Equivocal end‐of‐therapy imaging findings do not predict a higher risk of local relapse after definitive radiotherapy in pediatric Ewing sarcoma and rhabdomyosarcoma

alexandrossfakianakis shared this article with you from Inoreader Equivocal end‐of‐therapy imaging findings do not predict a higher risk of local relapse after definitive radiotherapy in pediatric Ewing sarcoma and rhabdomyosarcoma via Pediatric Blood & Cancer Abstract Background Posttherapy imaging studies can provide reassurance or induce anxiety regarding risk of recurrence for patients and their families. In some cases, it is difficult to determine if imaging findings represent posttreatment changes or residual disease. Equivocal radiographic findings can occur due to therapy-related inflammation or residual, inactive soft tissue masses, but it is unknown if such findings indicate an increased likelihood of local recurrence. The aim of this study was to assess the value of initial posttherapy scans for predicting local relapse in patients with Ewing sarcoma (EWS) or rhabdomyosarcoma (RMS) who received radiotherapy (RT) for local control. These findings are critical to inform clinicians' surveillance recommendations and ability to accurately counsel patients and their families. Procedure The primary endpoint was time to local progression (LP). Patients were classified as having posttherapy scans that were "positive" (residual disease within the RT field), "negative" (no evidence of residual disease within the RT field), or "equivocal" (no determination could be made). The value of initial posttreatment scans for predicting LP was assessed using positive predictive value (PPV) and negative predictive value (NPV). Results Negative imaging findings (n = 51) had an NPV of 88%, and positive imaging findings (n = 1) had a PPV of 100%. When equivocal findings (n = 16) were categorized with negative results (i.e., positive vs. equivocal/negative), the NPV was 90%. When equivocal findings were categorized with positive results (equivocal/positive vs. negative), the PPV was 12%. Conclusion Equivocal findings within the RT field on end-of-therapy imaging studies indicate no higher risk of local recurrence than negative findings. These results may contribute to appropriate surveillance schedules and accurate counseling of patients with RMS and EWS who have received RT for local control. View on Web

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Limited enhancement of antibody and B‐cell responses to prototype booster vaccination following SARS‐CoV‐2 Delta breakthrough infection

alexandrossfakianakis shared this article with you from Inoreader Limited enhancement of antibody and B‐cell responses to prototype booster vaccination following SARS‐CoV‐2 Delta breakthrough infection via Journal of Medical Virology Abstract COVID-19 vaccines are effective at preventing the ancestral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptomatic infection and severe disease. However, many new SARS-CoV-2 variants of concern (VOCs), including Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2) and the most recent Omicron (B.1.1.529) variants, continue to evolve with enhanced immune escape capabilities, posing serious challenges to the efficacy of current vaccines. Recent studies showed booster doses can remarkably reduce VOCs escape from neutralizing antibody response and can induce strong T-cell and memory B-cell responses[1-4](#ref-0001). Hybrid immunity resulting from the combinations of SARS-CoV-2 infection and vaccination has also been proved to produce antibodies with increased potency and breadth and elicit robust CD4+ T-cell populations with enhanced antiviral properties[5,6](#ref-0005). But is unclear that how infection and vaccination history affect immune imprinting and whether it's necessary to have a booster vaccination for people who had a breakthrough infection post-vaccination This article is protected by copyright. All rights reserved. View on Web

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Masseter muscle cross‐sectional area and late implant failure: A case–control study

alexandrossfakianakis shared this article with you from Inoreader Masseter muscle cross‐sectional area and late implant failure: A case–control study via Clinical Implant Dentistry and Related Research Abstract Introduction Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. Purpose This case–control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. Methods This case–control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. Results The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82–10.79; p < 0.01). Conclusion Higher masseter muscle CSA increases the risk of late implant failure. View on Web

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Lip Squamous Cell Carcinoma With Spontaneous Eruption and Drainage

alexandrossfakianakis shared this article with you from Inoreader Lip Squamous Cell Carcinoma With Spontaneous Eruption and Drainage via JAMA Otolaryngology–Head & Neck Surgery Online First A 69-year-old woman with a newly diagnosed squamous cell carci noma of the lower lip mucosa presented 3 days after initiating neoadjuvant immune checkpoint blockade immunotherapy with redness and swelling of the tumor site. What is your diagnosis? View on Web

