Treatment Time Research Articles

Analysis of clinical characteristics of amyotrophic lateral sclerosis patients initially diagnosed with abnormal laryngeal function

Objective: To study the laryngeal functional characteristics of patients with amyotrophic lateral sclerosis (ALS)disease diagnosed at the voice clinic. Methods: A retrospective analysis(case series study) was conducted on the laryngeal functional characteristics of 7 patients [2 males, 5 females, age ranged from 43 to 76(60.85±13.18)]with motor neuron disease who visited the voice clinic and were ultimately diagnosed by neurologists. The data included laryngostroboscopy, fiberoptic endoscopic examination of swallowing(FEES), acoustic analysis and laryngeal electromyography(LEMG). Descriptive methods were used for analysis. Results: ①There were 2 males and 5 females, with an average age of (60.85±13.18) years. They had previously visited the otolaryngology department more than twice, visit frequency with an average of 3.57 and an average diagnosis time of 12.28 months. The main complaints of the patient at the time of treatment were voice change, dysphagia or vocal fatigue. ②LEMG: Among 7 cases, 4 cases demonstrated neurogenic damage, all of which were bilateral, and 3 cases showed normal findings on examination. Spontaneous potentials (SP) were present in three cases for more than 6 months, with the longest duration being 24 months. Three cases exhibited the coexistence of spontaneous potential and reinnervated motor unit potentials (MUPs), and two cases showed bundle tremor potential.③Laryngostroboscopy revealed bilateral vocal fold asymmetry and glottic insufficiency in 7 cases, and decreased vocal cord movement in 4 cases, and vocal cord atrophy in 5 cases. FEES showed that 7 patients presented with mild to severe swallowing dysfunction, 3 cases had soft palate insufficiency and mild to severe food residues in the epiglottic valley and pyriform fossa. 1 case showed leakage and 1 case showed aspiration. Conclusions: Patients presenting with initial symptoms of abnormal laryngeal function should be vigilant for the possibility of motor neuron disease, especially when laryngostroboscopy reveals abnormal vocal fold movement and swallowing dysfunction. LEMG examination reveals bilateral neurogenic damage, prolonged spontaneous potential, coexistence of spontaneous potential and reinnervated MUPs, and the appearance of bundle tremor potential, which is beneficial for early detection of motor neuron disease.

The effects of heat treatment on chemical, biochemical, and microbiological properties of Ezine cheese

In this study, Ezine cheese was manufactured in accordance with different heat treatment norms (at 65 °C for 10, 20 and 30 minutes) and ripened for 180 days. Different heat treatment norms did not affect the chemical composition of the cheeses, while statistically significantly affected the water-soluble nitrogen (WSN) and 12% trichloroacetic acidsoluble nitrogen (TSN-SN) ratios. Although pH and protein were reduced during ripening, titration acidity, moisture, WSN, TCA-SN and amino acid ratio increased. αs1-casein was more hydrolyzed than β-casein during ripening in Ezine cheese. The heat treatment time increased, while the counts of total aerobic mesophilic bacteria and Escherichia coli decreased.

Consumption of antimicrobials for use in food-producing animals in New Zealand, a measure of progress in reduction from 2015 to 2022

ABSTRACT Aims To describe progress in the reduction of the consumption of antimicrobial drugs by food-producing animals in New Zealand to 2022 and to identify the animal production sectors where progress has been greatest, and those where opportunities remain. Methods Data were sourced from official government and industry reports to update previous estimates of consumption (as sales) of antimicrobial products applied to food-producing animals in New Zealand, European countries and the USA. Antimicrobial consumption (AMC) was estimated based on the amount of active ingredient sold, per kg of animal biomass standardised to the probable weight at time of treatment or lifetime mean weight but not slaughter weight (population correction unit; PCU). This methodology is widely used for international comparisons. Results The estimated gross consumption of antimicrobials in food-producing animals in New Zealand increased steadily from 2005 to 2013 (from 7.54 to 11.28 mg/PCU). From 2014 to 2018 the estimate flattened to a 5-year rolling mean of 10.40 mg/PCU. In 2019–2021 the consumption dropped. The NZ consumption in 2022 was substantially lower, estimated at 5.84 mg/PCU, 29% less than in 2005 and 45% less than the peak that occurred in 2017. Conclusions The use of antimicrobials in food-producing animals in New Zealand is at the lowest rate for nearly 20 years, at 5.8 mg/PCU. Key progress has been made particularly by the poultry industry. Clear future areas to be targeted include prophylactic use of intramammary products applied when drying off dairy cows and a more widespread strategic use in treatment of clinical mastitis. Clinical relevance Veterinarians in New Zealand should leverage the significant reduction achieved in AMC by food-producing animals by continuing to improve strategies for antimicrobial use to further reduce the risk of antimicrobial resistance.

