Dental implant failure rates with low insertion torque with a nonsubmerged surgical approach: A retrospective clinical study

alexandrossfakianakis shared this article with you from Inoreader Dental implant failure rates with low insertion torque with a nonsubmerged surgical approach: A retrospective clinical study via Clinical Implant Dentistry and Related Research Abstract Background It is currently unclear if a low insertion torque (IT) should prompt a clinician to submerge the dental implant at time of placement. Purpose This study aimed to analyze implant failure rates and marginal bone loss (MBL) as a function of IT and surgical approach. Materials and Methods A total of 197 patients who had received 295 Mozo Grau (MG) implants were included in this study. The healing of submerged or nonsubmerged implants was evaluated in regular IT (≥20–25 Ncm) or low IT (<20–25 Ncm) cases. Implant failure and MBL were evaluated before prosthesis placement and at 6 and 12 months after functional loading with generalized estimating equations. Results The overall 12-month implant failure rate was 4.8% (95% confidence interval [CI]: 2.7%–8.2%). When successful at 12 months, dental implants placed with low IT and nonsubmerging had the same MBL as implants dental implants placed with other approaches (mean difference = −0.02 mm; 95% CI −0.05 to 0.02). Low IT combined with nonsubmerging of the dental implant was associated with a 30-fold increased odds for dental implant failure (95% CI: 3.8–236.6). Conclusion low IT and nonsubmerged healing was associated with a high failure rate. View on Web

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Naphazoline and oxymetazoline are superior to epinephrine in enhancing the cutaneous analgesia of lidocaine in rats

alexandrossfakianakis shared this article with you from Inoreader Naphazoline and oxymetazoline are superior to epinephrine in enhancing the cutaneous analgesia of lidocaine in rats via Fundamental & Clinical Pharmacology Abstract This study observed the cutaneous analgesic effect of adrenergic agonists when combined with lidocaine. We aimed at the usefulness of 4 adrenergic agonists and epinephrine as analgesics or as tools to prolong the effect of local anesthetics using a model of cutaneous trunci muscle reflex (pinprick pain) in rats. We showed that subcutaneous 4 adrenergic agonists and epinephrine, as well as the local anesthetic bupivacaine and lidocaine, developed a concentration-dependent cutaneous analgesia. The rank order of the efficacy of different compounds (ED50; median effective dose) was epinephrine [0.013 (0.012 – 0.014) μmol] > oxymetazoline [0.25 (0.22 – 0.28) μmol] > naphazoline [0.42 (0.34 – 0.53) μmol] = bupivacaine [0.43 (0.37 – 0.50) μmol] > xylometazoline [1.34 (1.25 – 1.45) μmol] > lidocaine [5.86 (5.11 – 6.72) μmol] > tetrahydrozoline [6.76 (6.21 – 7.36) μmol]. The duration of full reco very caused by tetrahydrozoline, oxymetazoline, or xylometazoline was greater (P<0.01) than that induced via epinephrine, bupivacaine, lidocaine, or naphazoline at equianesthetic doses (ED25, ED50 , and ED75). Co-administration of lidocaine (ED50) with 4 adrenergic agonists or epinephrine enhanced the cutaneous analgesic effect. We observed that 4 adrenergic agonists and epinephrine induce analgesia by themselves, and such an effect has a longer duration than local anesthetics. Co-administration of lidocaine with the adrenergic agonist enhances the analgesic effect, and the cutaneous analgesic effect of lidocaine plus naphazoline (or oxymetazoline) is greater than that of lidocaine plus epinephrine. View on Web

