Quinolone Ear Drops and Achilles Tendon Rupture

alexandrossfakianakis shared this article with you from Inoreader Quinolone Ear Drops and Achilles Tendon Rupture via Clinical Infectious Diseases Advance Access Abstract Background Delayed eardrum healing has been observed in the ear opposite to the ear treated with otic quinolones (OQ) in rats. Case reports describe tendinopathies after OQ treatment, suggesting adverse systemic effects. Methods We studied patients 19-64 years with diagnosis of otitis externa or media in private insurance between 2005-2015. We compared OQ treatment against otic neomycin, oral amoxicillin or azithromycin. Outcomes included Achilles tendon rupture (ATR), Achilles tendinitis (AT) and all-type tendon rupture (ATTR). We applied an active comparator, new user design with 1-year look-back and ceased follow-up at initiation of systemic steroids or oral quinolones, external injury, hospitalization and after 35 days. We used trimmed stabilized inverse probability of treatment weights to balance comparison groups in a survival framework. Negative outcomes (clavicle fractures or sports injuries) were examined to rule out d ifferences due to varied physical activity (unmeasured confounding). Results We examined 1,501,009 treated otitis episodes. Hazard ratios (HR) for OQ exposure associated with ATR were 4.49 (95%CI 1.83-11.02), AT 1.04 (95%CI 0.73-1.50), ATTR 1.71 (95%CI 1.21-2.41). Weighted risk differences (RD) per 100,000 episodes for OQ exposure were ATR 7.80 (95%CI 0.72-14.89), AT 1.01 (95%CI –12.80-14.81), ATTR 18.57 (95%CI 3.60-33.53). Corresponding HRs and RDs for clavicle fractures and sports injuries were HR = 1.71 (95%CI 0.55-5.27) and HR = 1.45 (95%CI 0.64-3.30), suggesting limited residual confounding. Conclusions OQ exposure may lead to systemic consequences. Clinicians should consider this potential risk and counsel patients accordingly. Risk factors and mechanisms for this rare, adverse effect deserve further evaluation. Mechanistic and other clinical studies are warranted to corroborate this finding.Presented at the American Otological Soci ety 154th Annual Virtual Meeting; April 11, 2021 View on Web

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Three‐dimensional exoscope‐assisted single‐stage tracheal resection

alexandrossfakianakis shared this article with you from Inoreader Three‐dimensional exoscope‐assisted single‐stage tracheal resection via Head & Neck Abstract The three-dimensional (3D) 4K exoscope is a surgical tool recently introduced in numerous fields of otolaryngology, such as microvascular surgery, otology, and laryngology. However, other surgical fields may also benefit from this technology. In this case, a single-stage tracheal resection was planned with the aid of the 3D 4K exoscope, in a 75-year-old female with post-tracheostomy tracheal stenosis. High-quality magnification of the surgical field was obtained, with facilitated skeletonization of the laryngotracheal axis. The exoscope provided greater involvement in surgery and allowed more interactions among all operating room personnel and learners, as they could access the same field of view of the first surgeon, as well as perceiving depth of the surgical field with 3D technology. The exoscope represents a valid application in open surgery performed for laryngotracheal stenosis, with advantages of enhancing training and education, allowing precise surgical dissection, and re ducing risks of iatrogenic damage to surrounding structures. View on Web

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Locoregional failure after postoperative flank irradiation for nephroblastoma: Results from the French cohort of the SIOP‐2001 trial

alexandrossfakianakis shared this article with you from Inoreader Locoregional failure after postoperative flank irradiation for nephroblastoma: Results from the French cohort of the SIOP‐2001 trial via Pediatric Blood & Cancer Abstract Objective To describe locoregional failure (LRF) after postoperative flank radiotherapy (RT) among French patients with nephroblastoma included in the Société Internationale d'Oncologie Pédiatrique (SIOP)-2001 protocol. Patients and methods In selected SIOP-2001 patients, planning with simulation computed tomography (CT) scan and posttreatment CT scan demonstrating LRF were registered and analyzed. LRF was contoured and classified as in-field, marginal or out-of-field according to dose distribution. Results Total 316 French SIOP-2001 patients were treated with postoperative RT. Three patients with nephroblastoma developed LRF after flank RT. All failures were located within the retroperitoneum. In two patients, the relapse was within the RT field and in one it was classified as marginal. Conclusion LRF after postoperative flank RT for nephroblastoma was rare and exclusively situated in the retroperitoneum. These results point out this region as the most at risk of local relapse. A prospective evaluation of a target volume restricted to the retroperitoneum allowing the use of modern and highly conformal radiation techniques in order to decrease dose to normal tissues shall be encouraged. View on Web

