Background: The celiac-mesenteric trunk is an anatomic variant where there is a common origin for the superior mesenteric artery and celiac trunk. We sought to determine the prevalence of this ...variation in an Afro-Caribbean population. Methodology: Anatomic dissections were observed over 5 years, and specimens with celiac-mesenteric trunks were identified for detailed investigation. We measured celiac-mesenteric trunk diameters at their origin from the aorta. Results: Dissections were performed in sixty-nine cadavers at a mean age of 68 years (range 55–85). Only one celiac-mesenteric trunk (1.5%) was encountered in an Afro-Caribbean male. This cadaver had no other morphologic anomalies. The celiac-mesenteric trunk had an internal diameter of 13.06 mm at its origin (55% aortic diameter). Conclusion: In this Afro-Caribbean population, a celiac-mesenteric trunk was found in 1.5% of unselected cadavers. This formidable vessel was 55% of the aortic diameter. Therefore, healthcare professionals must be aware of this variant to avoid inadvertent injury during clinical interventions.
Shade selection with the help of shade guides and color matching the restorations to the natural dentition continues to be one of the most perplexing and frustrating problems in fixed prosthodontics. ...The purpose of the study was to evaluate the shade differences of the natural anterior teeth in different age groups and gender, within the cross sectional Bangalore, Karnataka population, using commercially available shade guides. The shade of a cross section of the population comprising of 400 subjects of both the sexes (800 incisors; 400 maxillary central incisors; 400 mandibular central incisors) visiting the outpatient Department of Government Dental College was selected randomly and evaluated visually by a single observer using three commonly used shade guides i.e. Vita Lumin, Chromascop and the Vita 3D Master. The incidence of the most common shades in the different age groups and gender using these shade guides was obtained and this data was subjected to the χ
2
test (
p
< 0.05—significant). The most common shade for the maxillary and mandibular incisors in the younger age group is A2/2R1.5/140 and A1/1M2/120 for the males and females using Vita Lumin, Vita 3D Master and Chromascop shade guides respectively. In the advanced age group the most common shade for the maxillary and mandibular incisors is A2/2R2.5/140 using the same order of shade guides. However the results showed no statistical significance in shade variation in males and females in different age groups using different shade guides. Although the incidence of males with darker teeth as compared to females was higher; the study showed no statistical significant correlation between shade differences in both the sexes. It is also observed that there is a significant darkening of teeth as the age advances.
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CMK, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Traditional descriptions of liver anatomy refer to a smooth, convex surface contacting the diaphragm. Surface depressions are recognized anatomic variants. There are many theories to explain the ...cause of the depressions. We discuss the theory that these are caused by hypertrophic muscular bands in the diaphragm.
Background In the classic descriptions of the human liver, the umbilical fissure (UF) is a long, narrow groove on the visceral surface that receives the ligamentum teres hepatis. In this study, we ...document the UF variations encountered in a series of cadaveric dissections. Methods We reported UF variations using the following classification: Type I refers to "normal" anatomy where there is a long, narrow groove. In type II, the UF was covered by a fibrotic band devoid of hepatic parenchyma. In type III variants, an extension of hepatic parenchyma partially covered but did not obliterate the UF. In type IV variants, the hepatic parenchyma formed a bridge over the UF, completely obliterating the groove. After institutional review board approval, we observed all consecutive cadaveric dissections over five years and recorded the characteristics and dimensions of each UF and its immediate relations. Results There were 69 cadavers, and variant UFs were present in 38 (55.1%) cadavers: type II (1.5%), type III (20.3%), and type IV (33.3%). Conclusions In this Jamaican population, only 44.9% of persons had conventional "normal" anatomy and 55.1% had UF variants. These variants are clinically significant, as they lead to misinterpretation of patient imaging and can hinder operative procedures on the liver.
Objective:
To determine the quality, content, and readability of patient education materials pertaining to otitis media across several popular online platforms focused on otolaryngology and pediatric ...primary care education.
Methods:
Online patient materials related to otitis media and directed toward parents were collected from the American Association for Family Practice (AAFP), ENT-Health section of the American Academy of Otolaryngology—Head and Neck Surgery, Healthychildren.org from the American Academy of Pediatrics, KidsHealth from Nemours, WebMD, and Wikipedia. Materials were analyzed for quality, content, and readability. The DISCERN instrument was used to score quality. A unique content score was generated based on the information provided on each website and on the medical and surgical management of otitis media. Readability scores were calculated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index.
Results:
Overall, content was well-balanced. Information from AAFP and Healthychildren.org was focused more on medical management than other sources. The average DISCERN scores showed all sources to be of good quality with minimal shortcomings. The AAFP and KidsHealth websites had some readability scores around the 8th-grade reading level, the National Institute of Health’s upper limit recommended for public health information; however, most websites were above this recommended reading level.
