Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

alexandrossfakianakis shared this article with you from Inoreader Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B via Journal of Medical Virology Abstract Background/Aims Nucleos(t)ide analogs (NA) cannot completely suppress the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This study aimed to identify the risk factors for HCC development in naïve CHB patients treated with current NA. Methods Patients receiving NA (n = 905) were recruited retrospectively from the 17 hospitals of the Japanese Red Cross Liver Study Group. All treatment-naïve patients had been receiving current NA continuously for more than one year until the end of the follow-up. We analyzed the accuracy of predictive risk score using area under receiver operating characteristic curve. Results The albumin–bilirubin (ALBI) score was significantly improved by NA therapy (−0.171 ± 0.396; p < 0.001 at week 48). A total of 72 (8.0%) patients developed HCC over a median follow-up of 6.2 (1.03–15.7) years. An independent predictive factor of HCC development was older age, cirrhosis, lower pl atelet counts at baseline and ALBI score, and alpha-fetoprotein (AFP) at 1 year after NA therapy according to multivariate analysis. The accuracy was assessed using the PAGE-B, mPAGE-B, aMAP, APA-B, and REAL-B scores that included these factors. Discrimination was generally acceptable for these models. aMAP and REAL-B demonstrated high discrimination with 0.866/0.862 and 0.833/0.859 for 3- and 5- years prediction from the status of one year after NA therapy, respectively. Conclusion Baseline age and platelet count, as well as ALBI and AFP one year after NA, were useful for stratifying carcinogenesis risk. The aMAP and REAL-B scores were validated with high accuracy in Japanese CHB patients. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The association between human papillomavirus and bladder cancer: evidence from meta‐analysis and two‐sample mendelian randomization

alexandrossfakianakis shared this article with you from Inoreader The association between human papillomavirus and bladder cancer: evidence from meta‐analysis and two‐sample mendelian randomization via Journal of Medical Virology Abstract Introduction Bladder cancer (BCa) is the tenth most common type of cancer worldwide, and human papillomavirus (HPV) is the most common sexually transmitted infection. However, the relationship between HPV infection and the risk of BCa is still controversial and inconclusive. Methods This systematic review and meta-analysis were conducted following the PRISMA 2020 reporting guideline. This study searched four bibliographic databases with no language limitation. The databases included PubMed (Medline), EMBASE, Cochrane Library and Web of Science. Studies evaluating the interaction between HPV infection and the risk of BCa from inception through May 21, 2022 were identified and used in this study. This study estimated the overall and type-specific HPV prevalence and 95% confidence intervals (95% CI) using Random Effects (RE) models and Fixed Effects (FE) models. In addition, this study also calculated the pooled odds ratio (pOR) and pooled risk ratio (pRR) with 95% CI to assess the effect of HPV infection on the risk and prognosis of bladder cancer. Two-sample mendelian randomization (MR) study using genetic variants associated with HPV E7 protein as instrumental variables was also conducted. Results This study retrieved 80 articles from the four bibliographic databases. Of the total, 27 were case-control studies, and 53 were cross-sectional studies. The results showed that the prevalence of HPV was 16% (95% CI, 11%–21%) among the BCa patients, most of which were HPV-16 (5.99% [95% CI, 3.03%–9.69%]) and HPV-18 (3.68% [95% CI, 1.72%–6.16%]) subtypes. However, the study found that the prevalence varied by region, detection method, BCa histological type, and sample source. A significantly increased risk of BCa was shown for the positivity of overall HPV (OR, 3.35 [95%CI, 1.75–6.43]), which was also influenced by study region, detection method, histological type and sample source. In addition, the study found that HPV inf ection was significantly associated with the progression of BCa (RR, 1.73 [95%CI, 1.39–2.15]). The two-sample MR analysis found that both HPV 16 and 18 E7 protein exposure increased the risk of BCa (HPV 16 E7 protein: IVW odds ratio [OR] per unit increase in protein level = 1.0004 [95% CI, 1.0002–1.0006]; P=0.0011; HPV 18 E7 protein: IVW odds ratio [OR] per unit increase in protein level = 1.0003 [95% CI, 1.0001–1.0005]; P=0.0089). Conclusion In conclusion, HPV may play a role in bladder carcinogenesis and contribute to a worse prognosis for patients with BCa. Therefore, it is necessary for people, especially men, to get vaccinated for HPV vaccination to prevent bladder cancer. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity‐modulated radiotherapy

alexandrossfakianakis shared this article with you from Inoreader Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity‐modulated radiotherapy via Head & Neck Abstract Background We seek to inform radiotherapy (RT) delivery for adenoid cystic carcinoma of the head and neck (ACC) by evaluating RT techniques and recurrence patterns. Methods We identified patients with ACC treated with curative-intent RT from 2005 to 2021. Imaging was reviewed to determine local recurrence (LR). Results Ninety-one patients were included. The 5-year LR risk was 12.2% (6.6–22.7). One patient each experienced a marginal and out-of-field recurrence. Patients receiving >60 Gy postoperatively had a 5-year LR risk of 0% compared to 10.7% (4.2–27.2) with ≤60 Gy. Those receiving 70 and <70 Gy definitively had a 5-year LR risk of 15.2% (2.5–91.6) and 33.3% (6.7–100.0), respectively. No patients had regional nodal failure. Conclusions Modern, conformal RT for ACC results in low rates of LR. Doses >60 and 70 Gy may improve control in the postoperative and definitive settings, respectively. Elective nodal treatment can be omitted in well-selected patients. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

