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The recurrent urinary tract infection health and functional impact questionnaire (RUHFI-Q): design and feasibility assessment of a new evaluation scale.

Can J Urol 2021 Jun;28(3):10729-10732

Department of Urology, University Hospital Limerick, Dooradoyle, Co. Limerick, Ireland.

Introduction: We aim to design a tool to assess the impact of recurrent urinary tract infection (rUTI) on quality of life (QoL) in adult women, given the notable absence of an established instrument for this purpose.

Materials And Methods: Best practice guidelines in health-related survey design were reviewed. A literature review informed creation of an interview guide. Read More

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Evaluating Factors Associated with the Cancellation and Delay of Elective Surgical Procedures: A Systematic Review.

Int J Qual Health Care 2021 Jun 8. Epub 2021 Jun 8.

Department of Management, Otago Business School, University of Otago, New Zealand.

Background: Elective surgery cancellation is considered a fundamental problem in health care services-it causes considerable disruption to patient flow, further eroding often already stretched operating capacity, and consequentially reduces both hospital performance and patient satisfaction. This research presents a systematic review (SR) of the reasons for surgery cancellation among different hospitals and countries. By highlighting these causes, we identify how to reduce cancellations thereby improving the use of surgical capacity and resources and create a more predicable patient flow. Read More

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[Elderly Glioma].

No Shinkei Geka 2021 May;49(3):647-659

Department of Neurosurgery, Hiroshima University Hospital.

Treatment of elderly glioma patients is a challenge in neurosurgery/neuro-oncology. The International Society of Geriatric Oncology(SIOG)recommends that elderly cancer patients undergo comprehensive geriatric assessment(CGA). The CGA score proved to be a significant predictor of mortality in this cohort, and it could be a useful treatment decision tool. Read More

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Endoscope-assisted techniques for evacuation of acute subdural haematoma in the elderly: The lesser of two evils? A scoping review of the literature.

Clin Neurol Neurosurg 2021 May 29;207:106712. Epub 2021 May 29.

Department of Neurosurgery, University Hospital of Wales, Cardiff, UK. Electronic address:

Introduction: Surgical evacuation of acute subdural haematoma (ASDH) in the elderly remains a point of contention due to the significant associated mortality. Therefore, there is a dire need for alternative treatment options. Endoscope-assisted techniques (EAT) have been increasingly reported over the last decade with variable outcomes. Read More

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Review of Venetoclax in CLL, AML and Multiple Myeloma.

J Pers Med 2021 May 24;11(6). Epub 2021 May 24.

Department of Haematology, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.

Venetoclax is a highly selective and effective B-cell lymphoma-2 (BCL-2) inhibitor, which is able to reinstate the apoptotic potential of cancer cells. With its full repertoire yet to be explored, it has changed the therapeutic landscape in haematological malignancies, and most particularly chronic lymphocytic leukaemia (CLL), acute myeloid leukaemia (AML) and multiple myeloma (MM). In CLL, it has shown remarkable efficacy both as monotherapy and in combination therapy. Read More

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FLT3 Tyrosine Kinase Inhibitors for the Treatment of Fit and Unfit Patients with FLT3-Mutated AML: A Systematic Review.

Int J Mol Sci 2021 May 30;22(11). Epub 2021 May 30.

Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Nice, 06200 Nice, France.

FLT3-mutated acute myeloid leukemia accounts for around 30% of acute myeloid leukemia (AML). The mutation carried a poor prognosis until the rise of tyrosine kinase inhibitors (TKIs). New potent and specific inhibitors have successfully altered the course of the disease, increasing the complete response rate and the survival of patients with FLT3-mutated AML. Read More

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Physiological Fitness and the Pathophysiology of Chronic Lymphocytic Leukemia (CLL).

Cells 2021 May 11;10(5). Epub 2021 May 11.

Division of Medical Oncology, Duke University School of Medicine, Durham, NC 27710, USA.

