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Paraneoplastic Neurologic Syndromes Associated With Merkel Cell Carcinoma.

Neurol Neuroimmunol Neuroinflamm

November 2024

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (N.L.C.-P., S.M.-C., M.V.-G., A.F., V.W., L.D.D., V.R., G.P., B.J., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314 (N.L.C.-P., S.M.-C., M.V.-G., A.F., V.W., L.D.D., V.R., G.P., B.J., J.H.), Université Claude Bernard Lyon 1, France; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND (N.L.C.-P.); Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA) (N.L.C.-P.), Málaga, Spain; Center for Sleep Sciences and Medicine (S.M.-C.), Stanford University, Palo Alto, CA; Department of Neuroscience (A.F.), Psychology, Pharmacology and Child Health. University of Florence, Italy; Clinical Neurology (A.V.), Santa Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC); Department of Medicine (DMED) (A.V.), University of Udine, Udine, Italy; Sorbonne Université (C.B.), Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin; OncoNeuroTox Group (C.B.), Center for Patients with Neurological Complications of Oncologic Treatments, GH Pitié-Salpetrière et Hôpital Percy, Paris; Immunology Department (D.G., F.N.), Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Service de Neurologie (O.F.), Centre Hospitalier de la Côte Basque, Bayonne; Department of Neurology (C.D.), University Hospital of Tours; and Service de Neurologie (A.B.), Centre Hospitalo-Universitaire Rennes, France.

Article Synopsis
  • The study focuses on understanding the clinical and immunologic characteristics of patients with paraneoplastic neurologic syndromes (PNSs) linked to Merkel cell carcinoma (MCC).
  • A total of 47 patients were analyzed, revealing common neurological disorders such as Lambert-Eaton myasthenic syndrome (LEMS) and encephalomyelitis, along with significant associations with specific neural antibodies.
  • The findings indicate that many patients initially presented without identifiable skin tumors but had lymph node metastases, and those without a primary tumor had a lower mortality rate compared to those with identified tumors.
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Stylet-driven leads have been recently introduced for conduction system pacing, while most of the previous experience has been obtained with lumenless leads. Design and structural characteristics of both lead types are significantly different, resulting in different implant techniques and independent learning curves. Lead performance appears to be comparable, whereas data on direct comparison of clinical outcomes are scarce.

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Background: Despite evidence supporting use of fractional flow reserve (FFR) and instantaneous waves-free ratio (iFR) to improve outcome of patients undergoing coronary angiography (CA) and percutaneous coronary intervention, such techniques are still underused in clinical practice due to economic and logistic issues.

Objectives: We aimed to develop an artificial intelligence (AI)-based application to compute FFR and iFR from plain CA.

Methods And Results: Consecutive patients performing FFR or iFR or both were enrolled.

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Article Synopsis
  • Over the years, treatment for people with hemophilia has gotten a lot better because of new scientific discoveries.
  • Despite these improvements, there are still some limits to the treatments that make us want to keep finding new options.
  • The goal is to make sure everyone with hemophilia, no matter their age or how severe it is, can get treatments that stop bleeding and let them live full lives.
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Article Synopsis
  • The study investigates the characteristics and quality of life (QoL) of patients diagnosed with childhood-onset craniopharyngioma, analyzing data from 66 patients treated between 2008 and 2022.
  • Most patients were diagnosed at a young age (around 5 years) and faced long-term complications, including significant endocrine issues and visual deficits.
  • QoL scores indicated that while patients rated their QoL higher than their parents did, factors like repeated surgeries, hypothalamic involvement, and the use of radiotherapy were found to negatively impact overall QoL.
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Background: Upadacitinib (UPA) is a selective, reversible Janus kinase inhibitor (JAKi) approved for the treatment of RA. However, there is still no solid evidence on the long-term efficacy of UPA in treated patients. The purpose of this study was to determine the efficacy of UPA to obtain remission or low disease activity (LDA) in a series of UPA patients in patients with RA after 6 and 12 months of treatment in a real-world setting.

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Left Atrial Appendage Occlusion vs Standard of Care After Ischemic Stroke Despite Anticoagulation.

JAMA Neurol

September 2024

Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands.

