Customised acoustic therapy delivered through a web‐based platform – an innovative approach to tinnitus treatment

alexandrossfakianakis shared this article with you from Inoreader Customised acoustic therapy delivered through a web‐based platform – an innovative approach to tinnitus treatment via Clinical Otolaryngology Abstract Objectives Customised acoustic therapy aims to moderate the neural pathways implicated in the pathophysiology of tinnitus. This study aimed to assess the efficacy of customised acoustic therapy administered via a web-based treatment platform. Design Clinical trial with prospective recruitment. 58 participants underwent six weeks of customised acoustic therapy. Setting Treatment was delivered for 2 hours each day using a smartphone, tablet or computer. Treatment was integrated into usual daily activities. Participants Participants with subjective tinnitus were recruited through public and private otolaryngology clinics and electronic and print media. Main Outcomes Measured FiveQ, a novel 5 question tinnitus questionnaire, was measured at baseline and each week of treatment. Statistical analyses, including Wilcoxon, Mann-Whitney and mixed linear regression, were used to assess treatment efficacy and identify factors associated with treatment response. Results 39/58 participants (67.2%) had an improvement in symptom severity scores, 4 had no change (6.9%) and 15 had a decline from baseline (25.9%). Mean FiveQ scores improved by 22.9% from 40.8 (SD=21.4) at baseline to 31.5 (SD=21.3) following 6 weeks of treatment (p<0.001). With the exception of the slight tinnitus group, all other groups (from mild to catastrophic) demonstrated a treatment response. Participants with low frequency tinnitus (<2000 Hertz) had a significantly greater treatment response (p<0.001). Conclusion Customised acoustic therapy administered via a web-based platform demonstrated encouraging efficacy. At least mild symptoms at baseline and low frequency tinnitus were associated with a greater treatment response. Customised acoustic therapy offers accessible and efficacious tinnitus treatment, however longer term clinical studies are required to confirm the observed initial benefit is maintained. View on Web

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Attentional biases for sad faces in offspring of mothers with a history of major depression: trajectories of change from childhood to adolescence

alexandrossfakianakis shared this article with you from Inoreader Attentional biases for sad faces in offspring of mothers with a history of major depression: trajectories of change from childhood to adolescence via Journal of Child Psychology and Psychiatry Background Theorists have proposed that the way children process social–emotional information may serve as a mechanism of risk for the intergenerational transmission of depression. There is growing evidence that infants and children of mothers with a history of major depressive disorder (MDD) during the child's life exhibit attentional avoidance of sad faces, which has been proposed as an early emerging emotion regulation strategy. In contrast, there is clear evidence that at-risk and depressed adolescents and adults exhibit difficulty disengaging attention from sad faces. Methods Seeking to link these two literatures, the current U.S.-based study used eye tracking within the context of an accelerated longitudinal design to assess attentional biases in 8–14-year-old offspring of mothers with a history MDD during the child's life (n = 123) or no history of MDD (n = 119) every six months for two years, allowing us to map trajectories of attention from age 8 to 16. Results Mother MDD history moderated age-based changes in children's gaze duration to sad (t[240] = 2.44, p = .02), but not happy (t[240] = 0.11, p = .91) or angry (t[240] = 0.67, p = .50), faces. Consistent our hypotheses, offspring of mothers with MDD exhibited significantly less attention to sad faces than offspring of never depressed mothers before age 8.5 but significantly more attention to sad faces after age 14.5, which was due to an increase in gaze duration to sad faces from childhood to adolescence among offspring of mothers with MDD (t[122] = 5.44, p < .001) but not among offspring of never depressed mothers (t[118] = 1.49, p = .14). Conclusions It appears that the form, and perhaps function, of attentional bias may shift across development in at-risk youth. To the extent that this is true, it has significant implications not only for theories of the intergenerational transmission of depression risk but also for prevention and early intervention efforts designed to reduce this risk. View on Web

