Endoscopic Multiport Approach for Exenteration of the Infratemporal Fossa

alexandrossfakianakis shared this article with you from Inoreader Endoscopic Multiport Approach for Exenteration of the Infratemporal Fossa via The Laryngoscope New minimally endoscopic multiport approach to infratemporal fossa. Step-by-step cadaveric dissection. Objective To demonstrate anatomic relationships pertinent to the endoscopic multiport approach to the infratemporal fossa (ITF). Discuss advantages and limitations of each individual approach. Study Design Cadaveric study. Methods Endoscopic and endoscopic-assisted endonasal transpterygoid, sublabial transmaxillary, endoscopic transorbital, and endoscopic transoral approaches to accessing the ITF were completed in five silicone-injected fresh cadaveric specimens (10 sides) with the assistance of 0, 30, and 450 rods-lens endoscopes. Image guidance was used to confirm and document the anatomical relationships encountered in each approach. Results The endonasal endoscopic transpterygoid approach provides better visualization and more direct exposure to median structures. Endoscopic-assisted sublabial transmaxillary approach enhances the field of exposure, angle of attack, and ease of instrumentation to the lateral part of the ITF. Endoscopic-assisted transorbital approach via the inferior orbital fissure provided cephalic and anterior access. Endoscopic-assisted transoral approach complements the access to lesions extending inferior to the hard palate or far lateral to the mandibular condyle. Conclusions A combination of minimal access infratemporal approaches can provide adequate exposure of the entire ITF while avoiding some of the morbidity associated with open approaches. Level of Evidence NA Laryngoscope, 2023 View on Web

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Office‐based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients

alexandrossfakianakis shared this article with you from Inoreader Office‐based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients via The Laryngoscope Objective To investigate the effect of office-based blue laser therapy of vocal fold polyps on voice. Methods The medical records and video recordings of patients who underwent office-based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office-based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index-10 (VHI-10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. Results A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male-to-female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid-third of the vocal fold. All patients who presented for follow-up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI-10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). Conclusion Office-based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. Level of Evidence 4 Laryngoscope, 2023 View on Web

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Dose‐Dependent Glucocorticoid Regulation of Transcription Factors in Vocal Fold Fibroblasts and Macrophages

alexandrossfakianakis shared this article with you from Inoreader Dose‐Dependent Glucocorticoid Regulation of Transcription Factors in Vocal Fold Fibroblasts and Macrophages via The Laryngoscope Steroid-based therapies are associated with variable outcomes for laryngeal disease. This study provides incremental data related to potential mechanisms of this variability including divergent effects on the glucocorticoid receptor phosphorylation. Objective Variable outcomes of glucocorticoid (GC) therapy for laryngeal disease are putatively due to diverse interactions of the GC receptor (GR) with cell signaling pathways, limited consideration regarding concentration-dependent effects, and inconsistent selection of GCs. In the current study, we evaluated the concentration-dependent effects of three frequently administered GCs on transcription factors with an emphasis on the phosphorylation of GR at Ser203 and Ser211 regulating the nuclear translocation of GR. This study provides foundational data regarding the diverse functions of GCs to optimize therapeutic approaches. Study design In vitro. Methods Human vocal fold fibroblasts and THP1-derived macrophages were treated with different concentrations of dexamethasone, methylprednisolone, and triamcinolone in combination with IFN-γ, TNF-α, or IL4. Phosphorylated STAT1, NF-κB family molecules, and phosphorylated STAT6 were analyzed by Western blotting. Ser211-phosphorylated GR (S211-pGR) levels relative to GAPDH and Ser203-phosphorylated GR (S203-pGR) were also analyzed. Results GCs differentially altered phosphorylated STAT1 and NF-κB family molecules in different cell types under IFN-γ and TNF-α stimuli. GCs did not alter phosphorylated STAT6 in IL4-treated macrophages. The three GCs were nearly equivalent. A lower concentration of dexamethasone increased S211-pGR/GAPDH ratios relative to increased S211-pGR/S203-pGR ratios regardless of cell type and treatment. Conclusion The three GCs employed in two cell lines had nearly equivalent effects on transcription factor regulation. Relatively high levels of Ser203-phosphorylation at low GC concentrations may be related to concentration-dependent differential effects of GCs in the two cell lines. Level of Evidence NA Laryngoscope, 2023 View on Web

