Clinical and laboratory responses to tigecycline in children

alexandrossfakianakis shared this article with you from Inoreader Clinical and laboratory responses to tigecycline in children via Journal of Clinical Pharmacy and Therapeutics Resistant bacterial infections have become more common in recent years, its treatment becomes a difficult problem. Tigecycline has a broad-spectrum antibacterial activity including resistant pathogens. Tigecycline may be a safe and important option in pediatric nosocomial infections due to resistant bacteria. Paediatric patients treated with tigecycline from 1 January 2010 to 31 October 2018 were analysed retrospectively to assess the efficacy and safety of tigecycline in children. Clinical response was considered cure in patients with all clinical signs of tigecycline-induced infection disappearing, a complete laboratory response, and improvement without further antibacterial therapy. The clinical response in patients who were not cured but recovered to the extent deemed appropriate by the researcher was evaluated as remission. Clinical response was considered failure in patients with no clinical improvement, culture positivity, acute-phase reactant elevation, and need for additi onal antibacterial therapy. There was a total of 25,251 patients, 1301 of whom were hospitalized in paediatric intensive care during the study. Paediatric patients who received tigecycline for at least 2 days (at least four doses) were analysed. This study included 91 children who received tigecycline treatment and met the inclusion criteria, aged 7 months to 17.5 years (median 8 years). The median length of hospital stay was 62 days (14–251 days). The median duration of antibiotic treatment before tigecycline treatment was 27 days (4–30 days). Among the most common were glycopeptides (95.6%) and carbapenems (89%). There were no significant differences in clinical response between tigecycline as monotherapy and as combined therapy (p = 0.742). Studies on the efficacy of tigecycline in children are not prospective due to safety concerns but contain data from limited cases in which it was used as salvage therapy. In our study, tigecycline was gi ven to 73.6% of patients as monotherapy, and this is the largest series involving monotherapy. The fact that the patients used long-term and multiple antimicrobial agents before tigecycline treatment (95.6% glycopeptides and 89% carbapenems) limited the options of antibiotics. Therefore, the rate of monotherapy was high, and clinical success did not differ significantly between patients who started tigecycline as monotherapy and combination therapy. Abstract What is known and objective The frequency of multidrug-resistant bacterial infections is increasing worldwide. Tigecycline may be an important option for children with life-threatening nosocomial infections due to multidrug-resistant bacteria. However, there are few published data on the use of tigecycline in paediatric patients. By examining the results of tigecycline use in children, we aimed to draw attention to the fact that tigecycline may be an alternative in the treatment of resistant infections in children. Methods Paediatric patients treated with tigecycline from 1 January 2010 to 31 October 2018 at Eskişehir Osmangazi University Medical Faculty, which is a tertiary hospital, were analysed retrospectively to assess the efficacy and safety of tigecycline treatment in children. Patients using tigecycline were identified using the pharmacy database. Clinical and laboratory data were obtained from the files. Results and discussion This study included 91 children aged 7 months to 17.5 years; 52 were female (57.1%). At least one predisposing factor was present in 98.9% of the patients. Fifty-one bacteria were isolated from 44 patients. The tigecycline resistance rate was 3.9%. Only 2 of 91 patients experienced one or more side effects of tigecycline. Tigecycline can be used as salvage therapy in resistant infections where options are limited, although definitive conclusions about the efficacy and safety of tigecycline in children cannot be reached. What is new and conclusion Tigecycline may be a safe and important option in paediatric nosocomial infections due to resistant bacteria. Resistant bacterial infections have become more common in recent years, its treatment becomes a difficult problem. Tigecycline has a broad-spectrum antibacterial activity including resistant pathogens. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thrombosis and hemorrhage experienced by hospitalized children with SARS‐CoV‐2 infection or MIS‐C: Results of the PICNIC registry

