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Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematologic malignancies and solid tumors: 2020 updated guidelines of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO/DGHO).

Hematologic and oncologic patients with chemo- or immunotherapy-related immunosuppression are at substantial risk for bacterial infections and Pneumocystis jirovecii pneumonia (PcP). As bacterial resistances are increasing worldwide and new research reshapes our understanding of the interactions between the human host and bacterial commensals, administration of antibacterial prophylaxis has become a matter of discussion. This guideline constitutes an update of the 2013 published guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology

Антибиотическое управление в случае предполагаемой нейтральной лихорадки (испытание ASTERIC): мультицентр, тип 1 гибридный протокол проведения экспериментальных исследований по вопросам эффективности, ступенчатый, выборочный и контролируемый.

ВВЕДЕНИЕ: Нейтропеническая лихорадка (НФ) имеет общий коэффициент смертности: 3-18%. Международные руководящие принципы рекомендуют всем пациентам, имеющим NF, получать антибиотики сверхширокого спектра (UBSA) в пределах 1 час регистрации аварийного отделения (ЭД). Тем не менее, 70% пациентов, поступающих в больницу с подозрением в наличии NF (SNF), не могут получить доступ к абсолютному числу нейтрофильов (ANC) в пределах 1 час, не имеет NF и не требует UBSA. В скорой и госпитализированных пациентах, имеющих SNF, мы предполагаем, что протокол ASTERIC эффективно и безопасно сокращает использов

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… ANC, absolute neutrophil count; CISNE, Clinical Index of Stable Febrile Neutropenia; ED, emergency department; HSCT, haematopoietic stem cell transplantation; MASCC, Multinational Association for Supportive Care in Cancer; MESW, Modified Early Warning Score; NF, neutropenic fever; sNF, suspected NF; … ANC, absolute neutrophil count; CISNE, Clinical Index of Stable Febrile Neutropenia; ED, emergency department; MASCC, Multinational Association for Supportive Care in Cancer; MEWS, Modified Early Warning Score; sNF, suspected neutropenic fever; UBSAs, ultrabroad-spectrum antibiotics. …

Advanced Practice Perspectives on Preventing and Managing Tumor Lysis Syndrome and Neutropenia in Chronic Lymphocytic Leukemia.

Tumor lysis syndrome (TLS) and neutropenia are significant toxicities in the treatment of chronic lymphocytic leukemia (CLL). Both TLS and neutropenia can lead to potentially life-threatening complications for patients with chronic lymphocytic leukemia undergoing antineoplastic therapy. This article focuses on diligent risk assessment, prophylaxis, early identification, monitoring, patient education, and prompt intervention for TLS and neutropenia. These are all necessary steps to reduce life-threatening complications. Guidelines are available for risk assessments for both TLS and neutropenia.

Does the Pathologic Fracture Predict Severe Paralysis in Patients with Metastatic Epidural Spinal Cord Compression (MESCC)?-A Retrospective, Single-Center Cohort Analysis.

Currently, there is uncertainty about the predictive factors for metastatic epidural spinal cord compression (MESCC) and consecutive symptomatology in tumor patients. Prognostic algorithms for identifying patients at risk for paralysis are missing. The influence of the pathologic fracture on the patient's symptoms is widely discussed in the literature and we hypothesize that pathologic fractures contribute to spinal cord compression and are therefore predictive of severe paralysis. We tested this hypothesis in 136 patients who underwent surgery for spinal metastases. The most common primary ca

SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment.

SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2-54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, in

Совпадение в полном тексте источника
… Clinical, radiological and laboratory data were collected, as previously reported [ 2 , 7 ], and the severity of patient illness was evaluated using the National Early Warning Score version 2 (NEWS-2) and the Charlson score [ 8 ]. … National Early Warning Score 2 (NEWS2) on admission predicts severe disease and in-hospital mortality from Covid-19—A prospective cohort study. Scand. J. Trauma Resusc. Emerg. Med. 2020;28:1–8. doi: 10.1186/s13049-020-00764-3. 9. …

Может ChatGPT4-vision Идентификация радиологического развития множественного склероза на МРТ мозга?

