BioMed, Volume 2, Issue 4 (December 2022) – 8 articles

While the use of drug-eluting stents (DES) has become the first-line strategy for treating coronary artery disease, there are still drawbacks with their use. As our understanding of coronary artery anatomy and physiology evolves, growing evidence supports the use of drug-coated balloons (DCB) not only in the treatment of in-stent restenosis but also in de novo lesions. The aim of this systematic review and meta-analysis is to determine if there is a difference in outcomes when DCBs are used versus when stents are used. PubMed, Cochrane and Web of Science databases were systematically searched. The primary outcome of the meta-analysis was acute vessel closure and the secondary outcomes were stent complications including major adverse cardiovascular events (MACE) and all-cause mortality. Eleven studies with a total of 2349 patients were included. No significant difference was found in terms of acute vessel closure between DCBs and all stents (2.6% vs. 1.0%, OR: 2.13 (0.74–6.44), I²: 4%, p = 0.16). Furthermore, there was no difference in MACE (6.8% vs. 10.1%, OR: 0.53 (0.27–1.04), I²: 48%, p = 0.06), all-cause mortality and target lesion revascularisation. This meta-analysis suggests that the use of DCBs is a safe alternative to stents when treating coronary artery disease. Full article

Background: To identify factors necessary for the proper inclusion of foreigners in Japanese healthcare, we conducted a survey to determine whether foreign residents, even those with high socioeconomic status, referred to as “Highly Skilled Foreign Professionals”, experience difficulties when visiting medical institutions in Japan, using satisfaction level as an indicator. Method: A five-point Likert-scale, anonymous, online questionnaire was administered to faculty and doctoral students enrolled at the Okinawa Institute of Science and Technology Graduate University (OIST). The respondents’ demographics and their opinions on what they found difficult or important during medical examinations, their impression of Japanese medical personnel, their requirements for language support and interpretation, and their opinions about local healthcare delivery systems were collected. The questionnaires were distributed and collected using Microsoft Forms. Results: Responses were obtained from 90 respondents (response rate: 20.7%). The percentage of respondents who were dissatisfied (bottom two of five Likert scales) with medical care in Japan was 23.4%. In univariate logistic regression analysis, 11 of 35 questions were significantly correlated with dissatisfaction with medical care (p < 0.1). Duration of stay, presence of family members living with the patient, satisfaction with life, and perceived usefulness of language support were negatively correlated with dissatisfaction with medical care, while communication problems with medical personnel, need for medical personnel to respect patients’ culture, religion, and privacy, and difficulty in getting to medical facilities were positively correlated with dissatisfaction with medical care. No significant correlations were found with age, gender, or Japanese language level. Multiple logistic regression analysis showed that the presence of family members living with the subject (AOR = 0.092, p = 0.010), the desire for multilingual documentation (AOR = 0.177, p = 0.046), the physician’s concern for the patient’s culture and religion (AOR = 8.347, p = 0.029), and difficulty in communication with healthcare providers (AOR = 6.54, p = 0.036) were significantly correlated with overall dissatisfaction with medical care. Discussion: On average, the targeted Highly Skilled Foreign Professionals did not have strong levels of dissatisfaction with Japanese healthcare, but when they did have dissatisfaction, it was related to language barriers, lack of cultural and religious considerations, and difficulty in communication with healthcare providers. We believe that the results indicate the focus points of support necessary for the inclusion of foreigners. We also believe that the finding that family cohabitation is associated with satisfaction with medical care is a useful insight into effective reciprocal support on the part of patients. Full article

The osseointegration process between the host’s bone tissue and the titanium implant is the key to success of implantology. The literature highlights the high success rate of osseointegrated implants, which is above 90%, and warns that some failures may occur, and every professional may face some inevitable failure. A longitudinal study was designed to evaluate the success rate of osseointegrated implants by taking into account the early failure of osseointegration. The study’s population included a convenience sample of all patients attending in four municipalities in the state of Paraíba, Brazil, belonging to the Brazilian Unified Health System (SUS) and those who underwent implant placements between November 2015 and November 2018 and were followed-up until March 2020. Data were extracted from the National Registry of Health Establishments (CNES), a database that contains data on all Brazilian health institutions. Of the total placed implants, 1.88% failed before prosthetic rehabilitation, corresponding to a success rate of 98.12%. The success and failure rates by anatomical region were also evaluated, which revealed, respectively, the values for the anterior maxilla (95.52% and 4.48%), posterior maxilla (97.53% and 2.47%), anterior mandible (97.13% and 2.87%), and posterior mandible (98.90% and 1.10%). We conclude that the posterior mandible performed better than the other bone types and anatomical regions. The anterior region of the maxilla was the one that presented the worst performance. Moreover, when compared, the posterior maxilla performed similarly to the anterior mandible and better than the anterior maxilla. Full article

