Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population

alexandrossfakianakis shared this article with you from Inoreader Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population via Most Recent Articles: Journal of Otolaryngology - Head & Neck Surgery Transcutaneous bone anchored hearing devices (BAHDs) were introduced in an effort to avoid potential complications associated with the abutment of percutaneous BAHDs. Transcutaneous BAHDs can be active or pass... View on Web

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Exhaled Mycobacterium tuberculosis Predicts Incident Infection in Household Contacts

alexandrossfakianakis shared this article with you from Inoreader Exhaled Mycobacterium tuberculosis Predicts Incident Infection in Household Contacts via Clinical Infectious Diseases Advance Access Abstract BackgroundHalting transmission of Mycobacterium tuberculosis (Mtb) by identifying infectious individuals early is key to eradicating tuberculosis (TB). Here we evaluate face mask sampling as a tool for stratifying the infection risk of individuals with pulmonary TB (PTB) to their household contacts. Methods Forty-six sputum-positive PTB patients in The Gambia (August 2016–November 2017) consented to mask sampling prior to commencing treatment. Incident Mtb infection was defined in 181 of their 217 household contacts as QuantiFERON conversion or an increase in interferon-γ of ≥1 IU/mL, 6 months after index diagnosis. Multilevel mixed-effects logistical regression analysis with cluster adjustment by household was used to identify predictors of incident infection. Results Mtb was detected in 91% of PTB mask samp les with high variation in IS6110 copies (5.3 × 102 to 1.2 × 107). A high mask Mtb level (≥20 000 IS6110 copies) was observed in 45% of cases and was independently associated with increased likelihood of incident Mtb infection in contacts (adjusted odds ratio, 3.20 [95% confidence interval, 1.26–8.12]; P = .01), compared with cases having low-positive/negative mask Mtb levels. Mask Mtb level was a better predictor of incident Mtb infection than sputum bacillary load, chest radiographic characteristics, or sleeping proximity. Conclusions Mask sampling offers a sensitive and noninvasive tool to support the stratification of individuals who are most infectious in high-TB-burden settings. Our approach can provide b etter insight into community transmission in complex environments. View on Web

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Posisep Versus PureRegen Gel for Post ESS Nasal Packing – A Randomized Blinded Prospective Study

alexandrossfakianakis shared this article with you from Inoreader Posisep Versus PureRegen Gel for Post ESS Nasal Packing – A Randomized Blinded Prospective Study via The Laryngoscope Objective Endoscopic sinus surgery (ESS) is the procedure of choice for chronic rhinosinusitis (CRS). Adhesions are the most common postoperative complications, causing recurrent disease and revision surgery. Postoperative care is thus essential for the healing of the operated cavity. A wide variety of packing materials are used to prevent bleeding and adhesions postoperatively. Two main absorbable packing materials are used: Foam-based packs (e.g., Posisep and Nasopore) and gel-based packs (PureRegen Gel – PRG). The current study is a randomized, blinded, prospective analysis of cavity healing using Posisep and PRG in ESS, aiming to compare the pros and cons of the two. Methods Patients with bilateral symmetric CRS were recruited for the study. At the end of surgery, one side was randomly packed with Posisep, whereas the other was packed with PRG. The postoperative cavity cleaning was video recorded and a blinded physician evaluated the mucosal healing. Results The side packed with Posisep had significantly less middle turbinate (MT) lateralization and adhesions yet dissolved significantly slower than the PRG, causing more mucosal edema. Severe MT scarring requiring recurrent medialization and adhesiolysis was exclusively observed in the PRG group. All differences were observed in the early postoperative period (up to 12 weeks after surgery). By that time, only the MT position was significantly different between groups, despite recurrent adhesiolysis and medialization. Conclusion The authors recommend using Posisep for MT support only when it is unstable or lateralized. Packing the surgical cavity in other cases with PRG is more beneficial. Level of Evidence 2 Laryngoscope, 2022 View on Web

