This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent author...This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.展开更多
Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial pr...Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.展开更多
Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants ...Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.展开更多
Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxil...Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxillary subperiosteal implantitis that caused sinusitis. A 59-year-old man was referred to our clinic in March 2003 with a chief complaint of pain and swelling in the bilateral upper molar region. He received a surgical operation for maxillary subperiosteal implant at another dental clinic in April 2001. CT scans demonstrated that the radiopacity of the right maxillary sinus extended to the ethmoid and frontal sinuses. Extensive surgical debridement was performed. The radiopacity of the right maxillary sinus in CT almost disappeared in a month. Two months later, the occlusal function was recovered using a new maxillary complete denture. The patient has had no symptoms and no occlusal disturbance by the denture for more than nine years.展开更多
Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods:...Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.展开更多
Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,random...Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.展开更多
AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS...AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.展开更多
Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability t...Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.展开更多
Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabricati...Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabrication,low-power consumption,fast response times,and versatility.Graphene,known for its exceptional mechanical properties,high electron mobility,and biocompatibility,is an ideal material for FET channels and sensors.The combination of graphene and FETs has given rise to flexible graphene field-effect transistors(FGFETs),driving significant advances in flexible electronics and sparked a strong interest in flexible biomedical sensors.Here,we first provide a brief overview of the basic structure,operating mechanism,and evaluation parameters of FGFETs,and delve into their material selection and patterning techniques.The ability of FGFETs to sense strains and biomolecular charges opens up diverse application possibilities.We specifically analyze the latest strategies for integrating FGFETs into wearable and implantable flexible biomedical sensors,focusing on the key aspects of constructing high-quality flexible biomedical sensors.Finally,we discuss the current challenges and prospects of FGFETs and their applications in biomedical sensors.This review will provide valuable insights and inspiration for ongoing research to improve the quality of FGFETs and broaden their application prospects in flexible biomedical sensing.展开更多
Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elas...To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.展开更多
Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for thes...Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.展开更多
Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-ter...Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.展开更多
Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effec...Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.展开更多
Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics...Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics,metallic nanoparticles and antimicrobial peptides,have been extensively used to deal with Ti implant infections.However,these chemical approaches suffer from potential toxicity,antibiotic resistance and poor long-term antibacterial performance.Hence,physical antibacterial surfaces on Ti-based implants have attracted increasing attention.The antibacterial behavior of different surfaces on Ti-based biomaterials against various bacteria only by physical properties of the implants themselves(e.g.,nanotopography)or exogenous physical stimulus(e.g.,photocatalysis)was reviewed,as well as parameters influencing the physical antibacterial processes,such as size,shape and density of the surface nanotextures,and bacterial growth phases.Besides,mechanisms of different fabrication techniques for the physical antibacterial surfaces on Ti-based biomaterials were also summarized.展开更多
Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated ...Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated with astigmatism.Methods We retrospectively collected data from 64 patients(aged 18-42 years)with moderate to high myopia complicated with astigmatism(128 eyes)undergoing either Toric-ICL(28 patients/56 eyes)or FS-LASIK(36 patients/72 eyes)at our department between January,2019 and December,2020.The changes of uncorrected distance visual acuity(UCVA),spherical equivalent(SE),mean astigmatism correction index(CI),corneal endothelial cell density(ECD)and intraocular pressure(IOP)following the procedures were compared between the two groups.Results In FS-LASIK group,all the eyes(72/72)achieved an UCVA≥1.0,similar to the rate in Toric-ICL group(55/56 eyes;P=0.2374).The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups[0.43±0.06 D(range:-1.0 to 1.50 D)vs 0.38±0.05 D(range:-0.75 to 1.00 D);P=0.56].The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group(0.8561 vs 0.7176;P<0.0001),and 88.89%of the eyes in FS-LASIK group and 69.64%in Toric-ICL group had postoperative astigmatism≤0.50 D.No significant changes were observed in postoperative corneal ECD in FS-LASIK group,whereas ECD decreased significantly after the procedure in Toric-ICL group(P=0.0057).The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP,but the patients receiving FS-LASIK had significantly reduced IOP after the procedure(P<0.001).Conclusion Although the patients included in Toric-ICL group had higher myopia and astigmatism,Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group.Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.展开更多
Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,c...Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.展开更多
Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a ...Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.展开更多
Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback fol...The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback following the procedure.Meanwhile,the global management of TAVI recipients has led to a minimalist approach with short postprocedural length of stay,which may be limited by the occurrence of late arrhythmic events in patients at high-risk.This review focuses on those strategies to overcome the conundrum between early discharge and new-onset conduction disturbances in elderly TAVI candidates and provides a perspective on future improvements in this field.展开更多
基金supported by the Fundamental Research Funds for the Central Universities(No.2023QZJH59/226-2023-00155)the National Natural Science Foundation of China(Nos.82370990 and 82201051)+1 种基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commis-sion(No.WKJ-ZJ-2335)the Innovative Talent of Zhejiang Provincial Health Commission,the Zhejiang“Xinmiao”Tal-ents Program(No.2023R401211),China.
