Background High blood urea nitrogen (BUN) is observed in a subset of patients with acute exacerbation of COPD (AECOPD) and may be linked to clinical outcome, but findings from previous studies have been inconsistent. Methods We performed a retrospective analysis of patients prospectively enrolled in the MAGNET AECOPD Registry study (ChiCTR2100044625). Receiver operating characteristic (ROC) was used to determine the level of BUN that discriminated survivors and non-survivors. Univariate and multivariate Cox proportional hazards regression analyses were performed to assess the impact of BUN on adverse outcomes. Results Overall, 13,431 consecutive inpatients with AECOPD were included in this study, of whom 173 died, with the mortality of 1.29%. The non-survivors had higher levels of BUN compared with the survivors [9.5 (6.8–15.3) vs 5.6 (4.3–7.5) mmol/L, P < 0.001]. ROC curve analysis showed that the optimal cutoff of BUN level was 7.30 mmol/L for in-hospital mortality (AUC: 0.782; 95% CI: 0.748–0.816; P < 0.001). After multivariate analysis, BUN level ≥7.3 mmol/L was an independent risk factor for in-hospital mortality (HR = 2.099; 95% CI: 1.378–3.197, P = 0.001), also for invasive mechanical ventilation (HR = 1.540; 95% CI: 1.199–1.977, P = 0.001) and intensive care unit admission (HR = 1.344; 95% CI: 1.117–1.617, P = 0.002). Other independent prognostic factors for in-hospital mortality including age, renal dysfunction, heart failure, diastolic blood pressure, pulse rate, PaCO2 and D-dimer. Conclusion BUN is an independent risk factor for in-hospital mortality in inpatients with AECOPD and may be used to identify serious (or severe) patients and guide the management of AECOPD. Clinical Trial Registration MAGNET AECOPD; Chinese Clinical Trail Registry NO.: ChiCTR2100044625; Registered March 2021, URL: http://www.chictr.org.cn/showproj.aspx?proj=121626 .
Human gait analysis is a growing field of research interest in medical treatment, sports training and structural health monitoring. In our study, we propose a low-cost insole design with wearable sensors based on piezoelectric discs (PZT) and an inertial measurement unit (IMU) to acquire the human gait. The sensors are placed at three points of a shoe sole: toe, metatarsal and heel. The human gait obtained from such an insole layout is significantly affected by plantar pressure distribution and alignment of the feet. The PZT sensors give an insight into the pressure map under the feet, and the IMUs record projection and orientation of the feet.
Background Peri-implant diseases are caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE and Cochrane Library. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of experimental peri-implant mucositis with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before February 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of thirty-one RCTs met the inclusion criteria. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; Er:YAG laser; diode laser; photodynamic therapy; local antibiotics; system antibiotics; probiotics; enamel matrix derivative. Follow-up ranged from 3 months to 1 years. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up (P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone at 3 months follow-up (P = 0.61), so is MD with probiotics and MD alone (P = 0.47), and so is systemic antibiotics and MD alone (P = 0.96). Conclusion.At present, we do not know which non-surgical intervention is superior to any other, and for the interventions having similar degrees of effectiveness we do not know which one has less side effects, is simpler and cheaper to use. It is necessary to conduct well-designed RCTs with longer follow-ups to assess the accurate effectiveness of therapies.
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Background Peri-implant diseases are mainly caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE, Cochrane Library and Science Direct. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of peri-implant diseases with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before June 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of eighteen RCTs met the inclusion criteria, of which 13 articles were included in the meta-analysis. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; photodynamic therapy; local antibiotics; systemic antibiotics; probiotics. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone in the treatment of peri-implant diseases at 3 months follow-up ( P = 0.84), so is MD with probiotics and MD alone ( P = 0.96), and so is systemic antibiotics and MD alone ( P = 0.47). Conclusion. MD adjunct with PDT is an effective treatment for peri-implant mucositis. However, there is still no effective non-surgical treatment for peri-implantitis.
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