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Κυριακή 10 Απριλίου 2022

Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth

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imageBackground: Uterine fibroids often cause intolerable symptoms leading to invasive treatments, most commonly hysterectomy. Reproductive tract infections are hypothesized to influence uterine fibroid development, but few studies exist, especially for the highly prevalent condition bacterial vaginosis (BV). Both fibroids and BV have documented racial–ethnic disparities, with higher burden in Blacks. Methods: With prospective data from a community-based study (four standardized ultrasound examinations over 5 years) in young Black women, we examined baseline BV associations with fibroid incidence and growth. We computed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incidence comparing BV and no BV (Nugent score ≥7 vs.
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Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology

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imageBackground: When new vaccine components or platforms are developed, they will typically need to demonstrate noninferiority or superiority over existing products, resulting in the assessment of relative vaccine effectiveness (rVE). This review aims to identify how rVE evaluation is being performed in studies of influenza to inform a more standardized approach. Methods: We conducted a systematic search on PubMed, Google Scholar, and Web of Science for studies reporting rVE comparing vaccine components, dose, or vaccination schedules. We screened titles, abstracts, full texts, and references to identify relevant articles. We extracted information on the study design, relative comparison made, and the definition and statistical approach used to estimate rVE in each study. Results: We identified 63 articles assessing rVE in influenza virus. Studies compared multiple vaccine components (n = 38), two or more doses of the same vaccine (n = 17), or vaccination timing or history (n = 9). One study compared a range of vaccine components and doses. Nearly two-thirds of all studies controlled for age, and nearly half for comorbidities, region, and sex. Assessment of 12 studies presenting both absolute and relative effect estimates suggested proportionality in the effects, resulting in implications for the interpretation of rVE effects. Conclusions: Approaches to rVE evaluation in practice is highly varied, with improvements in reporting required in many cases. Extensive consideration of methodologic issues relating to rVE is needed, including the stability of estimates and the impact of confounding structure on the validity of rVE estimates.
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Estimands and Estimation of COVID-19 Vaccine Effectiveness Under the Test-Negative Design: Connections to Causal Inference

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imageThe test-negative design is routinely used for the monitoring of seasonal flu vaccine effectiveness. More recently, it has become integral to the estimation of COVID-19 vaccine effectiveness, in particular for more severe disease outcomes. Because the design has many important advantages and is becoming a mainstay for monitoring postlicensure vaccine effectiveness, epidemiologists and biostatisticians may be interested in further understanding the effect measures being estimated in these studies and connections to causal effects. Logistic regression is typically applied to estimate the conditional risk ratio but relies on corre ct outcome model specification and may be biased in the presence of effect modification by a confounder. We give and justify an inverse probability of treatment weighting (IPTW) estimator for the marginal risk ratio, which is valid under effect modification. We use causal directed acyclic graphs, and counterfactual arguments under assumptions about no interference and partial interference to illustrate the connection between these statistical estimands and causal quantities. We conduct a simulation study to illustrate and confirm our derivations and to evaluate the performance of the estimators. We find that if the effectiveness of the vaccine varies across patient subgroups, the logistic regression can lead to misleading estimates, but the IPTW estimator can produce unbiased estimates. We also find that in the presence of partial interference both estimators can produce misleading estimates.
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Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis

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Abstract

Introduction

Human herpes virus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with significant morbidity and mortality.

Methods

The epidemiology of HHV-6 infections and their impact on outcome after allo-HSCT were retrospectively analyzed in 689 adult allo-HSCT recipients (January 2015-December 2018). Chromosomal integration of HHV-6 (ciHHV-6) in the donor was retrospectively investigated to critically evaluate antiviral treatment strategies.

Results

HHV-6 DNA in any specimen was found in 89 patients. HHV-6 infections (encephalitis (1), gastroenteritis (44), dermatitis (2), hepatitis (1) or pneumonitis (5)) were diagnosed in 53/689 patients (7.7%). Elevated levels of HHV-6 DNA were found in 38 patients (5.5%). CiHHV-6, analyzed in patients with HHV-6 viral loads ≥104 copies/mL, was identified in 4 patients (10/38 patients; 10.5%). Two of those displayed copy numbers of HHV-6 ranging from ≥ 2 × 105 to 2.5 × 106 copies/mL (HHV-6A). Here, ciHHV-6 was integrated into donor and not into the patients' cells. In this series of allo-HSCT recipients, 10.5% of patients with blood viral loads of HHV-6 showed ciHHV-6.

Conclusion

Screening of the donor for chromosomal integration of HHV-6 (ciHHV-6) before initiation of antiviral therapy is recommended.

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The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome

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Summary

Aim

This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs.

Methods

This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase.

Results

Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs.

Conclusion

The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs.

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Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players

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Abstract

Objective

This study aimed to examine the effects of spirulina supplementation on pro/antioxidant status, inflammation, and skeletal muscle damage markers immediately and 24h after exhaustive exercise in elite rugby players.

