Benefit and Harms of Radical Nephroureterectomy as Part of a Multimodal Treatment Strategy for Upper Tract Urothelial Carcinoma Patients Presenting with Clinical Evidence of Regional Lymph Node Metastasis: A Systematic Review and Meta-analysis by the European Association of Urology Guidelines.

Background And Objective: Given the uncertainty regarding the role of radical nephroureterectomy (RNU) as part of a multimodal treatment strategy for upper tract urothelial carcinoma (UTUC) patients with cN+ disease, we aimed to perform a systematic review and meta-analysis of the corresponding literature.

Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we identified 17 observational comparative and noncomparative studies, published between January 2000 and September 2024, evaluating UTUC patients with cTanyN+M0 disease (P) who received RNU as part of a multimodal treatment strategy (I), as compared with any treatment strategy if applicable (C), to assess oncological or postoperative outcomes (O). Meta-analyses were further performed, as appropriate.

Plasma effects on bacterial time-kill dynamics; insights from a PKPD modelling analysis.

In vitro time-kill curve (TKC) experiments are an important part of the pharmacokinetic- pharmacodynamic (PKPD) characterisation of antibiotics. Traditional TKCs use Mueller-Hinton broth (MHB), which lacks specific plasma components that could potentially influence the bacterial growth and killing dynamics, and affect translation to in vivo. This study aimed to evaluate the impact of plasma on the PKPD characterisation of two antibiotics; cefazolin and clindamycin.

Transcranial electrical evoked muscle potentials for pediatric neurosurgery: scoping review of stimulation techniques and success rates.

Purpose: The background of this scoping review is that pediatric neurosurgery in the vicinity of motor pathways is associated with the risk of motor tract damage. By measuring transcranial electrical evoked potentials in muscles (electromyogram) or from the spinal cord (epidural D-wave) functional disorders and impending damage can be detected during surgery and countermeasures can be initiated. The objective was to summarize stimulation techniques of transcranial electrical stimulation and the success rate of motor evoked potentials exclusively in children undergoing neurosurgery.

Hypoparathyroidism: Similarities and differences between Western and Eastern countries.

Backgroud: Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries.

Recurrent pneumothoraces caused by a high-grade lung carcinoma with trophoblastic differentiation: a case report.

Gestational trophoblastic neoplasms are tumors that occur during pregnancy, while non-gestational trophoblastic tumors have a similar histology but are present outside of gestation. Literature reports several cases of non-gestational trophoblastic tumors of primary pulmonary origin, which pose diagnostic challenges and are associated with a poor prognosis. This report details a case of somatic high-grade carcinoma with trophoblastic differentiation primarily manifesting in the left lung with recurrent pneumothoraces.

Health behaviours and mobile intervention use in patients recruited from general practitioners' practices in rural Bavaria.

Individuals living in rural areas report poorer health outcomes, including obesity, compared to individuals living in urban areas. Amongst others, this is due to restricted access to opportunities for healthy eating and physical activity. Interventions are urgently needed to address this gap.

Absolute standard hydrogen electrode potential and redox potentials of atoms and molecules: machine learning aided first principles calculations.

Constructing a self-consistent first-principles framework that accurately predicts the properties of electron transfer reactions through finite-temperature molecular dynamics simulations is a dream of theoretical electrochemists and physical chemists. Yet, predicting even the absolute standard hydrogen electrode potential, the most fundamental reference for electrode potentials, proves to be extremely challenging. Here, we show that a hybrid functional incorporating 25% exact exchange enables quantitative predictions when statistically accurate phase-space sampling is achieved thermodynamic integrations and thermodynamic perturbation theory calculations, utilizing machine-learned force fields and Δ-machine learning models.

Who will benefit from vorasidenib? Review of data from the literature and open questions.

The clinical efficacy of isocitrate dehydrogenase (IDH) inhibitors in the treatment of patients with grade 2 IDH-mutant (mIDH) gliomas is a significant therapeutic advancement in neuro-oncology. It expands treatment options beyond traditional radiation therapy and cytotoxic chemotherapy, which may lead to significant long-term neurotoxic effects while extending patient survival. The INDIGO study demonstrated that vorasidenib, a pan-mIDH inhibitor, improved progression-free survival for patients with grade 2 mIDH gliomas following surgical resection or biopsy compared to placebo and was well tolerated.

How do I prescribe and manage mIDH inhibitors in patients with IDH-mutant glioma?

Recent interest has been in using mIDH inhibitors in patients with IDH-mutant gliomas. This review paper summarizes the indications, side effects, recommended dosing, and management for patients on ivosidenib and vorasidenib.

Sedation Practices in Mechanically Ventilated Neurocritical Care Patients from 19 Countries: An International Cohort Study.

Background: Our objective was to characterize the impact of common initial sedation practices on invasive mechanical ventilation (IMV) duration and in-hospital outcomes in patients with acute brain injury (ABI) and to elucidate variations in practices between high-income and middle-income countries.

Methods: This was a post hoc analysis of a prospective observational data registry of neurocritically ill patients requiring IMV. The setting included 73 intensive care units (ICUs) in 18 countries, with a total of 1,450 patients with ABI requiring IMV.

MicroRNA-199a-5p may be a diagnostic biomarker of primary ITP.

There is no diagnostic test for primary immune thrombocytopenia (ITP). Certain microRNAs have shown to have diagnostic potential in ITP. We validated 12 microRNAs identified from two previous studies to find a diagnostic biomarker.

Maintenance therapy with a P2Y12 receptor inhibitor after cangrelor in patients with acute coronary syndrome. The ELECTRA-SIRIO 2 investigators' viewpoint.

According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within 30 minutes before the end of infusion in the case of a LD of prasugrel.