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Association of upper respiratory Streptococcus pneumoniae colonization with SARS-CoV-2 infection among adults

alexandrossfakianakis shared this article with you from Inoreader Association of upper respiratory Streptococcus pneumoniae colonization with SARS-CoV-2 infection among adults via Clinical Infectious Diseases Advance Access ABSTRACT Background Streptococcus pneumoniae interacts with numerous viral respiratory pathogens in the upper airway. It is unclear whether similar interactions occur with SARS-CoV-2. Methods We collected saliva specimens from working-age adults receiving SARS-CoV-2 molecular testing at outpatient clinics and via mobile community-outreach testing between July and November 2020 in Monterey County, California. Following bact erial culture enrichment, we tested for pneumococci by quantitative polymerase chain reaction (qPCR) targeting the lytA and piaB genes, and measured associations with SARS-CoV-2 infection via conditional logistic regression. Results Analyses included 1,278 participants, with 564 enrolled in clinics and 714 enrolled through outreach-based testing. Prevalence of pneumococcal carriage was 9.2% (117/1,278) among all participants (11.2% [63/564] clinic-based testing; 7.6% [54/714] outreach testing). Prevalence of SARS-CoV-2 infection was 27.4% (32/117) among pneumococcal carriers and 9.6% (112/1,161) among non-carriers (adjusted odds ratio [aOR]: 2.73; 95% confidence interval: 1.58-4.69). Associations between SARS-CoV-2 infection and pneumococcal carriage were enhanced in the clinic-based sample (aOR = 4.01 [2.08-7.75]) and among symptomatic participants (aOR = 3.38 [1.35-8.40]), when compared to fin dings within the outreach-based sample and among asymptomatic participants. Adjusted odds of SARS-CoV-2 co-infection increased 1.24 (1.00-1.55)-fold for each 1-unit decrease in piaB qPCR CT value among pneumococcal carriers. Last, pneumococcal carriage modified the association of SARS-CoV-2 infection with recent exposure to a suspected COVID-19 case (aOR = 7.64 [1.91-30.7] and 3.29 [1.94-5.59]) among pneumococcal carriers and non-carriers, respectively). Conclusions Associations of pneumococcal carriage detection and density with SARS-CoV-2 suggest a synergistic relationship in the upper airway. Longitudinal studies are needed to determine interaction mechanisms between pneumococci and SARS-CoV-2. View on Web

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Mediterranean Diet component oleic acid increases protective lipid‐mediators and improves trabecular bone in a Porphyromonas‐gingivalis‐inoculation‐model

alexandrossfakianakis shared this article with you from Inoreader Mediterranean Diet component oleic acid increases protective lipid‐mediators and improves trabecular bone in a Porphyromonas‐gingivalis‐inoculation‐model via Journal of Clinical Periodontology Abstract Background Therapeutic modulation of bacterial-induced inflammatory host response is being investigated in gingival inflammation and periodontal disease pathology. Therefore, dietary intake of monounsaturated fatty acid (FA) oleic acid (OA (C18:1)), main-component of Mediterranean-style diets, and Western-style diet component saturated FA palmitic acid (PA (C16:0)) were investigated for their modifying potential in a P.gingivalis-oral-inoculation-model. Methods Normal-weight C57BL/6-mice received OA-or PA-enriched diets (PA-ED, OA-ED, PA/OA-ED) or normal-standard-diet for 16 weeks and were inoculated with P.gingivalis/placebo (n=12/group). Gingival inflammation, alveolar bone structure, circulating lipid mediators and in vitro cellular response were determined. Results FA-treatment of P.gingivalis-LPS-incubated gingival fibroblasts (GFb) modified inflammatory activation, which only PA exacerbated with concomitant TNF-α-stimulation. Mice exhibited no signs of acute inflammation in gingiva or serum and no inoculation-and nutrition-associated changes of crestal alveolar bone. However, following P.gingivalis-inoculation, OA-ED improved oral trabecular bone-micro-architecture and enhanced circulating pro-resolving mediators Resolvin D4 (RvD4) and 4-hydroxydocosahexaenoic acid (4-HDHA), whereas PA-ED did not. In vitro-experiments demonstrated significantly improved differentiation in RvD4-and 4-HDHA-treated primary osteoblast-cultures and reduced expression of osteoclastogenic factors in GF. Further, P.gingivalis-infection of OA-ED animals led to a serum composition that suppressed osteoclastic differentiation in vitro. Conclusions Results underline preventive impact of Mediterranean-style-OA-EDs by indicating their pro-resolving nature beyond anti-inflammatory properties. View on Web

