective in reducing conjunctival bacteria before surgery and anterior chamber inflammation after surgery than those with eyelid eversion.

Impact of Tongue Reduction on Overall Speech Intelligibility, Articulation and Oromyofunctional Behavior in 4 Children with Beckwith-Wiedemann Syndrome

Objective: The purpose of this study was to determine the impact of partial glossectomy (using the keyhole technique) on speech intelligibility, articulation, resonance and oromyofunctional behavior. Patients and Methods: A partial glossectomy was performed in 4 children with Beckwith- Wiedemann syndrome between the ages of 0.5 and 3.1 years. An ENT assessment, a phonetic inventory, a phonemic and phonological analysis and a consensus perceptual evaluation of speech intelligibility, resonance and oromyofunctional behavior were performed. Results: It was not possible in this study to separate the effects of the surgery from the typical developmental progress of speech sound mastery. Improved speech intelligibility, a more complete phonetic inventory, an increase in phonological skills, normal resonance and increased motor-oriented oral behavior were found in the postsurgical condition. The presence of phonetic distortions, lip incompetence and interdental tongue position were still present in the postsurgical condition. Conclusion: Speech therapy should be focused on correct phonetic placement and a motor-oriented approach to increase lip competence, and on functional tongue exercises and tongue lifting during the production of alveolars. Detailed analyses in a larger number of subjects with and without Beckwith-Wiedemann syndrome may help further illustrate the long-term impact of partial glossectomy.

The efficacy of slide tracheoplasty in a growing rabbit model

PurposeSlide tracheoplasty for congenital tracheal stenosis was reported by Tsang. This procedure provides good results, but there are few studies about the tracheal growth of post-surgical condition. Recently, not only traditional posterior to anterior slide plasty but also right side to left side slide plasty was reported. We evaluated the tracheal growth after slide tracheoplasty in growing Japanese white rabbit model.MethodsThe Japanese white rabbits, weighing 1,600–2,400 g, were used for this study. One-third of the estimated length of the trachea was slantingly resected about an appropriate angle. We performed a slant, side-to-side tracheal anastomosis in two ways (slanted from the front to the back in four animals, and slanted from right to left in four animals) on growing rabbits as an animal model of slide tracheoplasty.ResultsAll the rabbits were alive until the 10th week after surgery. There was no evidence of differential growth in any part of the circumference of the normal and anastomotic tracheas. Histologically, all tracheal lumina were completely lined with normal respiratory epithelium and normal surrounding cartilage.ConclusionThe results presented that these two methods did not prevent the tracheal growth and trachea did not buckle macroscopically. Both slide tracheoplasties did not interrupt the growth of trachea.