PP162 Use Of The RenalGuard® System To Prevent Contrast-Induced Nephropathy

IntroductionContrast-induced nephropathy (CIN) is a common cause of hospital-acquired acute kidney injury (AKI) following the administration of contrast media for coronary interventions or procedures such as diagnostic coronary angiography. The optimal way of preventing CIN remains uncertain. However, preliminary intravenous hydration, minimizing the volume of contrast media, and avoiding the use of nephrotoxic drugs are recommended in current management guidelines. The aim of this analysis was to compare the RenalGuard® system with standard care.MethodsA comprehensive literature search was conducted in PubMed and Google Scholar to identify evidence on the clinical and economic effectiveness of forced diuresis with matched hydration using the RenalGuard system for preventing CIN. Multiple criteria decision analysis (MCDA) was used to assess the performance of the method in hospital settings, compared with alternative options.ResultsSeveral systematic reviews with meta-analyses demonstrated that forced diuresis with matched hydration using the RenalGuard system was associated with a significantly lower relative risk of CIN among high-risk patients with chronic kidney disease. However, the evidence supporting the advantage of the proposed method over current forced diuresis techniques with manual calculation of the volumes for matched hydration in the hospital setting was limited.ConclusionsAlthough the effectiveness of the RenalGuard system has been demonstrated in meta-analyses, its clinical advantage over forced diuresis with manual hydration calculation is uncertain. It is also worth noting the lack of evidence to date on this technology, the fact that it is still at the research stage in some countries, and that it is not included in CIN management guidelines.

The Scavenger Hunt: An Educational Technique for Preceptors and Athletic Training Students

Context Entry-level athletic trainers (ATs) often lack tools necessary to help build confidence and professional networks, especially if they are the only clinicians in their facility. One-way athletic training education can help is to encourage preceptors to assist in mentoring athletic training students (ATSs) as they navigate the shift from student to AT. Objective To describe 1 educational technique developed by a preceptor that showcases effective mentoring, networking, volunteer opportunities, and communication. Background Mentorship is important for all entry-level ATs. By providing opportunities before graduation and assisting ATSs in learning how to network and communicate with potential mentors, future ATs can then continue the mentoring pipeline as they accept preceptor positions. Description This activity was developed by a preceptor while the ATS was in her immersive setting. It provided the ATS an opportunity to develop networking skills while still having support from the preceptor as mentor and while also growing the number of colleagues in her network. By providing a self-discovery activity, the ATS learned how to effectively maneuver through a large conference while gaining confidence, contacts, and a better understanding of the profession. Clinical Advantage(s) The preceptor developed a mentoring relationship with the ATS while also giving her the opportunity to build connections and identify characteristics that she would like to have in future mentors. Conclusion(s) Networking is often a difficult skill for new professionals. By creating this scavenger hunt, the preceptor demonstrated effective mentoring in addition to pushing the ATS outside of her comfort zone to develop her own professional network and observe how professionals can give back to their association.

NAL Neck Artificial Ligament Lifting: Neck Rejuvenation with Polytetrafuotoethylene (PTFE) Bands

Background: The current surgical method allows a short recovery and minimally invasive technique with polytetrafluotoethylene (PTFE) bands application, minimal skin excision for a fallen platysma muscle and skin laxity in facelift surgery; the clinical advantage of this method is a short recovery and an anatomic less invasive dissection, ideal for also younger patients who want more and more short healing times. Methods: Retrospective analysis of a 294 cases series of patients seeking platysma and skin laxity increase of neck-face region were included in the study. All of them were primary neck-face lift performed with PTFE bands of dual mesh that are customized for suture to the platysma and anchored to the mastoid, creating a neck artificial ligament (NAL) that is buried into the muscle and tightened, without modifying the superficial musculoaponeurotic system and platysma. Result: Data collection on surgery time, implant dimension selection, and postoperative complications were included. The most frequent complications were rare and include 5 case of superficial epidermolysis (healed within 21 days) and 1 case of mild band infection (treated with antibiotics). The surgical results are still stable over time, like those of a normal facelift after 6 months. Conclusion: minimally invasive NAL application avoids a large dissection and deep modifications of the superficial musculoaponeurotic system and platysma getting a strong upward tension that lasts over time with stable results. Keywords: Cervicoplasty, Neck, Rejuvenation, Aging, Mandible, Platysma Muscle.

