Fourteen years old as the best age cutoff to differentiate prepubertal from pubertal papillary thyroid carcinoma

alexandrossfakianakis shared this article with you from Inoreader Fourteen years old as the best age cutoff to differentiate prepubertal from pubertal papillary thyroid carcinoma via Head & Neck Abstract Background It is unclear whether differences in clinical presentation and/or prognosis exist between prepubertal papillary thyroid cancer (PTC) and pubertal PTC. At present, there is a lack of definition for the appropriate cutoff age to define prepubertal PTC. Methods This study retrospectively reviewed 227 pediatric PTC patients (aged ≤18 years) who underwent initial surgery from March 2000 to December 2018. The median duration of follow-up was 85 months (range, 8–258). Results The age range was basically linearly related to multiple risk factors, such as T3–T4 disease, distant metastasis. Age (p = 0.032) was an independent risk factor for recurrence and persistent disease. Patients aged <14 years had obviously higher rates of extensive disease. The 10-year disease-free survival (DFS) rate of patients aged <14 years was 59.5% and that of patients aged ≥14 years was 82.6% (p = 0.004). Conclusions Fourteen years of age may be an appropriate cutoff to differentiate prepubertal PTC from pubertal PTC. View on Web

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Feasibility of clinical evaluation of individuals with increased risk for HPV‐associated oropharynx cancer

alexandrossfakianakis shared this article with you from Inoreader Feasibility of clinical evaluation of individuals with increased risk for HPV‐associated oropharynx cancer via Head & Neck Abstract Background Human papillomavirus-associated oropharynx squamous cell carcinoma (HPV-OPSCC) has no known pre-malignant lesion. While vaccination offers future primary prevention, there is current interest in secondary prevention. The feasibility of clinical evaluation of individuals at increased risk for HPV-OPSCC is unclear. Methods Individuals with risk factors for HPV-OPSCC were enrolled in a prospective study (MOUTH). Participants positive for biomarkers associated with HPV-OPSCC were eligible for a clinical evaluation which comprised a head and neck examination and imaging with ultrasound and/or magnetic resonance imaging (MRI). This study was designed to evaluate feasibility of clinical evaluation in a screening study. Results Three hundred and eighty-four participants were eligible for clinical evaluation. Of the 384, 204 (53%) completed a head and neck examination or imaging. Of these, 66 (32%) completed MRI (n = 51) and/or ultrasound (n = 64) studies. Conclusions Clinical evaluations, including head and neck examination and imaging, are feasible in the context of a screening study for HPV-OPSCC. View on Web

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Timing of Oral Feeding in Patients Who have Undergone Free Flap Reconstruction for Oral Cancer

alexandrossfakianakis shared this article with you from Inoreader Timing of Oral Feeding in Patients Who have Undergone Free Flap Reconstruction for Oral Cancer via The Laryngoscope Objective Determine the safety and effectiveness of a nasogastric tube removal plan designed to shorten nasogastric tube indwelling time after oral cancer surgery plus free flap reconstruction. Materials and Methods A parallel randomized clinical trial was conducted from May 2021 to December 2021 at Peking University School of Stomatology. Volunteers (n = 128) were separated into four groups: non-tracheostomy control and intervention groups and tracheostomy control and intervention groups. Control patients received the conventional nasogastric tube removal plan. Non-tracheotomy intervention patients were asked to swallow 5 ml of water on the first postoperative day. If there was no coughing, they were allowed progressively increasing amounts of water for the following 2 days. The nasogastric tube was removed only after ensuring level I/II performance on the Watian water swallowing test, no "wet voice" after drinking water, no marked decrease in blood oxygen saturation after drinking, and satisfactory daily oral nutritional intake. Tracheotomy intervention patients received the same protocol plus an additional Watian water swallowing test after tracheal tube removal. Results Nasogastric tube removal time was earlier in the intervention subgroups than in control subgroups: 5.0 ± 2.3 days versus 7.8 ± 3.9 days (p = 0.001) in non-tracheostomy patients and 9.8 ± 1.1 days versus 16.2 ± 13.0 days (p = 0.049) in tracheostomy patients. Incidence of wound complications and daily food intake were comparable between the groups. The incidence of pneumonia was lower in the tracheostomy intervention group than in the tracheostomy control group (12.5% vs. 3.1%, p = 0.162). Pharyngeal pain score was lower in tracheotomy intervention patients than in tracheotomy control patients (p = 0.029). Postoperative hospital stay was shorter in tracheotomy intervention patients than in tracheotomy control patients (p = 0.005). Conclusions On the basis of ensuring safety and effectiveness, patients undergone free flap reconstruction for oral cancer could be offered oral intake early after surgery, which will not increase the incidence of wound complications and pneumonia or adversely affecting the oral intake of the patients; it can also help minimize pharyngeal pain and shorten postoperative hospital stay of patients with a tracheotomy. Level of Evidence II Laryngoscope, 2022 View on Web

