Αρχειοθήκη ιστολογίου

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

Τρίτη 31 Μαΐου 2022

Solitary Splenic Metastasis From Endometrial Carcinoma Revealed on FDG PET/CT

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imageSolitary splenic metastasis from endometrial carcinoma is rare. We report a case of imaging findings of solitary splenic metastasis in a 53-year-old woman who underwent resection surgery of endometrial carcinoma of uterus 1 year ago. On FDG PET/CT, it presented as a solitary soft tissue mass with an SUVmax of 18.44. The postoperative pathology supported metastasis from endometrial carcinoma.
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Adherence Of Candida Albicans to Five Long‐Term Silicone‐Based Denture Lining Materials Bonded to CAD‐CAM Denture Base

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Abstract

Purpose

: Knowledge about quantifying the number as well as the retention and adhesion of Candida albicans blastoconidia to silicone denture liners is limited. Thus, the aim of this in vitro study was to explore the adherence of Candida albicans to the surface of five long-term silicone-based soft denture lining materials, using artificial saliva.

Materials & Methods

A total of 50 specimens (10 × 10 × 3 mm) of five long-term resilient liners (Molloplast-B; GC Reline Soft; Elite Soft Relining; Tokuyama Sofreliner S; Ufigel SC), bonded to a computer-aided design and computer-aided manufacturing denture base, were prepared. The specimens were inoculated and incubated in artificial saliva for 1h and 24h with a standardized (2.8 × 106 cfu/ml) Candida albicans suspension. At the end of the incubation period, the specimens were stained with acridine orange and observed, using fluorescence microscopy.

Results

: After 1h and in 24h, Molloplast B demonstrated significantly earlier adherence of Candida albicans cells compared to the other chairside materials (p<0.001 and p<0.001, respectively), where the mean number of cells also increased in the frontal parts. Regarding the rate of Candida albicans proliferation from 1h to 24 hours within the materials, there was an increase in all materials (Molloplast B: p<0.001; GC Reline Soft: p = 0.220; Elite Soft Relining: p = 0.032; Tokuyama Sofreliner S: p = 0.001; Ufigel Sc: p = 0.001). The Ufigel Sc showed a significant 2.5-fold increase at 24h.

Conclusions

: Long-term silicone denture liners accumulate a significant amount of Candida albicans blastoconidia and their coverage by them increases progressively over time.

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Melanin-Targeted PET Imaging Sheds Light on Pigment Epithelioma in Corpus Ciliare

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imageA 57-year-old woman had gradually decreased visual acuity in the left eye, accompanied by distension and pain. MRI demonstrated a small neoplasm in corpus ciliare, which promoted PET imaging for further assessment. 18F-FDG PET imaging found no obvious uptake in the lesion. However, melanin-targeted PET imaging demonstrated the lesion with avid 18F-PFPN (18F-N-(2-diethylaminoethyl)-4-(2-[2-ethoxy]-ethoxy)pyridine) accumulation (SUVmax, 7.1), which suggested it with melanin expression. Pigmented epithelial adenoma was further confirmed by pathology. Our case illustrated that pigmented epithelial adenoma is characterized by av id 18F-PFPN accumulations and can be detected even in a hidden location with a size of ≤5 mm.
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Flexural Strength of Various Provisional Restorative Materials for Rehabilitation After Aging

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Abstract

Purpose

Durability of provisional restoration is crucial for full-mouth reconstruction, which may be influenced by aging. This study evaluated the effect of aging on the flexural strength of provisional materials for oral rehabilitation.

Materials and Methods

Bar specimens (2×2×25 mm) were fabricated from CAD-CAM [Vita CAD-Temp® (VC), Telio®CAD (TC), artBloc® (RC)], auto polymerized- [Protemp™IV (PA), Luxatemp® (LA), Unifast™Trad (UA)].

Results

TCNG indicated the highest mean of σ (133.49 ±4.32), whereas VCNG indicated the lowest mean of σ (84.62 ±3.73) for non-aging. Upon aging process, TCAG revealed the highest mean of σ (123.11 ±4.55), while VCAG possessed the lowest mean of σ (84.05 ±6.39). Significant differences among various provisional materials were indicated (p = 0.001). Aging significantly affected flexural strength (p = 0.001).

Conclusions

The CAD-CAM provisional material possessed higher flexural strength than heat-polymerized PMMA and auto-polymerized PMMA, which was suggested as a provisional material for rehabilitation. Aging reduced strength for all materials tested.

