Incidence and characteristics of pseudoprogression in IDH-mutant high-grade gliomas: a POLA network study

alexandrossfakianakis shared this article with you from Inoreader Incidence and characteristics of pseudoprogression in IDH-mutant high-grade gliomas: a POLA network study via Neuro-Oncology Advance Access Abstract Background Incidence and characteristics of pseudoprogression in isocitrate dehydrogenase-mutant high-grade gliomas (IDHmt HGG) remain to be specifically described. Methods We analyzed pseudoprogression characteristics and explored the possibility of pseudoprogression misdiagnosis in IDHmt HGG patients, treated with radiotherapy (with or without chemotherapy), included in the French POLA network. Pseudoprogression was analyzed in patients with MRI available for review (reference cohort, n=200). Pseudoprogression misdiagnosis was estimated in this cohort and in an independent cohort (control cohort, n=543) based on progression free survival before and after first progression. Results In the reference cohort, 38 patients (19%) presented a pseudoprogression after a median time of 10.5 months after radiotherapy. Pseudoprogression characteristics were similar across IDHmt HGG subtypes. In most patients, it consisted in the appearance of one or several infracentimetric, asymptomatic, contrast-enhanced lesions occurring within 2 years after radiotherapy. The only factor associated with pseudoprogression occurrence was adjuvant PCV chemotherapy. Among patients considered as having a first true progression, 7 out of 41 (17%) in the reference cohort and 35 out of 203 (17%) in the control cohort were retrospectively suspected to have a misdiagnosed pseudoprogression. Patients with a misdiagnosed pseudoprogression were characterized by a time to event and an outcome similar to that of patients with a pseudoprogression but presented with larger and more symptomatic lesions. Conclusion In patients with an IDHmt HGG, pseudoprogression occurs later than in IDH-wildtype glioblastomas and seems not only frequent but also frequently misdiagnosed. Within the first 2 years after radiotherapy, the possibility of a pseudoprogression should be carefully considered. View on Web

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Optimized dual therapy for treatment‐naive patients of Helicobacter pylori infection: A large‐scale prospective, multicenter, open‐label, randomized controlled study

alexandrossfakianakis shared this article with you from Inoreader Optimized dual therapy for treatment‐naive patients of Helicobacter pylori infection: A large‐scale prospective, multicenter, open‐label, randomized controlled study via Helicobacter Abstract Background The efficacy and safety of high-dose amoxicillin (AMX) and proton pump inhibitors (PPI) dual therapy raises much more attention in recent years. Comparative studies among the dual therapies are required to explore more suitable regimens. This study compared the efficacy, adverse events, and patient compliance of three different high-dose dual regimens in treatment-naive patients of Helicobacter pylori (H. pylori) infection. Materials and Methods The study was a prospective, multicenter, open-label, randomized controlled trial, including H. pylori-infected treatment-naive patients at 12 tertiary hospitals in China. The eligible subjects received high-dose AMX and esomeprazole (ESO) dual therapy of different regimens. They were randomly assigned to group A (ESO 20 mg plus AMX 750 mg, Qid for 14 days), group B (ESO 40 mg Bid plus AMX 1 g Tid for 14 days), or group C (ESO 20 mg plus AMX 1 g, Tid for 14 days). The eradication rates, adverse events, and patient compliance of the three groups were compared. Results Between April 2021 and January 2022, a total of 1080 subjects were screened and 945 were randomized. The eradication rates in groups A, B, and C were 88.6% (95% CI 84.5%–91.9%), 84.4% (95% CI 80.0%–88.3%), and 86.7% (95% CI 82.4%–90.2%; p = .315), respectively, based on intention-to-treat analysis; 90.3% (95% CI 86.4%–93.3%), 85.5% (95% CI 81.1%–89.2%), and 87.8% (95% CI 83.6%–91.2%; p = .197), respectively, according to modified intention-to-treat analysis; and 90.4% (95% CI 86.5%–93.5%), 85.8% (95% CI 81.4%–89.5%), and 88.3% (95% CI 84.1%–91.7%; p = .202) in per-protocol analysis. History of antibiotics use in 2 years reduced eradication effect in group B (ESO 40 mg Bid, AMX 1 g Tid). The modified intention-to-treat eradication rates were 81.4% vs 90.0% among those with or without a history of antibiotics use in group B (p = .031). The adverse event rates were 13.7%, 12.7%, and 12.1% i n groups A, B, and C, respectively (p = .834). Patient compliance of the three groups was similar. Conclusions Two optimized AMX and PPI dual regimens (ESO 40 mg Bid or 20 mg Tid plus AMX 1 g Tid for 14 days) had similar efficacy, safety and compliance as compared with classical dual regimen (ESO 20 mg plus AMX 750 mg Qid for 14 days) in H. pylori-infected treatment-naive patients. View on Web

