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Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis.

Pharmacology 2021 Jun 24:1-9. Epub 2021 Jun 24.

Anesthesiology Department, Tianjin Medical University General Hospital, Tianjin, China.

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Read More

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A model-based source separation algorithm for lung perfusion imaging using electrical impedance tomography.

Physiol Meas 2021 Jun 24. Epub 2021 Jun 24.

Medical Information Technology, RWTH Aachen University, Aachen, Nordrhein-Westfalen, GERMANY.

Objective: Electrical impedance tomography (EIT) for lung perfusion imaging is attracting considerable interest in intensive care, as it might open up entirely new ways to adjust ventilation therapy. A promising technique is bolus injection of a conductive indicator to the central venous catheter, which yields the indicator-based signal (IBS). Lung perfusion images are then typically obtained from the IBS using the maximum slope technique. Read More

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Myoelectric analysis of upper-extremity muscles during robot-assisted bilateral wrist flexion-extension in subjects with poststroke hemiplegia.

Clin Biomech (Bristol, Avon) 2021 Jun 11;87:105412. Epub 2021 Jun 11.

Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. Electronic address:

Background: Muscle co-contraction during the execution of motor tasks or training is common in poststroke subjects. EMG-derived muscular activation indexes have been used to evaluate muscle co-contractions during movements. In addition, robot-assisted bilateral arm training provides a repetitive and stable training method to improve arm movements. Read More

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Direct oral anticoagulants for the treatment of pulmonary embolism in patients with renal impairment.

Thromb Res 2021 Jun 19;204:101-107. Epub 2021 Jun 19.

Department of Vascular Medicine, Klinikum Darmstadt GmbH, Darmstadt, Germany; Center for Thrombosis and Hemostasis, University of Mainz, Mainz, Germany. Electronic address:

Pulmonary embolism (PE) is associated with adverse outcomes and substantial morbidity and mortality. Patients with PE often have renal impairment because of shared risk factors and close links between the renal and cardiovascular systems. Furthermore, patients with PE and renal impairment are at increased risk of recurrent thrombosis. Read More

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Intravaginal 6.5 mg prasterone administration in postmenopausal women with overactive bladder syndrome: A pilot study.

Eur J Obstet Gynecol Reprod Biol 2021 Jun 12;263:67-71. Epub 2021 Jun 12.

Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy.

Objective: The aim of this study was to evaluate the impact of vaginally prasterone administration on postmenopausal women with genitourinary syndrome of menopause (GSM) affected by overactive bladder syndrome (OAB). A secondary aim of this study was to assess the efficacy of prasterone on VVA and quality of life (QoL).

Study Design: Thirty-two postmenopausal women with GSM and referred OAB symptoms received treatment with daily intravaginal prasterone 6. Read More

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Cancer cell membrane camouflaged iridium complexes functionalized black-titanium nanoparticles for hierarchical-targeted synergistic NIR-II photothermal and sonodynamic therapy.

Biomaterials 2021 Jun 18;275:120979. Epub 2021 Jun 18.

MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Sun Yat-Sen University, Guangzhou, 510006, PR China; MOE Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, 400201, PR China. Electronic address:

The diagnosis and treatment of cancer is one of the biggest medical challenges of the century. Despite significant improvements, there remains an urgent need for novel anticancer procedures. Among the most promising approaches, increasing attention has been devoted towards photothermal and sonodynamic therapy in which sensitizers are activated upon light/ultrasound radiation to generate a cytotoxic effect. Read More

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Antibiotic Prescribing Patterns for Hospitalized children with Community-Acquired Pneumonia in a Secondary Care Center.

J Infect Public Health 2021 Jun 2;14(8):1035-1041. Epub 2021 Jun 2.

Department of Pediatrics, College of Medicine, Majmaah University, Majmaah 11952, Saudi Arabia.

Background: Narrow-spectrum antibiotics are recommended as the first-line therapy for management of children hospitalized with community-acquired pneumonia (CAP). There are limited data evaluating the antibiotic prescription patterns for CAP in Saudi Arabia. The goal of this study to report on the antibiotic patterns in children hospitalized with CAP. Read More

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Effect of aromatherapy on sleep quality of adults and elderly people: A systematic literature review and meta-analysis.

