Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 19 Σεπτεμβρίου 2016
Electrochemical stability of ionic liquids: general influences and degradation mechanisms
The stability of ionic liquids is of paramount importance in selecting the appropriate ionic liquid for a well-defined application. This Review provides an overview of stability issues, both chemical and electrochemical, and the underlying degradation mechanisms that are known. The influence of various functionalities on the stability of the ionic liquid, influencing both the cationic as the anionic parts of the ionic liquid, still requires several careful studies.
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The Impact of Emergency Department Census on the Decision to Admit
Abstract
Objective
We evaluated the effect of Emergency Department (ED) census on disposition decisions made by ED physicians.
Methods
We performed a retrospective analysis using 18 months of all adult patient encounters seen in the main ED at an academic tertiary care center. Patient census information was calculated at the time of physician assignment for each individual patient, and included the number of patients in the waiting room (waiting room census) and number of patients being managed by the patient's attending (physician load census). A multiple logistic regression model was created to assess the association between these census variables and the disposition decision, controlling for potential confounders including ESI acuity, patient demographics, arrival hour, arrival mode, and chief complaint.
Results
49,487 patient visits were included in this analysis, of which 37% were admitted to the hospital. Both census measures were significantly associated with increased chance of admission; the OR (odds ratio) per patient increase for waiting room census was 1.011, (95% CI: 1.001-1.020), and the OR for physician load census was 1.010, (95% CI: 1.002-1.019). To put this in practical terms, this translated to a modeled rise from 35.3% to 40.1% when shifting from an empty waiting room and zero patient load to a 12-patient wait and 16-patient load for a given physician.
Conclusion
Waiting room census and physician load census at time of physician assignment were positively associated with the likelihood that a patient would be admitted, controlling for potential confounders. Our data suggests that disposition decisions in the ED are influenced not only by objective measures of a patient's disease state, but also by workflow related concerns.
This article is protected by copyright. All rights reserved.
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Shared Decision Making in the Emergency Department among patients with Limited Health Literacy: Beyond Slower and Louder
Abstract
Health literacy is "the degree to which individuals can obtain, process and understand the basic health information needed to make appropriate health decisions and access health services needed to prevent or treat illness." The prevalence of limited health literacy (LHL) among adult ED patients is as high as 88%. Numeracy, or the "ability to understand and use numbers in daily life," is a continuum of skills that ranges from basic recognition and computation of numbers to understanding and use of high level skills such as probability, risk, and randomization.
This article is protected by copyright. All rights reserved.
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Associations of Emergency Department Length-of-Stay with Publicly Reported Quality-of-Care Measures
Abstract
Objective
The Institute of Medicine identified emergency department (ED) crowding as a critical threat to patient safety. We assess the association between changes in publicly reported ED length-of-stay (LOS) and changes in quality-of-care measures in a national cohort of hospitals.
Methods
Longitudinal analysis of 2012 and 2013 data from the American Hospital Association (AHA) Survey, Center for Medicare and Medicaid Services (CMS) Cost Reports, and CMS Hospital Compare. We included hospitals reporting Hospital Compare timeliness measure of LOS for admitted patients. We used AHA and CMS data to incorporate hospital predictors of interest. We used the method of first differences to test for relationships in the change over time between timeliness measures and six hospital-level measures.
Results
The cohort consisted of 2,619 hospitals. Each additional hour of ED LOS was associated with a 0.7% decrease in proportion of patients giving a top satisfaction rating, a 0.7% decrease in proportion of patients who would "definitely recommend" the hospital, and a 6 minute increase in time to pain management for long bone fracture (p<0.01 for all). A one hour increase in ED LOS is associated with a 44% increase in the odds of having an increase in left without being seen (LWBS) (95% CI 25-68%). ED LOS was not associated with hospital readmissions (p=0.14) or time to percutaneous coronary intervention (p=0.14).
Conclusion
In this longitudinal study of hospitals across the US, improvements in ED timeliness measures are associated with improvements in the patient experience.
This article is protected by copyright. All rights reserved.
