Combination therapy with remdesivir and immunomodulators improves respiratory status in COVID‐19: A retrospective study

alexandrossfakianakis shared this article with you from Inoreader Combination therapy with remdesivir and immunomodulators improves respiratory status in COVID‐19: A retrospective study via Journal of Medical Virology Abstract Immunomodulators (tocilizumab/baricitinib) improve outcomes of coronavirus disease (COVID-19) patients, but the synergistic effect of remdesivir is unknown. The effect of combination therapy with remdesivir, immunomodulators, and standard treatment in COVID-19 patients was investigated. This retrospective, single-center study included COVID-19 patients who were treated with tocilizumab or baricitinib. The severity of respiratory status in the two groups on day 14 and day 28 and the duration to respiratory recovery in both groups were compared, and the effect of remdesivir use on respiratory status was examined in a multivariate analysis. Ninety-eight patients received tocilizumab or baricitinib; among them, 72 used remdesivir (remdesivir group) and 26 did not (control group). The remdesivir group achieved faster respiratory recovery than the control group (median 11 days vs. 21 days, p=0.033), faster weaning from supplemental oxygen (HR 2.54, 95% CI 1 .14–5.66, p=0.021). Age, body mass index, diabetes mellitus, and time from onset to oxygen administration were independent prognostic factors. The remdesivir group achieved better severity level at days 14 and 28 (p=0.033 and 0.003, respectively) and greater improvement from baseline severity (p=0.047 and 0.018, respectively). Remdesivir combination therapy did not prolong survival (HR 0.31, 95% CI 0.04–2.16, p=0.23). Among severely ill COVID-19 patients who received immunomodulator, remdesivir contributed to a shorter respiratory recovery time and better respiratory status at days 14 and 28. Concomitant remdesivir with immunomodulators and standard treatment may provide additional benefit in improving respiratory status of COVID-19 patients. This article is protected by copyright. All rights reserved. View on Web

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Clinical characteristics, outcomes, and seasonality of acute respiratory infection associated with single and co‐detected rhinovirus species among hospitalized children in Amman, Jordan

alexandrossfakianakis shared this article with you from Inoreader Clinical characteristics, outcomes, and seasonality of acute respiratory infection associated with single and co‐detected rhinovirus species among hospitalized children in Amman, Jordan via Journal of Medical Virology Abstract Background Rhinovirus (RV)-specific surveillance studies in the Middle East are limited. Therefore, we aimed to study the clinical characteristics, outcomes, and seasonality of RV-associated acute respiratory infection among hospitalized young children in Jordan. Methods We conducted a prospective viral surveillance study and enrolled children <2 years old admitted to a large public hospital in Amman, Jordan (2010–2013). Demographic and clinical data were collected by structured interviews and chart abstractions. Nasal and/or throat swabs were collected and tested for a panel of respiratory viruses, and RV genotyping and speciation was performed. Results At least one virus was detected in 2,641/3,168 children (83.4%). RV was the second most common virus detected (n=1,238; 46.9%) and was co-detected with another respiratory virus in 730 cases (59.0%). Children with RV co-detection were more likely than those with RV-only detection to have respiratory distress but had similar outcomes. RV-A accounted for about half of RV-positive cases (54.7%), while children with RV-C had a higher frequency of wheezing and reactive airway disease. RV was detected year-round and peaked during winter. Conclusions Though children with RV co-detection had worse clinical findings, neither co-detection nor species affected most clinical outcomes. This article is protected by copyright. All rights reserved. View on Web

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The diagnostic yield of head and neck imaging in symptomatic patients with a normal clinical examination

alexandrossfakianakis shared this article with you from Inoreader The diagnostic yield of head and neck imaging in symptomatic patients with a normal clinical examination via Head & Neck Abstract Aim Nationally, concern has been raised about the overuse of diagnostic testing. In patients with unilateral otalgia and no history of Head and Neck Cancer (HNC), 1% had a malignancy detected on imaging that was not detected on clinical examination. Methods We performed a retrospective review of "MRI soft tissue neck" scans performed at our hospital from May 2020 to May 2021. Patients were excluded if their scan was not ordered for HNC symptoms. Previous HNC patients undergoing follow-up imaging were also included. Results In total, 326 scan requests were analyzed. Of the 132 patients without clinical features of overt disease, only one received a new diagnosis of HNC. This patient had previously had a HNC and was undergoing routine follow-up imaging. Conclusion Our data demonstrate that performing MRI scans in symptomatic patients with a normal examination, FNE, and no history of HNC does not benefit the diagnosis or management of these patients. View on Web

