Endoscopic Multiport Approach for Exenteration of the Infratemporal Fossa

alexandrossfakianakis shared this article with you from Inoreader Endoscopic Multiport Approach for Exenteration of the Infratemporal Fossa via The Laryngoscope New minimally endoscopic multiport approach to infratemporal fossa. Step-by-step cadaveric dissection. Objective To demonstrate anatomic relationships pertinent to the endoscopic multiport approach to the infratemporal fossa (ITF). Discuss advantages and limitations of each individual approach. Study Design Cadaveric study. Methods Endoscopic and endoscopic-assisted endonasal transpterygoid, sublabial transmaxillary, endoscopic transorbital, and endoscopic transoral approaches to accessing the ITF were completed in five silicone-injected fresh cadaveric specimens (10 sides) with the assistance of 0, 30, and 450 rods-lens endoscopes. Image guidance was used to confirm and document the anatomical relationships encountered in each approach. Results The endonasal endoscopic transpterygoid approach provides better visualization and more direct exposure to median structures. Endoscopic-assisted sublabial transmaxillary approach enhances the field of exposure, angle of attack, and ease of instrumentation to the lateral part of the ITF. Endoscopic-assisted transorbital approach via the inferior orbital fissure provided cephalic and anterior access. Endoscopic-assisted transoral approach complements the access to lesions extending inferior to the hard palate or far lateral to the mandibular condyle. Conclusions A combination of minimal access infratemporal approaches can provide adequate exposure of the entire ITF while avoiding some of the morbidity associated with open approaches. Level of Evidence NA Laryngoscope, 2023 View on Web

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Office‐based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients

alexandrossfakianakis shared this article with you from Inoreader Office‐based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients via The Laryngoscope Objective To investigate the effect of office-based blue laser therapy of vocal fold polyps on voice. Methods The medical records and video recordings of patients who underwent office-based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office-based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index-10 (VHI-10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. Results A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male-to-female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid-third of the vocal fold. All patients who presented for follow-up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI-10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). Conclusion Office-based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. Level of Evidence 4 Laryngoscope, 2023 View on Web

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New regimens as first‐line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader New regimens as first‐line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized controlled trial via Helicobacter Abstract Background Helicobacter pylori eradication in penicillin-allergic patients is challenging. The effective regimen is lacking in areas with high antibiotic resistance and tetracycline unavailable. Minocycline, cefuroxime, and full-dose metronidazole are promising drugs. Aims To compare the eradication rate, safety, and compliance among three new bismuth quadruple therapies for first-line H. pylori eradication in penicillin-allergic patients. Methods This randomized trial was conducted on 450 naive patients with H. pylori infection and penicillin allergy. The 14-day minocycline-metronidazole-containing (minocycline 100 mg twice daily and metronidazole 400 mg four times/day), minocycline-cefuroxime-containing (minocycline 100 mg twice daily and cefuroxime 500 mg twice daily), and cefuroxime-metronidazole-containing (cefuroxime 500 mg twice daily and metronidazole 400 mg four times/day) bismuth quadruple therapies were randomly assigned to the participants. Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed 4–8 weeks after eradication to evaluate outcome. Results The differences of eradication rates in either intention-to-treat (84.0%, 82.7%, and 23 82.0%, p = .896) or per-protocol (91.7%, 90.9%, and 88.2%, p = .599) analysis among minocycline-metronidazole, minocycline-cefuroxime, and cefuroxime-metronidazole-containing bismuth quadruple therapies were statistically insignificant. The incidence of adverse events (35.1%, 22.6%, and 28.9%) and compliance (90.5%, 91.8%, and 91.9%) were similar. Taste distortion, nausea, and anorexia were more common in metronidazole-containing regimens, and dizziness was more common in minocycline-containing regimens. The allergy was rare (~3%). Conclusions The efficacies of three bismuth quadruple therapies containing minocycline, cefuroxime, and full-dose metronidazole (pairwise) for first-line H. pylori eradication in penicillin-allergic patients were similarly satisfactory with relatively good safety and compliance. The study was registered in the Chinese Clinical Trials Registration (ChiCTR1900023702). View on Web

