Management of iodine contrast induced salivary gland swelling (sialadenitis): experiences from an observational study.

BACKGROUND: Iodine contrast-induced sialadenitis (CIS) is an uncommon adverse effect to iodine-containing contrast exposition. There is scarce literature about its clinical course and demography. OBJECTIVES: (1) To determine the clinical course and management of CIS. (2) To understand if CIS might be as rare as reported. MATERIAL AND METHODS: A 2-month prospective observational study was conducted in the emergency room of a tertiary institution. ENT physicians on call received clinical formation about CIS while emergency physicians did not. During the study period, patients admitted at the emergency room matching the clinical and radiological features of CIS, were included. Information about demographics, iodine exposure, diagnostic workup, clinical course, and management was analyzed. RESULTS: ENT physicians on call detected 4 cases, however, emergency physicians did not. Patients were aged 68-76 years and presented a bilateral submandibular gland swelling debuting 12 to 72 h after an exposure to iodinated contrast. Characteristic ultrasonographic findings supported the diagnosis and the clinical course was self-limited after 60 to 150 h. CONCLUSIONS AND SIGNIFICANCE: Physicians' familiarity with CIS allows its detection and avoids costly and potentially harmful therapeutic/diagnostic efforts. The incidence is probably underestimated; however, further incidence studies are needed.

Influence of online opinions and interactions on the Covid-19 vaccination in Chile.

We analyze 6 months of Twitter conversations related to the Chilean Covid-19 vaccination process, in order to understand the online forces that argue for or against it and suggest effective digital communication strategies. Using AI, we classify accounts into four categories that emerge from the data as a result of the type of language used. This classification naturally distinguishes pro- and anti-vaccine activists from moderates that promote or inhibit vaccination in discussions, which also play a key role that should be addressed by public policies. We find that all categories display relatively constant opinions, but that the number of tweeting accounts grows in each category during controversial periods. We also find that accounts disfavoring vaccination tend to appear in the periphery of the interaction network, which is consistent with Chile's high immunization levels. However, these are more active in addressing those favoring vaccination than vice-versa, revealing a potential communication problem even in a society where the antivaccine movement has no central role. Our results highlight the importance of social network analysis to understand public discussions and suggest online interventions that can help achieve successful immunization campaigns.

Integrating Clinics, Laboratory, and Imaging for the Diagnosis of Common Variable Immunodeficiency-Related Granulomatous-Lymphocytic Interstitial Lung Disease.

Background: Granulomatous-lymphocytic interstitial lung disease (GLILD) is a distinct clinic-radio-pathological interstitial lung disease (ILD) that develops in 9% to 30% of patients with common variable immunodeficiency (CVID). Often related to extrapulmonary dysimmune disorders, it is associated with long-term lung damage and poorer clinical outcomes. The aim of this study was to explore the potential use of the integration between clinical parameters, laboratory variables, and developed CT scan scoring systems to improve the diagnostic accuracy of non-invasive tools. Methods: A retrospective cross-sectional study of 50 CVID patients was conducted in a referral unit of primary immune deficiencies. Clinical variables including demographics and comorbidities; analytical parameters including immunoglobulin levels, lipid metabolism, and lymphocyte subpopulations; and radiological and lung function test parameters were collected. Baumann's GLILD score system was externally validated by two observers in high-resolution CT (HRCT) scans. We developed an exploratory predictive model by elastic net and Bayesian regression, assessed its discriminative capacity, and internally validated it using bootstrap resampling. Results: Lymphadenopathies (adjusted OR 9.42), splenomegaly (adjusted OR 6.25), Baumann's GLILD score (adjusted OR 1.56), and CD8+ cell count (adjusted OR 0.9) were included in the model. The larger range of values of the validated Baumann's GLILD HRCT scoring system gives it greater predictability. Cohen's κ statistic was 0.832 (95% CI 0.70-0.90), showing high concordance between both observers. The combined model showed a very good discrimination capacity with an internally validated area under the curve (AUC) of 0.969. Conclusion: Models integrating clinics, laboratory, and CT scan scoring methods may improve the accuracy of non-invasive diagnosis of GLILD and might even preclude aggressive diagnostic tools such as lung biopsy in selected patients.

Effectiveness of Nasoalveolar Molding in the Unilateral Cleft Lip and Cleft Palate.

BACKGROUND: Cleft lip and palate develops during embryogenesis due to an alteration in the fusion of the tissues which will form the upper lip and palate. The rate of occurrence in Chile is 1.6 per 1000 live births. The object of the present study was to determine the effectiveness of the Grayson nasoalveolar molding appliance in reducing the gap between the alveolar segments in cases of unilateral cleft lip and palate by sex, age at start of treatment, initial gap between the alveolar segments, and number of checkups. METHODS: The study design was quasi-experimental, with measurements taken before and after surgery and no control group. The authors studied the medical records and models of a sample of 52 patients with complete unilateral cleft lip and palate who were discharged after treatment using Grayson nasoalveolar molding appliance. Treatment was considered effective when the final gap was 3 mm or less. Then the percentage of cases in which treatment was effective, applying statistical tests, including log regression, to assess the influence of other variables was calculated. RESULTS: The authors observed that the Grayson nasoalveolar molding appliance was effective in 69.23% of patients. Of the variables studied, the initial gap presented statistically significant differences (initial gap of 8-12 mm, effectiveness 82.61%); in the log regression, the same variable presented a statistically significant difference in the adjusted odds of effectiveness. CONCLUSION: Grayson nasoalveolar molding appliance presents good effectiveness in reducing the gap between the alveolar segments in patients with unilateral cleft lip and palate, especially in cases with a gap of 8 to 12 mm.