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A single bout of exercise improves vascular insulin sensitivity in adults with obesity.

Obesity (Silver Spring) 2021 Aug 2. Epub 2021 Aug 2.

Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA.

Objective: This crossover study explored the impact of a single bout of exercise on insulin-stimulated responses in conduit arteries and capillaries.

Methods: Twelve sedentary adults (49.5 [7. Read More

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Treatment of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma.

Ann Gastroenterol Surg 2021 Jul 24;5(4):538-552. Epub 2021 Feb 24.

Department of Surgery The Jikei University School of Medicine Tokyo Japan.

Background: Prognostic factors after treatment for intrahepatic recurrent hepatocellular carcinoma (RHCC) after hepatic resection (Hx) are controversial. The current study aimed to examine the impact of treatment modality on the prognosis of intrahepatic RHCC following Hx.

Methods: For control of variables, the subjects were 56 patients who underwent treatment for intrahepatic RHCC, three or fewer tumors, each measuring ≤3 cm in diameter without macroscopic vascular invasion (MVI), between 2000 and 2011. Read More

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Serious Complications After Epidural Catheter Placement: Two Case Reports.

Local Reg Anesth 2021 24;14:117-124. Epub 2021 Jul 24.

University Medical Center Rostock, Department of Neurology, Rostock, Germany.

Thoracic epidural analgesia (TEA) is a standard procedure in multimodal analgesia applied in major thoracic and abdominal surgeries. Two cases are presented with serious complications related to TEA. In both cases, earlier reaction of the treating physicians to patient-reported sensory symptoms could have prevented the complicated course. Read More

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The Effect of Preoperative Serratus Anterior Muscle Plane Block on Persistent Postsurgical Pain After Video-assisted Thoracic Surgery: A Retrospective Cohort Study.

Clin J Pain 2021 Aug 2. Epub 2021 Aug 2.

Department of Anesthesiology, Peking University People's Hospital.

Objectives: Acute pain intensity is a strong indicator for the occurrence of persistent postsurgical pain (PPP) after video-assisted thoracic surgery (VATS). The effect of preoperative Serratus Anterior Muscle Plane Block (SAPB) on PPP was investigated.

Methods: In this retrospective cohort study, data of 148 patients who underwent VATS for lung nodules in 2019 were collected. Read More

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Role of hippocampal orexin receptors in antinociception elicited by chemical stimulation of the lateral hypothalamus in the tail-flick test.

Behav Brain Res 2021 Jul 27;414:113492. Epub 2021 Jul 27.

Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

The lateral hypothalamus (LH) orexinergic neurons project to numerous brain regions implicated in pain perception, including the CA1 part of the hippocampal formation. Moreover, the roles of orexin receptors (OXRs) in the CA1 in anti-analgesic consequences of the LH chemical stimulation by carbachol, muscarinic receptor agonist, in acute pain have not been clarified. The current research showed OXRs antagonist administration's effect in the CA1 on analgesia elicited by the LH chemical stimulation in a tail-flick test as an acute model of pain. Read More

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Pulmonary-to-Systemic Arterial Shunt to Treat Children With Severe Pulmonary Hypertension.

J Am Coll Cardiol 2021 Aug;78(5):468-477

Congenital and Pediatric Cardiology Unit, Hospital Necker-Enfants Malades, APHP, Universitaire de Paris, Paris, France.

Background: The placement of a pulmonary-to-systemic arterial shunt in children with severe pulmonary hypertension (PH) has been demonstrated, in relatively small studies, to be an effective palliation for their disease.

Objectives: The aim of this study was to expand upon these earlier findings using an international registry for children with PH who have undergone a shunt procedure.

Methods: Retrospective data were obtained from 110 children with PH who underwent a shunt procedure collected from 13 institutions in Europe and the United States. Read More

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ABO-Incompatible Living Donor Liver Transplantation With a Simplified Desensitization and Immunosuppression Protocol: A Single-Center Retrospective Study.

Exp Clin Transplant 2021 Jul;19(7):676-685

From the Division of Hepatobiliary Pancreas and Transplant Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.

Objectives: New desensitization strategies have made ABO-incompatible living donor liver transplant an attractive option for patients with end-stage liver disease. We aimed to report our experience with 20 consecutive patients who underwent ABO-incompatible living donor liver transplant using a simplified desensitization and immunosuppression regimen.

