Sunday, April 3, 2022

Head and neck pedicled flap autonomization using a new high‐resolution indocyanine green fluorescence video‐angiography device

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Abstract

In head and neck oncologic surgery a reconstructive phase is often required and pedicled flaps are still a viable option, though they may need a pedicle division performed at a later stage. Several techniques are commonly used for perfusion assessment of the flaps, with indocyanine green (ICG) fluorescence video-angiography representing a promising tool. We used ICG video-angiography to evaluate the perfusion of two of the most commonly adopted pedicled flaps in the head and neck field (the supraclavicular and the paramedian forehead flap) before and after second-stage pedicle division, allowing a safer in-setting. Moreover, the new high-resolution device that we have employed added further accuracy to the traditional video-angiography, providing a real-time flap-to-normal skin ICG ratio. Indeed, ICG video-angiography proved to be a useful tool in head and neck reconstructive surgery and it may allow an earlier second-stage pedicle division.

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The TeleDent™ Teledentistry Platform by MouthWatch Now Integrates with Henry Schein’s Dentrix G6 and G7 Practice Management Software

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The healthcare industry has been on a steady progression toward tele-health  for a few years now.  Covid-19 pushed it more to the forefront of discussions due to its lack of direct contact between provider and patient.  Now as both patients and providers become more adjusted and accepting of the concept, the dental industry is seeing more and more companies supporting the idea.

The latest industry move in the tele-dentistry arena is with practice management software.  As most of you probably know, MouthWatch, LLC makes the incredibly popular MouthWatch intraoral camera.  However, they also are the parent company behind TeleDent, a tele-health company with a focus on dentistry.  

Now, the TeleDent platform can be integrated into Dentrix, the most popular practice management system.  If you are an office that is using either Dentrix G6 or Dentrix G7, you can enjoy T eleDent directly inside the system.

One of the biggest hinderances to acceptance of technology evolution is the lack of integration of new products into existing platforms.  Ease of use is important.  Multiple clicks to bring information into your existing informatics is a hassle.  Here is what MouthWatch is doing now:


MouthWatch, LLC recently announced the integration of its award-winning, market leading TeleDent teledentistry platform with Henry Schein's Dentrix G6 and G7 practice management software. 

According to MouthWatch LLC founder and CEO Brant Herman. "Deploying teledentistry is now easier for Dentrix G6 and G7 users. TeleDent's comprehensive, convenient, and secure virtual care platform is able to scale across the full spectrum of Dentrix G6 and G7 clients, from individual private practices to DSOs with hundreds of locations." 

TeleDent provides Dentrix G6 and G7 users with real-time two-way video confere ncing along with HIPAA-secure patient and provider messaging that can be used on desktop and mobile devices, so practitioners can conduct emergency triages, consultations, pre-visit screenings, post-op visits, and virtual case presentations either synchronously or asynchronously. 

Dental practices using these latest versions of Dentrix can now clinically integrate virtual consults with video recordings, patient records, and intraoral photos within the platform to ensure effective and thorough virtual dental care. What's more, the patient-facing messaging included in the TeleDent platform enables practitioners to communicate directly with patients, and also seamlessly collaborate and share diagnostic information with their dental teams and specialists, in a cloud-based portal. 

TeleDent/Dentrix G6 / G7 integration is now available for new and current TeleDent users. For more information, please contact Jay Martorelli, MouthWatch Director of Sales at sales@mout hwatch.com.

About TeleDent:

TeleDent, the all-in-one teledentistry solution from MouthWatch, LLC was designed to  help dental teams  connect with their patients and collaborate with their colleagues. The recent introduction of new features such as an intuitive, mobile-friendly patient portal, text messaging, and online patient intake, make it easier to connect with patients in the safe and convenient way they now expect. For example, new patient consults, post-op evaluations, home care instructions, specialist referrals and emergency triage can all be conducted with the highest degree of simplicity, security, and safety. TeleDent's professional grade technology can serve as the backbone of key virtual clinical workflows to increase 

efficiency and profitability. In recent years, TeleDent has received several prestigious industry awards, such as The 2020 and 2021 Cellerant Best of Class Award. In 2021, TeleDent also won Dentistry Today's&nb sp; Top Innovative Products, and Top 25 Aesthetic and Restorative Products awards. For more information visit www.TeleDent.com.

