Clinical Applications of Tranexamic Acid (TXA) in Plastic and Reconstructive Surgery.

PURPOSE: Tranexamic Acid (TXA) has gained increasing recognition as a valuable pharmacologic agent within plastic surgery. This study reviews the scientific evidence regarding the use of TXA in the full range of plastic and reconstructive surgery to provide clinical recommendations regarding for safe and effective use in various plastic surgical procedures. METHODS: A systematic review and meta-analysis were conducted following the PRISMA guidelines. An established appraisal process was used to rate the quality of articles (Grading of Recommendations Assessment, Development, and Evaluation methodology). RESULTS: Forty-five studies describing the use of TXA in plastic surgery were included. There is moderate-certainty evidence to support the use of intravenous administration of TXA in craniofacial surgery procedures to reduce blood-loss and transfusion requirements. There is high-certainty evidence to support the use of TXA in cosmetic surgery and intravenous administration in rhinoplasty procedures to reduce blood-loss. Further high-level studies are needed to determine TXA's effects on hematoma rates in facelift surgery and breast-related procedures. There is moderate-certainty evidence to support the use of TXA in burn care. Further studies are required to provide quantitative conclusions on the effects of TXA administration in microsurgery. CONCLUSIONS: This is the largest study to date on the use of TXA in plastic surgery and the first to provide clinical recommendations. The literature highlights TXA's promising role in the fields of craniofacial surgery, cosmetic surgery and burn care. Standardized, objective measurements are required to provide quantitative conclusions regarding TXAs effects on ecchymoses and edema in cosmetic surgery procedures.

The Race for a COVID-19 Vaccine: Current Trials, Novel Technologies, and Future Directions.

The Coronavirus Disease 2019 (COVID-19) pandemic has presented a major threat to public health worldwide alongside unprecedented global economic and social implications. In the absence of a "gold standard" treatment, the rapid development of a safe and effective vaccine is considered the most promising way to control the pandemic. In recent years, traditional vaccine technologies have seemed insufficient to provide global protection against the rapid spread of emerging pandemics. Therefore, the establishment of novel approaches that are independent of whole pathogen cultivation, cost-effective, and able to be rapidly developed and produced on a large scale are of paramount importance for global health. This article summarizes the current efforts to develop a COVID-19 vaccine, including the ongoing and future anticipated clinical trials. We also provide plastic and reconstructive surgeons with insight into the novel technologies currently utilized for COVID-19 vaccine development, focusing on the very promising viral-vector-based and gene-based vaccine technologies. Each platform has its own advantages and disadvantages related to its efficacy and ability to induce certain immune responses, manufacturing capacity, and safety for human use. Once the fundamental key challenges have been addressed for viral-vector-based and gene-based vaccines, these novel technologies may become helpful in winning the fight against COVID-19 and transforming the future of health care.

Cleaning of the root canal using Nd:YAP laser and its effect on the mineral content of the dentin.

OBJECTIVE: To compare the efficacy of root canal cleanliness with and without Nd:YAP laser and to assess the effect of the laser on the mineral content of the dentin. BACKGROUND DATA: A high degree of cleanliness of the canal when using Nd:YAG laser has been shown while the laser had been in contact with the canal wall. A new Nd:YAP laser has been studied recently, which is considered to be superior to Nd:YAG with regard to antibactericidal ability due to its 1.34-mu wavelength, which is in the infra red range. This wavelength is absorbed better in water that of Nd:YAG. MATERIALS AND METHODS: Fourteen extracted single rooted premplars were divided into two groups. In group 1, canals were cleaned, instrumented and shaped with K files. In group 2, initial preparation was done using K files and completed with a Nd:YAP laser. Teeth were then split longitudinally and submitted to SEM. RESULTS: The cleanliness of the laser treated teeth was significantly greater than teeth treated with K files alone (p<0.05). No difference in Ca and P content was detected when the use of K files was compared to the use of laser. CONCLUSIONS: It appears that Nd:YAP laser improves the cleanliness of the root canal. However, since Nd:YAP laser serves as an addition to K files, its clinical value for replacing conventional root canal instrumentation remains to be determined.

Cleaning of the root canal using Nd:YAP laser and its effect on the mineral content of the dentin.

OBJECTIVE: The aim of this study was to compare the efficacy of root canal cleanliness with and without Nd:YAP laser and to assess the effect of the laser on the mineral content of the dentin. BACKGROUND DATA: A high degree of cleanliness of the canal when using the Nd:YAG laser has been shown while the laser is in contact with the canal wall. A new Nd:YAP laser has been studied recently, which is considered to be superior to the Nd:YAG with regard to antibactericidal ability due to its 1.34 micro m wavelength, which is in the infra-red range. This wavelength is absorbed better in water than that of Nd:YAG. MATERIALS AND METHODS: Fourteen extracted single rooted premplars were divided into two groups. In group 1, canals were cleaned, instrumented, and shaped with K files. In group 2, initial preparation was done using K files and completed with a Nd:YAP laser. Teeth were then split longitudinally and submitted to scanning electron microscopy. RESULTS: The cleanliness of the laser-treated teeth was significantly greater than teeth treated with K files alone (p < 0.05). No difference in Ca and P content was detected when the use of K files was compared to the use of laser. CONCLUSION: It appears that the Nd:YAP laser improves the cleanliness of the root canal. However, since the Nd:YAP laser serves as an addition to K files, its clinical value for replacing conventional root canal instrumentation remains to be determined.