Surface modification of fabrics using dielectric barrier discharge plasma for improved antifouling performance

Surface modification of fabrics is an effective way to endow them with antifouling properties while still maintaining their key advantages such as comfort, softness and stretchability. Herein, an atmospheric pressure dielectric barrier discharge (DBD) plasma method is demonstrated for the processing of silk fabrics using 1H, 1H, 2H, 2H-perfluorodecyltriethoxysilane (PFDS) as the precursor. The results showed the successful grafting of PFDS groups onto the surface of silk fabrics without causing damage. Meanwhile, the gas temperature is rather low during the whole processing procedure, suggesting the non-equilibrium characteristics of DBD plasma. The influence on fabrics of the processing parameters (PFDS concentration, plasma treatment time and plasma discharge power) was systematically investigated. An optimum processing condition was determined to be a PFDS concentration of 8wt%, a plasma processing time of 40 s and a plasma power of 11.87 W. However, with prolonged plasma processing time or enhanced plasma power, the plasma-grafted PFDS films could be degraded. Further study revealed that plasma processing of silk fabrics with PFDS would lead to a change in their chemical composition and surface roughness. As a result, the surface energy of the fabrics was reduced, accompanied by improved water and oil repellency as well as enhanced antifouling performance. Besides, the plasma-grafted PFDS films also had good durability and stability. By extending the method to polyester and wool against different oil-/water-based stains, the DBD plasma surface modification technique demonstrated good versatility in improving the antifouling properties of fabrics. This work provides guidance for the surface modification of fabrics using DBD plasma to confer them with desirable functionalities.

Peri-implantitis, Risk of Recurrence and Implant Loss in Soldiers with Stage III/IV Periodontitis during 20-30 Years of Supportive Periodontal Therapy (SPT).

To help fill the knowledge gaps regarding the long-term effectiveness of peri-implantitis therapy, this retrospective study of soldiers with treated severe periodontitis (stage III gen. / IV) who had been undergoing adherent SPT for at least 20 years aimed to determine the frequency of peri-implantitis and patient-related risk factors for this, as well as the 10-year survival rates of dental implants under peri-implantitis therapy. The observation period was between 1993 and 2023. All patients were referred by their military dentists for specialist dental training and underwent systematic periodontal therapy. A multi-stage peri-implantitis treatment concept was used. In 86 (31%) of 276 patients (total treatment time 23.6 ± 2.8 years, 53.1 ± 20.4 SPT sessions), 296 implant restorations were performed to close gaps or lengthen rows of teeth. In 29 (33%) of the implant patients, peri-implantitis developed on 25% of the implants. As a result, 11% of all implants were lost within 10 years due to peri-implantitis. Peri-implantitis led to implant loss in 59% of affected patients and 45% of implants. The survival time of implants lost later was 8.4 ± 6.2 years. Peri-implantitis and implant loss rates increased statistically significantly in stage IV periodontitis as well as in heavy smokers. Patients with implant loss and peri-implantitis had received systemic antibiotics due to periodontitis recurrence statistically significantly more frequently than patients without peri-implantitis and without implants during the ≥ 20-year SPT (p 0.05). Based on the present results, the early extraction of teeth during SPT in patients with treated generalised periodontitis stage III and stage IV plus replacement with implants is not advantageous.

Targeted thoracic ultrasonography shows high diagnostic potential for interstitial pneumonia in feedyard cattle.

