Evaluation of guidelines for diagnosis and treatment of Helicobacter pylori infection

alexandrossfakianakis shared this article with you from Inoreader Evaluation of guidelines for diagnosis and treatment of Helicobacter pylori infection via Helicobacter Abstract Background To systematically evaluate the quality of the guidelines for the diagnosis and treatment of Helicobacter pylori infection and to analyze the differences and reasons for the key recommendations in the guidelines. Methods Databases and websites were systematically searched to obtain guidelines for the diagnosis and treatment of Helicobacter pylori infection. Four independent reviewers used the Guideline Evaluation Tool (AGREE II) to evaluate the included guidelines. The intraclass correlation coefficient (ICC) and Fleiss' kappa coefficient were used to measure the consistency of evaluation guidelines between guide reviewers. Differences between guidelines and the reasons for the differences were analyzed by comparing the recommendations of different guidelines and the evidence supporting the recommendations. Results A total of 17 guidelines for Helicobacter pylori infection were included in this study. The AGREE II scores of these guidelines were low overall, with 4 of them had a score of over 60%, which indicates that the guidelines are recommended, and 13 of them having a score ranging from 30 to 60%, which indicates that the guidelines are recommended but need to be revised, while no guideline had a score of 30% or less, which indicates that they were not recommended. The analysis of these guidelines found that there were some differences in the main recommendations. Not all guidelines recommend sequential therapy as the recommended therapy. Whether bismuth quadruple therapy should be used as the recommended first-line therapy is unclear. The antibiotic resistance rate is different in different regions. Combined with the local antibiotic sensitivity test, the eradication rate of Helicobacter pylori can be improved. Conclusion There are significant differences in the quality of Helicobacter pylori infection guidelines and the key recommendations. Improving the deficiencies of existing guidelines is an effective way to develop high-quality guidelines and make reasonable recommendations for the treatment of Helicobacter pylori infection in the future. View on Web

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ABRACADABRA literacy instruction for children with Down syndrome via telepractice during COVID‐19: A pilot study

alexandrossfakianakis shared this article with you from Inoreader ABRACADABRA literacy instruction for children with Down syndrome via telepractice during COVID‐19: A pilot study via British Journal of Educational Psychology Abstract Background COVID-19 has resulted in some educators and allied health practitioners transitioning to online delivery of literacy instruction. As far as we are aware, no studies have investigated online delivery of comprehensive literacy instruction for children with Down syndrome. Aims In this pilot study, we explore the efficacy of online delivery of ABRACADABRA (a free literacy web application) for children with Down syndrome, alongside supplementary parent-led shared book reading, during the COVID-19 pandemic. Sample Six children with Down syndrome, aged 8–12 years, participated in this within-participants design study. Methods Participants acted as their own controls with outcome variables measured at three timepoints: baseline, pre-instruction and post-instruction. Children participated in 16–18 hrs of one-to-one literacy instruction online over a 6-week instruction phase, along with twice weekly parent-led shared book reading activities. Results Outcomes from standardized assessments revealed statistically significant improvements in word- and passage-level reading accuracy skills over the instruction phase (pre-instruction to post-instruction) compared with the no-instruction control phase (baseline to pre-instruction). Improvements in reading comprehension skills were inconsistent across assessment measures and statistical analyses. Conclusion Children with Down syndrome can benefit from comprehensive literacy instruction delivered via telepractice. Our study provides critical initial evidence of successful service delivery during a global pandemic and beyond. View on Web

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The fate of interneurons, GABAA receptor sub‐types and perineuronal nets in Alzheimer's disease

alexandrossfakianakis shared this article with you from Inoreader The fate of interneurons, GABAA receptor sub‐types and perineuronal nets in Alzheimer's disease via Brain Pathology Abstract Alzheimer's disease (AD) is the most common neurological disease, which is associated with gradual memory loss and correlated with synaptic hyperactivity and abnormal oscillatory rhythmic brain activity that precedes phenotypic alterations and is partly responsible for the spread of the disease pathology. Synaptic hyperactivity is thought to be because of alteration in the homeostasis of phasic and tonic synaptic inhibition, which is orchestrated by the GABAA inhibitory system, encompassing subclasses of interneurons and GABAA receptors, which play a vital role in cognitive functions, including learning and memory. Furthermore, the extracellular matrix, the perineuronal nets (PNNs) which often go unnoticed in considerations of AD pathology, encapsulate the inhibitory cells and neurites in critical brain regions and have recently come under the light for their crucial role in synaptic stabilisation and excitatory-inhibitory balance and when disrupted, serve as a potential trigger for AD-associated synaptic imbalance. Therefore, in this review, we summarise the current understanding of the selective vulnerability of distinct interneuron subtypes, their synaptic and extrasynaptic GABAAR subtypes as well as the changes in PNNs in AD, detailing their contribution to the mechanisms of disease development. We aim to highlight how seemingly unique malfunction in each component of the interneuronal GABA inhibitory system can be tied together to result in critical circuit dysfunction, leading to the irreversible symptomatic damage observed in AD. View on Web

