Κυριακή 18 Σεπτεμβρίου 2022

Extracapsular dissection with a transparotid facial nerve dissection approach versus partial superficial parotidectomy for benign tumours in the tail of the parotid gland: a single-centre retrospective study of 89 patients

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The aims of this study were (1) to evaluate the transparotid facial nerve dissection approach (TFND), in which the intraparotid cervicofacial or temporofacial division is identified first through a superficial lobe incision; and (2) to compare extracapsular dissection with a TFND (ECD-TFND) with partial superficial parotidectomy with a retrograde approach (PSP) for benign tumours in the tail of the parotid gland with respect to surgical outcomes. Eighty-nine patients underwent PSP or ECD-TFND for benign tumours in the tail of the parotid gland: 49 were treated surgically with PSP and 40 with ECD-TFND. (Source: International Journal of Oral and Maxillofacial Surgery)
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Comparative effectiveness of BNT162b2 and mRNA-1273 booster dose after BNT162b2 primary vaccination against the Omicron variants: A retrospective cohort study using large-scale population-based registries in Japan

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Abstract
Background
Direct comparative effectiveness of booster doses of BNT162b2 and mRNA-1273 after BNT162b2 primary vaccination is unknown.
Methods
We investigated comparative effectiveness of BNT162b2 and mRNA-1273 booster dose using data from registry systems for vaccination and COVID-19 infection in a local city in Japan. We followed participants aged ≥16 years who completed the BNT162b2 primary vaccination between November 22, 2021, and April 15, 2022. We collected information on age, sex, vaccination status, vaccine type, and infection status. Age was categorized as 16–44, 45–64, 65–84, and ≥85 years. Vaccine effectiveness for mRNA-1273 and no booster vaccination against BNT162b2 was estimated using age-stratified Cox regression adjusted for age, sex, and days since the second vaccination. The estimated hazard ratios for mRNA-1273 and no booster vaccinations were integrated separately using random effects meta-analyses .
Results
During the study period, we identified 62,586 (40.4%), 51,490 (33.2%), and 40,849 (26.4%) participants who received BNT162b2, mRNA-1273, and no booster dose, respectively. The median age was 69, 71, and 47 years for BNT162b2, mRNA-1273, and no booster dose, respectively. The integrated hazard ratio with reference to BNT162b2 was 1.72 for no booster vaccination and 0.62 for mRNA-1273. The comparative effectiveness of mRNA-1273 was similar across age categories.
Conclusions
Both homologous and heterologous vaccinations are effective against Omicron variants. In the head-to-head comparison, the effect was stronger in people who received heterologous vaccination than in those who received homologous vaccination. These findings may help improve logistics and decision making in future vaccination programs.
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Πέμπτη 15 Σεπτεμβρίου 2022

Severe Arboviral Neuroinvasive Disease in Patients on Rituximab Therapy: A Review

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Abstract
With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days–1 year) and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be cou nseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies.
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Inhibition of kidney potassium channels by fluoxetine: in vivo and in vitro studies

