Laser biomodification of the bone bed surface for placement of spiral dental implants: a study based on scanning electron microscopy

Introduction: Various rotary and mechanical instruments are used in conventional oral surgery for osteotomies. Despite the implementation of effective cooling systems, it is difficult to prevent thermal damage to the adjacent bone caused by heat generated during the procedure. A smear layer forms on the surface, which can impede the interaction of blood elements with the underlying tissue, resulting in a delayed healing process. Aim: This study explores the possibility of overcoming these drawbacks by combining conventional methods with a pulsed Er:YAG laser. By examining the osteotomy surfaces using scanning electron microscopy (SEM), we investigated the potential synergistic effects that could benefit conventional implantology. Materials and methods: Split osteotomies were performed on mandibles of freshly euthanized domestic pigs (Sus scrofa domestica). With osteotomy surface examination, the experimental comparison involved two groups: group A - standard technique, and group B - surface ablation using an Er:YAG laser by applying our own method. The samples from both groups were examined using scanning electron microscopy (SEM). Results: In group A samples, the bone surface was smooth, with an amorphous layer and microcracks all over it. The thickness of this layer ranged from 21.77 µm to 136.2 µm, completely obstructing the Volkmann’s and Haversian canals. In group B, the borders were smooth and well defined. The bone structure remained unchanged, with empty intratrabecular spaces, no signs of carbonization, and open canals reaching the surface. The smear layer measured between 3.054 µm and 47.26 µm, with complete absence observed in some places. Conclusions: The present study provides evidence that ablation of the osteotomy surface using an Er:YAG laser leads to biomodification by eliminating the smear layer without altering the parameters of the bone bed

Genetic newborn screening and digital technologies: A project protocol based on a dual approach to shorten the rare diseases diagnostic path in Europe.

Since 72% of rare diseases are genetic in origin and mostly paediatrics, genetic newborn screening represents a diagnostic "window of opportunity". Therefore, many gNBS initiatives started in different European countries. Screen4Care is a research project, which resulted of a joint effort between the European Union Commission and the European Federation of Pharmaceutical Industries and Associations. It focuses on genetic newborn screening and artificial intelligence-based tools which will be applied to a large European population of about 25.000 infants. The neonatal screening strategy will be based on targeted sequencing, while whole genome sequencing will be offered to all enrolled infants who may show early symptoms but have resulted negative at the targeted sequencing-based newborn screening. We will leverage artificial intelligence-based algorithms to identify patients using Electronic Health Records (EHR) and to build a repository "symptom checkers" for patients and healthcare providers. S4C will design an equitable, ethical, and sustainable framework for genetic newborn screening and new digital tools, corroborated by a large workout where legal, ethical, and social complexities will be addressed with the intent of making the framework highly and flexibly translatable into the diverse European health systems

Serum Levels of Vitamin D in Patients with Multiple Myeloma

Aim: То investigate the serum levels of vitamin D in newly diagnosed patients with multiple myeloma.Patients and methods: In this study we measured the serum levels of vitamin D in 37 patients (19 women, 18 men) at a median age of 68 years and a diagnosis of MM according to the International Myeloma Working Group (IMWG) criteria. The immunoassay tests used for the quantification of 25 (OH) – Vitamin D were original ELISA kits Immundiagnostic and the measurement was done before starting the treatment.Results: Serum levels below the optimum (<30 ng/ml) were recorded in all 37 patients. The median value of vitamin D was 4.3±6.5 mg/ml, the maximum value measured was 24.7 mg/ml, which is below the lower limit of the reference value for deficiency.Conclusions: In this study, we found extremely low serum vitamin D levels in most of the newly diagnosed MM patients

Stochastic modelling of scalar time series of varicella incidence for a period of 92 years (1928-2019)

Introduction: Varicella is an acute, highly contagious disease, characterised by generalised vesicular exanthema caused by the initial infection with varicella zoster virus (VZV) which usually affects children aged 2 to 8 years. Aim: To analyse the changes of varicella incidence in Bulgaria over the period of 1928–2019. Materials and methods: The time series analysis is based on the official data for varicella incidence (per 100,000) in Bulgaria for ninety-two years (1928–2019), obtained from three major sources. We utilized the method to construct a time series model of overall incidence (1928–2019) using time series modeller in SPSS v. 25. We followed all three steps of the standard ARIMA methodology to establish the model – identification, parameter estimation, and diagnostic checking. Results: Stochastic scalar time series modelling of the varicella incidence from 1928 to 2019 was performed. The stochastic ARIMA (0,1,1) was identified to be the most appropriate model. The decomposition of varicella incidence time series into a stochastic trend and a stationary component was reasoned based on the model defined. In addition, we assessed the importance of the long-term and immediate effect of one shock. The long-term forecast was also under discussion. Conclusions: The ARIMA model (0,1,1) in our study is an adequate tool for presenting the varicella incidence trend and is suitable to forecast near future disease dynamics with acceptable error tolerance

Cost Analysis for Patients with Ventilator-Associated Pneumonia in the Neonatal Intensive Care Unit

The concept of improving the quality and safety of healthcare is well known. However, a follow-up question is often asked about whether these improvements are cost-effective. The prevalence of nosocomial infections (NIs) in the neonatal intensive care unit (NICU) is approximately 30% in developing countries. Ventilator-associated pneumonia (VAP) is the second most common NI in the NICU. Reducing the incidence of NIs can offer patients better and safer treatment and at the same time can provide cost savings for hospitals and payers. The aim of the study is to assess the direct costs of VAP in the NICU. This is a prospective study, conducted between January 2017 and June 2018 in the NICU of University Hospital “St. George” Plovdiv, Bulgaria. During this period, 107 neonates were ventilated for more than 48 h and included in the study. The costs for the hospital stay are based on the records from the Accounting Database of the setting. The differences directly attributable to VAP are presented both as an absolute value and percentage, based on the difference between the values of the analyzed variables. There are no statistically significant differences between patients with and without VAP in terms of age, sex, APGAR score, time of admission after birth and survival. We confirmed differences between the median birth weight (U = 924, p = 0.045) and average gestational age (t = 2.14, p = 0.035) of the patients in the two study groups. The median length of stay (patient-days) for patients with VAP is 32 days, compared to 18 days for non-VAP patients (U = 1752, p p p = 0.024). Our analysis confirms the results of other studies that the increased length of hospital stays due to VAP results in an increase in hospital costs. VAP is particularly associated with prematurity, low birth weight and prolonged mechanical ventilation

The Survey of Health Care Managers’ Attitude towards the Implementation of Information and Communication System for the Registration of Medical Errors

The aim of the study has been to examine attitudeand motivation of managers of Health Care Establishments forthe implementation of information and communication systemfor the registration and reporting of medical errors.A sociological method: anonymous inquiry sent by e-mail or bypost has been used to register the initial information. More thanhalf of the health care managers (59.6% (62)) are willing toimplement an information system for the registration of medicalerrors in their respective health care establishment