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Protective assessment of progesterone and its receptor on experimental diabetic neuropathy: Anti‐oxidant and anti‐inflammatory effects

alexandrossfakianakis shared this article with you from Inoreader Protective assessment of progesterone and its receptor on experimental diabetic neuropathy: Anti‐oxidant and anti‐inflammatory effects via Fundamental & Clinical Pharmacology Abstract Introduction Diabetes induces a disorder in mitochondrial activity, which causes damage to the nuclear and mitochondrial DNA, and ultimately increases the release of inflammatory cytokines and damages the sciatic nerve and dorsal root ganglion and induces neuropathy. It has been shown that progesterone has anti-inflammatory and anti-oxidative effects and prevents nerve cell damage. Therefore, the aim of this experiment was to investigate the effect of progesterone receptor neuroprotection on diabetic neuropathy. Methods Forty male Sprague-Dawley rats were divided into 4 groups, including control group, diabetic control group, diabetic control group+Progesterone(30mg/kg), diabetic control group+combination of Progesterone(30mg/kg) and RU486(10mg/kg). After the induction of diabetes, blood glucose level, body weight, behavioral tests, electrophysiological tests, oxidative and inflammatory factors, and histological parameters were measured. Results Progesterone treatment significantly reduced the level of sensitivity to hot plate without significant effect on glucose level, and significant changes were also observed in the results of tail flake test. In addition, the results showed that the administration of progesterone can improve MNCV and significantly reduce the serum levels of oxidative stress and inflammatory factors, as well as inflammation and edema around the sciatic nerve. However, RU486 inverted the beneficial effects of progesterone. Conclusion Progesterone can be considered as a protective agent in reducing DN because of its ability to reduce inflammation and nerve damage. In addition, RU486, a progesterone receptor blocker, inhibits the beneficial effects of progesterone on the DN, thus progesterone receptors play an important role in the neuroprotective effect of progesterone. View on Web

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‘Like ships in the night’: A qualitative investigation of the impact of childhood cancer on parents’ emotional and sexual intimacy

alexandrossfakianakis shared this article with you from Inoreader 'Like ships in the night': A qualitative investigation of the impact of childhood cancer on parents' emotional and sexual intimacy via Pediatric Blood & Cancer Abstract Background Childhood cancer is highly distressing for families and can place strain on parents' relationships. Parental functioning and cohesiveness are important predictors of family functioning and adaptation to stress. This qualitative study investigated the perceived impact of childhood cancer on parents' relationship with their partner, with a focus on emotional and sexual intimacy. Methods We conducted semi-structured interviews with 48 parents (42 mothers, six fathers) of children under the age of 18 who had completed curative cancer treatment. We analysed the interviews using thematic analysis. Results At interview, parents were on average 40.7 years old (SD = 5.5, range: 29–55 years), and had a child who had completed cancer treatment between 3 months and 10.8 years previously (M = 22.1 months). All participants were living with their partner in a married/de facto relationship. Most parents reported that their child's cancer treatment had a negative impact on emotional and sexual intimacy with their partner, with some impacts extending to the post-treatment period. Reasons for compromised intimacy included exhaustion and physical constraints, having a shifted focus, and discord arising from different coping styles. Some parents reported that their relationship strengthened. Parents also discussed the impact of additional stressors unrelated to the child's cancer experience. Conclusions Parents reported that childhood cancer had a negative impact on aspects of emotional and sexual intimacy, although relationship strengthening was also evident. It is important to identify and offer support to couples who experience ongoing relationship stress, which may have adverse effects on family functioning and psychological wellbeing into survivorship. View on Web

