Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient

alexandrossfakianakis shared this article with you from Inoreader Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient via Journal of Medical Virology ABSTRACT Monkeypox is a neglected zoonotic disease caused by Monkeypox virus (MPXV), a double-stranded DNA virus of the genus Orthopoxvirus. Here we present a case report of a 32-year-old man with MPXV infection who developed keratoconjunctivitis and Wessley immune ring with no identifiable cause other than ocular involvement by MPXV. We highlight the need of ophthalmologists exploring any ocular symptoms in MPXV-infected individuals. This article is protected by copyright. All rights reserved. View on Web

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Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test‐and‐treat program

alexandrossfakianakis shared this article with you from Inoreader Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test‐and‐treat program via Journal of Medical Virology Abstract Background Dried blood spots (DBS) are a reliable tool to diagnose viremic HCV infection. We evaluated the clinical performance of a DBS-based molecular assay for the assessment of cure and reinfection after on-site treatment at a harm reduction centre (HRC). Genotyping from DBS samples was also assessed to discriminate reinfection from treatment failure. Methods People who inject drugs (PWID) from an ongoing microelimination pilot at the largest HRC in Barcelona were included in the study. HCV-RNA detection from DBS collected after treatment (with follow-up at 12, 36 and 60 weeks) was compared with a molecular point-of-care test using finger-stick blood (GeneXpert). Baseline and follow-up DBS samples were genotyped by NS5B sequencing or commercial real-time PCR. Results Among treated patients, 193 follow-up DBS samples were tested. The DBS-based assay showed 100% specificity (129/129), and sensitivity ranged from 84.4% to 96.1% according to different viral load cut-offs (from detectable to 3000 IU/mL). Sensitivity as test of cure (follow-up 12) ranged from 85.1 to 97.4%. Among the 64 patients with recurrent viremia, 10.9% had low viral loads (≤1000 IU/mL); HCV genotyping allowed us to classify 73.5% of viremic cases either as reinfection or as treatment failure. Conclusions DBS samples are useful to assess cure and differentiate reinfection from relapse after HCV antiviral treatment in the real world, facilitating decentralization of treatment and post-treatment follow-up in PWID. However, a fraction of patients presented with low viral loads, limiting viremia detection and genotyping in DBS and, therefore, repeat testing is recommended. This article is protected by copyright. All rights reserved. View on Web

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Autogenous dentin graft versus alloplastic graft combined with socket shield for pre-implant socket preservation: a split-mouth randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader Autogenous dentin graft versus alloplastic graft combined with socket shield for pre-implant socket preservation: a split-mouth randomized clinical trial via International Journal of Oral and Maxillofacial Surgery via MedWorm.com After tooth extraction, alveolar bone resorption and labial bone plate thinning occur due to the lack of periodontal ligaments. The socket shield method was developed to preserve the alveolar ridge. A split-mouth study was performed in which eight patients were treated using alloplast with socket shield on one side (alloplast group, control) and autogenous dentin graft with socket shield on the contralateral side (dentin group, test). After 3 months, a trephine bone core was collected from all sites and evaluated by histological, histomorphometric, and radiographic analysis. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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The AUGIS Survival Predictor: Prediction of Long-Term and Conditional Survival After Esophagectomy Using Random Survival Forests

alexandrossfakianakis shared this article with you from Inoreader The AUGIS Survival Predictor: Prediction of Long-Term and Conditional Survival After Esophagectomy Using Random Survival Forests via Annals of Surgery - Most Popular Articles Objective: The aim of this study was to develop a predictive model for overall survival after esophagectomy using pre/postoperative clinical data and machine learning. Summary Background Data: For patients with esophageal cancer, accurately predicting long-term survival after esophagectomy is challenging. This study investigated survival prediction after esophagectomy using a Random Survival Forest (RSF) model derived from routine data from a large, well-curated, national dataset. Methods: Patients diagnosed with esophageal adenocarcinoma or squamous cell carcinoma between 2012 and 2018 in England and Wales who underwent an esophagectomy were included. Prediction models for overall survival were developed using the RSF method and Cox regression from 41 patient and disease characteristics. Calibration and discrimination (time-dependent area under the curve) were validated internally using bootstrap resampling. Results: The study analyzed 6399 patients, with 2625 deaths during follow-up. Median follow-up was 41 months. Overall survival was 47.1% at 5 years. The final RSF model included 14 variables and had excellent discrimination with a 5-year time-dependent area under the receiver operator curve of 83.9% [95% confidence interval (CI) 82.6%–84.9%], compared to 82.3% (95% CI 81.1%—83.3%) for the Cox model. The most important variables were lymph node involvement, pT stage, circumferential resection margin involvement (tumor at View on Web

