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International Journal of Surgery Case... Jun 2024Oblique facial clefts are uncommon congenital facial deformities. Among them, Tessier No. 3 cleft is an even rare malformation. This study presents a reconstructive...
INTRODUCTION AND IMPORTANCE
Oblique facial clefts are uncommon congenital facial deformities. Among them, Tessier No. 3 cleft is an even rare malformation. This study presents a reconstructive option and curative effect for oblique facial cleft deformity of Tessier No. 3.
CASE PRESENTATION
A 10-year-old girl was admitted to our hospital with "congenital facial deformity of right nose and mid-face". The clinical diagnosis was "oblique facial cleft of Tessier classification No. 3", also known as "naso-orbital cleft". The cleft was surgically repaired with an adjacent flap and nasolabial flap. After surgery, the case underwent uneventful healing with a surviving flap, and the deformity was well repaired. At 3 months to 1 year of follow-up, the flap had a similar feature (color and texture) to the contralateral tissue. A good outcome was obtained with minimal scar and face deformity.
CLINICAL DISCUSSION
Facial cleft is a clinical type of craniofacial cleft. The soft tissue feature of Tessier No. 3 cleft is that the fissure is located in the joint part of the middle nose, lateral nose, and maxillary process. The operation adopts the method of closing the fissure with soft tissue flap and pedicled flap transplantation is a priority method. In this clinical case, the patient with oblique facial cleft of Tessier classification No. 3 was repaired by the adjacent flap and nasolabial flap.
CONCLUSION
The application of the adjacent flap and nasolabial flap is a viable option for the reconstruction of oblique facial cleft deformity of Tessier No. 3 in oral surgery.
PubMed: 38945016
DOI: 10.1016/j.ijscr.2024.109981 -
Journal of Gastrointestinal and Liver... Jun 2024Mammoplasty, a common cosmetic procedure involving breast augmentation and reduction surgeries, has gained global popularity. Recently, attention has shifted towards...
BACKGROUND AND AIMS
Mammoplasty, a common cosmetic procedure involving breast augmentation and reduction surgeries, has gained global popularity. Recently, attention has shifted towards understanding the prevalence and significance of gastrointestinal (GI) symptoms following mammoplasty. This systematic review aims to consolidate existing literature to provide a comprehensive overview of the type and frequency of GI problems associated with various mammoplasty procedures.
METHODS
A systematic search of PubMed and Scopus databases was conducted until January 22, 2024, identifying observational and interventional studies examining GI symptoms post-mammoplasty. Inclusion criteria covered human studies, while exclusion criteria ensured specificity. Two independent investigators performed screening, and data extraction included study characteristics, surgical procedures, anesthesia methods, and interventions.
RESULTS
Nineteen studies, involving 2,487 subjects, were included in the review. Breast reconstruction emerged as the most studied procedure, followed by breast reduction, augmentation, mastectomy, and breast cancer surgery. Predominant GI symptoms included nausea and vomiting, with varying rates across mammoplasty types. Anesthesia modality influenced symptomatology, with general, local, and combined anesthesia associated with GI disturbances. Antiemetics, notably ondansetron and droperidol, showed variable efficacy. Non-pharmacological approaches, such as preoperative hypnosis, were explored for symptom management.
CONCLUSIONS
Our systematic review reveals insights into GI symptoms post-mammoplasty, emphasizing the common occurrence of symptoms such as nausea and vomiting, alongside less frequent manifestations such as constipation, dry mouth, retching, abdominal pain, and tightness. Variations in symptom prevalence were noted across diverse mammoplasty surgeries, anesthesia methods, and the use of antiemetics, underscoring the complex nature of post-mammoplasty GI disturbances.
Topics: Humans; Mammaplasty; Female; Postoperative Nausea and Vomiting; Gastrointestinal Diseases; Adult; Prevalence
PubMed: 38944853
DOI: 10.15403/jgld-5598 -
Journal of Gastrointestinal and Liver... Jun 2024Colonoscopy has a vital role in the diagnosis of inflammatory bowel disease (IBD), as well as in the estimation of disease severity, monitoring response to therapy, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
Colonoscopy has a vital role in the diagnosis of inflammatory bowel disease (IBD), as well as in the estimation of disease severity, monitoring response to therapy, and surveillance for neoplasia. We performed a systematic review of randomised trials of various bowel preparations for colonoscopy in IBD.
