Vaccines, Vol. 10, Pages 570: Changing Perspectives on Pediatric Human Papillomavirus (HPV)

alkiviadis.1961 shared this article with you from Inoreader Vaccines, Vol. 10, Pages 570: Changing Perspectives on Pediatric Human Papillomavirus (HPV) Vaccination among Dental Students and Residents Reveals Recent Increase in Vaccine Hesitancy Via Vaccines Vaccines, Vol. 10, Pages 570: Changing Perspectives on Pediatric Human Papillomavirus (HPV) Vaccination among Dental Students and Residents Reveals Recent Increase in Vaccine Hesitancy Vaccines doi: 10.3390/vaccines10040570 Authors: Rebecca Maginot Carolina Esteves Karl Kingsley This study was a retrospective analysis of previously collected anonymous survey data regarding vaccine awareness, beliefs, and knowledge among dental (DMD) students and postgraduate (PG) residents. The protocol for this study was approved by the Institutional Review Board (IRB) as exempt. A total of 341 responses were collected from n = 293 DMD students and n = 48 PG residents. Although most respondents agreed that vaccines were necessary, safe, and effective, over the past 4 years (2017–2020) a growing percentage of respondents disagreed. In addition, although most respondents disagreed that there are too many required vaccines, vaccines can make you sick, or are dangerous,a growing percentage of respondents now agreed with these statements. Finally, although most respondents were aware of the HPV vaccine, recently a growing percentage of both students and residents reported they had insufficient information about this vaccine. These results provide novel insights int o recent changes in attitudes and beliefs regarding vaccination among this population. Moreover, analysis of these shifts in attitudes and knowledge about HPV vaccination suggests that curricular integration of vaccine research and hesitancy may be needed to answer these questions in a supportive learning environment that fosters critical thinking and evidence-based practice and decision making. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Disease activity as a risk factor for venous thromboembolism in rheumatoid arthritis analysed using time-averaged DAS28CRP: a nested case–control study

alkiviadis.1961 shared this article with you from Inoreader Disease activity as a risk factor for venous thromboembolism in rheumatoid arthritis analysed using time-averaged DAS28CRP: a nested case–control study Via Latest Results Abstract The objective of this study is to clarify the clinical features and risk factors of venous thromboembolism (VTE) in patients with rheumatoid arthritis (RA). We retrospectively reviewed the prevalence of VTE in RA patients who visited Hokkaido University Hospital from 2010 to 2019 and had more than 2 years of follow-up. To explore the risk to develop VTE, we selected 260 RA patients without VTE (non-VTE) via density sampling and identified the risk factors for VTE by multivariate logistic regression analysis. Univariate conditional logistic regression analysis showed older age (p < 0.0001, Odds Ratio [OR] 1.08, 95% Confidence Interval [CI] 1.04–1.14), increase of the body mass index (BMI) (p = 0.001, OR 1.17, 95% CI 1.06–1.31), higher prevalence of RA-associated lung disease (p = 0.002, OR 2.10, 95% CI 1.33–3.30) and more frequent glucocorticoid usage (p = 0.001, OR 2.09, 95% CI 1.34–3.51) in RA p atients was associated with the development of VTE significantly. Furthermore, patients with higher time-averaged disease activity score 28 (DAS28) CRP were at elevated risk (p < 0.0001, OR 3.25, 95% CI 1.94–6.12). In conditional multivariate logistic regression analysis, time averaged DAS28CRP was significantly associated with the development of VTE (p = 0.0001, adjusted OR 3.40, 95% CI 1.77–7.85). Disease activity was identified as a major risk factor of VTE in patients with RA, suggesting that sustained clinical remission could be beneficial for decrease the risk of VTE. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of tocilizumab for refractory Takayasu arteritis: a retrospective study and literature review

