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Depression in patients with chronic otolaryngology symptoms - A vicious cycle. 有慢性耳鼻喉科症状的患者抑郁--恶性循环。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-15 DOI: 10.1186/s13005-024-00464-8
Meera Niranjan Khadilkar, Keshava Pai K, Thripthi Rai, Vijendra Shenoy, Deviprasad Dosemane

Background: Depression is a common comorbidity among individuals with otolaryngologic disorders, particularly those with longstanding conditions. This study aims at analysing the sociodemographic profile of depressive disorders in patients with chronic otolaryngology symptoms or conditions, and the correlation with PHQ-9 score.

Methods: A cross-sectional study was conducted on a hundred patients presenting to the outpatient department with chronic otolaryngology symptoms or conditions. They were requested to fill in the PHQ-9 questionnaire, containing questions based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for major depressive disorder (MDD).

Results: Median age was 39, male: female ratio was 1.17. Nasal obstruction (29%), ear discharge (25%), and headache (17%) were the common presenting complaints. Mean and median PHQ-9 scores were 5.03 and 4 respectively. Seven patients (7%) had MDD, while eleven (11%) had other depressive disorder; 9% of cases were found to have no significant otolaryngologic problem despite presenting with symptoms, two of which were found to have depressive disorder. Thirty-five (35%) and thirty-six (36%) patients had minimal and mild depressive symptoms respectively, while one (1%) had severe depressive symptoms. Statistical significance was noted for the duration of symptoms (p-value 0.005); high statistical significance was found for occupation and otolaryngology diagnosis (p-value < 0.001 each). PHQ-9 score showed statistical significance in comparison with gender and duration of symptoms (p-value 0.046 and 0.005 respectively). Correlation of severity of depressive disorder revealed statistical significance with gender (p-value 0.049) and high statistical significance with duration of symptoms (p-value < 0.001).

Conclusion: Chronic otolaryngology conditions are associated with significant morbidity, attributable to longstanding disturbing symptoms and prolonged treatment protocols, leading to depression. Nevertheless, depression in chronic otolaryngology disorders may aggravate or overlap the clinical symptoms or may go undetected. Hence it may be worthwhile to evaluate for depressive disorders in chronic patients presenting to otolaryngology.

背景:抑郁症是耳鼻咽喉科疾病患者,尤其是长期患病者的常见并发症。本研究旨在分析慢性耳鼻喉症状或病症患者抑郁障碍的社会人口学特征,以及与 PHQ-9 评分的相关性:方法:我们对 100 名因慢性耳鼻喉症状或病症到门诊部就诊的患者进行了横断面研究。要求他们填写 PHQ-9 问卷,其中的问题以第四版《精神疾病诊断与统计手册》(DSM-IV)中的重度抑郁障碍(MDD)为基础:中位年龄为 39 岁,男女比例为 1.17。鼻塞(29%)、耳流脓(25%)和头痛(17%)是常见的主诉。PHQ-9评分的平均值和中位数分别为5.03分和4分。7名患者(7%)患有多发性抑郁症,11名患者(11%)患有其他抑郁症;9%的病例尽管有症状,但没有明显的耳鼻喉问题,其中2名患者患有抑郁症。35%和36%的患者分别有轻微和轻度抑郁症状,1%的患者有严重抑郁症状。症状持续时间具有统计学意义(p 值为 0.005);职业和耳鼻喉科诊断具有高度统计学意义(p 值为 0.005):慢性耳鼻喉科疾病的发病率很高,这是因为长期的症状困扰和治疗方案的延长导致了抑郁症。然而,慢性耳鼻喉科疾病中的抑郁症可能会加重或重叠临床症状,也可能未被发现。因此,值得对耳鼻喉科慢性病患者进行抑郁障碍评估。
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引用次数: 0
Evaluating sagittal condylar inclination: a comparative analysis of various digital workflow measures. 评估矢状髁状突倾斜度:各种数字工作流程测量方法的比较分析。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-15 DOI: 10.1186/s13005-024-00471-9
Yeqing Wang, Xin Wang, Litong Li, Meng Cao

Introduction: This study aims to compare sagittal condylar inclination (SCI) measurements derived from three workflows: intraoral scan (IOS) aligned with cone-beam computed tomography (CBCT), IOS aligned with facial scan (FS), and a jaw motion analyzer (JMA) system, in a cohort of young individuals with established normal occlusion. Additionally, the study aims to identify sources contributing to variance in these measurement approaches.

Methods: Twenty-four healthy individuals exhibiting normal occlusion were enrolled in this clinical trial. The SCI was delineated using a virtual articulator (VA) by aligning IOS with both CBCT and FS, creating two distinct workflows labeled CBCT-IOS and FS-IOS, respectively. Concurrently, SCI measurements were also acquired using a JMA. The normality of data distribution for the difference in bilateral SCI measurements within each workflow was tested using the Shapiro-Wilk test. Depending on the outcomes of this test, we utilized either a paired-sample T-test or Wilcoxon test for bilateral SCI comparisons. The inter-workflow differences were assessed using the Kruskal-Wallis H test. Bland-Altman plots were assess the interchangeability and consistency across each pair of digital methods and to evaluate the aggregate consistency among the trio of digital approaches.

Results: The analysis revealed that the CBCT-IOS workflow yielded the lowest average SCI measurements, whereas the JMA workflow produced the highest values. No significant differences were found in the SCI measurements between the left and right sides obtained by CBCT-IOS and JMA (P > .05), with the exception of the FS-IOS workflow (P = .002). Additionally, inter-flow comparisons revealed no significant differences in SCI measurements (P > .05), except when contrasting the SCI as measured by CBCT-IOS and JMA (P = .0131). The Bland-Altman plots demonstrated a high degree of consistency and 95% limits of agreement across the three digital workflows.

