Neuroimaging for Patients With Dizziness

alexandrossfakianakis shared this article with you from Inoreader Neuroimaging for Patients With Dizziness Who Present to Outpatient Clinics vs EDs in the US Via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study uses commercial and Medicare Advant age claims to characterize neuroimaging use, timing, and spending as well as the factors associated with imaging acquisition within 6 months of presentation for dizziness in outpatient clinics vs emergency departments in the US. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth

alexandrossfakianakis shared this article with you from Inoreader Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth Via Epidemiology - Current Issue Background: Uterine fibroids often cause intolerable symptoms leading to invasive treatments, most commonly hysterectomy. Reproductive tract infections are hypothesized to influence uterine fibroid development, but few studies exist, especially for the highly prevalent condition bacterial vaginosis (BV). Both fibroids and BV have documented racial–ethnic disparities, with higher burden in Blacks. Methods: With prospective data from a community-based study (four standardized ultrasound examinations over 5 years) in young Black women, we examined baseline BV associations with fibroid incidence and growth. We computed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incidence comparing BV and no BV (Nugent score ≥7 vs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology

alexandrossfakianakis shared this article with you from Inoreader Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology Via Epidemiology - Current Issue Background: When new vaccine components or platforms are developed, they will typically need to demonstrate noninferiority or superiority over existing products, resulting in the assessment of relative vaccine effectiveness (rVE). This review aims to identify how rVE evaluation is being performed in studies of influenza to inform a more standardized approach. Methods: We conducted a systematic search on PubMed, Google Scholar, and Web of Science for studies reporting rVE comparing vaccine components, dose, or vaccination schedules. We screened titles, abstracts, full texts, and references to identify relevant articles. We extracted information on the study design, relative comparison made, and the definition and statistical approach used to estimate rVE in each study. Results: We identified 63 articles assessing rVE in influenza virus. Studies compared multiple vaccine components (n = 38), two or more doses of the same vaccine (n = 17), or vaccination timing or history (n = 9). One study compared a range of vaccine components and doses. Nearly two-thirds of all studies controlled for age, and nearly half for comorbidities, region, and sex. Assessment of 12 studies presenting both absolute and relative effect estimates suggested proportionality in the effects, resulting in implications for the interpretation of rVE effects. Conclusions: Approaches to rVE evaluation in practice is highly varied, with improvements in reporting required in many cases. Extensive consideration of methodologic issues relating to rVE is needed, including the stability of estimates and the impact of confounding structure on the validity of rVE estimates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis

alexandrossfakianakis shared this article with you from Inoreader Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis Via Transplant Infectious Disease Abstract Introduction Human herpes virus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with significant morbidity and mortality. Methods The epidemiology of HHV-6 infections and their impact on outcome after allo-HSCT were retrospectively analyzed in 689 adult allo-HSCT recipients (January 2015-December 2018). Chromosomal integration of HHV-6 (ciHHV-6) in the donor was retrospectively investigated to critically evaluate antiviral treatment strategies. Results HHV-6 DNA in any specimen was found in 89 patients. HHV-6 infections (encephalitis (1), gastroenteritis (44), dermatitis (2), hepatitis (1) or pneumonitis (5)) were diagnosed in 53/689 patients (7.7%). Elevated levels of HHV-6 DNA were found in 38 patients (5.5%). CiHHV-6, analyzed in patients with HHV-6 viral loads ≥104 copies/mL, was identified in 4 patients (10/38 patients; 10.5%). Two of those displayed copy numbers of HHV-6 ranging from ≥ 2 × 105 to 2.5 × 106 copies/mL (HHV-6A). Here, ciHHV-6 was integrated into donor and not into the patients' cells. In this series of allo-HSCT recipients, 10.5% of patients with blood viral loads of HHV-6 showed ciHHV-6. Conclusion Screening of the donor for chromosomal integration of HHV-6 (ciHHV-6) before initiation of antiviral therapy is recommended. This article is protected by copyright. All rights reserved View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial Via Clinical Implant Dentistry and Related Research Abstract Background The prosthetic emergence profile design might be an important factor in postsurgical mucosal recession etiology. Therefore, a restorative buccal emergence profile designed correctly might reduce gingival margin recession. Purpose To compare the marginal gingival level and the width/height (W/H) ratio between two profile configurations of single implant-supported restorations at molar sites. Materials and Methods Twenty-one patients requiring a single mandibular molar tooth replacement with supracrestal mucosal thickness ≥2 mm were recruited and randomly assigned to a prosthesis buccal emergence profile design based on the buccal mucosal W/H ratio (Test Group) or maintained the original emergence profile of the healing abutment (Control Group). Assessments were made before delivery of the definitive restoration (T0), at prosthesis placement (T1), one (T2), and 12 (T3) months after loading. The gingival margin level change (△GM), initial emergence angle, buccal mucosal W/H ratio, marginal bone loss (MBL), implant failure, and complications were assessed. Results The gingival recession in the test group (0.13 ± 0.32 mm) was significantly lower than in the control group (0.63 ± 0.38 mm) at T3 (p = 0.006). The initial emergence angle in the test group (31.4 ± 7.22 degrees) was significantly lower than the control group (40.0 ± 7.60 degrees) (p = 0.025). The W/H ratio in the test group at T2 was significantly higher than at T0 but remained stable thereafter. The W/H ratio presented a continued rising trend in the control group. Conclusions When the initial supracrestal soft tissue thickness was ≥2 mm, a restorative emergence profile based on the W/H ratio significantly reduced gingival margin recession. An emergence angle of 32.4 degrees showed better behavior in maintaining the gingival margin than 40 degrees. Clinical Trial Registration Number ChiCTR190002210. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome

