Biomechanical evaluation of plating techniques for fixing mandibular angle fractures: the introduction of a new 3D plate approach

Purpose

The aim of this study was to comparatively evaluate the use of a three-dimensional (3D) square-shaped plate for the treatment of mandibular angle fractures.

Materials and methods

Synthetic mandible replicas were used to evaluate the effectiveness of the 3D square plate along with three other mandibular angle plating techniques. The plating techniques consisted of: (1) a 3D miniplate (2?×?2 holes, square, 2 mm); (2) a 3D miniplate (6?×?2 holes, curved, 2 mm); (3) two miniplates (four holes, straight, 2 mm and 1.6 mm); and (4) one single miniplate (four holes, straight, 2 mm). Each group was subjected to incisal and homolateral molar region loading by a tensile materials testing machine (Monsanto Tensometer 20). Load stiffness values and peak measurements of the fracture gap distraction at the superior aspect of the mandible were measured. The mean values (±standard deviation) were derived and compared using one-way analysis of variance, with statistical significance set at p?<?0.05.

Results

For homolateral molar loading, statistically significant differences existed within groups (p?<?0.05). For incisal edge loading, no statistically significant differences were found for stiffness among the fixation methods tested. Gap distraction at the superior aspect of the mandible was limited for three of the groups tested.

Conclusion

Under the conditions tested, the 3D square plate system provided the most favorable mechanical behavior.     

Does Adherence to the Mediterranean Diet Have a Protective Effect against Asthma and Allergies in Children? A Systematic Review

Dietary pattern may potentially impact on the pathogenesis of asthma and allergies. The Mediterranean Diet (MD) has significant health benefits due to its antioxidant and anti-inflammatory properties. The aim of this systematic review was to investigate the effectiveness of adherence to the MD against asthma and allergies in childhood. Hence, a systematic literature search was conducted on PubMed, ESBCO (Cinahl), Scopus, and the Cochrane Library databases up to 26 January 2022. The total number of articles obtained, after the initial search on the databases was conducted, was 301. Twelve studies were included, after the removal of duplicates and screening for eligibility. Our findings indicated a protective role of the MD against childhood asthma, but they also imply that the MD probably does not affect the development of allergies. Nevertheless, the heterogeneity and limitations of the studies highlight the need for randomized controlled trials that will focus on the pediatric population and hopefully provide more robust evidence.     

Levobupivacaine versus ropivacaine infiltration analgesia for mastopexy: a comparative study of 2 long-acting anesthetic drugs in infiltrative anesthesia for mastopexy

A prospective double-blind study was conducted to compare the analgesic properties of levobupivacaine and ropivacaine in a bilaterally symmetrical mastopexy model. Both of these 2 long-acting local anesthetic amides are associated with lower cardiac and central nervous system toxicity than racemic bupivacaine, a widely used agent for long-lasting perioperative analgesia in esthetic procedures. In this study, each of the 18 patients undergoing bilateral mastopexy under conscious sedation received preoperative infiltration with levobupivacaine in 1 breast and equal volume of ropivacaine in the other. Patients were requested to assess their pain separately in each side every 2 hours and for 12 hours postoperatively on a visual analog scale. Overall analgesia achieved up to 12 hours postoperatively was found to be statistically different between the 2 local anesthetic factors in favor of levobupivacaine. At 2 hours postoperatively, no difference was found between the 2 local anesthetic agents in terms of analgesic efficacy (P = 0.298). However, postoperative pain scores recorded after infiltration with levobupivacaine were significantly lower than pain scores for the ropivacaine-infiltrated sides (P<0.001) at all other timeframes. Both anesthetics provided satisfactory analgesia for at least 10 hours, but constantly low pain scores were recorded for levobupivacaine for 10 hours postoperatively, whereas for ropivacaine only for 6 hours. At 12 hours, 66% of patients needed oral analgesia for pain in the ropivacaine-infiltrated breast. It is concluded that levobupivacaine is more effective for local infiltrative analgesia in mastopexy than ropivacaine, providing longer-lasting postoperative analgesia.     

Differential effects of two isoenergetic meals rich in saturated or monounsaturated fat on endothelial function in subjects with type 2 diabetes

OBJECTIVE—To examine the acute effects of consumption of monounsaturated (MUFAs) and saturated fatty acids (SAFAs) on endothelial function in subjects with type 2 diabetes.RESEARCH DESIGN AND METHODS—A total of 33 participants were examined after consumption of two different isocaloric meals: one rich in MUFA and one rich in SAFA, in the form of extra-virgin olive oil and butter, respectively. Endothelial function was assessed by determination of flow-mediated dilatation (FMD).RESULTS—FMD did not change significantly after the MUFA-rich meal but declined after the SAFA-rich meal. The FMD during the experiment, expressed as incremental area under the curve, increased after the MUFA-rich meal by 5.2 ± 2.5% and decreased after the SAFA-rich meal by 16.7 ± 6.0% (Δ = −11.5 ± 6.4%; P = 0.008).CONCLUSIONS—Consumption of an SAFA-rich meal is harmful for the endothelium, while a MUFA-rich meal does not impair endothelial function in subjects with type 2 diabetes.Endothelial dysfunction occurs early in the course of type 2 diabetes and contributes to the development of macrovascular complications of the disease (1,2). Consumption of saturated fatty acids (SAFAs) impairs endothelial function for up to 6 h postmeal (3), whereas data on the effect of monounsaturated fatty acids (MUFAs) on endothelial function in subjects with type 2 diabetes are limited. According to recent nutritional recommendations, individuals with diabetes should substitute SAFA for MUFA in their diet (4), and the predominant source of MUFA in many countries is oleic acid contained in olive oil. However, the effect of consumption of olive oil on endothelial function in subjects with type 2 diabetes is not known. We tested the hypothesis that consumption of MUFA in the form of olive oil exerts a better effect on endothelial function in subjects with type 2 diabetes than that associated with consumption of butter. Because endothelial function is affected by high blood glucose, lipid and insulin concentrations, and increased oxidative stress (2), we measured these parameters during the study.