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High‐frequency (10 kHz) Spinal Cord Stimulation (SCS) as a Salvage Therapy for Failed Traditional SCS: A Narrative Review of the Available Evidence

alexandrossfakianakis shared this article with you from Inoreader High‐frequency (10 kHz) Spinal Cord Stimulation (SCS) as a Salvage Therapy for Failed Traditional SCS: A Narrative Review of the Available Evidence via Pain Practice Abstract Introduction Traditional spinal cord stimulation (t-SCS) has been used to treat chronic pain for over 50 years. However, up to 30% of patients undergo explant, with the main indication being loss of efficacy (LoE), and few alternative treatment options exist for these patients. Strategies to mitigate LoE commonly include conversion to another type of SCS (termed 'salvage' or 'rescue'). This review summarizes the existing literature concerning the efficacy and safety of 10 kHz SCS as a salvage therapy. Methods We searched PubMed, the Cochrane Library, ClinicalTrials.gov, and other sources between January 2009 and April 2021. Records were retained if the authors reported clinical outcomes with a minimum of ≥3 months of follow-up in patients implanted with a Senza® 10 kHz SCS system in an effort to treat t-SCS LoE. Results Ten articles were eligible for inclusion, reporting 3 prospective studies and 7 retrospective reviews. In the single study that salvaged patients without a repeat trial prior to surgery, 81% of patients were responders (≥50% pain relief from baseline), with mean pain relief of 60%. Among repeat-trial studies, the responder rate ranged from 46% to 80%, and mean pain relief from 47% to 68%. No unanticipated therapy-related safety issues were reported among the included articles. Conclusion Preliminary data suggest that chronic back and/or leg pain patients with t-SCS LoE can experience improved and durable pain relief after conversion to 10 kHz SCS. However, additional research is needed to define predictors of success and establish whether salvage without a repeat trial is a viable conversion method. View on Web

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Use of antihypertensive drugs and risk of cutaneous melanoma: a nationwide nested case-control study

alexandrossfakianakis shared this article with you from Inoreader Use of antihypertensive drugs and risk of cutaneous melanoma: a nationwide nested case-control study via International Journal of Epidemiology - Advance Access Abstract Background Most antihypertensives can induce dermal photosensitivity, which may increase melanoma risk. However, corroborating evidence is limited. We examined the associations between use of antihypertensives and melanoma risk. Methods A nationwide nested case-control study was conducted using data from the Cancer Registry of Norway, the National Registry and the Norwegian Prescription Database in 2004–15. Ten controls were randomly selected for each melanoma case, matched on sex and birth year. The study included 12 048 cases and 117 895 controls. We estimated rate ratios (RRs) with 95% confidence intervals (CIs). All analyses were adjusted for ambient ultraviolet radiation (UVR). We additionally performed active comparator analyses, and sensitivity analyses by only including new users, distinguishing between exclusive and mixed users, allowing for different latency periods, and subgroup analyses by melanoma subtype and clinical stage. Results Compared with non-use, we observed a slightly increased melanoma risk in users of diuretics (RR 1.08, CI 1.01–1.15), calcium-channel blockers (RR 1.10, CI 1.04–1.18) and drugs affecting the renin-angiotensin system (RR 1.10, CI 1.04–1.16), but not for beta blockers (RR 0.97, CI 0.92–1.03). We found no heterogeneity of associations by melanoma subtype or clinical stage and no dose-response relationship between the cumulative defined daily doses (DDDs) and melanoma. No interaction was found between cumulative DDDs and ambient UVR. Conclusions Weak associations, with lack of a dose-response relationship and lack of interactions with ambient UVR, in the DDD analysis in this nationwide study do not support a causal relationship between antihypertensives and melanoma risk. View on Web

