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Increased deaths from fungal infections during the COVID-19 pandemic-National Vital Statistics System, United States, January 2020-December 2021

Clin Infect Dis. 2022 Jun 19:ciac489. doi: 10.1093/cid/ciac489. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19-associated fungal infections cause severe illness, but comprehensive data on disease burden are lacking. We analyzed US National Vital Statistics System (NVSS) data to characterize disease burden, temporal trends, and demographic characteristics of persons dying from fungal infections during the COVID-19 pandemic.

METHODS: Using NVSS’s January 2018-December 2021 Multiple Cause of Death Database, we examined numbers and age-adjusted rates (per 100,000 population) of fungal deaths by fungal pathogen, COVID-19 association, demographic characteristics, and year.

RESULTS: Numbers and age-adjusted rates of fungal deaths increased from 2019 (n = 4,833, rate 1.2, 95% confidence interval [CI] 1.2-1.3) to 2021 (n = 7,199, rate: 1.8, 95% CI = 1.8-1.8); of 13,121 fungal deaths during 2020-2021, 2,868 (21.9%) were COVID-19-associated. Compared with non-COVID-19-associated fungal deaths (n = 10,253), COVID-19-associated fungal deaths more frequently involved Candida (n = 776 [27.1%] versus n = 2,432 [23.7%]) and Aspergillus (n = 668 [23.3%] versus n = 1,486 [14.5%]) and less frequently involved other specific fungal pathogens. Fungal death rates were generally highest in non-White and non-Asian populations. Death rates from Aspergillus infections were approximately two times higher in the Pacific US census division compared with most other divisions.

CONCLUSIONS: Fungal deaths increased during 2020-2021 compared with previous years, primarily driven by COVID-19-associated fungal deaths, particularly those involving Aspergillus and Candida. Our findings may inform efforts to prevent, identify, and treat severe fungal infections in COVID-19 patients, especially in certain racial/ethnic groups and geographic areas.

PMID:35717660 | DOI:10.1093/cid/ciac489

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The evaluation of changes in maxillofacial bones using cone beam tomography in acromegaly

Med Oral Patol Oral Cir Bucal. 2022 Jun 19:25280. doi: 10.4317/medoral.25280. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the changes in craniofacial dimensions of newly diagnosed and untreated acromegaly patients, patients with non-functional pituitary adenoma and healthy individuals on Cone Beam Computed Tomography (CBCT).

MATERIAL AND METHODS: 50 newly diagnosed acromegaly patients who did not receive any treatment for acromegaly were included in the study (Group A). Twenty patients with nonfunctional pituitary adenoma (Group B) and 30 healthy individuals were included (Group C). Linear, angular and volumetric measurements were performed.

RESULTS: Mandibular length showed significant difference in acromegaly patients, and maxillar length statistically significant difference was found between the A-B and B-C (p> 0,05), no difference was found between the A-C (p<0,05). SNB and ANB angle was statistically different in all groups, while SNA angle was statistically different between group A-C and B-C. In volumetric measurements, a statistically significant difference was found between groups a-c and groups A-B (p< 0,05), no difference was found between groups B-C (p>0,05).

CONCLUSIONS: CBCT measurements showed that mandibular volume and length were increased in the acromegaly group compared to the group B-C. Present study is the first research that compares acromegaly patients in respect to changes in maxillofacial dimensions.

PMID:35717618 | DOI:10.4317/medoral.25280

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Risk factors for oral mucositis during chemotherapy treatment for solid tumors: a retrospective STROBE-guided study

Med Oral Patol Oral Cir Bucal. 2022 Jun 19:25253. doi: 10.4317/medoral.25253. Online ahead of print.

ABSTRACT

BACKGROUND: This study retrospectively analyzed the risk factors for transchemotherapy oral mucositis (OM).

MATERIAL AND METHODS: Before each chemotherapy cycle, patients were routinely evaluated for the presence/severity of OM based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded as follows: However, specific conditions such as mucositis are graded on a five-point scale: 0, absence of mucositis, grade 1 (Asymptomatic or mild), 2 (Presence of pain and moderate ulceration, without interference with food intake), 3 (severe pain with interference with food intake) or 4 (Life-threatening with the need for urgent intervention). Information from 2 years of evaluations was collected and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, and history of head and neck radiotherapy. The X² test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p<0.05).

