Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient

alexandrossfakianakis shared this article with you from Inoreader Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient via Journal of Medical Virology ABSTRACT Monkeypox is a neglected zoonotic disease caused by Monkeypox virus (MPXV), a double-stranded DNA virus of the genus Orthopoxvirus. Here we present a case report of a 32-year-old man with MPXV infection who developed keratoconjunctivitis and Wessley immune ring with no identifiable cause other than ocular involvement by MPXV. We highlight the need of ophthalmologists exploring any ocular symptoms in MPXV-infected individuals. This article is protected by copyright. All rights reserved. View on Web

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Discovery of Isojacareubin as a covalent inhibitor of SARS‐CoV‐2 main protease using structural and experimental approaches

alexandrossfakianakis shared this article with you from Inoreader Discovery of Isojacareubin as a covalent inhibitor of SARS‐CoV‐2 main protease using structural and experimental approaches via Journal of Medical Virology Abstract The ongoing pandemic with the emergence of immune evasion potential and particularly the current omicron sub variants intensified the situation further. Although vaccine are available but the immune evasion capabilities of the recent variants demand further efficient therapeutic choices to control the SARS-CoV-2 pandemic. Hence, considering the necessity of the small molecule inhibitor we target the main protease (3CLpro) which is an appealing target for the development of anti-viral drugs against the SARS-CoV-2. High-throughput molecular in silico screening of South African natural compounds database (SANCDB) reported as Isojacareubin and Glabranin the potential inhibitors for main protease. The calculated docking scores were reported to be -8.47 kcal/mol and -8.03 kcal/mol respectively. Moreover, the structural-dynamic assessment reported that Isojacareubin in complex with 3CLpro exhibit more stable dynamic behaviour than Glabranin. Inhibition assay indicated that Isojacareubin could inhibit SARS-CoV-2 3CLpro in a time- and dose-dependent manner, with IC50 values of 16.00±1.35 μM (60-min incubation). Next, the covalent binding sites of Isojacareubin on SARS-CoV-2 3CLpro was identified by biomass spectrometry which reported that Isojacareubin can covalently bind to thiols or Cysteine through Michael addition. To evaluate the inactivation potency of Isojacareubin, the inactivation kinetics was further investigated. The inactivation kinetic curves were plotted according to various concentrations with gradient-ascending incubation times. The K I value of Isojacareubin was determined as 30.71 μM, while the K inact value was calculated as 0.054 min-1. These results suggest that Isojacareubin is a covalent inhibitor of SARS-CoV-2 3CLpro. This article is protected by copyright. All rights reserved. View on Web

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Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test‐and‐treat program

alexandrossfakianakis shared this article with you from Inoreader Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test‐and‐treat program via Journal of Medical Virology Abstract Background Dried blood spots (DBS) are a reliable tool to diagnose viremic HCV infection. We evaluated the clinical performance of a DBS-based molecular assay for the assessment of cure and reinfection after on-site treatment at a harm reduction centre (HRC). Genotyping from DBS samples was also assessed to discriminate reinfection from treatment failure. Methods People who inject drugs (PWID) from an ongoing microelimination pilot at the largest HRC in Barcelona were included in the study. HCV-RNA detection from DBS collected after treatment (with follow-up at 12, 36 and 60 weeks) was compared with a molecular point-of-care test using finger-stick blood (GeneXpert). Baseline and follow-up DBS samples were genotyped by NS5B sequencing or commercial real-time PCR. Results Among treated patients, 193 follow-up DBS samples were tested. The DBS-based assay showed 100% specificity (129/129), and sensitivity ranged from 84.4% to 96.1% according to different viral load cut-offs (from detectable to 3000 IU/mL). Sensitivity as test of cure (follow-up 12) ranged from 85.1 to 97.4%. Among the 64 patients with recurrent viremia, 10.9% had low viral loads (≤1000 IU/mL); HCV genotyping allowed us to classify 73.5% of viremic cases either as reinfection or as treatment failure. Conclusions DBS samples are useful to assess cure and differentiate reinfection from relapse after HCV antiviral treatment in the real world, facilitating decentralization of treatment and post-treatment follow-up in PWID. However, a fraction of patients presented with low viral loads, limiting viremia detection and genotyping in DBS and, therefore, repeat testing is recommended. This article is protected by copyright. All rights reserved. View on Web

