Has Coca-Cola treatment become the first-line therapy for gastric bezoars,both in general and specifically for western countries?

Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.

Treatment of Peripheral Neuropathy: Combination Therapy Using LED Light, Extracorporeal Shockwave Therapy, Platelet Rich Plasma, and an Oral Dietary Supplement

Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is commonly associated with pain, numbness, tingling, burning, and cramping in the feet and legs. Current treatment options are limited to controlling pain, seizures and use of antidepressant medications. These treatments have undesirable side effects and don’t stop PN progression. Here we utilized a combination of individual-specific modalities to improve local circulation and relieve PN symptoms. Methods: We conducted an open-label, multicenter pilot trial with 34 subjects (19 males and 15 females ranging from 40 - 85 years of age). All of the participants were diagnosed with peripheral neuropathy and had bilateral symptoms in their feet, and many reported the same symptoms (pain, numbness, tingling, burning, and cramping) in their lower legs. The duration of symptoms ranged from four months to over six years. On Day 0, subjects were given a 90-day supply of the oral supplement with dosing instructions and a LED light therapy device. They also received three platelet-rich plasma (PRP) injections in their lower extremities. Subjects also received an extracorporeal shockwave therapy (ESWT) treatment for each foot and subsequently twice per week for the first six weeks, then once weekly for the duration of the study. Subjects filled out the Brief Pain Index (BPI) at weekly intervals. On Day 90, subjects completed the Patient Global Impression of Change (PGIC) survey. Results: There were significant responses to pain, as evidenced by BPI scores at weeks 8, 9, 10 and 11 (p = 0.02, 0.01, 0.02, and 0.003, respectively). Analysis of the final day PGIC survey showed a favorable outcome for 73% of participants (p = 0.003), with the majority reporting Very Much Improved. Conclusions: By utilizing a multi-modality treatment protocol that includes PRP, LED light therapy, ESWT and an oral dietary supplement, we observed significant reductions in BPI scores. Quality of life and their overall impression of change (PGIC) were significantly improved, and there were no significant side effects.

Oral Hygiene in the Presence of Orthodontic Therapy

Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic appliances that could be fixed or removable. However, it’s worth stating that these appliances interfere with tooth brushing, making it more difficult to brush teeth effectively. Orthodontics appliances therefore promote the accumulation of dental plaque, which results in both quantitative and qualitative changes in the oral microbiota, hence, exposing patients to several adverse effects such as White spot lesions, dental caries, periodontal pathologies and halitosis. For this reason, oral assessment of patients before, during and after treatment is necessary as well as oral hygiene instructions and motivation. Orthodontists therefore, should educate patients on oral and periodontal hygiene in order to control dental and periodontal complications. Prescriptions of plaque control materials adapted to each patient are done in order to optimize the final result and minimize unwanted complications.

Recurrent Transient Osteoporosis during Pregnancy and Treatment with Oral Bisphosphonates: A Case Report

Transient osteoporosis of the hip (TOH), also known as “Bone marrow edema Syndrome”, is a rare disorder mainly affecting pregnant women in their third trimester, as well as middle-aged, overweight men. A 30-year-old Caucasian female G2P2, with history of transient osteoporosis of both ankles and C-Section during the last pregnancy in 2011, presented progressively severe bilateral hip pain with onset already in the 12th gestational week. Imaging of the pelvis and bilateral hips with MRI obtained 6 days after the C-Section demonstrated bilateral bone-marrow edema of the hips. The patient was treated with a monthly single dose of 150 mg ibandronate acid per os, for 3 months and physiotherapy. Repeated MRI performed 5 months postpartum revealed a complete remission of the disease. In contrast to the first onset of transient osteoporosis during the first pregnancy, which was only treated conservatively without bisphosphonates, the remission of the disease and patient’s recovery with oral ibandronate therapy showed to be 4 months shorter. This case is unique in literature for both describing the onset of this rare disease twice in the same patient as well as its oral therapeutic approach.

Use of Oral Agents and/or Insulin in the Treatment of Diabetes during Pregnancy: An Examination of Outcomes in Pregestational versus Gestational Diabetics

The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.

