The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with excess of blasts at time of allo-HCT. Sequential (Seq) conditioning, whereby chemotherapy is followed rapidly by transplant conditioning, offers an opportunity to decrease disease burden, potentially improving outcomes allo-HCT outcomes. Herein we present the only analysis comparing Seq to myeloablative (MAC) and reduced intensity conditioning (RIC) specifically focussed on MDS patients with excess of blasts at allo-HCT. 303 patients were identified in the EBMT registry, receiving RIC (n = 158), Seq (n = 105), and MAC (n = 40). Median follow-up was 67.2 months and median age at allo-HCT was 59.5 years (IQR 53.5-65.6). For the entire cohort, 3 y overall survival (OS) was 50% (95% CI 45-56%) and relapse free survival (RFS) 45% (95% CI 40-51%). No significant differences in OS (log-rank p = 0.13) and RFS (log-rank p = 0.18) were observed between conditioning protocols. On multivariable analysis, lower performance status, worse IPSS-R cytogenetics, sibling donor (compared to 8/8 MUD) and ≥20% blasts at allo-HCT were associated with worse outcomes. In conclusion, the Seq protocol did little to influence the outcome in this high-risk group of patients, with outcomes mostly determined by baseline disease risk and patient characteristics such as performance status.
- MeSH
- chronická nemoc MeSH
- homologní transplantace metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- myelodysplastické syndromy * terapie MeSH
- nemoc štěpu proti hostiteli * etiologie MeSH
- příprava pacienta k transplantaci metody MeSH
- retrospektivní studie MeSH
- senioři MeSH
- transplantace hematopoetických kmenových buněk * metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Guidelines for pharmacy practitioners regarding various clinical pharmacy activities have been published in a number of countries. There is a need to review the guidelines and identify the scope of activities covered as a prelude to developing internationally acceptable common guidelines. AIM: To review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II instrument. METHOD: Medline, Embase, Guideline Central, International Pharmaceutical Abstracts, Google Scholar and Google (for grey literature) were searched for the period 2010 to January 2023. Guidelines which focused on any health care setting and any clinical pharmacy activity were included. Data were extracted and quality assessed independently by two reviewers using the English version of the AGREE II instrument. RESULTS: Thirty-eight guidelines were included, mostly originating from Australia (n = 10), Ireland (n = 8), UK (n = 7) and USA (n = 5). Areas covered included medication reconciliation, medicines optimisation, medication management and transition of care. As per the AGREE II assessment, the highest score was obtained for the scope and purpose domain and the lowest score for rigour of development, mainly due to non-consideration of literature/evidence to inform guideline development. CONCLUSION: Clinical pharmacy guidelines development processes need to focus on all quality domains and should take a systematic approach to guideline development. Guidelines need to further emphasise person-centred care and clinical communication. There is a scope to harmonise the guidelines internationally considering the diverse practices, standards and legislations across different geographies.
- MeSH
- farmacie * MeSH
- komunikace * MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
- Geografické názvy
- Austrálie MeSH
- Irsko MeSH
BACKGROUND: Telazorlimab is a humanized anti-OX40 monoclonal antibody being studied for treatment of T-cell-mediated diseases. OBJECTIVE: This randomized, placebo-controlled, phase 2b dose-range finding study investigated efficacy, safety, pharmacokinetics, and immunogenicity of telazorlimab in subjects with atopic dermatitis. METHODS: In this 2-part study (NCT03568162), adults (≥18 years) with moderate-to-severe disease were randomized to various regimens of subcutaneous telazorlimab or placebo for 16 weeks' blinded treatment, followed by 38 weeks' open-label treatment and 12 weeks' drug-free follow-up. Telazorlimab treatment groups (following a loading dose) in part 1 were 300 mg every 2 weeks; 300 mg every 4 weeks; or 75 mg every 4 weeks. Part 2 evaluated telazorlimab 600 mg every 2 weeks. The primary end point was percentage change from baseline in Eczema Area and Severity Index (EASI) at week 16. Safety assessments included incidence of treatment-emergent adverse events. RESULTS: The study randomized 313 subjects in part 1 and 149 in part 2. At 16 weeks, the least squares mean percentage change from baseline in EASI was significantly greater in subjects receiving telazorlimab 300 mg every 2 weeks (part 1) and 600 mg every 2 weeks (part 2) versus placebo (-54.4% vs -34.2% for part 1 and -59.0% vs -41.8% for part 2, P = .008 for both). Telazorlimab was well tolerated, with similar distribution of adverse events between telazorlimab- and placebo-treated subjects in both part 1 and part 2. CONCLUSION: Telazorlimab, administered subcutaneously at 300 mg every 2 weeks or 600 mg every 2 weeks following a loading dose, was well tolerated and induced significant and progressive clinical improvement in adults with moderate-to-severe atopic dermatitis.
