Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Κυριακή 10 Απριλίου 2022

Evaluation of interleukin‐38 levels in serum of patients with coronavirus disease 2019.

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Abstract

Interleukin-38 (IL-38) has recently been considered as a cytokine with anti-inflammatory properties in viral respiratory infections, particularly coronavirus disease 19 (COVID-19), but the evidence has not been well elucidated. Therefore, a case-control study was conducted to determine IL-38 serum levels in 148 patients with COVID-19 (45 moderate, 55 severe and 48 critical) and 113 controls. Results demonstrated that IL-38 levels did not show significant differences between patients and controls (68.7 [interquartile range: 62.7-75.6] vs. 67.7 [58.0-82.6] pg/mL; probability = 0.457). Similarly, patients stratified by disease severity, age group, gender or chronic disease showed no significant differences between IL-38 levels in each stratum. Whereas, overweight/obese patients had a significantly lower median of IL-38 compared to normal-weight patients. Further, IL-38 showed significantly higher levels in the age group ≥ 50 years of patients with crit ical illness than in the age group < 50 years. Female patients with severe disease also showed significantly elevated levels of IL-38 compared to male patients. In conclusion, the study indicated that serum IL-38 levels were not affected by COVID-19 infection, but the distribution of patients according to disease severity, age, gender and BMI may better reveal the role of IL-38 in disease pathogenesis.

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Neuroimaging for Patients With Dizziness

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This cross-sectional study uses commercial and Medicare Advant age claims to characterize neuroimaging use, timing, and spending as well as the factors associated with imaging acquisition within 6 months of presentation for dizziness in outpatient clinics vs emergency departments in the US.
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Video-Oculography to Guide Neuroimaging for Dizziness and Vertigo

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Dizziness and vertigo are among the most common presenting symptoms in both the emergency department (ED) and ambulatory outpatient clinics, with recent estimates suggesting roughly 18 million visits per year in the US (nearly 5 million to EDs and >13 million to outpatient clinics). These symptoms are caused by a wide array of conditions, but the most common benign causes are otologic, and the most common dangerous cause is stroke. Stroke accounts for 3% to 5% of dizziness presentations in the ED, and some evidence suggests that it may ac count for a similar percentage of dizziness presentations in ambulatory care clinics. Frontline clinicians are often poorly equipped to differentiate peripheral from central vestibular causes and are justifiably worried about missing strokes, so they often resort to neuroimaging as a knee-jerk diagnostic test response. Unfortunately, this choice leads to substantial ill effects, including frequent misdiagnoses and unnecessary imaging for millions of patients with inner ear causes of dizziness who should receive a diagnosis at the bedside, thus exposing patients to unnecessary irradiation (in the case of computed tomography [CT] scans) and incurring significant health care costs. Some estimates suggest that more than $1 billion is wasted each year on inappropriate CT scans alone.
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Bacterial Vaginosis and Prospective Ultrasound Measures of Uterine Fibroid Incidence and Growth

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imageBackground: Uterine fibroids often cause intolerable symptoms leading to invasive treatments, most commonly hysterectomy. Reproductive tract infections are hypothesized to influence uterine fibroid development, but few studies exist, especially for the highly prevalent condition bacterial vaginosis (BV). Both fibroids and BV have documented racial–ethnic disparities, with higher burden in Blacks. Methods: With prospective data from a community-based study (four standardized ultrasound examinations over 5 years) in young Black women, we examined baseline BV associations with fibroid incidence and growth. We computed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incidence comparing BV and no BV (Nugent score ≥7 vs.
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Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults

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imageBackground: Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5. Methods: We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes. Results: This study identified 14,627 deaths and had a total of 5 million person–years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%–35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results. Conclusion: Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation.
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Detection of human herpes virus 6 DNA and chromosomal integration after allogeneic hematopoietic stem cell transplantation: a retrospective single center analysis

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Abstract

Introduction

Human herpes virus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with significant morbidity and mortality.

Methods

The epidemiology of HHV-6 infections and their impact on outcome after allo-HSCT were retrospectively analyzed in 689 adult allo-HSCT recipients (January 2015-December 2018). Chromosomal integration of HHV-6 (ciHHV-6) in the donor was retrospectively investigated to critically evaluate antiviral treatment strategies.

Results

HHV-6 DNA in any specimen was found in 89 patients. HHV-6 infections (encephalitis (1), gastroenteritis (44), dermatitis (2), hepatitis (1) or pneumonitis (5)) were diagnosed in 53/689 patients (7.7%). Elevated levels of HHV-6 DNA were found in 38 patients (5.5%). CiHHV-6, analyzed in patients with HHV-6 viral loads ≥104 copies/mL, was identified in 4 patients (10/38 patients; 10.5%). Two of those displayed copy numbers of HHV-6 ranging from ≥ 2 × 105 to 2.5 × 106 copies/mL (HHV-6A). Here, ciHHV-6 was integrated into donor and not into the patients' cells. In this series of allo-HSCT recipients, 10.5% of patients with blood viral loads of HHV-6 showed ciHHV-6.

Conclusion

Screening of the donor for chromosomal integration of HHV-6 (ciHHV-6) before initiation of antiviral therapy is recommended.

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Decreased overall survival in patients with locally advanced head and neck cancer receiving definitive radiotherapy and concurrent cetuximab: National Cancer Database analysis

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Abstract

Background

Recently, randomized trials have questioned the efficacy of cetuximab-based bioradiotherapy compared to chemoradiation for patients with squamous cell carcinoma of the oropharynx, larynx, and hypopharynx (HNSCC). We compared the OS of patients treated with radiotherapy alone (RTonly), chemoradiotherapy (chemoRT), and bioradiotherapy (cetuxRT).