Complement Ther Med 2021 Jun 21;60:102739. Epub 2021 Jun 21.

Department of Nursing Science, College of Medicine, Chungbuk National University, 1, Chungdae-ro, Seowon-gu, Cheonju-si, Chungcheongbuk-do, 28644, Republic of Korea. Electronic address:

Purpose: The purpose of this study was to characterize studies on aromatherapy and sleep quality and to identify the measurable effects of aromatherapy on the sleep quality of adults and elderly people.

Methods: We searched eight electronic databases for relevant studies published between January 2011 and December 2019 using the medical subheadings, "adult or elderly," "aromatherapy or aroma intervention," and "sleep quality or sleep satisfaction." Statistical analyses of the combined effect sizes, homogeneity, heterogeneity, and trim-and-fill method were performed using MIX 2. Read More

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The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials.

Breast 2021 Jun 14;59:58-66. Epub 2021 Jun 14.

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany.

Objective: We assessed the value of breast ultrasound (US) performed at week 3 and 6 and at the end (EOT) of neoadjuvant therapy (NAT) for prediction of pathologic complete response (pCR, ypT0/is ypN0) in patients with HR+/HER2+, HR-/HER2-or HR-/HER2+ early breast cancer enrolled in the WSG-ADAPT subtrials.

Methods: US was performed at week 3 and 6 of NAT and at EOT in 401, 517, and 553 patients, respectively. Tumors with complete or partial response by US (RECIST 1. Read More

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Quality of YouTube videos on meningioma treatment using the DISCERN instrument.

World Neurosurg 2021 Jun 21. Epub 2021 Jun 21.

Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland.

Objective: To assess the quality of YouTube videos on meningioma treatment.

Methods: A search was performed on YouTube using the keywords "meningioma treatment", "meningeal tumor treatment", "meningioma brain tumor treatment", "meningioma cure", and "meningioma therapy". Sixty-one videos were independently evaluated by two fifth-year medical students using the DISCERN scoring system for quality analysis. Read More

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A Cavopulmonary Assist Device for long-term Therapy of Fontan Patients.

Semin Thorac Cardiovasc Surg 2021 Jun 21. Epub 2021 Jun 21.

Biofluid Mechanics Laboratory, Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. Electronic address:

Treatment of univentricular hearts remains restricted to palliative surgical corrections (Fontan pathway). The established Fontan circulation lacks a sub-pulmonary pressure source and is commonly accompanied by progressively declining hemodynamics. A novel cavopulmonary assist device (CPAD) may hold the potential for improved therapeutic management of Fontan patients by chronic restoration of biventricular equivalency. Read More

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AI-based monitoring of retinal fluid in disease activity and under therapy.

Prog Retin Eye Res 2021 Jun 21:100972. Epub 2021 Jun 21.

Department of Ophthalmology Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. Electronic address:

Retinal fluid as the major biomarker in exudative macular disease is accurately visualized by high-resolution three-dimensional optical coherence tomography (OCT), which is used world-wide as a diagnostic gold standard largely replacing clinical examination. Artificial intelligence (AI) with its capability to objectively identify, localize and quantify fluid introduces fully automated tools into OCT imaging for personalized disease management. Deep learning performance has already proven superior to human experts, including physicians and certified readers, in terms of accuracy and speed. Read More

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Hepatic artery infusion chemotherapy using mFOLFOX versus transarterial chemoembolization as initial treatment for locally advanced hepatocellular carcinoma: a propensity score-matching analysis.

J Vasc Interv Radiol 2021 Jun 21. Epub 2021 Jun 21.

Departments of Minimally Invasive Interventional Radiology, Center of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China. Electronic address:

Purpose: To compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil/leucovorin (mFOLFOX) against transarterial chemoembolization (TACE) as a locoregional treatment for patients with locally advanced HCC.

