Adjunctive Use Research Articles

Abstract TP90: Feasibility of Robotic Exoskeleton Intervention in the Stroke Population During Acute Hospitalization

Introduction: Patients hospitalized with a stroke have limited mobility during the acute recovery phase. Those requiring significant assistance to mobilize often experience greater periods of immobility. Research in subacute rehabilitation demonstrates safe and feasible use of robotic exoskeletons for upright positioning and reciprocal motions similar to gait kinematics post stroke. This study explores the feasibility and frequency of adverse events with robotic exoskeleton during acute hospitalization post stroke. Methods: Retrospective design using the electronic health record to identify patients hospitalized with a stroke between 1/1/19 and 12/31/22. Patients that completed a single session of robotic exoskeleton in conjunction with traditional physical therapy met criteria. All participants met the manufacturer’s criteria for device use. Those who did not complete robotic intervention were excluded. Thirty-four patients were included and data obtained from physical therapy documentation of the initial session in the robotic device. Data collected included adverse events atypical of physiologic responses found with traditional physical therapy movement strategies including fracture, cardiac event, skin tear, dislocation and declining neurologic function. Further data collected includes stroke etiology, location, post stroke day intervention completed, steps taken and duration of upright weight bearing in the device. Results: Data revealed 0 patients had an adverse event with a total of 5 sessions terminated, all in patients with ischemic infarcts. Reasons for termination included orthostatic hypotension, pain in stance and fatigue. The mean step count was 106 with standard deviation (SD)of 102. The mean upright time was 19 minutes with SD of 8 minutes. Intervention was initiated on average at day 8 with SD of 7 days. Conclusion: Robotic exoskeleton is feasible during acute hospitalization with patients post stroke and yields no adverse events. Adjunct use of this device allows patients to participate in weight bearing, upright posture and neuromuscular facilitation for reciprocal motion allowing movement which otherwise may not be possible at this acute stage given the burden of mobility and level of neurologic impairment.

Comparative Study of Azithromycin Versus Doxycycline Effect on the Resistin Level in Periodontitis Patients With Type 2 Diabetes: A Randomized Controlled Clinical Trial.

The present study aimed to determine if azithromycin (AZM) and doxycycline therapy, as an adjunct to scaling and root planning (SRP), modulate host response and improve clinical outcomes in periodontitis patients with type 2 diabetes mellitus (T2DM). Forty-five periodontal sites in 15 periodontitis patients with T2DM received nonsurgical periodontal therapy (NSPT). In Group I, patients were placebo (not receiving any medication), Group II patients received systemic AZM therapy (AZM 250 mg/day for five days), and Group III patients received doxycycline (20 mg twice per day for three months. The resistin level was collected and measured by enzyme-linked immunosorbent assay (ELISA). Gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, one-month, and three-month intervals. All groups showed improvement in clinicalparameters and resistin levels throughout the study. The mean resistin level at three months was the highest in Group I and the lowest in Group III. Patients in Group II showed a larger decrease in mean PD than those in Group I and III. Group III had the highest gain in mean CAL, with an increase of 1.78 mm in attachment. Resistinmight be a useful indicator of current disease status. In addition, benefits from adjunctive systemic use of AZM and doxycycline have been administered with non-surgical periodontal therapy.

Exploring the efficacy of ChatGPT in improving L2 writers’ use of English conjunctive adjuncts

Exploring the efficacy of ChatGPT in improving L2 writers’ use of English conjunctive adjuncts

Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: a systematic review and meta-analysis

BackgroundPhotodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS.Materials and methodsPubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses.ResultsElven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes.ConclusionsPDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted.

Comparative analysis of horizontal alveolar ridge augmentation: Guided bone regeneration versus screw-tenting techniques - A systematic review

