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Computed tomography-based delta-radiomics analysis for discriminating radiation pneumonitis in patients with esophageal cancer after radiation therapy.

Int J Radiat Oncol Biol Phys 2021 May 8. Epub 2021 May 8.

Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China. Electronic address:

Purpose: To construct a computed tomography (CT)-based delta-radiomics nomogram and corresponding risk classification system for individualized and accurate estimation of severe acute radiation pneumonitis (SARP) in patients with esophageal cancer (EC) after radiation therapy (RT).

Methods And Materials: 400 EC patients were enrolled from two independent institutions, and were divided into the training (n = 200) and validation cohorts (n = 200). 850 radiomics features of lung were extracted from treatment planning images, including the positioning CT before RT (CT) and the resetting CT after receiving 40-45Gy (CT). Read More

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Does traditional pharmacotherapy augment behavioral modification in the treatment of nocturia?

Neurourol Urodyn 2021 May 11. Epub 2021 May 11.

Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.

Aims: To assess the efficacy of traditional first-line non-antidiuretic pharmacotherapy for nocturia in the real-world outpatient urology setting.

Methods: We retrospectively analyzed voiding diaries from adult men treated for lower urinary tract symptoms (LUTS) at an outpatient urology clinic to identify pairs of voiding diaries with ≥1 nocturnal void at baseline and a corresponding follow-up diary completed within 1 year. We compared the odds of nocturia improvement (decrease of ≥1 nocturnal void) in patients started on LUTS pharmacotherapy versus behavioral modification alone. Read More

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HIV risk and pre-exposure prophylaxis interest among women seeking post-abortion care in Kenya: a cross-sectional study.

J Int AIDS Soc 2021 May;24(5):e25703

Department of Global Health, University of Washington, Seattle, USA.

Introduction: Post-abortion clinics located in regions with high HIV burden may ideal locations to integrate counselling and delivery of HIV pre-exposure prophylaxis (PrEP), aligning with normative goals for integrated delivery of HIV and reproductive health care. The objective of this study was to gauge the degree to which Kenyan women seeking care for a pregnancy loss, including induced abortion, are at risk for HIV and whether women would welcome an introduction to PrEP prior to discharge from post-abortion care.

Methods: We conducted a mixed-methods study from August 2019 to February 2020 with women ages 15 to 30 recruited sequentially as they were accessing post-abortion care at public and private facilities in Thika and Kisumu, Kenya. Read More

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A retrospective evaluation of highly active antiretroviral therapy simplification in patients with end-stage renal disease receiving hemodialysis.

Int J STD AIDS 2021 May 8:9564624211011902. Epub 2021 May 8.

Department of Pharmacy, Virginia Commonwealth University Health System, Richmond, VA, USA.

Antiretroviral (ARV) therapy in people living with HIV (PLWH) and end-stage renal disease (ESRD) on hemodialysis (HD) is complicated, requiring renally adjusted nucleoside reverse transcriptase inhibitors (NRTIs) and daily administration of non-renally eliminated agents. Recent data in PLWH with ESRD on HD demonstrate maintenance of viral suppression (82% with viral loads (VLs) <50 copies/mL) and favorable safety/tolerability profiles after ARV simplification with a fixed dose combination single tablet [elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF)]. Extrapolation of these data to all F/TAF formulations would allow ARV simplification to most PLWH with ESRD receiving HD. Read More

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Acetovanillone prevents cyclophosphamide-induced acute lung injury by modulating PI3K/Akt/mTOR and Nrf2 signaling in rats.

Phytother Res 2021 May 9. Epub 2021 May 9.

Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt.

Cyclophosphamide (CP) is a medication used as an anticancer drug and to suppress the immune system. However, its clinical applications are restricted because of the toxic and adverse side effects. The present study investigated the protective effect of acetovanillone (AV), a natural NADPH oxidase inhibitor, against acute lung injury (ALI) induced by CP. Read More

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Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals' Experiences.

J Autism Dev Disord 2021 May 8. Epub 2021 May 8.

Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain.

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services' use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Read More

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Getting to Zero: A Demonstration Project of Partner HIV Testing in the Prenatal Setting in Chicago, Illinois.

