Patient Satisfaction Research Articles

Investigating patient satisfaction with a hand therapy telehealth service during COVID-19.

Throughout the COVID-19 pandemic, outpatient hand therapy services were restricted. The use of telehealth was adopted to continue to provide care to patients with hand injuries. This survey aims to investigate patient satisfaction with hand therapy delivered via telehealth in a NSW public tertiary referral metropolitan setting and explore whether this differs for specific hand injury/conditions and treatments offered. Patients using hand therapy services via telehealth between 28 June 2021 and 27 May 2022 responded to a bespoke electronic survey. Participants were grouped depending on their particular injury/condition and treatment received. Analysis was conducted using MS Excel, and correlations were determined by using Fisher's exact test. No consumers were involved in the study design or analysis. Sixty-eight of 262 patients responded to the survey (26% response rate). Overall results showed high patient satisfaction (n = 55, 81%) with hand therapy delivered via telehealth with most patients agreeing that telehealth should be offered going forward (n = 59, 87%). Benefits reported by patients included convenience, reduced travel time and parking issues, and time saving. Patients receiving therapy for 'finger thumb bony injury with K wires' demonstrated a statistically significant association of lower satisfaction with telehealth (n = 3, 43%, P = 0.02). Patients receiving wound care over telehealth were just as satisfied with their experience (n = 15, 82%) as overall results (n = 55, 81%). The survey suggests that patients are satisfied with their experience of telehealth for hand therapy. Patients with finger thumb bony injuries with k wires may be less suitable for telehealth. Wound care appears to be well received over telehealth in a hand therapy population. There is little evidence to guide hand therapists in which conditions or injuries patients find can be managed well with telehealth. Patients who answered a survey about their experience with telehealth for their hand therapy management overall reported satisfaction with the experience. Some patients had undergone surgery for broken fingers and thumbs using wires to hold the bone together while it healed. These patients were less likely to find telehealth satisfactory for their hand therapy care. Most patients requiring wound care over telehealth found this satisfactory.

Comparison of denture space and patient satisfaction for neutral zone versus standard-designed digital dentures restoring mandibular resorbed ridges: A crossover randomized clinical trial.

To compare neutral-zone-designed and standard-designed digital complete dentures used to restore severely resorbed ridges through differential digital analysis of teeth arrangement position, shape of the polished surface, and assessment of patient satisfaction. This study applied a within-subject comparison of two denture forms: computer-aided design and computer-aided manufacturing (CAD-CAM) dentures designed based on the bone-support concept (control group) and CAD-CAM dentures designed based on the neutral-zone concept (test group). Twelve completely edentulous patients exhibiting advanced ridge atrophy were recruited, and they were randomly assigned to use one of the two dentures before the other. A comparison between the two groups' virtual denture confines was conducted using "Medit compare" digital software. The average values of three-dimensional deviations between the two dentures at different regions were calculated. The "patient denture assessment" questionnaire was used to gauge participants' satisfaction with their dentures. The obtained scores were used to compare the two denture types. The position of the neutral zone was significantly shifted at the level of both denture teeth and denture base outer limits (p = 0.001). The greatest deviation was calculated at the region of the palatal polished surface followed by lingual flange contours, while the buccal flanges displayed the least deviations (p≤0.05). Statistically significant differences were observed between patients' satisfaction with neutral zone and standard dentures regarding function and comfort, retention, and stability of lower dentures (p≤0.05). CAD-CAM neutral-zone dentures have distinctly different anatomical confines that can be clinically correlated to their better impact on patient acceptance.

