Αρχειοθήκη ιστολογίου

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

Τρίτη 7 Φεβρουαρίου 2023

Adjuvant Radiation and Survival Following Surgical Resection of Sinonasal Adenocarcinoma

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Adjuvant Radiation and Survival Following Surgical Resection of Sinonasal Adenocarcinoma

Sinonasal adenocarcinoma is a rare primary malignancy treated with surgical resection with or without adjuvant radiotherapy. In this study, we saw that radiation therapy may not have an attributable survival benefit.


Objectives

This study aims to investigate the utility of adjuvant radiation in patients who undergo surgical resection for the management of node-negative sinonasal adenocarcinoma (SNAC).

Study Design

Retrospective database review.

Methods

The 2004–2016 National Cancer Data Base (NCDB) was used to extract patients with surgically resected node-negative SNAC. Kaplan–Meier survival analysis and Cox-Proportional Hazards Modelling were used to analyze the impact of adjuvant radiation on overall survival (OS) following surgery.

Results

349 patients with SNAC underwent surgical resection. Of these patients, 154 (44.1%) received adjuvant radiotherapy (RT). Although there was no significant difference in race, age, or sex of those receiving RT, those receiving RT have more advanced diseases and are more likely to have positive margins. Kaplan Meier analysis showed no significant difference in 5-year OS in patient who received adjuvant RT in comparison to those who underwent surgical resection alone (65.7% vs. 72.6%, respectively; p = 0.378). In addition, when looking at only patients with positive margins, 5-year OS still did not have a significant difference (73.8% vs. 61.6%, respectively; p = 0.101). Only patients with clinical AJCC T4 showed a statistically significant survival benefit with adjuvant RT (56.9% vs. 29.9%, respectively; p = 0.009).

Conclusions

Adjuvant RT does not appear to provide a significant survival benefit in patients with resected SNAC, with the exception of those with clinically AJCC T4 disease.

Level of Evidence

4 Laryngoscope, 2023

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Prevalence of Apical Periodontitis in Patients with Autoimmune Diseases: A Case Control Study

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Abstract

Aim

The purpose of this case-control study was to compare the prevalence of Apical Periodontitis (AP) in patients affected by Autoimmune Disorders (AD) [Inflammatory Bowel Disease (IBD), Rheumatoid Arthritis (RA), and Psoriasis (Ps)] with the prevalence of AP in subjects without AD. The prevalences of AP in patients taking biologic medications, conventional medications and no medication were also compared.

Methodology

89 patients (2,145 teeth) with AD were investigated and the control group included 89 patients (2,329 teeth) with no systemic diseases. Full dental panoramic tomograms were used to determine the periapical status of the teeth. Additional variables investigated included patient's socio-demographic characteristics, medications taken by AD patients, the Decayed, Missing, and Filled Teeth (DMFT) index. The chi-square test and logistic regression analysis were used to evaluate the correlation between AD and AP. P-values lower than 0.05 were considered to be statistically significant.

Results

The prevalence of AP was 89.9% in AD patients and 74.2% in control subjects (odds ratio [OR]=3.75, p=0.015). The DMFT score was found to be significantly higher in the AD group (p=0.004). Patients with RA had the highest risk of being affected by AP, whereas those with IBD had the lowest risk. Multiple binary logistic regression analysis indicated that the teeth of AD patients who were not taking any medication or were being treated with biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) had a higher risk of being affected by AP than did the teeth of the control subjects (OR=1.42 and OR=2.03 respectively; p=0.010). The teeth of patients taking conventional DMARDs (cDMARDs) were less affected by AP compared with those of patients taking bDMARDs.

Conclusions

Patients with AD, whether treated or not with biologic medications, showed a higher prevalence of AP than did those in the control group. The DMFT index score, which was higher in AD patients compared with controls was identified as a significant predictor of AP prevalence.

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Estimating the effect of physical activity on cognitive function within the UK Biobank cohort

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Abstract
Background
Physical activity (PA) has been associated with benefits for cognitive function (CF), but previous estimates of the strength of this relationship may have been biased due to limitations in statistical modelling practices that are common among observational studies. We aimed to address this by using a rigorously constructed conceptual causal model to guide an empirical analysis estimating the effect of PA on CF in the UK Biobank cohort of middle-aged and older adults.
Methods
This study analysed a subsample of 334 227 adults from the UK Biobank prospective cohort study. PA was measured subjectively by self-report and by device using accelerometry, and CF was measured using objective cognitive tests. Composite CF measures were derived to represent general and domain-specific performance. Effect coefficients were estimated using regression models, adjusting for a wide range of confounders specified by the assumed caus al model, including genetic risk factors, and relevant health, sociodemographic and behavioural variables from across the lifespan.
Results
Results indicated very small effect sizes (standardized mean difference estimates all <0.01) of inconsistent direction, for both cross-sectional and longitudinal analyses.
Conclusions
The expected protective effect of PA on CF was not observed. This may reflect selection bias within UK Biobank, or the relatively young age of the sample at follow-up.
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Κυριακή 5 Φεβρουαρίου 2023

Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient

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ABSTRACT

Monkeypox is a neglected zoonotic disease caused by Monkeypox virus (MPXV), a double-stranded DNA virus of the genus Orthopoxvirus. Here we present a case report of a 32-year-old man with MPXV infection who developed keratoconjunctivitis and Wessley immune ring with no identifiable cause other than ocular involvement by MPXV. We highlight the need of ophthalmologists exploring any ocular symptoms in MPXV-infected individuals.