Oral Propranolol: A Useful Treatment for Infantile Hemangioma

Background: Infantile haemangioma is the commonest childhood tumor. Several lines of treatment are available. Recent reports have focused on the value of propranolol in treating rapidly proliferating haemangioma. The aim of this study was to assess oral propranolol in treatment for facial haemangioma. Patients and Methods: Fifteen patients with rapidly proliferating infantile facial haemangioma with cosmetic disfigurement were treated with oral propranolol. All patients had cardiovascular pre-treatment work-up and commenced on oral propranolol at 3 mg/kg/day. Results: A rapid decrease in hemangioma proliferation was seen in 100% of patients and significant regressions occuring in all patients. This treatment was well tolerated and had little side effects. Conclusions: Oral propranolol is a reliable and easily reproducible method for treatment of facial hemangioma.

Obstructive Sleep Apnea, Prevalence, Etiology &Role of Dentist &Oral Appliances in Treatment: Review Article

Objective: The aim of this article is to provide a detailed description for obstructive sleep apnea regarding its signs and symptoms, the way it is diagnosed, the risk factors, management, the role of dentists and oral appliances in treatment and consequences of untreated condition. Material and Method: Electronic searching was done in PubMed, Medline, EMBASE and CENTRAL databases. Inclusion criteria were: dental, oral and maxillofacial oriented articles. Exclusion criteria: cardiac, obesity and non dental oriented articles were excluded. Result: 59 articles meet the criteria. Conclusion: Obstructive sleep apnea (OSA) is a potentially life threatening disorder characterized by repeated collapse of the upper airway during sleep, with periodic cessation of breathing for more than ten seconds. The frequency of obstructive sleep apnea has been found to increase with age;ranging from two percent among children to two and half percent - six percent among adolescents. Overnight polysomnographic test at specialized sleep clinics remains the gold standard for diagnosing obstructive sleep apnea disorder. Management of this condition can be performed via surgical and non surgical methods. Continuous positive airway pressure represents the first line of treatment for most patients with obstructive sleep apnea.

Treatment of Irritable Bowel Syndrome by Oral Administration of Chinese Medicines and Retention-Enema——A Report of 50 Cases

Irritable bowel syndrome (IBS), a common disease of intestinal dysfunction, is also called emotional enteritis, mucous enteritis, irritable colon and so on1. It is often lingering with a long disease course and is easy to recur. The author has in recent years treated 50 cases of the disease by oral administration of Chinese medicines and retention-enema, with satisfactory results reported as follows.

2018—2022年某三级口腔专科医院工作人员职业暴露情况调查

目的:探讨口腔专科工作人员职业暴露危险因素和职业伤害情况,为制定针对性职业防护措施提供依据。方法:回顾性分析2018年1月1日—2022年12月31日某三级口腔专科医院工作人员的职业暴露现状,探讨口腔专科医护工作人员职业暴露的风险因素。结果:5年职业暴露率分别为9.65%、6.54%、4.96%、5.38%、3.96%。151名职业暴露人员中,84.77%的职业暴露源不明;以女性[128人(84.77%)]、护士[63人(41.72%)]为主;暴露科室主要以综合门诊科/部(21.85%)和牙周黏膜科(17.22%)为主;主要发生于口腔诊疗操作(48.34%);08:00~11:59(51.66%)是1 d中发生职业暴露次数最多的时间;手部(87.42%)是最主要的暴露部位;暴露器械多为根管锉、牙科钻、洁治器头(38.41%)及注射针头(33.11%);2020年后工作人员职业防护考核得分有大幅度提升(P<0.05)。结论:口腔专科职业暴露风险较综合医院有其专科特色,建议在推广安全器具使用的基础上,进行喷溅操作多、诊疗次数多的操作之前开展病人血源性检测,同时在进行职业安全防护、标准操作规程、职业暴露处置等相关培训时要结合人群特点,培训形式应与受训者群体特征相适应。