Telehealth-delivered physical activity interventions provided by maternal healthcare services influence postpartum women’s engagement in physical activity: a systematic review

The benefits of physical activity in the postpartum population are well documented, and regarded as being vitally important to the recovery process. Psychological health, musculoskeletal conditions, cardiorespiratory fitness and weight retention are among the postpartum health issues that physical activity can positively influence. Although international guidelines for physical activity postpartum have been published, there is a lack of current research into the effectiveness of, and patient compliance with, physical activity programmes in this population. Physiotherapists are well placed to deliver physical activity interventions for these women because of the multidisciplinary maternal healthcare services that are provided for them. The focus of this paper is to examine the available evidence regarding how the delivery and accessibility of physical activity programmes have changed with the exponential growth of telehealth. A detailed systematic literature search limited to randomized controlled trials published in English was performed for the period from 2014 to 2022. Four relevant publications were identified that utilized an element of telehealth physical activity in the postpartum population, although the timescale and definition of postpartum was not standardized across the papers. The findings of this literature review indicate that there is tentative support for the use of remote intervention as a means of improving physical activity in postpartum patients. The literature does not provide a consensus on the most appropriate length, type or duration of telehealth-delivered postpartum physical activity intervention for this population. There is a need for future high-quality research to investigate the effect of remote physical activity delivery on cost-effectiveness and patient satisfaction.

Platelet-rich plasma applications in the larynx: snake oil or stupendous?

To explore and summarize recent work examining the use of platelet-rich plasma (PRP) applications for vocal fold disorder. Intrachordal PRP injections have recently emerged as a treatment option for patients with damage to the lamina propria of the vocal fold (scar, atrophy, sulcus and inflammatory lesions). Studies support significant improvements in patient-reported and clinician-reported outcomes, and objective phonatory parameters. PRP demonstrates a good safety profile, absence of immune reactions, affordable cost model and improvement in mucosal wave features with resultant improved voice quality up to 12 months following treatment. PRP injection of the vocal folds is a novel repurposing of a previously validated technique, and emerging data shows consistent results across multiple centres, increasing confidence in use of this freely available material. Current published studies confirm improved voice outcomes compared with pretreatment measures and high patient satisfaction. Further research is required to properly assign the role of and ideal candidate for PRP applications, and to delineate durability of treatment.

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review.

Uptake of virtual care solutions in primary care settings has increased exponentially, and current evidence suggests high patient satisfaction but mixed clinician views. This paper aimed to identify factors influencing its' implementation to support delivery to the right patient, in the right clinical context, at the right time. Further, this paper evaluates how the updated Consolidated Framework for Implementation Research (CFIR) can be used to assess these factors that contribute to the uptake of virtual care innovations. This systematic scoping review identified empirical research on factors influencing the uptake of virtual care solutions in the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus, and Web of Science. The CFIR was used to code factors influencing the implementation of virtual care solutions. Inductive coding was used to generate new constructs where no appropriate CFIR construct could be identified. Fourteen eligible studies were identified as eligible for inclusion. Five common influencing factors were identified. Three are from the existing CFIR framework, and two are newly developed constructs. CFIR constructs included innovation relative advantage, capability, and IT infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference, and choice) but these were not prominently mentioned. Common factors influence virtual care uptake in Australian primary care. The CFIR assisted in conceptualizing these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further research is needed to understand whether they are applicable in multiple contexts. http://links.lww.com/IJEBH/A286.

Utilization of Rehabilitation Services and Rehabilitation-Related Patient Satisfaction Following Total Knee Arthroplasty—Results of the Prospective FInGK Study

(1) Background: This study aims to examine rehabilitation service utilization among total knee arthroplasty (TKA) subjects and the influencing factors associated with rehabilitation-related satisfaction. (2) Methods: The FInGK study was a single-center prospective cohort study. Patients (≥18 years) undergoing primary or revision TKA in a German university hospital were consecutively recruited between December 2019–May 2021. The subjects filled in a questionnaire one day before surgery (t0) and at two (t1) and 12 (t2) months postoperatively. Multivariable logistic regression was conducted to determine the variables associated with the subjects’ rehabilitation-related satisfaction. (3) Results: A total of 236 out of 241 (97.9%) subjects participated in t1 (59.3% female; mean age: 68.2 years). Overall, 94.7% underwent post-TKA rehabilitation measures, with inpatient rehabilitation being the predominant choice (85.4%). In total, 77.6% of those with rehabilitation were satisfied or very satisfied with their rehabilitation in general. Multivariable logistic regression showed that female sex (OR 3.42; CI 1.73–6.75) and satisfaction with the surgery in general after two months (OR 4.50; CI 1.96–10.33) were associated with the subjects’ rehabilitation-related satisfaction. (4) Conclusions: We found a high utilization of rehabilitation services following TKA and a high rehabilitation-related satisfaction. In international comparison, the utilization of inpatient rehabilitation services was very high. Future research should investigate the effective components for rehabilitation-related satisfaction in both in- and outpatient TKA rehabilitation.