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Transplacental transmission of SARS‐CoV‐2 immunoglobulin G antibody to infants from maternal COVID‐19 vaccine immunization before pregnancy

alexandrossfakianakis shared this article with you from Inoreader Transplacental transmission of SARS‐CoV‐2 immunoglobulin G antibody to infants from maternal COVID‐19 vaccine immunization before pregnancy via Journal of Medical Virology Abstract Background & aim Coronavirus disease 2019 (COVID-19) vaccine generates functional antibodies in maternal circulation that are detectable in infants, while the information is restricted to the usage of COVID-19 vaccine during pregnancy. In this study, we aimed to evaluate the effect of maternal COVID-19 vaccines before pregnancy. Method Infants were included from mothers with no inactivated COVID-19 vaccine, 1-dose, 2-dose and 3-dose before pregnancy, and SARS-CoV-2 IgG antibodies were tested. Comparative analysis was done between the groups. Results A total of 130 infants were enrolled in the study. Significantly higher levels of SARS-CoV-2 IgG antibodies in infants born to mothers with 3-dose COVID-19 vaccine before pregnancy compared with 1-dose and 2-dose groups (p<0.0001). The levels of antibodies decreased significantly with age in infants born to mothers with the 3-dose COVID-19 vaccine before pregnancy (r=-0.338, p=0.035), and it w as still higher than that 2-dose COVID-19 vaccine group. Conclusion The maternal SARS-CoV-2 antibodies produced from the inactivated COVID-19 vaccine before pregnancy can be transferred to newborns via the placenta. Maternal immunization with 3-dose of the COVID-19 vaccine before pregnancy could be more beneficial for both mothers and infants. This article is protected by copyright. All rights reserved. View on Web

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The widest use of paracetamol in home therapy might have actually increased the occurrence of severe forms of COVID‐19 in Italy, affecting hospitalization and death rates.

alexandrossfakianakis shared this article with you from Inoreader The widest use of paracetamol in home therapy might have actually increased the occurrence of severe forms of COVID‐19 in Italy, affecting hospitalization and death rates. via Journal of Medical Virology Abstract A recent contribution by Perico et al., recommended the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in the early stage of SARS-CoV2 infection, preventing the onset of a severe form of COVID-19 and hence reducing the hospitalization rate and the risk of mortality 1. Many previous reports from the same group 2-3 and from ours 4, showed that the use of paracetamol, as recommended by the Italian Ministry of Health since Nov 30 th 2020, usually associated with the advice to monitor one's own developing symptoms at home ("watchful waiting"), increased the risk to be hospitalized. This article is protected by copyright. All rights reserved. View on Web

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The use of electrodermal activity in pulpal diagnosis and dental pain assessment

alexandrossfakianakis shared this article with you from Inoreader The use of electrodermal activity in pulpal diagnosis and dental pain assessment via International Endodontic Journal Abstract Abstract Aims To explore whether electrodermal activity (EDA) can serve as a complementary tool for pulpal diagnosis (Aim 1) and an objective metric to assess dental pain before and after local anaesthesia (Aim 2). Methodology A total of 53 subjects (189 teeth) and 14 subjects (14 teeth) were recruited for Aim 1 and Aim 2, respectively. We recorded EDA using commercially available devices, PowerLab and Galvanic Skin Response (GSR) Amplifier, in conjunction with cold and electric pulp testing (EPT). Participants rated their level of sensation on a 0-10 visual analogue scale (VAS) after each test. We recorded EPT-stimulated EDA activity before and after the administration of local anaesthesia for participants who required root canal treatment (RCT) due to painful pulpitis. The raw data were converted to the time-varying index of sympathetic activity (TVSymp), a sensitive and specific parameter of EDA. Statistical analysis was performed using Python 3.6 and its Scikit-post hoc library. Results EDA activity was upregulated by the stimuli of cold and EPT testing in normal pulp. TVSymp signals were significantly increased in vital pulp compared to necrotic pulp by both, cold test and EPT. Teeth that exhibited intensive sensitivity to cold with or without lingering pain had increased peak numbers of TVSymp than teeth with mild sensation to cold. Pre- and post-anaesthesia EDA activity and VAS scores were recorded in patients with painful pulpitis. Post-anaesthesia EDA signals were significantly lower compared to pre-anaesthesia levels. Approximately 71 % of patients (10 out of 14 patients) experienced no pain during treatment and reported VAS score zero or 1. Majority of patients (10 out of 14) showed the reduction of TVSymp after the administration of anaesthesia. Two out of three patients who experienced increased pain during root canal treatment (post-treatment VAS > pre-treatment VAS) exhibited increased post-anaesthesia TVSymp. Conclusions Our data show promising results for using EDA in pulpal diagnosis and for assessing dental pain. While our testing was limited to subjects who had adequate communication skills, our future goal is to be able to use this technology to aid in the endodontic diagnosis of patients who have limited communication ability. View on Web

