bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cabozantinib as an emerging treatment for sarcoma
Authors: Schöffski Patrick , Blay Jean-Yves , Ray-Coquard Isabelle 
Published: May 2020

Purpose of review
Sarcomas are a diverse group of rare solid tumors with limited treatment options for patients with advanced, inoperable disease. Cabozantinib is a tyrosine kinase inhibitor currently approved for advanced renal cell, hepatocellular, and medullary thyroid carcinoma. Cabozantinib has potent activity against a variety of kinases, including MET, vascular endothelial growth factor receptor, and AXL, that are associated with sarcoma growth and development. Here we review the preclinical findings and clinical development of cabozantinib in the treatment of soft tissue sarcoma, gastrointestinal stromal tumors (GIST), osteosarcoma, and Ewing sarcoma.

Recent findings

In vitro, cabozantinib has shown relevant activity in inhibiting the growth and viability of soft tissue sarcoma, GIST, osteosarcoma, and Ewing sarcoma tumor cell lines. Cabozantinib also promoted the regression of GIST in various murine xenografts, including imatinib-resistant models. More than 10 prospective trials with cabozantinib that included patients with sarcomas have been completed or are currently ongoing. Clinical activity with cabozantinib has been recently reported in phase 2 clinical trials for patients with GIST and for patients with osteosarcoma or Ewing sarcoma.

Summary
Cabozantinib has shown promising activity for the treatment of various sarcomas, supporting further evaluation in this setting.
Bleb Plication for a Leaking Bleb After Trabeculectomy
Authors: Sugimoto Koichiro , Asano-Shimizu Kimiko , Murata Hiroshi , Yamashita Takehiro , Asaoka Ryo 
Published: May 2020

Purpose:
The purpose of this work was to report a new method for the repair of ischemic bleb leaks. Bleb leakage is a serious complication of glaucoma filtering surgery with mitomycin C. Many surgical methods have been proposed to seal the leakage from a bleb; however, this novel plication method is effective, relatively easy to perform, and safe.

Methods:
We describe the case reports of 2 patients with leakage from a bleb who were treated with the new method. The conjunctiva was lifted away from the sclera as extensively as possible around the ischemic conjunctiva toward the fornix using a bleb knife. Thereafter, 10-0 nylon sutures were applied between the nonischemic conjunctiva located just outside the ischemic conjunctiva and the corneal limbus. The ischemic conjunctiva was not removed, but covered with the nonischemic conjunctiva that was advanced toward the corneal limbus by these sutures.

Results:
After treatment, no recurrence of bleb leakage was observed. Moreover, no ischemic changes were observed in the advanced nonischemic conjunctiva or plicated conjunctiva.

Conclusion:
This new method of bleb plication was effective for sealing bleb leakage.
High Burden of Serious Bacterial Infections in African Children Treated for Cancer
Authors: Naidu Gita , Izu Alane , Poyiadjis Stelios , MacKinnon Diane , Rowe Biance , Madhi Shabir Ahmed 
Published: May 2020

Background:
Infections in children treated for cancer contribute to morbidity and mortality. There is a paucity of studies on the incidence, etiology, risk factors and outcome of bacterial infections in African children treated for cancer. The aim of the study was to delineate the epidemiology of infectious morbidity and mortality in children with cancer.

Methods:
The study enrolled children 1–19 years old with cancer and infections. Children were investigated for infection as part of standard of care.

Results:
One hundred sixty-nine children were enrolled, 82 with hematologic malignancies and 87 with solid tumors and 10.7% were HIV infected. The incidence (per 100 child-years) of septic episodes (101) microbiologically confirmed (70.9) septic episodes, Gram-positive (48.5) and Gram-negative (37.6) sepsis was higher in children with hematologic malignancies than in those with solid tumors. The most common Gram-positive bacteria were Coagulase-negative Staphylococci, Streptococcus viridans and Enterococcus faecium, while the most common Gram-negative bacteria were Escherichia coli, Acinetobacter baumannii and Pseudomonas species. The C-reactive protein and procalcitonin was higher in microbiologically confirmed sepsis. The case fatality risk was 40.4%; 80% attributed to sepsis. The odds of dying from sepsis were higher in children with profound [adjusted odds ratio (aOR) = 3.96; P = 0.004] or prolonged neutropenia (aOR = 3.71; P = 0.011) and profound lymphopenia (aOR = 4.09; P = 0.003) and independently associated with pneumonia (53.85% vs. 29.23%; aOR = 2.38; P = 0.025) and tuberculosis (70.83% vs. 34.91%; aOR = 4.3; P = 0.005).