External validation of the H‐index (host index) in patients with head and neck squamous cell carcinomas

alexandrossfakianakis shared this article with you from Inoreader External validation of the H‐index (host index) in patients with head and neck squamous cell carcinomas via Head & Neck Abstract Background The aim of the current study is to perform an external validation of the prognostic capacity of the H-index in patients with head and neck squamous cell carcinoma (HNSCC). Methods Retrospective study of 835 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx, or larynx. Results When applying the cutoffs proposed in the original description of the H-index (1.5 and 3.5), we observed an orderly and significant decrease in the disease-specific survival and overall survival as H-index increased. Additionally, we were able to observe a decrease in survival as the H-index increased regardless of the location, the extension of the tumor or the type of treatment performed. Conclusion We have validated the prognostic capacity of the H-index in patients with HNSCC regardless of the location of the primary tumor, the extent of the disease, or the type of treatment performed. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Heparin‐induced persistent hyperthermia with recurrent hyponatremia in hip fracture: Case report and review of literature

alexandrossfakianakis shared this article with you from Inoreader Heparin‐induced persistent hyperthermia with recurrent hyponatremia in hip fracture: Case report and review of literature via Journal of Clinical Pharmacy and Therapeutics Heparin is a commonly used anticoagulant in clinical practice. Few reports have been published of drug fever or hyponatremia caused by heparin, whose mechanism is still unclear. Here, we report a case of femoral neck fracture with persistent hyperthermia and recurrent hyponatremia caused by heparin, which was analyzed to provide novel insights and further reference for the clinical diagnosis of drug fever. Abstract What is Known and Objective Heparin is a commonly used anticoagulant in clinic. Persistent hyperthermia with recurrent hyponatremia caused by heparin is an extremely rare drug fever, which is difficult to judge in the early stage and is often misdiagnosed. Case Summary A 74-year-old elderly woman was admitted to our hospital due to left hip pain with limited mobility for 9 h. She was diagnosed with a femoral neck fracture, and continuous heparin anticoagulation was initiated. On the night of surgery, the patient developed high fever with a drop in the serum sodium concentration. Based on the patient's symptoms, signs, and results of the laboratory tests, postoperative absorptive heat and infectious fever were ruled out. After heparin discontinuation, her temperature and serum sodium concentration returned to the baseline levels. What is New and Conclusion Heparin can cause persistent or recurrent hyponatremia and should be considered in the identification of the aetiology this condition. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantifying Mycobacterium tuberculosis transmission dynamics across global settings: a systematic analysis

alexandrossfakianakis shared this article with you from Inoreader Quantifying Mycobacterium tuberculosis transmission dynamics across global settings: a systematic analysis via American Journal of Epidemiology - Advance Access Abstract The degree to which individual heterogeneity in the production of secondary cases ("superspreading") affects tuberculosis (TB) transmission has not been systematically studied. We searched for population-based or surveillance studies in which whole genome sequencing was used to estimate TB transmission and the size distributions of putative TB transmission clusters were enumerated. We fit cluster size distribution data to a negative binomial branching process model to jointly infer the transmission parameters $R$ (the reproductive number) and dispersion parameter, $k$, which quantifies the propensity of superspreading in a population (generally, lower values of $k$ ($<1.0$) suggest increased heterogeneity). Of 4,796 citations identified in our initial search, nine studies met inclusion criteria ($n=5$ all TB; $n=4$ drug resistant TB) from eight global settings. Estimated $R$ values (range: 0.10, 0.73) were below 1.0, consistent with declin ing epidemics in the included settings; estimated $k$ values were well below 1.0 (range: 0.02, 0.48), indicating the presence of substantial individual-level heterogeneity in transmission across all settings. We estimated that a minority of cases (range 2-31%) drive the majority (80%) of ongoing transmission at the population level. Identifying sources of heterogeneity and accounting for them in TB control may have a considerable impact on mitigating TB transmission. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Wastewater Surveillance for Infectious Disease: A Systematic Review

alexandrossfakianakis shared this article with you from Inoreader Wastewater Surveillance for Infectious Disease: A Systematic Review via American Journal of Epidemiology - Advance Access Abstract Wastewater surveillance of SARS-CoV-2 has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and COVID-19 cases. Though the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify what infectious diseases have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as well as themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and non-polio enteroviruses. Most studies of wastewater surveillance did not li nk what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules

alexandrossfakianakis shared this article with you from Inoreader Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study assesses the association of sociode mographic factors with the odds of receiving a biopsy, timeliness of the procedure, and risk of nodule malignancy. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of Tumor Bed Frozen Section to Assess Final Tumor Margin in Oral Cavity Carcinoma

alexandrossfakianakis shared this article with you from Inoreader Use of Tumor Bed Frozen Section to Assess Final Tumor Margin in Oral Cavity Carcinoma via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study evaluates the accuracy and imp lications of using intraoperative frozen section histopathology samples to assess tumor bed margins in patients undergoing surgery for oral cavity squamous cell carcinoma. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Stapedotomy Volume and Patient Sex With Better Outcome

alexandrossfakianakis shared this article with you from Inoreader Association of Stapedotomy Volume and Patient Sex With Better Outcome via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study evaluates demographic characte ristics, surgical characteristics, and audiometric data associated with closure of the air-bone gap to less than 10 dB or 15 dB. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.