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Avelumab vs docetaxel in patients with platinum-treated advanced non-small-cell lung cancer: 2-year follow-up from the JAVELIN Lung 200 phase 3 trial.

J Thorac Oncol 2021 Apr 9. Epub 2021 Apr 9.

Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France†; Gustave Roussy Cancer Campus, Villejuif, France. Electronic address:

Introduction: In the JAVELIN Lung 200 trial, avelumab (anti-PD-L1 antibody) did not significantly prolong overall survival (OS) vs docetaxel in patients with platinum-treated PD-L1+ NSCLC. We report >2-year follow-up data.

Methods: Patients with stage IIIB/IV or recurrent NSCLC with disease progression following platinum-doublet chemotherapy were randomized 1:1 to avelumab 10 mg/kg every 2 weeks or docetaxel 75 mg/m every 3 weeks. Read More

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His-purkinje system pacing upgrade improve the heart performances in patients suffering from pacing-induced cardiomyopathy with or without permanent atrial fibrillation.

Int J Cardiol 2021 Apr 9. Epub 2021 Apr 9.

Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China. Electronic address:

Introduction: The efficacy and safety of his-purkinje system pacing (HPSP) upgrades in patients with pacing-induced cardiomyopathy (PICM) and atrial fibrillation (AF) are still unknown.

Methods And Results: Patients with PICM were continuously enrolled from January 2018 to March 2020. All patients were further divided into AF subgroup and sinus rhythm subgroup. Read More

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Treatment for pure red cell aplasia after major ABO-incompatible allogeneic stem cell transplantation: a multicentre study.

Br J Haematol 2021 Apr 12. Epub 2021 Apr 12.

Haematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.

Pure red cell aplasia (PRCA) following allogeneic haematopoietic stem cell transplantation (aHSCT) with major ABO incompatibility is responsible for transfusion dependent anaemia, impaired quality of life and iron overload. We conducted a retrospective study, over a 10-year period, which included all consecutive patients who received a major ABO mismatched aHSCT, to assess the impact of specific treatment on PRCA. We did not observe any PRCA in the 57 aHSCT issued from cord blood. Read More

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Children with Primary Septic Arthritis Have a Markedly Lower Risk of Adverse Outcomes Than Those with Contiguous Osteomyelitis.

J Bone Joint Surg Am 2021 Apr 12. Epub 2021 Apr 12.

Children's Health System of Texas, Dallas, Texas.

Background: It is widely believed that septic arthritis poses a risk of joint destruction and long-term adverse outcomes for children if not treated emergently. In the present study, children who had primary confirmed septic arthritis were compared with those who had septic arthritis and adjacent osteomyelitis to evaluate differences that affect the relative risk of adverse outcomes.

Methods: Children who underwent multidisciplinary treatment for septic arthritis with or without contiguous osteomyelitis between 2009 and 2019 were retrospectively studied. Read More

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Comparison of Outcomes of Enoxaparin Bridge Therapy in HeartMate II versus HeartWare HVAD Recipients.

J Cardiovasc Pharmacol Ther 2021 Apr 12:10742484211006998. Epub 2021 Apr 12.

Department of Pharmacy, 12297NYU Langone Health, New York, NY, USA.

Background: There is a lack of robust data evaluating outcomes of enoxaparin "bridge" therapy in left ventricular assist device (LVAD) patients.

Methods: We performed a retrospective study of HeartMate II (HM II) and HeartWare HVAD recipients that received therapeutic enoxaparin as "bridge" therapy to describe bleeding and thrombotic events and compare outcomes between devices. The primary endpoint was the incidence of bleeding within 30 days of "bridge" episode. Read More

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Pembrolizumab in Patients With Metastatic Breast Cancer With High Tumor Mutational Burden: Results From the Targeted Agent and Profiling Utilization Registry (TAPUR) Study.

J Clin Oncol 2021 Apr 12:JCO2002923. Epub 2021 Apr 12.

American Society of Clinical Oncology, Alexandria, VA.

