Laser treatment and disease characteristics of peri-implantitis

Peri-implantitis is an inflammatory disease which affects the soft and hard tissues surrounding dental implants. Current theory is that peri-implantitis is a counterpart to periodontitis, which is the inflammatory disease that destroys the tooth’s supporting tissues. However, there are some key discrepancies and there is a need for more studies on the characteristics of peri-implantitis. If the disease is not stopped, there is a risk that the dental implant is lost. It has proven difficult to treat peri-implantitis with conventional nonsurgical or surgical treatments. This is also an area of peri-implantitis that needs further research. The overall aim was to evaluate laser treatment of peri-implantitis, as well as explore the patients’ experiences and disease characteristics. In study I, we tested the safety of using diode lasers on dental implants by evaluating two different wavelengths 445 nm and 970nm. The temperature increase in dental implants were tested in two different models, one being a PM. Rigorous amounts of cooling water and limiting the continuous irradiation time to a maximum of 15-20s seemed to be key factors, depending on the power setting. We also assessed potential surface alterations on titanium discs in SEM but did not see any. In study II, the patient’s experiences and sensations were explored qualitatively in semi-structured interviews. We confirmed previous findings of positive associations of dental implants and added some perspectives to them with some negative experiences. In this group of patients, already diagnosed with peri-implantitis, some reported feeling symptoms, which could mean that with education on early signs of inflammation, the patient can also monitor their peri-implant health. The experiences of laser treatment and mucosal flap surgery were that of slight discomfort and for both the localized anesthesia was described as the worst part. Those that received surgery mentioned the sutures as a main source of discomfort. This we confirmed quantitatively in study III, where the surgery patients rated their discomfort significantly higher during the first week of healing than those in the laser group. In study III, we could not establish equivalence in change of PPD and RBL between the laser treatment and mucosal flap surgery. Both treatments had similar numbers of unresponsive peri-implantitis lesions, but in the patients that improved in their PPD, the surgery had significantly higher pocket reduction. There was basically no difference in change of RBL, BOP, biomarkers, and bacteria between the treatments. In study IV, we found that the inflammatory profile and immune cell composition were similar between peri-implantitis and periodontitis. In homogenized soft tissue, peri-implantitis lesions had significantly higher levels of IL-1β, TNF-α, IL-4 IL-17A, IL-23, G-CSF, and BAFF, whereas periodontitis only had significantly higher levels of IL-1β, IL-4, and G-CSF, compared to non-disease controls. Although, peri-implantitis and periodontitis did not significantly differ, there was a tendency towards a stepwise increase in proportion of B cells, from lowest in controls to highest in peri-implantitis. The results in this thesis show the potential for 970 nm diode laser in treating peri-implantitis. With unique clinical data a suggested role for the treatment modality could be initial stages of peri-implantitis where extensive pocket elimination is not as needed. The findings also support the need for further studies in assessing the patients self-monitoring of peri-implant conditions as well as the potential difference in B cell proportion and activity between peri-implantitis and periodontitis

Using 445 nm and 970 nm Lasers on Dental Implants—An In Vitro Study on Change in Temperature and Surface Alterations

The aim of this study was to evaluate the safety of using a 445 nm laser on dental implants by comparing it with a laser with 970 nm wavelength. Two models, a pig mandible and glass ionomer cement, were used to evaluate the temperature increase in dental implants during laser irradiation with both wavelengths. Temperature was measured every second at four different places on the dental implants. Different power settings, effects of water cooling, distance of the laser fibre to the dental implant and continuous comparison to a pulsed laser beam were tested. Surface alterations on titanium discs after laser irradiation for 4 min at 2.0 W, were analysed in a scanning electron microscope (SEM). The maximum temperature and time to reach each of the thresholds were comparable between the 445 nm and 970 nm lasers. Neither the 445 nm nor the 970 nm wavelength showed any signs of surface alterations on the titanium discs. Using a 445 nm laser on dental implants is as safe as using a 970 nm laser, in terms of temperature increase and surface alterations. Applying a generous amount of cooling water and irradiating in short intervals is important when using lasers on dental implants

Caring for patients with substance abuse- nurses’ experiences : A literature review

