Pediatric renal tumor epidemiology: Global perspectives, progress, and challenges

alexandrossfakianakis shared this article with you from Inoreader Pediatric renal tumor epidemiology: Global perspectives, progress, and challenges via Pediatric Blood & Cancer Abstract Pediatric renal tumors account for 3%–11% of childhood cancers, the most common of which is Wilms tumor or nephroblastoma. Epidemiology plays a key role in cancer prevention and control by describing the distribution of cancer and discovering risk factors for cancer. Large pediatric research consortium trials have led to a clearer understanding of pediatric renal tumors, identification of risk factors, and development of more risk-adapted therapies. These therapies have improved event-free and overall survival for children. However, several challenges remain and not all children have benefited from the improved outcomes. In this article, we review the global epidemiology of pediatric renal tumors, including key consortium and global studies. We identify current knowledge gaps and challenges facing both high and low middle-incomes countries. View on Web

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Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes

alexandrossfakianakis shared this article with you from Inoreader Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes via Journal of Medical Virology Abstract Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no-use of metformin, the aHRs (95% CI) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic ne uralgia than metformin no-use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no-use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes. This article is protected by copyright. All rights reserved. View on Web

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Platelet‐rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: an in vivo study

alexandrossfakianakis shared this article with you from Inoreader Platelet‐rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: an in vivo study via Journal of Clinical Periodontology Abstract Aim It has been proposed that platelet-rich fibrin (PRF) can be used to support bone regeneration during alveolar ridge augmentation. The aim of this study was to determine if an approach utilizing PRF provides similar performance to the established guided bone regeneration (GBR) procedure. Materials and Methods Two-wall defects were surgically created in beagle dogs and treated in three experimental groups: (i) sticky bone (SB) substitute prepared using liquid PRF and deproteinized porcine bone mineral (DPBM), (ii) SB covered with solid PRF compressed into a membrane, and (iii) GBR performed using DPBM covered by a collagen membrane. The quantitative reverse-transcription polymerase chain reaction was applied to specimen after 1 week of healing, and microcomputed tomography (micro-CT) and histological outcomes were analyzed after 8 weeks of healing. Results Compared with GBR, PRF resulted in a moderate increase in the expression levels of osteoblast and osteoclast markers, osteocalcin, and calcitonin receptor. Moreover, PRF modestly increased angiogenesis and the inflammation markers VEGF and IL-6. Micro-CT and histological analyses confirmed the expected increased alveolar ridge area, with no significant differences between the three groups. Consistently, graft consolidation as indicated by new bone formation at the defect site did not differ significantly between groups. Conclusion The present results demonstrate that PRF-based approaches performed comparably to the established GBR procedure in terms of the consolidation of DPBM in two-wall alveolar defects. This article is protected by copyright. All rights reserved. View on Web

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Characteristics of Orbital Injuries Associated with Maxillofacial Trauma

alexandrossfakianakis shared this article with you from Inoreader Characteristics of Orbital Injuries Associated with Maxillofacial Trauma via The Laryngoscope Introduction The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures. Methods We performed a retrospective review of 1677 patients from 2015 to 2020 with midface fractures at a Level I trauma center. Isolated nasal bone and frontal process of the maxilla fractures were excluded. Demographic information, mechanism of injury, need for surgery, and ophthalmologic findings were documented. Statistical analysis was conducted using SPSS. Results 773 patients between the ages of 15 and 92 were identified. Trauma most commonly resulted from assault (63.8%). The association between the mechanism of injury and ocular injury was statistically significant (p = 0.003), with 78.6% of gunshot wounds and 44.3% of assault patients having an ocular injury. The Ophthalmology service evaluated 62.6% of cases preoperatively. Minor ocular injury occurred in 36% of patients, including 46.1% of isolated orbital floor, and 28.2% of zygomaticomaxillary complex fractures. Major ocular injury occurred in 10.5% of patients. Conclusions Over 10% of patients with midface fractures were found to have major ocular injuries. Ophthalmologic exams should be performed for all patients with midface fractures to guide clinical decision making and prevent further intraoperative ocular insults. Level of Evidence Level 4. This study represents a retrospective cohort study analyzing ocular injuries detected in patients presenting to a Level I trauma center with maxillofacial fractures between 2015 and 2020 Laryngoscope, 2022 View on Web

