Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review

xlomafota13 shared this article with you from Inoreader Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review Via Brazilian Oral Research Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions we re generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review

xlomafota13 shared this article with you from Inoreader Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review Via Brazilian Oral Research Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions we re generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of antihistamine-containing syrup on salivary metabolites: an in vitro and in vivo study

xlomafota13 shared this article with you from Inoreader Effect of antihistamine-containing syrup on salivary metabolites: an <em>in vitro</em> and <em>in vivo</em> study Via Brazilian Oral Research Abstract This study tested the null hypothesis that antihistamine-containing syrup does not change salivary metabolites in vitro and in vivo. For the in vitro experiments, saliva from 10 volunteers was mixed with a syrup or pill suspension of loratadine (1 mg/ml Claritin®, Schering-Plough, Rio de Janeiro, Brazil). For the in vivo experiment, 10 volunteers performed a mouth rinse with 10 mL of antihistamine syrup (Claritin®; Schering-Plough, Rio de Janeiro, Brazil) for 20 seconds and then discarded the rinse water. After 20 seconds, 5 mL of unstimulated whole saliva was spit into a plastic tube kept on ice. The protein profile of in vitro and in vivo experiments was analyzed using 12% sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The samples were also analyzed by nuclear magnetic resonance (NMR) spectroscopy, followed by Principal Component Analysis and Wilcoxon test (p < 0.05). There were differences in salivary metabolites after syrup interaction. The salivar y concentrations of acetate, n-caproate, arginine, glutamate, and lysine among other metabolites were reduced with the syrup in both in vivo and in vitro experiments (p < 0.05), but no differences were observed when the pill suspension was used (p > 0.05). Similar changes in metabolite profiles were observed in both in vitro and in vivo experiments. Electrophoresis revealed no difference in the salivary protein pattern. The null hypothesis was rejected because the intake of syrup medicine changes the salivary composition and influences oral homeostasis and susceptibility to oral diseases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents

xlomafota13 shared this article with you from Inoreader Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents Via Brazilian Oral Research Abstract The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had miss ing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97–3.32 and PR = 3.28; 95%CI: 1.61–6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03–1.67 and PR = 2.30; 95%CI: 1.18–4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics of Benign Paroxysmal Positional Vertigo Following an Earthquake

xlomafota13 shared this article with you from Inoreader Characteristics of Benign Paroxysmal Positional Vertigo Following an Earthquake Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 14:3489421996914. doi: 10.1177/0003489421996914. Online ahead of print. ABSTRACT INTRODUCTION: Benign Paroxysmal Positional Vertigo (BPPV) is a commonly encountered peripheral vestibular disorder. People exposed to massive earthquakes experience intense and long-term problem associated with dizziness. The purpose of our study is to investigate this relationship and to demonstrate the efficacy of the treatment modalities used in the managemen t of patients with post-earthquake dizziness. METHODOLOGY: The study was carried out by examining the retrospective records of patients who presented with dizziness to the otorhinolaryngological outpatient unit before and after the Elazig earthquake that occurred on 24th Jan 2020. Parameters evaluated include patients' age and gender, onset of dizziness, accompanying symptoms and comorbidities, videonystagmography (VNG) findings, pre- and post-treatment Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS). RESULTS: The number of patients who presented with dizziness to our outpatient clinic after the earthquake and were included in our study totaled 84. The number of patients who visited the outpatient clinic before the earthquake was identified to be 75. In the earthquake related group, while there was a statistically significant difference between residual symptoms (RS) and the need for repetitive repositioni ng maneuvers, there was no statistically significant difference detected for age, gender, and comorbidities. Also, no statistically significant difference was found in the pre- and post-treatment assessments of VAS, DHI, and HADS median values in the earthquake group. CONCLUSION: There was a remarkable increase in the number of patients presenting with dizziness in the early post-earthquake period. Management of these patients may differ from the classic BPPV. Residual symptoms appearing after performing repositioning maneuvers can be more commonly seen among these patients. PMID:33715462 | DOI:10.1177/0003489421996914 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Fiberoptic Endoscopic Evaluation of Swallowing Outcomes and Dysphagia Management in Neurodegenerative Diseases

