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European Heart Journal Mar 2018
2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed...
Topics: Fibrinolytic Agents; Humans; Peripheral Arterial Disease; Risk Factors; Vascular Surgical Procedures
PubMed: 28886620
DOI: 10.1093/eurheartj/ehx095 -
Biological Psychiatry Apr 2023The past decade has seen an explosion in the identification of genetic causes of neurodevelopmental disorders, including Mendelian, de novo, and somatic factors. These... (Review)
Review
The past decade has seen an explosion in the identification of genetic causes of neurodevelopmental disorders, including Mendelian, de novo, and somatic factors. These discoveries provide opportunities to understand cellular and molecular mechanisms as well as potential gene-gene and gene-environment interactions to support novel therapies. Stem cell-based models, particularly human brain organoids, can capture disease-associated alleles in the context of the human genome, engineered to mirror disease-relevant aspects of cellular complexity and developmental timing. These models have brought key insights into neurodevelopmental disorders as diverse as microcephaly, autism, and focal epilepsy. However, intrinsic organoid-to-organoid variability, low levels of certain brain-resident cell types, and long culture times required to reach maturity can impede progress. Several recent advances incorporate specific morphogen gradients, mixtures of diverse brain cell types, and organoid engraftment into animal models. Together with nonhuman primate organoid comparisons, mechanisms of human neurodevelopmental disorders are emerging.
Topics: Animals; Humans; Induced Pluripotent Stem Cells; Brain; Neurodevelopmental Disorders; Autistic Disorder; Organoids
PubMed: 36759260
DOI: 10.1016/j.biopsych.2023.01.012 -
BJU International Jan 2014The urinary reconstructive options available after radical cystectomy (RC) for bladder cancer are discussed, as are the criteria for selection of the most appropriate... (Review)
Review
CONTEXT
The urinary reconstructive options available after radical cystectomy (RC) for bladder cancer are discussed, as are the criteria for selection of the most appropriate diversion, and the outcomes and complications associated with different diversion options.
OBJECTIVE
To critically review the peer-reviewed literature on the function and oncological outcomes, complications, and factors influencing choice of procedure with urinary diversion after RC for bladder carcinoma.
EVIDENCE ACQUISITION
A Medline search was conducted to identify original articles, review articles, and editorials on urinary diversion in patients treated with RC. Searches were limited to the English language. Keywords included: 'bladder cancer', 'cystectomy', 'diversion', 'neobladder', and 'conduit'. The articles with the highest level of evidence were selected and reviewed, with the consensus of all of the authors of this paper.
EVIDENCE SYNTHESIS
Both continent and incontinent diversions are available for urinary reconstruction after RC. In appropriately selected patients, an orthotopic neobladder permits the elimination of an external stoma and preservation of body image without compromising cancer control. However, the patient must be fully educated and committed to the labour-intensive rehabilitation process. He must also be able to perform self-catheterisation if necessary. When involvement of the urinary outflow tract by tumour prevents the use of an orthotopic neobladder, a continent cutaneous reservoir may still offer the opportunity for continence albeit one that requires obligate self-catheterisation. For patients who are not candidates for continent diversion, the ileal loop remains an acceptable and reliable option.
CONCLUSIONS
Both continent and incontinent diversions are available for urinary reconstruction after RC. Orthotopic neobladders optimally preserve body image, while continent cutaneous diversions represent a reasonable alternative. Ileal conduits represent the fastest, easiest, least complication-prone, and most commonly performed urinary diversion.
Topics: Cystectomy; Female; Humans; Male; Patient Selection; Peer Review; Postoperative Complications; Quality of Life; Treatment Outcome; Urinary Bladder Neoplasms; Urinary Diversion; Urinary Reservoirs, Continent
PubMed: 24330062
DOI: 10.1111/bju.12121 -
BMJ (Clinical Research Ed.) Jan 2019To examine the effect of regular breakfast consumption on weight change and energy intake in people living in high income countries. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To examine the effect of regular breakfast consumption on weight change and energy intake in people living in high income countries.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Ovid Medline, and CINAHL were searched for randomised controlled trials published between January 1990 and January 2018 investigating the effect of breakfast on weight or energy intake. ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform search portal were also searched in October 2018 to identify any registered yet unpublished or ongoing trials.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Randomised controlled trials from high income countries in adults comparing breakfast consumption with no breakfast consumption that included a measure of body weight or energy intake. Two independent reviewers extracted the data and assessed the risk of bias of included studies. Random effects meta-analyses of the effect of breakfast consumption on weight and daily energy intake were performed.
RESULTS
Of 13 included trials, seven examined the effect of eating breakfast on weight change, and 10 examined the effect on energy intake. Meta-analysis of the results found a small difference in weight favouring participants who skipped breakfast (mean difference 0.44 kg, 95% confidence interval 0.07 to 0.82), but there was some inconsistency across trial results (I=43%). Participants assigned to breakfast had a higher total daily energy intake than those assigned to skip breakfast (mean difference 259.79 kcal/day, 78.87 to 440.71; 1 kcal=4.18 kJ), despite substantial inconsistency across trial results (I=80%). All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups (mean period seven weeks for weight, two weeks for energy intake). As the quality of the included studies was mostly low, the findings should be interpreted with caution.
CONCLUSION
This study suggests that the addition of breakfast might not be a good strategy for weight loss, regardless of established breakfast habit. Caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect. Further randomised controlled trials of high quality are needed to examine the role of breakfast eating in the approach to weight management.
