Αρχειοθήκη ιστολογίου

Τρίτη 19 Απριλίου 2022

Intestinal Blautia may protect against neutropenic fever in allogeneic transplant patients by augmenting the intestinal epithelium

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Abstract
Background
Neutropenic fever (NF) occurs in >70% of hematopoietic cell transplantation (HCT) recipients, without a documented etiology in most cases. Antibiotics used to prevent and treat NF disrupt the gut microbiota; these disruptions predict higher post-transplant mortality. We hypothesized that specific features in the gut microbial community may mediate the risk of NF.
Methods
We searched a large gut microbiota database in allogeneic HCT recipients (12,546 stool samples, 1,278 patients) to find pairs with (cases) vs. without (controls) NF on the same day relative to transplantation and with a stool sample on the previous day. 179 such pairs were matched in the underlying disease and graft source. Several other important clinical variables were similar between the groups.
Results
The gut microbiota of cases on the day before NF had a lower abundance of Blautia than their m atched controls on the same day post-transplant, suggesting a protective role for Blautia. Microbiota network analysis did not find any differences in community structure between the groups, suggesting a single-taxon effect. To identify putative mechanisms, we searched a gut microbiome and serum metabolome database of acute leukemia patients receiving chemotherapy and identified 139 serum samples collected within 24 hours after a stool sample from the same patient. Greater Blautia abundances predicted higher levels of next-day citrulline, a biomarker of total enterocyte mass.
Conclusions
These findings support a model where Blautia protects against NF by improving intestinal health. Therapeutic restoration of Blautia may help prevent NF, thus reducing antibiotic exposures and transplant-related mortality.
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Systematic review of neuroendocrine carcinomas of the oropharynx

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Abstract

Data describing features and management of oropharyngeal neuroendocrine carcinomas (NEC) remain sparse. A systematic review was performed. Patients were stratified by treatment modality and examined for disease progression and survival outcomes. Ninety-four patients from 50 publications were included. Average age at diagnosis was 59.7 years (range 14–83). 73.4% were male. Most studies did not document HPV status. Forty patients (85.1%) were p16 positive, and 34 (85.0%) were HPV-ISH positive. Overall survival was 75.4% at 1 year, and 40.0% at 2 years. Of patients with locoregional disease, 33.8% developed distant metastasis. 12.5% of patients developed locoregional recurrence. Patients who developed distant metastases had worse overall survival (p = 0.0004). No significant difference was found between treatment modalities. Human papilloma virus may be associated with oropharyngeal NEC. Current treatments provide locoregional control, but distant metastas es are common and confer low overall survival.

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Comparative analysis of the biological characteristics of three CV‐A10 clones adaptively cultured on Vero cells

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Abstract

Coxsackievirus A10 (CV-A10) is a major pathogen that causes hand, foot, and mouth disease. There are no effective therapeutic drugs for CV-A10 infection; therefore, CV-A10 vaccines should be developed. Previously, we isolated a CV-A10 strain (N25) that can be cultured on Vero cells. In this study, the N25 strain was plaque-purified thrice from Vero cells, and three clones were selected for adaptive culture. The three clones of the 5th, 12th, and 19th generations were compared and analyzed in terms of viral titers, plaque morphology, pathogenicity in suckling mice, and nucleotide and amino acid sequences of the complete genome. The infectivity titers of the three clones (P2-P22) were maintained at 6.5–7.0 lgCCID50/ml. The three clones began to proliferate at 6 h and peaked at 36 h; the corresponding CCID50 was in the range of 106.5−106.875/ml, which gradually decreased. The suckl ing mice in the challenged group exhibited clinical symptoms such as paralysis of the limbs, which gradually worsened until death. The inactivated vaccines prepared using the three clones efficiently induced antigen-specific serum antibodies in mice. There were eight nucleotide mutations in the three clones, which resulted in two and four amino acid substitutions in the VP3 and VP1 coding regions, respectively. The nucleotide and amino acid sequence homology between the three clones and N25 were 99.92%−100% and 99.78%−100%, respectively, indicating high genetic stability. Our findings provide a theoretical basis for screening CV-A10 vaccine candidate clones.

This article is protected by copyright. All rights reserved.

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Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: A systematic review and meta‐analysis of randomized clinical trials

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Abstract

Background and aims

Diabetes mellitus (DM) is one of the most prevalent chronic non-communicable diseases globally, and the only way to reduce its complications is good glycemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with Type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses since it allows greater flexibility in diet and could, in some people, reduce the burden of the disease.

This systematic review's primary objective was to assess carbohydrate counting efficacy in reducing glycated hemoglobin (HbA1c) and safety by not increasing hypoglycemia risk, inducing an increase in body weight or blood lipids, and reducing the quality of life of people with T1DM.

Methods

We included randomized controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least three months and with no restrictions in language, age, or settings. As a primary outcome, we consider the change of HbA1c within at least three months. Secondary outcomes were hypoglycemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality of life changes and diabetes treatment satisfaction questionnaires.

Results

Data from 11 studies with 899 patients were retrieved with a mean follow of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1c, SMD – 0.24% (95%CI -0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful HbA1c reduction, SMD – 0.52% (95%CI -0.82 to -0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c compared to usual diabetes education. Carbohydrate counting doesn't relate to any substantial change in blood lipids, body weight, hypoglycemia risk, or daily insulin dose. Finally, we analyzed the effect of trial duration with HbA1c reduction and found no significant change related to time.

Conclusions

Carbohydrate counting is an efficacious technique to safely reduce HbA1c in adults and children compared to standard diabetes education. And its effect doesn't seem to change with prolonged time. Standardization in reporting important outcomes like hypoglycemia and quality of life is vital to produce comparable evidence in carbohydrate counting clinical trials.

