Impact of Ischemia Duration on Lower Limb Salvage in Combat Casualties

alexandrossfakianakis shared this article with you from Inoreader Impact of Ischemia Duration on Lower Limb Salvage in Combat Casualties via Annals of Surgery - Most Popular Articles Introduction: The 6-hour threshold to revascularization of an ischemic limb is ubiquitous in the trauma literature, however, contemporary evidence suggests that this threshold should be less. This study aims to characterize the relationship between the duration of limb ischemia and successful limb salvage following lower extremity arterial trauma. Methods: This is a cohort study of the United States and UK military service members injured while serving in Iraq or Afghanistan between 2003 and 2013. Consecutive patients who sustained iliac, femoral, or popliteal artery injuries, and underwent surgery to attempt revascularization, were included. The association between limb outcome and the duration of limb ischemia was assessed using the Kaplan-Meier method. Results: One hundred twenty-two patients (129 limbs) who sustained iliac (2.3%), femoral (56.6%), and popliteal (41.1%) arterial injuries were included. Overall, 87 limbs (67.4%) were successfully salvaged. The probability of limb salvage was 86.0% when ischemia was ≤1 hour; 68.3% when between 1 and 3 hours; 56.3% when between 3 and 6 hours; and 6.7% when >6 hours (P View on Web

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Rapid Additive Manufacturing of a Superlight Obturator for Large Oronasal Fistula in Pediatric Patient

alexandrossfakianakis shared this article with you from Inoreader Rapid Additive Manufacturing of a Superlight Obturator for Large Oronasal Fistula in Pediatric Patient via The Laryngoscope This study developed a novel digital workflow to fabricate a 3D printed hollow obturator for the prosthetic reconstruction of palatal fistula. It will provide cleft surgeons and therapists a choice for treating children with large palatal fistula before the appropriate age for surgical reconstruction. Laryngoscope, 2022 View on Web

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Assessing transmission risks and control strategy for monkeypox as an emerging zoonosis in a metropolitan area

alexandrossfakianakis shared this article with you from Inoreader Assessing transmission risks and control strategy for monkeypox as an emerging zoonosis in a metropolitan area via Journal of Medical Virology Abstract Objective To model the spread of Monkeypox (MPX) in a metropolitan area for assessing the risk of possible outbreaks, and identifying essential public health measures to contain the virus spread. Methods The animal reservoir is the key element in the modelling of a zoonotic disease. Using a One Health approach, we model the spread of the MPX virus in humans considering potential animal hosts such as rodents (e.g., rats, mice, squirrels, chipmunks, etc.) and emphasize their role and transmission of the virus in a high-risk group, including gay and bisexual men-who-have-sex-with-men (gbMSM). From model and sensitivity analysis, we identify key public health factors and present scenarios under different transmission assumptions. Findings We find that the MPX virus may spill over from gbMSM high-risk groups to broader populations if efficiency of transmission increases in the higher-risk group. However, the risk of outbreak can be greatly reduced if at least 65% of symptomatic cases can be isolated and their contacts traced and quarantined. In addition, infections in an animal reservoir will exacerbate MPX transmission risk in the human population. Conclusion Regions or communities with a higher proportion of gbMSM individuals need greater public health attention. Tracing and quarantine (or "effective quarantine" by post-exposure vaccination) of contacts with MPX cases in high-risk groups would have a significant effect on controlling the spreading. Also, monitoring for animal infections would be prudent. This article is protected by copyright. All rights reserved. View on Web

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Improving causal inference of mediation analysis with multiple mediators using interventional indirect effects