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The Predictive Value of Pre-Endoscopic Risk Scores to Predict Adverse Outcomes in Emergency Department Patients with Upper Gastrointestinal Bleeding – A Systematic Review
Abstract
Objectives
Risk-stratification of emergency department (ED) patients with upper gastrointestinal bleeding (UGIB) using pre-endoscopic risk scores can aid ED physicians in disposition decision-making. We conducted a systematic review to assess the predictive value of pre-endoscopic risk scores for 30-day serious adverse events.
Methods
We searched MEDLINE, PubMed, Embase and the Cochrane Database of Systematic Reviews from inception to March 2015. We included studies involving adult ED UGIB patients evaluating pre-endoscopic risk scores and excluded reviews, case reports and animal studies. The composite outcome included 30-day mortality, recurrent bleeding and need for intervention. In 2 phases (screening and full review), 2 reviewers independently screened articles for inclusion and extracted patient level data and the consensus data was used for analysis. We reported sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratios with 95% confidence intervals.
Results
We identified 3,173 articles, of which 16 were included: 3 studied Glasgow Blatchford Score (GBS), 1 clinical Rockall score (cRockall) and 2 AIMS65; 6 compared GBS and cRockall, 3 compared GBS, a modification of the GBS and cRockall and 1 compared the GBS and AIMS65. Overall, the sensitivity and specificity of the GBS was 0.98 and 0.16 respectively; for the cRockall it was 0.93 and 0.24 respectively; and for the AIMS65 it was 0.79 and 0.61 respectively. The GBS with a cut-off point of 0 had a sensitivity of 0.99 and a specificity of 0.08.
Conclusion
The GBS with a cut-off point of 0 was superior over other cut-off points and risk scores for identifying low-risk patients but had a very low specificity. None of the risk scores identified by our systematic review were robust and hence, cannot be recommended for use in clinical practice. Future prospective studies are needed to develop robust new scores for use in ED patients with UGIB.
This article is protected by copyright. All rights reserved.
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Is blue dye still required during sentinel lymph node biopsy for breast cancer?
Mirjam CL Peek, Tibor Kovacs, Rose Baker, Hisham Hamed, Ash Kothari and Michael Douek
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KLRC3, a Natural Killer receptor gene, is a key factor involved in glioblastoma tumourigenesis and aggressiveness
Abstract
Glioblastoma is the most lethal brain tumour with a poor prognosis. Cancer stem cells (CSC) were proposed to be the most aggressive cells allowing brain tumour recurrence and aggressiveness. Current challenge is to determine CSC signature to characterize these cells and to develop new therapeutics. In a previous work, we achieved a screening of glycosylation-related genes to characterize specific genes involved in CSC maintenance. Three genes named CHI3L1, KLRC3 and PRUNE2 were found overexpressed in glioblastoma undifferentiated cells (related to CSC) compared to the differentiated ones. The comparison of their roles suggest that KLRC3 gene coding for NKG2E, a protein initially identified in NK cells, is more important than both two other genes in glioblastomas aggressiveness. Indeed, KLRC3 silencing decreased self-renewal capacity, invasion, proliferation, radioresistance and tumourigenicity of U87-MG glioblastoma cell line. For the first time we report that KLRC3 gene expression is linked to glioblastoma aggressiveness and could be a new potential therapeutic target to attenuate glioblastoma.
