Real‐world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high‐risk donor seropositive/recipient seronegative (D+R‐) liver transplant recipients (LTxR)

alexandrossfakianakis shared this article with you from Inoreader Real‐world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high‐risk donor seropositive/recipient seronegative (D+R‐) liver transplant recipients (LTxR) via Transplant Infectious Disease Abstract Background Despite superiority of preemptive therapy (PET) compared to universal prophylaxis for prevention of cytomegalovirus (CMV) disease in the CAPSIL randomized trial among CMV D+R- liver transplant recipients (LTxRs), real-world effectiveness may be lower because of logistical concerns about feasibility of PET. Methods We retrospectively assessed PET as standard clinical care at a single transplant center among 50 consecutive adult CMV D+R- LTxRs undergoing a first liver transplant between 4/4/2019 and 5/18/2021 and compared outcomes and adherence to those randomized to PET in the CAPSIL study (N = 100). The primary outcome was CMV disease and secondary outcomes were biopsy-confirmed acute allograft rejection, retransplant, invasive fungal infections, and death, all assessed by 1-year post-transplant. Exploratory outcomes included virologic parameters and measures of adherence to protocol-specified CMV qPCR monitoring. Results Baseline characteristics were similar between groups. The cumulative incidence of CMV disease at 1-year post-transplant was 4/50 (8%) versus 9/100 (9%) in the real-world and CAPSIL cohorts, respectively, p = 1.0. The rate of breakthrough CMV disease during the 100-day PET period was low (2/50 [4%]) and similar to the PET cohort from the CAPSIL study (3/100 [3%]).  All secondary and exploratory outcomes were not significantly different between the real-world and CAPSIL PET cohorts. Conclusions In this first reported study of real-world PET, the feasibility and effectiveness for CMV disease prevention and for other clinical outcomes in CMV D+R- LTxRs were similar to those reported with PET in a clinical trial. Additional studies to confirm feasibility and generalizability in other settings are warranted. View on Web

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Differences in morphology of temporomandibular joint ankylosis of traumatic and infective origin

alexandrossfakianakis shared this article with you from Inoreader Differences in morphology of temporomandibular joint ankylosis of traumatic and infective origin via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to determine whether there are any differences in morphology between temporomandibular joint ankylosis (TMJA) of traumatic and infective origin. Cone beam computed tomography (CBCT) scans of 25 patients (28 joints) with TMJA of traumatic origin (trauma group) and 15 patients (15 joints) with TMJA of infectious origin (infection group) were included. The following morphological parameters were evaluated on multiple sections of the CBCT scans: lateral juxta-articular bone growth, residual condyle, residual glenoid fossa, ramus thickening, ankylotic mass fusion line, sclerosis of the ankylosed condyle and spongiosa of the glenoid fossa, and mastoid and glenoid fossa air cell obliteration. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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A new glutamine synthetase index to evaluate hepatic lobular restoration in advanced fibrosis during anti‐HBV therapy

alexandrossfakianakis shared this article with you from Inoreader A new glutamine synthetase index to evaluate hepatic lobular restoration in advanced fibrosis during anti‐HBV therapy via Journal of Medical Virology Abstract Hepatic lobular architecture distortion is a deleterious turning point and a crucial histological feature of advanced liver fibrosis in chronic liver diseases. Regression of fibrosis has been documented in chronic hepatitis B (CHB) patients. However, whether lobular architecture could be restored following fibrosis regression after antiviral therapy is still unclear. Glutamine synthetase (GS) is generally expressed by perivenular hepatocytes around hepatic veins (HV). In this study, we defined abnormal lobular architecture (GSPT) as GS expressing in the vicinity of portal tracts (PT), which denotes parenchymal extinction and lobular collapse. We defined normal lobular architecture (GSHV) as GS positivity area not approximating PTs. Therefore, we propose a new GS-index, defined as the percentage of GSHV/(GSHV+GSPT), to evaluate the extent of architectural disruption and restoration. We evaluated 43 CHB patients with advanced fi brosis (Ishak stage ≥ 4). Post-treatment liver biopsy was performed after 78 weeks of anti-HBV therapy. The median GS-index improved from 7% (IQR: 0%-23%) at baseline to 36% (IQR: 20%-57%) at week 78 (P < 0.001). Totals of 22 patients (51%) had significant GS-index improvement from 0% (IQR: 0%-13%) to 55% (IQR: 44%-81%), while the other half had almost no change between 17% (IQR: 0%-33%) to 20% (IQR: 12%-31%). When GS-index78w ≥ 50% was used to define hepatic lobular restoration, 37% of patients (16/43) achieved lobular restoration, with much improvement in ALT and AST levels (median value of ∆/Baseline in ALT: restored vs. non-restored was 79.1% vs. 48.8%, P = 0.018; median value of ∆/Baseline in AST: restored vs. non-restored was 69.1% vs. 32.5%, P = 0.005). More importantly, lobular restoration correlated with fibrosis regression (median value of ∆/Baseline in Ishak stage: restored vs. non-restored was 25.0% vs. 0%, P = 0.008). Therefore, in the era of antiviral therapy for CHB, restoration of hepatic lobular architecture is achievable in patients with advanced fibrosis. GS-index provides additional insight into fibrosis regression that goes beyond collagen degradation. This article is protected by copyright. All rights reserved. View on Web

