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Πέμπτη 10 Νοεμβρίου 2022

Similarities and controversies in imaging of pediatric renal tumors: A SIOP‐RTSG and COG collaboration

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Abstract

Malignant renal tumors are rare in children, and Wilms tumors (WTs) are the most common subtype. Imaging plays an essential role in the diagnosis, staging, and follow-up of these patients. Initial workup for staging is mainly performed by cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Imaging approach within the two core international groups, the Children's Oncology Group (COG, North America) and the International Society of Pediatric Oncology - Renal Tumor Study Group (SIOP-RTSG, Europe), differs. Whereas abdominal ultrasound (US) is used for the initial diagnosis of a suspected pediatric renal tumor globally, COG protocols support the use of CT or MRI for locoregional staging, contrary to the preference for MRI over CT for abdominopelvic evaluation within the SIOP-RTSG. The purpose of this manuscript is to summarize current imaging approaches, highlighting differences and similarities within these core international grou ps, while focusing on future innovative efforts and collaboration within the HARMONICA initiative.
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Global survival trends for brain tumors, by histology: analysis

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Abstract
Background
Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.
Methods
We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.
Results
The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in s urvival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults.
Conclusions
To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Cetuximab-Based vs Carboplatin-Based Chemoradiotherapy for Patients With Head and Neck Cancer

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This cohort study compares survival with cetuximab-based and carboplatin-based chemoradiotherapy in locally advanced head and neck squamous cell carcinoma.
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Assessment of Fat Fractions in the Tongue, Soft Palate, Pharyngeal Wall, and Parapharyngeal Fat Pad by the GOOSE and DIXON Methods

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imageObjective The 2-point DIXON method is widely used to assess fat fractions (FFs) in magnetic resonance images (MRIs) of the tongue, pharyngeal wall, and surrounding tissues in patients with obstructive sleep apnea (OSA). However, the method is semiquantitative and is susceptible to B0 field inhomogeneities and R2* confounding factors. Using the method, although several studies have shown that patients with OSA have increased fat deposition around the pharyngeal cavity, conflicting findings was also reported in 1 study. This discrepancy necessitates that we examine the FF estimation method used in the earlier studies and seek a more accurate method to measure FFs. Materials and Methods We examined the advantages of using the GOOSE (globally optimal surface estimation) method to replace the 2-point DIXON method for quantifying fat in the tongue and surrounding tissues on MRIs. We first used phantoms with known FFs (true FFs) to validate the GOOSE method and examine the errors in the DIXON method. Then, we compared the 2 methods in the tongue, soft palate, pharyngeal wall, and parapharyngeal fat pad of 63 healthy participants to further assess the errors caused by the DIXON method. Six participants were excluded from the comparison of the tongue FFs because of technical failures. Paired Student t tests were performed on FFs to detect significant differences between the 2 methods. All measures were obtained using 3 T Siemens MRI scanners. Results In the phantoms, the FFs measured by GOOSE agreed with the true FF, with only a 1.2% mean absolute error. However, the same measure by DIXON had a 10.5% mean absolute error. The FFs obtained by DIXON were significantly lower than those obtained by GOOSE (P
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Deep Learning-Enhanced Parallel Imaging and Simultaneous Multislice Acceleration Reconstruction in Knee MRI

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imageObjectives This study aimed to examine various combinations of parallel imaging (PI) and simultaneous multislice (SMS) acceleration imaging using deep learning (DL)-enhanced and conventional reconstruction. The study also aimed at comparing the diagnostic performance of the various combinations in internal knee derangement and provided a quantitative evaluation of image sharpness and noise using edge rise distance (ERD) and noise power (NP), respectively. Materials and Methods The data from adult patients who underwent knee magnetic resonance imaging using various DL-enhanced acquisitions between June 2021 and January 2022 were retrospectively analyzed. The participants underwent conventional 2-fold PI and DL protocols with 4- to 8-fold acceleration imaging (P2S2 [2-fold PI with 2-fold SMS], P3S2, and P4S2). Three readers evaluated the internal knee derangement and the overall image quality. The diagnostic performance was calculated using consensus reading as a standard reference, and we conducted comparative evaluations. We calculated the ERD and NP for quantitative evaluations of image sharpness and noise, respectively. Interreader and intermethod agreements were calculated using Fleiss κ. Results A total of 33 patients (mean age, 49 ± 19 years; 20 women) were included in this study. The diagnostic performance for internal knee derangement and the overall image quality were similar among the evaluated protocols. The NP values were significantly lower using the DL protocols than with conventional imaging (P 0.12). Interreader and intermethod agreements were moderate-to-excellent (κ = 0.574–0.838) and good-to-excellent (κ = 0.755–1.000), respectively. In addition, the mean acquisition time was reduced by 47% when using DL with P2S2, by 62% with P3S2, and by 71% with P4S2, compared with conventional P2 imaging (2 minutes and 55 seconds). Conclusions The combined use of DL-enhanced 8-fold acceleration imaging (4-fold PI with 2-fold SMS) showed comparable performance with conventional 2-fold PI for the evaluation of internal knee derangement, with a 71% reduction in acquisition time.
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Τετάρτη 9 Νοεμβρίου 2022