Methods

Seventeen elite male Rugby Union players were randomly assigned to a Spirulina (SPI: n=9), or a placebo group (PLA: n=8) in a double-blind design. Subjects were supplemented with Spirulina platensis (5.7 g/d) or placebo (isoproteic and caloric) for 7 weeks. At baseline (W0) and after seven weeks of supplementation (W7), blood samples were obtained before (T0), immediately after (T1), and 24h after (T2) exhaustive exercise. The Yoyo Intermittent Recovery Test Level 2 was used as an exhaustive exercise to induce oxidative stress (OS), inflammation, and skeletal muscle damage. The studied parameters included Pro/antioxidant status markers (SOD, GPX, GSH/GSSG ratio, ox-LDL, and F2-Isop), inflammation markers (MPO and CRP), and skeletal muscle damage markers (LDH and CK).

Results

Our results showed that F2-Isop, CRP, and CK levels significantly increased at T1 only in PLA group (p<0.05, p<0.05, and p<0.001 respectively) with no change in SPI group which reflects the effect of spirulina to prevent lipid peroxidation, inflammation, and skeletal muscle damage induced by exhaustive exercise. Moreover, spirulina supplementation accelerated the return to baseline values given that F2-Isop, CRP, and CK levels at T2 were significantly lower than at T0 in SPI group (p<0.05, p<0.01, and p<0.001 respectively).

Conclusion

Based on the markers used in this study, our results report that spirulina supplementation potentially prevents exercise-induced lipid peroxidation, inflammation, skeletal muscle damage and may accelerate the recovery of some of these markers. Based on our findings, we recommend spirulina supplementation especially for athletes who do not achieve the recommended antioxidant dietary intake and who perform a high training load in order to reduce the magnitude of OS, inflammation, and skeletal muscle damage which could help to reduce performance losses and accelerate recovery after training/competitions throughout the season.

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Syphilisinfektion im HNO-Bereich

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Laryngorhinootologie
DOI: 10.1055/a-1808-7321

Die Anzahl der gemeldeten Syphilis-Fälle steigt seit Jahren an. Die sexuell übertragbare Erkrankung wird durch die Spirochäte Treponema pallidum Subspezies pallidum verursacht und verläuft hierbei in verschiedenen Stadien. In allen Stadien können hierbei Symptome im HNO-Bereich auftreten. Hierdurch ist bei passenden Symptomen eine Syphilis-Infektion als Differenzialdiagnose vom HNO-Arzt stets zu bedenken. So ist bei zunehmendem oralem Geschlechtsverkehr der Primäraffekt/harter Schanker zunehmend häufig im Mundraum zu beobachten. Zudem können Symptome nicht nur im Mundraum, sondern auch im Bereich des Ohrs, der Nase, des Larynx sowie auch zervikal und fazial auftreten. Die Diag nose wird hierbei über den direkten Erregernachweis oder über einen serologischen Nachweis gesichert. Die Spirochäte ist nicht kultivierbar. Der therapeutische Goldstandard ist die Gabe von Benzathin-Penicillin G oder Procain-Penicillin G. Als Alternative stehen Doxycyclin, Makrolide oder Ceftriaxon zur Verfügung. Bei einer Innenohr- oder Hirnnervenbeteiligung ist die zusätzliche Gabe eines Glukokortikoids zu empfehlen. Vor Durchführung der antibiotischen Therapie ist der Patient über die Möglichkeit einer Jarisch-Herxheimer-Reaktion aufzuklären. Bei einer Syphilis-Infektion ist stets eine kollegiale Zusammenarbeit mit den Venerologen zu empfehlen, sodass eine effektive und umfassende Diagnostik und Therapie erfolgen kann.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournal s:
Table of contents  |  Abstract  |  Full text

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Does closed-loop automated oxygen control reduce the duration of mechanical ventilation? A randomised controlled trial in ventilated preterm infants

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Many preterm infants require supplemental oxygen in the newborn period but experience frequent fluctuations of their oxygen saturation levels. Intermittent episodes of hypoxia or hyperoxia increase the risk of...
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Accurate fish-freshness prediction label based on red cabbage anthocyanins

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Publication date: Available online 9 April 2022

Source: Food Control

Author(s): Shuliang Fang, Zhihao Guan, Cheng Su, Wenshuo Zhang, Jian Zhu, Yuewei Zheng, Houbin Li, Pingping Zhao, Xinghai Liu

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Analysis of implant loss risk factors after simultaneous guided bone regeneration: A retrospective study of 5404 dental implants

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Abstract

Purpose

The purpose was to analyze the risk factors for implant loss after simultaneous guided bone regeneration (GBR).

