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Κυριακή 12 Φεβρουαρίου 2023

Persistent Features of Laryngeal Injury Following Endotracheal Intubation: A Systematic Review

AlexandrosSfakianakis shared this article with you from Inoreader
via Dysphagia
AbstractThis systematic review examined (i) prevalence, severity, and impact of persistent post-extubation laryngeal injury beyond hospital discharge and (ii) differences in persistent laryngeal injury between COVID-19 and non-COVID-19 populations. The review was completed following PRISMA-2020 guidelines. Four databases (PubMed, CINHAL complete, EMBASE, Web of Science) were searched (inception to March 2021). Screening, full text review and data extraction were completed by two reviewers. Primary outcomes were swallow, voice and cough and airway measures obtained after hospital discharge. Quality assessment was measured using Downs& Black Tool and Johanna Briggs Institute Checklist for Cohort Studies. Meta-analysis was not completed due to study heterogeneity. Six cohort studies were ...
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Association of infant Rib and Alp1 surface protein N-terminal domain immunoglobulin G and invasive Group B Streptococcal disease in young infants

AlexandrosSfakianakis shared this article with you from Inoreader
via Vaccine

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DISCUSSION: Lower serum RibN and Alp1N IgG GMC were evident in infants with invasive GBS disease compared with controls born to women colonized with GBS expressing the homotypic protein. These data support the evaluation of Alp family proteins as potential vaccine candidates against invasive GBS disease.PMID:36754766 | DOI:10.1016/j.vaccine.2023.01.071 (Source: Vaccine)
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A heterologous AZD1222 priming and BNT162b2 boosting regimen more efficiently elicits neutralizing antibodies, but not memory T cells, than the homologous BNT162b2 regimen

AlexandrosSfakianakis shared this article with you from Inoreader
via Vaccine

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CONCLUSION: nAbs are efficiently elicited by heterologous AZD1222/BNT162b2 vaccination, as well as prior infection/vaccination, whereas spike-specific CD4+T-cell responses are efficiently elicited by homologous BNT162b2 vaccination. Variant-recognizing immunity is more efficiently generated by prior infection/vaccination than the other homologous or heterologous vaccination regimens.PMID:36754764 | PMC:PMC9901539 | DOI:10.1016/j.vaccine.2023.01.063 (Source: Vaccine)
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typhoid conjugate vaccine (EuTCV) compared to Typbar-TCV ®

AlexandrosSfakianakis shared this article with you from Inoreader
via Vaccine

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Vaccine. 2023 Feb 9:S0264-410X(22)01524-9. doi: 10.1016/j.vaccine.2022.12.007. Online ahead of print.ABSTRACTThe typhoid conjugate vaccine (TCV) ensures a long-lasting protective immune response, requires fewer doses and is fit for children under 2 years of age. From Phase I study, EuTCV displayed considerable immunogenicity and reliable safety, thus endorsing further examination in Phase II/III trials. Therefore, a clinical Phase II/III study (NCT04830371) was conducted to evaluate its efficacy in healthy Filipino participants aged 6 months to 45 years through administration of the test vaccine (Arm A, B, and C) or comparator vaccine Typbar-TCV® (Arm D). Sera samples were collect ed pre-vaccination (Visit 1) and post-vaccination (Visit 4, Day 28) to assess the immunogenicity of EuTCV and ...
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Is Sudden Sensorineural Hearing Loss an Otologic Emergency? Evidence-Based Cutoff for Optimal Treatment Initiation for Sudden Unilateral Sensorineural Hearing Loss: A Case Series and Meta-Analyses