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Safety of day‐case endoscopic sinus surgery

alexandrossfakianakis shared this article with you from Inoreader Safety of day‐case endoscopic sinus surgery in England: An observational study using an administrative dataset via Clinical Otolaryngology Abstract Introduction As elective surgical services recover from the COVID-19 pandemic a movement towards day-case surgery may reduce waiting lists. However, evidence is needed to show that day-case surgery is safe for endoscopic sinus surgery (ESS). The aim of this study was to investigate the safety of day-case ESS in England. Design Secondary analysis of administrative data. Methods We extracted data from the Hospital Episodes Statistics database for the five years from 1st April 2014 to 31st March 2019. Patients undergoing elective ESS procedure aged ≥ 17 years were included. Exclusion criteria included malignant neoplasm, complex systemic disease and trans-sphenoidal pituitary surgery. The primary outcome was readmission within 30 days post-discharge. Multilevel, multivariable logistic regression modelling was used to compare outcomes for those operated on as day-cases and those with an overnight stay after adjusting for demographic, frailty, comorbidity and procedural covariates. Results Data were available for 49,223 patients operated on across 129 NHS hospital trusts. In trusts operating on more than 50 patients in the study period, rates of day-case surgery varied from 20.6% to 100%. Rates of day-case surgery increased from 64.0% in 2014/15 to 78.7 % in 2018/19. Day-case patients had lower rates of 30-day emergency readmission (odds ratio 0.71, 95% confidence interval 0.62 to 0.81). Outcomes for patients operated on in trusts with ≥80% day-case rates compared to patients operated on in trusts with <50% rates of day-case surgery were similar. Conclusions Our data support the view that ESS can safely be performed as day-case surgery in most cases, although it will not be suitable for all patients. There appears to be scope to increase rates of day-case ESS in some hospital trusts in England. View on Web

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Neck management of pathological N1 oral squamous cell carcinoma: a retrospective study

alexandrossfakianakis shared this article with you from Inoreader Neck management of pathological N1 oral squamous cell carcinoma: a retrospective study via International Journal of Oral and Maxillofacial Surgery via MedWorm.com This study was performed to compare the effects of neck dissection procedures on the prognosis of patients with pathological N1 (pN1) oral squamous cell carcinoma (OSCC), analyse factors affecting the prognosis, and provide a neck management strategy for clinical N1 (cN1) oral cancer. The study patients were divided into two groups according to the neck dissection: a selective neck dissection (SND) group (n  = 85) and a radical or modified radical neck dissection (RND/MRND) group (n = 22). There was no statistically significant difference in recurrence rates at local, regional, and distant sites between the SND and RND/MRND groups. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Central nervous system adverse events of ceftazidime/avibactam: A retrospective study using Food and Drug Administration Adverse Event Reporting System

