A bibliometric analysis of periodontology

This bibliometric study assessed periodontal/implant articles that were part of the five most‐cited dental articles in each of the years 2005‐2019. Periodontal/implant articles made up one to four articles in each of 14 years and totaled 40% of the yearly five most‐cited dental articles. The three core periodontal journals (Journal of Clinical Periodontology, Journal of Periodontology, and Periodontology 2000) increased ~50%‐100% in Journal Impact Factor from 2005 to 2015 and were among the 10 most‐cited dental journals in the 2015‐2019 period. The Journal of Clinical Periodontology and Periodontology 2000 were in several years assigned the highest Journal Impact Factor in dentistry. In summary, periodontal journals continue to publish high‐impact articles that are relevant for both oral health care and medicine.     

Increase of medical hospital length of stay by depression in stroke and amputation patients: a pilot study.

Past studies have found that medical patients with the diagnosis of depression (comorbidity) have longer hospital lengths of stay (LOS) than those without the diagnosis of depression. This suggested that scores on a depression scale would be positively correlated with LOS. On a rehabilitation ward, 14 stroke and 17 amputee patients were given the Geriatric Depression Scale (GDS) and lengths of stay were recorded. Correlations between GDS scores and LOS were +0.575 for stroke and +0.266 for amputee patients, both in the hypothesized direction. Explanations considered included: (1) depression and medical illness each produce morbidity which summate to require increased LOS; (2) depression delays medical recovery as well as the appearance of medical recovery, and (3) discharge planning is complicated by depression. When depression is associated with inpatient medical illness, DRGs may need to be reevaluated.     

Association of intraoperative hypothermia with oncologic outcomes following radical cystectomy

IntroductionIntraoperative hypothermia (IOH) has been suggested to adversely impact outcomes following surgery. The objective of this study was to evaluate the association between IOH and survival following radical cystectomy (RC).MethodsPatients who underwent RC for bladder cancer from 2003 to 2018 were identified in our cystectomy registry. Intraoperative temperatures were extracted from the anesthesia record. IOH was defined as a median intraoperative temperature <36°C, and severe IOH as ≤ 35°C. Time under 36°C was assessed as a continuous variable. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were estimated using the Kaplan-Meier method. Associations between IOH and outcomes were assessed with multivariable Cox proportional hazards models.ResultsA total of 852 patients were identified, among whom 274 (32%) had IOH. Median follow up among survivors was 4.9 years (IQR 2.4–8.7), during which time 483 patients died, including 343 from bladder cancer. Two-year survival was not significantly different between patients with and without IOH (CSS: 74% vs. 71%, P= 0.31; OS: 68% vs. 67%, P= 0.13). Following multivariable adjustment, neither IOH nor time under 36°C was significantly associated with survival. A total of 37 patients (4.3%) had severe IOH. These patients were observed to have significantly lower 2-year OS (56% vs. 68%, P= 0.005); however, this association did not remain statistically significant after multivariable adjustment (P= 0.92).ConclusionIOH was not independently associated with survival following RC. These data do not support IOH as a prognostic factor for cancer outcomes among patients undergoing RC.     

Comparision of blood loss between computer assisted and conventional total knee arthroplasty

Background:

Bleeding during total knee arthroplasty (TKA) can cause significant morbidity and mortality. One proposed benefit of computer assisted TKA is decreased bleeding as the femoral canal is not invaded. This study assessed blood loss between computer assisted surgery (CAS) and conventional TKA.

Materials and Methods:

73 consecutive patients (37 males, 36 females) underwent primary TKA between 2006 and 2009. Thirty eight patients underwent navigated TKA and 35 underwent conventional TKA for symptomatic osteoarthritis of the knee. These patients were matched for age, gender, and body mass index (BMI). Average age was 70.3 years (range 47-91 years). Mean BMI was 30 (range 17-49). Average preoperative hemoglobin was 13.26 g/dL (range 8.7-18.4 g/dL) in the navigated group and 13.47 g/dL (range 9.6-15.8 g/dL) in the conventional group (P = 0.9). Average tourniquet time was 110 min (range 90-150 min) in the navigated group and 96.7 min (range 60-145 min) in the conventional group (P = 0.77).