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Digital planning for two‐implant supported overdenture and bone reduction guide using cone beam computed tomography: Simple features for predictable outcomes

alexandrossfakianakis shared this article with you from Inoreader Digital planning for two‐implant supported overdenture and bone reduction guide using cone beam computed tomography: Simple features for predictable outcomes via Journal of Prosthodontics Abstract The two-implant-supported mandibular overdenture is considered a reliable treatment option to restore masticatory function. Digital planning has shown to improve the precision and accuracy of the surgical procedure. The outcomes are indeed pertinent to the ideal 3D positioning of the implant placement. Recently, the use of cone-beam computed tomography (CBCT) and intraoral ccan (IOS) have improved greatly the workflow of digital planning, however, the sophisticated technology caused confusion among the clinicians. The purpose of this case series was to exhibit the efficacy of a bone-supported guide in applying simultaneous implant placement and bone reduction solely based upon CBCT data. The bone reduction can therefore be determined accordingly, by adding windows to the guide, allowing the clinician to decide the amount of bone reduction as well as the location for implant placement. This novel surgical guide would not only fit properly on the bone, but also provide benefits of l ess-invasive surgery and the opportunity to place implants parallel. The digital workflow described not only simplifies the fabrication process, but also yields predictable surgical outcomes. This article is protected by copyright. All rights reserved View on Web

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Comparable humoral and cellular immunity against Omicron variant BA.4/5 of once‐boosted BA.1/2 convalescents and twice‐boosted COVID‐19‐naïve individuals

alexandrossfakianakis shared this article with you from Inoreader Comparable humoral and cellular immunity against Omicron variant BA.4/5 of once‐boosted BA.1/2 convalescents and twice‐boosted COVID‐19‐naïve individuals via Journal of Medical Virology Abstract The fourth vaccination dose confers additional protective immunity against SARS-CoV-2 infection in individuals with no prior coronavirus disease-19 (COVID-19). However, its immunological benefit against currently circulating BA.4/5 is unclear in individuals who have received a booster shot and been infected with Omicron variant BA.1/2. We analyzed immune responses in whom had been boosted once and did not have COVID-19 (n = 16), boosted once and had COVID-19 when BA.1/2 was dominant in the Korea (Hybrid-6M group, n = 27), and boosted twice and did not have COVID-19 (Vx4 group, n = 15). Antibody binding activities against RBDo BA.1 and RBDo.BA.4/5, antigen-specific memory CD4+ and CD8+ T-cell responses against BA.4/5, and B-cell responses against SARS-CoV-2 wild-type did not differ statistically between the Hybrid-6M and Vx4 groups. The humoral and cellular immune responses of the Hybrid-6M group against BA.4/5 were c omparable to those of the Vx4 group. Individuals who had been boosted and had an Omicron infection in early 2022 may not have high priority for an additional vaccination. This article is protected by copyright. All rights reserved. View on Web

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SARS‐CoV‐2 NSP7 inhibits type I and III IFN production by targeting the RIG‐I/MDA5, TRIF, and STING signaling pathways

alexandrossfakianakis shared this article with you from Inoreader SARS‐CoV‐2 NSP7 inhibits type I and III IFN production by targeting the RIG‐I/MDA5, TRIF, and STING signaling pathways via Journal of Medical Virology Abstract SARS-CoV-2 is a poor inducer of innate antiviral immunity, and the underlying mechanism still needs further investigation. Here, we reported that SARS-CoV-2 NSP7 inhibited the production of type I and III IFNs by targeting the RIG-I/MDA5, TLR3-TRIF, and cGAS-STING signaling pathways. SARS-CoV-2 NSP7 suppressed the expression of IFNs and IFN-stimulated genes induced by poly (I:C) transfection and infection with Sendai virus or SARS-CoV-2 virus-like particles. NSP7 impaired type I and III IFN production activated by components of the cytosolic dsRNA-sensing pathway, including RIG-I, MDA5, and MAVS, but not TBK1, IKKε, and IRF3-5D, an active form of IRF3. In addition, NSP7 also suppressed TRIF- and STING-induced IFN responses. Mechanistically, NSP7 associated with RIG-I and MDA5 prevented the formation of the RIG-I/MDA5−MAVS signalosome and interacted with TRIF and STING to inhibit TRIF-TBK1 and STING-TBK1 complex formation, thus reducing the subsequent IRF3 phosphorylation and nu clear translocation that are essential for IFN induction. In addition, ectopic expression of NSP7 impeded innate immune activation and facilitated virus replication. Taken together, SARS-CoV-2 NSP7 dampens type I and III IFN responses via disruption of the signal transduction of the RIG-I/MDA5−MAVS, TLR3-TRIF, and cGAS-STING signaling pathways, thus providing novel insights into the interactions between SARS-CoV-2 and innate antiviral immunity. This article is protected by copyright. All rights reserved. View on Web