alexandrossfakianakis shared this article with you from Inoreader Thrombosis and hemorrhage experienced by hospitalized children with SARS‐CoV‐2 infection or MIS‐C: Results of the PICNIC registry via Pediatric Blood & Cancer Abstract Introduction Coagulopathy and thrombosis associated with SARS-CoV-2 infection are well defined in hospitalized adults and leads to adverse outcomes. Pediatric studies are limited. Methods An international multicentered (n = 15) retrospective registry collected information on the clinical manifestations of SARS-CoV-2 and multisystem inflammatory syndrome (MIS-C) in hospitalized children from February 1, 2020 through May 31, 2021. This sub-study focused on coagulopathy. Study variables included patient demographics, comorbidities, clinical presentation, hospital course, laboratory parameters, management, and outcomes. Results Nine hundred eighty-five children were enrolled, of which 915 (93%) had clinical information available; 385 (42%) had symptomatic SARS-CoV-2 infection, 288 had MIS-C (31.4%), and 242 (26.4%) had SARS-CoV-2 identified incidentally. Ten children (1%) experienced thrombosis, 16 (1.7%) experienced hemorrhage, and two (0.2%) experienced both thrombosis and hemorrhage. Significantly prevalent prothrombotic comorbidities included congenital heart disease (p-value .007), respiratory support (p-value .006), central venous catheter (CVC) (p = .04) in children with primary SARS-CoV-2 and in those with MIS-C included respiratory support (p-value .03), obesity (p-value .002), and cytokine storm (p = .012). Comorbidities prevalent in children with hemorrhage included age >10 years (p = .04), CVC (p = .03) in children with primary SARS-CoV-2 infection and in those with MIS-C encompassed thromb ocytopenia (p = .001) and cytokine storm (p = .02). Eleven patients died (1.2%), with no deaths attributed to thrombosis or hemorrhage. Conclusion Thrombosis and hemorrhage are uncommon events in children with SARS-CoV-2; largely experienced by those with pre-existing comorbidities. Understanding the complete spectrum of coagulopathy in children with SARS-CoV-2 infection requires ongoing research. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

BCAP31 is involved in modulating colorectal cancer cell proliferation via the Emerin/β-catenin axis

alexandrossfakianakis shared this article with you from Inoreader BCAP31 is involved in modulating colorectal cancer cell proliferation via the Emerin/β-catenin axis via ScienceDirect Publication: Experimental Cell Research Publication date: Available online 15 June 2022 Source: Experimental Cell Research Author(s): Liping Han, Junyang Shi, Lili Zhao, Jiaqiang Deng, Yan Li, Hong Zhao, Huani Wang, Yan Yan, Fangdong Zou View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary tumor volume and prognosis for patients with p16-positive and p16-negative oropharyngeal squamous cell carcinoma treated with radiation therapy

alexandrossfakianakis shared this article with you from Inoreader Primary tumor volume and prognosis for patients with p16-positive and p16-negative oropharyngeal squamous cell carcinoma treated with radiation therapy via Radiation Oncology - Latest Articles The prescribed radiation dose to patients with oropharyngeal squamous cell carcinoma (OPSCC) is standardized, even if the prognosis for individual patients may differ. Easy-at-hand pre-treatment risk stratific... View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analgesia for Retinopathy of Prematurity Screening: A Systematic Review

alexandrossfakianakis shared this article with you from Inoreader Analgesia for Retinopathy of Prematurity Screening: A Systematic Review via Pain Practice Abstract Background and Aims Premature neonates require regular ophthalmological examination, generally indirect ophthalmoscopy, to screen for retinopathy of prematurity (ROP). Conventional analgesia is provided with topical anaesthetic eyedrops and oral sugar solution, but neonates still experience significant pain. Here, the literature base was examined to evaluate the usefulness of other pharmacological analgesics. Materials and Methods A systematic review was undertaken, adhering to a PROSPERO preregistered protocol in accordance with PRISMA guidelines (identifier CRD42022302459). Electronic databases were searched for primary research articles on pharmacological pain interventions used for ROP screening in neonates. The primary outcome measure was pain scores recorded using validated pain scoring tools, with and without pharmacological interventions in neonates during eye examination. For analysis, studies were separated into two categories: topical anaesthesia and alternative pharmacological treatments. Results Eleven studies met the inclusion criteria. Topical analgesia, oral paracetamol, and intranasal fentanyl were found to be effective in reducing the pain of eye examination. Oral morphine and inhaled nitrous oxide had no significant effect on premature infant pain profile (PIPP) scores during indirect ophthalmoscopy. Discussion In addition to topical anaesthesia, premedication with oral paracetamol is recommended during screening examination for ROP. The routine use of fentanyl is not recommended due to the risk of potential side effects. Non-pharmacological measures, such as sweet oral solutions and comfort techniques may also be employed. Further research is required to determine whether the use of nitrous oxide has a role, and to develop a safe and effective analgesic strategy to fully ameliorates the pain of ROP screening. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

