Pediatric renal tumor epidemiology: Global perspectives, progress, and challenges

alexandrossfakianakis shared this article with you from Inoreader Pediatric renal tumor epidemiology: Global perspectives, progress, and challenges via Pediatric Blood & Cancer Abstract Pediatric renal tumors account for 3%–11% of childhood cancers, the most common of which is Wilms tumor or nephroblastoma. Epidemiology plays a key role in cancer prevention and control by describing the distribution of cancer and discovering risk factors for cancer. Large pediatric research consortium trials have led to a clearer understanding of pediatric renal tumors, identification of risk factors, and development of more risk-adapted therapies. These therapies have improved event-free and overall survival for children. However, several challenges remain and not all children have benefited from the improved outcomes. In this article, we review the global epidemiology of pediatric renal tumors, including key consortium and global studies. We identify current knowledge gaps and challenges facing both high and low middle-incomes countries. View on Web

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Long‐term variations and potency of neutralizing antibodies against Omicron subvariants after CoronaVac inactivated booster: a 7‐month follow‐up study

alexandrossfakianakis shared this article with you from Inoreader Long‐term variations and potency of neutralizing antibodies against Omicron subvariants after CoronaVac inactivated booster: a 7‐month follow‐up study via Journal of Medical Virology Abstract The long-term protective efficacy of neutralizing antibodies (Nab) against Omicron subvariants after inactivated booster vaccines remains elusive. During the follow-up study, 54 healthy volunteers aged 20 to 31 years received inactivated CoronaVac booster vaccinations and were monitored for 221 days. The dynamic efficacy and durability of Nab against Omicron subvariants BA.1, BA.2, BA.2.12.2 and BA4/5 were assessed using a pseudotyped virus neutralization assay at up to 9 time points post-immunization. The antibody response against Omicron subvariants was substantially weaker than D614G, with BA.4/5 being the least responsive. The geometric mean titer (GMT) of Nab against Omicron subvariants BA.1, BA.2, BA.2.12.1, and BA.4/5 was 2.2-, 1.7-, 1.8-, and 2.2-fold lower than that against D614G (Ps<0.0001). The gap in Nab response between Omicron subvariants was pronounced during the 2 weeks–2 months following booster vaccination (Ps< 0.05). Seven months post booster, the antibody potency against D614G was maintained at 100% (50% for Nab titers ≥ 100 EC50), whereas 77.3% for BA.1, 90.9% for BA.2, 86.4% for BA.2.12.1, and 86.4% for BA.4/5 (almost 20% for Nab titers ≥ 100 EC50). Despite the inevitable immune escape, Omicron subvariants maintained sustained and measurable antibody potency post-booster vaccination during long-term monitoring, which could help optimize immunization strategies. This article is protected by copyright. All rights reserved. View on Web

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Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes

alexandrossfakianakis shared this article with you from Inoreader Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes via Journal of Medical Virology Abstract Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no-use of metformin, the aHRs (95% CI) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic ne uralgia than metformin no-use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no-use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes. This article is protected by copyright. All rights reserved. View on Web

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Relationship between carotid intima‐media thickness and periodontal disease in a Japanese urban population with and without hypertension: the Suita Study

alexandrossfakianakis shared this article with you from Inoreader Relationship between carotid intima‐media thickness and periodontal disease in a Japanese urban population with and without hypertension: the Suita Study via Journal of Clinical Periodontology Abstract Aim To investigate the association between periodontal disease and atherosclerosis and examine whether the association is modified by hypertension status. Materials and Methods In this cross-sectional study, 1,472 Japanese individuals aged 50-79 years who underwent a medical check-up, dental examination, and carotid ultrasonography were studied. Carotid atherosclerosis was expressed as the maximum and mean carotid intima-media thickness (max-IMT, mean-IMT) and the presence of stenosis (>75%). Periodontal status was examined by the Community Periodontal Index (CPI, codes 0-4). The participants were divided into 3 groups according to periodontal status (CPI0-2, CPI3, CPI4). Results A positive correlation was found between mean-IMT and periodontal disease after adjustment for cardiovascular risk factors in the entire cohort (mean-IMT in hypertensives: CPI0-2: 0.848 mm, CPI3: 0.857 mm, CPI4: 0.877 mm; normotensives: 0.782, 0.802, 0.826). In the entire cohort, the multivariable-adjusted odds ratio of stenosis based on mean-IMT significantly increased according to periodontal status in normotensives (odds ratio; CPI0-2: 1, CPI3: 1.39, CPI4: 2.53; P for trend=0.004), but only marginally significantly increased in hypertensives (1, 1.15, 1.55; P for trend=0.063). No significant relationships were observed for max-IMT in all analyses. Conclusion We observed an association between periodontal disease and atherosclerosis in normotensive and hypertensive participants. This article is protected by copyright. All rights reserved. View on Web