To use a novel approach of targeted thoracic point-of-care ultrasound (TT-POCUS) of the caudodorsal right lung to determine potential associations between TT-POCUS measurements and the presence of interstitial pneumonia (IP) in feedyard cattle. Cross-sectional study evaluated feedyard animals (n = 62; 358.4 ± 10.5 kg; heifer, n = 38; steer, n = 24) using TT-POCUS at time of respiratory disease treatment and microscopic assessment of lesions at subsequent mortality. Evaluations took place from July through December 2023. Pulmonary samples were collected at necropsy for histopathologic assessment, and lesions were used to diagnose IP or non-IP. Statistical models determined potential associations between IP, cattle demographic, and TT-POCUS measured variables. Evaluations of animals enrolled (n = 62) displayed significant associations with IP, including ultrasound lung score (ULS), B-line count, A-line count, and days on feed at treatment. Cattle with a ULS of 5 had the lowest probability of IP (0.12 ± 0.16) compared to cattle with a ULS of 2, 3, or 4 (0.72 ± 0.18, 0.93 ± 0.06, and 0.85 ± 0.08, respectively). Cattle with B-line counts > 5 had a higher probability of IP (0.86 ± 0.11) compared to cattle with 3 to 5 B-lines (0.38 ± 0.14). The probability of IP was higher in cattle with A-line counts < 3 (0.83 ± 0.10) compared to cattle with ≥ 3 A-lines (0.51 ± 0.15). Strategic targeted thoracic ultrasonography has potential a value of timely IP diagnosis in feedyard cattle, thereby offering important insights into therapeutic and management decisions. Targeted thoracic ultrasonography can be utilized as a method for IP diagnosis in feedyard cattle.

The Role of Minoxidil in Treatment of Alopecia Areata: A Systematic Review and Meta-Analysis

Background/Objectives: Minoxidil, in addition to its vasodilatory effect, has also immunomodulatory properties that may be partially responsible for its efficacy in alopecia areata. The aim of the study was to evaluate the efficacy of monotherapy with topical or oral minoxidil in alopecia areata. Methods: A systematic review and meta-analysis of the efficacy of monotherapy with minoxidil in alopecia areata was conducted following the PRISMA guidelines. Efficacy of minoxidil in alopecia areata was evaluated separately for three groups of the patients: (1) treated with 5% topical minoxidil, (2) less than 5% topical minoxidil, and (3) oral minoxidil. Therapeutic response was defined as any regrowth of terminal hair. Results: Of 244 articles, 13 were considered eligible for the further analysis. The study included 372 patients with alopecia areata (338 using topical minoxidil and 34 taking oral minoxidil). The mean time of treatment ranged from 2 to 60 weeks (mean: 27 weeks). The response rate for 5% topical was 82% (95% CI 0.7–0.93) and 58% (95% Cl 0.5–0.67) for the less than 5% topical minoxidil group. For the group of patients treated orally, the response rate was 82%. Conclusions: Minoxidil, both topical and oral, may be beneficial in monotherapy in patients with alopecia areata. 5% topical minoxidil is characterized by significantly higher efficacy compared to minoxidil at a lower concentration. There are no sufficient data to recommend minoxidil as a first-line therapeutic option for alopecia areata.

Standard requirements for clinical very high energy electron and ultra high dose rate medical devices

Very High-Energy Electrons (VHEE) present a promising innovation in radiation therapy (RT), particularly for the treatment of deep-seated tumors using Ultra High Dose Rate (UHDR) within the framework of FLASH-RT. VHEE offers significant advantages, such as improved tumor targeting, reduced treatment times, and potential utilization of the FLASH effect, which may minimize normal tissue toxicity. However, the lack of an international technical standard for VHEE systems, especially for UHDR applications, remains a critical challenge. Current standards for radiation therapy equipment, such as IEC 60601-2-1 and IEC 60601-2-64, do not encompass VHEE technology. This regulatory gap underscores the need for developing a structured international standard to ensure the basic safety and essential performance of VHEE medical devices. Addressing this challenge requires overcoming complex dose delivery issues, such as the interaction of multiple fields and beam conformality and incorporating novel techniques like broad beam or pencil beam scanning. Establishing comprehensive regulatory standards is essential to ensure patient safety, consistent treatment practices, and the successful clinical integration of VHEE systems. These standards must encompass design guidelines, radiation protection protocols, and integration with existing oncology practices. Collaborative research and development efforts are crucial to formulating evidence-based guidelines, fostering the safe and effective use of VHEE in clinical settings. By addressing these challenges, VHEE technology has the potential to revolutionize cancer therapy, particularly for deep-seated tumors, while enhancing therapeutic outcomes for patients.

