Αρχειοθήκη ιστολογίου

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

Πέμπτη 15 Δεκεμβρίου 2022

Acute‐phase response following one‐stage full‐mouth versus quadrant non‐surgical periodontal treatment in subjects with comorbid type 2 diabetes: A randomized clinical trial

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Abstract

Aim

To compare the level of inflammatory markers and endothelial function 24 hours (Day1) and 90 days (Day90) after conventional quadrant-wise (Q-SRP) versus one-stage full-mouth scaling (FM-SRP) in patients affected by type 2 diabetes mellitus (T2DM).

Methods

Patients affected by periodontitis and T2DM were randomly allocated to receive FM-SRP or Q-SRP and followed up at Day1 and Day90. Serum samples, vital signs and flow-mediated dilation (FMD) parameters were collected at baseline, Day1 and Day90. Periodontal variables were collected at baseline and Day90. The primary outcome was the C-reactive Protein (CRP) concentration at Day1 after periodontal treatment. The Student t-test for independent samples was used for between-group comparisons (Mann Whitney U test for non-normal data), while the ANOVA with post-hoc Tukey tests (Kruskal Wallis and Dunn tests for non-normal data) were used for intragroup comparisons.

Results

40 subjects were included. FM-SRP produced a significant increase in CRP and a significant reduction in FMD at Day1 compared to Q-SRP (p<0.05). The absolute change in HbA1c (mmol/mol) from baseline to Day90 was significantly improved in the Q-SRP (ΔHbA1c=-1.59 (SD=1.20)) compared to the FM-SRP group (ΔHbA1c=-0.8 (SD=0.95)) (p=0.04).

Conclusions

FM-SRP triggers a robust acute-phase response at 24 hours after treatment compared to Q-SRP. Such systemic acute perturbations may offset the benefic systemic effects of periodontal treatment in terms of HbA1c reduction and improvement in endothelial function in T2DM subjects.

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Long‐term impact of patients' compliance to peri‐implant maintenance therapy on the incidence of peri‐implant diseases: An 11‐year prospective follow‐up clinical study

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Abstract

Objective

To prospectively evaluate the incidence of peri-implant diseases and the associated risk factors during 11 years of peri-implant maintenance therapy (PIMT).

Material and Methods

A sample of 80 partially edentulous individuals rehabilitated with dental implants was invited to participate in a PIMT program (T1—prior to entering the PIMT program). After 11 years, 51 individuals remained regularly or irregularly adherent to PIMT (T2—last recall after 11 years) and were classified as regular (RC; n = 27) or irregular (IC; n = 24) compliers. Data of interest were analyzed using univariate and multivariate logistic regression analyses.

Results

The incidence of peri-implant mucositis and peri-implantitis observed at T2 in the IC group (70.8% and 37.5%, respectively) were significantly higher than those observed in the RC group (37.0% and 11.1%, respectively). The incidence of peri-implant diseases was mostly attributable to potentially modifiable risk factors, as such: RC group—PM (p = 0.013); IC group—high plaque index (p < 0.001), irregular compliance (p < 0.001), the presence of PM (p = 0.015) and periodontitis (p < 0.039).

Conclusion

Regular compliance during PIMT had a strong effect in minimizing the incidence of peri-implant diseases. Increasing regular dental visits and improving oral hygiene would provide benefits for preventing peri-implant diseases.

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Expansile Sphenoid Mycetoma Presenting With Headache and Galactorrhea

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jamanetwork.com

This case report describes an immunocompetent woman in her 30s with daily vertex headaches over 13 months duration who developed spontaneous galactorrhea and was diagnosed with noninvasive fungal sinusitis.
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Detection and Monitoring of Circulating Tumor HPV DNA in HPV-Associated Sinonasal and Nasopharyngeal Cancers

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jamanetwork.com

This prospective observational study examines if circulating tumor human papillomavirus DNA can be used as an accurate measure of disease status at the time of diagnosis, throughout treatment, and during monitoring in human papillomavirus-associated sinonasal and nasopharyngeal squamous cell carcinomas.
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Τετάρτη 14 Δεκεμβρίου 2022

Physiopathology of peri‐implant diseases

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Abstract

Background

Peri-implant health is characterized by the absence of clinical signs of soft tissue inflammation. Peri-implant diseases are initiated by the presence of bacterial biofilms and share a similar etiology as that involved in the onset of periodontal diseases.

Purpose

To summarize available evidence on the physiopathology of peri-implant diseases with emphasis on similarities and differences with periodontal diseases.

Materials and Methods

Evidence on the biologic mechanisms involved in the pathogenesis of peri-implant mucositis and peri-implantitis were explored in the recent scientific literature.

Results

Findings of studies in animals and in humans indicate that experimental peri-implant mucositis leads to a larger inflammatory connective tissue infiltrate and to a higher frequency of bleeding sites around implants compared with teeth. Tissue destruction at experimental peri-implantitis sites is more pronounced compared with that at experimental periodontitis sites. Although human periodontitis and peri-implantitis lesions share similarities with respect to etiology and clinical features, they represent distinct entities from a physiopathologic point of view.

Conclusions

Diagnosis of peri-implant health requires a clinical examination to confirm absence of peri-implant soft tissue inflammation. In order to make a correct diagnosis and select the appropriate therapeutic steps to manage peri-implant diseases, knowledge of their pathogenetic mechanisms is required.

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Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss

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Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss

We describe the results of exome sequencing for genetic diagnosis of hearing loss among a clinically heterogeneous cohort of 218 pediatric patients. We found a higher diagnostic rate for unilateral hearing loss than previously reported as well as a significant number of syndromic forms of hearing loss. Based on these results, we advocate for expanded access to genetic testing for phenotypically diverse hearing loss patients.


Objectives

Genetic testing is the standard-of-care for diagnostic evaluation of bilateral, symmetric, sensorineural hearing loss (HL). We sought to determine the efficacy of a comprehensive genetic testing method, exome sequencing (ES), in a heterogeneous pediatric patient population with bilateral symmetric, bilateral asymmetric, and unilateral HL.

Methods

Trio-based ES was performed for pediatric patients with confirmed HL including those with symmetric, asymmetric, and unilateral HL.

Results

ES was completed for 218 probands. A genetic cause was identified for 31.2% of probands (n = 68). The diagnostic rate was 40.7% for bilateral HL, 23.1% for asymmetric HL, and 18.3% for unilateral HL, with syndromic diagnoses made in 20.8%, 33.3%, and 54.5% of cases in each group, respectively. Secondary or incidental findings were identified in 10 families (5.52%).

Conclusion

ES is an effective method for genetic diagnosis for HL including phenotypically diverse patients and allows the identification of secondary findings, discovery of deafness-causing genes, and the potential for efficient data re-analysis.

Level of Evidence

Level IV Laryngoscope, 2022

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Induced Paresis for Awake Laryngoscopy Procedures

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Induced Paresis for Awake Laryngoscopy Procedures

This article describes an anesthetic technique that induces temporary adductor vocal fold paresis and dense sensory loss of the posterior glottis. This method allows for improved precision of treatment and patient tolerance during awake office-based laryngeal surgery.


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