Is Mpox an STI? Why narrowing the scope of this disease may be harmful

alexandrossfakianakis shared this article with you from Inoreader Is Mpox an STI? Why narrowing the scope of this disease may be harmful via Clinical Infectious Diseases Advance Access ABSTRACT The 2022 multi-national Mpox outbreak has been characterized by unprecedented spread among men who have sex with men outside of sub-Saharan Africa. Close contact during sex and intimacy has been well established as a key pathway for human-to-human transmission in the current outbreak. Discussions on whether to assign this illness as a sexually transmitted infection (STI) have been ongoing since the initiation of the outbreak. While sexual contact certainly appears to be a primary means of spread, classifying Mpox as an STI is inaccurate based on its known transmission dynamics, yields potential unintended consequences, and ignores the historical impact of the disease in Central and West Africa. Rather than focusing our energy on disease categorization, more effort should be placed on destigmatizing this illness and empowering communities at risk to protect themselves from Mpox. View on Web

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Errors in Data Reported in Meta-analysis of Complication Rates of Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma

alexandrossfakianakis shared this article with you from Inoreader Errors in Data Reported in Meta-analysis of Complication Rates of Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma via JAMA Otolaryngology–Head & Neck Surgery Online First In the Original Investigation, "Complication Rates of Total Thyroidectomy vs Hemithyroidectomy for Treatment of Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-analysis," published online May 5, 2022, and in the June issue of JAMA Otolaryngology–Head & Neck Surgery, the authors reported several errors for the studies included in the meta-analysis. The authors have published a Letter to explain the errors and corrections, which affect the text, Table, Figures, and Supplement, and indicate that none of the direction of the statistical findings, interpretations, or conclusions are affected. The article has been corrected. View on Web

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Clinical severity of Omicron sub‐variants BA.1, BA.2 and BA.5 in a population‐based cohort study in British Columbia, Canada

alexandrossfakianakis shared this article with you from Inoreader Clinical severity of Omicron sub‐variants BA.1, BA.2 and BA.5 in a population‐based cohort study in British Columbia, Canada via Journal of Medical Virology Abstract The SARS-CoV-2 variant Omicron emerged in late 2021. In British Columbia (BC), Canada, and globally, three genetically distinct sub-variants of Omicron, BA.1, BA.2 and BA.5, emerged and became dominant successively within an 8-month period. SARS-CoV-2 sub-variants continue to circulate in the population, acquiring new mutations that have the potential to alter infectivity, immunity and disease severity. Here, we report a propensity-matched severity analysis from residents of BC over the course of the Omicron wave, including 39,237 individuals infected with BA.1, BA.2 or BA.5 based on paired high-quality sequence data and linked to comprehensive clinical outcomes data between Dec. 23, 2021 and August 31, 2022. Relative to BA.1, BA.2 cases were associated with a 15% and 28% lower risk of hospitalization and Intensive Care Unit (ICU) admission (aHRhospital=1.17; 95%CI=1.096-1.252; aHRICU=1.368; 95%CI=1.152-1.624), whereas BA.5 infections were associated with a 1 8% higher risk of hospitalization (aHRhospital=1.18; 95%CI=1.133-1.224) after accounting for age, sex, co-morbidities, vaccination status, geography and social determinants of health. Phylogenetic analysis revealed no specific sub-clades associated with more severe clinical outcomes for any Omicron sub-variant. In summary, BA.1, BA.2 and BA.5 sub-variants were associated with differences in clinical severity, emphasizing how variant-specific monitoring programs remain critical components of patient and population-level public health responses as the pandemic continues. This article is protected by copyright. All rights reserved. View on Web