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Friends or foes: The mononuclear phagocyte system in ischemic stroke

alexandrossfakianakis shared this article with you from Inoreader Friends or foes: The mononuclear phagocyte system in ischemic stroke via Brain Pathology Pathophysiological effects of mononuclear phagocyte system MPS in ischemic stroke. Abstract Ischemic stroke (IS) is a major cause of disability and death in adults, and the immune response plays an indispensable role in its pathological process. After the onset of IS, an inflammatory storm, with the infiltration and mobilization of the mononuclear phagocyte system (MPS), is triggered in the brain. Microglia are rapidly activated in situ, followed by waves of circulating monocytes into the ischemic area. Activated microglia and monocytes/macrophages are mainly distributed in the peri-infarct area. These cells have similar morphology and functions, such as secreting cytokines and phagocytosis. Previously, the presence of the MPS was considered a marker of an exacerbated inflammatory response that contributes to brain damage. However, recent studies have suggested a rather complicated role of the MPS in IS. Here, we reviewed articles focusing on various functions of the MPS among different phases of IS, including recruitment, polarization, phagocytosis, angiogenesis, and in teraction with other types of cells. Moreover, due to the characteristics of the MPS, we also noted clinical research addressing alterations in the MPS as potential biomarkers for IS patients for the purposes of predicting prognosis and developing novel therapeutic strategies. View on Web

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The risk of acute myocardial infarction among patients with laboratory-confirmed invasive pneumococcal disease: a self-controlled case series study

alexandrossfakianakis shared this article with you from Inoreader The risk of acute myocardial infarction among patients with laboratory-confirmed invasive pneumococcal disease: a self-controlled case series study via Clinical Infectious Diseases Advance Access Abstract Background Major cardiovascular events, including acute myocardial infarction (AMI), have been reported among patients with certain viral and bacterial infections. Yet, whether invasive pneumococcal disease (IPD) increases the risk of AMI remains unclear. We examined whether laboratory-confirmed IPD was associated with the risk of AMI. Methods We conducted a self-controlled case series analysis among adult Tennessee residents with evidence of a first AM I hospitalization (2003-2019). Patient follow-up started 1 year prior to the earliest AMI and continued through the date of death, 1 year after AMI or end of study (12/2019). Periods for AMI assessment included the 7 to 1 days before IPD-specimen collection (pre IPD detection), day 0 through day 7 after IPD-specimen collection (current IPD), the 8 to 28 days after IPD-specimen collection (post IPD), and a control period (all other follow-up time). We used conditional Poisson regression to calculate incidence rate ratios and 95% confidence intervals (CI) for each risk period compared to control periods using within-person comparisons. Results We studied 324 patients hospitalized for AMI with a laboratory-confirmed IPD within 1 year before or after the AMI hospitalization. The incidence of AMI was significantly higher during the pre-IPD detection period (IRR:10.29; CI:6.33-16.73) and current IPD (IRR: 92.95; CI:72.17-119.71) periods, but non-significantly elevated in the post -IPD risk period (IRR: 1.83; CI:0.86-3.91) compared to control periods. An elevated AMI incidence was also observed in the post-IPD control period (29 to 364 days after IPD) [IRR: 2.95; CI:2.01-4.32]. Conclusions Hospitalizations with AMI were strongly associated with laboratory-confirmed IPD. View on Web

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The Long Outer-Hair-Cell RC Time Constant: A Feature, Not a Bug, of the Mammalian Cochlea

alexandrossfakianakis shared this article with you from Inoreader The Long Outer-Hair-Cell RC Time Constant: A Feature, Not a Bug, of the Mammalian Cochlea via JARO - Journal of the Association for Research in Otolaryngology via MedWorm.com AbstractThe cochlea of the mammalian inner ear includes an active, hydromechanical amplifier thought to arise via the piezoelectric action of the outer hair cells (OHCs). A classic problem of cochlear biophysics is that theRC (resistance-capacitance) time constant of the hair-cell membrane appears inconveniently long, producing an effective cut-off frequency much lower than that of most audible sounds. The longRC time constant implies that the OHC receptor potential —and hence its electromotile response—decreases by roughly two orders of magnitude over the frequency range of mammalian hearing, casting doubt on the hypothesized role of cycle-by-cycle OHC-based amplification in mammalian hearing. Here, we review published data and basic physics to show that t he "RC problem " has bee... View on Web

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Decisional Conflict in Patients With Head and Neck Cancer

alexandrossfakianakis shared this article with you from Inoreader Decisional Conflict in Patients With Head and Neck Cancer via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study examines assess decisional conflict amo ng patients with head and neck squamous cell carcinoma, the association between decisional conflict and quality of life, and the degree of control patients experience in the decision-making process. View on Web

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