Conclusion: SCI measurements obtained from the three digital workflows exhibit a high degree of consistency and are interchangeable, affirming their clinical applicability for precise SCI assessment in young individuals with normal occlusion.

简介:本研究旨在比较三种工作流程得出的矢状髁状突倾角(SCI)测量结果:与锥束计算机断层扫描(CBCT)对齐的口内扫描(IOS)、与面部扫描(FS)对齐的口内扫描(IOS)以及颌骨运动分析仪(JMA)系统。此外,该研究还旨在找出造成这些测量方法差异的原因:24名咬合正常的健康人参加了此次临床试验。通过将 IOS 与 CBCT 和 FS 对齐,使用虚拟关节器(VA)划定 SCI,创建两个不同的工作流程,分别标记为 CBCT-IOS 和 FS-IOS。同时,还使用 JMA 采集了 SCI 测量数据。使用 Shapiro-Wilk 检验法检验了每个工作流程中双侧 SCI 测量值差异的数据分布的正态性。根据检验结果,我们采用配对样本 T 检验或 Wilcoxon 检验进行双侧 SCI 比较。工作流程间的差异采用 Kruskal-Wallis H 检验进行评估。布兰德-阿尔特曼图评估了每对数字方法之间的互换性和一致性,并评估了三种数字方法之间的总体一致性:分析结果显示,CBCT-IOS 工作流程得出的 SCI 平均测量值最低,而 JMA 工作流程得出的数值最高。通过 CBCT-IOS 和 JMA 获得的左右侧 SCI 测量值没有发现明显差异(P > .05),但 FS-IOS 工作流程除外(P = .002)。此外,流程间比较显示 SCI 测量值无明显差异(P > .05),但 CBCT-IOS 和 JMA 测量的 SCI 值对比除外(P = .0131)。布兰-阿尔特曼图显示了三种数字工作流程的高度一致性和 95% 的一致性限值:结论:通过三种数字工作流程获得的 SCI 测量值具有高度一致性和互换性,这肯定了它们在临床上适用于对闭塞正常的年轻人进行精确的 SCI 评估。
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引用次数: 0
Biomechanical evaluation of stability after mandibular sagittal split osteotomy for advancement by Obwegeser-Dal Pont and Puricelli techniques using three-dimensional finite elements. 利用三维有限元对采用 Obwegeser-Dal Pont 和 Puricelli 技术进行下颌矢状劈开截骨术以推进后的稳定性进行生物力学评估。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-06 DOI: 10.1186/s13005-024-00468-4
Vinícius Matheus Szydloski, Jakson Manfredini Vassoler, João Vitor Saggin Bordin, Ana Bárbara Krummenauer Formenton, Mauro Gomes Trein Leite, Renan Langie, Alexandre Silva de Quevedo, Edela Puricelli, Deise Ponzoni

Background: The surgical treatment for mandibular repositioning using a bilateral sagittal split osteotomy (BSSO) favours the development of techniques that result in adequate repair and stability. In Puricelli's mandibular sagittal split osteotomy (PMSSO) proposal, the vertical lateral cut osteotomy is located in the interradicular space between the lower first molar and second premolar.

Objectives: This in silico study aimed to investigate the mechanical stability of PMSSO and compare it with the classical Obwegeser-Dal Pont technique for mandibular advancement.

Materials and methods: A computational geometric model of the mandible was created in a virtual environment using computer-aided design (CAD) software. After reproducing the advancements, two test groups were developed: GTOD10, Obwegeser-Dal Pont osteotomy, and GTP10, Puricelli osteotomy, both simulating a 10-mm mandibular advancement, allowing for measuring the area of overlap between bone segments. With the geometric changes promoted by the osteotomy, boundary conditions of displacement and force were applied to a CAD software based on finite element analysis (FEA), allowing for quantitative and comparative analysis of the stress and vertical displacement of the mandible, mechanical measurements that may be associated with strength and stiffness.

Results: A 17.48% higher stress was observed in the GTP10 group than in GTOD10. However, the region of highest stress in GTP10 was found in a part of the bone that was still intact and far from the area of fragility caused by lateral vertical osteotomy. In contrast, in GTOD10, the region with high stress was in a less resistant bone region. The GTP10 group showed a 28.73% lower displacement than GTOD10. The area of overlap between the proximal and distal segments of the mandible was 33.13% larger in the GTP10 than in the GTOD10 group.

Conclusion: The PMSSO method, performed in large mandibular advancements, keeps the point of highest stress away from the mandibular fragility zone. Considering the same amount of advancement, it also promotes less displacement and larger areas of bone overlap.

Clinical relevance: The results suggest that PMSSO, applied in large mandibular advancement, presents greater postoperative stability.