Materials And Methods: We retrospectively analyzed 20 ABO-incompatible living donor liver transplant cases (August 2015 to July 2019). Read More

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Improved outcome in AML relapse after allogeneic transplant with high-intensity chemotherapy followed by 2nd allogeneic stem cell transplant or donor lymphocyte infusion.

Ann Hematol 2021 Jul 29. Epub 2021 Jul 29.

Department of Medicine, Penn State Cancer Institute, 500 University Dr., Hershey, PA, 17033, USA.

Acute myeloid leukemia (AML) relapse after allogeneic stem cell transplant (alloSCT) remains a major therapeutic challenge. While patients with longer remission after initial alloSCT are recommended to receive cell therapy (CT) such as 2alloSCT or donor lymphocyte infusion (DLI), survival for patients who relapse within 6 months of alloSCT has been dismal. We evaluated the outcomes of AML relapse after alloSCT to assess the impact of different treatments on long-term survival. Read More

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Post-Operative Sleep Endoscopy with Target-Controlled Infusion After Palatopharyngoplasty for Obstructive Sleep Apnea: Anatomical and Polysomnographic Outcomes.

Nat Sci Sleep 2021 20;13:1181-1193. Epub 2021 Jul 20.

Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Introduction: The findings of drug-induced sleep endoscopy (DISE) are not always correlated with the outcome of upper airway surgery for obstructive sleep apnea (OSA), and whether multilevel surgery is truly required in treating multilevel obstruction identified in preoperative DISE remains an issue. We attempted to compare DISE findings before and after palatopharyngoplasty in patients with OSA because changes in DISE may be beneficial to better understand polysomnographic and anatomical outcomes.

Methods: This was a prospective cohort study for 34 patients with moderate to severe OSA who underwent palatopharyngoplasty at a tertiary care center from 2016 to 2018. Read More

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A Trial of Hyperimmune Globulin to Prevent Congenital Cytomegalovirus Infection.

N Engl J Med 2021 Jul;385(5):436-444

From the Department of Obstetrics and Gynecology, Brown University, Providence, RI (B.L.H., D.J.R., D.A.); George Washington University Biostatistics Center, Washington, DC (R.G.C., L.M.F.); the University of Texas Medical Branch, Galveston (G.R.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas Southwestern Medical Center, Dallas (B.M.C.); Northwestern University, Chicago (M.J.D., G.M.); Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (M.W.V.); the University of North Carolina at Chapel Hill, Chapel Hill (W.H.G.), and Duke University, Durham (G.K.S.) - both in North Carolina; the Department of Pediatrics (R.P.), University of Alabama at Birmingham (A.T.N.T.), Birmingham; Ohio State University, Columbus (M.M.C.), the University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); Case Western Reserve University, Cleveland (E.K.C.); Stanford University, Stanford, CA (Y.Y.E.-S.); the University of Pennsylvania, Philadelphia (S.P.), and the University of Pittsburgh, Pittsburgh (H.N.S.); Madigan Army Medical Center, Joint Base Lewis-McChord, WA (P.G.N.); and Washington University, St. Louis (G.A.M.).

Background: Primary cytomegalovirus (CMV) infection during pregnancy carries a risk of congenital infection and possible severe sequelae. There is no established intervention for preventing congenital CMV infection.

Methods: In this multicenter, double-blind trial, pregnant women with primary CMV infection diagnosed before 24 weeks' gestation were randomly assigned to receive a monthly infusion of CMV hyperimmune globulin (at a dose of 100 mg per kilogram of body weight) or matching placebo until delivery. Read More

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Retrospective comparison of reinfusion procedures and subsequent leukopenia in autologous stem cell transplantation.

Int J Hematol 2021 Jul 26. Epub 2021 Jul 26.

Department of Hematology, Oncology and Palliative Care, Vivantes Clinic Neukoelln, Rudower Str. 48, 12351, Berlin, Germany.