Chronic lymphocytic leukemia (CLL) is associated with physical dysfunction and low overall fitness that predicts poor survival following the commencement of treatment. However, it remains unknown whether higher fitness provides antioncogenic effects. We identified ten fit (CLL-FIT) and ten less fit (CLL-UNFIT) treatment-naïve CLL patients from 144 patients who completed a set of physical fitness and performance tests. Read More

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Therapeutic Use of Valproic Acid and All-Trans Retinoic Acid in Acute Myeloid Leukemia-Literature Review and Discussion of Possible Use in Relapse after Allogeneic Stem Cell Transplantation.

Pharmaceuticals (Basel) 2021 May 2;14(5). Epub 2021 May 2.

Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.

Even though allogeneic stem cell transplantation is the most intensive treatment for acute myeloid leukemia (AML), chemo-resistant leukemia relapse is still one of the most common causes of death for these patients, as is transplant-related mortality, i.e., graft versus host disease, infections, and organ damage. Read More

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Type 1A endoleak detachable coil embolization after endovascular aneurysm sealing: Case report.

Int J Surg Case Rep 2021 May 26;83:106024. Epub 2021 May 26.

Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.

Introduction: Endovascular aneurysm sealing (EVAS) with the Nellix system was introduced to reduce endovascular aneurysm repair (EVAR) perioperative complications, especially endoleaks. Herein we report a case of successful type 1A endoleak managed with detachable coils embolization after EVAS.

Presentation Of Case: A 77-year-old male was referred for abdominal pain. Read More

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Giant Myxoid Spindle Cell Neoplasm Presenting with Abdominal Swelling and Concurrent Weight Loss.

World Neurosurg 2021 May 28;152:1-2. Epub 2021 May 28.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, New York, USA. Electronic address:

Retroperitoneal sarcomas may grow extremely large before becoming clinically symptomatic, and curative resection often has high associated morbidity. An 83-year-old man presented with insidious-onset abdominal pain and weight loss owing to a 16.3 × 13. Read More

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Health-related quality of life with fixed-duration venetoclax-obinutuzumab for previously untreated chronic lymphocytic leukemia: Results from the randomized, phase 3 CLL14 trial.

Am J Hematol 2021 May 29. Epub 2021 May 29.

Department I of Internal Medicine and Center of Integrated Oncology Aachen, Bonn, Cologne, Duesseldorf; German CLL Study Group, University of Cologne, Cologne, Germany.

Chronic lymphocytic leukemia (CLL)-related symptoms impair the well-being of patients, making improvement of health-related quality of life (QoL) a goal of treatment. The CLL14 trial demonstrated higher efficacy of fixed-duration venetoclax-obinutuzumab compared to chlorambucil-obinutuzumab in patients with previously untreated CLL. To assess patients' QoL, the following patient-reported outcomes (PRO) measures were assessed: the M. Read More

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Physician-modified fenestrated Navion endograft for the treatment of a symptomatic postdissection thoracoabdominal aneurysm.

J Vasc Surg Cases Innov Tech 2021 Jun 15;7(2):344-349. Epub 2021 Apr 15.

Unit of Vascular Surgery, Department of Surgical Sciences, University of Turin, AOU Citta' della Salute e della Scienza, Turin, Italy.

We report the case of a physician-modified four-fenestration endograft for the emergent treatment of a 65-year-old patient with postdissection thoracoabdominal aneurysm deemed unfit for open surgery. The patient, after elective thoracic endovascular aneurysm repair as the first stage of a preplanned two-stage total thoracoabdominal endovascular repair, presented acute onset of dyspnea and thoracic pain. Computed tomography angiography (CTA) showed signs of contained rupture. Read More

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Antibody Therapies for Large B-Cell Lymphoma.

Biologics 2021 18;15:153-174. Epub 2021 May 18.

Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy.

