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Τρίτη 5 Ιουλίου 2022

Distribution of Serotypes Causing Invasive Pneumococcal Disease in Children from High-Income Countries and the Impact of Pediatric Pneumococcal Vaccination

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Abstract
Background
The introduction and adoption of pneumococcal conjugate vaccines (PCVs) into pediatric national immunization programs (NIPs) has led to large decreases in invasive pneumococcal disease (IPD) incidence caused by vaccine serotypes. Despite these reductions, the global IPD burden in children remains significant.
Methods
We collected serotype-specific IPD data from surveillance systems or hospital networks of all 30 high-income countries that met inclusion criteria. Data sources included online databases, surveillance system reports, and peer-reviewed literature. Percentage of serotyped cases covered were calculated for all countries combined and by PCV type in the pediatric NIP.
Results
We identified 8012 serotyped IPD cases in children <5 or ≤5 years old. PCV13 serotype IPD caused 37.4% of total IPD cases, including 57.1% and 25.2% for countries with PCV10 or PCV13 in the pediatric NIP, respectively, most commonly due to serotypes 3 and 19A (11.4% and 13.3%, respectively, across all countries). In PCV10 countries, PCV15 and PCV20 would cover an additional 45.1% and 55.6% of IPD beyond serotypes contained in PCV10, largely due to coverage of serotype 19A. In PCV13 countries, PCV15 and PCV20 would cover an additional 10.6% and 38.2% of IPD beyond serotypes contained in PCV13. The most common IPD serotypes covered by higher valency PCVs were 10A (5.2%), 12F (5.1%), and 22F and 33F (3.5% each).
Conclusions
Much of the remaining IPD burden is due to serotypes included in PCV15 and PCV20. The inclusion of these next generation PCVs into existing pediatric NIPs may further reduce the incidence of childhood IPD.
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Associated factors of primary snoring and obstructive sleep apnea in patients with sleep bruxism: a questionnaire study

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Abstract

Background

By being aware of the associated factors of primary snoring (PS) and obstructive sleep apnea (OSA) in sleep bruxism (SB) patients, dentists may contribute to the screening and early recognition of SB patients with PS or OSA.

Objective

To identify the associated factors of PS and OSA from questionnaire-based data in SB patients.

Methods

A total of 968 self-reported SB patients (31.6% men; median age 44.5 years) were retrospectively enrolled. Self-reported sleep-related breathing status (viz., no sleep-related breathing condition, PS, and OSA) was the dependent variable. Independent variables were questionnaire-based data on demographics, lifestyle, psychological status, pain, and sleep.

Results

For PS, no statistically significant associated factor was identified in analyses. For OSA, increased age (OR = 1.04 [1.03-1.06]), male gender (OR = 3.33 [2.17-5.00]), daily alcohol consumption (OR = 1.96 [1.18-3.33]), depression (OR = 1.10 [1.06-1.14]), daytime sleepiness (OR = 2.94 [1.85-4.76]), and high risk of gastroesophageal reflux disease (GERD; OR = 2.63 [1.52-4.76]) were found to be significant risk factors, while high risk of temporomandibular disorder (TMD) pain (OR = 0.51 [0.30-0.86]) and chronic pain (OR = 0.73 [0.59-0.90]) were significant protective factors. These results were confirmed in the subsequent network analysis.

Conclusion

Within the limitations of this study, no associated factor is identified for PS. For OSA, dentists should keep in mind that increased age, male gender, daily alcohol consumption, depression, daytime sleepiness, and high GERD risk are associated with increased OSA risk in SB patients, while high TMD pain risk and chronic pain are associated with decreased OSA risk in this population.
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Keratin5-cytoskeleton-BMP4 network regulates cell phenotype conversions during cardiac regeneration

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Publication date: Available online 4 July 2022

Source: Experimental Cell Research

Author(s): Xuelong Wang, Huiping Guo, Feifei Yu, Hui Zhang, Ying Peng, Chenghui Wang, Gang Wei, Jizhou Yan
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Validation of a health-related quality of life questionnaire in patients with recurrent Clostridioides difficile infection in ECOSPOR III, a Phase 3 randomized trial

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Abstract
Background
Debilitating symptoms of recurrent Clostridioides difficile infection (rCDI) often lead to long-term effects on health-related quality-of-life (HRQOL). In ECOSPOR III, SER-109, an investigational oral microbiome therapeutic, was superior to placebo in reducing rCDI. We investigated the validity, reliability, and responsiveness of a 32-item, CDI-specific questionnaire (Cdiff32) across mental, physical, and social domains in patients with rCDI.
Methods
In this post-hoc analysis of a Phase 3 clinical trial, 182 outpatients with rCDI completed Cdiff32 and EQ-5D at baseline, 1 and 8 weeks. Cdiff32 was evaluated for item performance, internal reliability, and convergent validity. To assess known-groups validity, Cdiff32 scores were compared across recurrent versus non-recurrent patients at week 1; internal responsiveness was evaluated in non-re current patients by 8 weeks by paired t-test.
Results
All 182 patients (mean age 65.5 ± 16.5, 59.9% female) completed baseline Cdiff32. Confirmatory factor analysis identified 3 domains (physical, mental, and social relationships) with good item fit. High internal reliability was demonstrated (Cronbach's alpha = 0.94 with all subscales > 0.80). Convergent validity was evidenced by significant correlations between Cdiff32 subscales and EQ-5D (r range: 0.29-0.37, p < 0.001). Cdiff32 differentiated recurrent from non-recurrent patients at week 1 (effect sizes: 0.38-0.42; p < 0.05 overall), with significant improvement from baseline to week 8 in non-recurrent patients (effect sizes: 0.75-1.02; p < 0.001 overall).
Conclusions
Cdiff32 is a valid, reliable, and responsive disease-specific HRQOL questionnaire fit-for-purpose for interventional treatment trials. The significant improvement in non-recurrent patients by 8 weeks demonstra tes the negative impact of rCDI on HRQOL.
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Δευτέρα 4 Ιουλίου 2022