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Beyond Laryngeal Clefts: Interarytenoid Injection Augmentation to Predict Success of Suture Augmentation in Children

alexandrossfakianakis shared this article with you from Inoreader Beyond Laryngeal Clefts: Interarytenoid Injection Augmentation to Predict Success of Suture Augmentation in Children via The Laryngoscope We present our work to children with persistent pharyngeal dysphagia and use the interarytenoid injection augmentation (IAIA) procedure as a diagnostic and therapeutic tool to help determine which patients will be the most likely to respond to interarytenoid suture augmentation (IASA) or laryngeal cleft repair. This work represents the largest series in the literature on IAIA procedures, including one of the oldest patient populations, which serves to isolate the impact of this intervention and improve the ability of this data to best predict which patient will respond to IASA. This data has been incredibly useful to better inform peri-operative conversations with the families of patients undergoing these procedures. Objective To assess the efficacy of interarytenoid injection augmentation (IAIA) and the ability of IAIA to predict response to interarytenoid suture augmentation (IASA) based on diet advancement on video fluoroscopic swallow studies (VFSS). Methods Retrospective cohort analysis of patients with persistent pharyngeal dysphagia at a tertiary children's hospital with VFSS pre- and post-IAIA were included between March 2011 and June 2019. Results Median age of the 229 patients was 2.2 years (5.8 months–19 years). Interarytenoid mucosal height (IAMH) was found to be above the false vocal folds in 112 patients (53.4%) and at true vocal folds in 10 (4.9%) patients. On VFSS post-IAIA, 95 (41.5%) patients were successfully advanced in recommended diet consistency, 115 (50.2%) were stable, and 19 (8.3%) needed thicker consistency. Paired t-tests on pre- and post-operative consistency scores showed significant improvement, p-value of <0.0001, 95% confidence interval (CI; 0.50–0.85). Poisson regression found no covariates with significant association with improvement on IAIA. For IASA patients, 35/60 (58.3%) improved on post-op VFSS. Paired t-tests on pre- and post-operative consistency scores showed significant improvement, p-value of <0.0001, 95% CI (0.63–1.33). Positive predictive value for IAIA predicting response to IASA was 77% with positive likelihood ratio of 2.3. The response to IAIA versus no response to IAIA likelihood ratios were found to have a statistically significant difference (p < 0.05). Conclusions Our study suggests IAIA yields objective improvement in swallow function on VFSS in nearly half of our patients and may be a reliable diagnostic tool to predict response to IASA in patients with persistent pharyngeal dysphagia with or without a laryngeal cleft. Level of Evidence Level 3 Laryngoscope, 2022 View on Web

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Myeloperoxidase‐positive bilineal mixed phenotype acute leukemia (B/T) with chromosome copy neutral loss of heterozygosity exhibits simultaneous diffuse leukemic infiltrations in the lung, bone, and endorachis

alexandrossfakianakis shared this article with you from Inoreader Myeloperoxidase‐positive bilineal mixed phenotype acute leukemia (B/T) with chromosome copy neutral loss of heterozygosity exhibits simultaneous diffuse leukemic infiltrations in the lung, bone, and endorachis via Pediatric Blood & Cancer View on Web

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Implants in the pterygoid region: An updated systematic review of modern roughened surface implants

alexandrossfakianakis shared this article with you from Inoreader Implants in the pterygoid region: An updated systematic review of modern roughened surface implants via Journal of Prosthodontics ABSTRACT Purpose To determine the survival rates of modern roughened surface dental implants in the pterygoid region. Material and Methods This systematic review was an update from a previously published systematic review in 2011, which largely reported data on older machined surface dental implants. An electronic search for articles in the English language literature published from January 1, 2010 to December 8, 2021 was performed using PubMed, Scopus, and CENTRAL search engines. After applying a systematic search process in 3 stages, the final list of selected articles on roughened surface pterygoid implants was obtained. Data from the selected articles were collated with data from pertinent articles on roughened implant surface from the previous systematic review. The combined data was then used for calculating the interval survival rate (ISR) and cumulative survival rate (CSR) of pterygoid implants. Results The initial electronic search resulted in 1263 titles. The systematic search process eventually resulted in 10 clinical studies reporting on modern roughened surface pterygoid implants. These 10 studies reported on a total of 911 pterygoid implants with 39 reported failures over a 6-year period. The majority of failures (37) were reported during the first year time interval and a majority of them (30) occurred before loading of the pterygoid implants. Only 2 late failures were reported after loading, during the 6th year time interval. The majority of implants were used for rehabilitation of full arch fixed implant supported prosthesis. At the maximum follow-up interval of 6 years, the cumulative survival rate of pterygoid implants with roughened surfaces was 95.5%, which was 5% higher than reported in the previous systematic review which combined machined and roughed surface pterygoid implants. Conclusions The survival rate of modern roughened surface dental implants in the pterygoid region is favorable at 95.5% over a 6 year period, and comparable to the existing evidence on survival of implants in other regions of the maxilla and mandible. This article is protected by copyright. All rights reserved View on Web

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Imaging of pediatric extremity soft tissue tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

alexandrossfakianakis shared this article with you from Inoreader Imaging of pediatric extremity soft tissue tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper via Pediatric Blood & Cancer Abstract Pediatric soft tissue tumors of the extremity include rhabdomyosarcoma and nonrhabdomyosarcoma neoplasms. This manuscript provides consensus-based imaging recommendations for imaging evaluation at diagnosis, during treatment, and following completion of therapy for patients with a soft tissue tumor of the extremity. View on Web

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