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    709; 95% confidence interval, 1.003 to 2.912; P = .049). CONCLUSIONS Hyperglycemia is associated with more advanced disease and poorer survival rates in patients with OSCC. It correlates with adverse clinicopathologic characteristics and longer hospital stay. Screening for hyperglycemia and maintenance of normal glycemic status during the treatment course is imperative in the treatment of OSCC. PURPOSE Sialendoscopy has effectively changed the paradigm for the treatment of sialolithiasis. Its effect on noncalculi-related recurrent sialadenitis is, however, unclear, especially regarding the long-term outcomes. The objectives of the present study were to evaluate the long-term efficacy of sialendoscopy for noncalculi-related recurrent sialadenitis and determine the clinical and intraoperative features that might be prognosticate outcomes. PATIENTS AND METHODS We performed a prospective cohort study of 33 consecutive patients who had undergone sialendoscopy for recurrent noncalculi-related sialadenitis by a single surgeon in a tertiary institution from January 2010 to December 2016. The patient-reported outcome measures were used as the primary determinant of treatment efficacy. The clinical features and endoscopic findings were evaluated as variables that might predict the treatment outcomes. The Fischer exact test was used to analyze the descriptive data, and a P value of  less then  .05 was considered to indicate statistical significance. selleck products RESULTS Of the 33 patients with recurrent noncalculi-related sialadenitis, 1 was lost to follow-up and thus excluded from the analysis. The mean and median follow-up period for the 32 patients was 27 and 21.5 months, respectively. Of the 33 patients, 28 (87.5%) reported symptom improvement, and 19 patients (59.4%) were symptom free after a single sialendoscopic treatment. The chronicity of symptoms, younger patient age, and concurrent autoimmune disease were predictive of recurrent symptoms despite sialendoscopy. CONCLUSIONS The use of sialendoscopy achieved sustained long-term improvements or resolution of symptoms for most patients with recurrent noncalculi-related sialadenitis. The data from our study support the benefits of sialendoscopy for patients with recurrent noncalculi-related sialadenitis. PURPOSE Numerous methods have been developed for blepharoplasty, including carbon dioxide (CO2) laser-assisted blepharoplasty. Although the superiority of CO2 laser compared with the scalpel for blepharoplasty has been proposed, to the best of our knowledge, no study has compared the clinical outcomes of blepharoplasty with the CO2 laser alone versus the combined use of a scalpel and CO2 laser. PATIENTS AND METHODS In the present randomized clinical trial, 21 healthy patients underwent bilateral upper eyelid blepharoplasty. For each patient, an initial skin incision was made using the CO2 laser (setting, continuous emission; ultrapulse mode; 3 W of power) on 1 side and a scalpel on the other side. The remaining blepharoplasty steps were conducted using the CO2 laser (setting, continuous emission; 9 W of power) in both groups. The patients were evaluated on postoperative days 1, 3, 7, 14, and 30 using the postoperative repair criteria, including edema and ecchymosis. The Manchester scar scale was used to evaluate the results at 60 days after surgery. RESULTS Our comparison of the 2 methods showed no significant differences at 1 month after surgery using the evaluation criteria. The scar index was not significantly different after 60 days, despite lower scores in the scalpel group. CONCLUSIONS In upper eyelid blepharoplasty, making an initial incision with a scalpel, followed by use of a laser provides advantages similar to those found by performing the entire procedure with a CO2 laser alone. DNA methylation (DNAm) – an epigenetic process that regulates gene expression – may represent a mechanism for the biological embedding of early traumatic experiences, including childhood maltreatment. Here, we conducted the first systematic review of human studies linking childhood maltreatment to DNAm. In total, 72 studies were included in the review (2008-2018). The majority of extant studies (i) were based on retrospective data in adults, (ii) employed a candidate gene approach (iii) focused on global maltreatment, (iv) were based on easily accessible peripheral tissues, typically blood; and (v) were cross-sectional. Two-thirds of studies (n = 48) also examined maltreatment-related outcomes, such as stress reactivity and psychiatric symptoms. While findings generally support an association between childhood maltreatment and altered patterns of DNAm, factors such as the lack of longitudinal data, low comparability across studies as well as potential genetic and ‘pre-exposure’ environmental confounding currently limit the conclusions that can be drawn. Key challenges are discussed and concrete recommendations for future research are provided to move the field forward. BACKGROUND The aim of this meta-analysis is to evaluate the association of fibrinogen with risk of dementia and its subtypes. METHODS Embase, Pubmed and Web of Science were retrieved systematically up to February 2019. Standard mean difference (SMD) with 95 % confidence intervals was estimated using random-effects models. RESULTS Sixteen studies involving 3,649 participants were summarized. Patients with all-cause dementia exhibited higher fibrinogen levels than those in non-dementia controls (SMD = 0.90 [0.43;1.36] p less then 0.01). Further subgroup analysis revealed a positive association of fibrinogen with vascular dementia (VaD) (SMD = 1.11 [0.45;1.78] p less then 0.01) rather than Alzheimer’s disease (AD) (SMD = 0.01 [-0.17;0.19]) p = 0.92) and Parkinson’s disease dementia (PDD) (SMD = 0.35 [-0.23;0.93] p = 0.24). This correlation was significant in Europeans (SMD = 0.92 [0.34;1.49] p less then 0.01), but probably not in Asian based populations (SMD = 1.04 [-0.09;2.17] p = 0.07), and gradually declined with advancing age (60 ≤ age less then 70 SMD = 1.22 [0.38;2.06] p less then 0.01; 70 ≤ age less then 80 SMD = 0.29 [0.04;0.53] p = 0.02; age ≥ 80 SMD = 0.01 [-0.12;0.15] p = 0.84). CONCLUSIONS Plasma fibrinogen is a potential risk factor for all-cause dementia and VaD under the age of 80, and is more obvious in cohorts with people of European descent.