Крупноязычная модель ChATGP теперь может принимать входные изображения GPT4-vision (GPT4V) версия. Цель заключалась в том, чтобы сравнить показатели работы GPT4V с подготовленными U-Net и ViT моделями трансформатора зрения (ViT) для идентификации развития множественных склерозов (MS) на магнитных резонансных изображениях (MRI). МЕТОДЫ: В качестве вклада в ChATGPT4V были представлены совместно зарегистрированные изображения MR с и без прогрессирования. zero- Эксперимент по выявлению радиологической прогрессии. Его показатели были сопоставлены с предварительно подготовленными моделями U-Net и VI

The impact of myelosuppression on quality of life of patients treated with chemotherapy.

Side effects from chemotherapy-induced myelosuppression can negatively affect patients' quality of life (QoL). Neutropenia increases infection risk, and anemia frequently results in debilitating fatigue. Additionally, the bleeding risk associated with thrombocytopenia can lead to fear and anxiety. However, traditional interventions for myelosuppression fall short of the ideal. Granulocyte colony-stimulating factors reduce the risk of severe neutropenia but commonly lead to bone pain. Erythropoiesis-stimulating agents are not always effective and may cause thromboembolic events, while transfusi

Risk Assessment and Risk-Adapted Treatment Selection: A Case-Based Approach for Chronic Lymphocytic Leukemia.

Selected Patient Cases From the APSHO Regional Lecture Series INTRODUCTION As the official publication of the Advanced Practitioner Society for Hematology and Oncology (APSHO), JADPRO is pleased to offer Part 3 of an accredited educational activity based on the recently concluded APSHO Regional Lecture Series. Hosted in collaboration with major cancer centers around the country, the APSHO Regional Lecture Series brought case-based didactic presentations and skills workshops to advanced practitioners. In the spirit of JADPRO, three accredited Grand Rounds articles by Beth Eaby-Sandy, MSN, CRNP,

Evaluating clinical heterogeneity in relapsing polychondritis through unsupervised cluster analysis.

BACKGROUND: As a rare autoimmune disease, relapsing polychondritis (RP) exhibits individual variations in clinical manifestations, treatment response and prognosis. To date, no biomarkers have been implemented to clinical practice.This study aimed to apply cluster analysis to identify the clinical phenotype, clarify their prognosis predictor, and monitor treatment decisions to improve the outcomes of patients. METHODS: A total of 135 RP patients hospitalized in two centers from January 2005 to December 2024 were involved in the study.The K-means clustering algorithm was used as the core clust

CAR-T cell therapies in autoimmune rheumatic diseases: a brief report on the clinical trial landscape, current status, and future perspectives.

Autoimmune rheumatic diseases (ARDs) are chronic inflammatory disorders where B cells play a key role. Traditional B-cell-targeted therapies have limitations, whereas CAR-T-cell therapy, which aims for a broader reset of the B-cell compartment by targeting B-cell surface markers such as CD19 or B-cell maturation antigen (BCMA), has unique advantages. Currently, most CAR-T cell trials for ARDs are in the early stages, with 64.29% (36/56 trials) of studies being phase I trials and only 7.14% (4/56 trials) progressing to phase II trials, primarily focusing on conditions, such as systemic lupus er

Profile of eliglustat tartrate in the management of Gaucher disease.

Gaucher disease (GD) is a lysosomal storage disorder caused by the deficient activity of acid beta glucosidase, with consequent accumulation of glucosylceramide in the spleen, liver, bone marrow, and various organs and tissues. Currently, the gold standard for GD treatment is enzyme replacement therapy (ERT). The efficacy of ERT in improving or stabilizing the visceral and hematological symptoms of GD is well-proven. However, since ERT has to be administered by frequent intravenous infusions, this therapeutic approach has an important impact on the patient's quality of life. Eliglustat tartrat

Цифровые биомаркеры и АИ для дистанционного мониторинга утомительного прогресса в области неврологических расстройств: подключение механизмов к клиническому применению.

Цифровые биомаркеры для мониторинга усталости в неврологических расстройствах представляют собой новаторский подход к преодолению разрыва между механистическим пониманием и клиническим применением. В настоящем перспективном документе рассматривается вопрос о том, каким образом меры, разработанные с помощью смартфонов и проанализированные с помощью искусственных методов интеллекта, могут трансформировать оценку усталости из субъективной, эпизодической отчетности в непрерывный, объективный мониторинг. Предлагаемые рамки для цифровой фенотификации на основе смартфонов содержат пассивные данные (о

Cellular therapies for rheumatic disease.

