Τρίτη 31 Μαΐου 2022

18F-FDG PET/CT Findings of MALT Lymphoma of Ureter

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imageMucosa-associated lymphoid tissue (MALT) lymphoma origin from the ureter is exceedingly rare. We report FDG PET/CT findings of MALT lymphoma in the distal right ureter in a 55-year-old woman who presented right abdominal pain for 10 days. Ultrasound revealed a hypoechoic mass in the right pelvis, which was surrounding the distal right ureter. 18F-FDG PET/CT demonstrated a high FDG uptake by the mass along with several FDG-avid enlarged lymph nodes in the abdominal cavity. Postoperative pathology demonstrated the ureteral mass as a MALT lymphoma.
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Solitary Splenic Metastasis From Endometrial Carcinoma Revealed on FDG PET/CT

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imageSolitary splenic metastasis from endometrial carcinoma is rare. We report a case of imaging findings of solitary splenic metastasis in a 53-year-old woman who underwent resection surgery of endometrial carcinoma of uterus 1 year ago. On FDG PET/CT, it presented as a solitary soft tissue mass with an SUVmax of 18.44. The postoperative pathology supported metastasis from endometrial carcinoma.
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Combined 18F-FDG PET/CT Radiomics and Sarcopenia Score in Predicting Relapse-Free Survival and Overall Survival in Patients With Esophagogastric Cancer

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imagePurpose The aim of this study was to determine if radiomic features combined with sarcopenia measurements on pretreatment 18F-FDG PET/CT can improve outcome prediction in surgically treated adenocarcinoma esophagogastric cancer patients. Patients and Methods One hundred forty-five esophageal adenocarcinoma patients with curative therapeutic intent and available pretreatment 18F-FDG PET/CT were included. Textural features from PET and CT images were evaluated using LIFEx software (lifexsoft.org). Sarcopenia measurements were done by measuring the Skeletal Muscle Index at L3 level on the CT component. Univariable and multivariable analyses were conducted to create a model including the radiomic parameters, clinical features, and Skeletal Muscle Index score to predict patients' outcome. Results In multivariable analysis, we combined clinicopathological parameters including ECOG, surgical T, and N staging along with imaging derived sarcopenia measurements and radiomic features to build a predictor model for relapse-free survival and overall survival. Overall, adding sarcopenic status to the model with clinical features only (likelihood ratio test P = 0.03) and CT feature (P = 0.0037) improved the model fit for overall survival. Similarly, adding sarcopenic status (P = 0.051), CT feature (P = 0.042), and PET feature (P = 0.011) improved the model fit for relapse-free survival. Conclusions PET and CT radiomics derived from combined PET/CT integrated with clinicopathological parameters and sarcopenia measurement might improve outcome prediction in patients with nonmetastatic esophagogastric adenocarcinoma.
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Adherence Of Candida Albicans to Five Long‐Term Silicone‐Based Denture Lining Materials Bonded to CAD‐CAM Denture Base

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Abstract

Purpose

: Knowledge about quantifying the number as well as the retention and adhesion of Candida albicans blastoconidia to silicone denture liners is limited. Thus, the aim of this in vitro study was to explore the adherence of Candida albicans to the surface of five long-term silicone-based soft denture lining materials, using artificial saliva.

Materials & Methods

A total of 50 specimens (10 × 10 × 3 mm) of five long-term resilient liners (Molloplast-B; GC Reline Soft; Elite Soft Relining; Tokuyama Sofreliner S; Ufigel SC), bonded to a computer-aided design and computer-aided manufacturing denture base, were prepared. The specimens were inoculated and incubated in artificial saliva for 1h and 24h with a standardized (2.8 × 106 cfu/ml) Candida albicans suspension. At the end of the incubation period, the specimens were stained with acridine orange and observed, using fluorescence microscopy.

