Blog Archive

Αλέξανδρος Γ. Σφακιανάκης

Tuesday, August 23, 2022

Is smallpox vaccination protective against Human Monkeypox?

alexandrossfakianakis shared this article with you from Inoreader

Abstract text

Human Monkeypox (HMPX) has been spreading to non-endemic countries rapidly during spring-summer 2022 through human-to-human transmission, involving thousands of people, mostly men-who-have-sex-with-men. Little is known about the degree of protection due to previous smallpox vaccination. The cases described in our series show a mild clinical presentation of HMPX in those previously vaccinated. Our data are encouraging, and further investigations may lead to a fast public health prevention strategy.

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A Case of infectious mononucleosis complicated with spontaneous atraumatic splenic rapture caused by Epstein‐Barr virus (EBV) infection

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Splenic rupture is the most serious complication of infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV) infection, with a mortality rate of over one in ten. We reported a case of spontaneous atraumatic splenic rupture secondary to IM in a young man. The patient presented with abdominal pain caused by splenic rupture as the initial symptom. The diagnosis and treatment process went through a series of twists and turns, including the emergency department, general surgery department and infection department. This case suggests that clinicians should consider the possibility of EBV infection in young patients with spleen rupture without obvious cause to avoid misdiagnosis and missed diagnosis.

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Is lithium neuroprotective? An updated mechanistic illustrated review

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Neurodegeneration is a pathological process characterized by progressive neuronal impairment, dysfunction, and loss due to mitochondrial dysfunction, oxidative stress, inflammation, and apoptosis. Many studies have shown that lithium protects against neurodegeneration. Herein, we summarize recent clinical and laboratory studies on the neuroprotective effects of lithium against neurodegeneration and its potential to modulate mitochondrial dysfunction, oxidative stress, inflammation, and apoptosis. Recent findings indicate that lithium regulates critical intracellular pathways such as phosphatidylinositol-3 (PI3)/protein kinase B (Akt)/glycogen synthase kinase-3 (GSK3β) and PI3/Akt/response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF).

Methods

We queried PubMed, Web of Science, Scopus, Elsevier, and other related databases using search terms related to lithium and its neuroprotective effect in various neurodegenerative diseases and events from January 2000 to May 2022. We reviewed the major findings and mechanisms proposed for the effects of lithium.

Results: Lithium's neuroprotective potential against neural cell degeneration is mediated by inducing anti-inflammatory factors, antioxidant enzymes, and free radical scavengers to prevent mitochondrial dysfunction. Lithium effects are regulated by two essential pathways: PI3/Akt/GSK3β and PI3/Akt/CREB/BDNF.

Conclusion

Lithium acts as a neuroprotective agent against neurodegeneration by preventing inflammation, oxidative stress, apoptosis, and mitochondrial dysfunction using PI3/Akt/GSK3β and PI3/Akt/CREB/BDNF signaling pathways.

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Effects of root canal enlargement on unprepared areas and coronal dentine thickness of three‐rooted maxillary first premolars with different root configurations: a stepwise micro‐CT study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations.

Methodology

Thirty three-rooted maxillary first premolars with 3 root configurations (n=10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2), and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels, and minimal dentine thickness. Statistic analyses were performed with one-way ANOVA post hoc Tukey tests and paired sample t-test at a significance level of 5%.

Results

No statistical differences were observed among groups regarding the morphometric parameters and static voxels (p > 0.05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p < 0.05), while no differences were observed in the other roots (p > 0.05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction of dentine thickness was higher in the buccal roots than in the palatal root (p < 0.05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3.

Conclusions

Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.

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The impact of branched‐chain amino acid supplementation on measures of glucose homeostasis in individuals with hepatic disorders: A systematic review of clinical studies

alexandrossfakianakis shared this article with you from Inoreader

ABSTRACT

Background

Branched chain amino acid (BCAA) supplementation may influence glucose metabolism in individuals with impaired glycemic profile. This systematic review investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis in individuals with hepatic disorders.

Methods

We searched PubMed, Web of Science, Cochrane Library, and Scopus for published clinical trials that investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis, including serum glucose and insulin, glycated hemoglobin (HbA1c) levels, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) scores.

Results

Eleven trials met the inclusion criteria. Only one study revealed a decrease in serum glucose from BCAA supplementation compared to three studies that showed increases. Five studies demonstrated no significant changes in serum glucose, and two studies displayed no changes in HbA1c following BCAA supplement ation. Serum levels of insulin were decreased in three studies, remained unchanged in one, whilst increased in the remaining three studies. BCAA supplementation reduced HOMA-IR scores in two studies, increased HOMA-IR scores in another two or resulted in no changes in two other studies.

Conclusions

BCAA supplementation in isolation had no effect on overall glucose homeostasis in individuals with hepatic disorders, although some improvements on serum insulin levels and HOMA-IR scores were observed. Overall, there is little evidence to support the utilization of BCAA supplementation as a potential nutritional strategy for improving measures of glucose homeostasis in individuals with hepatic disorders.

