Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 5 Φεβρουαρίου 2023

Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient

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ABSTRACT

Monkeypox is a neglected zoonotic disease caused by Monkeypox virus (MPXV), a double-stranded DNA virus of the genus Orthopoxvirus. Here we present a case report of a 32-year-old man with MPXV infection who developed keratoconjunctivitis and Wessley immune ring with no identifiable cause other than ocular involvement by MPXV. We highlight the need of ophthalmologists exploring any ocular symptoms in MPXV-infected individuals.

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Discovery of Isojacareubin as a covalent inhibitor of SARS‐CoV‐2 main protease using structural and experimental approaches

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Abstract

The ongoing pandemic with the emergence of immune evasion potential and particularly the current omicron sub variants intensified the situation further. Although vaccine are available but the immune evasion capabilities of the recent variants demand further efficient therapeutic choices to control the SARS-CoV-2 pandemic. Hence, considering the necessity of the small molecule inhibitor we target the main protease (3CLpro) which is an appealing target for the development of anti-viral drugs against the SARS-CoV-2. High-throughput molecular in silico screening of South African natural compounds database (SANCDB) reported as Isojacareubin and Glabranin the potential inhibitors for main protease. The calculated docking scores were reported to be -8.47 kcal/mol and -8.03 kcal/mol respectively. Moreover, the structural-dynamic assessment reported that Isojacareubin in complex with 3CLpro exhibit more stable dynamic behaviour than Glabranin. Inhibition assay indicated that Isojacareubin could inhibit SARS-CoV-2 3CLpro in a time- and dose-dependent manner, with IC50 values of 16.00±1.35 μM (60-min incubation). Next, the covalent binding sites of Isojacareubin on SARS-CoV-2 3CLpro was identified by biomass spectrometry which reported that Isojacareubin can covalently bind to thiols or Cysteine through Michael addition. To evaluate the inactivation potency of Isojacareubin, the inactivation kinetics was further investigated. The inactivation kinetic curves were plotted according to various concentrations with gradient-ascending incubation times. The K I value of Isojacareubin was determined as 30.71 μM, while the K inact value was calculated as 0.054 min-1. These results suggest that Isojacareubin is a covalent inhibitor of SARS-CoV-2 3CLpro.

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Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis

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Human Leukocyte Antigen Genotyping of Idiopathic Subglottic Stenosis

Idiopathic subglottic stenosis is a rare disease with incompletely understood pathophysiology. This study investigated for association with human leukocyte antigen allele variations, which have important contributions to other airway disease including granulomatosis with polyangiitis. There was no specific HLA association identified for idiopathic subglottic stenosis.


Objective

Despite recent scientific inquiry, idiopathic subglottic stenosis (iSGS) remains an enigmatic disease. The consistent demographics of the affected population suggest genetic factors may contribute to disease susceptibility. Given the inflammation observed in the affected proximal airway mucosa, we interrogated disease association with human leukocyte antigen (HLA) polymorphisms. Polymorphisms in the HLA locus have previously been shown to influence individuals' susceptibility to distinct inflammatory diseases.

Methods

High-resolution HLA typing of 37 iSGS patients was compared with 1,242,890 healthy Caucasian controls of European ancestry from the USA National Marrow Donor Program and 281 patients with granulomatosis with polyangiitis (GPA).

Results

Complete HLA genotyping of an iSGS population showed no significant associations when compared to a North American Caucasian control population. Unlike GPA patients, iSGS was not associated with allele DPB1*04:01 nor did allele homozygosity correlate with disease severity.

Conclusions

There was not a detectable HLA association observed in iSGS. These results support the concept that iSGS possesses a distinct genetic architecture from GPA. If genetic susceptibility exists in iSGS, it likely lies outside the HLA locus.

Level of Evidence

N/A, basic science Laryngoscope, 2023

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α‐KG Up‐regulates Autophagic Activity in Peri‐implant Environment and Enhances Dental Implant Osseointegration in Osteoporotic Mice

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Abstract

Aim

The osseointegration of dental implants is impaired among patients with osteoporosis, leading to significantly higher failure rate. This study set out to investigate the potential effects of alpha-ketoglutarate (α-KG) on implant osseointegration in an osteoporotic mouse model.

Material and Methods

Female C57BL/6 mice received ovariectomy and bilateral first maxillary molars extraction at the age of seven weeks. Dental implants were inserted eight weeks after tooth extraction. In one of the groups, α-KG was administered via drinking water throughout the experiment period. Specimens were collected on post-implant day (PID) 3, 7, 14, and 21 for micro-CT, histological and immunohistochemical analyses. At the same time, bone marrow-derived mesenchymal stem cells (BMMSCs) treated with α-KG were interrogated for osteogenic differentiation, autophagic activity, and apoptosis.

Results

α-KG supplement in drinking water resulted in enhanced dental implant osseointegration in ovariectomized mice, with upregulated osteogenic and autophagic activity and downregulated osteoclast differentiation and cell apoptosis. α-KG treated BMMSCs demonstrated enhanced activity in proliferation, survival, colony formation, osteogenic differentiation, as well as autophagic activity.

Conclusions

Systemic α-KG supplement effectively prevents the failure of dental implant osseointegration in mice under an osteoporotic state.