Materials And Methods: This retrospective study included adult patients with locally advanced HCC who received first-line treatment with either HAIC-mFOLFOX or conventional TACE monotherapy from January 2015 to December 2016. Outcomes included tumor response rates evaluated by imaging assessment using the modified Response Evaluation Criteria in Solid Tumors criteria, overall survival (OS), progression-free survival (PFS) and safety were compared. Read More

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Intra-arterial therapy for unresectable colorectal liver metastases: A meta-analysis.

J Vasc Interv Radiol 2021 Jun 21. Epub 2021 Jun 21.

Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore. Electronic address:

Purpose: To evaluate the efficacy of hepatic arterial infusion (HAI), conventional trans-arterial chemoembolization (cTACE), drug-eluting embolic trans-arterial chemoembolization (DEE-TACE), trans-arterial radioembolization (TARE) and their combinations with systemic chemotherapy (SCT) for unresectable colorectal liver metastases.

Methods: A search was conducted on EMBASE, Scopus, PubMed and Web of Science for prospective non-randomized studies and randomized controlled trials (RCTs) from inception to 20 June 2020. Survival data of patients were recovered from original Kaplan-Meier curves by exploiting a graphical reconstructive algorithm. Read More

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Management of Cardiac Sarcoidosis Using Mycophenolate Mofetil as a Steroid Sparing Agent.

J Card Fail 2021 Jun 21. Epub 2021 Jun 21.

Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, US. Electronic address:

Background: Cardiac sarcoidosis (CS) is a major cause of morbidity and mortality in patients with systemic sarcoidosis. Steroid sparing agents are increasingly used, despite lack of randomized trials or published guidelines to direct treatment.

Methods: This retrospective study included 77 patients with CS treated with prednisone monotherapy (n=32) or a combination with mycophenolate mofetil (MMF) (n=45) between 2003 and 2018. Read More

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The Impact of Depression on Outcomes in Patients with Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial.

J Card Fail 2021 Jun 21. Epub 2021 Jun 21.

Section of Cardiovascular Medicine; Yale University School of Medicine, New Haven, CT;. Electronic address:

Background: It remains unclear why depression is associated with adverse outcomes in heart failure (HF) patients. We examine the relationship between depression and clinical outcomes among patients with HF and reduced ejection fraction (HFrEF) managed with guideline directed medical therapy (GDMT).

Methods: Using the GUIDE-IT trial, 894 patients with HFrEF were stratified according to a history of depression, and Cox proportional hazards regression modeling was used to examine the association with outcomes. Read More

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In vitro evidence of propagation of superoxide dismutase-1 protein aggregation in canine degenerative myelopathy.

Vet J 2021 Jun 21:105710. Epub 2021 Jun 21.

Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan; The United Graduate School of Veterinary Sciences, Gifu University, 1-1 Yanagido, Gifu, 501-1193, Japan. Electronic address:

Canine degenerative myelopathy (DM) is a progressive and fatal neurodegenerative disorder that has been linked to mutations in the superoxide dismutase 1 (SOD1) gene. The accumulation of misfolded protein aggregates in spinal neurons and astrocytes is implicated as an important pathological process in DM; however, the mechanism of protein aggregate formation is largely unknown. In human neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS), cell-to-cell propagation of disease-relevant proteins has been demonstrated. Read More

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Multi-organ Targeting of HIV-1 Viral Reservoirs with Etravirine Loaded Nanostructured Lipid Carrier: An In-vivo Proof of Concept.

Eur J Pharm Sci 2021 Jun 21:105916. Epub 2021 Jun 21.

Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India. Electronic address:

The inadequate bioavailability and toxicity potential of antiretroviral therapy limit their effectiveness in the complete eradication of HIV from viral reservoirs. The penetration of these drugs into the brain is challenging because of the unfavorable physicochemical properties required to cross the membranes, limiting the transport of the drugs. Thus, in the current study, the authors report a nanocarrier-based drug delivery of a highly hydrophobic drug to overcome the existing limitations of the conventional therapies. Read More

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In vitro activity of cefiderocol, cefepime/zidebactam, cefepime/enmetazobactam, omadacycline, eravacycline, and other comparative agents against carbapenem-nonsusceptible Enterobacterales: Results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) in 2017-2020.