alkiviadis.1961 shared this article with you from Inoreader Efficacy of tocilizumab for refractory Takayasu arteritis: a retrospective study and literature review Via Latest Results Abstract To evaluate the efficacy and safety of tocilizumab (TCZ) in the treatment of refractory Takayasu arteritis (TAK). Eleven refractory TAK patients treated with TCZ at the First Affiliated Hospital of Anhui Medical University between 2017 July and 2020 December were respectively analyzed. We also respectively analyzed the studies on TCZ efficacy in patients with TAK, from PubMed/MEDLINE, Elsevier Science Direct between January 2010 and April 2021. The median age of 11 patients was 34(19–46) years. After 3 months of TCZ, a significant drop was found in median NIH (3[2–5] at baseline vs 1[0–2] after 6 months; p < 0.05), ITAS-2010 score (8.5[6–11] vs 6[1–10]; p < 0.05). One (9%) patient experienced relapse during TCZ treatment. After withdrawal of TCZ, one patient (9%) underwent relapse and nine patients (81%) were spared of GC use. In literature review, a total of 211 patients (mean age 35 years) were analyzed, inc luding 80 (38%) Chinese and 169 females (80%). Among the 211 patients, (154 patients) 73% achieved remission after the last infusion of TCZ; TAK relapsed in 6% of patients during TCZ treatment and 5% of the TCZ patients after the withdrawal of TCZ. A total of 95 types of adverse events were observed in the literature. Infection was the most common adverse effect, occurring in 50% of patients. TCZ could serve as an efficacious and safe agent for refractory TAK. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on 68Ga-FAPI-04 and 18F-FDG PET/CT

alexandrossfakianakis shared this article with you from Inoreader Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on 68Ga-FAPI-04 and 18F-FDG PET/CT Via Clinical Nuclear Medicine - Published Ahead-of-Print We report a case of tuberculosis peritonitis in a 26-year-old woman who presented with abdominal pain, fatigue, and weight loss for the last 4 months. Abdominal US and CT demonstrated intra-abdominal massive ascites, misty mesentery, and diffuse peritoneal thickening. In addition, 3 nodular lesions were detected in the right lung. 18F-FDG PET/CT showed hypermetabolism in lung nodules, mesenteric area, peritoneal thickening, and ascites. 68Ga-FAPI-04 (fibroblast activation protein–specific inhibitor) PET/CT imaging was also performed; high uptakes were detected in the same regions of 18F-FDG PET/CT. Tuberculosis diagnosis was made after histopathological examination of wedge resection of the right lung. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer

alexandrossfakianakis shared this article with you from Inoreader Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer Via Clinical Nuclear Medicine - Published Ahead-of-Print Purpose Patients with esophageal cancer can develop distant metastases between the start of neoadjuvant chemoradiotherapy (nCRT) and planned surgery (ie, interval distant metastases). 18F-FDG PET/CT restaging after nCRT detects interval distant metastases in ~8% of patients. This study aimed to identify patients for whom 18F-FDG PET/CT restaging after nCRT could be omitted using an existing prediction model predicting for interval distant metastases or by using clinical stage groups. Patients and Methods Patients with locally advanced esophageal cancer who underwent baseline and restaging 18F-FDG PET/CT, nCRT, and were planned for esophagectomy between 2017 and 2021 were eligible for inclusion in this retrospective study. The primary outcome was the existing model's external performance (ie, discrimination and calibration) for predicting interval distant metastases. The existing model predictors included tumor length, cN status, squamous cell carcinoma histology, and baseline SUVmax. The secondary outcome determined the clinical stage groups (AJCC/UICC eighth edition) for adenocarcinoma and squamous cell carcinoma for which the incidence of interval distant metastases was View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A multi-pollutant approach to estimating causal effects of air pollution mixtures on overall mortality in a large, prospective cohort.