Purpose: The TAPUR Study is a phase II basket trial that aims to identify signals of antitumor activity of commercially available targeted agents in patients with advanced cancers harboring genomic alterations known to be drug targets. Results in a cohort of patients with metastatic breast cancer (mBC) with high tumor mutational burden (HTMB) treated with pembrolizumab are reported.

Methods: Patients with advanced mBC received standard doses of either 2 mg/kg or 200 mg infusions of pembrolizumab every 3 weeks. Read More

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Feasibility of assessing progression of transthyretin amyloid polyneuropathy using nerve conduction studies: findings from the Transthyretin Amyloidosis Outcomes Survey (THAOS).

J Peripher Nerv Syst 2021 Apr 12. Epub 2021 Apr 12.

Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan.

Background And Aims: Patients with transthyretin amyloid polyneuropathy (ATTR-PN) show decreased motor and sensory nerve amplitudes and conduction. Electrophysiological changes over time may be sensitive indicators of progression. This analysis from the Transthyretin Amyloidosis Outcomes Survey (THAOS) assessed longitudinal changes in nerve conduction as signals of neurologic disease progression in patients with hereditary ATTR (ATTRv) amyloidosis. Read More

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Outcomes after cervical vertebral interbody fusion using an interbody fusion device and polyaxial pedicle screw and rod construct in 10 horses (2015-2019).

Equine Vet J 2021 Apr 12. Epub 2021 Apr 12.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, Colorado, 80523, USA.

Background: Further development of surgical techniques for equine cervical stabilisation is necessary to make the procedure less technically demanding, reduce complications, and improve outcomes.

Objective: To describe clinical outcomes and owner reports in horses undergoing placement of an interbody fusion device and polyaxial pedicle screw and rod construct for cervical vertebral fusion in horses with cervical vertebral compressive myelopathy.

Study Design: Retrospective case series. Read More

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Evaluation of Time-Limited Trials Among Critically Ill Patients With Advanced Medical Illnesses and Reduction of Nonbeneficial ICU Treatments.

JAMA Intern Med 2021 Apr 12. Epub 2021 Apr 12.

Los Angeles County Department of Health Services, Los Angeles, California.

Importance: For critically ill patients with advanced medical illnesses and poor prognoses, overuse of invasive intensive care unit (ICU) treatments may prolong suffering without benefit.

Objective: To examine whether use of time-limited trials (TLTs) as the default care-planning approach for critically ill patients with advanced medical illnesses was associated with decreased duration and intensity of nonbeneficial ICU care.

Design, Setting, And Participants: This prospective quality improvement study was conducted from June 1, 2017, to December 31, 2019, at the medical ICUs of 3 academic public hospitals in California. Read More

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Data Integration to Improve Real-world Health Outcomes Research for Non-Small Cell Lung Cancer in the United States: Descriptive and Qualitative Exploration.

JMIR Cancer 2021 Apr 12;7(2):e23161. Epub 2021 Apr 12.

Eli Lilly and Company, Indianapolis, IN, United States.

Background: The integration of data from disparate sources could help alleviate data insufficiency in real-world studies and compensate for the inadequacies of single data sources and short-duration, small sample size studies while improving the utility of data for research.

Objective: This study aims to describe and evaluate a process of integrating data from several complementary sources to conduct health outcomes research in patients with non-small cell lung cancer (NSCLC). The integrated data set is also used to describe patient demographics, clinical characteristics, treatment patterns, and mortality rates. Read More

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Sustained long-term benefits of patient support program participation in immune-mediated diseases: improved medication-taking behavior and lower risk of a hospital visit.

J Manag Care Spec Pharm 2021 Apr 12:1-11. Epub 2021 Apr 12.

AbbVie Inc., North Chicago, IL.

Patient support programs (PSPs) improve medication-taking behavior in the first 12 months of treatment for patients with immune-mediated diseases, but it is unknown if these benefits are sustained. As immune-mediated diseases continue to increase in prevalence and economic burden, understanding the potential value of PSPs in helping patients adhere to their long-term treatment plan and avoid costly hospital visits is crucial. Launched nationally in 2015, HUMIRA Complete (a PSP for adalimumab patients) provides an opportunity to study long-term effects of PSP participation, including the impact on medication-taking behavior and hospital visits. Read More

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Surgical outcomes of infective endocarditis in children: should we delay surgery for infective endocarditis?