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Platelet‐rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: an in vivo study

alexandrossfakianakis shared this article with you from Inoreader Platelet‐rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: an in vivo study via Journal of Clinical Periodontology Abstract Aim It has been proposed that platelet-rich fibrin (PRF) can be used to support bone regeneration during alveolar ridge augmentation. The aim of this study was to determine if an approach utilizing PRF provides similar performance to the established guided bone regeneration (GBR) procedure. Materials and Methods Two-wall defects were surgically created in beagle dogs and treated in three experimental groups: (i) sticky bone (SB) substitute prepared using liquid PRF and deproteinized porcine bone mineral (DPBM), (ii) SB covered with solid PRF compressed into a membrane, and (iii) GBR performed using DPBM covered by a collagen membrane. The quantitative reverse-transcription polymerase chain reaction was applied to specimen after 1 week of healing, and microcomputed tomography (micro-CT) and histological outcomes were analyzed after 8 weeks of healing. Results Compared with GBR, PRF resulted in a moderate increase in the expression levels of osteoblast and osteoclast markers, osteocalcin, and calcitonin receptor. Moreover, PRF modestly increased angiogenesis and the inflammation markers VEGF and IL-6. Micro-CT and histological analyses confirmed the expected increased alveolar ridge area, with no significant differences between the three groups. Consistently, graft consolidation as indicated by new bone formation at the defect site did not differ significantly between groups. Conclusion The present results demonstrate that PRF-based approaches performed comparably to the established GBR procedure in terms of the consolidation of DPBM in two-wall alveolar defects. This article is protected by copyright. All rights reserved. View on Web

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Characteristics of Orbital Injuries Associated with Maxillofacial Trauma

alexandrossfakianakis shared this article with you from Inoreader Characteristics of Orbital Injuries Associated with Maxillofacial Trauma via The Laryngoscope Introduction The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures. Methods We performed a retrospective review of 1677 patients from 2015 to 2020 with midface fractures at a Level I trauma center. Isolated nasal bone and frontal process of the maxilla fractures were excluded. Demographic information, mechanism of injury, need for surgery, and ophthalmologic findings were documented. Statistical analysis was conducted using SPSS. Results 773 patients between the ages of 15 and 92 were identified. Trauma most commonly resulted from assault (63.8%). The association between the mechanism of injury and ocular injury was statistically significant (p = 0.003), with 78.6% of gunshot wounds and 44.3% of assault patients having an ocular injury. The Ophthalmology service evaluated 62.6% of cases preoperatively. Minor ocular injury occurred in 36% of patients, including 46.1% of isolated orbital floor, and 28.2% of zygomaticomaxillary complex fractures. Major ocular injury occurred in 10.5% of patients. Conclusions Over 10% of patients with midface fractures were found to have major ocular injuries. Ophthalmologic exams should be performed for all patients with midface fractures to guide clinical decision making and prevent further intraoperative ocular insults. Level of Evidence Level 4. This study represents a retrospective cohort study analyzing ocular injuries detected in patients presenting to a Level I trauma center with maxillofacial fractures between 2015 and 2020 Laryngoscope, 2022 View on Web

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Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning

alexandrossfakianakis shared this article with you from Inoreader Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning via American Journal of Epidemiology - Advance Access Abstract We sought to determine whether machine learning and natural language processing (NLP) applied to electronic medical records could improve performance of automated healthcare claims-based algorithms to identify anaphylaxis events using data on 516 patients with outpatient, emergency department, or inpatient anaphylaxis diagnosis codes during 2015-2019 in two integrated healthcare institutions in the Northwest United States. We used one site's manually reviewed gold standard outcomes data for model development and the other's for external validation based on cross-validated (cv) area under the receiver operating characteristic curve (cv AUC), positive predictive value (PPV), and sensitivity. In the development site 154 (64%) of 239 potential events met adjudication criteria for anaphylaxis compared to 180 (65%) of 277 in the validation site. Logistic regression models using only structured claims data achieved a cv-AUC of 0.58 (95% CI: 0.54, 0. 63). Machine learning improved cv-AUC to 0.62 (0.58, 0.66); incorporating NLP-derived covariates further increased cv AUCs to 0.70 (0.66, 0.75) in development and 0.67 (0.63, 0.71) in external validation data. A classification threshold with cv-PPV of 79% and cv-sensitivity of 66% in development data had cv-PPV of 78% and cv-sensitivity of 56% in external data. Machine learning and NLP-derived data improved identification of validated anaphylaxis events. View on Web