alexandrossfakianakis shared this article with you from Inoreader A multi-pollutant approach to estimating causal effects of air pollution mixtures on overall mortality in a large, prospective cohort. Via Epidemiology - Published Ahead-of-Print Background: Several studies have confirmed associations between air pollution and overall mortality, but it is unclear to what extent these associations reflect causal relationships. Moreover, few studies to our knowledge have accounted for complex mixtures of air pollution. In this paper, we evaluate causal effects of a mixture of air pollutants on overall mortality in a large, prospective cohort of Dutch individuals. Methods: We evaluated 86,882 individuals from the LIFEWORK study, assessing overall mortality between 2013-2017 through national registry linkage. We predicted outdoor concentration of five air pollutants (PM2.5, PM10, NO2, PM2.5 absorbance, oxidative potential) with land-use regression. We used logistic regression and mixture modeling (weighted quantile sum and boosted regression tree models) to identify potential confounders, assess pollutants relevance in the mixture–outcome association, and investigate interactions and non-linearities. Based on these results, we built a multivariate generalized propensity score model to estimate causal effects of pollutant mixtures. Results: Regression model results were influenced by multicollinearity. Weighted quantile sum and boosted regression tree models indicated that all components contributed to a positive linear association with the outcome, with PM2.5 being the most relevant contributor. In the multivariate propensity score model, PM2.5 (OR=1.18, 95% CI:1.08,1.29) and PM10 (OR=1.02, 95% CI:0.91,1.14) were associated with increased odds of mortality per interquartile range increase. Conclusion: Using novel methods for causal inference and mixture modeling in a large prospective cohort, this study strengthened the causal interpretation of air pollution effects on overall mortality, emphasizing the primary role of PM2.5 within the pollutant mixture. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation

paythelady.61 shared this article with you from Inoreader Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To compare the effectiveness of chirp and tone burst stimuli in oVEMP and cVEMP testing for healthy adults Methods This study was conducted in 56 healthy volunteers (112 ears). Ocular and cervical VEMP (oVEMP, cVEMP) tests were performed for each participant using tone burst and chirp stimuli. VEMP response rates, latency of each peak (p1–n1, n1–p1), peak to peak amplitude (p1–n1 amplitude and n1–p1 amplitude), and rectified amplitudes were measured and compared between these two different stimuli. Results VEMP response rates with chirp stimuli are higher than the tone burst stimuli for both cVEMP and oVEMP tests (The difference was statistically significant for oVEMP, p = 0.001). Chirp stimuli have higher p1n1 amplitude and rectified amplitude and shorter p1and n1 latency then tone burst stimuli for cVEMP (p = 0.015, p = 0.007, p < 0.001, p < 0.001, respectively). Chirp stimuli also have higher n1p1 amplitude and shorter n1and p1 latency then tone burst stimuli for oVEMP (p = 0.006, p < 0.001, p < 0.001, respectively). Conclusion The present findings show that the chirp stimulus triggers earlier VEMP responses with higher amplitudes than the tone burst stimulus during cVEMP and oVEMP testing. VEMP response rate with chirp stimulus is also higher than the tone burst. Therefore chirp stimulus can be used in VEMP testing as effectively as, if not more than, tone burst stimulus in clinical practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome for sinonasal malignancies: a population-based survey

paythelady.61 shared this article with you from Inoreader Outcome for sinonasal malignancies: a population-based survey Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose Sinonasal malignancies (SNM) represent a rare and complex group of cancers that includes a wide range of histopathological subtypes. Data from population-based cohorts are scarce but warranted as a basis for randomized controlled treatment trials (RCTs). Our aim was to assess overall and histology subset-specific outcomes for SNM patients treated at a tertiary referral centre. Methods A retrospective, population-based, consecutive cohort of patients with SNMs diagnosed from 2001 through 2019 was examined. Outcome was analysed in relation to age, gender, site, stage, histopathology, and treatment. Results Two-hundred and twenty-six patients were identified, whereof 61% presented with stage IV disease. 80% completed treatment with curative intent, which comprised surgery with neoadjuvant (29%) or adjuvant (37%) radiotherapy, monotherapy with surgery (22%), definitive chemoradiotherapy (7%), or radiotherapy (5%). Median follow-up was 106 months. The 5- and 10-year overall survival rates were 57% and 35%, respectively. Median overall survival was 76 months (esthesioneuroblastoma: 147 months; adenocarcinoma: 117; salivary carcinoma: 88; mucosal melanoma: 69; squamous cell carcinoma: 51, undifferentiated carcinoma: 42; neuroendocrine carcinoma: 9; and NUT-carcinoma 5). The 5- and 10-year disease-free survival rates were 63% and 54%, respectively, and disease-specific survival 83% and 66%. Increasing age, stage IVB, melanoma histopathology, and treatment with definitive chemoradiotherapy emerged as significant independent prognostic risk factors for d isease-specific mortality (p ≤ 0.001). Conclusion The results indicate a seemingly good outcome in comparison to previous reports, particularly for mucosal melanoma, adenocarcinoma, and undifferentiated carcinoma. The study provides additional background for future RCTs focusing on histology subset-specific treatment for SNM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study

