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A critical care outreach team under strain - Evaluation of the service provided to patients with haematological malignancy during the Covid-19 pandemic.

PurposeCritical Care Outreach Teams (CCOTs) have been associated with improved outcomes in patients with haematological malignancy (HM). This study aims to describe CCOT activation by patients with HM before and during the Covid-19 pandemic, assess amny association with worse outcomes, and examine the psychological impact on the CCOT.Materials and methodsA retrospective, mixed-methods analysis was performed in HM patients reviewed by the CCOT over a two-year period, 01 July 2019 to 31 May 2021.ResultsThe CCOT increased in size during the surge period and reviewed 238 HM patients, less than in

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… The team is activated either by direct referral from ward teams or by responding to an increased National Early Warning Score (NEWS; Table 1 , online supplement). For NEWS >4 the ward medical team is asked to review the patient. … CCOT: Critical Care Outreach Team; HM: haematological malignancy; NEWS: National Early Warning Score. …

A year in pharmacology: new drugs approved by the US food and drug administration in 2025.

The US Food and Drug Administration approved 45 new drugs and 4 new cellular and gene therapy products in 2025, that is, a total of 49 new medical therapies. Oncology, hematology/immunotherapy, and cardiovascular/respiratory drugs remain most frequent. Among oncology drugs, there is a trend for targeting ever smaller subtypes of malignancies and/or rarer malignancies. Trends over the past 6 years include steady levels of first-in-indication (about 10%), first-in-class (about 38%), and next-in-class (about 51%) approvals. Along with a large share of approvals in orphan indications (> 50%), fast

The UK's Early Access to Medicines Scheme 10 years on: an evaluation using publicly available data.

ObjectivesTo investigate the drugs and indications that have passed through the UK's Early Access to Medicines Scheme (EAMS) to date, the type of evidence the regulator considers when accepting a drug into the EAMS, and potential risks to patients.DesignAnalysis of publicly available data: MHRA Public Assessment Reports; Electronic Medicines Compendium database; interactive Drug Analysis Profiles database; Eudravigilance database.SettingUnited Kingdom.ParticipantsThe 51 'scientific opinions' available on the MHRA website in June 2024.Main outcome measuresPublic Assessment Reports, pharmacovigi

A retrospective analysis of venous thromboembolism trends in chemotherapy-induced anemia: Red blood cell transfusion versus erythrocyte stimulating agent administration.

BackgroundPatients receiving a variety of chemotherapy regimens often develop chemotherapy-induced anemia (CIA), which contributes to poor outcomes including increased mortality. Prompt and effective treatment of CIA is essential to prevent fewer chemotherapy dose delays and reductions. Optimal therapy of CIA is controversial and involves the solitary and combined use of intravenous iron, red blood cell (RBC) transfusions, and erythropoietin stimulating agents (ESAs). Despite the baseline coagulopathies present in patients with malignancy, administration of both RBC transfusions and ESAs is as

Predicting Regulatory Product Approvals Using a Proposed Quantitative Version of FDA's Benefit-Risk Framework to Calculate Net-Benefit Score and Benefit-Risk Ratio.

BackgroundApproval of regulated medical products in the USA is based upon a rigorous review of the benefits and risks as performed by the US Food and Drug Administration (FDA) staff of scientists and is summarized in a descriptive and qualitative format called the FDA's Benefit-Risk Framework (BRF). This present method highlights the key factors in regulatory decision-making, but does not clearly define the reason for its final approval.MethodThis study proposes a quantitative version of FDA's BRF to calculate a Net-Benefit Score and a Benefit-Risk Ratio as a method to define a single-value su

Erythropoiesis-Stimulating Agents in the Management of Anemia in Chronic Kidney Disease or Cancer: A Historical Perspective.

Anemia is common in patients with cancer or with chronic kidney disease (CKD). Although the introduction of erythropoiesis-stimulating agents (ESAs) has transformed the management of anemia, their use has been complicated by a number of factors including frequent guideline updates, safety concerns and, in the United States, a Risk Evaluation and Mitigation Strategy (REMS) program, which aimed to ensure that the benefits of ESAs outweigh the risks. Many previous concerns around ESA use in cancer and CKD have been addressed by the reassuring results of post-approval studies, and biosimilar ESAs

Arrhythmias, conduction disorders and sudden cardiac death in cancer patients and survivors: expert opinion of the working groups on cardio-oncology and on electrophysiology of the hellenic cardiac society.

Advances in cancer therapeutics have significantly improved patient survival; however, cardiotoxic effects-including arrhythmias-have emerged as a growing clinical concern. This expert opinion, developed by the Working Groups on Cardio-Oncology and Electrophysiology of the Hellenic Cardiological Society, aims to raise awareness of the increasing burden of arrhythmias in cancer patients and survivors. This document explores the multifactorial etiology of arrhythmias in this population, including patient-related factors, the direct effects of malignancy, and the arrhythmogenic potential of thera

Immunodeficiencies in Adults: Key Considerations for Diagnosis and Management.

