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Τετάρτη 6 Απριλίου 2022

Vaccines, Vol. 10, Pages 570: Changing Perspectives on Pediatric Human Papillomavirus (HPV)

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Via Vaccines

Vaccines, Vol. 10, Pages 570: Changing Perspectives on Pediatric Human Papillomavirus (HPV) Vaccination among Dental Students and Residents Reveals Recent Increase in Vaccine Hesitancy

Vaccines doi: 10.3390/vaccines10040570

Authors: Rebecca Maginot Carolina Esteves Karl Kingsley

This study was a retrospective analysis of previously collected anonymous survey data regarding vaccine awareness, beliefs, and knowledge among dental (DMD) students and postgraduate (PG) residents. The protocol for this study was approved by the Institutional Review Board (IRB) as exempt. A total of 341 responses were collected from n = 293 DMD students and n = 48 PG residents. Although most respondents agreed that vaccines were necessary, safe, and effective, over the past 4 years (2017–2020) a growing percentage of respondents disagreed. In addition, although most respondents disagreed that there are too many required vaccines, vaccines can make you sick, or are dangerous,a growing percentage of respondents now agreed with these statements. Finally, although most respondents were aware of the HPV vaccine, recently a growing percentage of both students and residents reported they had insufficient information about this vaccine. These results provide novel insights int o recent changes in attitudes and beliefs regarding vaccination among this population. Moreover, analysis of these shifts in attitudes and knowledge about HPV vaccination suggests that curricular integration of vaccine research and hesitancy may be needed to answer these questions in a supportive learning environment that fosters critical thinking and evidence-based practice and decision making.

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Splenic calcifications: an unusual finding in systemic lupus erythematosus

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Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer

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imagePurpose Patients with esophageal cancer can develop distant metastases between the start of neoadjuvant chemoradiotherapy (nCRT) and planned surgery (ie, interval distant metastases). 18F-FDG PET/CT restaging after nCRT detects interval distant metastases in ~8% of patients. This study aimed to identify patients for whom 18F-FDG PET/CT restaging after nCRT could be omitted using an existing prediction model predicting for interval distant metastases or by using clinical stage groups. Patients and Methods Patients with locally advanced esophageal cancer who underwent baseline and restaging 18F-FDG PET/CT, nCRT, and were planned for esophagectomy between 2017 and 2021 were eligible for inclusion in this retrospective study. The primary outcome was the existing model's external performance (ie, discrimination and calibration) for predicting interval distant metastases. The existing model predictors included tumor length, cN status, squamous cell carcinoma histology, and baseline SUVmax. The secondary outcome determined the clinical stage groups (AJCC/UICC eighth edition) for adenocarcinoma and squamous cell carcinoma for which the incidence of interval distant metastases was
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High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

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Abstract

Background

It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex.

Materials and methods

All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2.

Results

MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD.

Conclusions

The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph.

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Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers

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Abstract

Background

To evaluate the utility of positron-emission tomography (FDG PET) in initial staging and management of head and neck cancers.

Methods

This is a retrospective study of 99 treatment naïve head and neck cancer patients treated between January 2017 and December 2020 at a tertiary teaching centre. Change in initial staging and management was noted based on PET scan compared to cross-sectional imaging (CT and MRI).

Results

There were 73 (73.7%) males and 26 (26.2%) females with male-to-female ratio of 2.8:1.Overall, change in management was seen in 36/99 (36.4%) patients due to PET scan. With regards to initial staging, T, N and M stage was changed in 14/99 (14.1%), 19/99 (19.1%) and 3/99 (3%) patients, respectively. These changes were significantly higher in patients with unknown primary (63.3%, p value −0.001) and N3 (41%, p −0.045) nodal disease.

Conclusion

PET-CT plays an important role in appropriate initial staging and subsequent treatment planning of head and neck cancers.

Advances in knowledge

Initial staging PETCT changes management in 36.4% cases. Accuracy of various different imaging modalities have been compared.

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Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects

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Abstract

Purpose

The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them.

Methods

Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9 skeletal patterns. Each subject was assigned a skeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9 groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group.

Results

No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9 skeletal patterns. However, class III growers had a significantly earlier onset of prepubertal growth (10.25 ± 1.56 years) when compared to that of class II high angle cases (11.11 ± 1.67 years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups.

Conclusion

A map was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern.

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