A systematic review and meta-analysis of rhinoplasty using the rhinoplasty outcome evaluation scale

Background: The purpose was to evaluate the role and impact of the rhinoplasty outcome evaluation (ROE) in rhinoplasty. Objectives: To systematically review the ability of ROE to assess rhinoplasty outcome in the very recent surgical approaches. Data sources: Searching MESH terms "rhinoplasty" and "rhinoplasty and ROE" on PubMed, Scopus, Embase, Google Scholar, and other major literature databases. Study eligibility criteria: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses model was adopted for eligibility criteria. Participants and interventions: A first large screening on 1,660 papers allowed the final retrieval of 896 reports, of which only 101 were eligible for all the inclusion criteria, which allowed finally to select a group of 12 reports published in the time range 2018-2021. Study appraisal and synthesis methods: Meta-regression with Durbin-Watson test, checking of meta-analysis bias with Rosenthal's estimator, and heterogeneity through the I 2 statistics were performed. The analysis included a Mantel-Haenszel test and associated or meta-analysis. Results: Twelve eligible and qualified papers were included in the meta-analysis, out of 1,263 patients, from 1,660 papers. ROE confirmed previous reports about its ability to discriminate preoperative from postoperative outcome (50/100), as from the different rhinoplasty approaches, a value very close to the functional Nasal Obstruction Symptom Evaluation scale. This study strengthens the role of ROE in the evaluation of rhinoplasty outcomes encouraging further research to improve ROE scale on different cultural habits and geographical areas. Limitations: The main limitations were due to the weak inclusion and exclusion criteria, methodological flaws with the statistical analysis, and poor data synthesis and evaluation in many papers about ROE

AUTHOR CORRECTION - ERS International Congress 2019:highlights from Best Abstract awardees

Lorna E. Latimer, Marieke Duiverman, Mahmoud I. Abdel-Aziz, Gulser Caliskan, Sara M. Mensink-Bout, Alberto Mendoza-Valderrey, Aurelien Justet, Junichi Omura, Karthi Srikanthan, Jana De Brandt. Breathe 2019; 15: e143–e149. This article from the December 2019 issue of Breathe was published with an error in the name of one of the authors. The corrected author list is shown above. The article has been corrected and republished online.</p

ERS International Congress 2019:highlights from Best Abstract awardees

#ERSCongress 2019: highlights from Best Abstract awardees http://bit.ly/2XWlD7Y

Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project

Background: SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. Methods: Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. Results: 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged &lt; 50&nbsp;years, but nearly halved after 60&nbsp;years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since &lt; 64&nbsp;days to 86.2% when time elapsed was &gt; 130&nbsp;days. Conclusions: The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.BackgroundSARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue.MethodsMulticentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose.Results13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged &lt; 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since &lt; 64 days to 86.2% when time elapsed was &gt; 130 days.ConclusionsThe risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics

LONGITUDINAL ANALYSIS OF TRENDS IN SMOKING HABITS AND IMPACT OF CHANGES IN SMOKING AND BODY MASS ON LUNG FUNCTION

The tobacco epidemic has been the driving force to establish the foundation of the battle against tobacco use and effective public policy measures using simple preventative and targeting strategies against nicotine dependence. However, smoking is still a widespread phenomenon at various forms in recent years and the assessment of smoking trends and behavioral changes will reflect the attributes of impacted age groups to identify smoking prone populations and lead to strategize preventative and recovery systems. We analyzed the long-term trends in smoking initiation and cessation in order to identify age- and gender specific changes in Australian population over a 70 year timeline, utilizing the data from two longitudinal studies on the general population from the Tasmanian Health Study (TAHS) and the Busselton Health Study (BHS). To determine the effect of both smoking status and weight change on lung function in the general population, we also performed an analysis on lung function outcomes modulated by smoking behavioral changes relative to weight gain over 20 years in the European Community Respiratory Health Survey (ECRHS). We estimated trends in the rates of smoking initiation (number of incident smokers divided by total time at risk) between 1920 and 1989, by sex and age groups (11-15, 16-20, 21-35 years). The rates of smoking initiation during young adolescence (11-15 years) increased steeply between 1925 and 1980 in females. After being relatively stable, they slightly increased after the 70\u2019s also among males. In the same period, the rates showed a completely different trend between males and females during late adolescence (16-20 years): initiation rates in males decreased steeply, whereas they steadily increased in females. Smoking initiation during late adolescence peaked in the \u201840s for males and decreased afterward, while in females initiation increased until the mid-\u201870s. These results reflect the shift of smoking trend from boys to girls among teens, and they highlight a sharp increase in smoking initiation among Australian female adolescents during the \u201870s and \u201880s that is consistent with information available from Europe. Our findings also showed that quitters with high weight gain had faster lung function decline compared to quitters with moderate weight gain at older ages, but not at younger ages, highlighting the importance of early smoking cessation and weight control among quitters. Using a historical perspective, this longitudinal study documents early signs of the successful implementation of tobacco control measures in the Australian population. It underlines the importance of encourging positive awareness and implementing strategies for early smoking cessation, parallel to promoting prevention and stronger intervention strategies in youth. In addition, empowering and monitoring active and healthy living can improve the outcomes of smoking cessation on lung function trajectories and mitigate the future risk of diseases like asthma and COPD

Perception of Trifocal IOL Performance in Young Adults with High Astigmatism and Hyperopia and its Improvement Using Small Incision Lenticule Extraction