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Emerging Omicron subvariants evade neutralizing immunity elicited by vaccine or BA.1/BA.2 infection

alexandrossfakianakis shared this article with you from Inoreader Emerging Omicron subvariants evade neutralizing immunity elicited by vaccine or BA.1/BA.2 infection via Journal of Medical Virology Abstract The newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.2.75 and BA.2.76 subvariants contained 35 and 29 additional mutations in its spike (S) protein compared to the reference SARS-CoV-2 genome, respectively. Here, we measured the evasion degree of the BA.1, BA.2, BA.4, BA.5, BA.2.75, and BA.2.76 subvariants from neutralizing immunity in people previously infected with the Omicron BA.1 and BA.2, determined the effect of vaccination on immune evasion, and compared the titers of neutralizing antibodies in serums between acute infection and convalescence. Results showed that the neutralization effect of serums from patients with different vaccination statuses and BA.1/BA.2 breakthrough infection decreased with the Omicron evolution from BA.1 to BA.2, BA.4, BA.5, BA.2.75, and BA.2.76. This study also indicated that the existing vaccines could no longer provide effective protection, especially for the emerging BA.2.75 and BA.2.76 subvariants. Therefo re, vaccines against emerging epidemic strains should be designed specifically. In the future, we can not only focus on the current strains, but also predict and design new vaccines against potential mutant strains. At the same time, we can combine the virus strains' infection characteristics to develop protective measures for virus colonization areas, such as nasal protection spray. Besides, further studies on the Y248N mutation of BA.2.76 subvariant were also necessary to explore its contribution to the enhanced immune evasion ability. This article is protected by copyright. All rights reserved. View on Web

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Clostridioides difficile near patient testing versus centralized testing: A pragmatic cluster randomized cross-over trial

alexandrossfakianakis shared this article with you from Inoreader Clostridioides difficile near patient testing versus centralized testing: A pragmatic cluster randomized cross-over trial via Clinical Infectious Diseases Advance Access Abstract Background Management of suspected C. difficile infections (CDI) in the hospital setting typically results in patient isolation, laboratory testing, infection control, and presumptive treatment. We investigated whether implementation of rapid near patient testing (NPT) reduced patient isolation time, hospital length of stay, antibiotic usage, and cost. Methods A two-period pragmatic cluster randomized crossover trial was conducted. 39 wards were randomized into two study arms. The primary outcome measure was effect of NPT on patient isolation time using a mixed effect generalized linear regression model. Secondary outcomes examined included hospital length of stay and antibiotic therapy based on a negative binomial regression model. Natural experiment (NE), intention-to-treat (ITT), and per protocol (PP) analyses was conducted. Results During the entire study period, a total of 656 patients received NPT for CDI and 166 7 received SOC testing. For the primary outcome, a significant decrease of patient isolation time with NPT was observed (NE 9.4 hours [p<0.01], ITT 2.3 [p<0.05], PP 6.7[p<0.1]). A significant reduction in hospital length of stay was observed with NPT for short stay (NE 47.4% [p<0.01], ITT 18.4% [p<0.01] and ITT 34.2% [p<0.01]). Each additional hour delay for a negative result increased metronidazole use (24 DDD per 1000 patients, p<0.05) and non-CDI treating antibiotics by 70.13 mg (p<0.01). NPT testing was found to save USD25.48 per patient when including test cost and patient isolation. Conclusions The cluster randomized cross-over trial demonstrated that implementation of CDI NPT can contribute to significant reductions in isolation time, hospital length of stay, antibiotic usage, and health care cost. View on Web

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A lifestyle pattern characterized by high consumption of sweet and salty snacks, sugar sweetened beverages and sedentary time is associated with blood pressure in families at risk for type 2 diabetes mellitus in Europe. The Feel4Diabetes Study.

alexandrossfakianakis shared this article with you from Inoreader A lifestyle pattern characterized by high consumption of sweet and salty snacks, sugar sweetened beverages and sedentary time is associated with blood pressure in families at risk for type 2 diabetes mellitus in Europe. The Feel4Diabetes Study. via Journal of Human Nutrition and Dietetics Abstract Objective Individuals from families at high-risk for type 2 diabetes mellitus (T2DM) are also in high risk for hypertension and cardiovascular disease. Studies identifying lifestyle patterns combining dietary, physical activity or sedentary variables and examining their possible role to developing blood pressure (BP) are limited. This study aimed to examine the association of different lifestyle patterns (LPs) with BP levels in families at high risk for T2DM in Europe. Research Methods & Procedures 1844 adults (31.6% males) at high-risk for T2DM across 6 European countries were included in this cross-sectional study using data from the baseline assessment of the Feel4Diabetes Study. BP measurements, dietary and physical activity assessments were conducted, and screen times was surveyed. Lifestyle patterns were revealed with Principal Component Analysis (PCA) of various data regarding diet, physical activity, screen time and smoking. Results 3 LPs were identified, LP3 (high consumption of sweet & salty snacks, sugar sweetened soft drinks and juices and high amount of screen time) was positively associated with diastolic BP [B, 0.52 95%CI (0.05-0.99)] and existence of hypertension [OR,1.12 95%CI (1.00-1.25)]. Participants in the highest tertile of LP3 spent mean 3 hours of screen time, consumed 1.5 portions of sweet and/or salty snacks and 1 liter of soft drinks on a daily basis, were associated with 12% higher risk of hypertension. Conclusion Focusing on the combination of eating and lifestyle behaviors may more accurately identify, and therefore guide preventive measures tailored to the specific needs of high-risk populations. This article is protected by copyright. All rights reserved. View on Web

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