About MouthWatch, LLC:

Founded in 2012, MouthWatch, LLC is a leader in innovative teledentistry solutions, digital case presentation tools and intraoral imaging devices. Since its formation, the company has pioneered the integration of digital imaging and communications technology in the field of oral health. This experience makes it possible for MouthWatch to take the lead in introducing the benefits of telemedicine to the world of dentistry. For more information, visit www.MouthWatch.com.


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Envista Obtains FDA Clearance for Assisted Intelligence Mandibular Nerve Tracing

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 We are seeing more and more artificial intelligence systems enter into the healthcare space and dentistry in general.  Envista is a large player in the dental space, owning several companies under t he "umbrella" of Envista.

Many of the companies that are owned by Envista have products in the tech sphere and the company works hard with research & development to expand the use of its technologies across its portfolio.

Now comes word that the company has received FDA clearance for mapping of the inferior alveolar nerve.  The process, which has been referred to as "nerve tracing" for years has, until now, required manual input from the doctor. 

Before this discovery, it was necessary for the office to take a CBCT scan and then manually trace points along the mandibular canal.  When completed, the software would plot a line through all of the points to indicate the location of the canal throughout the mandible.

Now... that process has been automated.  I recently made a post about the dental A.I. company Pearl and how that company's FDA clearance was a watershed moment in dentistry.  Now we've reached another A.I. milestone in the profession.  This announcement is groundbreaking and these types of A.I. assisted procedures are only going to become more commonplace.

The profession has shown the FDA that these types of systems work reliably and this is only the beginning.  Here is full announcement from Envista:

Envista announced today the 510(k) Food and Drug Administration (FDA) clearance of its Assisted Intelligence (AI) mandibular nerve tracing feature in its image acquisition and diagnostic software platform DTX Studio Clinic.

The tracing of the mandibular nerve in modern dentistry is of high significance as it influences the available therapeutic options for the patient. The proper visualization of the nerve can prevent complications. When done manually, it is a task that can be both time-consuming and error prone. DTX's AI capabilities supports clinicians as they perform this important task.

This clearance complements a series of AI-powered functionality in DTX Studio Clinic. In 2017, Envista obtained FDA clearance for its AI-driven 3D virtual tooth setup algorithm. In 2020, a further clearance was received for automatic tooth position identification and automated sorting of full-mouth x-ray series. On March 25, the FDA cleared the third AI-focused 510(k) for the fully automated mandibular nerve tracing on CBCT scans.

Amir Aghdaei, Envista CEO, said, "This cle arance is another important step towards our digital strategy of expanding the capabilities of our powerful, unified, and open dental diagnostic software platform DTX Studio Clinic. With its combination of a user-friendly interface and AI-driven functionality, DTX Studio Clinic reduces the time clinicians spend on time-consuming tasks, while simultaneously helping prevent complications and enabling increased focus on the patient. We are particularly proud of our fully automated mandibular nerve tracing functionality with its high clinical relevance for dental implant-based patient rehabilitations."

About Envista Holdings Corporation

Envista is a global family of more than 30 trusted dental brands, including Nobel Biocare, Ormco, DEXIS, and Kerr united by a shared purpose: to partner with professionals to improve lives. Envista helps its customers deliver the best possible patient care through industry-leading dental consumables, solutions, technology, and services. Our comprehensive portfolio, including dental implants and treatment options, orthodontics, and digital imaging technologies, covers a broad range of dentists' clinical needs for diagnosing, treating, and preventing dental conditions as well as improving the aesthetics of the human smile. With a foundation comprised of the proven Envista Business System (EBS) methodology, an experienced leadership team, and a strong culture grounded in continuous improvement, commitment to innovation, and deep customer focus, Envista is well equipped to meet the end-to-end needs of dental professionals worldwide. Envista is one of the largest global dental products companies, with significant market positions in some of the most attractive segments of the dental products industry. For more information, pl ease visit www.envistaco.com.

