Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Τετάρτη 19 Οκτωβρίου 2022

Volumetric change of bony cavity and shrinkage speed after marsupialization for odontogenic keratocyst and unicystic ameloblastoma

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The aim of this study was to evaluate the efficacy of marsupialization treatment for odontogenic keratocyst (OKC) and unicystic ameloblastoma (UA) based on the three-dimensional volumetric change over time, and to determine the difference between OKC and UA in terms of the absolute volume reduction (AVR) and absolute shrinkage speed (ASS), and whether they are correlated with the preoperative volume, time after marsupialization (time between marsupialization and second treatment), and patient age. (Source: International Journal of Oral and Maxillofacial Surgery)
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Development and validation of a potential biomarker to improve the assessment of liver fibrosis progression in patients with chronic hepatitis B

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Abstract

Objectives

We aimed to develop and validate a novel combined score to improve the assessment of liver fibrosis progression in patients with chronic hepatitis B (CHB).

Methods

The serum levels of hub genes were examined by qRT-PCR in three cohorts of CHB patients.

Results

For significant liver fibrosis (≥S2), the areas under the receiver operating characteristics curves (AUROCs) of the combined score were 0.838, 0.842 and 0.881 in the three cohorts, respectively. And for advanced liver fibrosis (≥S3), the AUROCs were 0.794, 0.801 and 0.901, respectively. Compared with the results of AUROCs for aspartate aminotransferase-to-platelet ratio (APRI) and fibrosis index based on four factors (FIB-4) in the validation cohorts, better clinical diagnostic value for assessing the progression of liver fibrosis was found in the combined score. Additionally, univariate ordered logistic regression analysis indicated that the combined score could serve as a more superior and stable risk factor than APRI and FIB-4 in the assessment of liver fibrosis. For CHB patients with normal alanine aminotransferase (ALT), our results further emphasized the diagnostic value of the combined score for significant fibrosis (≥S2) and advanced fibrosis (≥S3). Moreover, it was found that patients with the high combined score, who were associated with the advanced fibrosis stage, had higher levels of drug sensitivity and immune checkpoint expression.

Conclusion

The novel combined score could serve as a potential biomarker and contribute to improving the assessment of fibrosis stage in CHB patients.

This article is protected by copyright. All rights reserved.

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Cochlear Implants for Single‐Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

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Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

The current study was undertaken to report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). We present the largest cohort of patients with SSD treated with CI to date. This group demonstrates significant benefit with regards to speech recognition scores, tinnitus measures, and quality of life metrics. We present novel insights regarding the CIQOL-10 measure, correlation of speech recognition and QoL scores with daily usage "datalogging" as well as the impact of duration of deafness on outcomes for patients with CI for SSD.


Objective

To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD).

Methods

This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized.

Results

Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0–74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1–14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores.

Conclusions

Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD.

Level of Evidence

IV Laryngoscope, 2022

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Comparison of propeller flaps versus skin grafts for coverage of osteocutaneous fibula free flap donor site defects

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Abstract

Background

Authors compare use of propeller flaps versus skin grafts in defect coverage after fibula flap harvest.

Materials and Methods

Retrospective review of patients who received either PFPF or STSG. Primary predictor variable was technique, and secondary predictor variables were comorbidities. Primary outcome variable was flap/graft healing, and secondary outcome variables were cosmesis, adverse events, effect on activities of daily living (ADLs), pain, additional procedures, and cost. Statistical analysis performed via independent sample t tests, ANOVA, and χ 2 tests. Logistic regression analysis was performed.

Results

Study sample was 50 patients. PFPFs showed higher rates of success, while STSG showed increased complications and adverse events. Pain and ADLs significantly affected in STSG group. Cosmesis was better in the PFPF group, and overall cost was significantly higher in STSG group.

Conclusion

PFPFs show greater success rates, fewer complications, improved cosmesis, less pain, reduced cost compared to STSG for wound coverage after fibula flap harvest.

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Proton pump inhibitors and myocardial infarction: an application of active comparators in a self-controlled case series