paythelady.61 shared this article with you from Inoreader Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To analyze and compare surgical and audiological outcomes of conventional approaches versus laser CO2 surgery in stapes surgery. Methods 333 patients who underwent stapes surgery were enrolled in the study; the patient population was divided into three groups: group 1: 170 patients treated with conventional stapedotomy with manual microdrill (average age 49.13 years); group 2: 119 patients treated with conventional stapedotomy with electrical microdrill (average age 51.06 years); group 3: 44 patients (average age 50.4 years) who underwent CO2 laser stapedotomy. Intra-operative, postoperative outcomes and audiological results were investigated. Results The average surgical time of laser CO2 surgery was longer than for other surgical procedures. No statistical differences emerged in post-operative abnormal taste sensation. There was also no difference in postoperative dizziness. Air-bone gap (ABG) went down from 29.7 ± 10 dB (group 1) and 27.32 ± 9.20 (group 2) to 10 ± 6.9 dB (group 1) and 10.7 ± 6.03 dB (group 2). In group 3 the preoperative ABG was lowered from 28.3 ± 10.1 to 11.8 ± 10.9, with a statistical difference in auditory recovery (p = 0.0001); The group of patients treated with laser CO2 showed a percentage of patients with an ABG closure of between 0 and 10 dB higher than in the group treated with manual microdrills (77.2% vs. 60%, respectively; p = 0.03). Conclusion Overall surgical results of CO2 laser and conventional stapedotomy are comparable without any significant difference; however, the group treated with CO2 laser appears to have a percentage of patients with an ABG closure 0–10 dB higher than the group treated using the conventional technique. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature

paythelady.61 shared this article with you from Inoreader Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background Endolymphatic sac tumour (ELST) is a rare low-grade locally aggressive neoplasm arising from the endolymphatic duct or sac. It presents mostly with vestibulo-cochlear symptoms either sporadically or as part of von Hippel–Lindau (VHL) syndrome. Micro-neurosurgical excision remains the cornerstone of therapy with the role of radiotherapy (RT) being controversial. This is a clinico-pathological analysis of consecutive ELST patients presenting to a single-institution in India. Methods Neuropathology database of a tertiary-care comprehensive cancer centre was searched electronically to identify consecutive patients with histopathological diagnosis of ELST registered at the institute over last one decade. Data regarding demographic profile, clinical presentation, histopathological features, treatment details and outcomes were retrieved from electronic medical records for this retrospective analysis. Results Electronic search identified seven unique patients with biopsy-proven ELST registered at the institute between 2009 and 2020. Median age of the study cohort was 39 years (range 24–65 years) with strong male predilection (5:2 ratio) and left-sided preponderance (71%). Most common presenting symptoms were hearing loss (86%) and earache (71%) on affected side followed by headache (43%). All patients underwent maximal safe resection at initial diagnosis and were followed-up closely with periodic surveillance imaging. Two patients underwent salvage RT using high-precision conformal techniques at recurrence/progression. Conclusion ELST is a rare low-grade locally aggressive neoplasm that arises generally as part of VHL syndrome or sometimes sporadically. Gross total resection provides the best chance of cure with RT being reserved for unresectable disease, large residue, medical inoperability, or as salvage therapy for recurrent/progressive tumor. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

paythelady.61 shared this article with you from Inoreader High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.