Functional and biomechanical assessment of the hand following ulnar forearm free flap transfer: Prospective self‐controlled study

alexandrossfakianakis shared this article with you from Inoreader Functional and biomechanical assessment of the hand following ulnar forearm free flap transfer: Prospective self‐controlled study via Head & Neck Abstract Background There is a shortage of well-designed self-controlled studies evaluating hand biomechanics following ulnar forearm flap (UFF) harvest. This study was conducted to evaluate objective and subjective functional outcomes of the donor's hand following UFF harvest. Methods All patients undergoing UFF were included for analysis. Grip strength, wrist movement, forearm supination and pronation, pinch strengths, sensation to light touch and temperature, and hand dexterity were assessed preoperatively and at 1, 3, and 6 months postoperatively. In addition, DASH score (disabilities of the arm, shoulder, and hand score) and Patient and Observer Scar Assessment Scale (POSAS) were analyzed. Results A total of 18 patients were enrolled. A significant reduction in grip strength for donor's hand was observed between preoperative and postoperative 1 and 3 months (mean difference = 14 kg, 7.38 kg, respectively, p = 0.000 for all). A similar trend was observed for pinch strength and range of motion (p < 0.05). Three months after surgery, there is still a significant reduction in tip pinch, tripod pinch, wrist extension, and supination. All biomechanics outcomes returned to preoperative baseline at 6 months after surgery. No patients suffered significant changes in sensation to light touch, temperature, and numbness by 6 months. There was a significant increase in DASH score by 3.37 points 6 months after operation (p = 0.000). The POSAS score indicates satisfaction with the appearance of the donor site. Conclusions UFF is a safe and reliable option for oral cavity reconstruction with minimum donor site morbidities, mainly when cosmesis is paramount. Furthermore, objective hand biomechanics ultimately returns to its preoperative state within 6 months after surgery. View on Web

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Beta-lactam antibiotic therapeutic drug monitoring in critically ill patients: a systematic review and meta-analysis et al.

alexandrossfakianakis shared this article with you from Inoreader Beta-lactam antibiotic therapeutic drug monitoring in critically ill patients: a systematic review and meta-analysis et al. via Clinical Infectious Diseases Advance Access ABSTRACT Therapeutic drug monitoring (TDM) of beta-lactam antibiotics is recommended to address the variability in exposure observed in critical illness. However, the impact of TDM-guided dosing on clinical outcomes remains unknown. We conducted systematic review and meta-analysis on TDM-guided dosing and clinical outcomes (all-cause mortality, clinical cure, microbiological cure, treatment failure, hospital and ICU length of stay, target attainment, antibiotic-related adverse events, and emergence of resistance) in critically ill patients with suspected or proven sepsis. Eleven studies (n = 1463 participants) were included. TDM-guided dosing was associated with improved clinical cure (Relative Risk 1.17; 95% Confidence Interval [1.04, 1.31]), microbiological cure (1.14; [1.03, 1.27]), treatment failure (0.79; [0.66, 0.94]), and target attainment (1.85; [1.08, 3.16]). No associations with mortality and length of stay were found. TDM-guided dosing impr oved clinical and microbiological cure, and treatment response. Larger, prospective randomized trials are required to better assess the utility of beta-lactam TDM in critically ill patients. View on Web

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Periodontitis may induce gut microbiota dysbiosis via salivary microbiota

alexandrossfakianakis shared this article with you from Inoreader Periodontitis may induce gut microbiota dysbiosis via salivary microbiota via International Journal of Oral Science - Issue View on Web

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A hierarchical vascularized engineered bone inspired by intramembranous ossification for mandibular regeneration

alexandrossfakianakis shared this article with you from Inoreader A hierarchical vascularized engineered bone inspired by intramembranous ossification for mandibular regeneration via International Journal of Oral Science - Issue International Journal of Oral Science, Published online: 22 June 2022; doi:10.1038/s41368-022-00179-z A hierarchical vascularized engineered bone inspired by intramembranous ossification for mandibular regeneration View on Web

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Pregnancy exposure to phenols and anthropometric measures in gestation and at birth

alexandrossfakianakis shared this article with you from Inoreader Pregnancy exposure to phenols and anthropometric measures in gestation and at birth via Epidemiology - Published Ahead-of-Print Background: Some synthetic phenols alter pathways involved in fetal development. Despite their high within-subject temporal variability, earlier studies relied on spot urine samples to assess pregnancy exposure. In this study, we examined associations between prenatal phenol exposure and fetal growth. Methods: We measured concentrations of two bisphenols, four parabens, benzophenone-3, and triclosan in 478 pregnant women in two weekly pools of 21 samples each, collected at 18 and 34 gestational weeks. We used adjusted linear regressions to study associations between phenol concentrations and growth outcomes assessed twice during pregnancy and at birth. Results: Benzophenone-3 was positively associated with all ultrasound growth parameters in at least one time point, in males but not females. In females, butylparaben was negatively associated with third trimester abdominal circumference and weight at birth. We observed isolated associations for triclosan (negative) and for methylparaben and bisphenol S (positive) and late pregnancy fetal growth. Conclusions: Our results suggest associations between prenatal exposure to phenols and fetal growth. Benzophenone-3 was the exposure most consistently (positively) associated across all growth parameters. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on Web

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A novel homozygous missense mutation in the FASTKD2 gene leads to Lennox-Gastaut syndrome

alexandrossfakianakis shared this article with you from Inoreader A novel homozygous missense mutation in the <i>FASTKD2</i> gene leads to Lennox-Gastaut syndrome via Journal of Human Genetics - Issue - nature.com science feeds Journal of Human Genetics, Published online: 21 June 2022; doi:10.1038/s10038-022-01056-7 A novel homozygous missense mutation in the FASTKD2 gene leads to Lennox-Gastaut syndrome View on Web

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Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants

alexandrossfakianakis shared this article with you from Inoreader Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants via Journal of Oral Rehabilitation Abstract Background Studies addressing the training-induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking. Objective This study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task (OMT) on corticomotor control of the lips, masseter, and tongue muscles in young healthy participants. Methods A total of 22 young healthy volunteers performed 3 consecutive days of training in an OMT. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the lip, masseter, tongue, and first dorsal interosseous (FDI, internal control) muscles. MEPs were assessed by stimulus-response curves and corticomotor mapping at baseline and after OMT. The DDK rate from PaTaKa single syllable repetition and numeric rating scale (NRS) scores were also obtained at baseline and immediately after each OMT. Repeated-measures analysis of variance was used to detect differences at a significance level of 5%. Results There was a significant effect of OMT and stimulus intensity on the lips, masseter, and tongue MEPs compared to baseline (P < 0.001), but not FDI MEPs (P > 0.05). OMT increased corticomotor topographic maps area (P < 0.001), and DDK rates (P < 0.01). Conclusion Our findings suggest that 3 consecutive days of a repeated PaTaKa training in an OMT can induce neuroplastic changes in the corticomotor pathways of orofacial muscles, and it may be related to mechanisms underlying the improvement of orofacial fine motor skills due to short-term training. The clinical utility should now be investigated. View on Web

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