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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Risk Factors and Outcomes of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study of USRDS Data

alexandrossfakianakis shared this article with you from Inoreader Risk Factors and Outcomes of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study of USRDS Data via Clinical Infectious Diseases Advance Access ABSTRACT Background Kidney transplant recipients are at increased risk for invasive aspergillosis (IA), a disease with poor outcomes and substantial economic burden. We aimed to determine risk factors for posttransplant IA by using a national database and to assess the association of IA with mortality and allograft failure. Methods Using the United States Renal Data System database, we performed a retrospective case-control study of patients who underwent kidney transplant from 1998 through 2017. To evaluate risk factors for IA, we performed conditional logistic regression analysis by comparing characteristics between IA-infected patients and their matched uninfected controls. We performed Cox regression analysis to evaluate the effects of IA on mortality and death-censored allograft failure. Results We matched 359 patients with IA to 1,436 uninfected controls (1:4). IA was diagnosed at a median of 22.5 months (IQR, 5.4-85.2 mo nths) after kidney transplant. Risk factors for IA were Black/African American race, duration of pretransplant hemodialysis, higher Elixhauser Comorbidity Index score, weight loss, chronic pulmonary disease, need for early posttransplant hemodialysis, and a history of cytomegalovirus infection. Receiving an allograft from a living donor was protective against IA. IA was a strong independent predictor of 1-year mortality (adjusted hazard ratio, 5.02 [95% CI, 3.58-7.04], P < .001). Additionally, IA was associated with 1-year allograft failure (adjusted hazard ratio, 3.37 [95% CI, 1.96-5.77], P < .001). Conclusions Our findings emphasize the importance of timely transplant to mitigate the risk of posttransplant IA. An individualized approach to disease prevention is essential to decrease mortality and allograft failure. View on Web

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Epidemiology of human parainfluenza virus type 3 (HPIV-3) and respiratory syncytial virus (RSV) infections in the time of COVID-19: findings from a household cohort

alexandrossfakianakis shared this article with you from Inoreader Epidemiology of human parainfluenza virus type 3 (HPIV-3) and respiratory syncytial virus (RSV) infections in the time of COVID-19: findings from a household cohort in Maryland via Clinical Infectious Diseases Advance Access Abstract Background During the COVID-19 pandemic, human parainfluenza type 3 (HPIV-3) and respiratory syncytial virus (RSV) circulation increased as non-pharmaceutical interventions were relaxed. Using data from 175 households (n = 690 members) followed between November 2020–October 2021, we characterizedHPIV-3 and RSV burden in children aged 0-4 years and infection patterns in their households. Methods Households with ≥1 child aged 0-4 years were enrolled and members collected weekly nasal swabs (NS) and additional swabs with COVID-like illness onset. We tested all NS from symptomatic episodes in children aged 0-4 years for HPIV-3, RSV, and SARS-CoV-2 by reverse-transcriptase polymerase chain reaction (RT-PCR). Among children with HPIV-3 or RSV infection, we tested all contemporaneous NS collected from household members. We compared incidence rates (IRs) of symptomatic infection with each virus among children aged 0-4 years dur ing epidemic periods, identified household primary infections as the earliest detected infection, and examined community exposures associated with primary infection. Results Overall, 41/175 (23.4%) households had individuals with HPIV-3 (n = 45) or RSV (n = 46) infections. Among children aged 0-4 years, IRs of symptomatic infection/1,000 person-weeks were 8.7[6.0, 12.2] for HPIV-3, 7.6[4.8, 11.4] for RSV, and 1.9[1.0, 3.5] for SARS-CoV-2. 35/36 primary HPIV-3 or RSV infections occurred in children aged 0-4 years. Children with childcare/preschool attendance had higher odds of primary infection (OR = 10.81, 95% CI: 3.14-37.23). Conclusion Among children aged 0-4 years in this cohort, IRs of symptomatic HPIV-3 and RSV infection were four-fold higher than for SARS-CoV-2 during epidemic periods. HPIV-3 and RSV were almost exclusively introduced into households by infants and preschool children. View on Web

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Physiopathology of peri‐implant diseases

alexandrossfakianakis shared this article with you from Inoreader Physiopathology of peri‐implant diseases via Clinical Implant Dentistry and Related Research 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. View on Web

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Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss

alexandrossfakianakis shared this article with you from Inoreader Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss via The Laryngoscope 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 View on Web

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Induced Paresis for Awake Laryngoscopy Procedures

alexandrossfakianakis shared this article with you from Inoreader Induced Paresis for Awake Laryngoscopy Procedures via The Laryngoscope 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. View on Web

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