Αρχειοθήκη ιστολογίου

Κυριακή 15 Μαΐου 2022

Type 2 laryngeal cleft associated with OpitzG/BBB syndrome

alexandrossfakianakis shared this article with you from Inoreader

1-s2.0-S2173573522X00045-cov150h.gif

Publication date: May–June 2022

Source: Acta Otorrinolaringologica (English Edition), Volume 73, Issue 3

Author(s): Cristina García-Muro, Isabel Sáenz-Moreno, Fernando Gómez-Sáez, Ana Navazo-Eguia
View on Web
στις Δεν υπάρχουν σχόλια:

Survival Rate of Ultrawide Diameter Implants Placed Into Molar Postextraction Sockets and in Function for Up to 144 Months

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Purpose

Innovations in macroimplant design, specifically ultrawide implants 7.0 mm or greater in diameter, have allowed immediate molar replacement. This is a retrospective study assessing the survival rates of ultrawide diameter implants (7.0, 8.0, 9.0 mm) immediately placed into molar extraction sockets. Implants were followed up to 144 months post-placement.

Materials and methods

A retrospective study was conducted of all patients treated in a private surgical practice between January 1, 2008, and December 31, 2020, who received ultrawide dental implants (7.0, 8,0, 9.0mm.) placed immediately into molar extraction sockets. Wide diameter healing abutments were placed on all implants at the time of surgery. Abutments and crown restorations were fabricated after at least 4 months of unloaded healing. Patient age, gender, implant location and implant diameters were examined for survival. Insertion torque values at the time of placement and time in function were also evaluated. Biometric statistics were computed with P values (<0.05. Descriptive and bivariate statistics were computed; P values were set at .05.

Results

: Five hundred forty-four patients (225 males; 319 females) [average age 62.5 years; range 27 to 95] had 563 implants placed. Five hundred thirty-five of five hundred sixty-three (535/563) implants survived; 28 failed [clinical survival rate (CSR) 95.03%]. Number and time in function were: 0–12 years 100%; 0–9 years 85%; 0–6 years 69%; 0–3 years 35% or 10–12 years 16%; 7–9 years 16%; 4–6 years 34%; 0–3 years 35%. No significant differences were found between gender and implant failures (p = 0.22). Maxillary (266/285; 93.3%) and mandibular (269/278; 96.8%) implant CSRs were not significantly different. Three implant diameters were used: 7.0 mm (206/563) [36.6%]; 8.0 mm (267/563) [47.4%]; 9.0 mm (90/563) [15.9%]. Clinical survival rates were: 7.0 mm (201/206) [97.6%]; 8.0 mm (252/267) [94.4%]; 9.0 mm (82/90) [91.1%]. Mean age for patients with failed implants did not show any significant differences (p = 0.1398). Fifteen of the 28 failed implants failed within 120 da ys of surgical placement (prior to definitive restoration; [53.6%]; 4 implants failed between 4 and 12 months [14.3%]; 9 implants failed at least 1-year post-loading [32.1%].

Conclusions

The results of this long-term retrospective study regarding ultrawide diameter implants suggested that these implants were viable treatment options for immediate molar replacement following tooth extraction in either jaw with an unloaded healing protocol. High clinical survival rates were reported over a 144 month (12 year) timeframe.

This article is protected by copyright. All rights reserved
View on Web
στις Δεν υπάρχουν σχόλια:

Intranasal Spray Characteristics for Best Drug Delivery in Patients With Chronic Rhinosinusitis

alexandrossfakianakis shared this article with you from Inoreader

Objectives

To determine parameter combinations for effective drug delivery of intranasal spray steroids to the ostiomeatal complex (OMC) and maxillary sinus (MS) in patients with chronic rhinosinusitis (CRS).

Methods

Each patient's sinonasal cavity was reconstructed from computed tomography scans. Intranasal airflow and drug particle transport were simulated using computational fluid dynamic modeling. Airflow simulations were performed at 15 Pascal inhalation pressure. Intranasal spray particles of 1–100 μm were simulated at release speeds of 1, 5, and 10 m/s from 6 release locations (Bottom, Center, Top, Lateral, Lateral-Bottom, and Lateral-Top) at a nozzle insertion depth of 15 mm. Drug delivery simulations were performed in the head tilted forward position.

