Differences in oral anticoagulant prescriptions between specialists and non-specialists in patients with cardioembolic stroke caused by non-valvular atrial fibrillation

alkiviadis.1961 shared this article with you from Inoreader Differences in oral anticoagulant prescriptions between specialists and non-specialists in patients with cardioembolic stroke caused by non-valvular atrial fibrillation Via Latest Results Abstract Atrial fibrillation (AF) is a common disease encountered in daily practice; however, few patients with AF received oral anticoagulant (OAC) therapy. This study focused on differences in OAC prescriptions and influencing factors between specialists (neurological and cardiovascular) and non-specialists. A retrospective comparative analysis was conducted on 480 patients with acute cardioembolic stroke caused by non-valvular AF who were admitted to our hospital between January 1, 2015, and December 31, 2020. All patients had visited our hospital or other hospitals for their underlying diseases. Overall, 232 (specialist group SG) and 248 patients (non-specialist group NSG) were examined by specialists and non-specialists, respectively. The NSG had a significantly lower percentage of OAC prescriptions on admission than the SG (P < 0.01), even after propensity score matching. Factors influencing OAC prescription in the SG were age, hypertension, paroxy smal AF, dementia, CHADS2 score, and antiplatelet drug use, while those in the NSG were a history of cerebral infarction, paroxysmal AF, dementia, and antiplatelet drug use [SG: age, odds ratio (OR) 0.919, 95% confidence interval (CI) 0.865–0.976; hypertension, OR 0.266, 95% CI 0.099–0.713; paroxysmal AF, OR 0.189, 95% CI 0.055–0.658; dementia, OR 0.253, 95% CI 0.085–0.758; CHADS2 score, OR 2.833, 95% CI 1.682–4.942; and antiplatelet drug use, OR 0.072, 95% CI 0.025–0.206; NSG: cerebral infarction, OR 5.940, 95% CI 1.581–22.309; paroxysmal AF, OR 0.077, 95% CI 0.010–0.623; dementia, OR 0.077, 95% CI 0.014–0.438; and antiplatelet drug use, OR 0.024, 95% CI 0.004–0.152]. In conclusion, the OAC prescription rate was higher in patients with non-valvular AF whose family physicians were specialists at the time of cerebral infarction onset. In addition, in the SG, advanced age and hypertension were associated with not prescribing OAC, whereas a hig her CHADS2 score was associated with the prescription of OACs. In the NSG, a history of cerebral infarction was associated with the prescription of OACs. Further, paroxysmal AF, antiplatelet drug use, and dementia were associated with non-OAC therapy in both the groups. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer

alexandrossfakianakis shared this article with you from Inoreader Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer Via Clinical Nuclear Medicine - Published Ahead-of-Print Purpose Patients with esophageal cancer can develop distant metastases between the start of neoadjuvant chemoradiotherapy (nCRT) and planned surgery (ie, interval distant metastases). 18F-FDG PET/CT restaging after nCRT detects interval distant metastases in ~8% of patients. This study aimed to identify patients for whom 18F-FDG PET/CT restaging after nCRT could be omitted using an existing prediction model predicting for interval distant metastases or by using clinical stage groups. Patients and Methods Patients with locally advanced esophageal cancer who underwent baseline and restaging 18F-FDG PET/CT, nCRT, and were planned for esophagectomy between 2017 and 2021 were eligible for inclusion in this retrospective study. The primary outcome was the existing model's external performance (ie, discrimination and calibration) for predicting interval distant metastases. The existing model predictors included tumor length, cN status, squamous cell carcinoma histology, and baseline SUVmax. The secondary outcome determined the clinical stage groups (AJCC/UICC eighth edition) for adenocarcinoma and squamous cell carcinoma for which the incidence of interval distant metastases was View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

paythelady.61 shared this article with you from Inoreader Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS. Methods Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale. Results The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%). Conclusion Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects