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Update of the classification of midpalatal suture behaviour after surgically assisted rapid maxillary expansion using computed tomography

alexandrossfakianakis shared this article with you from Inoreader Update of the classification of midpalatal suture behaviour after surgically assisted rapid maxillary expansion using computed tomography via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to update the midpalatal suture classification after surgically assisted rapid maxillary expansion (SARME) using computed tomography (CT). Thirty-five patients with a transverse maxillary deficiency and unilateral or bilateral posterior crossbite underwent SARME with osteotomy of the pterygoid apophysis of the sphenoid. CT was performed before installation of the Hyrax expander appliance and after the final activation. Opening of the midpalatal suture was classified into three types: type I, total midpalatal suture opening from anterior nasal spine (ANS) to posterior nasal spine (PNS); type II, partial midpalatal suture opening from ANS to the transverse palatine suture, with partial or non-existent opening of the midpalatal suture posterior to the transverse pala... View on Web

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Multiagent Chemotherapy Followed by Stereotactic Body Radiotherapy Versus Conventional Radiotherapy for Resected Pancreas Cancer

alexandrossfakianakis shared this article with you from Inoreader Multiagent Chemotherapy Followed by Stereotactic Body Radiotherapy Versus Conventional Radiotherapy for Resected Pancreas Cancer via American Journal of Clinical Oncology - Current Issue Background and Purpose: Chemotherapy followed by margin-negative resection (R0) is the treatment of choice for patients with localized pancreatic ductal adenocarcinoma (PDAC). Neoadjuvant multiagent chemotherapy (MAC) or MAC then radiotherapy (RT) may optimize surgical candidacy. The purpose of this study was to compare pathologic outcomes of MAC followed by conventionally fractionated radiotherapy (CRT) versus stereotactic body radiotherapy (SBRT) for patients with resected PDAC. Methods: Patients diagnosed with nonmetastatic PDAC between 2012 and 2017 and who received preoperative MAC or MAC+RT were identified in the National Cancer Database. Variables associated with R0 and overall survival were identified with logistic regression and Cox analysis (P View on Web

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The role of Cannabis in treatment‐resistant Fibromyalgia women

alexandrossfakianakis shared this article with you from Inoreader The role of Cannabis in treatment‐resistant Fibromyalgia women via Pain Practice Abstract Background Fibromyalgia is a complex pain-focused syndrome. Previous studies showed that Cannabis is efficacious in promoting sleep, deepening and lengthening the sleep cycle, and good pain relief (compared to SSRIs and SNRIs). Purpose This study aimed to use the World Health Organization Quality of Life Bref questionnaire (WhoQoL-bref) to characterize the impact of Cannabis Treatment initiation on the quality of life in women suffering from treatment-resistant fibromyalgia. Methods a prospective cohort study involving 30 women aged 18-70 years old diagnosed with fibromyalgia, exhausted pharmacological fibromyalgia treatment, and started Cannabis treatment. Pregnant women were excluded. WhoQoL-bref was filled before Cannabis treatment initiation and one month following treatment. Results Women's average age was 46 years(±5), with a poor general quality of life (1.47±0.63), poor general health (1.47±0.78), pain and discomfort, and dependence on medication (3.77±1.3 and 3.07±1.74 respectively) prior to Cannabis intervention. Cannabis treatment for 30 days showed a marked improvement in general quality of life (1.97 scores, p < 0.01), general health (1.83, p<0.01), physical health ( 1.5, p<0.01), and psychological domain (1.3, p<0.01). Financial resources and home environment were not influenced by cannabis treatment (p=0.07, p=0.31, respectively). Conclusion Results suggest a potentially significant role of Cannabis in treatment-resistant Fibromyalgia women. Early Cannabis treatment may result in a beneficial short-term effect on the quality of life through its influence on pain, sleep, physical and psychological domains. Further studies are still indicated to understand this potential and its long-term beneficial impact. View on Web

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