Video-Oculography to Guide Neuroimaging for Dizziness and Vertigo

alexandrossfakianakis shared this article with you from Inoreader Video-Oculography to Guide Neuroimaging for Dizziness and Vertigo Via JAMA Otolaryngology–Head & Neck Surgery Online First Dizziness and vertigo are among the most common presenting symptoms in both the emergency department (ED) and ambulatory outpatient clinics, with recent estimates suggesting roughly 18 million visits per year in the US (nearly 5 million to EDs and >13 million to outpatient clinics). These symptoms are caused by a wide array of conditions, but the most common benign causes are otologic, and the most common dangerous cause is stroke. Stroke accounts for 3% to 5% of dizziness presentations in the ED, and some evidence suggests that it may ac count for a similar percentage of dizziness presentations in ambulatory care clinics. Frontline clinicians are often poorly equipped to differentiate peripheral from central vestibular causes and are justifiably worried about missing strokes, so they often resort to neuroimaging as a knee-jerk diagnostic test response. Unfortunately, this choice leads to substantial ill effects, including frequent misdiagnoses and unnecessary imaging for millions of patients with inner ear causes of dizziness who should receive a diagnosis at the bedside, thus exposing patients to unnecessary irradiation (in the case of computed tomography [CT] scans) and incurring significant health care costs. Some estimates suggest that more than $1 billion is wasted each year on inappropriate CT scans alone. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth

alexandrossfakianakis shared this article with you from Inoreader Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth Via Epidemiology - Current Issue Background: Uterine fibroids often cause intolerable symptoms leading to invasive treatments, most commonly hysterectomy. Reproductive tract infections are hypothesized to influence uterine fibroid development, but few studies exist, especially for the highly prevalent condition bacterial vaginosis (BV). Both fibroids and BV have documented racial–ethnic disparities, with higher burden in Blacks. Methods: With prospective data from a community-based study (four standardized ultrasound examinations over 5 years) in young Black women, we examined baseline BV associations with fibroid incidence and growth. We computed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incidence comparing BV and no BV (Nugent score ≥7 vs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology

alexandrossfakianakis shared this article with you from Inoreader Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology Via Epidemiology - Current Issue Background: When new vaccine components or platforms are developed, they will typically need to demonstrate noninferiority or superiority over existing products, resulting in the assessment of relative vaccine effectiveness (rVE). This review aims to identify how rVE evaluation is being performed in studies of influenza to inform a more standardized approach. Methods: We conducted a systematic search on PubMed, Google Scholar, and Web of Science for studies reporting rVE comparing vaccine components, dose, or vaccination schedules. We screened titles, abstracts, full texts, and references to identify relevant articles. We extracted information on the study design, relative comparison made, and the definition and statistical approach used to estimate rVE in each study. Results: We identified 63 articles assessing rVE in influenza virus. Studies compared multiple vaccine components (n = 38), two or more doses of the same vaccine (n = 17), or vaccination timing or history (n = 9). One study compared a range of vaccine components and doses. Nearly two-thirds of all studies controlled for age, and nearly half for comorbidities, region, and sex. Assessment of 12 studies presenting both absolute and relative effect estimates suggested proportionality in the effects, resulting in implications for the interpretation of rVE effects. Conclusions: Approaches to rVE evaluation in practice is highly varied, with improvements in reporting required in many cases. Extensive consideration of methodologic issues relating to rVE is needed, including the stability of estimates and the impact of confounding structure on the validity of rVE estimates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Estimands and Estimation of COVID-19 Vaccine Effectiveness Under the Test-Negative Design: Connections to Causal Inference

alexandrossfakianakis shared this article with you from Inoreader Estimands and Estimation of COVID-19 Vaccine Effectiveness Under the Test-Negative Design: Connections to Causal Inference Via Epidemiology - Current Issue The test-negative design is routinely used for the monitoring of seasonal flu vaccine effectiveness. More recently, it has become integral to the estimation of COVID-19 vaccine effectiveness, in particular for more severe disease outcomes. Because the design has many important advantages and is becoming a mainstay for monitoring postlicensure vaccine effectiveness, epidemiologists and biostatisticians may be interested in further understanding the effect measures being estimated in these studies and connections to causal effects. Logistic regression is typically applied to estimate the conditional risk ratio but relies on corre ct outcome model specification and may be biased in the presence of effect modification by a confounder. We give and justify an inverse probability of treatment weighting (IPTW) estimator for the marginal risk ratio, which is valid under effect modification. We use causal directed acyclic graphs, and counterfactual arguments under assumptions about no interference and partial interference to illustrate the connection between these statistical estimands and causal quantities. We conduct a simulation study to illustrate and confirm our derivations and to evaluate the performance of the estimators. We find that if the effectiveness of the vaccine varies across patient subgroups, the logistic regression can lead to misleading estimates, but the IPTW estimator can produce unbiased estimates. We also find that in the presence of partial interference both estimators can produce misleading estimates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults

alexandrossfakianakis shared this article with you from Inoreader Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults Via Epidemiology - Current Issue Background: Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5. Methods: We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes. Results: This study identified 14,627 deaths and had a total of 5 million person–years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%–35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results. Conclusion: Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis

alexandrossfakianakis shared this article with you from Inoreader Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis Via Transplant Infectious Disease Abstract Introduction Human herpes virus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with significant morbidity and mortality. Methods The epidemiology of HHV-6 infections and their impact on outcome after allo-HSCT were retrospectively analyzed in 689 adult allo-HSCT recipients (January 2015-December 2018). Chromosomal integration of HHV-6 (ciHHV-6) in the donor was retrospectively investigated to critically evaluate antiviral treatment strategies. Results HHV-6 DNA in any specimen was found in 89 patients. HHV-6 infections (encephalitis (1), gastroenteritis (44), dermatitis (2), hepatitis (1) or pneumonitis (5)) were diagnosed in 53/689 patients (7.7%). Elevated levels of HHV-6 DNA were found in 38 patients (5.5%). CiHHV-6, analyzed in patients with HHV-6 viral loads ≥104 copies/mL, was identified in 4 patients (10/38 patients; 10.5%). Two of those displayed copy numbers of HHV-6 ranging from ≥ 2 × 105 to 2.5 × 106 copies/mL (HHV-6A). Here, ciHHV-6 was integrated into donor and not into the patients' cells. In this series of allo-HSCT recipients, 10.5% of patients with blood viral loads of HHV-6 showed ciHHV-6. Conclusion Screening of the donor for chromosomal integration of HHV-6 (ciHHV-6) before initiation of antiviral therapy is recommended. This article is protected by copyright. All rights reserved View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome

alexandrossfakianakis shared this article with you from Inoreader The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome Via Journal of Oral Rehabilitation Summary Aim This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs. Methods This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase. Results Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs. Conclusion The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial Via Clinical Implant Dentistry and Related Research Abstract Background The prosthetic emergence profile design might be an important factor in postsurgical mucosal recession etiology. Therefore, a restorative buccal emergence profile designed correctly might reduce gingival margin recession. Purpose To compare the marginal gingival level and the width/height (W/H) ratio between two profile configurations of single implant-supported restorations at molar sites. Materials and Methods Twenty-one patients requiring a single mandibular molar tooth replacement with supracrestal mucosal thickness ≥2 mm were recruited and randomly assigned to a prosthesis buccal emergence profile design based on the buccal mucosal W/H ratio (Test Group) or maintained the original emergence profile of the healing abutment (Control Group). Assessments were made before delivery of the definitive restoration (T0), at prosthesis placement (T1), one (T2), and 12 (T3) months after loading. The gingival margin level change (△GM), initial emergence angle, buccal mucosal W/H ratio, marginal bone loss (MBL), implant failure, and complications were assessed. Results The gingival recession in the test group (0.13 ± 0.32 mm) was significantly lower than in the control group (0.63 ± 0.38 mm) at T3 (p = 0.006). The initial emergence angle in the test group (31.4 ± 7.22 degrees) was significantly lower than the control group (40.0 ± 7.60 degrees) (p = 0.025). The W/H ratio in the test group at T2 was significantly higher than at T0 but remained stable thereafter. The W/H ratio presented a continued rising trend in the control group. Conclusions When the initial supracrestal soft tissue thickness was ≥2 mm, a restorative emergence profile based on the W/H ratio significantly reduced gingival margin recession. An emergence angle of 32.4 degrees showed better behavior in maintaining the gingival margin than 40 degrees. Clinical Trial Registration Number ChiCTR190002210. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes