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Association of age-related decrease in intracellular-to-total water ratio with that in explosive strength of the plantar flexors: a cross-sectional study

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We aimed to investigate the association of age-related differences in the intracellular-to-total water ratio with explosive strength of the plantar flexors.
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Navigating the Regulatory Pathway for Medical Devices—a Conversation with the FDA, Clinicians, Researchers, and Industry Experts

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Abstract

Successful translation of new and innovative medical products from concept to clinical use is a complex endeavor that requires understanding and overcoming a variety of challenges. In particular, regulatory pathways and processes are often unfamiliar to academic researchers and start-ups, and even larger companies. Growing evidence suggests that the successful translation of ideas to products requires collaboration and cooperation between clinicians, researchers, industry, and regulators. A multi-stakeholder group developed this review to enhance regulatory knowledge and thereby improve translational success for medical devices. Communication between and among stakeholders is identified as a critical factor. Current regulatory programs and processes to facilitate communication and translation of innovative devices are described and discussed. Case studies are used to highlight the importance of flexibility when considering evidence requirements. We provide a revi ew of emerging strategies, opportunities, and best practices to increase the regulatory knowledge base and facilitate medical device translation by all stakeholders.

Graphical abstract

Clinicians, regulators, industry, and researchers require regulatory knowledge and collaboration for successful translation of innovative medical devices

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18F-FDG-PET/CT can be used to predict distant metastasis in hypopharyngeal squamous cell carcinoma

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Hypopharyngeal squamous cell carcinoma (HPSCC) has a high rate of distant metastasis, resulting in poor prognosis. The role of the maximum standardized uptake value (SUVmax), which was assessed via pretreatmen...
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In Vivo Murine Models of Cardiotoxicity Due to Anticancer Drugs: Challenges and Opportunities for Clinical Translation

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Abstract

Modern therapeutic approaches have led to an improvement in the chances of surviving a diagnosis of cancer. However, this may come with side effects, with patients experiencing adverse cardiovascular events or exacerbation of underlying cardiovascular disease related to their cancer treatment. Rodent models of chemotherapy-induced cardiotoxicity are useful to define pathophysiological mechanisms of cardiac damage and to identify potential therapeutic targets. The key mechanisms involved in cardiotoxicity induced by specific different antineoplastic agents are summarized in this state-of-the-art review, as well as the rodent models of cardiotoxicity by different classes of anticancer drugs, along with the strategies tested for primary and secondary cardioprotection. Current approaches for early detection of cardiotoxicity in preclinical studies with a focus on the application of advanced imaging modalities and biomarker strategies are also discussed.

Graphical abstract

Potential applications of cardiotoxicity modelling in rodents are illustrated in relation to the advancements of promising research topics of cardiotoxicity. Created with BioRender.com.

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Functional Impact and Regulation of Alternative Splicing in Mouse Heart Development and Disease

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Abstract

Alternative splicing (AS) plays a major role in the generation of transcript diversity. In the heart, roles have been described for some AS variants, but the global impact and regulation of AS patterns are poorly understood. Here, we studied the AS profiles in heart disease, their relationship with heart development, and the regulatory mechanisms controlling AS dynamics in the mouse heart. We found that AS profiles characterized the different groups and that AS and gene expression changes affected independent genes and biological functions. Moreover, AS changes, specifically in heart disease, were associated with potential protein–protein interaction changes. While developmental transitions were mainly driven by the upregulation of MBNL1, AS changes in disease were driven by a complex regulatory network, where PTBP1 played a central role. Indeed, PTBP1 over-expression was sufficient to induce cardiac hypertrophy and diastolic dysfunction, potentially by perturb ing AS patterns.

