Autoimmune seronegative limbic encephalitis following ChAdOx1‐S/nCoV‐19 vaccination in a patient with ankylosing spondylitis

alexandrossfakianakis shared this article with you from Inoreader Autoimmune seronegative limbic encephalitis following ChAdOx1‐S/nCoV‐19 vaccination in a patient with ankylosing spondylitis via Journal of Medical Virology Abstract Here we present a case in which a patient developed autoimmune seronegative limbic encephalitis following ChAdOx1-S/nCoV-19 (AZD1222; AstraZeneca) vaccination. Although it is known that vaccines containing SARS-CoV-2 antigens might enhance autoimmunity, such cases are rarely reported. We discuss this case with the present literature. This article is protected by copyright. All rights reserved. View on Web

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Sequence Analysis of Epstein‐Barr virus RPMS1 Gene in malignant hematopathy

alexandrossfakianakis shared this article with you from Inoreader Sequence Analysis of Epstein‐Barr virus RPMS1 Gene in malignant hematopathy of Northern China via Journal of Medical Virology Abstract The RPMS1 gene is the only member of the BamHI-A rightward transcripts (BARTs) family for which a full-length cDNA has been identified, and RPMS1 transcript has been confirmed in many EBV-positive malignancies. However, the effects of sequence variations of RPMS1 in hematological malignancies and their biological significance are unclear. To explore the association between RPMS1 gene variations and hematological malignancy, the RPMS1 gene of 391 EBV-positive samples from patients with EBV-positive leukemia, myelodysplastic syndromes (MDS) and lymphoma in northern China were sequenced. On the basis of phylogenetic tree and mutation characteristics of RPMS1, all the sequences were divided into five major types: RPMS1-A, RPMS1-B, RPMS1-C, RPMS1-E, and RPMS1-F. RPMS1-A type, similar to the prototype B95-8, was identified in 71.87% (281/391) of samples and was the major typ e in all subpopulations. The frequency of RPMS1-F type was significantly higher in all malignant hematopathy groups than in healthy donors. The Hodgkin lymphoma (HL) group contained more RPMS1-F than other malignant hematopathy groups, and acute myeloid leukemia (AML) contained more RPMS1-C type than other malignant hematopathy groups. Therefore, RPMS1-A is the main type of RPMS1 gene in northern China, and RPMS1-F may be associated with hematologic malignancies. This article is protected by copyright. All rights reserved. View on Web

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Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy

alexandrossfakianakis shared this article with you from Inoreader Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy via Journal of Clinical Pharmacy and Therapeutics The MarketScan® Commercial Database was queried from 2010 to 2016 to identify patients aged 18–64 years discharged from an inpatient hospitalization on vancomycin OPAT. The primary endpoint was hospital readmission with AKI within 42 days of index hospital discharge. A total of 14,196 patients were included in the study. Readmission with AKI occurred in 385 (2.7%) and was independently associated with chronic kidney disease, congestive heart failure, chronic liver disease, hypertension, septicemia, and concomitant OPAT with IV penicillins. Abstract Introduction Vancomycin is commonly used during outpatient parenteral antimicrobial therapy (OPAT). Therapeutic drug monitoring (TDM) of vancomycin is recommended to ensure effective and safe therapy, as use has been associated with acute kidney injury (AKI). Methods The MarketScan® Commercial Database was queried from 2010 to 2016 to identify patients aged 18–64 years discharged from an inpatient hospitalization on vancomycin OPAT. The primary endpoint was hospital readmission with AKI within 6 weeks of index hospital discharge. TDM was defined as at least one vancomycin level obtained during outpatient therapy. Bivariate analysis was used to examine associations with outcomes; significant factors were incorporated into a multivariable logistic regression model. Results A total of 14,196 patients were included in the study; median age was 54 years and 53.8% were male. Readmission with AKI occurred in 385 (2.7%) and was independently associated with chronic kidney disease (aOR 2.63 [95%CI 1.96–3.52]), congestive heart failure (1.81 [1.34–2.44]), chronic liver disease (1.74 [1.17–2.59]), hypertension (1.73 [1.39–2.17]), septicemia (1.61 [1.30–2.00]), and concomitant OPAT with IV penicillins (1.73 [1.21–2.49]) while skin and soft tissue infection (0.67 [0.54–0.83]) and surgical site infection (0.74 [0.59–0.93]) were associated with lower risk of readmission with AKI. TDM was not associated with lower risk of readmission with AKI. Conclusion Chronic kidney disease, congestive heart failure, hypertension, chronic liver disease, septicemia, and concomitant OPAT with IV penicillins were significantly associated with higher risk of readmission with AKI during vancomycin OPAT. View on Web