Magnetic mallets – A stroke of luck in implantology: A review

Magnetic mallet was introduced in dentistry by Bonwill in 1873. It was introduced with the aim of increasing the efficacy of hammered gold fillings. Magnetic mallet is a magnetodynamical handpiece with an ergonomical design. It comprises central control with force adjustment, sterilizable handpiece with different replaceable tips, and pedal control. It comes with an entire range of bone expanders/osteotomes, cutter, and other instruments. It is applicable for procedures such as tooth and root extraction, impacted tooth removal, delayed implant placement, bone manipulating and sinus lifting procedures, root apex resection, removal of crowns, bridges, and implant part. The use of magnetic mallet is said to provide with better clinical advantage.

Clinical Advantage of Attaining Index-Based Remission Criteria prior to Composite Remission in Treating Rheumatoid Arthritis

Background and objectives: The clinical advantage of targeting index-based remission criteria (IR) prior to Boolean remission (BR) was evaluated retrospectively. Materials and Methods: A total of 578 patients with rheumatoid arthritis (RA), who were treated for more than three years, were recruited. Patients who were treated to targeted IR and composite measure remission criteria such as BR from the first consultation were divided according to the turn of attaining BR and IR: IB-R, a group that matched IR at the same time BR is attained or earlier; BI-F, a group that attained BR followed by IR or failed; IR-BF, a group that could not attain BR despite attaining IR; Both-F, a group that failed to attain either BR or IR. Background factors were statistically compared among groups. The BR rate in patients who attained IR (BRR) and the rate of failure to attain IR in patients who failed to attain BR (BFR) were statistically evaluated. Results: Groups made of 225, 231, and 482 in IB-R; 160, 154, and 8 in BI-F; 18, 18, and 75 in IR-BF; and 175, 175, and 13 in Both-F when indexing the clinical disease activity index (CDAI), simplified disease activity index (SDAI), and 28-joints disease activity score with C-reactive protein (DAS28-CRP), respectively. Disease activity indices’ scores after BR demonstrated significantly higher in the BI-F group than in the IB-R group. BRR was 92.6%, 92.8%, and 86.5%, while BFR was 71.3%, 71.3%, and 13.8% when indexing CDAI, SDAI, and DAS28-CRP, respectively. Conclusions: Targeting CDAI and SDAI remission prior to BR contributes to a stable clinical course.

Cardiovascular Disorders Triggered by Obstructive Sleep Apnea—A Focus on Endothelium and Blood Components

Obstructive sleep apnea (OSA) is known to be an independent cardiovascular risk factor. Among arousal from sleep, increased thoracic pressure and enhanced sympathetic activation, intermittent hypoxia is now considered as one of the most important pathophysiological mechanisms contributing to the development of endothelial dysfunction. Nevertheless, not much is known about blood components, which justifies the current review. This review focuses on molecular mechanisms triggered by sleep apnea. The recurrent periods of hypoxemia followed by reoxygenation promote reactive oxygen species (ROS) overproduction and increase inflammatory response. In this review paper we also intend to summarize the effect of treatment with continuous positive airway pressure (CPAP) on changes in the profile of the endothelial function and its subsequent potential clinical advantage in lowering cardiovascular risk in other comorbidities such as diabetes, atherosclerosis, hypertension, atrial fibrillation. Moreover, this paper is aimed at explaining how the presence of OSA may affect platelet function and exert effects on rheological activity of erythrocytes, which could also be the key to explaining an increased risk of stroke.