Recovery from the damage of cranial radiation modulated by memantine, an NMDA receptor antagonist combined with hyperbaric oxygen therapy

alexandrossfakianakis shared this article with you from Inoreader Recovery from the damage of cranial radiation modulated by memantine, an NMDA receptor antagonist combined with hyperbaric oxygen therapy via Neuro-Oncology Advance Access Abstract Background Radiotherapy is an important treatment option for central nervous system malignancies. However, cranial radiation induces hippocampal dysfunction and white matter injury; this leads to cognitive dysfunction, and results in a reduced quality of life in patients. Excitatory glutamate signaling through N-methyl-D-aspartate receptors (NMDARs) plays a central role both in hippocampal neurogenesis and in the myelination of oligodendrocytes in the cerebrum. Methods We will provide the method for quantifying neurogenesis in human subjects in live brain during the cancer therapy. Neuroimaging using behavioral task we originally create, to examine human hippocampal memory pathway in patients with brain disorders. Results Treatment with memantine, a non-competitive NMDAR antagonist, reversed impairment in hippocampal pattern separation networks as detected by functional magnetic resonance imaging. Hyperbaric preconditi oning of the patients just before radiotherapy with memantine most reversed white matter injury as detected by whole brain analysis with Tract-Based Spatial Statics. Neuromodulation combined with the administration of hyperbaric oxygen therapy and memantine during radiotherapy facilitated the restoration of hippocampal function and white matter integrity, and improved higher cognitive function in patients receiving cranial radiation. Conclusions The method for therapy and diagnosis of hippocampal function we developed can be applicable to the patients received cranial radiation to restore the cognitive decline. The monitoring can be followed during the therapy that production of new neurons by which ability of pattern separation is increased, then recovery of pattern completion, followed by new score elevation. View on Web

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Risk factors for high level cytomegalovirus viremia in liver transplant recipients and associated outcomes

alexandrossfakianakis shared this article with you from Inoreader Risk factors for high level cytomegalovirus viremia in liver transplant recipients and associated outcomes via Transplant Infectious Disease Abstract Purpose To evaluate epidemiology, risk-factors and outcomes of high-level cytomegalovirus (CMV) viremia in liver transplant recipients. Methods Adult patients receiving a liver transplant between 1/1/2017-9/30/2020 were evaluated. Viral loads at UW Health Clinical Laboratories were required to allow for numerical comparison. Primary objective was incidence and outcomes of high-level (HL) CMV viremia (viral-load >100,000 IU/mL). Secondary objective was to elucidate risk factors to allow targeted interventions. Results 209 patients met inclusion criteria; 175 kept their graft for at least 240 days. Of these 9 patients developed HL CMV, 28 developed low-level (LL CMV, viral-load 250–100,000 IU/mL) and 138 did not develop CMV viremia. When comparing these 3 groups via classic statistical methods time from transplant to viremia was similar (HL 158 ± 77 days, LL 150 ± 76 days). Clinical factors were also similar with the exception of donor seropositivity (HL 87.5%, LL 70.4%, No CMV 49.6%, p = 0.025). HL CMV was significantly associated with graft loss (p < 0.0001) on Kaplan-Meier analysis; graft loss in the LL CMV group did not differ from the No CMV group (p = 0.96) To allow valid assessment of risk factors in the total study population (n = 209) models of time-varying covariates were used and Cox proportional hazards ratios were calculated. In this analysis HL CMV was associated with a significantly increased risk of graft loss (HR 5.6, p = 0.0016). When investigating risk factors associated with HL CMV, donor seropositivity significantly increased risk (HR 8.85, 95% CI 1.13–71.43, p = 0.038). Pre-transplant total bilirubin (HR 1.04, 95% CI 0.998–1.07, p = 0.06) trended towards significance. Recipient seronegativity, liver disease, clinical and allocation MELD, transplant surgery duration, age, sex, induction immunosuppression, and maintenance immunosuppression were not significantly associated with development of HL CMV. Conclusion HL CMV after liver transplant is uncommon but is associated with a significantly increased risk of graft loss that is not present in those patients who develop LL CMV or do not develop CMV viremia. Given these negative graft effects, CMV stewardship interventions targeting recipients of CMV seropositive allografts are warranted. Future larger scale studies evaluating the potential role of other factors in risk stratification are needed. This article is protected by copyright. All rights reserved View on Web

