Category: Nevin Manimala

Aesthet Surg J. 2023 Aug 19:sjad265. doi: 10.1093/asj/sjad265. Online ahead of print.

ABSTRACT

BACKGROUND: Capsular contracture is a known complication of breast augmentation and is among the top reasons for revision breast augmentation procedures. The use of acellular dermal matrices (ADM) has been shown to reduce the rate of capsular contracture in breast reconstruction and augmentation theorizing that it acts as a protective barrier between the implant capsule and inflammatory process responsible for capsular contracture. The role of ADM in treatment of capsular contracture has been investigated in numerous studies, using a variety of ADM.

OBJECTIVES: The aim of this study was to perform a systematic review of existing literature on the use of ADM for treatment of capsular contracture in aesthetic breast augmentation patients to investigate differences in efficacy between ADM types.

METHODS: PubMed, Embase, and CINAHL databases were systematically reviewed for articles pertaining to capsular contracture, acellular dermal matrices, and breast augmentation. Number of patients, type of ADM, Baker grade, follow-up time, complication rate, and capsular contracture rate were recorded from identified articles. Data was pooled from studies to calculate a capsular contracture rate for each ADM type with Chi-squared test performed for analysis. Identified studies with a comparative group were included in meta-analysis utilizing risk ratio (RR) to assess efficacy of ADM.

RESULTS: Nine articles using ADM for treatment of capsular contracture in breast augmentation met criteria for inclusion with a total of 481 breasts. Strattice (Lifecell Corporation, Branchburg, NJ) was the most commonly used ADM (n=391), followed by AlloDerm (n=57; Lifecell Corporation). There was a statistically significant difference in efficacy of ADM among the studied ADM types (p < 0.001). AlloDerm, FlexHD (MTF Biologics, Edison, NJ), and DermaMatrix have the lowest capsular contracture rates (0%). NeoForm (Mentor Corporation, Irving, TX) and SurgiMend (Integra LifeSciences, Princeton, NJ) have the highest capsular contracture rates (each 25%, but with n=4 and n=8, respectively). Strattice has a capsular contracture rate of 1.53% in the pooled data, and meta-analysis showed that Strattice reduces the risk of capsular contracture (RR 0.14 [95% CI 0.06, 0.31]) compared to conventional treatment.

CONCLUSIONS: Acellular dermal matrices appear to be effective at treating capsular contracture after breast augmentation while maintaining a low complication rate. Overall capsular contracture rates are low with the use of ADM. There is a statistically significant difference in efficacy among ADM type. Meta-analysis shows that Strattice is effective at reducing the risk of capsular contracture in breast augmentation patients compared to conventional treatment. Future research, especially in the form of randomized-controlled trials, is needed to further investigate the efficacy of various ADM in the treatment of capsular contracture.

PMID:37595294 | DOI:10.1093/asj/sjad265

J Cataract Refract Surg. 2023 Aug 14. doi: 10.1097/j.jcrs.0000000000001286. Online ahead of print.

ABSTRACT

PURPOSE: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (ray-trace LASIK) for correction of myopia in everyday clinical practice.

SETTING: Single site private practice.

DESIGN: Retrospective nonrandomised unmasked chart review.

METHODS: Consecutive, myopic eyes (range -8.25D sphere; astigmatism 0 to -4.25 D) treated with ray-trace LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap (Alcon) diagnostic device. The ray-trace based algorithm (InnovEyes algorithm, Alcon) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOA) were evaluated over 3 months.

RESULTS: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent (MRSE) was -3.39±1.58D (OD-3.84±1.63D, OS -3.98±1.75D). At Month 3, UDVA was ≥20/20 in all eyes, ≥20/16 in 89% (OD 90%, OS 89%), ≥20/12 in 51% (54% OD; 47% OS), and 20/10 in 8% (OD 8%; OS 9%) of eyes respectively. UCVA was within 1 line of preoperative CDVA in 98% of eyes (OD 98.5%; OS 98%) and 39% of eyes (OD 38%; OS 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOA (OD 0.06 ±0.133μm; OS 0.057±0.125μm; p<0.001). The spherical aberration decreased (OD-0.047±0.095μm, p<0.001; OS-0.051±0.091μm, p<0.001).

CONCLUSION: Ray-trace LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UCDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOA.

PMID:37595291 | DOI:10.1097/j.jcrs.0000000000001286

Am J Respir Crit Care Med. 2023 Aug 18. doi: 10.1164/rccm.202305-0873LE. Online ahead of print.

NO ABSTRACT

PMID:37595272 | DOI:10.1164/rccm.202305-0873LE

Phys Rev Lett. 2023 Aug 4;131(5):053801. doi: 10.1103/PhysRevLett.131.053801.

