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Inter-Operator Reliability of Dental Morphometric Measurements

REFERENCES 1. Harris E, Smith RN. Accounting for measurement error: a critical but often overlooked process. Arch Oral Biol . 2009;54S:107-117. 2. Bland JM, Altman DG. Statistical notes: measurement error. BMJ Clinical Research . 1996;313:744. 3. Smith R, Zaitoun H, Coxon T, et al. Defining new dental phenotypes using 3-D image analysis to enhance discrimination and insights into biological processes. Arch Oral Biol . 2009;54:S118-S125. 4. Brook A, Smith R, Elcock C, Al-Sharood M, Shah A, Karmo M. The measurement of tooth morphology

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Predictors of Left Ventricular Remodeling Post Acute Myocardial Infarction. Protocol for a Clinical Study

-type natriuretic peptide: time to incorporate natriuretic peptides in our practice. J Cardiovasc Med (Hagerstown) . 2006;7:414-415. 19. Maisel A, Krishnawswamy P, Nowak R. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med . 2002;11:55. 20. Neuhold S, Huelsmann M, Strunk G, et al. Comparison of copeptin B-type natriuretic peptide and amino-terminal pro-B-Type natriuretic peptide in patients with Chronic Heart Failure: Prediction of death at different stages of the disease. J Am Coll Cardiol . 2008

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Epicardial Fat and Coronary Vulnerability

. Measurement of epicardial fat thickness by transthoracic echocardiography for predicting high-risk coronary artery plaques. Heart Vessels . 2016;31:1758-1766. 17. Larsen BA, Laughlin GA, Saad SD, et al. Pericardial fat is associated with all-cause mortality but not incident CVD: the Rancho Bernardo Study. Atherosclerosis . 2015;239:470-475. 18. Rabkin SW, Campbell H. Comparison of reducing epicardial fat by exercise, diet or bariatric surgery weight loss strategies: a systematic review and meta-analysis. Obes Rev . 2015;16:406-415. 19. Higgins JP

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Noninvasive Imaging Biomarkers of Vulnerable Coronary Plaques – a Clinical Update

. Arterioscler Thromb Vasc Biol . 2006;26:2103-2109. 46. Motoyama S, Sarai M, Harigaya H, et al. Computed Tomographic Angiography Characteristics of Atherosclerotic Plaques Subsequently Resulting in Acute Coronary Syndrome. J Am Coll Cardiol . 2009;54:49-57. 47. Rudd JHF, Warburton EA, Fryer TD, et al. Imaging Atherosclerotic Plaque Inflammation With [ 18 F]-Fluorodeoxyglucose Positron Emission Tomography. Circulation . 2002;105:2708-2711. 48. Tawakol A, Migrino R, Hoffmann U, et al. Noninvasive in vivo measurement of vascular inflammation with F-18

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Comparative Measurements of Aortic Diameters Using Transthoracic Echocardiography and Thoracic Computed Tomography Angiography in Neonatal Aortic Coarctation

Abstract

Background: Critical aortic coarctation is defined as the severe narrowing of the isthmic aortic lumen, representing a neonatal cardiac emergency, part of the congenital heart diseases with duct-dependent systemic circulation.

Aim of the study: To assess the correlation between transthoracic echocardiography and computed tomography angiography (CTA) in the measurement of aortic diameters in a group of newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch.

Material and method: We performed a retrospective study on neonates diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch between January 1, 2015 and March 1, 2017. The studied parameters were diameters of the aorta at the level of the aortic annulus, coronary sinuses, sinotubular junction, ascending aorta, proximal and distal aortic arch, and the aortic isthmus. Measurements were obtained by transthoracic echocardiography and thoracic CTA.

Results: Fifteen newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch were included in this study. There was no statistically significant difference between the two imaging methods, the T test highlighting differences only between the measurements of the aortic annulus (p <0.016) and coronary sinuses (p <0.008). The patients included in the study associated other cardiovascular abnormalities: persistent ductus arteriosus (100%), atrial septal defect (100%), aortic arch hypoplasia (80%), bicuspid aortic valve (73.3%).

Conclusions: These methods reveal important information on the anatomy of the cardiovascular malformation and its impact on the clinical and paraclinical status of the patient, being fundamental for establishing an optimal therapeutic approach.

