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Πέμπτη 9 Ιουνίου 2022

Upper Airway Stimulation for Children With Down Syndrome and Obstructive Sleep Apnea

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The treatment of persistent obstructive sleep apnea (OSA) after an adenotonsillectomy is a challenge, especially for children with Down syndrome. As otolaryngologists with sleep subcertification, we are keenly aware of the current limitations for both medical and secondary surgical treatment options for this cohort. We applaud the insight of Yu and colleagues for their landmark investigation in this issue of JAMA Otolaryngology–Head & Neck Surgery on upper airway stimulation (UAS) for adolescents with Down syndrome and OSA, which expan ds the role of UAS from adults to children.
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A Middle-aged Woman With Parotid Swelling

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A 53-year-old woman with a history of coronary artery dise ase and prior myocardial infarction that was treated with warfarin presents to the emergency department after awakening with right preauricular and right upper neck swelling. What is your diagnosis?
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Within‐patient evaluation of chewing efficiency and maximum bite force of conventional dentures, fixed prostheses, and milled bar overdentures used for All‐on‐4 implant rehabilitation of atrophied mandibular ridges: A short‐term randomized trial

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Purpose

This crossover study aimed to evaluate chewing efficiency and maximum bite force (BF) of conventional dentures, fixed prostheses, and milled bar overdentures (MO) used for All-on-4 implant rehabilitation of atrophied mandibular ridges.

Methods

Sixteen edentulous participants with resorbed mandibular ridges received new conventional dentures (CD, control). Four implants were inserted after 3 months in the mandible using the All-on-4 protocol and loaded immediately with acrylic prosthesis. In a crossover manner, each patient had either fixed restoration (FR, 12 occlusal units) or MO (14 occlusal units) randomly in a crossover study design. Chewing efficiency was evaluated using the mixing ability test. The hue deviation (HD) of two-colored gum was calculated after being chewed for 5, 10, 20, 30, and 50 masticatory cycles. Maximum BF was evaluated using a BF device. HD and BF were measured after using CD, FR, and MO prostheses.

Results

For all groups, the highest HD (i.e., the lowest chewing efficiency) was noted with 5 strokes, followed by 10, 20, 30 strokes, and the lowest HD (i.e., the highest chewing efficiency) was noted with 50 strokes. For all number of chewing strokes, CD showed the highest HD, then FR, and MO recorded the lowest HD. The highest BF was observed with MO, then FR, and the lowest BF was noted with CD.

Conclusion

Within the limitations of this short-term investigation, both FR and MO used for All-on-4 implant rehabilitation of patients with resorbed mandibular ridges improve masticatory efficiency and maximum BFs compared to CD. However, MO was associated with significantly higher chewing efficiency and maximum BFs than fixed prosthesis.
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Epithelial –myoepithelial carcinoma of the maxillofacial and sinonasal region: a systematic review of presenting characteristics, treatment modalities, and associated outcomes

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Epithelial –myoepithelial carcinoma (EMC) is a rare salivary gland malignancy. Controversy exists in the literature regarding the effectiveness of treatment modalities employed in the management of EMC. This systematic review was undertaken to understand the presenting characteristics of EMC and identify the most common treatment modalities and their associated outcomes, in order to help guide an evidenced-based approach to the algorithm of care. The MEDLINE (PubMed) and Embase databases were searched (up to February 23, 2022), and the review was performed in accordance with the PRISMA statement. (Source: International Journal of Oral and Maxillofacial Surgery)
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Omicron (BA.1) and Sub‐Variants (BA.1.1, BA.2 and BA.3) of SARS‐CoV‐2 Spike Infectivity and Pathogenicity: A Comparative Sequence and Structural‐based Computational Assessment

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ABSTRACT

The Omicron variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread throughout the world. We used computational tools to assess the spike infectivity, transmission, and pathogenicity of Omicron (BA.1) and sub-variants (BA.1.1, BA.2, and BA.3) in this study. BA.1 has 39 mutations, BA.1.1 has 40 mutations, BA.2 has 31 mutations, and BA.3 has 34 mutations, with 21 shared mutations between all. We observed 11 common mutations in Omicron's receptor-binding domain and sub-variants. In pathogenicity analysis, the Y505H, N786K, T95I, N211I, N856K, and V213R mutations in omicron and sub-variants are predicted to be deleterious. Due to the major effect of the mutations characterising in the receptor-binding domain (RBD), we found that Omicron and sub-variants had a higher positive electrostatic surface potential. This could increase interaction between RBD and negative electrostatic surface potential human angiotensin-converting enzy me 2 (hACE2). Omicron and sub-variants had a higher affinity for hACE2 and the potential for increased transmission when compared to the wild type. Negative electrostatic potential of NTD value indicates that the Omicron variant binds receptors less efficiently than the Wild type. Given that at least one receptor is highly expressed in lung and bronchial cells, the electrostatic potential of NTD negative value could be one of the factors contributing to why the Omicron variant is thought to be less harmful to the lower respiratory tract. Among Omicron sub-lineages, BA.2 and BA.3 have a higher transmission potential than BA.1 and BA.1.1. We predicted that mutated residues in BA.1.1 (K478), BA.2 (R400, R490, R495), and BA.3 (R397 and H499) formation of new salt bridges and hydrogen bonds. Omicron and sub-variant mutations at Receptor-binding Motif (RBM) residues such as Q493R, N501Y, Q498, T478K, and Y505H all contribute significantly to binding affinity with human ACE2. Interactions with Omicron variant mutations at residues 493, 496, 498, and 501 seem to restore ACE2 binding effectiveness lost due to other mutations like K417N.