Machine learning-based lean service quality improvement by reducing waiting time in the healthcare sector

PurposeThe study presented healthcare service quality, lean thinking and Six Sigma to enhance patient satisfaction. Moreover, the notion of machine learning is combined with lean service quality to bring about the fundamental benefits of predicting patient waiting time and non-value-added activities to enhance patient satisfaction.Design/methodology/approachThe study applied the define, measure, analyze, improve and control (DMAIC) method. In the define phase, patient expectation and perception were collected to measure service quality gaps, whereas in the measure phase, quality function deployment (QFD) was employed to measure the high-weighted score from the patient's voice. The root causes of the high weighted score were identified using a cause-and-effect diagram in the analysis phase.FindingsThe study employed a random forest, neural network and support vector machine to predict the healthcare patient waiting time to enhance patient satisfaction. Performance comparison metrics such as root-mean-square error (RMSE), mean absolute error (MAE) and R2 were accessed to identify the predictive model accuracy. From the three models, the prediction performance accuracy of the support vector machine model is better than that of the neural network and random forest models to predict the actual data.Practical implicationsLean service quality improvement using DMAIC, QFD and machine learning techniques can be generalized to predict patient waiting times. This study provides better realistic insights into patient expectations by announcing waiting times to enable data-driven service quality deliveries.Originality/valuePrior studies lack lean service quality, Six Sigma and waiting time prediction to reduce healthcare waste. This study proposes lean service quality improvement through lean Six Sigma (LSS), i.e. DMAIC and machine learning techniques, along with QFD and cause-and-effect diagram.

Ultrasound-guided cryoablation of early breast cancer: safety, technical efficacy, patients' satisfaction, and outcome prediction with MRI/CEM: a pilot case-control study.

This pilot prospective study aimed to evaluate ultrasound-guided cryoablation of breast cancer (BC) by assessing: (i) technical efficacy as the presence of necrosis in surgical specimens and rate of complete tumor ablation; (ii) safety as incidence and severity of complications; and (iii) patients' satisfaction using a dedicated questionnaire. In addition, (iv) we tested the capability of magnetic resonance imaging (MRI) or contrast-enhanced mammography (CEM) to predict cryoablation efficacy. From 07/2022 to 01/2023, we enrolled 20 patients with early-stage BC scheduled for breast surgery. Ten of them, with a cryo-feasible cancer location, were sent to cryoablation (cryo-group) and ten to routine surgical practice (control group). Both groups underwent surgery and were asked to answer a satisfaction questionnaire. Of eleven patients screened for cryoablation, only one refused to be treated at another hospital (acceptance rate 10/11, 91%). Surgery was quadrantectomy in 19 cases and mastectomy in 1. In the cryo-group, the procedure was completed and steatonecrosis was observed in 10/10 cases, with complete tumor ablation in nine of them. The post-procedural status was evaluated with MRI in five patients, with CEM in four patients, and with ultrasound in one patient who refused MRI and CEM. MRI or CEM correctly predicted complete cryoablation in eight patients and incomplete cryoablation in one patient. Patients in both groups did not have serious complications and responded positively to satisfaction questionnaires. Ultrasound-guided cryoablation of early-stage BC is well accepted by patients, effective, and safe. MRI and CEM were able to predict the procedure's technical efficacy. https://clinicaltrials.gov/study/NCT05727813 updated February 14, 2023. Our pilot study showed that ultrasound-guided cryoablation is a promising nonsurgical alternative for treating early-stage BC. Ultrasound-guided cryoablation was effective and safe in early BC patients. The procedure was well-tolerated, with low morbidity and high patient satisfaction. MRI and CEM predicted cryoablation efficacy, in accordance with histopathologic findings. Cryoablation can be considered a potential alternative to surgery in selected patients.