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Infection evaluation in the early period after liver transplantation: a single‐center exploration

alexandrossfakianakis shared this article with you from Inoreader Infection evaluation in the early period after liver transplantation: a single‐center exploration via Transplant Infectious Disease Abstract Background Infection is a significant risk factor that impacts for perioperative morbidity and mortality in liver transplantation (LTx) patients and is difficult to evaluate quantitatively in the early posttransplantation period. Thus, a biomarker to assess the risk of infection and the prognosis of the recipient is highly desirable. Methods One hundred and twenty-eight consecutive patients with end-stage liver diseases undergoing LTx between January 1, 2020, and December 31, 2021, at the First Affiliated Hospital of Zhejiang University School of Medicine were screened retrospectively. Graft preservation fluid and blood samples were collected for culture, and other perioperative laboratory examination results were recorded, for assessment of infection status. Results After a follow-up period of 30 days, the survival rate among the 128 LTx recipients was 94.5%. Multivariable regression analysis showed that the logarithmically transformed neutrophil-to-lymphocyte ratio (NLR) (HR = 3.548, 95% CI: ; p = 0.041) on post-LTx day 1 and graft preservation fluid culture positivity (HR = 12.032, 95% CI: ; p = 0.006) were independent predictive factors for early prognosis after LTx. Conclusions Positive graft preservation fluid culture and the logarithmically transformed NLR on post-LTx day 1 were independent predictive factors for early prognosis after LTx. The logarithmically transformed NLR could provide an earlier indication than culture results in clinical practice. This article is protected by copyright. All rights reserved View on Web

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Omicron infection increases IgG binding to spike protein of predecessor variants

alexandrossfakianakis shared this article with you from Inoreader Omicron infection increases IgG binding to spike protein of predecessor variants via Journal of Medical Virology Abstract Background SARS-CoV-2 transmission in India in 2020-2022 was driven predominantly by Wild (Wuhan-Hu-1and D614G), Delta, and Omicron variants. The aim of this study was to examine the effect of infections on the humoral immune response and cross-reactivity to spike proteins of Wuhan-Hu-1, Delta, C.1.2., and Omicron. Objectives Residual archival sera (N=81) received between January 2020 and March 2022 were included. Infection status was inferred by a positive SARS-CoV-2 RT-PCR and/or serology (anti-N and anti-S antibodies) and sequencing of contemporaneous samples (N=18) to infer lineage. We estimated the levels and cross-reactivity of infection-induced sera including Wild, Delta, Omicron as well as vaccine breakthrough infections (Delta and Omicron). Results We found ~2-fold increase in spike-specific IgG antibody binding in post-Omicron infection compared to the pre-Omicron period, whilst the change in pre- and post-Delta infections were similar. Further investigation of Omicron-specific humoral responses revealed primary Omicron infection as an inducer of cross-reactive antibodies against predecessor variants, in spite of weaker degree of humoral response compared to Wuhan-Hu-1 and Delta infection. Intriguingly, Omicron vaccine-breakthrough infections when compared with primary infections, exhibited increased humoral responses against RBD (7.7-fold) and Trimeric S (Trimeric form of spike protein) (34.6-fold) in addition to increased binding of IgGs towards previously circulating variants (4.2 - 6.5-fold). Despite Delta breakthrough infections showing a higher level of humoral response against RBD (2.9-fold) and Trimeric S (5.7-fold) compared to primary Delta sera, a demonstrably reduced binding (36-49%) was observed to Omicron spike protein. Conclusions Omicron vaccine breakthrough infection results in increased intensity of humoral response and wider breadth of IgG binding to spike proteins of antigenically-distinct, predecessor variants. This article is protected by copyright. All rights reserved. View on Web

