Late reconstruction of extensive orbital floor fracture with a patient-specific implant in a bombing victim

Maximiliaan Smeets,Robin Snel,Yi Sun,Titiaan Dormaar,Constantinus Politis 대한구강악안면외과학회 2020 대한구강악안면외과학회지 Vol.46 No.5

Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patientspecific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.

Letter to the Editor : Measurement of Esophagogastric Junction Distensibility May Assist in Selecting Patients for Endoluminal Gastroesophageal Reflux Disease Surgery: Author`s Reply

( Fabienne G M Smeets ),( Daniel Keszthelyi ),( Ad A Masclee ),( Jose M Conchillo ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.3

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy-responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

( Fabienne G M Smeets ),( Daniel Keszthelyi ),( Nicole D Bouvy ),( Ad A M Masclee ),( Jose M Conchillo ) 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.2

Background/Aims In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of the EndoFLIP technique in GERD patients treated by TIF. Methods Forty-two GERD patients underwent EGJ distensibility measurement before TIF using the EndoFLIP technique. In a subgroup of 25 patients, EndoFLIP measurement was repeated both postoperative and at 6 months follow-up. Treatment outcome was assessed according to esophageal acid exposure time (AET; objective outcome) and symptom scores (clinical outcome) 6 months after TIF. Results Multiple logistic regression analysis showed that preoperative EGJ distensibility (OR, 0.16; 95% CI, 0.03-0.78; P = 0.023) and preoperative AET (OR, 0.62; 95% CI, 0.42-0.90; P = 0.013) were independent predictors for objective treatment outcome but not for clinical outcome after TIF. The best cut-off value for objective outcome was 2.3 mm2/mmHg for preoperative EGJ distensibility and 11% for preoperative AET. EGJ distensibility decreased direct postoperative from 2.0 (1.2-3.3) to 1.4 (1.0-2.2) mm2/mmHg (P = 0.014), but increased to 2.2 (1.5-3.0) at 6 months follow-up (P = 0.925, compared to preoperative). Conclusions Preoperative EGJ distensibility and preoperative AET were independent predictors for objective treatment outcome but not for clinical outcome after TIF. According to our data, the EndoFLIP technique has no added value either in the preoperative diagnostic work-up or in the post-procedure evaluation of endoluminal antireflux therapy. (J Neurogastroenterol Motil 2015;21:255-264)

The feasibility of immediately loading dental implants in edentulous jaws

Henningsen, Anders,Smeets, Ralf,Wahidi, Aria,Kluwe, Lan,Kornmann, Frank,Heiland, Max,Gerlach, Till Korean Academy of Periodontology 2016 Journal of Periodontal & Implant Science Vol.46 No.4

Purpose: Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods: A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1-8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results: A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions: Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws.

The feasibility of immediately loading dental implants in edentulous jaws

Anders Henningsen,Ralf Smeets,Aria Wahidi,Lan Kluwe,Frank Kornmann,Max Heiland,Till Gerlach 대한치주과학회 2016 Journal of Periodontal & Implant Science Vol.46 No.4

Purpose: Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods: A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1–8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results: A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions: Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws.

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest-Posttest Study

Ketelaar, Sarah M.,Nieuwenhuijsen, Karen,Bolier, Linda,Smeets, Odile,Sluiter, Judith K. Occupational Safety and Health Research Institute 2014 Safety and health at work Vol.5 No.4

Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods: We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study

Sarah M. Ketelaar,Karen Nieuwenhuijsen,Linda Bolier,Odile Smeets,Judith K. Sluiter 한국산업안전보건공단 산업안전보건연구원 2014 Safety and health at work Vol.5 No.4

Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers’ health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods: We applied a pretesteposttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p ¼ 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d ¼ .23) in the participants who had logged onto an EMH intervention (20%, n ¼ 26). Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

Electroanatomical Mapping of the Urinary Bladder

Fawzy Farag,Martin Koens,Marij Tijssen,Sytse de Jong,Timon Fabius,Johnny Tromp,Hendrikje van Breda,Joep Smeets,Wout Feitz,John Heesakkers 대한배뇨장애요실금학회 2016 International Neurourology Journal Vol.20 No.2

A noncontact mapping system (EnSite) was used for electroanatomical mapping of the bladder simultaneously with pressure flow study in three women with lower urinary tract symptoms. We selected the periods of obvious detrusor activity. Data were processed to remove baseline drift, and an envelope of electrovesicography (EVG) data was created. The correlation coefficient for the correlation between between the EVG envelope and the detrusor pressure (Pdet) was calculated. Bladder geometry was successfully created in all 3 patients. Simultaneous recording of EVG and pressure flow data was successful in 1 patient. Scatter plots were made of the highest correlation coefficient, showing a positive correlation between the Pdet and the envelope, and negative correlation between abdominal pressure (Pabd) and the envelope. Minimal electrical activity could be observed. Significant weak to moderate correlation coefficients were found for the correlations between Pdet and EVG and between Pabd and EVG.

Cost-Minimization Analysis of Midline Catheters versus Peripherally Inserted Central Catheters in Korea

Smeet Gala,심하나,Sook-Young Jeon,어윤재,이권선,권경우,배성윤 한국보건의료기술평가학회 2021 보건의료기술평가 Vol.9 No.1

Objectives: Due to the lack of an appropriate alternative vascular access device, peripherally inserted central catheter (PICCs) are used unnecessarily among patients who do not require longterm catheterization. Unnecessary use of PICCs can lead to catheter-related blood stream infections (CRBSIs) or other complications that pose a substantial clinical and economic burden on patients and healthcare systems. Introduction of midline catheters (MCs) provides a cost-saving option for patients who require mid-term catheterization. This study investigated the cost-difference of using MCs vs. PICCs following the inclusion of MCs on a reimbursement list in Korea. Methods: A costminimization analysis conducted from the healthcare system perspective compared the costs of device use, complications, and labor for MCs and PICCs in a Korean inpatient setting over a year. Clinical and cost inputs were obtained from literature searches and the Health Insurance Review and Assessment (HIRA) Service database. The base case assumed that MCs were not reimbursed and thus all patients received PICCs. The future scenario predicted total costs when MCs were reimbursed, leading to an increased use of MCs in clinical practice. Sensitivity analyses were conducted to identify key drivers of cost savings. Scenario analyses assessed cost savings when the estimated percentage of patients using MCs was altered in the model. Results: Introduction of MCs led to cost savings of KRW 9,374,456,648 over a year, attributed to lower device costs, lower rates of CRBSI, and shorter insertion time associated with MCs compared with PICCs. The mean duration of PICC insertion time, annual mean salary of healthcare professionals performing PICC insertions, and prevalence of CRBSI for PICCs were key drivers of cost savings. Cost savings were still observed when the percentage of patients receiving MCs was as low as 10% in the model. Conclusion: The availability of MCs presents a cost-saving option to patients who were receiving unnecessary PICCs for mid-term catheterization during hospitalization in Korea.