Topical timolol eyedrops are frequently used as medical treatment of glaucoma. They decrease the production of aqueous humor by blocking the beta adrenergic receptors of ciliary body. Although ...systemic absorption of eyedrops is negligible, still it can cause some serious side effects like bradycardia, heart block, bronchospasm, confusion and hypotension. We present a case who developed nightmares with use of topical beta-blockers. He was a chronic case of primary open angle glaucoma whose target intraocular pressure (IOP) couldn’t be achieved with latanoprost alone, the first line drug, so we put him on topical timolol twice daily dosage to further decrease the IOP. On his follow-up visit he complained about bad dreams since starting timolol eye drops. This case report will add to the list of already known other side effects of timolol usage in glaucoma patients.
Background
Parastomal hernia is a major clinical problem. In a randomized, clinical trial, a prosthetic mesh in a sublay position at the index operation reduced the rate of parastomal hernia at ...12-month follow-up, without any increase in the rate of complications. This study was designed to evaluate the rate of complications after 5 years.
Methods
Between January 2001 and April 2003, 54 patients who had a permanent ostomy were randomized to a conventional stoma or to a stoma with the addition of a mesh in a sublay position. A large-pore, lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.
Results
After 5 years, 21 patients with a conventional stoma were alive and parastomal herniation was recorded in 17 patients, of whom repair had been demanded in 5. In 15 patients operated on with the addition of a mesh herniation, that did not require repair, was present in 2 (
P
< 0.001). No fistulas or strictures developed. No mesh infection was noted and no mesh was removed during the study period.
Conclusions
At stoma formation, a prophylactic low-weight mesh in a sublay position is a safe procedure that reduces the rate of parastomal hernia.
Osteoporosis is defined as a systemic skeletal disease characterized by reduced bone mass and degeneration of bone tissue microarchitecture which leads to bone fragility and fracture risk. Annually, ...100 to 200 million people around the world are at risk for osteoporotic fractures. One way to prevent osteoporosis fracture is by using medications such as bisphosphonates. Alendronate is the most prescribed bisphosphonate in the world. The objective of this article is to evaluate the effect of alendronate on bone fracture healing.
15 adult male rats that were 60 days old were used, divided into three groups: A or Control, B (non-osteoporotic bones plus alendronate application) and C (osteoporotic bones plus alendronate application). Osteoporotic bones were compared with non-osteoporotic bones that underwent bone window creation and administration of alendronate sodium. These bones were submitted to radiographic and histological analysis.
All of Group A had complete bone healing, reaching the phase of bone remodeling. While in groups B and C, the rats were in the repair phase.
The drug alendronate interferes with delayed fracture healing and delayed bone remodeling. The article advises that studies in humans are needed in order to assess whether the alendronate interferes with bone healing.
COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population-based infection control measures known as “lockdowns”. Our study sought to compare ...disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza.
This is a retrospective population-based cohort study.
COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes from the Irish national hospitalisation dataset. The occurrences of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals (CIs), stratified by age.
Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs 8.3 days). The likelihood of all measures of disease severity was greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% CI 4.29–5.99, P < 0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups.
COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure that evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous “infodemic” that can undermine public health control measures.
•An improved time-varying mesh stiffness model for a helical gear pair considering axial mesh force component is proposed.•The axial tooth bending stiffness, axial tooth torsional shear stiffness and ...axial gear foundation stiffness models are proposed.•A rapid time-varying mesh stiffness calculation method is established, in which each stiffness components can be obtained by the integration along the gear width.
An improved time-varying mesh stiffness (TVMS) model of a helical gear pair is proposed, in which the total mesh stiffness contains not only the common transverse tooth bending stiffness, transverse tooth shear stiffness, transverse tooth radial compressive stiffness, transverse gear foundation stiffness and Hertzian contact stiffness, but also the axial tooth bending stiffness, axial tooth torsional stiffness and axial gear foundation stiffness proposed in this paper. In addition, a rapid TVMS calculation method is proposed. Considering each stiffness component, the TVMS can be calculated by the integration along the tooth width direction. Then, three cases are applied to validate the developed model. The results demonstrate that the proposed analytical method is accurate, effective and efficient for helical gear pairs and the axial mesh stiffness should be taken into consideration in the TVMS of a helical gear pair. Finally, influences of the helix angle on TVMS are studied. The results show that the improved TVMS model is effective for any helix angle and the traditional TVMS model is only effective under a small helix angle.
