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Locally applied bisphosphonates may improve the fixation of metal implants in bone. However, systemic bisphosphonate treatment is associated with a risk of osteonecrosis of the jaw (ONJ). We hypothesized that local delivery of bisphosphonate from the implant surface improves the fixation of dental implants without complications in a setting where systemic treatment induces ONJ. Forty rats were randomly allocated to 4 groups of 10. All groups received a titanium implant inserted in an extraction socket. Group I received the implants only. Group II received dexamethasone (0.5 mg/kg). Group III received dexamethasone as above plus alendronate (200 µg/kg). Group IV received zoledronate-coated implants and dexamethasone as above. The animals were sacrificed 2 weeks after tooth extraction. All 10 animals with systemic alendronate treatment developed large ONJ-like changes, while all with local treatment were completely healed. Implant removal torque was higher for the bisphosphonate-coated implants compared with the other groups (p < 0.03 for each comparison). Micro-computed tomography of the maxilla showed more bone loss in the systemic alendronate group compared with groups receiving local treatment (p = 0.001). Local bisphosphonate treatment appears to improve implant fixation in a setting where systemic treatment caused ONJ. [ABSTRACT FROM PUBLISHER]

Objective: It is known that a number of different drugs influence respiration. We hypothesised that certain drugs affect central or obstructive sleep apnoea in patients who have experienced a stroke. The aim of this study was to analyse the possible influence of drugs in this group of patients. Design and Setting: Cross-sectional study in a stroke rehabilitation unit. Study Participants: 132 patients (78 women and 54 men) consecutively admitted to a stroke rehabilitation unit, with a mean age of 77 ± 8 years. Main Outcome Measures: All patients underwent a brain computer tomography scan in the acute phase after the stroke. Overnight respiratory sleep recordings were performed on all patients 23 ± 7 days after experiencing a stroke. Medications were analysed at the time of the overnight respiratory sleep recordings. The number of central and obstructive apnoea-hypopnoea indices per hour of sleep was measured. Results: Both short- and long-acting calcium antagonists demonstrated a strong association with central apnoeas [short-acting B-value = 15.21, 95% confidence interval (CI) 5.6 to 24.8, p < 0.002; long-acting B-value = 10.05, 95% CI 3.7 to 16.4, p < 0.002]. This association was independent of hypertension, angina pectoris and cardiac arrhythmias. Oral estriol (estrogen) was negatively associated with central sleep apnoeas (B-value = -9.19, 95 % CI -15.4 to -3.0, p < 0.004). Antiepileptic drugs had the strongest association with obstructive apnoeas (B-value = 10.37, 95% CI 2.0 to 18.7, p < 0.016). Conclusions: Both short- and long-acting calcium antagonists were associated with central apnoeas-hypopnoeas, and antiepileptic drugs with obstructive apnoeas-hypopnoeas in stroke patients. However, the clinical significance of these findings is unclear and future studies are needed to elucidate a possible cause and effect. [ABSTRACT FROM AUTHOR]

The paper describes a new hot-wire method for simultaneous determination of thermal conductivity and heat capacity per unit volume of electrically insulating liquids and solids under pressure. The method uses dc heating of the hot wire, whereas the temperature increase is recorded by an ac bridge circuit. The temperature data obtained are analyzed using the exact solution instead of the commonly used long time approximation. The procedure was tested on a number of alcohols and water and the accuracy was found to be 1.5%. New data on glycerol up to 1.5 GPa are presented. The appearance of an automagnetoresistance effect when Ni is employed as hot-wire probe is discussed. [ABSTRACT FROM AUTHOR]

A prevalence study of psychiatric symptoms was performed in parts of a hospital catchment area in Mid-Sweden. In total 717 patients, aged 75 years and above, who were receiving care in an emergency hospital, three nursing homes, five old people's homes and two home medical care districts were included. All patients were examined using the OBS-scale (Organic Brain Syndrome Scale). Anxiety (51%), psychomotor slowing (45%), delirium (44%), depressed mood (41%), irritability (40%) and dementia (33%) were the most prevalent psychiatric symptoms or diagnoses in the sample but there were wide differences between the four care settings. The present study shows that the prevalence of dementia, delirium and psychiatric symptoms is high in all types of care settings for the elderly. It also demonstrates the need for psychiatric medical and nursing competence in all types of care for the elderly. [ABSTRACT FROM AUTHOR]

Radiostereometric Analysis (RSA) is the most accurate method for determining early micromotions of orthopedic implants. Computed Tomography Radiostereometric Analysis (CT-RSA) is a method that can be used to determine implant and bone micromovements using low-dose CT scans. This study aimed to evaluate the reliability of the CT-RSA method in measuring the interfragmental mobility in patients who have undergone a correction osteotomy due to a malunited distal radius fracture. Twenty-four patients were included and operated with a radiolucent volar plate. Markers were embedded in the plate and bone. RSA and CT examinations were obtained postoperatively up to 1-year postoperative. Micromovements of the distal radius segment relative to the proximal were compared between the methods with paired analysis and Bland-Altman plots. The limits of clinical significance were: dorsal/volar tilt < 10°, radial shortening < 5 mm, radial inclination ≥ 15°, and radial shift < 5 mm. For the dorsal/volar tilt, the paired analysis between the two methods, showed a mean difference (95% CI) of -0.06° (-0.67 to 0.55), for radial compression-0.04 mm (-0.09 to 0.01), for radial inclination 0.21° (-0.06 to 0.48), and for radial shift -0.07 mm (-0.21 to 0.07). The paired analysis for micromotions showed that the thresholds of clinical significance are excluded from the difference's 95% CI. The Bland-Altman plots showed comparable results up to 1 year, considering clinically relevant thresholds. In conclusion, the CT-RSA method is comparable to that of marker-based RSA in measuring micromotions after wrist osteotomy, as the differences between the methods are not clinically significant., (© 2024 The Author(s). Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)

