Major clinical results of mentoplasty: a systematic review

Introduction: In the context of oral and maxillofacial surgery, orthognathic surgery (OS) is used to improve the patient's facial appearance and to correct maxillary and mandibular deformities resulting from malocclusions, disease, or trauma. Objective: It was carried out a concise systematic review of the main clinical approaches to genioplasty (genioplasty), as well as the results of more current clinical studies, to show the state of the art of this surgery. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from February 2022 to May 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found. In total, 68 articles were fully evaluated and 23 were included and evaluated in this study. And of the total of 23 articles, only 09 articles were developed as the main clinical results. A total of 16 articles were excluded because they did not meet the GRADE classification, and 45 were excluded because they were at risk of bias. Mentoplasty represents one of the most common auxiliary procedures and may be associated with corrective surgery for dentofacial dysmorphisms. However, care must be taken with mental nerve injuries, asymmetries, and intraoperative bleeding are the main immediate complications of mentoplasty, and to minimize these risks, the ultrasonic piezoelectric osteotomy with the selective cutting of the mineralized structure stands out. Furthermore, one-piece mentoplasty based on a three-dimensional impression model proved to be very successful for the natural modeling of the mandible. Also, it has been shown that the use of piezotomes is advantageous in mentoplasty surgery compared to traditional surgical instruments. In the context of hylotherapy, the results of the study indicate slightly less residual edema at 18°C temperature on the 30th postoperative day. Finally, in orthognathic surgery, a fibrinolytic shutdown is significantly amplified by tranexamic acid

Major clinical results of virtual zygomatic implant and assessment of the risk of bias: a systematic review

Introduction: In the context of implantology and severe resorption, zygomatic implants (ZI) are indicated and the procedures can be completed with the placement of a custom-made provisional prosthesis, reducing surgical time and optimizing results. Digital (virtual) optimizations for the ZI were developed in computerized radiology machines that allowed improvements in diagnostic and therapeutic tools. Objective: It was carried out a systematic review of the main considerations and clinical outcomes of using digital tools for the optimization of the virtual zygomatic implant. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from January 2022 to April 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 94 articles were found. In total, 62 articles were fully evaluated and 41 were included and evaluated in this study, and of the total of 41 articles, only 14 articles were developed as the main clinical results of the virtual zygomatic implant. Reducing errors and complications is essential if zygomatic implants are to remain a viable treatment alternative, and further research on a guided approach to their placement is encouraged. The surgical guide system showed accuracy for all variables studied and allowed acceptable and accurate implant placement, regardless of the complexity of the case. Thus, the surgical and prosthetic plan, the position, the emergence, the shape of the implants, the position of the provisional prosthesis, the inter-arch relationships, and the surgical templates were designed in a virtual environment and previously performed by the surgeon in stereolithographic models, allowing the surgical procedure was significantly simplified

Ischemic wound revascularization by the stromal vascular fraction relies on host-donor hybrid vessels

Nonhealing wounds place a significant burden on both quality of life of affected patients and health systems. Skin substitutes are applied to promote the closure of nonhealing wounds, although their efficacy is limited by inadequate vascularization. The stromal vascular fraction (SVF) from the adipose tissue is a promising therapy to overcome this limitation. Despite a few successful clinical trials, its incorporation in the clinical routine has been hampered by their inconsistent results. All these studies concluded by warranting pre-clinical work aimed at both characterizing the cell types composing the SVF and shedding light on their mechanism of action. Here, we established a model of nonhealing wound, in which we applied the SVF in combination with a clinical-grade skin substitute. We purified the SVF cells from transgenic animals to trace their fate after transplantation and observed that it gave rise to a mature vascular network composed of arteries, capillaries, veins, as well as lymphatics, structurally and functionally connected with the host circulation. Then we moved to a human-in-mouse model and confirmed that SVF-derived endothelial cells formed hybrid human-mouse vessels, that were stabilized by perivascular cells. Mechanistically, SVF-derived endothelial cells engrafted and expanded, directly contributing to the formation of new vessels, while a population of fibro-adipogenic progenitors stimulated the expansion of the host vasculature in a paracrine manner. These data have important clinical implications, as they provide a steppingstone toward the reproducible and effective adoption of the SVF as a standard care for nonhealing wounds