Large B-cell lymphomas (LBCLs) constitute a subgroup of aggressive but highly curable lymphoproliferative diseases. Treatment of relapsed/refractory (R/R) patients still represents an unmet clinical need, and novel drugs and combinations are in continuous development. The pan-B cell panel of surface antigens that characterizes LBCL leads to a large umbrella of druggable targets. Read More

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Long-Term Outcomes of Thoracic Endovascular Repair for Aortic Arch Dissection Using Customized Single-Branched Fenestrated Stent-Graft.

Vasc Endovascular Surg 2021 May 26:15385744211010446. Epub 2021 May 26.

Department of Vascular Surgery, 12520Changhai Hospital, Naval Medical University, Shanghai, China.

Objectives: To report outcomes of thoracic endovascular repair using customized single-branched fenestrated stent-grafts in treatment of aortic arch dissections.

Materials And Methods: Between November 2009 and November 2011, 16 patients with aortic arch dissections underwent thoracic endovascular aortic repair utilizing customized unibody single-branched fenestrated stent-graft (UBFSG) in our institution.

Results: All 16 patients were male with mean age of 54. Read More

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Impact of the COVID-19 Pandemic on Radiotherapy Supply.

Radiol Res Pract 2021 5;2021:5550536. Epub 2021 May 5.

Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, Bari 70124, Italy.

Background: The impetuous entrance of the COVID-19 pandemic in Italy in March 2020, after the onset and diffusion in China, found the health system widely unfit to face the large amount of infected patients. The matter of this investigation was to evaluate how pandemic fear and guidelines for limiting the diffusion of SARS-CoV-2 virus could have impacted the regular supply of radiotherapy (RT) and the outcome of the treatments.

Materials And Methods: From March 9, 2020, to May 29, 2020, a register has been established to record patients that cancelled or postponed the RT appointment. Read More

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Large cell neuroendocrine carcinoma arising from the anterior mediastinum.

BMJ Case Rep 2021 May 25;14(5). Epub 2021 May 25.

Gastroenterology, Mater Dei Hospital, Msida, Malta.

Anterior mediastinal large cell neuroendocrine carcinomas (LCNECs) are extremely rare, extremely aggressive malignancies that carry a dismal prognosis. We discuss a woman aged 60 years who presented with a 2-month history of recurrent severe constant epigastric pain. Abdominal examination revealed massive hepatomegaly and a CT scan of the liver confirmed coarse liver lesions. Read More

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131I Ablation of an Entire Thyroid Gland in Locally Invasive Differentiated Thyroid Cancer Without Surgery.

Clin Nucl Med 2021 May 12. Epub 2021 May 12.

From the Department of Nuclear Medicine, Concord Hospital, Concord Faculty of Medicine and Health, University of Sydney, New South Wales Department of Endocrinology, Concord Hospital, Concord, Australia.

Abstract: A 79-year-old man with locally metastatic papillary thyroid cancer to left-sided cervical lymph nodes was referred for radioiodine therapy. He was considered unfit for thyroidectomy due to extensive local involvement and severe interstitial lung disease requiring continuous oxygen. The patient was treated with low doses of radioiodine (approximately 30 mCi) every 6 months with corticosteroid cover for 3 years with good effect. Read More

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Venetoclax-based combinations for the treatment of newly diagnosed acute myeloid leukemia.

Future Oncol 2021 May 24. Epub 2021 May 24.

Department of Internal Medicine, Division of Hematology & Oncology, University of California Davis School of Medicine, Sacramento, CA 95817, USA.

Elderly and/or unfit patients with acute myeloid leukemia have historically been challenging to manage as they were ineligible for what was considered standard of care treatment with induction chemotherapy. The emergence of venetoclax with hypomethylating agents or low-dose cytarabine has substantially improved outcomes in the frontline setting with manageable toxicity. However, this regimen can be challenging to deliver given its differences from standard intensive chemotherapy. Read More

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Proportional meta-analysis of open surgery or fenestrated-endograft repair for post-dissection thoracoabdominal aneurysms.

J Vasc Surg 2021 May 18. Epub 2021 May 18.

Unit of Vascular Surgery, Department of Surgical Sciences, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy.