Enhancing oyster mushroom growth and yield using air gliding arc discharge

Abstract Oyster mushroom cultivation can be hindered by slow budding and low yield. This study explored the potential of atmospheric pressure gliding arc discharge plasma to address these challenges. Two types (direct and indirect) of plasma treatment methods were applied to the mushroom spawn and the growth environment in oyster mushrooms. Physicochemical characterization of plasma-activated water (PAW) revealed increased conductivity, oxidation-reduction potential, and nitrate/nitrite levels, and hydrogen peroxide with longer treatment times. Plasma-treated spawn exhibited faster budding and earlier colonization compared to others. The longest stem was observed in spawn exposed to plasma for 3 minutes, while the largest stem diameter was found in spawn treated with plasma-activated water for 4 minutes. Mushrooms produced with a 4-minute PAW treatment had the highest total fresh weight and biological efficiency. Therefore, compared to control spawn, the production of mushroom spawn treated with plasma increased by a factor of 1.5. Overall, plasma treatment enhanced mushroom development and yield, indicating its positive impact on oyster growth.&amp;#xD;

Contact X-ray Brachytherapy (CXB) as a boost therapy after neoadjuvant (chemo)radiation in high-risk locally advanced rectal cancer.

Radical surgery following neoadjuvant therapy is the standard of care for locally advanced rectal cancer. A Contact X-ray Brachytherapy (CXB) boost can alternatively be used to treat residual disease post neoadjuvant (chemo)radiation, especially in patients who are not suitable for or do not wish to have surgery. Its role has mostly been studied to date in low to intermediate-risk patients. We have now evaluated the utility of CXB-boost in high-risk rectal cancers after their tumours have been significantly downstaged by neoadjuvant (chemo)radiation. Oncological outcomes and treatment tolerability were evaluated in 328 patients based on rectal cancer treatment risk stratification: low/intermediate risk (cT1-3ab, N0-1, M0, no extramural invasion (EMVI), mesorectal fascia (MRF) involvement >1mm) and high-risk (cT3cd-4/N2, M0, MRF≤1mm and/or EMVI positive). With median follow-up of 33(IQR:15-54) months and median age of 73(IQR:62-80) years, no significant differences were found between low/intermediate and high-risk groups in clinical complete response (78% vs 73%, p=0.32), local regrowth (16.6% vs 22.4%, p=0.41), nodal (1.8% vs 5.8%, p=0.051) or regional (1.3% vs 2.9%, p=0.33) relapse, or post-radiation toxicities (p=0.16). However, the high-risk group had a higher distant relapse rate (21.2% vs 10.7%, p=0.01), with no significant differences in 3-year organ preservation (80% vs 87%, p=0.25), 5-year disease-free (DFS) (62% vs 64%, p=0.46), or overall (OS) survivals (67% vs 64%, p=0.88). Longer treatment time, treatment gap >24 weeks between therapies, and administration of a higher than standard CXB dose were newly identified factors that negatively impacted outcomes. High-risk rectal cancer patients treated with CXB-boost had more distant relapses, but comparable locoregional tumour control, organ preservation, DFS and OS to lower-risk patients, with acceptable toxicities. CXB-boost is therefore a viable option for selected high-risk rectal cancer patients. Timely reassessment, prompt referral, and CXB dose optimisation are crucial for improving outcomes.

The Calcium Hydroxide Controversy: Does Calcium Hydroxide Weaken Teeth?