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PPAR Agonists Promote the Differentiation of Porcine Bone Marrow Mesenchymal Stem Cells into the Adipogenic and Myogenic Lineages
Purpose: The aim of this work was to evaluate the effect of PPAR agonists on the differentiation and metabolic features of porcine mesenchymal stem cells induced to the adipogenic or myogenic lineages. Methods: Bone marrow MSCs from neonate pigs were isolated and identified by cell proliferation, cell surface markers or the gene expression of stem cells (CD44, CD90, CD105 or Oct4 and Nanog, respectively). Cells were differentiated into adipose or muscle cells and treated with the PPAR agonists; adipogenic and myogenic differentiation was promoted by adding these compounds. The expression of PPAR#x03B3; (an adipose marker) and MyoD1 and MyHC (muscle markers), metabolic changes and expression levels of metabolic enzymes involved in glycolysis, lipogenesis, lipolysis and the pentose phosphate pathway were tested by qPCR. Results: MSCs from neonate pigs exhibited high proliferation and were positive for CD44, CD90 and CD105 markers and Oct4 and Nanog expression. The treatment that promoted the highest expression of PPAR#x03B3; was 50 µM of conjugated linoleic acid (CLA) c9 t11 (6.44 ± 0.69-fold, p ≤ 0.0001) in the adipose differentiation, and upregulation of HX2, ACCAα, ATGL, LPL and G6DP (p ≤ 0.0001) and downregulation of PFK and ACCAβ (p ≤ 0.0001) were found. For muscle differentiation, the best treatment was 50 µM of CLA c10 t12 (59.72 ± 4.72-fold, p ≤ 0.0001), and metabolic changes were upregulation of PFK, ACCAβ, G6DP, CPT1 and PPARβ/δ (p ≤ 0.0001), but no effect was observed with HX2 and ACCAα (p ≥ 0.05). Conclusions: Our results suggest that differentiated cells exhibit a typical cell lineage metabolism and higher efficiencies both in anabolism and catabolism.
Cells Tissues Organs
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Cells Tissues Organs
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Tunning optical properties of perovskite nanocrystals by supermolecular mercapto-[small beta]-cyclodextrin
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC04908G, Communication
DOI: 10.1039/C6CC04908G, Communication
Qi-Le Li, Wen-Xiu Lu, Neng Wan, Shou-Nian Ding
This work reports a host-guest interaction strategy for systematically manipulating the optical properties of cesium lead halide perovskites nanocrystals (CsPbBr3 NCs) by protectant-mediated mercapto-[small beta]-cyclodextrin (SH-[small beta]-CD). The fluorescence of CsPbBr3 NCs...
The content of this RSS Feed (c) The Royal Society of Chemistry
This work reports a host-guest interaction strategy for systematically manipulating the optical properties of cesium lead halide perovskites nanocrystals (CsPbBr3 NCs) by protectant-mediated mercapto-[small beta]-cyclodextrin (SH-[small beta]-CD). The fluorescence of CsPbBr3 NCs...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Optimal timing for hepatitis C therapy in US patients eligible for liver transplantation: a cost-effectiveness analysis
Summary
Background
Recurrence of hepatitis C virus (HCV) following liver transplantation (LT) is universal for those with ongoing viraemia and is associated with higher rates of allograft failure and death. However, the optimal timing of HCV treatment for patients awaiting transplant remains unclear.
Aim
To evaluate the comparative cost-effectiveness of treating HCV pre-LT vs. post-LT (pre-emptive or after HCV recurrence).
Methods
A Markov state-transition model was created to simulate the progression of a cohort of HCV-genotype 1 or 4 cirrhotic patients from the time of transplant listing until death. We then used this model to study the cost-effectiveness of ledipasvir–sofosbuvir (LDV/SOF) with ribavirin for 12 weeks, administered for three separate treatment strategies: (i) pre-LT; (ii) post-LT preemptively prior to HCV recurrence; or (iii) post-LT after HCV recurrence.
Results
In the base-case analysis using a median model for end-stage liver disease (MELD) score <25 at the time of transplant, we found that pre-LT treatment of HCV led to more QALYs for fewer dollars compared to other strategies. Analysis limited to living donor LT recipients revealed that pre-LT treatment was also the most cost-effective strategy. When the analysis was repeated for MELD ≥25, decompensated disease (Child–Pugh class B or C), and hepatocellular carcinoma cases, preemptive post-LT strategy was more cost-effective.
Conclusions
Treatment of HCV prior to liver transplantation appears to be the most cost-effective strategy for patients with a MELD score <25. For patients with a MELD ≥25 or decompensated cirrhosis, preemptive post-liver transplantation treatment before HCV recurrence is the most cost-effective strategy.
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The inter-relationship of symptom severity and quality of life in 2055 patients with primary biliary cholangitis
Summary
Background
Age at presentation with primary biliary cholangitis (PBC) is associated with differential response to ursodeoxycholic acid (UDCA) therapy. Younger-presenting patients are less likely to respond to treatment and more likely to need transplant or die from the disease. PBC has a complex impact on quality of life (QoL), with systemic symptoms often having significant impact.
