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Δευτέρα 29 Αυγούστου 2022

Coinfections in hospitalized patients with severe fever with thrombocytopenia syndrome: a retrospective study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with a high case fatality rate. Few studies have been performed on bacterial or fungal coinfections or the effect of antibiotics therapy.

Study design

A retrospective, observational study was performed to assess the prevalence of bacterial and fungal coinfections in patients hospitalized for SFTSV infection. The most commonly involved microorganisms and the effect of antimicrobial therapy were determined by the site and source of infection.

Results

A total of 1201 patients hospitalized with SFTSV infection were included; 359 (29.9%) had microbiologically confirmed infections, comprised of 292 with community-acquired infections (CAIs) and 67 with healthcare-associated infections (HAIs). Death was independently associated with HAIs, with a more significant effect than that observed for CAIs. For bacterial infections, only those acquired in hospital were associated with fatal outcomes, while fungal infection, whether acquired in hospital or community, was related to an increased risk of fatal outcomes. The infections in respiratory tract and bloodstream were associated with a higher risk of death than that in urinary tract. Both antibiotic and antifungal treatments were associated with improved survival for CAIs, while for HAIs, only antibiotic therapy was related to improved survival, and no effect from antifungal therapy was observed. Early administration of glucocorticoids was associated with an increased risk of HAIs.

Conclusion

The study provided novel clinical and epidemiological data and revealed risk factors, such as bacterial coinfections, fungal coinfections, infection sources, and treatment strategies associated with SFTS deaths/survival. This report might be helpful in curing SFTS and reducing fatal SFTS.

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The emergence, spread and vanishing of a French SARS‐CoV‐2 variant exemplifies the fate of RNA virus epidemics and obeys the Mistigri rule

alexandrossfakianakis shared this article with you from Inoreader

Abstract

The nature and dynamics of mutations associated with the emergence, spread and vanishing of SARS-CoV-2 variants causing successive waves are complex. We determined the kinetics of the most common French variant ("Marseille-4") for 10 months since its onset in July 2020. Here, we analysed and classified into subvariants and lineages 7,453 genomes obtained by next-generation sequencing. We identified two subvariants, Marseille-4A, which contains 22 different lineages of at least 50 genomes, and Marseille-4B. Their average lifetime was 4.1±1.4 months, during which 4.1±2.6 mutations accumulated. Growth rate was 0.079±0.045, varying from 0.010 to 0.173. Most of the lineages exhibited a bell-shaped distribution. Several beneficial mutations at unpredicted sites initiated a new outbreak, while the accumulation of other mutations resulted in more viral heterogenicity, increased diversity and vanishing of the lineages. Marseille-4B emerged when the other Marse ille-4 lineages vanished. Its ORF8 gene was knocked out by a stop codon, as reported in SARS-CoV-2 of mink and in the Alpha variant. This subvariant was associated with increased hospitalization and death rates, suggesting that ORF8 is a nonvirulence gene. We speculate that the observed heterogenicity of a lineage may predict the end of the outbreak.

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Radiological anatomical variations of the lateral nasal wall and anterior skull base amongst different populations: A systematic review and meta‐analysis

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Abstract

Objectives

To determine the anatomical variations of the lateral nasal wall and anterior skull base amongst populations in different geographical regions.

Design

Systematic review and meta-analysis.

Methods

Using PRISMA guidelines, SCOPUS and PUBMED databases were searched from inception until 1st March 2022. The regions and populations identified were from Europe, Asia, Middle East, Australia-New Zealand-Oceania, South America, North America and Africa. Random-effects model was used to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I 2 statistic and Cochran's Q test.

Main outcome measures

Anatomical variations of the lateral nasal wall and anterior skull base confirmed by computed tomography scan.

Results

56 articles were included with a total of 11805 persons. The most common anatomical variation of the ostiomeatal complex was pneumatization of the agger nasi (84.1%), olfactory fossa was Keros type 2 (53.8%) and ethmoids was asymmetry of the roof (42.8%). Sphenoethmoidal and suprabullar cells have a higher prevalence in North Americans (53.7%, 95% CI: 46.00-61.33) while asymmetry of ethmoid roof more common in Middle Easterns (85.5%, 95% CI: 0.00-100). Bent uncinate process has greater prevalence in Asians while supraorbital ethmoid cells and Keros type 3 more common in non-Asians. The overall studies have substantial heterogeneity and publication bias.

Conclusions

Certain anatomic variants are more common in a specific population. The 'approach of analysis' plays a role in the prevalence estimates and consensus should be made in future studies regarding the most appropriate 'approach of analysis' either by persons or by sides.

