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American College of Rheumatology Guidance Statement for Diagnosis and Management of VEXAS Developed by the International VEXAS Working Group Expert Panel.

OBJECTIVE: Vacuoles E1 enzyme X-linked autoinflammatory somatic syndrome (VEXAS) is a recently identified rare genetic disorder associated with somatic mutations in the UBA1 gene. VEXAS presents with a combination of inflammatory and hematologic manifestations, leading to increased morbidity and mortality. METHODS: Given the variability in disease presentation and the limited number of studies to date, no clinical documents currently exist to provide guidance to health care providers about the management of VEXAS. To address this gap, we formed an international multidisciplinary panel of VEXA

Stepping forward: T-cell redirecting bispecific antibodies in cancer therapy.

T cell-redirecting bispecific antibodies are specifically designed to bind to tumor-associated antigens, thereby engaging with CD3 on the T cell receptor. This linkage between tumor cells and T cells actively triggers T cell activation and initiates targeted killing of the identified tumor cells. These antibodies have emerged as one of the most promising avenues within tumor immunotherapy. However, despite success in treating hematological malignancies, significant advancements in solid tumors have yet to be explored. In this review, we aim to address the critical challenges associated with T

Resource Use and Care Quality Differences Among Medicare Beneficiaries Undergoing Chemotherapy.

ImportanceMedicare Advantage (MA) has grown significantly over the last decade; however, MA's performance for patients with serious conditions, such as cancer, remains unclear.ObjectiveTo compare resource use and care quality between MA and traditional Medicare (TM) beneficiaries undergoing cancer chemotherapy.Design, setting, and participantsThis cohort study used TM claims and MA encounter records from January 2015 to December 2019. Participants were MA and TM beneficiaries who initiated cancer chemotherapy between January 2016 and December 2019. Inverse probability of treatment weighting ba

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… We also conducted subgroup analyses by cancer type and MA plan type, defined as health maintenance organizations (HMOs) or preferred provider organizations (PPOs). The total population of TM beneficiaries was used for the analysis by plan type. We performed 3 sensitivity checks. …

Treatment pattern and clinical outcomes in multiple myeloma patients in Japan using the Medical Data Vision claims database.

Multiple myeloma therapy has made remarkable progress with the advent of new drugs. We explored the treatment pattern and outcomes in Japanese patients with multiple myeloma using the Medical Data Vision database. Patients were categorized as per the initial diagnosis period (2003-2015 and 2016-2020), considering the adoption of these new agents and then based on stem cell transplantation. Overall, 6438 patient data were extracted as eligible for data analysis, and the median age at the index diagnosis date was 72.0 years. Bortezomib/dexamethasone was the most common regimen for induction ther

Defining neuroblastoma: From origin to precision medicine.

Neuroblastoma (NB), a heterogenous pediatric tumor of the sympathetic nervous system, is the most common and deadly extracranial solid malignancy diagnosed in infants. Numerous efforts have been invested in understanding its origin and in development of novel curative targeted therapies. Here, we summarize the recent advances in the identification of the cell of origin and the genetic alterations occurring during development that contribute to NB. We discuss current treatment regimens, present and future directions for the identification of novel therapeutic metabolic targets, differentiation

Physiological Role and Use of Thyroid Hormone Metabolites - Potential Utility in COVID-19 Patients.

Thyroxine and triiodothyronine (T3) are classical thyroid hormones and with relatively well-understood actions. In contrast, the physiological role of thyroid hormone metabolites, also circulating in the blood, is less well characterized. These molecules, namely, reverse triiodothyronine, 3,5-diiodothyronine, 3-iodothyronamine, tetraiodoacetic acid and triiodoacetic acid, mediate both agonistic (thyromimetic) and antagonistic actions additional to the effects of the classical thyroid hormones. Here, we provide an overview of the main factors influencing thyroid hormone action, and then go on t

Воздействие слабости на риск инфицирования у пациентов, не имеющих права на трансплантацию, с множественными миэломами: систематический обзор и метаанализ.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Improvement of the left atrial systolic function after a surgical reduction of the high flow arteriovenous fistula.

BACKGROUND: High-output heart failure (HOHF) is a distinct cardiac complication in end-stage kidney disease (ESKD) patients with high-flow arteriovenous fistulae (AVFs). While AVF flow reduction improves hemodynamics and left atrial (LA) volume, its effect on LA systolic function remains unclear. OBJECTIVE: To evaluate changes in left atrial systolic function and left ventricular (LV) filling pressures following surgical AVF flow reduction in haemodialysis patients with high-flow fistulae. METHODS: In this prospective, single-centre interventional study, 28 ESKD patients (mean age 63 ± 15 ye

Advanced Diagnostic Techniques

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Immune Cell Hacking: Challenges and Clinical Approaches to Create Smarter Generations of Chimeric Antigen Receptor T Cells.

T cells equipped with chimeric antigen receptors (CAR T cells) have recently provided promising advances as a novel immunotherapeutic approach for cancer treatment. CAR T cell therapy has shown stunning results especially in B-cell malignancies; however, it has shown less success against solid tumors, which is more supposed to be related to the specific characteristics of the tumor microenvironment. In this review, we discuss the structure of the CAR, current clinical advantages from finished and ongoing trials, adverse effects, challenges and controversies, new engineering methods of CAR, and

Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging.

'See what you treat and treat what you see, at a molecular level', could be the motto of theranostics. The concept implies diagnosis (imaging) and treatment of cells (usually cancer) using the same molecule, thus guaranteeing a targeted cytotoxic approach of the imaged tumor cells while sparing healthy tissues. As the brilliant late Sam Gambhir would say, the imaging agent acts like a 'molecular spy' and reveals where the tumoral cells are located and the extent of disease burden (diagnosis). For treatment, the same 'molecular spy' docks to the same tumor cells, this time delivering cytotoxic

Percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracic and lumbar metastatic tumors.

