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21.
《Clinical Lymphoma, Myeloma & Leukemia》2022,22(8):608-617
BackgroundConsiderable progress has been made in therapeutic options for multiple myeloma (MM). Understanding the current landscape of MM treatment options and associated outcomes in the real world is important in providing key insights into clinical and knowledge gaps which could be targeted for further optimization.MethodsThe Canadian Myeloma Research Group Database (CMRG-DB) is a prospectively maintained disease-specific database with >7000 patients. The objective of this study was to describe the trends in the treatment landscape and outcomes including early mortality, time to next treatment, and overall survival (OS) in each line of treatment stratified by autologous stem cell transplant (ASCT) receipt among newly-diagnosed MM patients in Canada between 2007 and 2018.ResultsA total of 5154 patients were identified among which 3030 patients (58.8%) received an upfront ASCT and 2124 (41.2%) did not. At diagnosis, the median age was 64 years and 58.6% were males. Bortezomib and lenalidomide were most frequently used (>50%) in first and second-line treatment respectively among both the ASCT and non-ASCT cohort. The median OS was 122.0 months (95% Cl 115.0-135.0 months) and 54.3 months (95% CI 50.8-58.8 months) for the ASCT and non-ASCT cohort respectively with an incremental decrease in OS in each subsequent line of treatment.ConclusionWe present the largest study to date in the Canadian landscape showing the characteristics, therapy usage, and outcomes among MM patients. This information will be critical in benchmarking current outcomes and provide key insight into areas of unmet needs and gaps for improvement of MM patients nationally. 相似文献
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Effects of Paclitaxel and Carboplatin Combination on Mechanical Myocardial and Microvascular Functions: A Transthoracic Doppler Echocardiography and Two‐Dimensional Strain Imaging Study 下载免费PDF全文
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《Transfusion and apheresis science》2020,59(4):102855
The activation of the innate and adaptive immune systems by SARS-CoV-2 causes the release of several inflammatory cytokines, including IL-6. The inflammatory hypercytokinemia causes immunopathological changes in the lungs including vascular leakage, and alveolar edema. As a result of these changes in the lungs, hypoxia and acute respiratory distress syndrome occur in patients with COVID-19. Even though there are clinical trials on the development of therapeutics and vaccines, there are currently no licensed vaccines or therapeutics for COVID-19. Pharmacological approaches have shown poor results in sepsis-like syndromes caused by the hypercytokinemia. Suppressing the cytokine storm is an important way to prevent the organ damage in patients with COVID-19. Extracorporeal blood purification could be proposed as an adjunctive therapy for sepsis, aiming to control the associated dysregulation of the immune system, which is known to protect organ functions. Several extracorporeal blood purification therapies are now available, and most of them target endotoxins and/or the cytokines and aim improving the immune response. For this purpose, plasmapheresis and immunoadsorption may be an important adjunctive treatment option to manage the complications caused by cytokine storm in critically ill patients with COVID-19. 相似文献
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Selcen Yuksel Selim Ayhan Vugar Nabiyev Montse Domingo-Sabat Alba Vila-Casademunt Ibrahim Obeid Francisco Sanchez Perez-Grueso Emre Acaroglu 《The spine journal》2019,19(1):71-78
BACKGROUND CONTEXT
Health-related quality of life (HRQOL) parameters have been shown to be reliable and valid in patients with adult spinal deformity (ASD). Minimum clinically important difference (MCID) has become increasingly important to clinicians in evaluating patients with a threshold of improvement that is clinically relevant.PURPOSE
To calculate MCID and minimum detectable change (MDC) values of total scores of the Core Outcome Measures Index (COMI), Oswestry Disability Index (ODI), Physical Component Summary (PCS), Mental Component Summary (MCS) of the Short Form 36 (SF-36), and Scoliosis Research Society 22R (SRS-22R) in surgically and nonsurgically treated ASD patients who have completed an anchor question at pretreatment and 1-year follow-up.STUDY DESIGN/SETTING
Prospective cohort.PATIENT SAMPLE
Surgical and nonsurgical patients from a multicenter ASD database.OUTCOME MEASURES
Self-reported HRQOL measures (COMI, ODI, SF-36, SRS-22R, and anchor question).METHODS
A total of 185 surgical and 86 nonsurgical patients from a multicenter ASD database who completed pretreatment and 1-year follow-up HRQOL scales and the anchor question at the first year follow-up were included. The anchor question was used to determine MCID for each HRQOL measure. MCIDs were calculated by an anchor-based method using latent class analysis (LCA) and MDCs by a distribution-based method.RESULTS
All differences between means of baseline and first year postoperative total score measures for all scales demonstrated statistically significant improvements in the overall population as well as the surgically treated patients but not in the nonsurgical group. The calculated MDC and MCID values of HRQOL parameters in the entire study population were 1.34 and 2.62 for COMI, 10.65 and 14.31 for ODI, 6.09 and 7.33 for SF-36 PCS, 6.14 and 4.37 for SF-36 MCS, and 0.42 and 0.71 for SRS-22R. The calculated MCID values for surgical and non-surgical treatment groups were 2.76 versus 1.20 for COMI, 14.96 versus 2.45 for ODI, 7.83 versus 2.15 for SF-36 PCS, 5.14 versus 2.03 for SF-36 MCS, and 0.94 versus 0.11 for SRS-22R; the MDC values for surgical and nonsurgical treatment groups were 1.22 versus 1.51 for COMI, 10.27 versus 9.45 for ODI, 5.16 versus 6.77 for SF-36 PCS, 6.05 versus 5.67 for SF-36 MCS, and 0.38 versus 0.43 for SRS-22R.CONCLUSIONS
This study has demonstrated that MCID calculations for the HRQOL scales in ASD using LCA yield values comparable to other studies that had used different methodologies. The most important finding was the significantly different MCIDs for COMI, ODI, SF-36 PCS and SRS-22 in the surgically and nonsurgically treated cohorts. This finding suggests that a universal MCID value, inherent to a specific HRQOL for an entire cohort of ASD may not exist. Use of different MCIDs for surgical and nonsurgical patients may be warranted. 相似文献28.
《Journal of Clinical Orthopaedics and Trauma》2019,10(4):706-709
ObjectiveThe purpose of this study was to evaluate the visibility of the anterolateral ligament (ALL) by magnetic resonance imaging (MRI) in patients with chronic anterior cruciate ligament (ACL) rupture.Materials and methodsThis retrospective case – control study compared 1.5 - T MRI scans for 50 patients with a chronic ACL rupture with those of a control group of 50 patients with an intact ACL. The ALL was evaluated in three portions: femoral, meniscal, and tibial. The status of each portion was classified as visualized or non-visualized. Two radiologists separately reviewed all the MRI scans to evaluate interobserver reliability.ResultsAt least one portion of the ALL was visualized in 100% of the control group and 72% of the chronic ACL rupture group. All three portions of the ALL were identified in 72% of the control group but only 10% of the chronic ACL rupture group. In both groups, the most commonly visualized portion was the meniscal portion and the least visualized was the tibial portion. In 18% of the chronic ACL rupture group, no portion of the ALL was visualized.ConclusionsThe visibility of the ALL of the knee was significantly lower in patients with a chronic ACL rupture than in those with an intact one. 相似文献
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