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Insourcing and scaling a telemedicine solution in under 2 weeks: Lessons for the digital transformation of health care.

Healthc (Amst) 2021 Jul 19;9(3):100568. Epub 2021 Jul 19.

University of Pennsylvania Health System, Penn Medicine Center for Health Care Innovation, 3400 Civic Center Blvd, 14(th) Floor South Pavilion, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Office of the Chief Medical Information Officer, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Cardiology, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Electronic address:

The Covid-19 pandemic required rapid scale of telemedicine as well as other digital workflows to maintain access to care while reducing infection risk. Both patients and clinicians who hadn't used telemedicine before were suddenly faced with a multi-step setup process to log into a virtual meeting. Unlike in-person examination rooms, locking a virtual meeting room was more error-prone and posed a risk of multiple patients joining the same online session. Read More

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Hematopoietic Stem Cell Transplantation For Patients With Autosomal Recessive Complete Interferon Gamma Receptor 2 Deficiency: Experience In Oman.

Transplant Cell Ther 2021 Jul 19. Epub 2021 Jul 19.

Department of, Hematology, Sultan Qaboos University Hospital, Muscat, Oman; Apollo Hospital, Muscat, Oman. Electronic address:

Autosomal recessive complete interferon- gamma receptor-2 (IFN-γR2) deficiency is a rare potentially fatal primary immune deficiency that predisposes to disseminated mycobacterial disease.Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment. Few patients had been reported so far. Read More

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Outcomes for infants with congenital diaphragmatic hernia: A single campus review with low extracorporeal membrane oxygenation utilisation.

J Paediatr Child Health 2021 Jul 22. Epub 2021 Jul 22.

Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Aim: To report the outcome for infants with congenital diaphragmatic hernia (CDH) and identify clinical factors affecting outcome from a tertiary perinatal surgical campus where extracorporeal membrane oxygenation (ECMO) is available however rarely utilised.

Methods: A retrospective cohort study of infants with CDH born in a co-located perinatal neonatal intensive care unit (NICU) or retrieved into and managed at a surgical NICU: 2003-2018.

Results: One hundred and fifty-nine infants with CDH were identified. Read More

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Outcomes of Primary Ileocolic Resection for Pediatric Crohn's Disease in the Biologic Era.

J Pediatr Gastroenterol Nutr 2021 Jul 20. Epub 2021 Jul 20.

Department of Pediatrics. Mount Sinai Hospital and Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, New York, NY Department of Surgery, Mount Sinai Hospital and Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, New York, NY.

Objectives: Current clinical algorithms position surgery as the last option in pediatric Crohn's disease (CD). Studies suggest improved outcomes with earlier surgery, but pediatric postoperative outcomes data in the biologic era are limited. We aimed to describe the preoperative management and postoperative outcomes in a pediatric CD cohort who underwent ileocolic resection (ICR) at a tertiary care IBD center over the last decade. Read More

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Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction.

Cochrane Database Syst Rev 2021 07 22;7:CD013876. Epub 2021 Jul 22.

Cochrane UK, Oxford, UK.

Background: Olfactory dysfunction is an early and sensitive marker of COVID-19 infection. Although self-limiting in the majority of cases, when hyposmia or anosmia persists it can have a profound effect on quality of life. Little guidance exists on the treatment of post-COVID-19 olfactory dysfunction, however several strategies have been proposed from the evidence relating to the treatment of post-viral anosmia (such as medication or olfactory training). Read More

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Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow-up.

Brain Behav 2021 Jul 21. Epub 2021 Jul 21.

Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Background: Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement.

Objective: To investigate if treatment of minor visual hallucinations in Parkinson's disease with rivastigmine delays the progression to psychosis.

Methods: A multicenter, randomized, double-blind, placebo-controlled trial was conducted which aimed to recruit 168 patients with Parkinson's disease reporting minor visual hallucinations 4 weeks before it. Read More

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Hydroxycarbamide treatment reduces transcranial Doppler velocity in the absence of transfusion support in children with sickle cell anaemia, elevated transcranial Doppler velocity, and cerebral vasculopathy: the EXTEND trial.

Br J Haematol 2021 Jul 22. Epub 2021 Jul 22.

Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

EXpanding Treatment for Existing Neurological Disease (EXTEND) investigated whether hydroxycarbamide lowers transcranial Doppler (TCD) velocities in Jamaican children with sickle cell anaemia (SCA) and elevated TCD velocity with or without previous stroke. Forty-three children (age 2-17 years) with baseline maximum time-averaged mean velocity (TAMV) ≥ 170 cm/s were stratified into three risk categories based on treatment status and stroke history: Group 1 (no history of stroke, on hydroxycarbamide, n = 12); and Groups 2 (no stroke, no hydroxycarbamide, n = 21) and 3 (previous stroke, no hydroxycarbamide, n = 10). Open-label hydroxycarbamide at 20 mg/kg/day was commenced, with escalation to maximum tolerated dose (MTD) based on mild marrow suppression (average dose 25·4 ± 4·5 mg/kg/day). Read More

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The Combination of N60 with Mismatch Negativity Improves the Prediction of Awakening from Coma.

