Diagnostic Delay in Human Papillomavirus Negative Oropharyngeal Squamous Cell Carcinoma

alexandrossfakianakis shared this article with you from Inoreader Diagnostic Delay in Human Papillomavirus Negative Oropharyngeal Squamous Cell Carcinoma via The Laryngoscope Delays in care related to evaluations by multiple providers and misdiagnosis prolonged time to diagnosis in HPV(−)OPSCC. Improved patient and provider education is necessary to expedite the diagnosis of HPV(−)OPSCC. Objective Failure to recognize symptoms of non-human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV(−)OPSCC) at presentation can delay diagnosis and treatment. We aim to identify patient factors and provider practice patterns that delay presentation and care in HPV(−)OPSCC. Methods Retrospective review at a tertiary care center. Patients with HPV(−)OPSCC receiving treatment from 2006 to 2016. Patients were excluded if their date of symptom onset or diagnosis was unknown after thorough review of the electronic medical record or their tissue was not tested for HPV or p16. Clinical data, workup, and care timelines were abstracted. Univariate and multivariable linear regressions were performed to determine associations between patient and provider factors and delays in care. Results Of 70 included patients, 52 (74%) were male and mean age was 60.5 (SD = 9.0). Median time to diagnosis was 69 days (IQR = 32–127 days), with a median latency of 30 days (IQR = 12–61 days) from symptom onset to first presentation and 19.5 days (IQR = 4–46 days) from the first presentation to diagnosis. Most patients visited at least 2 providers (n = 52, 74%) before diagnosis. Evaluation by 3 or more providers prior to diagnosis was associated with significant delays in diagnosis of nearly a year (357.7 days, p < 0.001) and being treated or prescribed analgesia prior to diagnosis was significantly associated with delays in diagnosis (p = 0.004) on univariate regression analysis. Conclusions Delays in care related to evaluations by multiple providers and misdiagnosis prolonged time to diagnosis in HPV(−)OPSCC. Improved patient and provider education is necessary to expedite the diagnosis of HPV(−)OPSCC. Level of Evidence Level 4 Laryngoscope, 2022 View on Web

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Safety and efficacy of molnupiravir in SARS‐CoV‐2 infected patients: a real‐life experience

alexandrossfakianakis shared this article with you from Inoreader Safety and efficacy of molnupiravir in SARS‐CoV‐2 infected patients: a real‐life experience via Journal of Medical Virology Abstract Introduction Since the start of the SARS-CoV-2 pandemic, several treatments have been proposed to cure Coronavirus Disease 2019 (COVID-19) and prevent it. Molnupiravir is a ribonucleoside prodrug of N-hydroxycytidine with an in vitro e in vivo activity against SARS-CoV-2. Methods We conducted a retrospective cohort study including all people treated with Molnupiravir between the 10th of January and the 31th of March 2022 at the University Hospital of Sassari. Molnupiravir was prescribed, according to the Italian Agency of Drug indications, in patients with recent symptoms onset (≤5five days), no need of oxygen supplementation, and with a high risk of disease progression for the presence chronic diseases. Results We included 192 people with a mean age of 70.4±15.4 years; 144 (75%) patients were over 60 years. During the follow-up, 20 (10.4%) patients showed a disease progression. At the multivariate analysis, older age, having neurological dis ease, and having dyspnea at the onset of the symptoms, and acquiring SARS-CoV-2 infeciton during an hospital admission were associated with an increased risk of progression. On the contrary, early start of treatment was associated with a reduced risk of disease progression. Molnupiravir was also extremely safe since 13 (6.8%) adverse events were reported, with only one interruption. Conclusion Our study shows that Monlupiravir confirmed its efficacy and safety in a real-life cohort that included a high percentage of elderly people with a high comorbidity burden. This article is protected by copyright. All rights reserved. View on Web

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Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

alexandrossfakianakis shared this article with you from Inoreader Pediatric hematology providers' contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey via Pediatric Blood & Cancer Abstract Background Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet limited data are available regarding pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers' beliefs, practices, motivators, and barriers for providing contraceptive care to female AYAs with SCD. Methods Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess practices. Survey links were distributed nationwide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S.-accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, and logistic regression. Results Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed. Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Proportionally fewer trainees provided counseling compared with established providers (54% vs. 85%, p < .001), with a similar trend for prescribing (p = .05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea. Key motivators included patient request and disclosure of sexual activity. Key barriers included inadequate provider training, limited visit time, and perceived patient/parent interest. Conclusion Provider contraceptive practices for female AYAs with SCD varied, especially by provider status. Health beliefs regarding teratogenic potential of hydroxyurea did not correlate with contraceptive practices. Clinical guidelines, provider training, and patient/parent decision-making tools may be tested to assess whether provider contraceptive practices could be improved. View on Web