Standard operating procedures for autologous stem cell transplantation (SCT) aim to guarantee best possible engraftment. Three procedures are routinely used for transplant infusion: regular bag infusion (Procedure 1), injection via syringe (Procedure 2), and combination of regular bag infusion and syringe (Procedure 3). We conducted a retrospective analysis of all autologous stem cell transplants done in the hematology department of the Vivantes Clinic Neukoelln in Berlin, Germany, between January 1, 2016 and March 4, 2017. Read More

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[Study on the safety and effectiveness of low-dose tranexamic acid in operation of multi-level continuous thoracic ossification of ligament flavum].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jul;35(7):873-877

Department of Orthopedics, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan, 637000, P.R.China.

Objective: To investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF).

Methods: A clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. Read More

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CAR-T therapy in solid transplant recipients with post-transplant lymphoproliferative disease: case report and literature review.

Curr Res Transl Med 2021 Jul 22;69(4):103304. Epub 2021 Jul 22.

Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.

Patients with postransplant lymphoproliferative disease (PTLD) who are refractory to rituximab-based regimens have extremely poor prognosis. Data is lacking in the setting of solid organ transplantation (SOT)-related PTLD treated with chimeric antigen receptor T-cell (CAR-T) therapy. Moreover, limited information is available on the influence of concomitant immunosuppressive drugs on CAR-T function. Read More

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Callosal Diffusion-Restriction in Patients with Intracranial Hemorrhage.

J Stroke Cerebrovasc Dis 2021 Jul 20;30(9):105951. Epub 2021 Jul 20.

Department of Neurology, Cerebrovascular Center, Neurological Institute, Cleveland, OH, United States. Electronic address:

Objective: We aim to report the incidence and clinical characteristics of patients who were found to have diffusion restricting lesions of the corpus callosum (CC) on Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) following intracranial hemorrhage (ICH).

Design/methods: A retrospective cross-sectional analysis was performed of medical records of all adult patients admitted to a single tertiary center with a primary diagnosis of ICH and received nicardipine infusion over a 2-year period. Patients without MRI brain available or patients who underwent digital subtraction angiography (DSA) prior to MRI were excluded. 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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An Atypical Presentation of Severe Dissecting Aortic Aneurysm: A Case Report and Literature Review.

Cureus 2021 Jun 18;13(6):e15752. Epub 2021 Jun 18.

Clinical Research, University of Louisville, Louisville, USA.

A 55-year-old male patient with no past medical history presents to the ED to complain of exertional dyspnea and bilateral lower limb swelling. The patient was diagnosed with a severe dissecting aortic aneurysm on trans-thoracic echocardiography and later confirmed by a contrast CT aortogram. The patient was immediately started on anti-impulse therapy with labetalol infusion and underwent emergent aortic dissection repair. Read More

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Combination of Rescue Stenting and Antiplatelet Infusion Improved Outcomes for Acute Intracranial Atherosclerosis-Related Large-Vessel Occlusion.

Front Neurol 2021 5;12:608270. Epub 2021 Jul 5.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.

Intracranial atherosclerosis-related large-vessel occlusion caused by thrombo-occlusion (ICAS-LVO) has been regarded an important reason for refractoriness to mechanical thrombectomy (MT). To achieve better outcomes for ICAS-LVO, different endovascular strategies should be explored. We aimed to investigate an optimal endovascular strategy for ICAS-LVO. Read More

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Comparison of Esmolol and Dexmedetomidine Infusion in Attenuating Haemodynamic and Blood Glucose Response to Laryngoscopy and Intubation: A Single Blinded Study.

Malays J Med Sci 2021 Jun 30;28(3):46-55. Epub 2021 Jun 30.

Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: This study aims to compare the effect of infusions of two agents, dexmedetomidine and esmolol, with the control group in attenuating the haemodynamic stress response and neuroendocrine modulation surrogated by capillary blood glucose (BG) during the procedures.

Methods: Sixty patients aged 18-70 years old who underwent elective surgeries involving endotracheal intubation were randomised into three groups of equal size: i) control; ii) dexmedetomidine and iii) esmolol. Heart rate (HR) was measured at baseline (T0), after drug administration (T1), after induction of anaesthesia (T2), immediately after intubation (T3), and 3 min, 5 min and 10 min after intubation (T4, T5 and T6). Read More

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Impaired cerebrospinal fluid transport due to idiopathic subdural hematoma in pig: an unusual case.

BMC Vet Res 2021 Jul 20;17(1):250. Epub 2021 Jul 20.

Department of Experimental Medical Science, Lund University, Sölvegatan 17, BMC A1304, 223 62, Lund, SE, Sweden.

