BACKGROUND With advancements in the treatment of chronic liver disease(CLD),including liver transplantation(LT),quality of life and satisfaction after LT have become an important issue for pediatric patients and their...BACKGROUND With advancements in the treatment of chronic liver disease(CLD),including liver transplantation(LT),quality of life and satisfaction after LT have become an important issue for pediatric patients and their parents.More evidence-based information is needed to describe and assess the impact of pediatric CLD on parents and the satisfaction of parents with treatment to better understand their needs.AIM To assess the satisfaction of parents of pediatric LT patients and that of parents of pediatric CLD patients METHODS During this survey,data were collected from parents of pediatric patients who underwent LT between January 2010 and April 2017(LT group;n=91)and parents of pediatric patients with chronic liver disease(CLD group;n=94).Group comparisons were made based on the pediatric health-related quality of life(PedsQL)health care parent satisfaction scale,impact on family scale(IFS)and demographic characteristics.The PedsQL was administered to parents during a phone interview and the results were used to assess the health carerelated satisfaction of parents.The IFS was used to assess the impact of the child’s CLD status on the family.Demographic variables such as education level(elementary vs middle vs high vs university),monthly income(low vs middle vs high),and place of residence(village vs town vs city)were compared between CLD and LT parent groups.Finally,PedsQL and IFS results were also analyzed according to demographic variables.RESULTS A total of 185 parents aged 19 to 65 years were included.There were statistically significant differences between the LT and CLD groups in terms of career(P<0.001),monthly income(P=0.016),and education level(P=0.041).According to the PedsQL results,family inclusion,communication,technical skills,emotional needs,and overall satisfaction were significantly different between the groups;the LT group had consistently higher scores(P<0.001).Additionally,scores for the IFS parameters of financial impact,familial-social impact,personal strain,and total impact were consistently higher for the LT group(P<0.001).There were statistically significant relationships between education level,monthly income,and place of residence according to the IFS results but not the PedsQL results.There were inverse relationships between the difficulties that parents experience because of their child’s health and education levels,monthly income,and place of residence.However,no relationship was found between education level,monthly income,or place of residence and satisfaction with health care services provided in the hospital according to the PedsQL results.CONCLUSION Parents of children who underwent LT were very satisfied with the health care services provided to their children.However,they had more difficulties than parents of children with CLD.展开更多
AIM: To investigate possible disparities in perioperative morbidity and mortality among different body mass index(BMI) groups and to simulate the impact that these differences might have had on the cohort of patients ...AIM: To investigate possible disparities in perioperative morbidity and mortality among different body mass index(BMI) groups and to simulate the impact that these differences might have had on the cohort of patients undergoing cadaveric liver transplantation(LT).METHODS: All adult recipients undergoing first time LT for benign conditions and receiving a whole graft from brain-dead donors were selected from the united network of organ sharing registry. From January 1994 to June 2013, 48281 patients satisfied the inclusion criteria and were stratified by their BMI. The hypothesis that abnormal BMIs were independent predictors of inferior outcomes was tested with univariate and multivariate regression analyses.RESULTS: In comparison to normal weight recipients, underweight and morbidly obese recipients had increased 90-d mortality(adjusted OR = 1.737; 95%CI: 1.185-2.548, P = 0.005)(adjusted OR = 1.956; 95%CI: 1.473-2.597, P = 0.000) respectively and inferior patients' survivals(adjusted HR = 1.265; 95%CI: 1.096-1.461, P = 0.000)(adjusted HR = 1.157; 95%CI: 1.031-1.299, P = 0.013) respectively. Overall, patients' 5-year survival were 73.9% for normal-weight, 71.1% for underweight, 74.0% for overweight, 74.4% for class Ⅰ obese, 75.0% for class Ⅱ obese and 71.5% for class Ⅲ obese recipients. Analysis of hypothetical exclusion of underweight and morbidly obese patients from the pool of potential LT candidates would have improved the overall survival of the entire cohort by2.7%(95%CI: 2.5%-3.6%).CONCLUSION: Selected morbidly obese patients undergoing LT for benign conditions had 5-year survival rates clinically comparable to normal weight recipients. Impact analysis showed that exclusion of high-risk recipients(underweight and morbid obese patients) would not significantly improve the overall survival of the entire cohort of patients requiring LT.展开更多