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Development and validation of the Fat Attitudes Assessment Toolkit (FAAT): A multidimensional nonstigmatizing measure of contemporary attitudes toward fatness and fat people

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Abstract

Many instruments recommended for measuring attitudes toward fatness and "obesity" were developed in the 1990s, a time when the "obesity epidemic" was gaining momentum and anti-fat rhetoric was normative. Consequently, these instruments have tended to focus on assessing negative appraisals of fatness and fat people and reinforce weight stigma. As fat discourse has matured and expanded to incorporate fat positive attitudes, a nonstigmatizing way of measuring contemporary fat attitudes and beliefs in quantitative research is required. To address this need, we developed the Fat Attitudes Assessment Toolkit (FAAT). In this article, we describe the development of the FAAT and provide initial evidence for the scale's validity and psychometric properties across three studies. Study 1 included a systematic process for developing the extensive item pool that was reviewed by subject matter experts and a community panel. We explored and identified an initial multidimensional structure for the FAAT. Study 2 expanded and confirmed the factor structure with additional analyses in an independent sample and provided evidence for the overall reliability of the subscale scores and reliability as a function of gender and identification as fat. Construct and criterion validity of the subscale scores were also demonstrated. Study 3 provided evidence for the test-retest reliability of the FAAT subscales scores over time. The FAAT includes nine robust scales: Empathy, Activism Orientation, Size Acceptance, Attractiveness, Critical Health, General Complexity, Socioeconomic Complexity, Responsibility, and Body Acceptance. Specific subscales can be combined to form two composite measures: Fat Acceptance and Attribution Complexity. The scales that comprise the FAAT measure specific elements of attitudes towards fat people that are frequently targeted in weight stigma reduction research and activism; the FAAT thus offers a powerful and precise method for evaluating weight stigma reduction interventions that allows for an assessment of shifts toward more positive attitudes.

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Δευτέρα 30 Μαΐου 2022

Rib fixation in non–ventilator-dependent chest wall injuries: A prospective randomized trial

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imageBACKGROUND The aim of this study was to assess pain and quality of life (QoL) outcomes in patients with multiple painful displaced fractured ribs with and without operative fixation. Rib fractures are common and can lead to significant pain and disability. There is minimal level 1 evidence for rib fixation in non–ventilator-dependent patients with chest wall injuries. We hypothesized that surgical stabilization of rib fractures would reduce pain and improve QoL during 6 months. METHODS A prospective multicenter randomized controlled trial comparing rib fixation to nonoperative management of nonventilated patients with at least three consecutive rib fractures was conducted. Inclusion criteria were rib fracture displacement and/or ongoing pain. Pain (McGill Pain Questionnaire) and QoL (Short Form 12) at 3 and 6 months postinjury were assessed. Surgeons enrolled patients in whom they felt there was clinical equipoise. Patients who were deemed to need surgical fixation or who were deemed to be too well to be randomized to rib fixation were not enrolled. RESULTS A total of 124 patients were enrolled at four sites between 2017 and 2020. Sixty-one patients were randomized to operative management and 63 to nonoperative management. No differences were seen in the primary endpoint of Pain Rating Index at 3 months or in the QoL measures. Return-to-work rates improved between 3 and 6 months, favoring the operative group. CONCLUSION In this study, no improvements in pain or QoL at 3 and 6 months in patients undergoing rib fixation for nonflail, non–ventilator-dependent rib fractures have been demonstrated. LEVEL OF EVIDENCE Therapeutic/Care Management; Level II.
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Mitochondria play a key role in oxidative stress-induced pancreatic islet dysfunction after severe burns

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imageBACKGROUND Severe burns are often complicated with hyperglycemia in part caused by pancreatic islet dysfunction. Previous studies have revealed that in diabetes mellitus, the pancreatic islet dysfunction is partly attributed to oxidative stress. However, the role and mechanism of oxidative stress in hyperglycemia after severe burns remain unclear. Therefore, the purpose of this study was to explore the level and mechanism of oxidative stress in pancreatic islets after severe burns and the antioxidant effect of sodium pyruvate. METHODS A 30% total body surface area full-thickness burn model was established using male C57BL/6 mice. Fasting blood glucose and glucose-stimulated insulin secretion (GSIS) 24 hours post severe burns were detected. The levels of reactive oxygen species (ROS) and mitochondrial ROS of islets were detected. The activities of complexes in the mitochondrial respiratory chain of islets were measured. The main antioxidant defense system, glutaredoxin system, and thioredoxin system-related indexes were detected, and the expression of manganese superoxide dismutase (Mn-SOD) was measured. In addition, the antioxidant activity of sodium pyruvate was evaluated post severe burns. RESULTS After severe burns, fasting blood glucose levels increased, while GSIS levels decreased, with significantly elevated ROS levels of pancreatic islets. The activity of complex III decreased and the level of mitochondrial ROS increased significantly post severe burns. For the detoxification of ROS, the expressions of thioredoxin 2, thioredoxin reductase 2, and Mn-SOD located in mitochondria decreased. Sodium pyruvate reduced the level of mitochondrial ROS in islet cells and improved the GSIS of islets after severe burns. CONCLUSION The high level of mitochondrial ROS of islets is caused by reducing the activity of complex III in mitochondrial respiratory chain, inhibiting mitochondrial thioredoxin system, and downregulating Mn-SOD post severe burns. Sodium pyruvate plays an antioxidant role post severe burns in mice islets and improves the islet function.
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AAST multicenter prospective analysis of prehospital tourniquet use for extremity trauma

