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Τετάρτη 2 Νοεμβρίου 2022

Xanthomatous erosive arthritis: A new disease entity?

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Desmoid tumor occurrence in a patient with severe congenital neutropenia type 4: Case history and follow‐up

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Effects of COVID‐19 vaccination on platelet counts and bleeding in children, adolescents, and young adults with immune thrombocytopenia

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Abstract

Coronavirus disease 2019 (COVID-19) vaccines rarely cause de novo immune thrombocytopenia (ITP) but may worsen preexisting ITP in adults. Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines impact platelet counts and bleeding in children, adolescents, and young adults (C-AYA) with preexisting ITP is unknown. We report here the very limited effect of COVID-19 vaccination on platelet counts and bleeding in a single-center series of 2 C-AYA with ITP. No patient experienced worsening bleeding and only one child had a significant decrease in platelet count which improved spontaneously to her baseline without intervention. SARS-CoV2 vaccination was safe in C-AYA with ITP in this small cohort.
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Concurrence of a kinase‐dead BRAF and an oncogenic KRAS gain‐of‐function mutation in juvenile xanthogranuloma

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Identification Accuracy of Safety‐Relevant Environmental Sounds in Adult Cochlear Implant Users

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Identification Accuracy of Safety-Relevant Environmental Sounds in Adult Cochlear Implant Users

Twenty-one experienced cochlear implant users completed an Environmental Sound Identification (ESI) test consisting of 42 common environmental sounds, 28 of which were relevant to personal safety. Overall ESI accuracy was 57% correct for the safety-relevant sounds and 55% correct for control sounds, suggesting mediocre ESI accuracy in postlingual adult CI users. Deficits in identification of these sounds may put CI listeners at increased risk of accidents or injuries and may require a specific rehabilitation program to improve CI outcomes.


Objective

Examine cochlear implant (CI) users' ability to identify safety-relevant environmental sounds, imperative for safety, independence, and personal well-being.

Methods

Twenty-one experienced adult CI users completed an Environmental Sound Identification (ESI) test consisting of 42 common environmental sounds, 28 of which were relevant to personal safety, along with 14 control sounds. Prior to sound identification, participants were shown sound names and asked to rate the familiarity and, separately, relevance to safety of each corresponding sound on a 1–5 scale.

Results

Overall ESI accuracy was 57% correct for the safety-relevant sounds and 55% correct for control sounds. Participants rated safety-relevant sounds as more important to safety and more familiar than the non-safety sounds. ESI accuracy significantly correlated with familiarity ratings.

Conclusion

The present findings suggest mediocre ESI accuracy in postlingual adult CI users for safety-relevant and other environmental sounds. Deficits in the identification of these sounds may put CI listeners at increased risk of accidents or injuries and may require a specific rehabilitation program to improve CI outcomes.

Level of Evidence

4 Laryngoscope, 2022
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Extent of Surgery for Follicular Thyroid Carcinoma

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Extent of Surgery for Follicular Thyroid Carcinoma

Our study informs physicians and patients on the survival outcomes of undergoing operation for follicular thyroid cancer particularly when using clinical T staging as a stratification method. Similar survival between thyroidectomy versus lobectomy emphasizes that decisions on extent of surgery should take into careful consideration future quality of life as total thyroidectomy requires lifelong pharmacotherapy and higher risk of injury to adjacent structures whereas lobectomy poses higher risk of recurrence. Our findings suggest that demographic factors may ultimately play a bigger role in deciding extent of thyroid resection surgery given similar rates of survival.


Objectives

To examine the association between the extent of surgery and overall survival in follicular thyroid cancer (FTC) patients.

Study Design

Retrospective analysis of the National Cancer Database (NCDB).

