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Κυριακή 9 Οκτωβρίου 2022

Feasibility of clinical evaluation of individuals with increased risk for HPV‐associated oropharynx cancer

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Abstract

Background

Human papillomavirus-associated oropharynx squamous cell carcinoma (HPV-OPSCC) has no known pre-malignant lesion. While vaccination offers future primary prevention, there is current interest in secondary prevention. The feasibility of clinical evaluation of individuals at increased risk for HPV-OPSCC is unclear.

Methods

Individuals with risk factors for HPV-OPSCC were enrolled in a prospective study (MOUTH). Participants positive for biomarkers associated with HPV-OPSCC were eligible for a clinical evaluation which comprised a head and neck examination and imaging with ultrasound and/or magnetic resonance imaging (MRI). This study was designed to evaluate feasibility of clinical evaluation in a screening study.

Results

Three hundred and eighty-four participants were eligible for clinical evaluation. Of the 384, 204 (53%) completed a head and neck examination or imaging. Of these, 66 (32%) completed MRI (n = 51) and/or ultrasound (n = 64) studies.

Conclusions

Clinical evaluations, including head and neck examination and imaging, are feasible in the context of a screening study for HPV-OPSCC.

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Perioperative Hypercoagulability in Free Flap Reconstructions Performed for Intracranial Tumors

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Perioperative Hypercoagulability in Free Flap Reconstructions Performed for Intracranial Tumors

Patients with intracranial tumors have a higher risk of thromboembolic events. A multi-institutional retrospective chart review was performed of patients who underwent free tissue transfer for scalp/cranial reconstruction. There is an increase in perioperative flap thrombosis in patients with intracranial tumors undergoing free tissue scalp reconstruction, and anticoagulation appears to mitigate this risk.


Objective(s)

Patients with intracranial tumors have a higher risk of thromboembolic events. This risk increases at the time of surgical intervention. We have noted an anecdotal increase in perioperative flap thrombosis in patients undergoing free tissue transfer for intracranial tumor resection. This study aims to formally evaluate this risk.

Methods

A multi-institutional retrospective chart review was performed of patients who underwent free tissue transfer for scalp/cranial reconstruction. Perioperative thrombosis and free flap outcomes were evaluated.

Results

The 209 patients who underwent 246 free tissue transfers were included in the study. The 28 free flap scalp reconstructions were associated with intracranial tumors, 19 were performed following composite cranial resections with associated dural resection/reconstruction, and 199 were performed in the absence of intracranial tumors (control group). There was a significantly higher incidence of perioperative flap thrombosis in the intracranial tumor group (11/28, 39%) when compared to controls (38/199, 19%) (p = 0.0287). This was not seen when scalp tumors extended to the dura alone (4/19, 21%, p = 0.83). Therapeutic anticoagulation used for perioperative thrombosis (defined as intraoperative or in the immediate postoperative phase up to 5 days) was associated with a lower risk of flap failure, although this was not statistically significant (p = 0.148). Flap survival rates were equivalent between flaps performed for intracranial pathology (93.3%) and controls (95%).

Conclusion

There is an increase in perioperative flap thrombosis in patients with intracranial tumors undergoing free tissue scalp reconstruction. Anticoagulation appears to mitigate this risk.

Level of Evidence

This recommendation is based on level 3 evidence (retrospective case–control studies, systematic review of retrospective studies, and case reports) Laryngoscope, 2022

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Effect of sacubitril/valsartan on cognitive impairment in colchicine‐induced Alzheimer’s model in rats

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Abstract

Background

Alzheimer's disease (AD) is a complex neurodegenerative disease. There is epidemiological evidence that heart failure (HF) patients are at higher risk of developing AD and the impact of sacubitril/valsartan, the first angiotensin receptor-neprilysin inhibitor (ARNI) approved for HF, on cognitive functions is still controversial.

Objective

To investigate the effect of sacubitril/valsartan on cognitive functions in colchicine-induced AD rat model.

Methods

Forty adult male Wistar rats were equally allocated into four groups (each of 10 rats). Group I: normal control, Group II: intracerebroventricular injection of colchicine (15μg/5μl/bilaterally), Group III: colchicine (15μg/5μl/bilaterally, icv) + oral sacubitril/valsartan (100 mg/kg/day) for 25 days and Group IV: colchicine (15μg/5μl/bilaterally, icv) + oral valsartan (50 mg/kg/day) for 25 days. Behavioral assessment was done using Morris water maze and passive avoidance tasks. Biochemically, β-amyloid (1-40 and 1-42) peptides, oxidative stress (malondialdehyde and superoxide dismutase) and inflammatory (tumor necrosis factor-alpha) parameters were measured in hippocampus and prefrontal cortex.

Results

Sacubitril/valsartan exaggerated colchicine-induced cognitive impairment in both Morris water maze and passive avoidance tasks, and was associated with significant increase in β-amyloid accumulation, oxidative stress and inflammation versus valsartan.