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LEUKOTRIENE METABOLISM AND PROIFLAMMATORY CYTOKINES IN CRIMEAN CONGO HEMORRHAGIC FEVER

alexandrossfakianakis shared this article with you from Inoreader LEUKOTRIENE METABOLISM AND PROIFLAMMATORY CYTOKINES IN CRIMEAN CONGO HEMORRHAGIC FEVER via Journal of Medical Virology Abstract Crimean-Congo hemorrhagic fever (CCHF) is an emerging acute viral infection disease, yet its pathophysiology remains largely uncharacterized. Lipid mediators are molecules that play numerous roles in the physiologic and pathophysiologic conditions in certain viral diseases. No previous study evaluated the status of cysteinyl leukotrienes (CYSLT) and 5-lipoxygenase (5-LO) and their relationship with proinflammatory cytokines in CCHF. A total of 90 subjects including 60 CCHF patients and 30 healthy controls were enrolled the study. Serum CYSLT, 5-LO, interleukin-6 (IL-6) and ferritin levels were determined in the study population. Lower median 5-LO level was determined in patients compared to healthy controls (p = 0.0004). Higher ferritin (p < 0.001) and IL-6 (p < 0.001) levels in patients than healthy controls. No statistically significant difference was observed between patients and controls in terms of CYSLT levels. No statistically significant differ ences were observed between mild, moderate, and severe groups in terms of both 5-LO and CYSLT levels. IL-6 and ferritin levels were higher in severe group compared mild and moderate groups. In conclusion, changes in 5-LO enzyme and increased inflammation are related with the disease molecular mechanism. Higher inflammatory status contributes to the impaired hemostatic balance in CCHF. Thus, treatment strategies to reduce inflammation may help to prevent bleeding and DIC in patients. IL-6 and ferritin can be used to as an additional biomarker in the estmation of the prognosis and diagnosis of the patients. This article is protected by copyright. All rights reserved. View on Web

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Current immunoassays and detection of antibodies elicited by Omicron SARS‐CoV‐2 infection

alexandrossfakianakis shared this article with you from Inoreader Current immunoassays and detection of antibodies elicited by Omicron SARS‐CoV‐2 infection via Journal of Medical Virology Abstract Objectives To determine whether current commercial immunoassays are adequate for detecting anti-Omicron antibodies. Methods We analyzed the anti-SARS-CoV-2 antibody response of 23 unvaccinated individuals 1-2 months after an Omicron infection. All blood samples were tested with a live virus neutralization assay using a clinical Omicron BA.1 strain and 4 commercial SARS-CoV-2 immunoassays. We assessed three anti-Spike immunoassays (SARS-CoV-2 IgG II Quant (Abbott S), Wantaï anti-SARS-CoV-2 antibody ELISA (Wantaï), Elecsys Anti-SARS-CoV-2 S assay (Roche)) and one anti-Nucleocapsid immunoassay (Abbott SARS-CoV-2 IgG assay (Abbott N)). Results Omicron neutralizing antibodies were detected in all samples with the live virus neutralization assay. The detection rate of the Abbott S, Wantai, Roche and Abbott N immunoassays were 65.2%, 69.6%, 86.9% and 91.3%, respectively. The sensitivities of Abbott S and Wantai immunoassays were significantly lower t han that of the live virus neutralization assay (p=0.004, p=0.009; Fisher's exact test). Antibody concentrations obtained with anti-S immunoassays were correlated with Omicron neutralizing antibody concentrations. Conclusion These data provide clinical evidence of the loss of performance of some commercial immunoassays to detect antibodies elicited by Omicron infections. It highlights the need to optimize these assays by adapting antigens to the circulating SARS-CoV-2 strains. This article is protected by copyright. All rights reserved. View on Web