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Overexpression of circFNDC3B promotes the progression of oral tongue squamous cell carcinoma through the miR‐1322/MED1 axis

alexandrossfakianakis shared this article with you from Inoreader Overexpression of circFNDC3B promotes the progression of oral tongue squamous cell carcinoma through the miR‐1322/MED1 axis via Head & Neck Abstract Background The potential role of circFNDC3B in regulating oral tongue squamous cell carcinoma development (OTSCC) remains unknown. Methods The level of circFNDC3B in OTSCC tissues or cell lines was measured and its function in vitro and in vivo was analyzed. Interactions among circFNDC3B, miR-1322, and MED1 were verified by luciferase reporter and RNA pull-down assays. Results The level of circFNDC3B in tissues or cell lines of OTSCC was higher than that in control groups. siRNA-mediated circFNDC3B inhibition resulted in weakened proliferation, migration, and invasion, which was reversed by miR-1322. Overexpression of MED1 in OTSCC cells partially reversed the tumor suppression functions of si-circFNDC3B or miR-1322 mimics in vitro. circFNDC3B overexpression dramatically promoted tumor growth in vivo. circFNDC3B directly bound with miR-1322 and consequently promoted the MED1 expression in OTSCC cells. Conclusions The circFNDC3B/miR-1322/MED1 axis participates in OTSCC progression, which may provide novel therapeutic targets for OTSCC. View on Web

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Particular body odors matter: Disgust sensitivity differs across attachment groups

alexandrossfakianakis shared this article with you from Inoreader Particular body odors matter: Disgust sensitivity differs across attachment groups via Journal of Applied Social Psychology Abstract Extensive research has highlighted how one's attachment style influences the development and maintenance of romantic relationships. Disgust is a construct that conceptually overlaps with attachment style given both include elements of behavioral avoidance. However, no previous study has examined how one's attachment style may influence disgust-based avoidance of intimacy in romantic relationships. Therefore, the aim of the current study is to determine if adult attachment style is associated with olfactory disgust ratings towards eight body odor (BO) sources from their partner, previous partner, or others. The results revealed that disgust ratings of a partner's BO differed depending on attachment style. Specifically, the participants with a dismissing-avoidant attachment style rated their partner's BO as more disgusting than the secure, fearful-avoidant, or preoccupied styles. Moreover, participants with a dismissing-avoidant attachment style rated their partner's and strangers' BO equally disgusting whereas those in the other attachment groups rated strangers' BO as more disgusting than their partner's. View on Web

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Transposition nasolabial flap: A versatile flap for sensate reconstruction of lip defects

alexandrossfakianakis shared this article with you from Inoreader Transposition nasolabial flap: A versatile flap for sensate reconstruction of lip defects via Head & Neck Abstract Introduction Lip reconstruction aims at maintaining the function and aesthetics of the facial subunits. Sensation in the reconstructed lip helps in bolus formation, tactile discrimination, and thermal sensation. In this study, we aim to describe random pattern nasolabial flap for lip reconstruction using various functional parameters. Methodology This is a retrospective study of 22 patients with carcinoma lip who underwent surgical resection and reconstruction with sensate nasolabial flap. Several clinicopathological parameters were studied. Outcome parameters like oral competence, tactile sensation, thermal sensitivity of reconstructed lip and speech outcomes were evaluated. Result A functional outcome with 2–4 mm of two-point discrimination was obtained in 19 patients. All patients had intelligible speech. A mean sulcus depth of 19.59 mm was achieved. One patient had partial flap loss owing to wound infection. Conclusion Random pattern senate nasolabial flap offers a good functional outcome by maintaining the tactile and thermal sensitivity. View on Web

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Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis via Head & Neck Abstract The aim of this study is to determine whether the preventive positioning of a salivary bypass tube (SBT) after total laryngectomy (TL) reduces the incidence of postoperative pharyngocutaneous fistula (PCF) and pharyngeal stenosis (PS). This study was conducted in conformity with the PRISMA statement. 1960 patients with a median age of 62.0 years were included. A SBT was placed in 980 (50%) patients (SBT group). The cumulative PCF incidence in the SBT group was 15.8% (95% CI: 9.3–23.6). The measured pooled OR comparing PCF incidence in patients with SBT compared to those without was 0.40 (95% CI: 0.24–0.65). The pooled PS incidence in the SBT group was 12.3% (95% CI: 5.4–21.6). The measured pooled OR comparing PS incidence in patients with SBT compared to those without was 0.43 (95% CI: 0.24–0.65). PCF and PS could be prevented by the intra-operative placement of a SBT. View on Web