Bakgrund: Många människor är fördomsfulla mot patienter som har ett narkotikamissbruk. Patienter med narkotikamissbruk uttrycker att de blir behandlade annorlunda av sjuksköterskor inom vården -att de blir placerade i fack, bortprioriterade, ignorerade samt får sämre vård. Sjuksköterkors förhållningssätt beskrivs innehålla en drivkraft och ett gediget engagemang för patienter som missbrukar narkotika.  Syfte: Att beskrivasjuksköterskors erfarenheter av att vårda patienter med narkotikamissbruk.  Metod: I litteraturöversikten användes totalt 10 vårdvetenskapliga artiklar. Artiklarna hämtades från databaserna Academic Search Complete, CINAHL Complete och PsycInfo där sökorden som använts bland annat var ”nurse” ”substance abuse” och ”experiences”.Fribergs (2012) analysmetod har använts för att analysera de vårdvetenskapliga artiklarna.Den teoretiska referensramen som använts är Katie Erikssons caritativa vårdteori. Resultat: Resultatet visade sig i tre huvudteman och tre subteman. I det första temat ”Hur sjuksköterskor förhåller sig till vårdandet av narkotikamissbrukare” uppkom tre subteman; ”Sjuksköterskors attityder och fördomar” samt ”Stress & manipulation som hinder i vårdandet”. Under det huvudtemat beskrivs hur sjuksköterskors attityder och fördomar kan påverka den vården de ger till narkotikamissbrukare. I det andra temat ”Vad utbildning och kunskap har för betydelse i vårdandet” beskrivs det hur sjuksköterskor erfarit att deras brist på utbildning påverkat vårdandet och även varför god kompetens är betydelsefull. I det sista huvudtemat ”Oro, rädsla och ångest” belyses bland annat sjuksköterskors oro/rädsla för att vårda dessa patienter av olika anledningar. Diskussion: I diskussionsdelen belyser författarna de mest framträdande delarna i resultatdelen tillsammans med Katie Erikssons caritativa vårdteori. Sjuksköterkornas attityder/fördomar, misstro/manipulation samt utbildning diskuteras i förhållande till författarnas tankar, litteraturöversiktens bakgrundBackground: People are often prejudiced towards people with a substance abuse. Patients with a substance abuse express that nurses seems to care for them differently than with other patients –they feel like they’re being stigmatized, not being prioritized, ignored and that they receive less care than others. Commitment and urge are two components that should be contained in the nurses’ approach towards patients with substance abuse.   Aim: The aim of this study was to describenurses’ experiences of caring for patients with substance abuse.  Method: This litterature review was based on ten scientific articles. The articles were obtained from the databases Academic Search Complete, CINAHL Complete and PsycInfo. Some of the keywords that were used in the research were “nurse”, “substance abuse” and “experiences”.To analyse the articles we have used Fribergs (2012) method.The theoretical framework that was used in this literature review was Katie Erikssons caritative theory.  Results: The results of this litterature review show three main themes and two subthemes. The first theme “How nurses treat the substance abusers while they care for them”, include two subthemes “Nurses’ attitudes and prejudiced actions” and “How stress and manpulation can affect the care”. The theme highlights how nurses’ attitudes and prejudices affect the care they’re giving. The secondtheme, “The importance of education and knowledge in the care of patients who suffers from substance abuse”, describes nurses’ experiences of how their lack of education affects the care they’re giving and why it’s important to have good competence. The last theme “Worries, fears and anxiety” illuminates different reasons to why the nurses have these types of feelings when they’re caring for patients with a substance disorder.  Discussion: The discussion highlights the most outstanding parts of the result in association with Katie Erikssons caritative theory. Nurses’ attitudes/prejudices, distrust/manipulation and the importance of education are discussed in relation the authors’ thoughts, the background of the literature review and the theoretical frame

Stretch-induced contractile differentiation of vascular smooth muscle: sensitivity to actin polymerization inhibitors.

Signaling mechanisms for stretch-dependent growth and differentiation of vascular smooth muscle were investigated in mechanically loaded rat portal veins in organ culture. Stretch-dependent protein synthesis was found to depend on endogenous release of angiotensin II. Autoradiography after [35S]methionine incorporation revealed stretch-dependent synthesis of several proteins, of which SM22 and actin were particularly prominent. Inhibition of RhoA activity by cell-permeant C3 toxin increased tissue mechanical compliance and reduced stretch-dependent extracellular signal-regulated kinase (ERK)1/2 activation, growth, and synthesis of actin and SM22, suggesting a role of the actin cytoskeleton. In contrast, inhibition of Rho-associated kinase by Y-27632 did not reduce ERK1/2 phosphorylation or actin and SM22 synthesis and did not affect tissue mechanical compliance but still inhibited overall growth. The actin polymerization inhibitors latrunculin B and cytochalasin D both inhibited growth and caused increased tissue compliance. Whereas latrunculin B concentration-dependently reduced actin and SM22 synthesis, cytochalasin D did so at low (10-8 M) but not at high (10-6 M) concentration. The results show that stretch stabilizes the contractile smooth muscle phenotype. Stretch-dependent differentiation marker expression requires an intact cytoskeleton for stretch sensing, control of protein expression via the level of unpolymerized G-actin, or both

OpenMolcas: From Source Code to Insight

10.1021/acs.jctc.9b00532JOURNAL OF CHEMICAL THEORY AND COMPUTATION15115925-596