Background: Hypertension in patients with haemodialysis is mainly characterised by high pre-dialysis blood pressure (BP) due to body fluid retention before dialysis, and the BP tends to decrease after dialysis due to removal of water during dialysis. Intervals between haemodialysis treatments vary and a long inter-dialytic interval dialysis is associated with increased mortality., Objective: To examine variations in BP; how ambulatory BP vary during a dialysis treatment performed after the long inter-dialytic interval, that is, the first treatment of the week, compared to dialysis after a short inter-dialytic interval, and in the interval between the two dialysis sessions., Design: Exploratory non-interventional observational., Participants: Eleven patients with chronic kidney disease Stage 5 treated with haemodialysis were enroled. The mean age was 69 years (range 48-87) and mean dialysis duration 65 months (range 4-128)., Measurements: Ambulatory BP was recorded for 52 h including two haemodialysis treatments and one inter-dialytic interval. For statistical analyses the Wilcoxon signed ranks test was used., Results: Significant differences in systolic and diastolic BPs were observed between dialyses after long inter-dialytic interval and short inter-dialytic interval, respectively (systolic 122 mmHg vs. 114 mmHg, p = 0.012 and diastolic 62 mmHg vs. 61 mmHg, p = 0.036). In addition, the BP declined during the first 90 min during dialysis in both settings., Conclusions: Measuring ambulatory BP for 52 h in patient with chronic kidney disease and haemodialysis is feasible and show that both systolic and diastolic BP differ between dialysis treatments following inter-dialytic intervals of diverse length. These findings should be replicated in larger studies., (© 2025 The Author(s). Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.)

Opening remarks: These guidelines are the result of discussions within a diverse group of RSA researchers. They were approved in December 2023 by the board and selected members of the International Radiostereometry Society to update the guidelines by Valstar et al. [1]. By adhering to these guidelines, RSA studies will become more transparent and consistent in execution, presentation, reporting, and interpretation. Both authors and reviewers of scientific papers using RSA may use these guidelines, summarized in the Checklist, as a reference. Deviations from these guidelines should have the underlying rationale stated.

Objective: To investigate the cost-effectiveness of using Implant Movement Analysis (IMA) to follow up suspected aseptic loosening when the diagnosis after an initial X-ray is not conclusive, compared with a diagnostic pathway with X-ray follow-up., Methods: A health-economic model in the form of a decision tree was developed using quality-adjusted life years (QALY) from the literature, cost-per-patient data from a university hospital and the probabilities of different events from expert physicians' opinions. The base case incremental cost-effectiveness ratio (ICER) was compared with established willingness-to-pay thresholds and sensitivity analyses were performed to account for assumptions and uncertainty., Results: The base case ICER indicated that the IMA pathway was cost effective (SEK 99,681, compared with the SEK 500,000 threshold). In the sensitivity analysis, the IMA pathway remained cost effective during most changes in parameters. ICERs above the threshold value occurred in cases where a larger or smaller proportion of people receive immediate surgery., Conclusion: A diagnostic pathway using IMA after an inconclusive X-ray for suspected aseptic loosening was cost effective compared with a pathway with X-ray follow-up., (© 2023. The Author(s).)

The goal of a medico-legal autopsy is primarily to determine the cause and manner of death. To this end, the pathologist often uses auxiliary analyses, including histology. However, the utility of routine histology in all medico-legal autopsies is unknown. Earlier studies on the utility of routine histology have shown inconsistent effects, with some studies recommending it and others rejecting it. To study the degree to which histology informs on the underlying cause of death, we sent autopsy reports from suspension-, immersion-, fire-, and traffic-related deaths to senior board-certified forensic pathologists and had them assess the cause of death, first without knowledge of the histological findings and then with knowledge thereof. Fifty cases were identified in each of four subgroups: fire-, immersion-, suspension-, and traffic-related deaths. The autopsy reports were anonymized, and the histological findings and conclusions were removed. Two board-certified forensic pathologists independently reviewed the reports in each subgroup and assessed the manner and underlying cause of death (including their certainty of this assessment on a five-level scale) with and without access to histological findings. The probability of changing the underlying cause of death posthistology was low in all study groups. There was a slight increase in the degree of certainty posthistology in cases where the underlying cause of death was not changed, but only when the antehistology certainty was low. Our results suggest that histology does not meaningfully inform on the underlying cause of death in suspension-, immersion-, fire-, and traffic-related deaths except when antehistology certainty is low., (© 2023 The Authors. Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences.)