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Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning

alexandrossfakianakis shared this article with you from Inoreader Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning via American Journal of Epidemiology - Advance Access Abstract We sought to determine whether machine learning and natural language processing (NLP) applied to electronic medical records could improve performance of automated healthcare claims-based algorithms to identify anaphylaxis events using data on 516 patients with outpatient, emergency department, or inpatient anaphylaxis diagnosis codes during 2015-2019 in two integrated healthcare institutions in the Northwest United States. We used one site's manually reviewed gold standard outcomes data for model development and the other's for external validation based on cross-validated (cv) area under the receiver operating characteristic curve (cv AUC), positive predictive value (PPV), and sensitivity. In the development site 154 (64%) of 239 potential events met adjudication criteria for anaphylaxis compared to 180 (65%) of 277 in the validation site. Logistic regression models using only structured claims data achieved a cv-AUC of 0.58 (95% CI: 0.54, 0. 63). Machine learning improved cv-AUC to 0.62 (0.58, 0.66); incorporating NLP-derived covariates further increased cv AUCs to 0.70 (0.66, 0.75) in development and 0.67 (0.63, 0.71) in external validation data. A classification threshold with cv-PPV of 79% and cv-sensitivity of 66% in development data had cv-PPV of 78% and cv-sensitivity of 56% in external data. Machine learning and NLP-derived data improved identification of validated anaphylaxis events. View on Web

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Update of the classification of midpalatal suture behaviour after surgically assisted rapid maxillary expansion using computed tomography

alexandrossfakianakis shared this article with you from Inoreader Update of the classification of midpalatal suture behaviour after surgically assisted rapid maxillary expansion using computed tomography via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to update the midpalatal suture classification after surgically assisted rapid maxillary expansion (SARME) using computed tomography (CT). Thirty-five patients with a transverse maxillary deficiency and unilateral or bilateral posterior crossbite underwent SARME with osteotomy of the pterygoid apophysis of the sphenoid. CT was performed before installation of the Hyrax expander appliance and after the final activation. Opening of the midpalatal suture was classified into three types: type I, total midpalatal suture opening from anterior nasal spine (ANS) to posterior nasal spine (PNS); type II, partial midpalatal suture opening from ANS to the transverse palatine suture, with partial or non-existent opening of the midpalatal suture posterior to the transverse pala... View on Web

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Multiagent Chemotherapy Followed by Stereotactic Body Radiotherapy Versus Conventional Radiotherapy for Resected Pancreas Cancer

alexandrossfakianakis shared this article with you from Inoreader Multiagent Chemotherapy Followed by Stereotactic Body Radiotherapy Versus Conventional Radiotherapy for Resected Pancreas Cancer via American Journal of Clinical Oncology - Current Issue Background and Purpose: Chemotherapy followed by margin-negative resection (R0) is the treatment of choice for patients with localized pancreatic ductal adenocarcinoma (PDAC). Neoadjuvant multiagent chemotherapy (MAC) or MAC then radiotherapy (RT) may optimize surgical candidacy. The purpose of this study was to compare pathologic outcomes of MAC followed by conventionally fractionated radiotherapy (CRT) versus stereotactic body radiotherapy (SBRT) for patients with resected PDAC. Methods: Patients diagnosed with nonmetastatic PDAC between 2012 and 2017 and who received preoperative MAC or MAC+RT were identified in the National Cancer Database. Variables associated with R0 and overall survival were identified with logistic regression and Cox analysis (P View on Web

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Radiographic Response of Solitary Plasmacytomas After Conformal Radiotherapy May Be Delayed: Outcomes in the 3D Era

