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Κυριακή 11 Απριλίου 2021

Non-grafted versus grafted sinus lift procedures for implantation in the atrophic maxilla: a systematic review and meta-analysis of randomized controlled trials

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Publication date: Available online 10 April 2021

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): S.A.N. Lie, R.M.M.A. Claessen, C.A.W. Leung, H.-A. Merten, P.A.W.H. Kessler

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Large-Scale Phenomic and Genomic Analysis of Brain Asymmetrical Skew

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Abstract
The human cerebral hemispheres show a left–right asymmetrical torque pattern, which has been claimed to be absent in chimpanzees. The functional significance and developmental mechanisms are unknown. Here, we carried out the largest-ever analysis of global brain shape asymmetry in magnetic resonance imaging data. Three population datasets were used, UK Biobank (N = 39 678), Human Connectome Project (N = 1113), and BIL&GIN ( N = 453). At the population level, there was an anterior and dorsal skew of the right hemisphere, relative to the left. Both skews were associated independently with handedness, and various regional gray and white matter metrics oppositely in the two hemispheres, as well as other variables related to cognitive functions, sociodemographic factors, and physical and mental health. The two skews showed single nucleotide polymorphisms-based heritabilities of 4–13%, but also substantial polygenicity in causal mixture model analysis, and no individually significant loci were found in genome-wide association studies for either skew. There was evidence for a significant genetic correlation between horizontal brain skew and autism, which requires future replication. These results provide the first large-scale description of population-average brain skews and their inter-individual variations, their replicable associations with handedness, and insi ghts into biological and other factors which associate with human brain asymmetry.
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Association between Quantitative MR Markers of Cortical Evolving Organization and Gene Expression during Human Prenatal Brain Development

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Abstract
The relationship between structural changes of the cerebral cortex revealed by Magnetic Resonance Imaging (MRI) and gene expression in the human fetal brain has not been explored. In this study, we aimed to test the hypothesis that relative regional thickness (a measure of cortical evolving organization) of fetal cortical compartments (cortical plate [CP] and subplate [SP]) is associated with expression levels of genes with known cortical phenotype. Mean regional SP/CP thickness ratios across age measured on in utero MRI of 25 healthy fetuses (20–33 gestational weeks [GWs]) were correlated with publicly available regional gene expression levels (23–24 GW fetuses). Larger SP/CP thickness ratios (more pronounced cortical evolving organization) was found in perisylvian regions. Furthermore, we found a significant association between SP/CP thickness ratio and expression levels of the FLNA gene (mutated in p eriventricular heterotopia, congenital heart disease, and vascular malformations). Further work is needed to identify early MRI biomarkers of gene expression that lead to abnormal cortical development.
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Outcome Value and Task Aversiveness Impact Task Procrastination through Separate Neural Pathways

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Abstract
The temporal decision model of procrastination has proposed that outcome value and task aversiveness are two separate aspects accounting for procrastination. If true, the human brain is likely to implicate separate neural pathways to mediate the effect of outcome value and task aversiveness on procrastination. Outcome value is plausibly constructed via a hippocampus-based pathway because of the hippocampus's unique role in episodic prospection. In contrast, task aversiveness might be represented through an amygdala-involved pathway. In the current study, participants underwent fMRI scanning when viewing both tasks and future outcomes, without any experimental instruction imposed. The results revealed that outcome value increased activations in the caudate, and suppressed procrastination through a hippocampus-caudate pathway. In contrast, task aversiveness increased activations in the anterior insula, and increased procrastination via an amygdal a–insula pathway. In sum, this study demonstrates that people can incorporate both outcome value and task aversiveness into task valuation to decide whether to procrastinate or not; and it elucidates the separate neural pathways via which this occurs.
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The Range of Cardiogenic Shock Survival by Clinical Stage: Data From the Critical Care Cardiology Trials Network Registry

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Objectives: Cardiogenic shock presents with variable severity. Categorizing cardiogenic shock into clinical stages may improve risk stratification and patient selection for therapies. We sought to determine whether a structured implementation of the 2019 Society for Cardiovascular Angiography and Interventions clinical cardiogenic shock staging criteria that is ascertainable in clinical registries discriminates mortality in a contemporary population with or at-risk for cardiogenic shock. Design: We developed a pragmatic application of the Society for Cardiovascular Angiography and Interventions cardiogenic shock staging criteria—A (at-risk), B (beginning), C (classic cardiogenic shock), D (deteriorating), or E (extremis)—and examined outcomes by stage. Setting: The Critical Care Cardiology Trials Network is an investigator-initiated multicenter research collaboration coordinated by the TIMI Study Group (Boston, MA). Consecutive admissions with or at-risk for cardiogenic shock during two annual 2-month collection periods (2017–2019) were analyzed. Patients: Patients with or at-risk for cardiogenic shock. Measurements and Main Results: Of 8,240 CICU admissions reviewed, 1,991 (24%) had or were at-risk for cardiogenic shock. Distributions across the five stages were as follows: A: 33%; B: 7%; C: 16%; D: 23%; and E: 21%. Overall in-hospital mortality among patients with established cardiogenic shock was 39%; however, mortality varied from only 15.8% to 32.1% to 62.5% across stages C, D, and E (Cochran-Armitage ptrend
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Acute Kidney Injury Recovery Patterns in Critically Ill Patients: Results of a Retrospective Cohort Study