口腔临床诊疗中数字牙片影像技术的应用价值

目的探讨口腔临床诊疗中数字牙片影像技术的应用价值。方法选择2022年1月至2023年5月期间在本院口腔科就诊且需要拔牙治疗的50例正畸患者作为研究对象。患者在治疗前,完成数字化牙片摄影和传统牙片摄影。记录投照上、下颌牙齿X线倾斜的垂直平均角度,并统计牙齿根尖片的曝光时间,对比两种摄影技术对牙齿长度的测量结果。结果传统牙片摄影时,上颌和下颌切牙位、单尖牙、双尖牙位、第一磨牙位、第二及三磨牙位(足侧倾斜)选择投射角度低于数字化牙片摄影(P<0.05)。数字化牙片摄影投照上颌和下颌切牙位、单尖牙位、双尖牙位、第三磨牙位及第一、二磨牙位牙齿根尖片的曝光时间低于传统牙片摄影(P<0.05)。数字化牙片摄影对待拔除牙齿单根、双根颊和双根腭测量结果与游标卡尺测量结果相比,差异无统计学意义(P>0.05);传统牙片摄影对待拔除牙齿单根、双根颊和双根腭测量结果低于游标卡尺测量结果,差异具有统计学意义(P<0.05);以游标卡尺测量结果为依据,数字化牙片摄影和传统牙片摄影对待拔除牙齿单根、双根颊和双根腭测量结果相比,差异具有统计学意义(P<0.05)。结论数字牙片影像技术投照条件宽容度相对较大,投射时曝光时间短,对牙齿根尖的测量准确度较高,便于细致观察牙齿,应用于口腔临床诊疗的价值较高。

数字化集成技术在多学科联合辅助正畸治疗中的应用前景

随着人工智能的迅速发展,数字化技术在口腔医学领域中得到了广泛的应用,尤其在口腔多学科联合诊疗中扮演着重要角色。数字化技术的引入为正畸治疗为主的口腔多学科联合治疗提供了新的思路和方法,医生可以更准确地评估患者的口腔状况,多学科联合诊疗共同制定个性化的治疗方案,并在治疗过程中进行实时监测和调整,从而提高了治疗的精确性和效率。同时,数字化技术的应用为患者带来了更加精细化、个性化的治疗体验,为临床实践提供了可靠的技术支持和指导。就数字化技术在正畸治疗为主的口腔多学科诊疗中的临床应用作一综述。

口腔诊疗操作中高频接触表面的量性研究

目的 明确口腔诊疗操作中高频接触表面,为清洁消毒工作提供依据与指导。方法 采用直接观察法对北京市某三级甲等口腔医院7个门诊科室环境表面的接触时间与频次进行调查,计算平均接触频次、95%置信区间及累积接触频率。结果 口腔诊疗操作中环境表面平均接触26.75次/操作,平均接触频次最高为牙体牙髓病专业(46.25次/操作),最低为口腔黏膜病专业(10.19次/操作)。高频接触表面为无影灯手柄、综合治疗台操作面板及手柄(医生侧)、电脑键盘及鼠标、三用枪手柄及线前端、高速牙科手机及线前端,接触频次分别为3.99、3.85、2.65、1.86、1.40次/操作。所有口腔专业的高频接触表面均包含综合治疗台操作面板及手柄(医生侧),75%的专业包含电脑键盘及鼠标,50%的专业接触频次最高为无影灯手柄;环境表面平均接触频次最高为牙冠预备操作(113.50次/操作),最低为正畸咨询(8.50次/操作)。结论 不同口腔专业及不同口腔诊疗操作的高频接触表面不同,医疗机构应根据口腔科室高频接触表面的实际情况采取相应的清洁消毒及管理措施,切实提升环境清洁消毒质量。

基于环境听觉管理的舒适化口腔治疗应用于儿童牙科畏惧症的效果观察

目的:探讨基于环境听觉管理的舒适化口腔治疗应用于儿童牙科畏惧症的效果。方法:选取2021年1月-2022年7月医院收治的122例儿童牙科畏惧症患儿作为研究对象,随机分为对照组与观察组,各61例。对照组实施常规口腔治疗,观察组实施基于环境听觉管理的舒适化口腔治疗。比较两组患儿治疗前后生理应激水平、牙科畏惧症状、临床焦虑水平及舒适度变化。结果:观察组患儿治疗后舒张压、心率低于对照组,收缩压高于对照组(P<0.05);观察组患儿治疗后“害怕牙医”“让不认识的人碰”“医生钻牙”“想象钻牙的场景”“医生把工具放到嘴巴里”及总分低于对照组(P<0.05);观察组患儿临床焦虑水平轻于对照组(P<0.05);观察组患儿治疗后舒适度各维度评分、总分均高于对照组(P<0.05)。结论:基于环境听觉管理的舒适化口腔治疗应用于儿童牙科畏惧症中可促使生理应激水平保持稳定,提高舒适度,减轻患儿畏惧症状及焦虑水平。

