Contribution and safety of the side‐to‐end hypoglossal‐to‐facial transfer in multidisciplinary facial reanimation

alexandrossfakianakis shared this article with you from Inoreader Contribution and safety of the side‐to‐end hypoglossal‐to‐facial transfer in multidisciplinary facial reanimation Via Head & Neck Abstract Background This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques. Methods Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House–Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function. Results Ninety-four percent of cases reached HB grades III–IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184–4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375–10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial). Conclusions The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessing the risks associated with the emergence of Florona and possible preventive measures

alexandrossfakianakis shared this article with you from Inoreader Message: Κορωνοϊός: Τι είναι η Delmicron και η Florona REUTERS / MAY JAMES Το στέλεχος Όμικρον του SARS-CoV-2 κυριαρχεί πλέον στην Ευρώπη και οδηγεί σε κατακόρυφη αύξηση των νέων κρουσμάτων COVID-19. Πρόσφατα, δύο νέοι όροι έχουν έρθει στο προσκήνιο. Ο λόγος για τους όρους Delmicron και Florona. Οι Ιατροί της Θεραπευτικής Κλινικής της Ιατρικής Σχολής του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών Θεοδώρα Ψαλτοπούλου, Γιάννης Ντάνασης, Πάνος Μαλανδράκης και Θάνος Δημόπουλος (Πρύτανης ΕΚΠΑ) συνοψίζουν τα νεότερα σχετικά με τα Delmicron και Florona. Αρχικά πρέπει να σημειωθεί ότι και οι δύο όροι δεν αναφέρονται σε κάποιο νέο στέλεχος του SARS-CoV-2, αλλά σε συνύπαρξη του στελέχους Όμικρον είτε με το στέλεχος Δέλτα (Delmicron) είτε με την εποχική γρίπη (Florona). Σύμφωνα με τον Παγκόσμιο Οργανισμό Υγείας (ΠΟΥ), η επικράτηση του στελέχους Όμικρον δεν θα πρέπει να μας κάνει να λησμονήσουμε άλλες πολύ συχνές ιογενείς λοιμώξεις που συνυπάρχουν στην κοινότητα και μπορεί να εμφανιστούν παράλληλα σε ευάλωτα άτομα. Γι' αυτό το λόγο, τονίζεται η ανάγκη πλήρους εμβολιασμού με όλες τις απαραίτητες αναμνηστικές δόσεις τόσο έναντι του SARS-CoV-2 όσο και έναντι της εποχικής γρίπης, παράλληλα με την τήρηση των κανόνων σωματικής απομάκρυνσης για την πρόληψη της μετάδοσης και των δύο λοιμώξεων. Τι είναι η Delmicron: Ποια τα συμπτώματα Τα άτομα με εξασθενημένο ανοσοποιητικό σύστημα, τα άτομα μεγαλύτερης ηλικίας και με συνυπάρχουσες παθήσεις παρουσιάζουν αυξημένο κίνδυνο COVID-19 και μάλιστα είναι πιθανό να νοσήσουν ταυτόχρονα και από δύο επικρατούντα στελέχη του SARS-CoV-2, δηλαδή το Όμικρον και το Δέλτα. Η συλλοίμωξη με τα δύο στελέχη (Delmicron) μπορεί επίσης να παρατηρηθεί σε περιοχές με χαμηλή εμβολιαστική κάλυψη του πληθυσμού. Και αυτό ισχύει γιατί μπορεί το στέλεχος Όμικρον να είναι το κυρίαρχο, ωστόσο το στέλεχος Δέλτα δεν έχει εκλείψει. Στο γενικό πληθυσμό η πιθανότητα της ταυτόχρονης λοίμωξης με δύο στελέχη SARS-CoV-2 είναι χαμηλή, ωστόσο σε περιπτώσεις συνωστισμού μπορεί να συνυπάρχουν κρούσματα τόσο Δέλτα όσο και Όμικρον. Εάν τα άτομα που έχουν εξασθενημένο ανοσοποιητικό βρεθούν στο πλήθος, θα εκτεθούν πιθανότατα και στα δύο στελέχη και μπορεί να εμφανίσουν κλινική νόσο και από τα δύο στελέχη. Τα συμπτώματα είναι ουσιαστικά ο συνδυασμός των συμπτωμάτων από τα δύο στελέχη και περιλαμβάνουν εμπύρετο, βήχα, ανοσμία, αγευσία, πονοκέφαλο, καταρροή και πονόλαιμο. Τι είναι η Florona: Τα συμπτώματα και οι επιπλοκές Πολύ πρόσφατα αναφέρθηκε στο Ισραήλ η περίπτωση μιας εγκύου που προσήλθε στο νοσοκομείο για τοκετό και διαγνώσθηκε με παράλληλη λοίμωξη COVID-19 και γρίπης (Florona). Η ασθενής δεν είχε εμβολιαστεί για κανέναν από τους δύο ιούς. Παρόλο που ο όρος Florona μπορεί να προέκυψε πρόσφατα, η συλλοίμωξη δεν αποτελεί κάτι καινούργιο