Research of post-stroke locomotion via musculoskeletal (MSK) modeling has offered an unprecedented insight into pathological muscle function and its interplay with skeletal geometry and external stimuli. Advances in solving the dynamical system of post-stroke effort and the generic MSK models used have triggered noticeable improvements in simulating muscle activation dynamics of stroke populations. However, a review of these advancements to inform the scientific community has yet to be made.: PubMed and Scopus databases were used to perform a thorough literature search to identify relevant articles since 2010. Here, we review MSK methods and practices—developed in the last ten years—that have been utilized to explore post-stroke locomotion and examine how their outcomes can inform clinical practice.: Out of the 44 articles that were initially found, 19 were reviewed. The articles were categorized with respect to the type of assessment the MSK methods were used for.: This review notes the considerable competence of existing methods to address post-stroke motion deficits. However, the drawbacks in the implementation of such methods by non-experts due to the high skill demand and the lack of mature software technology for further dissemination of practices and outcomes remain non-trivial. Full article

Cardiovascular diseases require extensive diagnostic tests and frequent physician visits. With the advance in signal processing and sensor technology, now it is possible to acquire vital signs from the human body and process the signal to extract features necessary to primarily diagnose symptoms of cardiovascular disease early. This can help prevent deadly health incidents such as heart attack and or stroke, as well as reduce the number of visits to a health care facility. The proper detection of an elevated ST segment of ECG wave at an early stage may save the patient from having a heart attack or ST elevated myocardial infarction later. The use of a variety of complementary biomedical sensors can lead to a better diagnosis than what is possible when a single sensor is used. This paper proposes a MATLAB GUI which can detect elevated ST segments of ECG waves and use information from a variety of biomedical sensors to bring forth a technique to assess heart health to predict potential heart failure conditions. The proposed technique used fusion among multiple biomedical sensors to reduce the false alarm in diagnosis. Data from the online dataset were used to show the effectiveness and promise of the proposed detection of elevated ST segments and diagnosis techniques using the GUI. Full article

Do we have the right to wear masks during an infectious disease pandemic? If so, what is the underlying philosophical justification for this? During the COVID-19 pandemic, most people wore masks. Should the government be able to intervene to enforce mask wearing? It should be noted that the government’s encouragement to wear masks does not mean that people are encouraged to ignore them. In the field of public health ethics, many current debates boil down to establishing a balance between “individual freedom” and “the public good”. However, a clear definition of “the public good” has yet to emerge, which can make this debate difficult. Based on our philosophical analysis, we propose the following as a new right in the field of public health ethics: the “right to mask for self-protection”. Based on our proposed “right to mask for self-protection”, we offer a justification for the argument that all people have the right to wear a mask during an infectious disease pandemic or endemic. Full article

This preliminary study aimed to investigate physical activity (PA) and glycemic control changes in Japanese adult females with type 1 diabetes (T1D) before the COVID-19 pandemic and one year later. Twelve females with T1D who used continuous glucose monitoring devices and initially volunteered for the study between February and March 2020 were included. PA data, obtained using a triaxial accelerometer, and glycemic control, including glycated hemoglobin (HbA1c), glycoalbumin (GA), mean 24-h sensor glucose (SG), time above range (TAR > 180 mg/dL), time in range (TIR 70–180 mg/dL), and time below range (TBR < 70 mg/dL), were analyzed. One year later, long (≥10 min) bouts of moderate-to-vigorous-intensity PA and daily steps decreased by 35.1% and 6.0%, respectively, and TAR increased from 23.5% to 29.0%. Additionally, an increase in prolonged (≥30 min) sedentary behavior correlated with a decrease in TBR and an increase in mean 24-h SG, GA, and the GA/HbA1c ratio. Furthermore, a decrease in daily energy consumption correlated with a decrease in TIR. These results indicate that some forms of PA in Japanese T1D adults have not returned to their pre-pandemic status, even in the same season one year later, which could worsen glycemic control. Full article

Patellar tendinopathy is a common injury characterized by progressive activity-related anterior knee pain. It is highly prevalent in sports which involve jumping and changing direction. The aim of this paper is to review recent high-quality evidence regarding the effectiveness of physical therapy in the treatment of patellar tendinopathy. Randomized controlled trials (n = 22) researching the effects of exercise therapy, physical agents, and soft tissue techniques were included. The results show that exercise therapy is the most effective. While eccentric exercise is commonly used, very promising progressive tendon-loading exercise therapy programs are recently emerging. Extracorporeal shock wave therapy, dry needling, and orthoses are no more effective than eccentric exercises or placebo groups. Isometric and isotonic exercise, patellar strap, sports tape, and kinesiotaping have a short-term effect on functional improvement and pain reduction, while progressive tendon-loading exercise, dry needling, platelet-rich plasma, and extracorporeal shock wave therapy have long-term effects. Full article