Aim
To explain the impact of age at presentation on perceived QoL and the inter-related symptoms which impact upon it.
Methods
Using the UK-PBC cohort, symptoms were assessed using the PBC-40 and other validated tools. Data were available on 2055 patients.
Results
Of the 1990 patients reporting a global PBC-QoL score, 66% reported good/neutral scores and 34% reported poor scores. Each 10-year increase in age at presentation was associated with a 14% decrease in risk of poor perceived QoL (OR = 0.86, 95% CI: 0.75–0.98, P < 0.05). All symptom domains were similarly age-associated (P < 0.01). Social dysfunction was the symptom factor with the greatest impact on QoL. Median (interquartile range) PBC-40 social scores for patients with good perceived QoL were 18 (14–23) compared with 34 (29–39) for those with poor QoL.
Conclusion
The majority of patients with primary biliary cholangitis do not feel their QoL is impaired, although impairment is reported by a sizeable minority. Age at presentation is associated with impact on perceived QoL and the symptoms impairing it, with younger patients being more affected. Social dysfunction makes the greatest contribution to QoL impairment, and it should be targeted in trials aimed at improving life quality.
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High-resolution DOA extraction (for wireless communication systems): theoretical analysis and experimental verification
Dit onderzoek concentreert zich op één specifiek hoge resolutie parameter extractie algoritme, met name het SAGE algoritme. Met dat algoritme kunnen we de verschillende aankomstrichtingen van elk belangrijk pad extraheren. Op die manier wordt niet alleen de azimuthhoek en de elevatiehoek, maar ook de tijdsvertraging (of de afstand), de Doppler frequentieverschuiving en de complexe amplitude (of het vermogen) zeer precies geschat. De nauwkeurigheid van de schattingen en de invloed van positiefouten en koppeling worden onderzocht. Het algoritme wordt uitgetest met simulaties en geverifieerd met meetdata, die bekomen werden in een binnenhuisconfiguratie op de universiteit van Kassel. In het geval van grote antenneroosters en voor breedbandige metingen worden er aanpassingen aan dit algoritme voorgesteld. Ook het stralingspatroon wordt toegevoegd in dit algoritme. Daarnaast komen de berekening en realisatie van twee van de vijf ideale uniform verdeelde bolvormige antenneroosters aan bod. Zij lossen hiermee de dubbelzinnigheid van de fase op, die ontstaat als de aankomstrichtingen geschat moeten worden in de drie dimensies.
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Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases
British Journal of Surgery
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Safety and efficacy of daclatasvir-sofosbuvir in HCV genotype 1-mono-infected patients
Journal of Hepatology
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Delivering beneficial bacteria to the GI tract
Massachusetts Institute of Technology Research News
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Perioperative chemotherapy with FOLFOX in resectable gastroesophageal adenocarcinoma in real life practice: An AGEO multicenter retrospective study
Digestive and Liver Diseases
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Hepatic resection for hepatocellular carcinoma in cirrhotic patients with portal hypertension
Surgical Practice
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Effectiveness of pelvic physiotherapy in children with functional constipation, compared with standard medical care
Gastroenterology
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Clinical influence of anastomotic stricture caused by pancreatogastrointestinalstomy following pancreatoduodenectomy
Surgery Today
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Efficacy and safety of target combined chemotherapy in advanced gastric cancer: A meta-analysis and system review
BMC Cancer
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Simultaneous multi-slice echo planar diffusion weighted imaging of the liver and the pancreas: Optimization of signal-to-noise ratio and acquisition time and application to intravoxel incoherent motion analysis
European Journal of Radiology
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Childhood irritable bowel syndrome characteristics are related to both sex and pubertal development
The Journal of Pediatrics
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Single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy
Pediatric Surgery International
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Association between diabetes mellitus and cirrhosis mortality: the Singapore Chinese Health Study
Liver International
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Are anti-tumor necrosis factor trough levels predictive of mucosal healing in patients with inflammatory bowel disease?: A systematic review and meta-analysis
Journal of Clinical Gastroenterology
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The human gut microbiome of Latin America populations: A landscape to be discovered
Current Opinion in Infectious Diseases
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Plasma miR-122 and miR-200 family are prognostic markers in colorectal cancer
International Journal of Cancer
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A Popular myth - low-histamine diet improves chronic spontaneous urticaria - fact or fiction?
