Predictive Value of Risk Factors for Pharyngocutaneous Fistula After Total Laryngectomy

alexandrossfakianakis shared this article with you from Inoreader Predictive Value of Risk Factors for Pharyngocutaneous Fistula After Total Laryngectomy via The Laryngoscope Multiple patient-, disease-, and surgery-related factors are risk factors for pharyngocutaneous fistula. In particular, postoperative hypoproteinemia could be a good predictive factor for pharyngocutaneous fistula in patients undergoing total laryngectomy. Objectives To assess the predictive value of various risk factors for pharyngocutaneous fistula (PCF) after total laryngectomy. Methods The characteristics of each study were collected from six databases up to January of 2022. Risk for bias was assessed using the QUADAS-2 tool. Results A total of 58 studies in 9845 patients were included in the analysis. The incidence of PCF was 21.69%, 95% confidence intervals (CI) [0.20; 0.24] in the included studies. Age (OR = 1.33, 95% CI [1.12; 1.58]), postoperative anemia (OR = 2.29, 95% CI [1.47; 3.57]), diabetes mellitus (OR = 1.81, 95% CI [1.20; 2.71]), tumor site (above or below the glottis) (OR = 1.47, 95% CI [1.15; 1.88]), previous radiation therapy (OR = 2.06, 95% CI [1.56; 2.72]), previous tracheostomy (OR = 1.26, 95% CI [1.04; 1.53]), surgery timing (salvage vs. primary) (OR = 2.08, 95% CI [1.46; 2.97]), extended total laryngectomy (including pharyngectomy) (OR = 1.96, 95% CI [1.28; 3.00]), primary tracheoesophageal puncture (OR = 0.61, 95% CI [0.40; 0.93]), and postoperative hypoproteinemia (OR = 9.98, 95% CI [3.68; 27.03]) were significantly associated with the occurrence of PCF. In view of predictive ability, pos toperative hypoproteinemia showed the highest accuracy (sensitivity = 51%, specificity = 90%, area under the curve = 0.84). Conclusion Multiple patient-, disease-, and surgery-related factors are risk factors for PCF. In particular, postoperative hypoproteinemia could be a good predictive factor for PCF in patients undergoing total laryngectomy. Laryngoscope, 2022 View on Web

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The association of specific types of vegetables consumption with 10‐year type II diabetes risk: Findings from the ATTICA cohort study.

alexandrossfakianakis shared this article with you from Inoreader The association of specific types of vegetables consumption with 10‐year type II diabetes risk: Findings from the ATTICA cohort study. via Journal of Human Nutrition and Dietetics Abstract Background To investigate the association between vegetable consumption, in total as well as per type/ category, and 10-year type-2 diabetes mellitus (T2DM) incidence. Methodology ATTICA study was conducted during 2001-2012 in 3,042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetables' consumption (total, per type) was evaluated through a validated semi-quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10-year follow-up, data from 1,485 participants were used for the current analysis. Results After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had 0.42-times lower risk of developing T2DM [HR (95% CI): 0.42 (0.29, 0.61)]; the benefits of consumption we re greater in women [HR (95% CI): 0.29 (0.16, 0.53)] as compared to men [HR (95% CI): 0.56 (0.34, 0.92)]. Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men. Principal conclusions The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at population level. This article is protected by copyright. All rights reserved. View on Web

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Dysphagia in a Patient With Sarcoidosis

alexandrossfakianakis shared this article with you from Inoreader Dysphagia in a Patient With Sarcoidosis via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a woman in her 70s with a medical history of sarcoidosis, atrial fibrillation, asthma, gastroesophageal reflux disease, Schatzki's ring status after multiple dilations, pulmonary hypertension, and hypothyroidism who presented with a more than 10-year history of dysphagia and was found to have sarcoid involvement of the upper esophageal sphincter. View on Web