Results

Maximal OMC deposition was 0.78%–12.44%, while maximal MS deposition was 0.02%–1.03% across all simulations. In general, particles between 6 and 10 μm had the best OMC (at 1 m/s particle velocity) and MS (at 10 m/s particle velocity) deposition. Particles ranging from 21 to 30 μm also had superior OMC deposition. The lateral and lateral-top spray release locations produced maximum OMC deposition, but no one release location demonstrated an increase in MS deposition.

Conclusion

This preliminary study suggests that it is challenging to determine a common set of intranasal spray parameter combinations for effective drug delivery to the OMC and MSs. Although drug particle size and spray particle velocity seem to impact particle deposition patterns, spray release location appears to vary with anatomical differences between subjects, particularly when the MS is the target location for particle deposition. Laryngoscope, 2022
View on Web
στις Δεν υπάρχουν σχόλια:

Comparison of Adult and Pediatric Cochlear Implant Wound Complications: A Meta‐Analysis

alexandrossfakianakis shared this article with you from Inoreader
Comparison of Adult and Pediatric Cochlear Implant Wound Complications: A Meta-Analysis

The objective of this study is to compare age-related differences in wound complications following cochlear implantation (CI). CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low.


Objective

To compare age-related differences in wound complications following cochlear implantation (CI).

Methods

We performed a systematic review of PubMed, Cochrane Database, and Web of Science databases to identify original research evaluating the patient-level factors (demographics and medical history) associated with wound complications following CI. Outcomes were expressed as relative risk (RR) with 95% confidence intervals using the inverse variance method. Studies without comparison groups were described qualitatively.

Results

Thirty-eight studies representing 21,838 cochlear implantations were included. The rate of wound complications ranges from 0% to 22%. Patient age (adult versus pediatric) was the only factor with comparison groups appropriate for meta-analysis. The 10 studies (n = 9547 CI's) included in the meta-analysis demonstrated that adults had a higher incidence of overall wound complications (2.94%) than in children (2.44%) (RR 1.31, 95% CI 1.01–1.69). Adults had a higher incidence of general/unclassified wound complications (2.07%) than in children (1.34%) (RR 1.68, 95% CI 1.12–2.52). There was no difference between adults and children for specific complications such as hematoma, infection, or seroma. Elderly patients (over age 75) have wound complication rates that range from 1% to 4%. No studies contained comparison groups regarding other patient-level factors and CI wound complications.

Conclusion

CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low. There is a gap in CI research in consistently reporting wound complications and rigorous research investigating the impact of patient-level factors and wound complications.

Level of Evidence

Not applicable Laryngoscope, 2022
View on Web
στις Δεν υπάρχουν σχόλια:

Pharmacological and clinical monitoring in children with acute lymphoblastic leukemia treated with a biogeneric PEG‐l‐asparaginase product

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

l-Asparaginase (ASP) plays a crucial role in the treatment of childhood acute lymphoblastic leukemia (ALL). Currently, different ASP products are available in the market, including both native and pegylated drugs. Several biogeneric Escherichia coli ASP (GEN-ASP) products have been developed in response to shortages and expensiveness of the native E. coli ASP innovator compounds, but some concerns have been raised about their quality. Recently, a number of generic pegylated ASP products (GEN-PEG-ASP) have been marketed to substitute for the innovator product (PEG-ASP).

Methods

Clinical courses and serum asparaginase activity (SAA) levels were monitored in 12 children with ALL, who were treated in our institution with two doses of a GEN-PEG-ASP product, given IV at 2500 IU/m2 during the remission induction phase. Results were compared with those obtained in a reference cohort of 35 patients treated in our institution, who received the innovator PEG-ASP product at same dosage and within the same chemotherapy background.

Results

Compared to the reference cohort treated with PEG-ASP, SAA levels were significantly lower in the 12 patients receiving GEN-PEG-ASP (p < .0001); a higher proportion of ASP-associated hypersensitivity reactions (2/12 vs. 0/35; p = .061) and silent inactivation (3/12 vs. 0/35; p = .014) were observed in comparison with the reference cohort.

