Αρχειοθήκη ιστολογίου

Τετάρτη 20 Ιανουαρίου 2021

Influence of feldspar ceramic thickness on the properties of resin cements and restorative set

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Abstract

This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light‐ and dual‐cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE 00), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE 00, translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE 00, and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE 00 and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set.

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Hydroacoustic analysis and extraluminal compression surgical insights of venous pulsatile tinnitus

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This study aimed to quantitatively and qualitatively evaluate the hydroacoustic changes from "presence" to "disappearance" of pulsatile tinnitus (PT) with the extraluminal compression surgical technique. The recent issues of concern pertaining to the hydroacoustic characteristics of sigmoid sinus wall anomalies and distal transverse sinus stenosis (dTSS) were discussed.
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Protein arginine methyltransferase 1 contributes to the development of allergic rhinitis by promoting the production of epithelial-derived cytokines

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Antigens and IL-4 cooperate to upregulate PRMT1 expression in nasal epithelial cells, which results in increased TSLP, IL-25, and IL-33 production. These epithelial-derived cytokines contributes to AR development by promoting the differentiation into Th2 cytokines-producing cells
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Intranasal Ketorolac, Diagnosis and Desensitization for Aspirin Exacerbated Respiratory Disease

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Intranasal ketorolac has been proposed as a diagnostic test for AERD as well as a faster, safer and reliable addition to facilitate ASA desensitization. Objective : We conducted the first prospective study to dissect the impact of intranasal ketorolac incorporation during ASA desensitization versus standard oral protocols in concert with evaluating its diagnostic utility for AERD.
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Endoscopic Evaluation of Pharyngeal and Laryngeal Sensation in Patients with Chronic Obstructive Pulmonary Disease (COPD): A cross‐sectional study

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Abstract

Objective

To describe and compare the findings of endoscopic sensory assessment in COPD patients and healthy controls.

Design

A prospective cross‐sectional study.

Setting

Otorhinolaryngology outpatient clinic at a university hospital.

Participants

27 adults with COPD and 11 age‐matched healthy controls.

Main outcome measures

Group differences in light‐touch endoscopic tests of pharyngeal and laryngeal sensation, controlling for pooled salivary secretions in the pharynx and laryngo‐pharyngeal reflux as measured by the Reflux Finding Score (RFS).

Results

A significant difference in laryngeal sensation was found between the study groups (p = 0.047), with reduced laryngeal sensation in the COPD patients. Additionally, a significant relationship was found between impaired oropharyngeal sensation and the presence of pooled salivary secretions in the pharynx (p = 0.018), especially in the pyriform sinuses (p = 0.012). No differences in the frequency of abnormal Reflux Finding Scores were found between groups.

Conclusion

Individuals with COPD were significantly more likely to present with impaired laryngeal sensation. Additionally, impaired sensation in the oropharynx was associated with pooled salivary secretions in the pharynx.

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Voice outcomes after trans‐oral laser surgery for T1b squamous cell carcinoma of the glottis: our experience in 20 patients over 12 years.

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Abstract

Laryngeal cancer is uncommon, accounting for 1% of all malignancies in men and 0.3 per cent of all malignancies in women in the UK.1 Squamous cell carcinoma is the most common histological subtype.1 The most frequently affected sub‐site is the glottis, which includes the vocal cords, the anterior commissure, and the posterior commissure.2 T1b disease involves part or the whole of both vocal cords and often the anterior commissure, with no impaired mobility.2 The combined effect of early presentation and infrequent metastases means that oncological outcomes are generally excellent.1

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Admission avoidance in acute epistaxis

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Abstract

Objectives

To report changes in practice brought about by COVID‐19 and the implementation of new guidelines, and to explore factors relating to unscheduled re‐presentations for patients discharged from the emergency department (ED).

Design

Prospective multicentre national audit over 12 weeks from 6th April 2020.

Setting

UK secondary care ENT departments.

Participants

Adult patients with acute epistaxis.