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SARS‐CoV‐2 ORF10 antagonizes STING‐dependent interferon activation and autophagy

alexandrossfakianakis shared this article with you from Inoreader SARS‐CoV‐2 ORF10 antagonizes STING‐dependent interferon activation and autophagy via Journal of Medical Virology Abstract A characteristic feature of COVID-19, the disease caused by SARS-CoV-2 infection, is the dysregulated immune response with impaired type I and III interferon (IFN) expression and an overwhelming inflammatory cytokine storm. RIG-I-like receptors (RLRs) and cGAS-STING signaling pathways are responsible for sensing viral infection and inducing IFN production to combat invading viruses. Multiple proteins of SARS-CoV-2 have been reported to modulate the RLR signaling pathways to achieve immune evasion. Although SARS-CoV-2 infection also activates the cGAS-STING signaling by stimulating micronuclei formation during the process of syncytia, whether SARS-CoV-2 modulates the cGAS-STING pathway requires further investigation. Here, we screened 29 SARS-CoV-2-encoded viral proteins to explore the viral proteins that affect the cGAS-STING signaling pathway and found that SARS-CoV-2 ORF10 targets STING to antagonize IFN activation. Overexpression of ORF10 inhibits cGAS-ST ING-induced IRF3 phosphorylation, translocation, and subsequent IFN induction. Mechanistically, ORF10 interacts with STING, attenuates the STING-TBK1 association, and impairs STING oligomerization and aggregation and STING-mediated autophagy; ORF10 also prevents the endoplasmic reticulum (ER)-to-Golgi trafficking of STING by anchoring STING in the ER. Taken together, these findings suggest that SARS-CoV-2 ORF10 impairs the cGAS-STING signaling by blocking the translocation of STING and the interaction between STING and TBK1 to antagonize innate antiviral immunity. This article is protected by copyright. All rights reserved. View on Web

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Hypothyroidism After Using Superior Thyroid Artery as A Recipient Artery

alexandrossfakianakis shared this article with you from Inoreader Hypothyroidism After Using Superior Thyroid Artery as A Recipient Artery via The Laryngoscope The aim of this study was to evaluate whether the use of the superior thyroid artery (SThA) as a recipient vessel affect thyroid dysfunction in patients undergoing TPLE combined with hemithyroidectomy. Our study revealed there was no significant difference in the postoperative hypothyroidism between patients with SThA used and not. We suggest that even after hemithyroidectomy, with inferior thyroid arteries are preserved, the SThA can be used as a recipient vessel. Objective Superior thyroid artery (SThA) is a common recipient artery in free tissue transfer even after total pharyngolaryngoesophagectomy (TPLE) with hemithyroidectomy. The aim of this study was to evaluate whether the use of SThA as a recipient vessel affect thyroid function in patients undergoing TPLE with hemithyroidectomy. Methods From 2011 to 2020, 91 patients who underwent free jejunum transfer after TPLE with hemithyroidectomy were divided into two groups. In Group1 (n = 47), the contralateral SThA was used for the anastomosis. In Group2 (n = 44), other vessels were used. Retrospective chart review was performed comparing postoperative thyroid function between two groups. Results In group1, 17 patients presented hypothyroidism, 21 presented latent hypothyroidism and 9 presented no thyroid dysfunction comparing 15, 19, and 10 respectively in group 2. There were no significant differences between the two groups. Conclusion Even after hemithyroidectomy, with inferior thyroid arteries are preserved, the SThA can be used as a recipient vessel. Level of Evidence 3 Laryngoscope, 2022 View on Web