Neurocrit Care 2021 Jul 21. Epub 2021 Jul 21.

Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: Our objective was to evaluate the use of event-related potentials and the middle-latency somatosensory evoked potential (MLSEP) for the prediction of awakening in coma, determine the evaluation day that evoked potentials (EPs) best predict an awakening outcome, and determine whether the mismatch negativity (MMN) combined with the MLSEP, when recorded at 7 days after coma, improved the prediction of awakening from coma.

Methods: Design prospective blinded cohort study. Setting neurointensive care unit of a university hospital. Read More

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Neurological development and iron supplementation in healthy late-preterm neonates: a randomized double-blind controlled trial.

Eur J Pediatr 2021 Jul 21. Epub 2021 Jul 21.

Pediatric Neurology Unit, Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy.

Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and iron deficiency. The aim of the study is to assess the positive effect of iron supplementation on psychomotor development in healthy LPT. We designed a randomized placebo-controlled double-blind trial dividing the newborns into two groups. Read More

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Serotypes Carried by Young Children and Their Association With Acute Otitis Media During the Period 2016-2019.

Front Pediatr 2021 5;9:664083. Epub 2021 Jul 5.

Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.

(Sp) is a major cause of acute otitis media (AOM). Pneumococcal conjugate vaccine (PCV) programs have altered pneumococcal serotype epidemiology in disease and carriage. In this study, we used samples collected during a cross-sectional study to examine if the clinical picture of acute otitis media (AOM) in young children exposed to the PCV program in Belgium was related to the carried pneumococcal strains, and if their carriage profile differed from healthy children attending daycare centers. Read More

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Cowper's Glands Abscess with Spreading to Adjacent Organs and Tissues with Development of Septic Shock: An Extremely Rare Case.

Res Rep Urol 2021 15;13:501-507. Epub 2021 Jul 15.

Department of Endoscopic Urology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.

Background: We present here the first case of Cowper's gland abscess complicated by septic shock and breakthrough of the abscess into the paraurethral region, cavernous body, scrotum, and pararectal tissue.

Case Presentation: A 63-year-old patient was admitted with complaints of temperature increase up to 39°C, pain and enlargement of the perineum and the right half of the scrotum, frequent and difficulty urination, weakness, dizziness, dry mouth, and a sharp deterioration of the general condition. Clinical-laboratory data showed the presence of septic shock with unstable haemodynamics and many concomitant diseases. Read More

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The effect of calcium on the duration of acute gastroenteritis in children: A randomized clinical trial.

Med J Islam Repub Iran 2021 28;35:83. Epub 2021 Jun 28.

Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Currently, the role of calcium in reducing the duration and severity of diarrhea and its consequences has been considered as a topic of concern. The aim of this study was to evaluate the effect of oral calcium on the duration of acute gastroenteritis in children. This single-blind randomized clinical trial was performed from 2014 to 2016 at Ali Asghar Children's Hospital, Tehran, Iran. Read More

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Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up.

Geriatr Orthop Surg Rehabil 2021 9;12:21514593211024509. Epub 2021 Jul 9.

Department of Orthopaedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.

Introduction: Hip fracture patients have been severely affected by the COVID-19 pandemic; however, the sub acute effects of a concomitant SARS-CoV-2 infection and the outcomes in highly exposed developing countries are still unknown. Our objective is to describe the morbidity and mortality of elderly patients admitted for a hip fracture during the COVID-19 pandemic in Chile, with a minimum 90-day follow-up. Also, to elucidate predictors for mortality and to compare mortality results with the pre-pandemic era. Read More

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Real-world effectiveness of eribulin in heavily pretreated patients with metastatic breast cancer in China: a multicenter retrospective study.

Ther Adv Med Oncol 2021 9;13:17588359211030210. Epub 2021 Jul 9.

Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'an Road, Shanghai, 200032, P.R. China.

Background: Eribulin is a nontaxane microtubule inhibitor approved in China for patients with advanced breast cancer who show progression after ⩾2 lines of chemotherapy. The aim of this study was to determine the efficacy and safety profile of eribulin and explore potential predictive factors for the efficacy of eribulin among Chinese women with metastatic breast cancer (MBC) in real-world practice.

Patients And Methods: A total of 272 consecutive MBC patients who were treated with eribulin between November 2019 and October 2020 in 9 institutions nationwide were included in this study. Read More

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Prevalence of Prediabetes and Type-2 Diabetes Mellitus in Cricket Players: Multi-Cricket Clubs Cross Sectional Study.