METHODS
We searched various electronic databases (PubMed, Embase, and CENTRAL) for studies reporting about the use of various strategies to improve colonoscopy preparation in IBD. We included only randomized clinical trials (RCTs). A network meta-analysis was done using a frequentist approach to compare the effectiveness of various bowel preparations. The risk of bias was assessed using Cochrane risk of bias tool 2.0. Other outcome parameters like compliance, tolerance, acceptance, and adverse effects were assessed qualitatively.
RESULTS
Seven RCTs reporting about 960 patients were included. On comparison with 4 liter (L) of poliethylen glycol (PEG), oral sulfate solution (OR=1.1, 95%CI: 0.65-1.86); PEG2L/Ascorbate (OR=0.98, 95%CI: 0.65-1.48); PEG1L (OR=1, 95%CI: 0.55-1.81); PEG2L plus bisacodyl (OR=1.08, 95%CI: 0.71-1.65); PEG4L plus simethicone (OR=1, 95%CI: 0.67-1.50); PEG/ sodium picosulfate and magnesium citrate (SPMC) 1.5L (OR=0.99, 95%CI: 0.55-1.78); SPMC 2L (OR=1.09, 95%CI: 0.61-1.97) had similar effectiveness. Three RCTs reported compliance, five RCTs reported tolerance, two studies reported patient acceptance and five RCTs reported data on the willingness of patients to repeat the procedure in the future. Low-volume preparations had better compliance, tolerance, acceptance, and willingness to repeat. No difference in additional outcomes like change in disease activity after colonoscopy, procedure-related outcomes after colonoscopy like cecal intubation rate, and change in electrolyte levels were found.
CONCLUSION
Various bowel preparations had similar effectiveness in respect to colonoscopy preparation in IBD patients. Low-volume preparations have better compliance, tolerance, and acceptance. The systematic review was limited by a small number of included RCTs.
Topics: Humans; Colonoscopy; Randomized Controlled Trials as Topic; Cathartics; Inflammatory Bowel Diseases; Network Meta-Analysis
PubMed: 38944852
DOI: 10.15403/jgld-5433 -
Journal of Veterinary Internal Medicine Jun 2024Grapiprant is a novel anti-inflammatory drug approved for the treatment of pain associated with osteoarthritis in dogs.
BACKGROUND
Grapiprant is a novel anti-inflammatory drug approved for the treatment of pain associated with osteoarthritis in dogs.
OBJECTIVE
Compare the efficacy of grapiprant vs meloxicam for the management of postoperative joint pain in dogs.
ANIMALS
Forty-eight dogs presented with cranial cruciate ligament disease and treated by tibial plateau leveling osteotomy (TPLO) between May 2020 and May 2022.
METHODS
In this randomized, double blinded, prospective clinical trial, client-owned dogs with naturally occurring unilateral cruciate ligament rupture were enrolled on the day of surgery. The day after surgery, all animals received a subcutaneous injection of 0.2 mg/kg of meloxicam and were randomly assigned to receive either oral grapiprant (2 mg/kg) or meloxicam (0.1 mg/kg), once a day for 14 days, in a blinded manner. The primary endpoint of the study was the pain severity (PSS) and interference (PIS) scores, assessed by the Canine Brief Pain Inventory (CBPI) at day 3, 7, 10 and 15 after the surgery.
RESULTS
Three days after surgery, grapiprant treated dogs had lower PSS compared to meloxicam treated dogs with a mean ± SD of 2.76 ± 0.18 vs 3.25 ± 0.23, respectively (difference of -0.49 [95% CI -0.94 to -0.04], P = .032). Pain Interference Score was also lower in grapiprant group at day 3 (4.11 ± 0.18 vs 4.69 ± 0.16 in meloxicam group [difference of -0.58 {95% CI -1.03 to -0.13}, P = .013]) and at day 10 (2.23 ± 0.13 vs 2.72 ± 0.28 [difference of -0.49 {95% CI -0.92 to -0.01}, P = .049]).
CONCLUSIONS AND CLINICAL IMPORTANCE
Our study supports the use of grapiprant as an alternative analgesic to meloxicam for management of postoperative joint pain in dogs.
PubMed: 38944675
DOI: 10.1111/jvim.17136 -
Journal of Extracellular Vesicles Jul 2024Extracellular vesicles (EVs) play a crucial role in triggering tumour-aggressive behaviours. However, the energetic process by which tumour cells produce EVs remains...
