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Introduction: Gastrointestinal stromal tumors (GISTs), soft tissue sarcomas of the digestive tract, are associated with oncogenic mutations that led to the approval of tyrosine kinase inhibitors (TKIs) [1-2]. Considering the increased use of TKIs in clinical practice, it may be useful to identify unexpected adverse drug reactions (ADRs). Objective: The aim of this study was to describe better ADRs and to identify unexpected potential safety signals through the analysis of individual case safety reports (ICSRs) among TKIs approved for GIST collected into the European Spontaneous Reporting System (SRS) database. Methods: All ICSRs recorded starting from the drug approval up to 31 December 2021 with one of the following TKIs reported as suspected drug were included: imatinib (IM), sunitinib (SU), avapritinib (AVA), regorafenib (REG), and ripretinib (RIP). A descriptive analysis was conducted to assess all demographic characteristics. Moreover, a disproportionality analysis was performed using the Reporting Odds Ratio (ROR) with the corresponding 95% Confidence Interval (CI) to evaluate the frequency of ADRs for each TKI compared to all other TKIs. Results The number of analyzed ICSRs was 8,512 (Figure 1 Flowchart of ICSRs selection process): the 57.9% were related to IM, followed by SU (24.2%), AVA (13.1%), REG (2.7%), and RIP (2.1%). ICSRs were mainly serious (87.5%), related to males (51.7%), and to adults (44.7%);moreover, the 25.5% were fatal. The disproportionality analysis showed a higher reporting frequency of some unexpected ADRs for each TKI: gait disturbance (ROR 2.86;95% CI 1.90-4.29), hyperhidrosis (2.57;1.06-6.20), and hyperammonemia (3.92;1.05-14.60) for SU;cerebrovascular accident (6.23;2.18-17.84), hemoglobin decreased (2.23;1.08-4.61), and internal haemorrhage (14.44;3.94-52.92) for RIP;gastrointestinal ulcer (10.88;2.98-39.81) for REG;hepatic and lung cancer for IM (12.79;8.04-20.37 and 7.71;3.33-17.84, respectively);hallucination (24.33;9.02-65.68), mood swings (8.02;2.44-26.33), and stress (6.68;1.93-23.11), nephrolithiasis (6.69;2.15-20.77), pollakiuria (3.08;1.17-8.13), and dialysis (6.68;1.67-26.73), sinusitis (3.34;1.14-9.78), cellulitis (4.17;1.36-12.78), and COVID-19 (7.25;3.40-15.45), chills (2.36;1.22-4.58), limb fracture (3.53;1.63-7.60), hernia (9.23;3.71-23.00), diabetes mellitus (5.02;2.11-11.95), hyposideraemia (5.02;2.11-11.95), tinnitus (3.64;1.34-9.87), parosmia (5.00;1.12-22.38), Raynaud's phenomenon (5.00;1.12-22.38), and thyroid function test abnormal (8.90;1.99-39.83) for AVA. Conclusion: This study is largely consistent with results from literature but some unexpected ADRs were shown. Further studies are necessary to increase the awareness about the safety profiles of new TKIs approved for GISTs.
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OBJECTIVE: To investigate and analyze the genotyping, virulence genes and drug-resistant genes of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from skin and soft tissue infections in this area. METHODS: The skin secretions of 204 patients with skin and soft tissue infections in the Fifth Central Hospital of Tianjin between Jan. 2019 and Dec. 2020 were collected, and MRSA strains identified as non-repetitive strains were isolated. The Staphylococcal cassette chromosome mec (SCCmec) and Staphylococcal protein A gene (spa) genotyping and Panton-valentine leukocidin (PVL) gene carrying status were analyzed among the MRSA strains, and their relationship with drug resistance was analyzed. RESULTS: Totally 82 strains of S. aureus were isolated from the skin secretions of 204 patients with skin and soft tissue infections, including 44 strains of MRSA (53.66%). The most common SCCmec genotype was genotype III (accounting for 84.09%) and the most common spa genotype was genotype t030 (accounting for 84.09%). PVL genes encoding virulence factors were amplified in 5 strains (11.36%). The drug resistance rates of 44 MRSA strains to vancomycin and compound sulfamethoxazole were 0.00%, and all the strains were drug-resistant to penicillin. Different SCCmec and spa genotypes were highly resistant to erythromycin, cefazolin, clindamycin and levofloxacin, but the differences in drug resistance rates of different SCCmec genotypes to clindamycin and levofloxacin were significant (P < 0.05). The resistance rates of strains with PVL positive genes to chloramphenicol, gentamicin and tetracycline were significantly higher than those with PVL negative genes (P < 0.05). CONCLUSION: Strains carrying SCCmec III and spa t030 genotypes may be the dominant strains of MRSA in skin and soft tissue infections in this area. Spa genotypes and PVL gene have certain impact on drug resistance of MRSA, and the isolated MRSA strains are all sensitive to vancomycin and compound sulfamethoxazole, which can provide a reference for anti-MRSA treatment in this area.