Eur J Cardiothorac Surg 2021 Apr 11. Epub 2021 Apr 11.

Department of Pediatrics, Seoul National University, College of Medicine, Seoul National University Children's Hospital, Seoul, Republic of Korea.

Objectives: We compared the surgical outcomes of infective endocarditis (IE) between early surgery and non-early surgery groups in children.

Methods: From January 2000 to April 2020, we retrospectively reviewed 50 patients <18years of age who underwent first surgery for IE. Early surgery was defined as that performed within 2 days for left-sided IE and 7 days for right-sided IE after diagnosis. Read More

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Time Till Viral Clearance of Severe Acute Respiratory Syndrome Coronavirus 2 Is Similar for Asymptomatic and Non-critically Symptomatic Individuals.

Front Med (Lausanne) 2021 26;8:616927. Epub 2021 Mar 26.

Royal College of Surgeons in Ireland, Manama, Bahrain.

Despite the modeled estimations of the burden of asymptomatic spread, the duration of viral positivity and infectiousness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains understudied. The objective of the present study was to estimate and compare the time till viral clearance of SARS-CoV-2 in asymptomatic and non-critical symptomatic individuals. We studied 184 SARS-CoV-2-positive participants, of whom 145 were asymptomatic. Read More

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From less invasive to minimal invasive extracorporeal circulation.

J Thorac Dis 2021 Mar;13(3):1909-1921

Cardiothoracic Department, AHEPA University Hospital, Thessaloniki, Greece.

Development of minimally invasive cardiac surgery (MICS) served the purpose of performing surgery while avoiding the surgical stress triggered by a full median sternotomy. Minimizing surgical trauma is associated with improved cosmesis and enhanced recovery leading to reduced morbidity. However, it has to be primarily appreciated that the extracorporeal circulation (ECC) stands for the basis of nearly all MICS procedures. Read More

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Efficacy and safety of crizotinib plus bevacizumab in positive non-small cell lung cancer: an open-label, single-arm, prospective observational study.

Am J Transl Res 2021 15;13(3):1526-1534. Epub 2021 Mar 15.

School of Medicine, Nankai University Weijin Road 94#, Nankai District, Tianjin 300071, China.

Background: Crizotinib is a tyrosine kinase inhibitor (TKI) effective in positive non-small cell lung cancer (NSCLC) patients. Bevacizumab is an antiangiogenic monoclonal antibody, and improves clinical benefit of NSCLC in combination with EGFR-TKIs or chemotherapy. However, the efficacy and safety of crizotinib plus bevacizumab in treating naive positive NSCLC patients have not been studied. Read More

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Single-Center Review of Celiac Plexus/Retrocrural Splanchnic Nerve Block for Non-Cancer Related Pain.

Acad Radiol 2021 Apr 8. Epub 2021 Apr 8.

Department of Radiology, Mayo Clinic, 5779 E Mayo Blvd, Phoenix, AZ, 85054. Electronic address:

Rationale And Objectives: Celiac plexus and retrocrural splanchnic nerve (CP/RSN) blocks are widely used for cancer-related abdominal pain, but there is limited literature on their efficacy for non-cancer related pain. Our aim was to determine the indications and effectiveness of CT-guided CP/RSN blocks performed on patients with abdominal pain from non-cancer related sources.

Materials And Methods: CT-guided CP/RSN blocks for non-cancer related abdominal pain from 2011-2020 were retrospectively reviewed for patient demographics, procedure details, duration of pain relief, and complications. Read More

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Patient-Reported Function and Quality of Life After Revision Total Knee Arthroplasty: An Analysis of 10,727 Patients from the NHS PROMs Program.

J Arthroplasty 2021 Mar 19. Epub 2021 Mar 19.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK; Nuffield Orthopaedic Centre, Oxford, UK.

Background: The aim of the study was to investigate changes in patient-reported outcome measures (PROMs) after revision total knee arthroplasty (rTKA).

