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Conventionally, trapezius musculocutaneous flap is raised to harbour perforators located inferior to the scapular spine (i.e. ‘lower trapezius flap’). In this clinical study, we aimed to use trapezius perforators located superior to the scapular spine to raise a transversely oriented propeller fasciocutaneous flap based on the superficial cervical artery to reconstruct head and neck defects. Patients with head and neck defects who underwent reconstruction with a propeller trapezius perforator flap between August 2014 and October 2019 were evaluated. Demographic data of the patients, topographic data on defects and the flaps were analysed. A total of 14 patients underwent reconstruction with upper trapezius perforator flap with equal gender distribution. Defects were due to tumour resections, burn contractures and exposed foreign materials; located in occipital, temporal, parietal, midfacial and cervical areas; with sizes ranging between 8 × 7 cm and 22 × 19 cm. Overall patient satisfaction was assessed subjectively using a pre-determined set of questions. The sizes of the flaps ranged between 15 × 8 cm – 20 × 9 cm in non-expanded and 26 × 15 cm – 30 × 16 cm in expanded cases. One flap suffered distal superficial flap loss, which was treated with wound care. Follow up period of the patients ranged between 3 and 40 months with an average of 29 months. Using trapezius perforators located above the scapular spine provides thin transversely oriented propeller flaps to be used in head and neck reconstruction. In our series, this flap is further enhanced by pre-expansion for wider uses, e.g. facial resurfacing and releasing neck contractures.

The optimal approach to combine gemtuzumab-ozogamicin (GO) with various chemotherapy backbones and other newer agents safely remains to be determined.

We performed a retrospective analysis of the safety and outcomes of adult patients with newly diagnosed acute myeloid leukemia (AML) treated with GO with intensified versus standard anthracycline doses (daunorubicin dose 90 mg/m

vs 60 mg/m

) ± FLT3 inhibitors. HIF inhibitor The χ

test and Mann-Whitney U test were used to compare categorical and continuous data. Survival estimates were calculated by Kaplan-Meier method and survival comparisons made using log-rank test.

We report a 97% overall response rate in 34 patients with newly diagnosed AML with a median age of 54 years (19-75 years) treated with GO and standard induction. The 11 patients (100%) receiving GO plus daunorubicin dose 90 mg/m

as part of 7+3 induction achieved complete response versus 91% (20/22) complete response in the standard daunorubicin dose group (P=NS). No increased toxicity was noted with the higher daunorubicin dose or when GO and 7+3 were combined with FLT3 inhibitors in 3 younger patients (<60 years). Two older patients treated with GO+7+3 and FLT3i experienced grade 3 or higher cardiotoxicity. We observed a longer estimated event-free survival for patients with newly diagnosed AML in our cohort (median, 24 months; 95% confidence interval, 17.2 to not reached) compared with historical data.

We demonstrate that anthracycline dose intensification with GO may offer higher response rates without increased toxicity in younger patients presenting with de novo AML across European Leukemia Net risk categories.

We demonstrate that anthracycline dose intensification with GO may offer higher response rates without increased toxicity in younger patients presenting with de novo AML across European Leukemia Net risk categories.

This study aimed to compare three approaches of blood glucose monitoring (BGM) frequency attainment and to examine their associations with glycemic control in youth with type 1 diabetes (T1D).

Cross-sectional data was derived from the baseline assessment in three clinical trials. Clinical and demographic characteristics of youth with T1D was obtained by chart review. BGM frequency was assessed by parent-youth interview, chart review, and meter downloads. To examine the relationship between A1c and frequency of BGM we performed analysis of variance.

In youth with T1D (N = 385, 50% female, age 13.6 ± 2.5 years, 74% pump users), the 3 methods of assessing BGM frequency were significantly correlated. Frequency by self-report (6.4 ± 2.3 times/day) was significantly higher than both meter download (5.6 ± 2.4 times/day, p < 0.0001) and clinician report (5.7 ± 2.4 times/day, p < 0.0001). For all methods, more frequent BGM was associated with lower A1c and lower mean glucose (p < 0.0001). For each additional daily blood glucose check, there was a 0.2% decrease in A1c (p < 0.0001).

BGM remains a potent predictor of glycemic control, warranting continued targeting in clinical efforts to improve glycemic management in youth with T1D.

BGM remains a potent predictor of glycemic control, warranting continued targeting in clinical efforts to improve glycemic management in youth with T1D.

This study aimed to identify and prioritize factors contributing to the provision of periodontal care by certified diabetes nurse educators to outpatients with diabetes in medical settings in Japan.

Questionnaires were administered to 321 certified diabetes educator nurses from 1277 institutions. The practice of periodontal care was assessed, with factors contributing to periodontal care through items developed based on the capability, opportunity, and motivation-behavior model. Fisher’s exact tests and logistic regression were performed.

