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World Journal of Gastroenterology May 2024The article by Ker explores the treatment of peripancreatic fluid collection (PFC). The use of percutaneous drainage, endoscopy, and surgery for managing PFC are...
The article by Ker explores the treatment of peripancreatic fluid collection (PFC). The use of percutaneous drainage, endoscopy, and surgery for managing PFC are discussed. Percutaneous drainage is noted for its low risk profile, while endoscopic cystogastrostomy is more effective due to the wider orifice of the metallic stent. Surgical cystogastrostomy is a definitive treatment with a reduced need for reintervention, especially for cases with extensive collections and significant necrosis. The choice of treatment modality should be tailored to individual patient characteristics and disease factors, considering the expertise available.
Topics: Humans; Drainage; Treatment Outcome; Stents; Gastrostomy; Pancreatic Pseudocyst
PubMed: 38813046
DOI: 10.3748/wjg.v30.i17.2298 -
Turkish Journal of Medical Sciences 2023Developmental dysplasia of the hip (DDH) is the most common cause of secondary hip arthrosis. The primary purpose of this study was to assess the results of an oversized...
BACKGROUND/AIM
Developmental dysplasia of the hip (DDH) is the most common cause of secondary hip arthrosis. The primary purpose of this study was to assess the results of an oversized hemispherical cup via the press-fit technique used for Crowe type II and III DDH without screws and to determine if adequate medialization and initial stability of the acetabular component would allow us to avoid screw and graft use.
MATERIALS AND METHODS
Between February 2012 and May 2020, the current study analyzed 43 hips with Crowe type II and III DDH treated with a porous-coated cup by placing the press-fit technique or screw. The acetabular cup was fixed with the press-fit technique without additional screws in 27 hips and with screws in 16 hips. The inclusion criterion in this study was a minimum 2-year-period after the surgery.
RESULTS
The mean duration of follow-up was 6.83 2.67 years in the press-fit group and 6.21 2.01 years in the screw group. The mean age of the patients was 47.96 12.37 years in the press-fit group and 50.5 12.37 years in the screw group. Measurements revealed that the hip center of rotation (HCR) was located more medially and superiorly postoperatively than preoperatively in both groups. The mean cup coverage in the screw group was 85.58% 7.51% (75.3%-97.2%), while it was less than 90.41% 6.15% (76.3%-98.2%) in the press-fit group (p = 0.038). No component was revised because of loosening, and all of the implants were radiologically stable within the observation period. No statistically significant differences were observed regarding the postoperative limp-length discrepancy between the groups (p = 0.496).
CONCLUSION
Press-fit implantation of a porous-coated acetabular component without screws can also be used as an alternative method for THA in Crowe type II and III DDH. The initial stability was obtained using the press-fit technique with a small cup positioned more medially and superiorly, which may allow the surgeon to avoid screw and graft use.
Topics: Humans; Female; Male; Middle Aged; Adult; Arthroplasty, Replacement, Hip; Hip Prosthesis; Bone Screws; Bone Transplantation; Developmental Dysplasia of the Hip; Hip Dislocation, Congenital; Acetabulum; Treatment Outcome; Prosthesis Design
PubMed: 38813005
DOI: 10.55730/1300-0144.5712 -
APL Bioengineering Jun 2024The realm of implantable bioelectronics represents a frontier in medical science, merging technology, biology, and medicine to innovate treatments that enhance, restore,...
The realm of implantable bioelectronics represents a frontier in medical science, merging technology, biology, and medicine to innovate treatments that enhance, restore, or monitor physiological functions. This field has yielded devices like cochlear implants, cardiac pacemakers, deep brain stimulators, and vagus nerve stimulators, each designed to address a specific health condition, ranging from sensorineural hearing loss to chronic pain, neurological disorders, and heart rhythm irregularities. Such devices underscore the potential of bioelectronics to significantly improve patient outcomes and quality of life. Recent technological breakthroughs in materials science, nanotechnology, and microfabrication have enabled the development of more sophisticated, smaller, and biocompatible bioelectronic devices. However, the field also encounters challenges, particularly in extending the capabilities of devices such as retinal prostheses, which aim to restore vision but currently offer limited visual acuity. Research in implantable bioelectronics is highly timely, driven by an aging global population with a growing prevalence of chronic diseases that could benefit from these technologies. The convergence of societal health needs, advancing technological capabilities, and a supportive ecosystem for innovation marks this era as pivotal for bioelectronic research.
PubMed: 38812757
DOI: 10.1063/5.0209537 -
Arthroplasty Today Jun 2024A 68-year-old man was referred due to bilateral hip pain and gradual deterioration of walking. He had mold arthroplasties on both hips at the age of 7 years and has been...