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Peritoneal Metastases From Prostate Carcinoma Treated With 177Lu-PSMA-I&T

alexandrossfakianakis shared this article with you from Inoreader Peritoneal Metastases From Prostate Carcinoma Treated With 177Lu-PSMA-I&T via Clinical Nuclear Medicine - Published Ahead-of-Print A 71-year-old man was referred for 177Lu-PSMA therapy. He had metastatic castration-resistant prostate cancer, progressive on several treatment lines, with current PSA 260 μg/L and deteriorating condition. CT showed ascites with omental and peritoneal metastases, all positive on PSMA PET/CT. He was treated with 4 cycles of 7.4 GBq (0.2 Ci) 177Lu-PSMA-I&T. Posttherapy scans showed good targeting of all metastases. After 4 cycles, PSA had dropped to 44 μ/L. Four months after the fourth cycle, the patients' general condition had significantly improved, and PSA had decreased to 7.0 μg/L. View on Web

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High C‐reactive protein to lymphocyte ratio predicts mortality outcomes of patients with severe fever suffering from thrombocytopenia syndrome: a multi‐centre study in China.

alexandrossfakianakis shared this article with you from Inoreader High C‐reactive protein to lymphocyte ratio predicts mortality outcomes of patients with severe fever suffering from thrombocytopenia syndrome: a multi‐centre study in China. via Journal of Medical Virology Abstracts Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening infectious disease caused by the SFTS virus (SFTSV). This study aimed to evaluate the predictive power of C-reactive protein to lymphocyte ratio (CLR) and establish an early-warning model for SFTS mortality. We retrospectively analysed hospitalised SFTS patients in six clinical centres from May 2011 to May 2022. The efficacy of CLR prediction was evaluated by the receiver operating characteristic (ROC) analysis. A nomogram was established and validated. 882 SFTS patients (median age 64 years, 48.5% male) were enrolled in this study, with a mortality rate of 17.8%. The area under the ROC curve (AUC) of CLR was 0.878 (95% CI: 0.850-0.903, P<0.001), which demonstrates high predictive strength. The least absolute shrinkage and selection operator (LASSO) regression selected seven potential predictors. Multivariate logistic regression analysis determined three independent risk factors, including CLR, to construc t the nomogram. The performance of the nomogram displayed excellent discrimination and calibration, with significant net benefits in clinical uses. CLR is a brand-new predictor for SFTS mortality. The nomogram based on CLR can serve as a convenient tool for physicians to identify critical SFTS cases in clinical practice. This article is protected by copyright. All rights reserved. View on Web

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HBsAg (‐)/HBsAb (‐)/HBeAg (‐)/HBeAb (+)/HBcAb (+) predicts a high risk of hepatitis B reactivation in patients with B‐cell lymphoma receiving rituximab based immunochemotherapy

alexandrossfakianakis shared this article with you from Inoreader HBsAg (‐)/HBsAb (‐)/HBeAg (‐)/HBeAb (+)/HBcAb (+) predicts a high risk of hepatitis B reactivation in patients with B‐cell lymphoma receiving rituximab based immunochemotherapy via Journal of Medical Virology Abstract Patterns of hepatitis B virus reactivation (HBV-R) in HBsAg (-)/HBcAb (+) patients with B-cell non-Hodgkin lymphoma (NHL) receiving rituximab based immunochemotherapy have not been well described. The retrospective study included 222 HBsAg (-)/HBcAb (+) NHL patients as training cohort and 127 cases as validation cohort. The incidence of HBV-R in HBsAg (-)/HBcAb (+) B-cell NHL patients was 6.3% (14/222), of which that in HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was 23.7% (9/38). Multivariate analysis showed that HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) correlated with a high risk of HBV-R in B-cell lymphoma patients (training phase HR, 10.123; 95% CI, 3.389 to 30.239; P < 0.001; validation phase HR, 18.619; 95% CI, 1.684 to 205.906; P = 0.017; combined HR, 12.264; 95% CI, 4.529-33.207; P < 0.001). The mortality rate of HBsAg (-)/HBcAb (+) B-cell NHL caused by HBV-R was 14.3% (2/14) while that for HBV reactivated HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was up to 44.4% (4/9). As a high incidence of HBV-R and high mortality after HBV-R was found in HBsAg (-)/HBsAb (-)/HBcAb (+)/HBeAg (-)/HBeAb (+) patients with B-cell NHL receiving rituximab based immunochemotherapy, prophylactic antiviral therapy is recommended for these patients. This article is protected by copyright. All rights reserved. View on Web

