Evaluation the efficacy and safety of N‐acetylcysteine inhalation spray in controlling the symptoms of patients with COVID‐19: An open‐label randomized controlled clinical trial

alexandrossfakianakis shared this article with you from Inoreader Evaluation the efficacy and safety of N‐acetylcysteine inhalation spray in controlling the symptoms of patients with COVID‐19: An open‐label randomized controlled clinical trial via Journal of Medical Virology Abstract Background The aim of this study was to evaluate the effect and safety of N-acetylcysteine (NAC) inhalation spray in the treatment of patients with coronavirus disease 2019 (COVID-19). Methods This randomized controlled clinical trial study was conducted on patients with COVID-19. Eligible patients (n=250) were randomly allocated into the intervention group (routine treatment + NAC inhaler spray one puff per 12 hours, for 7 days) or the control group who received routine treatment alone. Clinical features, hemodynamic, hematological, biochemical parameters and patient outcomes were assessed and compared before and after treatment. Results The mortality rate was significantly higher in the control group than in the intervention group (39.2% vs 3.2%, P<0.001). Significant differences were found between the two groups (intervention and control, respectively) for white blood cell count (6.2 vs 7.8, P<0.001), hemoglobin (12.3 vs 13.3, P=0.002), C-reactive protein (CRP: 6 vs 11.5, P<0.0001) and aspartate aminotransferase (AST: 32 vs 25.5, P<0.0001). No differences were seen for hospital length of stay (11.98±3.61 vs 11.81±3.52, P=0.814) or the requirement for ICU admission (7.2% vs 11.2%, P=0.274). Conclusions NAC was beneficial in reducing the mortality rate in patients with COVID-19 and inflammatory parameters, and a reduction in the development of severe respiratory failure; however, it did not affect the length of hospital stay or the need for ICU admission. Data on the effectiveness of NAC for SARS-CoV-2 is limited and further research is required. Clinical Trial Registration This study Registered at Iranian Registry of Clinical Trials (IRCT20080901001165N55) dated 23-05-2020. This article is protected by copyright. All rights reserved. View on Web

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The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia

alexandrossfakianakis shared this article with you from Inoreader The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia via Pediatric Blood & Cancer Abstract Background Recent studies have demonstrated hematogones (HGs) expansion to be associated with favorable outcomes in hematological diseases, especially in patients with acute myeloid leukemia and patients undergoing hematopoietic stem cell transplantation. Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children. As of now, minimal residual disease (MRD) remains the most compelling independent prognostic factor in childhood ALL. There is need for more prognostic tools for evaluating relapse risk. Procedure The goal of this study was to assess the prognostic value of HGs on relapse-free survival (RFS) and overall survival (OS) in childhood ALL. In this prospective cohort study, a total of 122 subjects with definitive diagnosis of precursor B lymphoblastic leukemia were evaluated. Flow cytometric HG detection was performed in bone marrow aspirates after induction and consolidation therapy. Results The median follow-up period of patients was 35.5 ± 9.4 (SD) months. Patients who had at least 1.0% HGs had a significantly better RFS (p = .023). Moreover, univariate and multivariate analyses confirmed that positive HGs were independently associated with longer RFS (unadjusted model: hazard ratio = 0.33, 95% CI = 0.12–0.91, p = .031; adjusted model: hazard ratio = 0.30, 95% CI = 0.11–0.82, p = .020). Conclusions Along with the role of MRD, our study shows the significance of HGs as an independent prognostic factor. The results indicate the independent prognostic value of HGs on RFS after adjustment for other prognostic factors, and can be beneficial for risk stratification and treatment modifications amongst pediatric B-cell ALL patients. View on Web

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Endonasal Lacrimal Transposition to Expand Pre‐Lacrimal Medial Maxillectomy Approach

alexandrossfakianakis shared this article with you from Inoreader Endonasal Lacrimal Transposition to Expand Pre‐Lacrimal Medial Maxillectomy Approach via The Laryngoscope EPLA lacrimal transposition facilitates management of maxillary sinus/pterygopalatine fossa lesions and overcomes limitations such as the Simmen type I recess or IPMS pedicled on the medial wall, without increasing peri-operative morbidity. Laryngoscope, 2022 View on Web