Targeted delivery of cytotoxic proteins lipid-based nanoparticles to primary Langerhans cells.

Targeted delivery has emerged as a critical strategy in the development of novel therapeutics. The advancement of nanomedicine hinges on the safe and precise cell-specific delivery of protein-based therapeutics to the immune system. However, major challenges remain, such as developing an efficient delivery system, ensuring specificity, minimizing off-target effects, and attaining effective intracellular localization.

High Content Image Analysis of Cellular Responses of the Murine J774A.1 Cell Line and Primary Human Cells Alveolar Macrophages to an Extended Panel of Pharmaceutical Agents.

Introduction: In vitro screening of macrophages for drug-induced effects, such as phospholipidosis, is useful for detecting potentially problematic compounds in the preclinical development of oral inhaled products. High-content image analysis (HCIA) is a multi-parameter approach for cytotoxicity screening. This study provides new insights into HCIA-derived response patterns of murine J774A.

Circulatory microRNAs in acute coronary syndrome: An update.

Micro-ribonucleic acids (miRs) are small, non-coding RNAs, which play an important role in atherosclerotic plaque formation, development, and stability. Plaque destabilization and rupture lead to acute coronary syndromes (ACS). Previous studies have implicated several different miRs in the pathogenesis of atherosclerosis.

Decreased risk-proneness with increasing age in equally raised and kept wolves and dogs.

A basic mechanism of domestication is the selection for fearlessness and acceptance of humans as social partners, which may affect risk-taking behavior and the ability to use humans as social support, both at the behavioural and physiological levels. We combined behavioural observations with heart rate parameters (i.e.

Analyzing the association of critical illness and cardioversion success in patients with atrial fibrillation at the emergency department.

In critically ill patients with atrial fibrillation (AF), standard treatment algorithms might not be applicable. Emergency departments (ED) play a crucial role in implementing individualized treatment approaches. The aim of this study was to assess the association of lactate and cardioversion success rates in AF patients presenting to an ED.

A comic that explains palliative care: how patients experience comic-based educational material.

Objective: The aim of this study was to create a patient-centered comic on palliative care with and for patients admitted to a palliative care unit and to examine their experiences of graphic educational material.

Methods: This study employed a qualitative methodology using semi-structured interviews with advanced cancer patients admitted to the palliative care unit of the Medical University of Vienna. The data were analyzed using thematic analysis with the assistance of the MAXQDA software.

Aspirin and Hemocompatibility After LVAD Implantation in Patients With Atherosclerotic Vascular Disease: A Secondary Analysis From the ARIES-HM3 Randomized Clinical Trial.

Importance: The Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure (ARIES-HM3) study demonstrated that aspirin may be safely eliminated from the antithrombotic regimen after HeartMate 3 (HM3 [Abbott Cardiovascular]) left ventricular assist device (LVAD) implantation. This prespecified analysis explored whether conditions requiring aspirin (prior percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], stroke, or peripheral vascular disease [PVD]) would influence outcomes differentially with aspirin avoidance.

Objective: To analyze aspirin avoidance on hemocompatibility-related adverse events (HRAEs) at 1 year after implant in patients with a history of CABG, PCI, stroke, or PVD.

The burden of X-linked retinitis pigmentosa (XLRP) on patient experience and patient-reported outcomes (PROs): findings from the EXPLORE XLRP-2 study.

Background/aims: X-linked retinitis pigmentosa (XLRP) is considered one of the most severe forms of retinitis pigmentosa (RP), accounting for 5-15% of all RP cases and primarily affecting males. However, the real-world humanistic impacts of this disease on patients are poorly investigated, especially with respect to burdens faced by patients with varying disease severities.

Methods: EXPLORE XLRP-2 was an exploratory, multicentre, non-interventional study.

Surgical glove perforation during intramedullary nailing of intertrochanteric fractures.

Intramedullary nail fixation is a routine procedure for treatment of intertrochanteric fractures. Aseptic technique is vital for reducing postoperative complications, as intraoperative glove perforations increase the risk of surgical site infections. The aim of this study was to determine the incidence of surgical glove perforation during intramedullary nailing of intertrochanteric fractures and to identify surgery-specific steps at risk.

Phase separation of initiation hubs on cargo is a trigger switch for selective autophagy.

Autophagy is a key cellular quality control mechanism. Nutrient stress triggers bulk autophagy, which nonselectively degrades cytoplasmic material upon formation and liquid-liquid phase separation of the autophagy-related gene 1 (Atg1) complex. In contrast, selective autophagy eliminates protein aggregates, damaged organelles and other cargoes that are targeted by an autophagy receptor.

Critical Care Therapy After Cytoreductive Nephrectomy for Metastatic Kidney Cancer.

Objectives: To examine critical care therapy rates after cytoreductive nephrectomy in metastatic kidney cancer patients.

Design, Setting, And Patients: Relying on the National Inpatient Sample (2000-2019), we addressed critical care therapy use (total parenteral nutrition, invasive mechanical ventilation, renal replacement therapy, percutaneous endoscopic gastrostomy tube insertion, and tracheostomy) and in-hospital mortality in surgically treated metastatic kidney cancer patients. Estimated annual percentage changes and multivariable logistic regression models were fitted.

Identification of optimal portal pressure decrease to control ascites while minimizing hepatic encephalopathy after TIPS: A multicenter study.

Background Aims: Clinically-significant portal hypertension (CSPH) in liver cirrhosis patients can lead to refractory ascites. A transjugular-intrahepatic-portosystemic shunt (TIPS) treats CSPH but may cause overt hepatic encephalopathy (oHE). Our aim was to determine the optimal reduction of the portal pressure gradient (PPG) via TIPS to control ascites without raising oHE risk.