Int J Antimicrob Agents 2021 Jun 21:106377. Epub 2021 Jun 21.

Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

In this study, the susceptibility of carbapenem-nonsusceptible Enterobacterales (CNSE) to cefiderocol, cefepime/zidebactam, cefepime/enmetazobactam, omadacycline, eravacycline, and other comparative agents was examined. Non-duplicate Enterobacterales isolates from 16 Taiwanese hospitals were evaluated. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method, and susceptibility results were interpreted based on relevant guidelines. Read More

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Acetylation-induced PCK isoenzyme transition promotes metabolic adaption of liver cancer to systemic therapy.

Cancer Lett 2021 Jun 21. Epub 2021 Jun 21.

State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. Electronic address:

Sorafenib and lenvatinib are approved first-line targeted therapies for advanced liver cancer, but most patients develop acquired resistance. Herein, we found that sorafenib induced extensive acetylation changes towards a more energetic metabolic phenotype. Metabolic adaptation was mediated via acetylation of the Lys-491 (K491) residue of phosphoenolpyruvate carboxykinase isoform 2 (PCK2) (PCK2-K491) and Lys-473 (K473) residue of PCK1 (PCK1-K473) by the lysine acetyltransferase 8 (KAT8), resulting in isoenzyme transition from cytoplasmic PCK1 to mitochondrial PCK2. Read More

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Right to Try, Expanded Access Use, Project Facilitate and Clinical Trial reform.

Authors:
N K Reddy V Subbiah

Ann Oncol 2021 Jun 21. Epub 2021 Jun 21.

Department of Investigational Cancer Therapeutics (Phase 1 clinical trials program), Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas. USA; Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas. USA; MD Anderson Cancer Network, The University of Texas MD Anderson Cancer Center, Houston, Texas USA. Electronic address:

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IDENTIFICATION OF OPTIMAL THERAPEUTIC WINDOW FOR STEROID USE IN SEVERE ALCOHOL-ASSOCIATED HEPATITIS: A WORLDWIDE STUDY.

J Hepatol 2021 Jun 21. Epub 2021 Jun 21.

Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, CIBERehd, Barcelona, Spain.

Background: Corticosteroids are the only effective therapy for severe alcohol-associated hepatitis (AH), defined as MELD score >20. However, there are patients who may be too sick to benefit from therapy.

Aim: To identify the range of MELD score within which steroids are effective treatment for AH. Read More

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Commissioning and clinical implementation of an Autoencoder based Classification-Regression model for VMAT patient-specific QA in a multi-institution scenario.

Radiother Oncol 2021 Jun 21. Epub 2021 Jun 21.

Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. Electronic address:

Background And Purpose: To commission and implement an Autoencoder based Classification-Regression (ACLR) model for VMAT patient-specific quality assurance (PSQA) in a multi-institution scenario.

Materials And Methods: 1835 VMAT plans from seven institutions were collected for the ACLR model commissioning and multi-institutional validation. We established three scenarios to validate the gamma passing rates (GPRs) prediction and classification accuracy with the ACLR model for different delivery equipment, QA devices, and treatment planning systems (TPS). Read More

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Improving Secondary Fracture Prevention After Vertebroplasty: Implementation of a Fracture Liaison Service.

J Am Coll Radiol 2021 Jun 21. Epub 2021 Jun 21.

Department of Radiology, University of Wisconsin School of Medicine and Public Health. Electronic address:

Objective: The aim of our study was to evaluate a multidisciplinary fracture liaison service (FLS) to improve osteoporosis treatment and secondary fracture prevention for patients after vertebroplasty.

Methods: A retrospective chart review of consecutive vertebroplasty patients from January 2016 to January 2020. FLS began in December 2016 allowing for before-and-after comparison. Read More

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Once-daily savolitinib in Chinese patients with pulmonary sarcomatoid carcinomas and other non-small-cell lung cancers harbouring MET exon 14 skipping alterations: a multicentre, single-arm, open-label, phase 2 study.

Lancet Respir Med 2021 Jun 21. Epub 2021 Jun 21.

Hutchison MediPharma, Shanghai, China.

