Diagnosis and Management of Vocal Complications after Chondrolaryngoplasty

alexandrossfakianakis shared this article with you from Inoreader Diagnosis and Management of Vocal Complications after Chondrolaryngoplasty via The Laryngoscope Anterior commissure dislocation should be suspected with signs of vocal impairment after chondrolaryngoplasty. Following proper diagnosis, resuspension of the anterior commissure via feminization laryngoplasty approach can be an effective reparative technique. Objective Transfeminine patients (transwomen/feminine nonbinary folks assigned male at birth) can undergo chondrolaryngoplasty ("tracheal shave") to feminize their neck appearance. While isolated cases of vocal complications have been reported following the procedure, aggregated outcomes have not been quantitatively studied. We present acoustic and stroboscopic data to describe a patient cohort with vocal complications after chondrolaryngoplasty and discuss reparative surgical technique. Methods Subjective and objective data, including videostroboscopy, were collected from patients with voice complaints after chondrolaryngoplasty. Dislocated anterior commissures were reconstructed with feminization laryngoplasty. Postoperative voice data were recorded and statistically compared to preoperative data using paired t-tests. Results On consecutive chart review, of the 94 transfeminine women with prior outside history of chondrolaryngoplasty, 27 (29%) reported chronic postoperative hoarseness, deepened pitch, or loss of upper register. On endoscopy, short, lax vocal folds with persistent anterior glottic gap and phase asymmetry were commonly noted; anterior commissure dislocation was confirmed in-office by using needle localization through absent thyroid cartilage. After open resuspension of the anterior commissure with feminization laryngoplasty, post-repair modal-speaking, minimum, and maximum fundamental frequencies (F0) increased on average by 7, 8, and 5 semitones, respectively (p < 0.01), when compared to pre-repair values. On average, perioperative maximum phonation time did not change significantly (p = 0.15). Average self-assessment of vocal femininity increased by 48% (p < 0.01). Conclusion Anterior commissure dislocation should be suspected with signs of vocal impairment after chondrolaryngoplasty. Following proper diagnosis, resuspension of the anterior commissure via feminization laryngoplasty approach can be an effective reparative technique. Level of Evidence This work represents a 2011 OCEBM Level 4 evidence as a case series Laryngoscope, 2022 View on Web

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Reassessing Endotracheal Tube Size in Critically Ill Patients

alexandrossfakianakis shared this article with you from Inoreader Reassessing Endotracheal Tube Size in Critically Ill Patients via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor We read with great interest the article by Esianor and colleagues on endotracheal tube (ETT) size in critically ill patients. Laryngotracheal injuries after invasive mechanical ventilation range from reversible pressure injuries to permanent damage, scarring, fistulas, and transmural lesions. Endotracheal tubes larger than 7.0 mm pose greater risk of laryngeal injury, and ETTs larger than 7.5 mm are often selected for critically ill patients in efforts to improve airflow resistance, avoid blockage, and facilitate procedural int erventions. Little is known as to whether larger ETTs improve recovery. Esianor and colleagues found no difference in 30-day all-cause in-hospital survival between patients with small, appropriate, or large-for-height endotracheal tubes. If larger tubes do not improve survival, is survivorship a better focus? Even with optimally sized tubes, translaryngeal intubation carries risks for impaired speech, swallowing, and airway protection. The investigation presented new questions around selection of ETT size, and has several implications for current practice and future investigation. View on Web

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three-dimensional airway changes after fibula flap reconstruction for benign and malignant tumours in the anterior mandible

alexandrossfakianakis shared this article with you from Inoreader A comparative study of three-dimensional airway changes after fibula flap reconstruction for benign and malignant tumours in the anterior mandible via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Surgical treatment of tumours in the anterior mandible and surrounding tissues may result in defects which can be restored by a fibula free flap. The upper airway may change during this process. The purpose of this retrospective study was to evaluate upper airway changes after fibula free flap reconstruction. A total of 37 patients who underwent anterior mandibulectomy and fibula free flap reconstruction between 2012 and 2020 were recruited. Patients with benign and malignant tumours involving the anterior mandible were included. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Esthetic and clinical outcomes after immediate placement and restoration: Comparison of two implant systems in the anterior maxilla—A cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Esthetic and clinical outcomes after immediate placement and restoration: Comparison of two implant systems in the anterior maxilla—A cross‐sectional study via Clinical Implant Dentistry and Related Research Abstract Aim To assess the esthetic and clinical performance of a novel self-tapping implant system for single-tooth restorations in the esthetic zone after immediate placement and provisionalization. Materials and Methods This cross-sectional study included 52 patients contributing a total of 52 immediately placed and restored implants with ≥12 months after functional loading, comparing two different implant systems: Straumann® BLX (Institut Straumann AG, Basel, Switzerland; 25 patients) and Ankylos® (Dentsply Sirona, Hanau, Germany; 27 patients). As the primary outcome measure, peri-implant tissue esthetics were assessed by means of pink esthetics score (PES) rated by three independent clinicians. Moreover, as secondary outcome measures, the peri-implant tissue health was assessed by means of bleeding on probing, probing depth, and suppuration. Apart from that, the modified plaque index, keratinized mucosa width, and the presence of mucosal recessions were also assessed. When clinical signs suggested the possibility of peri-implantitis, radiographs were indicated to assess progressive bone loss. Results The mean PES ratings were 12.10 ± 1.10 for Ankylos versus 11.2 ± 1.86 for BLX, both achieving good esthetic results without significant differences (p = 0.143). There were no differences among most clinical parameters (plaque, bleeding on probing, probing depth, peri-implant mucosal recession), although peri-implant mucositis was present in one-third of the cases. The inter-rater agreement on esthetics was not significant (p < 0.250). Conclusion Within the limitations of the present study, it was concluded that the use of either BLX or Ankylos implant systems was associated to comparable peri-implant health and good pink esthetic outcomes during immediate implantation and restoration protocols, for at least 12 months. View on Web

