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Αλέξανδρος Γ. Σφακιανάκης

Thursday, June 24, 2021

Respiratory‐swallow coordination in a rat model of chemoradiation

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Abstract

Background

Chemoradiation treatment (CRT) for head and neck cancer (HNC) is associated with postswallow inhale events that elevate the risk of penetration/aspiration. The purpose of this study was to assess the validity of a rat model for investigating the effect of CRT on respiratory-swallow coordination.

Methods

Videofluoroscopic swallow study was performed on 10 Sprague-Dawley rats 3 months post-CRT (3 mg/kg Cisplatin, 10 fractions of 4.5 Gy/day radiotherapy to tongue base), and 10 naïve controls. We examined the effect of CRT on swallow apnea duration, diaphragm movement, and bolus kinematics.

Results

CRT rats had a significant increase in postswallow inhale (p = 0.008), which was associated with significantly longer swallow apnea durations, lower diaphragm displacement at swallow onset, and faster pharyngoesophageal bolus speed.

Conclusion

The rat CRT model is valid for the study of respiratory-swallow coordination due to the consistency of findings in this study with those reported in clinical CRT studies in HNC.

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Intranasal Steroid Use and Satisfaction in Allergic Rhinitis: A Cross-Sectional Study from an Asian Perspective

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Background: Intranasal steroid (INS) is the most effective medication class for controlling allergic rhinitis (AR) symptoms; however, its effectiveness is limited by patient compliance. Previous studies have explored INS use, compliance, satisfaction, and experience. There is, however, no Asian study on these factors in entirety. Objective: We aimed to investigate the rate of compliance to usage of INS and explore the reasons for noncompliance in our local populati on. Methods: We conducted a prospective cross-sectional study on 65 AR patients in a tertiary hospital. Recruited patients were administered a questionnaire to collect data about symptoms, INS use, and concerns they may have. Statistical analysis was performed using SPSS. Results: The overall compliance rate to INS was 63.1%. Noncompliance was associated with increased frequency of dosing (p = 0.050), presence of sensory attributes (p = 0.041), and forgetfulness (p = 0.049). The top 3 most frequent sensory attributes experienced by patients include throat rundown (29.2%), aftertaste (21.5%), and immediate taste (20.0%). There was a significant difference between brands of INS with regard to sensory attributes experienced (p = 0.003) but no side effects (p = 0.070). Conclusions: Identifying risk factors for noncompliance to INS can help health-care providers address difficulties faced by patients and hence i ncrease compliance, allowing better control of AR symptoms.
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Well-Demarcated Nasopharyngeal Mass in an Adolescent Male

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A 19-year-old man presents with left nasal obstruction, mild s eptal deviation, and a pedunculated mass on the posterior wall of the nasopharynx. What is your diagnosis?
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Association of COVID-19 Vaccination and Facial Nerve Palsy

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This case-control study examines whether the Pfizer-BioNTech BNT 162b2 vaccine is associated with an increased risk of acute-onset peripheral facial nerve palsy.
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Bell Palsy and COVID-19

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The emergency use authorization of the first 2 messenger RNA COVID-19 vaccines in the US has given rise to a fascinating study of otolaryngological medical and social influence issues. As of May 1, 2020, the COVID-19 pandemic has resulted in more than 151 million cases and 3.2 million deaths worldwide. In the US, these statistics include 32.4 million cases (9757 per 100 000 population) and 576 000 deaths (173 per 100 000 population). The cold sterility of numbers is difficult to put into context. Likewise, when Pfizer-BioNTech and Mode rna revealed cases of Bell palsy in their vaccine trials, concerns grew regarding the potential of the vaccines to cause Bell palsy. Numbers thrown out to either demonstrate or refute safety are likewise difficult for the public to contextualize. Epidemiologically, linking the vaccine with an adverse event requires accurate estimation of event incidence in association with the vaccine, comparison with a nonvaccinated group, and understanding of the background incidence.
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Incidence of Bell Palsy in Patients With COVID-19

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This cohort study compares the incidence of Bell palsy among p atients with COVID-19 and those vaccinated against the disease.
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Oral cancer awareness in North-Western Spain: a population-based study

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24401. doi: 10.4317/medoral.24401. Online ahead of print.

ABSTRACT

BACKGROUND: An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms.

MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016.

RESULTS: A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248).

CONCLUSIONS: General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm si gns. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment.

PMID:34162825 | DOI:10.4317/medoral.24401

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Gray value measurement for the evaluation of local alveolar bone density around impacted maxillary canine teeth using cone beam computed tomography

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24677. doi: 10.4317/medoral.24677. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate whether any relationship between local alveolar bone density and maxillary canine impaction using gray values from cone beam computed tomography.

MATERIAL AND METHODS: The cone beam computed tomography images of 151 patients were retrospectively evaluated. Maxillary canine was defined as an impacted tooth when root formation was complete and the patient's age older than 13 or the other side of the maxillary canine has completely erupted. Similarly, complete eruption was defined as the tooth in its expected occlusion and position. Using the cone beam computed tomography software, the region of interest which was 5 mm2 in area, was placed in the trabecular bone on cross sectional cone beam computed tomography images and the gray value measurements were recorded. After measuring the gray values of all the teeth, the images were grouped according to the field of view size. Comparison of the gray values of impacted and non-impacted teeth was made between images with the same field of view size.

