Zygomatic implant placement using a robot-assisted flapless protocol: proof of concept

alexandrossfakianakis shared this article with you from Inoreader Zygomatic implant placement using a robot-assisted flapless protocol: proof of concept via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Robotic assistance can help in physically guiding the drilling trajectory during zygomatic implant positioning. A new robot-assisted strategy for a flapless zygomatic implant placement protocol is reported here. In this protocol, a preoperative computed tomography scan is used to plan the surgical path. After surface registration, the ROSA robot (Zimmer Biomet Robotics) guides several steps, which are performed with shared control. The surgeon performs the drilling and tapping, guided by the robotic arm, which is positioned according to the planned trajectory. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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The link between allergic rhinitis and chronic rhinosinusitis

alexandrossfakianakis shared this article with you from Inoreader The link between allergic rhinitis and chronic rhinosinusitis via Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print Purpose of review Allergic rhinitis and chronic rhinosinusitis (CRS) are common disorders affecting millions of people worldwide. Although allergic rhinitis and CRS are distinct clinical entities, certain CRS endotypes share similar pathological mechanisms as those seen in patients with allergic rhinitis. This review assesses the literature behind the similarities and differences seen in patients with CRS and allergic rhinitis, and the role atopy might play in the pathophysiology of CRS. Recent findings In examining the associations between allergic rhinitis and CRS, most studies have focused primarily on CRS with nasal polyps and type 2 inflammation in CRS. Recent studies have demonstrated the similarities and differences in pathologic mechanisms behind allergic rhinitis and CRS, with an emphasis on patient endotypes, genetics, and the nasoepithelial immunologic barrier. Related immunopathology shared by allergic rhinitis and type 2 inflammation in CRS has allowed for therapeutic overlap with biologic treatments. Summary Allergic rhinitis and CRS often present as comorbid conditions, and understanding the relationship between allergic rhinitis and CRS is important when considering treatment options. Advances in understanding the genetics and immunology, as well as biologic and immunotherapeutic treatments have improved outcomes in patients with CRS, especially in the setting of atopy. View on Web

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Efficacy and safety of camrelizumab plus apatinib compared to apatinib monotherapy as third‐line or above therapy for metastatic colorectal cancer patients: A retrospective cohort study

alexandrossfakianakis shared this article with you from Inoreader Efficacy and safety of camrelizumab plus apatinib compared to apatinib monotherapy as third‐line or above therapy for metastatic colorectal cancer patients: A retrospective cohort study via Journal of Clinical Pharmacy and Therapeutics This study aimed to investigate the treatment efficacy and safety of camrelizumab (programmed cell death protein-1 (PD-1) inhibitor) plus apatinib as third-line or above therapy in metastatic colorectal cancer (mCRC) patients. Totally, 64 unresectable mCRC patients receiving camrelizumab plus apatinib (N = 31) and apatinib (N = 33) were retrospectively enrolled. It was found that disease control rate and objective response rate (ORR) were increased in camrelizumab plus apatinib group compared to apatinib group, but ORR did not achieve statistical significance. Besides, the median (95% confidence interval [CI]) progressive-free survival (PFS) and overall survival (OS) were 6.9 (3.7–10.1) and 11.5 (7.7–15.3) months in camrelizumab plus apatinib group, as well as 3.6 (1.7–5.5) and 6.7 (5.0–8.4) months in apatinib group. Additionally, PFS and OS were prolonged in camrelizumab plus apatinib group compared with apatinib group. The incidence of a dverse events did not differ between groups. Conclusively, camrelizumab (PD-1 inhibitor) plus apatinib achieves a better treatment efficacy than apatinib as third-line or above therapy with a good safety profile in mCRC patients. Abstract What Is Known and Objective Programmed cell death protein-1 (PD-1) inhibitors synergize apatinib for anti-tumour effect by regulating tumour microenvironment, vascular endothelial growth factor, hypoxia condition, immune response, etc. This study aimed to investigate the treatment efficacy and safety of camrelizumab (PD-1 inhibitor) plus apatinib as third-line or above therapy in metastatic colorectal cancer (mCRC) patients. Methods Totally, 64 unresectable mCRC patients receiving camrelizumab plus apatinib (N = 31) and apatinib (N = 33) were retrospectively enrolled. Results Disease control rate (80.6% vs. 57.6%) (P = 0.047) was elevated in camrelizumab plus apatinib group compared to apatinib group; however, objective response rate (22.6% vs. 6.1%) (P = 0.078) only showed an increasing trend but did not achieve statistical significance. Besides, the median (95% confidence interval [CI]) progressive-free survival (PFS) and overall survival (OS) were 6.9 (3.7–10.1) and 11.5 (7.7–15.3) months in camrelizumab plus apatinib group; meanwhile, the median (95% CI) PFS and OS were 3.6 (1.7–5.5) and 6.7 (5.0–8.4) months in the apatinib group. Additionally, PFS (P = 0.017) and OS (P = 0.006) were prolonged in camrelizumab plus apatinib group compared with apatinib group, which was confirmed by further multivariate Cox's proportional hazards regression analysis (hazard ratio [HR] = 0.340, P < 0.001 for PFS; HR = 0.271, P < 0.001 for OS). Th e incidence of total, grade 1–2, and grade 3–4 adverse events did not differ between groups (all P > 0.05). Conclusion Camrelizumab (PD-1 inhibitor) plus apatinib achieves a better treatment efficacy than apatinib as third-line or above therapy with a good safety profile in mCRC patients. View on Web