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjectives To study the need for defining unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) as an otologic emergency and establish an evidence-based cutoff for treatment initiation for optimal outcome. Methods A systematic literature search of "MEDLINE" via "PubMed," "Embase," and "Web of Science" and original case series comparing the outcome of steroidal treatment for ISSNHL as a function of delays of patient presentation, of diagnosis, and of treatment initiation. Total delay was defined as days from ISSNHL onset to first steroidal dose and divided into up to 3 days, up to 7 days, up to 14 days, and >14 days. Results The literature search identified 1,469 ears and our original case series contributed 154 ears suitable for study inclusion, resulting in 1,623 ears for statistical analysis. An odds ratio (OR) of 0.42 (95% confidence interval [CI], 0.25–0.71) was calculated for recovery if treatment had been initiated within the third day since the sudden occurrence of a unilateral hearing loss compared with treatment initiation on or after the fourth day (I2 = 40.1%). The calculated OR for recovery was 0.35 (95% CI, 0.26–0.47) when treatment was initiated during the first 7 days after the sudden hearing loss onset compared with a delay of 8 days or more (I2 = 52.1%). The OR was 0.31 (95% CI, 0.21–0.46) when treatment was initiated during the first 14 days after the event compared with a longer delay (I2 = 0.0%). Conclusion Unilateral ISSNHL should be considered a medical emergency. Initiating treatment before 3 days have elapsed since the event portends the best outcome. Level of Evidence Level I.
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Effects of Age at Implantation on Outcomes of Cochlear Implantation in Children with Short Durations of Single-Sided Deafness

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjective Children with single-sided deafness (SSD) show reduced language and academic development and report hearing challenges. We aim to improve outcomes in children with SSD by providing bilateral hearing through cochlear implantation of the deaf ear with minimal delay. Study Design Prospective cohort study of 57 children with SSD provided with cochlear implant (CI) between May 13, 2013, and June 25, 2021. Setting Tertiary children's hospital. Participants Children with early onset (n = 40) or later onset of SSD (n = 17) received CIs at ages 2.47 ± 1.58 years (early onset group) and 11.67 ± 3.91 years (late onset group) (mean ± SD). Duration of unilateral deafness was limited (mean ± SD = 1.93 ± 1.56 yr). Intervention Cochlear implantation of the deaf ear. Main Outcomes/Measures Evaluations of device use (data logging) and hearing (speech perception, effects of spatial release from masking on speech detection, localization of stationary and moving sound, self-reported hearing questionnaires). Results Results indicated that daily device use is variable (mean ± SD = 5.60 ± 2.97, range = 0.0–14.7 h/d) with particular challenges during extended COVID-19 lockdowns, including school closures (daily use reduced by mean 1.73 h). Speech perception with the CI alone improved (mean ± SD = 65.7 ± 26.4 RAU) but, in the late onset group, remained poorer than in the normal hearing ear. Measures of spatial release from masking also showed asymmetric hearing in the late onset group (t13 = 5.14, p = 0.001). Localization of both stationary and moving sound was poor (mean ± SD error = 34.6° ± 16.7°) but slightly improved on the deaf side with CI use (F1,36 = 3.95, p = 0.05). Decreased sound localization significantly correlated with poorer self-reported hearing. Conclusions and Relevance Benefits of CI in children with limited durations of SSD may be more restricted for older children/adolescents. Spatial hearing challenges remain. Efforts to increase CI acceptance and consistent use are needed.
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Predictors of Short-Term Changes in Quality of Life after Cochlear Implantation

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjective This study aimed 1) to measure the effect of cochlear implantation on health-related quality of life (HR-QOL) using the Cochlear Implant Quality of Life (CIQOL) questionnaire and 2) to determine audiologic, demographic, and non-CI/hearing-related QOL factors influencing the CIQOL. Study Design Prospective observational study. Setting Tertiary referral center. Patients and Interventions Thirty-seven adult patients with sensorineural hearing loss undergoing cochlear implantation. Main Outcome Measure(s) CIQOL-global score preimplantation and 6 months postimplantation. Physical function score as measured by the short-form survey, audiologic, and demographic variables. Results CIQOL showed significant improvement from preimplantation to 6 months postactivation with a mean difference of 14.9 points (95% confidence interval, 11.3 to 18.5, p
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Central Vertigo Disorder as Evidence of Creutzfeldt-Jakob Disease: A Case Report

