Τετάρτη 19 Οκτωβρίου 2022

Autoimmune seronegative limbic encephalitis following ChAdOx1‐S/nCoV‐19 vaccination in a patient with ankylosing spondylitis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Here we present a case in which a patient developed autoimmune seronegative limbic encephalitis following ChAdOx1-S/nCoV-19 (AZD1222; AstraZeneca) vaccination. Although it is known that vaccines containing SARS-CoV-2 antigens might enhance autoimmunity, such cases are rarely reported. We discuss this case with the present literature.

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Cochlear Implants for Single‐Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

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Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

The current study was undertaken to report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). We present the largest cohort of patients with SSD treated with CI to date. This group demonstrates significant benefit with regards to speech recognition scores, tinnitus measures, and quality of life metrics. We present novel insights regarding the CIQOL-10 measure, correlation of speech recognition and QoL scores with daily usage "datalogging" as well as the impact of duration of deafness on outcomes for patients with CI for SSD.


Objective

To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD).

Methods

This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized.

Results

Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0–74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1–14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores.

Conclusions

Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD.

Level of Evidence

IV Laryngoscope, 2022
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Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy

alexandrossfakianakis shared this article with you from Inoreader
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy

The MarketScan® Commercial Database was queried from 2010 to 2016 to identify patients aged 18–64 years discharged from an inpatient hospitalization on vancomycin OPAT. The primary endpoint was hospital readmission with AKI within 42 days of index hospital discharge. A total of 14,196 patients were included in the study. Readmission with AKI occurred in 385 (2.7%) and was independently associated with chronic kidney disease, congestive heart failure, chronic liver disease, hypertension, septicemia, and concomitant OPAT with IV penicillins.


Abstract

Introduction

Vancomycin is commonly used during outpatient parenteral antimicrobial therapy (OPAT). Therapeutic drug monitoring (TDM) of vancomycin is recommended to ensure effective and safe therapy, as use has been associated with acute kidney injury (AKI).

Methods

The MarketScan® Commercial Database was queried from 2010 to 2016 to identify patients aged 18–64 years discharged from an inpatient hospitalization on vancomycin OPAT. The primary endpoint was hospital readmission with AKI within 6 weeks of index hospital discharge. TDM was defined as at least one vancomycin level obtained during outpatient therapy. Bivariate analysis was used to examine associations with outcomes; significant factors were incorporated into a multivariable logistic regression model.

Results

A total of 14,196 patients were included in the study; median age was 54 years and 53.8% were male. Readmission with AKI occurred in 385 (2.7%) and was independently associated with chronic kidney disease (aOR 2.63 [95%CI 1.96–3.52]), congestive heart failure (1.81 [1.34–2.44]), chronic liver disease (1.74 [1.17–2.59]), hypertension (1.73 [1.39–2.17]), septicemia (1.61 [1.30–2.00]), and concomitant OPAT with IV penicillins (1.73 [1.21–2.49]) while skin and soft tissue infection (0.67 [0.54–0.83]) and surgical site infection (0.74 [0.59–0.93]) were associated with lower risk of readmission with AKI. TDM was not associated with lower risk of readmission with AKI.

Conclusion

Chronic kidney disease, congestive heart failure, hypertension, chronic liver disease, septicemia, and concomitant OPAT with IV penicillins were significantly associated with higher risk of readmission with AKI during vancomycin OPAT.
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Comparison of propeller flaps versus skin grafts for coverage of osteocutaneous fibula free flap donor site defects

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Authors compare use of propeller flaps versus skin grafts in defect coverage after fibula flap harvest.

Materials and Methods

Retrospective review of patients who received either PFPF or STSG. Primary predictor variable was technique, and secondary predictor variables were comorbidities. Primary outcome variable was flap/graft healing, and secondary outcome variables were cosmesis, adverse events, effect on activities of daily living (ADLs), pain, additional procedures, and cost. Statistical analysis performed via independent sample t tests, ANOVA, and χ 2 tests. Logistic regression analysis was performed.

Results

Study sample was 50 patients. PFPFs showed higher rates of success, while STSG showed increased complications and adverse events. Pain and ADLs significantly affected in STSG group. Cosmesis was better in the PFPF group, and overall cost was significantly higher in STSG group.

Conclusion

PFPFs show greater success rates, fewer complications, improved cosmesis, less pain, reduced cost compared to STSG for wound coverage after fibula flap harvest.
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A novel de novo KCNB1 variant altering channel characteristics in a patient with periventricular heterotopia, abnormal corpus callosum, and mild seizure outcome

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Disrupted tenogenesis in masseter as a potential cause of micrognathia

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International Journal of Oral Science, Published online: 18 October 2022; doi:10.1038/s41368-022-00196-y

Disrupted tenogenesis in masseter as a potential cause of micrognathia
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