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Case 327.

Radiology

March 2024

From the Intensive Care Unit (M.D., J.P., A.G., A.P., M.F.), Department of Pathological Anatomy and Cytology, Section of Oncology, Pathology and Molecular Biology (A.F., M.A.), Department of Radiology (A.M.), and Department of Pneumology and Thoracic Oncology and GRC-04 Theranoscan (A.P.), Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Tenon, Paris, France; Department of Experimental and Clinical Respiratory Neurophysiology (UMRS 1158), INSERM, Sorbonne Université, Paris, France (M.D.); and Intensive Care Unit (R3S), Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France (M.D., J.P.).

A 58-year-old man who was an active smoker was admitted twice to the intensive care unit (ICU) of a tertiary referral thoracic center for severe hypercapnic acute respiratory failure and persistent bilateral chest radiograph opacities that were unchanged over the course of the two ICU admissions within a 3-month period (Fig 1). He had obesity (body mass index, 36 kg/m), stage 3 vascular chronic renal insufficiency, and hebephrenic schizophrenia treated with haloperidol, carbamazepine, and cyamemazine. He reported chronic dyspnea on exertion, which worsened for 6 months.

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Background: Multi-detector contrast-enhanced abdominal computed tomography (CT) allows for the accurate detection and classification of traumatic splenic injuries, leading to improved patient management. Their effective use requires rapid study interpretation, which can be a challenge on busy emergency radiology services. A machine learning system has the potential to automate the process, potentially leading to a faster clinical response.

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Auxiliary Liver Transplantation for Cirrhosis: From APOLT to RAPID: A Scoping Review.

Ann Surg

March 2022

Department of Digestive, Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France.

Article Synopsis
  • The study reviews literature on auxiliary liver transplantation (ALT) for cirrhosis, highlighting its innovative two-stage approach called RAPID.
  • ALT involves surgically removing parts of a cirrhotic liver and transplanting a liver graft, allowing the native liver to function alongside it until the graft grows.
  • The results from 72 cirrhotic patients showed that this approach can lead to significant improvements in liver function and increase the likelihood of successful transplantation outcomes.
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There is a need for in vivo diagnostic imaging probes that can noninvasively measure tumor-infiltrating CD8+ leukocytes. Such imaging probes could be used to predict early response to cancer immunotherapy, help select effective single or combination immunotherapies, and facilitate the development of new immunotherapies or immunotherapy combinations. This study was designed to optimize conditions for performing CD8 PET imaging with Zr-Df-IAB22M2C and determine whether CD8 PET imaging could provide a safe and effective noninvasive method of visualizing the whole-body biodistribution of CD8+ leukocytes.

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Objectives: The primary objective of MATIS is to determine the efficacy of ruxolitinib (RUX) or fostamatinib (FOS) compared to standard of care (SOC) with respect to reducing the proportion of hospitalised patients progressing from mild or moderate to severe COVID-19 pneumonia. Secondary objectives, at 14 and 28 days, are to: Determine the efficacy of RUX or FOS to reduce mortality Determine the efficacy of RUX or FOS to reduce the need for invasive ventilation or ECMO Determine the efficacy of RUX or FOS to reduce the need for non-invasive ventilation Determine the efficacy of RUX or FOS to reduce the proportion of participants suffering significant oxygen desaturation Determine the efficacy of RUX or FOS to reduce the need for renal replacement therapy Determine the efficacy of RUX and FOS to reduce the incidence of venous thromboembolism Determine the efficacy of RUX and FOS to reduce the severity of COVID-19 pneumonia [graded by a 9-point modified WHO Ordinal Scale* Determine the efficacy of RUX or FOS to reduce systemic inflammation Determine the efficacy of RUX or FOS to the incidence of renal impairment Determine the efficacy of RUX or FOS to reduce duration of hospital stay Evaluate the safety of RUX and FOS for treatment of COVID-19 pneumonia.

Trial Design: A multi-arm, multi-stage (3-arm parallel-group, 2-stage) randomised controlled trial that allocates participants 1:1:1 and tests for superiority in experimental arms versus standard of care.

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