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The Role of Angiogenesis and Arteriogenesisin Myocardial Infarction and Coronary Revascularization

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Abstract

Surgical myocardial revascularization is associated with long-term survival benefit in patients with multivessel coronary artery disease. However, the exact biological mechanisms underlying the clinical benefits of myocardial revascularization have not been elucidated yet. Angiogenesis and arteriogenesis biologically leading to vascular collateralization are considered one of the endogenous mechanisms to preserve myocardial viability during ischemia, and the presence of coronary collateralization has been regarded as one of the predictors of long-term survival in patients with coronary artery disease (CAD). Some experimental studies and indirect clinical evidence on chronic CAD confirmed an angiogenetic response induced by myocardial revascularization and suggested that revascularization procedures could constitute an angiogenetic trigger per se. In this review, the clinical and basic science evidence regarding arteriogenesis and angiogenesis in both CAD and coro nary revascularization is analyzed with the aim to better elucidate their significance in the clinical arena and potential therapeutic use.

Graphical abstract

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Analysis of Different Techniques of Tonsillectomy: An Insight

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Abstract

Tonsillectomy is one of the most commonly performed surgical procedure in otolaryngology especially in children. This is an age old procedure which has seen continuous changes in the surgical technique from guillotine method to snare technique to coblation tonsillectomy, and is still evolving day by day. But there are no consensus as to which technique is the best or most appropriate for tonsillectomy. The objective of this study is to compare three different surgical techniques of tonsillectomy namely the Cold dissection snare technique (CDST), Bipolar electro-dissection technique (BEDT) and Harmonic scalpel technique (HST) and to identify the method which is safe, with less operative time, which offers decreased intra-operative blood loss and with lowest post-operative morbidity and complications. This prospective and comparative study was conducted over a time duration of 1 year 6 months from January 2018 to July 2019 after the approval from ethical committee. Total 150 cases of tonsillectomy were done by dividing into three groups of 50 cases each. The study showed maximum cases of tonsillitis in the age group less than 10 years and the most common indication for tonsillectomy being chronic recurrent tonsillitis. Harmonic scalpel technique (HST) had least operative time, least intra-operative blood loss, took minimum time for resumption of normal diet and normal activity and also had least pain score on post-operative day 1st, 5th, 10th and 15th. STATISTICS: Kruskall-Wallis and the non-parametric Analysis of variance (ANOVA) tests were applied to determine statistically significant variances. All the differences are found to be significant P < 0.05. Harmonic Scalpel Technique (HST) is the latest technique as it is associated with quicker procedure, less intraoperative blood loss and less post-operative pain.

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Endoscopic Adenoidectomy Replacing the Outdated Curette Adenoidectomy: Comparison of the Two Methods at a Tertiary Care Centre

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Abstract

To compare intraoperative and postoperative parameters of the two techniques of adenoidectomy, endoscope and microdebrider powered adenoidectomy and conventional adenoidectomy. Study Design Prospective study. Setting: Academic tertiary referral centre. In our study, cases of adenoid hypertrophy were randomly selected from the outpatient department of department of ORL & HNS. Out of these patients, 30 underwent Endoscopic adenoidectomy (EA) (Group A) and 30 underwent Conventional adenoidectomy (CA) (Group B). All of the patients were assessed pre-operatively, intra-operatively and post-operatively to compare the various parameters. The most common complaint in both the groups was mouth breathing with snoring. Intra-operative bleeding was 29.15 ml in group EA and 15.2 ml in group CA. Operative time for CA was shorter at 21.8 min as compared to 32.1 min for group EA. Residual adenoids and injury to adjacent structures were more common in group CA. Hospital stay was 3.2 days for EA patients and 3.43 days for CA patients. Resolution of symptoms was near comparable in both groups. Operative time and intra-operative bleeding are both significantly reduced with the CA as opposed to EA. However, injury to adjacent structures and residual adenoids occur significantly less in group EA. After weighing the risks and benefits, we can conclude that EA is comparatively better than CA.

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