FAM19A4/miR124-2 methylation testing and HPV16/18 genotyping in HPV-positive women under the age of 30 years

alexandrossfakianakis shared this article with you from Inoreader FAM19A4/miR124-2 methylation testing and HPV16/18 genotyping in HPV-positive women under the age of 30 years via Clinical Infectious Diseases Advance Access Abstract Introduction HSIL or CIN2/3 lesions in HPV-positive women <30 years have high spontaneous regression rates. To reduce overtreatment, biomarkers are needed to delineate advanced CIN lesions that require treatment. We analysed the FAM19A4/miR124-2 methylation test and HPV16/18 genotyping in HPV-positive women <30 years aiming to identify CIN2/3 lesions in need of treatment. Methods A European multicentre retrospective study was designed evaluating the FAM19A4/miR124-2 methylation test and HPV16/18 genotyping in cervical scrapes of 1,061 HPV-positive women aged 15-29 years (690 ≤CIN1, 166 CIN2 and 205 CIN3+). A subset of 62 CIN2 and 103 CIN3 were immunohistochemically characterized by HPV E4 expression, a marker for a productive HPV infection and p16ink4a and Ki-67, markers indicative for a transforming infection. CIN2/3 lesions with low HPV E4 expression and high p16ink4a/Ki-67 expression were considered as non-productive, transforming CIN, compatible with advanced CIN2/3 lesions in need of treatment. Results FAM19A4/miR124-2 methylation positivity increased significantly with CIN grade and age groups (<25, 25-29 and ≥30 years), while HPV16/18 positivity was comparable across age groups. FAM19A4/miR124-2 methylation positivity was HPV type independent. Methylation-positive CIN2/3 lesions had higher p16ink4a/Ki-67-immunoscores (p = 0.003) and expressed less HPV E4 (p = 0.033) compared with methylation-negative CIN2/3 lesions. These differences in HPV E4 and p16ink4a/Ki-67 expression were not found between HPV16/18-positive and non-16/18 HPV-positive lesions. Conclusions Compared with HPV16/1 8 genotyping, the FAM19A4/miR124-2 methylation test detects non-productive, transforming CIN2/3 lesions with high specificity in women <30 years, providing clinicians supportive information about the need for treatment of CIN2/3 in young HPV-positive women. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rebound Phenomenon after Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease-2019 in High-Risk Persons

alexandrossfakianakis shared this article with you from Inoreader Rebound Phenomenon after Nirmatrelvir/Ritonavir Treatment of Coronavirus Disease-2019 in High-Risk Persons via Clinical Infectious Diseases Advance Access ABSTRACT In a cohort of 483 high-risk patients treated with nirmatrelvir/ritonavir for coronavirus disease-2019, two patients (0.4%) required hospitalization by day 30. Four patients (0.8%) experienced rebound of symptoms, which were generally mild, at median of 9 days after treatment, and all resolved without additional COVID-19-directed therapy. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alterations in kinematics of temporomandibular joint associated with chronic neck pain