alexandrossfakianakis shared this article with you from Inoreader Improving causal inference of mediation analysis with multiple mediators using interventional indirect effects via Social and Personality Psychology Compass Abstract Mediation analysis is indispensable for investigating how a treatment causally affects an outcome via intervening variables. Existing discussions on the validity of causal inference drawn from mediation analysis have prioritized single mediator settings. In this article, we focus on improving causal inference when investigating multiple mediators. We pay particular attention to the prevalent practice of exploring mediated effects along various paths linking several mediators. Such approaches are fraught with stringent—yet often overlooked—causal assumptions that predicate valid inference of indirect or mediated effects. To mitigate the risk of incorrect inference, we introduce a conceptually and substantively novel approach from the causal inference literature: interventional indirect effects. Interventional indirect effects focus on the contributions of each distinct mediator to the treatment effect on the outcome. An appealing feature of this approach is that valid causal in ference of mediation analysis with multiple mediators can be attained without assuming a (correct) causal structure among the mediators. Using a social psychology experiment as a running example, we illustrate how researchers can readily estimate and interpret the proposed interventional effects in practice. We hope this article will encourage explaining and substantiating the causal assumptions underpinning mediation analysis with multiple mediators to fortify causal inference in psychology research. View on Web

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Relationships between squamous cell carcinoma antigen and cytokeratin 19 fragment values and renal function in oral cancer patients

alexandrossfakianakis shared this article with you from Inoreader Relationships between squamous cell carcinoma antigen and cytokeratin 19 fragment values and renal function in oral cancer patients via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA) are used to screen and monitor oral cancer patients. However, recent studies have reported that tumour markers become elevated as renal function decreases, regardless of tumour progression. A retrospective study was performed of 423 oral cancer patients who underwent blood testing for these tumour markers and other blood analytes during a 10-year period. The values of SCC-Ag and CYFRA increased significantly with decreasing renal function (P   (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Association between human papillomavirus infection and malignant transformation of sinonasal inverted papilloma: A systematic review and meta-analysis

alexandrossfakianakis shared this article with you from Inoreader Association between human papillomavirus infection and malignant transformation of sinonasal inverted papilloma: A systematic review and meta-analysis via ScienceDirect Publication: American Journal of Otolaryngology Publication date: Available online 11 September 2022 Source: American Journal of Otolaryngology Author(s): Fabio Ferreli, Matteo Di Bari, Antoine Moya-Plana, Federica Canzano, Emanuela Morenghi, Armando De Virgilio, Giuseppe Mercante, Giuseppe Spriano, Giovanni Colombo View on Web

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Sulopenem For The Treatment of Complicated Urinary Tract Infection Including Pyelonephritis: A Phase 3 Randomized Trial

alexandrossfakianakis shared this article with you from Inoreader Sulopenem For The Treatment of Complicated Urinary Tract Infection Including Pyelonephritis: A Phase 3 Randomized Trial via Clinical Infectious Diseases Advance Access Abstract Background Sulopenem is a thiopenem antibiotic being developed for the treatment of multidrug-resistant infections. The availability of both IV and oral formulations will facilitate earlier discharge of hospitalized patients. Methods Hospitalized adults with pyuria, bacteriuria and signs and symptoms of cUTI were randomized to five days of IV sulopenem followed by oral sulopenem etzadroxil/probenecid or five days of IV ertapenem followed by oral ciprofloxacin or amoxicillin-clavulanate, depending on baseline uropathogen susceptibility. The primary endpoint was the overall combined clinical and microbiologic response at the Test of Cure visit on Day 21. Results Of 1392 treated patients, 444 and 440 treated with sulopenem and ertapenem, respectively, had a positive urine culture at baseline and were eligible for the primary efficacy analyses. Organisms producing an extended spectrum beta-lactamase (ESBL) were identified in 26.6% of patients and fluoroquinolone non-susceptible pathogens in 38.6%. For the primary endpoint, noninferiority of sulopenem to the comparator regimen was not demonstrated, 67.8% vs. 73.9% (difference, -6.1%; 95% CI: -12.0, -0.1%). The difference was driven by the lower rate of asymptomatic bacteriuria in the subgroup of ertapenem-treated patients who stepped down to oral ciprofloxacin. No substantial difference in overall response was observed at any other timepoint. Both the IV and oral formulations of sulopenem were well-tolerated and compared favorably to the comparator regimen. Conclusions Sulopenem followed by oral sulopenem-etzadroxil/probenecid was not non-inferior to ertapenem followed by oral step-down therapy for the treatment of cUTI, driven by a lower rate of asymptomatic bacteriuria in those receiving ciprofloxacin. Both formulations of sulopenem were well-tolerated.Clinical Trial Registration: NCT03357614 View on Web

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