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    Effects of additional collagen in biphasic calcium phosphates: a study in a rabbit calvaria.

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    OBJECTIVES Biphasic calcium phosphates (BCP) are synthetic biomaterials developed as an alternative to the autogenous bone grafts and xenografts. The aim of the present study was to assess the influence of the addition of collagen onto the BCP resorption rate and bone formation. MATERIAL AND METHODS Eighteen male NWZ rabbits approximately 12 weeks of age were used. Critical size defects were randomly treated with bilayered BCP materials comprising 12% HA and 88% α-TCP with and without collagen or sham-operated, respectively. All defects were covered with a resorbable collagen membrane. Animals were euthanized after 3 and 12 weeks of healing and investigated by micro-CT, histologic, and histomorphometric analysis. RESULTS Woven bone formation was observed from the original bone at 3-week healing in all samples. After 3 months, mainly lamellar new bone in the peripheral area was observed. In the central region, both woven and lamellar bone were seen. Samples containing collagen showed less residual biomaterial than without collagen at both healing periods. Both types of granules were in close contact with new bone, yielding a complete defect closure at 3 months of healing. However, new bone volume and area was similar for both biomaterials. CONCLUSIONS Within its limitations, the study results qualify collagen as a biocompatible carrier for BCPs. The presence of collagen indicated neither significant impact on the resorption of the BCPs nor on bone formation. CLINICAL RELEVANCE The addition of collagen to BCPs might not be beneficial for the augmentation of extended bone deficiencies

    Decreasing incidence of stroke, ischemic heart disease and dementia in Norway, 1990-2019, a Global Burden of Disease Study: An Opportunity.

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    BACKGROUND The declining incidence of stroke, ischemic heart disease (IHD) and dementia (the triple threat) in Norway encourages further investigation. We analysed the risks and trends of the three conditions using data from the Global Burden of Disease study (GBD). METHODS We used GBD 2019 estimations for age-, sex-, and risk factor-specific incidence and prevalence of "the triple threat" and their risk factor-attributed deaths and disability combined and their age-standardised rates per 100,000 population in 2019 and their changes during 1990-2019. Data are presented in means and 95% uncertainty intervals (UI). RESULTS In 2019, 71.1 thousand Norwegian were living with dementia, 157.2 thousand with IHD, and 95.2 thousand with strokes. In 2019, there were 9.9 thousand (8.5 to 11.3) new cases of dementia (35.0% increase since 1990), 17.0 thousand (14.6 to 19.6) with IHD (3.6% decrease), and 8.0 thousand (7.0 to 9.1) with strokes (12.9% decrease) in Norway. During 1990-2019, their age-standardised incidence rates decreased significantly; dementia by -5.4% (-8.4 to -3.2), IHD by -30.0% (-31.4 to -28.6), and stroke by -35.3% (-38.3 to -32.2), respectively. There were significant declines in the attributable risks to both ENVIRONMENTAL and behavioural factors in Norway, but contradictory trends for metabolic risk factors during 1990-2019. CONCLUSIONS The risk of "the triple threat" conditions is declining in Norway, despite the increased prevalence. This offers the opportunity to find out why and how and to accelerate their joint prevention through new approaches and the promotion of the National Brain Health Strategy

    Characteristics of surgically induced astigmatism after standardized microincisional cataract surgery with a superior limbal incision.

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    PURPOSE To determine 1) if measurements of surgically induced astigmatism (SIA) as measured by keratometry (K) and total keratometry (TK) differ 2) if SIA affects the magnitude and/or meridian of keratometric astigmatism 3) if SIA evolves over time. SETTING Tertiary care center. DESIGN Retrospective data analysis. METHODS A swept-source OCT (SS-OCT) biometry dataset (IOLMaster700) consisting of 498 eyes (327 patients) from a tertiary care center was analyzed. For all eyes preoperative and postoperative biometric measurements at 1-, 3-, and 6-months postoperative visits were considered for vector analysis of SIAK and SIATK. RESULTS Centroids in right and left eyes were 0.26 dpt @5°/ 0.31 dpt @1° for SIAK and 0.27 dpt @4°/ 0.34 dpt @1° for SIATK. Centroids for difference vectors (DV) K-TK in right and left eyes were 0.02 dpt @ 176°/ 0.03 dpt @6°. The mean SIA magnitudes in right and left eyes were 0.48±0.41 dpt and 0.50±0.37 dpt for SIAK and 0.53±0.42 dpt and 0.54±0.40 dpt for SIATK. In eyes with ATR astigmatism, an increase in postoperative astigmatism magnitude was more common than a decrease. More than 30% of eyes showed changes in the meridian of more than 15°. CONCLUSION Overall, we observed differences in K- and TK-derived SIA, and changes in SIA magnitude over time. For post-surgical interventions, postoperative astigmatism meridian values should be measured to base treatments. Astigmatism magnitude showed a tendency to decrease for steep-meridian incisions and to increase in flat-meridian incisions

    Treatment of infected hybrid arch prosthesis with self-assembled bovine elephant trunk grafts.

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    Graft infections are associated with severe morbidity and mortality. The widespread use of the frozen elephant technique (FET) increases the incidence of complex aortic patients to suffer from graft infections. Surgery of these patients is challenging. Removal of the stent graft portion of the FET prosthesis via sternotomy carries the risk of irreparable damage to the descending aorta. There is currently no single-stage surgical strategy that allows for removal of all infected material apart from a hemi-clamshell approach. This approach is technically demanding and associated with significant morbidity and mortality. This results in conservative treatment in a substantial number of patients. Pericardial tube grafts have shown to be an excellent option in treating graft infections in various aortic segments with promising results concerning freedom of re-infection and survival. We report a single-stage, trans-sternal approach to remove all infected material and simultaneous treat the descending aorta to prevent aortic catastrophe in two consecutive cases

    Imaging in retinal vascular disease: A review.

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    Retinal vascular diseases represent a broad field of ocular pathologies. Retinal imaging is an important tool for diagnosis, prognosis and follow up of retinal vascular diseases. It includes a wide variety of imaging techniques ranging from colour fundus photography and optical coherence tomography to dynamic diagnostic options such as fluorescein angiography, and optical coherence tomography angiography. The newest developments in respective imaging techniques include widefield imaging to assess the retinal periphery, which is of especial interest in retinal vascular diseases. Automatic image analysis and artificial intelligence may support the image analysis and may prove valuable for prognostic purposes. This review provides a broad overview of the imaging techniques that have been used in the past, today and maybe in the future to stage and monitor retinal vascular disease with focus on the main disease entities including diabetic retinopathy, retinal vein occlusion, and retinal artery occlusion

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