Publications by authors named "Afif A"

Introduction: Femoral head (Pipkin) fractures are rare injuries typically caused by high-energy trauma. Classified into four types, their management remains debated, particularly for Pipkin type II fractures. This case report provides insights into surgical treatment, rehabilitation, and associated complications.

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Background: The most frequent type of non-Hodgkin lymphoma (NHL) is diffuse large B-cell lymphoma (DLBCL). Although lymph nodes are the most commonly affected organs compromising 70% of DLBCLs, only 5% of extranodal lymphomas represent skeletal muscle involvement. Specifically, abdominal wall muscle involvement is rare and there are only a few reported cases of DLBCL with this type of muscle involvement.

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Key Clinical Message: Mature mediastinal teratoma (MMT) is a benign tumor that is composed of well-differentiated tissues from all three germ cell layers. Malignant tumors have a distinct feature of adhering to the surrounding organs. Therefore, adhesion of MMT to the adjacent tissues, as a benign tumor, is rare and considered a surgical challenge.

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Background: The adipofascial anterolateral thigh (AF-ALT) free flap represents a versatile technique in head and neck reconstructions, with its applications increasingly broadening. The objective was to detail the novel utilization of the AF-ALT flap in orbital and skull base reconstruction, along with salvage laryngectomy onlay in our case series.

Method: We conducted a retrospective analysis at Roswell Park Comprehensive Cancer Center, spanning from July 2019 to June 2023, focusing on patient demographics and reconstructive parameters data.

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Background: This study compares the outcomes of osteocutaneous radial forearm free flap (OC-RFFF) and fibula free flap (FFF) reconstruction of mandibular osteoradionecrosis (ORN).

Methods: Retrospective review of patients undergoing OC-RFFF/FFF reconstruction for mandible ORN between 2005 and 2020 at a tertiary center. Patient characteristics, postoperative complications, and functional outcomes were evaluated using chi-squared and logistic regression analysis.

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  • The study aimed to compare how well the Modified Frailty Index and the Modified Surgical Apgar scores predict postoperative outcomes, specifically complications and mortality, in head and neck cancer patients.
  • The analysis involved 723 patients who underwent major surgeries from 2012 to 2015, with results showing that both scoring systems were significantly linked to 30-day complications, but the Modified Surgical Apgar score was more effective.
  • Ultimately, while both scores are valuable for assessing patient risk, the Modified Surgical Apgar score provided better predictive power, and using them together did not enhance accuracy significantly.
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  • * A 22-year-old patient experienced unexplained wrist pain, and after inconclusive X-rays, an MRI revealed reduced signal intensity in the triquetrum, confirming AVN.
  • * Despite the triquetrum's strong blood supply typically preventing AVN, this case emphasizes the need for awareness and proper diagnosis, advocating for further research on treatment options for such uncommon incidents.
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  • The study examines how the source of referral (dental vs. medical specialty) affects the stage of oral cavity squamous cell carcinoma (OSCC) when patients first present for treatment, emphasizing the importance of timely diagnosis.
  • Conducted at Roswell Park Comprehensive Cancer Center, it analyzed data from 215 patients diagnosed between 2014 and 2023, finding that those referred by dental providers presented with earlier disease stages compared to those referred by medical specialties.
  • The results indicated that early dental referrals significantly improved patient outcomes, with a noted increase in the likelihood of presenting at a less advanced T stage and lower rates of cervical nodal involvement.
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The average age and obesity prevalence are increasing globally. Both aging and metabolic disease burden increase the risk of oral squamous cell carcinoma (OSCC) through profound effects on the immunological and metabolic characteristics within the OSCC tumor microenvironment. While the mechanisms that link aging and obesity to OSCC remain unclear, there is evidence that the antitumor responses are diminished in both conditions.

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Background: The National Comprehensive Cancer Network (NCCN) guideline recommends consideration of weekly cisplatin as an alternative option for patients with head and neck cancer undergoing definitive chemoradiation. However, in a recent phase III trial (ConCERT), 20% of patients treated with weekly cisplatin could not receive a total of 200 mg/m, and the association of low adherence to weekly cisplatin and cancer control outcomes remains unclear. To fill this knowledge gap, we performed an observational cohort study of patients with head and neck cancer undergoing definitive chemoradiation with weekly cisplatin.