Journal of the European Academy of Dermatology and Venereology
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Can percutaneous cholecystostomy be a definitive treatment in the elderly?
Surgical Practice
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Effect of continuous positive airway pressure on liver enzymes in obstructive sleep apnea: A meta-analysis
The Clinical Respiratory Journal
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Biliary tract enhancement in gadoxetic acid-enhanced MRI correlates with liver function biomarkers
European Journal of Radiology
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Meta-analysis of associating liver partition with portal vein ligation and portal vein occlusion for two-stage hepatectomy
British Journal of Surgery
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Value of routine staging imaging studies for patients with stage III breast cancer
Background and Objectives
Routine staging imaging studies (RSIS) are optional in stage III breast cancer (BC). The impact of RSIS on treatment decisions and patient outcomes has not been extensively studied. The goal of this study was to determine whether RSIS in stage III BC affected treatment or patient outcomes.
Methods
Stage III BC patients from 2000 to 2010 were retrospectively identified. RSIS results and treatment plan in response to RSIS results were recorded. Univariate and multivariate Cox proportional hazards regression models with time-dependent covariates were used to assess associations between RSIS use and recurrence-free survival (RFS).
Results
Of 420 patients, 362 (86.2%) received RSIS. RSIS were negative in 264 (72.9%), indeterminate in 77 (18.3%), and positive in 21 patients (5.0%) for metastatic disease. Treatment was altered in 21 (5.8%) patients based on RSIS results (20 with metastatic disease, 1 with indeterminate disease). There was no difference in RFS with RSIS use on multivariate analysis (hazard ratio 1.3; 95% confidence interval 0.73–2.5, P = 0.32).
Conclusions
Most stage III BC patients underwent RSIS, but RSIS results infrequently affected treatment decisions. There was no significant difference in RFS with RSIS use. RSIS to identify metastatic disease for stage III BC has limited value. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.
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Surgical excision margin for primary acral melanoma
Background and Objectives
This study aimed to evaluate treatment outcomes of acral melanoma (AM) based on the excision margin.
Methods
A retrospective cohort study was conducted for patients with primary AM, analyzing recurrence rates, local and in-transit recurrence-free survival (LITRFS), disease-free survival (DFS), and melanoma-specific survival (MSS).
Results
Data from 129 patients of AM were analyzed. In 53 patients with thin AM (thickness ≤1 mm), neither recurrence nor mortality occurred regardless of whether the excision margin was >1 cm or not. Seventy-six patients had thick AM (thickness >1 mm), including 36 treated with a <2 cm excision margin and 40 with a 2 cm margin. Multivariate analyses revealed that a 2 cm margin was associated with a reduced rate of local recurrence (HR, 0.120; P-value = 0.023) and LITR (HR, 0.187; P-value = 0.013) compared with a <2 cm margin. DFS and MSS did not differ between the two groups.
Conclusions
Thin AM were successfully treated with a 1 cm excision margin. For thick AM, a 2 cm excision margin provided improved local control, compared with a <2 cm margin; however, this benefit did not translate into a survival gain. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.
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Distance to the anal verge is associated with pathologic complete response to neoadjuvant therapy in locally advanced rectal cancer
Background and Objectives
Achieving a pathologic complete response (pCR) after neoadjuvant therapy has been associated with better prognosis in rectal cancer patients. The objective of this study was to investigate the relationship between distance to the anal verge (DTAV) and pCR.
Methods
Review of a prospectively maintained database of patients with locally advanced rectal cancer who received neoadjuvant treatment was completed. Uni- and multivariate analysis assessed the association between DTAV and pCR after neoadjuvant therapy.
Results
Of 827 included patients, 20% had a pCR. We found that pCR rates were 11% for tumors <4 cm, 24% for tumors 4–6 cm, 30% for tumors at 6–8 cm, 17% for tumors 8–10 cm, and 14% for tumors >10 cm from the anal verge (P = 0.002). Multivariate analysis also showed a strong association between DTAV and pCR (P = 0.008). The bimodal distribution of pCR resulted in a lower odds ratio of pCR for tumors <4 and >8 cm from the anal verge.
