Real-World Treatment Patterns After Discontinuation of Venetoclax or BTKis in the Frontline Setting Among Older Adults With Chronic Lymphocytic Leukemia.

Purpose: Venetoclax and Bruton's tyrosine kinase inhibitors (BTKis) are key treatment options for patients with chronic lymphocytic leukemia (CLL) in the frontline setting. This study characterized postdiscontinuation treatment patterns and hospitalization of frontline venetoclax and BTKis in a national sample of older adults with CLL.

Methods: We identified 1,770 Medicare beneficiaries 66 years and older with CLL initiating venetoclax with obinutuzumab (VEN-O, n = 193) or BTKi treatment (n = 1,577) in the frontline setting between June 01, 2019, and June 30, 2020.

Elevated mutation rates in multi-azole resistant Aspergillus fumigatus drive rapid evolution of antifungal resistance.

The environmental use of azole fungicides has led to selective sweeps across multiple loci in the Aspergillus fumigatus genome causing the rapid global expansion of a genetically distinct cluster of resistant genotypes. Isolates within this cluster are also more likely to be resistant to agricultural antifungals with unrelated modes of action. Here we show that this cluster is not only multi-azole resistant but has increased propensity to develop resistance to next generation antifungals because of variants in the DNA mismatch repair system.

Enhanced Emergency Medical Services Case Definition to Identify Suspected Nonfatal Opioid Overdose-Related Incidents in Rhode Island.

Objectives: To improve rapid detection and response to spikes in suspected nonfatal opioid overdoses in the community, the Rhode Island Department of Health (RIDOH) sought to modify its case definition to align with newly released guidance from the Council of State and Territorial Epidemiologists (CSTE).

Methods: RIDOH used CSTE guidance to create 2 alternative criteria (CSTE-guided and RIDOH-modified CSTE) to replace one of RIDOH's original criteria. We gathered emergency medical services (EMS) records from 4 months in 2022 to determine whether they met any criteria, and we reviewed them to determine the accuracy of identifying an opioid overdose.

Immersive Virtual Reality to Reduce Pain and Anxiety in Individuals Undergoing Orthopedic Surgery for Acute Trauma: A Randomized Clinical Trial.

Controlling acute pain for individuals undergoing orthopedic surgery is highly desirable as it is related to various treatment outcomes. Immersive, virtual reality hypnosis (VRH) is one potential treatment modality to aid in pain management. This three-arm, randomized clinical trial evaluated the efficacy of two hypnosis interventions for reducing post-surgical pain and anxiety in addition to evaluating the effects on sleep quality, mental health, and physical functioning.