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Risk of waning humoral responses after inactivated or subunit recombinant SARS‐CoV‐2 vaccination in patients with chronic diseases: Findings from a prospective observational study in China

alexandrossfakianakis shared this article with you from Inoreader Risk of waning humoral responses after inactivated or subunit recombinant SARS‐CoV‐2 vaccination in patients with chronic diseases: Findings from a prospective observational study in China via Journal of Medical Virology Abstract Heterogeneity of antibody responses has been reported in SARS-CoV-2 vaccination recipients with underlying diseases. We investigated the impact of the presence of comorbidities on the humoral response to SARS-CoV-2 vaccination in patients with chronic disease (PWCD) and assessed the effect of the number of comorbidities on the humoral response to vaccination. In this study, neutralizing antibodies (NAbs) and IgG antibodies against the receptor-binding domain (RBD-IgG) were monitored following a full-course vaccination. In total, 1400 PWCD (82.7%, inactivated vaccines; 17.3%, subunit recombinant vaccine) and 245 healthy controls (65.7% inactivated vaccines, 34.3% subunit recombinant vaccine) vaccinated with inactivated or subunit recombinant SARS-CoV-2 vaccines, were included. The seroconversion and antibody levels of the NAbs and RBD-IgG were different in the PWCD group compared with those in the control group. Chronic hepatitis B (odds ratio [OR]: 0.65; 95% confidence interval [C I]: 0.46–0.93), cancer (OR: 0.65; 95% CI: 0.42–0.99), and diabetes (OR: 0.50; 95% CI: 0.28–0.89) were associated with lower seroconversion of NAbs. Chronic kidney disease (OR: 0.29; 95% CI: 0.11–0.76), cancer (OR: 0.38; 95% CI: 0.23–0.62), and diabetes (OR: 0.37; 95% CI: 0.20–0.69) were associated with lower seroconversion of RBD-IgG. Only the presence of autoimmune disease showed significantly lower NAbs and RBD-IgG titers. Patients with most types of chronic diseases showed similar responses to the controls, but humoral responses were still significantly associated with the presence of ≥2 coexisting diseases. Our study suggested that humoral responses following SARS-CoV-2 vaccination are impaired in patients with certain chronic diseases. This article is protected by copyright. All rights reserved. View on Web

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Coronavirus disease 2019 rebounds following nirmatrelvir/ritonavir treatment

alexandrossfakianakis shared this article with you from Inoreader Coronavirus disease 2019 rebounds following nirmatrelvir/ritonavir treatment via Journal of Medical Virology Abstract Nirmatrelvir/ritonavir (NMV-r) is an effective anti-SARS-CoV-2 agent and has been recommended in the treatment of non-hospitalized patients with COVID-19. In rare occasions, some patients experience virologic and symptomatic rebound after initial resolution, which we call COVID-19 rebound after NMV-r. Although COVID rebound can also occur after molnupiravir treatment or even no antiviral treatment, we have more serious concern about the rebound after NMV-r, which remains the most effective antiviral. Due to a lack of information about its frequency, mechanism, outcomes, and management, we conducted this review to provide comprehensive and updated information to address these questions. Based on the limited evidence, the incidence of COVID-19 rebound after NMV-r was less than 2%, and most cases developed 5–15 days after initiating NMV-r treatment. Almost all reported cases had mild symptoms, and the clinical condition gradually subsided without additional treatment. Overall, the clinical outcome was favourable, and only a small number of patients required emergency department visits or hospitalization. Regarding virologic rebound, culturable SARS-CoV-2 with possible transmission was observed, so re-isolation may be needed. This article is protected by copyright. All rights reserved. View on Web

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Recall of Daptomycin for Injection 500 mg/vial and Daptomycin for Injection 350 mg/vial Lot # R2200232 Due to Product Mix-Up

alexandrossfakianakis shared this article with you from Inoreader Accord Healthcare Inc. Issues Nationwide Voluntary Recall of Daptomycin for Injection 500 mg/vial and Daptomycin for Injection 350 mg/vial Lot # R2200232 Due to Product Mix-Up via Food and Drug Administration--Recalls/Safety Alerts Accord Healthcare, Inc. is voluntarily recalling a single lot of Daptomycin for Injection 500 mg/vial, and Daptomycin for Injection 350 mg/vial product contained in cartons imprinted with lot # R2200232 Exp: 01/2025 to the consumer/user level. View on Web

