Tailoring limb length based on total small bowel length in one anastomosis gastric bypass surgery (TAILOR study): study protocol for a randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader Tailoring limb length based on total small bowel length in one anastomosis gastric bypass surgery (TAILOR study): study protocol for a randomized controlled trial via Trials - Latest Articles The one anastomosis gastric bypass (OAGB) is being performed by an increasing number of bariatric centers over the world. However, the optimal length of the biliopancreatic (BP) limb remains a topic of discuss... View on Web

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Objective and PRO Measures of Trismus and Salivation Following Head and Neck Cancer Treatment

alexandrossfakianakis shared this article with you from Inoreader Objective and PRO Measures of Trismus and Salivation Following Head and Neck Cancer Treatment via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study compares objective with patient-rep orted outcome (PRO) measures of mouth function and salivary flow after head and neck cancer radiation therapy. View on Web

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Investigations Into Obesity and the Risk of Malignant Disease in Pediatric Thyroid Nodules—Reply

alexandrossfakianakis shared this article with you from Inoreader Investigations Into Obesity and the Risk of Malignant Disease in Pediatric Thyroid Nodules—Reply via JAMA Otolaryngology–Head & Neck Surgery Online First In Reply We thank Gallant et al for their interest in our recent publication regarding the association of body mass index (BMI) with thyroid cancer in children with thyroid nodules. We agree that differences in design may account for some discrepancies between our study and theirs. Different methods of calculating BMI z-scores might play a role, although our selection of the Centers for Disease Control and Prevention nomograms reflects their wide use in clinical practice. Similarly, our use of nodule diameter rather than nodule volume reflec ts current recommendations for thyroid nodule evaluation, and is unlikely to be relevant given the excellent correlation of these measures in our cohort (r = 0.97; 95% CI, 0.96-0.97). View on Web

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Investigations Into Obesity and the Risk of Malignant Disease in Pediatric Thyroid Nodules

alexandrossfakianakis shared this article with you from Inoreader Investigations Into Obesity and the Risk of Malignant Disease in Pediatric Thyroid Nodules via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor It is with great interest that we read the recent contribution from Ivanova et al, in which the authors found no association between body mass index z-score (BMIz) and the risk of malignant disease in pediatric thyroid nodules. The authors' findings contrast with our own study, in which we found BMIz to be a significant and independent predictor of pediatric thyroid cancer. We want to highlight a few differences between the studies, which may explain variance in the results. View on Web

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Risk of Stroke After Definitive Radiotherapy—Cause for Concern or Modest Risk?

alexandrossfakianakis shared this article with you from Inoreader Risk of Stroke After Definitive Radiotherapy—Cause for Concern or Modest Risk? via JAMA Otolaryngology–Head & Neck Surgery Online First With the rapidly increasing prevalence of oropharyngeal squamous cell carcinoma (OPSCC), largely driven by the human papillomavirus (HPV) epidemic, and with relative equipoise between radiation-based and surgery-based treatment protocols, there has been renewed interest in describing differences in functional outcomes between the 2 treatment modalities. Radiation is theoretically related to stroke risk due to carotid artery intimal injury, which could lead to the development of atherosclerosis. Both carotid artery stenosis and carotid intima -medial thickness have been shown to be associated with radiation therapy providing a biologic basis for the findings. A retrospective population-based cohort study of veterans with OPSCC authored by Sun et al reported a 12.5% imputed stroke risk within 10 years after treatment. The major finding of this study is that there was an observed 23% relative risk reduction of stroke in patients treated with definitive surgery as compared with those treated with definitive radiotherapy. Although there were notable differences between the groups at baseline, in particular higher T- and N-stage as well as worse ECOG performance status and Charlson Comorbidity Index in the nonsurgical group, the authors conducted propensity score–based analyses to account for these imbalances. Interestingly, there was no increase in stroke risk among surgical patients treated with adjuvant radiation as compared with those treated with surgery alone. (Other population-based studies have observed the same.) View on Web