paythelady.61 shared this article with you from Inoreader Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects Via Latest Results for Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Abstract Purpose The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them. Methods Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9 skeletal patterns. Each subject was assigned a skeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9 groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group. Results No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9 skeletal patterns. However, class III growers had a significantly earlier onset of prepubertal growth (10.25 ± 1.56 years) when compared to that of class II high angle cases (11.11 ± 1.67 years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups. Conclusion A map was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report

paythelady.61 shared this article with you from Inoreader Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report Via SAGE Publications Inc: Annals of Otology, Rhinology & Laryngology: Table of Contents Annals of Otology, Rhinology &Laryngology, Ahead of Print. Objectives:To report a case of a morbidly obese 17-year-old boy who presented 4 days post-tonsillectomy with acute deep venous thromboses and a massive pulmonary embolism. To describe a protocol and decision-making tree for providing anticoagulation in the immediate post-tonsillectomy period.Methods:A chart review and review of the literature.Results:The patient ultimately did well and had no bleeding from the tonsil beds or further thromboembolic complications. A review of the literature revealed no available data regarding the safety of anticoagulation in the immediate post-tonsillectomy period.Conclusions:We propose that if anticoagulation is needed within 14 days of tonsillectomy, submaximal anticoagulation with a reversible and titratable anticoagulant may be optimal. A multidisciplinary team approach is needed for these complex cases. Future reporting and investigation of anticoagulation post-tonsillec tomy is needed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantitative proteomics in medication‐related osteonecrosis of the jaw: a proof‐of‐concept study

paythelady.61 shared this article with you from Inoreader Quantitative proteomics in medication‐related osteonecrosis of the jaw: a proof‐of‐concept study Via Oral Diseases ABSTRACT Objective Medication-related osteonecrosis of the jaw (MRONJ) is a paradoxical effect associated with bone modifying agents (BMAs) and other drugs. Currently no valuable diagnostic or prognosis biomarkers exist. This goal of this research was to study MRONJ related salivary proteome. Materials and Methods This case-control aimed to study salivary proteome in MRONJ versus control groups i) formed from BMAs consumers and ii) healthy individuals to unravel biomarkers. 38 samples of unstimulated whole saliva (18 MRONJ patients, 10 BMA consumers, and 10 healthy controls) were collected. Proteomic analysis by SWATH-MS coupled to bioinformatics analysis was executed. Results 586 proteins were identified, 175 proteins showed significant differences among MRONJ versus controls. SWATH-MS revealed differentially expressed proteins among three groups, which have never isolated. These proteins had distinct roles including cell envelope organization, positive regulation of vesicle fusion, positive regulation of receptor binding, or regulation of low-density lipoprotein particle clearance. Integrative analysis prioritised 3 proteins (MMP9, AACT and HBD). Under receiver operating characteristic analysis, this panel discriminated MRONJ with a sensitivity of 90% and a specificity of 78.9%. Conclusion These findings may inform of a novel biomarker panel for MRONJ prediction or diagnosis. Nonetheless, further research is needed to validate this panel. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Applications of maxillary tuberosity block autograft

paythelady.61 shared this article with you from Inoreader Applications of maxillary tuberosity block autograft Via Journal of Esthetic and Restorative Dentistry Abstract Objective Autogenous bone grafts are considered the gold standard due to their compatibility and osteogenic potential to induce new bone formation through osteogenesis, osteoinduction, and osteoconduction. The aim of this paper was to describe clinical applications of the maxillary tuberosity block autograft in small and moderate localized defects of the alveolar process around implants and teeth. Clinical Considerations Maxillary tuberosity is often used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion, but not as a bone block graft. The maxillary tuberosity block autograft may also provide a valuable bone source for challenging situations such as immediate implant placement into types II and III extraction sockets, treatment of horizontal and vertical bone defects with simultaneous implantation, reconstruction of circumferential defects around implants, and preservation of alveolar ridge. Conclusions The advantages of the maxillary tuberosity include intraoral corticocancellous autogenous graft with fewer intraoperative difficulties, no need for donor site restoration, less morbidity, and an excellent correction of localized alveolar ridge defects. Clinical Significance Within the limitations of the presented case reports, the use of maxillary tuberosity block autograft has shown to be successful in alveolar ridges augmentation that lack both width and height. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.