AIDS Res Hum Retroviruses 2021 May 7. Epub 2021 May 7.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Women who experience HIV seroconversion during pregnancy are missed during early routine pregnancy HIV screening and are at high risk of perinatal HIV transmission. Male partner HIV testing during routine prenatal care may be an effective primary prevention strategy by identifying women at risk of seroconversion and mitigating their risk. Our objective was to assess interest in and uptake of male partner HIV testing services offered during prenatal care. Read More

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Malnutrition is Associated with Delayed Sputum Culture Conversion Among Patients Treated for MDR-TB.

Infect Drug Resist 2021 28;14:1659-1667. Epub 2021 Apr 28.

Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Oromia Regional State, Ethiopia.

Background: Clinicians use sputum culture conversion as an interim indicator of the efficacy of multi-drug resistant tuberculosis (MDR-TB) treatment and to determine treatment duration. Yet, limited studies have been published in Ethiopia.

Objective: The objective of this study was to determine the predictors of delayed culture conversion among patients receiving MDR-TB treatment at selected treatment centers in Ethiopia. Read More

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Evaluation of Topical Corticosteroid Use in Pregnancy and Risk of Newborns Being Small for Gestational Age and Having Low Birth Weight.

JAMA Dermatol 2021 May 5. Epub 2021 May 5.

Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.

Importance: Topical corticosteroids are frequently used during pregnancy. Limited data have raised concerns about an increased risk of the newborn being small for gestational age (SGA) and having low birth weight, in particular with use of potent to very potent agents during pregnancy.

Objective: To evaluate whether topical corticosteroid use in pregnancy is associated with increased risks of SGA and low birth weight. Read More

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Impact of Advising on Total Worker Health Implementation.

J Occup Environ Med 2021 Apr 3. Epub 2021 Apr 3.

Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17 Pl., W-3111, Mail Stop B119 HSC, Aurora, CO 80045 (Tenney, Dexter, Shapiro, Dally, Brown, Schwatka, Newman), Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045 (Tenney, Dally, Schwatka, Newman), University of Colorado School of Medicine, Adult & Child Consortium for Outcomes Research and Delivery Science (ACCORDS) Dissemination and Implementation program, Division of General Internal Medicine and Center for Women's Health Research, Anschutz Medical Campus, 12631 E. 17th Ave., Mailstop B180, Aurora, CO 80045 (Huebschmann), Principle, Workers Comp Advising LLC (McMillen), Department of Epidemiology, Colorado School of Public Health, and Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045 (Newman), Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 13001 E. 17 Place, Mailstop B119, Aurora, CO, 80045 (Newman).

Objective: Little is understood about the mechanisms for improving the adoption and implementation of Total Worker Health® (TWH) in workplace settings. The primary objective of this study was to identify whether the delivery of TWH advising is associated with subsequent changes in TWH in small-to-medium sized businesses.

Methods: We conducted a longitudinal study of a TWH intervention in 200 organizations completing Health Links Healthy Workplace Assessments™ between October 2016 and December 2019. Read More

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Is lung ultrasound score a useful tool to monitoring and handling moderate and severe COVID-19 patients in the general ward? An observational pilot study.

J Clin Monit Comput 2021 May 4. Epub 2021 May 4.

Anesthesiology, Department of Medicine and Surgery, Critical Care and Pain Medicine Division, University of Parma, Viale Gramsci 14, 43126, Parma, Italy.

Lung ultrasound is a well-established diagnostic tool in acute respiratory failure, and it has been shown to be particularly suited for the management of COVID-19-associated respiratory failure. We present exploratory analyses on the diagnostic and prognostic performance of lung ultrasound score (LUS) in general ward patients with moderate-to-severe COVID-19 pneumonia receiving O supplementation and/or noninvasive ventilation. From March 10 through May 1, 2020, 103 lung ultrasound exams were performed by our Forward Intensive Care Team (FICT) on 26 patients (18 males and 8 females), aged 62 (54 - 76) and with a Body Mass Index (BMI) of 30. Read More

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A randomized double-blind placebo-controlled trial of intravenous thiamine for prevention of delirium following allogeneic hematopoietic stem cell transplantation.

J Psychosom Res 2021 Apr 27;146:110503. Epub 2021 Apr 27.

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Objective: To determine if high dose intravenous (IV) thiamine can prevent delirium during hospitalization following allogeneic HSCT. Secondarily, we evaluated the effects of high dose IV thiamine on thiamine levels and explored risk factors for delirium.

