Πέμπτη 15 Σεπτεμβρίου 2022

Severe Arboviral Neuroinvasive Disease in Patients on Rituximab Therapy: A Review

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Abstract
With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days–1 year) and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be cou nseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies.
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Dupilumab use is associated with protection from COVID-19 mortality: A retrospective analysis

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Abstract
We previously found that type 2 immunity promotes COVID-19 pathogenesis in a mouse model. To test relevance to human disease we used electronic health record databases and determined that patients on dupilumab (anti-IL-4R monoclonal antibody that blocks IL-13 and IL-4 signaling) at the time of COVID-19 infection had lower mortality.
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Inhibition of kidney potassium channels by fluoxetine: in vivo and in vitro studies

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Abstract

In vitro studies have demonstrated that fluoxetine, a commonly used antidepressant drug, can modulate the activity of K+ channels. In the present study, we investigated the in vivo effect of acute and sub-chronic treatment of rats with fluoxetine on K+ renal transport. Furthermore, OK cells, a kidney epithelial cell line, was used in order to evaluate the in vitro effect of fluoxetine on K+ currents. In the sub-chronic study, fluoxetine was administrated daily (10 mg/kg, p.o.) for 15 days to male adult Wistar rats. In the acute study, rats were given increasing doses of fluoxetine (1, 3, 10, 30 and 50 mg/kg, p.o.) for 24 hours. Results from the sub-chronic study show that urinary K+ content (in mmol/L) was markedly reduced in the fluoxetine-treated animals (fluoxetine: 83±9; control: 131±10; P<0.001). K+ fractional renal excretion (in %) was also significantly lower in the fluoxetine group (fluoxetine : 6±1; control: 13±2; P<0.001). No significant changes was observed in creatinine clearance and on renal tubular Na+,K+-ATPase activity. Results obtained from the acute study demonstrate that, after a 24-hour administration, fluoxetine produced a dose-dependent decrease in urinary K+, with an ED50 (in mg/kg) of 4.2 (2.8; 5.5) and a maximal effect of 62% reduction. In vitro, fluoxetine produced a concentration-dependent inhibition of K+ currents in OK cells, with an EC50 of 107 (84.8; 129.5) μM. In conclusion, fluoxetine produces a marked reduction on urinary K+ excretion; this effect constitutes an in vivo evidence for the inhibitory action of fluoxetine on kidney epithelial K+ channels.
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Innate Immune Sensing of Nucleic Acid in Endodontic Infection

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Abstract

Innate immunity is the first line of defence and fight against microorganisms. Nucleic acids are important pathogen-associated molecular patterns to be recognized in innate immunity. There are three types of nucleic acid sensors, including endosomal sensors (NA-sensing TLRs), cytosolic DNA sensors (cGAS and AIM2), and cytosolic RNA sensors (RLG-I, MDA5 and LGP2). Recent studies have shown that nucleic acid sensors are expressed differently in a variety of dental pulp cells and mediate inflammation through complex pathways. Nucleic acid sensing may play a vital role in the development of endodontic infection. This review aims to summarise and analyze the possible roles of various nucleic acid sensors in endodontic infection. It may help better understand the pathogenesis of these diseases and find new strategies for prevention and treatment.
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Effect of TIVA on Pulmonary Complications in Microvascular Reconstruction for Head and Neck Cancer

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jamanetwork.com

This randomized clinical trial assesses the effect of total intravenous anesthesia vs inhalational anesthesia on postoperative pulmonary complications in patients undergoing microvascular reconstruction for head and neck cancer.
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A 3‐year prospective cohort on the incidence of prosthodontic complications associated with three implant treatment options for the edentulous mandible

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Abstract

Objective

this prospective study assessed the number and reasons for post-treatment visits due to prosthodontic complications in patients treated with three types of implant treatment for the edentulous mandible.