The aim of this article was to examine the research articles regarding biological and mechanical properties of cryopreserved teeth for potential use in tooth transplantation. A systematic review of literatures was per...The aim of this article was to examine the research articles regarding biological and mechanical properties of cryopreserved teeth for potential use in tooth transplantation. A systematic review of literatures was performed by Pubmed searching with assigned key words from January 1, 1990 to June 8, 2009. All articles were examined for inclusion criteria. Secondary search was conducted by hand-search through references of included articles from primary search. A total of 24 articles were obtained from both primary and secondary search and used as fundamental articles in this review. Periodontal ligament tissues of cryopreserved teeth were able to maintain their biological properties resulted in a satisfactory healing of periodontium. Dental pulp tissues,however, may be compromised by limitation of permeability of cryopreservative agent into pulp cavity. Therefore, an endodontic treatment of transplanted cryopreserved teeth was recommended. Cryopreserved teeth had comparable mechanical properties to those of normal teeth. Importantly, the success of cryopreserved tooth transplantation treatment in orthodontic patients was reported. The cryopreserved teeth for tooth banking have a potential clinical application for treatment of missing teeth. Case selection, however, is critical for treatment success. More studies and data regarding masticatory function and periodontal healing of transplanted cryopreserved teeth are needed.展开更多
To Editor,We read with interest the article entitled "Transplantation of cryopreserved teeth: a systematic review" (Osathanon, 2010). Although the author is to be congratulated for his systematic approach to cryo...To Editor,We read with interest the article entitled "Transplantation of cryopreserved teeth: a systematic review" (Osathanon, 2010). Although the author is to be congratulated for his systematic approach to cryopreserved tooth transplantation (CTT), we would like to draw your attention to some technical limitations of this review.展开更多
BACKGROUND: Dental anomalies are variations from the established well-known general anatomy and morphology of the tooth as a result of disturbances during tooth formation. They can be developmental, congenital, or acq...BACKGROUND: Dental anomalies are variations from the established well-known general anatomy and morphology of the tooth as a result of disturbances during tooth formation. They can be developmental, congenital, or acquired and may be localized to a single tooth or involve systemic conditions. AIM: To evaluate the prevalence of dental anomalies in patients who report to the Komfo Anokye Teaching Hospital (KATH) dental clinics. METHOD: A descriptive cross-sectional design was used with a sample size of 92 patients aged 18 or older, obtained through convenience sampling. Data analysis was performed using SPSS version 26.0. RESULTS: The study included 92 patients aged 18 to 72 years, with 47.8% males and 52.2% females. Dental anomalies were observed in 51.1% of participants, with a higher prevalence in females (55.3%). The most common anomalies were diastema (48.3%), impacted teeth (22.0%), dilaceration (11.9%), and peg-shaped lateral teeth (6.8%). CONCLUSION: This study highlights the importance of conducting thorough dental examinations to identify and address dental anomalies, which may have implications for treatment. Early detection and correction of these anomalies are crucial to prevent future complications.展开更多
文摘BACKGROUND With advancements in the treatment of chronic liver disease(CLD),including liver transplantation(LT),quality of life and satisfaction after LT have become an important issue for pediatric patients and their parents.More evidence-based information is needed to describe and assess the impact of pediatric CLD on parents and the satisfaction of parents with treatment to better understand their needs.AIM To assess the satisfaction of parents of pediatric LT patients and that of parents of pediatric CLD patients METHODS During this survey,data were collected from parents of pediatric patients who underwent LT between January 2010 and April 2017(LT group;n=91)and parents of pediatric patients with chronic liver disease(CLD group;n=94).Group comparisons were made based on the pediatric health-related quality of life(PedsQL)health care parent satisfaction scale,impact on family scale(IFS)and demographic characteristics.The PedsQL was administered to parents during a phone interview and the results were used to assess the health carerelated satisfaction of parents.The IFS was used to assess the impact of the child’s CLD status on the family.Demographic variables such as education level(elementary vs middle vs high vs university),monthly income(low vs middle vs high),and place of residence(village vs town vs city)were compared between CLD and LT parent groups.Finally,PedsQL and IFS results were also analyzed according to demographic variables.RESULTS A total of 185 parents aged 19 to 65 years were included.There were statistically significant differences between the LT and CLD groups in terms of career(P<0.001),monthly income(P=0.016),and education level(P=0.041).According to the PedsQL results,family inclusion,communication,technical skills,emotional needs,and overall satisfaction were significantly different between the groups;the LT group had consistently higher scores(P<0.001).Additionally,scores for the IFS parameters of financial impact,familial-social impact,personal strain,and total impact were consistently higher for the LT group(P<0.001).There were statistically significant relationships between education level,monthly income,and place of residence according to the IFS results but not the PedsQL results.There were inverse relationships between the difficulties that parents experience because of their child’s health and education levels,monthly income,and place of residence.However,no relationship was found between education level,monthly income,or place of residence and satisfaction with health care services provided in the hospital according to the PedsQL results.CONCLUSION Parents of children who underwent LT were very satisfied with the health care services provided to their children.However,they had more difficulties than parents of children with CLD.
