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

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Πέμπτη 26 Μαΐου 2022

COVID Salivary diagnostics: a comparative technical study

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ABSTRACT

Since the beginning of the COVID-19 pandemic, molecular diagnostics of SARS-CoV-2 have taken center stage in the detection of infected individuals for isolation purposes but also in the mass surveillance as a preventive strategy to contain the virus spread. While nasopharyngeal swabs (NPS) have remained the golden standard substrate, salivary diagnostic for SARS-CoV-2 has been proposed as an alternative and non-invasive measure in vulnerable individuals. Nevertheless, there is a widespread assumption that salivary RT-PCR does not match the quality of testing using NPS and particular care should be taken in respect to food or beverage intake, when sampling saliva. Our study indicates that without any precaution in the selection of 190 patients, nor restriction over the time-window of sampling, there is 99% match in the COVID-19 positivity between NPS and saliva when using RT-PCR, with a reported Delta in thermal cycles (Cts) values for the viral genes Envelop e (E) and Open reading frame 1ab (Orf1ab) between 0 and 2, a 98.7% Sensitivity and 100% Specificity. This high accuracy is maintained in pooling configurations that can be used for mass-testing purposes in professional and educational settings. The further advantage to using crude saliva as compared to NPS or mouthwash is that direct methods yield robust results. Overall, our study validates and promotes the use of salivary diagnostic for COVID-19 eliminating the need of a medical practitioner for the sampling, resolving the unpleasantness of the NPS intervention and empowering the patient to do self-testing in times of need.

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Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant women with type 1 diabetes; insights from the Diabetes and Pre‐eclampsia Intervention Trial (DAPIT)

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Abstract

Aim

To explore the relationships between carbohydrate intake, body mass index and glycaemic control (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM)

Methods

Secondary analysis of data was undertaken to assess dietary intake in a cohort of women who participated in a randomized controlled trial (RCT) of antioxidant supplementation to prevent pre-eclampsia (DAPIT10). Study specific peripheral venous blood samples were obtained for HbA1c at 26 weeks and 34 weeks. Diet was collected using a validated semi-quantitative food frequency questionnaire at 26-28 weeks gestation which assessed dietary intake over 2 weeks. Mean daily average nutrient intakes were analysed using Q Builder nutritional software (Tinuviel Software, UK) and SPSS Version 25).

Results

Dietary data were available for 547 pregnant women (72% of cohort) aged 29 years (95% CI 28.9-29.9) with average diabetes duration 11.8 years (95% CI 11.1-12.6). Averag e BMI (<16 weeks gestation) was 26.7 kg/m2 (95% CI 26.3 -27 range 18.8-45.6 kg/m2); 43% (n=234) were overweight (BMI 25.0 - 29.9kg/m2) and 20% (n= 112) were obese (BMI>30kg/m2). Differences in HbA1c and carbohydrate quantity and quality were found when adjusted for age and insulin dose. No differences between BMI group were observed in total carbohydrate and glycaemic control, however, differences were noted in fibre and glycaemic index.

Conclusion

Average quantity of dietary carbohydrate influenced HbA1c when adjusted for insulin dose however, BMI had less impact. More research is required on the relationship between carbohydrate consumption and glycaemic control in pregnancy.

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Septic shock with Chlamydia abortus infection

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Publication date: June 2022

Source: The Lancet Infectious Diseases, Volume 22, Issue 6

Author(s): Mengting Liu, Yin Wen, Hongguang Ding, Hongke Zeng

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12 T high static magnetic field suppresses osteosarcoma cells proliferation by regulating intracellular ROS and iron status

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Publication date: Available online 25 May 2022

Source: Experimental Cell Research

Author(s): Shenghang Wang, Ting Huyan, Chenge Lou, Peng Shang, Hao Zhang

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Activin A downregulates the CD69-MT2A axis via p38MAPK to induce erythroid differentiation that sensitizes BCR-ABL-positive cells to imatinib

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Publication date: Available online 26 May 2022

Source: Experimental Cell Research

Author(s): Chih-Wei Chen, Nai-Kuei Huang, Yueh-Lun Lee, Chia-Kwung Fan, Yen-Chou Chen, Chin-Wei Liu, Huei-Mei Huang

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Sleep Disordered Breathing in Children

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This Patient Page describes the symptoms and treatments for sl eep disordered breathing and sleep apnea in children.
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Pediatric Button Battery Injuries—Current State and What’s Next?

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The study by Philteos et al in this issue of JAMA Otolaryngology–Head & Neck Surgery is a systematic review of published cases of airway injury among pediatric patients who ingested button batteries (BBs). Although these types of severe complications associated with BB ingestion have been previously reported, to date this is the largest review focused on airway injuries. Given the direct proximity of the esophagus and the trachea, airway injury is a possible risk in cases of BB ingestion. The authors' review of the literature and dat a from the National Capital Poison Center (NCPC) database yielded 195 cases total. The mean age at BB ingestion was 17.8 months, and the mean time between ingestion and removal was 5.8 days. The duration of impaction is difficult to precisely determine because many ingestions are unwitnessed and have a delayed diagnosis. Button batteries at least 20 mm in diameter (with lithium chemistry) are more likely to become impacted in the pediatric esophagus, but smaller BBs (including those with nonlithium chemistry) also pose a substantial risk; 11% of the injury cases with known BB diameters in this report involved BBs smaller than 20 mm, with the smallest diameter being 10 mm. Tracheoesophageal fistula (TEF), a life-threatening complication of BB ingestion, was found to be the most common airway injury (79%). Most TEFs required surgical management, and all 14 deaths reported TEF involvement. Other airway complications found included unilateral and bilateral vocal cord paralysis, subglott ic stenosis, tracheal stenosis, and tracheomalacia. The use of injury mitigation strategies before or after BB removal was not assessed in this study, which is limited by the known underreporting of these cases to any data source. This review by Philteos et al describes complications from BB ingestions associated with airway injury, invaluably highlighting a significant source of pediatric morbidity and mortality.
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Taste Function in Patients With Head and Neck Cancer Receiving Intensity-Modulated Radiotherapy

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This cohort study evaluates the association between time cours e and recovery of taste dysfunction in patients with head and neck cancer receiving intensity-modulated radiotherapy.
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Changes in Cone-Beam CT Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

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This cohort study assesses changes in cone-beam computed tomog raphy airway measurements that occur after adenotonsillectomy in children with obstructive sleep apnea and examines whether these changes are correlated with apnea-hypopnea index reduction.
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Airway Complications Resulting From Pediatric Esophageal Button Battery Impaction

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This systematic review investigates pediatric airway injuries and their long-term sequalae after button battery ingestion.
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