Conclusion:
Patient education materials related to otitis media on academic and certain popular internet sites are good sources to obtain high-quality information on the topic. Patient educational background, prior knowledge and understanding of otitis media, and physician-patient partnership goals should be taken into account when referring patients to online materials.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
There have been no prior reports of the morphology of the caudate lobe of the liver in a Caribbean population. We sought to document the variations in caudate surface anatomy in this population. Two ...independent investigators observed 56 consecutive cadaveric dissections over a period of five years. Each liver was explanted using a standardized technique. The caudate lobe was observed and standardized measurements were taken using electronic calipers. There were 56 cadavers dissected over the study period. Morphologic anomalies of the caudate lobe were present in 64% of unselected persons in this Caribbean population. These included the presence of a linguiform process (64.3%), absence of a caudate process (28.6%), presence of an inferior caudate notch (21.4%), the presence of a vertical caudate fissure (19.6%) and the presence of a papillary process (10.7%). The caudate fissure co-existed with a caudate notch in 91.6% of our population. Only 36% of persons in this Caribbean population had normal caudate lobe anatomy. These variations carry clinical significance and are of importance to any clinician treating liver diseases in persons of Caribbean extract. This population has the highest prevalence of a linguiform process (64.3%) to be reported in medical literature. It is unclear why the incidence was so high in this Caribbean population, but it is tempting to think that there might be an ethnic predisposition since the majority of cadavers in our study were of Afro-Caribbean ethnicity (91.1%). Keywords Hepatic, Surface, Lobe, Segment, Caribbean, Liver.
Evaluate the authorship, content, quality, and readability of information on Transoral Robotic Surgery (TORS) available to patients online.
The technical search term “TORS Surgery” and layperson's ...term “robotic surgery of the mouth” were utilized to conduct a search of the top 50 websites on Google, Bing, and Yahoo. Websites were evaluated according to the HONcode evaluation of content and quality, and readability was assessed using the Flesch Reading Ease Formula, Flesch-Kincaid Grade Level Formula, SMOG readability formula, Coleman Liau Index formula, and Gunning Fog Index. Statistical analysis was conducted using the Fisher Freeman- Halton test to compare differences in authorship, quality, and content between the three search engines and the Fisher exact test was used to determine if there was a difference in these variables between the two search terms.
Overall, websites were predominantly from academic institutions with 97% mentioning benefits of TORS with 24% mentioning risks. 45% of TORS websites had no description of the TORS procedure, while 62% allowed individuals to make appointments. There was a significant difference in authorship with the layperson's terms yielding more news sources, but there were no significant differences in quality and content of information elicited through the technical and layperson search terms. The mean readability scores were Flesch Kincaid Grade Level 13.81(±3.32), Gunning-Fog Index 16.51(±3.39), SMOG 12.53(±2.40), and Automated Readability Index 14.05 (±4.17).
Current online information on TORS surgery may not provide balanced information for patients to make informed healthcare decisions. The current readability of online information regarding TORS far exceeds the average literacy level of average American adults.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We were unable to find a satisfactory explanation for the discordance between cadaveric dissections and our observations in living patients in the same Caribbean population. There is a possibility ...that these may be due to dynamic effects of diaphragmatic contraction, but this requires further investigation. We wish to stimulate discussion and encourage larger, well-designed clinical studies that could take into account the effect of neuromuscular blockers on diaphragmatic projections in living patients with HSGs.
A bronchogenic cyst is a rare developmental aberration that occurs in the paediatric age group. Over 50 cases of bronchogenic cysts have been reported in the literature. There is still a possibility ...of clinically misdiagnosing this condition as a more common congenital neck cyst like a branchial cyst. We report here the case of a 12-year-old female presenting with a neck swelling since birth who was diagnosed to have a bronchogenic cyst based on characteristic clinical and histopathological findings.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Oncogenesis is driven by germline, environmental and stochastic factors. It is unknown how these interact to produce the molecular phenotypes of tumors. We therefore quantified the influence of ...germline polymorphisms on the somatic epigenome of 589 localized prostate tumors. Predisposition risk loci influence a tumor's epigenome, uncovering a mechanism for cancer susceptibility. We identified and validated 1,178 loci associated with altered methylation in tumoral but not nonmalignant tissue. These tumor methylation quantitative trait loci influence chromatin structure, as well as RNA and protein abundance. One prominent tumor methylation quantitative trait locus is associated with AKT1 expression and is predictive of relapse after definitive local therapy in both discovery and validation cohorts. These data reveal intricate crosstalk between the germ line and the epigenome of primary tumors, which may help identify germline biomarkers of aggressive disease to aid patient triage and optimize the use of more invasive or expensive diagnostic assays.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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