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Αλέξανδρος Γ. Σφακιανάκης

Sunday, September 25, 2022

Antibody response six months after the booster dose of Pfizer in previous recipients of CoronaVac

alexandrossfakianakis shared this article with you from Inoreader

Abstract

The most widely used vaccines were mRNA, viral vector, and inactivated virus with two-dose schedules. In Brazil, the CoronaVac (Sinovac) was the first vaccine approved for emergency use and the third dose was administered, preferably, with the BNT162b2 vaccine. We evaluated antibody levels after six months of the booster dose with BNT162B2 in previous recipients of CoronaVac and whether a subsequent SARS-COV-2 infection enhances the antibody response. We analyze of the humoral response, S IgM for the SARS-CoV-2, S IgG and N IgG in samples collected before the third dose and six months after the third dose. The presence of antibodies was measured by using Abbott Architect i2000SR. The IgM and IgG anti-spike were stimulated mainly in 30D/3D with a decline over time. The IgG anti-N was stimulated predominantly in 90/3D and 180/3D. The N IgG levels were 50 and 35 times higher in the positive PCR group in 90/3D and 180/3D, respectively. The S IgG titers were 1.5 times elevated in the positive PCR group, in 180/3D. The BNT162b2 boosted the S IgG levels, decreasing after the 60 days. The booster shot induced IgM and IgG antibodies against Spike protein. Infection after vaccination increased antibodies against protein N.

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Emergence of S gene‐based quasispecies explains an optimal adaptation of Omicron BA.5 subvariant in the immunocompetent vaccinated human host

alexandrossfakianakis shared this article with you from Inoreader

Abstract

In this study, we collected two subsequent swabs from 7 immunocompetent up to date vaccinated healthcare workers undergoing mild symptomatic SARS-CoV-2 infection, and applied a next generation sequencing approach to establish the intra-host dynamics of SARS-CoV-2 quasispecies. Data obtained show that complex dynamics of viral quasispecies occur over a short period of time in patients infected with BA.1 and BA.2. as compared to patients infected with BA.2.3 and BA.5. The low frequency of quasispecies in BA.2.3- and BA.5-infected patients supports the hypothesis that these omicron sub-lineages are adapted to vaccine-elicited immune responses.

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Patient‐centric outcome assessment of endodontic microsurgery using periapical radiography versus Cone Beam Computed Tomography ‐ A randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

This study aimed to evaluate whether utilizing additional CBCT imaging has any effect on quality of life and healing outcome following periapical surgery compared to PR.

Methodology

The study was registered in ClinicalTrials.gov (NCT04333940). In this parallel group randomized controlled trial, fifty-two patients (88 teeth) with persistent apical periodontitis and periapical radiographic evidence of periapical lesion were randomly assigned to either PR or CBCT group. The primary predictor was the type of the imaging method (PR only or with additional CBCT). The primary outcome was patient's quality of life during the first week after periapical surgery and the secondary outcomes were duration of surgery and healing outcome at 12-month follow-up. Participants of both groups received periapical surgery based on the presurgical plan provided by the radiographic imaging methods. QoL was assessed using Modified Shugars questionnaire. Radiographic analysis for healing was conducted using Molven's criteria and modified P ENN 3D criteria. The categorical data between groups were analysed using the Chi-square test, while intragroup comparisons were analysed using the McNemar test. The average scores for each component of QoL (oral functions, general functions, pain, swelling and other symptoms), combined QoL scores (overall average of values of 13 variables) and analgesic usage on each day were calculated and analysed.

Results

At 12 months follow-up, fifty patients were evaluated. Participants in PR group reported significantly more swelling on first three days compared with CBCT group. The analgesic use was higher in the PR group on 2nd and 3rd day (Mann Whitney U test with Bonferroni correction; p < 0.007). A significant difference in the limitation of general functions was observed at the second day (p<0.07) with the higher values in the PR group. The combined QoL score between the two groups was found to be non-significant. However, none of the patients experienced intraoperative complications or neurovascular exposure. The mean surgical time was lesser in the CBCT group (p <0.05). Radiographic healing revealed a success rate of 96.2% for the PR group and 95.8% for the CBCT group with no significant difference between the groups.