alexandrossfakianakis shared this article with you from Inoreader The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome Via Journal of Oral Rehabilitation Summary Aim This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs. Methods This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase. Results Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs. Conclusion The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players

alexandrossfakianakis shared this article with you from Inoreader Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players Via Journal of Human Nutrition and Dietetics Abstract Objective This study aimed to examine the effects of spirulina supplementation on pro/antioxidant status, inflammation, and skeletal muscle damage markers immediately and 24h after exhaustive exercise in elite rugby players. Methods Seventeen elite male Rugby Union players were randomly assigned to a Spirulina (SPI: n=9), or a placebo group (PLA: n=8) in a double-blind design. Subjects were supplemented with Spirulina platensis (5.7 g/d) or placebo (isoproteic and caloric) for 7 weeks. At baseline (W0) and after seven weeks of supplementation (W7), blood samples were obtained before (T0), immediately after (T1), and 24h after (T2) exhaustive exercise. The Yoyo Intermittent Recovery Test Level 2 was used as an exhaustive exercise to induce oxidative stress (OS), inflammation, and skeletal muscle damage. The studied parameters included Pro/antioxidant status markers (SOD, GPX, GSH/GSSG ratio, ox-LDL, and F2-Isop), inflammation markers (MPO and CRP), and skeletal muscle damage markers (LDH and CK). Results Our results showed that F2-Isop, CRP, and CK levels significantly increased at T1 only in PLA group (p<0.05, p<0.05, and p<0.001 respectively) with no change in SPI group which reflects the effect of spirulina to prevent lipid peroxidation, inflammation, and skeletal muscle damage induced by exhaustive exercise. Moreover, spirulina supplementation accelerated the return to baseline values given that F2-Isop, CRP, and CK levels at T2 were significantly lower than at T0 in SPI group (p<0.05, p<0.01, and p<0.001 respectively). Conclusion Based on the markers used in this study, our results report that spirulina supplementation potentially prevents exercise-induced lipid peroxidation, inflammation, skeletal muscle damage and may accelerate the recovery of some of these markers. Based on our findings, we recommend spirulina supplementation especially for athletes who do not achieve the recommended antioxidant dietary intake and who perform a high training load in order to reduce the magnitude of OS, inflammation, and skeletal muscle damage which could help to reduce performance losses and accelerate recovery after training/competitions throughout the season. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Accurate fish-freshness prediction label based on red cabbage anthocyanins