This SR was registered in PROSPERO under code: CRD42020218499.

This article is protected by copyright. All rights reserved.

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HIGH RATE OF HCV REINFECTION AMONG RECENTLY INJECTING DRUG USERS: RESULTS FROM THE TRAP HEP C PROGRAM – A PROSPECTIVE NATIONWIDE, POPULATION-BASED STUDY

alexandrossfakianakis shared this article with you from Inoreader

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Abstract
Background
The Treatment as Prevention for Hepatitis C program started in 2016 in Iceland, offering treatment with direct-acting antivirals to hepatitis C virus (HCV)-infected individuals. Reinfections through injection drug use (IDU) can hamper elimination efforts. We determined reinfection rates (RIR) of HCV among patients in the program.
Methods
Clinical data were gathered prospectively. The study cohort consisted of HCV-cured patients with an estima ted sustained virologic response between February 1st 2016 and November 20th 2018, with follow-up until November 20th 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The RIR was expressed as reinfections/100 person-years (PYs).
Results
640 treatments of 614 patients (417 males, mean age 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 males). Follow-up was 672.1 PYs with median time to reinfection of 231.7 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 (34.4%) treatments. Stimulants were the preferred injected drug in 85.5% of patients with history of IDU. The RIR was 7.7/100 PYs. Using multivariate Cox proportional hazards models for interval-censored data, age (HR 0.96, 95% CI 0.94-0.99) and recent IDU (HR 2.91, 95% CI 1.48-5.76) were significantly associated with reinfection risk.
Conclusions
The RIR is high in a setting of widespread stimulant use, particularly in young people with recent IDU. Regular follow up is important among high-risk populations to diagnose reinfections early and reduce transmission.
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Three-dimensional volumetric analysis of the efficiency of marsupialization in patients with mandibular dentigerous cysts involving impacted third molars

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Publication date: Available online 18 April 2022

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Masatoshi Hirayama, Kazushige Inoue, Hidetaka Arita, Nozomu Takahashi, Hikaru Nakashima, Junki Sakata, Manabu Maeshiro, Yuka Nagao, Shunsuke Gohara, Keisuke Yamana, Yuichiro Matsuoka, Akira Yuno, Masafumi Nakamoto, Kenta Kawahara, Masashi Nagata, Akiyuki Hirosue, Daiki Fukuma, Ryoji Yoshida, Hideki Nakayama

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Does the Modified Frailty Index (mFI-5) Predict Adverse Outcomes in Maxillofacial Fracture Repair?

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Frailty has been recognized as a predictor of postoperative adverse outcomes in many surgical subspecialties. The purpose of this study was to evaluate the relationship between frailty and complications in patients undergoing operative repair of facial fractures. (Source: Journal of Oral and Maxillofacial Surgery)
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Reconstruction of Segmental Mandibular Defects with Use of Avascular Fibula Grafts

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Functional and cosmetic defects involving the maxillofacial complex may result from traumatic injury, developmental deformities, infections, and iatrogenic injury. Reconstruction of large segmental defects with the use of vascularized free flaps has been considered the gold standard in recent years. There are many logistical and economic considerations with vascularized free flaps, and therefore the authors aim to discuss an alternative. After appropriate patient selection, the use of non-vascularized reconstruction techniques has been shown to be effective. (Source: Journal of Oral and Maxillofacial Surgery)
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Malignant Transformation of Ossifying Fibroma to Juvenile Aggressive Ossifying Fibroma to Fibroblastic Osteosarcoma: A Case Report

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The researchers present a case of mandibular juvenile ossifying fibroma (JOF) undergoing malignant transformation to fibroblastic osteosarcoma (FOS) and propose to use this unique case report. In contrast to extragnathic OS (osteosarcoma), comprehensive genomic studies of gnathic OS are lacking and, hence, there are no validated diagnostic and therapeutic molecular targets for gnathic OS. Distinguishing fibroblastic OS of the jaws from its close mimics, such as ossifying fibroma (OF) and fibromatosis of the jaws, poses major challenge for pathologists. (Source: Journal of Oral and Maxillofacial Surgery)
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Enlargement of Inferior Alveolar Nerve Canal and Mental Neuropathy Associated with B-cell Lymphoma: A Case Report and Literature Review

alwin shared this article with you from Inoreader
Enlargement of an inferior alveolar nerve canal (IANC) on radiographic imaging can indicate the presence of a wide variety of pathologic entities. Oral and maxillofacial surgeons have the unique opportunity to regularly examine panoramic radiographs, and must exercise proficient clinical judgement when noting abnormal findings on imaging. While malignant processes associated with IANC enlargement are uncommon, these pathologies do occur and may be associated with significant sequelae, especially when accompanied by a delay in diagnosis in treatment. (Source: Journal of Oral and Maxillofacial Surgery)
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Mortality and Associated Variables of Full-mouth Extractions

alwin shared this article with you from Inoreader
Full-mouth extractions (FMEs) are common procedures that are classically performed electively due to caries and periodontal disease. Up to 17% of adults over the age of 65 and 2% of adults aged 20-64 in the United States are edentulous. At the University of Cincinnati Medical Center, approximately 250 FMEs are performed annually with nearly half performed on adults over the age of 50. There is currently an absence of data on this patient population and their overall outcomes. The authors hypothesize that FMEs are often performed on socioeconomically and medically vulnerable populations, thereby further compromising their conditions and potentially contributing to their demise. (Source: Journal of Oral and Maxillofacial Surgery)
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