Meningoencephalitis following Le Fort I osteotomy: a case report

alexandrossfakianakis shared this article with you from Inoreader Meningoencephalitis following Le Fort I osteotomy: a case report via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Le Fort I osteotomies, although they are common procedures, carry a degree of risk of injury to the surrounding structures. Skull base fractures and cerebrospinal fluid rhinorrhoea are amongst the most serious on the list of complications. This is the first reported case of meningoencephalitis post Le Fort I osteotomy, shedding some light on its identification, causes, and management. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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

VG161 activates systemic anti‐tumor immunity in pancreatic cancer models as a novel oncolytic herpesvirus expressing multiple immunomodulatory transgenes

alexandrossfakianakis shared this article with you from Inoreader VG161 activates systemic anti‐tumor immunity in pancreatic cancer models as a novel oncolytic herpesvirus expressing multiple immunomodulatory transgenes via Journal of Medical Virology Abstract The VG161 represents the first recombinant oncolytic herpes simplex virus type 1 carrying multiple synergistic anti-tumor immuno-modulating factors. Here, we report its anti-tumor mechanisms and thus provide firm theoretical foundation for the upcoming clinical application in pancreatic cancer. Generally, the VG161-mediated anti-tumor outcomes were analyzed by a collaboration of techniques, namely the single cell sequencing, airflow-assisted desorption electrospray ionization-mass spectrometry imaging (AFADSI-MSI) and Nanostring techniques. In vitro, the efficacy of VG161 together with immune checkpoint inhibitors (ICIs) has been successfully shown to grant a long-term anti-tumor effect by altering tumor immunity and remodeling tumor microenvironment (TME) metabolisms. Cellular functional pathways and cell subtypes detected from patient samples before and after the treatment had undergone distinctive changes including upregulated CD8+ T and NK cells. More importantly, significant antitumor signals have emerged since the administration of VG161 injection. In conclusion, VG161 can systematically activate acquired and innate immunity in pancreatic models, as well as improve the tumor immune microenvironment, indicative of strong anti-tumor potential. The more robusting anti-tumor outcome for VG161 monotherapy or in combination with other therapies on pancreatic cancer is worth of being explored in further clinical trials. 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.

Virome analysis provides new insights into the association between viruses and Parkinson's disease

alexandrossfakianakis shared this article with you from Inoreader Virome analysis provides new insights into the association between viruses and Parkinson's disease via Journal of Medical Virology Abstract Parkinson's disease (PD) is a kind of neurodegenerative disease that causes a huge burden to society. Previous studies have suggested the association between PD and multiple viruses. However, there is still a lack of a virome study about PD. This study systematically identified viruses from the public RNA-Seq data of more than 700 samples from both PD patients and the control group (most were healthy people). Only nine viruses such as Human betaherpesvirus 5 and Merkel cell polyomavirus have been detected in several human brain tissues of the central nervous system, the appendix, and blood of PD patients, and all of these viruses were also detected in the control group. Most viruses were observed to have low abundance in no more than three tissues. No statistically significant differences were observed between the virus abundance in the PD patients and the control group for all viruses. The positive rates of most viruses in PD patients were higher or similar to that in the control group, although those were less than 5% for most viruses. Overall, this is the first study to systematically investigate the virome in PD patients, and provides new insights into the association between viruses and PD. 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.

Long‐Term Binaural Hearing Improvements for Cochlear Implant Users with Asymmetric Hearing Loss

