Immunological effects of post-operative epidural analgesia versus oral opioids in VATS.

Introduction: Anaesthetic choices in cancer surgery, including the use of epidural analgesia, may affect immune function during the perioperative period and might play an important role in subsequent cancer spread and recurrence.

Methods: This was a prospective, randomised, controlled, double-blinded, single-centre study allocating patients scheduled for video-assisted thoracoscopic surgery (VATS) lobectomy to post-operative pain management using either thoracic epidural analgesia or oral morphine. We compared pre-, per-, and post-operative plasma levels of interleukin (IL)-6, IL-10, IL-12, and interferon (IFN)-γ using regression analysis, and conducted a two-year survival follow-up.

Preoperative nutritional support to tackle morbidity in multivisceral resection for retroperitoneal sarcoma. Early outcomes from a novel nutritional prehabilitation program in a prospective cohort.

Objective: Evaluate the feasibility and outcomes of the implementation of a routinely prehabilitation nutritional program (PNP) in retroperitoneal sarcoma (RPS) patients.

Summary Background Data: Rate of preoperative malnutrition is scarcely evaluated in RPS patients and the efficacy of a PNP in detecting and reverting malnutrition has not been studied.

Methods: Prospective study in a high-volume reference center for RPS; adult patients with primary or persistent RPS deemed surgically resectable were enrolled in a PNP.

Decoy receptors as biomarkers for exploring aetiology and designing new therapies.

Soluble decoy receptors (DR) are circulating proteins that act as molecular traps for ligands that modulate various signalling pathways. These proteins can be exploited as biomarkers and, in some cases, as drugs in various disease contexts. Inflammation is a key area where DRs have shown significant potential.

What are the clinical and research lessons learned from immunomodulators and other therapies during the COVID-19 pandemic?

Purpose Of Review: The development and use of immunomodulators and other therapies during the coronavirus disease 2019 (COVID-19) pandemic provided several lessons with respect to these therapies, and to how medical researchers and clinicians should approach the next pandemic.

Recent Findings: New or repurposed therapies, particularly immunomodulator treatments, for the treatment of an infectious disease will always be associated with inherent patient risk and this was the case during the COVID-19 pandemic. The concomitant development and use of effective antimicrobial therapies along with close monitoring for secondary infections is paramount for patient safety and treatment success.

Meta-analyses of phase I dose-finding studies: Application for the development of protein kinase inhibitors in oncology.

This study aimed to assess the feasibility of applying two recent phase I meta-analyses methods to protein kinase inhibitors (PKIs) developed in oncology and to identify situations where these methods could be both feasible and useful. This ancillary study used data from a systematic review conducted to identify dose-finding studies for PKIs. PKIs selected for meta-analyses were required to have at least five completed dose-finding studies involving cancer patients, with available results, and dose escalation guided by toxicity assessment.

Fatigue by the Chalder Questionnaire and post-hemodialysis recovery in a population of predominantly African descent: The PROHEMO.

Background/objective: A high prevalence of fatigue and a positive association between fatigue and post-hemodialysis recovery have been reported in predominantly white populations of maintenance hemodialysis (MHD) patients. The present study evaluates associations between self-reported fatigue by the 11-item Chalder Fatigue Questionnaire (CFQ-11) and the need for post-hemodialysis recovery in a predominantly African-descent MHD population.

Methods: A total of 233 patients (94% Black or Mixed-Race) participating in the "Prospective Study of the Prognosis of Patients on Maintenance Hemodialysis" (PROHEMO), Salvador, Brazil were recruited for this cross-sectional study.

The association between paternal diabetes mellitus and successful pregnancy-Examined in a nationwide population undergoing reproductive treatment.

Background: About 15% of all pregnancies end in pregnancy loss. As most studies have focused on maternal factors little is known regarding the influence of paternal factors on the chance of successful pregnancy.

Objectives: This cohort study aims to assess the chance of biochemical pregnancy, clinical pregnancy, and live-born children in couples where the male partner has diabetes mellitus (DM).

Stem cell collection and hematological recovery in the Fondazione Italiana Linfomi (FIL) MCL0208 clinical trial.

In the frontline high-dose phase 3 FIL-MCL0208 trial (NCT02354313), 8% of enrolled mantle cell lymphoma (MCL) patients could not be randomised to receive lenalidomide (LEN) maintenance vs observation after autologous stem cell transplantation (ASCT) due to inadequate hematological recovery and 52% of those who started LEN, needed a dose reduction due to toxicity. We therefore focused on the role played by CD34 + hematopoietic stem cells (PBSC) harvesting and reinfusion on toxicity and outcome. Overall, 90% (n = 245) of enrolled patients who underwent the first leukapheresis collected ≥ 4 × 10 PBSC/kg, 2.

Biomarkers in pulmonary infections: a clinical approach.

Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections.

Substantial discrepancies exist between registered protocol and published manuscript in trials on exercise interventions for chronic low back pain: a metaresearch study.

Objectives: Reporting bias, prevalent in biomedical fields, can undermine evidence credibility. Our objective was to evaluate the proportion of discrepancies between registered protocols and published manuscripts in randomized controlled trials (RCTs) on exercise interventions for patients with chronic low back pain (CLBP).

Study Design And Setting: We conducted a cross-sectional meta-research study, starting from the 2021 "Exercise therapy for CLBP" Cochrane Review.

Antihypertensive Drug Treatment and the Risk for Intrahemodialysis Hypotension.

Key Points: Antihypertensive medications are often used by hemodialysis patients, and intradialytic hypotension is a common complication in these patients. The study emulates a randomized clinical trial comparing antihypertensive drug treatment for the risk of hemodialysis hypotension in 4072 incident patients. Compared with calcium antagonists, and – blockers, angiotensin converting enzyme inhibitors or angiotensin II antagonists, and diuretics may increase the risk of hemodialysis hypotension.

Paternal Inflammatory Bowel Disease and the Risk of Pregnancy Loss.

Background: Only about 30% of conceptions end in live births, yet there are little data on paternal causes of pregnancy loss. Men with inflammatory bowel disease may have multiple disease-related issues that may affect fertility. We aimed to examine pregnancy outcomes in women undergoing assisted reproduction whose male partners had Crohn's disease or ulcerative colitis.

Comparative accuracy of ChatGPT-4, Microsoft Copilot and Google Gemini in the Italian entrance test for healthcare sciences degrees: a cross-sectional study.

Background: Artificial intelligence (AI) chatbots are emerging educational tools for students in healthcare science. However, assessing their accuracy is essential prior to adoption in educational settings. This study aimed to assess the accuracy of predicting the correct answers from three AI chatbots (ChatGPT-4, Microsoft Copilot and Google Gemini) in the Italian entrance standardized examination test of healthcare science degrees (CINECA test).

Risk Factors for Transient Hypoparathyroidism after Total Thyroidectomy: Insights from a Cohort Analysis.

Transient hypoparathyroidism (TH) is the main post-thyroidectomy complication, significantly impacting surgical outcomes, hospitalization length, and perceived perceived quality of life understood as mental and physical well-being. This study aims to identify possible associated risk factors. We analyzed 238 thyroidectomies (2020-2022), excluding instances of partial surgery, primary hyperparathyroidism, neck irradiation history, and renal failure.