Πέμπτη 31 Μαρτίου 2022

Key Issues in Use of Prophylactic Steroids to Prevent Hypocalcemia and Voice Dysfunction After Thyroidectomy—Reply

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In Reply We thank Ms Kane and colleagues for their feedback on our article.
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Expert consensus on dental caries management

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International Journal of Oral Science, Published online: 31 March 2022; doi:10.1038/s41368-022-00167-3

Expert consensus on dental caries management
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Τετάρτη 30 Μαρτίου 2022

Air polishing or hand and/or power-driven instruments in supportive periodontal therapy

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This review of air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments in supportive periodontal treatment and implant maintenance included 6 RCTs. 4 of the 6 included studies were considered to be at high risk of bias so the findings should be interpreted cautiously.

The post Air polishing or hand and/or power-driven instruments in supportive periodontal therapy appeared first on National Elf Service.

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The implicated clinical factors for outcomes in 304 patients with salivary duct carcinoma: Multi‐institutional retrospective analysis in Japan

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Abstract

Background

Salivary duct carcinoma (SDC) is a high-grade salivary malignancy that frequently occurs as the carcinomatous component of carcinoma ex pleomorphic adenoma. We herein examined the clinical factors affecting outcomes in a large cohort of SDC.

Methods

We selected 304 SDC cases and investigated clinical characteristics and the factors affecting outcomes.

Results

The median age of the cases examined was 68 years, the most common primary site was the parotid gland (238 cases), and there was a male predominance (M/F = 5:1). Outcomes were significantly worse when the primary tumor site was the minor salivary glands (SG) than when it was the major SG. Outcomes were also significantly worse in pN(+) cases (161 cases) than in pN0 cases, particularly those with a metastatic lymph node number ≥11. The cumulative incidence of relapse and distant metastases was significantly higher in stage IV cases than in stage 0–III cases.

Conclusions

The absolute number of lymph node metastases, higher stages, and the minor SG as the primary tumor site were identified as factors affecting the outcome of SDC.

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From a Slave to a Surgeon: David Kearney McDonogh, the First Black Otolaryngologist

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Otolaryngology–Head and Neck Surgery, Ahead of Print.
David McDonogh, born into chattel slavery in Louisiana in the early 1800s, accomplished the unfathomable by becoming the first Black otolaryngologist in the United States of America. With tireless determination and profound intellect, Dr McDonogh surmounted immeasurable adversity along his improbable journey to freedom and success as an eye, ear, nose, and throat doctor in New York. His doctorate in medicine was posthumously awarded to his great-great-granddaughter in 2018 by the Columbia University Vagelos College of Physicians and Surgeons. In this History of Otolaryngology piece, we share his extraordinary story.
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Subclonal heterogeneity sheds light on the transformation trajectory in IGLV3-21R110 chronic lymphocytic leukemia

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Blood Cancer Journal, Published online: 30 March 2022; doi:10.1038/s41408-022-00650-4

Subclonal heterogeneity sheds light on the transformation trajectory in IGLV3-21R110 chronic lymphocytic leukemia
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Comparison of the Osteogenic Effectiveness of an Autogenous Demineralized Dentin Matrix and Bio-Oss® in Bone Augmentation: A Systematic Review and Meta-analysis

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Publication date: Available online 29 March 2022

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Yanfei Li, Wanhang Zhou, Peiyi Li, Qipei Luo, Anqi Li, Xinchun Zhang

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Advances in Surgical Treatment of Rhinitis

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Abstract

Purpose of Review

Rhinitis is a heterogeneous diagnosis characterized by the presence of several nasal symptoms and it is only when pharmacotherapy fails that surgical treatment is considered. Over the years, multiple surgical techniques and approaches have been proposed to treat these patients. We aim to present a comprehensive literature review of the surgical management of rhinitis, including the most recent techniques and long-term outcome evaluations.

Recent Findings

Endoscopic techniques targeting the inferior turbinates, septum, and the parasympathetic neural supply to the nasal mucosa have evolved over the years to surgically address rhinitis; better understanding of rhinitis physiopathology has prompted the development of less invasive techniques with potentially similar outcomes and decreased morbidity.

Summary

For the management of allergic rhinitis, isolated outfracture of the inferior turbinate remains the least invasive technique and classical submucosal resection remains very much in favor among practitioners. A variety of methods to achieve adequate submucosal reduction of the inferior turbinate are also discussed, including the microdebrider, radiofrequency ablation, and coblation techniques. Regarding non allergic rhinitis, we assess both endoscopic vidian neurectomy and posterior nasal nerve neurectomy, two broadly effective, but elaborate, options necessitating general anesthesia and a visit to the operating room. We also discuss cryoablation of the posterior nasal nerve, which presents as a minimally invasive technique that can be performed as an in-office procedure.

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Anatomical variations in the relationship between the spinal accessory nerve and internal jugular vein: a systematic review and meta-analysis

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The relationship between the spinal accessory nerve and internal jugular vein is important for modified neck dissection surgery. Therefore, the aim of this review was to investigate variations in this relationship. Through a search of the PubMed, Scopus, Web of Science, LILACS, and SciELO databases, the review authors collected anatomical data for inclusion in a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four relationship patterns were identified and classified: type 1, the nerve lies superficial to the vein; type 2, the nerve lies deep to the vein; type 3, the nerve crosses the branches of the vein; type 4, the nerve splits and its branches pass around the vein.
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Τρίτη 29 Μαρτίου 2022

Fibrin immobilization vestibular extension (FIVE): A case series

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Abstract

Aims

The objective of the present case series is to report on the rationale, surgical technique and outcome of a protocol for peri-implant mucosal phenotype modification therapy, referred to as "fibrin immobilization vestibular extension (FIVE)".