背景:使用双侧下颌矢状劈开截骨术(BSSO)进行下颌复位的手术治疗有利于开发出能够实现充分修复和稳定性的技术。在 Puricelli 的下颌矢状劈开截骨术(PMSSO)方案中,垂直侧切截骨位于下第一磨牙和第二前磨牙之间的关节间隙:本研究旨在研究PMSSO的机械稳定性,并将其与经典的Obwegeser-Dal Pont下颌前突技术进行比较:使用计算机辅助设计(CAD)软件在虚拟环境中创建了下颌骨的计算几何模型。在复制了推进器后,开发了两个测试组:GTOD10(Obwegeser-Dal Pont 截骨术)和 GTP10(Puricelli 截骨术)都是模拟 10 毫米的下颌骨前移,可以测量骨段之间的重叠面积。根据截骨带来的几何变化,将位移和力的边界条件应用到基于有限元分析(FEA)的 CAD 软件中,对下颌骨的应力和垂直位移(可能与强度和刚度相关的力学测量值)进行定量比较分析:GTP10 组的应力比 GTOD10 组高 17.48%。然而,在 GTP10 组中,应力最高的区域位于骨质仍然完整的部分,远离因横向垂直截骨造成的脆性区域。相比之下,GTOD10 的高应力区域位于抵抗力较弱的骨骼区域。GTP10 组的位移量比 GTOD10 组低 28.73%。GTP10组下颌骨近段和远段的重叠面积比GTOD10组大33.13%:结论:PMSSO方法在下颌骨大范围前移时,可使最高应力点远离下颌骨脆性区。临床意义:临床相关性:研究结果表明,PMSSO 适用于下颌大范围前移,具有更高的术后稳定性。
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引用次数: 0
Proximal tibia for alveolar augmentation and augmentative rhinoplasty-a suitable option? A retrospective clinical study on donor and recipient site morbidity. 胫骨近端用于牙槽增高和隆鼻--合适的选择吗?关于供体和受体部位发病率的回顾性临床研究。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-30 DOI: 10.1186/s13005-024-00470-w
Paula Korn, Anastasia Melnikov, Matthias Kuhn, Samaneh Farahzadi, Günter Lauer, Tom Alexander Schröder

Background: Autologous bone grafts are essential in reconstructive oral and maxillofacial surgery, and depending on the donor site, they can be associated with specific harvesting morbidities. One of the most commonly applied bone grafts is the iliac crest bone graft, irrespective of other grafts, which might be associated with an easier surgical procedure or the possibility of harvesting them under local anaesthesia. Objective of the study is the clinical evaluation of proximal tibia bone grafts regarding their eligibility for maxillofacial bone grafting.

Methods: In this retrospective study, proximal tibia bone grafts were examined with regard to associated donor and recipient site morbidity and their suitability for alveolar ridge augmentation and rhinoplasty.

Results: In total, 21 tibia grafts were included. Fifty-seven percent of the bone grafts were used for alveolar ridge reconstruction, and 43% were used for augmentative rhinoplasty. No significant complications occurred during or after harvesting, but in 14.3% of the patients, minor wound healing disorders were recorded at the donor site, and in 19% of the patients, they were recorded at the recipient site. Statistically, patient sex, age, nicotine and alcohol abuse and metabolic diseases had no significant influence on the complication rate. Graft harvesting under local anaesthesia and at summer temperatures was associated with significantly more complications at the harvesting site (p < 0.05). In cases of dental implant insertion into augmented sites, the implants (n = 31) were followed up for a median period of 40.5 months, during this time 86.7% of the implants survived.

Conclusion: The proximal tibia is a suitable donor site for harvesting autologous bone grafts for alveolar ridge augmentation or rhinoplasty because the donor site morbidity is low, and in contrast to iliac crest bone grafts, they can be harvested under local anaesthesia, which might be advantageous for outpatient surgeries.

背景:自体骨移植在口腔颌面整形手术中至关重要,根据供骨部位的不同,自体骨移植可能与特定的取骨病症相关。最常用的骨移植物之一是髂嵴骨移植物,与其他移植物不同的是,髂嵴骨移植物可能与更简便的手术过程或在局部麻醉下采集骨移植物的可能性有关。本研究的目的是对胫骨近端植骨进行临床评估,以确定其是否符合颌面部植骨的要求:在这项回顾性研究中,对胫骨近端骨移植的相关供体和受体部位发病率及其是否适合用于牙槽嵴增高和鼻整形进行了检查:结果:共纳入 21 块胫骨移植物。结果:共纳入 21 块胫骨移植物,其中 57% 的骨移植物用于牙槽嵴重建,43% 用于隆鼻。取骨过程中或取骨后均未出现重大并发症,但有 14.3% 的患者在供骨部位出现轻微伤口愈合障碍,19% 的患者在受骨部位出现伤口愈合障碍。据统计,患者的性别、年龄、尼古丁和酒精滥用以及代谢性疾病对并发症发生率没有明显影响。在局部麻醉和夏季气温下采集移植物,采集部位的并发症明显增加(p 结论:胫骨近端是一个非常重要的部位:胫骨近端是采集自体骨移植物用于牙槽嵴增高术或鼻整形术的合适供体部位,因为供体部位的发病率较低,而且与髂嵴骨移植物相比,胫骨近端可以在局部麻醉下采集,这可能对门诊手术有利。
{"title":"Proximal tibia for alveolar augmentation and augmentative rhinoplasty-a suitable option? A retrospective clinical study on donor and recipient site morbidity.","authors":"Paula Korn, Anastasia Melnikov, Matthias Kuhn, Samaneh Farahzadi, Günter Lauer, Tom Alexander Schröder","doi":"10.1186/s13005-024-00470-w","DOIUrl":"10.1186/s13005-024-00470-w","url":null,"abstract":"<p><strong>Background: </strong>Autologous bone grafts are essential in reconstructive oral and maxillofacial surgery, and depending on the donor site, they can be associated with specific harvesting morbidities. One of the most commonly applied bone grafts is the iliac crest bone graft, irrespective of other grafts, which might be associated with an easier surgical procedure or the possibility of harvesting them under local anaesthesia. Objective of the study is the clinical evaluation of proximal tibia bone grafts regarding their eligibility for maxillofacial bone grafting.</p><p><strong>Methods: </strong>In this retrospective study, proximal tibia bone grafts were examined with regard to associated donor and recipient site morbidity and their suitability for alveolar ridge augmentation and rhinoplasty.</p><p><strong>Results: </strong>In total, 21 tibia grafts were included. Fifty-seven percent of the bone grafts were used for alveolar ridge reconstruction, and 43% were used for augmentative rhinoplasty. No significant complications occurred during or after harvesting, but in 14.3% of the patients, minor wound healing disorders were recorded at the donor site, and in 19% of the patients, they were recorded at the recipient site. Statistically, patient sex, age, nicotine and alcohol abuse and metabolic diseases had no significant influence on the complication rate. Graft harvesting under local anaesthesia and at summer temperatures was associated with significantly more complications at the harvesting site (p < 0.05). In cases of dental implant insertion into augmented sites, the implants (n = 31) were followed up for a median period of 40.5 months, during this time 86.7% of the implants survived.</p><p><strong>Conclusion: </strong>The proximal tibia is a suitable donor site for harvesting autologous bone grafts for alveolar ridge augmentation or rhinoplasty because the donor site morbidity is low, and in contrast to iliac crest bone grafts, they can be harvested under local anaesthesia, which might be advantageous for outpatient surgeries.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"66"},"PeriodicalIF":2.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Qualitative and quantitative assessment of infraoccluded deciduous teeth: a systematic review. 落叶齿闭锁的定性和定量评估:系统综述。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-30 DOI: 10.1186/s13005-024-00469-3
Teresa Temming, Susanne Waldmann, Anahita Jablonski-Momeni, Heike Korbmacher-Steiner