Physiotherapy management of acute perineal trauma: a patient satisfaction survey

Pelvic floor muscle (PFM) training is recommended in the immediate postpartum period because it can restore PFM function and prevent pelvic floor dysfunction. There are no national physiotherapy guidelines on how to deliver this intervention in the acute period. There is also no consensus on the need for outpatient follow-up to treat pelvic floor dysfunction that arises from perineal trauma, or as a preventative strategy in the long term. The aim of this study was to evaluate a current service provided for women with acute perineal trauma. The authors assessed patient satisfaction and compliance with physiotherapy advice, and identified preferences for future service development. One hundred and thirty patients completed satisfaction questionnaires after receiving inpatient physiotherapy treatment. Thirty consented to completing a retrospective telephone consultation about their care at 6–8 weeks postpartum. The questionnaire found high levels of satisfaction, and recorded a National Health Service Friends and Family Test score of 93. In the telephone consultation, 87% of the women reported that they were complying with ongoing PFM training. Eighty-five per cent of women who completed the questionnaire suggested that outpatient physiotherapy follow-up would be useful. Fifty per cent stated that options inclusive of outpatient follow-up would be useful for onward service development. Because of the high levels of satisfaction recorded and high compliance with the information provided in the acute postpartum period, it was concluded that the service should continue as it is. It is hoped that this service evaluation can be utilized as a benchmark for other acute and outpatient pelvic health physiotherapy services.

Evaluating the outcome of a physiotherapy intervention in the treatment of mastitis, blocked ducts and engorgement in the lactating breast

Physiotherapists are well placed within the multidisciplinary team to offer safe interventions for the management of the symptoms of mastitis, blocked ducts and engorgement (MBE). However, these are not widely utilized in the UK. The purpose of this service evaluation was to evaluate patient satisfaction with treatment and outcomes following a physiotherapy intervention. The World Health Organization recommends that all infants are breastfed exclusively for 6 months. Despite the known benefits, the UK has some of the lowest breastfeeding rates in the world. A primary cause of premature cessation is pain, which can result from MBE, with mastitis alone affecting up to 25% of lactating women. The target population was breastfeeding mothers who had utilized the clinic’s mastitis service for therapeutic treatment of MBE between January 2021 and January 2023. A service evaluation was conducted using telephone questionnaires. Verbal informed consent was obtained prior to data collection. The protocol, which was uniquely developed by the principal clinicians in this service evaluation, included therapeutic ultrasound, manual therapy, advice and education. Ninety-two per cent of participants found the treatment helpful, 76.5% reported an initial improvement in symptoms within 24 h of treatment, and 76% said that the protocol helped them to continue breastfeeding for longer. The participants reported that the protocol was effective for managing the symptoms of MBE, and that it supported an increase in breastfeeding duration.