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Cochlear Implants for Single‐Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

alexandrossfakianakis shared this article with you from Inoreader Cochlear Implants for Single‐Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness via The Laryngoscope The current study was undertaken to report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). We present the largest cohort of patients with SSD treated with CI to date. This group demonstrates significant benefit with regards to speech recognition scores, tinnitus measures, and quality of life metrics. We present novel insights regarding the CIQOL-10 measure, correlation of speech recognition and QoL scores with daily usage "datalogging" as well as the impact of duration of deafness on outcomes for patients with CI for SSD. Objective To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). Methods This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized. Results Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0–74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1–14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores. Conclusions Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD. Level of Evidence IV Laryngoscope, 2022 View on Web

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Proton pump inhibitors and myocardial infarction: an application of active comparators in a self-controlled case series

alexandrossfakianakis shared this article with you from Inoreader Proton pump inhibitors and myocardial infarction: an application of active comparators in a self-controlled case series via International Journal of Epidemiology - Advance Access Abstract BackgroundPrevious studies investigating potential cardiovascular adverse events of acid-suppressing drugs are susceptible to protopathic bias and confounding. We aimed to investigate the association between short-term risk of myocardial infarction (MI) and proton pump inhibitors (PPIs) using a self-controlled case series (SCCS) with an active comparator. Methods We conducted a SCCS using a population-wide database from Hong Kong from 2003–2014. Adult with ≥1 outpatient oral PPI prescription or H2 receptor antagonist (H2RA) and MI during the observation period were included. We used both simple ratio and effect modifier approaches to SCCS with active comparators to obtain comparator adjusted estimates. Results A total of 2802 and 1889 people with MI who had exposure to PPIs and H2RA were included respectively. We observed a higher risk of MI during days 1–14 following the start of PPI prescription (Incidence rate ratio (IRR): 2.30, 95 % confidence interval (CI): 1.76–3.00) versus baseline. Similarly, we observed a higher risk of MI during days 1–14 following the start of H2RA prescription (IRR: 2.46, 95%CI: 1.92–3.16) versus baseline. In the novel SCCS analyses, comparator adjusted estimates were 0.93 (95%CI: 0.57–1.30) and 0.83 (95%CI: 0.58–1.20) during days 1–14 in simple ratio and effect modifier approach, respectively. Conclusions We observed no difference in risk of MI associated with PPIs compared with baseline using H2RA as the active comparator. The elevated risk of MI associated with PPIs is likely due to protopathic bias. More studies are required to explore the feasibility of using active comparators in SCCS to address protopathic bias in addition to confounding. View on Web

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A novel de novo KCNB1 variant altering channel characteristics in a patient with periventricular heterotopia, abnormal corpus callosum, and mild seizure outcome

alexandrossfakianakis shared this article with you from Inoreader A novel de novo <i>KCNB1</i> variant altering channel characteristics in a patient with periventricular heterotopia, abnormal corpus callosum, and mild seizure outcome via Journal of Human Genetics - Issue - nature.com science feeds View on Web

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Associations of Prenatal First Trimester Essential and Nonessential Metal Mixtures with Body Size and Adiposity in Childhood.