The aim of this study was to systematically review bone volume changes obtained via the use of the Guided Bone Regeneration Technique (GBR-T) versus the Screw-Tenting Technique (ST-T) in horizontally defective alveolar ridges. In addition to review and compare rates of complications pertaining to post-operative dehiscence with membrane exposure, graft exposure, graft loss or other unforeseen complications and rates of implant placement into grafted sites. PRISMA protocol was used for systematic reviewing, electronic and manual searches of primary and secondary objectives were performed using the National Library of Medicine (MEDLINE via PubMed), EMBASE (Ovid), and EBSCO Host up to and including the 1st May 2023. Three articles qualified under the stipulated inclusion and exclusion criteria. Regarding GBR-T, the mean horizontal ridge bone gain was 2.47±3.16 mm with a mean complication rate of 16.50%, a mean graft loss rate of 11.70% and a mean implant placement rate of 91.30%. Regarding ST-T, the mean horizontal ridge bone gain was 4.76.02±2.57 mm with a mean complication rate of 9.30%, a mean graft loss rate of 2.80% and a mean implant placement rate of 98.10%. Both techniques are predictable in achieving horizontal ridge bone gains with low complication/failure rates leading to high second stage implant placement rates. The adjunctive use of tenting screws appears to be effective, offering additional benefit to the mechanism of space maintenance. Current evidence is however limited and of moderate risk-of-bias with heterogeneity within and between studies. Different interventions were performed by various clinicians with varying surgical skillsets in differing clinical environments using different biomaterials so caution must be used when interpreting these findings.

Contemporary Prophylactic Antibiotic Practices and Adjunct Therapies in Autologous Fat Grafting Procedures: A Survey of The Aesthetic Society Members.

Autologous fat grafting (AFG) is a widely used surgical technique that involves extracting a patient's own adipose tissue and transferring it to different areas of the body. This practice is still evolving. Guidelines for antibiotic prophylaxis and use of adjuncts in plastic surgery are currently limited, with a notable absence of standardized guidelines for AFG. In this survey, we assess contemporary antibiotic practices and adjuncts in AFG procedures. A 52-question survey was emailed to 3106 active members of The Aesthetic Society. Two hundred and ninety-three responses were recorded, representing a 9% response rate. We analyzed 288 responses. The most common AFG procedures were facial (38%), gluteal (34%), and breast (27%) augmentation. Preoperative antibiotics were used by 84.0% overall, with rates of 74.3%, 88.0%, and 92.7% in face, breast, and gluteal AFG, respectively. Lipoaspirate-antibiotic mixing was reported by 19.8%, mainly during gluteal AFG (46.9%), and less so in face (2.8%) and breast (8%) AFG. Notably, 46.9% of surgeons administered prolonged prophylaxis for 72 h or more. Tranexamic acid was utilized by 39.9% of the surveyed surgeons. Platelet-rich plasma was used by 5.6%. Doppler ultrasound was incorporated by 16.7% in AFG, with 21.5% in gluteal AFG, 14% in the face, and 19% in breast procedures. In this survey, we offer insights into antibiotic practices and adjunct therapies in AFG, especially intraoperative antibiotic mixing. Practices among members of The Aesthetic Society vary from guidelines. It is crucial to standardize practices and conduct further research to pave the way for evidence-based guidelines in AFG.

Unlocking the Potential of Acetazolamide: A Literature Review of an Adjunctive Approach in Heart Failure Management.

Background: Heart failure (HF) patients often experience persistent fluid overload despite standard diuretic therapy. The adjunctive use of acetazolamide, a carbonic anhydrase inhibitor, in combination with loop diuretics has shown promise in improving decongestion and diuretic efficacy. This literature review aims to analyze six studies evaluating the effectiveness of acetazolamide as an additive treatment for acute decompensated heart failure (ADHF) and its impact on various outcomes. Methods: We searched the PubMed database using the terms "acetazolamide heart failure". We refined our search with specific filters (as shown our PRISMA flow diagram) and exclusion criteria, narrowing down our results to five studies. We included an extra study via expert recommendation, ultimately including six studies for comprehensive analysis. Results: The review highlights the positive effects of acetazolamide on decongestion, natriuresis, and diuresis in HF patients. However, it also showcases the limitations of these trials. Discussion: While the reviewed studies demonstrate the potential benefits of acetazolamide in enhancing decongestion and diuretic efficiency, there are limitations to consider, including small sample sizes, lack of blinding, and limited external validity. Further research is needed to confirm these findings, compare acetazolamide with other diuretic combinations, and explore its effects in a broader population of heart failure patients, including those in the United States. The use of acetazolamide in HF management warrants continued investigation to optimize its role in improving decongestion and patient outcomes.

Opportunistic Use of Computed Tomography to Determine Muscle-Adipose Ratio Reliably Predicts Wound Complications after Kocher-Langenbeck Surgical Exposure of the Acetabulum.