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FACE-Q satisfaction following upper third facial gender-affirming surgery using custom bone-section guides

alexandrossfakianakis shared this article with you from Inoreader FACE-Q satisfaction following upper third facial gender-affirming surgery using custom bone-section guides via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Postoperative satisfaction after facial gender-affirming surgery (FGAS) has not yet been assessed using a validated questionnaire. There is currently no postoperative satisfaction questionnaire specific to transgender patients concerning facial surgery. The contributions of three-dimensional planning in fronto-orbital surgery in trans women and the use of bone cutting guides for facial feminization surgery have been demonstrated. The primary objective of this study was to evaluate postoperative satisfaction with the upper third of the face in trans women using a validated questionnaire – FACE-Q – after fronto-orbital surgery using custom-made bone cutting guides. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Outcome of Selective Root Canal Retreatment ‐ a retrospective study

alexandrossfakianakis shared this article with you from Inoreader Outcome of Selective Root Canal Retreatment ‐ a retrospective study via International Endodontic Journal Abstract Aim Selective root canal retreatment is when the treatment is limited to root(s) with radiographic evidence of periapical pathosis. The goals of this retrospective study were as follows: i) evaluate the clinical and radiographic (periapical radiographs (PR) or cone beam computerised tomographs (CBCT)) outcome of selective root canal retreatment after ≥ 12 months follow-up; ii) evaluate the periapical status of the unretreated roots; iii) assess tooth survival. Methods A retrospective study (January 2018 to April 2021) was conducted to identify permanent multirooted teeth that underwent selective root canal retreatment. Clinical records, PR and CBCT were examined to ascertain variables of interest. Outcomes (per root and per tooth) were classified into "favourable" or "unfavourable" using well-established clinical and radiographic healing criteria. Treatment outcomes for the whole tooth and per root were compared as well as bivariate associations between the treatment outcome of the retreated roots and the treatment-related parameters (quality of root filling, sealer extrusion, iatrogenic mishaps, type of restoration) were analysed using Fisher's exact test (α = 0.05). Survival was recorded in months. Results A total of 75 teeth (195 roots) in 75 subjects were available for outcome analysis. The favourable outcome per tooth was 86.7%. At follow-up, 92.6% of the retreated roots had a favourable outcome. From the unretreated roots, 3.5% showed radiographic signs of an emerging periapical lesion. No statistical difference was shown between the outcomes per root and per tooth between both groups. None of the treatment-related parameters had a direct influence on the outcome of the retreated roots. The survival rate at 12–48 months after retreatment was 91.5%. Conclusions Selective root canal retreatment is associated with a favourable outcome in a majority of cases. Untreated roots rarely developed radiographic signs of a new periapical lesion at follow-up. Future high-quality clinical trials with larger sample sizes and longer follow-up periods are required to confirm these findings. View on Web

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Apatinib plus paclitaxel versus paclitaxel monotherapy for platinum‐resistant recurrent ovarian cancer treatment: A retrospective cohort study

alexandrossfakianakis shared this article with you from Inoreader Apatinib plus paclitaxel versus paclitaxel monotherapy for platinum‐resistant recurrent ovarian cancer treatment: A retrospective cohort study via Journal of Clinical Pharmacy and Therapeutics This retrospective cohort study reviewed 70 platinum-resistant recurrent ovarian cancer (PROC) patients who received apatinib plus paclitaxel (apatinib plus paclitaxel group) (N = 32) or paclitaxel monotherapy (paclitaxel monotherapy group) (N = 38). The recommended regimens were as follows: paclitaxel (60 mg/m2) administrated once a week with a maximum of 18 weeks; apatinib (250–375 mg/day) administrated until disease progression or patient intolerance. Interestingly, disease control rate was elevated (84.4% vs. 60.5%, P = 0.028), whereas objective response rate only disclosed an increasing trend (lacked statistical significance) (37.5% vs. 18.4%, P = 0.074) in apatinib plus paclitaxel group compared with paclitaxel monotherapy group. Progression-free survival (median [95% CI]: 5.0 [2.5–7.5] months vs. 3.8 [2.4–5.2] months, P = 0.033) and overall survival (median [95% CI]: 21.1 [13.2–29.0] months vs. 14.8 [11.4–18.2] months, P = 0.032) were both prolonged in apatinib plus paclitaxel group compared to paclitaxel monotherapy group, which were further verified in the multivariate Cox's proportional hazard regression analyses (both P < 0.050). Additionally, the incidence of each adverse event was not different between the two groups (all P > 0.050). Collectively, apatinib plus paclitaxel exhibits better efficacy and acceptable toxicity compared with paclitaxel monotherapy in PROC patients. Abstract What Is Known and Objective Apatinib, an oral antiangiogenic drug, exerts potential anti-tumour effects on platinum-resistant recurrent ovarian cancer (PROC). This study intended to evaluate the efficacy and safety of apatinib plus paclitaxel compared to paclitaxel monotherapy in PROC patients. Methods This retrospective cohort study reviewed 70 PROC patients who received apatinib plus paclitaxel (apatinib plus paclitaxel group) (N = 32) or paclitaxel monotherapy (paclitaxel monotherapy group) (N = 38). The recommended regimens were as follows: paclitaxel (60 mg/m2) administrated once a week with a maximum of 18 weeks; apatinib (250–375 mg/day) administrated until disease progression or patient intolerance. Results and Discussion Disease control rate was elevated (84.4% vs. 60.5%, P = 0.028), whereas objective response rate only disclosed an increasing trend (lacked statistical significance) (37.5% vs. 18.4%, P = 0.074) in apatinib plus paclitaxel group compared with paclitaxel monotherapy group. Progression-free survival (median [95% confidence interval (CI)]: 5.0 [2.5–7.5] months vs. 3.8 [2.4–5.2] months, P = 0.033) and overall survival (median [95% CI]: 21.1 [13.2–29.0] months vs. 14.8 [11.4–18.2] months, P = 0.032) were both prolonged in apatinib plus paclitaxel group compared to paclitaxel monotherapy group, which were further verified in the multivariate Cox's proportional hazard regression analyses (both P < 0.050). Additionally, the incidence of each adverse event was not different between the two groups (all P > 0.050). What is New and Conclusion Apatinib plus paclitaxel exhibits better efficacy and acceptable toxicity compared with paclitaxel monotherapy in PROC patients. View on Web

