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81.
Osseoinductive elements for promoting osseointegration around immediate implants: a pilot study in the foxhound dog
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82.
Tamara Sussman Sharon Kaasalainen Eunyoung Lee Noori Akhtar-Danesh Patricia H. Strachan Kevin Brazil Robin Bonifas Valérie Bourgeois-Guérin Patrick Durivage Alexandra Papaioannou Laurel Young 《Journal of the American Medical Directors Association》2019,20(3):262-267
Objectives
This article reports findings on the usability and staff use of 5 condition- specific pamphlets of high prevalence in long-term care (LTC): dementia, heart failure, chronic obstructive pulmonary disease, renal failure, and frailty. The pamphlets were created in response to residents', families', and staff's recommendations for activating early reflections and communication about end-of-life care.Design
A mixed-method (qualitative and quantitative) survey design was used. Step 1 collected survey data on the usability of the pamphlets. Step 2 collected survey data on pamphlet use.Settings and Participants
Two nurses with specialized palliative care training, 2 resident/family representatives, 10 condition-specific specialists, and 33 LTC palliative leads reviewed the pamphlets for usability prior to distribution. A total of 178 LTC home staff in 4 participating LTC homes reported on pamphlet use.Measures
Specialists and resident/family representatives were asked to provide open comments and LTC home palliative leads were asked to complete a survey on the accuracy, readability, and relevance of the pamphlets. After 6 months of distribution, all staff in participating LTC homes were asked to complete a survey on pamphlet use, usefulness, and comfort with distribution.Results
The pamphlets were reportedly accurate, relevant, and easy to understand. Following 6 months of availability, most staff in LTC had read the pamphlets, found the information useful, and planned to share them. However, half of the staff questioned their role in pamphlet distribution and most had not distributed them. Regulated staff (ie, staff affiliated with a regulated profession) expressed more comfort sharing the pamphlets than care aides and support staff.Conclusions/Implications
Condition-specific pamphlets appear to hold promise in providing residents and families with relevant information that may activate early reflections and conversations about end-of-life care. However, structured implementation strategies, training, and discussions are required to improve staff comfort with distribution and explore roles in distribution and follow-up. 相似文献83.
84.
85.
In the developed world, the large birth cohorts of the so‐called baby boomer generation have arrived in medical and dental practices. Often, elderly patients are ‘young‐old’ baby boomers in whom partial edentulism is the predominant indication for implant therapy. However, the generation 85+ years of age represents a new challenge for the dental profession, as their lives are frequently dominated by dependency, multimorbidity and frailty. In geriatric implant dentistry, treatment planning is highly individualized, as interindividual differences become more pronounced with age. Nevertheless, there are four typical indications for implant therapy: (i) avoidance of removable partial prostheses; (ii) preservation of existing removable partial prostheses; (iii) stabilization of Kennedy Class I removable partial prostheses; and (iv) stabilization of complete prostheses. From a surgical point of view, two very important aspects must be considered when planning implant surgery in elderly patients: first, the consistent strive to minimize morbidity; and, second, the fact that coexisting medical risk factors are significantly more common in elderly patients. Modern three‐dimensional cone beam computed tomography imaging is often indicated in order to plan minimally invasive implant surgery. Computer‐assisted implant surgery might allow flapless implant surgery, which offers a low level of postoperative morbidity and a minimal risk of postsurgical bleeding. Short and reduced‐diameter implants are now utilized much more often than a decade ago. Two‐stage surgical procedures should be avoided in elderly patients. Implant restorations for elderly patients should be designed so that they can be modified to become low‐maintenance prostheses, or even be removed, as a strategy to facilitate oral hygiene and comfort in the final stage of life. 相似文献
86.
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
87.
Influence of hydroxyapatite granule size,porosity, and crystallinity on tissue reaction in vivo. Part A: synthesis,characterization of the materials,and SEM analysis
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88.
Thomas Desmidt Frédéric Andersson Bruno Brizard Paul-Armand Dujardin Jean-Philippe Cottier Frédéric Patat Jean-Pierre Réméniéras Valérie Gissot Wissam El-Hage Vincent Camus 《Ultrasound in medicine & biology》2018,44(11):2307-2313
Increasing evidence suggests that brain pulsatility is involved in the pathophysiology of various neurological and psychiatric disorders. However, it remains unclear whether high brain pulsatility is damaging to or protective of the brain in normal conditions, and this could depend on the age of the individual and the methods used to measure brain pulsatility. The goal of our study was to investigate associations between subcortical volumes and brain pulsatility as assessed with ultrasound in healthy young adults using both a conventional method (transcranial Doppler pulsatility index [TCD-PI]) and the innovative method of tissue pulsatility imaging (TPI), which allows a high level of detection of small brain movements (micrometers). Twenty-five females aged 18–55 with no history of significant medical disorder underwent magnetic resonance imaging and ultrasound assessment. The volumes of six subcortical regions known to be particularly sensitive to change in cerebral blood flow were measured and compared with brain pulsatility as assessed with TCD-PI and TPI. TCD-PI and TPI measures positively correlated with all subcortical regions, with the caudate nucleus having the strongest association. Linear regressions found that TCD-PI and TPI measures of brain pulsatility explained 16% to 67% of the variance of the subcortical volumes. Our results suggest that a greater pulsatility as assessed with ultrasound in healthy young adults may constitute a protective factor for brain structure. Ultrasound measures of brain pulsatility may be appropriate to provide costless, non-invasive, portable and highly sensitive markers of cerebral blood flow pulsatility related to brain structure. 相似文献
89.
Sébastien Touraine Valérie Bousson Rachid Kaci Caroline Parlier-Cuau Samuel Haddad Liess Laouisset David Petrover Jean-Denis Laredo 《The Foot》2013,23(2-3):88-92
We report the case of a 42-year-old man with histologically proven plantar fibromatosis (Ledderhose disease) demonstrating an uncommon brain gyriform pattern at MRI, so far exclusively described in the low-grade fibromyxoid sarcoma (LGFMS). An acoustic posterior enhancement at ultrasound, a high intensity on T2w and post-contrast T1wMR images were unusual and related to a high tumor cellularity at histology with no myxoid tissue. The juxtaposition of areas of high and low cellularity (with more fibrous material) in a multilobulated mass built a brain gyriform pattern at MR, similar to what was so far described exclusively in LGFMS. This case demonstrates that the brain gyriform pattern may also be observed in other soft tissue fibrous tumors with no myxoid material but with high cellularity areas alternating with fibrous zones of low cellularity. 相似文献