Conclusion:
The study emphasizes the high burden of sepsis in African children treated for cancer and highlights the association of tuberculosis and pneumonia as independent predictors of death in children with cancer.
Endobronchial Valve Placement for Persistent Air Leaks Secondary to Pulmonary Infections
Authors: Flora Arjan S. , Aragaki-Nakahodo Alejandro , Benzaquen Sadia 
Published: May 2020

Background:
Pneumothoraces associated with infectious diseases have a higher rate of treatment failure and longer length of hospital stay than those associated with obstructive lung diseases and malignancy. Little is mentioned in the medical literature concerning the use of endobronchial 1-way valves in treating alveolar-pleural fistulae (APF) caused by pulmonary infections.

Methods:
A 7-year, single-center, retrospective analysis of patients consented for exempted off-label use of the Olympus Spiration Implantable Endobronchial Valve system to control prolonged air leaks at the University of Cincinnati Medical Center.

Results:
Nineteen consecutive patients had 22 separate APF events from pulmonary infections during which a total of 101 valves were placed over 23 procedures (average 4.4±2.8 valves per procedure). The average time from the first chest tube placement to valve placement was 23.4±20.8 days (range, 2 to 84 d). Chest tubes were successfully removed in 19 (86.4%) of 22 APF events without further intervention. In events not including chest tubes remaining solely for empyema treatment after cessation of air leak (n=14), the average time from valve placement to the removal of all chest tubes was 12.8±20.2 days (1 to 81 d). Thirty and ninety day all-cause mortality was 15.8%. On average, valves were removed 64.1±27.1 days (range, 38 to 135 d) after placement.

Conclusion:
Based on our institutional experience, endobronchial valves may be a treatment option for select patients with persistent air leaks caused by pulmonary infections. Further standardized and comparative studies are required to fully understand the risks and benefits of this treatment.
Temporal trends in management and outcome of patients with acute coronary syndrome according to admission low-density lipoprotein cholesterol levels
Authors: Shuvy Mony , Peretz Alona , Gotsman Israel , Vorobeichik Dina , Shlomo Nir , Minha Saar , Pereg David 
Published: May 2020

Background
The importance of differences in baseline low-density lipoprotein cholesterol (LDL-C) levels and pretreatment with statins on the temporal improvement in outcome of acute coronary syndrome (ACS) patients has not been studied yet.

Methods
Patients were divided into two groups according to baseline LDL-C levels: LDL-C <130 mg/dl and LDL-C ≥130 mg/dl. Baseline characteristics, clinical data and outcomes were compared for each LDL-C group between patients enrolled in early (2000–2006), mid (2008–2010) and recent (2013–2016) surveys.

Results
The study population was comprised of 8343 patients. Patients with LDL-C <130 mg/dl were older and were more commonly pretreated with aspirin and statins compared to patients with LDL-C ≥130 mg/dl. Patients included in recent surveys were more frequently selected for an invasive strategy with coronary angiography and subsequent revascularization, and were more commonly treated with guideline-based medical therapy. For patients with a LDL-C ≥130 mg/dl, the temporal improvements in therapy were associated with lower 1-year mortality rates (7.2, 4.4 and 3.5% for patients in early, mid and late surveys, respectively, P = 0.006). That temporal improvement in outcomes existed only in statin-naïve patients. For patients with LDL-C <130 mg/dl, temporal improvement in treatment was not accompanied by a reduction in 30 day or 1-year mortality rates.

Conclusion
Treatment of ACS patients has improved over the past decades regardless of LDL-C levels. This improvement was accompanied by lower mortality rates in ACS patients with LDL-C ≥130 mg/dl, but not in patients with LDL-C <130 mg/dl.
An outlook on biomarkers in cardiogenic shock
Authors: Iborra-Egea Oriol , Montero Santi , Bayes-Genis Antoni 
Published: May 2020

Purpose of review
Cardiogenic shock is a severe complication with mortality rates of ∼50% that requires a rapid and complex management to aid and identify the highest and lowest risk patients. To that end, novel cardiogenic shock biomarkers are needed to improve risk stratification and to personalize therapy.

