Maximal exposure of the parapharyngeal internal carotid artery via transnasal and transoral corridors

alexandrossfakianakis shared this article with you from Inoreader Maximal exposure of the parapharyngeal internal carotid artery via transnasal and transoral corridors via Head & Neck Abstract Background The parapharyngeal internal carotid artery (pICA) could be surgically exposed through the transnasal and transoral corridors. However, their potential degree of exposure has not been established sufficiently. This study aims to elucidate the maximal exposure of the pICA via the transnasal and transoral corridors. Methods An endonasal transpterygoid nasopharyngectomy for exposure of the pICA was performed on eight cadaveric specimens (16 sides), while a transoral approach for exposure of the pICA was performed on six additional specimens (12 sides). In addition, the CT angiography of 60 consecutive patients (120 sides) was analyzed to establish the potential maximal exposure of the pICA through each corridor. Results The hard palate becomes a restricting factor for the inferior exposure of the pICA via the transnasal approach, whereas the entire pICA segment could be adequately displayed through the transoral corridor. The maximal exposed length of the pICA for a transnasal and transoral approach was 3.08 ± 0.30 cm and 6.56 ± 0.57 cm, respectively. This difference was statistically significant (p < 0.001). Conclusion An endonasal exposure of the pICA seems limited to its superior aspect, whereas the transoral corridor could provide adequate exposure of the entire length of pICA. View on Web

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

Determinants of dietary diversity among children 6‐23 months

alexandrossfakianakis shared this article with you from Inoreader Determinants of dietary diversity among children 6‐23 months: a cross‐sectional study in three regions of Haiti via Journal of Human Nutrition and Dietetics Abstract Background The Prenatal, perinatal, postnatal and nutritional support study (A3PN), was a four-year initiative aimed to reduce maternal mortality in Haiti. A cross-sectional study was developed to collect baseline data for evaluation purposes of the A3PN. The current study aims to determine the factors contributing to dietary diversity (DD) in Haitian children aged 6 to 23 months. Methods A cross-sectional study during two seasons (the lean season and the harvest season) was carried out in Haiti to assess the DD of children and their mothers using non-quantitative 24-hour recalls. Indicators of DD were Minimum Dietary Diversity for Children (MDD-C) and Minimum Dietary Diversity for Women (MDD-W). Mid-Upper Arm Circumference (MUAC) was measured in women and children and food security was assessed using the Household Hunger Scale (HHS). Focus groups were also conducted to gain a better understanding of quantitative findings. Results Only 7.3% of t he children included in this study met the MDD-C. Factors associated with MDD-C were the season (OR: 0.141 [0.039-0.513]), land ownership or rental (OR: 4.603 [1.233-17.188]), maternal education (OR: 0.092 [0.011-0.749]), the mother's responsibility for the main or secondary source of income for the household (OR: 2.883 [1.030-8.069]), and her DD (OR: 5.690 [1.916-16.892]). Focus groups revealed the existence of various food restrictions. Conclusion The results indicated that the low prevalence of MDD-C in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. They also suggest that to fight against hunger it is necessary to focus on women's well-being. This article is protected by copyright. All rights reserved. View on Web

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

The Natural Killer cell‐associated rs9916629‐C allele is a novel genetic risk factor for fatal COVID‐19

