Efficacy and Safety of Denileukin Diftitox-Cxdl, an Improved Purity Formulation of Denileukin Diftitox, in Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma.

Purpose: Denileukin diftitox (DD)-cxdl is a fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2. This phase III, multicenter, open-label, single-arm registrational trial evaluated the efficacy and safety of DD-cxdl in patients with relapsed/refractory (R/R) cutaneous T-cell lymphoma (CTCL).

Patients And Methods: In the main study, which followed a dose-finding lead-in, DD-cxdl was administered intravenously daily (5 days; 9 µg/kg/d once daily) every 21 days for up to eight cycles.

Parsing the thyroid cytopathology suspicious for malignancy diagnosis through molecular-derived risk of malignancy and other related parameters: Insights into nodule characteristics and practice patterns.

Introduction: Thyroid cytopathology cases with suspicious for malignancy (SFM) diagnosis often result in resection. However, molecular testing offers details that may provide additional insights. In this study, the molecular profiles of SFM cases from two institutions that routinely used ThyroSeq v3 (TSV3) were examined.

Large Solitary Lung Metastasis of a Matrix-Producing Metaplastic Breast Carcinoma: A Diagnostic Challenge.

Metaplastic breast carcinoma represents a diverse category of invasive breast cancers distinguished by the transformation of neoplastic epithelial cells into squamous cells or cells with mesenchymal appearance. Matrix-producing breast carcinoma is a variant of metaplastic breast carcinoma, an exceedingly uncommon malignancy accounting for less than 1% of all breast tumors. The precise origin of this tumor remains elusive; some molecular research points to a potential derivation from myoepithelial cells, while other studies emphasize the possibility of neoplastic transformation originating from multipotent stem cells.

Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions.

Background: Health care requires a delicate equilibrium of nurse health safety and patient safety outcomes. Shift work can disrupt this balance, resulting in poor outcomes for staff and patients.

Problem: Limited evidence exists on nurses' perceptions of shift work, fatigue countermeasures use, and interest in risk-mitigating interventions.

Applications of Volumetric Absorptive Microsampling Technique: A Systematic Critical Review.

Methods: A novel microsampling device called Volumetric Absorptive microsampling (VAMS), developed in 2014, appears to have resolved the sample inhomogeneity inherent to dried blood spots, with improved precision in the volume of sample collected for measuring drug concentration. A literature search was conducted to identify several analytical and pharmacokinetic studies that have used VAMS in recent years.

Results: The key factors for proper experimental design and optimization of the extraction of drugs and metabolites of interest from the device were summarized.

Impact of a Medication Optimization Clinic on Heart Failure Hospitalizations.

Efforts to optimize guideline-directed medical therapy (GDMT) through team-based care may affect outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This study evaluated the impact of an innovative medication optimization clinic (MOC) on GDMT and outcomes in patients with HFrEF. Patients with HFrEF who are not receiving optimal GDMT are referred to MOC and managed by a team comprised of a nurse practitioner or physician assistant, clinical pharmacist, and HF cardiologist.

Multiple Infection and Human Immunodeficiency Virus Superinfection Among Persons who Inject Drugs in Indonesia and Ukraine.

Background: The HIV Prevention Trials Network (HPTN) 074 study evaluated an integrated human immunodeficiency virus (HIV) treatment and prevention strategy among persons who inject drugs (PWID) in Indonesia, Ukraine, and Vietnam. We previously detected multiple HIV infection in 3 of 7 (43%) of seroconverters with 3-8 HIV strains per person. In this report, we analyzed multiple HIV infection and HIV superinfection (SI) in the HPTN 074 cohort.

Top Ten Tips Palliative Care Clinicians Should Know About Buprenorphine.

Pain management in palliative care (PC) is becoming more complex as patients survive longer with life-limiting illnesses and population-wide trends involving opioid misuse become more common in serious illness. Buprenorphine, a generally safe partial mu-opioid receptor agonist, has been shown to be effective for both pain management and opioid use disorder. It is critical that PC clinicians become comfortable with indications for its use, strategies for initiation while understanding risks and benefits.

Wound tissue segmentation by computerised image analysis of clinical pressure injury photographs: a pilot study.

Objective: Wound tissues can provide ample information about the wound development and healing process. However, the manual identification and measurement of wound tissue types is time-consuming and challenging due to the complexities of pressure injuries (PI). This study aims to develop an image analysis algorithm to automatically identify and differentiate wound tissue types from PI wound beds.

Deep-sequence phylogenetics to quantify patterns of HIV transmission in the context of a universal testing and treatment trial - BCPP/Ya Tsie trial.

Background: Mathematical models predict that community-wide access to HIV testing-and-treatment can rapidly and substantially reduce new HIV infections. Yet several large universal test-and-treat HIV prevention trials in high-prevalence epidemics demonstrated variable reduction in population-level incidence.