Objective: To determine outcomes of post-dissection thoracoabdominal aneurysms (pD-TAAAs) by either open or endovascular repair with fenestrated or branched endografts (F/B-TEVAR).

Methods: A systematic review was conducted for open or endovascular repair of pD-TAAAs, between January 2009 and February 2020. A meta-analysis was performed for post-operative complications and both early and late mortality and re-interventions. Read More

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Escape From Treatment; the Different Faces of Leukemic Stem Cells and Therapy Resistance in Acute Myeloid Leukemia.

Front Oncol 2021 3;11:659253. Epub 2021 May 3.

Department of Hematology, Amsterdam UMC, location VUmc, Cancer Center Amsterdam, Amsterdam, Netherlands.

Standard induction chemotherapy, consisting of an anthracycline and cytarabine, has been the first-line therapy for many years to treat acute myeloid leukemia (AML). Although this treatment induces complete remissions in the majority of patients, many face a relapse (adaptive resistance) or have refractory disease (primary resistance). Moreover, older patients are often unfit for cytotoxic-based treatment. Read More

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Trends over time in the incidence and use of hormonal therapy in endometrial cancer: a population-based study in the Netherlands.

Int J Gynecol Cancer 2021 May 17. Epub 2021 May 17.

Netherland Comprehensive Cancer Organisation (IKNL), Utrecht, Utrecht, The Netherlands.

Introduction: According to current guidelines, hormonal therapy may be applied in endometrioid type endometrial cancer as an alternative to surgery for fertility preservation and in medically unfit patients. Since it is unknown how often hormonal therapy is applied, the objective of this study was to investigate trends over time in hormonal therapy use in the background of the overall incidence of endometrial cancer.

Methods: All patients with endometrial cancer (n=48 222) registered in the Netherlands Cancer Registry in the period 1989-2018 were included. Read More

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A novel treatment regimen of granulocyte colony-stimulating factor combined with ultra-low-dose decitabine and low-dose cytarabine in older patients with acute myeloid leukemia and myelodysplastic syndromes.

Ther Adv Hematol 2021 30;12:20406207211009334. Epub 2021 Apr 30.

Department of Hematology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Juqian Road 185, Changzhou, Jiangsu 213000, China.

Background: Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) unfit for intensive chemotherapy are emergent for suitable treatment strategies. Hypomethylating agents and low-dose cytarabine have generated relevant benefits in the hematological malignancies over recent decades. We evaluated the efficacy and safety of the novel treatment regimen consisting of ultra-low-dose decitabine and low-dose cytarabine, with granulocyte colony-stimulating factor (G-CSF) in this population of patients. Read More

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Initial Results of Antegrade Laser Fenestrations Using Image Fusion Guidance and Company Manufactured Stent Grafts in Complex Aortic Aneurysm Repair.

Eur J Vasc Endovasc Surg 2021 May 13. Epub 2021 May 13.

Centre Hospitalier Universitaire Henri Mondor, Department of Vascular Surgery, Créteil, France. Electronic address:

Objective: The aim was to describe initial outcomes of physician modified stent grafts using antegrade laser fenestrations and image fusion guidance (LEVAR) and company manufactured custom made (CM) stent grafts for the treatment of complex abdominal aortic aneurysms (CAAAs), thoraco-abdominal aortic aneurysms (TAAAs) and type I endoleaks (T1ELs).

Methods: This was a retrospective single centre study. All LEVAR and Zenith (Cook) CM stent graft procedures between 1 January 2012 and 31 December 2018 were reviewed. Read More

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Postmenopausal hyperandrogenism.

Authors:
T Yoldemir

Climacteric 2021 May 14:1-9. Epub 2021 May 14.

Department of Obstetrics and Gynaecology, Marmara University Hospital, Istanbul, Turkey.

Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from the adrenal glands and/or ovaries clinically manifested by the presence of terminal hair in androgen-dependent areas of the body, and other manifestations of hyperandrogenism such as acne and alopecia or the development of virilization. In such circumstances, physicians must exclude the possibility of rare but serious androgen-producing tumors of the adrenal glands or ovaries. Worsening of undiagnosed hyperandrogenic disorders such as polycystic ovary syndrome, congenital adrenal hyperplasia, ovarian hyperthecosis, Cushing syndrome and iatrogenic hyperandrogenism should be considered for differential diagnosis. Read More

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Mortality risk estimation in acute calculous cholecystitis: beyond the Tokyo Guidelines.

World J Emerg Surg 2021 May 11;16(1):24. Epub 2021 May 11.

Department of Surgery, Autonomous University of Barcelona, Passeig Marítim de la Barceloneta, 25-29, 08003, Barcelona, Spain.

Background: Acute calculous cholecystitis (ACC) is the second most frequent surgical condition in emergency departments. The recommended treatment is the early laparoscopic cholecystectomy; however, the Tokyo Guidelines (TG) advocate for different initial treatments in some subgroups of patients without a strong evidence that all patients will benefit from them. There is no clear consensus in the literature about who is the unfit patient for surgical treatment. Read More

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A descriptive study on reasons for prolonged hospital stay in a tertiary hospital in Singapore.

J Nurs Manag 2021 May 9. Epub 2021 May 9.

Nursing Division, Singapore General Hospital, Singapore, Singapore.

Background: Our health care is facing with the challenges of bed crunch and increasing number of patients with prolonged hospital stay.

Aims: This study aimed to determine factors contributing to the prolonged hospital stay in a tertiary hospital in Singapore.

Methods: A random sample of 600 medical records of patients' staying in hospital for more than 21 days was retrieved. Read More

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A randomised evaluation of low-dose cytosine arabinoside (ara-C) plus tosedostat versus low-dose ara-C in older patients with acute myeloid leukaemia: results of the LI-1 trial.

Br J Haematol 2021 May 7. Epub 2021 May 7.

Department of Haematology, Nottingham University Hospitals, Nottingham, UK.

Older patients with acute myeloid leukaemia (AML) account for nearly half of those with the disease. Because they are perceived to be unfit for, unwilling to receive, or unlikely to benefit from conventional chemotherapy they represent an important unmet need. Tosedostat is a selective oral aminopeptidase inhibitor, which in phase I/II trials showed acceptable toxicity and encouraging efficacy. Read More

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Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis.

Br J Haematol 2021 May 7. Epub 2021 May 7.

Department of Haematology, Oxford University Hospital NHS Foundation Trust, Oxford, UK.

Mantle cell lymphoma (MCL) presenting in elderly, unfit patients represents a clinical challenge. Front-line 'attenuated' or low-intensity immunochemotherapy is often employed, although outcomes are relatively unexplored. We report outcomes of attenuated immunochemotherapy in 95 patients with MCL across 19 centres in the UK and Ireland considered unfit for full-dose rituximab-bendamustine or rituximab-cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP). Read More

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Is There a Role for Percutaneous Ablation for Early Stage Lung Cancer? What Is the Evidence?

Curr Oncol Rep 2021 May 5;23(7):81. Epub 2021 May 5.

Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France.

Purpose Of Review: For patients with early stage non-small-cell lung cancer (NSCLC), thermal ablation (TA) has become in the least two decades an option of treatment used worldwide for patients with comorbidities who are not surgical candidates. Here, we review data published with different TA techniques: radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation. This paper reviews also the comparison that has been made between TA and stereotactic radiotherapy (SBRT). Read More

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Management of Patients With Acute Cholecystitis After Percutaneous Cholecystostomy: From the Acute Stage to Definitive Surgical Treatment.

Front Surg 2021 15;8:616320. Epub 2021 Apr 15.

Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Percutaneous cholecystostomy (PC) has become an important procedure for the treatment of acute cholecystitis (AC). PC is currently applied for patients who cannot undergo immediate laparoscopic cholecystectomy. However, the management following PC has not been well-reviewed. Read More

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