RESULTS: Among 19,000 total evaluations of 3,529 patients during 5.32±4.7 chemotherapy cycles (CT) the prevalence of OM was 6.3% (n=1,195). Chemotherapy duration (p<0.001), female sex (p=0.001), adjuvant intention (p=0.008) and the use of carboplatin (p=0.001), cisplatin (p=0.029), docetaxel (p<0.001) and bevacizumab (p=0.026) independently increased the risk of mucositis. In head and neck tumors, 2018 year (p=0.017), chemotherapy duration (p=0.018), BMI>30 (p=0.008), radiotherapy (p=0.037) and use of carboplatin (p=0.046) and cyclophosphamide (p=0.010) increased this prevalence.

CONCLUSIONS: Cycles of chemotherapy, sex, cytotoxicity drugs, bevacizumab and head and neck radiotherapy increase the risk of OM in solid tumors.

PMID:35717621 | DOI:10.4317/medoral.25253

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Oral manifestations in SARS-CoV-2 infection

Med Oral Patol Oral Cir Bucal. 2022 Jun 19:25259. doi: 10.4317/medoral.25259. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to evaluate the prevalence of predisposing factors and oral manifestations in SARS-CoV-2 infection.

MATERIAL AND METHODS: 204 SARS-CoV-2 positive patients were included in the study. Questions regarding the systemic, periodontal health, oral hygiene habits, common symptoms and, oral manifestations of COVID-19 such as oral lesions, and dry mouth were included in the survey. The Visual Analogue Scale (VAS) was used.

RESULTS: 47.5% of individuals had various systemic diseases. Dry mouth (44.2%) and oral lesions (22.4%) were the most common oral manifestations in COVID-19 patients. Also, dry mouth had the highest VAS score. The most common oral lesion locations were buccal mucosa (15.2%) and tongue (10.8%). The majority of participants (142 patients) were affected by taste disorders. Patients who received periodontal treatment before SARS-CoV-2 infection reported fewer oral complaint and manifestations than those who did not receive periodontal therapy (p=0.032). There was no statistically significant difference between males and females on the presence of any oral manifestations, and taste disorders.

CONCLUSIONS: Our results showed that SARS-CoV-2 could cause oral manifestations. However various predisposing factors may be part of the etiology and promote oral findings.

PMID:35717616 | DOI:10.4317/medoral.25259

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Connexin 43, Bcl-2, Bax, Ki67, and E-cadherin patterns in oral squamous cell carcinoma and its relationship with GJA1 rs12197797 C/G

Med Oral Patol Oral Cir Bucal. 2022 Jun 19:25298. doi: 10.4317/medoral.25298. Online ahead of print.

ABSTRACT

BACKGROUND: To our knowledge, there is no useful and accurate prognostic biomarker or biomarkers for patients with oral squamous cell carcinoma (OSCC), a tumor with uncertain biological behavior, and unpredictable clinical progress. The purposes of this study were: a) to determine the expresión profile of Connexin 43, Bcl-2, Bax, E-cadherin, and Ki67 in patients with OSCC; b) identify the GJCA1 rs12197797 genotypic composition.

MATERIAL AND METHODS: A cross-sectional study using genomic DNA and biopsy samples extracted from the oral mucosa with/without OSCC, older than 18 years, both genders, attended at Facultad de Odontología, Universidad Nacional Córdoba. Immunostaining for Cx43, Bcl-2, Bax, E-cadherin, and Ki67 and genotyping GJA1 rs12197797 by RFLP were performed. Odds Ratio (95% CI), Spearman Coefficient were estimated. Mann-Whitney test was applied to analyze immunostaining between controls/cases (p <0.05 was set for statistical significance).

RESULTS: GG (mutant) was the most frequent genotype in patients with OSCC diagnosis (53.2%) in relation to CC “healthy” genotype (p=0.00487; OR=7.33; CI95% [1.1-54.7]). And, the allele G (mutant) had a presence in 75.5% of OSCC patients. However, no significant association was observed between alleles C/G and diagnosis (p=0.0565). The heterozygous genotype was the most frequent in the patients of both groups Cx43 and E-cadherin markers were lower in OSCCs in relation to controls. Ki67 and Bcl-2 immunolabeling were high on OSCC, and Bax immunomarker was diminished in OSCC.