A 68-year-old man was referred due to bilateral hip pain and gradual deterioration of walking. He had mold arthroplasties on both hips at the age of 7 years and has been functioning well for more than 5 decades. However, the original data on operative report and the prostheses were missing. The radiological examination revealed bilateral broken prosthetic material. Thus, stage bilateral revision total hip arthroplasty was performed. A detailed chemical analysis of retrieved mold arthroplasty implants proved that the acrylic material was noted to be the same composition with the difference in appearance likely being related to different thermal treatments originally applied to the implants. As presented in our clinical case, even obsolete implants may have good survivorship. According to the case presented, total hip arthroplasty could be considered an effective option with the desired functional outcome when conservative and joint-preserving measures are exhausted.
PubMed: 38812475
DOI: 10.1016/j.artd.2024.101401 -
Frontiers in Bioscience (Landmark... May 2024Recent studies highlighted the presence of anti-α-Gal antibodies in patients implanted with commercial bioprosthetic heart valves (BHVs). BHVs expose residual α-Gal...
BACKGROUND
Recent studies highlighted the presence of anti-α-Gal antibodies in patients implanted with commercial bioprosthetic heart valves (BHVs). BHVs expose residual α-Gal xenoantigen and their recognition by the circulating anti-Gal antibodies leads to opsonization of the device's tissue component with the consequent triggering of a deterioration pathway that culminates with calcification. Small animal models such as mice and rats have been broadly involved in the testing of biomaterials by subcutaneous implantation, especially for the effectiveness of BHVs anti-calcific treatments. However, since models employed for this purpose express α-Gal antigen, the implantation of BHVs' leaflets does not elicit a proper immunological response, so the calcification propensity may be dramatically underestimated.
METHODS
An α-Gal knockout (KO) mouse model has been created, using the CRISP/Cas9 approach, and adopted to assess the calcification potential of commercial BHVs leaflets through the surgical implantation in the back subcutis area. Calcium quantification was performed by inductively coupled plasma analysis; immune response against the BHVs leaflets and α-Gal silencing was evaluated through immunological assays.
RESULTS
Two months after the implantation of commercial BHV leaflets, the anti-Gal antibody titers in KO mice doubled when compared with those found in wild-type (WT) ones. Leaflets explanted from KO mice, after one month, showed a four-time increased calcium deposition concerning the ones explanted from WT. The degree of silencing of α-Gal varied, depending on the specific organ that was assessed. In any case, the animal model was suitable for evaluating implanted tissue responses.
CONCLUSIONS
Such mouse model proved to be an accurate tool for the study of the calcific propensity of commercial BHVs leaflets than those hitherto used. Given its reliability, it could also be successfully used to study even other diseases in which the possible involvement of α-Gal has been observed.
Topics: Animals; Heart Valve Prosthesis; Calcinosis; Mice, Knockout; Bioprosthesis; Mice; Disease Models, Animal; Mice, Inbred C57BL; Male
PubMed: 38812319
DOI: 10.31083/j.fbl2905181 -
Journal of Cardiothoracic Surgery May 2024Quadricuspid aortic valve (QAV) is a rare congenital anomaly characterized by the presence of four cusps instead of the usual three. It is estimated to occur in less...
BACKGROUND
Quadricuspid aortic valve (QAV) is a rare congenital anomaly characterized by the presence of four cusps instead of the usual three. It is estimated to occur in less than 0.05% of the population, with Type A (four equal-sized leaflets) accounting for roughly 30% of QAV subtypes. Based on limited clinical series, the usual presentation is progressive aortic valve regurgitation (AR) with symptoms occurring in the fourth to sixth decade of life. Severe aortic valve stenosis (AS) and acute AR are very uncommon.
CASE PRESENTATION
We describe two cases of Type A QAV in patients who remained asymptomatic until their seventies with very uncommon presentations: one with severe AS and one with acute, severe AR and flail leaflet. In Case A, a 72-year-old patient with history of moderate AS presents to clinic with progressive exertional dyspnea. During work-up for transcatheter vs. surgical replacement pre-operative computed tomography angiogram (CTA) reveals a quadricuspid aortic valve with severe AS, and the patient undergoes surgical aortic valve replacement. Pre-discharge transthoracic echocardiography (TTE) shows good prosthetic valve function with no gradient or regurgitation. In Case B, a 76-year-old patient is intubated upon arrival to the hospital for acute desaturation, found to have wide open AR on catheterization, and transferred for emergent intervention. Intraoperative TEE reveals QAV with flail leaflet and severe AR. Repair is considered but deferred ultimately due to emergent nature. Post-operative TTE demonstrates good prosthetic valve function with no regurgitation and normal biventricular function.
