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Teriparatide Promotes Bone Healing in Medication-Related Osteonecrosis of the Jaw: A Placebo-Controlled, Randomized Trial.

Medication-related osteonecrosis of the jaw (MRONJ) is an infrequent but morbid and potentially serious condition associated with antiresorptive and antiangiogenic therapies. Although MRONJ can be prevented by optimizing oral health, management of established cases is supportive and remains challenging. Teriparatide, an osteoanabolic agent that improves bone healing in preclinical studies and in chronic periodontitis, represents a potential treatment option.

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Necrosis of the Nissen-Sleeve Gastrectomy (N-SG) Wrap.

Sleeve gastrectomy (SG) is the highest performed bariatric procedure in the world. Gastro-oesophageal reflux disease (GERD) is widely debated topics after SG. Nissen-Sleeve gastrectomy (N-SG) technique was reported in 2016 as an alternative solution to this problem. They reported concern about valve ischaemia but did not report any such complication in the beginning of their experience. We would like to share video showing this complication and technique to manage it.

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Patient-reported chronic pain after open inguinal hernia repair with lightweight or heavyweight mesh: a prospective, patient-reported outcomes study.

Chronic pain after groin hernia repair is a significant problem, and it is unclear whether or not lightweight meshes help. This national register-based study investigated whether patients who underwent open anterior mesh inguinal hernia repair with lightweight mesh had less chronic pain than those who had hernia repair with heavyweight mesh.

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Early neurological manifestations of hospitalized COVID-19 patients.

Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK).

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Perioperative changes in platelet count in patients with atrial septal defect.

Platelet count and function change following atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO). However, the clinical significance of these changes remains unclear. We examined changes in platelet count, mean platelet volume (MPV) before and after ASO placement and the association between platelet count, MPV and various factors. We discussed the mechanism and clinical significance of changes in platelet count and MPV.

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Is antibiotic prophylaxis necessary in mid-urethral sling surgery?

Antibiotic prophylaxis is commonly used when implanting a mid-urethral sling (MUS) for female stress urinary incontinence. Use of antibiotics may lead to adverse events and the development of antibiotic resistance. This study compared a variety of outcomes after MUS surgery with and without antibiotic prophylaxis using data from the national Norwegian Female Incontinence Registry.

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Recent research and development of local anesthetic-loaded microspheres.

Local anesthetic drugs are widely used in postoperative analgesia, local nerve block in surgery, and in the therapy of chronic pain. Due to their short half-time, a single administration of local anesthetics merely maintains the nerve block for several hours, which cannot meet the long-term analgesia effect needed in clinical treatment. In order to break through this limitation of local anesthetics, research work regarding controlled drug release from microspheres has attracted broad and current interest. This review introduces the recent research and development in local anesthetic-loaded microspheres for future clinical applications, where for an efficient microsphere formulation, the most critical aspects are an optimum preparation method, a high loading efficiency, and an ideal release rate. This review first summarizes the recent preparation methods of local anesthetic-loaded microspheres, which includes emulsion-solvent evaporation, spray-drying, microfluidic droplets, and premix membrane emulsification technology. Next, strategies for increasing the loading efficiency of the drug in microspheres are reviewed based on the solidification conditions, polymer properties, microsphere formulation, including the external water phase, pH, and polymer concentration. Finally, the effects of the preparation conditions, material characteristics, particle characteristics, and hydrogel/microsphere composite systems on the controlled release behavior are summarized.

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Complications and re-operations after tension-free vaginal tape operation in women with stress urinary incontinence.

We evaluate intraoperative and short-term postoperative (≤ 3 months) complications and long-term re-operations (up to 6 years) after tension-free vaginal tape (TVT) operation in women with stress urinary incontinence (SUI).

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Post-Caesarean section niche-related impaired fertility: hypothetical mechanisms.

Caesarean section can result in an indentation of the myometrium at the site of the Caesarean scar, called a niche. Niches can cause symptoms of abnormal uterine blood loss, dysmenorrhoea, chronic pelvic pain and dyspareunia and are possibly related to subfertility. Various other explanations for the cause of subfertility after Caesarean section have been proposed in the literature, such as uterine pathology, intra-abdominal adhesions and women's reproductive choices. Not all niches cause symptoms and the relation with subfertility and a niche in the uterine scar still needs further study since direct evidence is lacking so far. Based on the limited available evidence, and in combination with observations made during sonographic hysteroscopic evaluations and laparoscopic niche repair, we propose and discuss three hypothetical mechanisms: (i) the environment for sperm penetration and implantation may be detrimental; (ii) there could be a physical barrier to embryo transfer and implantation; and (iii) psychogenic factors may reduce the likelihood of pregnancy. Several innovative surgical treatments have been developed and are being implemented for niche-related problems. Promising results are reported, but more evidence is needed before further implementation in daily practice. The additional value of niche resections should be compared to expectant management or fertility therapies, such as ART, in randomized controlled trials. Therefore, our suggested hypotheses should, for the time being, not be used for justification of any specific procedures outside clinical trials.

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The effectiveness of an oral opioid rescue medication algorithm for postoperative pain management compared to PCIA : A cohort analysis.

Standard protocols or algorithms are considered essential to ensure adequate analgesia. Germany has widely adopted postoperative protocols for pain management including oral opioids for rescue medication, but the effectiveness of such protocols has only been evaluated longitudinally in a before and after setting. The aim of this cohort analysis was to compare the effectiveness of an oral opioid rescue medication algorithm for postoperative management of pain to the gold standard of patient-controlled intravenous analgesia (PCIA).

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