The relationship between hepatitis B virus (HBV) and nonhepatocellular cancers remains inconclusive. This large case‐control study aimed to assess the associations between HBV infection status and ...multiple cancers. Cases (n = 50 392) and controls (n = 11 361) were consecutively recruited from 2008 to 2016 at the First Affiliated Hospital of Nanjing Medical University. Multivariable adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression by adjusting age and gender. A meta‐analysis based on published studies was also performed to verify the associations. Of these, 12.1% of cases and 5.5% of controls were hepatitis B surface antigen (HBsAg) seropositive. We observed significant associations between HBsAg seropositivity and esophagus cancer (aOR 95% CI = 1.32 1.13‐1.54), stomach cancer (1.46 1.30‐1.65), hepatocellular carcinoma (HCC; 39.11 35.08‐43.59), intrahepatic and extrahepatic bile duct carcinoma (ICC and ECC; 3.83 2.58‐5.67 and 1.72 1.28‐2.31), pancreatic cancer (PaC; 1.37 1.13‐1.65), non‐Hodgkin lymphoma (NHL; 1.88 1.61‐2.20) and leukemia (11.48 4.05‐32.56). Additionally, compared to participants with HBsAg−/anti‐HBs−/anti‐HBc−, participants with HBsAg−/anti‐HBs−/anti‐HBc+, indicating past HBV‐infected, had an increased risk of esophagus cancer (aOR 95% CI = 1.46 1.24‐1.73), stomach cancer (1.20 1.04‐1.39), HCC (4.80 3.95‐5.84) and leukemia (15.62 2.05‐119.17). Then the overall meta‐analysis also verified that HBsAg seropositivity was significantly associated with stomach cancer (OR 95% CI = 1.23 1.14‐1.33), ICC (4.05 2.78‐5.90), ECC (1.73 1.30‐2.30), PaC (1.26 1.09‐1.46), NHL (1.95 1.55‐2.44) and leukemia (1.54 1.26‐1.88). In conclusion, both our case‐control study and meta‐analysis confirmed the significant association of HBsAg seropositivity with stomach cancer, ICC, ECC, PaC, NHL and leukemia. Of note, our findings also suggested that the risk of stomach cancer elevated for people whoever exposed to HBV.
What's new?
Infection with hepatitis B virus (HBV) is an important cause of hepatocelluar carcinoma and may be linked to certain non‐hepatocellular cancers as well, including colon cancer and stomach cancer. This case‐control investigation of cancer patients in China shows that positivity for hepatitis B surface antigen (HBsAg) is significantly higher in cancer patients overall than in controls. Among Chinese patients, HBsAg seropositivity was associated particularly with stomach cancer, pancreatic cancer, intrahepatic and extrahepatic bile duct carcinoma, non‐Hodgkin lymphoma, and leukemia. These observations were consistent with meta‐analysis of previous studies exploring possible associations between HBV and non‐hepatocellular cancers.
Background and purpose
Specific respiratory tract infections, including COVID‐19, may cause smell and/or taste disorders (STDs) with increased frequency. The aim was to determine whether new‐onset ...STDs are more frequent amongst COVID‐19 patients than influenza patients.
Method
This was a case–control study including hospitalized patients of two tertiary care centres. Consecutive patients positive for COVID‐19 polymerase chain reaction (cases) and patients positive for influenza polymerase chain reaction (historical control sample) were assessed during specific periods, employing a self‐reported STD questionnaire.
Results
Seventy‐nine cases and 40 controls were included. No significant differences were found in basal features between the two groups. New‐onset STDs were significantly more frequent amongst cases (31, 39.2%) than in the control group (5, 12.5 %) adjusted odds ratio 21.4 (2.77–165.4, P = 0.003). COVID‐19 patients with new‐onset STDs were significantly younger than COVID‐19 patients without STDs (52.6 ± 17.2 vs. 67.4 ± 15.1, P < 0.001). Amongst COVID‐19 patients who presented STDs, 22 (70.9%) recalled an acute onset and it was an initial manifestation in 11 (35.5%). Twenty‐five (80.6%) presented smell disorders (mostly anosmia, 14, 45.2%) and 28 (90.3%) taste disorders (mostly ageusia, 14, 45.2%). Only four (12.9 %) reported concomitant nasal obstruction. The mean duration of STD was 7.5 ± 3.2 days and 12 patients (40%) manifested complete recovery after 7.4 ± 2.3 days of onset.