για την ιατρική κοινότητα. Ο ιός SARS-CoV-2 και ο ιός της γρίπης μεταδίδονται με παρόμοιο τρόπο, δηλαδή με την κοντινή επαφή σε απόσταση μικρότερη των 2 μέτρων μέσω αναπνευστικών σταγονιδίων ή/και αερολύματος κατά τη διάρκεια της ομιλίας, του βήχα και του πτερνίσματος. Οι δύο λοιμώξεις έχουν κοινά συμπτώματα όπως βήχας, πυρετό και καταρροή. Διαφορετικές δοκιμασίες PCR για τον ιό της γρίπης και για τον SARS-CoV-2 μπορεί να αποσαφηνίσουν σε κάθε περίπτωση την αιτιολογία των συμπτωμάτων. Και οι δύο λοιμώξεις μπορεί να έχουν σοβαρές επιπλοκές όπως πνευμονία, οξεία αναπνευστική ανεπάρκεια, πολυ-οργανική ανεπάρκεια, καρδιακά συμβάματα, εγκεφαλίτιδα, μυοκαρδίτιδα, ισχαιμικό εγκεφαλικό επεισόδιο και θάνατο. Unlike some of the claims made by fake news posts of social media, Florona is not a new Covid-19 variant. The last Covid-19 variant that was detected was Omicron and no further variants have since been identified by the World Health Organisation. The WHO does, however, confirm that co-infection with both Covid-19 (any variant) and the flu virus is indeed possible and added that the best way to avoid such a condition is to get vaccinated against both Covid-19 and Influenza. What are the symptoms of Florona? While both Covid-19 and influenza affect the respiratory system, there are some differences between the way flu and Covid-19 impacts health and manifests themselves. Symptoms of "Florona" include high fever, consistent chest pain or constriction, shortness of breath and loss of appetite. It can also lead to states of confusion and anxiety. According to the WHO, mild symptoms of a double Covid-19 and flu infection can be treated at home itself without requiring any hospitalisation. In severe cases, symptoms of Florona may also include pneumonia, myocarditis and inflammation in heart muscles. Is Florona a matter of concern? Both Covid-19 and flu are viruses that affect the respiratory tract and can cause severe illness and even death. While the symptoms and means of transmission for both viruses are the same, both have different treatments and different vaccines. Double infection with both viruses can cause complications the body and stress out the immune system. While "Florona" is not a new variant, the occurrence might be indicative of a weakened immune system under attack from two virus infections, Dr Nahla Abdel Wahab, Cairo University Hospital doctor, was quoted by Israeli media following the emergence of the disease. Amid the ongoing winter months, otherwise known as "flu season", season influenza breakouts are not uncommon in several countries. With Covid-19 cases also peaking across the world following the emergence of Omicron, fear of "Florona" cases spiking may not be unfounded. (Credit: Pixabay) How to prevent Florona? Following social distancing protocols, wearing masks and getting vaccinated against both Covid-19 and influenza is the only way to prevent Florona. Flu vaccines have been used since 1949, especially among vulnerable groups such as senior citizens. Meanwhile, a majority of countries have rolled out vaccination plans for their adult populations. Assessing the risks associated with the emergence of Florona and possible preventive measures Via Journal of Medical Virology Abstract The emergence of novel variants of SARS-CoV-2, especially the VOCs (variants of concern), has been considered a severe threat amid the mighty efforts of various nations to contain the negative repercussions of the COVID-19 pandemic caused by SARS-CoV-2. This article is protected by copyright. All rights reserved. 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Memory impairment and concentration problems in COVID‐19 survivors eight weeks after non‐ICU hospitalization: a retrospective cohort study

