Αρχειοθήκη ιστολογίου

Δευτέρα 25 Ιουλίου 2022

Epidemiology and genetic characterization of human metapneumovirus in pediatric patients

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Abstract

Human metapneumovirus (HMPV), which is distributed worldwide, is a significant viral respiratory pathogen responsible for causing acute respiratory tract infections (ARTIs) in children. The aim of the present study was to investigate the epidemiological and genetic characteristics of HMPV in pediatric patients in Hangzhou China following the peak of onset of COVID-19. A total of 1,442 throat swabs were collected from the pediatric patients with a diagnosis of ARTI from November 2020 to March 2021. The following viruses were detected by real-time PCR analysis: HMPV, RSV, adenovirus, hPIV1-3, influenza A, and influenza B. A two-step method was used to amplify the F genes of the HMPV-positive samples. Following sequencing, phylogenetic analyses were conducted using the MEGA version 7 software package. Among the 1,442 samples, 103 (7.14%) were positive for HMPV. No significant differences were observed in the gender distribution. The highest incidence of HMPV oc curred in children older than 6 years and the lowest was noted in children younger than 6 months. Lower respiratory tract infections were diagnosed at a higher rate than upper respiratory tract infections in HMPV-infected children. Only 10 HMPV-infected children (5.41%) were inpatients compared with 93 outpatients (7.39%). Co-infection was observed in 31 HMPV-positive samples including 24 samples of double infection and 7 samples of triple infection. A total of 61 F gene fragments of HMPV, which were approximately 727 bp in length were successfully sequenced. All the HMPVs belonged to the genotype B and were clustered into subgenotypes B1 (1.6%, 1/61) and B2 (98.4%, 60/61). A total of 4 specific amino acid substitutions were noted as follows: aa280, aa296, aa392, and aa396. These substitutions were present between sequences derived from the subgenotypes B1 and B2 in the fusion open reading frame from position 244 to 429. In conclusion, the present study provided significant informat ion regarding the epidemiological and genetic characteristics of HMPV in children living in Hangzhou. Following the first peak of the COVID-19 pandemic, HMPV was considered an important viral respiratory pathogen present in children with ARTI.

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Phase II study of intrathecal administration of trastuzumab in patients with HER2-positive breast cancer with leptomeningeal metastasis

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Abstract
Background
Patients with HER2-positive breast cancer (HER2+BC) develop central nervous system metastases twice as often as patients with luminal HER2-negative breast cancer. Leptomeningeal progression results in a drastically altered prognosis with limited therapeutic options. This phase II study was conducted in order to assess the efficacy of intrathecal (IT) trastuzumab in HER2+BC patients with leptomeningeal metastasis (LM), based on a phase I dose-escalation study that had determined the recommended weekly dose of 150 mg for phase II.
Methods
Eligible patients received weekly administrations of 150 mg of IT trastuzumab. The primary endpoint was clinical neurologic progression-free survival (LM-related-PFS) after 8 weeks. Overall survival (OS), toxicities and quality of life (QoL) were secondary endpoints.
Results
Among the 19 enrolled patients, 16 (84%) had concomitant brain metastases, 15 of them had re ceived prior radiotherapy to the brain. All patients had received at least one line of systemic anti-HER2 therapy.After 8 weeks, 14 patients (74%) were free of neurological progression. The median LM-related-PFS was 5.9 months and the median OS was 7.9 months. According to the QLQ-C30 and BN20 scales, the global health-related QoL status seemed preserved and no toxicity above grade 3 was observed.
Conclusions
Conducting studies on patients with LM poses significant challenges and ethical dilemmas inherent to this population. Despite some limits, this phase II study's findings in terms of clinical neurologic response and quality of life's control confirms weekly administration of 150 mg of IT trastuzumab as a valuable option for HER+BC patients with LM and support the interest for further investigations.
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Complete Digital Workflow for Prosthesis Prototype Fabrication with the Double Digital Scanning (DDS) Technique: A Prospective Study on 16 Edentulous Maxillae

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Abstract

Purpose

To assess the accuracy of fit of milled prosthesis prototypes for completely edentulous patients using a digital workflow.