To determine whether muscle-to-adipose ratio (MAR) along the course of a Kocher-Langenbeck (KL) incision is more accurate at predicting post-operative wound complications following acetabuluar fixation than waist-hip ratio (WHR) or body mass index (BMI). Retrospective case series. Level-1 Trauma Center.Patients/Participants: Patients who sustained an acetabular fracture and had fixation through a KL approach. The calculation of the MAR. Presence of a surgical site infection or a wound healing complication. 193 patients were included in the study and mean follow-up was 17.4 months. Thirty (15.5%) patients developed a wound complication. Seventeen (8.8%) patients developed a superficial infection and thirteen (6.7%) developed a deep infection. Mean BMI for those who developed a wound complication was 35.9. The mean MAR was 0.67 for patients who developed a wound complication versus 0.75 for those who did not. ROC analysis showed an area under curve (AUC) for BMI to be .717 (95% CI, .577-.857, p = .006) and for MAR to be .680 (inverted, 95% CI .507-.854, p = .022). The AUC for WHR was not statistically significant. MAR is a significant predictor of post-operative wound complication in obese patients undergoing treatment of posterior wall acetabular fractures. The higher rate of wound complications in patients with a low MAR should be considered in the treatment of these patients and may be used to guide discussion regarding the risks of surgery, as well as the potential use of adjuncts to reduce wound healing complications. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Immediate Effect of Dry Cupping along side Breathing Exercises on Chest Wall Mobility in a Patient with COPD: A Case Report

Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent respiratory disorders, caused by the obstruction of the respiratory pathway. It is a progressive disease that worsens with time, but it is treatable. Physiotherapists are widely acknowledged to have a significant role in the care of patients suffering from respiratory disease. They employ a number of tactics targeted at reducing the labour of breathing, enhancing ventilation, promoting function, and providing dyspnoea alleviation. Chest physical therapy may include postural corrections to promote ventilation, secretory retention control, breathing and whole-body exercises to increase strength and function, and the use of adjuncts to improve lung function. Cupping therapy is one of the ancient healing methods. It is used on the skin by creating a negative pressure inside the cup through various devices. Many studies have shown that cupping therapy has promising preventive and therapeutic effects in a variety of pathological conditions, such as high fever due to upper respiratory tract infection, pulmonary dysfunctions in asthmatic children, type 2 diabetes mellitus, autoimmune diseases such as rheumatoid arthritis, hypertension, myocardial infarction, and cardiac arrhythmias, and chronic fatigue syndrome. Here, the authors reported a case of a 74-year-old male patient demonstrating the positive effect of cupping therapy, particularly dry dynamic cupping, along with physical exercise to improve chest expansion or thoracic expansion and improve well-being in a patient suffering from COPD.

Surgical Site Infections in Major Lower Limb Amputation: An International Multicentre Audit (SIMBA): Study Protocol

Background: Over 3,000 major lower limb amputations (MLLA) occur in the UK per annum. A significant proportion of patients following MLLA will go on to develop a surgical site infection (SSI). SSIs can range from a simple superficial infection that is treated with oral antibiotic therapy to deeper infections which can lead to wound dehiscence and, ultimately, surgical revision. SSIs can have a significant impact on patient mobility, function, morbidity and mortality as well as wider effects on carers, community services and hospital systems. Despite these potential impacts there are limited data to determine the rate of SSI in patients undergoing MLLA, adjuncts that successfully prevent SSI, factors that predispose patients to SSI and compliance with national guidance set out by key stakeholders in vascular surgical care. Methods: To address this gap in evidence we propose a large, international, prospective, collaborative audit that aims to compare current practice against recommendations set out by the National Institute of Health and Care Excellence and The Vascular Society of Great Britain and Ireland and to determine the frequency of significant outcomes related to SSI (as defined by the Centre for Disease Control) in consecutive patients undergoing MLLA over an 8-month period including the incidence of SSI, wound dehiscence and surgical revision at 30 days, frequency of use of adjuncts designed to reduce SSI and predictors of SSI. Outcomes will also be captured at 1 year post-MLLA if funding permits. Discussion: This multicentre audit will allow us to describe the incidence and burden of SSI and wound dehiscence in patients undergoing MLLA. The strengths of this audit will lie in its use of contemporaneous data collection from numerous hospitals and the in-depth data collection focusing primarily on MLLA SSI. It is anticipated that the audit will provide impactful data for future comparisons with global practice and support the design of robust and meaningful studies.