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Cooled Radiofrequency Ablation of Genicular Nerves Provides 24‐Month Durability in the Management of Osteoarthritic Knee Pain: Outcomes from a Prospective, Multicenter, Randomized Trial

alexandrossfakianakis shared this article with you from Inoreader Cooled Radiofrequency Ablation of Genicular Nerves Provides 24‐Month Durability in the Management of Osteoarthritic Knee Pain: Outcomes from a Prospective, Multicenter, Randomized Trial via Pain Practice Abstract Objective To assess long-term outcomes of cooled radiofrequency ablation (CRFA) of genicular nerves for chronic knee pain due to osteoarthritis (OA). Methods A prospective, observational extension of a randomized, controlled trial was conducted on adults randomized to CRFA. Subjects were part of a 12-month clinical trial comparing CRFA of genicular nerves to a single hyaluronic injection for treatment of chronic OA knee pain, who then agreed to visits at 18- and 24-months post CRFA and had not undergone another knee procedure since. The subjects were evaluated for: pain using the Numeric Rating Scale (NRS), function using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), subjective benefit using the Global Perceived Effect (GPE) scale, quality of life using the EuroQol-5-Dimensions-5 Level (EQ-5D-5L) questionnaire, and safety. Results Of 57 subjects eligible, 36 enrolled; 32 completed the 18-month visit with a mean NRS score of 2.4 and 22 (69%) reporting ≥50% reduction in pain from baseline (primary endpoint); 27 completed the 24-month visit, with a mean NRS of 3.4 and 17 (63%) reporting ≥50% pain relief. Functional and quality of life improvements persisted similarly, with mean changes from baseline of 53.5% and 34.9% in WOMAC total scores, and 24.8% and 10.7% in EQ-5D-5L Index scores, at 18- and 24-months, respectively. There were no identified safety concerns in this patient cohort. Conclusion In this subset of subjects, CRFA of genicular nerves provided durable pain relief, improved function, and improved quality of life extending to 24 months post procedure, with no significant safety concerns. View on Web

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Efficacy of quadratus lumborum block on post‐operative pain and side‐effects in patients who underwent urological surgery: A meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Efficacy of quadratus lumborum block on post‐operative pain and side‐effects in patients who underwent urological surgery: A meta‐analysis via Pain Practice Abstract Background Ultrasound-guided quadratus lumborum block (QLB) is considered a novel nerve block for postoperative pain control. However, its efficacy after urological surgery remains unclear. Objectives The purpose of the current meta-analysis was to evaluate the effects of the QLB block versus control (placebo or no injection) on postoperative pain and other adverse outcomes after urological surgery, providing extensive evidence of whether quadratus lumborum block is suitable for pain management after urological surgery. Study Design Systematic review with meta-analysis of randomised clinical trials. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov to collect studies investigating the effects of QLB on analgesia after urological surgery. The primary outcomes included visual analogue scale (VAS) at rest and during movement, 24-h postoperative morphine consumption, and the incidence of postoperative nausea and vomiting (PONV). Results Overall, 13 randomised controlled trials (RCTs) were reviewed, including 751 patients who underwent urological surgery. The QLB group exhibited a lower VAS score post-operatively at rest or on movement at 0, 6, 12, and 24 h, with less 24-h postoperative morphine consumption and lower incidence of PONV. Limitations Although the result is stable, heterogeneity exists in the current research. Conclusions QLB exhibited a favourable effect of postoperative analgesia with reduced postoperative complications at rest or during movement after urological surgery. However, it is still a novel technology at a primary stage, which needs further research to develop. View on Web

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Influence of cross‐sectional area and fat infiltration of paraspinal muscles on analgesic efficacy of epidural steroid injection in elderly patients