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Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis

alexandrossfakianakis shared this article with you from Inoreader Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis via The Laryngoscope Idiopathic subglottic stenosis is a rare disease with incompletely understood pathophysiology. This study investigated for association with human leukocyte antigen allele variations, which have important contributions to other airway disease including granulomatosis with polyangiitis. There was no specific HLA association identified for idiopathic subglottic stenosis. Objective Despite recent scientific inquiry, idiopathic subglottic stenosis (iSGS) remains an enigmatic disease. The consistent demographics of the affected population suggest genetic factors may contribute to disease susceptibility. Given the inflammation observed in the affected proximal airway mucosa, we interrogated disease association with human leukocyte antigen (HLA) polymorphisms. Polymorphisms in the HLA locus have previously been shown to influence individuals' susceptibility to distinct inflammatory diseases. Methods High-resolution HLA typing of 37 iSGS patients was compared with 1,242,890 healthy Caucasian controls of European ancestry from the USA National Marrow Donor Program and 281 patients with granulomatosis with polyangiitis (GPA). Results Complete HLA genotyping of an iSGS population showed no significant associations when compared to a North American Caucasian control population. Unlike GPA patients, iSGS was not associated with allele DPB1*04:01 nor did allele homozygosity correlate with disease severity. Conclusions There was not a detectable HLA association observed in iSGS. These results support the concept that iSGS possesses a distinct genetic architecture from GPA. If genetic susceptibility exists in iSGS, it likely lies outside the HLA locus. Level of Evidence N/A, basic science Laryngoscope, 2023 View on Web

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Characteristics of Adults Undergoing Soft Tissue and Orthognathic Surgery for Obstructive Sleep Apnea

alexandrossfakianakis shared this article with you from Inoreader Characteristics of Adults Undergoing Soft Tissue and Orthognathic Surgery for Obstructive Sleep Apnea via The Laryngoscope Of those with obstructive sleep apnea, unique clinical and demographic characteristics were identified in those who underwent soft tissue and orthognathic sleep surgery. Trends in palate-related surgery, as well as the proportion that was female, were examined over time. Objective To identify clinical and demographic characteristics of adults with obstructive sleep apnea (OSA) undergoing soft tissue and orthognathic sleep surgery, assess temporal trends in surgery type and proportion of women undergoing surgery, and provide clinical perspective before wide-spread implementation of hypoglossal nerve stimulation (HGNS). Methods In a retrospective cohort study, adults diagnosed with OSA from 2009 to 2016 were identified in a large integrated healthcare system. Characteristics between cohort members who did and did not undergo sleep surgeries were compared. Multivariable logistic regression models examined associations of different characteristics with whether surgery was performed. Results Of 172,216 adults with OSA, 2,262 (1.3%) underwent sleep surgery during 2009–2017. The most common sleep surgery was palate surgery (56.9%), which decreased proportionately over time. In multivariable analysis, older age and obesity were associated with lower odds of undergoing surgery. Those who underwent tonsillectomy and adenoidectomy were more likely to have larger tonsils and not require additional surgery, whereas tongue reduction recipients were more likely to have severe OSA and require multiple surgery types. The proportion of women undergoing surgery increased over time (p < 0.001 from trend test). Conclusion Clinical and demographic characteristics associated with soft tissue and orthognathic sleep surgery were identified in a large adult cohort prior to widespread implementation of HGNS. An increase in sleep surgery among women and a decrease in palate surgery over time were observed. The findings provide clinical perspective on sleep surgery performed prior to implementation of HGNS and may inform future studies examining its associations with patient characteristics. Level of Evidence 3 Laryngoscope, 2023 View on Web

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gyrA mutations in Mycoplasma genitalium and their contribution to moxifloxacin failure: time for the next generation of resistance-guided therapy

alexandrossfakianakis shared this article with you from Inoreader gyrA mutations in Mycoplasma genitalium and their contribution to moxifloxacin failure: time for the next generation of resistance-guided therapy via Clinical Infectious Diseases Advance Access Abstract Background While single nucleotide polymorphisms (SNPs) in Mycoplasma genitalium parC contribute to fluoroquinolone treatment failure, data are limited for the homologous gene, gyrA. This study investigated the prevalence of gyrA SNPs, and their contribution to fluoroquinolone failure. Methods Samples from 411 patients (male and female) undergoing treatment for M. genitalium infection (Melbourne Sexual Health Centre, March 2019–February 2020) were analyzed by Sanger sequencing (gyrA and parC). For patients treated with moxifloxacin (n=194), the association between SNPs and microbiologic treatment outcome was analyzed. Results The most common parC SNP was G248T/S83I (21.1% of samples), followed by D87N (2.3%). The most common gyrA SNP was G285A/M95I (7.1%). Dual parC/gyrA SNPs were found in 8.6% of cases. One third of infections harboring parC G248T/S83I SNP had a concurrent SNP in gyrA conferring M95I. SNPs in gyrA co-occurred with parC S83I variations. Treatment failure was higher in patients with parC S83I/gyrA dual SNPs, when compared to infections with single S83I SNP alone from analysis of (i) 194 cases in this study (81.2% vs 45.8%, p=0.047), and (ii) pooled analysis of a larger population of 535 cases (80.6% vs 43.2%; p=0.0027), indicating a strong additive ef fect. Conclusions Compared to parC S83I SNP alone, M. genitalium infections with dual mutations affecting parC/gyrA had twice the likelihood of failing moxifloxacin. While AMR varies by region globally, these data indicate that gyrA should be considered as a target for future resistance assays in Australasia. We propose a strategy for the next generation of resistance-guided therapy incorporating parC and gyrA testing. View on Web