Beyond Boundaries of a Trial: Post-Market Clinical Follow-Up of SOYA Patients

Background/Objectives: osteoarthritis (OA) is a leading cause of disability. With an aging population and rising obesity rates, OA presents a growing challenge to health systems worldwide. Current OA treatments involve a mix of pharmacological and nonpharmacological interventions. Viscosupplementation with hyaluronic acid (HA) has proven effective, especially in knee OA, leading to its recommendation in international guidelines. This study investigates the sustained benefits of a single intra-articular HA injection beyond one year in patients coming from the SOYA trial, considering the EU MDR 2017/745 emphasis on post-market follow-up. Methods: A prospective, observational, open, post-marketing study in a cohort of patients that participated in the SOYA trial. Follow-up was carried out by means of a telephone survey, and the data were anonymized and coded so that patients could not be identified. The study was approved by the Alcorcón Hospital Institutional Review Board (Alcorcón, Madrid, Spain). Results: In the follow-up of the SOYA trial, 81.5% of patients sustained positive effects for over 6 months after the trial ended. This correlated with improved daily functioning, enhanced mood, and high patient satisfaction. Younger age and milder OA grades were associated with prolonged treatment effects. Notably, 82% of patients with >6 months of improvement did not require additional medication. Conclusions: the results of this study support the safety and performance of Adant® Plus as a treatment for patients with mild and moderate knee OA, with results lasting more than one year. Post-marketing studies are particularly relevant to examine the experience gained with the use of the device in routine clinical practice.

A Preservative-Free Combination of Sodium Hyaluronate and Trehalose Improves Dry Eye Signs and Symptoms and Increases Patient Satisfaction in Real-Life Settings: The TEARS Study.

Dry eye disease (DED) is a frequently observed condition characterized by ocular discomfort and visual disturbance. It is highly prevalent and impairs patients' quality of life (QoL). This study assessed the benefit of a preservative-free bioprotectant eye drop formulation containing sodium hyaluronate and trehalose (SH-trehalose) with regards to DED, as well as patient satisfaction, through a large-scale real-life survey. In a multi-center, international, prospective observational study, subjects with DED received SH-trehalose for 84 days. Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire-5 items (DEQ-5), and patient satisfaction were assessed at baseline, day 28, and day 84, and clinical evaluations included ocular surface staining, Schirmer test, tear film break-up time (TBUT), and conjunctival hyperemia at baseline and day 84. A total of 312 patients were evaluated, of whom 82.4% were women. The mean age was 57.9±15.2 years. The mean OSDI score at baseline was 41.7 ± 20.6. After 84 days, the mean OSDI score was 27.3 ± 19.8 (p < 0.001). The percentage of patients with a severe OSDI score decreased from 60.3 to 34.5%. The DEQ-5 score significantly (p < 0.001) improved after 28 and 84 days, as did patient satisfaction. Ocular surface staining, Schirmer test, TBUT, and conjunctival hyperemia scores improved significantly (all p < 0.001) for both eyes with SH-trehalose between baseline and day 84. Tolerance of SH-trehalose was good. SH-trehalose significantly improved the clinical signs and symptoms of DED after 84 days. Moreover, it significantly increased patient satisfaction and was well tolerated. NCT04803240.

Comparative Efficacy of Classic Versus Horizontal Incision Techniques in Skin-Reducing Mastectomy: A Single Center Retrospective Analysis.

Background: The reconstruction of large breasts carries a heightened risk profile. While skin-reducing mastectomy (SRM) techniques facilitate the correction of breast ptosis, they are frequently associated with a high incidence of vascular complications. This study compares two SRM techniques-the horizontal incision and the classic inverted T incision-by examining their clinical and surgical outcomes. Methods: We retrospectively analyzed data from 24 patients (30 breasts) who underwent SRM with immediate prosthetic reconstruction between 2019 and 2023 at the European Institute of Oncology in Milan, Italy. Our comparison focused on breast aesthetic outcome, reconstruction quality, complication rates (early and late), and patient satisfaction, utilizing the BREAST-Q questionnaire to gauge the latter. Results: Among the 24 patients included in the study, 16 (20 breasts) were treated with the inverted T technique, and 8 (10 breasts) with the horizontal incision approach. A higher overall complication rate was observed with the inverted T technique compared to the horizontal method, with early complications outnumbering late ones. The most common issues were recurrent seroma and skin necrosis leading to implant exposure. Notably, there were no cases of implant infection. Although the horizontal incision technique achieved slightly higher patient satisfaction scores, the difference was not statistically significant. Discussion: The inverted T and horizontal incision techniques each have unique benefits and drawbacks. Our findings indicate enhanced patient satisfaction and reduced complication rates with the horizontal incision technique. The selection of the technique should be customized based on the patient's individual risk factors, tissue quality, and preferences.