Conclusions

Our results highlighted different pharmacological profiles and different rates of hypersensitivity reactions and silent inactivation in the GEN-PEG-ASP cohort compared to those treated with the innovator product. Our findings suggest that a rigorous clinical attention and a thorough pharmacological monitoring are advisable in patients treated with GEN-PEG-ASP products.
View on Web
στις Δεν υπάρχουν σχόλια:

FDA approval summary: Crizotinib for pediatric and young adult patients with relapsed or refractory systemic anaplastic large cell lymphoma

alexandrossfakianakis shared this article with you from Inoreader

Abstract

In January 2021, the U.S. Food and Drug Administration (FDA) approved crizotinib for pediatric patients 1 year and older and young adults with relapsed or refractory systemic anaplastic large cell lymphoma (sALCL). This is the first approval for pediatric sALCL. Approval was based on a single-arm trial of crizotinib monotherapy that included 26 patients, aged 1–20 years, with previously treated sALCL. Efficacy was based on centrally assessed objective response rate (88%) and duration of response. Herein, we highlight unique aspects of the regulatory review, including extension of the indication to young adults, postmarketing safety, and dose optimization strategies.
View on Web
στις Δεν υπάρχουν σχόλια:

Ataxia‐telangiectasia after hepatoblastoma: The reverse chronology

alexandrossfakianakis shared this article with you from Inoreader
View on Web
στις Δεν υπάρχουν σχόλια:

Soft tissue phenotype modification predicts gingival margin long‐term (10‐year) stability: Longitudinal analysis of six randomized clinical trials

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

To assess the prognostic value of soft tissue phenotype modification following root coverage procedures for predicting the long-term (10-year) behaviour of the gingival margin.

Materials and Methods

Participants from six randomized clinical trials on root coverage procedures at the University of Michigan were re-invited for a longitudinal evaluation. Clinical measurements were obtained by two calibrated examiners. A data-driven approach to model selection with Akaike information criterion (AIC) was carried out via multilevel regression analyses and partial regression plotting for changes in the level of the gingival margin over time and interactions with the early (6-month) results of soft tissue phenotypic modification.

Results

One-hundred and fifty-seven treated sites in 83 patients were re-assessed at the long-term recall. AIC-driven model selection and regression analyses demonstrated that 6-month keratinized tissue width (KTW) and gingival thickness (GT) influenced the trajectory of the gingival margin similarly in a concave manner; however, GT was the driving determinant that predicted significantly less relapse in the treatments, with stability of the treated gingival margin obtained beyond values of 1.46 mm.

Conclusions

Among a compliant patient cohort, irrespective of the rendered therapy, the presence of at least 1.5 mm KTW and 1.46 mm GT was correlated with the long-term stability of the gingival margin.
View on Web
στις Δεν υπάρχουν σχόλια:

Analgesic effect of auricular point acupressure for acute pain in patients with dementia: study protocol for a randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader

13063.jpg

Common and frequent as acute pain is, it is often underestimated and undertreated in older people with dementia in nursing homes and inadequate pain management remains an issue.
View on Web
στις Δεν υπάρχουν σχόλια:

Association of oral bacteria with oral hygiene habits and self‐reported gingival bleeding

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aims

To describe associations of gingival bacterial composition and diversity with self-reported gingival bleeding and oral hygiene habits in a Norwegian regional-based population.

Material and methods

We explored gingival fluid microbiome composition (16S amplicon sequencing) in 484 adult participants (47% females, median age, 28 years) in the RHINESSA study in Bergen, Norway. We explored bacterial diversity and abundance differences by Community Periodontal Index (CPI) score, self-reported frequency of gingival bleeding and oral hygiene habits.

Results

Gingival bacterial diversity increased with increasing frequency of self-reported gingival bleeding, with higher Shannon diversity index for 'always' β = 0.51 and 'often' β = 0.75 (p < 0.001) compared to 'never' gingival bleeding. Frequent gingival bleeding was associated with higher abundance of several bacteria, such as Porphyromonas endodontalis, Treponema denticola, and Fretibacterium spp, but lower abundance of bacteria within the gram-positive phyla, Firmicutes and Actinobacteria. Flossing and rinsing with mouth wash twice daily was associated with higher total abundance of bacteria in the Proteobacteria phylum, but with lower bacterial diversity compared to those who never flossed or never used mouth wash.

Conclusion

A high frequency of self-reported gingival bleeding was associated with higher bacterial diversity than that found in participants reporting no gingival bleeding, and with higher total abundance of known periodontal pathogens such as Porphyromonas spp, Treponema spp, and Bacteriodes spp.
View on Web
στις Δεν υπάρχουν σχόλια:
Εγγραφή σε: Αναρτήσεις (Atom)