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The AUGIS Survival Predictor: Prediction of Long-Term and Conditional Survival After Esophagectomy Using Random Survival Forests

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imageObjective: The aim of this study was to develop a predictive model for overall survival after esophagectomy using pre/postoperative clinical data and machine learning. Summary Background Data: For patients with esophageal cancer, accurately predicting long-term survival after esophagectomy is challenging. This study investigated survival prediction after esophagectomy using a Random Survival Forest (RSF) model derived from routine data from a large, well-curated, national dataset. Methods: Patients diagnosed with esophageal adenocarcinoma or squamous cell carcinoma between 2012 and 2018 in England and Wales who underwent an esophagectomy were included. Prediction models for overall survival were developed using the RSF method and Cox regression from 41 patient and disease characteristics. Calibration and discrimination (time-dependent area under the curve) were validated internally using bootstrap resampling. Results: The study analyzed 6399 patients, with 2625 deaths during follow-up. Median follow-up was 41 months. Overall survival was 47.1% at 5 years. The final RSF model included 14 variables and had excellent discrimination with a 5-year time-dependent area under the receiver operator curve of 83.9% [95% confidence interval (CI) 82.6%–84.9%], compared to 82.3% (95% CI 81.1%—83.3%) for the Cox model. The most important variables were lymph node involvement, pT stage, circumferential resection margin involvement (tumor at
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Peritoneal Metastases From Prostate Carcinoma Treated With 177Lu-PSMA-I&T

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imageA 71-year-old man was referred for 177Lu-PSMA therapy. He had metastatic castration-resistant prostate cancer, progressive on several treatment lines, with current PSA 260 μg/L and deteriorating condition. CT showed ascites with omental and peritoneal metastases, all positive on PSMA PET/CT. He was treated with 4 cycles of 7.4 GBq (0.2 Ci) 177Lu-PSMA-I&T. Posttherapy scans showed good targeting of all metastases. After 4 cycles, PSA had dropped to 44 μ/L. Four months after the fourth cycle, the patients' general condition had significantly improved, and PSA had decreased to 7.0 μg/L.
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18F-FDG PET/CT Imaging Post Heart Transplantation Depicts High Accumulation at Sites of Previous Ventricular Assist Device Insertion

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imageA 37-year-old man with previous heart transplantation for dilated cardiomyopathy underwent screening for malignancy under posttransplantation immunosuppression. 18F-FDG PET/CT revealed uptake in 2 peritoneal sites of the pericardium that corresponded to the insertion sites of a left ventricular assist device that was used before transplantation. Additional abnormal uptake in the right axillary artery, aortic arch, and left femoral artery corresponded to the insertion sites for arterial inflow during cardiopulmonary bypass. Knowledge that FDG accumulation may occur at the insertion sites of an extracorporeal-circulatio n device enables unnecessary tests to be avoided.
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A high prevalence of neutrophil‐specific antibodies in ELANE‐mutated severe congenital neutropenia

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Abstract

An assay for neutrophil-specific antibodies is frequently used in the workup of chronic severe neutropenia and is suggestive of autoimmune, or sporadically alloimmune neutropenia, rather than severe congenital neutropenia (SCN). We analyzed a neutropenia consortium database for the outcomes of antibody testing initiated before receiving genetic diagnosis in Polish SCN cohort. Test results, performed in a single reference laboratory, were available for 14 patients with ELANE-mutated SCN or cyclic neutropenia, and were frequently positive (36%). We note that the trigger for genetic studies in severe neutropenia should not be affected by antibody-positivity and should be clinically driven.

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Real‐world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high‐risk donor seropositive/recipient seronegative (D+R‐) liver transplant recipients (LTxR)

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Real-world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high-risk donor seropositive/recipient seronegative (D+R-) liver transplant recipients (LTxR)


Abstract

Background

Despite superiority of preemptive therapy (PET) compared to universal prophylaxis for prevention of cytomegalovirus (CMV) disease in the CAPSIL randomized trial among CMV D+R- liver transplant recipients (LTxRs), real-world effectiveness may be lower because of logistical concerns about feasibility of PET.

Methods

We retrospectively assessed PET as standard clinical care at a single transplant center among 50 consecutive adult CMV D+R- LTxRs undergoing a first liver transplant between 4/4/2019 and 5/18/2021 and compared outcomes and adherence to those randomized to PET in the CAPSIL study (N = 100). The primary outcome was CMV disease and secondary outcomes were biopsy-confirmed acute allograft rejection, retransplant, invasive fungal infections, and death, all assessed by 1-year post-transplant. Exploratory outcomes included virologic parameters and measures of adherence to protocol-specified CMV qPCR monitoring.

Results

Baseline characteristics were similar between groups. The cumulative incidence of CMV disease at 1-year post-transplant was 4/50 (8%) versus 9/100 (9%) in the real-world and CAPSIL cohorts, respectively, p = 1.0. The rate of breakthrough CMV disease during the 100-day PET period was low (2/50 [4%]) and similar to the PET cohort from the CAPSIL study (3/100 [3%]).  All secondary and exploratory outcomes were not significantly different between the real-world and CAPSIL PET cohorts.

Conclusions

In this first reported study of real-world PET, the feasibility and effectiveness for CMV disease prevention and for other clinical outcomes in CMV D+R- LTxRs were similar to those reported with PET in a clinical trial. Additional studies to confirm feasibility and generalizability in other settings are warranted.

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Differences in morphology of temporomandibular joint ankylosis of traumatic and infective origin

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The aim of this study was to determine whether there are any differences in morphology between temporomandibular joint ankylosis (TMJA) of traumatic and infective origin. Cone beam computed tomography (CBCT) scans of 25 patients (28 joints) with TMJA of traumatic origin (trauma group) and 15 patients (15 joints) with TMJA of infectious origin (infection group) were included. The following morphological parameters were evaluated on multiple sections of the CBCT scans: lateral juxta-articular bone growth, residual condyle, residual glenoid fossa, ramus thickening, ankylotic mass fusion line, sclerosis of the ankylosed condyle and spongiosa of the glenoid fossa, and mastoid and glenoid fossa air cell obliteration. (Source: International Journal of Oral and Maxillofacial Surgery)
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