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Asymmetrical responding to male versus female other‐race categories in 9‐ to 12‐month‐old infants

alexandrossfakianakis shared this article with you from Inoreader Asymmetrical responding to male versus female other‐race categories in 9‐ to 12‐month‐old infants via British Journal of Psychology Abstract Faces can be categorized along various dimensions including gender or race, an ability developing in infancy. Infant categorization studies have focused on facial attributes in isolation, but the interaction between these attributes remains poorly understood. Experiment 1 examined gender categorization of other-race faces in 9- and 12-month-old White infants. Nine- and 12-month-olds were familiarized with Asian male or female faces, and tested with a novel exemplar from the familiarized category paired with a novel exemplar from a novel category. Both age groups showed novel category preferences for novel Asian female faces after familiarization with Asian male faces, but showed no novel category preference for novel Asian male faces after familiarization with Asian female faces. This categorization asymmetry was not due to a spontaneous preference hindering novel category reaction (Experiment 2), and both age groups displayed difficulty discriminating among male, but not female, other-race faces (Experiment 3). These results indicate that category formation for male other-race faces is mediated by categorical perception. Overall, the findings suggest that even by 12 months of age, infants are not fully able to form gender category representations of other-race faces, responding categorically to male, but not female, other-race faces. View on Web

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Increased sensitivity of Aggregatibacter actinomycetemcomitans to human serum is mediated by induction of a bacteriophage

alexandrossfakianakis shared this article with you from Inoreader Increased sensitivity of Aggregatibacter actinomycetemcomitans to human serum is mediated by induction of a bacteriophage via Molecular Oral Microbiology Summary Aggregatibacter actinomycetemcomitans, a Gram-negative oral pathobiont causing aggressive periodontitis and systemic infections demonstrates serum resistance. We have identified a dsDNA tailed bacteriophage S1249, which was found from this microorganism inducible by human serum to convert into lytic state to kill the bacterium. This phage demonstrated active transcripts when exposed to human serum: 20% of genes were up regulated greater than 10 folds and 45% of them were up regulated 5–10 folds, when the bacterium was grown in the presence of human serum compared to without. Transcriptional activation when grown in equine serum was less pronounced. This phage demonstrated a tail with the inner rigid tubes and outer contractile sheath, features of Myoviridae spp. Further characterization revealed that the lysogenized integration of the phage in the chromosome of A. actinomycetemcomitans occurred between the genes encoding for cold-shock DNA-binding domain-con taining protein (csp) and glutamyl-tRNA synthetase (gltX). Both phage DNA integrated lysogeny and non-integrated pseudolysogeny were identified in the infected bacterium. A newly generated, lysogenized strain using this phage displayed similar attributes, including 63% growth inhibition compared to its isogenic phage-free strain when in the presence of human serum. Our data suggest that bacteriophage S1249 can be induced in the presence of human serum and enters the lytic cycle, which reduces the viability of infected bacteria in vivo. This article is protected by copyright. All rights reserved View on Web

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Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients: A Prospective Observational Cohort Study

alexandrossfakianakis shared this article with you from Inoreader Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients: A Prospective Observational Cohort Study via Annals of Surgery - Most Popular Articles Objective: To investigate gut microbiota and intestinal barrier function changes after orthopedic surgery in elderly patients with either normal cognition (NC) or a prodromal Alzheimer disease phenotype (pAD) comprising either subjective cognitive decline (SCD) or amnestic mild cognitive impairment (aMCI). Background: Homeostatic disturbances induced by surgical trauma and/or stress can potentially alter the gut microbiota and intestinal barrier function in elderly patients before and after orthopedic surgery. Methods: In this prospective cohort study, 135 patients were subject to preoperative neuropsychological assessment and then classified into: NC (n=40), SCD (n=58), or aMCI (n=37). Their gut microbiota, bacterial endotoxin (lipopolysaccharide), tight junction (TJ) protein, and inflammatory cytokines in blood were measured before surgery and on postsurgical day 1, 3, and 7 (or before discharge). Results: The short-chain fatty acid (SCFA)-producing bacteria were lower while the gram-negative bacteria, lipopolysaccharide and TJ were higher preoperatively in both the SCD and aMCI (pAD) groups compared with the NC group. After surgery, a decrease in SCFA-producing bacteria, and an increase in both gram-negative bacteria and plasma claudin were significant in the pAD groups relative to the NC group. SCFA-producing bacteria were negatively correlated with TJ and cytokines in pAD patients on postsurgical day 7. Furthermore, surgery-induced perioperative metabolic stress and inflammatory responses were associated with gut microbiota alterations. Conclusions: Surgery exacerbates both preexisting microbiota dysbiosis and intestinal barrier dysfunction in pAD patients, all of which may be associated with systemic inflammation and, in turn, may lead to further cognitive deterioration. View on Web

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NUT carcinoma of the mandible in a child: case report and systematic review

alexandrossfakianakis shared this article with you from Inoreader NUT carcinoma of the mandible in a child: case report and systematic review via International Journal of Oral and Maxillofacial Surgery via MedWorm.com This report illustrates the management of mandibular NUT carcinoma in a pediatric patient, complemented by a systematic review of head and neck NUT carcinoma. A 5-year-old female presented with an enlarging jaw mass that was diagnosed as BRD4-NUTM1 carcinoma and was treated with hemimandibulectomy and chemoradiation. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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