Calcium hydroxide apexification has been used in the treatment of immature teeth with pulp necrosis and apical periodontitis for more than 50 years. However, the guidelines of the European Academy of Paediatric Dentistry (EAPD) and the American Association of Endodontists (AAE) 'Clinical recommendations for a regenerative procedure' recommend against calcium hydroxide apexification. The American Association of Endodontists "Clinical considerations for a regenerative procedure" do not list calcium hydroxide apexification as a treatment option for immature teeth with pulp necrosis. This review analyses the strength of the science that led to calcium hydroxide no longer being recommended by the EAPD and AAE regenerative guidelines. Many differences in the studies and failure to include adequate controls have resulted in inconsistent outcomes between studies. Furthermore, prior invitro studies have assessed narrow mechanical properties of teeth without a theoretical fracture mechanics model. Cvek's concerns regarding the thinness of the dentinal walls remain as a primary risk for tooth fracture with Class 3 root development fractured with an incidence of 77% compared to a fracture incidence of just 2% for mature teeth. This review develops a simple fracture mechanics approach to the phenomenon of transverse root fracture that provides a theoretical framework to why fragile roots are more likely to fracture when compared to mature teeth. Furthermore, the effect of the varying size access cavities has not been previously considered. Systematic reviews and clinical studies do attest to the success of all approaches for the treatment of immature teeth with pulp necrosis. Calcium hydroxide apexification is one of the recommended treatments in the International Association of Dental Traumatology guidelines. However, mineral trioxide aggregate (MTA) and hydraulic calcium silicate cements (HCSC's) may provide better outcomes and have the convenience for the patient of a shorter treatment time. Regenerative endodontic treatment (RET) is recommended when the tooth roots are very immature with Cvek Class 1-3 root development. However, the treatment of immature teeth with pulp necrosis remains a clinical challenge as does the risk of tooth fracture.

Predictive Modeling for Inactivation of Escherichia coli Biofilm with Combined Treatment of Thermosonication and Organic Acid on Polystyrene Surface

The present study aimed to evaluate the antibiofilm effect of combined sonication treatment with organic acids on polystyrene surfaces and to develop a predictive model for the inactivation of Escherichia coli biofilms. Polystyrene plates containing E. coli biofilms were subjected to sonication using different inactivation solutions (PBS, lactic acid, and acetic acid) at varying temperatures (20 °C, 40 °C, and 50 °C) and durations (2 and 5 min). The effects of temperature, treatment duration, and inactivation solution on E. coli biofilm removal were statistically significant (p &lt; 0.05). The use of organic acids, along with increased treatment time and temperature, led to a significant reduction in viable cell counts (0.43–6.21 log CFU/mL) and optical density (0.13–0.72 at OD600) of E. coli biofilms (p &lt; 0.05). The highest E. coli biofilm inactivation, with a reduction of 6.21 CFU/mL and 0.72 OD, was achieved by combining organic acid and thermosonication at 50 °C for 5 min. A significant positive correlation was observed between test methods based on viable cell count and optical density (OD) measurements. According to multiple linear regression analysis results, the R2 values of the predictive models for biofilm inactivation, based on viable cell count and OD measurements, were 0.84 and 0.80, respectively. Due to its higher accuracy, the predictive model developed using viable cell count data is recommended for applications in the food industry and processing sectors.

Analysis of the emergency standard ischemic stroke care system time points for in-hospital-onset ischemic stroke and community-onset stroke in general hospital

Objective: To analyze the treatment situation at each time node in the standard in-hospital-stroke(IHS) in the general hospital compared with that in the emergency(community)-onset stroke (COS) group. Methods: A single-center retrospective case-control study was performed.The clinical cases of acute COS group and IHS group who were treated by the same stroke green channel team at Peking Union Medical College Hospital from Jan.2021 to Apr.2024 were included. The treatment process of acute stage of stroke was divided into four time nodes (onset, recognition, admission, and treatment), and the time of each time node was compared and analyzed. Results: A total of 219 ischemic stroke cases were included, comprising 83 and 136 cases in IHS and COS groups, respectively. There were 134 male patients (61.2%) with a mean onset age of (66.3±15.1) years. IHS occurred across various departments, mainly in surgical departments(55/83, 66.2%). Of the perioperative IHS events, 93.7% (45/48) occurred after the surgery. Compared with the COS group, the IHS group showed a higher rate of post-waking stroke[11/32(34.4%) vs 18/136(13.2%), P=0.004], a lower rate of intravenous thrombolysis[9/32 (29.0%) vs 128/136 (94.8%), P0.001], and a higher rate of mechanical thrombectomy [11/32(34.4%) vs 4/136 (2.9%), P0.001].The overall median onset-CT time in the IHS group was shorter than that in the COS group[M (Q1, Q3)] [100 (59, 189)min vs 135(75, 210)min, P=0.030]. In different stages, median time from stroke onset to recognition[25(1, 140) vs 1(1, 30)min,P=0.005] and the on-site/reception CT [30 (19, 40) min vs 16 (11, 26) min, P=0.001] in the IHS group were longer than those in the COS group, while the median time from recognition to admission[30 (10, 48) min vs 76 (53, 137)min, P0.001]was shorter than that in the COS group. Conclusions: By using the standard ischemic stroke care system, the overall treatment time for IHS group is shorter than that of COS groups. However, compared with COS patients, the onset-recognition and admission to examination/treatment time was significantly prolonged for IHS patients, reflecting the need for further optimization of the standardized in-hospital stroke treatment process.