Immunodeficiencies in adults are increasingly recognized yet often remain underdiagnosed, leading to significant morbidity from recurrent infections, autoimmunity, and malignancy. Both primary immunodeficiencies (PIDs), now known as inborn errors of immunity (IEI), and secondary immunodeficiencies (SIDs) contribute to immune dysfunction in adults. Although SIDs are more common in adults due to factors like medications, malignancies, metabolic disorders, chronic conditions, and protein-losing conditions, IEI-particularly common variable immunodeficiency (CVID)-can also manifest in adulthood wit

Злоумышленные преобразования у пациентов с моноклонной гаммопатией неизвестного значения, обработанных терипаротидом для остеопороза: ретроспективное исследование двухцентра и анализ французской национальной базы данных о фармакологической бдительности.

UNLABELLED: Была проведена оценка злокачественных трансформаций у пациентов с моноклональной гаммопатией неопределенного значения, обработанных терипаратидом. Среди 29 только пациенты two Перешел к гематологическому искусству.one Множественная миелома, one Макроглобулинемия Уолденстрёма). Эти выводы обнадеживают и свидетельствуют о том, что ТПТ может оставаться одним из вариантов для отдельных пациентов с тяжелым остеопорозом и MGUS. ЦЕЛЬ: Остеопороз является широко распространенным заболеванием костей с ограниченными терапевтическими возможностями, особенно у пациентов, страдающих множественн

Immunomodulatory drugs in multiple myeloma: Impact of the SCARMET (Self CARe and MEdication Toxicity) educational intervention on outpatients' knowledge to manage adverse effects.

Long-term multiple myeloma therapy by immunomodulatory drugs (IMiDs) raises the question of management of adverse effects. The aim of this study is to assess the impact of an educational session for patients on the acquisition of knowledge to manage hematologic and thromboembolic adverse effects of IMiDs. In this prospective single-center study, patients attended an educational session with a hospital clinical pharmacist and a nurse. The primary endpoint was the patient's level of knowledge for the management of IMiDs adverse effects, assess with a dedicated questionnaire administered before t

Decoding Immunodeficiencies with Artificial Intelligence: A New Era of Precision Medicine.

Primary and secondary immunodeficiencies comprise a wide array of illnesses marked by immune system abnormalities, resulting in heightened vulnerability to infections, autoimmunity, and cancers. Notwithstanding progress in diagnostic instruments and an enhanced comprehension of the underlying pathophysiology, delayed diagnosis and underreporting persist as considerable obstacles. The implementation of artificial intelligence into clinical practice has surfaced as a viable method to enhance early detection, risk assessment, and management of immunodeficiencies. Recent advancements illustrate ho

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area.

BackgroundPatient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described.MethodsWe described all adults with COVID-19 or influenza discharged from inpatient medical services and medical-surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario. We compared patient outcomes using multivariable regression models, controlling for patient sociodemographic factors and comorbidity level. We validated the accuracy of 7

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… Development and external validation of a prognostic multivariable model on admission for hospitalized patients with COVID-19 . medRxiv 2020 Apr. 7 . 10.1101/2020.03.28.20045997 . 36 National Early Warning Score (NEWS) 2 . London (UK) : Royal College of Physicians . … Available: www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 ( accessed 2021 Jan. 20 ). 37 Gupta RK Marks M Samuels THA UCLH COVID-19 Reporting Group . …

Навигатор биомаркеров человека.

Биомаркеры играют ключевую роль в современных исследованиях медицины, особенно в ранней диагностике заболеваний и персонализированном лечении. Несмотря на то, что предыдущие исследования систематически обзоры маркеров в различных областях заболеваний, интегрированная система, которая связывает основные физиологические системы, охватывает множество органов и охватывает широкий спектр заболеваний, все еще отсутствует. В контексте современных вызовов здоровья, характеризующихся высокой распространенностью хронических заболеваний и широкими сопутствующими заболеваниями, создание панорамной системы

Dependence and clinical fragility in hematopoietic stem cell transplant and CAR-T therapy: a retrospective study.

PurposeAutologous and allogeneic hematopoietic stem cell transplantation and CAR-T cell therapy are standard treatments for patients affected by hematologic malignancies at different stages of their clinical pathway. Several adverse events accompany these therapies during patients' hospital stay, including psycho-emotional distress and various functional and social impairments.MethodsIn this monocentric study on 498 patients, various clinical and social fragility indices, registered within clinical documentation during the hospital stay, specifically at admission (within 24 h of entry) and dis

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… Warning Score—MEWS) [ 16 ], fall risk (Conley Scale) [ 17 ], pain (Numerical Rating Scale—NRS) [ 18 ], need of a more comprehensive discharge plan (Blaylock Risk Assessment Screening Score—BRASS) [ 19 , 20 ], and alteration in cognitive status (cognitive/perceptive functional model, for mental conditions … The Conley Scale [ 17 ] is used to identify fall risk (cutoff ≥ 2), while the Modified Early Warning Score (MEWS) [ 16 ] monitors clinical deterioration based on vital parameters. …

Шаги в направлении внедрения нейрофильтров в множестве склерозов: характеристики пациентов, которым необходимо уделять приоритетное внимание в клинической практике.