alexandrossfakianakis shared this article with you from Inoreader The Natural Killer cell‐associated rs9916629‐C allele is a novel genetic risk factor for fatal COVID‐19 via Journal of Medical Virology Abstract The severity of COVID-19 is associated with individual genetic host factors. Among these, genetic polymorphisms affecting natural killer (NK) cell responses, as variations in the HLA-E- (HLA-E*0101/0103), FcγRIIIa- (FcγRIIIa-158-F/V), and NKG2C- (KLRC2 wt/del) receptor, were associated with severe COVID-19. Recently, the rs9916629-C/T genetic polymorphism was identified that indirectly shape the human NK cell repertoire towards highly pro-inflammatory CD56bright NK cells. We investigated whether the rs9916629-C/T variants alone and in comparison to the other risk factors are associated with a fatal course of COVID-19. We included 1042 hospitalized surviving and 159 non-surviving COVID-19 patients as well as 1000 healthy controls. rs9916629-C/T variants were genotyped by TaqMan assays and were compared between the groups. The patients' age, comorbidities, HLA-E*0101/0103, FcγRIIIa-158-F/V, and KLRC2 wt/del variants were also determined. The presence of the rs9916629-C allele was a risk factor for severe and fatal COVID-19 (p<0.0001), independent of the patients' age or comorbidities. Fatal COVID-19 was more frequent in younger patients (<69.85 years) carrying the FcγRIIIa-158-V/V (p<0.006) and in older patients expressing the KLRC2 del variant (p<0.003). Thus, patients with the rs9916629-C allele have a significantly increased risk for fatal COVID-19 and identification of the genetic variants may be used as prognostic marker for hospitalized COVID-19 patients. This article is protected by copyright. All rights reserved. View on Web

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

Risk Factors and Outcomes of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study of USRDS Data

alexandrossfakianakis shared this article with you from Inoreader Risk Factors and Outcomes of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study of USRDS Data via Clinical Infectious Diseases Advance Access ABSTRACT Background Kidney transplant recipients are at increased risk for invasive aspergillosis (IA), a disease with poor outcomes and substantial economic burden. We aimed to determine risk factors for posttransplant IA by using a national database and to assess the association of IA with mortality and allograft failure. Methods Using the United States Renal Data System database, we performed a retrospective case-control study of patients who underwent kidney transplant from 1998 through 2017. To evaluate risk factors for IA, we performed conditional logistic regression analysis by comparing characteristics between IA-infected patients and their matched uninfected controls. We performed Cox regression analysis to evaluate the effects of IA on mortality and death-censored allograft failure. Results We matched 359 patients with IA to 1,436 uninfected controls (1:4). IA was diagnosed at a median of 22.5 months (IQR, 5.4-85.2 mo nths) after kidney transplant. Risk factors for IA were Black/African American race, duration of pretransplant hemodialysis, higher Elixhauser Comorbidity Index score, weight loss, chronic pulmonary disease, need for early posttransplant hemodialysis, and a history of cytomegalovirus infection. Receiving an allograft from a living donor was protective against IA. IA was a strong independent predictor of 1-year mortality (adjusted hazard ratio, 5.02 [95% CI, 3.58-7.04], P < .001). Additionally, IA was associated with 1-year allograft failure (adjusted hazard ratio, 3.37 [95% CI, 1.96-5.77], P < .001). Conclusions Our findings emphasize the importance of timely transplant to mitigate the risk of posttransplant IA. An individualized approach to disease prevention is essential to decrease mortality and allograft failure. View on Web

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

Physiopathology of peri‐implant diseases

alexandrossfakianakis shared this article with you from Inoreader Physiopathology of peri‐implant diseases via Clinical Implant Dentistry and Related Research Abstract Background Peri-implant health is characterized by the absence of clinical signs of soft tissue inflammation. Peri-implant diseases are initiated by the presence of bacterial biofilms and share a similar etiology as that involved in the onset of periodontal diseases. Purpose To summarize available evidence on the physiopathology of peri-implant diseases with emphasis on similarities and differences with periodontal diseases. Materials and Methods Evidence on the biologic mechanisms involved in the pathogenesis of peri-implant mucositis and peri-implantitis were explored in the recent scientific literature. Results Findings of studies in animals and in humans indicate that experimental peri-implant mucositis leads to a larger inflammatory connective tissue infiltrate and to a higher frequency of bleeding sites around implants compared with teeth. Tissue destruction at experimental peri-implantitis sites is more pronounced compared with that at experimental periodontitis sites. Although human periodontitis and peri-implantitis lesions share similarities with respect to etiology and clinical features, they represent distinct entities from a physiopathologic point of view. Conclusions Diagnosis of peri-implant health requires a clinical examination to confirm absence of peri-implant soft tissue inflammation. In order to make a correct diagnosis and select the appropriate therapeutic steps to manage peri-implant diseases, knowledge of their pathogenetic mechanisms is required. View on Web