文摘AIM: To investigate possible disparities in perioperative morbidity and mortality among different body mass index(BMI) groups and to simulate the impact that these differences might have had on the cohort of patients undergoing cadaveric liver transplantation(LT).METHODS: All adult recipients undergoing first time LT for benign conditions and receiving a whole graft from brain-dead donors were selected from the united network of organ sharing registry. From January 1994 to June 2013, 48281 patients satisfied the inclusion criteria and were stratified by their BMI. The hypothesis that abnormal BMIs were independent predictors of inferior outcomes was tested with univariate and multivariate regression analyses.RESULTS: In comparison to normal weight recipients, underweight and morbidly obese recipients had increased 90-d mortality(adjusted OR = 1.737; 95%CI: 1.185-2.548, P = 0.005)(adjusted OR = 1.956; 95%CI: 1.473-2.597, P = 0.000) respectively and inferior patients' survivals(adjusted HR = 1.265; 95%CI: 1.096-1.461, P = 0.000)(adjusted HR = 1.157; 95%CI: 1.031-1.299, P = 0.013) respectively. Overall, patients' 5-year survival were 73.9% for normal-weight, 71.1% for underweight, 74.0% for overweight, 74.4% for class Ⅰ obese, 75.0% for class Ⅱ obese and 71.5% for class Ⅲ obese recipients. Analysis of hypothetical exclusion of underweight and morbidly obese patients from the pool of potential LT candidates would have improved the overall survival of the entire cohort by2.7%(95%CI: 2.5%-3.6%).CONCLUSION: Selected morbidly obese patients undergoing LT for benign conditions had 5-year survival rates clinically comparable to normal weight recipients. Impact analysis showed that exclusion of high-risk recipients(underweight and morbid obese patients) would not significantly improve the overall survival of the entire cohort of patients requiring LT.
基金supported by Young Investigator Research Promotion Grant, Chulalongkorn Uni- versity
文摘The aim of this article was to examine the research articles regarding biological and mechanical properties of cryopreserved teeth for potential use in tooth transplantation. A systematic review of literatures was performed by Pubmed searching with assigned key words from January 1, 1990 to June 8, 2009. All articles were examined for inclusion criteria. Secondary search was conducted by hand-search through references of included articles from primary search. A total of 24 articles were obtained from both primary and secondary search and used as fundamental articles in this review. Periodontal ligament tissues of cryopreserved teeth were able to maintain their biological properties resulted in a satisfactory healing of periodontium. Dental pulp tissues,however, may be compromised by limitation of permeability of cryopreservative agent into pulp cavity. Therefore, an endodontic treatment of transplanted cryopreserved teeth was recommended. Cryopreserved teeth had comparable mechanical properties to those of normal teeth. Importantly, the success of cryopreserved tooth transplantation treatment in orthodontic patients was reported. The cryopreserved teeth for tooth banking have a potential clinical application for treatment of missing teeth. Case selection, however, is critical for treatment success. More studies and data regarding masticatory function and periodontal healing of transplanted cryopreserved teeth are needed.
文摘To Editor,We read with interest the article entitled "Transplantation of cryopreserved teeth: a systematic review" (Osathanon, 2010). Although the author is to be congratulated for his systematic approach to cryopreserved tooth transplantation (CTT), we would like to draw your attention to some technical limitations of this review.
文摘BACKGROUND: Dental anomalies are variations from the established well-known general anatomy and morphology of the tooth as a result of disturbances during tooth formation. They can be developmental, congenital, or acquired and may be localized to a single tooth or involve systemic conditions. AIM: To evaluate the prevalence of dental anomalies in patients who report to the Komfo Anokye Teaching Hospital (KATH) dental clinics. METHOD: A descriptive cross-sectional design was used with a sample size of 92 patients aged 18 or older, obtained through convenience sampling. Data analysis was performed using SPSS version 26.0. RESULTS: The study included 92 patients aged 18 to 72 years, with 47.8% males and 52.2% females. Dental anomalies were observed in 51.1% of participants, with a higher prevalence in females (55.3%). The most common anomalies were diastema (48.3%), impacted teeth (22.0%), dilaceration (11.9%), and peg-shaped lateral teeth (6.8%). CONCLUSION: This study highlights the importance of conducting thorough dental examinations to identify and address dental anomalies, which may have implications for treatment. Early detection and correction of these anomalies are crucial to prevent future complications.