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A high prevalence of neutrophil‐specific antibodies in ELANE‐mutated severe congenital neutropenia

alexandrossfakianakis shared this article with you from Inoreader A high prevalence of neutrophil‐specific antibodies in ELANE‐mutated severe congenital neutropenia via Pediatric Blood & Cancer Abstract An assay for neutrophil-specific antibodies is frequently used in the workup of chronic severe neutropenia and is suggestive of autoimmune, or sporadically alloimmune neutropenia, rather than severe congenital neutropenia (SCN). We analyzed a neutropenia consortium database for the outcomes of antibody testing initiated before receiving genetic diagnosis in Polish SCN cohort. Test results, performed in a single reference laboratory, were available for 14 patients with ELANE-mutated SCN or cyclic neutropenia, and were frequently positive (36%). We note that the trigger for genetic studies in severe neutropenia should not be affected by antibody-positivity and should be clinically driven. View on Web

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Differentiation of Bolus Texture During Deglutition via High‐Density Surface Electromyography: A Pilot Study

alexandrossfakianakis shared this article with you from Inoreader Differentiation of Bolus Texture During Deglutition via High‐Density Surface Electromyography: A Pilot Study via The Laryngoscope This pilot study evaluated high-density surface electromyography (HDsEMG) during pharyngeal swallows of five different bolus textures from eight healthy human subjects. Results indicate HDsEMG can differentiate swallows of varying consistencies through analysis of EMG signal features such as power and peak counts while maintaining a spatial orientation. This may prove useful in both future diagnostic and behavioral swallow applications. Objective Swallowing is a complex neuromuscular task. There is limited spatiotemporal data on normative surface electromyographic signal during swallow, particularly across standard textures. We hypothesize the pattern of electromyographic signal of the anterior neck varies cranio-caudally, that laterality can be evaluated, and categorization of bolus texture can be differentiated by high-density surface electromyography (HDsEMG) through signal analysis. Methods An HDsEMG grid of 20 electrodes captured electromyographic activity in eight healthy adult subjects across 240 total swallows. Participants swallowed five standard textures: saliva, thin liquid, puree, mixed consistency, and dry solid. Data were bandpass filtered, underwent functional alignment of signal, and then placed into binary classifier receiver operating characteristic (ROC) curves. Muscular activity was visualized by creating two-dimensional EMG heat maps. Results Signal analysis results demonstrated a positive correlation between signal amplitude and bolus texture. Greater differences of amplitude in the cranial most region of the array when compared to the caudal most region were noted in all subjects. Lateral comparison of the array revealed symmetric power levels across all subjects and textures. ROC curves demonstrated the ability to correctly classify textures within subjects in 6 of 10 texture comparisons. Conclusion This pilot study suggests that utilizing HDsEMG during deglutition can noninvasively differentiate swallows of varying texture noninvasively. This may prove useful in future diagnostic and behavioral swallow applications. Level of Evidence Level 4 Laryngoscope, 2023 View on Web

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Real‐world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high‐risk donor seropositive/recipient seronegative (D+R‐) liver transplant recipients (LTxR)

alexandrossfakianakis shared this article with you from Inoreader Real‐world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high‐risk donor seropositive/recipient seronegative (D+R‐) liver transplant recipients (LTxR) via Transplant Infectious Disease Abstract Background Despite superiority of preemptive therapy (PET) compared to universal prophylaxis for prevention of cytomegalovirus (CMV) disease in the CAPSIL randomized trial among CMV D+R- liver transplant recipients (LTxRs), real-world effectiveness may be lower because of logistical concerns about feasibility of PET. Methods We retrospectively assessed PET as standard clinical care at a single transplant center among 50 consecutive adult CMV D+R- LTxRs undergoing a first liver transplant between 4/4/2019 and 5/18/2021 and compared outcomes and adherence to those randomized to PET in the CAPSIL study (N = 100). The primary outcome was CMV disease and secondary outcomes were biopsy-confirmed acute allograft rejection, retransplant, invasive fungal infections, and death, all assessed by 1-year post-transplant. Exploratory outcomes included virologic parameters and measures of adherence to protocol-specified CMV qPCR monitoring. Results Baseline characteristics were similar between groups. The cumulative incidence of CMV disease at 1-year post-transplant was 4/50 (8%) versus 9/100 (9%) in the real-world and CAPSIL cohorts, respectively, p = 1.0. The rate of breakthrough CMV disease during the 100-day PET period was low (2/50 [4%]) and similar to the PET cohort from the CAPSIL study (3/100 [3%]).  All secondary and exploratory outcomes were not significantly different between the real-world and CAPSIL PET cohorts. Conclusions In this first reported study of real-world PET, the feasibility and effectiveness for CMV disease prevention and for other clinical outcomes in CMV D+R- LTxRs were similar to those reported with PET in a clinical trial. Additional studies to confirm feasibility and generalizability in other settings are warranted. View on Web

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