Methods

Patients who underwent surgical intervention for FTC from 2004 to 2015 were selected. Patients were >18 years old, with tumor size 1–4 cm, no other malignancies, and >0 follow up time. Patients were divided into two cohorts based on extent of surgery: lobectomy (≥1 lobe resected) and thyroidectomy (total or near total resection). Pearson's chi-squared analysis was used to compare cohorts. Kaplan–Meier survival and Cox hazards models were utilized to determine overall survival between two cohorts with p < 0.05 used for significance.

Results

A total of 6871 patients were identified with FTC, of which 1507 patients underwent lobectomy and 5364 patients underwent total thyroidectomy. There were no significant differences in patient demographics, comorbidity index, local spread, or tumor grade. Patients undergoing lobectomy had mean survival of 12.94 versus 12.71 years for those undergoing thyroidectomy. Extent of surgery was not associated with a significant difference in survival (5 years OS = 96% in lobectomy and 95.5% in total thyroidectomy, p = 0.08). Stratification by tumor grade resulted in no significant difference in survival between lobectomy and thyroidectomy.

Conclusion

Survival time was not significantly different in patients with more extensive resection of FTC.

Level of Evidence

3 Laryngoscope, 2022
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Spatial‐temporal dynamics and time series prediction of HFRS in mainland China: a long‐term retrospective study

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Abstract

Hemorrhagic fever with renal syndrome (HFRS) is highly endemic in mainland China. The current study aims to characterize the spatial-temporal dynamics of HFRS in mainland China during a long-term period (1950-2018). A total of 1,665,431 cases of HFRS were reported with an average annual incidence of 54.22 cases/100,000 individuals during 1950-2018. The joint regression model was used to define the global trend of the HFRS cases with an increasing-decreasing-slightly increasing-decreasing-slightly increasing trend during the 68 years. Then spatial correlation analysis and wavelet cluster analysis were used to identify four types of clusters of HFRS cases located in central and northeastern China. Lastly, the Prophet model predicts that 14,223 cases of HFRS will occur in mainland China during 2019-2038. Our findings will help reduce the knowledge gap on the transmission dynamics and distribution patterns of the HFRS in mainland China and facilitate to take rel evant preventive and control measures for the high-risk epidemic area.

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Irradiation accelerates SARS‐CoV‐2 infection by enhancing sphingolipid metabolism

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ABSTRACT

Cancer patients who receive radiotherapy have a high risk of SARS-CoV-2 infection, but the concrete reason remains unclear. Herein, we investigated the influence of irradiation on the vulnerability of cancer cells to SARS-CoV-2 using S pseudovirions and probed the underlying mechanism via RNA-seq and other molecular biology techniques. Owing to the enhancement of sphingolipid metabolism, irradiation accelerated pseudovirion infection. Mechanistically, irradiation induced the expression of acid sphingomyelinase (ASM), which catalyses the hydrolysis of sphingomyelin to ceramide, contributing to lipid raft formation and promoting SARS-CoV-2 invasion. Inhibition of lipid raft formation with methyl-β-cyclodextrin (MβCD) or the tyrosine kinase inhibitor genistein and ASM suppression through small interfering RNA or amitriptyline (AMT) treatment abolished the enhancing effect of irradiation on viral infection. Animal experiments supported the finding that irradiation promoted SARS-CoV-2 S pseudovirion infection in A549 cell tumour-bearing BALB/c nude mice, whereas AMT treatment dramatically decreased viral infection. This study discloses the role of sphingolipid metabolism in irradiation-induced SARS-CoV-2 infection, thus providing a potential target for clinical intervention to protect patients receiving radiotherapy from COVID-19.