alexandrossfakianakis shared this article with you from Inoreader Central nervous system adverse events of ceftazidime/avibactam: A retrospective study using Food and Drug Administration Adverse Event Reporting System via Journal of Clinical Pharmacy and Therapeutics In this commentary, we analyzed reports of nervous system disorders associated with ceftazidime/avibactam, meropenem, imipenem, ceftazidime, ceftriaxone, and cefepime in the FAERS database from 1 January 2015 to 31 March 2022. We found that ceftazidime/avibactam showed a relatively stronger sign central nervous system adverse events than meropenem, ceftazidime and ceftriaxone in real world. The poor clinical outcome of these events should attract clinical attention, especially for patients with older than 65 years old and long treatment courses. Abstract What is known and objective Many antibiotics are well known for being associated with adverse events (AEs) of central nervous system, ceftazidime/avibactam (CAZ/AVI) is a novel β-lactam/β-lactamase inhibitor combinations. In this commentary, we analyzed reports of nervous system disorders associated with CAZ/AVI, meropenem, imipenem, ceftazidime, ceftriaxone, and cefepime in the Food and Drug Administration (FDA) Adverse Event Reporting System database from January 2015 to March 2022. Comment The reporting odds ratios (RORs) method was used to detect the safety signals. Up to 15.62% of CAZ/AVI AEs exhibit nervous system disorders associated with CAZ/AVI. A nervous system disorder signal was detected for CAZ/AVI compared with meropenem, ceftazidime, and ceftriaxone. Compared with meropenem, imipenem, ceftazidime, and ceftriaxone, encephalopathy, myoclonus, reported with CAZ/AVI exhibited significant RORs. What is new and conclusion This study found that CAZ/AVI showed a relatively stronger sign nervous system disorder than meropenem, ceftazidime, and ceftriaxone in the real world. The poor clinical outcome of these events should attract clinical attention, especially for patients with older than 65 years old and long treatment courses. View on Web

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Abnormal TSH Prior to Surgery in Children with Graves' Disease Predicts Abnormal TSH Following Thyroidectomy

alexandrossfakianakis shared this article with you from Inoreader Abnormal TSH Prior to Surgery in Children with Graves' Disease Predicts Abnormal TSH Following Thyroidectomy via The Laryngoscope Objective To identify variables that are associated with poor compliance to thyroid hormone replacement therapy in children after total thyroidectomy. Method A retrospective cohort study of children who underwent total thyroidectomy by high-volume pediatric otolaryngologists between 1/2014 and 9/2021. Postoperative poor compliance was characterized by at least three separate measurements of high TSH levels not associated with radioactive iodine treatment. Results There were 100 patients, ages 3–20 years old who met inclusion criteria; 44 patients underwent thyroidectomy for cancer diagnosis, and 56 for Graves' disease. The mean follow-up time was 36.5 months (range 3.0–95.6 months). Overall, 42 patients (42%) were found to have at least three measurements of high TSH during follow-up, and 29 patients (29%) were diagnosed with clinical hypothyroidism. Sex, race, income, insurance type, and benign versus malignant etiology for thyroidectomy were not associated with adherence to therapy. Multivariate regression analysis identified patients with Graves' disease and hyperthyroidism at the time of surgery and Hispanic ethnicity to be associated with postoperative clinical hypothyroidism (OR 9.38, 95% CI 2.16–49.2, p = 0.004 and OR 6.15, 95% CI 1.21–36.0, p = 0.033, respectively). Conclusions Preoperative hyperthyroidism in patients with Graves' disease and Hispanic ethnicity were predictors of postoperative TSH abnormalities. Preoperative counseling for patients and their families on the implications of total thyroidectomy and the need for life-long medications postoperatively is necessary. Efforts should be made to evaluate and improve adherence to therapy pre-and postoperatively in patients with Graves' disease. Level of Evidence 4 Laryngoscope, 2022 View on Web

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