文摘This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.
基金supported by the National Key Research and Development Program of China(2023YFC2412600)the National Natural Science Foundation of China(52271243,52171233,82370924,82170929)+3 种基金the Beijing Natural Science Foundation(L212014)the Beijing Nova Program(20230484459)the National Clinical Key Discipline Construction Project(PKUSSNKP-T202103)the Research Foundation of Peking University School and Hospital of Stomatology(PKSS20230104).
文摘Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.
文摘Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.
文摘Subperiosteal implants are generally used in the severely resorbed areas, and although dwindling in use, they have shown to be successful treatment options for the edentulous dental patients. We report a case of maxillary subperiosteal implantitis that caused sinusitis. A 59-year-old man was referred to our clinic in March 2003 with a chief complaint of pain and swelling in the bilateral upper molar region. He received a surgical operation for maxillary subperiosteal implant at another dental clinic in April 2001. CT scans demonstrated that the radiopacity of the right maxillary sinus extended to the ethmoid and frontal sinuses. Extensive surgical debridement was performed. The radiopacity of the right maxillary sinus in CT almost disappeared in a month. Two months later, the occlusal function was recovered using a new maxillary complete denture. The patient has had no symptoms and no occlusal disturbance by the denture for more than nine years.
文摘Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.
基金supported by PT.Catur Dakwah Crane Pharmacy,an Indonesian pharmaceutical company.The funding was granted through a mutual agreement between the research team and the company,under the coordination of the National Population and Family Planning Board(BKKBN Indonesia).The funder provided financial support only and had no role in the study design,data collection,analysis,interpretation of data,or the decision to submit the manuscript for publication.
文摘Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.
文摘AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.
基金supported by National Institutes of Health R03DE027492 to Shareef Dabdoubsupported by National Institutes of Health,project number 7R01DE027857-06supported by National Institutes of Health R56DE033913 awarded to Purnima Kumar.
文摘Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.
基金supported by the National Key R&D Plan of China(Grant No.2023YFB3210400)the National Natural Science Foundation of China(No.62174101)+2 种基金the Major Scientific and Technological Innovation Project of Shandong Province(2021CXGC010603)the Fundamental Research Funds of Shandong University(2020QNQT001)Collaborative Innovation Center of Technology and Equipment for Biological Diagnosis and Therapy in Universities of Shandong,Collaborative Innovation Center of Technology and Equipment for Biological Diagnosis and Therapy in Universities of Shandong,the Natural Science Foundation of Qingdao-Original exploration project(No.24-4-4-zrjj-139-jch).
文摘Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabrication,low-power consumption,fast response times,and versatility.Graphene,known for its exceptional mechanical properties,high electron mobility,and biocompatibility,is an ideal material for FET channels and sensors.The combination of graphene and FETs has given rise to flexible graphene field-effect transistors(FGFETs),driving significant advances in flexible electronics and sparked a strong interest in flexible biomedical sensors.Here,we first provide a brief overview of the basic structure,operating mechanism,and evaluation parameters of FGFETs,and delve into their material selection and patterning techniques.The ability of FGFETs to sense strains and biomolecular charges opens up diverse application possibilities.We specifically analyze the latest strategies for integrating FGFETs into wearable and implantable flexible biomedical sensors,focusing on the key aspects of constructing high-quality flexible biomedical sensors.Finally,we discuss the current challenges and prospects of FGFETs and their applications in biomedical sensors.This review will provide valuable insights and inspiration for ongoing research to improve the quality of FGFETs and broaden their application prospects in flexible biomedical sensing.