Conclusion

Participants in the CBCT group experienced substantially less early postoperative swelling and limitation in general functions, in comparison with the PR group. However, preoperative CBCT had no effect on other QoL parameters and intraoperative complications in medium-risk patients. Furthermore, CBCT did not exhibit any added advantage over periapical radiography in terms of assessing healing outcome following endodontic microsurgery. CBCT offered surgically relevant anatomic information for presurgical planning and ensured the treatment rendition with a significantly reduced operative time.

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Optimal Timing of the Salivary Pepsin Test for the Diagnosis of Laryngopharyngeal Reflux

alexandrossfakianakis shared this article with you from Inoreader
Optimal Timing of the Salivary Pepsin Test for the Diagnosis of Laryngopharyngeal Reflux

Salivary pepsin testing combined waking, 1 h and 2 h after breakfast and lunch, and 1 h after dinner has almost the same diagnostic value as MTPSPT, and testing at these time points can be an effective method for diagnosing LPR.


Objective

To investigate the optimal time point for diagnosing laryngopharyngeal reflux (LPR) through combining 24-h hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24-h HEMII-pH) monitoring and the multi-time point salivary pepsin test (MTPSPT).

Study Design

Prospective uncontrolled trial.

Method

Patients with and without LPR symptoms were included as the test group and the control group, respectively. The patients in the test group underwent 24-h HEMII-pH and MTPSPT. The results of 24-h HEMII-pH were used as a diagnostic criterion for LPR, and the diagnostic value of salivary pepsin tests performed at different time points was compared by receiver operating characteristic (ROC) analysis.

Results

A total of 153 patients were included. Based on 24-h HEMII-pH, the positive rate of LPR in the test group of patients was 84.00%. In the control group, only one person (3.57%) had a positive salivary pepsin test result. The area under the curve (AUC) of the MTPSPT was 0.827. In addition, we separately calculated the AUC of the combined salivary pepsin test at different time points, and found good diagnostic value (AUC = 0.799) when the test was combined with the waking, 1 and 2 h after breakfast and lunch, and 1 h after dinner tests. However, when the number of tests were further increased, the diagnostic value did not improve significantly.

Conclusion

Salivary pepsin testing combined with waking, 1 h and 2 h after breakfast and lunch, and 1 h after dinner has almost the same diagnostic value as MTPSPT, and testing at these time points can be an effective method for diagnosing LPR.

Level of Evidence

3 Laryngoscope, 2022

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Association of treated and untreated chronic hepatitis C with the incidence of active tuberculosis disease: a population-based cohort study.

alexandrossfakianakis shared this article with you from Inoreader

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Abstract
Background
Hepatitis C virus (HCV) infection causes dysregulation and suppression of immune pathways involved in the control of tuberculosis (TB) infection. However, data on the role of chronic hepatitis C as a risk factor for active TB are lacking. We sought to evaluate the association between HCV infection and the development of active TB.
Methods
We conducted a cohort study in Georgia among adults tested for HCV antibodies (January 2015 – September 2o2o) and followed longitudinally for the development of newly diagnosed active TB. Data were obtained from the Georgian National programs of hepatitis C and TB. The exposures of interest were untreated and treated HCV infection. Cox proportional hazards model was used to calculate adjusted hazards ratios.
Results
A total of 1,828,808 adults were included (median follow-up time: 26 months, IQR: 13-39 months). Active TB was diagnosed in 3,163 (0.17%) individuals after a median of 6 months follow-up (IQR: 1-18 months). The incidence rate per 100,000 person-years was 296 among persons with untreated HCV infection, 109 among those with treated HCV infection, and 65 among HCV-negative persons. In multivariable analysis, both untreated (aHR = 2.9, 95%CI: 2.4-3.4) and treated (aHR = 1.6, 95%CI: 1.4-2.0) HCV infection were associated with a higher hazard of active TB, compared to HCV-negative persons.
Conclusions
Adults with HCV infection, particularly untreated i ndividuals, were at higher risk of developing active TB disease. Screening for latent TB infection and active TB disease should be part of clinical evaluation of people with HCV infection, especially in high TB burden areas.
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Co-administration of Oral Cholera Vaccine with Oral Polio Vaccine among Bangladeshi Young Children: A Randomized Controlled Open Label Trial to Assess Interference