CONCLUSIONS: We hypothesized that the oral epithelium losses Connexin 43 and E-cadherin in the membrane, which modifies cell differentiation. The Ki67 and Bcl2 overexpression would increase the cell density in the tissue, by promoting proliferation and decreasing apoptosis. And, this study shows evidence that patients who carry on allele G of GJA1rs12197797 could be at risk of developing OSCC.

PMID:35717615 | DOI:10.4317/medoral.25298

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Smartphone-based home workout program for shift-work nurses working during the COVID-19 pandemic

Nurs Health Sci. 2022 Jun 19. doi: 10.1111/nhs.12969. Online ahead of print.

ABSTRACT

This study aimed to develop a smartphone-based home workout program for shift-work nurses to increase their levels of exercise and examine its effects on health (sleep disturbance, fatigue, musculoskeletal problems, and resilience) and nursing performance. For this quasi-experimental study with a nonequivalent control group, 54 shift-work nurses were recruited from two general wards at a hospital in Korea and assigned to the intervention and control groups. Nurses in the intervention group were encouraged to exercise regularly using the home workout application for 18 weeks. For the first 12 weeks, text-message counseling and environmental improvement were carried out; only environmental improvement was implemented in the remaining 12-18 weeks. The control group did not receive any intervention. After excluding dropouts, the data of the final 25 participants in the intervention group and 24 participants in the control group were analyzed. Compared with the control group, the intervention group showed statistically significant improvements in physical and psychological health. Hospital organizations could adopt a smartphone-based home workout program to overcome obstacles to exercise, which could lead to positive health outcomes for shift-work nurses. This article is protected by copyright. All rights reserved.

PMID:35717610 | DOI:10.1111/nhs.12969

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Comparison of functional outcome and patient satisfaction between patients with socket prosthesis and patients treated with transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation

Eur J Trauma Emerg Surg. 2022 Jun 18. doi: 10.1007/s00068-022-02018-6. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this retrospective analysis was to investigate and evaluate differences in functional outcome and satisfaction of patients treated with a TOPS and patients using socket prosthesis after transfemoral amputation.

METHODS: This retrospective comprehensive analysis included patients from a single hospital, and was conducted between February 2017 and December 2018. Overall n = 139 patients with prosthesis were included and divided into two comparable groups (socket- and TOPS group). Incomplete data sets were excluded. This led to n = 36 participants for the socket- and n = 33 for the TOPS group. Functional outcome and satisfaction were evaluated by Patient Reported Outcome Measures (PROMs). The used PROMs were: Questionnaire for Persons with a Transfemoral Amputation (Q-TFA), EQ5D-5L, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Prosthesis Mobility Questionnaire (PMQ 2.0) and Functional Independence Measure (FIM).

RESULTS: Significant results in favor of TOPS patients were identified for the EQ-5D 5L (p = 0.004), Q-TFA (p = 0.000), SAT-PRO (p = 0.000) and PMQ 2.0 (p = 0.000). For FIM, no statistical significance was found (p = 0.318).

CONCLUSION: In this study, transfemoral amputees treated with an osseointegrated prosthetic attachment (TOPS) showed significantly higher scores for mobility and satisfaction. This demonstrates the high potential of TOPS in the prosthetic treatment of patients with transfemoral amputation with regard to their functional abilities in daily life.

PMID:35717545 | DOI:10.1007/s00068-022-02018-6

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Effectiveness and Safety of Idarucizumab for Periprocedural Cardiac Tamponade After Catheter Ablation of Atrial Fibrillation in Dabigatran Recipients: A Retrospective Controlled Study

Am J Cardiovasc Drugs. 2022 Jun 18. doi: 10.1007/s40256-022-00536-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the effectiveness and safety of idarucizumab for periprocedural cardiac tamponade after catheter ablation of atrial fibrillation (AF) in patients treated with dabigatran.