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
基金supported by National Natural Science Foundation of China(52271117)Educational Commission of Hunan Province of China(23A0107)High Technology Research and Development Program of Hunan Province of China(2022GK4038).
文摘To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.
文摘Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.
基金supported by the Natural Science Foundation of Sichuan Province(grant number:25NSFSC0265).
文摘Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
基金supported by the China Agriculture Research System(CARS-35-PIG)the National Natural Science Foundation of China(32272847,U22A20516)+1 种基金the National Key Research and Development Program of China(No.2021YFF1000602)the Key Research and Development Program of Shaanxi Province(No.2022ZDLNY01–04)。
文摘Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.
基金National Natural Science Foundation of China(52171114)。
文摘Infections associated with titanium(Ti)-based implants present significant challenges in clinical treatments,especially when biofilms already form on the implant surface.Many antimicrobial agents,including antibiotics,metallic nanoparticles and antimicrobial peptides,have been extensively used to deal with Ti implant infections.However,these chemical approaches suffer from potential toxicity,antibiotic resistance and poor long-term antibacterial performance.Hence,physical antibacterial surfaces on Ti-based implants have attracted increasing attention.The antibacterial behavior of different surfaces on Ti-based biomaterials against various bacteria only by physical properties of the implants themselves(e.g.,nanotopography)or exogenous physical stimulus(e.g.,photocatalysis)was reviewed,as well as parameters influencing the physical antibacterial processes,such as size,shape and density of the surface nanotextures,and bacterial growth phases.Besides,mechanisms of different fabrication techniques for the physical antibacterial surfaces on Ti-based biomaterials were also summarized.
文摘Objective To compare the efficacy of toric implantable collamer lens(Toric-ICL)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia correction in patients with moderate to high myopia complicated with astigmatism.Methods We retrospectively collected data from 64 patients(aged 18-42 years)with moderate to high myopia complicated with astigmatism(128 eyes)undergoing either Toric-ICL(28 patients/56 eyes)or FS-LASIK(36 patients/72 eyes)at our department between January,2019 and December,2020.The changes of uncorrected distance visual acuity(UCVA),spherical equivalent(SE),mean astigmatism correction index(CI),corneal endothelial cell density(ECD)and intraocular pressure(IOP)following the procedures were compared between the two groups.Results In FS-LASIK group,all the eyes(72/72)achieved an UCVA≥1.0,similar to the rate in Toric-ICL group(55/56 eyes;P=0.2374).The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups[0.43±0.06 D(range:-1.0 to 1.50 D)vs 0.38±0.05 D(range:-0.75 to 1.00 D);P=0.56].The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group(0.8561 vs 0.7176;P<0.0001),and 88.89%of the eyes in FS-LASIK group and 69.64%in Toric-ICL group had postoperative astigmatism≤0.50 D.No significant changes were observed in postoperative corneal ECD in FS-LASIK group,whereas ECD decreased significantly after the procedure in Toric-ICL group(P=0.0057).The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP,but the patients receiving FS-LASIK had significantly reduced IOP after the procedure(P<0.001).Conclusion Although the patients included in Toric-ICL group had higher myopia and astigmatism,Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group.Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
文摘Diabetic patients often suffer higher orthopedic implant failure rates due to high blood sugar causing inflammation and oxidative stress.While molecular hydrogen(H_(2))shows anti-inflammatory and antioxidant promise,current delivery methods lack precision for sustained implantsite treatment.A collaborative team led by Prof.
基金funded by a IBYE23_0002 grant supported by Instituto de investigación biom-édica de Salamanca IBSAL,Castilla y León (Spain) and by a GRS 2860/A1/2023 by Gerencia Regional de Salud o f Castilla y León (Spain)。
文摘Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
文摘The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation(TAVI)has not decreased compared to other complications,and nowadays is by far the most frequent drawback following the procedure.Meanwhile,the global management of TAVI recipients has led to a minimalist approach with short postprocedural length of stay,which may be limited by the occurrence of late arrhythmic events in patients at high-risk.This review focuses on those strategies to overcome the conundrum between early discharge and new-onset conduction disturbances in elderly TAVI candidates and provides a perspective on future improvements in this field.