alexandrossfakianakis shared this article with you from Inoreader

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Abstract
Background
Cholera remains a public health threat for low- and middle-income countries, particularly in Asia and Africa. ShancholTM, an inactivated oral cholera vaccine (OCV) is currently in use globally. OCV and oral poliovirus vaccines (OPV) could be administered concomitantly but the immunogenicity and safety of coadministration among children aged 1-3 years is unknown.
Method
We undertook an open-label, randomized, controlled, inequality trial in Dhaka city, Bangladesh. Healthy children aged 1-3 years were randomly assigned to one of the three groups: bivalent OPV (bOPV)-alone, OCV-alone, or combined bOPV + OCV and received vaccines on the day of enrollment and 28 days later. Blood samples were collected on the day of enrollment, day 28, and day 56. Serum poliovirus neutralizing antibodies and vibriocidal antibodies against V. cholerae O1 were assessed using microneutralization assays.
Results
A total of 579 children aged 1‒3 years were recruited, 193 children per group. More than 90% of the children completed visits at day 56. Few adverse events following immunization were recorded and were equivalent among study arms. On day 28, 60% (90% Confidence interval, 53%-67%) and 54% (46%-61%) of participants with co-administration of bOPV + OCV responded to polioviruses type 1 and 3 respectively, compared to 55% (47%-62%) and 46% (38%-53%) in the bOPV-only group. Additionally, >50% of participants showed a ≥4-fold increase in vibriocidal antibody titre responses on day 28, comparable to the responses observed in OCV-only arm.
Conclusions
Co-administration of bOPV and OCV is safe and effective in children aged 1-3 years and can be cost-beneficial.
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Application of Cinnarizine in Migraine Prevention: A Systematic Review and Meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

To investigate and analyze the available data on the prophylactic effectiveness of cinnarizine in migraine disorder.

Background

Cinnarizine has demonstrated encouraging potential in preventing the attacks of migraine. Therefore, we opted to evaluate whether its sole administration leads to positive outcomes.

Methods

The PubMed, Scopus, Web of Science, and Embase databases were searched for English-only original interventional studies published until April 2022, then screened for relevancy and eligibility. The resulting data from the included studies, including the primary(i.e., headache episode frequency, intensity, duration, monthly timing, and analgesic intake frequency) and secondary(i.e., reported adverse events, quality of life, and activities of daily living) outcome changes compared to placebo and active controls(e.g., sodium valproate and propranolol) were then recorded by two independent assessors. Ultimately, these data were synthesized qualitatively and quantitatively(achieved by determining the mean difference via the random-effects model).

Results

A total of 10 studies comprising seven randomized controlled trials and three quasi-experimental studies were included. Compared to placebo, cinnarizine demonstrated significant improvements in migraine episode frequency(Mean difference= -3.10; Confidence interval=[-3.33, -2.88]; P-value<0.001; I2 <0.001%), and intensity(Mean difference= -1.54; Confidence interval=[-2.08, -0.99]; P value<0.001; I2 <37.97%). Moreover, cinnarizine led to similar or better results when compared to active controls, including sodium valproate, topiramate, and propranolol.

Conclusions

Cinnarizine can be considered a safe and effective medication for migraine prophylaxis. However, the relatively small sample size made reaching a definite conclusion impossible. Therefore, a higher number of randomized controlled trials are recommended to be taken place to clarify the situation further.

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Tooth survival after endodontic treatment

alexandrossfakianakis shared this article with you from Inoreader

Abstract

There are several measures that are, or could be, in use in relation to estimating the outcome of endodontic treatments. It is important to reflect on when and why a certain outcome measure is used; when caring for an individual patient it is obvious that the goal always should be a tooth in a healthy state, that is striving to remove any infection and aim for the tooth to have healthy periapical tissues. For patients in general and for society, it is also interesting to know if endodontic treatments will lead to retention of teeth in a functioning state. From epidemiological studies, with high prevalence of root filled teeth with periapical radiolucencies, it is implied that dentists and/or patients accept the retention of a root filled tooth with persistent apical periodontitis. However, we do not know if or how this affects the health of the individual.