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Guidance on the use of convalescent plasma to treat immunocompromised patients with COVID-19

alexandrossfakianakis shared this article with you from Inoreader Guidance on the use of convalescent plasma to treat immunocompromised patients with COVID-19 via Clinical Infectious Diseases Advance Access Abstract COVID-19 convalescent plasma (CCP) is a safe and effective treatment for COVID-19 in immune compromised (IC) patients. IC patients have a higher risk of persistent infection, severe disease and death from COVID-19. Despite the continued clinical use of CCP to treat IC patients, the optimal dose, frequency/schedule, and duration of CCP treatment has yet to be determined, and related best practices guidelines are lacking. A group of individuals with expertise spanning infectious diseases, virology and transfusion medicine was assembled to render an expert opinion statement pertaining to the use of CCP for IC patients. For optimal effect, CCP should be recently and locally collected to match circulating variant. CCP should be considered for the treatment of IC patients with acute and protracted COVID-19; dosage depends on clinical setting (acute vs protracted COVID-19). CCP containing high-titer SARS-CoV-2 antibodies, retains activity against circul ating SARS-CoV-2 variants, which have otherwise rendered monoclonal antibodies ineffective. View on Web

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The relationship between childhood leukaemia and childhood asthma: A pharmacoepidemiological study from the Netherlands

alexandrossfakianakis shared this article with you from Inoreader The relationship between childhood leukaemia and childhood asthma: A pharmacoepidemiological study from the Netherlands via Pediatric Blood & Cancer Abstract Background It has been suggested that childhood asthma lowers the risk of childhood leukaemia. Studies have found an inverse association between these conditions. However, most studies on this relationship are based on questionnaires and telephone interviews, introducing recall bias. Therefore, we conducted a matched case–control study based on drug prescription data to assess the relationship between both conditions. Methods In a large database, covering more than one million individuals, we identified cases of children who had been prescribed 6-mercaptopurine (6-MP). This drug is used in the outpatient maintenance therapy of childhood leukaemia. We matched every child with leukaemia on sex and age (±6 months) to children without leukaemia (controls). The variable of having had asthma was defined as receiving at least two prescriptions for an inhaled corticosteroid within 12 months. Results We identified 59 children aged 2–18 who had been prescribed 6-MP (cases), and they were matched to 21,918 controls. Of the children with childhood leukaemia, three (5%) had childhood asthma, whereas in the control group 4889 (22%) had childhood asthma (odds ratio [OR] 0.19; 95% confidence interval 0.06–0.60). Conclusion In this study on the relationship between childhood asthma and childhood leukaemia, we found a strong inverse association. View on Web

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Equivocal end‐of‐therapy imaging findings do not predict a higher risk of local relapse after definitive radiotherapy in pediatric Ewing sarcoma and rhabdomyosarcoma

alexandrossfakianakis shared this article with you from Inoreader Equivocal end‐of‐therapy imaging findings do not predict a higher risk of local relapse after definitive radiotherapy in pediatric Ewing sarcoma and rhabdomyosarcoma via Pediatric Blood & Cancer Abstract Background Posttherapy imaging studies can provide reassurance or induce anxiety regarding risk of recurrence for patients and their families. In some cases, it is difficult to determine if imaging findings represent posttreatment changes or residual disease. Equivocal radiographic findings can occur due to therapy-related inflammation or residual, inactive soft tissue masses, but it is unknown if such findings indicate an increased likelihood of local recurrence. The aim of this study was to assess the value of initial posttherapy scans for predicting local relapse in patients with Ewing sarcoma (EWS) or rhabdomyosarcoma (RMS) who received radiotherapy (RT) for local control. These findings are critical to inform clinicians' surveillance recommendations and ability to accurately counsel patients and their families. Procedure The primary endpoint was time to local progression (LP). Patients were classified as having posttherapy scans that were "positive" (residual disease within the RT field), "negative" (no evidence of residual disease within the RT field), or "equivocal" (no determination could be made). The value of initial posttreatment scans for predicting LP was assessed using positive predictive value (PPV) and negative predictive value (NPV). Results Negative imaging findings (n = 51) had an NPV of 88%, and positive imaging findings (n = 1) had a PPV of 100%. When equivocal findings (n = 16) were categorized with negative results (i.e., positive vs. equivocal/negative), the NPV was 90%. When equivocal findings were categorized with positive results (equivocal/positive vs. negative), the PPV was 12%. Conclusion Equivocal findings within the RT field on end-of-therapy imaging studies indicate no higher risk of local recurrence than negative findings. These results may contribute to appropriate surveillance schedules and accurate counseling of patients with RMS and EWS who have received RT for local control. View on Web