CONCLUSIONS
QAV can present as progressive severe AS and acute AR, with symptoms first occurring in the seventh decade of life. The optimal treatment for QAV remains uncertain. Although aortic valve repair or transcatheter option may be feasible in some patients, aortic valve replacement remains a tenable option.
Topics: Humans; Aged; Aortic Valve; Male; Aortic Valve Stenosis; Aortic Valve Insufficiency; Echocardiography; Female; Heart Valve Prosthesis Implantation
PubMed: 38812010
DOI: 10.1186/s13019-024-02696-w -
BMC Musculoskeletal Disorders May 2024The emerging of the C2 isthmus screw fixation technique is gaining popularity in the setting of atlantoaxial dislocation or other conditions requiring fixation of C2....
BACKGROUND
The emerging of the C2 isthmus screw fixation technique is gaining popularity in the setting of atlantoaxial dislocation or other conditions requiring fixation of C2. However, the biomechanical stability of this fixation is poorly understood.
PURPOSE
To compare and elucidate the biomechanical stability of C2 pedicle screw (C2PS), C2 isthmus screw (C2IS) and C2 short isthmus screw (C2SIS) fixation techniques in atlantoaxial dislocation (AAD).
METHOD
A three-dimensional finite element model (FEM) from occiput to C3 was established and validated from a healthy male volunteer. Three FEMs, C1 pedicle screw (PS)-C2PS, C1PS-C2IS, C1PS-C2SIS were also constructed. The range of motion (ROM) and the maximum von Mises stress under flexion, extension, lateral bending and axial rotation loading were analyzed and compared. The pullout strength of the three fixations for C2 was also evaluated.
RESULT
C1PS-C2IS model showed the greatest decrease in ROM with flexion, extension, lateral bending and axial rotation. C1PS-C2PS model showed the least ROM reduction under all loading conditions than both C2IS and C2SIS. The C1PS-C2PS model had the largest von Mises stress on the screw under all directions followed by C1PS-C2SIS, and lastly the C1PS-C2IS. Under axial rotation and lateral bending loading, the three models showed the maximum and minimum von Mises stress on the screw respectively. The stress of the three models was mainly located in the connection of the screw and rod. Overall, the maximum screw pullout strength for C2PS, C2IS and C2SIS were 729.41N, 816.62N, 640.54N respectively.
CONCLUSION
In patients with atlantoaxial dislocations, the C2IS fixation provided comparable stability, with no significant stress concentration. Furthermore, the C2IS had sufficient pullout strength when compared with C2PS and C2SIS. C2 isthmus screw fixation may be a biomechanically favourable option in cases with AAD. However, future clinical trials are necessary for the evaluation of the clinical outcomes of this technique.
Topics: Humans; Finite Element Analysis; Atlanto-Axial Joint; Male; Biomechanical Phenomena; Joint Dislocations; Range of Motion, Articular; Adult; Pedicle Screws; Bone Screws; Spinal Fusion
PubMed: 38811940
DOI: 10.1186/s12891-024-07470-6 -
BMC Oral Health May 2024In this study, the antimicrobial activity of three different cleanser tablets on S. mutans and C. albicans adhesion to PMMA, polyamide and 3D printed resin was...
BACKGROUND
In this study, the antimicrobial activity of three different cleanser tablets on S. mutans and C. albicans adhesion to PMMA, polyamide and 3D printed resin was investigated.
METHODS
40 samples were prepared for PMMA (SR Triplex Hot), polyamide (Deflex) and 3D printed resin (PowerResins Denture) materials and divided into four subgroups for cleansers (Aktident™, Protefix™, Corega™ tablets and distilled water) (n = 5). After the surface preparations were completed, the samples were immersed separately in tubes containing the prepared microorganism suspension and incubated at 37˚C for 24 h. After the incubation, the samples were kept in the cleanser solutions. The samples were then transferred to sterile saline tubes. All the tubes were vortexed and 10 µl was taken from each of them. Sheep blood agar was inoculated for colony counting. The inoculated plates were incubated for 48 h for S. mutans and 24 h for C. albicans. After incubation, colonies observed on all plates were counted. Statistical analyses were done with three-way ANOVA and Tukey's multiple comparison test.
RESULTS
Polyamide material registered the highest colony count of S. mutans, whereas PMMA registered the lowest. Significant differences in S. mutans adherence (p = 0.002) were found between the three denture base materials, but no such difference in C. albicans adherence (p = 0.221) was identified between the specimens. All three cleanser tablets eliminated 98% of S. mutans from all the material groups. In all these groups, as well, the antifungal effect of Corega™ on C. albicans was significantly higher than those of the other two cleanser tablets.
