“Hole‐Punch” Technique for Recurrent Auricular Hematomas

alexandrossfakianakis shared this article with you from Inoreader "Hole‐Punch" Technique for Recurrent Auricular Hematomas via The Laryngoscope Effective treatment of auricular hematomas can be a challenging problem for both the otolaryngologist and the patient. Recurrence rates are high even with proper drainage and bolstering. The hole-punch technique is a powerful tool to address the difficult problem of recurrent auricular hematomas and avoid disfiguring deformities of the ear. Laryngoscope, 2022 View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluate the safety and efficacy of dura sealant patch in reducing cerebrospinal fluid leakage following elective cranial surgery (ENCASE II): study protocol for a randomized, two-arm, multicenter trial

alexandrossfakianakis shared this article with you from Inoreader Evaluate the safety and efficacy of dura sealant patch in reducing cerebrospinal fluid leakage following elective cranial surgery (ENCASE II): study protocol for a randomized, two-arm, multicenter trial via Trials - Latest Articles Cerebrospinal fluid (CSF) leakage is a frequent and challenging complication in neurosurgery, especially in the posterior fossa, with a prevalence of 8%. It is associated with substantial morbidity and increas... View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

ELF4 is a critical component of a miRNA-transcription factor network and is a bridge regulator of glioblastoma receptor signaling and lipid dynamics

alexandrossfakianakis shared this article with you from Inoreader ELF4 is a critical component of a miRNA-transcription factor network and is a bridge regulator of glioblastoma receptor signaling and lipid dynamics via Neuro-Oncology Advance Access Abstract Background The loss of neurogenic tumor suppressor microRNAs miR-124, miR-128, and miR-137 is associated with glioblastoma's undifferentiated state. Most of their impact comes via the repression of a network of oncogenic transcription factors. We conducted a high-throughput functional siRNA screen in glioblastoma cells and identify E74 like ETS transcription factor 4 (ELF4) as the leading contributor to oncogenic phenotypes. Methods In vitro and in vivo assays were used to assess ELF4 impact on cancer phenotypes. We characterized ELF4's mechanism of action via genomic and lipidomic analyses. A MAPK reporter assay verified ELF4's impact on MAPK signaling, and qRT-PCR and western blotting were used to corroborate ELF4 regulatory role on most relevant target genes. Results ELF4 knockdown resulted in significant proliferation delay and ap optosis in GBM cells and long-term growth delay and morphological changes in glioma stem cells (GSCs). Transcriptomic analyses revealed that ELF4 controls two interlinked pathways: 1) Receptor tyrosine kinase signaling, and 2) Lipid dynamics. ELF4 modulation directly affected Receptor Tyrosine Kinase (RTK) signaling, as mitogen-activated protein kinase (MAPK) activity was dependent upon ELF4 levels. Furthermore, shotgun lipidomics revealed that ELF4 depletion disrupted several phospholipid classes, highlighting ELF4's importance in lipid homeostasis. Conclusions We found that ELF4 is critical for the GBM cell identity by controlling genes of two dependent pathways: RTK signaling (SRC, PTK2B, TNK2) and lipid dynamics (LRP1, APOE, ABCA7, PLA2G6, and PITPNM2). Our data suggests that targeting these two pathways simultaneously may be therapeutically beneficial to GBM patients. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional evaluation of postoperative stability: a comparative study between surgery-first and surgery-late protocols

alexandrossfakianakis shared this article with you from Inoreader Three-dimensional evaluation of postoperative stability: a comparative study between surgery-first and surgery-late protocols via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The main objective of this study was to compare the stability of the surgery-first and surgery-late approaches according to the standardized centre protocols, by three-dimensional evaluation after 1 year of follow-up. A retrospective study was designed that included a test group (surgery-first protocol) and a control group (surgery-late protocol), with a follow-up period of at least 1 year (average 14 months; range 12 –24 months). Stability was evaluated using linear and angular measurements by superimposing cone beam computed tomography images obtained at specific points in time: preoperatively, 1 month after surgery, and at the end of the orthodontic treatment. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic Delay in Human Papillomavirus Negative Oropharyngeal Squamous Cell Carcinoma

