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Αλέξανδρος Γ. Σφακιανάκης

Tuesday, May 17, 2022

Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharynx cancer: a multi-centre study

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Publication date: Available online 17 May 2022

Source: Radiotherapy and Oncology

Author(s): J.M. Price, C.M. West, L.M. Dixon, Z. Iyizoba-Ebozue, K. Garcez, L. Lee, A. McPartlin, F. Slevin, A. Sykes, R.J.D. Prestwich, D.J. Thomson

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Isoniazid prophylaxis in liver transplant recipient with latent tuberculosis; Is it harmful for transplanted liver?

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Abstract

Background

: Liver transplantation (LT) is considered the only treatment for patients with end-stage liver disease and, despite its incredible impacts on the patients' health status, places them in an immunocompromised state in which opportunistic infection would find a way to present. Latent Tuberculosis Infection (LTBI) is the most common form of TB and can be diagnosed through Tuberculin Skin Test (TST) or Interferon-Gamma Release Assays (IGRA). LT recipients are at significant risk of TB activation. There is no strict guideline to approaching these cases though, in most centers, Isoniazid (INH) would be prescribed prophylactically. INH is a hepatotoxic medication and can have adverse effects on the transplanted liver. There is no consensus on this issue; therefore, we aimed to survey the potential hepatotoxic effects of INH among LT recipients in Shiraz, Iran.

Methods

: A retrospective cohort study was conducted among LT candidates and recipients at Abu Ali Sina Organ Transplantation Center between 1993 and 2019. All the cases underwent TST and chest X-ray to detect LTBI. All the LTBI were treated with INH from six to nine months and followed by the level of liver enzymes for quick detection of hepatotoxicity. A control group was selected among LT recipients and matched for age, gender, MELD score, and donor age.

Results

: Among 4895 medical records reviewed, 55 (1.12%) cases had LTBI. Neither INH-related hepatotoxicity, nor signs and symptoms that were suspicious to TB reactivation were reported. Overall, three deaths were reported, two because of myocardial infarction and one due to pneumonia. Ten patients (18.2%) experienced acute rejection as confirmed with pathology and responded to methylprednisolone. Aspartate aminotransferase (AST) was diminished from pre-LT time to the first time after transplantation; after that, it showed a steady pattern. Meanwhile, Alanine transaminase (ALT) was constant before and one stage later and decreased after that. Statistical analyses only showed significant changes in the total bilirubin titer between the case and control groups.

Conclusion

: This survey showed prophylactic management of LTBI with INH in LT candidates and recipients was associated with no hepatotoxicity or related death. It seems INH prophylaxis is safe in LT settings and can efficiently prevent TB activation; however, careful monitoring for adverse effects and liver enzymes elevation is highly recommended.

This article is protected by copyright. All rights reserved

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Anidulafungin biliary passage in liver transplant patients

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Effects of different universal adhesives and surface treatments on repair bond strength between resin composites

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Abstract

Objective

This study aimed to evaluate the effects of different universal adhesives and surface treatments on the repair bond strength between resin composites.

Materials and Methods

A total of 220 composite samples were divided into three groups according to the adhesive resin to be applied: 1) Scotchbond Universal, 2) G-Premio Bond, and 3) Peak Universal Bond. They were then divided into seven subgroups according to surface treatments (n = 10): A) air abrasion, B) air abrasion+silane, C) hydrofluoric acid, D) hydrofluoric acid+silane, E) air abrasion+hydrofluoric acid+silane, F) silane, and G) no surface treatment (negative control). After surface treatment, a repair composite was applied. Samples aged in the thermocycle were subjected to micro-tensile bond strength testing. Cohesive strength values of 10 non-aged composite blocks were used as a positive control. Kruskal–Wallis and one-way ANOVA tests were used for statistical evaluation. Fractured surfaces were evaluated using a scanning electron microscope.

Results

In Scotchbond Universal and G-Premio Bond, the mean micro-tensile bond strength value of the no surface treatment subgroup was significantly lower than that of the positive control. All subgroups of Peak Universal Bond showed similar values to the positive control.

Conclusion

While Scotchbond Universal and G-Premio Bond required mechanical roughening before adhesive application, Peak Universal Bond did not require any surface treatment.

Clinical Significance

Different universal adhesives may show different repair bonding strengths with different surface treatments. Since achieving a standard in this regard can be associated with many independent factors, clinicians should determine how to apply the adhesive they use most effectively with the most appropriate surface treatment based on their own clinical experience.