Material and Methods

The protocol utilized entailed apical positioning and stabilization of peri-implant flap with modular screws. The screws were also used for the immobilization of solid matrix platelet-rich fibrin to fill the gap created between apically positioned flap and the crestal margin of the flap.

Results

A total of 30 patients (12 male, 18 females) with 93 implants were treated with FIVE protocol for various indications, including for vestibular extension following alveolar ridge augmentation (N = 6), preprosthetic (N = 9), postprosthetic (N = 2), and peri-implantitis (N = 13). The keratinized mucosal width preoperatively was 1.67 mm with 95% confidence interval [CI] (1.46, 1.88). Immediately following FIVE surgery, the vestibule was extended to 9.10 with 95% CI (8.44, 9.76). At 3 months, 4.9 mm (95% CI: 4.5–5.2 mm) of peri-implant keratinized mucosal width was present. The keratinized mucosal width remained relatively stable thereafter and was 4.0 mm (95% CI: 3.5–4.5 mm) at 3 years post-FIVE surgery. When overall group means across all time points were analyzed, maxilla had mean of 6.1 mm (95% CI: 5.8–6.5) versus mandible exhibited mean of 5.1 mm (95% CI: 4.6–5.6 mm). The mean of maxilla was si gnificantly higher than that of the mandible (p < 0.0001) across all time points. Treatment of peri-implantitis with FIVE lead to significant pocket reduction and wide band of keratinized mucosa. Seven of 38 implants in 3 of 13 peri-implantitis patients were removed due to advanced peri-implantitis.

Discussion

The present case series provides proof-of-principle data for efficacy of FIVE for peri-implant phenotype modification therapy that generated attached keratinized mucosa in a variety of applications. This protocol provides an alternative to procedures involving harvesting of autogenous mucosal graft.

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Management of Benign Salivary Gland Conditions

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Surg Clin North Am. 2022 Apr;102(2):209-231. doi: 10.1016/j.suc.2022.01.001. Epub 2022 Mar 8.

ABSTRACT

In this section, we discuss the management of benign salivary gland disease. Pathologies vary from sialolithiasis, salivary duct stenosis, sialadenitis, infectious glandular disease, autoimmune glandular disease, and radioactive iodine-induced disease. We discuss both novel techniques in the diagnosis and management of these diseases, including ultrasound, sialendoscopy, minor salivary gland biopsy, and botulinum toxin injection, which allow for both the alleviation of symptoms and gland preservation.

PMID:35344693 | DOI:10.1016/j.suc.2022.01.001

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Natural history, predictive factors of apparent disease (structural or biochemical) and spontaneous excellent response in patients with papillary thyroid carcinoma and indeterminate response to initial therapy with radioiodine

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Endocrine. 2022 Mar 28. doi: 10.1007/s12020-022-03040-9. Online ahead of print.

ABSTRACT

BACKGROUND: About 20% of patients with papillary thyroid carcinoma (PTC) submitted to total thyroidectomy followed by radioactive iodine (RAI) exhibit an indeterminate response to therapy. The aim was to evaluate the natural history, predictive factors of apparent disease (structural or biochemical), and spontaneous excellent response in patients with PTC and an initial indeterminate response to RAI therapy defined based on unstimulated Tg (u-Tg).

METHODS: We evaluated 164 patients who were initially treated with total thyroidectomy and RAI and who had an indeterminate response to therapy (u-Tg between 0.2 and 1 ng/ml, undetectable anti-Tg antibodies [TgAb], and neck ultrasonography [US] without anomalies). None of the patients received empirical therapy with RAI. The patients were followed up for 24 to 144 months (median 72 months).

RESULTS: Apparent disease occurred in 16 patients (9.7%), including 13 with structural disease and 3 with u-Tg elevation > 1 ng/ml, but no tumor was detected by the imaging methods (biochemical disease). A higher frequency of disease was observed in patients with >3 lymph node metastases (LNM) and initial u-Tg >0.35 ng/ml. The frequency was only 2% among patients with ≤3 LNM and u-Tg ≤0.35 ng/ml and 9.7% among patients with > 3 LNM or u-Tg >0.35 ng/ml, while the frequency was 27% in patients with >3 LNM and u-Tg >0.35 ng/ml. In the absence of any additional therapy, u-Tg was <0.2 ng/ml (excellent response) in the last assessment in 70 patients (42.7%). Only initial u-Tg was associated with a higher probability of spontaneously achieving an excellent response: 40/72 patients (55.5%) with u-Tg ≤0.35 ng/ml versus 30/92 patients (32.6%) with u-Tg >0.35 ng/ml.

CONCLUSIONS: A minority of patients with PTC and an initial indeterminate response to RAI defined based on u-Tg develop apparent disease (structural or biochemical) and many spontaneously achieve an excellent response. The risk of disease can be refined based on parameters such as the extent of lymph node involvement and initial Tg concentration.

PMID:35347578 | DOI:10.1007/s12020-022-03040-9

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