BACKGROUND: Securing the airway in the emergency department (ED) is a high-stakes procedure; however, the primary success and complication rate are largely unknown in Germany. The aim of this study was a retrospective analysis of prospectively collected resuscitation room data for endotracheal intubation (ETI) regarding indications, performance and complications.
METHODS: Between 1 January 2020 and 30 June 2023 all ETIs conducted in the ED (Kliniken Maria Hilf, Moenchengladbach, Germany) were analyzed following approval by the ethics committee (EK 23-369). Primary intubations performed by the anesthesiology department were excluded. The core medical team of the ED underwent a six-week training program including a two-week anesthesia rotation prior to performing ETI in the ED. There were standard operating procedures (SOP) for both rapid sequence induction (RSI) and airway exchange with a placed laryngeal tube (LT) utilizing video laryngoscopy (C-Mac, Storz), rocuronium for relaxation and primary intubation with an elastic bougie. The primary success rate, overall success rate and intubation-related complications were analyzed. Additionally, the factor of consultant ED staff and residents was evaluated with respect to the primary success rate.
RESULTS: During the study period 499 patients were intubated by the core ED team and 28 patients underwent airway exchange from LT to ETI. Primary success could be achieved in 489/499 (98.0%) ETI and in 25/28 (89.3%) LT exchange patients. Surgically achieved securing of the airway was carried out in 5/527 (0.9%) patients in a cannot intubate situation and 11/527 (2.2%) patients suffered cardiac arrest minutes after the ETI. The overall first pass success rate of endotracheal tube placement was 514/527 (97.4%). The comparison of the primary success of consultants (168/175; 96.0%) vs. residents 320/325 (98.5%) yielded no significant differences (p = 0.08).
CONCLUSIONS: In clinical acute and emergency medicine, a standardized approach utilizing video laryngoscopy and a bougie following a structured training concept, can achieve an above-average high primary success rate with simultaneous low severe complications in the high-risk collective of critically ill emergency patients in an intrahospital setting.
UNASSIGNED: HINTERGRUND: Erfolgs- und Komplikationsraten endotrachealer Intubationen (ETI) in zentralen Notaufnahmen (ZNA) sind in Deutschland weitestgehend unbekannt. Ziel dieser Arbeit ist daher eine retrospektive Evaluation durchgeführter ETI in Bezug auf Indikationen, Performanz und Komplikationen.
METHODS: Nach Freigabe der Ethikkommission (EK 23-369) erfolgte die Analyse aller ETI von PatientInnen (Kliniken Maria Hilf, Mönchengladbach), die im Zeitraum vom 01.01.2020 bis 30.06.2023 durch das ärztliche ZNA-Team durchgeführt wurden. Beim Polytrauma durchgeführte ETI durch die Klinik für Anästhesiologie wurden ausgeschlossen. Das ärztliche ZNA-Kernteam durchlief ein sechswöchiges Ausbildungskonzept inklusive zweiwöchigem Atemwegstraining im Zentral-OP. Für die Rapid Sequence Induction (RSI) und die Umintubation bei einliegendem Larynxtubus (LT) existieren Standard Operating Procedures (SOP) mit Videolaryngoskopie (C-MAC, Storz), Relaxierung und primärer Intubation mit elastischem Bougie. Primäre Erfolgsrate, Gesamterfolgsrate, intubationsassoziierte Komplikationen und der Einfluss einer „Facharztqualifikation“ sollten analysiert werden.
UNASSIGNED: Bei 499 PatientInnen wurde die Indikation zur ETI, bei 28 PatientInnen zum Wechsel von LT auf ETI gestellt. Ein primärer Erfolg wurde bei 489/499 (98,0 %) bzw. 25/28 (89,3 %) detektiert, Gesamterfolgsrate 97,4 % (514/527). Ein chirurgischer Atemweg wurde bei 5/527 (0,9 %) PatientInnen bei „cannot intubate“ durchgeführt, 11/527 (2,2 %) PatientInnen erlitten in den Minuten nach der ETI einen Herz-Kreislauf-Stillstand. Ein Einfluss einer Facharztqualifikation auf den Primärerfolg konnte nicht festgestellt werden (168/175, 96,0 % (Facharzt) vs. 320/325 98,5 % (Nicht-Facharzt), p = 0,08).
UNASSIGNED: In der klinischen Akut- und Notfallmedizin kann mit einer standardisierten Vorgehensweise nach strukturiertem Ausbildungskonzept eine im internationalen Vergleich überdurchschnittliche hohe primäre Erfolgsrate erzielt werden, bei Minimierung schwerwiegender Komplikationen in dem Hochrisikokollektiv kritisch kranker NotfallpatientInnen.