Research on doctor-patient communication teaching for oncology residents: a new teaching model.

At present, there is no specific teaching method for doctor-patient communication for oncology residents. This study combined BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) teaching model and SBAR (situation-background-assessment-recommendation) communication model to try a new teaching and assessment model of doctor-patient communication, aiming to explore and improve the teaching method of doctor-patient communication for oncology residents. Ninety residents were randomly divided into two groups: the experimental group (n = 45) was trained with the BOPPPS teaching model combined with the SBAR communication model, the routine teaching method was adopted in the control group (n = 45). Indicators of assessment included doctor-patient communication skills, satisfaction with teaching, and patient satisfaction. The scores for doctor-patient communication ability were significantly better in experimental group than control group (p < 0.05). The degree of satisfaction degree (very satisfied + satisfied) of the experimental group were higher than control group (p < 0.05). The overall teaching satisfaction of the experimental group was 100.00%, the control group was 77.78%, p < 0.001. Patients' satisfaction with the residents in the experimental group (93.3%) was significantly higher than control group (80.0%), p = 0.043. The application of the BOPPPS combined with the SBAR can effectively enhance residents' doctor-patient communication ability and improve teaching satisfaction and patient satisfaction. This new model can effectively improve resident physician‒patient communication ability, which is worth actively promoting in clinical teaching work.

The effectiveness of custom hard-shell 3D-printed foot orthoses in a cohort of patients who did not respond to treatment with custom ethylene-vinyl-acetate (EVA) foot orthoses

BackgroundPatients who do not achieve positive outcomes with custom ethylene-vinyl-acetate (EVA) foot orthoses will often be escalated to other services for treatment, which may include surgery. ObjectiveThis study aimed to explore the effectiveness of custom hard-shell 3D-printed foot orthoses for patients who did not respond to treatment with custom EVA foot orthoses and were being considered for treatment escalation. DesignAn eight-week clinical evaluation and a two-year review of relevant medical records. MethodThirty-six consecutive patients with a range of musculoskeletal lower limb pathology who remained symptomatic after 12-weeks use of custom EVA foot orthoses were fitted with custom hard-shell 3D-printed foot orthoses. The Foot Health Status Questionnaire was used to assess patients at baseline and eight-week follow-up in conjunction with the Client Satisfaction with Device module of the Orthotics and Prosthetics User Survey. Patients were categorised as responders or non-responders based on their change in pain scores. A review of relevant medical records two years after receiving their orthoses determined if patients required further treatment for their initial condition. ResultsAcross the full cohort there were significant improvements in pain, function and foot health. At follow-up, responders reported significantly improved pain, function and foot health compared with non-responders. Twenty-six patients (12 responders, 14 non-responders) required no further treatment for their original condition after two years. ConclusionsCustom hard-shell 3D-printed foot orthoses have the potential to improve pain, function, foot health, and provide satisfaction in patients with lower limb musculoskeletal conditions which do not improve with custom EVA foot orthoses.

Medium- to Long-term Outcomes of Fasciotomy for Chronic Exertional Compartment Syndrome: A 6-Year Mean Follow-up Study.