Recent findings
Established biomarkers such as BNP, NT-proBNP, ST2, and troponins provide insufficient predictive value in cardiogenic shock. More recent biomarkers, including DPP3, adrenomedullin, angiopoietin 2, and the CS4P score are gaining momentum. DPP3 showed early prediction of refractory status and survival in cardiogenic shock. The CS4P score is based on the levels of liver fatty acid-binding protein (L-FABP), beta-2-microglobulin (B2M), fructose-bisphosphate aldolase B (ALDOB), and SerpinG1 (IC1). These proteins are not cardiac-specific but reflect multiorgan dysfunction, systemic inflammation, and immune activation. The CS4P improved reclassification of 32% of patients compared with the CardShock risk score.

Summary
A new wave of research focused on novel proteomic and molecular techniques, is providing new candidates that promise to aid clinical decision-making and patient stratification in cardiogenic shock. The CS4P score is emerging as the most robust, yet it requires prospective validation in cardiogenic shock patients managed with circulatory and ventricular assist devices.
Liver stiffness measurement is a potent predictor of histological fibrosis regression after hepatitis C virus clearance
Authors: Qiu Li-Xia , Liu Ya-Li , Lin Wei , Liu Yi-Rong , Yu Hai-Bin , Wang Xin-Xin , Sun Ya-Meng , Jin Rong-Hua , Hu Zhong-Jie , Zhang Jing 
Published: May 2020

Background
Most of the studies on fibrosis regression prediction were based on noninvasive fibrosis markers and differ greatly. The ‘Beijing fibrosis classification’ can use histological results to classify fibrosis into progressive or ‘nonprogressive’ according to fibrotic septal morphology. We use this standard which served as the gold standard in order to find fibrosis regression predictors.

Aim
To study the predictors of fibrosis regression after hepatitis C virus clearance according to histological fibrosis staging by the ‘Beijing fibrosis classification’.

Materials and methods
This was a prospective cohort study. A total of 68 patients with advanced liver fibrosis or compensated cirrhosis who achieved sustained virological response were enrolled. Patients with the Ishak scores lower than 3 seemed to have fibrosis regression. The others were divided into the fibrosis progressive group and the nonprogressive group according to the ‘Beijing fibrosis classification’. Predictors of fibrosis regression were studied by logistic regression using baseline factors and the dynamic change in noninvasive fibrosis factors.

Results
Eighteen patients were assigned to the progressive group, and the others were assigned to the nonprogressive group. The baseline liver stiffness measurements (LSMs) of the progressive and nonprogressive groups were 14.35 (11.3, 27.3) kPa and 11.3 (8.3, 14.2) kPa, respectively, P = 0.02. The baseline LSM was the only predictor of fibrosis progression. With a cutoff of 11.85 kPa, the AUC was 0.71 (0.5, 0.9), and the negative predictive value was 0.92.

Conclusions
The baseline LSM was found to be the only predictor of fibrosis regression, 11.85 kPa is a possible ‘hepatic fibrosis return point’.
Muscle strength and physical performance, rather than muscle mass, correlate with mortality in end-stage liver disease
Authors: Sidhu Sandeep Singh , Saggar Kavita , Goyal Omesh , Varshney Tarun , Kishore Harsh , Bansal Namita , Sidhu Samarth Singh 
Published: May 2020

Objectives
Sarcopenia is characterized by the loss of skeletal muscle mass, strength and performance. The study aimed to provide cut off values of various Sarcopenia parameters [computerized tomography skeletal muscle index (SMI), handgrip strength (HGS), gait velocity and chair stand] to predict mortality in end-stage liver disease (ESLD).

Methods
The inclusion criteria were age 18–75 years, model for end-stage liver disease > 15. All patients with advanced heart, lung, kidney diseases, active malignancy were excluded from the study. Sarcopenia indices were compared between survivors and non-survivors to find cut off value for prediction of mortality in ESLD patients.