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Bedaquiline, Delamanid, Linezolid and Clofazimine for Treatment of Pre-extensively Drug-Resistant Tuberculosis

alexandrossfakianakis shared this article with you from Inoreader Bedaquiline, Delamanid, Linezolid and Clofazimine for Treatment of Pre-extensively Drug-Resistant Tuberculosis via Clinical Infectious Diseases Advance Access Abstract Background Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) remain low globally. Availability of newer drugs has given scope to develop regimens that can be patient-friendly, less toxic, with improved outcomes. We proposed to determine the effectiveness of an entirely oral, short-course regimen with Bedaquiline and Delamanid in treating MDR-TB with additional resistance to fluoroquinolones (MDR-TBFQ+) or second-line injectable (MDR-TBSLI+). Methods We prospectively determined the effectiveness and safety of combining two new drugs with two repurposed drugs - Bedaquiline, Delamanid, Linezolid, and Clofazimine for 24-36 weeks in adults with pulmonary MDR-TBFQ+ or/and MDR-TBSLI+. The primary outcome was a favorable response at end of treatment, defined as two consecutive negative cultures taken four weeks apart. The unfavorable outcomes included bacteriologic or clin ical failure during treatment period. Results Of the 165 participants enrolled, 158 had MDR-TBFQ+. At the end of treatment, after excluding 12 patients due to baseline drug susceptibility and culture negatives, 139 of 153 patients (91%) had a favorable outcome. Fourteen patients (9%) had unfavorable outcomes: four deaths, seven treatment changes, two bacteriological failures, and one withdrawal. During treatment, 85 patients (52%) developed myelosuppression, 69 (42%) reported peripheral neuropathy, and none had QTc(F) prolongation >500msec. At 48 weeks of follow-up, 131 patients showed sustained treatment success with the resolution of adverse events in the majority. Conclusion After 24-36 weeks of treatment, this regimen resulted in a satisfactory favorable outcome in pulmonary MDR-TB patients with additional drug resistance. Cardiotoxicity was minimal, and myelosuppression, while common, was detected early and treated successfully. View on Web

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Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: a cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: a cross‐sectional study via International Endodontic Journal Abstract Aim This study aimed to quantitatively and qualitatively determine the proteomic profile of apical periodontitis (AP) in Type 2 Diabetes Mellitus (T2DM) patients in comparison to systemically non-compromised patients, and to correlate the protein expression of both groups with their biological functions. Methodology The sample consisted of 18 patients with asymptomatic AP divided into two groups according to the presence of T2DM: diabetic group - patients with T2DM (n = 9) and control group - systemically healthy patients (n = 9). After sample collection, the root canal samples were prepared for proteomic analysis using reverse-phase liquid chromatography mass spectrometry. Label-free quantitative proteomic analysis was performed by Protein Lynx Global Service software. Differences in protein expression between groups were calculated using t-test (p < 0.05). Biological functions were analyzed using the Homo sapiens UniProt database. Results A total of 727 human proteins were identified in all samples. Among them, 124 proteins common to both groups were quantified, out of which 65 proteins from the diabetic group showed significant differences compared with the control: 43 up-regulated (p < 0.05) and 22 down-regulated (p < 0.05) proteins. No significant differences in protein expression were seen for the remaining 59 proteins (p > 0.05). Most proteins with differences in expression were related to immune/inflammatory response. Neutrophil gelatinase-associated lipocalin, Plastin-2, Lactotransferrin, and 13 isoforms of immunoglobulins were up-regulated. In contrast, Protein S100-A8, Protein S100-A9, Histone H2B, Neutrophil defensin 1, Neutrophil defensin 3, and Prolactin-inducible protein were down-regulated. Conclusions Quantitative differences were demonstrated in the expression of proteins common to diabetic and control groups, mainly related to immune response, oxidative stress, apoptosis, and proteolysis. These findings revealed biological pathways that provide the basis to support clinical findings on the relationship between AP and T2DM. View on Web

