Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

alexandrossfakianakis shared this article with you from Inoreader Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer via The Laryngoscope Objective End-flexible-rigidscopic transoral surgery (E-TOS) is a new and minimally invasive transoral surgery for resection of Tis-selected T3 pharyngolaryngeal cancers. We evaluated long-term oncological outcomes and whether postoperative voice and swallowing function were preserved following E-TOS. Methods In this retrospective single-center study, 154 patients treated with E-TOS using a curved retractor, flexible-tip rigid endoscope, and thin curved instruments were included. Their survival rate, larynx preservation rate, and disease control rate were estimated using the Kaplan–Meier method. Postoperative voice function was evaluated using both objective and subjective tests. Postoperative swallowing function was assessed using the Hyodo score and the functional outcome swallowing scale. Results The 3-year and 5-year overall survival, disease-specific survival, disease-free survival, laryngectomy-free survival, local control, and loco-regional control rates post E-TOS were 89.8% and 82.2%, 95.6% and 92.3%, 78.5% and 70.3%, 87.2% and 80.9%, 93.9% and 92.5%, and 87.2% and 85.7%, respectively. Both objective and subjective postoperative voice and swallowing function tests were within normal limits in more than 90% of the patients. Conclusion E-TOS is an effective, safe, low-cost, and minimally invasive transoral surgery for Tis-selected T3 pharyngolaryngeal cancer; it also preserves postoperative voice, larynx, and swallowing function. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Extrarenal Wilms tumor with hypertension and dilated cardiomyopathy in an infant: A report of an unusual case

alexandrossfakianakis shared this article with you from Inoreader Extrarenal Wilms tumor with hypertension and dilated cardiomyopathy in an infant: A report of an unusual case via Pediatric Blood & Cancer Abstract While Wilms tumors are the most frequently detected kidney cancer type in children, extrarenal Wilms tumors (ERWTs) remain rare. This report is the first to describe hypertension and dilated cardiomyopathy in a patient with an ERWT. A 6-month-old male infant presented with an abdominal mass and paroxysmal hypertension; echocardiography revealed dilated cardiomyopathy with an ejection fraction of 34%, as well as substantially increased plasma renin activity. Pathology yielded a definitive diagnosis of ERWT. Cardiac function and blood pressure gradually returned to normal after tumorectomy. The early diagnosis of such a tumor together with efficient oncologic treatment are vital to optimal patient outcomes. View on Web

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Non‐carious cervical lesions (NCCLs): morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration

alexandrossfakianakis shared this article with you from Inoreader Non‐carious cervical lesions (NCCLs): morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration via Journal of Prosthodontics Abstract Purpose : To synthesize the literature regarding non-carious cervical lesions (NCCLs) and propose clinical guidelines when lesion restoration is indicated. Material and Methods : A PubMed search was performed related to NCCL morphology, progression, prevalence, etiology, pathophysiology, and restoration. Results : NCCLs form as either rounded (saucerlike) depressions with smooth, featureless surfaces that progress mainly in height or as V-shaped indentations that increase in both height and depth. Prevalence ranges from less than 10% to over 90% and increases with age. Common locations are the facial surfaces of maxillary premolars. They have a multifactorial etiology due to personal habits such as excessive horizontal toothbrushing and consumption of acidic foods and drinks. Occlusal factors have been identified as contributing to the prevalence of NCCLs in some studies whereas other studies indicate there is no relationship. The concept of abfraction has been proposed whereby mechanical stress from occlusal loading plays a role in the development and progression of NCCLs with publications supporting the concept and others indicating it lacks the required clinical documentation. Regardless of the development mechanism, demineralization occurs and they are one of the most common demineral ization diseases in the body. Treatment should be managed conservatively through preventive intervention with restorative treatment delayed until it becomes necessary due to factors such as lesion progression, impact on patient's quality of life, sensitivity, poor esthetics, and food collection may necessitate restoration. Composite resins are commonly used to restore NCCLs although other materials such as glass ionomer and resin-modified glass ionomer are also used. Sclerotic dentin does not etch like normal dentin and therefore it has been recommended to texture the dentin surface with a fine rotary diamond instrument to improve restoration retention. Some clinicians use mechanical retention to increase retention. Beveling of enamel is used to increase the bonding area and retention as well as enhance the esthetic result by gradually creating a color change between the restoration and tooth. Both multi-step and single-step adhesives have been used. Dentin etching should be increas ed to 30 seconds due to the sclerotic dentin with the adhesive agent applied using a light scrubbing motion for 20 seconds but without excessive force that induces substantial bending of a disposable applicator. Both flowable and sculptable composite resins have been successfully used with some clinicians applying and polymerizing a layer of flowable composite resin and then adding an external layer of sculptable composite resin to provide enhanced resistance to wear. When caries is present, silver diamine fluoride has been used to arrest the caries rather than restore the lesion. Conclusions : Non-carious cervical lesions (NCCLs) form as smooth saucerlike depressions or as V-shaped notches. Prevalence values as high as 90% and as low as 10% have been reported due to habits such as excessive toothbrushing and an acidic diet. Occlusal factors have been proposed as contributing to their presence but it remains controversial. Publications have both supported and challenged the concept of abfraction. They are one of the most common demineralization diseases in the body. Conservative treatment through prevention is recommended with restorative treatment delayed as long as possible. When treatment is needed, composite resins are commonly used with proposed restorative guidelines including texturing the sclerotic dentin, beveling the enamel, potential use of mechanical retention, 30 seconds of acid etching, and use of either multi-step or single-step adhesives in conjunction with a light scrubbing motion for 20 seconds without excessive force placed on disposable applicators. This article is protected by copyright. All rights reserved View on Web