Dacryocystorhinostomy (DCR) is a procedure that bypasses an obstruction in the nasolacrimal duct system. DCR can be categorized into two primary techniques: external and endoscopic. This review aims to assess the success rate of external DCR procedures, both with and without the use of a stent. This study compared the outcomes of primary DCR with and without silicone intubation in multiple studies. The reviewed studies consistently showed that silicone intubation significantly improves the success rates of DCR, with success rates ranging from 80% to 95%. The involved studies suggest that silicone intubation offers specific advantages in complex cases involving distant and common canaliculus blockages and recurrent DCR surgeries. This review emphasizes that multiple studies have documented higher success rates of external dacryocystorhinostomy (DCR) when silicone tubes are utilized as stents. Furthermore, external DCR has been identified as the preferred procedure among medical professionals.

OBJECTIVE: The aim is to investigate the influence of an active otitis media on the success rate of tympanoplasty in patients with a chronic otitis media (COM) and a tympanic membrane perforation.
UNASSIGNED: PubMed, Embase and the Cochrane Library.
METHODS: The inclusion criteria were studies on closure rates of tympanoplasty performed in COM patients of any age with a tympanic membrane perforation caused by COM. The exclusion criteria were studies on patients undergoing concomitant mastoidectomy, ossicular chain reconstruction, tuboplasty, adenoidectomy, revision tympanoplasty, patients with perforations due to other conditions than COM, and letters to editors, commentaries, conference abstracts and case reports. The included articles were critically appraised using the QUIPS tool. Data on tympanic membrane closure rate were extracted, odds ratio (OR) and 95% confidence intervals (CI) of the closure rate with a wet versus a dry ear were calculated.
RESULTS: The search was performed on 1 February 2023. Of 4671 articles, 16 studies were included and critically appraised. Of these observational studies (nine prospective, seven retrospective), with a total of 1509 patients (dry ear group n = 1003; wet ear group n = 506), two studies stated a significant difference in success rate, one in favour of a dry ear and one in favour of a wet ear at time of surgery. All other studies did not show a statistically significant difference. Overall, the risk of bias was considered moderate to high.
CONCLUSIONS: We found no significant prognostic value of having an active otitis media during tympanoplasty on tympanic membrane closure rates. Because the overall risk of bias was considered moderate to high, no strong conclusions can be made. To be able to answer this question with higher levels of evidence, high-quality prospective or randomized studies are needed.

We investigate the nexus between education spending and education success measured through attainment rate for 50 US states. Our emphasis is mainly to use state-level data on education spending which occur in general and specific terms. The outcome from our finding can be summarized as follows. One, education spending constitutes a significant factor that motivates people for higher education and it is a motivating factor that ensures completion. Two, we establish further emphasis with the types of spending and its differing stance on education success. While general spending plays important roles in this regard, specific (particularly spending on capital project) is found to reverse the success rate. This suggests that capital spending on education necessarily needs to reach a defined threshold to incite positive check in the current nexus. Three, the magnitude of impact for total spending is lower than when general spending is used, which make the impact of capital spending more conspicuous. Lastly, we also establish asymmetric impact of spending across differing categories between Black Belt and Non-Black Belt states. While the spending pattern is significant for both regions, the magnitude is higher for the Black Belt region indicating the tendency of the region to benefit more when spending improves. We further offer important policy stance.

OBJECTIVE: There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes.
METHODS: The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement.
RESULTS: In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups.
CONCLUSIONS: Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.

