Enhanced liver fibrosis score stratifies hepatocellular carcinoma risk in patients with hepatitis B surface antigen seroclearance

alexandrossfakianakis shared this article with you from Inoreader Enhanced liver fibrosis score stratifies hepatocellular carcinoma risk in patients with hepatitis B surface antigen seroclearance via Clinical Infectious Diseases Advance Access Abstract In this prospective study involving 337 chronic hepatitis B patients who achieved spontaneous HBsAg seroclearance (SC), serum Enhanced Liver Fibrosis (ELF) before SC was associated with hepatocellular carcinoma (HCC) (hazard ratio 2.588), and ELF <10.8 was associated with >97% reduction in risk of HCC development in patients with ageSC≥50 (n = 190). View on Web

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Reduced Odds of SARS-CoV-2 Reinfection after Vaccination among New York City Adults, July–November 2021

alexandrossfakianakis shared this article with you from Inoreader Reduced Odds of SARS-CoV-2 Reinfection after Vaccination among New York City Adults, July–November 2021 via Clinical Infectious Diseases Advance Access Abstract Background Belief that vaccination is not needed for individuals with prior infection contributes to COVID-19 vaccine hesitancy. Among individuals infected with SARS-CoV-2 before vaccines became available, we assessed whether vaccinated individuals had reduced odds of reinfection. Methods We conducted a case-control study among adult New York City residents who tested positive for SARS-CoV-2 infection in 2020, did not test positive again >90 days after initial positive test through July 1, 2021, and did not die before July 1, 2021. Case-patients with reinfection during July–November 2021 and control subjects with no reinfection were matched (1:3) on age, sex, timing of initial positive test in 2020, and neighborhood poverty level. Matched odds ratios (mOR) and 95% confidence intervals (CI) were calculated using conditional logistic regression. Results Of 349,827 eligible adults, 2,583 were reinfected during July� �November 2021. Of 2,401 with complete matching criteria data, 1,102 (45.9%) were known to be symptomatic for COVID-19-like-illness, and 96 (4.0%) were hospitalized. Unvaccinated individuals, compared with individuals fully vaccinated within the prior 90 days, had elevated odds of reinfection (mOR, 3.21; 95% CI, 2.70, 3.82), of symptomatic reinfection (mOR, 2.97; 95% CI, 2.31, 3.83), and of reinfection with hospitalization (mOR, 2.09; 95% CI, 0.91, 4.79). All three vaccines authorized or approved for use in the U.S. were similarly effective. Conclusion Vaccination reduced odds of reinfections when the Delta variant predominated. Further studies should assess risk of severe outcomes among reinfected persons as new variants emerge, infection- and vaccine-induced immunity wanes, and booster doses are administered. View on Web

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Supporting the Art: Medication Adherence Patterns in Persons Prescribed Ingestible Sensor-enabled Oral Pre-Exposure Prophylaxis to Prevent HIV Infection

alexandrossfakianakis shared this article with you from Inoreader Supporting the Art: Medication Adherence Patterns in Persons Prescribed Ingestible Sensor-enabled Oral Pre-Exposure Prophylaxis to Prevent HIV Infection via Clinical Infectious Diseases Advance Access Abstract Background Timely, accurate adherence data may support oral PrEP success and inform prophylaxis choice. We evaluated an FDA-approved digital health feedback system (DHFS) with ingestible-sensor-enabled (IS) tenofovir-disoproxil-fumarate plus emtricitabine (Truvada®) in persons starting oral PrEP. Methods HIV-negative adults were prescribed IS-Truvada® with DHFS for 12 weeks to observe medication taking behavior. Baseline demographics, urine toxicology and self-report questionnaires were obtained. Positive detection accuracy and adverse events were computed as percentages, with Kaplan Meier Estimate for persistence-of-use. In participants persisting ≥ 28 days, adherence patterns (taking and timing) were analyzed and mixed-effects logistic regression modelled characteristics associated with treatment adherence. Results Seventy-one participants enrolled, mean age 37.6 years (range 18-69), 90.1% male, 77.5% white, 33.8% Hispanic, 95.8% housed and 74.6% employed. Sixty-three participants (88.7%) persisted ≥28 days, generating 4987 observation days, average 79.2 (29-105). Total confirmed doses were 86.2% (CI95 82.5, 89.4), decreasing over time, OR 0.899 (CI95 0.876, 0.923) per week, p < 0.001; 79.4% (CI95 66.7%, 87.3%) of participants had ≥80% adherence. Pattern analysis showed days without confirmed doses clustered (p = 0.003); regular dose timing was higher among participants with ≥80% confirmed doses (0.828, CI95 0.796 to 0.859) than among those with <80% (0.542, CI95 0.405 to 0.679) p < 0.001. In multi-predictor models, better adherence was associated with older age, OR 1.060 (CI95 1.033, 1.091) per year, p < 0.001; negative vs positive methamphetamine screen, OR 5.051 (CI95 2.252, 11.494), p < 0.001. Conclusions DHFS with IS-Truvada® distinguished adherent persons from those potentially at risk of prophylactic failure. Ongoing methamphetamine substance use may impact oral PrEP success. View on Web