Methods

study groups comprised patients treated with single-implant overdenture (G-I; n=11), 2-implant overdenture (G-II; n=13), and 4-implant fixed prosthesis (G-III; n=13). Programmed recall visits occurred at the 6-, 12- and 36-month follow-ups. The management of prosthodontic complications occurred continuously in unscheduled appointments. Data analysis included calculation of incidence rates, chi-square and Kruskal-Wallis tests, and Poisson regression with robust error variance to model the occurrence of visits due to prosthodontic complications.

Results

there were 89 unscheduled appointments during the entire follow-up period, ranging from 0 to 7 (mean=2.41; SD=2.2) per patient. No between-group differences were found regarding the frequency of unscheduled visits. However, the duration of the appointments (scheduled and unscheduled) was significantly higher for G-III (p<0.001). The length of follow-up was the only predictor of the number of post-insertion visits (p=0.004). The frequency of prosthodontic events was higher for G-I and G-II compared to G-III (p<0.001). Nearly half of the events in G-I and G-II were matrix replacements, and artificial teeth fracture was more frequent in G-III.

Conclusions

all patients were at risk of post-delivery prosthodontic complications and required regular recall visits to achieve satisfactory function and to prevent further problems. Overdentures required higher rates of maintenance visits, particularly for replacement of the retentive inserts, while fixed implant prostheses required longer clinical times for management of complications when compared to overdentures.
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Risk factors for lower border notching after bilateral mandibular sagittal ramus advancement: three-dimensional evaluation

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The objective of this study was to calculate the incidence of MLBN and identify risk factors. This single-centre, retrospective study was performed between January 2018 and November 2020, in the Maxillofacial Surgery Department, Centre Hospitalier Universitaire, Caen. Patients who underwent BSSO advancement and had cone beam computed tomography (CBCT) scans obtained preoperatively, immediately postoperative (within 1 week), and late postoperative ( ≥1 year) were included. (Source: International Journal of Oral and Maxillofacial Surgery)
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Clinical performance of implant supported mandibular overdentures with cantilever bar and stud attachments: A retrospective study

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Abstract

Background

Treatment of edentulous patients with implant-supported over-dentures improves denture's retention and stability. Published data concerning implant-supported overdenture with cantilever bars that claimed that can affect the survival and bone loss of implants are scarce.

Purpose

The purpose of this study was to evaluate 5-year clinical performance of mandibular implant-supported over-dentures with different attachment systems.

Materials and methods

In this retrospective study, 103 patients who had received mandibular over-dentures supported by two implants were evaluated in a 5-year follow up. Studied groups were patients with Spherblock ball attachment (58 patients), Dolder bar with cantilever (36 patients), and Locator attachment (9 patients). Marginal bone-loss around implants, prosthetic complications, soft tissue status of the implants (gingival index, plaque index, pocket depth, and bleeding on probing) were used to compare studied groups. Visual Analogue Scale (VAS) criteria was used to assay patient's satisfaction. One-way ANOVA, Scheffe, Kruskal–Wallis, Mann–Whitney, and Fisher's exact tests, were used for the data analysis (α = 0.05).

Results

One hundred and three patients (46 male, 57 female, mean age 64.7 ± 8.6) with 206 implants (Strauman) were studied. The implant survival rate was 100% with mean bone loss of 0.22 mm around implants in 5 years. Prosthetic complications including attachment wear and denture fracture occurred more often with ball attachments. The number of attachment replacement, and post insertion appointments were significantly less in patients with bar attachments (p < 0.05). Pocket depth and gingival index were less in the ball attachment (p < 0.05).

Conclusion

Mandibular overdenture supported by two implants can be considered a successful treatment in edentulous patients. The frequency of prosthetic complication is higher in unsplinted than splinted superstructures.
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Scarless Neck Feminization: Chondrolaryngoplasty Through Endoscopic Transoral Vestibular Approach

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Scarless Neck Feminization: Chondrolaryngoplasty Through Endoscopic Transoral Vestibular Approach

We present in this paper a novel approach to perform endoscopic chondrolaryngoplasty without any external visible scars. The technique involves utilizing the endoscopic transoral vestibular approach. We have modified the technique by using the placement of a suture immediately above the anterior commissure, which provides a marker for the inferior extent of cartilage resection. Laryngoscope, 2022
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