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New regimens as first‐line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader New regimens as first‐line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized controlled trial via Helicobacter Abstract Background Helicobacter pylori eradication in penicillin-allergic patients is challenging. The effective regimen is lacking in areas with high antibiotic resistance and tetracycline unavailable. Minocycline, cefuroxime, and full-dose metronidazole are promising drugs. Aims To compare the eradication rate, safety, and compliance among three new bismuth quadruple therapies for first-line H. pylori eradication in penicillin-allergic patients. Methods This randomized trial was conducted on 450 naive patients with H. pylori infection and penicillin allergy. The 14-day minocycline-metronidazole-containing (minocycline 100 mg twice daily and metronidazole 400 mg four times/day), minocycline-cefuroxime-containing (minocycline 100 mg twice daily and cefuroxime 500 mg twice daily), and cefuroxime-metronidazole-containing (cefuroxime 500 mg twice daily and metronidazole 400 mg four times/day) bismuth quadruple therapies were randomly assigned to the participants. Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed 4–8 weeks after eradication to evaluate outcome. Results The differences of eradication rates in either intention-to-treat (84.0%, 82.7%, and 23 82.0%, p = .896) or per-protocol (91.7%, 90.9%, and 88.2%, p = .599) analysis among minocycline-metronidazole, minocycline-cefuroxime, and cefuroxime-metronidazole-containing bismuth quadruple therapies were statistically insignificant. The incidence of adverse events (35.1%, 22.6%, and 28.9%) and compliance (90.5%, 91.8%, and 91.9%) were similar. Taste distortion, nausea, and anorexia were more common in metronidazole-containing regimens, and dizziness was more common in minocycline-containing regimens. The allergy was rare (~3%). Conclusions The efficacies of three bismuth quadruple therapies containing minocycline, cefuroxime, and full-dose metronidazole (pairwise) for first-line H. pylori eradication in penicillin-allergic patients were similarly satisfactory with relatively good safety and compliance. The study was registered in the Chinese Clinical Trials Registration (ChiCTR1900023702). View on Web

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Evaluation of the quality of life and the satisfaction level after reconstruction with anterior iliac crest graft and implant supported fixed prosthesis treatment

alexandrossfakianakis shared this article with you from Inoreader Evaluation of the quality of life and the satisfaction level after reconstruction with anterior iliac crest graft and implant supported fixed prosthesis treatment via Journal of Prosthodontics Abstract Purpose To evaluate oral health-related quality of life (OHRQoL) and satisfaction levels related to treatment in patients who have complete implant treatment and prosthetic rehabilitation after anterior iliac crest grafting. Materials and Methods Fifty-four patients (37 F, 17 M) with a total of 487 implants placed and implant-supported fixed prosthesis treatment completed were included in the study. OHIP-14 scale and satisfaction Likert scale questions were used to evaluate the oral health-related quality of life and the satisfaction levels related to the treatment applied, respectively. To compare the outcomes, the significance test and the Mann-Whitney U-test were used. One-way analysis of variance (ANOVA) and Kruskal-Wallis were used to assess the significance of differences among or between the groups. Results The quality of life was higher and the mean OHIP-14 scores were lower in women, older patients, and longer follow-up period, recorded as 13.6 ± 10.3 (p:0.263), 12.9 ± 11.3 (p: 0.079), and 11.8 ± 9.6 (p: 0.015*), respectively. Also, satisfaction levels of the patients related to the treatment were 83.3%. Conclusions The treatment of severely atrophic jaws with anterior iliac crest for the implant and prosthetic rehabilitation has a positive effect on the quality of life, this effect has increased with time, and the satisfaction levels of the patients related to this procedure were high and their expectations regarding this treatment were met at a high level. This article is protected by copyright. All rights reserved View on Web

