Early hip fracture surgery and rehabilitation. How to improve functional quality outcomes. A retrospective study

INTRODUCTION

Hip fractures are one of the major disability causes associated with a high morbidity and mortality rate. Early surgery and stable fixation could be associated with better pain control, possibly lower mortality rates, and early recovery of autonomy.

FEM Analysis Applied to OT Bridge Abutment with Seeger Retention System

OBJECTIVE

 The purpose of this investigation is to highlight the technical components of a new kind of screw-retained dental implant prosthesis. The hypothesis is whether the OT Bridge (Rhein 83 S.R.L.; Bologna, Italy) system could be applied without secondary screw in the "all-on-four" retention system, thanks to the presence of an internal seeger.

MATERIALS AND METHODS

 By using engineering device such as finite element method (FEM) and von Mises investigation, it has been studied how the fixed prosthodontics for full-arch retention can be influenced by the presence of the screw for stabilizing it.

RESULTS

 In a dental implant, one model with four different configurations of the full-arch prosthesis retainer and the seeger has been investigated and then examined in contrast with or without the passant screw for locking the system. The experiments of this virtual study highlighted different features and mechanical behaviors of prosthodontic attachments.

CONCLUSION

 The first two configurations, respectively those in which there are four and three connection screws, are safe and predictable. Therefore, the presence of the seeger significantly improves the stability and the retention of the whole prosthesis.

FEM Analysis of Dental Implant-Abutment Interface Overdenture Components and Parametric Evaluation of Equator® and Locator® Prosthodontics Attachments

The objective of this investigation was to analyze the mechanical features of two different prosthetic retention devices. By applying engineering tools like the finite element method (FEM) and Von Mises analyses, we investigated how dental implant devices hold out against masticatory strength during chewing cycles. Two common dental implant overdenture retention systems were analyzed and then compared with a universal—common dental abutment. The Equator^® attachment system and the Locator^® arrangement were processed using the FEM Ansys^® Workbench. The elastic features of the materials used in the study were taken from recent literature. Results revealed different responses for both the devices, and both systems guaranteed a perfect fit over the axial load. However, the different design and shape involves the customized use of each device for a typical clinical condition of applying overdenture systems over dental implants. The data from this virtual model showed different features and mechanical behaviors of the overdenture prosthodontics attachments. A three-dimensional system involved the fixture, abutment, and passant screws of three different dental implants that were created and analyzed. Clinicians should find the best prosthetic balance to better distribute the stress over the component, and to guarantee the patients clinical long-term results.

Fem and Von Mises Analysis of OSSTEM ® Dental Implant Structural Components: Evaluation of Different Direction Dynamic Loads

Purpose:

The objective of this investigation is to study prosthodontics and internal components resistance to the masticatory stress and considering different force directions by using Finite Element Method analysis (FEM). The structural materials of the components are usually Titanium alloy grade 4 or 5 and thus, guarantee the integration of the fixture in the bone due to the osteointegration phenomena. Even if the long-term dental implant survival rate is easy to be obtained and confirmed by numerous researches, the related clinical success, due to the alteration of the mechanical and prosthodontics components is still controversial.

Methods:

By applying engineering systems of investigations like FEM and Von Mises analyses, it has been investigated how dental implant material was held against the masticatory strength during the dynamic masticatory cycles. A three-dimensional system involved fixture, abutment and the connection screws, which were created and analyzed. The elastic features of the materials used in the study were taken from recent literature data.

Results:

Data revealed a different response for both types of devices, although implant neck and dental abutment showed better results for all conditions of loading while the abutment screw represented aweak point of the system.

Conclusion:

The data of this virtual model showed all the features of different prosthetic retention systems under the masticatory load. Clinicians should find better prosthetic balance in order to better distribute the stress over the component and to guarantee patients’ clinical long-term results.

Prevalence and Correlates of Anemia and Uncontrolled Anemia in Chronic Hemodialysis Patients – The Campania Dialysis Registry

Background

This study investigated prevalence and correlates of anemia and uncontrolled anemia in chronic hemodialysis patients.

Methods

A cross-sectional analysis was performed on registry data for 2,746 chronic (<6 months) hemodialysis patients aged 25–84. Data collection included years of dialysis, hours of dialysis/wk, disease causing hemodialysis, body mass index (BMI), erythropoietin (EPO) treatment, hemoglobin, markers of viral hepatitis, serum albumin, calcium, and phosphorus.

Results

Prevalence was 88.7% for anemia (hemoglobin <11 g/100 mL and EPO treatment at any Hb level), 39.4% for uncontrolled anemia (hemoglobin<11 g/100 mL). Gender, years of dialysis, hereditary cystic kidney disease (HCKD), and low BMI (<24 kg/m2) were independent correlates of anemia (P<0.001). Gender, HCKD, low BMI, serum albumin and calcium were independent correlates of uncontrolled anemia (P<0.05). An interaction was found between age (not correlated with anemia and uncontrolled anemia) and the association of gender with uncontrolled anemia (P<0.05). EPO doses were higher in patients with high prevalence of uncontrolled anemia than in patients with low prevalence (i.e., women vs men, other diseases vs HCKD, low vs not-low BMI, P<0.01). Gender, years of dialysis, HCKD, BMI, serum albumin, and calcium were independent correlates of the hemoglobin/EPO dose ratio in patients on EPO treatment (P<0.05).

Conclusion

Anemia and uncontrolled anemia are more frequent in hemodialysis patients with short-term dialysis, diseases other than HCKD, low BMI, and female gender. Gender effect was lower in elderly patients. Uncontrolled anemia was also associated with low serum albumin and calcium, suggesting that these parameters are indices of EPO resistance.