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Constitutive programmed death ligand 1 expression protects gastric G‐cells from Helicobacter pylori–induced inflammation

alexandrossfakianakis shared this article with you from Inoreader Constitutive programmed death ligand 1 expression protects gastric G‐cells from Helicobacter pylori–induced inflammation via Helicobacter Abstract Introduction Gastric intestinal metaplasia (GIM) is a premalignant lesion, highly associated with Helicobacter pylori infection. Previous studies have shown that H. pylori is able to induce the expression of programmed death ligand 1 (PD-L1), an inhibitory immune modulator, in gastric cells. Our aim was to investigate whether tissues from GIM patients may exploit PD-L1 expression upon H. pylori infection to evade immunosurveillance. Methods Immunohistochemistry was performed for PD-L1 and enteroendocrine markers somatostatin and gastrin on samples derived from a cohort of patients with known GIM, both before and after H. pylori eradication. To determine the identity of any observed PD-L1-positive cells, we performed multiplex immunofluorescent staining and analysis of single-cell sequencing data. Results GIM tissue was rarely positive for PD-L1. In normal glands from GIM patients, PD-L1 was mainly expressed by gastrin-positive G-cells. While the D-cell and G-cell compartments were both diminished 2-fold (p = .015 and p = .01, respectively) during H. pylori infection in the normal antral tissue of GIM patients, they were restored 1 year after eradication. The total number of PD-L1-positive cells was not affected by H. pylori, but the percentage of PD-L1-positive G-cells was 30% higher in infected subjects (p = .011), suggesting that these cells are preferentially rescued from destruction. Conclusions Antral G-cells frequently express PD-L1 during homeostasis. G-cells seem to be protected from H. pylori-induced immune destruction by PD-L1 expression. GIM itself does not express PD-L1 and is unlikely to escape immunosurveillance via expression of PD-L1. View on Web

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Effectiveness of root resection techniques compared with root canal retreatment or apical surgery for the treatment of apical periodontitis and tooth survival: A systematic review

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of root resection techniques compared with root canal retreatment or apical surgery for the treatment of apical periodontitis and tooth survival: A systematic review via International Endodontic Journal Abstract Background To manage apical periodontitis in root filled maxillary and mandibular molars, root resection techniques may be employed to avoid the loss of the tooth. Objectives To systematically analyse the effectiveness of root resection techniques (root resection/crown resection/root amputation) for the management of apical periodontitis with non-surgical root canal retreatment or apical surgery by the evaluation of clinical and patient-related outcomes (PROMS), in human experimental studies and longitudinal studies. Methods An electronic literature search in PubMed, MEDLINE via OVID interface, EMBASE, and Cochrane Central, supplemented by a manual hand search of the grey literature, was performed up to 25th September 2021. Randomised controlled trials, comparative clinical trials, and observational studies reporting on the outcome (tooth survival and patient-reported outcome measures with a minimum follow-up of one year) of root resection techniques for treating apical periodontitis were identified. The risk of bias was evaluated using the Newcastle-Ottawa scale. Results From a total of 2098 reports, 36 were considered for further screening. Three retrospective studies, published between 2018 and 2020, were included in this systematic review. A high heterogeneity in terms of protocols, study design and the reported outcomes were observed. The risk of bias was scored as low to moderate. These three studies consisted of data from 305 resected teeth, from 254 patients, with a follow-up period of 1-16.8 years. Overall, 151 teeth were extracted during the follow-up period. In these studies, root resection treatment was carried out on 42 teeth exclusively for endodontic reasons. One of these studies reported 12 out of 23 teeth lost at follow-up. None of the studies reported on PROMS. Discussion Although root resection techniques may be used for treating teeth with apical periodontitis, the data are limited. Furthermore, the studies are very heterogeneous and associated with high risk of bias. Conclusions Given the current level of available evidence, it is not possible to recommend, or dismiss, root resection techniques for managing apical periodontitis. View on Web