Background: Infraocclusion of deciduous teeth is a frequent dental anomaly caused by ankylosis accompanied by local growth disturbance. During puberal growth spurt an increasing progression of infraocclusion is detected. The clinical classification of ankylosed deciduous teeth varies considerably among scientific studies. The aim of this paper is to present an up-to-date overview of the variety of methods.

Methods: The systematic literature search followed the PRISMA guidelines and included the analysis of the following databases and study registries: PubMed (MEDLINE), the Cochrane Library, Web of Science, Embase.com and ClinicalTrials.gov from database inception until September 23, 2024. Studies that investigated at least one ankylosed deciduous tooth per participant in a quantitative or qualitative manner were included. Studies that evaluated only histological data were excluded. Controlled and uncontrolled clinical studies, retrospective studies, observational studies and cross-sectional studies were included. The studies were restricted to English and German languages. Case reports, case series, comments, expert opinions, letters to the editor, literature reviews and studies enrolling less than 10 patients or 10 infraoccluded teeth in total were excluded.

Results: Of 5645 records, 42 papers qualified for the final analysis. The evaluation of infraoccluded deciduous teeth was mainly (n = 37) performed by quantitative and semiquantitative assessment of the extent of infraposition at the occlusal level. The measurement reference differed considerably. Fewer studies have analyzed ankylosed deciduous teeth at the alveolar level by examining the contour of the alveolar ridge (n = 7) or the height of the alveolar process (n = 5). Even fewer studies (n = 4) have performed qualitative analysis at the skeletal level by evaluating the influence of the vertical skeletal growth pattern on the incidence of ankylosed deciduous teeth.

Conclusions: To carry out a comprehensive evaluation of infraoccluded deciduous teeth, an assessment of the occlusal, alveolar and potentially skeletal levels is advisable. Radiographic investigations i.e. panoramic radiographs are therefore essential as a supplement to clinical examination. There is a need for standardization and objectification of the methods for the classification of infraoccluded deciduous teeth to give a general recommendation of clinical performance.

Registration: This systematic review has been registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42024555842.

背景:乳牙内隐窝是一种常见的牙齿畸形,是由局部生长紊乱引起的牙槽骨强直造成的。在青春期生长高峰期,会发现牙齿咬合不齐的情况越来越严重。不同科学研究对乳牙强直的临床分类存在很大差异。本文旨在介绍各种方法的最新概况:系统性文献检索遵循 PRISMA 指南,包括对以下数据库和研究登记的分析:PubMed (MEDLINE)、Cochrane 图书馆、Web of Science、Embase.com 和 ClinicalTrials.gov。以定量或定性方式调查每位参与者至少一颗强直性乳牙的研究均被纳入。仅评估组织学数据的研究除外。研究包括对照和非对照临床研究、回顾性研究、观察性研究和横断面研究。研究仅限于英语和德语。病例报告、系列病例、评论、专家意见、致编辑的信、文献综述以及少于 10 名患者或总共少于 10 颗闭锁牙齿的研究均被排除在外:结果:在 5645 条记录中,42 篇论文符合最终分析条件。对闭锁乳牙的评估主要(n = 37)通过对咬合水平上的闭锁程度进行定量和半定量评估来完成。测量的参考值差别很大。较少研究通过检查牙槽嵴的轮廓(7 例)或牙槽突的高度(5 例)来分析牙槽骨水平的缺失乳牙。通过评估骨骼垂直生长模式对乳牙强直发生率的影响,在骨骼层面进行定性分析的研究更少(4 项):要对闭锁乳牙进行全面评估,最好对咬合、牙槽和潜在的骨骼水平进行评估。因此,作为临床检查的补充,射线检查(即全景射线照片)是必不可少的。有必要对乳牙内隐裂的分类方法进行标准化和客观化,以便为临床表现提供一般性建议:本系统综述已在国际系统综述前瞻性登记簿(PROSPERO)中登记,登记号为:CROD4202455584:CRD42024555842。
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引用次数: 0
MRI and CT imaging characteristics in parotid tumors with false-negative fine-needle aspirations. 腮腺肿瘤细针穿刺假阴性的 MRI 和 CT 成像特征。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-26 DOI: 10.1186/s13005-024-00467-5
Hyun Jee Lee, Hee Jin Kang, Jong Hwan Lee, Min Kyeong Lee, Su Il Kim, Young Chan Lee, Young-Gyu Eun

