Manningtimmermann5129
We report this case not only for its exceptional rarity but also to discuss the lacunae that exist in the current classification systems that might facilitate an erroneous categorization of these rare tumors. Standardization of nomenclature and defining criteria is imperative to ensure accurate diagnosis, optimal management, and a better understanding of the biology of these enigmatic tumors.
To curb opioid overprescription and diversion, 49 states have implemented mandatory prescription drug monitoring programs (PDMPs). This study aims to examine the changes in analgesic prescription patterns associated with mandatory PDMP usage by oral and maxillofacial surgeons.
This retrospective observational cohort study analyzed analgesic prescriptions after third molar surgeries from the University of Pennsylvania from July 2016 to December 2019. Because Pennsylvania mandated PDMP usage on January 1, 2017, we analyzed prescriptions 6 months prior to and for each 6-month interval after implementation.
Prescriptions after 13,430 procedures on 6437 patients across 7 6-month periods were analyzed. Patients in all study periods had an average age of 40 years and there was a slight majority of females. After PDMP implementation, patients who received analgesics had an 80% lower odds of receiving an opioid option after adjusting for age, sex, and procedural severity. When an opioid was prescribed, the mean pills per script decreased from 20.18 to 10.96 1 year after PDMP implementation.
Mandatory PDMP usage was associated with decreased odds of a patient receiving an opioid analgesic and with a decrease in mean opioid pills per script. PDMPs may be helpful in reducing opioid prescriptions by oral and maxillofacial surgeons after third molar surgery.
Mandatory PDMP usage was associated with decreased odds of a patient receiving an opioid analgesic and with a decrease in mean opioid pills per script. PDMPs may be helpful in reducing opioid prescriptions by oral and maxillofacial surgeons after third molar surgery.
The objective of this study was to evaluate the dimensional changes in alveolar bone and soft tissue after dental extraction/postextraction in alveoli filled/grafted with collagen (Collacone) compared with those left empty/ungrafted.
Twenty-three patients with a single maxillary incisor to be extracted were included in the study. The patients were randomized into either the treatment group, receiving a collagen sponge, or into the control group with an empty alveolus. All participants were examined and followed with cone beam computed tomography and 3-dimensional soft tissue scanning procedures during the healing process. The outcomes were statistically evaluated with Mann-Whitney U tests.
Seventeen patients were available for follow-up. The radiographic outcome showed an average loss of bone in the bucco-palatal width of 1.15 mm (range, 0.2-2.2) in the test group and 0.57 mm (range, 0-1.6) among the controls. There was no significant difference between the 2 groups (P=.092). The soft tissue topography height measurements revealed an average decrease of 1.737 mm (range, 0.118-2.872) in the test group and 1.899 mm (range, 0.454-3.014) in the control group. The difference was not significant (P=.847).
The use of a Collacone collagen sponge does not enhance the bone and soft tissue healing outcome after extraction of an incisor in the maxilla compared with leaving the alveolus empty.
The use of a Collacone collagen sponge does not enhance the bone and soft tissue healing outcome after extraction of an incisor in the maxilla compared with leaving the alveolus empty.
The aim of this study was to evaluate the influence of viral load and lymphocyte count on survival of patients who presented with human immunodeficiency virus (HIV)-associated oral Kaposi's sarcoma.
Thirty-one cases (from January 2010 to December 2019) of oral Kaposi's sarcoma in patients with HIV from 2 oral pathology centers in Brazil were reviewed, considering clinical data and correlation of viral load and lymphocyte count with overall survival. Overall survival rates were estimated by a Kaplan-Meier analysis and compared using a log-rank test. The factors introduced stepwise into a Cox proportional hazard model to identify the independent predictors of survival. A P value <.05 was considered significant.
Most of the patients were males (90.3%) with a mean age of 32.4 years (range, 19-58). Hard palate, soft palate, and tongue were the most affected sites. Treatment, viral load >999 copies/mL, CD4
level ≤200 cells/mm
, CD4
/CD8
level ≤0.39 cells/mm
, and CD4
nadir level <50 cells/mm
were related to overall survival.
Survival of patients affected by oral HIV-associated Kaposi's sarcoma is influenced by treatment, viral load, CD4
, CD4
/CD8
, and CD4
nadir count.
Survival of patients affected by oral HIV-associated Kaposi's sarcoma is influenced by treatment, viral load, CD4+, CD4+/CD8+, and CD4+ nadir count.
The objective of this study was identification of the transcription factor binding sites (TFBS) in the promoter of HOX genes and elucidation of the comprehensive interaction of transcription factors (TFs)/genes with HOX.
Promoter sequences of HOXA3, HOXA5, HOXA9, HOXA10, HOXA13, HOXB5, HOXC10, HOXC12, and HOXD10 were analyzed to predict the TFBS and their targets using TRANSFAC, TRRUST, and Harmonizome. Functional analysis of the processed data sets was carried out using DAVID and GATHER gene annotation tools. A network of regulatory interactions was constructed using NetworkAnalyst and a comprehensive illustration of the TF-gene network was constructed with HOX as a central hub using the Encyclopedia of DNA Elements chromatin immunoprecipitation sequencing data. Further, the enriched network was constructed to elucidate the roles of these genes in the various pathways.