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Autogenous dentin graft versus alloplastic graft combined with socket shield for pre-implant socket preservation: a split-mouth randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader Autogenous dentin graft versus alloplastic graft combined with socket shield for pre-implant socket preservation: a split-mouth randomized clinical trial via International Journal of Oral and Maxillofacial Surgery via MedWorm.com After tooth extraction, alveolar bone resorption and labial bone plate thinning occur due to the lack of periodontal ligaments. The socket shield method was developed to preserve the alveolar ridge. A split-mouth study was performed in which eight patients were treated using alloplast with socket shield on one side (alloplast group, control) and autogenous dentin graft with socket shield on the contralateral side (dentin group, test). After 3 months, a trephine bone core was collected from all sites and evaluated by histological, histomorphometric, and radiographic analysis. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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The AUGIS Survival Predictor: Prediction of Long-Term and Conditional Survival After Esophagectomy Using Random Survival Forests

alexandrossfakianakis shared this article with you from Inoreader The AUGIS Survival Predictor: Prediction of Long-Term and Conditional Survival After Esophagectomy Using Random Survival Forests via Annals of Surgery - Most Popular Articles Objective: The aim of this study was to develop a predictive model for overall survival after esophagectomy using pre/postoperative clinical data and machine learning. Summary Background Data: For patients with esophageal cancer, accurately predicting long-term survival after esophagectomy is challenging. This study investigated survival prediction after esophagectomy using a Random Survival Forest (RSF) model derived from routine data from a large, well-curated, national dataset. Methods: Patients diagnosed with esophageal adenocarcinoma or squamous cell carcinoma between 2012 and 2018 in England and Wales who underwent an esophagectomy were included. Prediction models for overall survival were developed using the RSF method and Cox regression from 41 patient and disease characteristics. Calibration and discrimination (time-dependent area under the curve) were validated internally using bootstrap resampling. Results: The study analyzed 6399 patients, with 2625 deaths during follow-up. Median follow-up was 41 months. Overall survival was 47.1% at 5 years. The final RSF model included 14 variables and had excellent discrimination with a 5-year time-dependent area under the receiver operator curve of 83.9% [95% confidence interval (CI) 82.6%–84.9%], compared to 82.3% (95% CI 81.1%—83.3%) for the Cox model. The most important variables were lymph node involvement, pT stage, circumferential resection margin involvement (tumor at View on Web

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68Ga-FAPI PET/MRI and 18F-FDG PET/CT in a Case With Extensive Portal Vein Tumor Thrombus

alexandrossfakianakis shared this article with you from Inoreader 68Ga-FAPI PET/MRI and 18F-FDG PET/CT in a Case With Extensive Portal Vein Tumor Thrombus via Clinical Nuclear Medicine - Published Ahead-of-Print 18F-FDG PET/CT has been reported to be useful in differentiating tumor thrombus and bland thrombus. There are few reports on 68Ga-FAPI PET imaging features of tumor thrombus. Herein, we report a 46-year-old man with extensive tumor thrombus in the portal vein due to hepatic malignancy on 18F-FDG PET/CT and 68Ga-FAPI PET/MRI. View on Web

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A Persistent Left-Sided Superior Vena Cava Detected on a O-15-H2O PET/CT of the Heart

alexandrossfakianakis shared this article with you from Inoreader A Persistent Left-Sided Superior Vena Cava Detected on a O-15-H2O PET/CT of the Heart via Clinical Nuclear Medicine - Published Ahead-of-Print A persistent left-sided superior vena cava (PLSVC) is an uncommon finding with a prevalence of up to 0.5% in the general population. The PLSVC appears when the left anterior cardinal vein fails to regress as the ligament of Marshall during embryologic development. It is usually asymptomatic and discovered incidentally; however, its recognition is important because it might complicate invasive cardiovascular procedures. In this case, we report an incidental finding of a PLSVC detected on the O-15-H2O PET/CT of a patient who was referred for myocardial perfusion imaging. View on Web

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