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A Mediterranean and Low‐Fat dietary intervention in Non‐Alcoholic Fatty Liver Disease patients ‐Exploring participant experience and perceptions about dietary change.

alexandrossfakianakis shared this article with you from Inoreader A Mediterranean and Low‐Fat dietary intervention in Non‐Alcoholic Fatty Liver Disease patients ‐Exploring participant experience and perceptions about dietary change. via Journal of Human Nutrition and Dietetics Abstract Background A Mediterranean Diet (MD) appears to be beneficial in NAFLD patients in Mediterranean countries, however the acceptability of a MD in non-Mediterranean populations has not been thoroughly explored. This study aimed to explore the acceptability, through understanding the barriers and enablers of MD and low-fat diet (LFD) interventions as perceived by Australian adults from multicultural backgrounds, with NAFLD, who participated. Methodology Semi-structured telephone interviews were performed with 23 NAFLD trial participants at the end of a 12-week dietary intervention in a multicentre, parallel, randomised clinical trial. Data was analysed using thematic analysis. Results Participants reported that they enjoyed taking part in the MD and LFD interventions and perceived that they had positive health benefits from their participation. Compared to the LFD, the MD group placed greater emphasis on enjoyment and intention to maintain dietary changes. Novelty, convenience and the ability to swap food/meals were key enablers for the successful implementation for both of the dietary interventions. Flavour and enjoyment of food, expressed more prominently by MD intervention participants, were fundamental components of the diets with regard to reported adherence and intention to maintain dietary change. Conclusions Participants randomised to the MD reported greater acceptability of the diet than those randomised to the LFD, predominantly related to perceived novelty and palatability of the diet. This article is protected by copyright. All rights reserved. View on Web

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Variations in Practices and Preferences of Vocal Fold Injection Materials: A National Survey

alexandrossfakianakis shared this article with you from Inoreader Variations in Practices and Preferences of Vocal Fold Injection Materials: A National Survey via The Laryngoscope This study looking at provider preferences in terms of VFI injectables demonstrates significant variations in preferences in regards to VFI injectable materials. HA-based products are the most frequently utilized by providers as their-mid-term longevity, ease of use, and favorable fibroelastic properties make them favorable for various indications. Understanding the rationale behind variations in practice is crucial to guide new providers in material selection and provide information to patients undergoing these procedures. Background Vocal fold injection augmentation (VFI) is a common procedure for the treatment of glottic insufficiency. Material options for VFI and decisions regarding material selection are not standardized and often based on clinician preference. Objective This study aims to understand the variations in provider preference and utilization of injectable materials for VFI. Methods A 40-question survey was sent to 158 academic laryngologists. Questions pertained to the type of injectable materials used including brand preferences and rationale for preferences. Results Ninety-seven of the 158 laryngologists contacted participated in the survey (61.4%). The most frequently used injectable materials were Hyaluronic Acid (HA)-based products. Carboxymethylcellulose (CMC)-based products were preferred for trial augmentation (57.2%), HA-based products were preferred for acute/subacute vocal fold paralysis, presbyphonia, and sulcus/scar (54.2%, 61.5%, 44.7%, 41.7% respectively), and Calcium Hydroxyapatite (CaHA)-based products were preferred for long-term paralysis (28.1%). CMC-based products were discontinued by 21.8% of participants, largely due to quick material resorption. 17.8% of participants discontinued HA-based products largely due to adverse events and 26.0% abandoned CaHA-based products mostly due to inflammatory properties causing vocal fold stiffness and material unpredictability. Over 30% of respondents reported wanting to reinitiate micronized alloderm Cymetra® as an available injectable. Conclusion Our survey demonstrated that there are significant variations in practice and preferences in regard to injectable material selection for VFI. As there is limited data on the direct material comparison, understanding the rationale behind these variations is crucial to guide new providers in material selection and provide information to patients undergoing these procedures. Level of Evidence 5 Laryngoscope, 2022 View on Web