Extracellular vesicles (EVs) play a crucial role in triggering tumour-aggressive behaviours. However, the energetic process by which tumour cells produce EVs remains poorly understood. Here, we demonstrate the involvement of β-hexosaminidase B (HEXB) in mediating EV release in response to oxidative stress, thereby promoting the development of hepatocellular carcinoma (HCC). Mechanistically, reactive oxygen species (ROS) stimulate the nuclear translocation of transcription factor EB (TFEB), leading to the upregulation of both HEXB and its antisense lncRNA HEXB-AS. HEXB-AS can bind HEXB to form a protein/RNA complex, which elevates the protein stability of HEXB. The stabilized HEXB interacts with lysosome-associated membrane glycoprotein 1 (LAMP1), disrupting lysosome-multivesicular body (MVB) fusion, which protects EVs from degradation. Knockdown of HEXB efficiently inhibits EV release and curbs HCC growth both in vitro and in vivo. Moreover, targeting HEXB by M-31850 significantly inhibits HCC growth, especially when combined with GW4869, an inhibitor of exosome release. Our results underscore the critical role of HEXB as a modulator that promotes EV release during HCC development.
Topics: Extracellular Vesicles; Carcinoma, Hepatocellular; Animals; Oxidative Stress; Humans; Liver Neoplasms; Mice; Up-Regulation; Cell Line, Tumor; Cell Proliferation; RNA, Long Noncoding; Reactive Oxygen Species; Gene Expression Regulation, Neoplastic; Male; Mice, Nude
PubMed: 38944674
DOI: 10.1002/jev2.12468 -
Surgery Jun 2024Multimodal therapy regimens became the standard of care for patients with esophageal cancer, whereas surgical resection remains at the center of curative treatment...
BACKGROUND
Multimodal therapy regimens became the standard of care for patients with esophageal cancer, whereas surgical resection remains at the center of curative treatment modalities. Current guidelines provide no recommendations on the extent of the oral resection margin, especially in the era of neoadjuvant therapy. Therefore, this study aimed to evaluate the relationship between the oral tumor-free resection margin and overall survival.
METHODS
Retrospective study with 382 1:1 propensity-matched patients out of 660 patients, operated between 2013 and 2019, with an Ivor-Lewis-esophagectomy for adenocarcinoma and squamous cell carcinoma of the esophagus or esophagogastric junction after neoadjuvant therapy. Independent pathologists measured the oral resection margin after formalin fixation.
RESULTS
The mean oral tumor-free resection margin was 37.2 ± 0.6 mm. The ideal cut-off for survival differences was determined for 33 mm. Patients with an oral resection margin of more than 33 mm had a better median overall survival (≤33 mm: 45.0 months, 95% confidence interval: 22.4-67.6 months, >33 mm: not reached, P = .005). An oral resection margin of more than 33 mm proved to be an independent favorable prognostic factor for patients' overall survival in multivariate Cox regression analyses (P = .049).
CONCLUSION
This study analyzed a patient cohort retrospectively after curative intended Ivor-Lewis-esophagectomy after neoadjuvant therapy. An oral resection margin of more than 33 mm is a factor for improved overall survival. Therefore, a minimum resection margin of 34 mm after fixation could be suggested.
PubMed: 38944588
DOI: 10.1016/j.surg.2024.04.037 -
Photodiagnosis and Photodynamic Therapy Jun 2024Photobiomodulation therapy (PBMT) has been employed for the prevention and treatment of oral mucositis in patients with head and neck cancer undergoing treatment....
BACKGROUND
Photobiomodulation therapy (PBMT) has been employed for the prevention and treatment of oral mucositis in patients with head and neck cancer undergoing treatment. However, information about the survival of patients receiving PBMT is still lacking. Therefore, the aim of this study was to correlate the survival of patients who either received or did not receive PBMT, combined with cancer treatments, and to assess whether the number of PBMT sessions had a positive impact on survival.
METHODS
The records of 751 patients seen at Hospital de Caridade São Vicente de Paulo diagnosed with head and neck cancer, treated by D.L.P., the sole operator of PBMT, between 2000 and 2016, were analyzed. The median survival rates were compared by analyzing diagnostic staging, the combination of cancer treatments, and the number of PBMT sessions. Correlation analyses were performed to assess the interactions between the number of PBMT sessions and survival.