Methods: Randomized, double-blind, placebo-controlled trial in patients undergoing allogeneic HSCT at a U. Read More

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Progressive apraxia of speech: delays to diagnosis and rates of alternative diagnoses.

J Neurol 2021 May 4. Epub 2021 May 4.

Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Background: Progressive apraxia of speech (PAOS) is a neurodegenerative disorder of speech programming distinct from aphasia and dysarthria, most commonly associated with a 4-repeat tauopathy. Our objective was to better understand the reasons for possible delays or diagnostic errors for patients with PAOS.

Methods: Seventy-seven consecutive PAOS research participants from the Neurodegenerative Research Group were included in this study. Read More

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Intra-tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants.

Pediatr Pulmonol 2021 May 4. Epub 2021 May 4.

Department of Women's and Children's Health, Neonatal Intensive Care Unit, University of Padua School of Medicine, Padua, Italy.

Objectives: To compare the efficacy of intra-tracheal (IT) surfactant/budesonide (SB) with that of surfactant alone (S) in reducing the rate of bronchopulmonary dysplasia (BPD) at 36 weeks post-menstrual age (PMA), we included extremely preterm very low birth weight (VLBW) infants with severe respiratory distress syndrome (RDS) in our tertiary neonatal level of care unit (Padua, Italy).

Study Design: A retrospective chart review of two cohorts of extremely preterm VLBW neonates (<28  gestation weeks, birth weight [BW] < 1500 g) born in two consequent epochs (2017-2018/2018-2019) were compared. The SB group received surfactant (200 mg/kg 1st dose) and budesonide (0. Read More

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The EMA assessment of pembrolizumab as monotherapy for the first-line treatment of adult patients with metastatic microsatellite instability-high or mismatch repair deficient colorectal cancer.

ESMO Open 2021 Apr 30;6(3):100145. Epub 2021 Apr 30.

Oncology & Haematology Office, European Medicines Agency, Amsterdam, The Netherlands.

On 21 January 2021, the European Commission amended the marketing authorisation granted for pembrolizumab to include the first-line treatment of microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) metastatic colorectal cancer (mCRC) in adults. The recommended dose of pembrolizumab was either 200 mg every 3 weeks or 400 mg every 6 weeks by intravenous infusion. Pembrolizumab was evaluated in a phase III, open-label, multicentre, randomised trial versus standard of care (SOC: FOLFOX6/FOLFIRI alone or in combination with bevacizumab/cetuximab) as first-line treatment of locally confirmed mismatch repair-deficient or microsatellite instability-high stage IV CRC. Read More

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Impact of Intrathecal Fentanyl on Hospital Outcomes for Patients Undergoing Primary Total Hip Arthroplasty With Neuraxial Anesthesia.

Arthroplast Today 2021 Apr 14;8:200-203. Epub 2021 Apr 14.

Anne Arundel Medical Center, Annapolis, MD, USA.

Background: Intrathecal opioids have been used to reduce pain after total joint arthroplasty; however, the utility of these drugs is disputed. We examined the impact of eliminating intrathecal fentanyl on outcomes for patients undergoing direct anterior approach total hip arthroplasty (THA).

Methods: Retrospective review of 376 THA patients from a single institution was conducted. Read More

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Investigation of an ALDH1A1-specific inhibitor for suppression of weight gain in a diet-induced mouse model of obesity.

Int J Obes (Lond) 2021 May 1. Epub 2021 May 1.

Department of Comparative Medicine, University of Washington, Seattle, WA, USA.

Background: Retinoic acid (RA) controls diverse physiological functions including weight regulation and energy metabolism. It has been reported that mice lacking ALDH1A1, one of the aldehyde dehydrogenases (ALDH) that synthesize RA, are healthy and resistant to weight gain, raising the possibility that inhibiting this enzyme might treat obesity. We previously demonstrated that treatment with a pan-ALDH1A enzyme inhibitor, WIN18446, suppressed weight gain in mice fed a high-fat diet (HFD), but caused increased hepatic lipidosis and reversible male infertility. Read More

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An experimental study on phytochemical composition and memory enhancing effect of Ginkgo biloba seed extract.

Folia Med (Plovdiv) 2021 Apr;63(2):203-212

Medical University of Plovdiv, Plovdiv, Bulgaria.