Background: We report the effects of the presentation of an idiopathic subdural hematoma (SDH) in an adult domestic pig on the glymphatic system, a brain-wide solute clearance system. This accidental finding is based on our recently published study that described this system for the first time in large mammals. Our current results define the need to investigate cerebrovascular pathologies that could compromise glymphatic function in gyrencephalic animal models as a tool to bridge rodent and human glymphatic studies. Read More

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Tumor Volume as Predictor of Pathologic Complete Response Following Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer.

Am J Clin Oncol 2021 Jul 19. Epub 2021 Jul 19.

Radiation Therapy Unit, Oncology Institute Department of Nuclear Medicine, Rambam Health Care Campus Technion School of Medicine, Haifa, Israel.

Purpose: Neoadjuvant chemoradiation followed by surgery is the current standard of care in the treatment of locally advanced rectal cancer. Those who achieved pathologic complete response, following this standard of care, complete pathologic response (pCR) had better outcome. Until now there are no reliable clinical parameters to predict this response. Read More

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Use of Outpatient Intravenous Calcitropes for Heart Failure in the United States.

J Card Fail 2021 Jul 12. Epub 2021 Jul 12.

University of Colorado School of Medicine, Aurora, CO.

Rationale: Outpatient calcitrope infusions-i.e., cardiac inotropes milrinone and dobutamine-are often used for bridge-to-transplantation and palliation in advanced heart failure, but few data exist about real world use of these agents. Read More

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Thoracic paravertebral nerve catheter reduces postoperative opioid use for vertebral body tethering patients.

Spine Deform 2021 Jul 15. Epub 2021 Jul 15.

Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, USA.

Purpose: Vertebral body tethering is increasingly being performed, yet postoperative pain management has not yet been optimized. We sought to determine whether the addition of a thoracic paravertebral block in addition to a standard multimodal postoperative pain management program could provide greater pain relief, reduced analgesic requirement, and reduced length of stay.

Methods: Patients who underwent VBT at a single tertiary referral center were retrospectively reviewed. Read More

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Rapidly progressive aortic stenosis treated with transcatheter aortic valve implantation in a patient with Fabry disease: a case report.

Eur Heart J Case Rep 2021 Jun 17;5(6):ytab124. Epub 2021 Jun 17.

Division of Cardiology, Cardiology Department, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina.

Background: Fabry disease (FD) is a rare lysosomal storage disease, caused by mutations in the gene encoding the enzyme α-galactosidase A (α-Gal A). Cardiac involvement is one of the main causes of death and it is characterized by progressive concentric left ventricular hypertrophy (LVH), which in most cases is symmetric. Mild thickening of the left-sided valves is seen in as many as a quarter of patients. Read More

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Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19.

N Engl J Med 2021 Jul 14. Epub 2021 Jul 14.

From Massachusetts General Hospital and Harvard Medical School, Boston (M. Dougan); Eli Lilly (A.N., A.C.A., J.V.N., K.L.C., M. Durante, G.O., A.E.S., T.R.H., P.J.E., R.E.H., N.L.K., J.S., D.R.P., M.C.D., P. Klekotka, L.S., D.M.S.), and Franciscan Health (I.S.) - both in Indianapolis; Valley Clinical Trials-Northridge, Northridge (M.A.), the Department of Medicine, Women's Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles (P.C.), and Long Beach Clinical Trials, Long Beach (B.H.) - all in California; the Las Vegas Medical Research Center, Las Vegas (B.M.); Baylor University Medical Center and Baylor Scott and White Research Institute, Dallas (R.L.G.), and Gadolin Research, Beaumont (R.P.) - both in Texas; NOLA Research Works, New Orleans (C.H.), and Clinical Trials of Southwest Louisiana, Lake Charles (J.M.) - both in Louisiana; Vitalink Research, Union, SC (J.B.); Eastside Research Associates, Redmond, WA (C.C.); Monroe Biomedical Research, Monroe, NC (A.I.); Cook County Health, Chicago (G.H.); Indago Research and Health Center, Hialeah, FL (J.C.); and Georgetown University, Washington, DC (P. Kumar).

