The COURAGE to face ISCHEMIA: Applying data from randomized studies to real-life

Author(s):  
Gal Tsaban ◽  
Doron Zahger ◽  
Yigal Abramowitz
Keyword(s):  
2020 ◽  
pp. 1-14
Author(s):  
Osnat Bairey ◽  
Liat Shargian-Alon ◽  
Tali Siegal

Primary central nervous system lymphoma is a rare aggressive disease that largely affects elderly patients and is associated with poor prognosis. The optimal treatment approach is not yet defined and it consists of induction and consolidation phases. The combination of high-dose (HD) methotrexate-based chemotherapy followed by whole-brain radiotherapy (WBRT) prolongs the median progression-free survival (PFS) and overall survival 2- to 3-fold as compared to WBRT alone but is associated with significant delayed neurotoxicity. Alternative strategies are being investigated in order to improve disease outcomes and spare patients the neurocognitive side effects. These include reduced-dose WBRT, non-myeloablative HD chemotherapy, or HD chemotherapy with autologous stem cell transplantation (HDC/ASCT). There are no randomized studies that compare all these consolidation regimens head to head but recently HDC/ASCT has been evaluated versus WBRT in prospective randomized studies. These studies proved that WBRT and HDC/ASCT yield similar 2-year PFS with preserved or improved cognitive function after HDC/ASCT. Yet, the proportion of patients treated with such intensive consolidation is low, both in real life and in specialized centers, leaving many unsettled issues. This review is appraising current dilemmas related to the choice of consolidating therapeutic modalities, their associated acute and delayed toxicity, and future prospects for alternative approaches in the elderly.


2020 ◽  
Vol 48 (2) ◽  
pp. 399-409
Author(s):  
Baizhen Gao ◽  
Rushant Sabnis ◽  
Tommaso Costantini ◽  
Robert Jinkerson ◽  
Qing Sun

Microbial communities drive diverse processes that impact nearly everything on this planet, from global biogeochemical cycles to human health. Harnessing the power of these microorganisms could provide solutions to many of the challenges that face society. However, naturally occurring microbial communities are not optimized for anthropogenic use. An emerging area of research is focusing on engineering synthetic microbial communities to carry out predefined functions. Microbial community engineers are applying design principles like top-down and bottom-up approaches to create synthetic microbial communities having a myriad of real-life applications in health care, disease prevention, and environmental remediation. Multiple genetic engineering tools and delivery approaches can be used to ‘knock-in' new gene functions into microbial communities. A systematic study of the microbial interactions, community assembling principles, and engineering tools are necessary for us to understand the microbial community and to better utilize them. Continued analysis and effort are required to further the current and potential applications of synthetic microbial communities.


2010 ◽  
Vol 11 (2) ◽  
pp. 60-65
Author(s):  
Francine Wenhardt

Abstract The speech-language pathologist (SLP) working in the public schools has a wide variety of tasks. Educational preparation is not all that is needed to be an effective school-based SLP. As a SLP currently working in the capacity of a program coordinator, the author describes the skills required to fulfill the job requirements and responsibilities of the SLP in the school setting and advises the new graduate regarding the interview process and beginning a career in the public schools.


2006 ◽  
Vol 5 (1) ◽  
pp. 119-119
Author(s):  
M MACDONALD ◽  
N HAWKINS ◽  
M SHAW ◽  
J MCMURRAY ◽  
H DARGIE ◽  
...  

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Rastan ◽  
Noory ◽  
Zeller

We have investigated the role of drug-eluting stents on patency rates after treatment of focal infrapopliteal lesions in patients with intermittent claudication and critical limb ischemia. Reports indicate that drug-eluting stents reduce the risk of restenosis after percutaneous infrapopliteal artery revascularization. A Pub Med, EMBASE, Cochrane database review search of non-randomized studies investigating patency rates, target lesion revascularisation rates, limb salvage rates and mortality rates in an up to 3-year follow-up period after drug-eluting stent placement was conducted. In addition, preliminary results of randomized studies comparing drug-eluting stents with bare-metal stents and plain balloon angioplasty in treatment of focal infrapopliteal lesions were included in this review. A total of 1039 patients from 10 non-randomized and randomized studies were included. Most commonly used drug-eluting stents were sirolimus-eluting. The mean follow-up period was 12.6 (range 8 - 24). The mean 1-year primary patency rate was 86 ± 5 %. The mean target lesion revascularization rate and limb salvage rate was 9.9 ± 5 % and 96.6 %±4 %, respectively. Results from non-randomized and preliminary results from prospective, randomized trials show a significant advantage for drug-eluting stents in comparison to plain balloon angioplasty and bare-metal stents concerning target lesion patency and in parts target lesion revascularisation. No trial reveals an advantage for drug-eluting stents with regard to limb salvage and mortality.


2014 ◽  
Vol 25 (4) ◽  
pp. 233-238 ◽  
Author(s):  
Martin Peper ◽  
Simone N. Loeffler

Current ambulatory technologies are highly relevant for neuropsychological assessment and treatment as they provide a gateway to real life data. Ambulatory assessment of cognitive complaints, skills and emotional states in natural contexts provides information that has a greater ecological validity than traditional assessment approaches. This issue presents an overview of current technological and methodological innovations, opportunities, problems and limitations of these methods designed for the context-sensitive measurement of cognitive, emotional and behavioral function. The usefulness of selected ambulatory approaches is demonstrated and their relevance for an ecologically valid neuropsychology is highlighted.


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