Introduction: The Ginkgo biloba L. tree is considered as one of the oldest species on Earth. It is known as a "living fossil" dating back approximately 200 million years. Read More

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Characteristics of the HIV cascade of care and unsuppressed viral load among gay, bisexual and other men who have sex with men living with HIV across Canada's three largest cities.

J Int AIDS Soc 2021 Apr;24(4):e25699

Ryerson University, Toronto, ON, Canada.

Introduction: Treatment as prevention strategies have been variously applied across provinces in Canada. We estimated HIV care cascade indicators and correlates of unsuppressed viral load (VL) among gay, bisexual and other men who have sex with men (GBM) recruited in Vancouver, Toronto and Montreal.

Methods: Sexually active GBM, aged ≥16 years, were recruited through respondent-driven sampling (RDS) from February 2017 to August 2019. Read More

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Targeting synovial fibroblast proliferation in rheumatoid arthritis (TRAFIC): an open-label, dose-finding, phase 1b trial.

Lancet Rheumatol 2021 May 9;3(5):e337-e346. Epub 2021 Mar 9.

Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.

Background: Current rheumatoid arthritis therapies target immune inflammation and are subject to ceiling effects. Seliciclib is an orally available cyclin-dependent kinase inhibitor that suppresses proliferation of synovial fibroblasts-cells not yet targeted in rheumatoid arthritis. Part 1 of this phase 1b/2a trial aimed to establish the maximum tolerated dose of seliciclib in patients with active rheumatoid arthritis despite ongoing treatment with TNF inhibitors, and to evaluate safety and pharmacokinetics. Read More

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Long-Term Immunological and Virological Outcomes in Children Receiving Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Sciences, Southern Ethiopia.

J Immunol Res 2021 9;2021:2498025. Epub 2021 Apr 9.

Hawassa University College of Medicine and Health Sciences, School of Medical Laboratory Science, Ethiopia.

Purpose: To determine immunological and virological failure and associated factors among children infected with human immunodeficiency virus receiving antiretroviral treatments at Hawassa University Hospital, Southern Ethiopia.

Methods: A hospital-based cross-sectional study was conducted among 273 HIV-infected children from July 1 to December 1, 2019. Data were collected using a structured questionnaire and review of patient records. Read More

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Women in larger bodies' experiences with contraception: a scoping review.

Reprod Health 2021 Apr 29;18(1):89. Epub 2021 Apr 29.

School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.

Background: As the prevalence of obesity increases and the age of onset decreases, more women of reproductive age will be living in larger bodies. Research on weight-related efficacy and safety has informed clinical guidelines for routine and emergency contraceptive use by women with a higher body mass index; however, patient perspectives are needed to understand women in larger bodies' experiences with contraception and contraceptive care. This scoping review summarizes the literature on women in larger bodies' experiences with contraception with the goal of gaining a better understanding of the nature of these experiences and identifying gaps in the existing research. Read More

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Atorvastatin-Eluting Contact Lenses: Effects of Molecular Imprinting and Sterilization on Drug Loading and Release.

Pharmaceutics 2021 Apr 22;13(5). Epub 2021 Apr 22.

Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.

Statins are receiving increasing attention in the ophthalmic field. Their activity as 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors is clinically used to regulate cholesterol levels and leads to pleiotropic effects, which may help in the management of diabetes-related ocular pathologies. This work aims to design bioinspired contact lenses (CLs) with an affinity for atorvastatin by mimicking the active site of HMG-CoA reductase. Read More

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Pregnancy-Related Extracellular Vesicles Revisited.

Int J Mol Sci 2021 Apr 9;22(8). Epub 2021 Apr 9.

Department of Surgical Oncology, Prof. Dr. Alexandru Trestioreanu Oncology Institute, Carol Davila University of Medicine and Pharmacy, 252 Fundeni Rd., 022328 Bucharest, Romania.

Extracellular vesicles (EVs) are small vesicles ranging from 20-200 nm to 10 μm in diameter that are discharged and taken in by many different types of cells. Depending on the nature and quantity of their content-which generally includes proteins, lipids as well as microRNAs (miRNAs), messenger-RNA (mRNA), and DNA-these particles can bring about functional modifications in the receiving cells. During pregnancy, placenta and/or fetal-derived EVs have recently been isolated, eliciting interest in discovering their clinical significance. Read More

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COVID-19's Impact on Willingness to Be Vaccinated against Influenza and COVID-19 during the 2020/2021 Season: Results from an Online Survey of Canadian Adults 50 Years and Older.