Множественный склероз (MS) — хроническое заболевание центральной нервной системы, характеризующееся нейродегенерацией и воспалением. Нейрофильтральная световая цепочка (NfL), являющаяся белком, высвобождающимся во время аксоновых травм, получила признание в качестве потенциального биомаркера для мониторинга прогресса и реакции MS. Имеющиеся данные свидетельствуют о том, что NfL (bNfL) представляет собой минимально инвазивный, экономичный инструмент для отслеживания нейроаксональных повреждений. Регулярная оценка БНФЛ позволяет выявлять субклинические заболевания, направлять интенсификацию лече

Выбрать первоначальную терапию MS; факторы личного характера, болезни и лекарственные средства.

Инициирование болезни, изменяющей терапию у пациента с недавно поставленным диагнозом повторного склероза, в настоящее время предоставляет наилучшую возможность повлиять на их последующий курс лечения. В этой статье рассматриваются личные факторы, характеристики представления заболеваний и данные о текущих заболеваниях, изменяющих терапию, с точки зрения выбора первоначального лечения в этой среде. Хотя показатели для прогнозирования на индивидуальном уровне остаются ненадежными, особенно для тех, кто имеет мягкие представления, имеющиеся в настоящее время данные об относительной эффективности

Development and Validation of a Prediction Model for 1-Year Mortality in Patients With a Hematologic Malignancy Admitted to the ICU.

ObjectivesTo develop and validate a prediction model for 1-year mortality in patients with a hematologic malignancy acutely admitted to the ICU.DesignA retrospective cohort study.SettingFive university hospitals in the Netherlands between 2002 and 2015.PatientsA total of 1097 consecutive patients with a hematologic malignancy were acutely admitted to the ICU for at least 24 h.InterventionsNone.Measurements and main resultsWe created a 13-variable model from 22 potential predictors. Key predictors included active disease, age, previous hematopoietic stem cell transplantation, mechanical ventila

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… A recent study introduced an adjusted version of the modified early warning score (MEWS) pre-ICU to predict in-hospital mortality and identify deteriorating patients with a hematologic malignancy who might benefit from ICU admission ( 14 ). … Lee JR, Jung YK, Kim HJ, et al. : Derivation and validation of modified early warning score plus SpO 2 /FiO 2 score for predicting acute deterioration of patients with hematological malignancies. Korean J Intern Med 2020; 35:1477–1488 15. …

Search for novel biomarkers of febrile neutropenia in hematological patients: an overview.

A single-center prospective study was conducted at a tertiary care hospital in Kuopio Finland over the past two decades, searching for novel biomarker candidates to predict complicated course of febrile neutropenia (FN) in hematological patients. In Dec 2006‒Dec 2015, 85 patients with acute myeloid leukemia and 179 autologous hematopoietic stem cell transplant recipients were included. More than 20 biomarkers were evaluated in subsequent patient cohorts and compared to C-reactive protein (CRP) and procalcitonin (PCT). The samples were taken on d0-d2 from the beginning of FN. Here, we provide a

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… Jones M NEWSDIG: the National Early Warning Score Development and Implementation Group Clin Med (Lond) 2012 12 6 501 3 10.7861/clinmedicine.12-6-501 23342400 PMC5922584 Jones M. NEWSDIG: the National Early Warning Score Development and Implementation Group. … Predicting mortality in patients with suspected sepsis at the emergency department; a retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS One. 2019;14(1):e0211133. 10.1371/journal.pone.0211133. 30682104 10.1371/journal.pone.0211133 PMC6347138 81. …

Breaking bad news: an active learning method for medical students.

BackgroundBreaking bad news is one of the most difficult aspects of communication in medicine. The objective of this study was to assess the relevance of a novel active learning course on breaking bad news for fifth-year students.MethodsStudents were divided into two groups: Group 1, the intervention group, participated in a multidisciplinary formative discussion workshop on breaking bad news with videos, discussions with a pluri-professional team, and concluding with the development of a guide on good practice in breaking bad news through collective intelligence; Group 2, the control group, r

Drug-induced herpes zoster: a pharmacovigilance analysis of FDA adverse event reports from 2004 to 2024.

BACKGROUND: Herpes zoster severely impacts patients' quality of life and therapeutic results. This research utilized data from the FDA Adverse Event Reporting System (FAERS) to examine the prevalence and attributes of drug-induced herpes zoster. METHODS: We analyzed FAERS reports about zoster from Q1 2004 to Q3 2024 and developed a list of possible pathogenic agents. Ranked the 30 medicines with the greatest incidence of reported herpes zoster cases. Statistical disproportionality analysis was employed to identify an elevated reporting frequency of herpes zoster linked to a particular medicat