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Retrograde peri‐implantitis: incidence and possible co‐existing factors. A retrospective analysis

alexandrossfakianakis shared this article with you from Inoreader Retrograde peri‐implantitis: incidence and possible co‐existing factors. A retrospective analysis via Australian Dental Journal Abstract Objectives To evaluate the incidence of Retrograde peri-implantitis (RPI) generally and the incidence of RPI with an endodontic-treated adjacent tooth and/or a periapical radiolucency. Methods The retrospective case-control study included the follow-up periapical images of single dental implants. Two calibrated graduate endodontic residents evaluated simultaneously the presence of RPI and the adjacent teeth status (a previous root canal treatment (RCT) and the periapical status). Results Six hundred eleven dental implants were included in this study. Twenty-three implants with RPI were detected (the incidence of RPI was 3.7%). Thirty-one adjacent teeth to the implants with RPI were recognized. Out of them, seven teeth had a previous RCT and periapical radiolucency or no RCT and periapical radiolucency. The odds ratios for RPI in an implant with periapical radiolucency or with RCT at the adjacent tooth are 6.67 (95% CI 2.7-16.5), p<0.05; and 0.11 (95% CI 0.007 - 1.9), p>0.05 respectively. Conclusions Based on periapical radiographs, the RPI incidence was 3.7% in the present study. The incidence of RPI increased in cases with adjacent teeth that had periapical radiolucency. Previous RCT in teeth adjacent to implants without apical radiolucency is not correlated with RPI. © 2022 Australian Dental Association. View on Web

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Comparison of transfusion reactions in children and adults: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Comparison of transfusion reactions in children and adults: A systematic review and meta‐analysis via Pediatric Blood & Cancer Abstract Background There are no international standards or normalizations for diagnosing and treating complications from blood transfusions. We comprehensively compared the incidence of adverse blood transfusions in children and adults. Methods Available literature on blood transfusion adverse reactions in children and adults prior to November 27, 2021 was collected from several electronic databases. This meta-analysis was performed using Revman 5.2 and Stata 15.1. Results The incidence of transfusion reactions is higher in children than in adults. Children transfused with red blood cells and platelets exhibited a higher incidence of transfusion reaction than that of adults. Moreover, the incidence of allergic and febrile non-hemolytic transfusion reactions was significantly higher in children than in adults. The incidence of some rare transfusion reactions was also significantly higher in children than in adults. Conclusion The incidence of transfusion reactions in children and adults is varied. Guidelines for children are necessary. View on Web

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Safety and value of pre‐transplant antibiotic allergy delabeling in a quaternary transplant center

alexandrossfakianakis shared this article with you from Inoreader Safety and value of pre‐transplant antibiotic allergy delabeling in a quaternary transplant center via Transplant Infectious Disease Abstract Background Self-reported antibiotic allergies, also known as antibiotic allergy labels, are common and may lead to worse patient outcomes. Within immunocompromised patients, antibiotic allergy labels can lead to inappropriate use of antimicrobials and may limit options for prophylactic and therapeutic options in the post-transplant period. While antibiotic allergy delabeling is considered an important aspect of antibiotic stewardship protocols, evidence and awareness of its application in transplant recipients is limited. Methods We describe our experience with an antibiotic allergy delabeling intervention in the pre-transplant evaluation period and its impact on post-transplant antimicrobial utilization. This was a retrospective analysis of patients with an antibiotic allergy label who underwent evaluation for solid organ or stem cell transplantation between 2015–2020. Patients included in this analysis were those who completed pre-transplant antibiotic allergy delabeling through our Drug Allergy Clinic and were retained in care for six months after transplant. Results Twenty-six of 27 patients underwent pre-transplant antibiotic allergy delabeling and safely received the delabeled antibiotic post-transplant. There were no reported side effects to the delabeled antibiotic within 6 months post-transplant. Specific examination of sulfonamide (sulfa)-antibiotic delabeling showed cost savings of $254 to $2,910 per patient in the post-transplant period compared to the use of alternative antibiotics for prophylaxis protocol. Conclusion Antibiotic allergy delabeling prior to transplant is safe, is of high value, and should be considered in the pre-transplant evaluation period. More resources are needed for the development of delabeling guidelines and support for broad implementation of pre-transplant antibiotic allergy delabeling programs. This article is protected by copyright. All rights reserved View on Web

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