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

Asthma and Respiratory Infections from Birth to Young Adulthood: The Espoo Cohort Study

alexandrossfakianakis shared this article with you from Inoreader Asthma and Respiratory Infections from Birth to Young Adulthood: The Espoo Cohort Study via American Journal of Epidemiology - Advance Access Abstract We applied the population-based prospective Espoo Cohort Study (n=2,568) to identify potential susceptibility of subjects with asthma to respiratory tract infections (RTIs). Information on the occurrence of asthma and of both upper and lower respiratory tract infections (URTIs and LRTIs) was collected with a questionnaire at the baseline, the 6 year- and the 20 year-follow-up studies, and from the National Health Registries. We estimated age- and sex-specific incidence rate differences (IRD) and incidence rate ratios (IRR) applying negative binomial regression. Meta-regression was used to summarize the age-specific IRRs from childhood to 27 years of age. Individuals with asthma at any age during the follow-up had an increased risk of URTIs (aIRD 72.6, 95% CI: 50.6, 94.7 per 100 person-year; aIRR: 1.27, 1.20, 1.35) and LRTIs (aIRD 25.5, 17.9, 33.1; aIRR 2.87, 2.33, 3.53) from childhood to young adulthood. In young adulthood, the association betwee n asthma and URTIs was stronger in women than men, while such was not detected for LRTIs. We provide strong evidence that subjects with asthma experience more RTIs from preschool age up to young adulthood compared to those without asthma. Thus, they constitute a susceptible population for RTIs. Especially women with asthma are at high risk. View on Web

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

Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss

alexandrossfakianakis shared this article with you from Inoreader Exome Sequencing Expands the Genetic Diagnostic Spectrum for Pediatric Hearing Loss via The Laryngoscope We describe the results of exome sequencing for genetic diagnosis of hearing loss among a clinically heterogeneous cohort of 218 pediatric patients. We found a higher diagnostic rate for unilateral hearing loss than previously reported as well as a significant number of syndromic forms of hearing loss. Based on these results, we advocate for expanded access to genetic testing for phenotypically diverse hearing loss patients. Objectives Genetic testing is the standard-of-care for diagnostic evaluation of bilateral, symmetric, sensorineural hearing loss (HL). We sought to determine the efficacy of a comprehensive genetic testing method, exome sequencing (ES), in a heterogeneous pediatric patient population with bilateral symmetric, bilateral asymmetric, and unilateral HL. Methods Trio-based ES was performed for pediatric patients with confirmed HL including those with symmetric, asymmetric, and unilateral HL. Results ES was completed for 218 probands. A genetic cause was identified for 31.2% of probands (n = 68). The diagnostic rate was 40.7% for bilateral HL, 23.1% for asymmetric HL, and 18.3% for unilateral HL, with syndromic diagnoses made in 20.8%, 33.3%, and 54.5% of cases in each group, respectively. Secondary or incidental findings were identified in 10 families (5.52%). Conclusion ES is an effective method for genetic diagnosis for HL including phenotypically diverse patients and allows the identification of secondary findings, discovery of deafness-causing genes, and the potential for efficient data re-analysis. Level of Evidence Level IV Laryngoscope, 2022 View on Web

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

Induced Paresis for Awake Laryngoscopy Procedures

alexandrossfakianakis shared this article with you from Inoreader Induced Paresis for Awake Laryngoscopy Procedures via The Laryngoscope This article describes an anesthetic technique that induces temporary adductor vocal fold paresis and dense sensory loss of the posterior glottis. This method allows for improved precision of treatment and patient tolerance during awake office-based laryngeal surgery. View on Web

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