CONCLUSIONS
According to the study's results, it may be better to pay attention to surface smoothness when using polyamide material to prevent microorganism retention. Cleanser tablets are clinically recommended to help maintain hygiene in removable denture users, especially Corega tablets that are more effective on C. albicans.
Topics: Candida albicans; Streptococcus mutans; Denture Bases; Denture Cleansers; Polymethyl Methacrylate; Nylons; Tablets; Colony Count, Microbial; Dental Materials; Bacterial Adhesion; Anti-Infective Agents; Materials Testing
PubMed: 38811903
DOI: 10.1186/s12903-024-04403-6 -
BMC Oral Health May 2024The aim of this study was to assess the outcomes of the combination technique of strip free gingival grafts (SFGG) and xenogeneic collagen matrix (XCM) in augmenting the... (Clinical Trial)
Clinical Trial
BACKGROUND
The aim of this study was to assess the outcomes of the combination technique of strip free gingival grafts (SFGG) and xenogeneic collagen matrix (XCM) in augmenting the width of keratinized mucosa (KMW) around dental implants, and compare its efficacy with the historical control group (FGG).
METHODS
Thirteen patients with at least one site with KMW ≤ 2 mm after implant surgery were included and received SFGG in combination with XCM. Another thirteen patients with the same inclusion and exclusion criteria from the previous trial received FGG alone. The same outcomes as the previous trial were evaluated. KMW, thickness of keratinized mucosa (KMT), gingival index (GI) and probing depth (PD) were measured at baseline, 2 and 6 months. Postoperative pain, patient satisfaction and aesthetic outcomes were also assessed.
RESULTS
At 6 months after surgery, the combination technique could attain 3.3 ± 1.6 mm of KMW. No significant change could be detected in GI or PD at 6 months compared to those at 2 months (p > 0.05). The postoperative pain and patient satisfaction in VAS were 2.6 ± 1.2 and 9.5 ± 1.2. The total score of aesthetic outcomes was 3.8 ± 1.2. In the historical FGG group, 4.6 ± 1.6 mm of KMW was reported at 6 months, and the total score of aesthetic outcomes was higher than the combination technique (4.8 ± 0.7 vs. 3.8 ± 1.2, p < 0.05).
CONCLUSIONS
The combination technique of SFGG and XCM could increase KMW and maintain peri-implant health. However, this combination technique was associated with inferior augmentation and aesthetic outcomes compared with FGG alone.
TRIAL REGISTRATION
This clinical trial was registered in the Chinese Clinical Trial Registry with registration number ChiCTR2200057670 on 15/03/2022.
Topics: Humans; Dental Implants; Female; Male; Collagen; Middle Aged; Gingiva; Adult; Patient Satisfaction; Periodontal Index; Gingivoplasty; Keratins; Esthetics, Dental; Treatment Outcome; Pain, Postoperative; Mouth Mucosa
PubMed: 38811896
DOI: 10.1186/s12903-024-04184-y -
Scientific Reports May 2024Poly-ε-caprolactone (PCL) has been widely used as biocompatible materials in tissue engineering. They have been used in mammalian cell proliferation to polarization and...
Poly-ε-caprolactone (PCL) has been widely used as biocompatible materials in tissue engineering. They have been used in mammalian cell proliferation to polarization and differentiation. Their modified versions had regulatory activities on mammalian macrophages in vitro. There are also studies suggesting different nanofiber diameters might alter the biological activities of these materials. Based on these cues, we examined the inflammatory activities and adherence properties of mammalian macrophages on electrospun PCL nanofibrous scaffolds formed with PCL having different nanofiber diameters. Our results suggest that macrophages could easily attach and get dispersed on the scaffolds. Macrophages lost their inflammatory cytokine TNF and IL6 production capacity in the presence of LPS when they were incubated on nanofibers. These effects were independent of the mean fiber diameters. Overall, the scaffolds have potential to be used as biocompatible materials to suppress excessive inflammatory reactions during tissue and organ transplantation by caging and suppressing the inflammatory cells.
Topics: Nanofibers; Macrophages; Animals; Mice; Inflammation; Tissue Scaffolds; Polyesters; Tissue Engineering; Biocompatible Materials; Interleukin-6; Lipopolysaccharides; RAW 264.7 Cells; Tumor Necrosis Factor-alpha; Cell Adhesion
PubMed: 38811651
DOI: 10.1038/s41598-024-61450-3