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Abstract

In vitro studies have demonstrated that fluoxetine, a commonly used antidepressant drug, can modulate the activity of K+ channels. In the present study, we investigated the in vivo effect of acute and sub-chronic treatment of rats with fluoxetine on K+ renal transport. Furthermore, OK cells, a kidney epithelial cell line, was used in order to evaluate the in vitro effect of fluoxetine on K+ currents. In the sub-chronic study, fluoxetine was administrated daily (10 mg/kg, p.o.) for 15 days to male adult Wistar rats. In the acute study, rats were given increasing doses of fluoxetine (1, 3, 10, 30 and 50 mg/kg, p.o.) for 24 hours. Results from the sub-chronic study show that urinary K+ content (in mmol/L) was markedly reduced in the fluoxetine-treated animals (fluoxetine: 83±9; control: 131±10; P<0.001). K+ fractional renal excretion (in %) was also significantly lower in the fluoxetine group (fluoxetine : 6±1; control: 13±2; P<0.001). No significant changes was observed in creatinine clearance and on renal tubular Na+,K+-ATPase activity. Results obtained from the acute study demonstrate that, after a 24-hour administration, fluoxetine produced a dose-dependent decrease in urinary K+, with an ED50 (in mg/kg) of 4.2 (2.8; 5.5) and a maximal effect of 62% reduction. In vitro, fluoxetine produced a concentration-dependent inhibition of K+ currents in OK cells, with an EC50 of 107 (84.8; 129.5) μM. In conclusion, fluoxetine produces a marked reduction on urinary K+ excretion; this effect constitutes an in vivo evidence for the inhibitory action of fluoxetine on kidney epithelial K+ channels.
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Innate Immune Sensing of Nucleic Acid in Endodontic Infection

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Abstract

Innate immunity is the first line of defence and fight against microorganisms. Nucleic acids are important pathogen-associated molecular patterns to be recognized in innate immunity. There are three types of nucleic acid sensors, including endosomal sensors (NA-sensing TLRs), cytosolic DNA sensors (cGAS and AIM2), and cytosolic RNA sensors (RLG-I, MDA5 and LGP2). Recent studies have shown that nucleic acid sensors are expressed differently in a variety of dental pulp cells and mediate inflammation through complex pathways. Nucleic acid sensing may play a vital role in the development of endodontic infection. This review aims to summarise and analyze the possible roles of various nucleic acid sensors in endodontic infection. It may help better understand the pathogenesis of these diseases and find new strategies for prevention and treatment.
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A 3‐year prospective cohort on the incidence of prosthodontic complications associated with three implant treatment options for the edentulous mandible

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Abstract

Objective

this prospective study assessed the number and reasons for post-treatment visits due to prosthodontic complications in patients treated with three types of implant treatment for the edentulous mandible.

Methods

study groups comprised patients treated with single-implant overdenture (G-I; n=11), 2-implant overdenture (G-II; n=13), and 4-implant fixed prosthesis (G-III; n=13). Programmed recall visits occurred at the 6-, 12- and 36-month follow-ups. The management of prosthodontic complications occurred continuously in unscheduled appointments. Data analysis included calculation of incidence rates, chi-square and Kruskal-Wallis tests, and Poisson regression with robust error variance to model the occurrence of visits due to prosthodontic complications.

Results

there were 89 unscheduled appointments during the entire follow-up period, ranging from 0 to 7 (mean=2.41; SD=2.2) per patient. No between-group differences were found regarding the frequency of unscheduled visits. However, the duration of the appointments (scheduled and unscheduled) was significantly higher for G-III (p<0.001). The length of follow-up was the only predictor of the number of post-insertion visits (p=0.004). The frequency of prosthodontic events was higher for G-I and G-II compared to G-III (p<0.001). Nearly half of the events in G-I and G-II were matrix replacements, and artificial teeth fracture was more frequent in G-III.

Conclusions

all patients were at risk of post-delivery prosthodontic complications and required regular recall visits to achieve satisfactory function and to prevent further problems. Overdentures required higher rates of maintenance visits, particularly for replacement of the retentive inserts, while fixed implant prostheses required longer clinical times for management of complications when compared to overdentures.
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Risk factors for lower border notching after bilateral mandibular sagittal ramus advancement: three-dimensional evaluation

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The objective of this study was to calculate the incidence of MLBN and identify risk factors. This single-centre, retrospective study was performed between January 2018 and November 2020, in the Maxillofacial Surgery Department, Centre Hospitalier Universitaire, Caen. Patients who underwent BSSO advancement and had cone beam computed tomography (CBCT) scans obtained preoperatively, immediately postoperative (within 1 week), and late postoperative ( ≥1 year) were included. (Source: International Journal of Oral and Maxillofacial Surgery)
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