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Neuroendokrine Tumoren im Kopf-, Halsbereich

alexandrossfakianakis shared this article with you from Inoreader Neuroendokrine Tumoren im Kopf-, Halsbereich via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1976-9641 Hintergrund Neuroendokrine Tumoren (NET) sind benigne oder maligne Neoplasien, die entwicklungsgeschichtlich der Neuralleiste oder paraganglionären Zellen des vegetativen Nervensystems entstammen. Die alte Bezeichnung Karzinoid (karzinomähnlicher Tumor) ist noch sehr verbreitet, jedoch inzwischen obsolet. Lediglich 0,5–2 % aller Neoplasien des Menschen sind neuroendokrine Tumoren, welche überwiegend gastrointestinal oder bronchopulmonal lokalisiert sind. Die Inzidenz beträgt 9.263/100.000. Jedoch ist nur 1 % der Kopf-Hals-Tumore neuroendokriner Genese. Fallzahlstarke Langzeitstudien und Leitlinien zur Diagnose und Therapie im Kopf-Hals Bereich fehlen. Ziel dieser Arbeit ist der wertende Vergleich bekannter Therapiestrategien und daraus folgender Krankheitsverläufe sowie deren Vergleich mit dem Schrifttum anhand eigener Fälle unterschiedlicher Lokalisation und Ausdehnung. Patienten und Methoden In unserer Klinik wurden zwischen 2010 und 2017 14 Patienten mit neuroendokrinen Tumoren im Kopf-Hals-Bereich behandelt. 8 Patienten davon wurden primär operativ mit adjuvanter Radiochemotherapie versorgt. 6 Patienten erhielten eine primäre Radiochemotherapie in kurativer Absicht. 1 Patient erhielt auf Grund des Tumorprogress nach der primären Radiochemotherapie eine weitere Chemotherapie mit palliativer Indikation. Ergebnisse Die Tumorlokalisationen verteilen sich auf den Larynx (n = 7), die Glandula parotis (n = 2) und auf die Nasenhaupt- und -nebenhöhlen (n=5). Von den 8 operierten Patienten konnte in sechs Fällen eine in-sano Resektion (R0) erreicht werden. Die im Kollektiv gemessene Gesamtüberlebensrate beträgt im Mittel 19±6 Monate. Von den 14 untersuchten Patienten erlitten zwei Patienten ein Rezidiv, wovon ein Patient nach 7 Monaten verstarb und ein Patient 32 Monate nach der Nachresektion Rezidiv-frei lebt. In zwei Fällen sprach das NET nicht auf die kombinierte RCT an und die Patienten verstarben jeweils nach sechs und 13 Monaten. Die Überlebenszeit ist abhängig vom T-Stadium des NET sowie vom Erreichen einer R0-Resektion. Die R0-Resektion bietet eine höhere Überlebenswahrscheinlichkeit als die primäre RCT. Schlussfolgerung Patienten mit NET des Kopf-Hals-Bereiches müssen in spezialisierten Zentren interdisziplinär behandelt werden. Zur Erfassung dieser Daten ist eine Tumordatenbank notwendig. Jedoch sind aufgrund der niedrigen Inzidenz keine Studien auf hohem Evidenzniveau zu erwarten. Nach effizienter Diagnosestellung sollte zeitliche Verzögerung unmittelbar im Rahmen einer interdisziplinären Tumorkonferenz eine individuelle auf den Patienten zugeschnittene Therapie erfolgen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

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Treatment outcomes and cost comparisons for older adults with T4 laryngeal squamous cell cancer

alexandrossfakianakis shared this article with you from Inoreader Treatment outcomes and cost comparisons for older adults with T4 laryngeal squamous cell cancer via Head & Neck Abstract Background To evaluate treatment modalities of T4 larynx cancer in older adults using SEER-Medicare. Methods The database was queried for patients aged 66 and older with nonmetastatic T4 laryngeal squamous cell cancer from 2006 to 2015. Treatment modalities compared were surgery plus chemoradiation (SCR), surgery plus radiation (SR), chemoradiation (CR), surgery (S), and radiation (R). Multivariate analysis and Kaplan–Meier methods were used to explore the relationship of treatment modality and survival. Total cancer-related costs were calculated. Results A total of 438 patients met inclusion criteria. Patients receiving CR or SR had similar CSS to SCR (HR 1.36 and HR 1.24, respectively). Those receiving S (HR 2.00) or R (HR 2.41) had significantly worse CSS. Similar findings were observed for OS. Cancer care-related costs were not significantly different but highest in SCR ($162215) and lowest in R ($121421). Conclusion Older patients with T4 larynx cancer had similar survival rates when treated with CR, SR, and SCR. Average total health care costs were not significantly different between modalities. Patients not eligible for triple-modality could consider these other treatment options. View on Web

