Chase Farm Hospital

The current study aimed to assess the oropharyngeal space using cone-beam computed tomography (CBCT) and its effect on airway volume both before and after denture placement. For this investigation, a total of 15 individuals with fully edentulous upper and lower ridges, ranging in age from 40 to 70, were taken into consideration. A recording of the pulmonary function test was made both prior to and following full denture recovery. Prior to finishing denture therapy, the patient underwent a CBCT scan while standing erect and wearing a cephalostat. For one patient, two tomographs were recorded. The initial skull tomography was obtained prior to the rehabilitation of prosthetic limbs. After receiving prosthetic rehabilitation, the second tomograph was taken. On Demand 3D and CS 3D imaging software were used to take the measurements. The maxillary and mandibular complete dentures were fabricated using standardized techniques. Following prosthesis insertion, a CBCT scan of the skull was performed, and the results were recorded and analyzed. The mean oropharyngeal space measurement before and after complete denture rehabilitation was 9.18 mm and 10.20 mm, respectively. It was discovered that there was a statistically significant difference (p = 0.001). The oropharynx's mean volume before complete denture rehabilitation was 5533.50 mm3, and it was 6562.39 mm3 after denture rehabilitation was finished. A statistically significant difference was discovered (p = 0.028). On conclusion, a statistically significant difference was found between the airway volume and oropharyngeal space prior to and following denture rehabilitation. Reducing apnea-hypopnea episodes can be achieved by minimizing pharyngeal collapsibility in patients by providing complete dentures that are created with acceptable and potentially improved vertical dimension of occlusion within the limits of permissible tissues. The CBCT image enables it to be simple to distinguish between empty space and soft tissues. One benefit of wearing a denture while sleeping for edentulous patients with obstructive sleep apnea is that it helps decrease apnea-hypopnea episodes. This happens because wearing a denture causes changes to the soft tissue, pharyngeal airway space, jaw, and tongue positions. How to cite this article: Raj K, Soni M, Hatila S, et al. Assessment of the Oropharyngeal Space Using CBCT and Its Impact on Volume of Airway Prior and after Denture Placement: In Vivo Study. J Contemp Dent Pract 2024;25(10):936-940.

ABSTRACT Positive Behavior Support (PBS) is a framework that attempts to help reduce challenging behaviors displayed by service users however, little is known about the role of nurses and their perceptions of PBS. This qualitative study aimed to explore nurses’ perceptions and their roles in the PBS implementation in two forensic learning disabilities units in London. 19 nursing staff with experience implementing PBS were interviewed. Six themes were derived from thematic analysis, with findings in line with previous research. Recommendations highlighted introducing protected time for nursing staff to discuss PBS on the ward and providing more structured training and informed supervision.

Key annual events in the sheep calendar can have a significant impact on production, efficiency and, therefore, farm profits. Veterinarians can play an important and proactive role in these key events, and examination of rams for breeding is an opportunity for veterinary input into a sheep flock. Testing before mating can identify subfertile and infertile rams.

This study aimed to present a retrospective case series of the long-term results of severe hallux valgus treated with triple osteotomy of the first ray. Patients with severe hallux valgus treated with a basal medial opening wedge, distal chevron, and Akin osteotomy from 2008 to 2012 were identified from the electronic medical records. Radiological outcomes such as pre- and postoperative hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle) were collected. Patients were contacted to complete foot and ankle outcome score (FAOS). Nineteen patients underwent 20 triple osteotomies of the first ray. Clinical data and FAOS were collected at a median follow-up of 10.2 years. There was a significant improvement in hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle from pre- to postoperatively, both at initial and final radiographic follow-up (P < .0001). Patient satisfaction was high, with median FAOS of 94.5 (symptoms), 97 (function/activities of daily living), 100 (function/sport and recreation), 85 (foot and ankle-related quality of life), and 100 (pain). Triple first-ray osteotomy is a successful mode of treatment for severe hallux valgus, with high levels of patient satisfaction and excellent improvement in radiological parameters measured over long-term follow-up.