BACKGROUND: This prospective clinical study evaluates the effect of a silicone stent tube (SST) on the success rate of endonasal-endoscopic dacryocystorhinostomy (EN-DCR) to treat primary acquired nasolacrimal duct obstruction.
METHODS: Patients were randomly assigned to receive EN-DCR with or without SST intubation over a period of 3 months. The surgery was performed using standardized techniques. Patients were assessed at three different timepoints: one day, 12 weeks and 24 weeks after the surgery. The results were compared in order to evaluate statistical differences. Surgical success was determined by means of positive irrigation procedures, as well as by the improvement of symptoms and a high level of patient satisfaction.
RESULTS: A total of 56 randomized cases completed 24 weeks of follow up. 1 Patient dropped out due to malignant genesis of the nasolacrimal duct obstruction. After 24 weeks of follow up no statistically significant differences in levels of epiphora (p > .10) or patency (p > .16) were revealed. Comparisons regarding changes in time did not show levels of significance (p > .28).
CONCLUSIONS: This study could not confirm a statistically significant benefit or disadvantage for SST Insertion in EN-DCR.

OBJECTIVE: To evaluate the longevity of cantilevered zirconia-based resin-bonded fixed partial dentures (RBFPDs) in replacing missing posterior teeth, as well as the quality of life and patient satisfaction experienced by those receiving zirconia RBFPDs.
METHODS: A prospective single-arm uncontrolled clinical trial was conducted to replace one or more missing premolars or molars with a span of 5 to 8 mm using cantilevered zirconia RBFPDs. Thirty-six participants with 40 prostheses were recruited and underwent a 3-year clinical evaluation. The retainer designs included a minimum thickness of 0.8 mm, a minimum of 200° circumferential wraparound with an occlusal bar, and a connector dimension of 3 × 3 mm. Patient-reported outcomes, including patient satisfaction and Oral Health Impact Profile (OHIP), were assessed.
RESULTS: The average age of participants was 45.8 years, and 72.5 % were women. The success rate of the posterior zirconia RBFPDs was 76.2 %, with an estimated mean success duration of 46.1 months. The survival rate was 88.1 %, with an estimated mean survival duration of 49.4 months. Participants were highly satisfied with the treatment, achieving an average satisfaction score of 80.8 ± 11.9. Participants\' total OHIP scores decreased from 52.3 to 39.6 after 3 years, indicating a significant improvement in oral health-related quality of life (P = 0.009).
CONCLUSIONS: After 3 years, a moderately high survival rate and favourable patient-reported outcomes of posterior cantilevered zirconia RBFPDs were achieved. Therefore, it can be recommended as a conservative treatment option to replace missing posterior teeth, provided that retainer design considerations are taken into account.
CONCLUSIONS: Cantilevered zirconia RBFPDs for posterior teeth can serve as a conservative treatment option that is both aesthetically pleasing and biocompatible. It offers a more cost-effective alternative compared to dental implants, which are often prohibitively expensive for the majority of patients. This approach has the potential to greatly improve patient-reported outcomes.

Responsible for a significant morbidity and mortality, smoking remains a major public health issue. Smoking cessation clinics are an integral part of the fight against smoking. This retrospective study, carried out between January 2022 and January 2023 on 106 patients who attended the smoking cessation clinics in the Respiratory Department of the University Hospital of Liège, was designed to assess patient cessation rates at 6 months and 1 year, and to identify any factors predicting success or failure. Our data showed a cessation rate of 25 % at 6 months and 19 % at 1 year. Age was slightly more advanced in those who succeeded in smoking cessation at one year (p = 0.05). The obtained cessation rate strongly supports the utility of our smoking cessation clinic for patients wishing to quit smoking.
Responsable d’une morbi-mortalité importante, le tabagisme reste un enjeu, non négligeable, de santé publique. Les consultations d’aide au sevrage font partie intégrante des moyens mis en œuvre pour lutter contre le tabagisme dans une optique de prévention. Cette étude rétrospective, menée entre janvier 2022 et janvier 2023, auprès de 106 patients ayant fréquenté les consultations de tabacologie du Service de Pneumologie du CHU de Liège, avait pour objectifs d’évaluer les taux de sevrage des patients à 6 mois et à 1 an et d’identifier d’éventuels facteurs prédictifs de succès, ou d’échec, au sein de l’échantillonnage étudié. L’analyse des données a démontré un taux de sevrage de 25 % à 6 mois et de 19 % à 1 an. L’analyse des facteurs démographiques montre une moyenne d’âge plus élevée chez les patients qui réussissent leur sevrage à 1 an (p = 0,05). Le taux de sevrage obtenu atteste de la pertinence et de la nécessité de notre accompagnement auprès des patients désireux de cesser de fumer.