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HTLV‐1 persistent infection and ATLL oncogenesis

alexandrossfakianakis shared this article with you from Inoreader HTLV‐1 persistent infection and ATLL oncogenesis via Journal of Medical Virology Abstract Human T-cell leukemia virus type 1 (HTLV-1) is an oncogenic retrovirus; whereas HTLV-1 mainly persists in the infected host cell as a provirus, it also causes a malignancy called adult T-cell leukemia/lymphoma (ATLL) in about 5% of infection. HTLV-1 replication is in most cases silent in vivo and viral de novo infection rarely occurs; HTLV-1 rather relies on clonal proliferation of infected T cells for viral propagation as it multiplies the number of the provirus copies. It is mechanistically elusive how leukemic clones emerge during the course of HTLV-1 infection in vivo and eventually cause the onset of ATLL. This review summarizes our current understanding of HTLV-1 persistence and oncogenesis, with the incorporation of recent cutting-edge discoveries obtained by high-throughput sequencing. This article is protected by copyright. All rights reserved. View on Web

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Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

alexandrossfakianakis shared this article with you from Inoreader Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper via Pediatric Blood & Cancer Abstract Imaging in hematopoietic stem cell transplantation patients is not targeted at evaluating the transplant per se. Rather, imaging is largely confined to evaluating peri-procedural and post-procedural complications. Alternatively, imaging may be performed to establish a baseline study for comparison should the patient develop certain post-procedural complications. This article looks to describe the various imaging modalities available with recommendations for which imaging study should be performed in specific complications. We also provide select imaging protocols for different indications and modalities for the purpose of establishing a set minimal standard for imaging in these complex patients. View on Web

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Caring for a child with retinoblastoma: Experience of Ethiopian parents

alexandrossfakianakis shared this article with you from Inoreader Caring for a child with retinoblastoma: Experience of Ethiopian parents via Pediatric Blood & Cancer Abstract Objective This study explored the lived experience of parents of children with retinoblastoma. Design and method A phenomenological qualitative study design was used, and a purposive sampling technique to recruit parents of children with retinoblastoma. Semi-structured interviews were conducted to document the lived experience of participants, who were asked to narrate their experiences caring for a child with retinoblastoma, thinking back to the day they learned about their child's condition, as well as their thoughts about the future. The interviews were conducted in Amharic and Oromo language, and audio recordings were transcribed and translated to English. Data were analyzed using thematic analysis. Results Thirteen parents (seven mothers, six fathers) participated in the study. Collectively, the children of the participants represented all the stages of the retinoblastoma journey (i.e., diagnosis, treatment, remission, and recurrence). Five major themes emerged from the thematic data analysis: (a) reactions when learning the child's condition; (b) receiving health care; (c) costs of caregiving; (d) support; and (e) uncertainties. Conclusion The lived experiences of parents of children with retinoblastoma revealed a significant mental health and psychosocial burden. The sources of mental distress were found to be complex and varied. Holistic care for retinoblastoma should include programs that address the biopsychosocial needs of caregivers. View on Web

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The varied spectrum of nephroblastomatosis, nephrogenic rests, and Wilms tumors: Review of current definitions and challenges of the field

alexandrossfakianakis shared this article with you from Inoreader The varied spectrum of nephroblastomatosis, nephrogenic rests, and Wilms tumors: Review of current definitions and challenges of the field via Pediatric Blood & Cancer Abstract The diagnosis of multiple or diffuse renal lesions in a child is challenging by imaging and/or pathology. Optimal management requires distinguishing benign lesions such as nephrogenic rests from cancerous lesions such as Wilms tumor, but this is often difficult or impossible. This difficulty is compounded by the overlapping nature of our current radiologic and pathologic definitions of lesions along the spectrum of nephrogenic rests/nephroblastomatosis. We provide a review of these issues, as a collaborative effort between the Children's Oncology Group Renal Tumor Committee and International Society of Pediatric Oncology Renal Tumor Study Group. Our aim is to discuss current challenges in diagnosis and management of these renal lesions, encouraging future work toward consensus definitions for research and patient care. View on Web

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Ninety‐day mortality following transoral robotic surgery or radiation at Commission on Cancer‐accredited facilities

alexandrossfakianakis shared this article with you from Inoreader Ninety‐day mortality following transoral robotic surgery or radiation at Commission on Cancer‐accredited facilities via Head & Neck Abstract Background Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment. View on Web

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