Oral swabs tested with Xpert MTB/RIF Ultra for diagnosis of pulmonary tuberculosis in children: a diagnostic accuracy study

alexandrossfakianakis shared this article with you from Inoreader Oral swabs tested with Xpert MTB/RIF Ultra for diagnosis of pulmonary tuberculosis in children: a diagnostic accuracy study via Clinical Infectious Diseases Advance Access Abstract Background Microbiological diagnosis of childhood tuberculosis may be difficult. Oral swabs are a potential non-invasive alternative to sputum for diagnosis. Methods A prospective diagnostic accuracy study of oral swabs (buccal and tongue) for pulmonary tuberculosis (PTB) diagnosis in children (aged ≤15 years) in two South African hospital sites. Children with cough of any duration and either: a positive tuberculin skin test, TB contact, loss of weight or chest X-ray suggestive of PTB were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Ultra) and liquid culture. Oral swabs were taken preceding sputum, frozen and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed TB, Unconfirmed TB (received TB treatment) or unlikely TB according to NIH consensus definitions based on sputum microbiological results. Results Among 291 participants (median age 32 [IQR 14-73] months), 57 (20%) were living with HIV and 87 (30%) were malnourished. 90 (31%) had confirmed PTB (six (7%) with rifampicin-resistant TB), 157 (54%) unconfirmed PTB and 44 (15%) unlikely TB. One oral swab was obtained from 126 (43%) participants (96 tongue, 30 buccal) and two swabs from 165 (57%) (110 tongue, 55 buccal). Sensitivity was low; 22% (95% CI 15-32) for all swabs combined (confirmed PTB as reference), but specificity was high (100%, 95% CI 91-100). The highest sensitivity was 33% (15-58) among participants living with HIV. Overall yield was 6.9% with one oral swab, and 7.2% with two. Conclusions Ultra on oral swabs provides poor yield for microbiologic PTB confirmation in children. View on Web

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Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharynx cancer: a multi-centre study

alexandrossfakianakis shared this article with you from Inoreader Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharynx cancer: a multi-centre study via radiotheraphy Publication date: Available online 17 May 2022 Source: Radiotherapy and Oncology Author(s): J.M. Price, C.M. West, L.M. Dixon, Z. Iyizoba-Ebozue, K. Garcez, L. Lee, A. McPartlin, F. Slevin, A. Sykes, R.J.D. Prestwich, D.J. Thomson View on Web

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The Conventional Technique Versus the No-touch Isolation Technique for Primary Tumor Resection in Patients With Colon Cancer (JCOG1006): A Multicenter, Open-label, Randomized, Phase III Trial

alexandrossfakianakis shared this article with you from Inoreader The Conventional Technique Versus the No-touch Isolation Technique for Primary Tumor Resection in Patients With Colon Cancer (JCOG1006): A Multicenter, Open-label, Randomized, Phase III Trial via Annals of Surgery - Most Popular Articles Objective: This phase III trial evaluated whether the no touch was superior to the conventional in patients with cT3/T4 colon cancer. Background: No touch involves ligating blood vessels that feed the primary tumor to limit cancer cell spreading. However, previous studies did not confirm the efficacy of the no touch. Methods: This open-label, randomized, phase III trial was conducted at 30 Japanese centers. The eligibility criteria were histologically proven colon cancer; clinical classification of T3–4, N0–2, andM0; and patients aged 20 to 80years. Patients were randomized (1:1) to undergo open surgery with conventional or the no touch. Patients with pathological stage III disease received adjuvant capecitabine chemotherapy. The primary endpoint was disease-free survival (DFS) according to the intention-to-treat principle. Results: Between January 2011 and November 2015, 853 patients were randomized to the conventional group (427 patients) or the no touch group (426 patients). The 3-year DFS were 77.3% [95% confidence interval (CI) 73.1%–81.0%] and 76.2% (95% CI 71.9%–80.0%) in the conventional and no touch groups, respectively. The superiority of no touch was not confirmed: hazard ratio for DFS = 1.029 (95% CI 0.800– 1.324; 1-sided P = 0.59). Operative morbidity was observed in 31 of 427 conventional patients (7%) and 26 of 426 no touch patients (6%). All grade adverse events were similar between the conventional and no touch groups. No in-hospital mortality occurred in either group. Conclusion: The present study failed to confirm the superiority of the no touch. View on Web

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