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Objectives: Acute kidney injury, acute kidney injury severity, and acute kidney injury duration are associated with both short- and long-term outcomes. Despite recent definitions, only few studies assessed pattern of renal recovery and time-dependent competing risks are usually disregarded. Our objective was to describe pattern of acute kidney injury recovery, change of transition probability over time and their risk factors. Design: Monocenter retrospective cohort study. Acute kidney injury was defined according to Kidney Disease Improving Global Outcomes definition. Renal recovery was defined as normalization of both serum creatinine and urine output criteria. Competing risk analysis, time-inhomogeneous Markov model, and group-based trajectory modeling were performed. Setting: Monocenter study. Patients: Consecutive patients admitted in ICU from July 2018 to December 2018 were included. Interventions: None. Measurements and Main Results: Three-hundred fifty patients were included. Acute kidney injury occurred in 166 patients at ICU admission, including 64 patients (38.6%) classified as acute kidney disease according to Acute Disease Quality Initiative definition and 44 patients (26.5%) who could not be classified. Cumulative incidence of recovery was 25 % at day 2 (95% CI, 18–32%) and 35% at day 7 (95% CI, 28–42%). After adjustment, need for mechanical ventilation (subdistribution hazard ratio, 0.42; 95% CI, 0.23–0.74) and severity of the acute kidney injury (stage 3 vs stage 1 subdistribution hazard ratio, 0.11; 95% CI, 0.03–0.35) were associated with lack of recovery. Group-based trajectory modeling identified three clusters of temporal changes in this setting, associated with both acute kidney injury recovery and patients' outcomes. Conclusions: In this study, we demonstrate Acute Disease Quality Initiative to allow recovery pattern classification in 75% of critically ill patients. Our study underlines the need to take into account competing risk factors when assessing recovery pattern in critically ill patients. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. Mariotte reports personal fees from Sanofi outside the submitted work. Dr. Valade reports personal fees for teaching from Sanofi and Gilead, "invitation to congress" from Pfizer, and personal fees from PR editions for expert opinion outside the submitted work. Dr. Zafrani's institution received funding from Jazz Pharmaceuticals outside the submitted work. Dr. Azoulay has received fees for lectures from Gilead, Pfizer, Baxter, and Alexion, and his research group has been supported by Ablynx, Fisher & Paykel, Jazz Pharma, and MSD. Dr. Darmon declares having received a grant from MSD, speaker fees from MSD, Astellas, and Gilead-Kite and having attended an advisory board for Gilead-Kite. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: michael.darmon@aphp.fr Copyright © by 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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Anticoagulation Therapy in Patients With Coronavirus Disease 2019: Results From a Multicenter International Prospective Registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019 [HOPE-COVID19])

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Objectives: No standard therapy, including anticoagulation regimens, is currently recommended for coronavirus disease 2019. Aim of this study was to evaluate the efficacy of anticoagulation in coronavirus disease 2019 hospitalized patients and its impact on survival. Design: Multicenter international prospective registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019). Setting: Hospitalized patients with coronavirus disease 2019. Patients: Five thousand eight hundred thirty-eight consecutive coronavirus disease 2019 patients. Interventions: Anticoagulation therapy, including prophylactic and therapeutic regimens, was obtained for each patient. Measurements and Main Results: Five thousand four hundred eighty patients (94%) did not receive any anticoagulation before hospitalization. Two-thousand six-hundred one patients (44%) during hospitalization received anticoagulation therapy and it was not associated with better survival rate (81% vs 81%; p = 0.94) but with higher risk of bleeding (2.7% vs 1.8%; p = 0.03). Among patients admitted with respiratory failure (49%, n = 2,859, including 391 and 583 patients requiring invasive and noninvasive ventilation, respectively), anticoagulation started during hospitalization was associated with lower mortality rates (32% vs 42%; p
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Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study