xlomafota13 shared this article with you from Inoreader Impact of Fiberoptic Endoscopic Evaluation of Swallowing Outcomes and Dysphagia Management in Neurodegenerative Diseases Via The Laryngoscope Objectives/Hypothesis To determine the incidence of abnormal fiberoptic endoscopic evaluation of swallowing (FEES) findings in patients with progressive neurologic disorders and identify the most commonly implemented dysphagia management strategies. Study Design Retrospective Review. Methods A retrospective review was performed of patients with neurodegenerative disease who underwent FEES at a tertiary‐care center between 2008 and 2019. Patient demographics, diagnosis, and Eating Assessment Tool‐10 (EAT‐10) scores were recorded. Rates of penetration, aspiration, and functional change in management (FCIM) to include dietary modifications, home exercises, swallow therapy, surgical intervention (injection augmentation or esophageal dilation), or alternative means of nutrition (i.e., percutaneous enteral gastrostomy [PEG] tube) were calculated. Results Two hundred nine FEES assessments were performed in 178 patients with a mean age of 64.8 years (standard deviation = ±14). The most common diagnoses were amyotrophic lateral sclerosis (32%) followed by Parkinson's disease or Parkinsonism (26%). FEES demonstrated penetration in 72.5% of patients and aspiration in 14.6%. Mean EAT‐10 scores differed between patients with aspiration versus penetration versus normal FEES (24.7 vs. 14.9 vs. 13.9, respectively, P < .001). An FCIM was recommended in 88% of patients and most commonly included self‐directed modifications (43%). Overall, 4.5% of patients underwent surgical intervention. A PEG tube was recommended for either supplemental or sole form of nutrition in 19% of the entire cohort. Conclusions Most patients with neurodegenerative diseases presenting with dysphagia demonstrated abnormal FEES findings necessitating an FCIM, suggesting early dysphagia evaluation may be warranted in this cohort. These findings correlate with worsened EAT‐10 scores in patients with aspiration or penetration on FEES. Level of Evidence 4 Laryngoscope, 131:726–730, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

xlomafota13 shared this article with you from Inoreader Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members Via The Laryngoscope Objectives/Hypothesis To investigate the definition of a clear margin and the use of frozen section (FS) among practicing head and neck surgeons in oral cancer management. Study Design Cross‐sectional survey. Methods We designed a survey that was sent to American Head and Neck Society (AHNS) members via an email link. Results A total of 185 (13% of 1,392) AHNS members completed our survey. Most surgeons surveyed (96.8%) use FS to supplement oral cavity squamous cell carcinoma resections. Fifty‐five percent prefer a specimen‐based approach. The majority of respondents believe FS is efficacious in guiding re‐resection of positive margins, with 81% considering the new margin to be negative. More than half of respondents defined a distance of >5 mm on microscopic examination as a negative margin. Conclusions To avoid oral cancer resections that result in positive margins on final analysis, and thus the need for additional therapy, most surgeons surveyed use FS. A majority of surveyed surgeons now prefer a specimen‐based approach to margin assessment. Although there is a debate on what constitutes a negative margin, most surgeons surveyed believe it to be >5 mm on microscopic examination. Level of Evidence 4 Laryngoscope, 131:782–787, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emotional and Personality Traits are Determinants of Activity Avoidance in Chronic Rhinosinusitis Patients

xlomafota13 shared this article with you from Inoreader Emotional and Personality Traits are Determinants of Activity Avoidance in Chronic Rhinosinusitis Patients Via The Laryngoscope Objectives Chronic rhinosinusitis (CRS), like other sinonasal diseases, may be associated with avoidance of daily activities. Our goal was to identify characteristics associated with avoidance of activities due to CRS. Materials and Methods A total of 194 CRS patients were recruited. CRS symptom burden was assessed with the 22‐item Sinonasal Outcome Test (SNOT‐22). SNOT‐22 nasal, sleep, ear/facial discomfort and emotional/psychological subdomain scores were calculated. Depressed mood was assessed using the two‐item Patient Health Questionnaire (PHQ‐2). Personality traits including conscientiousness, neuroticism, agreeableness, openness, and extraversion were assessed using the Big Five Inventory‐10 (BFI‐10) questionnaire. As the primary outcome, participants rated how often in the prior week that they had avoided any activities in day‐to‐day life due to their nasal or sinus symptoms on a scale of "never," "rarely," "sometimes," "often," or "extremely often." Ordinal regression models, with bootstrap validation, were used to identify associations between activity avoidance and participants' characteristics. Results On multivariable analysis, SNOT‐22 score (odds ratio [OR] = 1.03, 95% CI, 1.01–1.04, P = .026), and conscientiousness personality trait (OR = 1.38, 95% CI, 1.05–1.81, P = .019) were positively associated with activity avoidance while age (OR = 0.98, 95% CI, 0.96–0.99, P = .049) was negatively associated with activity avoidance. Of CRS symptom burden/SNOT‐22 subdomains, only the emotional/psychological subdomain score (OR = 1.28, 95% CI, 1.12–1.46, P < .001) was associated with activity avoidance. Conclusion Younger age and the conscientiousness personality trait were associated with activity avoidance in CRS patients. Of CRS‐associated symptomatology, sadness and embarrassment were associated with activity avoidance. Emotional traits and personality most strongly predict avoidance of activities in CRS patients. Level of Evidence 2c. Laryngoscope, 131:707–712, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Disruption of Sinonasal Epithelial Nrf2 Enhances Susceptibility to Rhinosinusitis in a Mouse Model