Pak J Med Sci 2021 Jul-Aug;37(4):959-965

Anusha Sultan Meo, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.

Background & Objectives: Sports activities are highly beneficial for improving the human health and reducing the risk of diseases. This cross sectional study aimed to investigate the prevalence of prediabetes and Type-2 diabetes mellitus in cricket players compared to population based non-elite athlete control subjects.

Methods: The present matched cross sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period October 2019 to February 2020. Read More

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January 2021

Adherence to an eHealth Self-Management Intervention for Patients with Both COPD and Heart Failure: Results of a Pilot Study.

Int J Chron Obstruct Pulmon Dis 2021 15;16:2089-2103. Epub 2021 Jul 15.

Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.

Background: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) often coexist and share periods of symptom deterioration. Electronic health (eHealth) might play an important role in adherence to interventions for the self-management of COPD and CHF symptoms by facilitating and supporting home-based care.

Methods: In this pilot study, an eHealth self-management intervention was developed based on paper versions of multi-morbid exacerbation action plans and evaluated in patients with both COPD and CHF. Read More

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Retrospective study of glycemic variability, BMI, and blood pressure in diabetes patients in the Digital Twin Precision Treatment Program.

Sci Rep 2021 Jul 21;11(1):14892. Epub 2021 Jul 21.

Twin Health, Mountain View, CA, USA.

The objective of this retrospective observational cohort study was to measure glycemic variability and reductions in body mass index (BMI), blood pressure (BP), and use of antihypertensive medications in type 2 diabetes (T2D) patients participating in the digital twin-enabled Twin Precision Treatment (TPT) Program. Study participants included 19 females and 45 males with T2D who chose to participate in the TPT Program and adhered to program protocols. Nine additional enrollees were excluded due to major program non-adherence. Read More

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Return on investment of a model of access combining triage with initial management: an economic analysis.

BMJ Open 2021 Jul 21;11(7):e045096. Epub 2021 Jul 21.

School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia.

Objectives: Timely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model.

Design: Using a prospective pre-post design, an economic analysis was completed comparing the health system costs for participants who were referred for community outpatient services post-implementation of STAT with a traditional waitlist comparison group. Read More

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The diagnostic challenge of acute Q fever endocarditis.

BMJ Case Rep 2021 Jul 21;14(7). Epub 2021 Jul 21.

Internal Medicine Department, Hospital de Santa Marta - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.

A 79-year-old man was admitted to our ward with symptomatic heart failure 2 months after aortic valve replacement due to severe aortic stenosis. On the third day following admission, he became febrile (>38°C) while manifesting an increase in inflammatory markers. Endocarditis was suspected despite negative blood cultures. Read More

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Myositis and myasteniform syndrome related to pembrolizumab.

BMJ Case Rep 2021 Jul 21;14(7). Epub 2021 Jul 21.

Pharmacy Department, Hospital Vall d'Hebron, Barcelona, Spain.

This case report concerns a 63-year-old man affected by metastatic undifferentiated liposarcoma. After receiving pembrolizumab as a second-line treatment in a clinical trial, the patient experienced an immune-mediated myocarditis, myositis and myasteniform syndrome. The last two adverse events showed significant clinical relevance in terms of severity, duration and the required specific treatment. Read More

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Positive change in asthma control using therapeutic patient education in severe uncontrolled asthma: a one-year prospective study.

Asthma Res Pract 2021 Jul 21;7(1):10. Epub 2021 Jul 21.

Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 151 Yan Jiang Rd, 510000, Guangzhou, P.R. China.

Background: Severe asthma is difficult to control. Therapeutic patient education enables patients to better understand their disease and cope with treatment, but the effect of therapeutic patient education in severe uncontrolled asthma is unclear. We evaluated whether therapeutic patient education is effective in improving asthma control and decreasing the frequency of exacerbations in severe uncontrolled asthma. Read More

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Acupuncture in addition to standard conservative treatment for overactive bladder; a feasibility trial for a randomized controlled study.

Neurourol Urodyn 2021 Jul 21. Epub 2021 Jul 21.

Department of Sport, Exercise and Rehabilitation, Programme Lead BSc Physiotherapy, Northumbria University, Newcastle upon Tyne, UK.

Aims: This study aims to assess the feasibility of an randomized controlled trial (RCT) to test treatment efficacy of acupuncture for symptoms of overactive bladder syndrome (OAB), a common long-term condition with physical, psychological, social and sexual consequences.

Methods: A total of 30 participants were recruited and randomized to either standard conservative management for OAB or standard conservative management plus acupuncture. Standard care consisted of individually tailored advice regarding bladder health, pelvic floor exercises and lifestyle adjustments. Read More

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An intranasal vaccine durably protects against SARS-CoV-2 variants in mice.

