Πέμπτη 15 Δεκεμβρίου 2022

Recommendation for imaging follow‐up strategy based on time‐specific disease failure for nasopharyngeal carcinoma

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Abstract

Background

To develop a common follow-up strategy for appropriate imaging examination at an appropriate time for nasopharyngeal carcinoma (NPC).

Methods

Independent prognostic factors were identified by Cox regression analysis, and a nomogram model was developed. Random survival forest (RSF) model was constructed to depict probability of disease failure during a 5-year follow-up and establish a reasonable risk-based follow-up strategy.

Results

The nomogram model finally categorized the patients into three risk groups. RSF model demonstrated distribution trends for local and regional recurrences, bone metastasis, liver metastasis, and lung metastasis of NPC. Adequate imaging at follow-up should be considered between 10 and 21 months for patients at moderate-risk of recurrence or metastasis and 7–36 months for those at high-risk.

Conclusions

The temporal distribution of incidence rates of recurrence or metastasis varied among different risk groups. We recommend implementing a focused and targeted imaging surveillance intervention at appropriate times to improve its efficiency and reduce costs.

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Acute‐phase response following one‐stage full‐mouth versus quadrant non‐surgical periodontal treatment in subjects with comorbid type 2 diabetes: A randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

To compare the level of inflammatory markers and endothelial function 24 hours (Day1) and 90 days (Day90) after conventional quadrant-wise (Q-SRP) versus one-stage full-mouth scaling (FM-SRP) in patients affected by type 2 diabetes mellitus (T2DM).

Methods

Patients affected by periodontitis and T2DM were randomly allocated to receive FM-SRP or Q-SRP and followed up at Day1 and Day90. Serum samples, vital signs and flow-mediated dilation (FMD) parameters were collected at baseline, Day1 and Day90. Periodontal variables were collected at baseline and Day90. The primary outcome was the C-reactive Protein (CRP) concentration at Day1 after periodontal treatment. The Student t-test for independent samples was used for between-group comparisons (Mann Whitney U test for non-normal data), while the ANOVA with post-hoc Tukey tests (Kruskal Wallis and Dunn tests for non-normal data) were used for intragroup comparisons.

Results

40 subjects were included. FM-SRP produced a significant increase in CRP and a significant reduction in FMD at Day1 compared to Q-SRP (p<0.05). The absolute change in HbA1c (mmol/mol) from baseline to Day90 was significantly improved in the Q-SRP (ΔHbA1c=-1.59 (SD=1.20)) compared to the FM-SRP group (ΔHbA1c=-0.8 (SD=0.95)) (p=0.04).

Conclusions

FM-SRP triggers a robust acute-phase response at 24 hours after treatment compared to Q-SRP. Such systemic acute perturbations may offset the benefic systemic effects of periodontal treatment in terms of HbA1c reduction and improvement in endothelial function in T2DM subjects.

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Long‐term impact of patients' compliance to peri‐implant maintenance therapy on the incidence of peri‐implant diseases: An 11‐year prospective follow‐up clinical study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

To prospectively evaluate the incidence of peri-implant diseases and the associated risk factors during 11 years of peri-implant maintenance therapy (PIMT).

Material and Methods

A sample of 80 partially edentulous individuals rehabilitated with dental implants was invited to participate in a PIMT program (T1—prior to entering the PIMT program). After 11 years, 51 individuals remained regularly or irregularly adherent to PIMT (T2—last recall after 11 years) and were classified as regular (RC; n = 27) or irregular (IC; n = 24) compliers. Data of interest were analyzed using univariate and multivariate logistic regression analyses.

Results

The incidence of peri-implant mucositis and peri-implantitis observed at T2 in the IC group (70.8% and 37.5%, respectively) were significantly higher than those observed in the RC group (37.0% and 11.1%, respectively). The incidence of peri-implant diseases was mostly attributable to potentially modifiable risk factors, as such: RC group—PM (p = 0.013); IC group—high plaque index (p < 0.001), irregular compliance (p < 0.001), the presence of PM (p = 0.015) and periodontitis (p < 0.039).

Conclusion

Regular compliance during PIMT had a strong effect in minimizing the incidence of peri-implant diseases. Increasing regular dental visits and improving oral hygiene would provide benefits for preventing peri-implant diseases.

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Expansile Sphenoid Mycetoma Presenting With Headache and Galactorrhea

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jamanetwork.com

This case report describes an immunocompetent woman in her 30s with daily vertex headaches over 13 months duration who developed spontaneous galactorrhea and was diagnosed with noninvasive fungal sinusitis.
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Detection and Monitoring of Circulating Tumor HPV DNA in HPV-Associated Sinonasal and Nasopharyngeal Cancers

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jamanetwork.com

This prospective observational study examines if circulating tumor human papillomavirus DNA can be used as an accurate measure of disease status at the time of diagnosis, throughout treatment, and during monitoring in human papillomavirus-associated sinonasal and nasopharyngeal squamous cell carcinomas.
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