Background: Savolitinib is a selective MET tyrosine-kinase inhibitor. We investigated the activity and safety of savolitinib in patients with pulmonary sarcomatoid carcinoma and other non-small-cell lung cancer (NSCLC) subtypes positive for MET exon 14 skipping alterations (METex14-positive).

Methods: We did a multicentre, single-arm, open-label, phase 2 study across 32 hospitals in China. Read More

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Analysis of SARS-CoV-2 variant mutations reveals neutralization escape mechanisms and the ability to use ACE2 receptors from additional species.

Immunity 2021 Jun 8. Epub 2021 Jun 8.

NexVac Research Center, Comprehensive AIDS Research Center, Center for Infectious Disease Research, Beijing Advanced Innovation Center for Structural Biology, School of Medicine, Tsinghua University, Beijing 100084, China; Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen 518132, China. Electronic address:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to emerge during the global pandemic and may facilitate escape from current antibody therapies and vaccine protection. Here we showed that the South African variant B.1. Read More

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Squaric Ester-Based, pH-Degradable Nanogels: Modular Nanocarriers for Safe, Systemic Administration of Toll-like Receptor 7/8 Agonistic Immune Modulators.

J Am Chem Soc 2021 Jun 24. Epub 2021 Jun 24.

Max Planck Institute for Polymer Research, 55128 Mainz, Germany.

Small-molecular Toll-like receptor 7/8 (TLR7/8) agonists hold promise as immune modulators for a variety of immune therapeutic purposes including cancer therapy or vaccination. However, due to their rapid systemic distribution causing difficult-to-control inflammatory off-target effects, their application is still problematic, in particular systemically. To address this problem, we designed and robustly fabricated pH-responsive nanogels serving as versatile immunodrug nanocarriers for safe delivery of TLR7/8-stimulating imidazoquinolines after intravenous administration. Read More

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Symptomatic and Functional Response and Remission From the Open-Label Treatment-Optimization Phase of a Study With DR/ER-MPH in Children With ADHD.

J Clin Psychiatry 2021 Jun 22;82(4). Epub 2021 Jun 22.

Ironshore Pharmaceuticals & Development, Inc., Camana Bay, Grand Cayman, Cayman Islands.

Delayed-release and extended-release methylphenidate (DR/ER-MPH), the first stimulant predicted to be absorbed primarily in the colon, demonstrated significant improvements in attention-deficit/hyperactivity disorder (ADHD) symptoms and functional impairment from awakening until evening versus placebo in clinical trials. The clinical significance of these improvements was explored post hoc by examining response and remission thresholds as well as safety in the context of dose optimization.

Data from the open-label, treatment-optimization phase of a phase 3 study of DR/ER-MPH in children (aged 6-12 years) with ADHD, as diagnosed by criteria and enrolled between July 2015 and March 2016, were analyzed. Read More

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The Use of Integrase Strand Transfer Inhibitors to Treat HIV in Pregnancy.

J Midwifery Womens Health 2021 May;66(3):403-406

Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.

For pregnant women with HIV, antiretroviral therapy (ART) plays a key role in prevention of perinatal transmission. Newer antiretroviral regimens now contain integrase strand transfer inhibitors, which have been found to rapidly suppress HIV viral load in nonpregnant women; however, there are limited data for use in pregnancy. Here, we present the case of a pregnant woman with well-controlled HIV on a well-tolerated prepregnancy regimen of bictegravir, emtricitabine, and tenofovir alafenamide. Read More

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Barriers and potential solutions to international collaboration in neuro-oncology clinical trials: Challenges from the Australian perspective.

Asia Pac J Clin Oncol 2021 Jun 24. Epub 2021 Jun 24.

Cooperative Trials Group for Neuro-Oncology, National Health and Medical Research Council Clinical Trials Centre, Sydney, Australia.

Aim: The neuro-oncology community in Australia is well positioned to collaborate internationally, with a motivated trials group, strong regulatory bodies and an attractive fiscal environment. We sought to identify gaps in the Australian neuro-oncology clinical trials landscape and describe strategies to increase international trial access in Australia.

Methods: We searched clinical trial registries to identify active adult primary brain cancer trials. Read More

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