Results:

Average postoperative hemoglobin in the navigated group was 10.34 g/dL (range 7.5-14.8 g/dL) and in the conventional group was 10.03 g/dL (range 7.5-12.2 g/dL) (P = 0.17). Six patients in both groups required blood transfusions. The mean drain collection was 599 mL (range 150-1370 mL) in the navigated group and 562 mL (range 750-1000 mL) in the conventional group (P = 0.1724). These results suggest that there is no significant reduction in blood loss in CAS TKA.

Conclusion:

These results suggest that there is no significant difference in blood loss in CAS TKA and conventional TKA. This study also highlights the heterogeneity of methods used in studies related to CAS TKA. We believe that there is a need for a large multicenter prospective randomized controlled trial to be performed before a consensus can be reached on the influence of CAS techniques on blood loss during primary TKA.     

Impact of a Recent Lead Recall on Utilization of Implantable Cardioverter Defibrillators: Data from the NCDR ICD Registry™

Impact of Recalls on ICD Utilization . Introduction: Underutilization of ICDs is well documented. It has been hypothesized that device recalls, and the resultant negative publicity, may contribute. Methods and Results: To determine if the October 2007 recall of the Medtronic Fidelis lead was associated with a decrease in volume of ICD procedures in the United States, we analyzed data submitted to the ICD Registry? between July 2006 and December 2008. Time‐series analyses were performed comparing actual and predicted implant volumes following the recall, using monthly data from July 2006 to September 2007 to establish a trend line. Observed data points falling outside the 95% CIs from the trend line were considered statistically significant. The study cohort includes 173,616 implantations in 658 hospitals. Before October 2007, an average of 5,952 devices, 4,910 for primary prevention, were implanted per month. Following the recall, the average monthly number of implants was modestly lower at 5,623 (P = 0.05), 4,601 for primary prevention (P = 0.01.) However, as volume was decreasing prior, in time‐series analysis, the observed monthly implant volume for primary prevention devices differed from expected based on the trend line for only 1 month. The proportion of Medtronic implants declined from 51.1% in the 15 months prior to the recall to 45.8% in the 15 months of the recall or after (P < 0.01), falling outside the 95% CI of the trend line for 3 months in time‐series analysis. Conclusions: A recent well‐publicized lead recall had minimal impact on ICD utilization either overall or for primary prevention. (J Cardiovasc Electrophysiol, Vol. 23, pp. 861‐865, August 2012)     

Transforming growth factor beta 1 inhibits placental differentiation and human chorionic gonadotropin and human placental lactogen secretion

Previously, no inhibitors of placental differentiation have been described. In this study, we determined the effect of transforming growth factor beta 1 (TGF beta 1) on cytotrophoblast differentiation. Monolayer cultures of pure cytotrophoblasts were exposed to 0.001-10 ng/ml TGF beta 1 with and without the presence of 10 ng/ml epidermal growth factor (EGF), an inducer of placental differentiation. Over 7 days of culture, in 11 separate experiments, phase contrast microscopy demonstrated marked inhibition of EGF-induced syncytial formation by TGF beta 1. Basal human (h)CG and h-placental lactogen (PL) release were reduced compared to control by fractions of 0.75 (TGF beta 1/control) and 0.54, respectively. EGF alone induced fractional (EGF/control) increases in hCG and hPL release of 2.46 and 2.68, respectively. However, this stimulation was significantly inhibited by 10 ng/ml TGF beta 1. Dose-response studies showed that maximal TGF beta 1 inhibition of EGF-stimulated hormone secretion occurred at 0.1 ng/ml or more TGF beta 1. Partial differentiation (syncytium formation) occurred despite the presence of TGF beta 1, suggesting a portion of cytotrophoblasts were committed to differentiation at the time of culture. We conclude that TGF beta 1 acts as a major inhibitor of trophoblast differentiation and concomitant peptide hormone secretion.