alexandrossfakianakis shared this article with you from Inoreader Long‐Term Binaural Hearing Improvements for Cochlear Implant Users with Asymmetric Hearing Loss via The Laryngoscope Cochlear implant (CI) recipients with unilateral hearing loss reached early asymptote for binaural hearing abilities, and CI recipients with asymmetric hearing loss continued to improve out to 5-years post-activation for spatial release from masking when the masker was presented toward the better hearing ear. There was a significant correlation with improvement and age at implantation and contralateral hearing thresholds which may influence these differences. Objective To assess long-term binaural hearing abilities for cochlear implant (CI) users with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). Methods A prospective, longitudinal, repeated measures study was completed at a tertiary referral center evaluating adults with UHL or AHL undergoing cochlear implantation. Binaural hearing abilities were assessed with masked speech recognition tasks using AzBio sentences in a 10-talker masker. Performance was evaluated as the ability to benefit from spatial release from masking (SRM). SRM was calculated as the difference in scores when the masker was presented toward the CI-ear (SRMci) or the contralateral ear (SRMcontra) relative to the co-located condition (0°). Assessments were completed pre-operatively and at annual intervals out to 5 years post-activation. Results Twenty UHL and 19 AHL participants were included in the study. Linear Mixed Models showed significant main effects of interval and group for SRMcontra. There was a significant interaction between interval and group, with UHL participants reaching asymptotic performance early and AHL participants demonstrating continued growth in binaural abilities to 5 years post-activation. The improvement in SRM showed a significant positive correlation with contralateral unaided hearing thresholds (p = 0.050) as well as age at implantation (p = 0.031). Conclusions CI recipients with UHL and AHL showed improved SRM with long-term device use. The time course of improvement varied by cohort, with the UHL cohort reaching asymptotic performance early and the AHL cohort continuing to improve beyond 1 year. Differences between cohorts could be driven by differences in age at implantation as well as contralateral unaided hearing thresholds. Level of Evidence Level III Laryngoscope, 2022 View on Web

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

Oral Premalignant and Malignant Lesions in Fanconi Anemia Patients

alexandrossfakianakis shared this article with you from Inoreader Oral Premalignant and Malignant Lesions in Fanconi Anemia Patients via The Laryngoscope Objective There is a lack of data supporting cancer surveillance in pediatric Fanconi Anemia patients. We sought to describe the rates of upper aerodigestive lesions and malignancy in this population to augment current management guidelines. Methods A retrospective cohort study of patients with Fanconi Anemia from a quaternary referral center between 2007–2021 was completed for head and neck cancer risk. Results One hundred and five FA patients were reviewed. Average age at presentation was 11.3 years old and 90.5% of patients underwent hematopoietic stem cell transplant (HSCT). A total of 8.6% of patients had leukoplakia or erythroplakia and 3.8% developed malignancy. The standardized incidence ratio of head and neck malignancy was 483.8. Patients presented with leukoplakia and malignancy at an average age of 14.6 and 25.1 years old, respectively. Malignancies were aggressive and marked by recurrence. There were no premalignant or malignant lesions found on flexible laryngoscopy. This series represents the largest longitudinal series of pediatric FA head and neck lesions. Conclusions Fanconi Anemia patients should begin screening for head and neck cancer at age 10 or after HSCT. Level of Evidence Level 4 Laryngoscope, 2022 View on Web

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

Endoscopic pituitary surgery: A national database review

alexandrossfakianakis shared this article with you from Inoreader Endoscopic pituitary surgery: A national database review via Head & Neck Abstract Background Pituitary tumors surgery is increasingly performed via endoscopic transsphenoidal approach (TSP). This study describes outcomes of TSP surgery in the United States. Methods A retrospective cross-sectional analysis of adult patients with pituitary adenoma was performed using the Nationwide Readmissions Database, 2010–2015. Results A total of 5891 patients were identified. The average age was 51.29 ± 0.29 years. The risk of postoperative epistaxis, diabetes insipidus, cerebrospinal fluid (CSF) leak, and other general postoperative complications was 0.71%, 10.20%, 8.35%, and 2.37%, respectively. Independent risk factors of CSF leak included: age <65-year, male, body mass index ≥25, and multiple comorbidities (p < 0.001 each). The prevalence of CSF leak was not associated with hospital TSP volume and teaching status. Conclusion This study provides a national epidemiological perspective on TSP in the United States. The risk of postoperative CSF leak appears to be associated with intrinsic patient factors rather than resource and expertise availability. View on Web