Conclusion

Sacubitril/valsartan caused deleterious effect on cognitive impairment and biochemical alterations in colchicine-induced AD rat model. Hence, special caution should be taken following long-term intake of ARNI on cognitive functions.

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Protective assessment of progesterone and its receptor on experimental diabetic neuropathy: Anti‐oxidant and anti‐inflammatory effects

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Abstract

Introduction

Diabetes induces a disorder in mitochondrial activity, which causes damage to the nuclear and mitochondrial DNA, and ultimately increases the release of inflammatory cytokines and damages the sciatic nerve and dorsal root ganglion and induces neuropathy. It has been shown that progesterone has anti-inflammatory and anti-oxidative effects and prevents nerve cell damage. Therefore, the aim of this experiment was to investigate the effect of progesterone receptor neuroprotection on diabetic neuropathy.

Methods

Forty male Sprague-Dawley rats were divided into 4 groups, including control group, diabetic control group, diabetic control group+Progesterone(30mg/kg), diabetic control group+combination of Progesterone(30mg/kg) and RU486(10mg/kg). After the induction of diabetes, blood glucose level, body weight, behavioral tests, electrophysiological tests, oxidative and inflammatory factors, and histological parameters were measured.

Results

Progesterone treatment significantly reduced the level of sensitivity to hot plate without significant effect on glucose level, and significant changes were also observed in the results of tail flake test. In addition, the results showed that the administration of progesterone can improve MNCV and significantly reduce the serum levels of oxidative stress and inflammatory factors, as well as inflammation and edema around the sciatic nerve. However, RU486 inverted the beneficial effects of progesterone.

Conclusion

Progesterone can be considered as a protective agent in reducing DN because of its ability to reduce inflammation and nerve damage. In addition, RU486, a progesterone receptor blocker, inhibits the beneficial effects of progesterone on the DN, thus progesterone receptors play an important role in the neuroprotective effect of progesterone.

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LEUKOTRIENE METABOLISM AND PROIFLAMMATORY CYTOKINES IN CRIMEAN CONGO HEMORRHAGIC FEVER

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Abstract

Crimean-Congo hemorrhagic fever (CCHF) is an emerging acute viral infection disease, yet its pathophysiology remains largely uncharacterized. Lipid mediators are molecules that play numerous roles in the physiologic and pathophysiologic conditions in certain viral diseases. No previous study evaluated the status of cysteinyl leukotrienes (CYSLT) and 5-lipoxygenase (5-LO) and their relationship with proinflammatory cytokines in CCHF. A total of 90 subjects including 60 CCHF patients and 30 healthy controls were enrolled the study. Serum CYSLT, 5-LO, interleukin-6 (IL-6) and ferritin levels were determined in the study population. Lower median 5-LO level was determined in patients compared to healthy controls (p = 0.0004). Higher ferritin (p < 0.001) and IL-6 (p < 0.001) levels in patients than healthy controls. No statistically significant difference was observed between patients and controls in terms of CYSLT levels. No statistically significant differ ences were observed between mild, moderate, and severe groups in terms of both 5-LO and CYSLT levels. IL-6 and ferritin levels were higher in severe group compared mild and moderate groups. In conclusion, changes in 5-LO enzyme and increased inflammation are related with the disease molecular mechanism. Higher inflammatory status contributes to the impaired hemostatic balance in CCHF. Thus, treatment strategies to reduce inflammation may help to prevent bleeding and DIC in patients. IL-6 and ferritin can be used to as an additional biomarker in the estmation of the prognosis and diagnosis of the patients.

This article is protected by copyright. All rights reserved.

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Recovery of gland function after endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton ’s duct

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The aim of this study was to evaluate the gland function of patients following endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton 's duct. The study cohort comprised 115 patients who had undergone successful endoscopy-assisted lithotomy for hilo-parenchymal stones (mean diameter 7.7 mm). Gland function was evaluated at a mean 12 months after surgery using ultrasonography, sialography, and/or sialometry. Postoperative ultras onography of 51 affected glands revealed a regular gland size in 58.8%, normal parenchyma density in 51.0%, and ductal ectasia in 80.4%. (Source: International Journal of Oral and Maxillofacial Surgery)
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Gut Microbiota May Mediate the Impact of Chronic Apical Periodontitis on Atherosclerosis in Apolipoprotein E‐deficient Mice

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Abstract

Aim

There are growing evidences linking chronic apical periodontitis (CAP) to atherosclerosis. Gut microbiota is found to be involved in the development of atherosclerosis. Recent studies have shown that CAP could change the diversity and composition of the gut microbiota. It was therefore, we hypothesized that gut microbiota and its metabolites could mediate the impact of CAP on atherosclerosis.