xlomafota13 shared this article with you from Inoreader Disruption of Sinonasal Epithelial Nrf2 Enhances Susceptibility to Rhinosinusitis in a Mouse Model Via The Laryngoscope Objectives/Hypothesis Oxidative stress has been postulated to play an important role in chronic rhinosinusitis. Nrf2 is a transcription factor that is involved in the regulation of multiple antioxidant genes, and its function has been previously shown to be important in sinonasal inflammation. Although the sinonasal implications of whole body Nrf2 −/− has been reported, the function of sinonasal epithelial expression of Nrf2 has not been studied. The primary aim of this study was to generate a mouse model that is genetically deficient in epithelial‐specific Nrf2 and to understand its role in regulating sinonasal inflammation. Study Design Basic science. Methods An epithelial‐specific Nrf2 knockout mouse was generated by crossing Krt5‐cre(K5) with Nrf2flox/flox . A papain‐induced model of rhinosinusitis was performed in the resulting K5 Nrf2−/− mouse. Immunohistochemistry was performed to quantify goblet cell hyperplasia. Mucosal cellular infiltrates were quantified using flow cytometry, and tissue cytokines were measured using an enzyme‐linked immunosorbent assay. Lastly, the cellular source of type 2 cytokines was determined using intracellular cytokine staining. Results Papain‐sensitized mice lacking epithelial‐specific Nrf2 demonstrate increased goblet cell hyperplasia, significant tissue eosinophilia, and statistically significant increase in mucosal IL‐13 when compared to Nrf2 wild‐type mice. Lastly, mucosal T cells were identified as the cellular source of IL‐13. Conclusions We demonstrate enhanced severity of eosinophilic sinonasal inflammation from disruption of the epithelial‐specific Nrf2 pathway. The responsiveness of Nrf2‐directed antioxidant pathways may act as a major determinant of susceptibility to eosinophilic inflammation and may have potential as a therapeutic target for chronic rhinosinusitis. Level of Evidence NA Laryngoscope, 131:713–719, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Recumbent Position Affects Nasal Resistance: A Systematic Review and Meta‐Analysis

xlomafota13 shared this article with you from Inoreader The Recumbent Position Affects Nasal Resistance: A Systematic Review and Meta‐Analysis Via The Laryngoscope Objective Nasal diseases are among the main motives for the early discontinuation of continuous positive airway pressure therapy and for long‐term therapeutic compliance with mandibular advancement device. Although our clinical experience leads us to the belief that recumbency impacts nasal airflow in some patient populations, there is no consensus regarding the magnitude of this effect and the specific group of patients who are the most affected by this condition. In this study, we conducted a meta‐analysis to assess the effect of the recumbent position on nasal resistance and nasal airflow. Review Methods PubMed (Medline), Cochrane Library, EMBASE, Scopus, and SciELO databases were checked for relevant studies by two members of the YO‐IFOS study group. The two authors extracted the data. The main outcome was expressed as the difference between nasal resistance and nasal airflow before and after recumbency. Results Nine studies with a total population of 291 individuals were included in the meta‐analysis for nasal resistance after recumbency. We found a statistically significant difference in nasal airway resistance of −0.18 Pa sec/cm3 as compared to before and after recumbency through rhinomanometry (RMM) analysis. A subgroup analysis revealed a variation of −0.20 Pa sec/cm3 for patients with snoring or sleep apnea and − 0.10 Pa sec/cm3 for healthy individuals. Regarding nasal airflow measured with RMM, three studies (n = 32) in asymptomatic controls revealed a statistically significant difference of 47.33 ml/sec. Conclusions Recumbency increases nasal resistance and diminishes nasal airflow. This finding is of utmost importance in snorers and sleep apnea patients. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How Enhancing Immunity to Low‐Risk HPV Could Cure Recurrent Respiratory Papillomatosis

xlomafota13 shared this article with you from Inoreader How Enhancing Immunity to Low‐Risk HPV Could Cure Recurrent Respiratory Papillomatosis Via The Laryngoscope Recurrent respiratory papillomatosis (RRP) is currently treated with repeat surgical resection of papillomatous disease that does not address the fundamental underlying issue of chronic infection with low‐risk human papillomavirus. Here, we review the biology and immunology of low‐risk human papillomavirus (HPV) infections. Antiviral or antiangiogenic adjuvant treatments similarly address the papillomatous disease itself but do not activate HPV immunity. It is likely that only through immune‐mediated clearance of low‐risk HPV infection can patients with RRP be cured. In some patients, this occurs spontaneously. In others with more aggressive disease, adjuvant immunotherapy to activate immunity may be needed. Based on current understanding of antiviral immune responses, the only rational strategy to clear HPV‐infected epithelial cells is through activation of the T‐lymphocyte arm of the adaptive immune response. Translation of immunotherapies that are Food and Drug Administration‐approved or under clinical study for cancer, such as immune checkpoint blockade or engineered therapeutic vaccines, may provide a path toward tolerable and efficacious adjuvant immunotherapy for RRP. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.