RESUMEN
The benefits of specialist geriatric assessment in acute medical units are debated and it is unclear if there is a reduction in readmission rates for older patients with specialist geriatric care compared to general acute medical care. We examined readmission rates for 2414 older patients who had been discharged from the acute medical unit at the Norfolk and Norwich University Hospital, either by acute medicine or older people's medicine (OPM), both of which teams were consultant-led. We found no significant difference in readmission rates between patients discharged by the acute medical team as compared to the OPM team. This finding was robust to a variety of sensitivity analyses, including different lengths of stay, or readmissions at different time intervals. Hence, acute medical teams may be able to achieve similar levels of quality care for older patients to specialist geriatric teams.
RESUMEN
The biocompatibility of titanium implants in bone depends on the response shown by cells in contact with the implant surface. Several developments have been targeted at achieving successful implant treatment. The aim of this study was to develop a novel preparation procedure to evaluate the bone cell response produced at the bone-implant interface using the technique scanning electron microscopy with backscattered electron imaging (SEM-BSE). Dental prostheses with an SLA-modified or TOP-modified surface were implanted in a toothless part of the mandibula in female pigs. The animals were sacrificed 12 weeks after surgery, at which time block specimens containing the implants were obtained. These specimens were then processed for SEM-BSE by optimizing a protocol involving chemical fixation and heavy metal staining. In addition, element distribution maps for the implant-bone tissue interface were obtained using a microanalytical system based on energy-dispersive X-ray spectrometry (EDS). This novel visualisation approach enabled a comprehensive study of the extracellular matrix and cell components of the host tissues neoformed around the implant. SEM-BSE images also provided ultrastructural details of the bone cells. This technique appears to be an effective and very promising tool for detailed studies on the implant-bone tissue interface and the host response to the bone incorporation process.