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101.
Francesco Pierantoni Umberto Basso Marco Maruzzo Evelina Lamberti Davide Bimbatti Giuseppina Tierno Eleonora Bergo Antonella Brunello Vittorina Zagonel 《Journal of Geriatric Oncology》2021,12(2):290-297
BackgroundThere is poor data on the prognostic role of Comprehensive Geriatric Assessment (CGA) in older patients with metastatic renal cell carcinoma (mRCC) treated with first line Tyrosine Kinase Inhibitors (TKIs).Materials and MethodsWe retrospectively reviewed the clinical charts of mRCC patients older than 70 years treated at our Institute with first-line Sunitinib or Pazopanib for at least 6 months. Every patient received a CGA at baseline and was identified as fit, vulnerable or frail according to Balducci's Criteria. We then assessed the impact of CGA category on survival, disease control and tolerability of TKIs.ResultsWe identified 86 eligible patients. Median age: 74.5 years, 56% males; 45.4% were fit, 37.2% vulnerable and 17.4% frail at CGA. There were no significant differences in the rate of Grade (G)1–2 and G3-4 toxicities, dose reduction rates, PFS and OS between Sunitinib and Pazopanib. Fit, vulnerable and frail patients achieved significantly different median PFS (18.9 vs 11.2 vs 5.1 months; p < 0.001) and OS (35.5 vs 14.6 vs 10.9 months; p < 0.001). Patients categorized as fit had higher chance of receiving a second-line treatment (66.6% vs 28.9% in vulnerable/frail; p = 0.002). The incidence of G3/4 events was significantly lower in the fit subgroup (19% vs 45% in vulnerable/frail; p = 0.0025).ConclusionsIn our retrospective single-center experience, CGA could accurately discriminate patients with higher risk of experiencing G3/4 toxicities, shorter PFS, and lower chance of receiving a second line treatment. CGA strongly impacted on OS, independently from International mRCC Database Consortium (IMDC) classification. 相似文献
102.
Marco Das 《The British journal of radiology》2021,94(1120)
In 2017, the long awaited results of the ATTRACT trial were published in the New England Journal of Medicine leaving the scientific community with disappointment as the study did not show the expected results. Producing not the expected outcome is not uncommon in science – furthermore, it is important to disapprove common beliefs. But has the ATTRACT trial really the power to change our practice? Are the results correct in terms of evidence based on the methods used?In 2017, the long awaited results of the ATTRACT trial were published in the New England Journal of Medicine1,2 leaving the scientific community with disappointment as the study did not show the expected results. Producing not the expected outcome is not uncommon in science – furthermore, it is important to disapprove common beliefs. But has the ATTRACT trial really the power to change our practice? Are the results correct in terms of evidence based on the methods used? To understand the results, it is important to analyze the methods of the trial and to discuss them in a broader view. 相似文献
103.
Jeremy Ben-Shoshan Hind Alosaimi Pascal Thériault Lauzier Michele Pighi Yeela Talmor-Barkan Pavel Overtchouk Giuseppe Martucci Marco Spaziano Ariel Finkelstein Hemal Gada Nicolo Piazza 《JACC: Cardiovascular Interventions》2021,14(2):185-194
ObjectivesThe purpose of this study was to assess the concordance between transcatheter aortic valve implantation angles generated by the “double S-curve” and “cusp-overlap” techniques.BackgroundThe “double S-curve” and “cusp-overlap” methods aim to define optimal fluoroscopic projections for transcatheter aortic valve replacement (TAVR) with a self-expandable device.MethodsThe study included 100 consecutive patients undergoing TAVR with self-expanding device planned by multidetector computed tomography. TAVR was performed using the double S-curve model, as a view in which both the aortic valve annulus and delivery catheter planes are displayed perpendicularly on fluoroscopy. Optimal projection according to the cusp-overlap technique was retrospectively generated by overlapping the right and left cups on the multidetector computed tomography annular plane. The angular difference between methods was assessed in spherical 3 dimensions and on the left and right anterior oblique (RAO) and cranial and caudal (CAU) axes.ResultsThe double S-curve and cusp-overlap methods provided views located in the same quadrant, mostly the RAO and CAU, in 92% of patients with a median 3-dimensional angular difference of 10.0° (interquartile range: 5.5° to 17.9°). The 3-dimensional deviation between the average angulation obtained by each method was not statistically significant (1.49°; p = 0.349). No significant differences in average coordinates were noted between the double S-curve and cusp-overlap methods (RAO: 14.7 ± 15.2 vs. 12.9 ± 12.5; p = 0.36; and CAU: 27.0 ± 9.4 vs. 26.9 ± 10.4; p = 0.90). TAVR using the double S-curve was associated with 98% device success, low complication rate, and absence of moderate-to-severe paravalvular leak.ConclusionsThe double S-curve and cusp-overlap methods provide comparable TAVR projections, mostly RAO and CAU. TAVR using the double S-curve model is associated with a high rate of device success and low rate of procedural complications. 相似文献
104.