Conclusion
New‐onset STDs were significantly more frequent amongst COVID‐19 patients than influenza patients; they usually had an acute onset and were commonly an initial manifestation. The use of STD assessment in anamnesis as a hint for COVID‐19 and to support individuals’ self‐isolation in the current epidemic context is suggested.
Some studies suggest that periodontal diseases increase the risk of oral cancer, but contradictory results also exist. Inadequate control of confounders, including life course exposures, may have ...influenced prior findings. We estimate the extent to which high levels of periodontal diseases, measured by gingival inflammation and recession, are associated with oral cancer risk using a comprehensive subset of potential confounders and applying a stringent adjustment approach. In a hospital‐based case‐control study, incident oral cancer cases (N = 350) were recruited from two major referral hospitals in Kerala, South India, from 2008 to 2012. Controls (N = 371), frequency‐matched by age and sex, were recruited from clinics at the same hospitals. Structured interviews collected information on several domains of exposure via a detailed life course questionnaire. Periodontal diseases, as measured by gingival inflammation and gingival recession, were evaluated visually by qualified dentists following a detailed protocol. The relationship between periodontal diseases and oral cancer risk was assessed by unconditional logistic regression using a stringent empirical selection of potential confounders corresponding to a 1% change‐in‐estimates. Generalized gingival recession was significantly associated with oral cancer risk (Odds Ratio = 1.83, 95% Confidence Interval: 1.10–3.04). No significant association was observed between gingival inflammation and oral cancer. Our findings support the hypothesis that high levels of periodontal diseases increase the risk of oral cancer.
What's new?
Can gum disease predict the onset of oral cancer? As with many such questions, there's data supporting both sides. A new report comes down on the side of yes—periodontal disease is associated with risk of oral cancer. It's a complex question, because both gum disease and oral cancer share certain established risk factors, such as smoking. These authors applied stringent criteria to correct for potential confounders. They evaluated periodontal disease by measuring inflammation and recession of the gums and determined that gingival recession—but not inflammation—did significantly associate with oral cancer risk.
Background. Infants with pertussis infection are at risk of severe clinical illness and death. Several countries, including the United Kingdom, have introduced maternal pertussis vaccination during ...pregnancy to protect infants from infection following national increases in pertussis notifications. The objective of this study was to estimate the effectiveness of maternal pertussis vaccination in protecting infants against laboratory-confirmed pertussis infection. Methods. A case-control study was undertaken in England and Wales between October 2012 and July 2013. Cases were infants aged <8 weeks at onset with pertussis infection tested by real-time polymerase chain reaction or culture. Family doctors of each case were asked to identify healthy infants born consecutively after the case in each practice, to act as controls. Fifty-eight cases and 55 controls were included in this study. Odds ratios (ORs) were calculated for the association between maternal vaccination and infant pertussis infection. The vaccine effectiveness (VE) was calculated as 1 – OR. This was adjusted for sex, geographical region, and birth period. Results. Mothers of 10 cases (17%) and 39 controls (71%) received pertussis vaccine in pregnancy. This gave an unadjusted VE of 91% (95% confidence interval CI, 77%–97%). Adjusted VE was 93% (95% CI, 81%–97%). Conclusions. Maternal pertussis vaccination is effective in preventing pertussis infection in infants aged <8 weeks and may be considered in other countries experiencing high levels of pertussis notifications.
Background
Diseases caused by Streptococcus pneumoniae (S. pneumoniae) continue to cause substantial morbidity and mortality globally. Whilst pneumococcal polysaccharide vaccines (PPVs) have the ...potential to prevent disease and death, the degree of protection afforded against various clinical endpoints and within different populations is uncertain.
Objectives
To assess the efficacy and effectiveness of PPVs in preventing pneumococcal disease or death in adults. We did not assess adverse events.
Search methods
We searched CENTRAL 2012, Issue 6, MEDLINE (January 1966 to June Week 2, 2012) and EMBASE (1974 to June 2012).
Selection criteria
We considered randomised controlled trials (RCTs) in adults, provided the study outcome met the definition of the outcome considered in the review. We also considered non‐RCTs in adults, where the study assessed PPV effectiveness against culture‐confirmed invasive pneumococcal disease (IPD), provided the study controlled for important confounding factors.
