Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

alexandrossfakianakis shared this article with you from Inoreader Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B via Journal of Medical Virology Abstract Background/Aims Nucleos(t)ide analogs (NA) cannot completely suppress the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This study aimed to identify the risk factors for HCC development in naïve CHB patients treated with current NA. Methods Patients receiving NA (n = 905) were recruited retrospectively from the 17 hospitals of the Japanese Red Cross Liver Study Group. All treatment-naïve patients had been receiving current NA continuously for more than one year until the end of the follow-up. We analyzed the accuracy of predictive risk score using area under receiver operating characteristic curve. Results The albumin–bilirubin (ALBI) score was significantly improved by NA therapy (−0.171 ± 0.396; p < 0.001 at week 48). A total of 72 (8.0%) patients developed HCC over a median follow-up of 6.2 (1.03–15.7) years. An independent predictive factor of HCC development was older age, cirrhosis, lower pl atelet counts at baseline and ALBI score, and alpha-fetoprotein (AFP) at 1 year after NA therapy according to multivariate analysis. The accuracy was assessed using the PAGE-B, mPAGE-B, aMAP, APA-B, and REAL-B scores that included these factors. Discrimination was generally acceptable for these models. aMAP and REAL-B demonstrated high discrimination with 0.866/0.862 and 0.833/0.859 for 3- and 5- years prediction from the status of one year after NA therapy, respectively. Conclusion Baseline age and platelet count, as well as ALBI and AFP one year after NA, were useful for stratifying carcinogenesis risk. The aMAP and REAL-B scores were validated with high accuracy in Japanese CHB patients. This article is protected by copyright. All rights reserved. View on Web

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The association between human papillomavirus and bladder cancer: evidence from meta‐analysis and two‐sample mendelian randomization

alexandrossfakianakis shared this article with you from Inoreader The association between human papillomavirus and bladder cancer: evidence from meta‐analysis and two‐sample mendelian randomization via Journal of Medical Virology Abstract Introduction Bladder cancer (BCa) is the tenth most common type of cancer worldwide, and human papillomavirus (HPV) is the most common sexually transmitted infection. However, the relationship between HPV infection and the risk of BCa is still controversial and inconclusive. Methods This systematic review and meta-analysis were conducted following the PRISMA 2020 reporting guideline. This study searched four bibliographic databases with no language limitation. The databases included PubMed (Medline), EMBASE, Cochrane Library and Web of Science. Studies evaluating the interaction between HPV infection and the risk of BCa from inception through May 21, 2022 were identified and used in this study. This study estimated the overall and type-specific HPV prevalence and 95% confidence intervals (95% CI) using Random Effects (RE) models and Fixed Effects (FE) models. In addition, this study also calculated the pooled odds ratio (pOR) and pooled risk ratio (pRR) with 95% CI to assess the effect of HPV infection on the risk and prognosis of bladder cancer. Two-sample mendelian randomization (MR) study using genetic variants associated with HPV E7 protein as instrumental variables was also conducted. Results This study retrieved 80 articles from the four bibliographic databases. Of the total, 27 were case-control studies, and 53 were cross-sectional studies. The results showed that the prevalence of HPV was 16% (95% CI, 11%–21%) among the BCa patients, most of which were HPV-16 (5.99% [95% CI, 3.03%–9.69%]) and HPV-18 (3.68% [95% CI, 1.72%–6.16%]) subtypes. However, the study found that the prevalence varied by region, detection method, BCa histological type, and sample source. A significantly increased risk of BCa was shown for the positivity of overall HPV (OR, 3.35 [95%CI, 1.75–6.43]), which was also influenced by study region, detection method, histological type and sample source. In addition, the study found that HPV inf ection was significantly associated with the progression of BCa (RR, 1.73 [95%CI, 1.39–2.15]). The two-sample MR analysis found that both HPV 16 and 18 E7 protein exposure increased the risk of BCa (HPV 16 E7 protein: IVW odds ratio [OR] per unit increase in protein level = 1.0004 [95% CI, 1.0002–1.0006]; P=0.0011; HPV 18 E7 protein: IVW odds ratio [OR] per unit increase in protein level = 1.0003 [95% CI, 1.0001–1.0005]; P=0.0089). Conclusion In conclusion, HPV may play a role in bladder carcinogenesis and contribute to a worse prognosis for patients with BCa. Therefore, it is necessary for people, especially men, to get vaccinated for HPV vaccination to prevent bladder cancer. This article is protected by copyright. All rights reserved. View on Web

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Wastewater Surveillance for Infectious Disease: A Systematic Review

alexandrossfakianakis shared this article with you from Inoreader Wastewater Surveillance for Infectious Disease: A Systematic Review via American Journal of Epidemiology - Advance Access Abstract Wastewater surveillance of SARS-CoV-2 has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and COVID-19 cases. Though the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify what infectious diseases have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as well as themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and non-polio enteroviruses. Most studies of wastewater surveillance did not li nk what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations. View on Web

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Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules

alexandrossfakianakis shared this article with you from Inoreader Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study assesses the association of sociode mographic factors with the odds of receiving a biopsy, timeliness of the procedure, and risk of nodule malignancy. View on Web

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Use of Tumor Bed Frozen Section to Assess Final Tumor Margin in Oral Cavity Carcinoma

alexandrossfakianakis shared this article with you from Inoreader Use of Tumor Bed Frozen Section to Assess Final Tumor Margin in Oral Cavity Carcinoma via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study evaluates the accuracy and imp lications of using intraoperative frozen section histopathology samples to assess tumor bed margins in patients undergoing surgery for oral cavity squamous cell carcinoma. View on Web

