Tuesday, May 10, 2022

First detection of SARS‐CoV‐2 Omicron BA.4 variant

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Abstract

At the time of writing, the world continues to witness the extraordinarily rapid evolution and selection of SARS-CoV-2, with the Omicron variants comprising five lineages known as BA.1, BA.2, BA.3, BA.4 and BA.5. In this study, there were 141 SARS-CoV-2 positive nasopharyngeal specimens tested using the RT-PCR BA.1 assay during January-April 2022. Of these, 83.0% specimens were BA.1. While the prevalence rate of BA.1 continued to decrease, BA.2 emerged. Interestingly, BA.4 was detected for the first time in Western Pennsylvania, United States. While the unexpected detection of BA.4 in our study is interesting, and even a single case, our finding underscores the importance of genomic surveillance as a critical tool for tracking emerging variants of SARS-CoV-2

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High-flow nasal cannula versus standard low-flow nasal cannula during deep sedation in patients undergoing radiofrequency atrial fibrillation catheter ablation: a single-centre randomised controlled trial

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To our knowledge, there are few trials studying the effect of high-flow nasal cannula (HFNC) during deep sedation. Our hypothesis is that high-flow nasal cannula (HFNC) will prevent hypoxemia and desaturation ...
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Evaluation of Lipocalin-2 and Twist expression in thyroid cancers and its relationship with epithelial mesenchymal transition

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Publication date: Available online 10 May 2022

Source: Annals of Diagnostic Pathology

Author(s): Pınar Celepli, İrem Bigat, Sefika Karabulut, Salih Celepli, Sema Hücümenoğlu

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Alpha variant coronavirus outbreak in a nursing home despite high vaccination coverage: molecular, epidemiological and immunological studies

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Background
Vaccination may control the COVID-19 pandemic, including in nursing homes where many high-risk people live. We conducted extensive outbreak investigations.
Methods
We studied an outbreak at a nursing home in Switzerland where vaccination uptake of mRNA vaccines against SARS-CoV-2 was 82% among residents as of Jan 21/2021. After a vaccinated symptomatic HCW was diagnosed with COVID-19 on Feb 22, we did an outbreak investigations in house A (47 residents, 37 HCWs) using SARS-CoV-2-specific PCR in nasopharyngeal swabs. We performed whole-genome sequencing of SARS-CoV-2 and serological analyses.
Results
We identified 17 individuals with positive PCR tests; ten residents (five vaccinated) and seven HCWs (three vaccinated). Median age among residents was 86 years (interquartile range [IQR] 70-90) and 49 years (IQR 29-59) among HCWs. Among the five vaccinated residents, 60% had mild disease and had 40% no symptoms, whereas all five unvaccinated residents had mild to severe disease and two died. The vaccine effectiveness for the prevention of infection among the residents was 73.0% (95% Cl 24.7-90.1). The 12 available genomes were all alpha variants. Neutralizing titers were significantly higher in vaccinated individuals upon re-exposure (>1 week after diagnosis) than in vaccinated, unexposed HCWs (p=0.012). Transmission networks indicated four likely or possible transmissions from vaccinated to other individuals, and 12 transmission events from unvaccinated individuals.
Conclusions
COVID-19 outbreaks can occur in nursing homes, including transmission from vaccinated persons to others. Outbreaks might occur silently, underlining the need for continued testing and basic infection control measures in these high-risk settings.
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Competing responses to global inequalities in access to COVID vaccines: Vaccine Diplomacy and Vaccine Charity Versus Vaccine Liberty