alexandrossfakianakis shared this article with you from Inoreader Influence of cross‐sectional area and fat infiltration of paraspinal muscles on analgesic efficacy of epidural steroid injection in elderly patients via Pain Practice Abstract Background An assessment of paraspinal muscle degeneration based on magnetic resonance imaging has been used to investigate both sarcopenia and myosteatosis. The morphologic changes in cross-sectional area and fat infiltration of the paraspinal muscles can affect pain outcomes after epidural steroid injection. Methods Patients ≥ 65 years of age who underwent fluoroscopy-guided lumbar epidural steroid injections were enrolled. Good analgesia was defined as ≥ 50% reduction in pain score at 4 weeks after injection. Cross-sectional area and grade of fat infiltration of the paraspinal muscles on magnetic resonance images at the level of L3-L4 disc were measured. Patient demographics, pain-related factors, clinical factors, and paraspinal muscle measurements were compared between good and poor analgesia groups. The factors associated with pain outcome after injection were identified using multivariate analysis. Results A total of 245 patients consisting of 149 and 96 patients in the good and poor analgesia groups, respectively, fully satisfied the study criteria for analysis. Patients of older age, opioid use, and high-grade foraminal stenosis were frequently observed in the poor analgesia group. The grade of fat infiltration of the paraspinal muscles was significantly higher in the poor analgesia group (Grade 2, 20.8 vs. 42.7%, P < 0.001), and this result was predominantly observed in female patients. However, there was no difference in muscle cross-sectional area between the two groups (18.29 ± 3.16 vs. 18.59 ± 3.03 cm2/m2, P = 0.460). The percentage of patients with good analgesia decreased as the grade of fat infiltration increased (Grade 0 = 75.0%, Grade 1 = 65.8%, Grade 2 = 43.0%, P < 0.001). Multivariate logistic regression analysis revealed that pre-injection opioid use [adjusted odds ratio (aOR) = 1.926, 95% confidence interval (CI) = 1.084–3.422, P = 0.025], moderate to severe foraminal stenosis (aOR = 2.859, 95% CI = 1.371–5.965, P = 0.005), and high-grade fat infiltration of the paraspinal muscles (aOR = 4.258, 95% CI = 1.805–10.043, P = 0.001) were significantly associated with poor analgesia after injection. Conclusion High fat infiltration of the paraspinal muscles at the mid-lumbar region appeared to be an independent factor associated with poor analgesia after epidural steroid injection in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care. However, cross-sectional area of the paraspinal muscles was not associated with pain relief after injection. View on Web

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Screw‐Retained Surgical Guide for Implant Placement in Terminal Dentition Patients With Existing Implants

alexandrossfakianakis shared this article with you from Inoreader Screw‐Retained Surgical Guide for Implant Placement in Terminal Dentition Patients With Existing Implants via Journal of Prosthodontics ABSTRACT For patients with existing implants in need of additional implant placement, the use of the existing implants for guide fixation seems to be a logical alternative. Current options for the fabrication of surgical guides involve creating surgical guides that are mucosa-borne and/or retained by fixation pins. Since these existing techniques involve inherent inaccuracies, the fabrication of surgical guides that are screw-retained at the implant- or abutment-level would eliminate the introduction of those same fundamental inaccuracies. The purpose of the present technical report is to illustrate a step-by-step digitally planned guided implant placement protocol for terminal dentition patients with salvageable existing implants requiring full-arch implant rehabilitation. The advantages of this protocol include enhancing the accuracy of guided implant placement with screw-retention vs the traditional mucosa- or fixation pin support. Thus, this simplifies the transition from failing teeth to implants by ensuring that fixed provisionalization serves both functional and esthetic requirements. This protocol can also predictably reduce chairside time and adjustments at the surgical implant placement appointment. This article is protected by copyright. All rights reserved View on Web

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Novel cancer gene discovery using a forward genetic screen in RCAS-PDGFB-driven gliomas

alexandrossfakianakis shared this article with you from Inoreader Novel cancer gene discovery using a forward genetic screen in RCAS-PDGFB-driven gliomas via Neuro-Oncology Advance Access Abstract Background Malignant gliomas, the most common malignant brain tumors in adults, represent a heterogeneous group of diseases with poor prognosis. Retroviruses can cause permanent genetic alterations that modify genes close to the viral integration site. Methods Here we describe the use of a high-throughput pipeline coupled to the commonly used tissue-specific retroviral RCAS-TVA mouse tumor model system. Utilizing next generation sequencing, we show that retroviral integration sites can be reproducibly detected in malignant stem cell lines generated from RCAS-PDGFB-driven glioma biopsies. Results A large fraction of common integration sites contained genes that have been dysregulated or misexpressed in glioma. Others overlapped with loci identified in previous glioma-related forward genetic screens, but several novel putative cancer-causing genes were also found. Integrating retroviral tagging and clinical data, Ppfibp1 was highlighted as a frequently tagged novel glioma-causing gene. Retroviral integrations into the locus resulted in Ppfibp1 upregulation, and Ppfibp1-tagged cells generated tumors with shorter latency upon orthotopic transplantation. In human gliomas, increased PPFIBP1 expression was significantly linked to poor prognosis and PDGF treatment resistance. Conclusions Altogether, the current study has demonstrated a novel approach to tagging glioma genes via forward genetics, validating previous results, and identifying PPFIBP1 as a putative oncogene in gliomagenesis. View on Web

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