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Asymptomatic Patients and Rising Incidence of Thyroid Cancer

alexandrossfakianakis shared this article with you from Inoreader Asymptomatic Patients and Rising Incidence of Thyroid Cancer via JAMA Otolaryngology–Head & Neck Surgery Current Issue To the Editor The overdiagnosis of thyroid cancer has been a global public health problem. We read the recent study by Sajisevi et al in which the authors retrospectively analyzed data from 1328 patients who underwent thyroid-directed surgery and suggested limiting overtreatment of asymptomatic thyroid cancer. Herein, we raise several concerns. View on Web

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Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea

alexandrossfakianakis shared this article with you from Inoreader Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea via JAMA Otolaryngology–Head & Neck Surgery Current Issue This randomized clinical trial examines whether modified uvulopalatopharyngoplasty is more effective than tonsillectomy alone for treating adults with tonsillar hypertrophy and moderate to severe obstructive sleep apnea. View on Web

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American Thyroid Association Guidelines and Management of Papillary Thyroid Carcinoma

alexandrossfakianakis shared this article with you from Inoreader American Thyroid Association Guidelines and Management of Papillary Thyroid Carcinoma via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study determines how the 2009 and 2015 Americ an Thyroid Association guidelines may have corresponded with trends in the management of patients with low-risk papillary thyroid carcinoma. View on Web

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Berichtetes und gemessenes Riech- und Schmeckvermögen in einer Long-COVID-Kohorte

alexandrossfakianakis shared this article with you from Inoreader Berichtetes und gemessenes Riech- und Schmeckvermögen in einer Long-COVID-Kohorte via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1970-6510 Einleitung Störungen des Riech- und Schmecksinns werden häufig zahlenmäßig übereinstimmend als Long-COVID-Symptom beklagt. Anhand von Befunden einer Spezialsprechstunde (HNO-LCS) soll geklärt werden, wie groß tatsächlich der Anteil pathologischer olfaktorischer bzw. gustatorischer Diagnosen in dieser Kohorte ist. Methodik 48 erwachsene Patienten, die die HNO-LCS aus eigenem Leidensdruck aufsuchten, wurden nach ihrer Anamnese befragt, sie schätzten ihr Riech- (SER) und Schmeckvermögen (SES) mit Schulnoten ein und absolvierten als Riechtest den erweiterten Sniffin'Sticks-Test und als Schmecktest den 3-Tropfen-Test. Aus dem SDI-Riechscore und dem totalen Schmeckscore (SScore-total) wurden anhand von Normwerten Diagnosen erstellt. Zwischen den gemessenen Scores und der Selbsteinschätzung und zwischen SER und SES wurden Korrelationen berechnet. Ergebnisse Tatsächliche pathologische chemosensorische Diagnosen bestanden bei 90% der Patienten. Pathologische olfaktorische Diagnosen waren doppelt so häufig wie gustatorische. Bei 10% der Kohorte war keine pathologische Diagnose verifizierbar. Bei 6 Patienten wurde ein Anosmie-Ageusie-Syndrom diagnostiziert. SER korrelierte stark mit SDI. SES korrelierte moderat mit SScore-total. SER korrelierte stark mit SES. Schlussfolgerungen Bei der Interpretation berichteter chemosensorischer Symptome besteht die Gefahr einer Konfusion von Riechen und Schmecken durch die Betroffenen. Deshalb ist die Überprüfung der chemischen Sinne mit validierten Tests in Long-COVID-Ambulanzen wichtig. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

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Main Causal Agents of Occupational Asthma

alexandrossfakianakis shared this article with you from Inoreader Main Causal Agents of Occupational Asthma in France, Reported to the National Network for Occupational Disease Vigilance and Prevention (RNV3P) 2001–2018 via Annals of Work Exposures and Health Advance Access Abstract Objectives The definition of work-related Asthma (WRA) has changed in recent years and new etiologies and agents have been identified. The aim of this study is to describe the main causal agents of WRA in France in the period 2001–2018 in the main work sectors. Methods Data were collected from the French national network of occupational health surveillance and prevention [Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)], Data between 2001 and 2018 with at least a probable or certain association with one occupational agent, were included. Results Work sectors with more cases OF WRA included personal service activities (10.6%), food industry (10.2%) and healthcare activities (7.6%). WRA cases were most frequently related to flour (10%), quaternary ammoniums compounds (5.3%), isocyanates (5.1%) and cleaning products (4.8%). Conclusion Occupational exposure to specific ag ents capable of causing WRA is still present, and four agents represent more than 25% of the cases. Actions to prevent respiratory exposure are still relevant. View on Web