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Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta‐analysis via Head & Neck Abstract It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis evaluated the accuracy of FNAC in the diagnosis of WT in the parotid gland and WT growth rate. For determination of FNAC accuracy, 17 studies, encompassing 1710 cases, were included. Pulled random model estimates of sensitivity, specificity, PPV, and NPV were 93.7% (95%CI: 92.1, 95.3), 97.9% (95%CI: 97, 98.9), 93.3% (95%CI: 91.5, 95.1), and 97.4% (95%CI: 96.4, 98.4), respectively. FNAC is highly reliable for the diagnosis of WT of the parotid. The high PPV value suggests that patients with a cytological diagnosis of WT of the parotid may be assigned to active surveillance. View on Web

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Efficacy and safety of cervicothoracic epidural blood patch for patients with spontaneous intracranial hypotension

alexandrossfakianakis shared this article with you from Inoreader Efficacy and safety of cervicothoracic epidural blood patch for patients with spontaneous intracranial hypotension via Pain Practice Abstract Background Epidural blood patch (EBP) is a generally effective treatment for spontaneous intracranial hypotension (SIH) caused by cerebrospinal fluid (CSF) leakage through the spinal dura mater. It is still unclear, however, whether application near the leakage site (targeted EBP) is more effective than distal application (untargeted EBP). Further, EBP targeted to high thoracic or cervical spine levels is infrequent due to greater technical requirements and potential complications. Here we examined the safety and efficacy of EBP applied to high thoracic or cervical spine levels. Methods We retrospectively reviewed the clinical and outcome data of 13 patients receiving cervical or high thoracic EBP for SIH. All patients were referred by neurologists following poor response to conservative treatment and presented with persistent headache aggravated by orthostatic changes. Results Neuroimaging confirmed CSF leakage, and targeted EBP resulted in immediate pain improvement. Repeated injections provided additional improvement for patients with recurrent headache. No serious adverse events were documented during follow-up. Conclusion Based on recent studies and our clinical experience, we conclude that EBP targeted to the high thoracic and cervical spine is safe and effective for early-stage SIH. View on Web

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p53 missense mutant G242A subverts natural killer cells in sheltering mouse breast cancer cells against immune rejection

alexandrossfakianakis shared this article with you from Inoreader p53 missense mutant G242A subverts natural killer cells in sheltering mouse breast cancer cells against immune rejection via ScienceDirect Publication: Experimental Cell Research Publication date: Available online 18 May 2022 Source: Experimental Cell Research Author(s): Mohammad B. Uddin, Kartik R. Roy, Ronald A. Hill, Sagor C. Roy, Xin Gu, Li Li, Qian-Jin Zhang, Zongbing You, Yong-Yu Liu View on Web

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Endoscopic modified transseptal bi-nostril approach for pituitary tumors. Efficacy of complex preservation of every turbinate and olfaction: A STROBE analysis

alexandrossfakianakis shared this article with you from Inoreader Endoscopic modified transseptal bi-nostril approach for pituitary tumors. Efficacy of complex preservation of every turbinate and olfaction: A STROBE analysis via ScienceDirect Publication: European Annals of Otorhinolaryngology, Head and Neck Diseases Publication date: Available online 18 May 2022 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): T. Takeda, K. Omura, E. Mori, R. Mori, Y. Ishii, N. Otori View on Web

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