alexandrossfakianakis shared this article with you from Inoreader JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes Via Blood Cancer Journal - Issue - nature.com science feeds Blood Cancer Journal, Published online: 08 April 2022; doi:10.1038/s41408-022-00646-0 JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Syphilisinfektion im HNO-Bereich

alexandrossfakianakis shared this article with you from Inoreader Syphilisinfektion im HNO-Bereich Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1808-7321 Die Anzahl der gemeldeten Syphilis-Fälle steigt seit Jahren an. Die sexuell übertragbare Erkrankung wird durch die Spirochäte Treponema pallidum Subspezies pallidum verursacht und verläuft hierbei in verschiedenen Stadien. In allen Stadien können hierbei Symptome im HNO-Bereich auftreten. Hierdurch ist bei passenden Symptomen eine Syphilis-Infektion als Differenzialdiagnose vom HNO-Arzt stets zu bedenken. So ist bei zunehmendem oralem Geschlechtsverkehr der Primäraffekt/harter Schanker zunehmend häufig im Mundraum zu beobachten. Zudem können Symptome nicht nur im Mundraum, sondern auch im Bereich des Ohrs, der Nase, des Larynx sowie auch zervikal und fazial auftreten. Die Diag nose wird hierbei über den direkten Erregernachweis oder über einen serologischen Nachweis gesichert. Die Spirochäte ist nicht kultivierbar. Der therapeutische Goldstandard ist die Gabe von Benzathin-Penicillin G oder Procain-Penicillin G. Als Alternative stehen Doxycyclin, Makrolide oder Ceftriaxon zur Verfügung. Bei einer Innenohr- oder Hirnnervenbeteiligung ist die zusätzliche Gabe eines Glukokortikoids zu empfehlen. Vor Durchführung der antibiotischen Therapie ist der Patient über die Möglichkeit einer Jarisch-Herxheimer-Reaktion aufzuklären. Bei einer Syphilis-Infektion ist stets eine kollegiale Zusammenarbeit mit den Venerologen zu empfehlen, sodass eine effektive und umfassende Diagnostik und Therapie erfolgen kann. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournal s: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players

alexandrossfakianakis shared this article with you from Inoreader Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players Via Journal of Human Nutrition and Dietetics Abstract Objective This study aimed to examine the effects of spirulina supplementation on pro/antioxidant status, inflammation, and skeletal muscle damage markers immediately and 24h after exhaustive exercise in elite rugby players. Methods Seventeen elite male Rugby Union players were randomly assigned to a Spirulina (SPI: n=9), or a placebo group (PLA: n=8) in a double-blind design. Subjects were supplemented with Spirulina platensis (5.7 g/d) or placebo (isoproteic and caloric) for 7 weeks. At baseline (W0) and after seven weeks of supplementation (W7), blood samples were obtained before (T0), immediately after (T1), and 24h after (T2) exhaustive exercise. The Yoyo Intermittent Recovery Test Level 2 was used as an exhaustive exercise to induce oxidative stress (OS), inflammation, and skeletal muscle damage. The studied parameters included Pro/antioxidant status markers (SOD, GPX, GSH/GSSG ratio, ox-LDL, and F2-Isop), inflammation markers (MPO and CRP), and skeletal muscle damage markers (LDH and CK). Results Our results showed that F2-Isop, CRP, and CK levels significantly increased at T1 only in PLA group (p<0.05, p<0.05, and p<0.001 respectively) with no change in SPI group which reflects the effect of spirulina to prevent lipid peroxidation, inflammation, and skeletal muscle damage induced by exhaustive exercise. Moreover, spirulina supplementation accelerated the return to baseline values given that F2-Isop, CRP, and CK levels at T2 were significantly lower than at T0 in SPI group (p<0.05, p<0.01, and p<0.001 respectively). Conclusion Based on the markers used in this study, our results report that spirulina supplementation potentially prevents exercise-induced lipid peroxidation, inflammation, skeletal muscle damage and may accelerate the recovery of some of these markers. Based on our findings, we recommend spirulina supplementation especially for athletes who do not achieve the recommended antioxidant dietary intake and who perform a high training load in order to reduce the magnitude of OS, inflammation, and skeletal muscle damage which could help to reduce performance losses and accelerate recovery after training/competitions throughout the season. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.