Δευτέρα 23 Μαΐου 2022

Ergebnisse und Lebensqualität nach individueller computer-gestützter Rekonstruktion des MittelgesichtesOutcome and Quality of Life after Individual Computer-AssistedReconstruction of the Midface

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Laryngorhinootologie 2022; 101: S90-S102
DOI: 10.1055/a-1669-6154

Defekte im Bereich des Mittelgesichtes sind oftmals nicht nur von funktioneller Bedeutung, auch die ästhetische Komponente solcher angeborenen oder erworbenen Deformitäten beeinträchtigen maßgeblich die Lebensqualität der Patienten. So bedingen Rekonstruktionen des Mittelgesichtes nicht nur lediglich verlorengegangenes oder nicht angelegtes Gewebe zu ersetzen, sondern vielmehr vorhersagbare Ergebnisse sowohl hinsichtlich Ästhtetik als auch Funktion für den individuellen Patienten zu erzielen. Digitale Planungsmöglichkeiten unter Einbeziehung von unterschiedlichen Oberflächen- und Volumendaten in Kombination mit modernen additiven Fertigungstechniken zur Biomodell- und Implantat-Herstellung sowie intraoperativer Unterstützung durch Nutzung realer und virtueller 3D-Volumendaten bei Navigation und intraoperativer Bildgebung aber auch Ergebnissicherung durch postoperative Analyse haben heute in die moderne Mittelgesichtsrekonstruktion Einzug gehalten und setzen neue Standards für die medizinische Versorgung. Ziel dieses Referates ist es im Folgenden die modernen Möglichkeiten der patienten-spezifischen Mittelgesichtsrekonstruktion unter Einbeziehung computer-assistierer Planungs- und Fertigungstechniken darzustellen.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Understanding Variation in Rotavirus Vaccine Effectiveness Estimates

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Background: Estimates of rotavirus vaccine effectiveness (VE) in the U.S. appear higher in years with more rotavirus activity. We hypothesized rotavirus VE is constant over time but appears to vary as a function of temporal variation in local rotavirus cases and/or misclassified diagnoses. Methods: We analyzed 6 years of data from eight U.S. surveillance sites on 8-59-month olds with acute gastroenteritis symptoms. Children's stool samples were tested via enzyme immunoassay (EIA); rotavirus-positive results were confirmed with molecular testing at the US Centers for Disease Control and Prevention (CDC). We defined rotavirus gastroenteritis cases by either positive on-site EIA results alone or positive EIA with CDC confirmation. For each case definition, we estimated VE against any rotavirus gastroenteritis, moderate-to-severe disease, and hospitalization using two mixed-effect regression models: the first including year plus a year–vaccination interaction, and the second including annual percent of rotavirus positive tests plus a percent positive–vaccination interaction. We used multiple overimputation to bias-adjust for misclassification of cases defined by positive EIA alone. Results: Estimates of annual rotavirus VE against all outcomes fluctuated temporally, particularly when we defined cases by on-site EIA alone and used a year–vaccination interaction. Use of confirmatory testing to define cases reduced, but did not eliminate, fluctuations. Temporal fluctuations in VE estimates further attenuated when we used a percent positive–vaccination interaction. Fluctuations persisted until bias-adjustment for diagnostic misclassification. Conclusions: Both controlling for time-varying rotavirus activity and bias-adjusting for diagnostic misclassification are critical for estimating the most valid annual rotavirus VE. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Latent class models of early-life trauma and incident breast cancer

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Background: Psychosocial trauma has been hypothesized to influence breast cancer risk, but little is known about how co-occurring traumas—particularly during early life—may impact incidence. We examine the relationship between multiple measures of early-life trauma and incident breast cancer. Methods: The Sister Study is a prospective cohort study of U.S. women (N=50,884; enrollment 2003-2009; ages 35-74). Of 45,961 eligible participants, 3,070 developed invasive breast cancer or ductal carcinoma in situ through 2017. We assessed trauma before age 18 using previously studied measures (cumulative score, individual trauma type, and substantive domain) and a six-class latent variable to evaluate co-occurring traumas. We accounted for missing data using multiple imputation and estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models. Results: Approximately 49% of participants reported early-life trauma. Using the latent class variable approach, breast cancer hazard was higher among participants who had sexual trauma or household dysfunction (HR=1.1; CI:0.93, 1.3), or moderate (HR=1.2; CI:0.99, 1.4) but not high trauma (HR=0.66; CI:0.44, 0.99) compared to low trauma. Breast cancer HRs associated with sexual early-life trauma or household dysfunction were elevated for pre- and post-menopausal breast cancer and by estrogen receptor status. We found no effect modification by race–ethnicity. Estimated effects were attenuated with report of constant childhood social support. Conclusions: Breast cancer incidence varied by latent patterns of co-occurring early-life trauma. Models capturing childhood social support and trauma patterning, rather than cumulative or discrete indicators, may be more meaningful in breast cancer risk assessment. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Comparison between the radial forearm and groin soft tissue free flaps for reconstruction in patients with oral cavity cancer: a quality of life analysis

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The purpose of this study was to compare the effects of the radial forearm free flap (RFFF) and groin soft tissue free flap (GSFF) on the quality of life (QoL) of patients undergoing reconstructive surgery after resection for oral cancer. A retrospective analysis of 48 patients was performed. The Vancouver Scar Scale (VSS), University of Washington Quality of Life (UW-QOL) questionnaire, and 14-item Oral Health Impact Profile (OHIP-14) questionnaire were used to evaluate the donor site scars and QoL of the patients. (Source: International Journal of Oral and Maxillofacial Surgery)
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Promoter hypermethylation of GALR1 acts as an early epigenetic susceptibility event in colorectal carcinogenesis

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