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Objectives: In patients with coronavirus disease 2019–associated acute respiratory distress syndrome, sedatives and opioids are commonly administered which may lead to increased vulnerability to neurologic dysfunction. We tested the hypothesis that patients with coronavirus disease 2019–associated acute respiratory distress syndrome are at higher risk of in-hospital mortality due to prolonged coma compared with other patients with acute respiratory distress syndrome matched for disease severity. Design: Propensity-matched cohort study. Setting: Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA). Patients: All mechanically ventilated coronavirus disease 2019 patients between March and May 2020 were identified and matched with patients with acute respiratory distress syndrome of other etiology. Interventions: None. Measurements and Main Results: Using clinical data obtained from a hospital registry, we matched 114 coronavirus disease 2019 patients to 228 noncoronavirus disease 2019–related acute respiratory distress syndrome patients based on baseline disease severity. Coma was identified using the Richmond Agitation Sedation Scale less than or equal to –3. Multivariable logistic regression and mediation analyses were used to assess the percentage of comatose days, sedative medications used, and the association between coronavirus disease 2019 and in-hospital mortality. In-hospital mortality (48.3% vs 31.6%, adjusted odds ratio, 2.15; 95% CI, 1.34–3.44; p = 0.002), the percentage of comatose days (66.0% ± 31.3% vs 36.0% ± 36.9%, adjusted difference, 29.35; 95% CI, 21.45–37.24; p
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Time to Initiation of Renal Replacement Therapy Among Critically Ill Patients With Acute Kidney Injury: A Current Systematic Review and Meta-Analysis

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Objectives: The optimal time to initiate renal replacement therapy in critically ill patients with acute kidney injury is controversial. We investigated the effect of such earlier versus later initiation of renal replacement therapy on the primary outcome of 28-day mortality and other patient-centered secondary outcomes. Design: We searched MEDLINE (via PubMed), EMBASE, and Cochrane databases to July 17, 2020, and included randomized controlled trials comparing earlier versus later renal replacement therapy. Setting: Multiple centers involved in eight trials. Patients: Total of 4,588 trial participants. Intervention: Two independents investigators screened and extracted data using a predefined form. We selected randomized controlled trials in critically ill adult patients with acute kidney injury and compared of earlier versus later initiation of renal replacement therapy regardless of modality. Measurements and Main Results: Overall, 28-day mortality was similar between earlier and later renal replacement therapy initiation (38.43% vs 38.06%, respectively; risk ratio, 1.01; [95% CI, 0.94–1.09]; I2 = 0%). Earlier renal replacement therapy, however, shortened hospital length of stay (mean difference, –2.14 d; [95% CI, –4.13 to –0.14]) and ICU length of stay (mean difference, –1.18 d; [95% CI, –1.95 to –0.42]). In contrast, later renal replacement therapy decreased the use of renal replacement therapy (relative risk, 0.69; [95% CI, 0.58–0.82]) and lowered the risk of catheter-related blood stream infection (risk ratio, 0.50, [95% CI, 0.29–0.86). Among survivors, renal replacement therapy dependence at day 28 was similar between earlier and later renal replacement therapy initiation (risk ratio, 0.98; [95% CI, 0.66–1.40]). Conclusions: Earlier or later initiation of renal replacement therapy did not affect mortality. However, earlier renal replacement therapy was associated with significantly shorter ICU and hospital length of stay, whereas later renal replacement therapy was associated with decreased use of renal replacement therapy and decreased risk of catheter-related blood stream infection. These findings can be used to guide the management of critically ill patients with acute kidney injury. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Drs. Naorungroj, Neto, Eastwood, and Bellomo contributed to conceptualization and methodology. Drs. Naorungroj, Neto, Yanase, Bagshaw, and Wald contributed to material preparation and analysis. Dr. Naorungroj contributed to writing-original draft preparation. Drs. Naorungroj, Neto, Yanase, Bagshaw, Wald, and Bellomo contributed to writing-review and editing. Each author contributed important intellectual content during article drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. Dr. Neto reported receiving lecture fee from Drager outside the submitted work. Dr. Yanase reported receiving scholarship for PhD course in Monash University from Japan Student Services Organization and Endeavour Scholarship. Dr. Wald reports receiving speaker fees and unrestricted research funding from Baxter. Dr. Bagshaw reported receiving fees for scientific advisory and grants from Baxter; he reported receiving fees for scientific advisory from Diagnostics and Spectral Medical, Canada, all outside the submitted work; he is supported by a Canada Research Chair in Critical Care Nephrology. Dr. Bellomo reported receiving grants from Baxter International outside the submitted work. The remaining authors have disclosed that they have no potential conflicts of interest. Registration: The study was registered with the Prospective Register of Systematic Reviews (CRD42020188951) on May 27, 2020. For information regarding this article, E-mail: rinaldo.bellomo@austin.org.au Copyright © by 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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Association Between Incident Delirium Treatment With Haloperidol and Mortality in Critically Ill Adults