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Τετάρτη 8 Ιουνίου 2022

Influence of bone morphology on the mechanobiological stimuli distribution of maxillary anterior labial bone: A biomechanical study

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Abstract

Objective

This study intended to ascertain the dimensional effects of labial bone thickness and height on the mechanobiological stimuli distribution of maxillary anterior labial bone through biomechanical analysis.

Material and methods

Twelve 3D finite element models of an anterior maxillary region with an implant were computer-simulated, including four levels of labial bone thicknesses (2, 1.5, 1.0, and 0.5 mm) and three levels of labial bone heights (normal, reduced by 1/3, reduced by 1/2). A 45° buccolingual oblique load of 100 N was applied to the implant restoration.

Results

Equivalent stress and principal strain mainly concentrated on crestal bone around the implant neck. The maximum equivalent stress in bone decreased as labial bone mass decreased, while the maximum principal strain and the displacement of dental implant increased as labial bone mass decreased. No significant difference of these three indicators was observed, when the labial bone thickness changed in the range of 2.0–1.0 mm with sufficient labial bone height.

Conclusions

In terms of biomechanics, the thickness of labial bone plate was recommended ≥1 mm. Sufficient labial bone height was warranted to prevent the stability of the implants from being seriously affected. The labial bone heights were more effective than thicknesses on the mechanobiological stimuli response of the dental implant-bone system.

Clinical significance

For this 3D finite element study, the biomechanical responses under different bone mass conditions were explored, in order to predict the process of bone remodeling and provide valid clinical recommendations for the decision-making process regarding the choices of tissue augmentation for some specific esthetic implantation cases for future clinical applications.
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Effect of Telehealth Interventions on Blood Pressure Control: A Meta-analysis

alexandrossfakianakis shared this article with you from Inoreader
imageThe aim of this study was to find out the effects of telehealth interventions on blood pressure control by conducting a meta-analysis. Six databases were used. The literature review covered the period between December 1, 2020, and January 26, 2021. The meta-analysis was conducted by comprehensive Meta-Analysis Software version 2.2. Categorical variables were analyzed by odds ratios at a confidence interval of 95%. In data formatting and analysis, independent groups (sample size, P value); independent groups (mean, SD); Cohen's d, SE; and paired groups (N, P value) were used. The bias risk was assessed based on the Revise d Cochrane Risk-of-Bias Tool for Randomized Trials. Total sample size including 22 studies was 11 120. It was determined that interventions performed through telehealth applications had a significant effect on blood pressure control (odds ratio = −0.14; 95% confidence interval = −0.20 to −0.08; P
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Interdisciplinary Management of a Patient with Dentinogenesis Imperfecta Type II Using a Combination of CAD‐CAM and Analog Techniques: A Clinical Report

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Type II dentinogenesis imperfecta is an autosomal dominant condition that affects dentin which increase the complexity of the predictability of the restorative treatment. Computer-aided design and computer-aided manufacturing (CAD-CAM) technologies permit the creation of highly accurate devices and dental prostheses that simplify the planning and execution of advanced implant surgery and full-mouth rehabilitation. This clinical report presents the interdisciplinary management of a 20-year-old male with dentinogenesis imperfecta type II. In this article, a combination of analog and CAD-CAM technologies were used to fabricate devices that aided planning, assisted intermaxillary fixation and implant placement, served as interim prostheses, and permitted the accurate establishment of esthetics and occlusion of the definitive full-arch prostheses.

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Investigational PET tracers in neuro-oncology—What’s on the horizon? A report of the PET/RANO group

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Many studies in patients with brain tumors evaluating innovative PET tracers have been published in recent years, and the initial results are promising. Here, the Response Assessment in Neuro-Oncology (RANO) PET working group provides an overview of the literature on novel investigational PET tracers for brain tumor patients. Furthermore, newer indications of more established PET tracers for the evaluation of glucose metabolism, amino acid transport, hypoxia, cell proliferation, and others are also discussed. Based on the preliminary findings, these novel investigational PET tracers should be further evaluated considering their promising potential. In particular, novel PET probes for imaging of translocator protein and somatostatin receptor overexpression as well as for immune system reactions appear to be of additional clinical value for tumor delineation and therapy monitoring. Progress in developing these radiotracers may contribute to improvi ng brain tumor diagnostics and advancing clinical translational research.
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SARS‐CoV‐2and Mutation RT‐qPCR Test Positivity Correlation with ABO and Rh Blood Types

alexandrossfakianakis shared this article with you from Inoreader

ABSTRACT

Introduction

Studies show that there may be a relationship between ABO blood type and SARS-CoV-2transmission. It was aimed to determine by investigating the blood type of patients whose one-step reverse transcription and real-time polymerase chain reaction (RT-qPCR) test was positive for Sars-CoV-2.

Materials and Methods

ABO and Rh blood type of individuals whose RT-qPCR test was positive for SARS-CoV-2were examined and an evaluation was made to identify whether there was a relationship between them or not.

Results

The blood type data of 44.928 SARS-CoV-2positive RT-qPCR test results has been obtained. 17.656 (39.29%) were delta, 8048 (17.91%) were alpha, 800 (1.78%) were beta and 3000 (6.67%) were omicrons while 15.424 (34.33%) SARS-CoV-2positive mutation was found to be negative.

Discussion

Our study suggests that O and Rh (-) blood types may provide protection against delta, AB and Rh (+) blood types may hinder omicron infection while A and Rh (+) blood types may be more vulnerable to alpha and delta while B and Rh (+) are more sensitive to beta mutation.

Conclusion

Molecular mechanism underlying the relationship between blood types and SARS-CoV-2infection needs further molecular studies and multi-centered studies.

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