Methodology

Twenty-four 5-week-old lipoprotein E knockout (apoE-/-) mice were randomly divided into four groups: the CAP group, Con group, Co-CAP (cohoused with CAP), and Co-Con (cohoused with Con) group. In the CAP group, sterile cotton wool containing P. gingivalis was placed into the exposed pulp chamber, followed by coronal resin-based composite restoration of the bilateral maxillary first and second molars. In the Con group, a sham operation was performed. Biweekly, mice in the CAP group were anesthetized to check the sealing of coronal access. Meanwhile, the animals in the Con group were anesthetized. The cohousing approach was used to introduce gut microbiota from the CAP and Con groups into the Co-CAP and Co-Con groups, respectively. Alterations in the abundance and diversity of the gut microbiota were detected using 16S rRNA sequencing, Oil red O staining was used to demonstrate the extent of lesions, and serum levels of trimethylamine N-oxide (TMAO), and immunohist ochemistry of flavin-containing monooxygenase 3 (FMO3) in liver were used to assess TMAO-related metabolic alterations.

Results

Alterations of alpha and beta diversity were shown both in the CAP and the Co-CAP groups. Moreover, the percentage of atherosclerotic lesion area increased in the CAP and Co-CAP groups (p<.05). Linear discriminant analysis effect size (LEfSe) at the family level found the increases of Lachnospiraceae and Ruminococcaceae (P<.05), which were positively correlated with serum TMAO levels (P<.05). In the redundancy analysis technique (RDA), serum levels of TMAO were positively associated with the atherosclerotic lesions. Co-occurrence analysis revealed that the relative abundances of Lachnospiraceae and Porphyromonadacae were positively correlated with both the percentage of lesion area and TMAO level (P<.05)

Conclusion

Thus, within the limitations of this study, the data suggest that the gut microbiota can mediate the effects of CAP on atherosclerosis.

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Automated Detection of Smiles as Discrete Episodes

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Abstract

Background

Patients seeking restorative and orthodontic treatment expect an improvement in their smiles and oral health-related quality of life. Nonetheless, the qualitative and quantitative characteristics of dynamic smiles are yet to be understood.

Objective

To develop, validate, and introduce open-access software for automated analysis of smiles in terms of their frequency, genuineness, duration, and intensity.

Materials and Methods

A software script was developed using the Facial Action Coding System (FACS) and artificial intelligence to assess activations of (1) cheek raiser, a marker of smile genuineness; (2) lip corner puller, a marker of smile intensity; and (3) perioral lip muscles, a marker of lips apart. Thirty study participants were asked to view a series of amusing videos. A full-face video was recorded using a webcam. The onset and cessation of smile episodes were identified by two examiners trained with FACS coding. A Receiver Operating Characteristic (ROC) curve was then used to assess detection accuracy and optimise thresholding. The videos of participants were then analysed off-line to automatedly assess the features of smiles.

Results

The area under the ROC curve for smile detection was 0.94, with a sensitivity of 82.9% and a specificity of 89.7%. The software correctly identified 90.0% of smile episodes. While watching the amusing videos, study participants smiled 1.6 (±0.8) times per minute.

Conclusions

Features of smiles such as frequency, duration, genuineness, and intensity can be automatedly assessed with an acceptable level of accuracy. The software can be used to investigate the impact of oral conditions and their rehabilitation on smiles.

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Effect of Ceftriaxone on Intestinal Transit Time

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Abstract

Background

Ceftriaxone reduces gallbladder and ileal contractility. Many studies have shown that ceftriaxone causes biliary sludge and pseudolithiasis. However, its effect on intestinal transit time has not been investigated. This study aimed to investigate the effect of ceftriaxone on intestinal transit time.

Material and Method

Sixteen rats were examined in two groups: The study group (GroupA, n=8) was administered 100mg/kg ceftriaxone intramuscularly for 7 days. The control group (GroupB, n=8) was administered intramuscular distilled water for 7 days. On the 7th day, amixture of 2 cc barium and saline was given orally to both groups. Barium transit was evaluated using serial digital X-ray images.

Results

The stomach was full and transition into the small intestine loop was observed in all rats at 45 min in both groups. At the 2nd hour, colonic transition was observed in two rats in group A (2/8, 25%) and in seven in group B (7/8, 87.5%). At the 4th hour, five (62.5%) rats in group A had transverse colonic transition, and all rats in group B (8/8, 100%) had transverse and/or left colonic transition. At the 6th hour, no rat in group A had rectal transition, and all rats in group B (8/8, 100%) had complete passage of colonic contrast material.

Conclusion

Ceftriaxone significantly prolongs the small intestine transit time, large intestine transit time, and total intestinal transit times.

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Hybrid mandibular Bologna midline distractor  in combination with surgically assisted rapid maxillary expansion for transverse facial expansion: clinical and cephalometric results

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Transverse maxillomandibular hypoplasia can be treated with surgically assisted rapid maxillary expansion (SARME) in association with mandibular symphyseal distraction (MSD). This paper introduces a hybrid mandibular Bologna midline distractor (BMD); the effectiveness of the distractor in combination with SARME for the treatment of transverse skeletal deficiency was evaluated. This two-centre study included 10 patients with a transverse arch width deficit>7  mm and dental crowding, in both the maxilla and mandible, treated with SARME and MSD. (Source: International Journal of Oral and Maxillofacial Surgery)
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