Effect of Early Oral Administration of Doxycycline on Macrolide Resistance in Children with Mycoplasma Pneumoniae Pneumonia: A Retrospective Study

Aims/Background Mycoplasma pneumoniae pneumonia (MPP) is typically a benign and self-limiting disease. This study aimed to investigate the effect of early oral administration of doxycycline on macrolide resistance in children with MPP. Methods This study retrospectively analyzed the clinical data of 173 MPP children treated with macrolides at the Second Affiliated Hospital of Mudanjiang Medical University from March 2020 to March 2023. Nine cases that did not meet the inclusion criteria were excluded, leaving 164 children. They were divided into Group A (early oral administration of doxycycline + macrolide treatment) (n = 85) and Group B (macrolide treatment alone) (n = 79) based on whether early oral administration of doxycycline was given. Drug sensitivity results and adverse reactions after treatment were statistically analyzed. Based on the drug sensitivity results, the MPP children were classified as having either macrolide-resistant mycoplasma pneumoniae (MRMP) or macrolide-sensitive mycoplasma pneumoniae (MSMP) infections. A stratified analysis was performed to compare the disappearance time of fever, disappearance time of shortness of breath, disappearance time of rales, and symptom improvement time on chest X-ray examination, and to further explore the clinical efficacy of early oral administration of doxycycline in different groups of children. Results No significant differences were found in baseline data such as age, sex, and weight between the two groups (p &gt; 0.05). A total of 112 out of 164 children developed macrolide resistance (68.29%), with 47 cases in Group A and 65 cases in Group B, indicating a significant difference between the two groups (p &lt; 0.05). The two groups showed a significant difference in macrolide sensitivity levels after treatment (p &lt; 0.05), with no significant difference in the incidence of adverse reactions (p &gt; 0.05). After treatment, the time to the disappearance of febrile fever, time to disappearance time of fever, disappearance time of shortness of breath, disappearance time of rales, symptom improvement time on chest X-ray examination, and time to administration of macrolides after treatment were shorter in children with MRMP in group A than in children with MRMP in group B (p &lt; 0.05). In contrast, MSMP children in both groups exhibited no significant differences in symptom disappearance time and duration of macrolides treatment (p &gt; 0.05). Conclusion Early oral administration of doxycycline is a safe and effective treatment for MPP. It helps relieve symptoms in MRMP children, shortens the duration of macrolide use, and reduces the incidence of macrolide resistance.

Real world delays in antivenom administration: patient, snake or hospital factors (ASP-33)