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Discovery of Isojacareubin as a covalent inhibitor of SARS‐CoV‐2 main protease using structural and experimental approaches

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Abstract

The ongoing pandemic with the emergence of immune evasion potential and particularly the current omicron sub variants intensified the situation further. Although vaccine are available but the immune evasion capabilities of the recent variants demand further efficient therapeutic choices to control the SARS-CoV-2 pandemic. Hence, considering the necessity of the small molecule inhibitor we target the main protease (3CLpro) which is an appealing target for the development of anti-viral drugs against the SARS-CoV-2. High-throughput molecular in silico screening of South African natural compounds database (SANCDB) reported as Isojacareubin and Glabranin the potential inhibitors for main protease. The calculated docking scores were reported to be -8.47 kcal/mol and -8.03 kcal/mol respectively. Moreover, the structural-dynamic assessment reported that Isojacareubin in complex with 3CLpro exhibit more stable dynamic behaviour than Glabranin. Inhibition assay indicated that Isojacareubin could inhibit SARS-CoV-2 3CLpro in a time- and dose-dependent manner, with IC50 values of 16.00±1.35 μM (60-min incubation). Next, the covalent binding sites of Isojacareubin on SARS-CoV-2 3CLpro was identified by biomass spectrometry which reported that Isojacareubin can covalently bind to thiols or Cysteine through Michael addition. To evaluate the inactivation potency of Isojacareubin, the inactivation kinetics was further investigated. The inactivation kinetic curves were plotted according to various concentrations with gradient-ascending incubation times. The K I value of Isojacareubin was determined as 30.71 μM, while the K inact value was calculated as 0.054 min-1. These results suggest that Isojacareubin is a covalent inhibitor of SARS-CoV-2 3CLpro.

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Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis

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Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis

Idiopathic subglottic stenosis is a rare disease with incompletely understood pathophysiology. This study investigated for association with human leukocyte antigen allele variations, which have important contributions to other airway disease including granulomatosis with polyangiitis. There was no specific HLA association identified for idiopathic subglottic stenosis.


Objective

Despite recent scientific inquiry, idiopathic subglottic stenosis (iSGS) remains an enigmatic disease. The consistent demographics of the affected population suggest genetic factors may contribute to disease susceptibility. Given the inflammation observed in the affected proximal airway mucosa, we interrogated disease association with human leukocyte antigen (HLA) polymorphisms. Polymorphisms in the HLA locus have previously been shown to influence individuals' susceptibility to distinct inflammatory diseases.

Methods

High-resolution HLA typing of 37 iSGS patients was compared with 1,242,890 healthy Caucasian controls of European ancestry from the USA National Marrow Donor Program and 281 patients with granulomatosis with polyangiitis (GPA).

Results

Complete HLA genotyping of an iSGS population showed no significant associations when compared to a North American Caucasian control population. Unlike GPA patients, iSGS was not associated with allele DPB1*04:01 nor did allele homozygosity correlate with disease severity.

Conclusions

There was not a detectable HLA association observed in iSGS. These results support the concept that iSGS possesses a distinct genetic architecture from GPA. If genetic susceptibility exists in iSGS, it likely lies outside the HLA locus.

Level of Evidence

N/A, basic science Laryngoscope, 2023

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α‐KG Up‐regulates Autophagic Activity in Peri‐implant Environment and Enhances Dental Implant Osseointegration in Osteoporotic Mice

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Abstract

Aim

The osseointegration of dental implants is impaired among patients with osteoporosis, leading to significantly higher failure rate. This study set out to investigate the potential effects of alpha-ketoglutarate (α-KG) on implant osseointegration in an osteoporotic mouse model.

Material and Methods

Female C57BL/6 mice received ovariectomy and bilateral first maxillary molars extraction at the age of seven weeks. Dental implants were inserted eight weeks after tooth extraction. In one of the groups, α-KG was administered via drinking water throughout the experiment period. Specimens were collected on post-implant day (PID) 3, 7, 14, and 21 for micro-CT, histological and immunohistochemical analyses. At the same time, bone marrow-derived mesenchymal stem cells (BMMSCs) treated with α-KG were interrogated for osteogenic differentiation, autophagic activity, and apoptosis.

Results

α-KG supplement in drinking water resulted in enhanced dental implant osseointegration in ovariectomized mice, with upregulated osteogenic and autophagic activity and downregulated osteoclast differentiation and cell apoptosis. α-KG treated BMMSCs demonstrated enhanced activity in proliferation, survival, colony formation, osteogenic differentiation, as well as autophagic activity.

Conclusions

Systemic α-KG supplement effectively prevents the failure of dental implant osseointegration in mice under an osteoporotic state.

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