Methods: A total of 10,727 patients undergoing elective rTKA were recruited from the UK National Health Service PROMs data set from 2013 to 2019. PROMs were collected at baseline and six months to assess joint function (Oxford Knee Score, OKS) and quality of life (EQ-5D). Read More

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Role of Krebs von den lungen-6 (KL-6) in assessing hypersensitivity pneumonitis.

Tuberc Respir Dis (Seoul) 2021 Apr 6. Epub 2021 Apr 6.

chest department, faculty of medicine Cairo university.

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with ILD. Serum KL-6/MUC1 levels have been demonstrated to be useful for evaluating various ILD. Read More

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Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency.

Pediatr Diabetes 2021 Apr 10. Epub 2021 Apr 10.

Department of Pediatrics, Oncology and Hematology, Medical University of Łódź, Sporna Str., Łódź, Poland.

Background: Type 1 diabetes (T1D) may coexist with primary immunodeficiencies, indicating a shared genetic background.

Objective: To evaluate the prevalence and clinical characteristics of immunoglobulin deficiency (IgD) among children with T1D.

Methods: Serum samples and medical history questionnaires were obtained during routine visits from T1D patients aged 4-18 years. Read More

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Survival of advanced melanoma patients treated with immunotherapy and targeted therapy: a real-world study.

Pharmacoepidemiol Drug Saf 2021 Apr 11. Epub 2021 Apr 11.

School of Pharmacy, University of Queensland, Woolloongabba, Australia.

Introduction: We aimed to examine the survival outcomes plus patient and treatment characteristics of advanced melanoma patients treated with first-line immunotherapy (IT), targeted therapy (TT), and chemotherapy (CTH) and compare findings with information from pivotal trials for each therapy.

Materials And Methods: We retrospectively reviewed the use of systematic IT, TT and CTH therapies in melanoma patients in four Queensland public hospitals. We estimated median duration of overall survival (OS) and survival rates (6 months, 1, and 2 years) using Kaplan-Meier methods. Read More

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Long-term outcomes of oligometastatic breast cancer patients treated with curative intent: an updated report.

Breast Cancer 2021 Apr 11. Epub 2021 Apr 11.

Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, Japan.

Background: Oligometastatic breast cancer (OMBC) is characterized by limited metastatic tumor numbers and sites. We have reported a 20-year overall survival (OS) rate and relapse-free rate (RFR) of 34.1% and 27. Read More

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Impairment of right ventricular longitudinal strain associated with severity of pneumonia in patients recovered from COVID-19.

Int J Cardiovasc Imaging 2021 Apr 11. Epub 2021 Apr 11.

Istanbul Medical Faculty, Department of Cardiology, Istanbul University, Topkapi Mahallesi, Turgut Ozal Millet Caddesi, 34093, Fatih/Istanbul, Turkey.

Myocardial injury caused by COVID-19 was reported in hospitalized patients previously. But the information about cardiac consequences of COVID-19 after recovery is limited. The aim of the study was comprehensive echocardiography assessment of right ventricular (RV) in patients recovered from COVID-19. Read More

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Preoperative amlodipine is efficacious in preventing intraoperative HDI in pheochromocytoma- pilot RCT.

J Clin Endocrinol Metab 2021 Apr 11. Epub 2021 Apr 11.

Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Background: Preoperative blockade with α-blockers is recommended in patients with pheochromocytoma/paraganglioma (PPGL). The data on calcium channel blockade (CCB) in PPGL is scarce. We aimed to compare the efficacy of CCB and α-blockers on intraoperative haemodynamic instability (HDI) in PPGL. Read More

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Closed-loop vagal nerve stimulation for intractable epilepsy: A single-center experience.

Seizure 2021 Apr 1;88:95-101. Epub 2021 Apr 1.

Department of Neurological Surgery, Weill-Cornell Medicine/NewYork-Presbyterian Hospital, 525 East 68th Street, Box 99, New York, NY, USA.