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Immunogenicity of novel DNA vaccines encoding receptor‐binding domain (RBD) dimer‐Fc fusing antigens derived from different SARS‐CoV‐2 variants of concern

alexandrossfakianakis shared this article with you from Inoreader Immunogenicity of novel DNA vaccines encoding receptor‐binding domain (RBD) dimer‐Fc fusing antigens derived from different SARS‐CoV‐2 variants of concern via Journal of Medical Virology Abstract The continuously emerging of SARS-CoV-2 variants of concern (VOCs) led to a decline in effectiveness of the first-generation vaccines. Therefore, optimized vaccines and vaccination strategies, which show advantages in protecting against VOCs, are urgently needed. Here we constructed an optimized DNA vaccine plasmid containing built-in CpG adjuvant, and designed vaccine candidates encoding five forms of antigens derived from Wuhan-Hu-1. The results showed that plasmid with RBD dimer-Fc fusing antigen (2RBD-Fc) induced the highest level of RBD-specific IgG and neutralizing antibodies in mice. Then 2dRBD-Fc and 2omRBD-Fc vaccines, respectively derived from delta and omicron VOCs, were constructed. The 2dRBD-Fc induced potent humoral and cellular immune responses, while the immunogenicity of 2omRBD-Fc was low. We also observed that sequential immunization with 2RBD-Fc, 2dRBD-Fc and 2omRBD-Fc effectively elicited neutralizing antibodies against each immunized strain, and RBD-specific T cell responses. To be noted, the Wuhan-Hu-1, delta and omicron neutralizing antibody titers induced by sequential immunization were comparable to that induced by repetitive immunization with 2RBD-Fc, 2dRBD-Fc or 2omRBD-Fc respectively. The results suggest that sequential immunization with DNA vaccines encoding potent antigens derived from different VOCs, may be a promising strategy to elicit immune responses against multiple variants. This article is protected by copyright. All rights reserved. View on Web

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SARS‐CoV‐2 NSP7 inhibits type I and III IFN production by targeting the RIG‐I/MDA5, TRIF, and STING signaling pathways

alexandrossfakianakis shared this article with you from Inoreader SARS‐CoV‐2 NSP7 inhibits type I and III IFN production by targeting the RIG‐I/MDA5, TRIF, and STING signaling pathways via Journal of Medical Virology Abstract SARS-CoV-2 is a poor inducer of innate antiviral immunity, and the underlying mechanism still needs further investigation. Here, we reported that SARS-CoV-2 NSP7 inhibited the production of type I and III IFNs by targeting the RIG-I/MDA5, TLR3-TRIF, and cGAS-STING signaling pathways. SARS-CoV-2 NSP7 suppressed the expression of IFNs and IFN-stimulated genes induced by poly (I:C) transfection and infection with Sendai virus or SARS-CoV-2 virus-like particles. NSP7 impaired type I and III IFN production activated by components of the cytosolic dsRNA-sensing pathway, including RIG-I, MDA5, and MAVS, but not TBK1, IKKε, and IRF3-5D, an active form of IRF3. In addition, NSP7 also suppressed TRIF- and STING-induced IFN responses. Mechanistically, NSP7 associated with RIG-I and MDA5 prevented the formation of the RIG-I/MDA5−MAVS signalosome and interacted with TRIF and STING to inhibit TRIF-TBK1 and STING-TBK1 complex formation, thus reducing the subsequent IRF3 phosphorylation and nu clear translocation that are essential for IFN induction. In addition, ectopic expression of NSP7 impeded innate immune activation and facilitated virus replication. Taken together, SARS-CoV-2 NSP7 dampens type I and III IFN responses via disruption of the signal transduction of the RIG-I/MDA5−MAVS, TLR3-TRIF, and cGAS-STING signaling pathways, thus providing novel insights into the interactions between SARS-CoV-2 and innate antiviral immunity. This article is protected by copyright. All rights reserved. View on Web