There is limited evidence for comparing operative and non-operative management of closed, extra-articular distal humeral shaft fractures. This study aims to evaluate these outcomes. A comparative retrospective study was performed for patients who underwent either operative fixation or conservative management with a humeral brace, with clinical and radiological outcomes at minimum 2-year follow-up. Forty-two patients with median 4.6years follow-up were included; 24 had surgical fixation and 18 were managed with humeral brace. Assessment of clinical and radiological outcomes demonstrated few statistically significant functional differences between the two groups. Surgical patients achieved faster union for non-comminuted fractures. All patients maintained functional range of motion, with similar complication rates. This study suggests that similar outcomes can be achieved with both managements, though faster union times may be seen in the operative group. Further studies are recommended to evaluate the impact of fracture comminution causing delayed unions.

A 31 year old man with spina bifida and a ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt in situ presented with sudden onset dyspnoea and pleuritic chest pain. He reported a nine month history of increasing breathlessness. Clinical signs of right heart strain were present. Echocardiography estimated the pulmonary artery pressure to be 86 mm Hg. Computed tomography pulmonary angiogram confirmed acute pulmonary embolism (PE) and chronic pulmonary thromboembolic disease. He was anticoagulated but unfortunately had a cardiac arrest and succumbed. VA CSF shunts were used for the treatment of hydrocephalus between the 1950s and 1980s. Although most VA shunts sited for hydrocephalus in childhood have been removed, some may remain in situ in adults. These patients are at risk of PE and development of chronic thromboembolic pulmonary hypertension (CTEPH). Removal of the VA shunt should be considered when patients are shown to be shunt independent. We advise the regular screening of patients with VA CSF shunts for pulmonary hypertension with pulse oximetry, electrocardiography, chest radiography and echocardiography as it is preventable, detectable and treatable.

To assess the correlation between ultrasound findings of cystic endometrium and hysteroscopic and histopathologic findings. A retrospective study was performed across two London hospital sites between January and December 2020. The percentage chance of having either endometrial hyperplasia or cancer was lower in our cohort of women with postmenopausal bleeding and ultrasound findings of cystic endometrium, compared with population estimates for women with postmenopausal bleeding alone (4.1% vs 10%-15% for endometrial cancer and 1.4% vs 5%-10% for endometrial hyperplasia). Conversely, a higher proportion of women in our cohort were diagnosed with endometrial polyps compared with population estimates for postmenopausal bleeding (68% vs 2%-12%). The rate of endometrial hyperplasia was significantly higher in our cohort of premenopausal women with abnormal uterine bleeding and cystic endometrium compared with population estimates for premenopausal patients with abnormal uterine bleeding (15.4% vs 1.4%). Cystic endometrium appears to be a powerful predictor of endometrial pathology. The high rate of endometrial hyperplasia in premenopausal women with cystic endometrium would advocate the need to obtain histologic diagnoses. Further studies are required to confirm whether cystic endometrium in women with postmenopausal bleeding confers a lower risk of endometrial hyperplasia and cancer.

Non-union in non-operatively managed humeral shaft fractures are associated with significant morbidity. Hence, developing a robust system that could help with early diagnosis is important. We aimed to evaluate the validity of the Radiographic Union Score for HUmeral fractures (RUSHU) at 6 weeks (RUSHU-6) and test whether a RUSHU at 12 weeks (RUSHU-12) would be a better predictor of non-union. We retrospectively reviewed all non-operatively managed humeral diaphyseal fractures from 2012 to 2018. Statistical analysis was used to determine the cut-off RUSHU-12 and evaluate the effect of RUSHU-6 and RUSHU-12 on non-union prediction. In sum, 32 patients had radiographs at 6 weeks post-injury, 27 of which also had radiographs at 12 weeks. A RUSHU cut-off of 9 was the best predictor of non-union at 12 weeks. Only RUSHU-12 had a statistically significant influence predicting non-union (P = 0.011) and there was a significant correlation (P = 0.003) between score progression from RUSHU-6 to RUSHU-12 and the development of non-union. A RUSHU-12 of <9 and a low score progression between 6 and 12 weeks suggest superior predictive value in determining the likelihood of non-union. Further validation in the form of a large multicentred study is however required.