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Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

alexandrossfakianakis shared this article with you from Inoreader Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma via Head & Neck Abstract Background Metabolic response assessment for oropharyngeal squamous cell carcinoma (OPSCC) aids in identifying locoregional persistence/recurrence (LRR). The Hopkins Criteria are a standardized qualitative response assessment system using posttreatment FDG-PET/CT. Methods We conducted a retrospective cohort study of patients with node-positive OPSCC treated with definitive (chemo)radiotherapy. We assessed Hopkins Criteria performance for LRR, then developed and validated a competing-risks model. Results Between 2004 and 2018, 259 patients were included with median follow-up of 43 months. The Hopkins Criteria sensitivity, specificity, negative predictive value, and accuracy were 68%, 88%, 95%, and 85%. The 36-month cumulative incidence of LRR was greater with positive scores (45% vs. 5%, HR 12.60, p < 0.001). PET/CTs performed ≤10 weeks after radiotherapy were associated with a four-fold increase in pathologically negative biopsies/surgeries (36% vs. 9%, p = 0.03). The AUC for LRR was 0.89 using a model integrating the Hopkins score. Conclusions The Hopkins Criteria predict LRR with high accuracy for OPSCC response assessment. View on Web

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MRI has a limited role in investigating odynophagia if examination is normal: a binary logistic regression analysis of 484 patients presenting to a tertiary head and neck clinic

alexandrossfakianakis shared this article with you from Inoreader MRI has a limited role in investigating odynophagia if examination is normal: a binary logistic regression analysis of 484 patients presenting to a tertiary head and neck clinic via Clinical Otolaryngology Abstract Introduction Investigation of head and neck cancers places a significant burden on the National Health Service and effective resource allocation is of perpetual importance. Existing risk calculators are designed to stratify the likelihood of underlying malignancy according to symptoms, but are less relevant in secondary care as they do not integrate clinical examination findings (e.g. naso-endoscopy). We looked to evaluate the utility of magnetic resonance imaging (MRI) in investigating patients with unilateral odynophagia and a normal clinical examination. Methods A retrospective analysis was conducted over a 54-month period; 484 consecutively-recruited adult patients who underwent MRI of the neck for suspected malignancy were included. Imaging reports, case notes, and histopathology results were reviewed. Patients with previously diagnosed/treated malignancy, undergoing surveillance, or those with pathology of the salivary glands, oral cavity or thyroid gland, were excluded. A multivariate binary logistical regression model was performed to calculate the odds ratios and probabilities of malignancy for each presenting symptom, with and without negative nasoendoscopy findings. Results The overall incidence of malignancy within the cohort was 173/484 patients (35.7%; 95% CI 31.5 – 40.2%) with no cases of malignancy in patients presenting with odynophagia and a normal nasoendoscopy (0/39). The presence of a neck lump was significantly associated with malignancy, (OR 2.03 p = 0.001; 95% CI 1.59 – 2.58), as was dysphagia (OR 1.52 p = 0.009; 95%CI 1.11 - 2.11). Conversely, globus was found to have an inverse association (OR 0.41 p < 0.001; 95% CI 0.24 – 0.70). Summary New patients presenting with odynophagia alone and normal endoscopy or globus have a low likelihood of underlying malignancy, justifying reassurance and follow-up in the event of persistent symptoms. Contrariwise, patients with a neck lump, dysphagia, odynophagia and multiple concurrent aerodigestive tract symptoms, or an abnormal endoscopy have a high likelihood of underlying malignancy and should be investigated accordingly. View on Web

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A systematic review of the feasibility and safety of day case nasal and/or palatopharyngeal surgery in patients with obstructive sleep apnoea

alexandrossfakianakis shared this article with you from Inoreader A systematic review of the feasibility and safety of day case nasal and/or palatopharyngeal surgery in patients with obstructive sleep apnoea via Clinical Otolaryngology Abstract Introduction Recent guidelines suggest obstructive sleep apnoea (OSA) is not an absolute contraindication for same day discharge following surgery. The aim of this systematic review was to examine the feasibility and safety of day case nasal and/or palatopharyngeal surgery in patients with OSA. Methods We performed a systematic search of PubMed, EMBASE and the Cochrane library. Quality assessment of included studies was done. The protocol of this systematic review was registered with PROSPERO (CRD42021273451). Results A total of 1836 patients from ten observational studies were included. There were 268 (15.4%) nasal surgeries, 738 palatopharyngeal surgeries (42.4%) and 735 (42.2%) combined nasal and palatopharyngeal surgery. The majority of patients had moderate to severe OSA. A total of 860 patients (49.8%) were successfully discharged as day cases. There were no standard criteria for daycase surgery. Post-anaesthetic respiratory events were reported in 86/1750 (4.9%) patients. Oxygen desaturation was the most common respiratory event (83.7%, n = 72). There was no mortality reported. Conclusion Current data suggests day surgery is feasible in carefully selected patients with OSA undergoing nasal and/or palatopharyngeal surgery. Further well-designed prospective studies with an emphasis on the systematic assessment of complications are required to establish safety and daycase criteria. View on Web

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