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Predictive Value of Risk Factors for Pharyngocutaneous Fistula After Total Laryngectomy

alexandrossfakianakis shared this article with you from Inoreader Predictive Value of Risk Factors for Pharyngocutaneous Fistula After Total Laryngectomy via The Laryngoscope Multiple patient-, disease-, and surgery-related factors are risk factors for pharyngocutaneous fistula. In particular, postoperative hypoproteinemia could be a good predictive factor for pharyngocutaneous fistula in patients undergoing total laryngectomy. Objectives To assess the predictive value of various risk factors for pharyngocutaneous fistula (PCF) after total laryngectomy. Methods The characteristics of each study were collected from six databases up to January of 2022. Risk for bias was assessed using the QUADAS-2 tool. Results A total of 58 studies in 9845 patients were included in the analysis. The incidence of PCF was 21.69%, 95% confidence intervals (CI) [0.20; 0.24] in the included studies. Age (OR = 1.33, 95% CI [1.12; 1.58]), postoperative anemia (OR = 2.29, 95% CI [1.47; 3.57]), diabetes mellitus (OR = 1.81, 95% CI [1.20; 2.71]), tumor site (above or below the glottis) (OR = 1.47, 95% CI [1.15; 1.88]), previous radiation therapy (OR = 2.06, 95% CI [1.56; 2.72]), previous tracheostomy (OR = 1.26, 95% CI [1.04; 1.53]), surgery timing (salvage vs. primary) (OR = 2.08, 95% CI [1.46; 2.97]), extended total laryngectomy (including pharyngectomy) (OR = 1.96, 95% CI [1.28; 3.00]), primary tracheoesophageal puncture (OR = 0.61, 95% CI [0.40; 0.93]), and postoperative hypoproteinemia (OR = 9.98, 95% CI [3.68; 27.03]) were significantly associated with the occurrence of PCF. In view of predictive ability, pos toperative hypoproteinemia showed the highest accuracy (sensitivity = 51%, specificity = 90%, area under the curve = 0.84). Conclusion Multiple patient-, disease-, and surgery-related factors are risk factors for PCF. In particular, postoperative hypoproteinemia could be a good predictive factor for PCF in patients undergoing total laryngectomy. Laryngoscope, 2022 View on Web

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Feasibility of robotic thyroidectomy via hairline incision using da Vinci single port system: Initial experience with 40 consecutive cases

alexandrossfakianakis shared this article with you from Inoreader Feasibility of robotic thyroidectomy via hairline incision using da Vinci single port system: Initial experience with 40 consecutive cases via Head & Neck Abstract Background This study aimed to introduce our robotic technique, which can minimize dissection extent using the da Vinci SP robotic system via hairline incision. Methods Forty patients underwent robotic thyroidectomy using the da Vinci SP robotic system via a hairline incision between February 2020 and April 2021 at Ulsan University Hospital. All procedures were performed successfully by one surgeon using the SP robotic system. Results Hemithyroidectomies were performed in 32 patients and total thyroidectomies in eight patients. Central neck dissection was performed in 32 patients. The overall mean operative time was 140.2 ± 50.7 min, and the mean console time was 74.0 ± 42.7 min. All patients were discharged on the second or third day after operation without any complications. Conclusions Robotic thyroidectomy using the SP robotic system via hairline incision is technically feasible and safe, with a shorter incision length when compared with that of the Xi system. View on Web