Methods: To elucidate patterns of HIV spread in universal test-and-treat trials, we quantified the contribution of geographic-location, gender, age, and randomized-HIV-intervention to HIV transmissions in the 30-community Ya Tsie trial in Botswana.

Evaluating the Effects of a Medication Adherence Packaging Program on Outcomes in Older People.

To determine the impact of an adherence packaging and medication synchronization program on hospital visits for older people living independently in the community. A retrospective pre-post study that evaluated patient outcomes over a 24-month period was conducted. Patient-specific socio-demographic, medical, and hospital visit-related data were collected for 12 months before and after patient enrollment in the adherence packaging program.

Regulating MR Safety Standards.

Magnetic resonance (MR) imaging uses magnetic fields and radio waves to generate an image of the body. Though it is considered safe because it does not emit ionizing radiation, the strong magnetic fields produced by the MR scanner require unique safety considerations. The American College of Radiology (ACR) has provided guidance documents on MR safety since 2002 and recently updated and reorganized these documents into the ACR Manual on MR Safety.

A Brief Communication Curriculum Improves Resident and Nurse Communication Skills and Patient Satisfaction.

Background: Despite the ever-expanding role that the patient experience plays in healthcare, effective strategies proven to increase patient satisfaction ratings remain scarce. At the University of Pittsburgh Medical Center, we identified patient-doctor and patient-nurse communication as an area for intervention to improve suboptimal patient satisfaction among medicine inpatients. We posited that the likely reasons for underperformance in this area were a lack of adequate training in bedside communication skills.

Health Literacy and Clear Bedside Communication: A Curricular Intervention for Internal Medicine Physicians and Medicine Nurses.

Introduction: Communication remains the backbone of patient-provider relationships, and many health outcomes have been directly attributed to both effective and ineffective communication. We developed an educational intervention to improve bedside communication and increase use of health literacy principles, in part as a response to suboptimal inpatient satisfaction scores.

Methods: Our intervention consisted of a beside communication curriculum among 37 attending medicine physicians, 76 internal medicine residents, and 85 bedside nurses.

Hemostasis testing and therapeutic plasma exchange: Results of a practice survey.

Introduction: Performing therapeutic plasma exchange (TPE) with albumin replacement decreases coagulation factor and platelet levels. No defined guidelines exist regarding laboratory testing to assess hemostasis in patients undergoing TPE.

Materials And Methods: A survey to evaluate hemostasis testing with TPE was distributed using online survey software.

Hemostasis management and therapeutic plasma exchange: Results of a practice survey.

Background: Patients undergoing therapeutic plasma exchange (TPE) may present with risks for hemorrhage or thrombosis. Use of replacement fluids devoid of coagulation factors will decrease factor levels and platelet levels. There are no established guidelines for hemostasis management in these situations.

Iontophoretic transdermal fentanyl for the management of acute perioperative pain in hospitalized patients.

Introduction: Intravenous (I.V.) morphine administered through a patient-controlled system currently represents the gold standard treatment for moderate to severe acute postoperative pain.

Sufentanil Sublingual Tablet System for the Management of Postoperative Pain after Knee or Hip Arthroplasty: A Randomized, Placebo-controlled Study.

Background: Complications with IV patient-controlled analgesia include programming errors, invasive access, and impairment of mobility. This study evaluated an investigational sufentanil sublingual tablet system (SSTS) for the management of pain after knee or hip arthroplasty.

Methods: This prospective, randomized, parallel-arm, double-blind study randomized postoperative patients at 34 U.

The value of a medical student radiology triage program in enhancing clinical education and skills.

Rationale And Objectives: The Medical Student Radiology Triage Program (MSRTP) at Dartmouth-Hitchcock Medical Center recruits third- and fourth-year medical students to streamline imaging workflow for on-call radiology residents. We sought to evaluate the benefit of this program for improving medical student education.

Materials And Methods: Members of the program were surveyed anonymously from 2010 to 2012 using a web-based survey.

Peritoneal tuberculosis in an immunocompetent, unknown risk patient.

A 36-year-old man with no significant past medical history presented with two-month abdominal distention, night sweats, and weight loss of 15 Ib. He had no known exposure to tuberculosis. PPD test was negative prior to the hospital admission.

Distinct profiles of oxidative stress-related and matrix proteins in adult bone and soft tissue osteosarcoma and desmoid tumors: a proteomics study.

Osteosarcomas rarely occur in older adults. Proteomics has not been reported to date in osteosarcoma occurring in the older adult population. This proteomic investigation was conducted to identify differentially expressed proteins in osteosarcoma occurring in various backgrounds from older adults.

Therapeutic hypothermia after cardiac arrest.

Irreversible brain damage and death are common outcomes after cardiac arrest, even when resuscitation is initially successful. Chances for both survival and a good neurologic outcome are improved when mild hypothermia is induced shortly after reperfusion. Unfortunately, this treatment is often omitted from advanced cardiac life support protocols.