Backgrounds: Preoperative imaging, particularly with magnetic resonance imaging (MRI) and computed tomography (CT) scans, plays a crucial role in distinguishing between benign and malignant parotid gland tumors, while the reliability of Ultrasound-Guided Fine Needle Aspiration (FNA) in diagnosing these masses remains a topic of debate.

Methods: This two-center retrospective analysis was conducted on 347 patients with parotid gland tumors who had FNA and preoperative imaging (CT or MRI). All patients underwent surgery and final histopathological examination was available, along with complete medical records between January 2008 and May 2023.

Results: Among the 347 patients, 318 (92%) had benign and 10 (3%) had malignant tumors based on FNA, with 19 (5%) unsatisfactory specimens. Final histological diagnosis revealed 303 (87%) benign and 44 (13%) malignant lesions, with a false-negative rate of 10.6% for FNA. Multivariate analysis identified irregular shape and invasion as independent predictors of malignancy in patient with benign or unsatisfactory FNA results. The odds ratio for irregular shape was 3.06 and for invasion was 12.73.

Conclusion: Imaging characteristics, such as irregular shape and invasion may indicate towards malignant parotid tumors, even in patients with false-negative benign findings in FNA.

背景:术前成像,尤其是磁共振成像(MRI)和计算机断层扫描(CT)在区分腮腺良性肿瘤和恶性肿瘤方面起着至关重要的作用,而超声引导下细针抽吸术(FNA)诊断这些肿块的可靠性仍是一个争论不休的话题:本研究对 347 例腮腺肿瘤患者进行了两中心回顾性分析,这些患者均进行了 FNA 和术前成像(CT 或 MRI)。2008年1月至2023年5月期间,所有患者均接受了手术和最终组织病理学检查,并提供了完整的病历资料:在 347 名患者中,318 人(92%)为良性肿瘤,10 人(3%)为恶性肿瘤,19 人(5%)标本不满意。最终组织学诊断显示,303 例(87%)为良性病变,44 例(13%)为恶性病变,FNA 的假阴性率为 10.6%。多变量分析发现,形状不规则和浸润是良性或 FNA 结果不满意的患者发生恶性肿瘤的独立预测因素。不规则形状的几率比为 3.06,侵犯的几率比为 12.73:不规则形状和浸润等影像学特征可能预示着腮腺肿瘤的恶性程度,即使是 FNA 结果为假阴性的良性患者也不例外。
{"title":"MRI and CT imaging characteristics in parotid tumors with false-negative fine-needle aspirations.","authors":"Hyun Jee Lee, Hee Jin Kang, Jong Hwan Lee, Min Kyeong Lee, Su Il Kim, Young Chan Lee, Young-Gyu Eun","doi":"10.1186/s13005-024-00467-5","DOIUrl":"10.1186/s13005-024-00467-5","url":null,"abstract":"<p><strong>Backgrounds: </strong>Preoperative imaging, particularly with magnetic resonance imaging (MRI) and computed tomography (CT) scans, plays a crucial role in distinguishing between benign and malignant parotid gland tumors, while the reliability of Ultrasound-Guided Fine Needle Aspiration (FNA) in diagnosing these masses remains a topic of debate.</p><p><strong>Methods: </strong>This two-center retrospective analysis was conducted on 347 patients with parotid gland tumors who had FNA and preoperative imaging (CT or MRI). All patients underwent surgery and final histopathological examination was available, along with complete medical records between January 2008 and May 2023.</p><p><strong>Results: </strong>Among the 347 patients, 318 (92%) had benign and 10 (3%) had malignant tumors based on FNA, with 19 (5%) unsatisfactory specimens. Final histological diagnosis revealed 303 (87%) benign and 44 (13%) malignant lesions, with a false-negative rate of 10.6% for FNA. Multivariate analysis identified irregular shape and invasion as independent predictors of malignancy in patient with benign or unsatisfactory FNA results. The odds ratio for irregular shape was 3.06 and for invasion was 12.73.</p><p><strong>Conclusion: </strong>Imaging characteristics, such as irregular shape and invasion may indicate towards malignant parotid tumors, even in patients with false-negative benign findings in FNA.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"64"},"PeriodicalIF":2.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient self rated pain: headache versus migraine a retrospective chart review. 患者自评疼痛:头痛与偏头痛的回顾性病历审查。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-26 DOI: 10.1186/s13005-024-00465-7
Elizabeth Toigo, Erin Pellot, Hannah Lyons, Peter McAllister, Martin Taylor

Background: The International Classification of Headache Disorders (ICHD-3) uses moderate or severe pain intensity in the diagnostic criterion for migraine. However, few studies have analyzed pain rating on a visual analog scale to identify the numerical intensity that correlates with migraine.

Objective: To evaluate the impact of daily self-rated headache pain among patients with either episodic or chronic migraine. This study specifically aims to evaluate the probability of patients labeling their head pain as a headache vs. migraine based on the pain level reported.

