Πέμπτη 13 Οκτωβρίου 2022

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

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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.

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

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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.

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Wastewater Surveillance for Infectious Disease: A Systematic Review

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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.
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Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules

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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.
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Association of Neoadjuvant Pembrolizumab for OCSCC With Adverse Events After Surgery

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This cohort study evaluates the incidence of postoperativ e adverse events in treatment-naive patients receiving neoadjuvant pembrolizumab for advanced oral cavity cancer when compared with matched controls.
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Plasma Circulating Tumor HPV DNA and HPV-Related Oropharynx Cancer—A Caution—Reply

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In Reply Dr Johnson and colleagues raise a good point, as expressed in our article, that our findings should not be inferred to suggest that circulating tumor human papillomavirus (HPV) DNA (ctHPVDNA) is ready to be used for screening. Our observation that no ctHPVDNA was detected in healthy participants with detectable salivary HPV DNA or E6 serum antibody suggests a low false-positive rate (ie, suggests good specificity). However, as pointed out in the discussion of our research letter, and by Johnson et al, it is possible that the detecti on methods used in our study could be insensitive, and additional research is needed to verify the finding of high specificity in our study.
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A Novel Molecular Test for Determining HPV Integration Status in HPV-Positive Oropharynx Cancers

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This diagnostic study describes the development of an ass ay for human papillomavirus–driven cancers of the oropharynx and the role viral integration could play in the process.
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