RESULTS: A total of 151 patients, 101 (66.9%) female and 50 (33.1%) male, were included in the study. The mean age of the patients was 24.94 ±13.9. In images with a 40X40 field of view, the gray values of the impacted canine teeth were higher than the gray values of the non-impacted ones and statistically significant difference was found between them (p=0.003). However no statistically significant difference was found between the gray values of impacted and non-impacted canine teeth in 60x60 and 100x50 field of view (p=0.197, p=0.170, respectively).

CONCLUSIONS: We suggest using the smallest field of view size when evaluating bone density using gray values from cone beam computed tomography images and we support the idea that the local increased bone density may influence on impaction.

PMID:34162816 | DOI:10.4317/medoral.24677

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Application of remote online learning in oral histopathology teaching in China

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24441. doi: 10.4317/medoral.24441. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to investigate the application of remote learning and virtual microscopy in oral histopathology teaching, a unique experience in China. The oral histopathology teaching in Nanjing Medical University has been extraordinary.

MATERIAL AND METHODS: 98 third-year dental students of Grade 2016 took oral histopathology theoretical course face-to-face in 2019 (Traditional group). The 94 participants of Grade 2017 took online oral histopathology course using digital methods(E-Learning platform and Virtual Simulation Experiment Teaching Center for Dentistry) in 2020. During the practical laboratory sessions, the students in both Traditional group and Online group observed the same glass slides for morphological learning. A questionnaire survey explored students' attitudes towards the remote onl ine learning.

RESULTS: The mean Theory test scores of the Online group (80.93±12.15) were significantly higher than those of the Traditional group (73.65±8.46) (P < 0.01). The mean total scores of the Online group (82.94±10.76) were significantly higher than those of the Traditional group (77.25±7.55) (P < 0.01). The percentage of high total test score (test score > 85) of the Online group (54%) was also significantly higher than that of the Traditional group (15%) (P< 0.01). Furthermore, both remote learning and virtual microscopy courses were well accepted by students according to the questionnaire.

CONCLUSIONS: This study found that remote learning and virtual technology have a positive impact on oral histopathology. The findings reveal that the application of remote online learning has enhanced oral histopathology teaching in China.

PMID:34162817 | DOI:10.4317/medoral.24441

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Oral complaints in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24647. doi: 10.4317/medoral.24647. Online ahead of print.

ABSTRACT

BACKGROUND: Acute myeloid leukemia belongs to proliferative diseases of the hematopoietic system. It is currently the leading indication for allogeneic hematopoietic stem cell transplantation. This study was designed to determine the most common subjective oral mucosa complaints in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used.

MATERIAL AND METHODS: Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups depending on the intensity of the conditioning regimen before transplantation: myeloablative and reduced-intensity chemotherapy. The oral symptoms were evaluated based on an authorial questionnaire designed for this analysis. The following oral mucosa subjective complaints were included: pain, paraesthesia, b urning mouth sensation, taste disorders, excessive salivation, halitosis, and dryness of the oral mucosa.

RESULTS: The most commonly reported subjective oral complaint in the examined patients was xerostomia, which was found in 92% of patients during the second visit, followed by spontaneous pain in the mouth (55%), burning (36%), and dysgeusia (20%). It occurred significantly more frequently in patients who underwent myeloablative conditioning. Moreover, it was observed that the frequency of complaints increased considerably after the transplantation, reaching a peak intensity during the second week following the procedure.

CONCLUSIONS: Oral complaints significantly decrease the patients' quality of life during the transplantation and may lead to premature termination of the treatment. As the number of transplantations in patients with acute myeloid leukemia increases, further investigations of oral complaints and symptoms induced by the disease itself and by the therap eutic approaches are required.

PMID:34162819 | DOI:10.4317/medoral.24647

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Comparison of the effect of ginger and aloe vera mouthwashes on xerostomia in patients with type 2 diabetes: A clinical trial, triple-blind

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:23998. doi: 10.4317/medoral.23998. Online ahead of print.

ABSTRACT

BACKGROUND: Ginger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimed to compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Abbas diabetes clinic (Iran).

MATERIAL AND METHODS: In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied. One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group was only given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. The symptoms and severity of xerostomia were measured before and after the intervention by the questionnaire proposed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test used to measure the normality of vari ables, and Chi-square and McNemar used to compare the scores questionnaire proposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 was considered as statistically significant in all these tests.

RESULTS: The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35 years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scores of xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the ginger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was 2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severity related to xerostomia, respectively(p<0.001).

CONCLUSIONS: The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloe vera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According to the results of this study, ginger and aloe vera mouthwashes could significantly decrease xerostomia and promote oral health in patients with diabetes.

PMID:34162822 | DOI:10.4317/medoral.23998

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