Vaccines (Basel) 2021 Apr 5;9(4). Epub 2021 Apr 5.

Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS B3H 2E1, Canada.

There is considerable overlap in age-related risk factors for influenza and COVID-19. We explored the impact of the pandemic on anticipated influenza and COVID-19 vaccination behaviour in the 2020/2021 season. In May 2020, we conducted online surveys of Canadian adults 50 years and older via a market research panel platform, as part of a series of annual surveys to understand experiences with influenza. Read More

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A Herbal Formula in the Therapy of Acute Postviral Rhinosinusitis.

Turk Arch Otorhinolaryngol 2021 Mar 26;59(1):33-42. Epub 2021 Mar 26.

Institute of Pharmacy, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia.

Objective: To assess the effects and adverse events of preparation Sinulan forte containing extracts of five medicinal plants in comparison to mometasone furoate nasal spray (MFNS) in therapy of acute postviral rhinosinusitis (APRS).

Methods: We included 46 APRS patients in this prospective investigation and randomized to two groups. The patients in group 1 (n=23) received MFNS 200 μg two times/day for ten days, and patients in group 2 (n=23) received Sinulan forte, tablets 225 mg per os, two times/day also for ten days. Read More

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[Nephrology in Sub-saharan Africa: Past, present, future].

Nephrol Ther 2021 Apr;17S:S37-S44

Service de néphrologie, centre hospitalier universitaire Aristide-Le Dantec, avenue Pasteur, BP 3001, Dakar, Sénégal.

Nephrology was a relatively poorly known specialty in sub-Saharan Africa until the early 1980s, because of low awareness and lack of access to diagnosis and renal replacement therapies. Nephrology has seen progress on the continent despite an unfavourable economic and geopolitical environment. With a prevalence of fewer than five nephrologists per million inhabitants, the training of nephrologists, now carried out on the continent, allowed to have more than 200 specialists trained in the last decade in French-speaking sub-Saharan Africa. Read More

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Efficacy and safety of nelfinavir in asymptomatic and mild COVID-19 patients: a structured summary of a study protocol for a multicenter, randomized controlled trial.

Trials 2021 Apr 28;22(1):309. Epub 2021 Apr 28.

Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.

Objectives: The aim of this trial is to evaluate the antiviral efficacy, clinical efficacy, and safety of nelfinavir in patients with asymptomatic and mild COVID-19.

Trial Design: The study is designed as a multicenter, open-label, blinded outcome assessment, parallel group, investigator-initiated, exploratory, randomized (1:1 ratio) controlled clinical trial.

Participants: Asymptomatic and mild COVID-19 patients will be enrolled in 10 university and teaching hospitals in Japan. Read More

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PTEN is a predictive biomarker of trastuzumab resistance and prognostic factor in HER2-overexpressing gastroesophageal adenocarcinoma.

Sci Rep 2021 Apr 27;11(1):9013. Epub 2021 Apr 27.

Department of Surgery, Graduate School of Medicine, Kyoto University, 54, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Poor trastuzumab (Tmab) response of patients with human epidermal growth factor receptor 2-overexpressing gastric or gastroesophageal junction adenocarcinoma (HER2-GEA) is associated with the inhibition of phosphatase and tensin homolog (PTEN) expression. In this multicenter, retrospective observational study, pathological samples of patients with HER2-GEA receiving Tmab-combined chemotherapy were immunohistochemically analyzed for PTEN expression. The primary endpoints were disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). Read More

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Capecitabine plus temozolomide in patients with grade 3 unresectable or metastatic gastroenteropancreatic neuroendocrine neoplasms with Ki-67 index <55%: single-arm phase II study.

ESMO Open 2021 Apr 23;6(3):100119. Epub 2021 Apr 23.

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Grade 3 neuroendocrine neoplasms (NENs) of gastroenteropancreatic (GEP) origin with Ki-67 indices <55% do not respond well to platinum-based chemotherapy. The combination of capecitabine and temozolomide (CAPTEM) has shown favorable responses in grade 1-2 NENs, but has rarely been studied in patients with grade 3 NENs.

Patients And Methods: This open-label, single-arm phase II trial included patients with unresectable or metastatic grade 3 NENs of GEP origin with Ki-67 indices <55% enrolled between June 2017 and July 2020. Read More

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