Objective Early antivenom administration is essential for effective treatment. We investigated the delays in antivenom administration. Methods We reviewed snakebites from the Australian Snakebite Project (2006–2021) given antivenom, presenting to hospital within 12 h. We extracted demographics, snake type, time of bite, hospital arrival, blood collection, antivenom treatment and hospital transfer. Results There were 2,169 patients recruited to Australian Snakebite Project 1,132 patients received antivenom within 12 h of the bite, and 1,019 of these were envenomated: median age 41 years (IQR: 24–57 years); 738 (72%) males. A pressure bandage was applied in 950 (93%), a median of 15 min (IQR: 5–30 min) post-bite. Specific snakes were identified by venom assays in 855 patients (80%), including 328 brown snakes (32%), 173 tiger snakes (17%), 74 rough-scaled snakes (7%), 85 red-bellied black snakes (8%), 49 taipans (5%) and 26 death adders (3%). Seventy-seven patients (7%) received antivenom without envenomation. The median length of hospital stay was 41 h (IQR: 24–67 h). The median time to hospital was 60 min (IQR: 30–105 min), to first blood tests was 90 min (IQR: 59–154 min) and to antivenom was 235 min (IQR: 155–345 min). There was a median delay in blood tests of 20 min (IQR: 10–37 min) and a median delay to antivenom of 147 min (IQR: 84–249 min). Non-specific systemic symptoms occurred in 641 (63%) patients, which occurred a median of 24 min (IQR: 10–60 min) post-bite, which was at a median of 180 min (IQR: 106 to 275 min) prior to antivenom administration. Time to antivenom in the 314 transferred patients was similar to those not transferred. Time to antivenom was significantly shorter for 189 patients given antivenom prior to transfer, median 183 min (IQR: 110–270 min), compared to 130 patients given antivenom after transfer, median 363 min (IQR: 289–513 min; P <0.001). Discussion Antivenom administration was delayed on average by 2.5 h after hospital presentation, despite three-quarters arriving in hospital within 3 h, the optimal time for antivenom administration. Patients requiring transfer received antivenom in a similar time, but earlier if administered prior to transfer, highlighting the possible benefits of pragmatic clinical decision-making prior to blood tests. Conclusion We found the leading cause of delays to antivenom administration after patients arrive in hospital was waiting for blood results. Systemic symptoms occurred early in most cases and could be given greater weight in decisions about early antivenom.

Treatment of Delayed Hypersensitivity After Injection of Nasal Fillers.

Soft tissue filler injection is the second most commonly performed cosmetic procedure worldwide, with augmentation rhinoplasty being the most common filling surgery in Asian countries because Asians predominantly have a low nasal bridge. With the increasing pursuit of beauty, the adverse reactions after injection not only damage the patient's appearance but also greatly affect their quality of life. Therefore, exploring effective methods to address adverse reactions after nasal filler injections is necessary. Herein, we aimed to explore safe and effective drug doses and concentrations for the treatment of two patients who developed an allergic reaction after a nasal filling by intralesional drug injection. Two patients developed severe swelling and deformity of the nose after the injection of fillers 6 months to 1 year prior to presentation. High-frequency ultrasound and local conditions revealed inflammation in the injected area. The patients were administered the combination of 0.7% triamcinolone acetonide, 0.42% 5-fluorouracil, and 0.7% lidocaine into the affected area; they were followed up for 6 months. After three times of treatment, swelling and sclerosis disappeared after 44.5 ± 2.12 days. No adverse effects of the infections were observed. This drug regimen may represent a safe and effective therapeutic strategy for the treatment of complications after soft tissue filler injections.

Assessment of Efficacy on the Treatment of Localized Vitiligo With a Combination of 308 nm Excimer Light and 2940 Erbium Laser: A Retrospective Study.

A 308 nm excimer light is an effective treatment for vitiligo, with fewer treatment times, rapid obvious effects, relatively complete pigment recovery, good patient compliance, and safe and effective treatment for children. The disadvantage of this treatment is that some patients have a plateau during which the skin lesion reduction rate slows down or stalls after multiple treatments. Treatment data were collected from all vitiligo patients in the Dermatology Department, distinguishing between those who underwent 308 nm excimer light treatment alone and those who received a combination of 308 nm excimer light and 2940 erbium laser treatment. Of the 104 patients, 60 were treated with 308 nm excimer light only, and 44 were treated with a combination of a 2940 erbium laser and 308 nm excimer light. In contrast to the treatment of 308 nm excimer light alone, the combined treatment of the 2940 erbium laser and 308 nm excimer light significantly increased the speed and degree of repigmentation in vitiligo. Our study demonstrates that the combination of 308 nm excimer light and 2940 nm erbium laser treatment can improve the treatment response for vitiligo, decrease the occurrence of treatment plateaus associated with 308 nm excimer light, and improve efficacy. ChiCTR2000036712 (24/08/2020).

