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Τετάρτη 7 Σεπτεμβρίου 2022

Alterations in Vaginal Microbiota among Pregnant Women with COVID‐19

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Abstract

The maintenance of vaginal microbiota is an important factor to achieve optimum pregnancy outcomes. The study aims to describe the alterations in the composition of vaginal microbiota in pregnant women with COVID-19. This was a prospective case-control study. Vaginal swabs were collected from uninfected pregnant women (n=28) and pregnant women with COVID-19 (n=19) during the active phase of infection and within a month after recovering from infection. The vaginal microbiota on the swabs was examined by 16S rRNA gene sequencing. Shannon index indicates that alpha diversity is significantly higher in women with COVID-19 (P=0.012). There was a significant decrease in Firmicutes (P=0.014) with an increase in Bacteroidota (P=0.018) phyla and a decrease in Lactobacillus (P=0.007) genus in women with COVID-19 than those of uninfected pregnant women. The relative abundance of L.crispatus, L.iners, L.gasseri, and L.jenseni i were lower in the COVID-19 group than in uninfected pregnant women. In subgroup analysis, the amount of Ureaplasma spp. was higher in women with moderate/severe than those of asymptomatic/mild disease (P=0.036). The study revealed that vaginal dysbiosis with low abundance of Lactobacillus species occurred in pregnant women infected with SARS-CoV-2. These findings may lead to new studies to elucidate the risk of pregnancy adverse outcomes related to COVID-19.

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Buccal fat pad as a sealant in palatal mucosa tearing: technical note

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For patients with a dentofacial deformity undergoing a planned segmentation of the maxilla for the management of a transverse maxillary arch discrepancy, palatal mucosa tearing may occur during sawing or palatal expansion traction, giving rise to an oronasal communication. This technical note describes the covering of a tear in the palatal mucosa using a buccal fat pad (BFP) flap, in the context of maxillary segmentation during Le Fort I osteotomy. Through the limited buccal incision used for the Le Fort I osteotomy, a small incision is made in the right periosteum posteriorly, and a supraperiosteal dissection is performed to access the BFP. (Source: International Journal of Oral and Maxillofacial Surgery)
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Three‐dimensional exoscope‐assisted single‐stage tracheal resection

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Abstract

The three-dimensional (3D) 4K exoscope is a surgical tool recently introduced in numerous fields of otolaryngology, such as microvascular surgery, otology, and laryngology. However, other surgical fields may also benefit from this technology. In this case, a single-stage tracheal resection was planned with the aid of the 3D 4K exoscope, in a 75-year-old female with post-tracheostomy tracheal stenosis. High-quality magnification of the surgical field was obtained, with facilitated skeletonization of the laryngotracheal axis. The exoscope provided greater involvement in surgery and allowed more interactions among all operating room personnel and learners, as they could access the same field of view of the first surgeon, as well as perceiving depth of the surgical field with 3D technology. The exoscope represents a valid application in open surgery performed for laryngotracheal stenosis, with advantages of enhancing training and education, allowing precise surgical dissection, and re ducing risks of iatrogenic damage to surrounding structures.
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Myeloperoxidase‐positive bilineal mixed phenotype acute leukemia (B/T) with chromosome copy neutral loss of heterozygosity exhibits simultaneous diffuse leukemic infiltrations in the lung, bone, and endorachis

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Imaging of pediatric extremity soft tissue tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

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Abstract

Pediatric soft tissue tumors of the extremity include rhabdomyosarcoma and nonrhabdomyosarcoma neoplasms. This manuscript provides consensus-based imaging recommendations for imaging evaluation at diagnosis, during treatment, and following completion of therapy for patients with a soft tissue tumor of the extremity.
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Implants in the pterygoid region: An updated systematic review of modern roughened surface implants

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ABSTRACT

Purpose

To determine the survival rates of modern roughened surface dental implants in the pterygoid region.

Material and Methods

This systematic review was an update from a previously published systematic review in 2011, which largely reported data on older machined surface dental implants. An electronic search for articles in the English language literature published from January 1, 2010 to December 8, 2021 was performed using PubMed, Scopus, and CENTRAL search engines. After applying a systematic search process in 3 stages, the final list of selected articles on roughened surface pterygoid implants was obtained. Data from the selected articles were collated with data from pertinent articles on roughened implant surface from the previous systematic review. The combined data was then used for calculating the interval survival rate (ISR) and cumulative survival rate (CSR) of pterygoid implants.