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ImmunoModulatory Effect of IL‐35 Gene Transfected Mesenchymal Stem Cells on Allergic Asthma

alexandrossfakianakis shared this article with you from Inoreader ImmunoModulatory Effect of IL‐35 Gene Transfected Mesenchymal Stem Cells on Allergic Asthma via Fundamental & Clinical Pharmacology Abstract Asthma is a common respiratory disease which has no definitive treatment at now. Immune response shifting from T helper (Th)1 to the Th2 is a main problem in asthma, and immunomodulation can help to control asthma. IL-35 and Mesenchymal Stem Cells (MSCs) have regulatory effect on the immune system, and may have the ability to control asthma pathology. After culturing MSCs, expression vector of IL-35 (pUNO1-mIL35elasti) was transduced to the MSCs and then, asthmatic mice were treated with MSCs, MSCs-vector, MSCs-vector-IL-35 and no treatment. AHR, levels of the cytokines, total and OVA specific immunoglobulin (Ig)E, LTB4, and LTC4 were measured. Lung tissue histopathology was also done. MSCs were successfully transduced by pUNO1-mIL35elasti vector, and IL-35 was produced in transduced cells. AHR, levels of the Cytokines, IgEs, LTs, goblet cell hyperplasia, mucus secretion, peribronchial and perivascular inflammation were controlled by MSCs therapy. In MSCs-IL-35 group, these controls were stronger than MSCs without IL-35 group. MSCs had strong effect on control of asthma. Transfected MSCs by expressing IL-35 gene could significantly better control allergic asthma symptoms than MSCs without IL-35. In the future, identification of the IL-35 mechanism of action would be useful to improve cytokine-cell based therapies. View on Web

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Risk Factors for Post‐Tonsillectomy Respiratory Events in Children With Severe Obstructive Sleep Apnea

alexandrossfakianakis shared this article with you from Inoreader Risk Factors for Post‐Tonsillectomy Respiratory Events in Children With Severe Obstructive Sleep Apnea via The Laryngoscope This is a retrospective single-institution cohort study of pediatric patients with severe obstructive sleep apnea who were admitted postoperative after tonsillectomy. We identified multiple potential risk factors for postoperative respiratory events including Black ethnicity, Down syndrome, age, %sleep time with SpO2 <90% on sleep study. Objectives/Hypothesis To identify risk factors for postoperative respiratory events in pediatric patients with severe obstructive sleep apnea (OSA). Methods Retrospective single-institution retrospective cohort study of pediatric patients with severe OSA who were admitted postoperatively after tonsillectomy. Patients who experienced respiratory events after surgery were identified and differences between the respiratory event and no event groups were compared. Results There were 887 patients included in this study. 14.8% (n = 131) experienced a documented respiratory event. The following risk factors were found to be most significant: %sleep time with O2 < 90% (tb90) (95% CI = 1.07–1.14, OR = 1.10, p < 0.001), Black race (95% CI = 1.53–3.58, OR = 2.34, p < 0.001), primary neurologic co-morbidity (1.67–6.32, OR = 3.27, p < 0.001), Down syndrome (1.25–5.94, OR = 2.72, p = 0.01), and age (0.84–0.94, OR = 0.88, p < 0.001). Regression modeling demonstrated that the rate of respiratory events increased with tb90. Conclusions Our results demonstrate that there are other potential risk factors outside of AHI and O2 nadir that are associated with respiratory events after tonsillectomy. Black race and prolonged desaturations during polysomnography (PSG) are independent risk factors. Measures of abnormal gas exchange on PSG may be better at identifying at risk patients. Level of Evidence 4 Laryngoscope, 2022 View on Web

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A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal

alexandrossfakianakis shared this article with you from Inoreader A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal via The Laryngoscope In this report, we present a case of an elderly patient who suffered cochlear implant electrode array misplacement into the posterior semicircular canal, resulting in vestibular symptoms and severe downstream sequelae. The risk of misplacement may be higher in patients with a history of chronic otitis media or prior otologic surgery, and with the use of pre-curved electrode arrays. Electrophysiological testing and intraoperative imaging may allow for early detection and intervention in these cases. Cochlear implant electrode array misplacement is a rare but serious complication that may result in failure of hearing rehabilitation, non-auditory percepts, vestibular disturbance, or damage to adjacent neurovascular structures. We present a case of an elderly patient who suffered electrode array misplacement into the posterior semicircular canal, resulting in vestibular symptoms and severe downstream sequelae. The risk of misplacement may be higher in patients with a history of chronic otitis media or prior otologic surgery, and with the use of pre-curved electrode arrays. Electrophysiological testing and intraoperative imaging may allow for early detection and intervention in these cases. Laryngoscope, 2022 View on Web