Kindlin-2 loss in condylar chondrocytes causes spontaneous osteoarthritic lesions in the temporomandibular joint in mice

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Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5066 Patients in the National Database of Hospital-based Cancer Registries in Japan

alexandrossfakianakis shared this article with you from Inoreader
imageObjective: To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer. Summary Background Data: Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival. Methods: We retrieved the 2008 to 2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Centerin Japan, divided the patients into a ≥75 group (75–79 years; n = 2935) and a ≥80 group (80 years or older; n = 2131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the 2 groups. Results: A significantly greater percentage of patients were treated with esoph-agectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥ 75 group and 39.0% in the ≥80 group (P
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Fastigial nuclei surgical damage and focal midbrain disruption implicate PAG survival circuits in cerebellar mutism syndrome

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Abstract
Background
Pediatric postoperative cerebellar mutism syndrome (CMS) is a rare but well-known complication of medulloblastoma (Mb) resection with devastating effects on expressive language, mobility, cognition, and emotional regulation that diminishes quality of life for many Mb survivors. The specific anatomical and neuronal basis of CMS remains obscure. We address this issue by identifying patterns of surgical damage and secondary axonal degeneration in Mb survivors with CMS.
Methods
Children with Mb deemed high-risk for CMS based on intraventricular location of the tumor had T1 images analyzed for location(s) of surgical damage using a specially developed algorithm. We used three complementary methods of spatial analysis to identify surgical damage linked to CMS diagnosis. Magnetization transfer ratio (MTR) images were analyzed for evidence of demyelination in anatomic regions downstream of the cerebellum, indicating neuronal dysfunction.
Results
Spatial analyses highlighted damage to the fastigial nuclei and their associated cerebellar cortices as the strongest predictors of CMS. CMS-related MTR decrease was greatest in the ventral periaqueductal grey area (PAG) and highly consistent in the left red nucleus.
Conclusion
Our evidence points to disruption of output from the fastigial nuclei as a likely causal trigger for CMS. We propose that core CMS symptoms result from a disruption in the triggering of survival behaviors regulated by the PAG, including the gating of vocalization and volitional movement. The fastigial nuclei provide the densest output to the PAG from the cerebellum, thus sparing these structures may provide a greater likelihood of CMS prevention.
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Κυριακή 3 Ιουλίου 2022

Comparison between the radial forearm and superficial circumflex iliac artery perforator free flaps for oral soft tissue reconstruction

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The radial forearm free flap (RFFF) is widely used for oral reconstruction. The superficial circumflex iliac artery perforator (SCIP) flap is an increasingly utilized alternative. The cases of 165 patients who received either an RFFF or SCIP flap for oral reconstruction at Chris O ′Brien Lifehouse, Sydney were reviewed. The aim was to report on patient, pathology, treatment, and outcome variables and to compare these between the two flap groups. A RFFF was used in 126 patients and a SCIP flap in 39 patients. (Source: International Journal of Oral and Maxillofacial Surgery)
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Cone beam computed tomography volumetric airway changes after orthognathic surgery: a systematic review

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The aim of this systematic review was to provide a structured overview of three-dimensional airway volume changes in relation to various orthognathic surgeries. Clinical human studies performing pre- and postoperative three-dimensional airway volume assessments to investigate volumetric changes of the airway after orthognathic surgery were included. Pre-determined inclusion and exclusion criteria were applied in an extensive search of the PubMed, Embase, and Web of Science electronic databases. The cut-off date was set to January 1, 2022. (Source: International Journal of Oral and Maxillofacial Surgery)
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Exploring the impact of metabolic imaging in head and neck cancer treatment

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Abstract

Background

Target volume delineation is performed with anatomical imaging for head and neck cancer. Molecular imaging allows the recognition of specific tumor regions. Its inclusion in the pathway could lead to changes in delineation and resultant treatment plans.

Methods

PRISMA methodology was adhered to when selecting the articles for analysis and only full articles were quality assessed.

Results

Seventeen articles were included. Gross tumor volume (GTV) primary, GTV nodal, and other target volumes were evaluated. Positron emission tomography/computerized tomography (PET/CT) produced smaller primary GTVs, although not with diffusion-weighted imaging-magnetic resonance imaging (DWI-MRI) or PET/MRI. The impact of these image modalities on GTV nodal did not display any consistency. Additionally, there was considerable heterogeneity in metrics comparing delineations. Four studies included appraised the dosimetric impact of the changes in target volume delineation.

Conclusion

Quantifying the impact of molecular imaging is difficult, due to heterogeneity in reporting metrics in molecular imaging modalities and a paucity of detail regarding delineation method and guideline adherence.
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