There is a vast amount of published literature concerning dental veneers; however, the effects of tooth preparation, aging, veneer type, and resin cement type on the failure of dental veneers in laboratory versus clinical scenarios are not clear. The purpose of the present narrative review was to determine the principal factors associated with failures of dental veneers in laboratory tests and to understand how these factors translate into clinical successes/failures. Articles were identified and screened by the lead author in January 2024 using the keywords \'\'dental veneer\", \"complication\", \"survival rate\", \"failure\", and \"success rate\" using PubMed/Medline, Scopus, Google Scholar, and Science Direct. The inclusion criteria included articles published between January 1999 and January 2024 on the topics of preparation of a tooth, aging processes of the resin cement and veneer, translucency, thickness, fabrication technique of the veneer; shade, and thickness of the resin cement. The exclusion criteria included articles that discussed marginal and internal fit, microhardness, water sorption, solubility, polishability, occlusal veneers, retention, surface treatments, and wear. The results of the present review indicated that dental veneers generally have a high survival rate (>90% for more than 10 years). The amount of preserved enamel layer plays a paramount role in the survival and success rates of veneers, and glass-ceramic veneers with minimal/no preparation showed the highest survival rates. Fracture was the primary failure mechanism associated with decreased survival rate, followed by debonding and color change. Fractures increased in the presence of parafunctional activities. Fewer endodontic complications were associated with veneer restorations. No difference was observed between the maxillary and mandibular teeth. Clinical significance: Fractures can be reduced by evaluation of occlusion immediately after cementation and through the use of high-strength veneer materials, resin cements with low moduli, and thin layers of highly polished veneers. Debonding failures can be reduced with minimal/no preparation, and immediate dentin sealing should be considered when dentin is exposed. Debonding can also be reduced by preventing contamination from blood, saliva, handpiece oil, or fluoride-containing polishing paste; through proper surface treatment (20 s of hydrofluoric acid etching for glass ceramic followed by silane for 60 s); and through use of light-cured polymerization for thin veneers. Long-term color stability may be maintained using resin cements with UDMA-based resin, glass ceramic materials, and light-cure polymerization with thin veneers.

OBJECTIVE: The use of various methotrexate (MTX) protocols for the treatment of ectopic pregnancy is well established. This study aimed to evaluate the efficacy of single- and double-dose MTX protocols for the treatment of pregnancy of unknown location (PUL).
METHODS: This retrospective study was conducted in the Department of Gynaecological Endocrinology, University Hospital, Krakow, Poland. Haemodynamically stable women with PUL were enrolled between January 2014 and September 2023. Demographics, gestational age and treatment outcomes were compared between women in the single-dose MTX group and women in the double-dose MTX group. The primary outcome was the success rate, measured as the number of women treated without surgical intervention. The secondary outcome was the number of days of MTX needed to achieve an appropriate decrease in beta-human chorionic gonadotrophin (β-hCG).
RESULTS: Two hundred and eleven women (mean age 33 ± 1.8 years) with PUL were enrolled in the study, with an overall success rate of 89.1 %. Single- and double-dose MTX protocols were found to have comparable treatment success rates (93 % and 95 %, respectively). Women with lower initial serum β-hCG (<2000 mIU/ml) had higher treatment efficacy compared with women with higher initial serum β-hCG (96.5 % vs 71.4 %), regardless of protocol type. The length of hospital stay for the women treated with the single-dose MTX protocol was 1 day shorter compared with that for the women treated with the double-dose MTX protocol.
CONCLUSIONS: Single- and double-dose MTX protocols have comparable efficacy and safety, and should be equally considered in women with PUL with initial β-hCG < 2000 mIU/ml.