Purpose: A new class of heart-rate sensing, closed-loop vagal nerve stimulator (VNS) devices for refractory epilepsy may improve seizure control by using pre-ictal autonomic changes as an indicator for stimulation. We compared our experience with closed- versus open-loop stimulator implantation at a single institution.

Methods: We conducted a retrospective chart review of consecutive VNS implantations performed from 2004 to 2018. Read More

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Effect of nasal corticosteroid in the treatment of anosmia due to COVID-19: A randomised double-blind placebo-controlled study.

Am J Otolaryngol 2021 Apr 7;42(5):103033. Epub 2021 Apr 7.

Department of Surgery, College of Medicine, University of Anbar, Ramadi, 31001, Iraq.

Objectives: Anosmia is a common debilitating symptom of the novel coronavirus disease 2019 (COVID-19). Currently, there is no satisfactory treatment of anosmia. Therefore, this study was conducted to evaluate the therapeutic effect of nasal betamethasone drops in the recovery of olfaction in COVID-19-associated anosmia. Read More

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Laparoscopic liver resection for huge (≥10 cm) hepatocellular carcinoma: A coarsened exact-matched single-surgeon study.

Surg Oncol 2021 Apr 3;37:101569. Epub 2021 Apr 3.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore; Duke NUS Medical School, Singapore. Electronic address:

Introduction: Laparoscopic liver resection (LLR) is increasingly being utilised worldwide for the management of both benign and malignant liver tumours. However, there is limited data to date regarding the safety and feasibility of this approach for huge (≥10 cm) hepatocellular carcinomas (HCCs). We present here our early experience performing LLR for huge HCCs. Read More

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Outcomes of Surgical Treatment for Mycobacterium abscessus Complex Pulmonary Disease.

Ann Thorac Surg 2021 Apr 8. Epub 2021 Apr 8.

Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan.

Background: Mycobacterium abscessus complex pulmonary disease is notoriously difficult to treat by medication alone. We report our experience with resectional surgery combined with pre- and postoperative multidrug chemotherapy for the treatment of patients with Mycobacterium abscessus complex pulmonary disease.

Methods: This is a retrospective review of 33 patients undergoing lung resection for Mycobacterium abscessus complex pulmonary disease at a single center in Japan between January 2008 and December 2019. Read More

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Outcome of Repeat Venoarterial Extracorporeal Membrane Oxygenation in Postcardiotomy Cardiogenic Shock.

J Cardiothorac Vasc Anesth 2021 Mar 6. Epub 2021 Mar 6.

Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. Electronic address:

Objective: Data on patients requiring a second run of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in patients affected by postcardiotomy cardiogenic shock (PCS) are very limited. The authors aimed to investigate the effect of a second run of VA-ECMO on PCS patient survival.

Design: Retrospective analysis of an international registry. Read More

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Prevalence and associated factors of hypertension among adults with diabetes mellitus in northern Sudan: a cross-sectional study.

BMC Cardiovasc Disord 2021 Apr 10;21(1):168. Epub 2021 Apr 10.

Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia.

Background: Hypertension and diabetes mellitus (DM), are highly prevalent worldwide health non-communicable diseases, and are associated with chronic complications. The co-existence of both conditions accelerates the related complications and increases morbidities and mortalities. A cross-sectional study was conducted in Nahr an Nil State (River Nile State) in Sudan between May and August 2018 to identify the prevalence of hypertension and risk factors among patients with DM in that region. Read More

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Long-term ocular biometric variations after scleral buckling surgery in macula-on rhegmatogenous retinal detachment.

BMC Ophthalmol 2021 Apr 10;21(1):172. Epub 2021 Apr 10.

Ophthalmology Unit - Department of Sense Organs, Sapienza University of Rome - Policlinico Umberto I University Hospital, Rome, Italy.

Background: Myopic shift and biometric ocular changes have been previously observed after scleral buckling (SB) surgery in rhegmatogenous retinal detachment (RRD), but long term-term outcomes had not yet been explored. The purpose of present study is to evaluate long term ocular biometric changes in patients with primary macula-on RRD treated with SB.

Methods: In this retrospective, observational study, we reviewed the medical records of patients undergoing SB surgery for macula-on RRD. Read More

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