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Abstract
BackgroundPrevious studies investigating potential cardiovascular adverse events of acid-suppressing drugs are susceptible to protopathic bias and confounding. We aimed to investigate the association between short-term risk of myocardial infarction (MI) and proton pump inhibitors (PPIs) using a self-controlled case series (SCCS) with an active comparator.
Methods
We conducted a SCCS using a population-wide database from Hong Kong from 2003–2014. Adult with ≥1 outpatient oral PPI prescription or H2 receptor antagonist (H2RA) and MI during the observation period were included. We used both simple ratio and effect modifier approaches to SCCS with active comparators to obtain comparator adjusted estimates.
Results
A total of 2802 and 1889 people with MI who had exposure to PPIs and H2RA were included respectively. We observed a higher risk of MI during days 1–14 following the start of PPI prescription (Incidence rate ratio (IRR): 2.30, 95 % confidence interval (CI): 1.76–3.00) versus baseline. Similarly, we observed a higher risk of MI during days 1–14 following the start of H2RA prescription (IRR: 2.46, 95%CI: 1.92–3.16) versus baseline. In the novel SCCS analyses, comparator adjusted estimates were 0.93 (95%CI: 0.57–1.30) and 0.83 (95%CI: 0.58–1.20) during days 1–14 in simple ratio and effect modifier approach, respectively.
Conclusions
We observed no difference in risk of MI associated with PPIs compared with baseline using H2RA as the active comparator. The elevated risk of MI associated with PPIs is likely due to protopathic bias. More studies are required to explore the feasibility of using active comparators in SCCS to address protopathic bias in addition to confounding.
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Associations of Prenatal First Trimester Essential and Nonessential Metal Mixtures with Body Size and Adiposity in Childhood.

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Background: Prenatal nonessential metals may contribute to postnatal adiposity, while essential metals may have metabolic benefits. We evaluated joint and individual associations between prenatal metals and childhood adiposity. Methods: We measured concentrations of six nonessential (arsenic, barium, cadmium, cesium, lead, mercury) and four essential (magnesium, manganese, selenium, zinc) metals in first trimester maternal blood from a pre-birth cohort. We collected anthropometric measures in early childhood, mid-childhood, and early adolescence including subscapular+tricep skinfold thickness (mm) (N=715-859), waist circumference (cm) (N=717-882), and BMI (z-score) (N=716-875). We measured adiposity in mid-childhood and early adolescence using bone densitometry total- and trunk fat-mass index (kg/m2) (N=511-599). We estimated associations using adjusted quantile g-computation and linear regression. Results: The nonessential metal mixture was associated with higher total (β=0.07, 95% CI: 0.01, 0.12) and trunk fat-mass index (β=0.12, CI: 0.02, 0.22), waist circumference (β=0.01, CI: 0.00, 0.01), and BMI (β=0.24, CI: 0.07, 0.41) in mid-childhood, and total fat-mass index (β=0.07, CI: 0.01, 0.14) and BMI (β=0.19, CI: 0.02, 0.37) in early adolescence. The essential metal mixture was associated with lower early adolescence total (β= –0.11, CI: -0.17, -0.04) and trunk fat-mass index (β=-0.13, CI: -0.21, -0.05), subscapular+tricep skinfold thickness (β=-0.02, CI: -0.03, -0.00), waist circumference (β=-0.003, CI: -0.01, -0.00), and BMI (β=-0.16, CI: -0.28, -0.04). Cadmium and cesium were individually associated with childhood adiposity at different timepoints. Conclusions: Prenatal first trimester essential metals were associated with lower childhood adiposity, whereas nonessential metals were associated with higher adiposity into adolescence. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Development and Validation of Algorithms to Estimate Live Birth Gestational Age in Medicaid Analytic eXtract Data

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Background: While healthcare utilization data are useful for post-marketing surveillance of drug safety in pregnancy, the start of pregnancy and gestational age at birth are often incompletely recorded or missing. Our objective was to develop and validate a claims-based live birth gestational age algorithm. Methods: Using the Medicaid Analytic eXtract (MAX) linked to birth certificates in three states, we developed four candidate algorithms based on: preterm codes; preterm or post-term codes; timing of prenatal care; and prediction models - using conventional regression and machine-learning approaches with a broad range of pre-specified and empirically selected predictors. We assessed algorithm performance based on mean squared error (MSE) and proportion of pregnancies with estimated gestational age within 1 and 2 weeks of the gold standard, defined as the clinical or obstetric estimate of gestation on the birth certificate. We validated the best performing algorithms against medical records in a nationwide sample. We quantified misclassification of select drug exposure scenarios due to estimated gestational age as positive predictive value (PPV), sensitivity, and specificity. Results: Among 114,117 eligible pregnancies, the random forest model with all predictors emerged as the best performing algorithm: MSE 1.5; 84.8% within 1 week and 96.3% within 2 weeks, with similar performance in the nationwide validation cohort. For all exposure scenarios, PPVs were >93.8%, sensitivities >94.3%, and specificities >99.4%. Conclusions: We developed a highly accurate algorithm for estimating gestational age among live births in the nationwide MAX data, further supporting the value of these data for drug safety surveillance in pregnancy. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Disrupted tenogenesis in masseter as a potential cause of micrognathia

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International Journal of Oral Science, Published online: 18 October 2022; doi:10.1038/s41368-022-00196-y

Disrupted tenogenesis in masseter as a potential cause of micrognathia
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