Methods

Patients with stage III–IVB HNSCC treated with RTonly, chemoRT, or cetuxRT were identified in the National Cancer Database. OS was estimated using Cox proportional hazards. Analyses were conducted on the overall cohort and propensity matched cohorts.

Results

31 014 patients were treated with RTonly (22%), chemoRT (72%), or cetuxRT (6%) from 2013 to 2016. The 2-year OS was 69% for RTonly, 79% for chemoRT, and 66% for cetuxRT (p < 0.001). In the overall and propensity-matched cohorts, chemoRT and RTonly were associated with improved OS as compared to cetuxRT (p ≤ 0.001).

Conclusion

Compared to chemoRT or RTonly, cetuxRT is associated with decreased OS for patients with HNSCC, suggesting minimal benefit of bioradiotherapy in this population.

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The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome

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Summary

Aim

This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs.

Methods

This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase.

Results

Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs.

Conclusion

The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs.

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Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial

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Abstract

Background

The prosthetic emergence profile design might be an important factor in postsurgical mucosal recession etiology. Therefore, a restorative buccal emergence profile designed correctly might reduce gingival margin recession.

Purpose

To compare the marginal gingival level and the width/height (W/H) ratio between two profile configurations of single implant-supported restorations at molar sites.

Materials and Methods

Twenty-one patients requiring a single mandibular molar tooth replacement with supracrestal mucosal thickness ≥2 mm were recruited and randomly assigned to a prosthesis buccal emergence profile design based on the buccal mucosal W/H ratio (Test Group) or maintained the original emergence profile of the healing abutment (Control Group). Assessments were made before delivery of the definitive restoration (T0), at prosthesis placement (T1), one (T2), and 12 (T3) months after loading. The gingival margin level change (△GM), initial emergence angle, buccal mucosal W/H ratio, marginal bone loss (MBL), implant failure, and complications were assessed.

Results

The gingival recession in the test group (0.13 ± 0.32 mm) was significantly lower than in the control group (0.63 ± 0.38 mm) at T3 (p = 0.006). The initial emergence angle in the test group (31.4 ± 7.22 degrees) was significantly lower than the control group (40.0 ± 7.60 degrees) (p = 0.025). The W/H ratio in the test group at T2 was significantly higher than at T0 but remained stable thereafter. The W/H ratio presented a continued rising trend in the control group.

Conclusions

When the initial supracrestal soft tissue thickness was ≥2 mm, a restorative emergence profile based on the W/H ratio significantly reduced gingival margin recession. An emergence angle of 32.4 degrees showed better behavior in maintaining the gingival margin than 40 degrees.

Clinical Trial Registration Number

ChiCTR190002210.

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JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes

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Blood Cancer Journal, Published online: 08 April 2022; doi:10.1038/s41408-022-00646-0

JAK2 V617F polycythemia vera and essential thrombocythemia: dynamic clinical features associated with long-term outcomes
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Spirulina supplementation prevents exercise‐induced lipid peroxidation, inflammation and skeletal muscle damage in elite rugby players

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Abstract

Objective

This study aimed to examine the effects of spirulina supplementation on pro/antioxidant status, inflammation, and skeletal muscle damage markers immediately and 24h after exhaustive exercise in elite rugby players.

Methods

Seventeen elite male Rugby Union players were randomly assigned to a Spirulina (SPI: n=9), or a placebo group (PLA: n=8) in a double-blind design. Subjects were supplemented with Spirulina platensis (5.7 g/d) or placebo (isoproteic and caloric) for 7 weeks. At baseline (W0) and after seven weeks of supplementation (W7), blood samples were obtained before (T0), immediately after (T1), and 24h after (T2) exhaustive exercise. The Yoyo Intermittent Recovery Test Level 2 was used as an exhaustive exercise to induce oxidative stress (OS), inflammation, and skeletal muscle damage. The studied parameters included Pro/antioxidant status markers (SOD, GPX, GSH/GSSG ratio, ox-LDL, and F2-Isop), inflammation markers (MPO and CRP), and skeletal muscle damage markers (LDH and CK).

Results

Our results showed that F2-Isop, CRP, and CK levels significantly increased at T1 only in PLA group (p<0.05, p<0.05, and p<0.001 respectively) with no change in SPI group which reflects the effect of spirulina to prevent lipid peroxidation, inflammation, and skeletal muscle damage induced by exhaustive exercise. Moreover, spirulina supplementation accelerated the return to baseline values given that F2-Isop, CRP, and CK levels at T2 were significantly lower than at T0 in SPI group (p<0.05, p<0.01, and p<0.001 respectively).

Conclusion

Based on the markers used in this study, our results report that spirulina supplementation potentially prevents exercise-induced lipid peroxidation, inflammation, skeletal muscle damage and may accelerate the recovery of some of these markers. Based on our findings, we recommend spirulina supplementation especially for athletes who do not achieve the recommended antioxidant dietary intake and who perform a high training load in order to reduce the magnitude of OS, inflammation, and skeletal muscle damage which could help to reduce performance losses and accelerate recovery after training/competitions throughout the season.

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The effect of intranasal insulin on appetite and mood in women with and without obesity: an experimental medicine study

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International Journal of Obesity, Published online: 09 April 2022; doi:10.1038/s41366-022-01115-1

The effect of intranasal insulin on appetite and mood in women with and without obesity: an experimental medicine study
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