PURPOSE OF REVIEW: Cellular therapies, particularly chimeric antigen receptor (CAR)-modified lymphocytes, have progressed from experimental oncology into serious consideration for selected autoimmune rheumatic diseases. Autologous and emerging allogeneic CAR-T platforms now offer the possibility of deep, drug-free remission in systemic lupus erythematosus (SLE), idiopathic inflammatory myopathies (IIM), systemic sclerosis (SSc), and related conditions for which conventional therapies remain inadequate. This timely article reviews the rationale, current clinical experience, safety profile, and

Цифровая двойная модель для подкрепления клинического решения на основе фактических данных при многократном лечении миэломы.

За последнее десятилетие в области лечения миеломы (ММ) был достигнут значительный прогресс. Несмотря на эффективность новых веществ, реакция пациентов, как правило, остается весьма непредсказуемой. С ростом когнитивной нагрузки, создаваемой за счет сложного и меняющегося ландшафта лечения, инструменты оказания помощи, основанные на данных, становятся все более популярными. Подходы, основанные на модели, такие как цифровые близнецы (ДТ), позволяют имитировать возможные ответы на набор входных параметров, основанных на ретроспективных наблюдениях. В контексте поддержки принятия решений о лечени

Терапия сотовой связи для руматоидного артрита.

Химерическая антигенная рецепторная (CAR) клеточная терапия Т произвела революцию в лечении лейкемии, лимфомы и множественных миеломы, реанимировав на поверхности этих клеток антигены CD19 и BCMA. В последнее время появляется все больше свидетельств того, что эти клеточные методы лечения могут также быть направлены против аутоиммунных заболеваний, включая системный волчаньий эритематос, системный склероз, расстройство спектрального спектра нейромиелита, миастения гравис, идиопатический воспалительный миосит, множественный склероз и ревматоидный артрит. На сегодняшний день ten Пациенты с ревмат

Epidemiological and economic impact of pre-exposure prophylaxis with targeted immunotherapies for COVID-19 among immunosuppressed patients in Argentina.

BACKGROUND: Some immunosuppressive disorders have shown substantially lower protection after COVID-19 vaccination against severe outcomes. Therefore, pre-exposure prophylaxis is proposed. Targeted immunotherapy with monoclonal antibodies represents an option for preventing severe COVID-19. However, there is a lack of epidemiological and economic information on pre-exposure prophylaxis with targeted immunotherapies against COVID-19 among immunosuppressed patients. Thus, this study aims to identify and estimate the size of target population and direct medical costs related to pre-exposure prophy

2022 International Cancer Education Conference Late-Breaking Abstracts

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Post hip fracture orthogeriatric care-a Canadian position paper addressing challenges in care and strategies to meet quality indicators.

INTRODUCTION: Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. Less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying osteoporosis. OBJECTIVE: A multidisciplinary Canadian hip fracture working group has developed practical recommendations to meet Canadian quality indicators in post hip fracture care. METHODS: A comprehensive narrative review was conducted to identify and synthesize key articles on post hip fracture orthogeriatric care for each of the individual sections

Автоматическое отслеживание активного движения в многоразовом склерозе с использованием неконтролируемого машинного обучения

Справочная информация: Выявление активных повреждений в магнитно-резонансной съемке (MRI) имеет решающее значение для диагностики и планирования лечения множественных склерозов (MS). Активные повреждения МРТ выявляются после применения противопоказательных агентов на основе гадолиния (ГБЦА). Однако недавние исследования показали, что неоднократное применение ГБЦН приводит к накоплению ГД в тканях. Кроме того, администрация ГБКА увеличивает расходы на медицинское обслуживание. Таким образом, для повышения безопасности пациентов и снижения расходов на медицинское обслуживание важное значение име

Myxedema Coma as the Initial Presentation of Undiagnosed Hypothyroidism: A Rare but Reversible Emergency.

Myxedema coma is a rare, life-threatening endocrine emergency representing the extreme manifestation of untreated hypothyroidism. It usually presents with nonspecific symptoms such as confusion, hypothermia, and bradycardia, which can lead to delayed recognition, particularly in elderly patients with multiple comorbidities. We report the case of a 77-year-old man with hypertension, stage 4 chronic kidney disease, anemia of chronic disease, myeloma, and prostate cancer who presented with reduced consciousness following a period of increasing lethargy and confusion. On arrival, he was hypotensiv