Hyperopia is a kind of refractive error in which incoming light is focused behind, instead of on, the retina wall due to insufficient accommodation by the lens. It is likely affected by ethnicity, geography, and a family history of hyperopia or accommodative esotropia and is categorized as low ( 64 2.00D), moderate (2.00-4.00 D), and high (&gt; 4.00D). Beyond hyperopia refractive error, patients may have poor accommodative function or visual perceptual skills

SARS-CoV-2 and Its Variants in Thrice-Infected Health Workers: A Case Series from an Italian University Hospital

We described a SARS-CoV-2 thrice-infected case series in health workers (HW) to evaluate patient and virus variants and lineages and collect information on variables associated with multiple infections

Impact of age and comorbidities on short- and long-term outcomes of patients undergoing surgery for colorectal cancer

As the world population is progressively ageing, more and more elderly patients will require cancer surgery. Although curative surgery is the treatment of choice for resectable colorectal cancer (CRC), it is still debated whether elderly frail patients should undergo major cancer surgery due to the increased risk of postoperative and long-term mortality. The aim of this retrospective study was to evaluate the impact of age and comorbidities on postoperative mortality/morbidity and long-term outcomes, looking for potential age-related survival differences

Usefulness and Limitations of Anti-S IgG Assay in Detecting Previous SARS-CoV-2 Breakthrough Infection in Fully Vaccinated Healthcare Workers

Introduction: The anti-spike (S) IgG assay is the most widely used method to assess the immunological response to COVID-19 vaccination. Several studies showed that subjects with perivaccination infection have higher anti-S IgG titers. However, a cut-off has not yet been identified so far for distinguishing infected subjects after vaccination. This study thus evaluates the performance of the anti-S IgG assay in identifying subjects with breakthrough infections (BIs) and its potential usefulness for screening healthcare workers (HCWs). Methods: Out of 6400 HCWs of the University Hospital of Verona vaccinated with two doses of BNT162b2, 4462 never infected before subjects who had completed primary vaccination were tested for IgG anti-S 6 to 9 months after the second dose. Of these, 59 (1.3%) had a BI. The discriminant power of IgG anti-S in detecting previous breakthrough infection was tested by constructing receiver operating characteristic (ROC) curves. Results: The discriminant power for BI was rather good (area under the curve (AUC), 0.78) and increased with decreasing time elapsed between antibody titer assessment and previous SARS-CoV-2 infection. Accuracy (AUC) sensitivity increased from 0.78 (95% CI 0.70–0.85) for BI in the previous six months to 0.83 (95% CI 0.67–0.99) for those in the previous two months, and from 0.68 to 0.80, respectively. The specificity (0.86) and optimal cut-off (935 BAU/mL) remained unchanged. However, BI were rather rare (1.3%), so the positive predictive value (PPV) was low. Only 40 of the 664 HCWs with antibody titer &gt; 935 BAU/mL had previously confirmed BI, yielding a PPV of only 6.0%. When adopting as cut-off the 90th percentile (1180 BAU/mL), PPV increased to 7.9% (35/441). Conclusions: The anti-S IgG assay displayed good sensitivity and specificity in discriminating subjects with BI, especially in recent periods. However, BIs were rare among HCWs, so that the anti-S IgG assay may have low PPV in this setting, thus limiting the usefulness of this test as a screening tool for HCWs. Further studies are needed to identify more effective markers of a previous infection in vaccinated subjects

Diagnostic Accuracy of a Rapid SARS-CoV-2 Antigen Test Among People Experiencing Homelessness: A Prospective Cohort and Implementation Study

Introduction: Detection strategies in vulnerable populations such as people experiencing homelessness (PEH) need to be explored to promptly recognize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. This study investigated the diagnostic accuracy of a rapid SARS-CoV-2 Ag test in PEH during two pandemic waves compared with gold standard real-time multiplex reverse transcription polymerase chain reaction (rtRT-PCR). Methods: All PEH ≥ 18&nbsp;years requesting residence at the available shelters in Verona, Italy, across two cold-weather emergency periods (November 2020-May 2021 and December 2021-April 2022) were prospectively screened for SARS-CoV-2 infection by means of a naso-pharyingeal swab. A lateral flow immunochromatographic assay (Biocredit® COVID-19 Ag) was used as antigen-detecting rapid diagnostic test (Ag-RDT). The rtRT-PCR was performed with Allplex™ SARS-CoV-2 assay kit (Seegene). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as measures for diagnostic accuracy. Results: Overall, 503 participants were enrolled during the two intervention periods for a total of 732 paired swabs collected: 541 swabs in the first period and 191 in the second. No significant differences in demographic and infection-related characteristics were observed in tested subjects in the study periods, except for the rate of previous infection (0.8% versus 8%; p &lt; 0.001) and vaccination (6% versus 73%; p &lt; 0.001). The prevalence of SARS-CoV-2 in the cohort was 8% (58/732 swabs positive with rtRT-PCR). Seventeen swabs were collected from symptomatic patients (7%). Among them, the concordance between rtRT-PCR and Ag-RDT was 100%, 7 (41.2%) positive and 10 negative pairs. The overall sensitivity of Ag-RDT was 63.8% (95% CI 60.3-67.3) and specificity was 99.8% (95% CI 99.6-100). PPV and NPV were 97.5% and 96.8%, respectively. Sensitivity and specificity did not change substantially across the two periods (65.1% and 99.8% in 2020-2021 vs. 60% and 100% in 2021-2022). Conclusions: A periodic Ag-RDT-based screening approach for PEH at point of care could guide preventive measures, including prompt isolation, without referral to hospital-based laboratories for molecular test confirmation in case of positive detection even in individuals asymptomatic for COVID-19. This could help reduce the risk of outbreaks in shelter facilities