In conjunction with an endodontic treatment the prognosis is considered and since the prognostic factors seem to be somewhat different depending on whether one is considering for example the outcome ´healthy periapical tissues´ or ´tooth survival´ they are equally important to know. Factors affecting the outcome ´healthy periapical tissues´ probably has to do with removal of infection and reconstituting the barrier to prevent leakage whilst ´tooth survival´ is more likely associated with factors outside of the classical endodontic field such as restorability and avoidance of further destruction of tooth substance.

This narrative review will focus on tooth survival after endodontic treatment and root canal treatment will be the focus. As a crude estimation, there is to be an annual loss of 2% of teeth which have received a root canal treatment. Of the pre-, peri- and postoperative factors that have been studied in conjunction with root canal treatments the restoration of the tooth is the factor that has been most extensively studied. Many studies imply that root filled teeth restored with indirect restorations have a better survival than teeth restored with direct restorations, it is not possible to determine whether this indeed is a prognostic factor.

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Effects of vitamin D supplementation on muscle function and recovery after exercise‐induced muscle damage: a systematic review.

alexandrossfakianakis shared this article with you from Inoreader

ABSTRACT

Background

Vitamin D is essential for the optimal health of the skeletal system. However, this vitamin is also involved in other functions of the human body, such as muscle, immune and inflammatory ones. Some studies suggest that adequate levels of vitamin D support muscular function during exercise and accelerate recovery because they reduce specific pro-inflammatory cytokine levels, but those results have not always been observed. Therefore, this review aims to evaluate the effects of vitamin D supplementation on inflammation, oxidative stress and recovery after exercise.

Methods

This systematic review was conducted using the PRISMA guidelines. A literature search of SPORTDiscuss, PubMed, Web of Science and Scopus was performed from inception through February, 2021. The articles' methodological quality was assessed with the PEDro scale.

Results

After the application of the inclusion and exclusion criteria, 11 eligible articles were included. A ll the studies were considered of moderate methodological quality. Ten studies involved regular vitamin D supplementation for more than 7 days, and one study performed acute vitamin D supplementation 24 h before exercise.

Conclusions

The existing evidence suggests that vitamin D supplementation for periods of more than 1 week with a minimum dose of 2000 IU/day appears to be an efficacious strategy for attenuating muscle damage and inflammation after exercise. The potential positive effects on muscle function, muscle pain and oxidative stress need to be confirmed with new investigations. Further research is also required to clarify the adequate vitamin D dosage to obtain positive effects without adverse effects.

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Blood counts in children with Down syndrome

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Children with Down syndrome (DS) are more likely to have hematologic and immunologic abnormalities compared to their typically developing peers, but normal ranges have not been defined. The goal of this study was to create references for complete blood counts (CBCs) in patients with DS.

Methods

A retrospective investigation of 355 (male = 196, 55.2%; mean age = 6.49 years, SD = 5.07) healthy pediatric patients with DS who received a CBC between 2011 and 2017 as part of their medical care at a single, large, pediatric teaching hospital. Control data on 770 healthy patients without DS were included. Descriptive statistics were performed on demographic and clinical characteristics. Kruskal–Wallis H tests, nested analysis-of-variance tests, and t-tests were run to determine the significant associations.

Results

Age-related normative curves for healthy children with DS outlining 2.5th, 25th, 50th, 75th, and 97.5th percentiles are provided for total white blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, and platelet, absolute neutrophil, absolute lymphocyte, eosinophil, monocyte, and basophil counts. Statistical differences were found between children with and without DS receiving care at the same hospital based on matched age/sex groups.

Conclusions

This study demonstrates that patients with DS have different reference ranges for multiple blood counts compared to those without DS, creating a new resource for pediatricians to refer to when evaluating CBCs in this population.

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