alexandrossfakianakis shared this article with you from Inoreader Radiographic Response of Solitary Plasmacytomas After Conformal Radiotherapy May Be Delayed: Outcomes in the 3D Era via American Journal of Clinical Oncology - Current Issue Objective: Although recurrence rates after radiotherapy for solitary plasmacytoma (SP) are well established, little is known about how SP responds radiographically, as most historical patients were treated in the 2D era. We evaluated the response to radiotherapy among SP patients staged and treated with 3D techniques, including proton therapy, which has not yet been previously reported. Methods and Materials: Between 2007 and 2021, 15 SP patients (4 extramedullary, 11 bone) staged with 3D imaging and bone marrow evaluation were consecutively treated with definitive radiotherapy. The best response was categorized in 9 evaluable patients according to response evaluation criteria in solid tumors (RECIST) and positron emission tomography response criteria in solid tumors (PERCIST). Results: With a median follow-up of 34 months, 4 patients relapsed. The median time to the best response was ~2 years (26.6 mo RECIST, 25.4 mo PERCIST). Response rates differed based on response assessment criteria. PERCIST was associated with higher rates of complete (85.7%) or partial response (14.3%) compared with RECIST (16.7% complete, 33.3% partial). Two-year and 4-year PFS for extramedullary SP were 100% and 75%, compared with 91% and 55% for bone (P=0.75). Patients treated with proton therapy (n=5) did not appear to have different patterns of relapse (1 marginal, 1 distant) compared with those treated with photons or electrons (n=10; 2 distant). Conclusions: More conformal dose distribution with proton therapy does not appear to alter patterns of recurrence. Although response rates differ based on criteria by both RECIST and PERCIST assessments, the radiographic response may be slow and requires validation in other cohorts. View on Web

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Safety and outcome of ultrasound‐guided tunneled central venous catheter in children

alexandrossfakianakis shared this article with you from Inoreader Safety and outcome of ultrasound‐guided tunneled central venous catheter in children with cancers from low middle‐income country: A prospective study via Pediatric Blood & Cancer Abstract Background Central venous access devices (CVAD) are vital for cancer therapeutics in pediatric oncology. Tunneled vascular access devices (TVAD) are preferred in children for prolonged and frequent vascular access. Data on insertion, care, and complications of CVAD in children from low middle-income countries (LMIC) are scarce, heterogeneous, and retrospective. Procedure This prospective observational study on eligible children <12 years with pediatric malignancies requiring chemotherapy for minimum 6 months from diagnosis excluded children with mucosal bleeding, coagulopathy, and infections. TVAD insertion was ultrasound (USG) guided. Number of catheter-days, surgical and nonsurgical complications, and risk factors for catheter-related bloodstream infections (CRBSI) were noted TVAD removal due to complications, therapy completion, tumor progression, or death. Results Data from 61 of 86 eligible children with median age 42 months (range 1–144) were analyzed. Hematological malignancy and severe thrombocytopenia were seen in 37/61 (61%) and 18/61 (30%) children, respectively. First-attempt success rate was 74%. Surgical complications were seen in four of 61 (7%). Nonsurgical complications were seen in 33/61 (54%) children; CRBSI was commonest 24/61 (39%), causing removal of TVAD in 14/61 (23%). Incidence per 1000 catheter-days for CRBSI was 3.24. Antibiotic lock therapy could salvage nine of 24 TVAD with CRBSI. Thrombus and accidental removal was seen in six of 61 (10%) and four of 61 (7%). None of the studied risk factors were significantly associated with CRBSI. The mean insertion duration of TVAD was 121 ± 90 days. Conclusion USG-guided TVAD insertion is safe and reliable way for chemotherapy administration with acceptable complications in children with malignancies in LMIC, including children with severe thrombocytopenia. View on Web

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Let's talk about faces: Identifying faces from verbal descriptions

alexandrossfakianakis shared this article with you from Inoreader Let's talk about faces: Identifying faces from verbal descriptions via British Journal of Psychology Abstract Face descriptions inform real-world identification decisions, for example when eyewitnesses describe criminal perpetrators. However, it is unclear how effective face descriptions are for identification. Here, we examined the accuracy of face identification from verbal descriptions, and how individual differences in face perception relate to producing and using descriptions for identification. In Study 1, participants completed a face communication task in pairs. Each participant saw a single face, and via verbal communication only, the pair decided if they were viewing the same person or different people. Dyads achieved 72% accuracy, compared to 81% when participants completed the task individually by matching face pairs side-by-side. Performance on the face communication and perceptual matching tasks were uncorrelated, perhaps due to low measurement reliability of the face communication task. In subsequent studies, we examined the abilities of face 'describers' (Study 2) and 'identifiers' separately (Study 3). We found that 'super-recognizers' – people with extremely high perceptual face identification abilities – outperformed controls in both studies. Overall, these results show that people can successfully describe faces for identification. Preliminary evidence suggests that this ability – and the ability use facial descriptions for identification – has some association with perceptual face identification skill. View on Web

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