ABSTRACT

We investigate the turn-on process in a laser cavity where the round-trip time is several orders of magnitude greater than the active medium timescales. In this long delay limit, we show that the universal evolution of the photon statistics from thermal to Poissonian distribution involves the emergence of power dropouts. While the largest number of these dropouts vanish after a few round-trips, some of them persist and seed coherent structures similar to dark solitons or Nozaki-Bekki holes described by the complex Ginzburg-Landau equation. These coherent structures connect stationary laser emission domains having different optical frequencies. Moreover, they emit intensity bursts which travel at a different speed, and, depending on the cavity dispersion sign, they may collide with other coherent structures, thus leading to an overall turbulent dynamics. The dynamics is well-modeled by delay differential equations from which we compute the laser coherence time evolution at each round-trip and quantify the decoherence induced by the collisions between coherent structures.

PMID:37595237 | DOI:10.1103/PhysRevLett.131.053801

Clin Nurse Spec. 2023 Sep-Oct 01;37(5):237-243. doi: 10.1097/NUR.0000000000000766.

ABSTRACT

PURPOSE/AIMS: Evidence is required to inform effective interventions promoting publication among clinical nurses. This study examined the effect of a mentored writing program on clinical nurse perceptions of writerly self-efficacy and publication.

DESIGN: A mixed-methods, pretest-posttest study design with an education intervention was implemented. The Revised for Nursing Practice – Postsecondary Writerly Self-efficacy Scale (RNP-PSWSES) measured perception of writerly self-efficacy before and after intervention. Manuscripts submitted for publication were counted.

METHODS: The purposive, convenience sample included registered nurses with completed research, evidence-based practice, or quality improvement projects. Subjects participated in a 3-month structured mentored writing program and completed the RNP-PSWSES survey before and after program completion. A Wilcoxon signed rank test was performed to determine the significance of difference between the pretest and posttest, and the number of published manuscripts was reported.

RESULTS: The RNP-PSWSES items identified pretest-posttest Cronbach’s α (.728, .818). Posttest RNP-PSWSES scores were statistically significantly higher than pretest scores (z = -1.96, P = .050) with a large effect size of r = 0.69. Two manuscripts were accepted for publication, and 1 manuscript was withdrawn after the third request for revisions.

CONCLUSIONS: In this study, mentored writing workshops improve nurses’ perceptions of writing ability and increase publications. Generalization of findings is limited by small sample size. Clinical nurse specialists are critical to champion writing and publication.

PMID:37595198 | DOI:10.1097/NUR.0000000000000766

Holist Nurs Pract. 2023 Sep-Oct 01;37(5):E69-E74. doi: 10.1097/HNP.0000000000000599.

ABSTRACT

Psychological problems among nursing students are well documented. Unfortunately, only a minority of these populations seek help related to their psychological distress. Yoga exercises improve individuals’ psychological distress and cardiovascular outcomes. Therefore, we conducted this study to test the feasibility and preliminary efficacy of our health promotion theme-based yoga program to reduce the participants’ stress levels and anxiety symptoms and improve their blood pressure and heart rate. This study has a pre/posttest quasi-experimental design. A convenience sampling method was used to recruit the participants who were 18 years or older and could speak and read English. Individuals with any contraindication to participate in yoga or receiving any medications for their mental health or cardiovascular health were excluded from the study. The Perceived Stress Scale and the Depression Anxiety Stress Scale-21 were used to measure the participants’ stress levels and anxiety symptoms, respectively. Their blood pressure and heart rate were measured by using a standard blood pressure measuring machine. Participants received 50 minutes of weekly yoga sessions in groups and also performed individual yoga sessions 3 times a week for 8 weeks. Descriptive statistics were used to answer our research questions. Our recruitment rate of 47% (n = 19) was lower than our anticipated rate of 80%; however, we had a retention rate of 90%. There was a reduction in participants’ stress levels and anxiety symptoms from the preintervention phase to the postintervention phase. A larger study and a randomized controlled trial are warranted to draw conclusions.

PMID:37595123 | DOI:10.1097/HNP.0000000000000599

Holist Nurs Pract. 2023 Sep-Oct 01;37(5):260-267. doi: 10.1097/HNP.0000000000000602.

ABSTRACT

This study sought to determine complementary and alternative medicine (CAM) methods used by older adults during the COVID-19 pandemic. The sample for this descriptive study comprised 415 adults older than 65 years who completed an online questionnaire between August and October 2020. The study used descriptive statistical methods and a χ2 test for the statistical analysis of data. In the study, 55.4% of participants had used one or more CAM methods during the pandemic. The most frequently used methods were vitamin and mineral supplements (48.5%) and herbal products (37.2%). The study determined that 43.1% of participants did not inform their health care professionals of the method they had used. It is possible that the use of CAM methods by older adults during the pandemic and the decrease in the frequency of seeking care at health care institutions could complicate the management of health problems related to the use of CAMs.

PMID:37595118 | DOI:10.1097/HNP.0000000000000602

Otolaryngol Head Neck Surg. 2023 Aug 18. doi: 10.1002/ohn.503. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether nonopioid analgesic regimens, taken after discharge for thyroid and parathyroid surgery have noninferior pain outcomes in comparison to opioid analgesic regimens. Secondarily, we sought to determine if nonopioid analgesic regimens decrease the number of opioid medications taken after thyroid and parathyroid surgery, and to assess adverse events associated with opioid versus nonopioid regimens.