Alessandro Mandurino-Mirizzi Vilma Kajana Stefano Cornara Alberto Somaschini Andrea Demarchi Marco Galazzi Gabriele Crimi Marco Ferlini Rita Camporotondo Massimiliano Gnecchi Maurizio Ferrario Luigi Oltrona-Visconti Gaetano M. De Ferrari 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2021,31(7):2140-2143
BackgroundContrast associated-acute kidney injury (CA-AKI) has been associated with adverse outcomes after ST-segment elevation myocardial infarction (STEMI). However, early markers of CA-AKI are still needed to improve risk stratification. We investigated the association between elevated serum uric acid (eSUA) and CA-AKI in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).Methods and resultsSerum creatinine (Scr) was measured at admission and 24, 48 and 72 h after pPCI. CA-AKI was defined as an increase of 25% (CA-AKI 25%) or 0.5 mg/dl (CA-AKI 0.5) of Scr level above the baseline after 48 h following contrast administration. Multivariable analyses to investigate CA-AKI predictors were performed by binary logistic regression and multivariable backward logistic regression model.In the 3023 patients considered, CA-AKI was more frequent among patients with eSUA as compared with patients with normal SUA levels, considering both CA-AKI definitions (CA-AKI25%: 20.8% vs 16.2%, p < 0.012; CA-AKI 0.5: 10.1% vs 5.8%, p < 0.001). The association between eSUA and CA-AKI was confirmed at multivariable analyses (CA-AKI 25%: odd ratio 1.32, 95% CI 1.03–1.69, p = 0.027; CA-AKI 0.5: odd ratio 1.76, 95% CI 1.11–2.79, p = 0.016).ConclusionElevated serum uric acid is associated with CA-AKI after reperfusion in patients with STEMI treated with pPCI. 相似文献
105.
106.
David J. Seiffge MD Gian Marco De Marchis MD Masatoshi Koga MD PhD Maurizio Paciaroni MD Duncan Wilson PhD Manuel Cappellari MD Kosmas Macha MD Georgios Tsivgoulis MD Gareth Ambler PhD Shoji Arihiro MD Leo H. Bonati MD Bruno Bonetti MD Bernd Kallmünzer MD Keith W. Muir MD PhD Paolo Bovi MD Henrik Gensicke MD Manabu Inoue MD Stefan Schwab MD Shadi Yaghi MD Martin M. Brown MD PhD FRCP Philippe Lyrer MD Masahito Takagi MD PhD Monica Acciarrese MD Hans Rolf Jager MD FRCP Alexandros A. Polymeris MD Kazunori Toyoda MD PhD Michele Venti MD Christopher Traenka MD Hiroshi Yamagami MD PhD Andrea Alberti MD Sohei Yoshimura MD PhD Valeria Caso MD Stefan T. Engelter MD David J. Werring MD PhD FRCP the RAF RAF-DOAC CROMIS- SAMURAI NOACISP Erlangen and Verona registry collaborators 《Annals of neurology》2020,87(5):677-687
107.
Nouchine Hadjikhani MD PhD Daniel S. Albrecht PhD Caterina Mainero MD PhD Eri Ichijo MS Noreen Ward MS Cristina Granziera MD PhD Nicole R. Zürcher PhD Oluwaseun Akeju MD Guillaume Bonnier PhD Julie Price PhD Jacob M. Hooker PhD Vitaly Napadow PhD Matthias Nahrendorf MD PhD Marco L. Loggia PhD Michael A. Moskowitz MD 《Annals of neurology》2020,87(6):939-949
108.
Nicolás García MD Julio Rosales MD Cristóbal Greene MD Guillermo Droppelmann MSc PhD Marco A. Verdugo MD 《Journal of ultrasound in medicine》2020,39(1):165-168
The aim of this study was to describe a perineural ultrasound-guided infiltration technique for management of radial tunnel syndrome and to report its preliminary results in 54 patients. A mixture of a saline solution, a local anesthetic, and a corticosteroid solution was infiltrated in the perineural region at the arcade of Frohse. Pain was reported in 100% of patients before the procedure versus 1.9% after the procedure. Scratch collapse and Cozen test results were positive in 98.1% and 66.7% of patients before infiltration, respectively, versus 5.6% and 9.2% after infiltration. All variables had statistically significant differences between preprocedure and postprocedure evaluations (P < .01). 相似文献
109.
Borrelli Enrico Grosso Domenico Vella Giovanna Sacconi Riccardo Battista Marco Querques Lea Zucchiatti Ilaria Prascina Francesco Bandello Francesco Querques Giuseppe 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2020,258(12):2621-2628
Graefe's Archive for Clinical and Experimental Ophthalmology - To estimate the impact of delayed care during the coronavirus disease 2019 (COVID-19) pandemic on the outcomes of patients with... 相似文献
110.
AbstractTeaching and learning practices often fail to incorporate new concepts in the ever-evolving field of medical education. Although medical education research provides new insights into curricular development, learners’ engagement, assessment methods, professional development, interprofessional education, and so forth, faculty members often struggle to modernize their teaching practices. Communities of practice (CoP) for faculty development offer an effective and sustainable approach for knowledge management and implementation of best practices. A successful CoP creates and shares knowledge in the context of a specific practice toward the development of expertise. CoPs’ collaborative nature, based on the co-creation of practical solutions to daily problems, aligns well with the goals of applying best practices in health professions education and training new faculty members. In our article, we share 12 tips for implementing a community of practice for faculty development. The tips were based on a comprehensive literature review and the authors’ experiences. 相似文献