Materials and Methods

: Sixteen patients received intraoral full-arch digital scans with the double digital scanning (DDS) technique and the generated standard tessellation language (STL) files were superimposed and imported into computer-aided design software (Exocad DentalCAD, exocad GmbH, Darmstadt, Germany) for design. After design, each master STL file was used for computer-aided manufacturing of the prosthesis prototypes through a complete digital workflow. The primary outcome was the accuracy of fit assessment of the digitally fabricated prototypes on verified patient master stone casts. Two blinded clinicians tested the accuracy of fit of the milled prosthesis prototypes on the verified master stone casts utilizing the screw-resistance test and direct observation.

Results

: Out of the 16 digitally fabricated prototypes from intraoral full-arch digital scans, all 16 presented with accurate fit on verified master stone casts.

Conclusions

: Digitally fabricated full-arch prosthesis prototypes can be generated with a complete digital workflow leading to clinically acceptable fit.

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Analysis of Th cell subsets in local and systemic environments from experimental periodontitis rats

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Abstract

Objectives: To explore the effect of periodontitis on Th cell subsets in local and systemic environments.

Methods: 32 male Sprague-Dawley rats were randomly divided into periodontitis and control groups. Silk ligatures were applied to the mandibular first (M1) molars in the periodontitis group. Inflammation and alveolar bone loss around the M1 molars were analyzed by histological staining and micro-computed tomography. The mRNA expression of IFN-γ, IL-4, IL-17 and IL-10 in the gingiva were detected by qRT-PCR. The proportions of Th1, Th2, Th17 and Treg cells in the submandibular lymph nodes, peripheral blood and jaw bone marrow were tested using flow cytometry.

Results: More inflammatory cells and alveolar bone resorption was found in the periodontitis group, with upregulated mRNA expression of IFN-γ, IL-17 and IL-10. The proportion of Th1 and Th17 cells was significantly elevated in submandibular lymph nodes, and the proportion of Th1, Th2 and Th17 cells was significantly elevated in peripheral blood, while the proportion of Th1, Th17 and Treg cells was significantly elevated in jaw bone marrow in the periodontitis group.

Conclusion: This study suggests periodontitis affects the differentiation of Th cell subsets in both local and systemic environments, resulting in an increased proportion of proinflammatory cells.

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Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

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Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE-Perf Scale

The NOSE-Perf scale is a patient-reported outcome measure specific to nasal septal patients. NOSE-Perf data are presented for a large heterogenous group of patients.


Objective

To objectively identify and quantitate presenting nasal symptoms in patients with a septal perforation using the validated NOSE-Perf scale.

Study Design

Case series retrospective review.

Methods

The medical records from August 2018 through January 2022 of patients at a tertiary care academic center with a septal perforation, and who completed the NOSE-Perf questionnaire, were reviewed. Perforation symptoms were identified and quantified using the 12-item NOSE-Perf scale (score range 0–48). NOSE-Perf findings were correlated to patient demographics, perforation etiology, and perforation length. NOSE-Perf scores of patients who pursued treatment were compared with those who did not.

Results

NOSE-Perf data were collected from 202 patients. Nasal crusting was noted in 94.1% of patients and was the most severe symptom reported (mean 2.9 of 4.0). Nasal congestion, difficulty breathing, and nasal obstruction followed in prevalence and severity. The mean total NOSE-Perf score was 23.7. Linear regression analysis demonstrated a weakly negative association of NOSE-Perf score with patient age and weakly positive association with increasing perforation length. NOSE-Perf scores were significantly higher in women and in patients pursuing treatment.

Conclusion

This is the first study to use the validated NOSE-Perf scale to objectively characterize and establish baseline septal perforation symptomatology. The NOSE-Perf scale can play a role in the standardization of perforation evaluation and treatment outcomes assessment. Laryngoscope, 2022

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