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B Fleiter

Publications and source records attributed to B Fleiter.

6 recordsLinked to original sources
PubMed2005

Sensitivity and specificity of a new MRI method evaluating temporo-mandibular joint disc-condyle relationships: an in vivo study.

The aim of this study was to evaluate sensitivity and specificity of a new method to locate temporo-mandibular joint (TMJ) disc using magnetic resonance imaging (MRI) and analyze disc-condyle relationships, in asymptomatic subjects and patients with disc displacement. Twenty-nine sagittal MRI of 16 subjects, 8 asymptomatic volunteers and 8 subjects with anterior disc displacement, were carried out during controlled opening from intercuspal position up to a 25 mm opening. Selected sections were analyzed with a graphic computerized system of coordinates. The total surface area (TS) of disc section was separated into anterior surface area (AS) and posterior surface area. Areas were determined by computer. Two trained examiners drew images at random. The reliability of AS/TS ratio index was evaluated in a previous study. AS/TS ratio sensitivity (Se) and specificity (Sp) were calculated closed mouth, 5 mm open and 25 mm open mouth. Best sensitivity (Se=0.63) and specificity (Sp=0.81) were obtained when MRI was realized with closed mouth and 25 mm open mouth. Lower sensitivity was observed when MRI was performed either with closed mouth (Se=0.54) or 25 mm open mouth (Se=0.18). Lower specificity was observed with 5 mm open mouth (Sp=0.68). In conclusion, it was confirmed as well that MRI of anterior disc displacement should be performed with closed mouth and opened mouth. Thus, further studies are required to assess disc displacement and mechanical alterations and to evaluate the risk of direct damage on TMJ tissues.

Adolescent↗
PubMed2005

Proposed graphical system of evaluating disc-condyle displacements of the temporomandibular joint in MRI.

The aim of this preliminary study was to standardize the reading of magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). The MRI was conducted on a control group of eight subjects. In this study, the analysis of joint relationships was limited to the oblique sagittal plane, during the movement of controlled opening. The sections were analyzed by a computer-assisted quantitative method of graphical evaluation. The total surface area (TS) of the disc section was divided into an anterior surface area (AS) and a posterior area (PA), in accordance with a line joining the center of the condyle (C) to the center of the articular tubercle of the temporal bone (T). The disc-condyle relationships in the chosen plane of section were evaluated by the AS/TS ratio. If TS remains relatively constant, the AS/TS values on average decrease from 0.5 to 0.3 between the closed mouth position and the 25 mm open position. The results show good intra-observer reproducibility (p=0.26), evaluated by Wilcoxon's test. In conclusion, this protocol enables the displacement of the disc-condyle assembly during mouth opening to be described. Observed on a larger sample, the AS/TS would be able to show a range of variability in functional disc positions.

Adult↗
PubMed2003

[Psychopharmacological treatment in the pre-clinical emergency medicine].

Psychiatric emergencies are a common cause for a call for the pre-clinical emergency physician (EP). However, previous studies reported serious problems in diagnosing and particularly treating these patients. Although evidence-based treatment guidelines and algorithms exist for the most important somatic disorders the EP has to deal with, they do not for psychiatric emergencies. It is the aim of this review, subsequent to an extensive overview on the available literature, to provide the reader with differentiated suggestions for pharmacological crisis intervention as well as with treatment recommendations for different psychiatric disorders with an emphasis on the special needs in the pre-clinical emergency medicine. After conducting a literature research from 1971 to 2002, 31 double-blind trials were found comparing different antipsychotics and benzodiazepines for efficacy and tolerability. Further, pharmacological data and product information of the most commonly used drugs were evaluated. Following, antipsychotics and benzodiazepines were generally assessed for their usefulness in the pre-clinical emergency medicine, the advantages of different drugs for specific indications are presented and dosage recommendations are given. As an antipsychotic, haloperidol still is the drug of choice. Within the benzodiazepines, lorazepam seems to have advantages over diazepam. An antipsychotic medication is particularly indicated for the treatment of schizophrenia, mania, drug-induced psychoses and delirium whereas benzodiazepines are favourable for the treatment of anxiety, restlessness and agitation due to neurotic or reactive circumstances. There is some evidence suggesting that newer generation, so-called "atypical" antipsychotics may play a role in the treatment of psychiatric emergencies, however, controlled trials are necessary to substantiate their potential benefits in the preclinical emergency medicine.

Anti-Anxiety Agents↗