Clinical Outcomes and Economic Burden of Seasonal Influenza and Other Respiratory Virus Infections in Hospitalized Adults

alexandrossfakianakis shared this article with you from Inoreader Clinical Outcomes and Economic Burden of Seasonal Influenza and Other Respiratory Virus Infections in Hospitalized Adults via Journal of Medical Virology ABSTRACT Background The cost of influenza and other respiratory virus infections should be determined to analyze the real burden of these diseases. We aimed to investigate the clinical outcomes and cost of illness due to respiratory virus infections in hospitalized adult patients. Methods Hospitalized patients who had nasal swab sampling for a suspected viral infection between 1 August 2018 to 31 March 2019 were included. Outcome variables were oxygen requirement, mechanical ventilation need, intensive care unit admission and cost. Results At least one viral pathogen was detected in 125 (47.7%) of 262 patients who were included in the study. Fifty-five (20.9%) of the patients were infected with influenza. Influenza-positive patients had higher rates for respiratory support, intensive care unit admission and mortality compared to all other patients. The average cost of hospitalization per person was 2,879.76 USD in the influenza-negative group, while the same cost was 3,274.03 USD in the influenza-positive group. Although all of the vaccinated influenza-positive patients needed oxygen support, neither of them required invasive mechanical ventilation or intensive care unit admission. The average hospitalization cost per person was 779.70 USD in the vaccinated group compared to 3,762.01 USD in the unvaccinated group. Disease-related direct cost of influenza in the community was estimated as 22,776,075.61 USD in the 18-65 years of age group and 15,756,120.02 USD in the 65 years of age and over group per year. Conclusion Influenza, compared to other respiratory virus infections, can lead to untoward clinical outcomes and mortality as well as higher direct medical costs in adults. This article is protected by copyright. All rights reserved. View on Web

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The T‐shaped FST pharyngoplasty step‐by‐step closure technique

alexandrossfakianakis shared this article with you from Inoreader The T‐shaped FST pharyngoplasty step‐by‐step closure technique via Head & Neck Abstract Pharyngocutaneous fistula is one of the most common and serious complications associated with total laryngectomy. Numerous studies tried to evaluate causative and predisposing factors associated with this complication, but data are considerably variable and there is still no international consensus. Incidence rate varies considerably between studies, with reported rates from 3% to 65%. This 4K video presents our T-shaped four-step technique (FST) for closing the pharyngeal mucosa after total laryngectomy in a step-by-step manner. All sutures were performed by braided absorbable 3/0 26 mm 1/2c (Vicryl plus 3.0; Ethicon, Somerville, NJ, USA). Recordings were performed using a Karl Storz 4K 3D VITOM® exoscope (Karl Storz SE & Co. KG, Tuttlingen, Germany). We have been described this technique through a high-definition video, showing each step, and tips from the authors. Our T-shaped pharyngoplasty closure technique can be divided into four steps: 1. "Key Stitches"; 2. "A rea Refinement Stitches"; 3. "Modified Connell Suture"; 4. "Modified Purse String Suture." Our T-shaped FST closure technique proved to be an effective and reproducible method, which we feel could be the preferred choice for primary pharyngoplasty closure. View on Web