alexandrossfakianakis shared this article with you from Inoreader Alterations in kinematics of temporomandibular joint associated with chronic neck pain via Journal of Oral Rehabilitation Abstract Background Temporomandibular disorder (TMD) is an umbrella term for pain and dysfunction of the temporomandibular joint (TMJ) and its associated structures. Patients with TMD show changes in TMJ kinematics and masticatory muscle activation. TMD is commonly comorbid with non-specific chronic neck pain (NCNP), which may be one of the risk factors for TMD. Objectives This study aimed to investigate whether patients with NCNP have altered TMJ kinematics and masticatory muscle activity. Methods This was a cross-sectional exploratory study including 19 healthy participants and 20 patients with NCNP but without TMD symptoms. TMJ kinematics was measured during mouth opening and closing, jaw protrusion and jaw lateral deviation. Surface electromyography was used to record the muscle activity of the anterior temporalis, masseter, sternocleidomastoid, and upper trapezius while clenching. Furthermore, cervical posture, cervical range of motion (ROM), and pressure pain threshold of the neck and masticatory muscles were measured. Results Compared with the healthy group, the NCNP group showed significantly reduced upper cervical rotation ROM (p=0.041), and increased condylar path length (p=0.02), condylar translation (opening p=0.034, closing p=0.011), and mechanical pain sensitivity of the upper trapezius (p=0.018). Increased condylar translation was significantly correlated with reduced upper cervical mobility and poor cervical posture (r=−0.322 to −0.397; p=0.012–0.046). Conclusion Increased condylar translation and path length in patients with NCNP may indicate poor control of TMJ articular movement, which may result from neck pain or may be a compensation for limited neck mobility. Evaluation of excessive TMJ translation may be considered in patients with NCNP. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of a long noncoding RNA Gm17501 as a novel negative regulator of cardiac hypertrophy

alexandrossfakianakis shared this article with you from Inoreader Identification of a long noncoding RNA Gm17501 as a novel negative regulator of cardiac hypertrophy via ScienceDirect Publication: Experimental Cell Research Publication date: Available online 14 June 2022 Source: Experimental Cell Research Author(s): Zhuomin Liang, Wendong Fan, Hao Chen, Zhan-Peng Huang, Rong Fang, Bin Dong, Chen Chen, Jiayong Li, Gang Dai, Ruicong Xue, Yugang Dong, Chen Liu View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation between the intensity of Helicobacter pylori colonization and severity of gastritis: Results of a prospective study

alexandrossfakianakis shared this article with you from Inoreader Correlation between the intensity of Helicobacter pylori colonization and severity of gastritis: Results of a prospective study via Helicobacter Abstract Helicobacter pylori infection is strongly associated with chronic gastritis and is probably the main course of chronic inflammation in the gastric mucosa. Gradually, H. pylori gastritis will result in gastric atrophy and intestinal metaplasia. Identifying the relationship between intensity of colonization and activity of gastritis helps the clinician in more effective treatment and post-treatment follow-ups. The aim of our work was to analyze the relationship between the density of H. pylori colonization of the gastric mucosa and the severity of histological parameters of gastritis (inflammation activity, gastric atrophy, and intestinal metaplasia). This was a prospective monocentric study conducted from January 2020 to December 2020, collecting patients naive to any anti-H. pylori treatment and having a chronic H. pylori infection documented by histological examination. Epidemiological, endoscopic, and anathomopathological da ta were collected. Ninety-seven patients with a mean age of 42.6 years [18–65 years] and a sex ratio of M/F = 0.64 were included. The density of H. pylori colonization was mild (+) in 43.3% of patients, moderate (++) in 47.4% of patients, and significant (+++) in 9.3% of patients. Nearly, ten per cent of patients had no gastritis, 33% had mild gastritis, 50.5% had moderate gastritis, and 6.2% had severe gastritis. Gastric atrophy and intestinal metaplasia were found in 44.3% and 10.3% of our population, respectively. Patients with mild H. pylori colonization rates had the highest level of mild activity (59.5%). There was a statistically significant association between the severity of H. pylori infection and gastritis activity (p < .001). Gastric atrophy was significantly associated with the intensity of H. pylori colonization (p = .049). No significant relationship was found between the in tensity of colonization and metaplasia (p = .08). Our study shows that there is a statistically significant association between the density of H. pylori and histopathological findings including gastritis activity and intestinal atrophy. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.