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Mendelian randomization suggests a potential causal effect of eosinophil count on influenza vaccination responsiveness

alexandrossfakianakis shared this article with you from Inoreader Mendelian randomization suggests a potential causal effect of eosinophil count on influenza vaccination responsiveness via Journal of Medical Virology Abstract Currently, the clinical factors affecting immune responses to influenza vaccines have not been systematically explored. The mechanism of low responsiveness to influenza vaccination (LRIV) is complicated and not thoroughly elucidated. Thus, we integrate our in-house genome-wide association studies (GWAS) analysis result of LRIV (N = 111, Ncase [Low Responders] = 34, Ncontrol [Responders] = 77) with the GWAS summary of 10 blood-based biomarkers (sample size ranging from 62,076 to 108,794) deposited in BioBank Japan (BBJ) to comprehensively explore the shared genetics between LRIV and blood-based biomarkers to investigate the causal relationships between blood-based biomarkers and LRIV by Mendelian randomization (MR). The applications of four MR approaches (inverse-variance-weighted (IVW), weighted median, weighted mode, and generalized summary-data-based Mendelian randomization (GSMR)) suggested that the genetically instrumented LRIV was associated with decreased eosinophil count (� � = -5.517 to -4.422, p-value = 0.004 to 0.039). Finally, we conclude that the low level of eosinophil count is a suggestive risk factor for LRIV. This article is protected by copyright. All rights reserved. View on Web

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The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia

alexandrossfakianakis shared this article with you from Inoreader The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia via Pediatric Blood & Cancer Abstract Background Recent studies have demonstrated hematogones (HGs) expansion to be associated with favorable outcomes in hematological diseases, especially in patients with acute myeloid leukemia and patients undergoing hematopoietic stem cell transplantation. Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children. As of now, minimal residual disease (MRD) remains the most compelling independent prognostic factor in childhood ALL. There is need for more prognostic tools for evaluating relapse risk. Procedure The goal of this study was to assess the prognostic value of HGs on relapse-free survival (RFS) and overall survival (OS) in childhood ALL. In this prospective cohort study, a total of 122 subjects with definitive diagnosis of precursor B lymphoblastic leukemia were evaluated. Flow cytometric HG detection was performed in bone marrow aspirates after induction and consolidation therapy. Results The median follow-up period of patients was 35.5 ± 9.4 (SD) months. Patients who had at least 1.0% HGs had a significantly better RFS (p = .023). Moreover, univariate and multivariate analyses confirmed that positive HGs were independently associated with longer RFS (unadjusted model: hazard ratio = 0.33, 95% CI = 0.12–0.91, p = .031; adjusted model: hazard ratio = 0.30, 95% CI = 0.11–0.82, p = .020). Conclusions Along with the role of MRD, our study shows the significance of HGs as an independent prognostic factor. The results indicate the independent prognostic value of HGs on RFS after adjustment for other prognostic factors, and can be beneficial for risk stratification and treatment modifications amongst pediatric B-cell ALL patients. View on Web