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The Arterial Pattern of the Upper Nasal Septum (S‐Point) and Potential Role in Severe Epistaxis

alexandrossfakianakis shared this article with you from Inoreader The Arterial Pattern of the Upper Nasal Septum (S‐Point) and Potential Role in Severe Epistaxis via The Laryngoscope The previously described S-point, corresponds to the medial projection of the middle turbinate axilla in the superior nasal septum and has been identified as a common source of severe epistaxis. The rich anatomical patterns of vascularization of the S-point area could explain why this area is a common site of severe epistaxis and guide its surgical cauterization when an obvious vascular ectasia is not visualized. Objectives The previously described S-point, corresponds to the medial projection of the middle turbinate axilla in the superior nasal septum and has been identified as a common source of severe epistaxis. The objective is to define the anatomical patterns of vascularization of the S-point area that could explain its clinical relevance. Methods Thirty-three nasal septums of latex-injected formalin-embalmed and fresh human cadaveric heads were dissected to analyze the arterial arrangement of the S-point area. Measurements and patterns of vascularization were described. Results The S-point area, was consistently surrounded by a single or multiple arterial anastomotic arches consistently formed superiorly by the anterior ethmoidal and posterior ethmoidal artery branches, and inferiorly by the posterior septal artery. The caliber of the arterial arches was typically larger than the caliber of the arterial branches supplying them. A single arch was present in 36.3% of septums, and multiple arches in 63.6%. The mean distance from the S-point to the anterior limit of the arch was 9 mm, to the posterior arch when the present was 3 mm, to the superior limit 6 mm, to the inferior limit 6 mm, and to the nasal roof was 10 mm. Conclusion This study demonstrates the dense arterial configuration of the S point area, which is characterized by a single or multiple vascular arches of greater caliber than the branches of origin. This finding could explain why the S-point area is a frequent source of epistaxis, and guide its surgical cauterization when an obvious vascular ectasia is not visualized. Level of Evidence N/A Laryngoscope, 2022 View on Web

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Is drug‐induced sleep endoscopy associated with better outcomes after soft tissue surgery for sleep apnea? A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Is drug‐induced sleep endoscopy associated with better outcomes after soft tissue surgery for sleep apnea? A systematic review and meta‐analysis via Clinical Otolaryngology Abstract Objectives The aim was to estimate the effect of drug-induced sleep endoscopy (DISE) on surgical outcomes after soft tissue surgery for obstructive sleep apnea (OSA). Design and setting Systematic review and meta-analysis. Participants Adult patients with OSA and candidates for soft tissue surgery, with and without preoperative DISE, were included. Main outcomes measures A systematic literature search of Medline, Web of Science, and Cochrane databases was performed from inception to December 31, 2021. Studies directly comparing patients with and without preoperative DISE were included. Success rate, change in apnea-hypopnea index (AHI), change in minimum SpO2 and change in Epworth Sleepiness Scale (ESS) score were extracted. Random-effect models were used to pool estimates. Results Seven out of 619 articles were included, representing 791 patients (389 in the DISE group and 402 in the no DISE group). DISE was neither associated with a higher success rate (pooled OR 1.34, 95% CI 0.69 – 2.59, p=0.39) after soft tissue surgery for OSA, nor a significant change in AHI (-4.69 events/hour, 95% CI -11.10 – 1.72, p=0.15), minimal SpO2 (mean increase of 2.02%, 95% CI -0.26 – 4.29, p=0.08) and ESS (mean difference of 1.29, 95% CI -0.48 – 3.05, p=0.15) when compared to patients without preoperative DISE. Conclusions Soft tissue surgery does not give better results after DISE compared to when DISE is not performed. However, given the overall low level of evidence of included studies, future well-conducted studies should confirm or overturn these results and clarify the added value of DISE. This article is protected by copyright. All rights reserved. View on Web