METHODS: We retrospectively studied 28 patients who received catheter ablation of AF and developed periprocedural cardiac tamponade. Patients were divided into two groups: control group (14 cases) and the study group (14 cases). Patients in the control group were administered warfarin bridged with low molecular weight heparin, while patients in the study group were given dabigatran for anticoagulation. Heparin was used for anticoagulation during surgery in both groups. Patients with cardiac tamponade in control group was reversed with protamine and the ones in study group were given protamine and idarucizumab. In the two groups, operative time, time to resume anticoagulation, bleeding time, length of hospital stay, hemodynamic parameters, coagulation function parameters, number of patients undergoing thoracotomy for hemostasis, pericardiocentesis drainage volume, and pericardial drainage retention time were recorded.

RESULTS: There was no statistical difference in operative time and length of hospital stay between the two groups (p > 0.05); however, time to resume anticoagulation and bleeding time were significantly lower in the study group than in the control group, with a statistical difference (p < 0.05). After anticoagulation therapy, there was no apparent change and no statistical difference in the hemodynamic parameters and SaO2 between the two groups (p > 0.05). The pericardial drainage volume retention time was significantly shorter in the study group than in the control group, with a statistical difference (p < 0.05).

CONCLUSION: Idarucizumab can rapidly and effectively reverse the anticoagulant effect of dabigatran in patients with AF who have periprocedural cardiac tamponade after catheter ablation.

PMID:35717554 | DOI:10.1007/s40256-022-00536-7

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Effect of Levofloxacin on the Efficacy and Adverse Events in Intravesical Bacillus Calmette-Guerin Treatment for Bladder Cancer: Results of a Randomized, Prospective, Multicenter Study

Eur Urol Focus. 2022 Jun 15:S2405-4569(22)00130-4. doi: 10.1016/j.euf.2022.06.002. Online ahead of print.

ABSTRACT

BACKGROUND: Although bacillus Calmette-Guerin (BCG) is a standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), a high rate of adverse events with a variety of grades remains a difficulty.

OBJECTIVE: In this randomized, prospective, multicenter study, we examined whether levofloxacin, given after each intravesical instillation of BCG, could improve its tolerance in patients with intermediate- to high-risk urothelial carcinoma of the bladder without compromising its efficacy.

DESIGN, SETTING, AND PARTICIPANTS: Overall, 106 Japanese patients (85 men and 21 women; age: median, 69.5 yr) with primary or recurrent NMIBC were randomized after transurethral resection to induce treatment with intravesical BCG plus levofloxacin (group 1) or BCG alone (group 2).

INTERVENTION: Patients who underwent intravesical instillation of BCG were randomized with or without levofloxacin administration.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Adverse events were assessed using the National Cancer Institute-Common Toxicity Criteria version 3.0. Cumulative incidence functions and Kaplan-Meier methods were applied to estimate survival outcomes.

RESULTS AND LIMITATIONS: There was no significant difference in baseline characteristics between the groups. The completion rate of group 1 (85.5%) was not significantly lower than that of group 2 (76.5%; p = 0.321). There was no significant difference in the completion rate of patients with pollakisuria, painful micturition, gross hematuria, fever elevation, and others between the groups. The incidence of adverse events in patients with high-grade pollakisuria (7.3% vs 25.4%, p = 0.041) and fever (0% vs 9.1%, p = 0.034) was significantly lower in group 1. The 5-yr progression-free and cancer-specific survival rates were significantly better in group 1.

CONCLUSIONS: Prophylactic levofloxacin administration may reduce the severity of adverse events and contribute to better outcomes from BCG intravesical therapy in patients with NMIBC.

PATIENT SUMMARY: Levofloxacin administration seems to be a safe and effective therapy for non-muscle-invasive bladder cancer patients treated with bacillus Calmette-Guerin intravesical therapy.

PMID:35717522 | DOI:10.1016/j.euf.2022.06.002

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ASO Visual Abstract: Impact of Preoperative CEA Uptrend on Survival Outcomes in Patients with Colorectal Liver Metastasis after Hepatectomy

Ann Surg Oncol. 2022 Jun 18. doi: 10.1245/s10434-022-12008-y. Online ahead of print.

NO ABSTRACT

PMID:35717514 | DOI:10.1245/s10434-022-12008-y