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Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?

alexandrossfakianakis shared this article with you from Inoreader Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care? via Transplant Infectious Disease Abstract Background Limited evidence is available to inform the duration of antibiotic treatment in kidney transplant recipients with bacterial acute graft pyelonephritis. Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation suggest a 14–21 day duration. Methods A four-question survey was constructed to determine the current standard of practice for the duration of treatment for acute graft pyelonephritis. The survey was distributed among members of the Infectious Diseases and the Kidney Pancreas Communities of Practice of the American Society of Transplantation. Results Among 144 survey respondents, 87 (60%) were infectious disease physicians, and 36 (25%) were transplant nephrologists. Although most (55%) respondents preferred a 14-day duration, a spread between 7 and 28 days was observed. Goals of treatment and drivers for longer duration differed between infectious disease physicians and transplant nephrologists. Conclusions Although most respondents prefer a 14-day duration of treatment for acute graft pyelonephritis, a wide range of responses was seen between 7 and 28 days. More evidence is needed to inform optimal treatment duration in this common infectious complication after transplantation. View on Web

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Design of customized soft tissue substitutes for anterior single‐tooth and posterior double‐tooth defects: An in vitro study

alexandrossfakianakis shared this article with you from Inoreader Design of customized soft tissue substitutes for anterior single‐tooth and posterior double‐tooth defects: An in vitro study via Journal of Esthetic and Restorative Dentistry Abstract Objective This study aims to validate the standardized procedure for designing soft tissue substitutes (STS) adapted to optimally fit single-tooth defects in the anterior jaws and double-tooth defects in the posterior jaw and to compare mathematically modeled average shapes. Materials and Methods Casts from 35 patients with 17 single-tooth defects in anterior region and 21 double-tooth defects in posterior region were scanned. STS were designed and sectioned in 3D slices meshes. Thickness values were documented respecting mesial-distal and buccal-lingual orientations. Graphs were embedded into images, and hierarchical clustering was applied to group STS according to shape and thickness. Results STS clustered into two groups per defect type. For anterior single defects, STS (n = 4) were either a small and thin oval: 7 mm buccal-lingual, 4–5 mm mesial-distal direction and 1.1–1.5 mm thick or a larger oval (n = 13): 9 mm buccal-lingual, 5–7 mm mesial-distal and 1.6 m thick. For posterior double tooth defects, STS (n = 10) were either narrow, long and thick: 6–7 mm buccal-lingual, 16–20 mm mesial-distal and 2.2 thick or a wide, thinner rectangle (n = 11): 9–11 mm buccal-lingual, 12–14 mm mesial-distal and 1.1–1.5 mm thick. Conclusions The study validated the standardized digital method to design grafts for soft tissue volume augmentation and identified four average shapes for anterior single-tooth and posterior double-tooth soft tissue defects. Clinical Significance We developed and validated a standardized digital method to design an optimal geometrical shape of a soft tissue substitute for oral volume augmentation and combined it with mathematical modeling to identify average shapes for single-interior, and double-posterior tooth defects. The identified average shapes offer the possibility to produce better-fitted xenografts or synthetic STS blocks requiring minimal chair-side adaptation leading to reduced clinical time and patient discomfort and potentially improving soft tissue volume augmentation outcomes. View on Web

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