Background: Patients with underlying medical conditions are at increased risk for severe coronavirus disease 2019 (Covid-19). Whereas vaccine-derived immunity develops over time, neutralizing monoclonal-antibody treatment provides immediate, passive immunity and may limit disease progression and complications.

Methods: In this phase 3 trial, we randomly assigned, in a 1:1 ratio, a cohort of ambulatory patients with mild or moderate Covid-19 who were at high risk for progression to severe disease to receive a single intravenous infusion of either a neutralizing monoclonal-antibody combination agent (2800 mg of bamlanivimab and 2800 mg of etesevimab, administered together) or placebo within 3 days after a laboratory diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Read More

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Bivalirudin for the prevention of hepatic artery thrombosis in pediatric liver transplantation.

Pediatr Transplant 2021 Jul 13:e14068. Epub 2021 Jul 13.

Division of Transplant Surgery, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: Early hepatic artery thrombosis (HAT) after liver transplantation is a serious complication that frequently results in graft loss and the need for retransplantation. Although studies have reported on various operative and endovascular treatment approaches, pharmacologic strategies for the prevention or management of HAT are not well defined. Patients with blood clotting disorders, those with a contraindication to heparin, and those who have previously developed HAT represent unique challenges in management. Read More

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Brown tumour mimicking skeletal metastasis.

BMJ Case Rep 2021 Jul 13;14(7). Epub 2021 Jul 13.

Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Brown tumours of bone are highly vascular osteolytic lesions that depict a reparative cellular process instead of a neoplastic process in hyperparathyroidism (HPT) patients. These tumours have the potential to be aggressive and destructive. We report a case of a 30-year-old woman who presented with left thigh and lower back pain. Read More

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Transcatheter arterial embolization for severe blunt liver injury in hemodynamically unstable patients: a 15-year retrospective study.

Scand J Trauma Resusc Emerg Med 2021 Jul 14;29(1):66. Epub 2021 Jul 14.

Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

Background: Transcatheter arterial embolization (TAE) is the first-line nonsurgical treatment for severe blunt liver injury in patients, whereas operative management (OM) is recommended for hemodynamically unstable patients. This study investigated the comparative efficacy of TAE in hemodynamically unstable patients who responded to initial infusion therapy.

Methods: This retrospective study enrolled patients with severe blunt liver injuries, which were of grades III-V according to the American Association for the Surgery of Trauma Organ Injury Scale (OIS). Read More

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Gene therapy for aromatic L-amino acid decarboxylase deficiency by MR-guided direct delivery of AAV2-AADC to midbrain dopaminergic neurons.

Nat Commun 2021 07 12;12(1):4251. Epub 2021 Jul 12.

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder characterized by deficient synthesis of dopamine and serotonin. It presents in early infancy, and causes severe developmental disability and lifelong motor, behavioral, and autonomic symptoms including oculogyric crises (OGC), sleep disorder, and mood disturbance. We investigated the safety and efficacy of delivery of a viral vector expressing AADC (AAV2-hAADC) to the midbrain in children with AADC deficiency (ClinicalTrials. Read More

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Expanding the phenotype of mucopolysaccharidosis type II retinopathy.

Ophthalmic Genet 2021 Jul 12:1-6. Epub 2021 Jul 12.

Centre for Eye Research Australia, East Melbourne, Australia.

: To report novel retinal findings in two male patients with mucopolysaccharidosis type II (Hunter syndrome) receiving long-term human recombinant idursulfase enzyme replacement therapy.: Two males aged 19 and 26 years who had received enzyme replacement therapy for 12 and 13 years, respectively, with good compliance and no infusion-related reactions, were examined clinically and underwent optical coherence tomographic scanning of the retina and electroretinography testing.: Case 1 had visual acuity 20/32 in each eye and case 2 had visual acuity 20/25 in each eye. Read More

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Safety and tolerability of Miltuximab - a first in human study in patients with advanced solid cancers.

Asia Ocean J Nucl Med Biol 2021 ;9(2):86-100

Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

Objectives: Miltuximab is a chimeric antibody targeting Glypican-1 (GPC-1), a cell surface antigen which is overexpressed in solid cancers. Miltuximab has shown promising safety and efficacy in radioimmunotherapy models of prostate cancer. This first in human study used Miltuximab radiolabelled with Gallium-67 ([Ga]Ga-DOTA-Miltuximab). Read More

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January 2021