Methods: A retrospective chart review was conducted on patients with a clinical diagnosis of migraine from July 1, 2014, to July 1, 2019.

Results: Data of 114 subjects (57 episodic migraine and 57 chronic migraine) were used for analysis. Patients with episodic migraine on average rated a migraine more severe than a headache (4.1 vs. 6.4; p < 0.001). Patients with chronic migraine on average also rated migraine more severe than a headache (4.3 vs. 6.8; p = 0.0054). Chronic migraine patients transitioned from calling head pain a headache to a migraine significantly later than episodic migraine patients (4.5 vs. 6.8; p < 0.05).

Conclusion: A migraine is perceived as having higher pain intensity than a headache in patients with both episodic and chronic migraine. On average, patients with chronic migraine had a higher pain rating at which they report head pain to be considered a migraine.

背景:国际头痛疾病分类(ICHD-3)将中度或重度疼痛强度作为偏头痛的诊断标准。然而,很少有研究通过分析视觉模拟量表的疼痛评分来确定与偏头痛相关的数字强度:目的:评估发作性偏头痛或慢性偏头痛患者每日自我评定的头痛程度对偏头痛的影响。本研究特别旨在评估患者根据所报告的疼痛程度将其头部疼痛标注为头痛与偏头痛的概率:对2014年7月1日至2019年7月1日期间临床诊断为偏头痛的患者进行回顾性病历审查:对114名受试者(57名发作性偏头痛患者和57名慢性偏头痛患者)的数据进行了分析。发作性偏头痛患者平均认为偏头痛比头痛更严重(4.1 vs. 6.4;P 结论:偏头痛比头痛更严重:发作性偏头痛和慢性偏头痛患者都认为偏头痛的疼痛强度高于头痛。平均而言,慢性偏头痛患者将头部疼痛视为偏头痛的疼痛等级更高。
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引用次数: 0
Amphiregulin promotes activated regulatory T cell-suppressive function via the AREG/EGFR pathway in laryngeal squamous cell carcinoma. 安非拉酮通过AREG/EGFR途径促进喉鳞状细胞癌中活化的调节性T细胞的抑制功能
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-26 DOI: 10.1186/s13005-024-00466-6
Hang Li, Ruihua Fang, Renqiang Ma, Yudong Long, Rui He, Huanhuan Lyu, Lin Chen, Yihui Wen

Background: Activated regulatory T cells (aTregs) play a vital role in promoting a tumor immunosuppressive microenvironment in laryngeal squamous cell carcinoma (LSCC). However, the regulatory factors that induce the generation of aTregs are not clear. Herein, we investigated the effect of amphiregulin (AREG) on the production of aTregs in the tumor microenvironment of LSCC.

Methods: Immunohistochemical (IHC) analysis was conducted to examine the expression of AREG and FOXP3, and their association with clinical parameters and patient outcomes was demonstrated. The expression level of EGFRs in three functional subsets of Tregs was assessed, and the induction of CD4+ T cells into aTregs in the presence or absence of AREG or Gefitinib was analyzed using flow cytometry.

Results: Our results showed a higher expression level of AREG was significantly related to advanced clinical stage and worse survival, particularly with increased infiltration of Tregs in LSCC tumor tissue. The in vitro study showed that AREG significantly promoted the differentiation of aTregs, and enhanced the inhibitory effect of Tregs on T cell proliferation, which could be reversed by epidermal growth factor receptor (EGFR) inhibitors. In addition, we found that EGFR was highly expressed in aTregs, but not in other subsets of Tregs. It is suggested that AREG might induce aTregs, and enhance the immunosuppressive function of Tregs via the AREG/EGFR signal pathway.

Conclusions: Collectively, this study revealed the role and mechanism of AREG in negative immune regulation, and targeting AREG might be a novel immunotherapy for LSCC.