RESULTS
PBMT increased survival by 55.14%, from 1.07 (Without PBMT) to 1.66 years (With PBMT) for the total population and more significantly in Group 41 (stages III and IV, radiation therapy/chemotherapy, with more than five PBMT sessions), the median survival value of 1.83 years, which represents a 66.36% higher survival rate. In all the analyzed populations, the larger number of sessions was associated with better survival. In terms of survival, advanced stages III and IV almost equated with stages I and II in the absence of PBMT.
CONCLUSIONS
PBMT seems to interfere with the survival of patients with head and neck cancer, corroborating its recommendation for the treatment of mucositis, but further research is needed to investigate possible synergistic effects between PBMT and cancer treatments.
PubMed: 38944404
DOI: 10.1016/j.pdpdt.2024.104248 -
Photodiagnosis and Photodynamic Therapy Jun 2024Photodynamic therapy is garnering increasing attention in oral science. Despite its promising potential, further exploration is warranted to delve into the research...
BACKGROUND
Photodynamic therapy is garnering increasing attention in oral science. Despite its promising potential, further exploration is warranted to delve into the research paradigms and evolving trends within oral science. Therefore, this study aimed to conduct a comprehensive bibliometric analysis of photodynamic therapy in oral science (PDTOS), investigating research landscapes, identifying key contributors, analyzing collaborative networks, pinpointing emerging research directions, and exploring factors influencing high citations.
METHODS
Research and review articles in PDTOS were retrieved from the Web of Science Core Collection database up to December 31, 2023. The R package "bibliometrix" and VOSviewer were utilized for visualizing collaboration networks and keyword co-occurrence, alongside trend analysis. Negative binomial regression was used to model factors affecting citation counts.
RESULTS
A total of 2784 articles with significant international collaboration (23.14%) were analyzed. Brazil, China, the USA, Iran, and Italy led in publications, with predominant USA-European collaborations. The University of Sao Paulo in Brazil was the most published institution in the field. Photodiagnosis and Photodynamic Therapy was the core journal in the field and has the highest number of publications. The main research fields included photodynamic therapy, antibacterial and anticancer treatment, management, and peri-implant periodontitis, with a recent focus on peri-implantitis. Factors such as international cooperation, funding, article age, type, author count, and references significantly influenced citations.
CONCLUSIONS
This research provided valuable insights into PDTOS trends and knowledge structures. These findings underscored a significant increase in the number of PDTOS publications, urging strengthened international cooperation. Emerging research has focused on peri-implantitis and nano-photosensitizer materials. Authors should consider various citation-related factors in their research endeavors.
PubMed: 38944403
DOI: 10.1016/j.pdpdt.2024.104261 -
Journal of Dentistry Jun 2024To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by...
OBJECTIVE
To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction.
METHODS
A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models.
RESULTS
Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284).
CONCLUSION
This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults.
CLINICAL SIGNIFICANCE
Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.
PubMed: 38944265
DOI: 10.1016/j.jdent.2024.105215 -
Clinical Medicine (London, England) Jun 2024We aimed to assess the appropriateness of penicillin allergy (PenA) assessment conducted by clinical teams and to review the safety of subsequent exposure of these...
OBJECTIVES
We aimed to assess the appropriateness of penicillin allergy (PenA) assessment conducted by clinical teams and to review the safety of subsequent exposure of these patients to penicillin.
METHODS
Opportunistic, prospective observational study of usual clinical care, between 16/05/23 and 14/08/23, of inpatients with a PenA and requiring antibiotics, in a 750-bed hospital in England. To assess the appropriateness of management, PenA patients prescribed penicillins were grouped into risk categories using a validated antibiotic allergy assessment tool: eligible for de-label on history alone (direct de-label; DDL), eligible for direct oral challenge (DOC), high risk or unable to obtain history.
RESULTS
Of the 123 patients admitted with a PenA (or sensitivity record) and exposed to a penicillin, data were collected for 50. Their PenA records were grouped follows: eligible for DDL 34 (68%), eligible for DOC 11 (22%), high risk 4 (8%) and unable to obtain history 1 (2%). In 14/50 (28%) patients there was no evidence of a current PenA assessment in the medical notes.
CONCLUSIONS
Using the allergy risk tool, most patients with penA records were exposed to penicillin appropriately. However, patients meeting high risk criteria were also exposed to penicillin when the tool excluded them. PenA assessment needs to be carried out with appropriate training and governance structures in place.
PubMed: 38944245
DOI: 10.1016/j.clinme.2024.100225