Advancement in periodontal accelerated osteogenic orthodontics: Exploring the synergy between periodontal and orthodontic treatment – A case report

Periodontally accelerated osteogenic orthodontics (PAOO) is a surgical technique that merges targeted corticotomy, particle grafting, and appropriate orthodontic forces. This approach shortens treatment duration, enhances tooth stability, and prevents the relapse of tooth movement. By leveraging the regional acceleratory phenomenon, PAOO promotes faster orthodontic tooth movement and improves the healing process of bone. It also increases the width of the alveolar bone, reduces the overall treatment time, enhances post-treatment stability, and minimizes the risk of dehiscence. The focus of this case study was to gauge the therapeutic effects of this surgical procedure alongside soft and hard-tissue augmentation in a patient undergoing treatment for orthodontic malocclusion.

Efficacy of 30% silver diamine fluoride compared to atraumatic restorative treatment in arresting dentin caries lesions in preschoolers: a randomized clinical trial.

To compare the efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting caries lesions. Variables such as treatment time, adverse effects/parental aesthetic perception, anxiety and patients' behavior were also evaluated. Children (3.53 ± 1.03 years) with dentin caries lesions on the occlusal surface of primary molars were randomized into test (SDF) and control (ART) groups. To determine the presence of caries, dmf-t and ICDAS indexes were used. Caries lesions were also classified according to activity (active or inactive). The time required to perform treatments was recorded and the children's anxiety was assessed by a Facial Image Scale. The adverse events/aesthetic perception were registered by the operator and caregivers. The Frankl Behavioral Scale assessed patients' behavior. The chi-square/Fisher's exact and Mann-Whitney tests were used for comparisons between the groups. Of the 118 participants who received treatment (SDF, n = 59; ART, n = 59), after 12-month follow-up, 91.5% (43/47) of caries lesions in the SDF and 90.2% (46/51) in the ART group were arrested (p = 1.000). After 24 months, 72% (18/25) were arrested in the SDF group and 95.2% (20/21) in the ART. The treatment times were 6.08 ± 1.72 and 13.58 ± 4.83, for SDF and ART, respectively (p < 0.001). No statistically significant difference of adverse effects, aesthetic perception, anxiety, and patients' behavior were found between the groups. SDF was similar to ART in arresting caries lesion but required less time for treatment. The anxiety, adverse effects/aesthetic perception and patients' behavior were also similar between the groups. CLINICAL RELEVANCE: The use of SDF may be a faster and less invasive alternative for the treatment of caries lesions. Clinical trial registration number and date of registration: NCT03063307. September 2016.

Pseudomonas aeruginosa biofilm decontamination and removal by Ar/H2O cold atmospheric plasma in endoscope-like tubing

Abstract In medical device disinfection, removing bacteria and biofilms is challenging due to the poor penetration of detergents into the biofilm matrix. This is specifically true for endoscopes, which cannot be fully sterilized. This paper presents a new technique for decontaminating and removing P. aeruginosa biofilm from endoscope tubing using cold atmospheric plasma (CAP). The CAP is produced everywhere inside a contaminated tube under sustained Ar/H2O flow. The tube arrangement mimics the working channel environment of an endoscope, which is particularly difficult to sterilize. The discharge’s chemical activity was optimized by increasing the voltage without increasing the total power, which enhanced the production of hydroxyl radicals (OH) and hydrogen peroxide (H2O2). The disinfection treatment was tested on 24 h grown biofilm using the crystal violet assay for biofilm removal and the regrowth assay for bacterial decontamination. The treatments demonstrated effective decontamination capabilities at all treatment times with no bacterial regrowth. Etching of the biofilm sample by OH radicals was observed. After 30 min of treatment, only 18 ± 4% of biofilm remained on the surface, indicating near-complete biofilm removal and total absence of bacterial regrowth. This preliminary study demonstrates the effectiveness of using the direct contact of an Ar/H2O plasma to decontaminate and remove biofilm from complex shapes, such as flexible polytetraethylene tubes. It has the potential to enhance and shorten the disinfection of medical equipment, such as endoscopes.