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  • This review discusses recent advancements in facial reanimation surgery, focusing on techniques like muscle transposition and free functional muscle transfer (FFMT) to treat chronic facial paralysis.
  • Key findings include comparisons between single and dual innervated FFMT, the reanimation of specific facial areas, and new donor sites for muscle transfer.
  • The ongoing standard for dynamic facial reanimation remains Gracilis FFMT, while muscle transposition is suitable for older or medically unfit patients seeking quicker results, highlighting the need for standardized reporting in future research.
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Immediate reconstruction and dental rehabilitation for ablative defects of the head and neck in one surgery is now a commonly used technique among reconstructive surgeons. Often patients are edentulous or partially edentulous in the jaw opposing that with pathology. In this case, only rehabilitating the dental arch affected by pathology would not render the patient with a functional occlusion.

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The widespread use of computed tomography (CT) has increased the incidence of small renal cell masses. We aimed to evaluate the usefulness of the angular interface sign (ice cream cone sign) to differentiate a broad spectrum of small renal masses using CT. The prospective study included CT images of patients with exophytic renal masses ≤ 4 cm in maximal dimension.

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Importance: Combined modality therapy, such as chemoradiotherapy, often results in significant morbidity among patients with head and neck cancer. Although the role of body mass index (BMI) varies based on cancer subtypes, its association with treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer remains unclear.

Objective: To evaluate the role of BMI in treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer undergoing chemoradiotherapy.

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  • The study investigates the lymphocyte-monocyte ratio (LMR) as a potential prognostic biomarker for survival outcomes in North American patients with head and neck cancer undergoing chemoradiation treatment.
  • Researchers analyzed data from 476 patients, revealing that lower LMR scores were linked to worse overall and cancer-specific survival, with higher LMR scores correlating with improved survival outcomes.
  • After properly adjusting for biases, they confirmed that a median LMR value of 3.8 could serve as a critical threshold, where patients with LMRs below this value had significantly lower chances of survival.
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Additive manufactured (AM) Titanium-6Aluminum-4Vanadium (Ti64) scaffolds display unique mechanical and biological properties for implant devices. The elastic modulus can be tailored by adjusting the porosity, further facilitating bone ingrowth. Although Ti64 implants are biocompatible, the effects of AM surfaces without porous structures, and how the topography and surface chemistry of the respective surfaces affect the osteogenesis of bone marrow-derived mesenchymal stromal cells (BMSCs) has not yet been revealed.

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Background: Selective tibial neurotomy (STN) has already demonstrated its effectiveness to reduce foot deformities and spasticity, but assessment according to a goal-centered approach is missing.

Objective: To evaluate the effectiveness of STN associated with a postoperative rehabilitation program for the treatment of the spastic foot, according to a goal-centered approach.

Methods: Interventional study (before-after STN and rehabilitation program) with observational design including consecutive adult patients with spastic foot, who received STN followed by a rehabilitation program, was performed.

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  • Recent studies challenge the 10 pack-years smoking threshold previously used for risk assessment, leaving the actual threshold undefined.
  • A study focusing on head and neck cancer patients found that exceeding 22 pack-years of smoking is linked to worse overall survival and progression-free survival.
  • Analysis showed that heavy smokers (more than 22 pack-years) have a higher risk of distant failure, while no significant risk was found with the previously used 10 pack-years threshold.
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Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is the causative agent of COVID-19 which was detected in late 2019 in Wuhan, China. As of September 2022, there have been over 612 million confirmed cases of COVID-19 with over 6.5 million associated deaths.

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Introduction: Percutaneous thermal ablation of inconspicuous lesions can be challenging. Fusion ultrasound (FUS) allows the use of previously performed diagnostic imaging like computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET-CT) to localise hepatocellular carcinoma (HCC) for treatment. This paper illustrates FUS case studies of pre-, intra- and post-ablation imaging of inconspicuous HCC, supplemented by use of contrast-enhanced ultrasound (CEUS).

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  • This study aimed to determine the best hemoglobin (Hgb) threshold for predicting outcomes in head and neck cancer patients undergoing chemoradiation, identifying 11.4 as the critical level.
  • Among 496 patients analyzed, low Hgb levels (below 11.4) correlated with significantly worse overall survival (OS) and progression-free survival (PFS), especially in those with HPV-negative tumors.
  • The findings suggest that while low Hgb is a strong negative prognostic factor for patients with HPV-negative head and neck cancers, it does not significantly impact those with HPV-positive tumors.
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Background: Transoral laser microsurgery is widely used for treating T1/T2 glottic cancers. Hyaluronic acid (HA) is commonly used in vocal cord augmentation. We investigated the impact of intra-operative injection laryngoplasty on voice outcomes in early glottic cancer.

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