- Publikační typ
- časopisecké články MeSH
The occurrence of toxic bloom-forming cyanobacteria, Microcystis aeruginosa, has been frequently reported worldwide. These colony forming toxic cyanobacteria harbour a wide range of heterotrophic bacterial communities. The present study has attempted to understand the bloom dynamics of M. aeruginosa along with isolating their colony-associated culturable heterotrophic bacteria from two freshwater ponds in south India with a persisting cyanobacterial bloom. The monthly monitoring of these study areas revealed the conducive role of warm, stagnant waters with high nutrients in forming M. aeruginosa bloom. The peak values of temperature, nitrate, and phosphate at station 1 reached up to 30.5 °C, 4.48 mg/L, 1.64 mg/L, and at station 2, 31 °C, 3.45 mg/L, and 0.62 mg/L, respectively. Twenty-eight bacterial isolates belonging to Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, Actinobacteria, and Firmicutes were obtained during the study. Among these 28 isolates, Firmicutes was dominant with the M. aeruginosa bloom from both the study areas.
- MeSH
- Bacteria klasifikace genetika izolace a purifikace růst a vývoj MeSH
- biodiverzita * MeSH
- DNA bakterií genetika MeSH
- eutrofizace MeSH
- fylogeneze * MeSH
- Microcystis * růst a vývoj klasifikace genetika MeSH
- RNA ribozomální 16S * genetika MeSH
- sladká voda mikrobiologie MeSH
- teplota MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Indie MeSH
In recent years new modern therapeutic concepts have been developed in the treatment of malignant eyelid tumors; however, surgical restoration remains an important component of the therapeutic options addressed, which include microsurgical tumor excision into healthy tissue and subsequent coverage of the defects. An ophthalmic surgeon experienced in oculoplastic surgery is responsible for the recognition and evaluation of the existing alterations and planning a procedure together with the patient that meets the patient's expectations. The planning of surgery must always be individualized and fit the initial findings. Depending on the defect size and localization, different coverage strategies are available to the surgeon. To ensure successful reconstruction, every surgeon should master a wide range of reconstructive techniques.
- MeSH
- chirurgové * MeSH
- lidé MeSH
- nádory kůže * chirurgie MeSH
- nádory očního víčka * chirurgie MeSH
- oftalmologie * MeSH
- zákroky plastické chirurgie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Dalbavancin is increasingly being used for long-term treatment of subacute and chronic staphylococcal infections. In this study, a new Bayesian model was implemented and validated using MwPharm software for accurately forecasting the duration of pharmacodynamic target attainment above the efficacy thresholds of 4.02 mg/L or 8.04 mg/L against staphylococci. Forecasting accuracy improved substantially with the a posteriori approach compared with the a priori approach, particularly when two measured concentrations were used. This strategy may help clinicians to estimate the duration of optimal exposure with dalbavancin in the context of long-term treatment.
- MeSH
- antibakteriální látky * terapeutické užití farmakologie MeSH
- Bayesova věta MeSH
- lidé MeSH
- mikrobiální testy citlivosti MeSH
- stafylokokové infekce * farmakoterapie MeSH
- Staphylococcus MeSH
- teikoplanin terapeutické užití farmakologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The study analyses outcomes of the surgical treatment of odontogenic sinusitis that concurrently address sinusitis and its dental source. METHODS: A total of 364 adult patients were included, representing 13% of all patients we have operated on for any rhinosinusitis over the past 18 years. The diagnosis was based on both ENT and dental examinations including CT imaging. Patients were divided into three groups: (1) FESS with dental surgery without antrotomy, (2) FESS with intraoral antrotomy, and (3) intraoral surgery without FESS. The mean postoperative follow-up was 15 months. RESULTS: First group involved 64%, second group 31%, and third group 6% of the cases. The one-stage combined ENT and dental approach was used in 94% of cases (group 1 and 2) with a success rate of 97%. Concerning FESS, maxillary sinus surgery with middle meatal antrostomy only was performed in 54% of patients. Oroantral communication flap closure was performed in 56% of patients (success rate 98%). Healing was achieved within 3 months. The majority (87%) of patients were operated on unilaterally for unilateral findings. Over the past 18 years, a 6% increase of implant-related odontogenic sinusitis was observed. CONCLUSION: Odontogenic sinusitis is common, tending to be unilateral and chronic. Its dental source needs to be uncovered and treated and should not be underestimated. Close cooperation between ENT and dental specialists has a crucial role in achieving optimal outcomes. The one-stage combined surgical approach proves to be a reliable, safe, fast and effective treatment.
INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
- MeSH
- delfská metoda MeSH
- demence * terapie MeSH
- konsensus MeSH
- lidé MeSH
- péče o umírající * MeSH
- předběžné plánování péče * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Discrepancy between the morphology of the acetabular margin and the design of hemispheric acetabular cups used in total hip arthroplasty may produce postoperative hip pain due to an iliopsoas impingement at the iliopsoas notch. This study aimed to determine the anatomical features of the iliopsoas notch in the Central European sample, and to test whether the morphology of the proximal femur affects the size of the iliopsoas notch. METHODS: The sample was composed of 40 matched pairs of dry hip bones and corresponding femora. The depth and length of the iliopsoas notch were measured and correlated with the available demographic data. The anthropometric parameters of the proximal femur were calculated using image-analysis software, and their association with the measurements of the iliopsoas notch was tested. RESULTS: The iliopsoas notch was present in all specimens and featured four morphological configurations: curved (61.3%), angular (16.2%), irregular (16.2%), and straight (6.3%). Its size was found to be larger in males (P = 0.014 for depth, P < 0.001 for length). No significant difference existed between the sides. The height and age of the specimens did not correlate with the size of the iliopsoas notch. Furthermore, neither the femoral neck version, the lesser trochanteric version, nor the angle between the neck of the femur and the lesser trochanter influenced the dimensions of the iliopsoas notch. CONCLUSION: The iliopsoas notch is a consistent landmark of the acetabulum, although its anatomical appearance is widely variable. The iliopsoas notch arrangement cannot be predicted perioperatively based on the morphology of the proximal femur. The various shapes and sex-related differences detected in this study could be used for designing new hip implants or could be utilized during cup positioning in total hip arthroplasty.
- MeSH
- acetabulum * anatomie a histologie MeSH
- dolní končetina MeSH
- femur chirurgie MeSH
- kosterní svaly chirurgie MeSH
- lidé MeSH
- náhrada kyčelního kloubu * škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIMS: Missed nursing care (MNC) significantly affects patient safety and quality of care. It is a widely used concept that has been studied in different settings, but research in paediatric care is quite limited. Therefore, this descriptive cross-sectional study aimed to report the prevalence, patterns, correlates, factors and predictors of MNC in paediatric care units in two central European countries. DESIGN: A cross-sectional comparative study. METHODS: Data collection was carried out between June and November 2021 using the MISSCARE Survey-Pediatric. The study included 441 registered nurses working in paediatric care units in the Czech Republic and Slovakia. Data were analysed using descriptive and inferential statistics in the SPSS 25.0 statistical program. RESULTS: Almost all nurses, 92.7% of nurses missed at least one nursing activity during the last shift. The most missed care activity in both countries was the promotion of neuroevolutionary development, and the most prominent reasons were labour resources. MNC was weakly but significantly correlated with nurse experience in the current position and was predicted by the country, nurse education and overtime hours (p ≤ .05). Differences in prevalence of MNC and reasons for MNC were identified based on several variables (p ≤ .05). CONCLUSION: The assessment of MNC in paediatric settings is often a neglected area, although the prevalence in this study was moderate. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse staff shortages, as a global problem, have many impacts on patient outcomes in the delivery of nursing care. However, there are also many factors that can reduce the prevalence of MNC. More research should focus on a closer examination of these factors that involve hospital and nurse variables. REPORTING METHOD: The study was carried out according to the STROBE checklist and the RANCARE guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
- MeSH
- dětské sestry * MeSH
- dítě MeSH
- lidé MeSH
- nemocnice MeSH
- ošetřovatelská péče * MeSH
- personál sesterský nemocniční * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