Results

: After 1h and in 24h, Molloplast B demonstrated significantly earlier adherence of Candida albicans cells compared to the other chairside materials (p<0.001 and p<0.001, respectively), where the mean number of cells also increased in the frontal parts. Regarding the rate of Candida albicans proliferation from 1h to 24 hours within the materials, there was an increase in all materials (Molloplast B: p<0.001; GC Reline Soft: p = 0.220; Elite Soft Relining: p = 0.032; Tokuyama Sofreliner S: p = 0.001; Ufigel Sc: p = 0.001). The Ufigel Sc showed a significant 2.5-fold increase at 24h.

Conclusions

: Long-term silicone denture liners accumulate a significant amount of Candida albicans blastoconidia and their coverage by them increases progressively over time.

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Development and validation of the Fat Attitudes Assessment Toolkit (FAAT): A multidimensional nonstigmatizing measure of contemporary attitudes toward fatness and fat people

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Abstract

Many instruments recommended for measuring attitudes toward fatness and "obesity" were developed in the 1990s, a time when the "obesity epidemic" was gaining momentum and anti-fat rhetoric was normative. Consequently, these instruments have tended to focus on assessing negative appraisals of fatness and fat people and reinforce weight stigma. As fat discourse has matured and expanded to incorporate fat positive attitudes, a nonstigmatizing way of measuring contemporary fat attitudes and beliefs in quantitative research is required. To address this need, we developed the Fat Attitudes Assessment Toolkit (FAAT). In this article, we describe the development of the FAAT and provide initial evidence for the scale's validity and psychometric properties across three studies. Study 1 included a systematic process for developing the extensive item pool that was reviewed by subject matter experts and a community panel. We explored and identified an initial multidimensional structure for the FAAT. Study 2 expanded and confirmed the factor structure with additional analyses in an independent sample and provided evidence for the overall reliability of the subscale scores and reliability as a function of gender and identification as fat. Construct and criterion validity of the subscale scores were also demonstrated. Study 3 provided evidence for the test-retest reliability of the FAAT subscales scores over time. The FAAT includes nine robust scales: Empathy, Activism Orientation, Size Acceptance, Attractiveness, Critical Health, General Complexity, Socioeconomic Complexity, Responsibility, and Body Acceptance. Specific subscales can be combined to form two composite measures: Fat Acceptance and Attribution Complexity. The scales that comprise the FAAT measure specific elements of attitudes towards fat people that are frequently targeted in weight stigma reduction research and activism; the FAAT thus offers a powerful and precise method for evaluating weight stigma reduction interventions that allows for an assessment of shifts toward more positive attitudes.
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Δευτέρα 30 Μαΐου 2022

Regeneration of keratinized tissue around teeth and implants following coronal repositioning of alveolar mucosa with and without a connective tissue graft. An experimental study in dogs

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Abstract

Aim

To compare clinical and histological keratinized tissue formation around teeth and implants following coronal repositioning of alveolar mucosa with or without a connective tissue graft.

Methods

In 9 beagle dogs, the third and fourth premolars (P3, P4) were extracted from one side of the maxilla. Three months after the tooth extraction, a full-thickness buccal flap was raised and 2 implants were placed in those healed areas. On the contralateral side, a buccal flap was also raised at the P3, P4 area. Before suturing, the dogs were randomly assigned to 3 study groups (control, non-keratinized tissue [NKT], and non-keratinized tissue connective tissue graft [NKT-CTG]). In the control group, the buccal flaps were repositioned around the teeth (P3, P4) on one side, and implants on the other side, presenting an adequate band of keratinized tissue (KT). For the NKT and NKT-CTG groups, this buccal KT was then excised. In the NKT group, the buccal flap without KT (alveolar mucosa) was repositioned around the teeth and implants. In the NKT-CTG group, a connective tissue graft taken from the excised KT was sutured to the buccal alveolar mucosa and then both were repositioned around the teeth and implants. The clinical height of the KT was measured at baseline and at 1, 2, and 3 months of healing. The animals were sacrificed at 3 months, at which point the KT height was measured histologically.

Results

The control group presented normal healing with a band of KT surrounding the teeth and implants. In the NKT and NKT-CTG groups, a new KT band approximately 2 mm in height (measured clinically and histologically) spontaneously formed around all teeth, regardless of whether a connective tissue graft had been placed. In the NKT implant group, no new KT was observed (clinically or histologically). Around the implants in the NKT-CTG group, a small amount of KT was formed in just 2 of the 6 implants.