alexandrossfakianakis shared this article with you from Inoreader Associations of Prenatal First Trimester Essential and Nonessential Metal Mixtures with Body Size and Adiposity in Childhood. via Epidemiology - Published Ahead-of-Print Background: Prenatal nonessential metals may contribute to postnatal adiposity, while essential metals may have metabolic benefits. We evaluated joint and individual associations between prenatal metals and childhood adiposity. Methods: We measured concentrations of six nonessential (arsenic, barium, cadmium, cesium, lead, mercury) and four essential (magnesium, manganese, selenium, zinc) metals in first trimester maternal blood from a pre-birth cohort. We collected anthropometric measures in early childhood, mid-childhood, and early adolescence including subscapular+tricep skinfold thickness (mm) (N=715-859), waist circumference (cm) (N=717-882), and BMI (z-score) (N=716-875). We measured adiposity in mid-childhood and early adolescence using bone densitometry total- and trunk fat-mass index (kg/m2) (N=511-599). We estimated associations using adjusted quantile g-computation and linear regression. Results: The nonessential metal mixture was associated with higher total (β=0.07, 95% CI: 0.01, 0.12) and trunk fat-mass index (β=0.12, CI: 0.02, 0.22), waist circumference (β=0.01, CI: 0.00, 0.01), and BMI (β=0.24, CI: 0.07, 0.41) in mid-childhood, and total fat-mass index (β=0.07, CI: 0.01, 0.14) and BMI (β=0.19, CI: 0.02, 0.37) in early adolescence. The essential metal mixture was associated with lower early adolescence total (β= –0.11, CI: -0.17, -0.04) and trunk fat-mass index (β=-0.13, CI: -0.21, -0.05), subscapular+tricep skinfold thickness (β=-0.02, CI: -0.03, -0.00), waist circumference (β=-0.003, CI: -0.01, -0.00), and BMI (β=-0.16, CI: -0.28, -0.04). Cadmium and cesium were individually associated with childhood adiposity at different timepoints. Conclusions: Prenatal first trimester essential metals were associated with lower childhood adiposity, whereas nonessential metals were associated with higher adiposity into adolescence. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on Web

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Development and Validation of Algorithms to Estimate Live Birth Gestational Age in Medicaid Analytic eXtract Data

alexandrossfakianakis shared this article with you from Inoreader Development and Validation of Algorithms to Estimate Live Birth Gestational Age in Medicaid Analytic eXtract Data via Epidemiology - Published Ahead-of-Print Background: While healthcare utilization data are useful for post-marketing surveillance of drug safety in pregnancy, the start of pregnancy and gestational age at birth are often incompletely recorded or missing. Our objective was to develop and validate a claims-based live birth gestational age algorithm. Methods: Using the Medicaid Analytic eXtract (MAX) linked to birth certificates in three states, we developed four candidate algorithms based on: preterm codes; preterm or post-term codes; timing of prenatal care; and prediction models - using conventional regression and machine-learning approaches with a broad range of pre-specified and empirically selected predictors. We assessed algorithm performance based on mean squared error (MSE) and proportion of pregnancies with estimated gestational age within 1 and 2 weeks of the gold standard, defined as the clinical or obstetric estimate of gestation on the birth certificate. We validated the best performing algorithms against medical records in a nationwide sample. We quantified misclassification of select drug exposure scenarios due to estimated gestational age as positive predictive value (PPV), sensitivity, and specificity. Results: Among 114,117 eligible pregnancies, the random forest model with all predictors emerged as the best performing algorithm: MSE 1.5; 84.8% within 1 week and 96.3% within 2 weeks, with similar performance in the nationwide validation cohort. For all exposure scenarios, PPVs were >93.8%, sensitivities >94.3%, and specificities >99.4%. Conclusions: We developed a highly accurate algorithm for estimating gestational age among live births in the nationwide MAX data, further supporting the value of these data for drug safety surveillance in pregnancy. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on Web

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Disrupted tenogenesis in masseter as a potential cause of micrognathia

alexandrossfakianakis shared this article with you from Inoreader Disrupted tenogenesis in masseter as a potential cause of micrognathia via International Journal of Oral Science - Issue International Journal of Oral Science, Published online: 18 October 2022; doi:10.1038/s41368-022-00196-y Disrupted tenogenesis in masseter as a potential cause of micrognathia View on Web

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