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A Dual‐targeting Near‐infrared Biomimetic Drug Delivery System for HBV Treatment

alexandrossfakianakis shared this article with you from Inoreader A Dual‐targeting Near‐infrared Biomimetic Drug Delivery System for HBV Treatment via Journal of Medical Virology Abstract Hepatitis B virus (HBV) infection is a serious global public health threat. It remains elusive to achieve a functional HBV cure with currently available antivirals. Herein, a photo-responsive delivery vehicle composed of Nd3+-sensitized core-shell upconversion nanoparticle (UCNP), mesoporous silica nanoparticle (MSN), antisense oligonucleotides (ASO), and capsid-binding inhibitor C39 was established, which was named UMAC according to the initials of its components. Subsequently, the as-synthesized delivery vehicle was encapsulated by β-D-galactopyranoside (Gal) modified red blood cell (RBC) membrane vesicles, which enabled precise targeting of the liver cells (UMAC-M-Gal). Both in vitro and in vivo experiments demonstrated that this biomimetic system could successfully achieve controlled drug release under light conditions at 808 nm, leading to effective suppression of HBV replication in this dual-targeted therapeutic approach. Together, these results sub stantiate the system has huge prospects for application to achieve functional HBV cure, and provides a promising novel strategy for drug delivery. This article is protected by copyright. All rights reserved. View on Web

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AZD7442 (Tixagevimab/Cilgavimab) for Post-exposure Prophylaxis of Symptomatic COVID-19

alexandrossfakianakis shared this article with you from Inoreader AZD7442 (Tixagevimab/Cilgavimab) for Post-exposure Prophylaxis of Symptomatic COVID-19 via Clinical Infectious Diseases Advance Access Abstract Background We report primary results of a phase 3 trial of AZD7442 (tixagevimab/cilgavimab) for post-exposure prophylaxis to prevent symptomatic coronavirus disease 2019 (COVID-19) Methods Adults without prior SARS-CoV-2 infection or COVID-19 vaccination were enrolled within 8 days of exposure to a SARS-CoV-2–infected individual and randomized 2:1 to a single 300-mg AZD7442 dose (one 1.5-mL intramuscular injection each of tixagevimab and cilgavimab consecutively) or placebo. Primary endpoints were safety and first post-dose SARS-CoV-2 reverse-transcription–polymerase-chain-reaction (RT-PCR)–positive symptomatic COVID-19 event before day 183. Results 1121 participants were randomized and dosed (mean age 46 years; 49% females; AZD7442, n=749; placebo, n=372). Median (range) follow-up was 49 (5–115) and 48 (20–113) days for AZD7442 and placebo, respectively. Adverse events occurred in 162/749 (21.6%) and 111/372 (29.8%) participants with AZD7442 and placebo, respectively, mostly mild/moderate. RT-PCR–positive symptomatic COVID-19 occurred in 23/749 (3.1%) and 17/372 (4.6%) AZD7442- and placebo-treated participants, respectively (relative risk reduction 33.3%; 95% confidence interval [CI] –25.9 to 64.7; P=.21). In predefined subgroup analyses of 1073 (96%) participants who were SARS-CoV-2 RT-PCR–negative (n=974 [87%]) or missing an RT-PCR result (n=99 [9%]) at baseline, AZD7442 reduced RT-PCR–positive symptomatic COVID-19 by 73.2% (95% CI 27.1 to 90.1) versus placebo. Conclusions This study did not meet the primary efficacy endpoint of post-exposure prevention of symptomatic COVID-19 with AZD7442 versus placebo. However, predefined analysis of participants who were SARS-CoV-2 RT-PCR–negative or missing an RT-PCR result at baseline support a role for AZD7442 in preventing symptomatic COVID-19. View on Web

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