Background
Mixed cell populations from oral tissues may be superior to pure stem cells for regenerative approaches. Therefore, the aim of the present study was to explore the osteogenic potential of ...mixed cells derived from oral connective tissues compared to alveolar osteoblasts.
Materials and methods
Primary cells were isolated from the alveolar bone, periodontal ligament and gingiva. Following characterization by colony formation, growth capacity and flow cytometry, all cells were subjected to osteogenic differentiation induction and screened for a large panel of osteogenic markers using western blots, qPCR arrays, and matrix mineralization and alkaline phosphatase quantification.
Results
Non-induced mixed cells from gingiva showed higher colony formation efficiency but decreased proliferation compared to non-induced periodontal mixed cells, while both entities revealed similar surface markers tested in this setup. Following osteogenic induction, all cell populations individually expressed receptors with distinctively activated downstream effectors. Gene expression of induced periodontal mixed cells was similar to alveolar osteoblasts, but was differently modulated in gingival mixed cells. The latter failed to achieve osteogenic differentiation in terms of matrix mineralization and alkaline phosphatase activity, which was well observed in periodontal mixed cells and osteoblasts.
Conclusion
Mixed cells from periodontal ligament but not from gingiva feature an inherent osteogenic capacity in vitro. From these results, it can be concluded that periodontal cells do not require further stem cell enrichment in order to qualify for bone regeneration.
Clinical relevance
Our data contribute to the development of novel cell-based therapies using mixed cells from the periodontal ligament in regenerative periodontics.
Objective
Emerging evidence demonstrates the positive health benefits of light physical activity (LPA) for cancer survivors. Yet, little research has explored modifiable factors that facilitate or ...hinder LPA behavior in this population. Correlates of LPA among cancer survivors were examined, and stratified by moderate‐to‐vigorous physical activity (MVPA) status.
Methods
A cross‐sectional analysis using the American Cancer Society's Studies of Cancer Survivors‐I (N = 1751) was conducted. Correlates of interest were health‐care provider support for physical activity, perceived health competence, perceived social support, unsupportive partner behaviors, and perceived susceptibility to cancer recurrence. The primary outcome was self‐reported LPA categorized at 0, 1‐59, 60‐119, and 120+ minutes per week. Multivariable ordinal regressions using forced entry were conducted, stratified by MVPA status.
Results
Adjusted multivariable models revealed that, among those reporting no MVPA (n = 757), greater provider support for physical activity (adjusted odds ratio aOR = 1.51; 95% CI, 1.05‐2.17; P = 0.03), greater perceived health competence (aOR = 1.44; 95% CI, 1.10‐1.88; P = 0.01), and greater unsupportive partner behaviors (aOR = 1.06; 95% CI, 1.01‐1.12; P = 0.03) were significantly correlated with higher LPA. No social cognitive constructs were correlated with LPA among those already engaging in MVPA (n = 994).
Conclusions
LPA interventions targeting cancer survivors not engaging in any MVPA are warranted and may optimize limited intervention resources. Furthermore, interventions may be more efficacious by applying behavior change techniques that incorporate health‐care provider support and improves health competence and positive interpersonal skills.
Both biologic and permanent (synthetic) meshes are used for abdominal wall reconstruction. Biologic mesh has the advantage of eventual incorporation, which makes it generally preferred in ...contaminated patients compared with synthetic mesh (Ann Surg. 2013;257:991-996). However, synthetic mesh has been shown to have decreased long-term hernia recurrence despite increased complications (JAMA Surg. 2022;157:293-301). Ovitex (TelaBio, Ltd, Auckland, New Zealand) is a combined reinforced biologic mesh with a permanent Prolene suture weave that theoretically combines incorporation with a long-term strength component. We hypothesize that a reinforced biologic will have a similar complication profile but decreased long-term hernia recurrence.