背景:活化的调节性 T 细胞(aTregs)在促进喉鳞状细胞癌(LSCC)的肿瘤免疫抑制微环境中发挥着重要作用。然而,诱导aTregs产生的调节因素尚不清楚。在此,我们研究了两性胰岛素(AREG)对LSCC肿瘤微环境中aTregs生成的影响:免疫组化(IHC)分析检测了AREG和FOXP3的表达,并证明了它们与临床参数和患者预后的关系。评估了三个功能性Tregs亚群中表皮生长因子受体的表达水平,并使用流式细胞术分析了在有无AREG或吉非替尼的情况下CD4+ T细胞被诱导成aTregs的情况:结果:我们的研究结果表明,AREG表达水平越高,临床分期越晚,生存率越低,特别是与LSCC肿瘤组织中Tregs浸润增加密切相关。体外研究表明,AREG能明显促进aTregs的分化,增强Tregs对T细胞增殖的抑制作用,而表皮生长因子受体(EGFR)抑制剂能逆转这种抑制作用。此外,我们还发现表皮生长因子受体在 aTregs 中高表达,而在 Tregs 的其他亚群中却没有表达。这表明 AREG 可能诱导 aTregs,并通过 AREG/EGFR 信号通路增强 Tregs 的免疫抑制功能:综上所述,本研究揭示了AREG在负性免疫调节中的作用和机制,靶向AREG可能是治疗LSCC的一种新型免疫疗法。
{"title":"Amphiregulin promotes activated regulatory T cell-suppressive function via the AREG/EGFR pathway in laryngeal squamous cell carcinoma.","authors":"Hang Li, Ruihua Fang, Renqiang Ma, Yudong Long, Rui He, Huanhuan Lyu, Lin Chen, Yihui Wen","doi":"10.1186/s13005-024-00466-6","DOIUrl":"10.1186/s13005-024-00466-6","url":null,"abstract":"<p><strong>Background: </strong>Activated regulatory T cells (aTregs) play a vital role in promoting a tumor immunosuppressive microenvironment in laryngeal squamous cell carcinoma (LSCC). However, the regulatory factors that induce the generation of aTregs are not clear. Herein, we investigated the effect of amphiregulin (AREG) on the production of aTregs in the tumor microenvironment of LSCC.</p><p><strong>Methods: </strong>Immunohistochemical (IHC) analysis was conducted to examine the expression of AREG and FOXP3, and their association with clinical parameters and patient outcomes was demonstrated. The expression level of EGFRs in three functional subsets of Tregs was assessed, and the induction of CD4<sup>+</sup> T cells into aTregs in the presence or absence of AREG or Gefitinib was analyzed using flow cytometry.</p><p><strong>Results: </strong>Our results showed a higher expression level of AREG was significantly related to advanced clinical stage and worse survival, particularly with increased infiltration of Tregs in LSCC tumor tissue. The in vitro study showed that AREG significantly promoted the differentiation of aTregs, and enhanced the inhibitory effect of Tregs on T cell proliferation, which could be reversed by epidermal growth factor receptor (EGFR) inhibitors. In addition, we found that EGFR was highly expressed in aTregs, but not in other subsets of Tregs. It is suggested that AREG might induce aTregs, and enhance the immunosuppressive function of Tregs via the AREG/EGFR signal pathway.</p><p><strong>Conclusions: </strong>Collectively, this study revealed the role and mechanism of AREG in negative immune regulation, and targeting AREG might be a novel immunotherapy for LSCC.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"62"},"PeriodicalIF":2.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bovine pulp extracellular matrix hydrogel for regenerative endodontic applications: in vitro characterization and in vivo analysis in a necrotic tooth model. 用于牙髓再生的牛髓细胞外基质水凝胶:坏死牙模型的体外表征和体内分析。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-22 DOI: 10.1186/s13005-024-00460-y
Hisham Elnawam, Abdelrahman Thabet, Ahmed Mobarak, Nesma Mohamed Khalil, Amr Abdallah, Samir Nouh, Rania Elbackly

Background: Regenerative endodontic procedures (REPs) offer the promise of restoring vitality and function to a previously necrotic and infected tooth. However, the nature of regenerated tissues following REPs remains unpredictable and uncontrollable. Decellularized extracellular matrix scaffolds have gained recent attention as scaffolds for regenerative endodontics.

Objectives: Preparation and characterization of a bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel for regenerative endodontic applications. Biocompatibility and regenerative capacity of the prepared scaffold were evaluated in vivo in a canine animal model.

Methods: Fifteen freshly extracted bovine molar teeth were used to prepare P-ECM hydrogels following approval of the institutional review board of the faculty of dentistry, Alexandria University. Decellularization and lyophilization of the extracted pulp tissues, DNA quantification and histological examination of decellularized P-ECM were done. P-ECM hydrogel was prepared by digestion of decellularized pulps. Prepared scaffolds were evaluated for protein content and release as well as release of VEGF, bFGF, TGF-β1 and BMP2 using ELISA. Rabbit dental pulp stem cells' (rDPSCs) viability in response to P-ECM hydrogels was performed. Finally, proof-of-concept of the regenerative capacity of P-ECM scaffolds was assessed in an infected mature canine tooth model following REPs versus blood clot (BC), injectable platelet-rich fibrin (i-PRF) or hyaluronic acid (HA). Statistical analysis was done using independent t test, the Friedman test and chi-square tests (p value ≤ 0.05).

Results: DNA was found to be below the cut-off point (50 ng/mg tissue). Histological evaluation revealed absence of nuclei, retention of glycosaminoglycans (GAGs) and collagen content, respectively. P-ECM hydrogel had a total protein content of (493.12 µg/µl) and protein release was detected up to 14 days. P-ECM hydrogel also retained VEGF, bFGF, TGF-β1 and BMP2. P-ECM hydrogel maintained the viability of rDPSCs as compared to cells cultured under control conditions. P-ECM hydrogel triggered more organized tissues compared to BC, i-PRF and HA when used in REPs for necrotic mature teeth in dogs. Periapical inflammation was significantly less in HA and P-ECM groups compared to blood-derived scaffolds.

Conclusion: Bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel scaffold retained its bioactive properties and demonstrated a promising potential in regenerative endodontic procedures compared to conventional blood-derived scaffolds.

