Alterations in Vaginal Microbiota among Pregnant Women with COVID‐19

alexandrossfakianakis shared this article with you from Inoreader Alterations in Vaginal Microbiota among Pregnant Women with COVID‐19 via Journal of Medical Virology Abstract The maintenance of vaginal microbiota is an important factor to achieve optimum pregnancy outcomes. The study aims to describe the alterations in the composition of vaginal microbiota in pregnant women with COVID-19. This was a prospective case-control study. Vaginal swabs were collected from uninfected pregnant women (n=28) and pregnant women with COVID-19 (n=19) during the active phase of infection and within a month after recovering from infection. The vaginal microbiota on the swabs was examined by 16S rRNA gene sequencing. Shannon index indicates that alpha diversity is significantly higher in women with COVID-19 (P=0.012). There was a significant decrease in Firmicutes (P=0.014) with an increase in Bacteroidota (P=0.018) phyla and a decrease in Lactobacillus (P=0.007) genus in women with COVID-19 than those of uninfected pregnant women. The relative abundance of L.crispatus, L.iners, L.gasseri, and L.jenseni i were lower in the COVID-19 group than in uninfected pregnant women. In subgroup analysis, the amount of Ureaplasma spp. was higher in women with moderate/severe than those of asymptomatic/mild disease (P=0.036). The study revealed that vaginal dysbiosis with low abundance of Lactobacillus species occurred in pregnant women infected with SARS-CoV-2. These findings may lead to new studies to elucidate the risk of pregnancy adverse outcomes related to COVID-19. This article is protected by copyright. All rights reserved. View on Web

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Management of childhood cancer survivors at risk for thyroid function abnormalities: A Delphi study

alexandrossfakianakis shared this article with you from Inoreader Management of childhood cancer survivors at risk for thyroid function abnormalities: A Delphi study via Pediatric Blood & Cancer Abstract Background Thyroid function abnormalities can occur after treatment for childhood cancer. Evidence for the management of thyroid dysfunction among asymptomatic childhood cancer survivors (CCS) is lacking. We used a Delphi consensus methodology to expand guidelines for screening asymptomatic CCS at risk for thyroid dysfunction and explore recommendations for the clinical management of abnormal results. Procedure A Delphi panel of 40 expert physicians representing oncology, endocrinology, and primary care participated in three rounds of anonymous, iterative questionnaires formatted as clinical scenarios. Consensus is defined as ≥ 90% of panelists agree with recommendation and disagreement as < 70% agree. Results Panelists reached consensus that CCS treated with radiation including neck, total body, whole brain, brain including the hypothalamic-pituitary axis (HPA), and therapeutic meta-iodobenzylguanidine (MIBG) should have annual, lifelong screening using serum thyroid-stimulating hormone (TSH) and free T4 starting within one year off-treatment (98%). Panelists disagreed on continuing to screen CCS for thyroid dysfunction after immunotherapy associated with acute thyroid injury (31%-50%). There was also disagreement on indications for brain (17%-43%) or thyroid (50%-65%) imaging, laboratory tests to assess the HPA (29%-75%), and TSH threshold to initiate treatment of subclinical hypothyroidism. Lack of evidence was the most frequent rationale panelists offered for not recommending additional testing or medications. Panelists' recommendations did not vary by geography, specialty, or survivorship clinical experience. Conclusions Consensus was reached on most recommendations for screening and management of cancer treatment-related thyroid dysfunction. Screening after completion of thyroid-toxic immunotherapy, indications for imaging, and treatment of subclinical hypothyroidism are areas of disagreement for further investigation. View on Web

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Myeloperoxidase‐positive bilineal mixed phenotype acute leukemia (B/T) with chromosome copy neutral loss of heterozygosity exhibits simultaneous diffuse leukemic infiltrations in the lung, bone, and endorachis

alexandrossfakianakis shared this article with you from Inoreader Myeloperoxidase‐positive bilineal mixed phenotype acute leukemia (B/T) with chromosome copy neutral loss of heterozygosity exhibits simultaneous diffuse leukemic infiltrations in the lung, bone, and endorachis via Pediatric Blood & Cancer View on Web

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Associations between findings of Fusobacterium necrophorum or beta-hemolytic streptococci and complications in pharyngotonsillitis - a registry-based study in Southern Sweden