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

Mini‐hyper CVD + CRIB (condensed rituximab, inotuzumab ozogamicin, and blinatumomab) for refractory pediatric B‐acute lymphoblastic leukemia

alexandrossfakianakis shared this article with you from Inoreader Mini‐hyper CVD + CRIB (condensed rituximab, inotuzumab ozogamicin, and blinatumomab) for refractory pediatric B‐acute lymphoblastic leukemia via Pediatric Blood & Cancer Abstract Relapsed or refractory pediatric patients with B-acute lymphoblastic leukemia (B-ALL) have high rates of toxicities and relapse, and novel therapy is needed. We present a case of a 5-year-old male child with high-risk B-ALL that was refractory to several re-induction regimens. He was put into minimal residual disease-negative remission after re-induction with chemotherapy plus overlapping rituximab, inotuzumab ozogamicin, and blinatumomab, termed mini-hyper-CVD (cyclophosphamide, vincristine, and dexamethasone) plus CRIB (condensed rituximab, inotuzumab ozogamicin, and blinatumomab). This regimen was well tolerated, and he received his transplant and engrafted with no significant infections, toxicities, or sinusoidal obstruction syndrome. This is the first reported use of a condensed sequential immunotherapy/chemotherapy regimen in a pediatric leukemia patient. View on Web

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

Non‐neutropenic fever in children with cancer: Management, outcomes and clinical decision rule validation

alexandrossfakianakis shared this article with you from Inoreader Non‐neutropenic fever in children with cancer: Management, outcomes and clinical decision rule validation via Pediatric Blood & Cancer Abstract Introduction Fever and infection are an important complication of childhood cancer therapy. Most research and guideline development has focussed on febrile neutropenia, with a paucity directed at non-neutropenic fever (NNF). We describe the clinical presentation, management and outcomes of NNF in children with cancer, and externally validate the Esbenshade Vanderbilt (EsVan) clinical decision rules (CDR) to predict bacteraemia. Method Using a prospective database, retrospective data were collected on consecutive NNF episodes (fever ≥38.0°C and absolute neutrophil count >1.0 cells/mm3). Sensitivity, specificity and area under the receiver operator characteristic curve (AUC-ROC) of the CDR were compared to derivation study. Results There were 203 NNF episodes occurring in 125 patients. Severe sepsis was uncommon (n = 2, 1%) and bacteraemia occurred in 10 (4.9%, 95% confidence interval [CI]: 2.7%–8.8%) episodes. A confirmed or presumed bacterial infection requiring antibiotics occurred in 31 (15%) patients. Total 202 (99%) episodes received at least one dose of intravenous broad-spectrum antibiotic and 141 (70%) episodes were admitted to hospital. Six (3%) episodes required intensive care unit (ICU)-level care and there were no infection-related deaths. The EsVan 1 rule had an AUC-ROC of 0.67, 80% were identified as low risk, and sensitivity and specificity were 50% and 81.5%, respectively, for a risk threshold of 10%. Conclusions Serious infection and adverse outcome are uncommon in children with NNF. Many children did not have a bacterial cause of infection identified, but were still treated with broad-spectrum antibiotics and admitted to hospital. National clinical practice guidelines should be developed for this important cohort to enable risk stratification and optimise antibiotic management. Further research is required to determine appropriateness of EsVan CDR in our cohort. View on Web