Data collection and analysis
Two review authors assessed trial quality of RCTs and three review authors extracted the data. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using a random‐effects model. Two review authors assessed study quality and extracted data for non‐RCTs. We calculated ORs and 95% CIs using a random‐effects model following the conversion of each study outcome to a log OR and standard error (SE).
Main results
Twenty‐five studies met our inclusion criteria (18 RCTs involving 64,852 participants and seven non‐RCTs involving 62,294 participants). Meta‐analysis of the RCTs found strong evidence of PPV efficacy against IPD with no statistical heterogeneity (OR 0.26, 95% CI 0.14 to 0.45; random‐effects model, I2 statistic = 0%). There was efficacy against all‐cause pneumonia in low‐income (OR 0.54, 95% CI 0.43 to 0.67, I2 statistic = 19%) but not high‐income countries in either the general population (OR 0.71, 95% CI 0.45 to 1.12, I2 statistic = 93%) or in adults with chronic illness (OR 0.93, 95% CI 0.73 to 1.19, I2 statistic = 10%). PPV was not associated with substantial reductions in all‐cause mortality (OR 0.90, 95% CI 0.74 to 1.09; random‐effects model, I2 statistic = 69%). Vaccine efficacy against primary outcomes appeared poorer in adults with chronic illness. Non‐RCTs provided evidence for protection against IPD in populations for whom the vaccine is currently utilised (OR 0.48, 95% CI 0.37 to 0.61; random‐effects model, I2 statistic = 31%). This review did not consider adverse events as it was outside the scope of the review.
Authors' conclusions
This meta‐analysis provides evidence supporting the recommendation for PPV to prevent IPD in adults. The evidence from RCTs is less clear with respect to adults with chronic illness. This might be because of lack of effect or lack of power in the studies. The meta‐analysis does not provide evidence to support the routine use of PPV to prevent all‐cause pneumonia or mortality.
Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. ...In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines.
A STROCSS 2021 steering group was formed to come up with proposals to update STROCSS 2019 guidelines. An expert panel of researchers assessed these proposals and judged whether they should become part of STROCSS 2021 guidelines or not, through a Delphi consensus exercise.
42 people (89%) completed the DELPHI survey and hence participated in the development of STROCSS 2021 guidelines. All items received a score between 7 and 9 by greater than 70% of the participants, indicating a high level of agreement among the DELPHI group members with the proposed changes to all the items.
We present updated STROCSS 2021 guidelines to ensure ongoing good reporting quality among observational studies in surgery.
•STROCSS 2019 guidelines were updated through a DELPHI consensus exercise.•High level of agreement was noted, among the 42 DELPHI group members, with the proposed changes to all the items.•Updated STROCSS 2021 guideline is presented.
Objectives
The aim of this study was to investigate whether the quadrivalent human papillomavirus (HPV) vaccine Gardasil is associated with a change in the risk of autoimmune disorders (ADs) in young ...female subjects.
Design
Systematic case–control study of incident ADs associated with quadrivalent HPV vaccination in young women across France.
Participants and setting
A total of 113 specialised centres recruited (from December 2007 to April 2011) females aged 14–26 years with incident cases of six types of ADs: idiopathic thrombocytopenic purpura (ITP), central demyelination/multiple sclerosis (MS), Guillain–Barré syndrome, connective tissue disorders (systemic lupus erythematosus, rheumatoid arthritis/juvenile arthritis), type 1 diabetes mellitus and autoimmune thyroiditis. Control subjects matched to cases were recruited from general practice.
Analysis
Multivariate conditional logistic regression analysis; factors included age, geographical origin, smoking, alcohol consumption, use of oral contraceptive(s) or vaccine(s) other than Gardasil received within 24 months before the index date and personal/family history of ADs.
Results
Overall, 211 definite cases of ADs were matched to 875 controls. The adjusted odds ratio (OR) for any quadrivalent HPV vaccine use was 0.9 95% confidence interval (CI) 0.5–1.5. The individual ORs were 1.0 (95% CI 0.4–2.6) for ITP, 0.3 (95% CI 0.1–0.9) for MS, 0.8 (95% CI 0.3–2.4) for connective disorders and 1.2 (95% CI 0.4–3.6) for type 1 diabetes. No exposure to HPV vaccine was observed in cases with either Guillain–Barré syndrome or thyroiditis.
Conclusions
No evidence of an increase in the risk of the studied ADs was observable following vaccination with Gardasil within the time periods studied. There was insufficient statistical power to allow conclusions to be drawn regarding individual ADs.
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