Article Synopsis
  • Patients with a heart condition called atrial fibrillation (AF) who have strokes can still be at very high risk of having more strokes, even when taking medication to prevent them.
  • Left atrial appendage occlusion (LAAO) is a special procedure aimed at helping these patients avoid future strokes.
  • A study compared two groups – one that had LAAO and one that only continued their usual medication – and found that there was still a risk of strokes in both groups over a two-year period.
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  • Researchers believe that lung ultrasound scores (LUS) can better predict cardiac risks in elderly patients undergoing hip fracture surgery, compared to existing methods like the Revised Cardiac Risk Index and ASA Physical Status.
  • The study involved 877 patients across 11 Italian hospitals, finding a significant correlation between higher LUS scores and complications, with a notable incidence of major adverse cardiovascular events (MACE).
  • Results showed that a preoperative LUS score of 8 or higher was more effective at predicting MACE than traditional scoring methods, indicating its potential as a valuable tool for risk assessment in this patient population.
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Article Synopsis
  • Cardiac resynchronization therapy (CRT) using biventricular (BIV) pacing is aimed at heart failure patients but some don't respond; MultiPoint Pacing (MPP) might offer better results for these non-responders.
  • In a study with 3724 patients treated with BIV, 1639 were identified as non-responders and some were randomized to MPP or continued BIV pacing.
  • Results showed MPP led to better outcomes with a 33% success rate in reducing heart failure events compared to 23.5% in BIV, and MPP also resulted in fewer hospitalizations for heart failure.
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Article Synopsis
  • Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is now widely recognized as a key tool for diagnosing hypertension, moving from specialist-only use to broader applications.
  • Advances in technology and the growing emphasis on hypertension diagnosis have allowed general practitioners and trained non-medical providers, like in community pharmacies, to utilize ABPM effectively.
  • To mitigate confusion around roles and responsibilities in the use of ABPM, experts from the Italian Society of Hypertension created a guide for training healthcare professionals in its proper implementation and management.
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Article Synopsis
  • - Enfortumab vedotin (EV) is effective for patients with advanced urothelial carcinoma who have previously received platinum chemotherapy and immune therapy, despite lacking research on those treated with avelumab maintenance.
  • - A study of 182 patients showed a median overall survival of 12.7 months and a progression-free survival of 7.9 months, with 39% achieving a positive response to EV after avelumab treatment.
  • - The study confirms EV's effectiveness, suggesting it can be a viable option for patients previously treated with avelumab, with manageable side effects like grade ≥ 3 neuropathy and skin rash occurring in a minority of cases.
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Article Synopsis
  • * Data were collected from 408 PCD patients across 12 countries, focusing on their lung function and the presence of common respiratory pathogens, with a significant finding that those with certain pathogens had lower lung function scores.
  • * The results indicated that certain pathogens were strongly associated with decreased lung function, particularly in adults, highlighting the need for early eradication strategies and timely treatment of infections in PCD patients.
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Multifragmentary and displaced zygomaticomaxillary complex (ZMC) fractures are often a challenge for the maxillofacial surgeon. The aim of this study was to evaluate the improved performance in the management of patients with tripod fracture of the orbito-zygomaticomaxillary complex, using two different methods of virtual surgical planning - virtual reduction and mirroring - compared with traditional management. A cohort of 60 patients was selected and divided into three groups, each consisting of 20 individuals.

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Genetic variants in patients with recurrent pericarditis.

J Cardiovasc Med (Hagerstown)

November 2024

Cardiology and Cardiothoracic Department.

Aims: Presence of family cases and multiple recurrences of pericarditis suggest the existence of a possible genetic background in at least 10% of cases. The aim of the present study is to describe the genetic landscape of a cohort of patients with multiple recurrences (at least two recurrences).

Methods: Retrospective cohort study of consecutive adult patients referred for at least two episodes of recurrences in a tertiary referral centre.

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Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses.

Eur Neuropsychopharmacol

January 2025

Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York, USA. Electronic address:

Article Synopsis
  • The COH-FIT study is a large, multi-country survey aimed at identifying factors affecting wellbeing and mental health outcomes during the COVID-19 pandemic, involving a representative sample of 121,066 adults.
  • Researchers analyzed both modifiable (like coping strategies and pre-pandemic stress) and non-modifiable factors (such as age, gender, and socioeconomic status), finding significant negative effects on wellbeing and psychopathology scores during the pandemic.
  • The study identified 15 modifiable and 9 non-modifiable risk factors, alongside 13 modifiable and 3 non-modifiable protective factors, emphasizing the importance of social support and coping strategies in mental health outcomes.
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Surgical management of anastomotic leakage related to ovarian cancer surgery: a narrative review.

Front Surg

September 2024

Department of Medical Area (DMED), Clinic of Obstetrics and Gynecology Unit, Santa Maria Della Misericordia Hospital, Azienda Sanitaria Friuli Centrale, Udine, Italy.

This narrative review describes the state of the art in the management of anastomotic leakage in ovarian cancer. Multiple surgical procedures, including bowel resection, are often required to achieve "optimal" cytoreduction in locally advanced ovarian cancer. Intestinal anastomosis is currently the most common way to restore bowel continuity.

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Article Synopsis
  • Hyperkalemia (HK) impacts the effectiveness of renin-angiotensin system (RAS) inhibitors and mineralocorticoid receptor antagonists (MRAs) in patients with heart failure with reduced ejection fraction (HFrEF).
  • The study analyzed patients with HFrEF and either HK or a history of HK during a run-in phase designed to optimize their RAS inhibitor and MRA doses using patiromer.
  • Results showed significant increases in the use of RAS inhibitors and MRAs among patients meeting the optimization criteria, indicating that patiromer helped enhance treatment for those with HK or a history of HK.
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Background: Voluntary PCa screening frequently results in excessive use of unnecessary diagnostic tests and an increasing risk of detection of indolent PCa and unaffordable costs for the various national health systems. In this scenario, the Italian Society of Urology (Società Italiana di Urologia, SIU) proposes an organized flow chart guiding physicians to improve early diagnosis of significant PCa avoiding unnecessary diagnostic tests and prostate biopsy.