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjective To report a case of Creutzfeldt-Jakob disease (CJD) that presented atypical initial manifestations and highlight the importance of complementary investigation to avoid diagnosis delay. Patients A 54-year-old female patient who presented with vertigo with positional nystagmus, nausea, and vomiting as initial CJD manifestations. Intervention Neuro-otological and brain magnetic resonance images, which showed abnormal hyperintense cortical signal in both hemispheres. Main Outcome Measure We reached a presumptive diagnosis of the prion disease after the first magnetic resonance imaging. Eventually, the patient presented with typical neurological findings and met the criteria for probable CJD. Results Our case report presents a patient with sporadic CJD who experienced dizziness as an initial manifestation and met the diagnostic criteria for probable CJD a few weeks after symptoms onset. Conclusion We believe that this case may serve to help otolaryngologists pay better attention to cases of dizziness associated with neurological signs and highlight the importance of complementary investigation using magnetic resonance imaging and neuro-otological tests to prevent delayed or incorrect diagnosis.
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Cochlear Implantation after Stereotactic Radiosurgery for Vestibular Schwannoma: Initial Hearing Improvement and Longevity of Hearing Restoration

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjective The following research question was asked: In patients with vestibular schwannoma (VS) that underwent stereotactic radiosurgery (SRS) and cochlear implantation, were improvements in hearing function observed, and what was the cochlear implant (CI) failure rate of in these patients? Data Sources PubMed/Medline, CINAHL (EBSCOhost), and Web of Science articles without restrictions on publication dates were searched. Study Selection Inclusion criteria required that the article was a report, a series, or a retrospective review with individual case data available. Non-English articles were excluded. Inclusion criteria required that patients were with VS and underwent subsequent SRS and cochlear implantation. Patients receiving microsurgery or stereotactic radiotherapy on the ipsilateral ear were excluded from this study. Data Extraction Included studies were evaluated using full-text evaluation, and data on study characteristics (author names, gender), clinical data (syndromic information, SRS modality), hearing outcomes, and device failure were extracted. Data Synthesis Means and averages were obtained for all continuous variables. Percentages were ascertained for all categorical variables. Conclusions The majority of patients undergoing CI placement in VS treated with SRS achieved open-set speech perception (79.2%) or environmental sound awareness (6.8%). Twelve implants (20.3%) failed. Three patterns were associated with failure: 1) immediate-onset failure, 2) initial benefit with delayed failure, 3) poor local control with device explantation.
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Effect of a CI Programming Fitting Tool with Artificial Intelligence in Experienced Cochlear Implant Patients

AlexandrosSfakianakis shared this article with you from Inoreader
imageObjective Cochlear implants (CIs) are the treatment of choice for patients with severe to profound hearing loss. The hearing results, however, considerably vary across patients. This may partly be due to variability in the CI fitting. We investigated the effect of FOX, a software tool to program CIs using artificial intelligence (AI), on hearing outcomes. Methods Forty-seven experienced CI patients who came to our tertiary CI center for their annual follow-up between 2017 and 2020 were recruited for this study. They received a new CI map created by the AI software tool. CI parameters and auditory outcomes obtained with this new map were compared with those of the initial manual map after 15 days of take-home experience. Within-patient differences were assessed. At the end of the study, the patients were offered a choice to continue using the AI map or to revert to their old manual map. Results Several auditory outcomes improved with the AI map, namely, pure tone audiometric threshold at 6,000 Hz (median improvement 10 dB, range = −20 to 50 dB, Z = −2.608, p = 0.008), phonemic discrimination scores (median improvement 10%, range = 0% to 30%, Z = −4.061, p = 0.001), and soft-intensity (median improvement of 10%, range = −20% to 90%, Z = −4.412, p
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