A review of oral and maxillofacial surgery journals’ contribution to undergraduate surgical education

We searched the Medline database of 4 leading international journals of oral and maxillofacial surgery (OMFS) for all articles containing the terms “undergraduate”, “medical student”, or “dental student” in the abstract, title, or keywords, from the earliest paper to 2013, to identify and review publications that related to the education of undergraduate medical and dental students. We found 130 articles, of which 22 (17%) met the inclusion criteria. Most were published by teams based in the United States, followed by those from the United Kingdom and Germany. The earliest was published in 1986. Since then, most have been published in the Journal of Oral and Maxillofacial Surgery (0.33/year) and the least in the International Journal of Oral and Maxillofacial Surgery (0.11/year). Eleven original research articles concerned dental students and 4 concerned medical students. Three studies looked at both groups and compared them with their qualified counterparts. There is a relative paucity of articles relating to the education of undergraduates, particularly medical students, in OMFS journals, although the number has increased over the last decade. There is a need for more educational papers to be aimed at students interested in pursuing OMFS as a career.     

Fabrication of a phospholipid membrane-mimetic film on the luminal surface of an ePTFE vascular graft

A stabilized, membrane-mimetic film was produced on the luminal surface of an ePTFE vascular graft by in situ photopolymerization of an acrylate functonalized phospholipid using a fiber optic diffusing probe. The phospholipid monomer was synthesized, prepared as unilamellar vesicles, and fused onto close-packed octadecyl chains that were components of an amphiphilic terpolymer anchored onto the polyelectrolyte multilayer (PEM) by electrostatic interactions. Scanning electron microscopy (SEM) confirmed that gelatin impregnation of the graft followed by the subsequent biomimetic film coating filled in the fibril and node structure of the luminal surface of the ePTFE graft and was smooth. The lipid film displayed an initial advancing contact angle of 44 degrees , which increased to 55 degrees after being subjected to a wall shear rate of 500s(-1) for 24h at 37 degrees C in phosphate buffered saline (PBS). Fourier transform (FT-IR) spectroscopy was used to characterize the stages of biomimetic film assembly and confirmed the stability of the film under shear flow conditions. In vivo assessment using a baboon femoral arteriovenous shunt model demonstrated minimal platelet and fibrinogen deposition over a 1-h blood-contacting period. The results of this study confirm the versatility of a biomimetic film coating system by successfully transferring the methodology previously developed for planar substrates to the luminal surface of an ePTFE vascular graft.     

In pursuit of enhanced recovery after total joint replacement: a narrative review of drivers of length of stay

A continual increase in the prevalence of osteoarthritis drives growing demand for total joint arthroplasty. So far, a decrease in length of stay has been the target for health professionals globally. However, a consensus pathway of achieving this has not yet been reached. This article reviews recent advances in pre‐operative and perioperative factors impacting length of stay.     

Fabrication and characterization of heparin functionalized membrane-mimetic assemblies

A membrane-mimetic assembly incorporating surface bound heparin was fabricated as a system to improve the hemocompatibility of blood-contacting devices. As a model system, heparin was chemically modified by end-point conjugation to biotin and immobilized onto membrane-mimetic thin films via biotin-streptavidin interactions. Heparin surface density, determined by radiochemical titration, confirmed that surface density was directly related to the molar concentration of biotinylated lipid within the assembled membrane-mimetic film. The capacity of surface bound heparin to promote ATIII-mediated thrombin inactivation was investigated in a parallel plate flow chamber under simulated venous and arterial wall shear rates of 50 and 500 s(-1), respectively. Significantly, we observed that the rate of thrombin inactivation approached a maximum at a heparin surface concentration greater than 4.4 pmol/cm(2) (61 ng/cm(2)). In the process, mass transport limited regimes were identified for heparin potentiated thrombin inactivation under both simulated venous and arterial conditions.     

Membrane-mimetic films containing thrombomodulin and heparin inhibit tissue factor-induced thrombin generation in a flow model

Membrane-mimetic thin films containing thrombomodulin (TM) and/or heparin were produced and their capacity to inhibit thrombin generation evaluated in a continuous flow system. Tissue factor (TF) along with TM and heparin were immobilized in spatially restricted zones as components of a membrane-mimetic film. Specifically, TF was positioned as an upstream trigger for thrombin generation and TM and/or heparin positioned over the remaining downstream portion of test films. Peak and steady-state levels of thrombin were decreased by antithrombin III (ATIII), as well as by surface bound heparin and TM. Although physiologic concentrations of ATIII have the capacity to significantly inhibit thrombin activity, surface bound TM and heparin nearly abolished steady-state thrombin responses. In particular, surface bound TM appears to be superior to heparin in reducing local thrombin concentrations. These studies are the first to demonstrate the additive effect of surface bound heparin and TM as a combined interactive strategy to limit TF-induced thrombin formation.     

Seroprevalence of torch infection in bad obstetric history

Primary infection with TORCH complex [Toxoplasma, Rubella, Cytomegalovirus (CMV), and Herpes simplex virus II (HSV-II)] in pregnant women can lead to adverse outcome which are initially inapparent or asymptomatic and thus difficult to diagnose on clinical grounds. Over a one-year period 380 serum samples were collected from pregnant women having bad obstetric history, attending antenatal clinic. In the present study we have shown the prevalence of Toxoplasma, Rubella, CMV, HSV-II infection in pregnant women by demonstrating the presence of IgM and IgG antibodies by ELISA test. It was found that, IgM antibodies were positive in 40 (10.52%) for Toxoplasma, 102 (26.8%) for Rubella, 32 (8.42%) for CMV and 14 (3.6%) for HSV-II. IgG antibodies were positive in 160 (42.10%) for Toxoplasma, 233 (61.3%) for Rubella, 346 (91.05%) for CMV 145 (33.58%) for HSV-II. Hence all antenatal cases with bad obstetric history should be routinely screened for TORCH as early diagnosis and appropriate intervention, will help in proper management of these cases.