Binding sites for E2F1, HNF3α, SP3, and KLF6 were common to promoter regions of all of the HOX genes. The functional annotation and pathway analysis elucidated the regulatory activity of a distinct set of TF-genes in interaction with HOX. A P value ≤.05 and false discovery rate ≤0.01 were considered statistically significant.
We have confirmed that the predicted TFBSs in the HOX gene promoters function in transcriptional regulation by modulating target gene activity. TF-gene interactions are crucial to understanding oral carcinogenesis.
We have confirmed that the predicted TFBSs in the HOX gene promoters function in transcriptional regulation by modulating target gene activity. TF-gene interactions are crucial to understanding oral carcinogenesis.
Carotid body tumors (CBTs) are benign but challenging. This study compared outcomes of 3 techniques of the surgical treatment of CBTs.
This retrospective observational study was conducted from April 2013 to March 2019. The 38 patients enrolled in the study had primary tumors, including 1 with bilateral tumors and another with adrenal gland pheochromocytoma. We collected data on age, sex, size of tumor, Shamblin classification, treatment, blood loss, operative time, hospital stay, complications, and recurrence. Statistical analyses were performed using IBM SPSS Statistics version 20 software.
Twenty-four patients were male, and 12 were female, and they ranged in age from 11 to 71 years. Cases were assigned to Shamblin groups I (n=6), II (n=19), and III (n=14). Tumor size ranged from 2.0×2.0 cm to 5.0×6.0 cm. Eleven CBTs underwent blunt dissection (BD), 20 underwent BD plus resection of external carotid artery division plus vessels of encapsulation with allograft dermal matrix (BD+RECA+VE), and 8 tumors underwent surgical resection of tumors plus common carotid artery-internal carotid artery artificial vascular reconstruction (SR +C-IAVR). No perioperative death or stroke occurred. There was a significant difference between Shamblin groups I, II, and III in terms of the size of the tumor, type of treatment used, blood loss, operative time, hospital stay, and complications. Six patients had mandibular branch facial nerve transient paresis; 7 patients had hypoglossal nerve dysfunction; 3 patients had Horner syndrome; and dysphasia occurred in 2 patients. The patients were seen in follow-up for 16 to 45 months, and 1 recurrence was observed.
Three surgical techniques-BD, BD+RECA+VE, and SR+C-IAVR-are safe and feasible for the treatment of CBTs according to Shamblin classifications.
Three surgical techniques-BD, BD + RECA + VE, and SR + C-IAVR-are safe and feasible for the treatment of CBTs according to Shamblin classifications.
To assess setup reproducibility of low kneefix with feetfix (LKF-FF) system and its operator-reported convenience by reference to low dual leg positioner (LDLP), among patients treated with pelvic radiotherapy.
A retrospective controlled trial was carried out at the radiotherapy unit. It included patients who underwent radical radiotherapy to the pelvis using VMAT, and who benefitted from LDLP (N = 30) or LKF-FF (N = 30) immobilization system. Average absolute shifts (AAS) and total vector errors (TVE) were computed and compared between the two systems, using translational (lateral, longitudinal and vertical) and rotational (X, Y and Z planes) directions. learn more Accuracy rates were computed on pooled data including 1529 VMAT images, 819 in LDLP and 710 in LKF-FF groups, using different cutoffs. Radiotherapists' subjective assessment of the device's ease of setup, handling, cleaning, and storage, and patient comfort was carried out comparatively between the two devices.
No statistically significant difference wed LKF-FF system outperformed LDLP in terms of setup reproducibility, notably in rotational directions, where it enhanced setup accuracy rates by up to 19%. Long-term use of LKF-FF may improve the users' satisfaction.Diagnostic test accuracy studies are performed in order to determine the value of a diagnostic test. Primary studies of diagnostic accuracy describe the accuracy of a test calculated using the number of true and false positive and negative cases of a given diagnosis of interest. Systematic reviews of diagnostic test accuracy are performed to identify accuracy of a test but also to investigate where the test might sit in a diagnostic pathway or determine how different tests compare against each other. This introductory discussion paper aims to give the reader an overview of the various features in primary and secondary diagnostic test accuracy study designs for medical imaging professionals.Extracranial malignant rhabdoid tumors are rare and aggressive tumors that typically occur in the pediatric age group and have a poor prognosis. Herein, we report a case of a one year and five months old male infant who was referred with the diagnosis of malignant rhabdoid tumor of the liver. Magnetic resonance guided stereotactic body radiotherapy was administered with concomitant chemotherapy. Treatment was well tolerated with no severe acute side effects. A 40.8% volumetric reduction of the tumor was observed at the last fraction of MR guided radiotherapy. Résumé Les tumeurs rhabdoïdes malignes extracrâniennes sont des tumeurs rares et agressives qui surviennent généralement dans le groupe d'âge pédiatrique et dont le pronostic est mauvais. Nous rapportons ici le cas d'un enfant de sexe masculin d'un an et cinq mois qui a été référé avec le diagnostic de tumeur rhabdoïde maligne du foie. Une radiothérapie corporelle stéréotaxique guidée par résonance magnétique a été administrée avec une chimiothérapie concomitante.