Operative treatment of chronic exertional compartment syndrome (CECS) with fasciotomy is effective for symptomatic resolution, but outcomes at medium- to long-term follow-up are unclear. Patients will have favorable satisfaction at medium- to long-term follow-up and a high return to sport (RTS) rate after fasciotomy for treatment of CECS. Cross-sectional. Level 3. Retrospective review of patients who underwent fasciotomy for treatment of CECS from 2010 to 2021. Outcomes were assessed using Tegner Activity Scale, symptom resolution, patient satisfaction, return to activities, and EQ-5D-5L survey. Fifty patients (23 male and 27 female) were included. Mean age at time of surgery was 29.0 ± 11.6 years with mean follow-up 6.0 ± 2.3 years (range, 2.6-10.9). Tegner activity scores at final follow-up were improved compared with symptom onset (mean, 5.2 vs 3.3; P < 0.01). Increased preoperative symptom duration correlated with decreased RTS (β = -0.447; P = 0.01) and return to work (RTW) (β = -0.572; P = 0.01). Patients with a previous psychiatric diagnosis (n = 15) had lower rates of RTS (β = -0.358; P = 0.03) and RTW (β = -0.471, P = 0.02). Mean time to RTS was 5.5 ± 6.1 months. Mean visual analogue scale satisfaction rate was 74.4; 36 (72.0%) patients would be willing to have their fasciotomy again. Patients with fasciotomy of 1 to 2 compartments had higher Tegner score at final follow-up (P = 0.02) than those who had fasciotomy of >3 compartments; 19 (38.0%) patients reported experiencing paresthesia after their operation. No patients experienced major complications. Medium- to long-term outcomes of patients with CECS treated with fasciotomy demonstrated high satisfaction levels and high RTS rate. However, rate of minor complications including paresthesia, swelling, and cramping was high.

Efficacy and safety of the oral JAK3/TEC family kinase inhibitor ritlecitinib over 24 months: integrated analysis of the ALLEGRO phase 2b/3 and long-term phase 3 clinical studies in alopecia areata.

The ALLEGRO phase 2a and 2b/3 studies demonstrated that ritlecitinib is efficacious and well tolerated in adult and adolescent patients with alopecia areata (AA) up to 48 weeks. The efficacy of ritlecitinib through Month 24 and safety through data cutoff were assessed in the ALLEGRO phase 2b/3 study and the ongoing long-term, open-label, phase 3 ALLEGRO-LT study. Patients aged ≥12 years with AA and ≥50% scalp hair loss from ALLEGRO-2b/3 who rolled over to ALLEGRO-LT after up to 48 weeks were included. Proportions of patients with responses based on clinician-reported Severity of Alopecia Tool (SALT) score of ≤20 and ≤10, eyebrow assessment (EBA) and eyelash assessment (ELA), patient global impression of change (PGI-C) and patient satisfaction with hair growth are reported through Month 24 for patients who received ritlecitinib 50 mg daily with or without a 200-mg 4-week daily loading dose. Observed and imputed data (last observation carried forward [LOCF]) were reported until December 9, 2022. Safety was assessed throughout. At Month 12, SALT score ≤20 was achieved by 45.1% and 45.9% (observed) and 40.3% and 41.8% (LOCF) of the 191 and 194 patients who received ritlecitinib 50 mg and ritlecitinib 200/50 mg, respectively. At Month 24, proportions increased to 60.8% and 63.1% (observed) and 46.1% and 50.8% (LOCF), respectively. Patients with abnormal EBA or ELA scores at baseline achieved responses at Month 24 (EBA observed: 57.6% [50 mg], 61.0% [200/50 mg]; EBA LOCF: 46.8% [50 mg], 50.9% [200/50 mg]; ELA observed: 51.2% [50 mg], 62.7% [200/50 mg]; ELA LOCF: 43.2% [50 mg], 51.7% [200/50 mg]). PGI-C response was achieved by patients at Month 24 (observed: 70.0% [50 mg], 76.4% [200/50 mg]; LOCF: 56.6% [50 mg], 65.5% [200/50 mg]). Safety profiles for both treatment groups were consistent with the known safety profile of ritlecitinib. Ritlecitinib has clinically meaningful and sustained efficacy beyond 1 year with a favourable safety and tolerability profile, supporting its long-term use in patients aged ≥12 years with AA. ClinicalTrials.gov: NCT03732807, NCT04006457.

Does Injectable Platelet-Rich Fibrin Combined With Autogenous Demineralized Dentine Enhance Alveolar Ridge Preservation? A Randomized Controlled Trial.