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Epidemiology and Etiology of Chronic Rhinosinusitis in Asia – a Narrative Review

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Despite having a similar prevalence to Western populations, literature on chronic rhinosinusitis (CRS) in the Asian population is sparse. There is limited data on the epidemiology and etiology of CRS in Asia.

Objectives

To review the current literature on the epidemiology and etiology of chronic rhinosinusitis (CRS) in Asia.

Methods

This is a narrative review of published data on the epidemiology and etiology of CRS. Studies on CRS in Asian countries, published in English and indexed on PubMed or Google Scholar were reviewed. Where available, data extracted included epidemiology, endotype and cytokine profiles and genetic profiles.

Results and Conclusion

The prevalence of CRS in Asia ranges widely from 2.1% -28.4%. Type 2 inflammation has been reported in 5-55% of Asian patients, with lower levels of Type 2 cytokines reported in head to head comparisons of Western vs Asian patients. Notably, there exists marked heterogeneity in criterion of the tissue eosinophilic infiltration for diagnosis of type 2 chronic rhinosinusitis. Our review suggests that differences in prevalence of CRS and proportion of eosinophilic CRS between Asia and Europe and the Americas requires further study. Large-scale Asian studies utilizing standardized definitions are needed to bridge this gap. Head to head genetic and microbiomal analysis may also be useful in understanding differences in CRS between the Asian and Western populations.

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The analgesic and anti‐hemorrhagic efficacy of platelet‐rich plasma in tonsillectomy: A systematic review and meta‐analysis of randomized controlled trials

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Abstract

Aim

To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluated the analgesic and anti-hemorrhagic efficacy of platelet-rich plasma (PRP) among patients undergoing tonsillectomy.

Methods

PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were screened from inception until July 2021, and updated in December 2021. Risk of bias of the included studies was evaluated according to the Cochrane Collaboration tool. The efficacy endpoints were summarized as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI).

Results

Seven RCTs were analyzed, comprising a total of 392 patients. Risk of bias evaluation showed an overall high risk in one RCT, low risk in four RCTs, and some concerns in two RCTs. The pooled results revealed that the mean postoperative pain score was significantly reduced in favor of the PRP group compared with the control group (SMD=-1.38, 95% CI [-1.91, -0.85], p<0.001). Subgroup analysis showed the effect estimate was statistically significant for early postoperative pain (day 0 to day 3), without substantial difference between both groups on late postoperative pain (day 5 and day 7). Moreover, the rate of postoperative hemorrhage was significantly reduced in favor of the PRP group compared with the control group (RR=0.16, 95% CI [0.05, 0.50], p=0.001). Subgroup analysis showed the effect estimate was statistically significant for the rate of primary and secondary hemorrhage.

Conclusion

PRP was associated with significant reduction in postoperative pain and hemorrhage among patients undergoing tonsillectomy.

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Κυριακή 28 Αυγούστου 2022

Study on the surface properties of different commercially available CAD/CAM materials for implant‐supported restorations

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

To determine if there are any differences in surface characteristics (surface roughness and contact angle) among different CAD/CAM materials indicated for fabricating implant-supported restorations, following all the material preparation protocols provided by the manufacturer.

Materials and Methods

One-hundred forty-four specimens were divided into six groups: RBC (resin-based composite), PMMA (polymethyl methacrylate), PEEK (polyether ether ketone), ZP (zirconia polished), ZG (zirconia glazed) and CoCr4 (CoCr4 alloy). The experimental part included surface roughness (SR) and contact angle of water (WCA) analyses, fulfilled with Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM) view of surface topography. The data were analyzed using Kruskal-Wallis test with a Dunn's post hoc analysis, the correlation between measurements was tested using Spearman's rank correlation coefficient and all data were presented as mean ± SD.

Results

ZG specimens were significantly rougher compared to other groups (p ≤ 0.05). The WCA measurements revealed significantly lower mean values in ZG group (p ≤ 0.05), contrary to PEEK and CoCr4, where significantly higher mean values were observed, compared to other groups (p ≤ 0.05). There exist a moderate negative correlation between the SR and WCA (ρ = −0.41). AFM 3D and SEM 2D images presented more or less heterogeneous surface of all materials.

Conclusions

There were statistically significant differences in surface roughness and contact angle among tested material groups. Moderate negative correlation was found between surface roughness and contact angle of tested material groups.

Clinical Significance

The study gives us a better understanding of influence of physicochemical characteristics of investigated materials on their surface properties and provides useful knowledge for future researches in a view of material's behavior under in vivo conditions, when it comes to a question of features related to surface quality, such as microbial adhesion, corrosion, wear, biocompatibility and esthetics.

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