STUDY REGISTRATION
PROSPERO registration number CRD42017057687.
Topics: Body Weight; Breakfast; Energy Intake; Feeding Behavior; Humans; Randomized Controlled Trials as Topic
PubMed: 30700403
DOI: 10.1136/bmj.l42 -
European Journal of Vascular and... Mar 2018
Review
Editor's Choice - 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS).
Topics: Diagnostic Techniques, Cardiovascular; Disease Management; Europe; Humans; Peripheral Arterial Disease; Practice Guidelines as Topic; Societies, Medical; Vascular Surgical Procedures
PubMed: 28851596
DOI: 10.1016/j.ejvs.2017.07.018 -
EuroIntervention : Journal of EuroPCR... Apr 2023Despite significant advances in pharmacological, electrophysiological and valve therapies for heart failure with reduced ejection fraction (HFrEF), the associated... (Review)
Review
Despite significant advances in pharmacological, electrophysiological and valve therapies for heart failure with reduced ejection fraction (HFrEF), the associated morbidity, mortality and healthcare costs remain high. With a constantly growing heart failure population, the existing treatment gap between current and advanced heart failure therapies (e.g., left ventricular [LV] assist devices, heart transplantation) reflects a large unmet need, calling for novel therapeutic approaches. Left ventricular remodelling and dilatation, with or without scar formation, is the hallmark of cardiomyopathy and is associated with poor prognosis. In the era of exciting advances in structural heart interventions, the advent of minimally invasive, device-based therapies directly targeting the LV geometry and promoting physical reverse remodelling has created a new frontier in the battle against heart failure. Interventional heart failure therapy is a rapidly emerging field, encompassing structural heart and minimally invasive hybrid procedures, with two left ventriculoplasty devices currently under investigation in pivotal clinical trials in the US. This review addresses the rationale for left ventriculoplasty, presents the prior surgical and percutaneous attempts in the field, provides an overview of the novel transcatheter left ventriculoplasty devices and their respective trials, and highlights potential challenges associated with establishing such device-based therapies in our armamentarium against heart failure.
Topics: Humans; Heart Failure; Stroke Volume; Cardiac Surgical Procedures; Cardiomyopathies; Ventricular Function, Left
PubMed: 37092265
DOI: 10.4244/EIJ-D-22-00544 -
EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion - an update.Europace : European Pacing,... Feb 2020
PubMed: 31504441
DOI: 10.1093/europace/euz258 -
Cancer Medicine Apr 2023Lenalidomide-based regimens are commonly used for early relapse in patients with relapsed and/or refractory multiple myeloma (RRMM) receiving at least one prior line of...
BACKGOUND
Lenalidomide-based regimens are commonly used for early relapse in patients with relapsed and/or refractory multiple myeloma (RRMM) receiving at least one prior line of therapy. In the absence of head-to-head comparison, matching-adjusted indirect comparison (MAIC) was conducted to demonstrate efficacy and safety of isatuximab+carfilzomib+dexamethasone (Isa-Kd) versus daratumumab + lenalidomide + dexamethasone (Dara-Rd) in RRMM.
METHODS
Patient-level data from IKEMA trial (Isa-Kd, n = 179) were matched to aggregate data from POLLUX (Dara-Rd, n = 286). Hazard ratios (HR) and 95% confidence intervals (CI) for progression-free survival (PFS) and overall survival (OS) were generated by weighted Cox proportional hazard models. Odds ratios (OR), 95% CI, and p-value were calculated for ≥very good partial response (≥VGPR) and treatment-emergent adverse events (TEAEs).
RESULTS
After matching, no significant differences were observed between Isa-Kd and Dara-Rd in baseline characteristics except for patients with >3 prior lines (0.0% vs. 4.9%). Isa-Kd showed significantly better PFS (HR [95% CI]: 0.46 [0.24-0.86]; p = 0.0155), statistically non-significant improvement favoring Isa-Kd in OS (0.47 [0.20-1.09]; 0.0798), and ≥VGPR (OR [95% CI]: 1.53 [0.89-2.64]; p = 0.1252) than Dara-Rd. Odds of occurrence were significantly lower for some all-grade and grade 3/4 TEAEs with Isa-Kd than Dara-Rd.
CONCLUSION
These results support Isa-Kd as an efficacious treatment for early relapse in non-lenalidomide refractory patients.
Topics: Humans; Multiple Myeloma; Lenalidomide; Antineoplastic Combined Chemotherapy Protocols; Neoplasm Recurrence, Local; Dexamethasone; Recurrence
PubMed: 36726287
DOI: 10.1002/cam4.5584 -
Sensors (Basel, Switzerland) Feb 2023Mitigation or even elimination of adverse effects caused by ionizing radiation is the main scope of the radiation protection discipline. The interaction of radiation... (Review)
Review
Mitigation or even elimination of adverse effects caused by ionizing radiation is the main scope of the radiation protection discipline. The interaction of radiation with living matter is quantified and correlated with biological effects by dose. The Sievert is the most well-known quantity, and it is used with the equivalent and effective dose to minimize stochastic effects. However, Gray is the reference quantity for sizing tissue reactions that could occur under high-exposure conditions such as in a radiation emergency. The topics addressed in this review are the choice to move from Sievert to Gray, how the operational quantities for environmental and individual monitoring of the detectors should consider such a change of units, and why reference levels substitute dose levels in emergency exposure.
Topics: Humans; Drug-Related Side Effects and Adverse Reactions; Radiation, Ionizing
PubMed: 36850517
DOI: 10.3390/s23041918