Conclusions
Patients with low tumors (<4 cm) and higher tumors (>8 cm), were less likely to have a pCR. Further investigation is warranted to determine if these observations are related to tumor biology or possibly differences in radiation technique. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.
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Prognostic value of occult tumor cells obtained by peritoneal lavage in patients with resectable pancreatic cancer and no ascites: A systematic review
The poor survival of patients with resectable pancreatic cancer might be related to the presence of occult peritoneal tumor cells (OPTC). This systematic review studies the prognostic value of cytology and carcinoembryonic antigen (CEA) by real-time polymerase chain reaction in peritoneal fluid. The results suggest that presence of OPTC is related to a worse survival in patients with resectable pancreatic cancer. Future studies should investigate its possible role in selecting patients for specific treatment strategies. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.
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Enantioselective construction of branched 1,3-dienyl substituted quaternary carbon stereocenters by asymmetric allenyl Claisen rearrangement
Chem. Commun., 2016, Advance Article
DOI: 10.1039/C6CC06481G, Communication
DOI: 10.1039/C6CC06481G, Communication
Yangbin Liu, Haipeng Hu, Lili Lin, Xiaoyu Hao, Xiaohua Liu, Xiaoming Feng
The enantioselective Claisen rearrangement of allenyl vinyl ethers was realized to access branched 1,3-dienyl-substituted all-carbon quaternary stereocenters using a NiII-N,N[prime or minute]-dioxide complex.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
The enantioselective Claisen rearrangement of allenyl vinyl ethers was realized to access branched 1,3-dienyl-substituted all-carbon quaternary stereocenters using a NiII-N,N[prime or minute]-dioxide complex.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
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Increasing use of nonsurgical therapy in advanced-stage oral cavity cancer: A population-based study
Abstract
Background
National guidelines support surgical-based treatment and offer nonsurgical therapy as an alternative for advanced-stage oral cavity squamous cell carcinoma (SCC). There are limited data evaluating current utilization of these therapies and their survival outcomes.
Methods
A total of 5856 patients were found in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2008 with resectable advanced-stage oral cavity SCC tumors. Outcomes were disease-specific survival (DSS) and overall survival (OS).
Results
Surgical therapy had significantly improved mean DSS and OS (115 and 71 months, respectively) compared to nonsurgical therapy (63 and 35 months, respectively; p < .001). The use of nonsurgical therapy was significantly associated with the hard palate, and patients who were single, divorced, and black, with T3, T4, and N3 tumors, and the percent utilization has significantly increased from 12% to 20% (p < .05).
Conclusion
Utilization of nonsurgical therapy for advanced-stage oral cavity SCC is increasing and is independently associated with a reduction in survival, as well as patient factors traditionally associated with reduced access to medical care and advanced T and N classifications. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
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Hyperbaric oxygen therapy for maxillary bone radiation-induced injury: A 15-year single-center experience
ABSTRACT
Background
Although hyperbaric oxygen therapy (HBOT) is used to treat chronic radiation tissue injury, clinical evidence supporting its use in maxillary bone osteoradionecrosis (ORN) is lacking. Therefore, the purpose of this study was to report our results of collected patient outcomes from a single center's large experience using HBOT to treat maxillary bone ORN.
Methods
From 1999 to 2015, 21 patients received treatment for maxillary bone ORN at our center. The medical records were retrospectively reviewed for the following variables: age, sex, comorbidities, tumor stage and site, previous surgery, previous radiotherapy or chemoradiation therapy, HBOT data, response to treatment and further management.
Results
A positive clinical outcome from HBOT occurred in 85.7% of patients with ORN and was proven radiologically in 14 of 15 patients (93.3%). In 5 patients, reconstructive surgery was required thereafter.
Conclusion
Controversy exists regarding the management of ORN of the maxillofacial skeleton. Our large, single-center experience probably supports the efficacy of HBOT for maxillary bone ORN. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
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