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The Conventional Technique Versus the No-touch Isolation Technique for Primary Tumor Resection in Patients With Colon Cancer (JCOG1006): A Multicenter, Open-label, Randomized, Phase III Trial

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imageObjective: This phase III trial evaluated whether the no touch was superior to the conventional in patients with cT3/T4 colon cancer. Background: No touch involves ligating blood vessels that feed the primary tumor to limit cancer cell spreading. However, previous studies did not confirm the efficacy of the no touch. Methods: This open-label, randomized, phase III trial was conducted at 30 Japanese centers. The eligibility criteria were histologically proven colon cancer; clinical classification of T3–4, N0–2, andM0; and patients aged 20 to 80years. Patients were randomized (1:1) to undergo open surgery with conventional or the no touch. Patients with pathological stage III disease received adjuvant capecitabine chemotherapy. The primary endpoint was disease-free survival (DFS) according to the intention-to-treat principle. Results: Between January 2011 and November 2015, 853 patients were randomized to the conventional group (427 patients) or the no touch group (426 patients). The 3-year DFS were 77.3% [95% confidence interval (CI) 73.1%–81.0%] and 76.2% (95% CI 71.9%–80.0%) in the conventional and no touch groups, respectively. The superiority of no touch was not confirmed: hazard ratio for DFS = 1.029 (95% CI 0.800– 1.324; 1-sided P = 0.59). Operative morbidity was observed in 31 of 427 conventional patients (7%) and 26 of 426 no touch patients (6%). All grade adverse events were similar between the conventional and no touch groups. No in-hospital mortality occurred in either group. Conclusion: The present study failed to confirm the superiority of the no touch.
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Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020

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Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for stud...
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Genome-wide DNA methylation profiling and exome sequencing resolved a long-time misdiagnosed case

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Journal of Human Genetics, Published online: 18 May 2022; doi:10.1038/s10038-022-01043-y

Genome-wide DNA methylation profiling and exome sequencing resolved a long-time misdiagnosed case
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Effects of Adolescent-Focused Integrated Social Protection on depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania’s Cash Plus Intervention

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Abstract
We assessed the impacts of Tanzania's Cash Plus adolescent-focused intervention on depression. In this pragmatic cluster-randomized controlled trial, 130 villages were randomly allocated to intervention or control (1:1). Youth aged 14-19 years living in households receiving governmental cash transfers were invited to participate. The intervention included an intensive period (12-session course) and aftercare period (9-months mentoring, productive grants, and strengthened health services). We examined intervention impacts on the 10-item Centre for Epidemiological Studies Depression Scale (0-30) and exhibiting depressive symptomatology (≥10 scale), which were collected at baseline (April-June 2017), midline (May-July 2018), and endline (June-August 2019). Using intention-to-treat methodology, logistic and generalized linear models estimated effects for binary and continuous outcomes, respectively. Quantile regressions (QR) estimated effects acr oss the scale. From 2458 baseline participants, 941 intervention and 992 control adolescents were re-interviewed at both follow-ups. At endline, the intervention reduced the odds of depressive symptomatology (adjusted odds ratio 0.67 [95% CI 0.52 to 0.86]), with an undetectable mean scale difference (effect -0.36 [95%CI -0.84 to 0.11]). QR results demonstrated an intervention effect along the upper distribution of the scale. Integration of multi-sectoral initiatives within existing social protection shows potential to improve mental health among youth in low-resource settings.
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The influence of implant design on implant stability in low‐density bone under guided surgical template in inexperienced surgeons: A pilot randomized controlled clinical trial using resonance frequency analysis

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Abstract

Introduction

There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact.

Aim

To investigate the implant stability in relation to two different implant designs, a cylindrical shaped single-threaded design (CS/ST) and a tapered shaped double-threaded design (TS/DT) using resonance frequency analysis over the first 8 weeks after implantation.

Materials and Methods

Twenty-eight implants were randomly allocated using computer-generated random numbers into two groups and were placed as single tooth implant in the posterior arch in human jaw as specimens. iCAT™ CBCT scan (Hatfield, PA) was used to determine the bone density according to Misch's Bone classification. The osseotomy sites were prepared and implants were placed with guided surgical template by inexperienced surgeons which were prepared with the same implant planning software (3shape® implant studio). The implant stability was measured using the resonance frequency analysis Osstell® ISQ (Osstell AB, Sweden) on the implant level over the first 8 weeks at three different time intervals. A mean implant stability quotient (ISQ) value was recorded at each measurement time points. The first ISQ of each implant recorded at the time of implant placement were considered as baseline and were the so-called primary stability.

Results

All 28 dental implants were analyzed. A similar pattern of implant stability changes was observed in both implant designs. A significant decreased was found at the first 4 weeks after implantation (p < 0.05) before ascending to maximum cumulative stability by the eighth week (p < 0.05). Between the two groups, TS/DT group had a higher mean ISQ values than that of the CS/ST group at all three observation periods but did not reach statistical significance (p = 0.69). Regarding different types of bone, TS/DT showed a significant difference in mean ISQ values in D4 bone. To date, all 28 implants are in function with no failure/and or complications.

Conclusions

The difference in implant design did not significantly influence the implant stability. TS/DT shows superiority over CS/ST when placed in D4 bone and offer a significant advantage due to their positive bounce back of the ISQ values by the eighth week after implant installation.

Clinical Trial Registration: TCTR20211020005.

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