BACKGROUND AND AIM: With the greatly prolonged survival of cancer patients, more and more patients develop bone metastasis, especially spinal metastasis. Therefore, it is very important to choose the best surgical plan for patients with spinal metastasis in different conditions. This paper aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of thoracic and lumbar metastatic tumors. METHODS: Forty patients with thoracic and lumbar metastatic tumors were treated with PPSF combined with PVP and fol

Периоперативные соображения для пациентов с множественной миеломой.

Множественная миелома — неизлечимый рак, характеризующийся распространением клональных плазменных клеток, в основном в костном мозге, но вызывающий широкомасштабные системные осложнения. Кроме того, этот рак обычно встречается у пожилых пациентов, которые часто являются слабыми и страдают от многочисленных коморбидов. Общемировая распространенность множественной миеломы неуклонно возрастает, а терапевтические достижения способствуют повышению уровня выживания. Существует несколько осложнений миеломы, о которых анестезиолог должен знать в связи с самим заболеванием, конкретными и подкрепляющими

Amyloidoses in Onco-Nephrology Practice: A Multidisciplinary Case-Based Conference Report.

Introduction and objectiveAmyloidoses are a heterogeneous group of disorders resulting from deposition of amyloid fibrils into extracellular tissues. While the kidneys are one of the most frequent sites of amyloid deposition, amyloid deposits can also affect a wide range of organ systems, including the heart, liver, gastrointestinal tract, and peripheral nerves. The prognosis of amyloidosis, especially with cardiac involvement, remains poor; however, a collaborative approach applying new tools for diagnosis and management may improve outcomes. In September 2021, the Canadian Onco-Nephrology In

Novel diagnostic approaches and therapeutic management of mucormycosis: insights from a retrospective monocentric cohort study.

BACKGROUND: Mucormycosis is a rare, opportunistic fungal infection with high mortality rates, predominantly affecting immunocompromised patients. Its management is challenging due to diagnostic complexity and limited therapeutic options. METHODS: This retrospective cohort study analyzed 21 cases of mucormycosis diagnosed at the University Hospital of Liège between July 2018 and August 2023. Clinical, microbiological, and radiological data were evaluated to identify risk factors, treatment modalities, and outcomes. RESULTS: Hematological malignancies (82%) and immunosuppressive therapy (53%)

Amino acid metabolism in primary bone sarcomas.

Primary bone sarcomas, including osteosarcoma (OS) and Ewing sarcoma (ES), are aggressive tumors with peak incidence in childhood and adolescence. The intense standard treatment for these patients consists of combined surgery and/or radiation and maximal doses of chemotherapy; a regimen that has not seen improvement in decades. Like other tumor types, ES and OS are characterized by dysregulated cellular metabolism and a rewiring of metabolic pathways to support the biosynthetic demands of malignant growth. Not only are cancer cells characterized by Warburg metabolism, or aerobic glycolysis, bu

A comprehensive overview on antibody-drug conjugates: from the conceptualization to cancer therapy.

Antibody-Drug Conjugates (ADCs) represent an innovative class of potent anti-cancer compounds that are widely used in the treatment of hematologic malignancies and solid tumors. Unlike conventional chemotherapeutic drug-based therapies, that are mainly associated with modest specificity and therapeutic benefit, the three key components that form an ADC (a monoclonal antibody bound to a cytotoxic drug via a chemical linker moiety) achieve remarkable improvement in terms of targeted killing of cancer cells and, while sparing healthy tissues, a reduction in systemic side effects caused by off-tum

Characteristics and Risk Factors of Ultra-High-Risk Patients with Newly Diagnosed Multiple Myeloma.

ObjectiveTo investigate the clinical characteristics and risk factors of ultra-high-risk (UHR) patients with newly diagnosed multiple myeloma (MM).MethodsWe screened UHR patients with a survival of less than 24 months and we selected patients with a concurrent survival of more than 24 months as a control group. We retrospectively analyzed the clinical characteristics of UHR patients with newly diagnosed MM and screened related risk factors.ResultsIn total we analyzed 477 patients, which included 121 (25.4%) UHR patients and 356 (74.6%) control patients. Median overall survival (OS) and progres

Разногласия по признаку пола в агрессивном сексуальном поведении.

Навязчивое сексуальное поведение — это неспособность контролировать сильные, повторяющиеся сексуальные порывы или желания, приводящие к сексуальному поведению, вызывающему серьезные страдания или расстройство. По данным исследований, связанных с навязчивым сексуальным поведением, среди мужчин больше мужчин. Существуют различия по признаку пола в симптомах и поведении, связанных с CSB, например, сексуальное возбуждение и мотивация. МЕТОДЫ: Систематический поиск в базах данных PubMed/Medline и Scopus в период с января 2000 года по январь 2026 года с использованием терминов поиска, связанных с се

Shortage of plasma-derived medicinal products: what is next? narrative literature review on its causes and counteracting policies in Italy.

Introduction: This paper describes the peculiarities of the plasma-derived medicinal product (PDMP) market and illustrates the results of a review of the literature on policies aimed at counteracting the shortage of PDMPs. Characteristics of PDMPs: Plasma is primarily used for the industrial production of blood products (80%). The demand for PDMPs, particularly immunoglobulins (IGs), is increasing. However, the production of PDMPs is complex, long (7-12 months), and expensive, accounting, according to US estimates, for 57% of the total costs of PDMPs compared to 14% for small molecules. PDMP m