Materials and Methods

Patients who underwent implant placement with simultaneous GBR between January 2011 and December 2018 were screened for this study. The cumulative survival rate (CSR) was calculated using the life table method. Log-rank test and Kaplan–Meier survival estimates were used to identify potential risk factors for implant loss. The association between the investigated variables and implant loss was determined using hazard ratios (HRs) obtained from a multivariate Cox regression analysis.

Results

A total of 3973 patients with 5404 implants were included in this study. The CSRs of the implants at 1, 5, and 10 years were 99.6%, 98.9%, and 98.7%, respectively. Male patient (HR = 2.94, 95% CI: 1.41–6.14), periodontitis (HR = 4.26, 95% CI: 2.05–9.86), tissue-level implants (HR = 3.02, 95% CI: 1.30–6.98), narrow implants (HR = 2.71, 95% CI: 1.12–6.57), and implant length ≤10 mm (HR = 2.91, 95% CI: 1.41–6.02) significantly increased the risk of implant loss (p < 0.05). The risk of implant loss was significantly higher in the maxillary posterior region (HR = 2.26, 95% CI: 1.04–4.90) than in the maxillary anterior region (p < 0.05). Compared to Straumann, Nobel (HR = 4.07, 95% CI: 1.75–9.44) and other implant systems (HR = 14.23, 95% CI: 4.32–46.85) showed a significantly higher risk of implant loss (p < 0.05).

Conclusion

Male patient, periodontitis, maxillary posterior region, Nobel implant system, other implant systems, tissue-level implants, narrow implants, and implant length ≤10 mm were considered risk factors for implant loss after simultaneous GBR.

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Tooth‐cusp preservation with lithium disilicate onlay restorations: A fatigue resistance study

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Abstract

Objectives

This study examined the in vitro fatigue resistance of maxillary premolars with 2 mm or 3 mm preserved cusp thicknesses restored with lithium disilicate onlays.

Materials and Methods

Premolars(N = 48) were divided into six groups. Onlays for groups 1 to 4 preserved a 3 mm functional (G1), 2 mm functional (G2), 3 mm nonfunctional (G3), or 2 mm nonfunctional (G4) buccal-lingual cusp width. Onlays for group 5 (G5, control) replaced both cusps. Group 6 (G6) samples were identical to G1 with added retentive boxes. Lithium disilicate onlays were exposed to thermocycling (10 000 cycles, 5°C-55°C, 30s/cycle) and mechanical loading (1.2 million cycles at 1.4 Hz and 70 N). All samples were examined for onlay debonding or cusp or onlay fracture.

Results

Failure rates were 75%(G1), 0.0%(G2), 12.5%(G3), 0.0%(G4), 0.0%(G5), and 0.0%(G6). The difference in percent failure between the groups preserving the functional cusps (37.5%) and the groups preserving the nonfunctional cusps (6.3%) was statistically significant (P = .04; 95%CI:2.11-55.66). No cusp or restoration fractures were observed; all failures were due to debonding of the restoration.

Conclusion

Teeth with thin remaining cusps that were restored with bonded lithium disilicate onlay restorations were not prone to fracture. Retentive preparation features that physically eliminated lateral displacement prevented onlay debonding even though the ceramic-enamel margin was directly at the occlusal contact.

Clinical significance

The use of adhesively retained lithium disilicate ceramic onlays may be a viable alternative to full coverage restorations and may challenge traditionally accepted principals related to preparation resistance and retention form of ceramic partial coverage restorations.

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Laryngoscopic Findings of Age‐related Vocal Fold Atrophy are Reliable but not Specific

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Abstract

Objectives

We aimed to evaluate the reliability of laryngoscopic features of vocal fold atrophy as assessed by novice otolaryngology trainees and expert laryngologists.

Design

Two expert fellowship-trained laryngologists and three non-expert otolaryngology resident trainees were recruited to view 50 anonymized laryngo-stroboscopic examinations of patients presenting with dysphonia and non-voice, laryngeal complaints. Reviewers were asked to stratify the patient's age, provide an opinion about the presence of age-related vocal fold atrophy, and specify which laryngoscopy features were present to make the diagnosis.

Setting

Tertiary care laryngology practice.

Participants

Two fellowship-trained laryngologists and three trainee otolaryngologists.

Main outcome measures

Accuracy of age categorization was determined and Kappa analysis was performed to assess inter-rater agreement.

Results

The mean age of patients was 54.9 years old with near equal male to female distribution. The overall accuracy of age category determination by raters was only 30.8%. Kappa analysis demonstrated fair agreement regarding the presence of vocal fold atrophy in non-expert reviewers, and moderate agreement amongst expert reviewers. Features of glottic gap, muscular atrophy of vocal folds, and prominent vocal processes were all identified with high agreement (>80.0%).

Conclusion

Our study illustrates that while raters can agree on the presence of age-related vocal fold atrophy, the findings may be non-specific and do not necessarily correlate with age.

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