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Two-centre experience in the treatment of thyroglossal duct remnants using the modified muscle-sparing Sistrunk technique

alexandrossfakianakis shared this article with you from Inoreader Two-centre experience in the treatment of thyroglossal duct remnants using the modified muscle-sparing Sistrunk technique via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The Sistrunk procedure has long been the method of choice for treating patients with thyroglossal duct remnants (TDRs). However, the extent of the surgical resection in the suprahyoid segment of the TDR remains controversial, as this anatomical site is the origin of both disease recurrence and surgical morbidity. The aim of this two-centre retrospective cohort study was to investigate the outcomes of a modified muscle-sparing Sistrunk procedure in primary TDRs. The primary predictor was the surgical approach, and the outcome variable was the recurrence rate. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Friends or foes: The mononuclear phagocyte system in ischemic stroke

alexandrossfakianakis shared this article with you from Inoreader Friends or foes: The mononuclear phagocyte system in ischemic stroke via Brain Pathology Pathophysiological effects of mononuclear phagocyte system MPS in ischemic stroke. Abstract Ischemic stroke (IS) is a major cause of disability and death in adults, and the immune response plays an indispensable role in its pathological process. After the onset of IS, an inflammatory storm, with the infiltration and mobilization of the mononuclear phagocyte system (MPS), is triggered in the brain. Microglia are rapidly activated in situ, followed by waves of circulating monocytes into the ischemic area. Activated microglia and monocytes/macrophages are mainly distributed in the peri-infarct area. These cells have similar morphology and functions, such as secreting cytokines and phagocytosis. Previously, the presence of the MPS was considered a marker of an exacerbated inflammatory response that contributes to brain damage. However, recent studies have suggested a rather complicated role of the MPS in IS. Here, we reviewed articles focusing on various functions of the MPS among different phases of IS, including recruitment, polarization, phagocytosis, angiogenesis, and in teraction with other types of cells. Moreover, due to the characteristics of the MPS, we also noted clinical research addressing alterations in the MPS as potential biomarkers for IS patients for the purposes of predicting prognosis and developing novel therapeutic strategies. View on Web

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The risk of acute myocardial infarction among patients with laboratory-confirmed invasive pneumococcal disease: a self-controlled case series study

alexandrossfakianakis shared this article with you from Inoreader The risk of acute myocardial infarction among patients with laboratory-confirmed invasive pneumococcal disease: a self-controlled case series study via Clinical Infectious Diseases Advance Access Abstract Background Major cardiovascular events, including acute myocardial infarction (AMI), have been reported among patients with certain viral and bacterial infections. Yet, whether invasive pneumococcal disease (IPD) increases the risk of AMI remains unclear. We examined whether laboratory-confirmed IPD was associated with the risk of AMI. Methods We conducted a self-controlled case series analysis among adult Tennessee residents with evidence of a first AM I hospitalization (2003-2019). Patient follow-up started 1 year prior to the earliest AMI and continued through the date of death, 1 year after AMI or end of study (12/2019). Periods for AMI assessment included the 7 to 1 days before IPD-specimen collection (pre IPD detection), day 0 through day 7 after IPD-specimen collection (current IPD), the 8 to 28 days after IPD-specimen collection (post IPD), and a control period (all other follow-up time). We used conditional Poisson regression to calculate incidence rate ratios and 95% confidence intervals (CI) for each risk period compared to control periods using within-person comparisons. Results We studied 324 patients hospitalized for AMI with a laboratory-confirmed IPD within 1 year before or after the AMI hospitalization. The incidence of AMI was significantly higher during the pre-IPD detection period (IRR:10.29; CI:6.33-16.73) and current IPD (IRR: 92.95; CI:72.17-119.71) periods, but non-significantly elevated in the post -IPD risk period (IRR: 1.83; CI:0.86-3.91) compared to control periods. An elevated AMI incidence was also observed in the post-IPD control period (29 to 364 days after IPD) [IRR: 2.95; CI:2.01-4.32]. Conclusions Hospitalizations with AMI were strongly associated with laboratory-confirmed IPD. View on Web

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