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Recovery of gland function after endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton ’s duct

alexandrossfakianakis shared this article with you from Inoreader Recovery of gland function after endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton 's duct via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to evaluate the gland function of patients following endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton 's duct. The study cohort comprised 115 patients who had undergone successful endoscopy-assisted lithotomy for hilo-parenchymal stones (mean diameter 7.7 mm). Gland function was evaluated at a mean 12 months after surgery using ultrasonography, sialography, and/or sialometry. Postoperative ultras onography of 51 affected glands revealed a regular gland size in 58.8%, normal parenchyma density in 51.0%, and ductal ectasia in 80.4%. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Reference Susceptibility Testing and Genomic Surveillance of Clostridioides difficile, United States, 2012-17

alexandrossfakianakis shared this article with you from Inoreader Reference Susceptibility Testing and Genomic Surveillance of Clostridioides difficile, United States, 2012-17 via Clinical Infectious Diseases Advance Access Abstract Background Antimicrobial susceptibility testing (AST) is not routinely performed for Clostridioides difficile and data evaluating minimum inhibitory concentrations (MICs) are limited. We performed AST and whole genome sequencing (WGS) for 593 C. difficile isolates collected between 2012-2017 through the Centers for Disease Control and Prevention's Emerging Infections Program. M ethods MICs to six antimicrobial agents (ceftriaxone, clindamycin, meropenem, metronidazole, moxifloxacin, and vancomycin) were determined using the reference agar dilution method according to Clinical and Laboratory Standards Institute guidelines. WGS was performed on all isolates to detect the presence of genes or mutations previously associated with resistance. Results Among all isolates, 98.5% displayed a vancomycin MIC ≤ 2 μg/mL and 97.3% displayed a metronidazole MIC ≤ 2 μg/mL. Ribotype 027 (RT027) isolates displayed higher vancomycin MICs (MIC50: 2 μg/mL; MIC90: 2 μg/mL) than non-RT027 isolates (MIC50: 0.5 μg/mL; MIC90: 1 μg/mL) (P < 0.01). No vanA/B genes were detected. RT027 isolates also showed higher MICs to clindamycin and moxifloxacin and were more likely to harbor associated resistance genes or mutations. Conclusions Elevated MICs to antib iotics used for treatment of C. difficile infection were rare and there was no increase in MICs over time. The lack of vanA/B genes or mutations consistently associated with elevated vancomycin MICs suggests there are multifactorial mechanisms of resistance. Ongoing surveillance of C. difficile using reference AST and WGS to monitor MIC trends and the presence of antibiotic resistance mechanisms is essential. View on Web

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Nosocomial malaria transmissions resolved by genomic analyses – a retrospective case report study in France (2007-2021)

alexandrossfakianakis shared this article with you from Inoreader Nosocomial malaria transmissions resolved by genomic analyses – a retrospective case report study in France (2007-2021) via Clinical Infectious Diseases Advance Access Abstract Background Exposure of blood to malaria parasites can lead to infection even in the absence of the anopheles mosquito vector. During a stay in a healthcare facility, accidental inoculation of the skin with blood from a malaria patient might occur, referred to as nosocomial malaria transmission. Methods Between 2007 and 2021, we identified six autochthonous malaria cases that occurred in six different French hospitals, originating from nosocomial transmi ssion and imported malaria patients being the infection source. Four cases were observed during the COVID-19 pandemic. The genetic relatedness between source and nosocomial infections was evaluated by genome-wide short tandem repeats (STRs) and single-nucleotide polymorphisms (SNPs). Results None of the patients with autochthonous malaria had travel history to an endemic area nor had been transfused. For each case, both the source and recipient patients stayed a few hours in the same ward. After diagnosis, autochthonous cases were treated with antimalarials and all recovered except one. Genetically, each pair of matched source/nosocomial parasite infections showed less than 1% of different genome-wide STRs, and less than 6.9% (<1.5% for monoclonal infections) of different SNPs. Similar levels of genetic differences were obtained for parasite DNA samples that were independently sequenced twice as references of identical infections. Parasite phylogenomic results were consi stent with travel information reported by the source patients. Conclusions Our study demonstrates that genomics analyses may resolve nosocomial malaria transmissions, despite the uncertainty regarding the modes of contamination. Nosocomial transmission of potentially life-threatening parasites should be taken into consideration in settings or occasions where compliance with universal precautions is not rigorous. View on Web

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