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Post‐operative survival in head & neck cancer patients with elevated troponins

alexandrossfakianakis shared this article with you from Inoreader Post‐operative survival in head & neck cancer patients with elevated troponins via Clinical Otolaryngology Abstract Objective The strenuous demands of head and neck cancer surgery (HNS) place patients at increased risk of myocardial injury. Troponin positivity (TP) post-operatively is a predictor of increased complications and mortality. The present study is the first to investigate the effects of TP on potential delays in adjuvant treatment and disease-specific survival. Methods All patients undergoing HNS from 2014 to 2016 had troponins measured at a single academic center. Relevant patient data was extracted on retrospective chart review. Results Of 166 patients, 26 (15.6%) developed TP post-operatively. There was no significant difference between cohorts for baseline characteristics except for age. Overall and disease-specific survival for TP patients were respectively 45.9% and 57.4% at 3 years. There was no significant difference between cohorts for overall & disease-specific survival, and time to adjuvant therapy. Conclusion No significant association was found between TP and overall & disease-specific survival, and time to adjuvant therapy. View on Web

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Oncologic Outcomes After Clinically Node-Negative Salvage Laryngectomy

alexandrossfakianakis shared this article with you from Inoreader Oncologic Outcomes After Clinically Node-Negative Salvage Laryngectomy via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study investigates the association of elective nec k dissection vs observation with oncologic outcomes among patients who received clinically node-negative salvage total laryngectomy. View on Web

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Multimodale Therapie bei lokal fortgeschrittenem kutanem Plattenepithelkarzinom

alexandrossfakianakis shared this article with you from Inoreader Multimodale Therapie bei lokal fortgeschrittenem kutanem Plattenepithelkarzinom via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1949-2936 Die Therapieoptionen für lokal fortgeschrittene oder metastasierte Plattenepithelkarzinome waren bisher stark begrenzt und nicht standardisiert. Durch die Zulassung des monoklonalen Antikörpers Cemiplimab, der gegen den programmed death-1-Rezeptor (PD-1) gerichtet ist, hat sich die Prognose der betroffenen Patienten deutlich gebessert, wobei z.T. anhaltende Komplettremissionen erzielt werden können.In der vorgestellten Kasuistik wurde ein multimorbider, 81-jähriger Patient aufgrund eines ausgedehnten Plattenepithelkarzinoms frontoparietal mit Schädelkalotteninfiltration und Einbruch nach intrakraniell zunächst mit Cemiplimab behandelt. Immunvermittelte Nebenwirkungen sind nicht aufgetreten. Bei klinischer und radiologischer Remission wurde der Restbefund interdisziplinär operativ versorgt, wobei die defekte Schädelkalotte rekonstruiert wurde. Histologisch wurde eine pathologische Komplettremissio n des Plattenepithelkarzinoms nachgewiesen. 6 Monate postoperativ ergab sich kein Anhalt für ein Lokalrezidiv oder Metastasen.Dieser Fall zeigt exemplarisch einen Patienten, der trotz seines hohen Alters und Ko-Morbidität von der Therapie mit Cemiplimab profitiert hat. Darüber hinaus demonstriert dieser Fall die Relevanz eines interdisziplinären/multimodalen Therapieregimes im Management dieser in der Inzidenz deutlich ansteigenden Tumorentität. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

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Staphylococcus aureus Carrier Types are not Evidence of Population Heterogeneity

alexandrossfakianakis shared this article with you from Inoreader Staphylococcus aureus Carrier Types are not Evidence of Population Heterogeneity via American Journal of Epidemiology - Advance Access Abstract Asymptomatic colonization by Staphylococcus aureus is a precursor for infection, so identifying the mode and source of transmission which leads to colonization could help target interventions. Longitudinal studies have shown that some people are persistently colonized for years, while others seem to carry S. aureus for weeks or less, and conventional wisdom attributes this disparity to an underlying risk factor in the persistently colonized. We analyze published data with mathematical models of acquisition and carriage to compare this hypothesis with alternatives. The null model assumes a homogeneous population and still produces highly variable colonization durations (mean of 1.94 years, 5th percentile 0.1 years, 95th percentile 5.8 years). Simulations show that this inherent variability, combined with censoring in longitudinal cohort studies, i s sufficient to produce the appearance of "persistent carriers," "intermittent carriers," and "noncarriers" in data. Our estimates for colonization duration exhibit sensitivity to the assumption that false positives can occur despite being rare, but our model-based approach simultaneously estimates specificity and sensitivity along with epidemiological parameters. Our results show it is plausible that S. aureus colonizes people indiscriminately, and improved understanding of the types of exposures which result in colonization is essential. View on Web

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