妊娠期口腔急症的临床考量

妊娠期是口腔疾病患病和治疗的特殊时期,妊娠期发生的口腔急症需得到恰当的处置。一方面,孕妇生理环境、个人习惯的改变增加了部分口腔疾病的易患性;另一方面,为了保证孕妇和胎儿安全,临床治疗策略局限。孕妇应掌握口腔健康知识、增强口腔保健意识。口腔医生应在“孕前预防,孕期治标,孕后治本”的原则下,根据不同的妊娠时期制定合适的治疗方案,以最安全、简单、有效的手段控制急症、防止疾病进展,避免对孕妇和胎儿的不良影响。防治结合,让孕妇和口腔医生共同维护妊娠期口腔健康。本文围绕妊娠期治疗原则,对妊娠期口腔急症治疗的时机选择、临床管理和不同疾病的治疗策略等进行了总结。

口腔急诊科死亡病例分析

为了解口腔专科医院急诊科死亡病例的临床特点,提高口腔专科医院的急诊救治水平,我们收集了北京大学口腔医院急诊科2010年1月至2023年1月期间死亡病例的临床资料并进行回顾性分析。分析的数据包括死亡患者的性别、年龄、主诉、颌面部疾病诊断、全身基础疾病状况、抢救情况、死亡原因和死亡的季节分布。结果显示,13年间共发生死亡病例8例(男性5例,女性3例),年龄为40~86岁,中位年龄66岁。8例患者中,5例主诉症状为口腔癌出血,1例为口腔癌术后胸闷、呼吸困难,1例为颌面部创伤后意识丧失,1例为口腔糜烂无法进食。8例患者均合并有高血压、冠心病、糖尿病、肾功能衰竭、脑梗塞等基础疾病中的一项及以上,其中2例患者表现为恶液质。5例患者的死亡原因为口腔癌破裂出血或外科手术伤口愈合不良、出血引发呼吸循环衰竭,1例为尿毒症、高钾血症致循环衰竭,1例为颌面部创伤后口底组织肿胀致窒息,另一例为口腔癌术后急性心肌梗死致循环衰竭。6例患者在入院前已发生意识丧失、呼吸心跳停止,2例患者在入院后医生治疗时发生意识丧失、呼吸心跳骤停,所有患者均接受了心肺复苏及部分高级生命支持措施,平均抢救时长46 min。因口腔急诊科患者死亡发生率较低,医务人员参与急救的机会少,应定期组织急救技能培训、演练和考核。急救设施(如心电监护仪、除颤仪、简易呼吸器、氧气供给系统、负压吸引系统、气管内插管与气管切开器械)应常备,急救药品储备要充足,并安排专人定期维护。死亡病例主要发生于伴有全身基础疾病的老年口腔癌出血患者。颌面外科医生对老年口腔癌术后的患者要加强宣教,提高患者及家属的急诊意识。急诊医务人员要加强自身的急救技能训练,接诊此类患者时也要加强急救意识。

次溴酸对口腔综合治疗台水路系统消毒效果的研究

目的观察次溴酸对口腔综合治疗台水路系统(dental unit waterlines,DUWLs)的消毒效果。方法选取医院DUWLs,包括三用喷枪、牙科手机、水杯注水器各20台,将3种设备以1~20编号排列,1~10号设备纳入实验组,11~20号设备纳入对照组。对照组不进行DUWLs消毒,实验组使用次溴酸消毒。分别于每日诊疗前,冲洗3min后进行水样检测,采集时间为第0、1、2、3、4、5、8、10、15、20、25、30天,共采样12次。构建广义估计方程,比较两组不同时点手机插口部位,水杯出水部位,三用枪插口部位菌落计数;比较DUWLs水样合格率。结果构建广义估计方程,对两组手机插口部位,水杯出水部位,三用枪插口部位菌落计数进行截距、组别、时点、组别×时点的固定效应的显著性检验,两组数据在不同时点间变化差异有统计学意义(P<0.05)。两组首次开诊前实验组三用枪插口部位菌落计数较对照组多16800,差异有统计学意义(P<0.05);对照组第30天时菌落计数较首次开诊前减少29000;实验组第30天时菌落计数减少量较对照组多35250,差异有统计学意义(P<0.05)。两组首次开诊前两组手机插口部位菌落计数差异无统计学意义(P>0.05);对照组第30天时菌落计数较首次开诊前减少86900;实验组第30天时菌落计数减少量较对照组多16350,差异无统计学意义(P>0.05)。两组首次开诊前水杯出水部位菌落计数比较差异无统计学意义(P>0.05);对照组第30天时菌落计数较首次开诊前减少25550;实验组第30天时菌落计数减少量较对照组多11800,差异有统计学意义(P<0.05)。实验组诊疗前、冲洗3min后手机插口部位,水杯出水部位,三用枪插口部位合格率均高于对照组,差异有统计学意义(P<0.05)。结论使用次溴酸进行DUWLs消毒能够减少菌落计数,提高水样合格率。