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The effectiveness of low‐dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: a systematic review with meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader The effectiveness of low‐dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: a systematic review with meta‐analysis via Pain Practice Abstract Objective To evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus active physical interventions on pain intensity and disability in adults with nonspecific chronic low back pain. Introduction Research has shown that primary care biopsychosocial interventions (PCBI) can reduce pain intensity and disability. While scattered studies support low-dosed (<= 15 treatment hours) PCBI, no systematic review exists comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP). Inclusion Criteria Randomised controlled trials that evaluate low-dosed PCBI compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older), who suffer from CLBP were included. Not recommended interventions that feature only passive therapies, spinal surgery, or pharmacological treatment, and studies with inpatient multidisciplinary-based rehabilitation (MBR) were excluded. Methods Databases were searched from inception to December 31, 2021. Language was restricted to English or German. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" were used. Sources were CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. Search was finished on March 08, 2022. Data appraisal, extraction, and synthesis followed JBI guidance for systematic reviews of effectiveness. Risk of Bias was assessed using JBI 13-item checklist for randomised controlled trials. The GRADE approach for grading the certainty of evidence was followed. Systematic review registration number PROSPERO 2022 CRD42022302771 Results Eighteen RCTs were found eligible and 15 trials comprising a total of 1531 participants suffering from CLBP were entered in the meta-analyses. Risk of Bias was low. Overall evidence was moderate. Significant effects in favour of PCBI were found for pain intensity post-treatment (standardized mean difference (SMD) = - 1.09,  95% confidence interval (CI) = - 1.84 to - 0.34, I2 = 97%, P = 0.004) as well as at short-term (SMD = - 0.23,  95% CI = - 0.39 to -0.08, I2 = 0%, P = 0.004), long-term (SMD = - 0.79,  95% CI = - 1.42 to - 0.17, I2 = 96%, P = 0.01) and very long-term (SMD = - 1.13,  95% CI = - 1.93 to - 0.33, I2 = 94%, P = 0.005) follow-up. Significant effects in favour of PCBI for physical function were found post-treatment (SMD = - 1.33,  95% CI = - 2.17 to - 0.49, I2 = 97%, P = 0.002) at short-term (SMD = - 0.20, 95% CI = - 0.36 to - 0.04, I2 =  ;0%, P = 0.01), and at long-term follow-up (SMD = - 1.17, 95% CI = - 2.06 to - 0.28, I2 = 98%, P = 0.01). The results were characterised by high heterogeneity due to different types (cognitive behavioural therapy, pain-neuroscience education, mindfulness, motivation), delivery modes (individual and/or group), durations (3 to 12 weeks) and contact times (2 to 15 hours) of PCBI. In sensitivity analysis outliers were removed to reduce heterogeneity. The results remained significant for pain intensity at short-term (SMD = - 0.23,  95% CI = - 0.39 to - 0.08, I2 = 0%, P = 0.004), and long-term follow-up (SMD = - 0.22,  95% CI = - 0.41 to - 0.03, I2 = 39%, P = 0.02). Conclusions This meta-analysis suggests that low-dosed PCBI has favourable effects in terms of disability and pain intensity compared to active physical treatments alone. All conducted meta-analyses indicate that biopsychosocial interventions produce better outcomes than active physical treatment alone. Therefore, we strongly recommend decision makers and clinical practitioners to analyse how psychosocial elements can be introduced into outpatient (low-dosed) CLBP interventions. View on Web

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high‐viscosity glass ionomer restorative systems in small class II restorations

alexandrossfakianakis shared this article with you from Inoreader Five‐year randomized clinical trial to evaluate the clinical performance of high‐viscosity glass ionomer restorative systems in small class II restorations via Journal of Esthetic and Restorative Dentistry Abstract Objective Evaluate and compare the 5-year clinical performance of three high-viscosity glass ionomer restorative materials in small class II restorations. Materials and Methods Forty patients, each with four class II restorations, were enrolled in this trial. A total of 160 restorations were placed, 25% for each material, as follows: three high-viscosity conventional glass ionomer restorative systems (Ketac Universal Aplicap, EQUIA Forte and Riva Self Cure HV) and a microhybrid resin composite system (Filtek Z250). Clinical evaluation was performed at baseline and after 1, 3, and 5 years by two independent examiners using FDI criteria. Epoxy resin replicas were observed under scanning electron microscope (SEM) to examine surface characteristics. Data were analyzed with Kruskal-Wallis, Mann–Whitney U, Friedman, and Wilcoxon signed-rank tests (p < 0.05). Results The success rates were 100% for resin composite, 97.4% for Ketac Universal, and 94.9% for both EQUIA Forte and Riva HV restorations. Statistically significant differences were observed between all groups in terms of surface luster and color match criteria (p < 0.05). Statistically significant changes were found over time for all criteria except for fracture of material, postoperative hypersensitivity, recurrence of caries, tooth integrity, periodontal response, adjacent mucosa, and oral health criteria (p > 0.05). SEM evaluations were in accordance with the clinical findings. Conclusions Although drawbacks in surface luster and color match appeared over the 5-year evaluation period, the three high-viscosity glass ionomer restorative materials provided successful clinical performance in small to medium sized class II cavities compared to microhybrid resin composite. Clinical Significance Glass ionomer restorations exhibited clinical performance similar to that of microhybrid resin composite restorations in small class II cavities subsequent to 5-year evaluation. View on Web

