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Clinical Inspection (clinical + inspection)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Immediate post-traumatic upper incisor reconstruction using composite resin materials

DENTAL TRAUMATOLOGY, Issue 1 2008
Vlatko Panduric
Clinical inspection revealed a complex crown fracture of the central incisor as well as a simple horizontal fracture of the lateral incisor crown of the enamel-dentin type. Vertical fracture separated the palatal enamel wall from the rest of the lateral incisor crown. After the completion of the endodontic sanitation, root canals were prepared for prefabricated composite posts and crown reconstructions were performed with the Finger Tip Technique by using composite resin materials. The advantage of this kind of reconstruction is preservation of the hard dental crown tissue removed in case of prosthetic therapy, especially in younger patients. Reconstruction can be finished in one visit, without the need for a dental technician and laboratory. [source]

Beneficial effect of hyperbaric oxygen on island flaps subjected to secondary venous ischemia,

MICROSURGERY, Issue 2 2002
Thomas J. Gampper M.D.
The potential for hyperbaric oxygen therapy (HBO) to decrease the untoward effects of a secondary ischemic event was studied in the rat superficial epigastric flap model. The secondary venous ischemic flap was created by cross-clamping the vascular pedicles for 2 h. Twenty-four hours later, the flap was reelevated and the venous pedicle was occluded for 5 h. Thirty-two rats were divided into three groups. In experimental group 1, animals received HBO treatment immediately prior to the initial flap elevation and ischemia at 2 atmosphere pressures for 90 min. In experimental group 2, the rats underwent a similar course except for a second 90-min HBO course immediately prior to the secondary venous occlusion. The rats without HBO therapy were used as controls. The results showed that all control flaps were nonviable at 1 week by clinical inspection and fluorescein injection. Complete flap survival occurred in 20% of group 1 flaps and 30.8% of group 2 flaps. Partial flap survival occurred in the rest of the flaps in these two groups, with mean survival areas of 48% and 55%, respectively. In conclusion, HBO treatments significantly increase the survival of flaps subjected to a secondary ischemia, even if administered before the primary ischemia. Administering HBO prior to secondary venous ischemia was marginal, which may be due to the effect of O2 given by HBO not lasting longer than 5 h. © 2002 Wiley-Liss, Inc. MICROSURGERY 22:49,52 2002 [source]

Review article: Low-molecular-weight heparin as an alternative anticoagulant to unfractionated heparin for routine outpatient haemodialysis treatments

NEPHROLOGY, Issue 5 2009
ANDREW DAVENPORT
SUMMARY Unfractionated heparin is currently the most widely used anticoagulant for outpatient haemodialysis. However, unfractionated heparin is a series of molecules, and as such has variable pharmacodynamics. Low-molecular-weight heparins were developed to improve both drug pharmacokinetic and dynamics, so to provide a reliable predictable clinical effect. The low-molecular-weight heparins are potent agents, but have an increased half-life compared with unfractionated heparin, and also require specialist laboratory monitoring. Despite these apparent drawbacks, low-molecular-weight heparins have become the anticoagulants of choice in Western Europe for routine outpatient haemodialysis sessions, due to the reliability of their clinical effect, and ease of administration, coupled with cost reduction. In standard clinical practice laboratory monitoring is not routinely performed, with drug dosing assessed by clinical inspection of the extracorporeal circuit, and the time for fistula needle sites to stop bleeding. [source]

Shoulder Disability After Different Selective Neck Dissections (Levels II,IV Versus Levels II,V): A Comparative Study

THE LARYNGOSCOPE, Issue 2 2005
Johnny Cappiello MD
Abstract Objectives/Hypothesis: The objective was to compare the results of clinical and electrophysiological investigations of shoulder function in patients affected by head and neck carcinoma treated with concomitant surgery on the primary and the neck with different selective neck dissections. Study Design: Retrospective study of 40 patients managed at the Department of Otolaryngology, University of Brescia (Brescia, Italy) between January 1999 and December 2001. Methods: Two groups of 20 patients each matched for gender and age were selected according to the type of neck dissection received: patients in group A had selective neck dissection involving clearance of levels II,IV, and patients in group B had clearance of levels II,V. The inclusion criteria were as follows: no preoperative signs of myopathy or neuropathy, no postoperative radiotherapy, and absence of locoregional recurrence. At least 1 year after surgery, patients underwent evaluation of shoulder function by means of a questionnaire, clinical inspection, strength and motion tests, electromyography of the upper trapezius and sternocleidomastoid muscles, and electroneurography of the spinal accessory nerve. Statistical comparisons of the clinical data were obtained using the contingency tables with Fisher's Exact test. Electrophysiological data were analyzed by means of Fisher's Exact test, and electromyography results by Kruskal-Wallis test. Results: A slight strength impairment of the upper limb, slight motor deficit of the shoulder, and shoulder pain were observed in 0%, 5%, and 15% of patients in group A and in 20%, 15%, and 15% of patients in group B, respectively. On inspection, in group B, shoulder droop, shoulder protraction, and scapular flaring were present in 30%, 15%, and 5% of patients, respectively. One patient (5%) in group A showed shoulder droop as the only significant finding. In group B, muscle strength and arm movement impairment were found in 25% of patients, 25% showed limited shoulder flexion, and 50% had abnormalities of shoulder abduction with contralateral head rotation. In contrast, only one patient (5%) in group A presented slight arm abduction impairment. Electromyographic abnormalities were less frequently found in group A than in group B (40% vs. 85% [P = .003]), and the distribution of abnormalities recorded in the upper trapezius muscle and sternocleidomastoid muscle was quite different: 20% and 40% in group A versus 85% and 45% in group B, respectively. Only one case of total upper trapezius muscle denervation was observed in group B. In both groups, electroneurographic data from the side of the neck treated showed a statistically significant increase in latency (P = .001) and decrease in amplitude (P = .008) compared with the contralateral side. There was no significant difference in electroneurographic data from the side with and the side without dissection in either group. Even though a high number of abnormalities was found on electrophysiological testing, only a limited number of patients, mostly in group B, displayed shoulder function disability affecting daily activities. Conclusion: The study data confirm that clearance of the posterior triangle of the neck increases shoulder morbidity. However, subclinical nerve impairment can be observed even after selective neck dissection (levels II,IV) if the submuscular recess is routinely dissected. [source]