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Viruses Responsible for Acute Respiratory Infections Before (2016‐2019) and During (2021) Circulation of the SARS‐CoV‐2 virus in Pediatric Patients in a Reference Center at Barranquilla Colombia: A Pattern Analysis

alexandrossfakianakis shared this article with you from Inoreader Viruses Responsible for Acute Respiratory Infections Before (2016‐2019) and During (2021) Circulation of the SARS‐CoV‐2 virus in Pediatric Patients in a Reference Center at Barranquilla Colombia: A Pattern Analysis via Journal of Medical Virology Summary Objective To evaluate the behavior of the viruses responsible for acute respiratory infections before (2016-2019) and after (2020-2021) the start of the circulation of the SARS-CoV-2 virus in pediatric patients treated at a reference center from Barranquilla, Colombia. Materials and methods A descriptive observational study was carried out, and data were obtained by reviewing the influenza-like illness and severe acute respiratory infection database in the pediatric population of the sentinel surveillance reference center in the district of Barranquilla during the years 2016 - 2021, applying inclusion and exclusion criteria. Results During 2016-2019, the average age of individuals was 1.3 (±1.7) years, during 2021, it was 2.3 (±3.5) years. The distribution by sex was similar, predominantly male. August and February were the months with the highest record of symptoms for 2016-2019 and 2021, respectively, the most frequent being cough, fever, shortness of breath, and diarrhea. By 2021 there was a higher use of antibiotics and antivirals reported than in 2016-2019. Most patients tested negative for viral detection. When comparing the percentage of viruses detected by age group and years of detection, positivity was lower in 2021 by every age group, and respiratory Syncytial Virus (RSV) was the most frequently detected. Conclusions There was less virus positivity in viral detection tests in the pediatric population in 2021. RSV persists as the main etiology affecting this population, especially infants. The use of antibiotic therapy in viral infections continues to be a problematic practice in their management. Sentinel surveillance can be strengthened throughout the country. This article is protected by copyright. All rights reserved. View on Web

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The HBV web: An insight into molecular interactomes between the Hepatitis B virus and its host en route to hepatocellular carcinoma.

alexandrossfakianakis shared this article with you from Inoreader The HBV web: An insight into molecular interactomes between the Hepatitis B virus and its host en route to hepatocellular carcinoma. via Journal of Medical Virology ABSTRACT Hepatitis B virus (HBV) is a major aetiology associated with the development and progression of hepatocellular carcinoma (HCC), the most common primary liver malignancy. Over the past few decades, direct and indirect mechanisms have been identified in the pathogenesis of HBV-associated HCC which include altered signaling pathways, genome integration, mutation-induced genomic instability, chromosomal deletions and rearrangements. Intertwining of the HBV counterparts with the host cellular factors, though well established, needs to be systemized to understand the dynamics of host-HBV crosstalk and its consequences on HCC progression. Existence of a vast array of protein-protein and protein-nucleic acid interaction databases has led to the uncoiling of the compendia of genes/gene products associated with these interactions. This review covers the existing knowledge about the HBV-host interplay and brings it down under one canopy emphasizing on the HBV-host interactomics; and thereby highlights new strategies for therapeutic advancements against HBV-induced HCC. This article is protected by copyright. All rights reserved. View on Web

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Infectivity of pseudotyped SARS‐CoV‐2 variants of concern in different human cell types and inhibitory effects of recombinant spike protein and entry‐related cellular factors

alexandrossfakianakis shared this article with you from Inoreader Infectivity of pseudotyped SARS‐CoV‐2 variants of concern in different human cell types and inhibitory effects of recombinant spike protein and entry‐related cellular factors via Journal of Medical Virology Abstract Since the report of the first COVID-19 case in 2019, SARS-CoV-2 variants of concern (VOCs) have continued to emerge, manifesting diverse infectivity, evasion of host immunity and pathology. While ACE2 is the predominant receptor of SARS-CoV-2, TMPRSS2, Kim-1, NRP-1, CD147, furin, CD209L and CD26 have also been implicated as viral entry-related cofactors. To understand the variations in infectivity and pathogenesis of VOCs, we conducted infection analysis in human cells from different organ systems using pseudoviruses of VOCs including Alpha, Beta, Gamma and Delta. Recombinant spike S1, RBD, ACE2, Kim-1 and NRP-1 proteins were tested for their ability to block infection to dissect their roles in SARS-CoV-2 entry into cells. Compared with wild type SARS-CoV-2 (WT), numerous VOCs had significant increases of infectivity across a wide spectrum of cell types. Recombinant ACE2 protein more effectively inhibited the infection of VOCs including Delta and Omicron (BA .1 and BA.2) than that of WT. Interestingly, recombinant S1, RBD, Kim-1 and NRP-1 proteins inhibited the infection of all pseudoviruses in a manner dependent on the levels of ACE2 expression in different cell types. These results provide insights into the diverse infectivity of SARS-CoV-2 VOCs, which might be helpful for managing the emergence of new VOCs. This article is protected by copyright. All rights reserved. View on Web

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