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Global access to COVID vaccines has been extraordinarily unequal and remains an ongoing source of global health insecurities due to the evolution of viral variants in the bodies of the unvaccinated. There have nevertheless been at least three significant alternatives developed to this disastrous bioethical failure. These alternatives are reviewed in this article in the terms of 'vaccine diplomacy', 'vaccine charity', and 'vaccine liberty'. Vaccine diplomacy includes the diverse bilateral deliveries of vaccines organized by the geopolitical considerations of countries strategically seeking various kinds of global and regional advantages in international relations. Vaccine charity centrally involves the humanitarian work of the global health agencies and donor governments that have organized the COVAX program as an antidote to unequal access. Despite their many promises, however, both vaccine diplomacy and vaccine charity have failed to deliver the doses needed to overcome the global vaccination gap. Instead, they have unfortunately served to immunize the global vaccine supply system from more radical demands for a 'People's Vaccine', technological transfer and compulsory licensing of vaccine intellectual property (IP). These more radical demands represent the third alternative to vaccine access inequalities. As a mix of NGO-led and politician-led social justice demands, they are diverse and multifaceted, but together they have been articulated as calls for vaccine liberty. After first describing the realities of vaccine access inequalities, this article compares and contrasts the effectiveness thus far of the three alternatives. In doing so, it also provides a critical bioethical framework for reflecting on how the alternatives have come to compete with one another in the context of the vaccine property norms and market structures entrenched in global IP law. The uneven and limited successes of vaccine dipl omacy and vaccine charity in delivering vaccines in underserved countries can be re-considered in this way as compromised successes that not only compete with one another, but which have also worked together to undermine the promise of universal access through vaccine liberty.
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Evidence of clinical impact supports a new petition for Medicare coverage of 18F-FDG-PET/CT in the evaluation of Staphylococcus aureus bacteremia: a focused literature review and call to action

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Abstract
Staphylococcus aureus bacteremia (SAB) causes considerable morbidity and mortality and requires comprehensive assessment for metastatic infection. The roles of routine imaging beyond echocardiography in SAB, including 18F-FDG-PET/CT, remain contentious. We performed a literature review of studies reporting impact of 18F-FDG-PET/CT on the clinical management or outcomes of SAB published through 3/1/2022. We identified seven observational studies, in which 18F-FDG-PET/CT frequently identified metastatic foci of infection, revealed foci undetected by prior investigations, led to additional source control procedures, and was associated with fewer infection relapses and lower mortality. Calculated numbers needed to treat (NNTs) for receipt of 18F-FDG-PET/CT were 7-9 to change antimicrobial therapy, 10-27 to lead to an additional source control procedure, and 4-8 to prevent death. These data are comparable to the evidence for clinical impact of other diagnostic modalities accepted as standard of care in SAB, and form a compelling basis for advocacy to expand access to 18F-FDG-PET/CT.
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Does a combination of self‐reported signs related to central sensitization and pressure pain threshold allow for a more detailed classification of pain‐related characteristics in patients with chronic musculoskeletal pain?: A cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objectives

The clinical utility of combining the central sensitization (CS) inventory (CSI) with the pressure pain threshold (PPT) in assessing the effect of central sensitization on pain is unknown. This study aimed to investigate (1) the effects of CSI, PPT, and their interaction on pain and (2) the characteristics of clinical symptoms in patients with chronic musculoskeletal pain grouped according to the CSI score and PPT value.

Method

A total of 187 participants with chronic musculoskeletal pain were recruited. PPT, brief pain inventory, widespread pain index, pain-catastrophizing scale, EuroQol-5 dimension, and CSI were assessed. Multiple regression analyses were performed using pain intensity and interference scores as dependent variables and the CSI score and PPT value as independent variables. Hierarchical cluster analysis was also performed to classify the participants into subgroups according to the CSI score and PPT value. Following the classification, pain-related characteristics and health-related QOL were compared among the subgroups.

Results

Multiple regression analyses demonstrated that only the CSI score significantly affected pain intensity and interference. As a result of the cluster analysis, three groups were identified: cluster 1 (n = 61, CSI low/PPT low group), cluster 2 (n = 78, CSI low/PPT high group), and cluster 3 (n = 48, CSI high/PPT low group). The CSI high/PPT low group had higher incidence of pain-related symptoms than the CSI low groups regardless of the PPT value.

Conclusions

Combined CSI and PPT may not fully allow a detailed classification of pain-related characteristics. The CSI may be clinically more useful for assessing the effect of CS on pain-related symptoms.

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Influence of lingual plate fracture pattern on remodelling site during the healing process of sagittal split ramus osteotomy

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The purpose of this study was to investigate whether differences in the pattern of the lingual plate split in sagittal split ramus osteotomy (SSRO) affect the remodelling of the split site. Sixty-one patients with mandibular prognathism (122 sides) underwent SSRO. Computed tomography (CT) was performed at 1 week and 1 year after SSRO. Bone splits were classified according to the lingual split scale (LSS) and the lateral bone cut end (LBCE) by evaluating CT images at 1 week. The remodelling at the split sites was evaluated by superimposing the CT images obtained at 1 week and 1 year. (Source: International Journal of Oral and Maxillofacial Surgery)
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