Recommendation for imaging follow‐up strategy based on time‐specific disease failure for nasopharyngeal carcinoma

alexandrossfakianakis shared this article with you from Inoreader Recommendation for imaging follow‐up strategy based on time‐specific disease failure for nasopharyngeal carcinoma via Head & Neck Abstract Background To develop a common follow-up strategy for appropriate imaging examination at an appropriate time for nasopharyngeal carcinoma (NPC). Methods Independent prognostic factors were identified by Cox regression analysis, and a nomogram model was developed. Random survival forest (RSF) model was constructed to depict probability of disease failure during a 5-year follow-up and establish a reasonable risk-based follow-up strategy. Results The nomogram model finally categorized the patients into three risk groups. RSF model demonstrated distribution trends for local and regional recurrences, bone metastasis, liver metastasis, and lung metastasis of NPC. Adequate imaging at follow-up should be considered between 10 and 21 months for patients at moderate-risk of recurrence or metastasis and 7–36 months for those at high-risk. Conclusions The temporal distribution of incidence rates of recurrence or metastasis varied among different risk groups. We recommend implementing a focused and targeted imaging surveillance intervention at appropriate times to improve its efficiency and reduce costs. View on Web

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Tuberculosis treatment without rifampin in kidney/kidney–pancreas transplantation: A case series report

alexandrossfakianakis shared this article with you from Inoreader Tuberculosis treatment without rifampin in kidney/kidney–pancreas transplantation: A case series report via Transplant Infectious Disease Tuberculosis treatment without rifampin in kidney/kidney pancreas transplantation. Abstract Background The best approach to tuberculosis (TB) treatment in transplanted patients is still unknown. Current guidelines are based on evidence either extrapolated from other populations or observational. Rifampin-containing regimens have strong pharmacokinetic interactions with immunosuppressive regimens, with high rates of organ dysfunction and ∼20% mortality. This report describes the results obtained using non-rifampin-containing regimens to treat confirmed TB in adult patients with kidney/kidney–pancreas transplantation. Methods Retrospective data analysis from confirmed TB cases in adult kidney/kidney–pancreas transplant recipients (2006–2019), treated "de novo" with non-rifampin-containing regimens. Results Fifty-seven patients had confirmed TB. Thirty patients were treated "de novo" with non-rifampin-containing regimens. These patients' mean age was 49.24 (±11.50) years. Induction immunosuppression was used in 22 patients. Maintenance immunosuppression was tacrolimus–mycophenolate–steroids in 13 (43%), sirolimus–mycophenolate–steroids in 6 (20%), and other immunosuppressive regimens in 11 (36%). Belatacept was used in four patients. TB localizations: pulmonary 43%; disseminated 23%; extrapulmonary 33%. Twenty-seven (90%) patients completed treatment with isoniazid, ethambutol, and levofloxacin (12 months, 23; 9 months, 3; 6 months, 1); 12 of these patients also received pyrazinamide for the first 2 months and were cured with functioning grafts. One patient (3%) lost the graft while on treatment. Two patients (7%) died while on TB treatment. Median (range) follow-up after completion of TB treatment was 32 (8–150) months. No TB relapses were observed. Conclusions Results with non-rifampin-containing TB treatments in this case series were better (in terms of mortality and graft dysfunction) than those previously described with rifampin-containing regimens in transplanted patients. View on Web

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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

alexandrossfakianakis shared this article with you from Inoreader 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 via Journal of Clinical Periodontology 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. View on Web

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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

alexandrossfakianakis shared this article with you from Inoreader 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 via Clinical Implant Dentistry and Related Research 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. View on Web

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Expansile Sphenoid Mycetoma Presenting With Headache and Galactorrhea

alexandrossfakianakis shared this article with you from Inoreader Expansile Sphenoid Mycetoma Presenting With Headache and Galactorrhea via JAMA Otolaryngology–Head & Neck Surgery Online First 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. View on Web

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