Evaluation of aloe vera gel as a local drug delivery agent in the treatment of chronic periodontitis: A clinical and microbiological study

Abstract Background: Local delivery of antibacterial agents into periodontal pockets provides a multitude of benefits over systemic antimicrobials resulting in the increased preference for such use among periodontal health-care providers. Aim: The study aims to determine the antimicrobial efficacy of adjunctive use of the herbal extract “aloe vera gel” (Aloe vera (L.) Burm. f.) along with scaling and root planing (SRP) in patients with chronic periodontitis. Materials and methods: This prospective, single-blind randomized split-mouth clinical trial was done among 22 subjects diagnosed with chronic periodontitis. Periodontal parameters and mean log counts of porphyromonas gingivalis (P. gingivalis) evaluated using real-time polymerase chain reaction were recorded. SRP was performed both at control and test sites. The evaluation of clinical and microbiological parameters was done at baseline and 3 months’ post-intervention. Data were analyzed using Statistical Package for Social Sciences (SPSS) V.20 software. Results: While significant improvement in both clinical and microbiological parameters from baseline to three months was observed in both the test and control sites, the mean reduction in plaque index, periodontal pocket depth, and mean log colony-forming unit counts of P. gingivalis were significantly higher in the test sites compared to the control sites. Conclusion: The results of this study reject the null hypothesis in favor of the alternative hypothesis that adjunctive application of locally delivered aloe vera gel for the treatment of chronic periodontitis enhances the beneficial effects of mechanical therapy.

Biomechanical analysis of Corvis tonometry parameters in patients with hypotony after glaucoma filtering surgery

Aims/Purpose: Postoperative hypotony is a common complication of glaucoma filtering surgery, particularly with adjunctive use of antimetabolites, such as mitomycin C and 5‐fluorouracil. Precautions may be taken intraoperatively and postoperatively to decrease the likelihood of hypotony. Sometimes, despite these measures, the low‐pressure syndrome still can occur, the management of which can be difficult. The cornea has a complex biomechanical structure that determines its response under stress conditions and there are so many studies related with glaucoma and corneal biomechanical properties. However, in the best of our knowledge, there are no reports concerning the corneal parameters in patients with hypotony. This study aimed to investigate the possible correlation of hypotony risk after a filtering surgery with different corneal parameters obtained by Corvis.Methods: A retrospective case control study of 30 eyes with chronic hypotony (IOP ≤6 mmHg for more than a month) after glaucoma filtering surgery at the Hospital Universitari Germans Trias i Pujol. In all patients, the IOP (represented in mmHg) and following parameters were obtained using the Corvis device: deformation amplitude ratio (DA), Ambrósio's relational thickness (ARTh), stiffness parameter at first applanation (SPA1), Integrated radius (IR), Stress strain index (SSI) and pachymetry (represented in μm).Results: The results will be represented as the value in eyes with hypotony after glaucoma filtering surgery (cases) vs the healthy eye (control). IOP 4.4 ± 1.8 vs 18.1 ± 7.7. Pachymetry 527 ± 53.4 vs 549.1 ± 94. SPA1 65.2 ± 19.1 vs 111 ± 17.1 in controls (p < 0.05). ARTh 495 ± 170 vs 523 ± 222. IR 10.9 ± 2.67 vs 8.4 ± 1.36 (p < 0.05). DA 5.6 ± 0.7 vs 5 ± 0.5 (p < 0.05). SSI 1.3 ± 1.4 vs 1.6 ± 1.4.Conclusions: SP‐A1 value decreased while the IOP decreased, suggesting that the lower corneal stiffness could increase the percentage of hypotony due to the different ocular biomechanical properties in these eyes, so therefore, it could be considered a risk marker for hypotonia in patients who are going to undergo glaucoma filtering surgery.

Adjunctive use of laser biostimulation with nonsurgical periodontal therapy: a split-mouth, randomized, case-control study in diabetic and nondiabetic periodontitis patients.