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Switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e‐Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients

alexandrossfakianakis shared this article with you from Inoreader Six months multicentre pilot open label single‐arm study to evaluate patient experience, acceptability and satisfaction of switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e‐Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients via Journal of Clinical Pharmacy and Therapeutics AVA® is a new electromechanical injection device for self-injecting certolizumab pegol (CZP). Thirty four patients were included (28 women) RA 11, PsA 10 and axial axSpA 13. Patients reported >90% adherence assessed with AVA® injection log and the full dose of CZP was injected on all patients with AVA® device. No safety findings related to AVA® CZP administration were identified. AVA® device is an advantageous delivery option for CZP. This study provides further evidence to support that AVA® device is a valid method for switching CZP from syringe or pen with highly preference in patients with RA, PsA and axSpa. Abstract What Is Known and Objective The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients. Method A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA® questionnaire. Patients were instructed on proper administration of CZP by AVA®. After 2 and 6 months of CZP self-injections using the AVA®, patient experience, adherence, preference and safety of each administration was assessed using post-AVA® questionnaire. Results and Discussion Thirty four patients were included (28 women). All patients self-administered CZP AVA® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA® assessed with the injection log. Pain at the injection site was reduced after switching to AVA®. Twenty nine patients preferred CZP AVA® and five patients preferred the CZP pen. No safety-related findings related to AVA® CZP administration were identified. What Is New and Conclusion The AVA® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA. View on Web

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Trotabresib, an oral potent bromodomain and extraterminal inhibitor, in patients with high-grade gliomas: a phase I, “windowofopportunity” study

alexandrossfakianakis shared this article with you from Inoreader Trotabresib, an oral potent bromodomain and extraterminal inhibitor, in patients with high-grade gliomas: a phase I, "windowofopportunity" study via Neuro-Oncology Advance Access Abstract Background The bromodomain and extraterminal protein (BET) inhibitor trotabresib has demonstrated antitumor activity in patients with advanced solid tumors, including high-grade gliomas. CC-90010-GBM-001 (NCT04047303) is a phase I study investigating the pharmacokinetics, pharmacodynamics, and CNS penetration of trotabresib in patients with recurrent high-grade gliomas scheduled for salvage resection. Methods Patients received trotabresib 30 mg/day on days 1–4 before surgery, followed by maintenance trotabresib 45 mg/day 4 days on/24 days off after surgery. Primary endpoints were plasma pharmacokinetics and trotabresib concentrations in resected tissue. Secondary and exploratory endpoints included safety, pharmacodynamics, and antitumor activity. Results Twenty patients received preoperative trotabresib and underwent resection with no delays or cancellations of surgery; 16 patients received maintenance trot abresib after recovery from surgery. Trotabresib plasma pharmacokinetics were consistent with previous data. Mean trotabresib brain tumor tissue:plasma ratio was 0.84 (estimated unbound partition coefficient [KPUU] 0.37), and modulation of pharmacodynamic markers was observed in blood and brain tumor tissue. Trotabresib was well tolerated; the most frequent grade 3/4 treatment-related adverse event during maintenance treatment was thrombocytopenia (5/16 patients). Sixmonth progression-free survival was 12%. Two patients remain on treatment with stable disease at cycles 25 and 30. Conclusions Trotabresib penetrates the blood–brain-tumor barrier in patients with recurrent high-grade glioma and demonstrates target engagement in resected tumor tissue. Plasma pharmacokinetics, blood pharmacodynamics, and safety were comparable with previous results for trotabresib in patients with advanced solid tumors. Investigation of adjuvant trotabresib + temozolomide and concom itant trotabresib + temozolomide + radiotherapy in patients with newly diagnosed glioblastoma is ongoing (NCT04324840). View on Web

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