alexandrossfakianakis shared this article with you from Inoreader Accurate fish-freshness prediction label based on red cabbage anthocyanins Via ScienceDirect Publication: Food Control Publication date: Available online 9 April 2022 Source: Food Control Author(s): Shuliang Fang, Zhihao Guan, Cheng Su, Wenshuo Zhang, Jian Zhu, Yuewei Zheng, Houbin Li, Pingping Zhao, Xinghai Liu View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngoscopic Findings of Age‐related Vocal Fold Atrophy are Reliable but not Specific

alexandrossfakianakis shared this article with you from Inoreader Laryngoscopic Findings of Age‐related Vocal Fold Atrophy are Reliable but not Specific Via Clinical Otolaryngology Abstract Objectives We aimed to evaluate the reliability of laryngoscopic features of vocal fold atrophy as assessed by novice otolaryngology trainees and expert laryngologists. Design Two expert fellowship-trained laryngologists and three non-expert otolaryngology resident trainees were recruited to view 50 anonymized laryngo-stroboscopic examinations of patients presenting with dysphonia and non-voice, laryngeal complaints. Reviewers were asked to stratify the patient's age, provide an opinion about the presence of age-related vocal fold atrophy, and specify which laryngoscopy features were present to make the diagnosis. Setting Tertiary care laryngology practice. Participants Two fellowship-trained laryngologists and three trainee otolaryngologists. Main outcome measures Accuracy of age categorization was determined and Kappa analysis was performed to assess inter-rater agreement. Results The mean age of patients was 54.9 years old with near equal male to female distribution. The overall accuracy of age category determination by raters was only 30.8%. Kappa analysis demonstrated fair agreement regarding the presence of vocal fold atrophy in non-expert reviewers, and moderate agreement amongst expert reviewers. Features of glottic gap, muscular atrophy of vocal folds, and prominent vocal processes were all identified with high agreement (>80.0%). Conclusion Our study illustrates that while raters can agree on the presence of age-related vocal fold atrophy, the findings may be non-specific and do not necessarily correlate with age. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tooth‐cusp preservation with lithium disilicate onlay restorations: A fatigue resistance study

alexandrossfakianakis shared this article with you from Inoreader Tooth‐cusp preservation with lithium disilicate onlay restorations: A fatigue resistance study Via Journal of Esthetic and Restorative Dentistry Abstract Objectives This study examined the in vitro fatigue resistance of maxillary premolars with 2 mm or 3 mm preserved cusp thicknesses restored with lithium disilicate onlays. Materials and Methods Premolars(N = 48) were divided into six groups. Onlays for groups 1 to 4 preserved a 3 mm functional (G1), 2 mm functional (G2), 3 mm nonfunctional (G3), or 2 mm nonfunctional (G4) buccal-lingual cusp width. Onlays for group 5 (G5, control) replaced both cusps. Group 6 (G6) samples were identical to G1 with added retentive boxes. Lithium disilicate onlays were exposed to thermocycling (10 000 cycles, 5°C-55°C, 30s/cycle) and mechanical loading (1.2 million cycles at 1.4 Hz and 70 N). All samples were examined for onlay debonding or cusp or onlay fracture. Results Failure rates were 75%(G1), 0.0%(G2), 12.5%(G3), 0.0%(G4), 0.0%(G5), and 0.0%(G6). The difference in percent failure between the groups preserving the functional cusps (37.5%) and the groups preserving the nonfunctional cusps (6.3%) was statistically significant (P = .04; 95%CI:2.11-55.66). No cusp or restoration fractures were observed; all failures were due to debonding of the restoration. Conclusion Teeth with thin remaining cusps that were restored with bonded lithium disilicate onlay restorations were not prone to fracture. Retentive preparation features that physically eliminated lateral displacement prevented onlay debonding even though the ceramic-enamel margin was directly at the occlusal contact. Clinical significance The use of adhesively retained lithium disilicate ceramic onlays may be a viable alternative to full coverage restorations and may challenge traditionally accepted principals related to preparation resistance and retention form of ceramic partial coverage restorations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Status of IDH mutations in chondrosarcoma of the jaws

