Medicine
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General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. ⋯ The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.
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Randomized Controlled Trial
Relationship between the proficiency level and anxiety-reducing effect in a one-time heart rate variability biofeedback: A randomized controlled trial.
Previous studies have reported that the proficiency level of heart rate variability biofeedback (HRVBF) contributes significantly to the anxiety-reducing effects in continuous HRVBF interventions. Meanwhile, anxiety-reducing effects have been confirmed in one-time HRVBF interventions as well as continuous HRVBF; however, no study has analyzed the relationship between the proficiency level of a one-time HRVBF and its anxiety-reducing effects. To pursuit the effectiveness of a one-time HRVBF intervention, it is necessary to clarify whether the proficiency level is an important predictor of anxiety-reducing effects from a dose-response relationship between these 2 variables. The purpose of this study was to examine the dose-response relationship between the proficiency level and anxiety-reducing effects of a one-time HRVBF. ⋯ These results suggest that there is no close relationship between the proficiency level and anxiety-reducing effect in one-time HRVBF and that HRVBF is effective in reducing anxiety regardless of individual differences in the proficiency level. Therefore, a one-time HRVBF may be a useful breathing technique for reducing state anxiety without specific education and breathing techniques.
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According to scientific literature, cryoablation (CA) and electrochemotherapy (ECT) have been used for the treatment of small renal masses. However, no data have been published regarding the combination of these techniques as therapy of primary kidney cancers. Therefore, we report the case of an old woman affected by localized kidney cancer and discuss the potential therapeutic application of CA combined with subsequent deep ECT in this setting. ⋯ This combined strategy proved to be safe and effective. Moreover, the application of these blended loco-regional techniques showed several other advantages such as reduced hospitalization and a shorter period of convalescence respect to standard surgery.
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Pulmonary sarcomatoid carcinoma (PSC) is an extremely rare biphasic tumor characterized by a mixture of malignant epithelial and mesenchymal cells. Owing to the rarity, as well as the lack of typical manifestations and imaging signs, the rate of misdiagnosis is high. Herein, we present a case of PSC misdiagnosed as pleural mesothelioma in a 59-year-old man. ⋯ PSC, despite its rarity, should be considered in the differential diagnosis of lung cancer. Besides, biopsy, histopathology, and specific immunohistochemical staining of larger tissue specimens can be contributing to the accurate diagnosis of PSC.
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To compare the femoral tunnel characteristics using a rigid versus flexible reamer during anterior cruciate ligament reconstruction. It was hypothesized that the employment of a flexible reamer along with femoral tunnel would exhibit longer tunnel length and more acute femoral graft tunnel angle compared to the case of a rigid reamer. The study population included 28 patients who underwent anatomical single-bundle anterior cruciate ligament reconstruction using transportal technique and were able to take postoperative computed tomography (CT) evaluation. ⋯ Our data suggest that the flexible reamer can provide sufficient tunnel length for the suspensory fixation with a fixed loop. Whereas, the femoral graft-tunnel angle through flexible reaming at 90° of knee flexion was more acute compared to rigid reaming at 120° of knee flexion. Study Design: level of evidence III.