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Efficacy of stabilization splint and low level laser therapy for patients with chronic closed lock from non‐reducible displaced temporo‐mandibular joint discs. A parallel randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader Efficacy of stabilization splint and low level laser therapy for patients with chronic closed lock from non‐reducible displaced temporo‐mandibular joint discs. A parallel randomized clinical trial via Journal of Oral Rehabilitation Abstract Background Stabilization splint therapy (SST) and low level laser therapy (LLLT) are effective non-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown. Aim To assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR . Methods This parallel randomized clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores, and time required to achieve normal state, were evaluated at baseline, one week, two weeks, four weeks, three months, and six months after the intervention. Data was collected and analyzed using SPSS software. Results Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II. Conclusion All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases but the combined SST and LLLT group seems to provide the best and quickest improvement. View on Web

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Influence of a resorbable collagen membrane for alveolar bone graft on clinical outcomes and ridge volume stability in cleft alveolus

alexandrossfakianakis shared this article with you from Inoreader Influence of a resorbable collagen membrane for alveolar bone graft on clinical outcomes and ridge volume stability in cleft alveolus via International Journal of Oral and Maxillofacial Surgery via MedWorm.com This study compared the clinical outcomes, graft quality, and graft quantity after alveolar bone grafting with and without a resorbable collagen membrane. Twenty unilateral cleft patients undergoing defect repair with cancellous iliac bone were assigned to either the collagen membrane group (Mb group) or standard group without a membrane (St group). Postoperative pain and swelling, bone density, and bone volume and quality were assessed. The Mb group showed significantly lower postoperative pain than the St group (P   (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Dendritic spine loss in epileptogenic Type II focal cortical dysplasia: Role of enhanced classical complement pathway activation

alexandrossfakianakis shared this article with you from Inoreader Dendritic spine loss in epileptogenic Type II focal cortical dysplasia: Role of enhanced classical complement pathway activation via Brain Pathology Abstract Dendritic spines are the postsynaptic sites for most excitatory glutamatergic synapses. We previously demonstrated a severe spine loss and synaptic reorganization in human neocortices presenting Type II focal cortical dysplasia (FCD), a developmental malformation and frequent cause of drug-resistant focal epilepsy. We extend the findings, investigating the potential role of complement components C1q and C3 in synaptic pruning imbalance. Data from Type II FCD were compared with those obtained in focal epilepsies with different etiologies. Neocortical tissues were collected from 20 subjects, mainly adults with a mean age at surgery of 31 years, admitted to epilepsy surgery with a neuropathological diagnosis of: cryptogenic, temporal lobe epilepsy with hippocampal sclerosis, and Type IIa/b FCD. Dendritic spine density quantitation, evaluated in a previous paper using Golgi impregnation, was available in a subgroup. Immunohistochemistry, in situ hybridization, electron microscopy, a nd organotypic cultures were utilized to study complement/microglial activation patterns. FCD Type II samples presenting dendritic spine loss were characterized by an activation of the classical complement pathway and microglial reactivity. In the same samples, a close relationship between microglial cells and dendritic segments/synapses was found. These features were consistently observed in Type IIb FCD and in 1 of 3 Type IIa cases. In other patient groups and in perilesional areas outside the dysplasia, not presenting spine loss, these features were not observed. In vitro treatment with complement proteins of organotypic slices of cortical tissue with no sign of FCD induced a reduction in dendritic spine density. These data suggest that dysregulation of the complement system plays a role in microglia-mediated spine loss. This mechanism, known to be involved in the removal of redundant synapses during development, is likely reactivated in Type II FCD, particularly in Type IIb; loc al treatment with anticomplement drugs could in principle modify the course of disease in these patients. View on Web

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Epstein–Barr virus‐positive diffuse large B‐cell lymphoma onset as familial hemophagocytic lymphohistiocytosis in an infant

alexandrossfakianakis shared this article with you from Inoreader Epstein–Barr virus‐positive diffuse large B‐cell lymphoma onset as familial hemophagocytic lymphohistiocytosis in an infant via Pediatric Blood & Cancer View on Web

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