alexandrossfakianakis shared this article with you from Inoreader Diagnostic Delay in Human Papillomavirus Negative Oropharyngeal Squamous Cell Carcinoma via The Laryngoscope Delays in care related to evaluations by multiple providers and misdiagnosis prolonged time to diagnosis in HPV(−)OPSCC. Improved patient and provider education is necessary to expedite the diagnosis of HPV(−)OPSCC. Objective Failure to recognize symptoms of non-human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV(−)OPSCC) at presentation can delay diagnosis and treatment. We aim to identify patient factors and provider practice patterns that delay presentation and care in HPV(−)OPSCC. Methods Retrospective review at a tertiary care center. Patients with HPV(−)OPSCC receiving treatment from 2006 to 2016. Patients were excluded if their date of symptom onset or diagnosis was unknown after thorough review of the electronic medical record or their tissue was not tested for HPV or p16. Clinical data, workup, and care timelines were abstracted. Univariate and multivariable linear regressions were performed to determine associations between patient and provider factors and delays in care. Results Of 70 included patients, 52 (74%) were male and mean age was 60.5 (SD = 9.0). Median time to diagnosis was 69 days (IQR = 32–127 days), with a median latency of 30 days (IQR = 12–61 days) from symptom onset to first presentation and 19.5 days (IQR = 4–46 days) from the first presentation to diagnosis. Most patients visited at least 2 providers (n = 52, 74%) before diagnosis. Evaluation by 3 or more providers prior to diagnosis was associated with significant delays in diagnosis of nearly a year (357.7 days, p < 0.001) and being treated or prescribed analgesia prior to diagnosis was significantly associated with delays in diagnosis (p = 0.004) on univariate regression analysis. Conclusions Delays in care related to evaluations by multiple providers and misdiagnosis prolonged time to diagnosis in HPV(−)OPSCC. Improved patient and provider education is necessary to expedite the diagnosis of HPV(−)OPSCC. Level of Evidence Level 4 Laryngoscope, 2022 View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fatigue resistance and fracture strength of narrow‐diameter one‐piece zirconia implants with angled abutments

alexandrossfakianakis shared this article with you from Inoreader Fatigue resistance and fracture strength of narrow‐diameter one‐piece zirconia implants with angled abutments via Journal of Esthetic and Restorative Dentistry Abstract Objective Zirconia implants are assumed to satisfy the esthetic requirements that titanium implants cannot meet, however, there are not enough studies in the literature about narrow-diameter and angled zirconia implants that can be preferred especially in the anterior region. This in vitro study aimed to evaluate the fatigue resistance and fracture strength of narrow-diameter zirconia implants with angled abutments. Materials and Methods Forty-eight one-piece experimental zirconia implants and monolithic zirconia crowns were produced from 3-YTZP blanks. The implant diameters (3.0 or 3.7 mm) and the restoration types were determined according to three intraoral regions (upper central incisors, lower central incisors, and upper canine), and abutments were designed as straight or 15° angled. The samples were subjected to chewing simulation corresponding to 5 years of clinical performance and then the static loading test. The survival rates of groups were measured by the Kaplan–Meier log-rank test, and the fracture load values were estimated by using Kruskal–Wallis and Mann–Whitney U tests (p < 0.05). Results All 3.0 mm diameter implants failed the fatigue test. The fatigue resistance of the implants with angled abutments was significantly lower than the straight abutments, and different crown designs were found to affect survival rates significantly. The fracture strengths of the surviving groups were above the maximum physiological chewing forces, and the differences were not significant. Conclusions The implant diameter, abutment angle, and restoration type have a significant effect on the fatigue behavior of zirconia implants. Clinical Significance The fracture strengths of the one-piece zirconia implants with a 3.7 mm diameter and a 15° abutment angle are above the chewing forces for the anterior intraoral region. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

alexandrossfakianakis shared this article with you from Inoreader Pediatric hematology providers' contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey via Pediatric Blood & Cancer Abstract Background Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet limited data are available regarding pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers' beliefs, practices, motivators, and barriers for providing contraceptive care to female AYAs with SCD. Methods Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess practices. Survey links were distributed nationwide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S.-accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, and logistic regression. Results Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed. Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Proportionally fewer trainees provided counseling compared with established providers (54% vs. 85%, p < .001), with a similar trend for prescribing (p = .05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea. Key motivators included patient request and disclosure of sexual activity. Key barriers included inadequate provider training, limited visit time, and perceived patient/parent interest. Conclusion Provider contraceptive practices for female AYAs with SCD varied, especially by provider status. Health beliefs regarding teratogenic potential of hydroxyurea did not correlate with contraceptive practices. Clinical guidelines, provider training, and patient/parent decision-making tools may be tested to assess whether provider contraceptive practices could be improved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.