正畸患者口腔健康素养综合量表的编制及信效度检验

目的 编制正畸患者口腔健康素养综合评估工具,并对其信效度进行检验。方法 对成人口腔健康素养问卷、牙科畏惧调查量表及改良牙科焦虑量表进行翻译后形成量表初始版,通过7个省的11所三级口腔专科医院的28名专家的2轮函询和预调查,形成正畸患者口腔健康素养综合量表的最终版本,并于2022年9月至12月选取在南京医科大学附属口腔医院接受口腔正畸治疗的362例患者为调查对象,对该量表进行信效度检验。结果 探索性因子分析提取5个公因子,累积方差贡献率为51.293%。验证性因子分析显示χ~2/df=1.509,RMSEA=0.031,CFI=0.948,TLI=0.939,模型适配度良好。最终形成包含阅读理解和知识能力、决策能力、计算能力、倾听能力、心理状态5个维度,共25个条目的量表。结论 正畸患者口腔健康素养综合量表信效度较好,可作为评估正畸患者口腔健康素养综合水平的工具。

以口腔黏膜溃疡为首发表现的结外鼻型NK/T细胞淋巴瘤的多学科诊疗1例

结外鼻型NK/T细胞淋巴瘤(extranodal nasal type NK/T-cell lymphoma,ENKTL)是一种以破坏面部中份结构为主的NK/T细胞来源的非霍奇金淋巴瘤,临床少见。以口腔黏膜溃疡为首发症状的病例罕见且易与其他疾病相混淆,在诊断上极其困难。本文报道1例以颊黏膜及牙龈溃疡为首发表现的ENKTL的多学科诊疗,并分析该疾病的临床病理学特征、诊断、鉴别诊断和治疗,以期为临床诊治相关病例提供参考。

无托槽隐形矫治术用于口腔正畸效果和安全性观察

目的探讨无托槽隐形矫治术用于口腔正畸的效果和安全性。方法选取医院2021年1月至7月收治的口腔正畸患者80例,按随机数字表法分为对照组和观察组,各40例。对照组患者予常规矫正固定术治疗,观察组患者予无托槽隐形矫治术治疗,对比两组患者的治疗效果。结果观察组患者的总有效率为97.50%,显著高于对照组的85.00%(P<0.05)。观察组患者的不良反应发生率为7.50%,显著低于对照组的25.00%(P<0.05)。治疗后,两组患者的牙齿功能指标美观度、牙齿固定、咀嚼功能、咬合能力评分均显著升高(P<0.05),且观察组均显著高于对照组(P<0.05);两组患者的健康状况调查简表(SF-36)精神状态、情感功能、社会功能、生理职能评分均显著升高(P<0.05),且观察组均显著高于对照组(P<0.05)。结论无托槽隐形矫治术治疗口腔正畸的效果良好,可改善患者的健康状况和牙齿功能,且安全性良好。

小剂量红霉素联合益生菌口服治疗早产儿喂养不耐受的效果

目的探析早产儿喂养不耐受采用小剂量红霉素联合益生菌口服治疗的效果。方法在2021年4月至2023年4月福建省莆田市第一医院收治的喂养不耐受早产儿中选取100例配合研究,依据随机数表法分为两组,每组各50例。对照组采用小剂量红霉素治疗,观察组在对照组基础上加之益生菌口服治疗。比较两组临床有效率、症状改善时间、早产儿体重增加值及不良反应发生率。结果观察组临床有效率高于对照组,差异有统计学意义(P<0.05)。观察组症状改善时间包括胃潴留消失时间为(4.32±1.02)d、呕吐消失时间为(3.56±1.12)d、腹胀消失时间为(2.78±0.56)d,均短于对照组,差异有统计学意义(P<0.05)。观察组生长发育指标包括身高、头围、体重均高于对照组,差异有统计学意义(P<0.05)。结论早产儿喂养不耐受选取小剂量红霉素联合益生菌口服治疗的效果明显,其各症状改善时间明显缩短,可提升早产儿生长发育情况,临床上可借鉴及推广。