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Effectiveness of root canal treatment for vital pulps compared with necrotic pulps in the presence or absence of signs of periradicular pathosis: a systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of root canal treatment for vital pulps compared with necrotic pulps in the presence or absence of signs of periradicular pathosis: a systematic review and meta‐analysis via International Endodontic Journal Abstract Background Pre-operative pulpal status may influence the outcomes of root canal treatment (RCTx) according to various measures used. Objectives To compare effectiveness of RCTx of teeth with a vital pulp versus a necrotic pulp using a range of clinical and patient-related outcomes, for the development of S3-Level clinical practice guidelines. Methods A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until 29 March 2022. Clinical studies published in English language comparing the stipulated outcomes of RCTx of teeth with vital versus necrotic pulp were included. The Newcastle-Ottawa Scale was adapted to assess study quality. Effects of pulpal status were estimated and expressed as risk ratio (RR) using fixed- and random-effect meta-analyses. The quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Results Twenty-eight studies published between 1961 and 2021 were included. Five studies have investigated the 'tooth survival' outcome, four reported pulpal status was not a significant predictor, consistent with meta-analysis finding (RR: 1.00; 95% CI: 1.00, 1.00; n=3). Seven studies reported pulpal status had no significant influence on post-operative pain, regardless of duration after treatment. Sixteen studies have analysed 'periapical health', eleven revealed pulpal status had no significant influence. Meta-analyses revealed the influence was not significant if pre-operative periapical radiolucency was absent (RR: 0.95; 95% CI: 0.90, 1.00; n=9) but significant if it was present (RR: 1.12; 95% CI: 1.05, 1.19; n=11). Most studies were classified as 'some concerns' (n=16) to 'low' (n=10) risk of bias (RoB). Discussion Evidence is limited and only available for three outcomes when comparing the effectiveness of RCTx in permanent teeth with vital pulp versus pulp necrosis. Nevertheless, the quality of available evidence was moderate to high. The 'periapical health' data heterogeneity could be explained by pre-operative radiolucency, thus RCTx was found more effective for prevention than resolution of apical periodontitis. Conclusions There was no significant difference in the 'tooth survival', 'post-operative pain' and 'evidence of apical radiolucency' outcomes of RCTx in teeth with vital or necrotic pulps. View on Web

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Unveiling HERV‐K113‐ENV as SARS‐CoV‐2 severity admissible biomarker by mining transcriptome data

alexandrossfakianakis shared this article with you from Inoreader Unveiling HERV‐K113‐ENV as SARS‐CoV‐2 severity admissible biomarker by mining transcriptome data via Journal of Medical Virology Abstract Discovering the severity biomarker for SASR-CoV-2 can reduce the unnecessary hospital occupancy of COVID-19-positive adult people. Here we report the human endogenous retrovirus K113 envelope (HERV-K113-ENV) transcription as an admissible SARS-CoV-2 severity biomarker by the mining of adult Indian whole-blood transcriptome data. This article is protected by copyright. All rights reserved. View on Web

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Response assessment in pediatric craniopharyngioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group

alexandrossfakianakis shared this article with you from Inoreader Response assessment in pediatric craniopharyngioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group via Neuro-Oncology Advance Access Abstract Craniopharyngioma is a histologically benign tumor of the suprasellar region for which survival is excellent but quality of life often poor secondary to functional deficits from tumor and treatment. Standard therapy consists of maximal safe resection with or without radiation therapy. Few prospective trials have been performed, and response assessment has not been standardized. The Response Assessment in Pediatric Neuro-Oncology (RAPNO) committee devised consensus guidelines to assess craniopharyngioma response prospectively. Magnetic resonance imaging (MRI) is the recommended radiologic modality for baseline and follow-up assessments. Radiologic response is defined by two-dimensional measurements of both solid and cystic tumor components. In certain clinical contexts, response of solid and cystic disease may be differentially considered based on their unique natural histories and responses to treatment. Importantly, the committee incorporated fu nctional endpoints related to neuro-endocrine and visual assessments into craniopharyngioma response definitions. In most circumstances, cystic disease should be considered progressive only if growth is associated with acute, new-onset or progressive functional impairment. Craniopharyngioma is a common pediatric CNS tumor for which standardized response parameters have not been defined. A RAPNO committee devised guidelines for craniopharyngioma assessment to uniformly define response in future prospective trials. View on Web

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Hyperkalaemia and potassium binders: Retrospective observational analysis looking at the efficacy and cost effectiveness of calcium polystyrene sulfonate and sodium zirconium cyclosilicate

