The University Medical Center Schleswig-Holstein (German: Universitätsklinikum Schleswig-Holstein, abbreviated as UKSH) is a university hospital, located in Kiel and Lübeck in the German state of Schleswig-Holstein. Its aim is to ensure medical care in Schleswig-Holstein.
We aimed to assess symptoms in patients after SARS-CoV-2 infection and to identify factors predicting prolonged time to symptom-free. COVIDOM/NAPKON-POP is a population-based prospective cohort of adults whose first on-site visits were scheduled ≥ 6 months after a positive SARS-CoV-2 PCR test. Retrospective data including self-reported symptoms and time to symptom-free were collected during the survey before a site visit. In the survival analyses, being symptom-free served as the event and time to be symptom-free as the time variable. Data were visualized with Kaplan–Meier curves, differences were tested with log-rank tests. A stratified Cox proportional hazard model was used to estimate adjusted hazard ratios (aHRs) of predictors, with aHR < 1 indicating a longer time to symptom-free. Of 1175 symptomatic participants included in the present analysis, 636 (54.1
The achieved technological maturity of electrical impedance tomography (EIT) and the clinical need of the information provided by this functional imaging method has intensified research activities on the medical use of chest EIT. The recent years have witnessed an accelerated research covering not only the experimental setting but also the clinical environment with the major focus on mechanically ventilated patients, both in the perioperative period or as part of the intensive care treatment. Patients of all age groups are being included in clinical investigations and studies using EIT. The major objectives for use of EIT are the monitoring of regional lung and cardiovascular function, identification of adverse events (pneumothorax, alveolar overdistension and collapse, pulmonary embolism) and guidance for individualised therapy (selection of ventilator setting, positioning and physical therapy). Our review describes the most recent achievements of experimental and clinical research on chest EIT. The provided information helps to identify the current hot topics in EIT research and to guide further improvements of EIT technology and applications that are still needed to enforce the establishment of chest EIT in routine patient care.
ABSTRACT:Core-binding factor acute myeloid leukemia (CBF-AML) is associated with KIT mutations and deregulated expression of KIT. We report results from the randomized, open-label, phase 3 trial of intensive chemotherapy with or without the multikinase inhibitor dasatinib in adult patients with CBF-AML. Patients received "3+7" induction therapy, followed by 4 cycles of high-dose cytarabine; in the investigational arm, patients received dasatinib 100 mg daily on days 8 to 21 in induction, and on days 6 to 28 in consolidation cycles, followed by 12-month single-agent dasatinib 100 mg daily. Primary end point was event-free survival (EFS). Secondary end points included overall survival, relapse-free survival, and cumulative incidence of relapse. A total of 202 patients were randomly assigned to the standard arm (n = 102) and to the dasatinib arm (n = 100). Median age was 49 years (range, 18-77); 94 patients had t(8;21), 108 had inv(16)/t(16;16); and 58 (28.7%) patients had a KIT comutation. There was no statistically significant difference in EFS (hazard ratio, 0.92; 95% confidence interval, 0.63-1.33; P = .66) or secondary end points between treatment arms. There was also no significant difference in EFS in subgroup analyses according to age, CBF-AML type, and KIT mutation status. The incidence of serious adverse events was higher in the investigational arm (64%) than in the standard arm (36%). In patients with CBF-AML, the addition of dasatinib to intensive chemotherapy failed to improve survival outcomes. The addition of dasatinib was associated with an increase in toxicity. This trial was registered at www.ClinicalTrials.gov as NCT02013648.
Measurable residual disease (MRD) can predict relapse in patients with advanced myelodysplastic neoplasms (MDS) or acute myeloid leukemia (AML). We report the long-term efficacy and safety of MRD-guided preemptive azacitidine treatment to prevent relapse in the phase 2 RELAZA2 trial. Patients with MDS or AML after either intensive chemotherapy only or consecutive allogeneic stem cell transplantation were prospectively screened for imminent relapse by molecular MRD assessment. Patients who became MRD positive (MRDpos) during screening received azacitidine for up to 2 years to prevent relapse. The primary endpoint was the proportion of patients alive and relapse-free six months after azacitidine start. Of 357 patients screened, 119 (33.3%) became MRDpos, of whom 95 (79.8%) were eligible for azacitidine treatment. The primary endpoint was met; 60 (63%) patients were relapse-free (95% confidence interval 54-71%, P<0.0001) six months after azacitidine initiation with no new safety signals. Of 60 patients achieving MRD response during the first six cycles of azacitidine, 31 (52%) maintained response without hematological relapse for ≥2 years following azacitidine initiation. The median treatment-free duration following azacitidine discontinuation was 20.8 months; the longest ongoing response was 104 months. After a median follow-up of 6.6 years, 15 initial responders (25%) remained alive and in remission. Among screened patients who remained continuously MRDneg, 60-month overall survival and relapse-free survival were 88% and 79%, respectively. Continuously MRDneg patients display a very favorable prognosis. A majority of MRDpos patients can be effectively treated with azacitidine with potential long-term remission even after termination of azacitidine. Clinicaltrials.gov: NCT01462578.
BACKGROUND/AIM:Many patients with prostate cancer receive moderately hypo-fractionated radiotherapy (mHF-RT). Inappropriate bladder filling during the mHF-RT course increases urinary toxicity. This study investigated the impact of pre-RT bladder volumes on the subsequent filling status. PATIENTS AND METHODS:One-hundred-and-nineteen prostate cancer patients irradiated with mHF-RT (60 Gy in 20 fractions) were included in this retrospective study from three European countries. The impact of pre-RT bladder volumes on the number of fractions with a volume <200 ml was examined. RESULTS:In case of a pre-RT bladder volume <200, <250, and <300 ml, the corresponding mean number of fractions with a bladder volume <200 ml during mHF-RT was 16.6 (±5.0), 15.9 (±5.6), and 15.1 (±5.9), respectively. The impact of the pre-RT volume (<200 vs. ≥200 ml, <250 vs. ≥250, <300 vs. ≥300 ml) on the number of fractions with a volume <200 ml was always highly significant (p<0.0001). CONCLUSION:Pre-RT bladder volumes <200 ml, <250 ml, and <300 ml were significantly associated with higher numbers of bladder volumes <200 ml during mHF-RT. These findings will lead to an amendment to a prospective trial.