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imageBACKGROUND Tourniquet use for extremity hemorrhage control has seen a recent increase in civilian usage. Previous retrospective studies demonstrated that tourniquets improve outcomes for major extremity trauma (MET). No prospective study has been conducted to date. The objective of this study was to evaluate outcomes in MET patients with prehospital tourniquet use. We hypothesized that prehospital tourniquet use in MET decreases the incidence of patients arriving to the trauma center in shock. METHODS Data were collected prospectively for adult patients with MET at 26 Level I and 3 Level II trauma centers from 2015 to 2020. Limbs with tourniquets applied in the prehospital setting were included in the tourniquet group and limbs without prehospital tourniquets were enrolled in the control group. RESULTS A total of 1,392 injured limbs were enrolled with 1,130 tourniquets, including 962 prehospital tourniquets. The control group consisted of 262 limbs without prehospital tourniquets and 88 with tourniquets placed upon hospital arrival. Prehospital improvised tourniquets were placed in 42 patients. Tourniquets effectively controlled bleeding in 87.7% of limbs. Tourniquet and control groups were similarly matched for demographics, Injury Severity Score, and prehospital vital signs (p > 0.05). Despite higher limb injury severity, patients in the tourniquet group were less likely to arrive in shock compared with the control group (13.0% vs. 17.4%, p = 0.04). The incidence of limb complications was not significantly higher in the tourniquet group (p > 0.05). CONCLUSION This study is the first prospective analysis of prehospital tourniquet use for civilian extremity trauma. Prehospital tourniquet application was associated with decreased incidence of arrival in shock without increasing limb complications. We found widespread tourniquet use, high effectiveness, and a low number of improvised tourniquets. This study provides further evidence that tourniquets are being widely and safely adopted to improve outcomes in civilians with MET. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.
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The public health burden of geriatric trauma: Analysis of 2,688,008 hospitalizations from Centers for Medicare and Medicaid Services inpatient claims

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imageBACKGROUND Geriatric trauma care (GTC) represents an increasing proportion of injury care, but associated public health research on outcomes and expenditures is limited. The purpose of this study was to describe GTC characteristics, location, diagnoses, and expenditures. METHODS Patients at short-term nonfederal hospitals, 65 years or older, with ≥1 injury International Classification of Diseases, Tenth Revision, were selected from 2016 to 2019 Centers for Medicare and Medicaid Services Inpatient Standard Analytical Files. Trauma center levels were linked to Inpatient Standard Analytical Files data via American Hospital Association Hospital ID and fuzzy string matching. Demographics, care location, diagnoses, and expenditures were compared across groups. RESULTS A total of 2,688,008 hospitalizations (62% female; 90% White; 71% falls; mean Injury Severity Score, 6.5) from 3,286 hospitals were included, comprising 8.5% of all Medicare inpatient hospitalizations. Level I centers encompassed 7.2% of the institutions (n = 236) but 21.2% of hospitalizations, while nontrauma centers represented 58.5% of institutions (n = 1,923) and 37.7% of hospitalizations. Compared with nontrauma centers, patients at Level I centers had higher Elixhauser scores (9.0 vs. 8.8) and Injury Severity Score (7.4 vs. 6.0; p
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Factors associated with limitation of care after fatal injury

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imageBACKGROUND There is variability in end-of-life care of trauma patients. Many survive resuscitation but die after limitation of care (LoC). This study investigated LoC at a level I center. METHODS Adult trauma deaths between January 2016 and June 2020 were reviewed. Patients were stratified into "full code" versus any LoC (i.e., do not resuscitate, no escalation, or withdrawal of care) and by timing to LoC. Emergency department and "brain" deaths were excluded. Unadjusted logistic regression and Cox proportional hazards were used for analyses. Results include n (%) and odds ratios (ORs) with 95% confidence intervals (CIs), with α = 0.05. RESULTS A total of 173 patients were included; 15 patients (8%) died full code and 158 (91%) died after LoC. Seventy-seven patients (48%) underwent incremental LoC. Age (OR, 1.05; 95% CI, 1.02–1.08; p = 0.0010) and female sex (OR, 3.71; 95% CI, 1.01–13.64; p = 0.0487) increased the odds of LoC; number of anatomic injuries (OR, 0.91; 95% CI, 0.85–0.98; p = 0.0146), chest injuries (Abbreviated Injury Scale [AIS] score chest, >3) (OR, 0.02; 95% CI, 0.01–0.26; p = 0.0021), extremity injury (AIS score, >3) (OR, 0.08; 95% CI, 0.01–0.64; p = 0.0170), and hospital complications equal to 1 (OR, 0.21; 95% CI, 0.06–0.78; p = 0.0201) or ≥2 (OR, 0.19; 95% CI, 0.04–0.87; p = 0.0319) decreased the odds of LoC. For those having LoC, final limitations were implemented in
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