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Limited enhancement of antibody and B‐cell responses to prototype booster vaccination following SARS‐CoV‐2 Delta breakthrough infection

alexandrossfakianakis shared this article with you from Inoreader Limited enhancement of antibody and B‐cell responses to prototype booster vaccination following SARS‐CoV‐2 Delta breakthrough infection via Journal of Medical Virology Abstract COVID-19 vaccines are effective at preventing the ancestral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptomatic infection and severe disease. However, many new SARS-CoV-2 variants of concern (VOCs), including Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2) and the most recent Omicron (B.1.1.529) variants, continue to evolve with enhanced immune escape capabilities, posing serious challenges to the efficacy of current vaccines. Recent studies showed booster doses can remarkably reduce VOCs escape from neutralizing antibody response and can induce strong T-cell and memory B-cell responses[1-4](#ref-0001). Hybrid immunity resulting from the combinations of SARS-CoV-2 infection and vaccination has also been proved to produce antibodies with increased potency and breadth and elicit robust CD4+ T-cell populations with enhanced antiviral properties[5,6](#ref-0005). But is unclear that how infection and vaccination history affect immune imprinting and whether it's necessary to have a booster vaccination for people who had a breakthrough infection post-vaccination This article is protected by copyright. All rights reserved. View on Web

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Intracapsular Dissection Approaches (Enucleation) in Surgical Resection of Carotid Body Tumors

alexandrossfakianakis shared this article with you from Inoreader Intracapsular Dissection Approaches (Enucleation) in Surgical Resection of Carotid Body Tumors via The Laryngoscope Intracapsular dissection approaches in surgical resection of carotid body tumors. Laryngoscope, 2023 View on Web

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Masseter muscle cross‐sectional area and late implant failure: A case–control study

alexandrossfakianakis shared this article with you from Inoreader Masseter muscle cross‐sectional area and late implant failure: A case–control study via Clinical Implant Dentistry and Related Research Abstract Introduction Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. Purpose This case–control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. Methods This case–control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. Results The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82–10.79; p < 0.01). Conclusion Higher masseter muscle CSA increases the risk of late implant failure. View on Web

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Lip Squamous Cell Carcinoma With Spontaneous Eruption and Drainage

alexandrossfakianakis shared this article with you from Inoreader Lip Squamous Cell Carcinoma With Spontaneous Eruption and Drainage via JAMA Otolaryngology–Head & Neck Surgery Online First A 69-year-old woman with a newly diagnosed squamous cell carci noma of the lower lip mucosa presented 3 days after initiating neoadjuvant immune checkpoint blockade immunotherapy with redness and swelling of the tumor site. What is your diagnosis? View on Web

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Emerging Omicron subvariants evade neutralizing immunity elicited by vaccine or BA.1/BA.2 infection

alexandrossfakianakis shared this article with you from Inoreader Emerging Omicron subvariants evade neutralizing immunity elicited by vaccine or BA.1/BA.2 infection via Journal of Medical Virology Abstract The newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.2.75 and BA.2.76 subvariants contained 35 and 29 additional mutations in its spike (S) protein compared to the reference SARS-CoV-2 genome, respectively. Here, we measured the evasion degree of the BA.1, BA.2, BA.4, BA.5, BA.2.75, and BA.2.76 subvariants from neutralizing immunity in people previously infected with the Omicron BA.1 and BA.2, determined the effect of vaccination on immune evasion, and compared the titers of neutralizing antibodies in serums between acute infection and convalescence. Results showed that the neutralization effect of serums from patients with different vaccination statuses and BA.1/BA.2 breakthrough infection decreased with the Omicron evolution from BA.1 to BA.2, BA.4, BA.5, BA.2.75, and BA.2.76. This study also indicated that the existing vaccines could no longer provide effective protection, especially for the emerging BA.2.75 and BA.2.76 subvariants. Therefo re, vaccines against emerging epidemic strains should be designed specifically. In the future, we can not only focus on the current strains, but also predict and design new vaccines against potential mutant strains. At the same time, we can combine the virus strains' infection characteristics to develop protective measures for virus colonization areas, such as nasal protection spray. Besides, further studies on the Y248N mutation of BA.2.76 subvariant were also necessary to explore its contribution to the enhanced immune evasion ability. This article is protected by copyright. All rights reserved. View on Web

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