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Neuromuscular monitoring: an update

Australia and New Zealand. Anaesth Intensive Care 2013; 41: 374-379 6. Kopman AF, Yee PS, Neuman GG. Relationship of the train-offour fade ratio to clinical signs and symptoms of residual paralysis in awake volunteers. Anesthesiology 1997; 86: 765-771 7. Brull SJ, Naguib M. What we know: precise measurement leads to patient comfort and safety. Anesthesiology 2011; 115: 918-920. doi: 10.1097/ALN.0b013e318234367d 8. Naguib M, Kopman AF, Ensor JE. Neuromuscular monitoring and postoperative residual curarisation: a meta

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Personalized Surgical Planning – The Use of 3D Printing in Oncological Pathology

Abstract

Introduction. Among the cases of malignant tumors, gathering 30% of them, the most frequent is the osteosarcoma. It occurs especially in children and young adults, the mean age being 14 years old. The treatment consists initially in neoadjuvant chemotherapy, followed by the surgical removal of the tumor. Due to aggressive malignant features (rapid increase in size, tendency to invade surrounding tissues, variable location), in multiple cases, the surgical treatment of osteosarcoma becomes a true challenge. Materials and methods. Nowadays, it is possible to create 3D printed models, by using CT and MRI, which are superior to the 3D graphical reconstructions. The 3D printing technique facilitates the production of these 1:1 scale printed models that faithfully embody the patient’s particular features concerning the anatomic pathology. The benefits gained from using such a modern tool allow the orthopedic surgeons to establish the measurements of a precise resection and to simulate the surgical maneuvers, as part of an elaborated modern surgical planning. Results. In this article, we presented the case of a 10-year-old patient diagnosed with femoral osteosarcoma and treated with neoadjuvant chemotherapy followed by GMRS surgical approach based on a preoperative planning involving a 3D printed model. This piece was used to provide precise information regarding the tumor, to allow preoperative measurements and a surgical simulation. Conclusion. The surgical accuracy can be increased by using a personalized preoperative planning based on a 3D printed model, leading to a lower rate of long/ short-term complications, recurrences, or metastases.

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Pupillary dilation reflex and pupillary pain index evaluation during general anaesthesia: a pilot study

Abstract

Background. Pupillary response by pupillary dilatation reflex (PDR) is a robust reflex, even measurable during general anaesthesia. However, the ability of infrared pupillometry to detect PDR differences obtained by intraoperative opioid administration in anaesthesized patients remains largely unknown. We analyzed the performance of automated infrared pupillometry in detecting differences in pupillary dilatation reflex response by a inbuilt standardized nociceptive stimulation program in patients under general anesthesia with a standardized propofol/fentanyl scheme. Methods. In this single center, interventional cohort study 38 patients (24-74 years) were enrolled. Patients were anesthetized with propofol until loss of consciousness. Two dynamic pupil measurements were performed in each patient (before opioid administration and after opioid steady state). Automated infrared pupillometry was used to determine PDR during nociceptive stimulations (10-60 mA) applied by a inbuilt pupillary pain index protocol (PPI) to the skin area innervated by the median nerve. Increasing stimulations by protocol are device specific and automatically performed until pupil dilation of > 13%. Pupil characteristics, blood pressure, heart rate values were collected. Results. After opioid administration, patients needed a higher stimulation intensity (45.26 mA vs 30.79 mA, p = 0.00001). PPI score showed a reduction after analgesic treatment (5.21 vs 7.68, p = 0.000001), resulting in a 32.16% score reduction. Conclusions. PDR via automated increased tetanic stimulation may reflect opioid effect under general anaesthesia. Further research is required to detect possible confounding factors such as medication interaction and optimization of individualized opioid dosage.

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Burnout syndrome in the Anaesthesia and Intensive Care Unit

References 1. Freudenberger HJ, Richerson G. Burn-Out: The High Cost of High Achievement. 1 st edition. Garden City, NY: Anchor Press; 1980. 2. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav 1981; 2: 99-113. doi: 10.1002/job.4030020205 3. Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout Syndrome in Critical Care Nursing Staff. Am J Respir Crit Care Med 2007; 175: 698-704. doi: 10.1164/rccm.200606-806OC 4. Hagau N, Pop RS. Prevalence of burnout in Romanian anaesthesia

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