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

Association of viral load with TRAIL, IP‐10, CRP biomarker signature and disease severity in children with respiratory tract infection or fever without source: a prospective, multicentre cohort study

alexandrossfakianakis shared this article with you from Inoreader Association of viral load with TRAIL, IP‐10, CRP biomarker signature and disease severity in children with respiratory tract infection or fever without source: a prospective, multicentre cohort study via Journal of Medical Virology Abstract Background To investigate the association of viral load (VL) with (i) tumor necrosis factor-related apoptosis inducing ligand (TRAIL), interferon-gamma induced protein-10, C-reactive protein and a combinatorial score (BV score); and (ii) clinical severity. Study Design In this prospective, multicentre cohort sub-study, children with respiratory tract infection or fever without source were enrolled. VL for influenza virus, rhinovirus, respiratory syncytial virus, and adenovirus were measured from nasopharyngeal swabs. The reference standard diagnosis was established based on expert panel adjudication. Results Of 1140 recruited patients, 333 had a virus mono-detection. VL for the aggregated dataset correlated with TRAIL and IP-10 levels, with length of oxygen therapy, and inversely with the BV score. On single viral level, only influenza virus yielded a correlation with TRAIL, IP-10 levels, and the BV score. Children with a viral reference standar d diagnosis had significantly higher VL than those with bacterial infection (p = 0.0005). Low TRAIL (incidence rate ratio, IRR 0.6, 95% confidence interval, CI 0.39-0.91) and young age (IRR 0.62, 95%CI 0.49-0.79) were associated with longer hospital stay, while young age (IRR 0.33, 95%CI 0.18-0.61), low TRAIL (IRR 0.25, 95%CI 0.08-0.76), and high VL (IRR 1.16, 95%CI 1.00-1.33) were predictive of longer oxygen therapy. Conclusion These findings indicate that VL correlates with biomarkers and may serve as a complementary tool pertaining to disease severity. 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.

Asystole Induced by Trigeminocardiac Reflex during Zygomatic Fracture Repositioning: A Rare Case Report

alexandrossfakianakis shared this article with you from Inoreader Asystole Induced by Trigeminocardiac Reflex during Zygomatic Fracture Repositioning: A Rare Case Report via ScienceDirect Publication: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Publication date: Available online 31 August 2022 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Reon Morioka, Tatsuo Okui, Junichi Kanayama, Hiroto Tatsumi, Satoe Okuma, Akira Kato, Tomoko Ichiyama, Takahiro Kanno View on Web

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

Survival Outcomes of Patients with Mycosis Fungoides Involving the External Ear and Ear Canal

alexandrossfakianakis shared this article with you from Inoreader Survival Outcomes of Patients with Mycosis Fungoides Involving the External Ear and Ear Canal via The Laryngoscope This manuscript reports our retrospective review of 40 patients with mycosis fungoides, and it demonstrates a comparison in outcomes of patients with ear involvement with those without ear involvement. Overall survival was shorter when the ear canals were involved. Objectives/Hypothesis Mycosis Fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. Disease involvement of specific locations may be more significant than simply the symptoms associated with that site; it is possible that involvement of certain sites could be associated with poor prognosis. We aimed to evaluate the outcomes of patients with MF with documented involvement of the EAC and external ear. Study Design Retrospective analysis. Methods We retrospectively reviewed 40 patients with MF that were treated by otologists between 2012 and 2021. Results We report the largest series of patients with MF involving the external ear and EAC. Of the 40 patients included in this study, 17 presented with Mycosis Fungoides in the otologic region (MFO). Of these 17 MFO patients, 2/17 had involvement of the external ear only, 3/17 of the EAC only, 11/17 of both the external ear and EAC, and 1/17 of the periauricular skin. Of note, 11/14 (79%) patients presenting with EAC disease died compared to11/26 (42%) of patients without involvement. In addition, eight of the 13 (62%) patients with external ear involvement died compared to 14/27 (52%) of patients without involvement. Ear canal involvement was associated with a statistically significant shorter overall survival duration in patients with MF (p = 0.03). Furthermore, disease in the EAC was found to have a hazard ratio value of 2.565 (CI 1.102–5.970). Conclusions Involvement of the EAC by MF portends a poor prognosis. This finding highlights the need for a more in-depth otologic evaluation of patients with MF. Level of Evidence Level 4 Laryngoscope, 2022 View on Web

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