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Morphology of Peri‐Implant Tissues around Permanent Prostheses with Various Emergence Angles Following Free Gingival Grafting

alexandrossfakianakis shared this article with you from Inoreader Morphology of Peri‐Implant Tissues around Permanent Prostheses with Various Emergence Angles Following Free Gingival Grafting via Journal of Prosthodontics Abstract Purpose To analyze the tissue morphology around implant-supported prostheses by digital technology and to evaluate the effect of prosthetic contours on the changes in tissues following free gingiva graft procedure. Material and Methods A total of 53 implants in 32 patients receiving free gingiva grafts were selected. These had previously presented insufficient keratinized mucosa width (KMW). At the follow-up visits (mean: 16.66 ±9.97 months), the implant position and tissue condition were documented with an oral scanner. Vertical soft tissue thickness (VT), measured from the implant-abutment connection to the marginal tissues, and horizontal soft tissue thickness (HT), at the level of the platform, were calculated. The VT, HT and emergence angle (EA) of prostheses were assessed by 3Shape analyzing software. The final KMW was measured by clinical assessment. Marginal bone loss (MBL) was calculated in the follow-up bitewing radiographs. Results The mean VT in the study was 2.65 ±0.75 mm at the mid-buccal sites, 3.74 ±1.22 mm at the mesial, 3.16 ±1.08 mm at the distal, and 2.53 ±0.92 at the mid-lingual aspects. The mid-buccal HT was 1.45 ±0.53 mm while the mid-lingual was 1.05 ±0.43 mm (P = 0.008). Interestingly, prostheses with mid-buccal EA>30∘ exhibited slightly lower VT, but higher HT, than the ones with EA≤30∘. Prostheses with proximal EA>30∘ displayed slightly more MBL, compared to prostheses with EA≤30∘. The mean KMW was 4.08 ±1.10 mm. Conclusions Free gingival grafting is a predictable treatment approach to augmenting soft tissue 3-dimensionally. Prostheses with EA≤30∘ were preferable for preserving the maximal VT and maintaining crestal bone stability. This article is protected by copyright. All rights reserved View on Web

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The association of specific types of vegetables consumption with 10‐year type II diabetes risk: Findings from the ATTICA cohort study.

alexandrossfakianakis shared this article with you from Inoreader The association of specific types of vegetables consumption with 10‐year type II diabetes risk: Findings from the ATTICA cohort study. via Journal of Human Nutrition and Dietetics Abstract Background To investigate the association between vegetable consumption, in total as well as per type/ category, and 10-year type-2 diabetes mellitus (T2DM) incidence. Methodology ATTICA study was conducted during 2001-2012 in 3,042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetables' consumption (total, per type) was evaluated through a validated semi-quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10-year follow-up, data from 1,485 participants were used for the current analysis. Results After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had 0.42-times lower risk of developing T2DM [HR (95% CI): 0.42 (0.29, 0.61)]; the benefits of consumption we re greater in women [HR (95% CI): 0.29 (0.16, 0.53)] as compared to men [HR (95% CI): 0.56 (0.34, 0.92)]. Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men. Principal conclusions The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at population level. This article is protected by copyright. All rights reserved. View on Web

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Dysphagia in a Patient With Sarcoidosis

alexandrossfakianakis shared this article with you from Inoreader Dysphagia in a Patient With Sarcoidosis via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a woman in her 70s with a medical history of sarcoidosis, atrial fibrillation, asthma, gastroesophageal reflux disease, Schatzki's ring status after multiple dilations, pulmonary hypertension, and hypothyroidism who presented with a more than 10-year history of dysphagia and was found to have sarcoid involvement of the upper esophageal sphincter. View on Web

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Hypothyroidism After Using Superior Thyroid Artery as A Recipient Artery

alexandrossfakianakis shared this article with you from Inoreader Hypothyroidism After Using Superior Thyroid Artery as A Recipient Artery via The Laryngoscope The aim of this study was to evaluate whether the use of the superior thyroid artery (SThA) as a recipient vessel affect thyroid dysfunction in patients undergoing TPLE combined with hemithyroidectomy. Our study revealed there was no significant difference in the postoperative hypothyroidism between patients with SThA used and not. We suggest that even after hemithyroidectomy, with inferior thyroid arteries are preserved, the SThA can be used as a recipient vessel. Objective Superior thyroid artery (SThA) is a common recipient artery in free tissue transfer even after total pharyngolaryngoesophagectomy (TPLE) with hemithyroidectomy. The aim of this study was to evaluate whether the use of SThA as a recipient vessel affect thyroid function in patients undergoing TPLE with hemithyroidectomy. Methods From 2011 to 2020, 91 patients who underwent free jejunum transfer after TPLE with hemithyroidectomy were divided into two groups. In Group1 (n = 47), the contralateral SThA was used for the anastomosis. In Group2 (n = 44), other vessels were used. Retrospective chart review was performed comparing postoperative thyroid function between two groups. Results In group1, 17 patients presented hypothyroidism, 21 presented latent hypothyroidism and 9 presented no thyroid dysfunction comparing 15, 19, and 10 respectively in group 2. There were no significant differences between the two groups. Conclusion Even after hemithyroidectomy, with inferior thyroid arteries are preserved, the SThA can be used as a recipient vessel. Level of Evidence 3 Laryngoscope, 2022 View on Web