Methods: According to available evidence and international guidelines [i.

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To contrast opportunistic PCa screening, the European Union Council suggested extending screening programs to PCa by recommending the implementation of a stepwise approach in the EU Countries to evaluate the feasibility and effectiveness of an organized program based on PSA testing in combination with additional MRI as a follow-up test. The objective of this expert-based document is to propose an organized PCa screening program according to the EU Council recommendations. The Italian Society of Urology (SIU) developed a team of experts with the aim to report 1) the most recent epidemiologic data about incidence, prevalence, and mortality of PCa; 2) the most important risk factors to identify categories of men with an increased risk to eventually develop the disease; 3) the most relevant studies presenting data on population-based screening; and 4) the current recommendations of the leading International Guidelines.

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Efficacy of early use of percutaneous stellate ganglion block for electrical storms.

Eur Heart J Acute Cardiovasc Care

December 2024

Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.

Article Synopsis
  • Electrical Storm (ES) is a critical condition that can be managed effectively using a technique called Percutaneous Stellate Ganglion Block (PSGB), which has shown positive results when used alongside standard therapy.
  • In a study analyzing 180 patients, those who received PSGB early experienced a significant reduction in arrhythmic events within the hour following the block compared to the hour before, although the overall effectiveness was similar to those who received PSGB later.
  • The findings suggest that early use of PSGB could help reduce the frequency of defibrillations and potentially lessen the risk of a more severe, refractory ES, demonstrating its effectiveness in early treatment settings.
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Sex dependence of postoperative pulmonary complications - A post hoc unmatched and matched analysis of LAS VEGAS.

J Clin Anesth

December 2024

Amsterdam University Medical Center, Department of Anaesthesiology, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Amsterdam University Medical Center, Department of Intensive Care, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands.

Article Synopsis
  • The study aimed to investigate whether there are differences in postoperative pulmonary complications (PPCs) between males and females following surgery under general anesthesia, using data from the LAS VEGAS study involving 146 hospitals across 29 countries.
  • A total of 9,697 patients were analyzed in two cohorts: an unmatched cohort (55.1% female, 44.9% male) and a matched cohort (50% female and male), finding no significant differences in PPC rates between the genders in both cohorts.
  • The study concluded that, in this international patient population, the incidence of PPCs did not differ significantly between males and females, as well as noting comparable hospital stays and mortality rates.*
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Background: The impact of the order of treatment with checkpoint inhibitors or BRAF/MEK inhibitors on the development of brain metastases in patients with metastatic unresectable V600-mutant melanoma is unknown. The SECOMBIT trial examined the impact of the order of receipt of these treatments in such patients.

Methods: In this three-arm trial, we reviewed patients without brain metastases who received the BRAF/MEK inhibitors encorafenib and binimetinib until they had progressive disease followed by the immune checkpoint inhibitors ipilimumab and nivolumab (arm A); or treatment with ipilimumab and nivolumab until they had progressive disease followed by encorafenib and binimetinib (arm B); or treatment with encorafenib and binimetinib for 8 weeks followed by ipilimumab and nivolumab until they had progressive disease followed by retreatment with encorafenib arm binimetinib (arm C).

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Article Synopsis
  • - Patient-reported outcome measures (PROMs) are tools that help assess a patient's health at a specific time and are important for personalized healthcare.
  • - The paper reviews the use of visual analog scales (VAS) for measuring asthma and allergic rhinitis control, particularly focusing on the MASK-air app, which includes electronic VAS forms.
  • - A randomized controlled trial was conducted to validate the electronic VAS, and further evaluations confirmed the effectiveness of VAS questions and additional medication scores for allergic asthma symptoms.
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Global and risk-group stratified well-being and mental health during the COVID-19 pandemic in adults: Results from the international COH-FIT Study.

Psychiatry Res

December 2024

Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Zucker Hillside Hospital, Northwell Health, New York, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA. Electronic address:

Article Synopsis
  • There is a lack of comprehensive international studies examining multidimensional mental health and wellbeing before and during the COVID-19 pandemic, particularly identifying at-risk groups and effective coping strategies.
  • The COH-FIT survey, conducted from April 2020 to June 2022 in 30 languages, assessed changes in well-being and psychopathology among over 121,000 participants, revealing significant declines in mental health during the pandemic.
  • Key findings indicated that certain demographics, such as young adults and people in low-income countries, were particularly affected, while coping strategies like exercise, internet use, and maintaining social contacts emerged as the most effective for managing stress.
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