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Objective: To evaluate the impact of the Covid-19 outbreak on surgical management of musculoskeletal oncology patients. Methodology: A total of 76 patients were identified and included in this observational study for which data was collected from the databases of Hayatabad Medical Complex, Peshawar & Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan from March till August 2020. Patients having malignant bone and soft tissue tumours and locally aggressive benign tumours were included in this study. All the patients underwent PCR investigation for SARS-CoV-19 virus pre-operatively and surgeries were performed in PCR negative and asymptomatic PCR positive patients only, with protective equipment.
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Early diagnosis of pulmonary implications is fundamental for the treatment of several diseases, such as idiopathic pulmonary fibrosis, rheumatoid arthritis, connective tissue diseases and interstitial pneumonia secondary to COVID-19 among the many. Recent studies prove that a wide class of pulmonary diseases can be early detected by auscultation and suitably developed algorithms for the analysis of lung sounds. Indeed, the technical characteristics of sensors have an impact on the quality of the acquired lung sounds. The availability of a fair and quantitative approach to sensors’comparison is a prerequisite for the development of new diagnostic tools. In this work the problem of a fair comparison between sensors for lung sounds is decoupled into two steps. The first part of this study is devoted to the identification of a synthetic material capable of mimicking the acoustic behavior of human soft tissues;this material is then adopted as a reference. In the second part, the standard skin is exploited to quantitatively compare several types of sensors in terms of noise floor and sensitivity. The proposed methodology leads to reproducible results and allows to consider sensors of different nature, e.g. laryngophone, electret microphone, digital MEMS microphone, mechanical phonendoscope and electronic phonendoscope. Finally, the experimental results are interpreted under the new perspective of equivalent sensitivity and some important guidelines for the design of new sensors are provided. These guidelines could represent the starting point for improving the devices for acquisition of lung sounds. IEEE
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OBJECTIVES: The aim of the study was the long-term assessment of the condition of periodontal tissues after corticotomy-assisted orthodontic expansion in patients with transverse maxillary deficiency. MATERIALS AND METHODS: The study included a group of 18 adults (9 women, 9 men) aged between 24 and 40 years who were at least 5 years post treatment. The following parameters were assessed: the full mouth plaque index (FMPI), full mouth bleeding on probing (FMBOP), probing depth (PD), clinical attachment level (CAL), gingival recession height (GR), recession width (RW), papilla height (PH), papilla width (PW), bone sounding (BS), phenotype, and KT. RESULTS: During examination performed at least 5 years after the completion of orthodontic treatment, the values of PD and CAL were found to be considerably decreased compared to the examination one year post treatment (PD: -0.23; 95% Cl: -0.29, -0.16) (CAL: -0.04; 95% Cl: -0.17, 0.10). The other parameters-FMPI, FMBOP, GR, RW, PH, PW, BS, phenotype, and KT-did not change significantly. CONCLUSIONS: Corticotomy-assisted orthodontic arch expansion does not have a negative effect on the periodontium in long-term observations. CLINICAL RELEVANCE: Orthodontic arch expansion can lead to bone dehiscence and gingival recession. Long-term observations revealed that corticotomy-assisted orthodontic expansion of the upper arch is not followed by negative changes in periodontal status.
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Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.