Main outcome measures

Re‐presentation within 10 days for patients discharged from the ED.

Results

83 centres from all four UK nations submitted 2,631 valid cases. The majority of cases were ED referrals (89.7%, n=2,358/2,631). 54.6% were discharged from the ED following ENT review (n=1,267/2,322), of whom 19.5% re‐presented within 10 days (n=245/1,259) and 6.8% were ultimately admitted (n=86/1,259).

46.7% of patients had a non‐dissolvable pack inserted by ED prior to referral to ENT (n=1,099/2,355).

The discharge rates for ED patients and their subsequent re‐presentation rates were as follows: non‐dissolvable packs, 29.5% discharged (n=332/1125), 18.2% re‐presented (n=60/330); dissolvable products, 71.1% discharged (n=488/686), 21.8% re‐presented (n=106/486); cautery only, 89.2% discharged (n=247/277), 20.0% re‐presented (n=49/245); and no intranasal intervention, 85.5% discharged (n=200/234), 15.2% re‐presented (n=30/198).

Univariable logistic regression showed that not being packed by ED, antiplatelet medications, failed cautery and recent epistaxis treatment were significant predictors of re‐presentation within 10 days.

Conclusions

Management of acute epistaxis was notably affected during the initial peak of the pandemic, with a shift towards reduced admissions. This national audit highlights that many patients who may previously have been admitted to hospital may be safely discharged from the ED following acute epistaxis.

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Risk factors of orbital complications in outpatients presenting with severe rhinosinusitis: a case‐control study

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Abstracts

Objectives

We assessed associations of potential factors with orbital complications in acute rhinosinusitis (ARS) patients.

Design

An unmatched case–control study

Setting

A tertiary referral hospital in Thailand

Participants

Consecutive outpatients of any age with severe ARS (visual analog scale ≥ 7) with and without orbital complications.

Main outcome measures

Patients were enrolled from January 2013 to December 2018. Forty‐three ARS patients (55.8% female, median age 45.6, (range 2.0‐93.0) years) were included, with 19 patients in the complicated group and 24 in the uncomplicated group. Patient characteristics (gender, age, diabetes, immune status), symptoms and signs, site of infection, and type of pathogenic bacteria were recorded and assessed their associations with orbital complications by univariable and multivariable logistic regression analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results

The most common orbital complication was subperiosteal abscess (42.1%), followed by orbital cellulitis (15.8%) and cavernous sinus thrombosis (10.5%). Multivariable logistic regression analysis demonstrated a positive association with orbital complications (pseudo R2 0.4) for ethmoid sinusitis (OR 31.1, 95% CI [2.3–430.6]) and a short duration of symptoms (OR 0.9, 95% CI [0.8–0.9]).

Conclusions

Orbital complications were associated with ethmoid sinusitis with a short duration of ARS symptoms.

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Dissolvable intranasal haemostatic agents for acute epistaxis

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Abstract

Introduction

Nasal packing is the mainstay of epistaxis management; however, packs cause patient discomfort and can lead to hospital admission. Absorbable haemostats provide clotting factors or act as a substrate to stimulate clotting and represent a potential treatment alternative. A systematic review was performed to evaluate the efficacy of topical haemostats in the management of epistaxis.

Methods

A systematic literature search of 7 databases was performed. Only eligible randomised controlled‐trials (RCTs) and observational studies were included. The primary outcome was short‐term haemostatic success (<7 days). Secondary outcomes included long‐term haemostatic control (no re‐bleeding 7‐30 days), patient discomfort and adverse effects. Meta‐analysis was performed where possible.

Results

Of 2,249 records identified, 12 were included in the qualitative synthesis and 4 RCTs were included in meta‐analysis. The following haemostats were reported: gelatin‐thrombin matrix (n=8), aerosolised/gel tranexamic acid (n=1), cellulose agents (n=2), and fibrin sealants (n=1). Studies involving tranexamic acid on removable delivery devices (e.g. pledgets) were excluded. There was heterogeneity in outcome measures and inclusion criteria (coagulopathies/anticoagulants were excluded in 3 RCTs and 2 observational studies). The short‐term haemostatic success varied between studies (13.9% to 100%). No significant post‐procedural complications were reported. The meta‐analysis favoured absorbable haemostatic agent versus packing (risk ratio 1.20; 95% confidence interval 1.05 to 1.37; p=0.007). The risk of bias across all studies was moderate to high.