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Recording jaw relation of a pediatric patient with ectodermal dysplasia and complete anodontia using a digital mini arch tracer: A case report

alexandrossfakianakis shared this article with you from Inoreader Recording jaw relation of a pediatric patient with ectodermal dysplasia and complete anodontia using a digital mini arch tracer: A case report via Journal of Prosthodontics Abstract Children with ectodermal dysplasia and complete anodontia experience difficulties in oral rehabilitation because of the small arch size. A case of a 7-year-old boy, whose arch size (length and width) was 30–40% smaller than that of a male adult and who presented with difficulties in jaw relation recording using commercially available devices is described. A digital workflow involving a mini arch tracer was introduced. Primary impressions were made using three-dimensionally (3D) printed mini trays produced based on the patient's computed tomography images, and digital primary casts were obtained based on the scanned and reversed primary impressions. The final custom impression trays with mini tracing plates were designed based on the primary casts. In addition, the hand shank, retention plate, and retainers were placed on the designed custom trays and 3D-printed to produce an individual arch tracer system. In addition, two height checking buckles were designed to help adjust the height of a tracing screw. Finally, the jaw relation of the patient was recorded and transferred, and a set of complete dentures were delivered, satisfying both the patient and his family. This article is protected by copyright. All rights reserved View on Web

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GPCR/endocytosis/ERK signaling/S2R is involved in the regulation of the internalization, mitochondria-targeting and -activating properties of human salivary histatin 1

alexandrossfakianakis shared this article with you from Inoreader GPCR/endocytosis/ERK signaling/S2R is involved in the regulation of the internalization, mitochondria-targeting and -activating properties of human salivary histatin 1 via International Journal of Oral Science - Issue International Journal of Oral Science, Published online: 15 August 2022; doi:10.1038/s41368-022-00181-5 GPCR/endocytosis/ERK signaling/S2R is involved in the regulation of the internalization, mitochondria-targeting and -activating properties of human salivary histatin 1 View on Web

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Understanding Variation in Rotavirus Vaccine Effectiveness Estimates in the United States: The Role of Rotavirus Activity and Diagnostic Misclassification

alexandrossfakianakis shared this article with you from Inoreader Understanding Variation in Rotavirus Vaccine Effectiveness Estimates in the United States: The Role of Rotavirus Activity and Diagnostic Misclassification via Epidemiology - Current Issue Background: Estimates of rotavirus vaccine effectiveness (VE) in the United States appear higher in years with more rotavirus activity. We hypothesized rotavirus VE is constant over time but appears to vary as a function of temporal variation in local rotavirus cases and/or misclassified diagnoses. Methods: We analyzed 6 years of data from eight US surveillance sites on 8- to 59-month olds with acute gastroenteritis symptoms. Children's stool samples were tested via enzyme immunoassay (EIA); rotavirus-positive results were confirmed with molecular testing at the US Centers for Disease Control and Prevention. We defined rotavirus gastroenteritis cases by either positive on-site EIA results alone or positive EIA with Centers for Disease Control and Prevention confirmation. For each case definition, we estimated VE against any rotavirus gastroenteritis, moderate-to-severe disease, and hospitalization using two mixed-effect regression models: the first including year plus a year–vaccination interaction, and the second including the annual percent of rotavirus-positive tests plus a percent positive–vaccination interaction. We used multiple overimputation to bias-adjust for misclassification of cases defined by positive EIA alone. Results: Estimates of annual rotavirus VE against all outcomes fluctuated temporally, particularly when we defined cases by on-site EIA alone and used a year–vaccination interaction. Use of confirmatory testing to define cases reduced, but did not eliminate, fluctuations. Temporal fluctuations in VE estimates further attenuated when we used a percent positive–vaccination interaction. Fluctuations persisted until bias-adjustment for diagnostic misclassification. Conclusions: Both controlling for time-varying rotavirus activity and bias-adjusting for diagnostic misclassification are critical for estimating the most valid annual rotavirus VE. View on Web

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