alexandrossfakianakis shared this article with you from Inoreader Hyperkalaemia and potassium binders: Retrospective observational analysis looking at the efficacy and cost effectiveness of calcium polystyrene sulfonate and sodium zirconium cyclosilicate via Journal of Clinical Pharmacy and Therapeutics Both CPS and SZC are equally effective at lowering acutely raised potassium concentrations with a cost analysis that favours CPS. Any claims of benefits of newer agents over established medications need to be explored in randomized trials. Abstract What is Known and Objective Hyperkalaemia is a common medical emergency in patients admitted to hospital. There is a limited evidence base supporting some of the commonly applied treatment strategies. Although, NICE has recommended the use of sodium zirconium cyclosilicate (SZC) (TA599) and patiromer (TA623) in both acute and chronic hyperkalaemia, there is a limited evidence base for their use in acute hyperkalaemia in the hospital setting, particularly when compared to the present standard of care calcium polystyrene sulfonate (CPS). Methods A retrospective review of the electronic patient record system across our hospital over a 6-month period identified 138 patients who received either SZC (65 patients) or CPS (73 patients) to manage hyperkalaemia, investigating their efficacy and cost effectiveness. Results were analysed using simple descriptive statistics. Based on the results a naïve cost comparison between the two drugs was made. Results and Discussion CPS and SZC both effectively reduced plasm potassium concentrations in patients with hyperkalaemia (6.07 and 6.03 mmol/L respectively) by 1.17 mmol/L and 1.24 mmol/L taking a similar amount of time to work (2.97 days vs. 3 days). The principle causes of hyperkalaemia identified were acute kidney injury, medication, and chronic kidney disease. Cost comparison analysis which took into account raw product price and time needed to dispense medications revealed that CPS has slightly better cost effectiveness compared to SZC albeit at a cost of increased staff input. What is New and Conclusion Both CPS and SZC were equally effective at lowering acutely raised potassium concentrations. The cost difference between the two products appears to be small. Claims regarding the benefits of newer agents over older established medications need to be properly explored in randomized trials rather than being based on small scale non-comparative studies. View on Web

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Extracapsular dissection with a transparotid facial nerve dissection approach versus partial superficial parotidectomy for benign tumours in the tail of the parotid gland: a single-centre retrospective study of 89 patients

alexandrossfakianakis shared this article with you from Inoreader Extracapsular dissection with a transparotid facial nerve dissection approach versus partial superficial parotidectomy for benign tumours in the tail of the parotid gland: a single-centre retrospective study of 89 patients via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aims of this study were (1) to evaluate the transparotid facial nerve dissection approach (TFND), in which the intraparotid cervicofacial or temporofacial division is identified first through a superficial lobe incision; and (2) to compare extracapsular dissection with a TFND (ECD-TFND) with partial superficial parotidectomy with a retrograde approach (PSP) for benign tumours in the tail of the parotid gland with respect to surgical outcomes. Eighty-nine patients underwent PSP or ECD-TFND for benign tumours in the tail of the parotid gland: 49 were treated surgically with PSP and 40 with ECD-TFND. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Comparative effectiveness of BNT162b2 and mRNA-1273 booster dose after BNT162b2 primary vaccination against the Omicron variants: A retrospective cohort study using large-scale population-based registries in Japan

alexandrossfakianakis shared this article with you from Inoreader Comparative effectiveness of BNT162b2 and mRNA-1273 booster dose after BNT162b2 primary vaccination against the Omicron variants: A retrospective cohort study using large-scale population-based registries in Japan via Clinical Infectious Diseases Advance Access Abstract Background Direct comparative effectiveness of booster doses of BNT162b2 and mRNA-1273 after BNT162b2 primary vaccination is unknown. Methods We investigated comparative effectiveness of BNT162b2 and mRNA-1273 booster dose using data from registry systems for vaccination and COVID-19 infection in a local city in Japan. We followed participants aged ≥16 years who completed the BNT162b2 primary vaccination between November 22, 2021, and April 15, 2022. We collected information on age, sex, vaccination status, vaccine type, and infection status. Age was categorized as 16–44, 45–64, 65–84, and ≥85 years. Vaccine effectiveness for mRNA-1273 and no booster vaccination against BNT162b2 was estimated using age-stratified Cox regression adjusted for age, sex, and days since the second vaccination. The estimated hazard ratios for mRNA-1273 and no booster vaccinations were integrated separately using random effects meta-analyses . Results During the study period, we identified 62,586 (40.4%), 51,490 (33.2%), and 40,849 (26.4%) participants who received BNT162b2, mRNA-1273, and no booster dose, respectively. The median age was 69, 71, and 47 years for BNT162b2, mRNA-1273, and no booster dose, respectively. The integrated hazard ratio with reference to BNT162b2 was 1.72 for no booster vaccination and 0.62 for mRNA-1273. The comparative effectiveness of mRNA-1273 was similar across age categories. Conclusions Both homologous and heterologous vaccinations are effective against Omicron variants. In the head-to-head comparison, the effect was stronger in people who received heterologous vaccination than in those who received homologous vaccination. These findings may help improve logistics and decision making in future vaccination programs. View on Web

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