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Objectives: Haloperidol is commonly administered in the ICU to reduce the burden of delirium and its related symptoms despite no clear evidence showing haloperidol helps to resolve delirium or improve survival. We evaluated the association between haloperidol, when used to treat incident ICU delirium and its symptoms, and mortality. Design: Post hoc cohort analysis of a randomized, double-blind, placebo-controlled, delirium prevention trial. Setting: Fourteen Dutch ICUs between July 2013 and December 2016. Patients: One-thousand four-hundred ninety-five critically ill adults free from delirium at ICU admission having an expected ICU stay greater than or equal to 2 days. Interventions: Patients received preventive haloperidol or placebo for up to 28 days until delirium occurrence, death, or ICU discharge. If delirium occurred, treatment with open-label IV haloperidol 2 mg tid (up to 5 mg tid per delirium symptoms) was administered at clinician discretion. Measurements and Main Results: Patients were evaluated tid for delirium and coma for 28 days. Time-varying Cox hazards models were constructed for 28-day and 90-day mortality, controlling for study-arm, delirium and coma days, age, Acute Physiology and Chronic Health Evaluation-II score, sepsis, mechanical ventilation, and ICU length of stay. Among the 1,495 patients, 542 (36%) developed delirium within 28 days (median [interquartile range] with delirium 4 d [2–7 d]). A total of 477 of 542 (88%) received treatment haloperidol (2.1 mg [1.0–3.8 mg] daily) for 6 days (3–11 d). Each milligram of treatment haloperidol administered daily was associated with decreased mortality at 28 days (hazard ratio, 0.93; 95% CI, 0.91–0.95) and 90 days (hazard ratio, 0.97; 95% CI, 0.96–0.98). Treatment haloperidol administered later in the ICU course was less protective of death. Results were stable by prevention study-arm, predelirium haloperidol exposure, and haloperidol treatment protocol adherence. Conclusions: Treatment of incident delirium and its symptoms with haloperidol may be associated with a dose-dependent improvement in survival. Future randomized trials need to confirm these results. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by ZonMw program Goed Gebruik Geneesmiddelen (dossier number 836031004). ZonMw had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Dr. Duprey's efforts are supported by the National Institute of Aging 1F31AG066460-01. Drs. Duprey, Devlin, Briesacher, and Saczynski received support for article research from the National Institutes of Health. Dr. Duprey disclosed off-label product use of haloperidol for delirium. Dr. van den Boogaard's institution received funding and support for research from ZonMw. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this aticle, E-mail: j.devlin@neu.edu Copyright © by 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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A Comparison of Thrombosis and Hemorrhage Rates in Patients With Severe Respiratory Failure Due to Coronavirus Disease 2019 and Influenza Requiring Extracorporeal Membrane Oxygenation

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Objectives: Extracorporeal membrane oxygenation is a lifesaving therapy for patients with severe acute respiratory distress syndrome refractory to conventional mechanical ventilation. It is frequently complicated by both thrombosis and hemorrhage. A markedly prothrombotic state associated with high rates of venous thromboembolism has been described in patients with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) infection. These rates have currently not been described during extracorporeal membrane oxygenation in comparison to other viral pneumonias. Design: Retrospective observational study. Setting: Single high-volume tertiary critical care department at a university hospital. Patients: Patients 16 years old or greater receiving venovenous extracorporeal membrane oxygenation between March 1, 2020, and May 31, 2020, with coronavirus disease 2019 were compared with a cohort of patients with influenza pneumonia between June 1, 2012, and May 31, 2020. Interventions: None. Measurements and Main Results: The rates of venous thromboembolism and hemorrhage were compared in patients with coronavirus disease 2019 against a historic population of patients with influenza pneumonia who required extracorporeal membrane oxygenation. There were 51 patients who received extracorporeal membrane oxygenation due to coronavirus disease 2019 and 80 patients with influenza. At cannulation for extracorporeal membrane oxygenation, 37% of patients with coronavirus disease 2019 compared with 8% of patients with influenza had filling defects on CT pulmonary angiography (p = 0.0001). Catheter-associated deep vein thrombosis shown on ultrasound Doppler after decannulation was present in 53% with coronavirus disease 2019 versus 25% with influenza (p = 0.01). The rates of intracranial hemorrhage at the time of cannulation were 16% with coronavirus disease 2019 and 14% with influenza (p = 0.8). Elevated D-dimer levels were seen in both conditions and were significantly higher in those with pulmonary thromboemb olism than those without in coronavirus disease 2019 (p = 0.02). Fibrinogen and C-reactive protein levels were significantly higher in those with coronavirus disease 2019 than influenza (p
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