Surgical treatment of peri‐implantitis: Prognostic indicators of short‐term results

Aim

To evaluate the clinical and radiographic short‐term (6 months) effect of surgical treatment of peri‐implantitis, and to identify prognostic indicators affecting the outcome using a multilevel statistical model.

Materials & Methods

A total of 143 implants (45 patients) with a diagnosis of progressive peri‐implantitis (progressive bone loss (PBL) ≥2.0 mm and bleeding on probing (BoP)/suppuration) received surgical treatment. Clinical and radiographic parameters were assessed 6 months postoperatively. Potential prognostic indicators on subject, implant and site level prior to surgery were analysed to evaluate the effect on individual and composite outcomes using multilevel logistic regression analysis.

Results

At the 6‐month evaluation, none of the implants demonstrated PBL and 14% of the implants were registered with the absence of bleeding and no pocket probing depth ≥6 mm. Multilevel regression analysis identified, among others, suppuration, pocket probing depth >8 mm, bone loss >7 mm and the presence of plaque as criteria associated with the outcome.

Conclusion

Resective peri‐implantitis surgery seemed to reduce the amount of peri‐implant inflammation. However, most of the sites continued to have BoP/suppuration. Thus, long‐term maintenance and evaluation is warranted. The effect of treatment was reduced by some prognostic indicators such as the presence of suppuration prior to interception and peri‐implant bone loss exceeding 7 mm.     

Evaluation of the Lyra Direct Strep Assay To Detect Group A Streptococcus and Group C and G Beta-Hemolytic Streptococcus from Pharyngeal Specimens

The Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group A and β-hemolytic groups C/G using rapid antigen-negative pharyngeal specimens (n = 161). The Lyra assay correctly detected all β-hemolytic streptococci (group A, n = 19; group C/G, n = 5). In batch mode, the Lyra assay reduced intralaboratory turnaround time by 60% (18.1 h versus 45.0 h) but increased hands-on time by 96% (3 min 16 s versus 1 min 40 s per specimen).     

Filtration efficiency of surgical sterilization fabric for respiratory protection during COVID-19 pandemic

BackgroundDue to COVID-19 and high demand for respirators, some healthcare professionals have been using the Halyard H600 fabric as an alternative to N95 respirators without testing the filtration efficiency of the fabric with established scientific methods. The purpose of this study was to assess the efficiency of the Halyard H600 as a respirator filtering material as compared to the NIOSH-certified N95 and P100 filters, and determine if H600 is a good alternative for respiratory protection for healthcare professionals during the COVID-19 pandemic.MethodsThree filter types (Halyard H600, N95, and P100) were challenged with salt particles inside an exposure chamber at a flow rate of 43 LPM and relative humidity of 40 ± 2%. N95 and P100 respirator filters were tested initially to establish the validity of the chamber, followed by the Halyard H600 fabric. Particle penetration was measured using an aerosol spectrometer. The filtration efficiency was calculated for different particle sizes by measuring the particle number concentration upstream and downstream of the filter. The pressure drop across the filter materials was measured using a manometer.ResultsThe efficiency of the P100 for particles ≥250 nm was 100%. The N95 efficiency was 97 ± 1% at 275 nm, 99 ± 0% at 324 nm, and 100% for larger particles. The Halyard H600 fabric had a variable efficiency with an average of 62 ± 28% at 275 nm, 89 ± 8% at 324 nm, and 100% efficiency for particles >450 nm. The pressure drop values for P100 and N95 were 32 and 8 mmH₂O, respectively. The Halyard H600 fabric resistance increased dramatically from 30 mmH₂O at the start of the exposure to 65 mmH₂O after 16-minutes of exposure.ConclusionThe high variability in filter efficiency for particles ≤324 nm and the increased fabric breathing resistance demonstrate that the Halyard H600 has an inferior performance and is not a good substitute for N95 and P100. Thus, the use of the Halyard H600 fabric for respiratory protection is not recommended.     

Seeing It Helps: Movement-related Back Pain Is Reduced by Visualization of the Back During Movement

OBJECTIVES:: The aim of this study was to determine whether visualization of the back influenced parameters of movement-related pain in people with chronic nonspecific low back pain. METHODS:: We used a randomized cross-over experiment in which 25 participants performed repeated lumbar spine movements under 2 conditions. In the visual feedback condition, patients were able to visualize their back as it moved by the use of mirrors. In the control condition, the mirror was covered so no visualization of the back was possible. RESULTS:: The average postmovement pain intensity after participants had moved with visual feedback was less (35.5±22.8 mm) than when they moved without visual feedback (44.7±26.0 mm). This difference was statistically significant (mean difference=9.3, 95% confidence interval: 2.8-15.7 F(1,22)=8.82, P=0.007). The average time to ease after participants had moved with visual feedback was shorter (44.5 s±53.8) than when they moved without visual feedback (94.4 s±80.7). This difference was also statistically significantly (mean difference=49.9, 95% confidence interval: 19.3-80.6, F(1,22)=8.82, P=0.003). DISCUSSION:: Patients with chronic nonspecific low back pain reported less increase in pain and faster resolution of pain when moving in an environment that enabled them to visualize their back. This is consistent with emerging research on the use of mirror visual feedback in other long-standing pain problems and suggests that similar lines of inquiry may be worth pursuing in the chronic nonspecific low back pain population.     

Nasopharyngeal Microbiota in Healthy Children and Pneumonia Patients

Our study is the first to compare the nasopharyngeal microbiota of pediatric pneumonia patients and control children by 454 pyrosequencing. A distinct microbiota was associated with different pneumonia etiologies. Viral pneumonia was associated with a high abundance of the operational taxonomic unit (OTU) corresponding to Moraxella lacunata. Patients with nonviral pneumonia showed high abundances of OTUs of three typical bacterial pathogens, Streptococcus pneumoniae complex, Haemophilus influenzae complex, and Moraxella catarrhalis. Patients classified as having no definitive etiology harbored microbiota particularly enriched in the H. influenzae complex. We did not observe a commensal taxon specifically associated with health. The microbiota of the healthy nasopharynx was more diverse and contained a wider range of less abundant taxa.     

Recent Advances in Diverticular Disease

Diverticular disease is common and accounts for substantial health care utilization in the USA. Recent publications in the areas of diverticulosis and diverticular disease have highlighted several notable advances that are now changing practice. Despite colonic diverticula being common, only 1–4 % of individuals with colonic diverticula will develop diverticulitis. After a first occurrence of acute diverticulitis, the risk of recurrence is 20 % at 5 years. Complications most commonly occur with the first occurrence of acute diverticulitis and not with recurrent episodes. After an episode of diverticulitis, many patients continue to experience chronic gastrointestinal symptoms. Prophylactic surgery is an option to reduce the risk of recurrence and its negative impact on quality of life. Importantly, the rationale for surgery is no longer to prevent complications because this risk is low. The review concludes with practical recommendations for patients with diverticulosis and diverticular disease.     

BECOMING BICULTURAL: CHINESE AMERICAN WOMEN AND THEIR DEVELOPMENT

Ethnic and racial diversity in the United States has led to increasing interest in research on biculturalism, yet the meaning and underlying processes of biculturalism in the context of development in young adults are not well understood. Fifteen interviews were conducted with second-generation Chinese American women to explore how being bicultural fit into their lives. Data analysis yielded a developmental map that reflected their experiences throughout life as minority women. Findings suggest that biculturalism is more than being functionally competent in two cultures, it is both a behavioral and psychological orientation in life. From the findings of this study, we have increased our knowledge of Asian American women's development and provided a foundation for nursing research with minority women.