A single-center retrospective review was performed from January 2013 to January 2022. Baseline patient characteristics and outcomes including 90-day complications and recurrence were compared. Categorical and continuous variables were analyzed with χ2 and Wilcoxon rank sum tests, respectively. Predictors of postoperative complications and hernia recurrence were analyzed via univariate logistic regression and multivariate logistic regression with backward stepwise selection with a threshold of P < 0.2.
Two hundred fifty-four patients underwent abdominal wall reconstruction biologic mesh (Strattice, Allergan; FlexHD, MTF Biologics; Alloderm, Allergan; Surgisis Gold, Cook Biotech; Ovitex, Telabio) with retrorectus (66.5%) or intraperitoneal (33.5%) mesh placement. Sixty-six of these used reinforced biologic mesh (Ovitex, TelaBio). Baseline characteristics were comparable including preoperative hernia size measured on CT. The mean follow-up time was 343 days. The majority of patients underwent component separation (80.3% bilateral, 11.4% unilateral, 8.3% none). On univariate analysis, reinforced biologic mesh did not impact 90-day complication rates (P = 0.391) or hernia recurrence rates (P = 0.349). On multivariate analysis, reinforced mesh had no impact on complication or recurrence rates (P > 0.2). A previous history of infected mesh was an independent risk factor for hernia recurrence (P = 0.019). Nonreinforced biologics were more likely to be used in instances of previous mesh infection (P = 0.025), bowel resection (P = 0.026), and concomitantly at the time of stoma takedown (P = 0.04). Reinforced biologics were more likely to be used with a history of previous hernia repair with recurrence not due to infection (P = 0.001). Body mass index >35 was an independent risk factor across both groups for 90-day complications (P = 0.028).
Reinforced versus nonreinforced biologics have similar risk profile and recurrence rate when placed primary fascial repair achieved. In abdominal walls with history of infection, or abdominal wall reconstruction performed concomitantly at the time of stoma takedown or bowel resection/anastomosis, nonreinforced biologics were used more commonly with no difference in negative outcomes. This implies that they may have a role for use in contaminated surgical cases. Reinforced biologics were more commonly used as a mesh choice in the setting of previous hernia repair with recurrence with no difference in outcomes. This implies that the reinforced nature may be useful in situations where extra reinforcement of already traumatized abdominal wall tissue is needed. Retrorectus or intraperitoneal placement of any biologic mesh is acceptable and should be chosen based off surgeon comfort and anticipated cost saving of individual mesh brands. There may be a role for reinforced mesh in the setting of previous failed hernia repair with weakened fascia, as well as nonreinforced in contaminated cases.
Current geometric optimization methods do not fully consider the overall structure of the model, which may make the effect of geometric optimization of the hex meshes for the models with concave ...curves unsatisfactory. To this end, this paper proposes an approach to structure-aware geometric optimization of hex meshes. In the approach, by relocating the position of the base complex of the hex mesh, the overall parameterized energy is reduced to obtain an optimized geometric embedding. First, a frame field which conforms to the base complex structure of the input hex mesh is generated. Then, a parameterization that satisfies the structure constraints is established based on the frame field. Finally, the positions of the singular lines of the hex mesh are optimized according to the gradient of the parameterization energy function, and the key isoparametric surfaces are used as the position constraints of the vertices of the patches of the base complex to optimize the whole hex mesh. The experimental results show that the scaled Jacobian value of hex meshes can be effectively improved by the proposed method.
•The parameterization energy is reduced to obtain an optimized geometric embedding.•The singular lines are relocated to achieve a less global volume distortion.•The patches are optimized on the extracted isoparametric surfaces.•A topologically compatible frame field is designed to support the parameterization.
The use of transvaginal mesh implants for POP and urinary incontinence is currently being extensively debated among experts as well as the general public. Regulations surrounding the use of these ...implants differ depending on the country. Although in the USA, the UK, in Canada, Australia, New Zealand, and France, transvaginal mesh implants have been removed from the market, in most mainland European countries, Asia, and South America, they are still available as a surgical option for POP correction. The aim of this review is to provide an overview of the historical timeline and the current situation worldwide, as well as to critically discuss the implications of the latest developments in urogynecological patient care and the training of doctors.
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