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Serum vitamin D and cardiometabolic risk factors

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Abstract

Low serum 25-hydroxyvitamin D (25(OH)D) concentrations have been associated with greater adiposity and an adverse cardiometabolic risk profile, yet findings are inconsistent and the role of vitamin D status in cardiovascular disease (CVD) remains uncertain. We aimed to examine the associations between serum 25(OH)D and CVD risk factors in the British population. We analysed data on 2842 subjects aged ≥40 years enrolled in the National Diet and Nutrition Survey (NDNS 2008–2018). Based on serum 25(OH)D concentrations, study subjects were grouped in three categories: vitamin D deficiency (<25 nmol/L), vitamin D insufficiency (25-49 nmol/L) and vitamin D sufficiency status (≥50 nmol/mL). Differences in CVD risk factors between vitamin D deficiency or insufficiency and vitamin D sufficiency status were expressed in standard deviation scores (SDSs) and estimated through weighted multiple linear regression models. We found that vitamin D deficiency was directly associated with B MI, waist circumference, triglycerides and inversely associated with high-density lipoprotein cholesterol (HDL) values. The strongest associations were found between vitamin D deficiency and triglycerides (0.50 SDS, 95% CI: 0.24, 0.77) among men, and vitamin D deficiency and waist circumference (0.70 SDS, 95% CI: 0.56, 0.94), BMI (0.63 SDS, 95% CI: 0.39, 0.88) and triglycerides (0.54 SDS, 95% CI: 0.30, 0.77) among women. When adjusting for BMI the association with triglyceride attenuated (from 0.50 SDS to 0.39 SDS among men and from 0.54 SDS to 0.30 SDS among women). Our data indicates a relationship between inadequate vitamin D status and an adverse CVD risk profile. However, interventional studies are needed to establish possible benefits of vitamin D supplementation on cardiovascular risk.

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Immune‐modified Glasgow prognostic score: A new prognostic marker for head and neck cancer

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

The modified Glasgow prognostic score (mGPS) includes C-reactive protein and serum albumin levels and is a useful prognostic tool for malignant tumors. The immune system affects cancer progression and recurrence and treatment response. We hypothesized that increasing the lymphocyte count improves mGPS, and we created a new prognostic marker termed immune-mGPS (imGPS).

Methods

This study included 461 patients with head and neck squamous cell carcinoma (HNSCC). The imGPS was calculated as the conventional mGPS with one additional point for a low lymphocyte count (<1250/μL).

Results

Addition of the lymphocyte count to mGPS significantly increased the area under the time-dependent receiver operating characteristic curve for overall and progression-free survivals. The added predictive abilities of this tool were supported by improvement in both net reclassification and integrated discrimination.

Conclusion

imGPS is a more accurate predictor of clinical outcome in patients with HNSCC than mGPS.

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The Duration and Magnitude of Postdischarge Venous Thromboembolism Following Colectomy

alexandrossfakianakis shared this article with you from Inoreader
imageObjective: To assess the impact of current guidelines by reporting weekly postoperative postdischarge venous thromboembolism (VTE) rates. Summary Background Data: Disparity exists between the postoperative thromboprophylaxis duration colectomy patients receive based on surgical indication, where malignant resections routinely receive 28 days extended thromboprophylaxis into the postdischarge period and benign resections do not. Methods: English national cohort study of colectomy patients between 2010 and 2019 using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Stratified by admission type and surgical indication, absolute incidence rates (IRs) per 1000 person-years and adjusted incidence rate ratios (aIRRs) for postdischarge VTE were calculated for the first 4 weeks following resection and postdischarge VTE IRs for each postoperative week to 12 weeks postoperative. Results: Of 104,744 patients, 663 (0.63%) developed postdischarge VTE within 12 weeks after colectomy. Postdischarge VTE IRs per 1000 person-years for the first 4 weeks postoperative were low following elective resections [benign: 20.66, 95% confidence interval (CI): 13.73–31.08; malignant: 28.95, 95% CI: 23.09–36.31] and higher following emergency resections (benign: 47.31, 95% CI: 34.43–65.02; malignant: 107.18, 95% CI: 78.62–146.12). Compared with elective malignant resections, there was no difference in postdischarge VTE risk within 4 weeks following elective benign colectomy (aIRR=0.92, 95% CI: 0.56–1.50). However, postdischarge VTE risks within 4 weeks following emergency resections were significantly greater for benign (aIRR=1.89, 95% CI: 1.22–2.94) and malignant (aIRR=3.13, 95% CI: 2.06–4.76) indications compared with elective malignant colectomy. Conclusions: Postdischarge VTE risk within 4 weeks of colectomy is ∼2-fold greater following emergency benign compared with elective malignant resections, suggesting emergency benign colectomy patients may benefit from extended VTE prophylaxis.
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