Conclusions

The evidence suggests haemostatic agents are effective at managing acute epistaxis when compared with nasal packing. More data are required before recommendations can be made regarding management in patients on anticoagulants.

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mRNA COVID-19 vaccine is well tolerated in patients with cutaneous and systemic mastocytosis with mast cell activation symptoms and anaphylaxis

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Mastocytosis encompasses a heterogeneous group of diseases characterized by the presence of clonal mast cells (MCs) in tissues and symptoms of MC activation, including anaphylaxis.1 Vaccination has been shown to cause exacerbation of MC mediator-related symptoms.2 Vaccines against coronavirus disease 2019 (COVID-19) are the solution to the current pandemic, but reports of anaphylaxis following vaccination with the BNT162b2 Pfizer-BioNTech mRNA vaccine have emerged.3 As such, it is important to provide evidence of the safety of mRNA vaccines in populations at risk for anaphylaxis, including patients with mastocytosis and MC activation symptoms.
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Low‐ and high‐dose radioiodine ablation for low‐/intermediate‐risk differentiated thyroid cancer

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Abstract

Background

To determine whether 1.1 GBq radioiodine therapy is as effective as 3.7 GBq for ablation in Chinese patients with differentiated thyroid cancer (DTC).

Methods

In this single‐center randomized study, we compared the successful radioiodine ablation rates of 1.1 GBq and 3.7 GBq for patients with DTC.

Results

At 6–8 months after radioiodine ablation, there were 95 (39%) patients in the 1.1 GBq group and 79 (32%) patients in the 3.7 GBq group with thyroid hormone withdrawal (THW), and ablation success rates were 84% versus 80%, respectively; and 149 (61%) patients in the 1.1 GBq group and 169 (68%) patients in the 3.7 GBq group without THW, and ablation success rates were 89% versus 90%, respectively. In total, the ablation was successful in 412 (87%) of the 474 patients, and it was similar between the two groups.

Conclusions

Low‐dose radioiodine ablation was as effective as high dose in Chinese DTC patients.

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PI3k inhibitors (BKM120 and BYL719) as radiosensitizers for head and neck squamous cell carcinoma during radiotherapy

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journal.pone.0245715.g005&size=inline

by Fu-Cheng Chuang, Chih-Chun Wang, Jian-Han Chen, Tzer-Zen Hwang, Shyh-An Yeh, Yu-Chieh Su

Approximately 500,000 new cases of head and neck squamous cell carcinoma (HNSCC) are reported annually. Radiation therapy is an important treatment for oral squamous cell carcinoma (OSCC). The survival rate of patients with HNSCC remained low (50%) in decades because of radiation therapy failure caused by the radioresistance of HNSCC cells. This study aimed to identify PI3K inhibitors that can enhance radiosensitivity. Results showed that pan-Phosphoinositide 3-kinases (PI3K) inhibitor BKM120 and class I α-specific PI3K inhibitor BYL719 dose-dependently reduced the growth of OSCC cells but not that of radioresistant OML1-R cells. The combination treatment of BKM120 or BYL719 with radiation showed an enhanced inhibitory effect on OSCC cells and radioresistant OML1-R cells. Furthermore, the enhanced inhibitory effect of the combination treatment was confirmed in patient-derived OSCC cells. The triple combination treatment of mTOR inhibitor AZD2014 and BKM120 or AZD2014 and BYL719 with radiation showed a significantly enhanced inhibitory effect on radioresistant OML1-R cells. These results suggest that the PI3K inhibitors are potential therapeutic agents with radiosensitivity for patients with OSCC.
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