背景:牙髓再生术(REP)有望恢复先前坏死和感染的牙齿的活力和功能。然而,牙髓再生术后再生组织的性质仍然无法预测和控制。脱细胞细胞外基质支架作为牙髓再生治疗的支架最近受到了关注:制备和表征用于牙髓再生的牛牙髓源性细胞外基质(P-ECM)水凝胶。在犬科动物模型中评估了所制备支架的生物相容性和再生能力:方法:经亚历山大大学牙科学院审查委员会批准,使用 15 颗新鲜拔出的牛臼齿制备 P-ECM 水凝胶。对提取的牙髓组织进行脱细胞和冻干处理,对脱细胞的 P-ECM 进行 DNA 定量和组织学检查。通过消化脱细胞的牙髓组织制备了 P-ECM 水凝胶。使用 ELISA 评估了制备的支架的蛋白质含量和释放量,以及 VEGF、bFGF、TGF-β1 和 BMP2 的释放量。此外,还检测了兔牙髓干细胞(rDPSCs)对 P-ECM 水凝胶的存活率。最后,在受感染的成熟犬牙模型中评估了 P-ECM 支架的再生能力概念验证,即 REP 与血凝块(BC)、可注射富血小板纤维蛋白(i-PRF)或透明质酸(HA)的对比。统计分析采用独立 t 检验、弗里德曼检验和卡方检验(P 值≤ 0.05):结果:发现 DNA 低于临界点(50 纳克/毫克组织)。组织学评估分别显示无细胞核、保留糖胺聚糖(GAGs)和胶原蛋白含量。P-ECM 水凝胶的总蛋白质含量为(493.12 µg/µl),蛋白质释放时间长达 14 天。P-ECM 水凝胶还保留了 VEGF、bFGF、TGF-β1 和 BMP2。与在对照条件下培养的细胞相比,P-ECM 水凝胶保持了 rDPSCs 的活力。与 BC、i-PRF 和 HA 相比,P-ECM 水凝胶在用于犬坏死成熟牙齿的 REPs 时,能引发更有组织的组织。与血液衍生支架相比,HA 和 P-ECM 组的根尖周炎明显较少:结论:与传统的血液来源支架相比,牛牙髓来源的细胞外基质(P-ECM)水凝胶支架保留了其生物活性特性,并在牙髓再生手术中表现出了巨大的潜力。
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引用次数: 0
Dentofacial and skeletal effects of two orthodontic maxillary protraction protocols: bone anchors versus facemask. 两种上颌正畸牵引方案对牙面和骨骼的影响:骨锚与面罩。
IF 2.4 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-18 DOI: 10.1186/s13005-024-00462-w
Maike Tabellion, Jörg Alexander Lisson

Background: Maxillary retrognathia and/or mandibular prognathia are resulting in class III malocclusion. Regarding orthodontic class III malocclusion treatment, the literature reports several treatment approaches. This comparative clinical study investigated two maxillary protraction protocols including bone anchors and Delaire type facemask.

Methods: Cephalometric radiographs of n = 31 patients were used for data acquisition. The patients were divided into two groups according to their treatment protocol: bone anchored protraction (n = 12, 8 female, 4 male; mean age 11.00 ± 1.76 years; average application: 13.50 ± 5.87 months) and facemask protraction (n = 19, 11 female, 8 male; mean age 6.74 ± 1.15 years; average application: 9.95 ± 4.17 months). The evaluation included established procedures for measurements of the maxilla, mandibula, incisor inclination and soft tissue. Statistics included Shapiro-Wilk- and T-Tests for the radiographs. The level of significance was set at p < 0.05.

Results: The cephalometric analysis showed differences among the two groups. SNA angle showed significant improvements during protraction with bone anchors (2.30 ± 1.18°) with increase in the Wits appraisal of 2.01 ± 2.65 mm. SNA angle improved also during protraction with facemask (1.22 ± 2.28°) with increase in the Wits appraisal of 1.85 ± 4.09 mm. Proclination of maxillary incisors was larger in patients with facemask (3.35 ± 6.18°) and ML-SN angle increased more (1.05 ± 1.51°) than in patients with bone anchors. Loosening rate of bone anchors was 14.58%.

Conclusions: Both treatment protocols led to correction of a class III malocclusion. However, this study was obtained immediately after protraction treatment and longitudinal observations after growth spurt will be needed to verify the treatment effects over a longer period. The use of skeletal anchorage for maxillary protraction reduces unwanted side effects and increases skeletal effects needed for class III correction.

背景介绍上颌后缩和/或下颌前突导致 III 类错牙合畸形。关于 III 类错牙合畸形的正畸治疗,文献报道了多种治疗方法。这项临床对比研究调查了两种上颌前突治疗方案,包括骨锚和德莱尔型面罩:方法: 收集 n = 31 名患者的头颅X光片数据。根据治疗方案将患者分为两组:骨固定牵引(n = 12,8 名女性,4 名男性;平均年龄为 11.00 ± 1.76 岁;平均应用时间为 13.50 ± 5.87 个月:13.50 ± 5.87 个月)和面罩牵引(n = 19,女性 11 人,男性 8 人;平均年龄 6.74 ± 1.15 岁;平均应用时间:9.95 ± 4.17 个月)。评估包括测量上颌骨、下颌骨、门牙倾斜度和软组织的既定程序。统计数据包括对射线照片的 Shapiro-Wilk 检验和 T 检验。显著性水平设定为 p 结果:头颅测量分析表明两组之间存在差异。在使用骨锚进行牵引时,SNA 角有明显改善(2.30 ± 1.18°),Wits 评估值增加了 2.01 ± 2.65 mm。在使用面罩进行牵引时,SNA 角也有所改善(1.22 ± 2.28°),Wits 评估值增加了 1.85 ± 4.09 mm。与使用骨锚的患者相比,使用面罩的患者上颌切牙的倾斜度更大(3.35 ± 6.18°),ML-SN 角的增加幅度更大(1.05 ± 1.51°)。骨锚松动率为 14.58%:两种治疗方案都能矫正 III 类错牙合畸形。结论:两种治疗方案都能矫正 III 度错牙合畸形,但本研究是在牵引治疗后立即进行的,因此需要在生长高峰后进行纵向观察,以验证较长时间内的治疗效果。在上颌前突治疗中使用骨骼锚可以减少不必要的副作用,并提高 III 类错牙合畸形矫正所需的骨骼效果。
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引用次数: 0
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