>70% of certified diabetes educator nurses did not provide periodontal care for diabetes patients. The respondents who assessed people’s oral conditions were more likely to engage in individual or group education and consult for oral management professionals than those who did not. Significant factors for such assessment were low psychological capability and reflective motivation, irregular and weak intention to engage in oral management, and working at an institution without an outpatient department specializing in diabetes.

The education for certified diabetes educator nurses who do not work at an institution with an outpatient department specialized in diabetes care should be prioritized. Particularly, education to improve knowledge, skills, and confidence in oral assessments and to make periodontal management regular is needed.

The education for certified diabetes educator nurses who do not work at an institution with an outpatient department specialized in diabetes care should be prioritized. Particularly, education to improve knowledge, skills, and confidence in oral assessments and to make periodontal management regular is needed.

The present study was designed to investigate the correlation between the bony morphology of the mandibular condyle and the occurrence of temporomandibular joint (TMJ) idiopathic anterior dislocation.

A comparative retrospective study was conducted among 14 patients presenting idiopathic anterior dislocations (study group) and 15 patients who did not suffer from any TMJ disorders (control group). All patients underwent a multidetector computed tomography scan demonstrating the full extent of their joints. The scans of 58 joints were reconstructed and analyzed by tools available in Dolphine3 software. Mandibular condyle size and volume were measured, and its shape was characterized.

Shape, width, length, height, and volume of the mandibular condyles did not differ statistically between the study and control groups.

Mandibular condyle morphology does not affect TMJ idiopathic anterior dislocation.

Mandibular condyle morphology does not affect TMJ idiopathic anterior dislocation.

To assess the effects of opaque eye coverage on anxiety in candidates for surgical removal of impacted third molars.

This randomized clinical trial was conducted in candidates for surgical extraction of bilateral, vertical, class IC impacted maxillary third molars or bilateral, mesioangular class IC impacted mandibular third molars. Patients with moderate anxiety (dental anxiety scale range, 9-14) were selected. Surgical extraction of the bilateral third molars was performed in 2 separate visits with and without covering the eyes using surgical drapes. Pulse rate (PR), systolic and diastolic blood pressure (BP), and respiratory rate (RR) were measured immediately after surgery. Moreover, after surgery, the patients were asked to rate their dental anxiety on a visual analog scale (VAS) from 0 to 10. The collected data were used for statistical analysis.

Sixty patients with a mean age of 21.31 years participated in the study. PR, systolic BP, RR, and VAS were significantly higher with eye coverage (P < .001). Diastolic BP was not significantly different between the 2 surgical sessions (with or without eye coverage) (P=.157).

In patients with moderate dental anxiety, covering the eyes during surgical extraction of third molars may contribute to the increase of dental anxiety.

In patients with moderate dental anxiety, covering the eyes during surgical extraction of third molars may contribute to the increase of dental anxiety.Xeroderma pigmentosum (XP) is a rare inherited disease caused by deficiencies in DNA damage repair, which mainly results from the failure of nucleotide excision repair or defects in translesion DNA synthesis. The development of multiple malignancies is one of the most prominent features of this condition, which is clinically characterized by the occurrence of hyperpigmentation and lesions associated with sunlight exposure. Lip squamous cell carcinoma in patients with XP has rarely been reported, and information regarding the genetic analysis of these patients is limited. In this report, a case of a 20-year-old patient who developed squamous cell carcinoma in the lower lip is described. Although the tumor was surgically excised, the patient presented with recurrence a few months later. Targeted sequencing using a customized panel of DNA repair genes revealed a mutation in POLH, the gene encoding DNA polymerase eta. Therefore, molecular characterization is important to further improve the understanding of possible phenotype-genotype correlations and mechanisms involved in the pathogenesis of XP.

The aim of this study was to analyze patients with thrombophilia who underwent oral and/or maxillofacial surgery at our center.

We performed a retrospective analysis of patients with hereditary or acquired thrombophilia who had undergone oral/maxillofacial surgery between January 1, 2000 and December 31, 2019. Data regarding demographic and patient characteristics, surgical treatment modalities, antithrombotic therapies, and complications were analyzed.

A total of 76 eligible patients (26 male, 50 female) were included in this study, with a mean follow-up period of 3.8 months (range, 0-51 months). The mean age at time of surgery was 44.7 ± 19.4 years. Seven different hereditary and acquired thrombophilia were identified factor V Leiden (n=31; 40.8%), prothrombin G20210A mutation (n=5; 6.6%), protein C deficiency (n=4; 5.3%), protein S deficiency (n=11; 14.5%), antiphospholipid syndrome (n=10; 13.2%), hyperhomocysteinemia (n=8; 10.5%), and elevated factor VIII (n=2; 2.6%). Complications occurred in 9 patients (11.