The present trial evaluated the first-time application of autogenous demineralized dentin graft with injectable platelet-rich fibrin (ADDG + i-PRF) versus autogenous demineralized dentin graft (ADDG), in alveolar ridge preservation (ARP) in the maxillary aesthetic zone. Twenty-two maxillary (n = 22) non-molar teeth indicated for extraction were randomized into two groups (n = 11/group). Extracted teeth were prepared into ADDG, implanted into extraction sockets with or without i-PRF amalgamation and covered by collagen sponge. Cone-beam computed tomography scans at baseline and 6 months were compared to assess ridge-dimensional changes. Keratinized tissue width, patient satisfaction, pain score and chair time were recorded. In the course of dental implant placements at 6 months, bone core biopsies of engrafted sites were obtained and analysed histomorphometrically. Reduction in ridge width was 1.71 ± 1.08 and 1.8 ± 1.35 mm, while reduction in ridge height was 1.11 ± 0.76 and 1.8 ± 0.96 mm for ADDG + i-PRF and ADDG, respectively (p > 0.05). Significant differences in keratinized tissue width reduction were notable between ADDG + i-PRF and ADDG (0.12 ± 0.34 and 0.58 ± 0.34 mm respectively; p = 0.008). Postoperative pain scores were significantly lower in ADDG + i-PRF (p = 0.012). All patients in the two groups were satisfied with no differences in chair time (p > 0.05). No differences in total percentage area of newly formed bone, soft tissue or graft particles were observed between the groups (p > 0.05). ADDG alone or in combination with i-PRF yields similar results regarding ARP clinically, quality of the formed osseous tissues, as well as patients' satisfaction. Yet, the addition of i-PRF to ADDG tends to preserve the keratinized tissue and lessen postoperative pain.

A New Era of Tooth Preparation and Gingitage Retraction Technique: A Case Report

The demand for procedures intended to improve dental aesthetics has increased recently. Preserving the teeth and surrounding soft structures to the greatest extent possible is preferred in this situation by both patients and dentists. When using fixed prostheses, maintaining the stability and health of soft tissues is a constant struggle. Bone tissue health and soft tissue health are directly correlated. The long-term efficacy of prosthetic therapy thus depends on preserving tissue health and being free of mucositis. This case report describes the successful application of the gingitage technique in a patient requiring aesthetic enhancement of the gingival margins surrounding dental restorations. The patient presented with uneven gingival contours and mild inflammation around subgingival margins of existing restorations, compromising both function and aesthetics. Results demonstrated significant improvements in gingival health, a more balanced gingival margin, and an enhanced aesthetic outcome. Follow-up assessments revealed stable gingival contours and an overall increase in patient satisfaction. This case report underscores the effectiveness of the gingitage technique as a minimally invasive solution for enhancing soft tissue aesthetics and supporting the longevity of dental restorations.

HealthChain: A blockchain‐based framework for secure and interoperable electronic health records (EHRs)

AbstractCurrently, there is no unified Electronic Health Record (EHR) system connecting major healthcare organizations such as hospitals, medical centers, and specialists. Blockchain technology, with its unique features, provides an ideal platform for developing a large‐scale electronic health record system. In this article, the authors introduce HealthChain, a novel blockchain‐based secure EHR system that integrates advanced encryption techniques, a robust consent management system, cross‐platform interoperability, and enhanced scalability. Unlike existing EHR systems, HealthChain allows patients to have comprehensive control over their health data, ensuring that access is strictly regulated according to their preferences. The experimental results demonstrate several significant improvements over traditional EHR systems. HealthChain reduces data access times by 30%, and its interoperability rate with various healthcare systems is 40% higher than that of other blockchain‐based EHR solutions. Security is greatly enhanced, with HealthChain experiencing 50% fewer data breaches due to its advanced encryption and smart contract‐based access controls. Moreover, patient satisfaction has increased by 35% as a result of better control and access to their health records. These findings highlight HealthChain as not only a feasible and effective solution for managing health records but also a significant advancement over existing systems.