alexandrossfakianakis shared this article with you from Inoreader Memory impairment and concentration problems in COVID‐19 survivors eight weeks after non‐ICU hospitalization: a retrospective cohort study Via Journal of Medical Virology Abstract Background Studies on the SARS-CoV-1 have shown long term effects on health, rehabilitation and quality of life in patients. Objective To evaluate effects on recovery and mental health in COVID-19 survivors Methods A single centre, retrospective cohort study in (non ICU admitted) adult patients with COVID-19 infection was conducted. Next to baseline characteristics during hospital admission, data on remaining symptoms and radiographic abnormalities were extracted at the 8-week follow-up at the outpatient clinic. The HADS (Hospital Anxiety and Depression Scale) was used to detect anxiety and depression. Results 211 patients were included, median age 63 years, 61% male, with overweight (average BMI 28.6 kg/m2). At the outpatient clinic 13% of the patients were symptom free, whereas 25% reported more than three symptoms. Persisting physical symptoms were mainly fatigue 68%, dyspnea 56% and cough 26%. Most patients had norma lisation of chest X-ray (61.1%) and oxygen saturation (89.9%). Interestingly, 33% reported memory impairment and concentration problems 28%. 7.8% scored for anxiety and 7.1% for depression on the HADS. Correlations were found between the number of physical symptoms and scores on the HADS. Conclusion Only 13% had symptom free recovery after 8 weeks. Besides physical symptoms memory problems were frequently seen. The number of mental and physical symptoms were correlated. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study Via Journal of Human Nutrition and Dietetics Abstract Background Disease-related-malnutrition predicts poor clinical outcomes in elderly patients, and screening is pivotal to identify patients at nutritional risk. This study aimed to investigate nutrition screening rates in electronic patient records, and validate the scores given. Secondary was to investigate whether the proportion of patients at risk differed between patients where screening was documented and those where no screening was documented. Methods This cross-sectional observational study was conducted in a Danish university hospital during November 2020. Patients aged 65 years or more admitted to a medical department were included. The Nutrition Risk Screening (NRS-2002) tool was used to identify patients at nutritional risk, both in routine clinical care, where data were collected retrospectively, and during a validation process in a random patient sample, where data were collected prospectively. Results In total, 817 patients were ad mitted for more than 24 hours. Of these, an NRS-2002 score was documented in 294 (36%), among whom 177 (60%) were at nutritional risk. In 146 patients where no score was documented, 88 (60%) were at risk. Validation was possible in 91 patients where a record-based score and a validated score were documented. The specificity of the record-based score was 100%, while the sensitivity was 75%, indicating that routine screening underestimated nutritional risk (p<0.001, proportion difference 19%(95%CI 10;28%)). Conclusions: Electronic documentation does not solve issues about compliance with nutritional risk screening. In patients where screening was not documented, the occurrence of nutritional risk was similar, indicating that omission of screening is not related to the score. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Examining the role of brooding, distress, and negative urgency in dysregulated behaviors: A cross‐sectional study in treatment‐seeking young people

alexandrossfakianakis shared this article with you from Inoreader Examining the role of brooding, distress, and negative urgency in dysregulated behaviors: A cross‐sectional study in treatment‐seeking young people Via Journal of Clinical Psychology Abstract Objective Dysregulated behaviors including substance use, disordered eating, and nonsuicidal self-injury (NSSI) have significant negative implications for individuals and health systems. It is therefore paramount to understand factors influencing behavioral dysregulation, to inform prevention and treatment approaches. The literature suggests that distress and rumination (brooding) prompt individuals to engage in behavioral dysregulation for distraction (Emotional Cascade Model), although these concepts have limited investigation in clinical, treatment-seeking samples, particularly alongside negative urgency. This cross-sectional study sought to examine the relationships of brooding, distress, and negative urgency with behavioral dysregulation, as well as the moderating effect of negative urgency between brooding and behavioral dysregulation, in treatment-seeking young people. Method A total of 385 treatment-seeking young people completed cross-sectional, self-report measures of distress, rumination, negative urgency, and engagement in dysregulated behaviors (NSSI, alcohol use, drug use, binge eating, and purging) over the past 1−3 months. Results Structural equation modeling revealed that only negative urgency, and not brooding or distress, had a significant positive relationship with behavioral dysregulation. Negative urgency did not significantly moderate the relationship between brooding and behavioral dysregulation. Conclusions These findings reinforce the importance of considering negative urgency in the conceptualization, prevention, and treatment of behavioral dysregulation, and contribute to the knowledge of the relationship between brooding and various dysregulated behaviors within a treatment-seeking sample. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans

alexandrossfakianakis shared this article with you from Inoreader Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans Via Journal of Clinical Psychology Abstract Objective Combat-exposed veterans risk encountering events that disrupt beliefs. To facilitate reduced discrepancy between prior beliefs and current trauma appraisals, veterans may engage in a process of meaning-making. Meaning-making can lead to positive outcomes, such as integrating the traumatic event into one's life narrative or adapting global meaning (meaning made) or elicit distress. Given these potentially different outcomes, this study examined potential correlates of posttraumatic stress symptom (PTSS) severity and meaning made, including relationship attachment dimensions of anxiety and avoidance, and difficulties with emotion regulation, while controlling for combat exposure. Method Veterans receiving mental health services at a Veterans Affairs (VA) Medical Center and a VA community-based outpatient clinic (N = 130) completed measures through a paper-and-pencil survey. Almost all participants (92%) were male, with a mean age of 55.92 years. Results In terms of meaning made, lower levels of attachment anxiety and emotional clarity (an aspect of emotion regulation) predicted higher meaning made. In terms of PTSS severity, higher attachment avoidance, attachment anxiety, and difficulties engaging in goal-directed behavior (an aspect of emotion regulation) significantly predicted higher PTSS severity. Conclusion Aspects of both attachment style and emotion regulation difficulties affect meaning made and PTSS severity. These constructs may be especially relevant for clinicians working with veterans to help PTSS and support meaning made postcombat. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Spinal Cord Stimulation System with a Battery‐Free Micro Implantable Pulse Generator

alexandrossfakianakis shared this article with you from Inoreader A Novel Spinal Cord Stimulation System with a Battery‐Free Micro Implantable Pulse Generator Via Pain Practice Abstract Spinal cord stimulation (SCS) is effective for the treatment of chronic intractable pain of the trunk and limbs. The mechanism of action may be based, at least in part, upon the gate control theory; however, new waveforms may suggest other mechanisms. Although benefits of the SCS technology generally outweigh the complications associated with SCS, some complications such as infection and skin erosion over the implant can result in device removal. Additional reasons for device removal, such as pocket pain and battery depletion, have driven technological innovations including battery-free implants and device miniaturization. The neurostimulation system described here was specifically designed to address complications commonly associated with implantable batteries and/or larger implantable devices. The benefits of the small size are further augmented by a minimally invasive implant procedure. Usability data show that patients found this novel neurostimulation system to be easy to use and comfortable to wear. What is more, clinical data demonstrate that the use of this system provides statistically significant reduction in pain scores with responder rates (defined as ≥ 50% reduction in pain) of 78% in the low back and 83% in the leg(s). Advances in miniaturization technology arose from the considerable shrinkage of the integrated circuit, with an increase in performance, according to Moore's law (1965). However, commensurate improvements in battery technology have not maintained a similar pace. This has prompted some manufacturers to place the battery outside, against the skin, thereby allowing a massive reduction in the implant volume, with the hopes of fewer device-related complications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Digital Determination and Recording of Edentulous Maxillomandibular Relationship Using A Jaw Movement Tracking System

alexandrossfakianakis shared this article with you from Inoreader Digital Determination and Recording of Edentulous Maxillomandibular Relationship Using A Jaw Movement Tracking System Via Journal of Prosthodontics Abstract Purpose To establish a direct digital method for determining and recording edentulous maxillomandibular relationship using a custom-made jaw movement tracking system and evaluate its accuracy. Materials and methods A novel jaw tracking system was used to record the trajectory of habitual opening-closing jaw movement, and mandibular rest position (MRP) in 10 edentulous patients. 3D surface scanning was performed on the conventional maxillomandibular impressions and facial structures of patients in MRP. The multi-source data were registered using a custom-made recording tool. A plane parallel to the ala-tragus and horizontal lines was constructed 2 mm above the MRP, and its vertical position was used to determine the vertical relationship. The intersections of the trajectory passing through the plane were located, and their density distributions were analyzed. The coordinates of highest density, which presented the highest repeatability of jaw movement, were used to construct the digital maxillomandibular relationship (test group). The maxillomandibular relationship of the new complete dentures with artificial teeth in the intercuspal position was defined as the control group. The displacement s of the anterior reference point and 3D deviations of the entire mandibular arch were measured and compared between the test and control groups using a Wilcoxon signed-ranks test and a one-sample t-test, respectively. Results With reference to the centric relationship position, the maximum displacements of the anterior reference points were in the horizontal anteroposterior direction for both groups, and there were no significant differences. Compared to the control group, the 3D deviations of the entire mandibular arch in the test group were significant (95% confidence interval: 0.76 mm to 1.35 mm, P < 0.001). Conclusions By analyzing the individual trajectory features obtained by the in-house developed jaw tracking system, a digital method for determining and recording edentulous maxillomandibular relationships was established; however, the accuracy needs to be further improved. This article is protected by copyright. All rights reserved View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial

alexandrossfakianakis shared this article with you from Inoreader Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial Via Clinical Implant Dentistry and Related Research Abstract Objective Soft tissue esthetics for immediate implant is considered challenging when restoring a tooth in an esthetic zone. This study aimed to evaluate the buccal aspect after immediate implant using the dual-zone therapeutic concept compared to grafting the buccal gap to the bone crest. Materials and methods Twenty-four patients were randomly assigned into either immediate implant with the dual-zone therapeutic concept (DZ, test group) or with bone grafting till buccal bone crest with immediate temporization (BCG, control group). Pink esthetic score (PES), buccal bone loss (BBL), mid-facial recession (MFR), soft tissue thickness (STT), keratinized tissue width (KTW), post-operative swelling (POS), and patient satisfaction (PS) were evaluated for 1 year. Results At 12 months the PES in the test group was 11.36 ± 1.69, and 10.80 ± 1.55 in the control group, with no statistically significant difference (p = 0.45). MFR in the DZ and BCG groups was 0.27 ± 0.34 and 0.45 ± 0.44 after 12 months with no statistical significance difference (p = 0.195). The STT assessment showed a statistically significant increase in both groups, however the intergroup comparison was statistically not significant (p = 0.23). The mean KTW in the DZ and BCG groups was 4.55 ± 1.08 and 4.20 ± 0.82 mm, respectively with no statistical significance (p = 0.42). There was no statistical significant difference in patient satisfaction between the two groups except in question number 10 concerning the post-operative swelling which was higher in the DZ group (p = 0.009). Conclusions Both treatment modalities are considered reliable methods to achieve good soft tissue esthetics. However, both treatment modalities were not effective in preventing facial bone resorption despite the use of bone graft. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

First-line therapy in non-small cell lung cancer patients with EGFR activating mutations: a consideration of the clinical position of osimertinib based on the subset of Japanese patients in the FLAURA study

alexandrossfakianakis shared this article with you from Inoreader First-line therapy in non-small cell lung cancer patients with EGFR activating mutations: a consideration of the clinical position of osimertinib based on the subset of Japanese patients in the FLAURA study Via Japanese Journal of Clinical Oncology - current issue Abstract Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been established as the standard first-line treatment for patients with previously untreated advanced non-small cell lung cancer (NSCLC) with an EGFR activating mutation. In the FLAURA study, osimertinib, third-generation EGFR-TKI, resulted in significantly longer progression-free survival and overall survival (OS) than first-generation EGFR-TKIs (gefitinib or erlotinib) in patients with previously untreated advanced NSCLC with an EGFR activating mutation. Osimertinib is now widely used as first-line therapy for those patients. In Japanese subset analysis of the FLAURA study, the median progression-free survival was prolonged by osimertinib (19.1 months) relative to gefitinib (13.8 months). However, there was no apparent OS benefit, albeit at the level of an exploratory post-hoc analysis. Although the safety profile in the Japanese subset was generally consistent with the overall population, the incidence of liver enzyme increases in the gefitinib group and that of interstitial lung disease/pneumonitis in the osimertinib group was higher among Japanese patients. There is now an increasing number of first-line treatment options for NSCLC with EGFR mutations, including EGFR-TKIs in combination with platinum-doublet chemotherapy or anti-angiogenic drugs. These combinations show progression-free survival benefits similar to osimertinib regardless of the mutation type. Therefore, a first-line combination regimen followed by osimertinib remains an attractive strategy. We review data from the randomized clinical trials of first-line EGFR-TKIs including a subset of Japanese patients and discuss first-line therapies for patients with NSCLC harbouring EGFR mutations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma

alexandrossfakianakis shared this article with you from Inoreader Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma Via JAMA Otolaryngology–Head & Neck Surgery Online First This systematic review and meta-analysis compares surgical complication rates between total thyroidectomy and hemithyroidectomy in the treatment of papillary thyroid microcarcinomas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.