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Monkeypox: Early Estimation of Basic Reproduction Number R0 in Europe

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Abstract

This world outbreak of Monkeypox-MPX infections outside Africa emerged on May 2022 in Europe and spread worldwide with unique characteristics: inter-human contagion and infection in men without specific previous immunization, prevalently men-having-sex-with-men MSM. Phylogenetic analysis confirmed a unique clade, the West African clade, subclade IIb. On August 30, WHO stated 48,895 laboratory confirmed cases from 101 different countries, of which 28,050 were in Europe. It has therefore become important to define new epidemiological indices. Starting from our new surveillance system EpiMPX open data, we defined an early R0 measure, using European ECDC confirmed cases from the epidemic start to the end of August 2022; our early R0 pooled median is 2.44, with high variability between countries. We observed the higher R0 in Portugal and Germany, followed by Italy, Spain and France. Anyway, these high estimates refer to the MSM gr oup rather than to the general population. Early estimation of R0 can be used to support the epidemiological understanding of transmission dynamics and contain MPX from spreading in naive populations and core groups with risk factors. MPX is in an evolving situation with much to learn and to do to combat the current epidemic outbreak.

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Sources of Nutrition Advice and Desired Nutrition Guidance in Oncology Care: Patient's Perspectives

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Abstract

Introduction

To describe the proportion of cancer patients and survivors who receive nutrition advice, the sources of that advice, and to explore the nutrition advice this cohort would like to have received.

Methods

A descriptive cross-sectional survey was completed by 211 cancer patients and survivors recruited through two hospitals in the North-West of Ireland. The survey consisted of open-ended and closed questions that aimed to explore the provision of and sources of nutrition advice and desired guidance in this cohort. Descriptive analysis was conducted using SPPS, while open-ended questions underwent thematic analysis.

Results

Respondents were mainly female (n=133, 63%), aged 50-69 years old (n=118, 56%), attending the outpatient department (n=128, 60.7%) and less than five years since diagnosis (n=150, 71.7%). Breast (n=69, 32.7%) was the most common cancer type. Respondents experienced, on average, 5 (±3.1) nutrition impact symptoms. Th e most common were changes in taste/smell (n=122, 57.8%). While 53.6% (n=113) reported being given advice, only 34.1% (n=72) received this advice from a dietitian. The main sources of nutritional advice were friends and family. Respondents expressed their desire for nutrition advice from a dietitian and that this should be individualised, clear and practical. There was also a desire to avoid misinformation and uncertainty.

Conclusion

Results can be used to tailor nutrition support for this group. There is a need to ensure that patients and survivors consistently receive evidence-based advice tailored to their needs, cancer stage and treatment stage.

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Wound healing in endoscopic sinus surgery ‐ Phase 1 clinical trial evaluating the role of Chitogel with adjuvants

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background & Objectives

Ostial stenosis and persistent inflammation are the main reasons for revision endoscopic sinus surgery (ESS). Post-operative (PO) dressings can improve PO wound healing and patient outcomes after ESS. This study aimed to determine the safety and efficacy of Chitogel, with and without Deferiprone (Def) and Gallium Protoporphyrin (GaPP), as a promoter of wound healing to improve surgical outcomes.

Design, Setting & Outcome

A double-blinded, randomized control human clinical trial was conducted in patients undergoing ESS as treatment for CRS. Participants underwent functional endoscopic sinus surgery (1) or FESS with drill out (DO) as required and were randomised to receive test product Chitogel, Chitogel in combination with Def or Def-GaPP versus no packing (control). Patients were followed up at 2, 6 and 12 weeks PO, outcome scores such as SNOT-22, VAS and LKS, pre and post-surgery (12 weeks) were compared.

Results

79 patients completed the study, there was a significant reduction in SNOT-22 score and improvement of VAS at 12-week in patients treated with Chitogel compared to control (p<0.05). In those patients, the mean ostium area for the Chitogel and the Chitogel + Def + GaPP groups were higher across all 3 sinuses compared to the no-treatment control group, without statistical significance. Sphenoid sinus ostium was significantly more patent in patients treated with Chitogel compared to control at the 12-week time point (p < 0.05).

Conclusion

Chitogel as a post-operative dressing after ESS results in the best patient reported symptom scores and objective measurements. The combination of Def and GaPP to Chitogel though proving safe, had no effect on the ostium patency or mucosal healing.
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