In vitro Inhibition of Biofilm Formation on Silicon Rubber Voice Prosthesis: Α Systematic Review and Meta-Analysis

Introduction: Biofilm formation on voice prostheses is the primary reason for their premature implant dysfunction. Multiple strategies have been proposed over the last decades to achieve inhibition of biofilm formation on these devices. The purpose of this study was to assess the results of the available in vitro biofilm inhibition modalities on silicone rubber voice prostheses. Methods: We conducted a systematic search in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases up to February 29, 2020. A total of 33 in vitro laboratory studies investigating the efficacy of different coating methods against Candida, Staphylococcus, Streptococcus, Lactobacilli, and Rothia biofilm growth on silicone rubber medical devices were included. Subgroup analysis linked to the type of prevention modality was carried out, and quality assessment was performed with the use of the modified CONSORT tool. Results: Data from 33 studies were included in qualitative analysis, of which 12 qualified for quantitative analysis. For yeast biofilm formation assessment, there was a statistically significant difference in favor of the intervention group (standardized mean difference [SMD] = −1.20; 95% confidence interval [CI] [−1.73, −0.66]; p < 0.0001). Subgroup analysis showed that combined methods (active and passive surface modification) are the most effective for biofilm inhibition in yeast (SMD = −2.53; 95% CI [−4.02, −1.03]; p = 0.00001). No statistically significant differences between intervention and control groups were shown for bacterial biofilm inhibition (SMD = −0.09; 95% CI [−0.68, 0.46]; p = 0.65), and the results from the subgroup analysis found no notable differences between the surface modification methods. After analyzing data on polymicrobial biofilms, a statistically significant difference in favor of prevention methods in comparison with the control group was detected (SMD = −2.59; 95% CI [−7.48, 2.31]; p = 0.30). Conclusions: The meta-analysis on biofilm inhibition demonstrated significant differences in favor of yeast biofilm inhibition compared to bacteria. A stronger inhibition with the application of passive or combined active and passive surface modification techniques was reported

Mastoid obliteration with synthetic materials: a review of the literature

Canal wall down mastoidectomy is a surgical technique used for the eradication of middle ear disease. The remaining large mastoid bowl is associated with a number of issues; one of the main techniques that have been developed in order to avoid such problems is the obliteration of the mastoid cavity. The materials used for this reason are either biological or synthetic. The purpose of this survey is to review the published literature related to the therapeutic value of mastoid obliteration with synthetic materials. We searched Web of Science, PubMed, and MEDLINE from 2008 to 2018 using the criteria mastoid obliteration, canal wall down mastoidectomy, chronic otitis media, and cholesteatoma. The search focused on papers concerning the mastoid obliteration with synthetic material, as we focused on looking for outcomes and reported complications. Out of a total of 244 citations, 15 articles were identified, where patients underwent mastoid obliteration with synthetic materials. Most authors used bioactive glass as a filler material. Mastoid obliteration resulted in a decrease in the complications associated with the open mastoid cavity. On the basis of the available limited literature, it seems that mastoid obliteration with synthetic materials is a valuable and safe surgical technique for patients who undergo canal wall down mastoidectomy. The bioactive glass appears to be the most reliable synthetic material

Heterozygous Alterations of TNFRSF13B/TACI in Tonsillar Hypertrophy and Sarcoidosis

TNFRSF13B/TACI defects have been associated with CVID pathogenesis and/or phenotype, especially the development of benign lymphoproliferation and autoimmunity. Our purpose was to investigate the role of TNFRSF13B/TACI defects in the pathogenesis of two common lymphoproliferative disorders, namely, sarcoidosis and tonsillar hypertrophy (TH). 105 patients (71 with sarcoidosis and 34 with TH, including 19 without infectious causative and 15 due to Haemophilus influenzae) were analyzed for TNFRSF13B/TACI defects. Two out of 19 TH patients without infectious cause (10.5%) and 2 patients with sarcoidosis (2.8%) displayed rare TNFRSF13B/TACI defects (I87N, L69TfsX12, E36L, and R202H, resp.). Both mutations identified in TH patients have been assessed as deleterious for protein function, while the patient with the R202H mutation and sarcoidosis exhibited also sIgG4D. Our study further supports the notion that TNFRSF13B/TACI defects alone do not result in CVID but may be also found frequently in distinct clinical phenotypes, including benign lymphoproliferation and IgG subclass deficiencies

Epidermoid cyst of the floor of the mouth: two case reports

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Hemangiopericytoma of the neck

Hemangiopericytoma (HPC) is an exceedingly rare tumor of uncertain malignant potential. Approximately 300 cases of HPC have been reported since Stout and Murray described HPCs as "vascular tumors arising from Zimmerman's pericytes" in 1942. After further characterization, the WHO reclassified HPC as a fibroblastic/myofibroblastic tumor. Long term follow up is mandatory because the histologic criteria for prediction of biologic behavior are imprecise. There are reports of recurrence and metastasis many years after radical resection. The head and neck incidence is less than 20%, mostly in adults

Brucella Melitensis As Causative Agent for Neck Abscess in an Endemic Area

Background: Brucellosis, a zoonotic disease, is very common in the Mediterranean basin and a major concern in livestock areas. We present a rare case of a Brucella-caused abscess in the neck of a stock-breeder in an endemic Greek area. Case Report: A 39-year-old male, living in the rural area of Thessaly, presented with a mass in the left area of his neck. Clinical examination and imaging tests revealed an abscess in the left sternocleidomastoid muscle. Sampling of the abscess by fine-needle aspiration yielded inflammatory fluid (17x103 cells/μL). Molecular sequencing (16S rRNA polymerase chain reaction) performed directly in the clinical sample identified the presence of Brucella melitensis within 24 hours after material sampling. The microorganism was isolated in agar media four days later. The Rose-Bengal test was negative, while the Brucellacapt test showed titer 1/320. Given the results obtained with these molecular techniques, the patient was offered treatment with streptomycin (1 g for 3 weeks) and oral doxycycline (100 mg twice daily for 6 weeks), concurrently. Conclusion: In areas endemic for brucellosis, the investigation of a patient with a neck abscess should include Brucella spp. among possible causative agent