Results

The initial electronic search resulted in 1263 titles. The systematic search process eventually resulted in 10 clinical studies reporting on modern roughened surface pterygoid implants. These 10 studies reported on a total of 911 pterygoid implants with 39 reported failures over a 6-year period. The majority of failures (37) were reported during the first year time interval and a majority of them (30) occurred before loading of the pterygoid implants. Only 2 late failures were reported after loading, during the 6th year time interval. The majority of implants were used for rehabilitation of full arch fixed implant supported prosthesis. At the maximum follow-up interval of 6 years, the cumulative survival rate of pterygoid implants with roughened surfaces was 95.5%, which was 5% higher than reported in the previous systematic review which combined machined and roughed surface pterygoid implants.

Conclusions

The survival rate of modern roughened surface dental implants in the pterygoid region is favorable at 95.5% over a 6 year period, and comparable to the existing evidence on survival of implants in other regions of the maxilla and mandible.

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Associations between findings of Fusobacterium necrophorum or beta-hemolytic streptococci and complications in pharyngotonsillitis - a registry-based study in Southern Sweden

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Abstract
Background
Most pharyngotonsillitis guidelines focus on the identification of group A streptococci (GAS), guided by clinical scores determining whom to test with a rapid antigen detection test (RADT). Nevertheless, many RADT-negative patients are evaluated for Group C/G streptococci (GCS/GGS) and Fusobacterium necrophorum, yet their importance remains debated. Our primary aim was to evaluate associations between complications and findings of F. necrophorum, GAS or GCS/GGS in pharyngotonsillitis.
Methods
This was a retrospective, registry-based study of pharyngotonsillitis cases tested for F. necrophorum (PCR) and beta-hemolytic streptococci (culture) in the Skåne Region, Sweden 2013-2020. Patients with prior complications or antibiotics (30 days) were excluded. Data were retrieved from registries and electron ic charts. Logistic regression analyses were performed with a dichotomous composite outcome of complications as primary outcome, based on ICD-10-codes. Cases with negative results (PCR and culture) were set as reference category. Complications within 30 days were defined as peritonsillar or pharyngeal abscess, otitis, sinusitis, sepsis or septic complications, recurrence of pharyngotonsillitis (after 15-30 days) or hospitalization.
Results
Of 3700 registered cases, 28% had F. necrophorum, 13% GCS/GGS, 10% GAS and 54% negative results. 30-day complication rates were high (20%). F. necrophorum OR 1.8 (95CI 1.5-2.1) and GAS OR 1.9 (95CI 1.5-2.5) were associated with complications whereas GCS/GGS were negatively associated with complications OR 0.7 (95CI 0.4-0.98).
Conclusion
Our results indicate F. necrophorum as a relevant pathogen in pharyngotonsil litis, whereas the relevancy of testing for GCS/GGS is questioned. Yet, which patient to test and treat for F. necrophorum remains to be defined.
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Pregnancy status at the time of COVID-19 vaccination and incidence of SARS-CoV-2 infection

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Abstract
Background
Pregnant women are recommended to receive COVID-19 vaccines; however, relative effectiveness of vaccination by pregnancy status is unclear.
Methods
We compared the relative effectiveness of mRNA COVID-19 vaccines according to whether women received both while pregnant (n= 7,412), one dose while pregnant (n = 3,538), both while postpartum (n = 1,856), or both doses while neither pregnant nor postpartum (n = 6,687). We estimated risk of SARS-CoV-2 infection starting 14 days after the second dose using Cox regression, reporting hazard ratios (HR) and 95% confidence intervals (CI). Secondly, we examined relative effectiveness of a third (booster) dose while pregnant compared to outside pregnancy. The major circulating variant during the study period was the Delta variant.
Results
54% of women received two doses of the BNT162b2 vaccine, 16% received two doses of the mRNA-1273 vaccine, while 30% receiv ed one dose of both vaccines. Compared to women who received both doses while neither pregnant nor postpartum, the adjusted HR for a positive SARS-CoV-2 PCR test was similar if the woman received both doses while pregnant (1.04; 95% CI: 0.94, 1.17), one dose while pregnant and one dose before or after pregnancy (1.03; 95% CI: 0.93, 1.14), or both doses while postpartum (0.99; 95% CI: 0.92, 1.07). The findings were similar for BNT162b2 (Pfizer-BioNTech Comirnaty) and mRNA-1273 (Moderna Spikevax), and during Delta- and Omicron-dominant periods. We observed no differences in the relative effectiveness of the booster dose according to pregnancy status.
Conclusions
We observed similar effectiveness of mRNA vaccines against SARS-CoV-2 infection among women regardless of pregnancy status at the time of vaccination.
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