Cell Rep 2021 Jul 10:109452. Epub 2021 Jul 10.

Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address:

SARS-CoV-2 variants that attenuate antibody neutralization could jeopardize vaccine efficacy. We recently reported the protective activity of an intranasally administered spike protein-based chimpanzee adenovirus-vectored vaccine (ChAd-SARS-CoV-2-S) in animals, which has advanced to human trials. Here, we assessed its durability, dose response, and cross-protective activity in mice. Read More

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Clinical Efficacy of Mebeverine for Persistent Nocturnal Enuresis after Orthotopic W-Neobladder.

BJU Int 2021 Jul 21. Epub 2021 Jul 21.

Urology department - Urology and nephrology Center, Mansoura, Egypt.

Objectives: Nocturnal incontinence has significantly impacted the quality of life in the ileal orthotopic bladder substitute (OBS) patients. Herein, we investigate the usefulness of mebeverine for nocturnal incontinence in OBS male patients.

Materials And Methods: A randomized trial was carried out for the nocturnal incontinent adult male patients. Read More

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Chronic limbic epilepsy models for therapy discovery: Protocols to improve efficiency.

Epilepsia 2021 Jul 21. Epub 2021 Jul 21.

SEIN: Epilepsy Institute in the Netherlands Foundation Heemstede, Heemstede, The Netherlands.

Objective: There have been recommendations to improve therapy discovery for epilepsy by incorporating chronic epilepsy models into the preclinical process, but unpredictable seizures and difficulties in maintaining drug levels over prolonged periods have been obstacles to using these animals. We report new protocols in which drugs are administered through a new chronic gastric tube to rats with higher seizure frequencies to minimize these obstacles.

Methods: Adult rats with spontaneous limbic seizures following an episode of limbic status epilepticus induced by electrical hippocampal stimulation were monitored with long-term video- electroencephalography (EEG). Read More

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Phase I study of Ibrutinib and the CXCR4 antagonist Ulocuplumab in CXCR4 mutated Waldenstrom Macroglobulinemia.

Blood 2021 Jul 21. Epub 2021 Jul 21.

Harvard Medical School, United States.

MYD88 and CXCR4 mutations are common in Waldenström Macroglobulinemia (WM). Mutated CXCR4 (CXCR4Mut) impacts BTK-inhibitor response. We conducted a Phase I trial of the CXCR4-antagonist ulocuplumab with ibrutinib in this first-ever study to target CXCR4Mut in WM. Read More

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Corneal Endothelial Layer Parameters in Patients Undergoing Strabismus Surgery.

J Pediatr Ophthalmol Strabismus 2021 Jul-Aug;58(4):254-260. Epub 2021 Jul 1.

Purpose: To investigate the effects of horizontal and oblique strabismus surgery on the corneal endothelial cell layer.

Methods: Eighty-three eyes of 56 patients were prospectively evaluated. Corneal endothelial cell layer analysis was performed with a specular microscopy device (EM-3000; Tomey Corporation) preoperatively and 1 day, 2 weeks, and 2 months postoperatively. Read More

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Transepithelial accelerated corneal cross-linking for keratoconus eyes with maximum keratometry values larger than 58 Diopter.

J Cataract Refract Surg 2021 Jun 23. Epub 2021 Jun 23.

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences.

Purpose: To evaluate the safety and efficacy of transepithelial accelerated corneal cross-linking (CXL) for advanced keratoconus eyes with maximum keratometry (Kmax) values >58 diopter (D).

Setting: Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.

Design: Prospective parallel control study. Read More

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Infants born preterm and infants born full-term generate more selective leg joint movement during the scaffolded mobile task.

Infancy 2021 Jul 20. Epub 2021 Jul 20.

Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.

Infants born very preterm (PT), prior to 32 weeks gestation, are at increased risk of developing cerebral palsy. Children with spastic cerebral palsy have impaired selective leg joint movement, which contributes to lifelong walking limitations. We investigated whether infants born PT generated more selective hip-knee joint movement (e. Read More

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Long-term prevention of hereditary angioedema attacks with lanadelumab: the HELP OLE Study.

Allergy 2021 Jul 21. Epub 2021 Jul 21.

Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, CA, USA.

Background: The aim was to evaluate long-term effectiveness and safety of lanadelumab in patients ≥12y old with hereditary angioedema (HAE) 1/2 (NCT02741596).

Methods: Rollover patients completing the HELP Study and continuing into HELP OLE received one lanadelumab 300-mg dose until first attack (dose-and-wait period), then 300mg q2wks (regular dosing stage). Nonrollovers (newly enrolled) received lanadelumab 300mg q2wks from day 0. Read More

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