Twenty-five to thirty per cent of diffuse large B-cell lymphoma (DLBCL) presents as limited stage (I-II). Prognosis is generally excellent with four to six cycles of R-CHOP alone (rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone) or combined-modality therapy with three or four cycles and involved-site radiotherapy (RT). There is growing interest in optimising algorithms to retain disease control whilst minimising long-term toxicity, with several recent studies focusing on the safety of abbreviating chemotherapy and omitting RT in low-risk patients and the utility of PET-based response-adapted approaches. As these studies are limited to younger patients without risk factors, application of similar approaches in elderly or higher-risk patients is hampered by a lack of evidence. Whilst there has been a move away from using RT in low-risk patients, it remains a useful adjunct in specific situations. Current evidence cannot exclude a clinically meaningful benefit from RT even in low-risk patients and, given the low expected toxicity from modern RT techniques, a risk-benefit assessment should be individualised and considered in a multidisciplinary fashion. The optimal approach for extranodal limited-stage DLBCL (~40% of cases) varies according to site of origin. Herein we discuss the latest clinical trial evidence and how this can be applied in routine practice.
Background: Current guidelines lack recommendations regarding the use of proton pump inhibitors (PPIs) for preventing upper gastrointestinal bleeding (UGIB) among patients at low risk for UGIB treated with dual antiplatelet therapy for ischemic stroke (IS). Our objective was to assess the effectiveness of PPIs in lowering the risk of significant UGIB in this patient group.
Methods And Results: A retrospective cohort study was conducted involving patients at low risk for UGIB admitted for IS between 2014 and 2018 and treated with dual antiplatelet therapy.
Introduction: Out-of-hospital cardiac arrest (OHCA) is characterized by the cessation of mechanical cardiac activity and voluntary circulation occurring outside of a hospital setting, making it the leading cause of death worldwide. Recently, the optimal approach to airway management has been a subject of controversy.
Methods: Follow PRISMA guidelines for systematic evaluation and meta-analysis.
Purpose: Traditional Chinese medicine possesses distinct advantages in the treatment of acute lumbar sprains, and Tuina (Chinese massage) is a commonly employed therapeutic method. This study employed a Bayesian meta-analysis to assess the efficacy and safety of Tuina therapy for acute lumbar sprain with the aim of providing more evidence-based medical substantiation for clinical practice.
Patients And Methods: Randomized controlled trials of Tuina therapy for acute lumbar sprains published in CNKI, CSPD, CCD, CBM, PubMed, Embase, Cochrane Library, and Web of Science were searched up to August 7, 2024.
Background And Objective: Although generally low-risk, hyaluronic acid (HA) dermal fillers can lead to late-onset edema, particularly in the periocular region. This condition typically manifests three to four months post-injection and requires specialized management, usually with hyaluronidase. However, increased use of hyaluronidase has resulted in instances of post-hyaluronidase syndrome, leading to unaesthetic outcomes.
AP-HP Hotel-Dieu Hospital, Centre de Recherche épidémiologie et Statistiques (CRESS-UMR1153), Centre d'épidémiologie Clinique, Inserm / Université Paris Cité / AP-HP, Centre Virchow-Villermé, Centre Equator France, Paris, France.
Background: Immune checkpoint inhibitors (ICIs) have demonstrated their efficacy with a 7.5-year overall survival (OS) close to 50% for advanced stages. The design of clinical trials provides for treatment until progression or toxicity, or for a maximum duration of two years.