Obesity-related SNPs and weight gain following first-line antiretroviral therapy

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Abstract
Background
We studied the association of obesity-related SNPs (OR-SNPs) with weight gain after antiretroviral therapy (ART) in people with HIV (PWH).
Methods
Participants were ART-naïve PWH from the Spanish HIV Research Cohort who started ART from 2014 onwards and had blood/DNA deposited in the cohort Biobank. The primary outcome was change in weight at 96 weeks after starting ART. We genotyped 14 OR-SNPs from a meta-analysis of GWAS body mass index (B MI) loci. Changes over time in weight and BMI were studied using adjusted linear mixed models (A-LMM).
Results
A total of 1,021 PWH were included. The mean weight gain over 96 weeks was 2.90 (95% CI: 2.54–3.26) Kg. Factors associated with higher weight gain were female sex, birth in Sub-Saharan Africa, prior AIDS, CD4+ < 200 cells/uL, HIV-RNA > 100,000 copies/mL, negative HCV serology, and use of tenofovir alafenamide. A significant association was found between ZC3H4 rs3810291 GG genotype and BCDIN3D/FAIM2 rs7138803 GG genotypes polymorphisms and weight and BMI increase. The estimated adjusted mean (SE) of weight gains were 4.26 (0.56) Kg in ZC3H4 rs3810291 GG carriers and 2.66 (0.19) Kg in AA/AG carriers (P = 0.007). Likewise, the estimated means (SE) weight gain at 96 weeks were 3.35 (0.29) Kg in BCDIN3D/FAIM2 rs7138803 GG carriers and 2.51 (0.24) Kg in AG/AA carriers (P = 0.020).
Conclusions
Genetic factors may play a role in weight gain after ART initiation. Further work is needed to replicate our findings and understand how the identified SNPs lead to higher weight gain in this context.
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Comprehensive analysis of HHV‐6 and HHV‐7‐related gene signature in prognosis and response to temozolomide of glioma

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Abstract

Background

Human herpesvirus (HHV)-6 and HHV-7 have been detected in central nervous system and glioma tissue, while their exact role in glioma remains uncertain.

Methods

Omics profiles and clinical information were downloaded from public databases, including TCGA cohort for training set and the CGGA cohorts for validation sets. Differentially expressed genes between HHV-6 and HHV-7 infected or non-infected glioma patients were screened for establishing the HHV-6 and HHV-7 infection (HI) model through Lasso regression analysis. Bioinformatics methods were used to analyze the correlation between HI scores and prognosis, metastasis in glioma patients. Predictable efficacy of HI in temozolomide-resistance and HI-related genetic signatures were also explored.

Results

The HI model was constructed as: Risk score = (0.014709*DIRAS3) + (0.029787*TEX26) + (0.223492*FBXO39) + (0.074951*MYBL1) + (0.060202*HILS1). The 5 gene signature showed good perfor mance in predicting survival time for glioma patients, while higher HI score is correlated with malignant features. Moreover, DNA mismatch repair genes were augmented in glioma patients with higher HI score as well as non-response to temozolomide treatment, which was in parallel with the transcriptomic result of temozolomide-resistant glioma cell.

Conclusions

Targeting the five gene signature is beneficial for prognosis of glioma patients, especially in glioma patients underwent temozolomide treatment.

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Uprighting a Mesially Tilted Molar Using Customized Titanium Healing Abutment of an Adjacent Osseointegrated Implant

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Abstract

This case report evaluates the use of a customized healing abutment of a dental implant to upright a mesially tilted molar using elastic separating rings. The external surface of the healing abutment was roughened by air particle abrasion, and a flowable composite was applied as a collar around it. The size of the resin collar was increased several times during the molar uprighting treatment by replacing the elastic ring. The uprighting procedure was evaluated after 2 months using radiographic and clinical evaluations. After treatment, the mesiodistal space above the implant was increased from 6 mm to 9 mm as follows: 2 mm by uprighting the second molar and 1 mm by mesial shifting the second premolar, and then a screw-retained zirconia crown was placed to restore the implant. The healing abutment of the implant can be modified by adding a resin collar and used as orthodontic anchorage for uprighting the adjacent tilted molar to facilitate the prosthetic procedure. Neither special instruments nor an orthodontic background are required for this minor tooth movement.

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Expression of Ki-67 and P16 are related with HPV in squamous cell carcinoma of the external auditory canal

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Squamous cell carcinoma of the external auditory canal (EACSCC) is an uncommon tumor and responsible for no more than 0.2% of all the head and neck malignancies. Although there is remarkable research evidence ...
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Τρίτη 8 Νοεμβρίου 2022

Efficacy and tolerability of concomitant use of bedaquiline and delamanid for multidrug- and extensively drug-resistant tuberculosis: a systematic review and meta-analysis

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Abstract
The introduction of two novel drugs, bedaquiline and delamanid, has given hope for better and shorter treatments of drug-resistant tuberculosis. A systematic review was conducted to evaluate the efficacy and safety of concomitant bedaquiline and delamanid administration. Pooled estimates of WHO-defined favorable treatment outcome and significant QTc-interval prolongation (QTc ≥500 ms or ≥60 ms increase from baseline) were calculated using a random effects model. Thirteen studies including a total of 1031 individuals with multidrug-resistant/rifampicin-resistant tuberculosis who received bedaquiline and delamanid were included. The pooled estimate of favorable treatment outcome was 73.1% (95%CI: 64.3-81.8). Sputum culture conversion at six months ranged from 61-95%. Overall, the pooled proportion of QTc-prolongation was 7.8% (95%CI: 4.1-11.6) and few cardiac events were reported (0.8%, n = 6/798). Rates of sputum culture conversion and favorable treatment outcome were high in patients treated concomitantly with bedaquiline and delamanid, and the treatment seemed tolerable with low rates of clinically significant cardiac toxicity.
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