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Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: a cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: a cross‐sectional study via International Endodontic Journal Abstract Aim This study aimed to quantitatively and qualitatively determine the proteomic profile of apical periodontitis (AP) in Type 2 Diabetes Mellitus (T2DM) patients in comparison to systemically non-compromised patients, and to correlate the protein expression of both groups with their biological functions. Methodology The sample consisted of 18 patients with asymptomatic AP divided into two groups according to the presence of T2DM: diabetic group - patients with T2DM (n = 9) and control group - systemically healthy patients (n = 9). After sample collection, the root canal samples were prepared for proteomic analysis using reverse-phase liquid chromatography mass spectrometry. Label-free quantitative proteomic analysis was performed by Protein Lynx Global Service software. Differences in protein expression between groups were calculated using t-test (p < 0.05). Biological functions were analyzed using the Homo sapiens UniProt database. Results A total of 727 human proteins were identified in all samples. Among them, 124 proteins common to both groups were quantified, out of which 65 proteins from the diabetic group showed significant differences compared with the control: 43 up-regulated (p < 0.05) and 22 down-regulated (p < 0.05) proteins. No significant differences in protein expression were seen for the remaining 59 proteins (p > 0.05). Most proteins with differences in expression were related to immune/inflammatory response. Neutrophil gelatinase-associated lipocalin, Plastin-2, Lactotransferrin, and 13 isoforms of immunoglobulins were up-regulated. In contrast, Protein S100-A8, Protein S100-A9, Histone H2B, Neutrophil defensin 1, Neutrophil defensin 3, and Prolactin-inducible protein were down-regulated. Conclusions Quantitative differences were demonstrated in the expression of proteins common to diabetic and control groups, mainly related to immune response, oxidative stress, apoptosis, and proteolysis. These findings revealed biological pathways that provide the basis to support clinical findings on the relationship between AP and T2DM. View on Web

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Endonasal access to the lateral poststyloid space: Far lateral extension of an endoscopic endonasal corridor

alexandrossfakianakis shared this article with you from Inoreader Endonasal access to the lateral poststyloid space: Far lateral extension of an endoscopic endonasal corridor via Head & Neck Abstract The styloid process constitutes the posterolateral boundary for an endonasal exposure of the infratemporal fossa. This study aims to explore the feasibility of a far-lateral extension to the lateral poststyloid space via an endonasal corridor. An endonasal dissection was performed on six cadaveric specimens (12 sides). Following an endoscopic endonasal access to the parapharyngeal space, the styloid process and the tympanic portion of the temporal bone were removed to reveal the jugular bulb and the extratemporal facial nerve. Distances from the anterior nasal spine to the relevant landmarks were measured using a surgical navigation device. Through an endonasal corridor, only the anteroinferior aspect of the jugular bulb was exposed. Conversely, the extratemporal facial nerve could be sufficiently exposed, and the deep temporal nerve could be transposed to the stylomastoid foramen. The average horizontal distances from the nasal spine to the posterior tract of V3, stylo id process, and facial nerve were 79.33 ± 3.41, 97.10 ± 4.74, and 104.77 ± 4.42 mm, respectively. Access to the lateral poststyloid space via an endonasal corridor is feasible, potentially providing an alternative approach to address select lesions extending to this region. The deep temporal nerve has a similar diameter to that of the facial nerve; thus, providing potential reinnervation of the facial nerve. View on Web

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