Conclusion

After surgical excision of KT, spontaneous KT is formed around teeth but not around implants, regardless of the placement of a connective tissue graft.

This article is protected by copyright. All rights reserved.
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Experimental method for haplotype phasing across the entire length of chromosome 21 in trisomy 21 cells using a chromosome elimination technique

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Rib fixation in non–ventilator-dependent chest wall injuries: A prospective randomized trial

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imageBACKGROUND The aim of this study was to assess pain and quality of life (QoL) outcomes in patients with multiple painful displaced fractured ribs with and without operative fixation. Rib fractures are common and can lead to significant pain and disability. There is minimal level 1 evidence for rib fixation in non–ventilator-dependent patients with chest wall injuries. We hypothesized that surgical stabilization of rib fractures would reduce pain and improve QoL during 6 months. METHODS A prospective multicenter randomized controlled trial comparing rib fixation to nonoperative management of nonventilated patients with at least three consecutive rib fractures was conducted. Inclusion criteria were rib fracture displacement and/or ongoing pain. Pain (McGill Pain Questionnaire) and QoL (Short Form 12) at 3 and 6 months postinjury were assessed. Surgeons enrolled patients in whom they felt there was clinical equipoise. Patients who were deemed to need surgical fixation or who were deemed to be too well to be randomized to rib fixation were not enrolled. RESULTS A total of 124 patients were enrolled at four sites between 2017 and 2020. Sixty-one patients were randomized to operative management and 63 to nonoperative management. No differences were seen in the primary endpoint of Pain Rating Index at 3 months or in the QoL measures. Return-to-work rates improved between 3 and 6 months, favoring the operative group. CONCLUSION In this study, no improvements in pain or QoL at 3 and 6 months in patients undergoing rib fixation for nonflail, non–ventilator-dependent rib fractures have been demonstrated. LEVEL OF EVIDENCE Therapeutic/Care Management; Level II.
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The Kampala Trauma Score: A 20-year track record

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imageQuantifying the severity of traumatic injury has been foundational for the standardization of outcomes, quality improvement research, and health policy throughout the evolution of trauma care systems. Many injury severity scores are difficult to calculate and implement, especially in low- and middle-income countries (LMICs) where human resources are limited. The Kampala Trauma Score (KTS)—a simplification of the Trauma Injury Severity Score—was developed in 2000 to accommodate these settings. Since its development, numerous instances of KTS use have been documented, but extent of adoption is unknown. More importantly , does the KTS remain useful for determining injury severity in LMICs? This review aims to better understand the legacy of the KTS and assess its strengths and weaknesses. Three databases were searched to identify scientific papers concerning the KTS. Google Scholar was searched to identify grey literature. The search returned 357 papers, of which 199 met inclusion criteria. Eighty-five studies spanning 16 countries used the KTS in clinical settings. Thirty-seven studies validated the KTS, assessing its ability to predict outcomes such as mortality or need for admission. Over 80% of these studies reported the KTS equalled or exceeded more complicated scores at predicting mortality. The KTS has stood the test of time, proving itself over the last twenty years as an effective measure of injury severity across numerous contexts. We recommend the KTS as a means of strengthening trauma systems in LMICs and suggest it could benefit high-income trauma systems that do not measure injury sev erity.
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Resource utilization and secondary overtriage for patients with traumatic renal injuries in a regional trauma system

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imageBACKGROUND While renal trauma management has shifted to conservative nonoperative management, insufficient data exist to guide interhospital renal trauma transfer protocols. Secondary overtriage is defined as the potentially avoidable transfer of patients from a lower to a higher-level trauma center despite the lack of need for higher-level care. The goal of this study was to determine the prevalence and predictors of secondary overtriage in renal trauma patients to a level 1 trauma center. METHODS A retrospective cohort study was performed of all renal trauma patients transferred to a level 1 institution between 2005 and 2017. Secondary overtriage was defined as a potentially avoidable transfer that consisted of hospital stay
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