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91.
Sara Amghar-Maach Alba Sánchez-Torres Octavi Camps-Font Cosme Gay-Escoda 《Journal of prosthodontic research》2018,62(4):391-396
Purpose
To answer the PICO question: “Among patients to whom an implant is placed, does the piezoelectric surgery (PS) compared to the conventional drilling (CS) achieve higher implant stability, increase surgical time or improve implant survival rate?”Study selection
Two independent authors screened the literature through MEDLINE, Cochrane Library and Scopus. Randomized or non-randomized controlled trials, prospective and retrospective cohort studies comparing implant stability and/or clinical outcomes with PS versus CS used for implant site preparation published in the last 10 years were included in the search.Results
Five of the 177 articles initially found were included in the meta-analysis. No statistically significant differences were found between PS and CS for implant stability quotient (ISQ) at baseline (SMD: 0.31; 95 %CI: ?0.59 to 1.20; p = 0.5). However, ISQ values were significantly higher at 2 months (SMD: 0.52; 95 %CI: 0.03–1.00; p = 0.04) and at 3 months (SMD: 0.74; 95 %CI: 0.17–1.32; p = 0.01) for CS. PS needed significantly more time than CS (SMD: 1.74; 95 %CI: 0.42–3.06; p = 0.01) in order to be performed. No differences for implant survival rates were found when comparing both techniques (RR: 0.52; 95 %CI: 0.09–2.88; p = 0.45).Conclusions
PS has not demonstrated superiority to conventional drilling for implant stability during the healing period. PS needs significantly longer surgery time than CS. Differences for implant survival rate were not found between the two techniques. 相似文献92.
Setor K. Kunutsor Michael R. Whitehouse Ashley W. Blom Tim Board Peter Kay B. Mike Wroblewski Valérie Zeller Szu-Yuan Chen Pang-Hsin Hsieh Bassam A. Masri Amir Herman Jean-Yves Jenny Ran Schwarzkopf John-Paul Whittaker Ben Burston Ronald Huang Camilo Restrepo Javad Parvizi Sergio Rudelli Emerson Honda David E. Uip Guillem Bori Ernesto Muñoz-Mahamud Elizabeth Darley Alba Ribera Elena Cañas Javier Cabo José Cordero-Ampuero Maria Luisa Sorlí Redó Simon Strange Erik Lenguerrand Rachael Gooberman-Hill Jason Webb Alasdair MacGowan Paul Dieppe Matthew Wilson Andrew D. Beswick The Global Infection Orthopaedic Management Collaboration 《European journal of epidemiology》2018,33(10):933-946
One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators. We analysed IPD of 1856 participants with PJI of the hip from 44 cohorts across four continents. The primary outcome was re-infection (recurrence of infection by the same organism(s) and/or re-infection with a new organism(s)). Hazard ratios (HRs) for re-infection were calculated using Cox proportional frailty hazards models. After a median follow-up of 3.7 years, 222 re-infections were recorded. Re-infection rates per 1000 person-years of follow-up were 16.8 (95% CI 13.6–20.7) and 32.3 (95% CI 27.3–38.3) for one-stage and two-stage strategies respectively. The age- and sex-adjusted HR of re-infection for two-stage revision was 1.70 (0.58–5.00) when compared with one-stage revision. The association remained consistently absent after further adjustment for potential confounders. The HRs did not vary importantly in clinically relevant subgroups. Analysis of pooled individual patient data suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating PJI of the hip. 相似文献
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Raquel Almeida-Dias Marta Garrote Joan Cid Maria-Jesús Mustieles Cristina Alba Miquel Lozano 《Journal of clinical apheresis》2019,34(4):503-506
Essential thrombocytosis (ET) is a chronic myeloproliferative neoplasm characterized by the presence of thrombocytosis and it can be complicated by thrombotic and/or hemorrhagic events. Treatment options include low-dose aspirin and cytoreductive agents such as hydroxyurea. In cases of extreme thrombocytosis, therapeutic thrombocytapheresis can be a useful procedure. We present a case of a 61-year-old-man previously diagnosed with CALR-mutated ET, who develop acute myeloid leukemia. When recovering after induction chemotherapy, he developed an extreme thrombocytosis up to 2337 × 109/L regardless hydroxyurea was started. Two therapeutic trombocytapheresis were performed and anagrelide was added to cytoreductive regimen. Platelet count stabilized around 570 × 109/L. Both procedures were performed with the Spectra Optia Apheresis System version 11.3 (Terumo BCT) and we decided to use a higher collection preference and lower collection speed than manufacturer's recommendations. Platelet count decreased from 2380 × 109/L to 1035 × 109/L in the first procedure and from 1813 × 109/L to 768 × 109 in the second procedure. Platelet collection efficiency was calculated to be 110.3% and 86.1% in the first and second thrombocytapheresis, respectively. Therapeutic thrombocytapheresis with Spectra Optia is a safe and efficient therapy to treat patients with primary thrombocytosis while effect of cytoreductive agents is attained. Platelet collection efficiency was calculated to be higher than previously reported. We suggest that changes in technical parameters such as a deeper aspiration point and/or lower collection speed may increase procedure's efficiency. 相似文献
97.
Sarah Heili Frades María del Pilar Carballosa de Miguel Alba Naya Prieto Marina Galdeano Lozano Xavier Mate García Ignacio Mahillo Fernández Itziar Fernández Ormaechea Laura Álvarez Suárez Farah Ezzine de Blas María José Checa Venegas Nicolás González Mangado Germán Peces Barba 《Archivos de bronconeumologia》2019,55(12):634-641
IntroductionHistorically, it has been assumed that Intermediate Respiratory Care Units (IRCU) were efficient, because they saved costs by reducing the number of admissions to intensive care units (ICU), and effective, because they specialized in respiratory diseases.MethodsThe number of IRCU admissions and mortality rate, historically and in 2016, were evaluated. For 2016, the grouped Related Diagnostic Groups (DRGs) were also described, and the savings achieved under all budgetary headings by avoiding UCI stays were calculated. A multivariate analysis was performed to associate costs with mean weights and complexity, and multiple logistic regression was performed on all patients admitted from 2004 to 2017 to describe the variables associated with mortality in our unit.ResultsAn IRCU generates savings of €500,000/year by reducing length of ICU stay. Analysis of the 2016 cohort shows that costs correlate with mean weight and mortality, and consequently complexity. The multivariate logistic regression analysis of the 2004–2017 cohort found respiratory frequency, leukopenia, anemia, hyperkalemia, and acidosis to be the variables best associated with mortality. The area under the curve for the logistic model was 0.75.ConclusionThe IRCU analyzed in our study was efficient in terms of ‘avoided costs’ and savings associated with complexity. Our results suggest that IRCUs have a lower mortality rate than other similar units, and are therefore a safe environment for patients. 相似文献
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