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Perioperative treatment

Perioperative management in patients who are to undergo a surgical operation is extremely important to achieve the optimum outcome of surgery. The effective reduction of postoperative mortality and postoperative morbidity for all age classes is connected to improvements in surgical and anesthesiology techniques as well as in advanced perioperative management (Fast- Track) [1]. Perioperative activity can be broken down into procedures carried out: - before the operation (intestinal preparation, pre-operative nutrition, antibiotic prophylaxis, antithrombotic prophylaxis, bladder catheter); - during the operation (insertion of nasogastric probe (NGP), fluid therapy, abdominal drainage); - after the operation (early oral feeding, NRS pain control (Numeric Pain Intensity Scale), early mobilization). Improvements in perioperative activity have meant a reduction of hospitalization and with it an improvement in the outcome of the patient, guaranteeing a lower degree of operative and preoperative stress, excellent pain control, and a reduction in organ dysfunction, as well as a saving of hospital resources [2]

A Census of Tandemly Repeated Polymorphic Loci in Genic Regions Through the Comparative Integration of Human Genome Assemblies

Polymorphic Tandem Repeat (PTR) is a common form of polymorphism in the human genome. A PTR consists in a variation found in an individual (or in a population) of the number of repeating units of a Tandem Repeat (TR) locus of the genome with respect to the reference genome. Several phenotypic traits and diseases have been discovered to be strongly associated with or caused by specific PTR loci. PTR are further distinguished in two main classes: Short Tandem Repeats (STR) when the repeating unit has size up to 6 base pairs, and Variable Number Tandem Repeats (VNTR) for repeating units of size above 6 base pairs. As larger and larger populations are screened via high throughput sequencing projects, it becomes technically feasible and desirable to explore the association between PTR and a panoply of such traits and conditions. In order to facilitate these studies, we have devised a method for compiling catalogs of PTR from assembled genomes, and we have produced a catalog of PTR for genic regions (exons, introns, UTR and adjacent regions) of the human genome (GRCh38). We applied four different TR discovery software tools to uncover in the first phase 55,223,485 TR (after duplicate removal) in GRCh38, of which 373,173 were determined to be PTR in the second phase by comparison with five assembled human genomes. Of these, 263,266 are not included by state-of-the-art PTR catalogs. The new methodology is mainly based on a hierarchical and systematic application of alignment-based sequence comparisons to identify and measure the polymorphism of TR. While previous catalogs focus on the class of STR of small total size, we remove any size restrictions, aiming at the more general class of PTR, and we also target fuzzy TR by using specific detection tools. Similarly to other previous catalogs of human polymorphic loci, we focus our catalog toward applications in the discovery of disease-associated loci. Validation by cross-referencing with existing catalogs on common clinically-relevant loci shows good concordance. Overall, this proposed census of human PTR in genic regions is a shared resource (web accessible), complementary to existing catalogs, facilitating future genome-wide studies involving PTR

Table_5_A Census of Tandemly Repeated Polymorphic Loci in Genic Regions Through the Comparative Integration of Human Genome Assemblies.XLSX

<p>Polymorphic Tandem Repeat (PTR) is a common form of polymorphism in the human genome. A PTR consists in a variation found in an individual (or in a population) of the number of repeating units of a Tandem Repeat (TR) locus of the genome with respect to the reference genome. Several phenotypic traits and diseases have been discovered to be strongly associated with or caused by specific PTR loci. PTR are further distinguished in two main classes: Short Tandem Repeats (STR) when the repeating unit has size up to 6 base pairs, and Variable Number Tandem Repeats (VNTR) for repeating units of size above 6 base pairs. As larger and larger populations are screened via high throughput sequencing projects, it becomes technically feasible and desirable to explore the association between PTR and a panoply of such traits and conditions. In order to facilitate these studies, we have devised a method for compiling catalogs of PTR from assembled genomes, and we have produced a catalog of PTR for genic regions (exons, introns, UTR and adjacent regions) of the human genome (GRCh38). We applied four different TR discovery software tools to uncover in the first phase 55,223,485 TR (after duplicate removal) in GRCh38, of which 373,173 were determined to be PTR in the second phase by comparison with five assembled human genomes. Of these, 263,266 are not included by state-of-the-art PTR catalogs. The new methodology is mainly based on a hierarchical and systematic application of alignment-based sequence comparisons to identify and measure the polymorphism of TR. While previous catalogs focus on the class of STR of small total size, we remove any size restrictions, aiming at the more general class of PTR, and we also target fuzzy TR by using specific detection tools. Similarly to other previous catalogs of human polymorphic loci, we focus our catalog toward applications in the discovery of disease-associated loci. Validation by cross-referencing with existing catalogs on common clinically-relevant loci shows good concordance. Overall, this proposed census of human PTR in genic regions is a shared resource (web accessible), complementary to existing catalogs, facilitating future genome-wide studies involving PTR.</p