alexandrossfakianakis shared this article with you from Inoreader Associations between findings of Fusobacterium necrophorum or beta-hemolytic streptococci and complications in pharyngotonsillitis - a registry-based study in Southern Sweden via Clinical Infectious Diseases Advance Access Abstract Background Most pharyngotonsillitis guidelines focus on the identification of group A streptococci (GAS), guided by clinical scores determining whom to test with a rapid antigen detection test (RADT). Nevertheless, many RADT-negative patients are evaluated for Group C/G streptococci (GCS/GGS) and Fusobacterium necrophorum, yet their importance remains debated. Our primary aim was to evaluate associations between complications and findings of F. necrophorum, GAS or GCS/GGS in pharyngotonsillitis. Methods This was a retrospective, registry-based study of pharyngotonsillitis cases tested for F. necrophorum (PCR) and beta-hemolytic streptococci (culture) in the Skåne Region, Sweden 2013-2020. Patients with prior complications or antibiotics (30 days) were excluded. Data were retrieved from registries and electron ic charts. Logistic regression analyses were performed with a dichotomous composite outcome of complications as primary outcome, based on ICD-10-codes. Cases with negative results (PCR and culture) were set as reference category. Complications within 30 days were defined as peritonsillar or pharyngeal abscess, otitis, sinusitis, sepsis or septic complications, recurrence of pharyngotonsillitis (after 15-30 days) or hospitalization. Results Of 3700 registered cases, 28% had F. necrophorum, 13% GCS/GGS, 10% GAS and 54% negative results. 30-day complication rates were high (20%). F. necrophorum OR 1.8 (95CI 1.5-2.1) and GAS OR 1.9 (95CI 1.5-2.5) were associated with complications whereas GCS/GGS were negatively associated with complications OR 0.7 (95CI 0.4-0.98). Conclusion Our results indicate F. necrophorum as a relevant pathogen in pharyngotonsil litis, whereas the relevancy of testing for GCS/GGS is questioned. Yet, which patient to test and treat for F. necrophorum remains to be defined. View on Web

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Pregnancy status at the time of COVID-19 vaccination and incidence of SARS-CoV-2 infection

alexandrossfakianakis shared this article with you from Inoreader Pregnancy status at the time of COVID-19 vaccination and incidence of SARS-CoV-2 infection via Clinical Infectious Diseases Advance Access Abstract Background Pregnant women are recommended to receive COVID-19 vaccines; however, relative effectiveness of vaccination by pregnancy status is unclear. Methods We compared the relative effectiveness of mRNA COVID-19 vaccines according to whether women received both while pregnant (n= 7,412), one dose while pregnant (n = 3,538), both while postpartum (n = 1,856), or both doses while neither pregnant nor postpartum (n = 6,687). We estimated risk of SARS-CoV-2 infection starting 14 days after the second dose using Cox regression, reporting hazard ratios (HR) and 95% confidence intervals (CI). Secondly, we examined relative effectiveness of a third (booster) dose while pregnant compared to outside pregnancy. The major circulating variant during the study period was the Delta variant. Results 54% of women received two doses of the BNT162b2 vaccine, 16% received two doses of the mRNA-1273 vaccine, while 30% receiv ed one dose of both vaccines. Compared to women who received both doses while neither pregnant nor postpartum, the adjusted HR for a positive SARS-CoV-2 PCR test was similar if the woman received both doses while pregnant (1.04; 95% CI: 0.94, 1.17), one dose while pregnant and one dose before or after pregnancy (1.03; 95% CI: 0.93, 1.14), or both doses while postpartum (0.99; 95% CI: 0.92, 1.07). The findings were similar for BNT162b2 (Pfizer-BioNTech Comirnaty) and mRNA-1273 (Moderna Spikevax), and during Delta- and Omicron-dominant periods. We observed no differences in the relative effectiveness of the booster dose according to pregnancy status. Conclusions We observed similar effectiveness of mRNA vaccines against SARS-CoV-2 infection among women regardless of pregnancy status at the time of vaccination. View on Web

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Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

alexandrossfakianakis shared this article with you from Inoreader Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy via Journal of Clinical Periodontology ABSTRACT Aim The aim of this study was to investigate patient and tooth-level factors that may predict tooth loss and periodontitis progression in patients who have undergone at least 5 years of periodontal maintenance. Methods In this retrospective cohort study, 135 patients were examined after active periodontal therapy (APT) and periodontal maintenance for 5.09-8.65 years (mean 6.16±0.74 years). Regression models were applied to identify risk factors associated with tooth loss and disease progression. Results Stage IV periodontitis (Incidence Rate Ratio (IRR)=4.61; 95%CI [2.97,7.18], p<0.001), the presence of ≥5 sites with probing pocket depth (PPD)≥5mm at the end of APT (IRR=2.04; 95%CI [1.32,3.20], p<0.01), and residual PPD≥7mm at the end of APT (OR=3.01; 95%CI [1.14, 7.94], p<0.05) were risk factors for tooth loss. Residual PPD of 5mm (OR=2.02; 95%CI [1.20, 3.40], p<0.01) and 6mm (OR=2.41; 95%CI [1.22, 4.76], p<0.05) at the end of APT were risk factors for disease progression. Above 3mm, each 1mm increase in maximum PPD/clinical attachment loss was associated with an increased risk of tooth loss and disease progression. Conclusions Stage IV periodontitis is associated with an increased risk of tooth loss. Teeth with PPD≥5mm at the end of APT are at risk of periodontitis progression or tooth loss. This article is protected by copyright. All rights reserved. View on Web

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