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Seroprevalence of Kaposi’s Sarcoma‐Associated Herpesvirus and Risk Factors in Jiuquan area, China

alexandrossfakianakis shared this article with you from Inoreader Seroprevalence of Kaposi's Sarcoma‐Associated Herpesvirus and Risk Factors in Jiuquan area, China via Journal of Medical Virology Abstract The seroprevalence of Kaposi's sarcoma-associated herpesvirus (KSHV) is high in Xinjiang, China. But the seroprevalence of KSHV and risk factors are still unknown in Gansu which is adjacent to Xinjiang. 678 serum samples of general population and 87 serum samples of syphilis patients from Jiuquan, Gansu were tested for antibodies against KSHV including one latent protein (ORF73) and two lytic proteins (ORF65 and K8.1) using the ELISA. The total KSHV-seropositive rate was 15.9% in 678 serum samples of Jiuquan area, the KSHV-seropositive rate of males was higher than females (18.0% VS 14.6%, P > 0.05). The Uygur, Kazakh, Hui, Manchu and Mongolian population had a higher seroprevalence of KSHV than the Han population (43.8%, 40.0%, 34.5%, 30.3%, 35.0% VS 11.0%, respectively) among the ethnic groups in Jiuquan. Compared to the Han, Uygur, Kazak, Hui, Manchu and Mongolian people had an increase in the risk of KSHV of 528.9%, 439.1%, 325.6%, 251.6%, 335. 4% (P < 0.001, P < 0.001, P < 0.001, P = 0.002, P = 0.003, respectively). The serum prevalence of KSHV in subjects aged < 20 years, 20-50 years and > 50 years was 13.8%, 14.7% and 20.1%, respectively. Compared to the subjects aged < 20 years, 20-50 years and > 50 years had an increase in the risk of KSHV of 7.4% and 56.9% (P = 0.829 and P = 0.204, respectively). Compared to the positive rate of KSHV in the general population of Anhui, the positive rate of KSHV was significantly higher in the general population of Jiuquan area (15.9% VS 9%, P < 0.01). There was no significant difference in the positive rate of KSHV between the Han population of Jiuquan and the Han population of Anhui (P > 0.05). In the population of syphilis patients of Jiuquan area, the positive rate of KSHV was 30.7%, which was higher than that of the general population in Gansu area (P < 0.05). This study indicates that Gansu has a high seroprevalence of KSHV. Ethnicity and syphilis are risk factors for KSHV infection. This article is protected by copyright. All rights reserved. View on Web

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The effect of clinical interventions on the oral health‐related quality of life in older adults

alexandrossfakianakis shared this article with you from Inoreader The effect of clinical interventions on the oral health‐related quality of life in older adults via Australian Dental Journal Abstract This paper reviews the literature to assess the effectiveness of oral health interventions in influencing oral health-related quality of life (OHRQoL) in older adults. Clinical studies published in 2010 onwards reporting oral health interventions in older adults and subsequent changes in OHRQoL were systematically searched in Medline, Web of Science and EMBASE databases. Reporting followed Preferred Reporting Items for Systematic Review and Meta-Analysis criteria. Eligibility evaluation and data abstraction from eligible studies were guided by predefined PICO questions and bias assessment by the Quality in Prognosis Studies tool. The search retrieved 144 articles. Of the 20 articles that met the eligibility criteria, 45% (9) reported a statistically significant improvement in OHRQoL. The majority of studies were conducted in adults with complete edentulism (70%) and mainly focused on implant provision to support a removable prosthesis (30%). The search indicates the limited scope of current literature on geriatric dental interventions, focusing mainly on denture realignments, denture fabrication and implant placement. Although the majority of the oral health interventions focused on edentulism and removable prostheses, there are many areas of oral health interventions and their potential impact on OHRQoL in this demographic group that have yet to be explored. View on Web

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