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Association of Neoadjuvant Pembrolizumab for OCSCC With Adverse Events After Surgery

alexandrossfakianakis shared this article with you from Inoreader Association of Neoadjuvant Pembrolizumab for OCSCC With Adverse Events After Surgery via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study evaluates the incidence of postoperativ e adverse events in treatment-naive patients receiving neoadjuvant pembrolizumab for advanced oral cavity cancer when compared with matched controls. View on Web

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A Novel Molecular Test for Determining HPV Integration Status in HPV-Positive Oropharynx Cancers

alexandrossfakianakis shared this article with you from Inoreader A Novel Molecular Test for Determining HPV Integration Status in HPV-Positive Oropharynx Cancers via JAMA Otolaryngology–Head & Neck Surgery Current Issue This diagnostic study describes the development of an ass ay for human papillomavirus–driven cancers of the oropharynx and the role viral integration could play in the process. View on Web

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Improved Survival after Liver Transplantation for Patients with HIV and HIV/HCV Coinfection in the INSTI and DAA eras

alexandrossfakianakis shared this article with you from Inoreader Improved Survival after Liver Transplantation for Patients with HIV and HIV/HCV Coinfection in the INSTI and DAA eras via Clinical Infectious Diseases Advance Access Abstract Background Patients with human immunodeficiency virus (HIV) with and without hepatitis C virus (HCV) coinfection had poor outcomes after liver transplant (LT). Integrase strand transfer inhibitors (INSTI) and direct-acting antivirals (DAA) changed the treatment landscape for HIV and HCV, respectively; their impact on LT outcomes remains unclear. Methods This retrospective analysis of adults with HIV monoinfection (n = 246) and HIV/HCV coinfection (n = 286) who received LT compared mortality in patients with HIV who received LT before vs. after approval of INSTI and in patients with HIV/HCV coinfection who received LT before vs after approval of DAA. In secondary analysis, we compared the outcomes in the different eras with those of propensity score (PS) matched control cohorts of LT recipients without HIV or HCV infection. Results HIV monoinfected LT recipients did not experience a significant improvement in su rvival between the pre-INSTI and INSTI recipients with HIV (aHR 0.70 [0.36-1.34). However, recipients with HIV/HCV coinfection in the DAA era had a 47% reduction (aHR 0.53 [0.31-9.2] in one-year mortality than co-infected recipients in the pre-DAA era. Compared to non-HIV or HCV recipients, HIV monoinfected recipients had higher mortality during the pre-INSTI era (aHR, ), but survival was comparable between groups during the INSTI era (aHR, ). HIV/HCV coinfected recipients also experienced comparable survival during the DAA era compared to non-HIV or HCV recipients (aHR, ). Conclusions Post-LT survival for patients with HIV monoinfection and HIV/HCV coinfection has improved with the introduction of INSTI and DAA therapy, suggesting that LT has become safer in these populations. View on Web

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Two-Stage Modeling to Identify How Colorectal Cancer Risk Changes With Period and Cohort

alexandrossfakianakis shared this article with you from Inoreader Two-Stage Modeling to Identify How Colorectal Cancer Risk Changes With Period and Cohort via American Journal of Epidemiology - Advance Access Abstract Colorectal cancer (CRC) incidence rates have decreased among adults aged 50 and older while increasing in adults under age 50. Understanding these trends is challenging due to the multiple related time scales of age, period of diagnosis, and birth cohort. We analyzed rectal, distal colon, and proximal colon cancer incidence rates for individuals aged 20 and older from the Surveillance, Epidemiology, and End Results program for diagnosis years 1978-2017. We used a two-stage generalized linear model to describe age, period, and cohort effects for incidence. We first estimated birth cohort effects among people under 45. We used these results to specify prior distributions for cohort effects in a Bayesian model to estimate period effects among people 45 and older. There was no evidence of period effects for people under age 45. Risk for rectal and distal colon cancer increased for later birth cohorts. Compared to the 1943-1952 birth cohort, the 1983- 1992 birth cohort had 2.1 times the risk of rectal cancer, 1.8 times the risk of distal colon cancer and 1.3 times the risk of proximal colon cancer. For people over 45, period effects show declines in CRC risk that are attributable to screening. View on Web

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Optimizing SARS-CoV-2 Pooled Testing Strategies Through Differentiated Pooling for Distinct Groups

alexandrossfakianakis shared this article with you from Inoreader Optimizing SARS-CoV-2 Pooled Testing Strategies Through Differentiated Pooling for Distinct Groups via American Journal of Epidemiology - Advance Access Abstract Pooled testing has been successfully used to expand SARS-CoV-2 testing, especially in settings requiring high volumes of screening of lower-risk individuals, but efficiency of pooling declines as prevalence rises.We propose a differentiated pooling strategy that independently optimizes pool sizes for distinct groups with different probabilities of infection to further improve the efficiency of pooled testing. We compare the efficiency (results obtained per test kit used) of the differentiated strategy to a traditional pooling strategy in which all samples are processed using uniform pool sizes under a range of scenarios.For most scenarios, differentiated pooling is more efficient than traditional pooling. In scenarios examined here, an improvement in efficiency of up to 3.94 results per test kit could be obtained through differentiated versus traditional pooling, with more likely scenarios resulting in 0.12 to 0.61 additional results per kit. Und er circumstances similar to those observed in a university setting, implementation of our strategy could result in an improvement in efficiency between 0.03 to 3.21 results per test kit.Our results can help identify settings, such as universities and workplaces, where differentiated pooling can conserve critical testing resources. View on Web

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