alexandrossfakianakis shared this article with you from Inoreader Status of IDH mutations in chondrosarcoma of the jaws Via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim was to analyse the relationship between mutations of the isocitrate dehydrogenase gene (IDH) and clinical characteristics of chondrosarcoma of the jaw in order to provide new information on its molecular pathology. Tissue samples were collected from 25 patients diagnosed with chondrosarcoma of the jaw. IDH mutations were detected through polymerase chain reaction and direct sequencing. Clinicopathological data were analysed retrospectively. The study included 14 female and 11 male patients; the median patient age was 38 years. (Source: International Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High‐Dose Clopidogrel versus Ticagrelor in CYP2C19 intermediate or poor metabolizers after percutaneous coronary intervention: A Meta‐Analysis of Randomized Trials

alexandrossfakianakis shared this article with you from Inoreader High‐Dose Clopidogrel versus Ticagrelor in CYP2C19 intermediate or poor metabolizers after percutaneous coronary intervention: A Meta‐Analysis of Randomized Trials Via Journal of Clinical Pharmacy and Therapeutics For patients after percutaneous coronary interventions (PCI), clopidogrel combined with aspirin is a conventional dual antiplatelet therapy (DAPT) method. However, clopidogrel resistance exists in some populations, especially in East Asian populations, due to the CYP2C19 gene polymorphism. The current guidelines are very clear on DAPT method for CYP2C19 genotype of ultrarapid metabolizers (UM), extended metabolizers (EM) and poor metabolizer (PM) after PCI, but how to intermediate metabolizers (IM) choose drugs was not clear. This is the first systematic review to preferentially recommend ticagrelor for antiplatelet therapy over high-dose clopidogrel for patients carrying CYP2C19 LOF alleles after PCI with follow-up time of more than 3 months. Abstract What is known and objective For patients after percutaneous coronary interventions (PCI), clopidogrel combined with aspirin is a conventional dual antiplatelet therapy (DAPT) method. Because the genetic polymorphism of CYP2C19 gene leads to clopidogrel resistance, guidelines for antiplatelet recommendations in CYP2C19 of ultrarapid metabolizers (UM), extended metabolizers (EM) and poor metabolizers (PM) are clear. However, there is no clear recommendation as to whether ticagrelor or double dose clopidogrel is the best antiplatelet regimen for CYP2C19 of intermediate metabolizers (IM). To evaluate the efficacy and safety of ticagrelor (combined with aspirin) and high-dose clopidogrel (combined with aspirin) in patients after PCI with CYP2C19 loss-of-function (LOF) alleles. Methods We searched the following databases to select RCTs of comparing ticagrelor with high-dose clopidogrel in patients after PCI with CYP2C19 LOF alleles: CNKI, Wanfang Data, PubMed, Clinical trials, Cochrane, Web of Science and Embase. Major adverse cardiovascular events (MACEs), platelet function and TIMI bleeding event were defined as the outcomes. revman 5.3 software was used to perform meta-analysis. Results and discussion A total of 14 RCTs with 2351 patients were enrolled. Meta-analysis showed that compared with high-dose clopidogrel, ticagrelor had reduced incidence of MACEs (OR = 0.32, 95% Cl: 0.23–0.44, p < 0.00001), stent thrombosis (OR: 0.24, 95%CI: 0.13–0.44, p < 0.00001), myocardial infarction OR: 0.42, 95%CI: 0.22–0.80, p = 0.008), revascularization (OR: 0.29, 95%CI: 0.10–0.82, p = 0.02) and unstable angina (OR: 0.47, 95%CI: 0.29–0.77, p = 0.003) in patients after PCI with CYP2C19 LOF alleles. A subgroup analysis showed that ticagrelor reduced the risk of MACEs compared with high-dose clopidogrel regardless of the type of metabolizer. Compared with high-dose clopidogrel, ticagrelor significantly reduced the risk of MACE with longer follow-up period (more than 3 months) without increasing the risk of bleeding (OR: 0.89, 95%CI: 0.53–1.49, p = 0.30), while ele vated dyspnoea (OR: 5.62, 95%CI: 3.07–10.28, p < 0.00001). What is new and conclusions For patients carrying CYP2C19 LOF alleles after PCI, ticagrelor may be better than high-dose clopidogrel in reducing the risk of MACEs, while dyspnoea incidents should be alerted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.