Laser biostimulation therapy (LBT) is suggested to have positive effects on periodontal healing. This study evaluated LBT with nonsurgical periodontal therapy (NSPT) in diabetes mellitus (DM) and systemic health (SH) conditions. Thirty periodontitis patients (15 with DM and 15 with SH) were included in the study, which had a split-mouth design, by applying LBT in the mouth of the same systemic condition. Thus, 4 study groups were formed, as 1) NSPT - DM: NSPT alone in DM, 2) NSPT + LBT - DM: NSPT + LBT application in DM, 3) NSPT - SH: NSPT alone in SH, and 4) NSPT + LBT - SH: NSPT + LBT application in SH. NSPT was performed on days 15, 30, 37, 44, 51, 58, and 65. LBT was performed 6 times on days 30, 37, 44, 51, 58, and 65 with an Nd:YAG laser. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed as the clinical parameters and recorded at baseline and days 30, 37, and 72. Gingival crevicular fluid levels of interleukin 1 beta (IL-1β) and IL-10 were evaluated by ELISA as the biochemical parameters at baseline and on days 30, 37, and 72. Clinical parameters had improved in all of the groups on day 72 (p < 0.01). PPD and CAL improved more in the DM group with NSPT and LBT group than in the DM group with NSPT without LBT on day 37 (p < 0.05). IL-1β decreased and IL-10 increased in all of the groups on day 72 (p < 0.01). This change was more evident in the DM group with NSPT and LBT than in the DM group with NSPT without LBT on day 7 (p < 0.05). These results revealed the short-term impacts of LBT on periodontal healing, which return to ineffectiveness with repeated irradiation. Therefore, it may be speculated that LBT via the protocol herein may have a short-term antiinflammatory contribution to NSPT, only in impaired healing conditions such as DM.

A Comparative Study on the Use of Modal Adjuncts Based on Learners’ Corpus

A Comparative Study on the Use of Modal Adjuncts Based on Learners’ Corpus

A narrative review of intraoperative adjuncts and techniques to minimize radiation during complex endovascular aneurysm repair

BackgroundRadiation exposure is a known risk to both patients and providers during endovascular aortic aneurysm repair (EVAR). Complex EVAR procedures, such as fenestrated and branched EVAR, inherently involve longer fluoroscopy times and increased radiation doses. While adhering to the as low as reasonably achievable principles and ensuring appropriate personal protective equipment for all operating room staff remains essential, the use of intraoperative techniques and adjuncts to decrease radiation specifically during complex EVAR is necessary. This review aims to summarize intraoperative radiation reduction techniques to provide valuable insights to vascular surgeons and interventional proceduralists to enhance radiation safety during complex EVAR. MethodsThis review focused on intraoperative techniques and adjuncts that have been used to decrease intraoperative radiation exposure to patients and operators. Published and presented preclinical results, prospective and retrospective study data, and future directions are presented. ResultsWe highlight several intraoperative adjuncts and techniques for reducing radiation exposure during complex EVAR including image fusion, digital zooming, intravascular ultrasound examination, Fiber Optic RealShape (FORS) technology, and robotic navigation systems. Short-term outcomes suggest that these techniques are safe, feasible, and effective and decrease radiation exposure to both patients and operators. ConclusionsDecreasing radiation exposure during complex EVAR remains of critical importance. The presented techniques offer promising avenues for significantly decreasing radiation exposure to both patients and providers while maintaining procedural efficacy during complex EVAR.

Prescribing patterns of adjunctive therapy for the treatment of type 1 diabetes mellitus among Australian endocrinologists.

Many people living with type 1 diabetes (type 1 diabetes mellitus (T1DM)) do not meet glycaemic targets. Adjunctive therapies have both risks and metabolic benefits and may have a role in selected patients. To review the prescribing patterns of adjunctive therapy for the treatment of T1DM diabetes in Australia. We conducted an online survey of Australian endocrinologists and endocrinology registrars. We surveyed the frequency of, motivations and concerns regarding the prescription of metformin, dipeptidyl peptidase-4 (DPP-IV) inhibitors, sodium-glucose transport protein 2 (SGLT-2) inhibitors and glucagon-like peptide 1 receptor agonist (GLP1RA) in T1DM. Fifty-two practitioners participated. Most respondents (94%) had prescribed adjuncts for the treatment of T1DM in some form. Weight (89%), large insulin doses (73%), glycaemic variability (52%), high HbA1c (48%) and the presence of cardiovascular disease (48%) were the most common factors determining the use of adjuncts. The most commonly prescribed adjuncts were metformin (94%) and SGLT-2 inhibitors (65%). Respondents who had never prescribed an SGLT-2 inhibitor (n = 18) reported risk of diabetic ketoacidosis (DKA) (100%), off-label status (39%), lack of evidence (39%), withdrawal of support from the European Medicines Agency (17%) and cost (17%) as factors contributing to their decision. Thirty-one respondents (60%) had prescribed a GLP1RA. Among those who had never prescribed a GLP1RA (n = 21), off-label status (57%), lack of evidence (48%), cost (38%) and expected lack of efficacy (14%) were factors affecting their decision. Only five respondents (10%) had prescribed a DPP-IV inhibitor. Australian endocrinologists commonly prescribe adjuncts to address cardiometabolic concerns in T1DM. DKA risk and off-label status are significant factors contributing to reluctance to prescribe.