DATA SOURCES: PubMed, Embase, Cochrane.

REVIEW METHODS: A comprehensive search of the literature was performed according to the PRISMA guidelines, and identified 1299 nonduplicate articles for initial review of which 2 randomized controlled trials (RCTs) were identified as meeting all eligibility criteria. Meta-analysis was not conducted due to heterogeneity in the data and statistical analyses.

RESULTS: Both RCTs included in this systematic review found no significant differences in postoperative pain scores between individuals discharged with a nonopioid only analgesic regimen compared to analgesic regimen that included oral opioid medications. One study reported significantly increased number of postoperative calls related specifically to pain in the nonopioid arm compared to the opioid arm (15.6% vs. 3.2%, P = .045).

CONCLUSION: This systematic review of RCTs revealed a limited number of studies examining nonopioid versus opioid postoperative pain medications among adults who undergo thyroid and parathyroid surgery. Among the 2 RCTs on this topic, there is a shared finding that nonopioid analgesic regimens are noninferior to opioid analgesic regimens in managing postoperative pain after thyroid and parathyroid surgery, supporting the use of nonopioid pain regimens given the risk of opioid dependence associated with prescription opioid medications.

PMID:37595107 | DOI:10.1002/ohn.503

Gen Dent. 2023 Sep-Oct;71(5):58-63.

ABSTRACT

The aim of this study was to evaluate the relationships between the apices of posterior teeth and the maxillary sinus floor, comparing the results of assessments performed with panoramic radiography and cone beam computed tomography (CBCT). This retrospective cross-sectional study consisted of 96 participants with a total of 302 maxillary posterior teeth. On both panoramic radiographs and corresponding CBCT images, 735 roots were classified into 3 categories according to their topographic relationship with the maxillary sinus: class 1, clear, distinct distance between the root tips and the floor of the sinus; class 2, roots adjacent to the floor of the maxillary sinus; or class 3, roots protruding into the maxillary sinus cavity. Panoramic radiographic signs of root protrusion into the sinus (class 3) were categorized as projection, discontinuity, missing lamina dura, darkening, or kinking. The observed data were analyzed using statistical software, and the Cohen κ coefficient was calculated. The level of significance was set at P < 0.05. Multiple logistic regression was performed to identify the predictive radiographic signs of protrusion into the sinus. The overall correlations between panoramic radiography and CBCT classifications were 90.8%, 66.8%, and 47.1% for the class 1, class 2, and class 3 categories, respectively. The radiographic signs of projection and darkening were significant predictors of root protrusion (P < 0.05). Panoramic radiography is reliable for assessing root posi¬tions when there is a clear distance between the roots and the floor of the maxillary sinus. However, when the roots are in contact with or have protruded into the sinus on panoramic images, the results are not definitive, and CBCT should be performed.

PMID:37595085

Gen Dent. 2023 Sep-Oct;71(5):38-44.

ABSTRACT

Demand for direct esthetic restorations is high, but shade matching can be challenging. Some manufacturers claim that a single product is able to match all colors of the human dentition, eliminating shade matching challenges. This in vivo study, which followed the International Commission on Illumination’s (CIE) CIEDE2000 color difference standard (ΔE₀₀), aimed to quantify the shade matching and blending capabilities of a single-shade composite (Omnichroma PLT) used as a direct veneer. A color difference of ΔE₀₀ ≤ 1.8 was set as the acceptability threshold. Ten participants with an unrestored and noncarious maxillary left central incisor were enrolled in the study. Direct spectrophotometric measurements (CIE L*a*b*) were made on the tooth and then on composite cured on the tooth. Consistency in measurements and composite resin placement were attained through the use of a specially designed jig. A digital photograph was then taken with the composite in place, and colorimetric software was used to obtain the L*a*b* values at the most incisal and cervical edges of the restoration. These values were compared to those of the natural tooth structure immediately adjacent to the composite resin. The ΔE₀₀ scores were calculated to determine the composite’s ability to match the tooth shade beneath it (ΔE_m) and to blend with the incisal (ΔE_i) and cervical (ΔE_c) tooth shades. Mean scores for ΔE_m, ΔE_i, and ΔE_c were calculated, and an independent t test (α = 0.05) was used to compare means for ΔE_i and ΔE_c. The mean (SD) ΔE₀₀ values were 6.16 (2.38), 3.90 (2.47), and 6.84 (1.80) for ΔE_m, ΔE_i, and ΔE_c, respectively. A statistically significant difference (P = 0.008) was observed between ΔE_i and ΔE_c. As a direct veneer, the tested composite did not meet the acceptability threshold for any ΔE₀₀ measurement; however, it was better at matching the incisal third of the tooth than it was the other thirds. More in vivo studies are needed to verify and expand on these results.

PMID:37595082