Comparative, Controlled, Retrospective Study of Patient-Reported Outcomes After Meniscectomy With Adjunctive Use of Platelet-Rich Plasma or Amniotic Umbilical Cord Tissue.

Background: Meniscal tears are one of the most frequent injuries to the knee, with an estimated incidence of 222 per 100,000 individuals aged 18 to 55 years based on magnetic resonance imaging. Poor outcomes following meniscal surgical interventions are common and have led many surgeons to use biologic augmentation strategies to enhance the healing. Methods: We conducted a single-center, retrospective, observational study of patients who underwent arthroscopic meniscectomy with and without adjunctive platelet-rich plasma (PRP) or the particulate form of amniotic umbilical cord (AMUC) tissue. We evaluated patient-reported outcomes on the visual analog scale for pain, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm Knee Scoring Scale, 12-Item Short Form Survey, and Knee Injury and Osteoarthritis Outcome Score (KOOS) during a 1-year postoperative period. Complications and follow-up procedures were also evaluated. Results: We evaluated 113 patients who underwent meniscectomies from November 2010 to March 2017. Pain severity was significantly decreased only in the AMUC group at 6 months (P=0.0143). Patients in the AMUC group demonstrated significant improvement in functional recovery based on the IKDC and the KOOS subscales of pain, symptoms, activities of daily living, and sport and recreation function at 6 months. Patients in the PRP group had a significant benefit in the KOOS subscales of pain, symptoms, sport and recreation function, and knee-related quality of life at 3 months. Improvement in the control group was less substantial. Patients in the PRP group had more complications and follow-up procedures (30.0%) than patients in the AMUC group (8.3%). Conclusion: In our study population, arthroscopic meniscectomy with adjunctive use of AMUC tissue improved patient-reported outcomes and reduced the reoperation rate compared to conventional technique or adjunctive use of PRP.

Surgical outcomes of petalloid multilayered inverted internal limiting membrane flaps in extra-large macular holes.

To analyze the surgical outcomes of petalloid multilayered inverted internal limiting flap using perfluorocarbon liquid (PFCL) in extra-large macular holes (MHs) (minimum linear diameter >550 µm and basal diameter [BD] >1000 µm). This was a prospective interventional series of 103 eyes of 99 patients with extra-large MHs which were treated with 25-gauge pars plana vitrectomy, petalloid multilayered inverted internal limiting membrane flaps under PFCL and 15% perfluoropropane (C3F8) gas tamponade. Intraoperative optical coherence tomography (i-OCT) was used to confirm correct positioning of flaps. Follow-up was at 1 week, 1 month, and 3 months postoperatively. Mean age of patients was 58.282 ± 16.3 years. Mean preoperative best corrected visual acuity (BCVA) was logarithm of minimum angle of resolution (logMAR) 1.206 ± 0.384, and the value at the third month was logMAR 0.793 ± 0.337. Mean minimum linear diameter (MLD) was 711.96 ± 270.744 µm. MLD ranged from 557µm (minimum MLD) to 2657 µm (maximum MLD). Mean BD was 1301.165 ± 425.914 µm. Type 1 closure was seen in 92.2% eyes, 5.8% eyes had type 2 closure, and 1.9% eyes had type 3 closure. Eyes with both type 1 closure (P = 0.001) and type 2 closure (P = 0.009) showed a significant improvement in BCVA postoperatively at 3 months. Petalloid multilayered inverted internal limiting membrane flap under PFCL technique with adjunctive use of i-OCT showed improved morphological and functional outcomes in the treatment of extra-large MHs. We present here a large series of extra-large MHs, in which a novel technique of petalloid multilayered inverted ILM flaps was used.

Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial.

To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.

Diode laser targeting red-complex bacteria in periodontitis: a systematic review.

This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.