Results
One hundred sixty-one subjects suffering from ESLD were enrolled. The cutoff value of the SMI to identify high risk of mortality in sarcopenia patients is ≤21.2 cm2/m2, area under the curve (AUC) 0.537 [95% confidence interval (CI) 0.456–0.616]. The cutoff value of the hand grip strength to identify high-risk mortality is ≤25.3 kilogram-force, AUC 0.682 (95% CI 0.604–0.753). The cutoff value of the gait velocity for the same is as ≤0.84 m/s, AUC 0.551 (95% CI 0.459–0.641). The cutoff value of the chair stand is ≥20.9 seconds, AUC 0.956 (95% CI 0.910–0.983). In the multivariate analysis, HGS, gait velocity and chair stand correlated with mortality.

Conclusion
The current study is a comprehensive Asian study that gives the cut off values of Sarcopenia: muscle mass, strength and performance which identify high risk of mortality in ESLD patients. Muscle strength and performance correlated with mortality.
Validation of regional myocardial blood flow quantification using three-dimensional PET with rubidium-82: repeatability and comparison with two-dimensional PET data acquisition
Authors: Manabe Osamu , Klein Ran , Katoh Chietsugu , Magota Keiichi , deKemp Robert A. , Naya Masanao , Tamaki Nagara , Yoshinaga Keiichiro 
Published: May 2020

Introduction
Three-dimensional (3D) data acquisition is now standard on PET/computed tomography scanners. The aim of this study was to evaluate the repeatability of myocardial blood flow (MBF) estimation with rubidium-82 (82Rb) 3D PET and to validate regional MBF measurements by comparison with two-dimensional (2D) PET.

Patients and methods
Fifteen healthy individuals (31.6 ± 11.4 years old) were enrolled for the evaluation of the short-term repeatability of rest 3D MBF quantification. Another 19 healthy individuals (35.3 ± 12.6 years old) underwent rest and pharmacological stress PET using 2D and 3D data acquisition within a 1-month interval. The injected dose was 1500 MBq for 2D and 555 MBq for 3D PET acquisition.

Results
MBF at rest showed good repeatability [whole left ventricular MBF; 0.54 ± 0.13 vs. 0.52 ± 0.13 mL/min/g, P = 0.98]. Rest MBF, stress MBF, and myocardial flow reserve (MFR) were not significantly different between 3D and 2D data acquisition. 3D MBF correlated well with 2D MBF over a wide flow range for both whole left ventricular (r = 0.97, P < 0.0001) and regional values (r = 0.61, P < 0.0001).

Conclusion
MBF measured with 3D PET showed very good test-retest repeatability. Whole left ventricular and regional MBF measurements obtained using lower 82Rb-dose 3D PET were highly correlated over a wide range with those from 2D PET. Therefore, MBF with 3D PET can be applied using a lower 82Rb dosage in clinical settings with reduced radiation exposure.
Transition from childhood to adolescence: steps to be taken
Authors: de Kort Laetitia M.O. 
Published: May 2020

Purpose of review
The aim of this article is to give an overview of recent literature on transitional care of children with complex urological disease.

Recent findings
Most studies on transitional care concerned spina bifida patients. Assessment of current practices revealed that formalized clinics for transitional care may improve healthcare. However, there is still little consensus among healthcare providers on how to organize transitional care. A widely recognized problem is a lack of interested, dedicated, and well-trained staff for transitional care and lifelong follow-up of complex urological patients and also a lack of funding. The timing of the pediatric urologist's transfer to adult care may be helped by measuring transitional readiness in adolescent patients. Outcomes could also expose specific issues as were patients need assistance or education. Introduction of a transitional protocol made patients feel more ready for transition. However, even in established transitional clinics, there is a lack of disease-specific awareness of sexuality and fertility issues among patients.

Summary
Although there is growing awareness of the importance of well-organized and protocolled transitional care for young patients with complex urological disease, this is by no means sufficiently implemented. Furthermore, there is shortage of dedicated and experienced healthcare providers and a lack of funding.
Novel therapies for advanced urologic cancers
Authors: Heidenreich Axel 
Published: May 2020

Purpose of review
Systemic treatment of advanced urogenital malignancies has changed significantly in recent years and it will continue to change rapidly in upcoming years. It is the scope of this review article to providing the reader with the most recently approved treatment strategies to be used in daily routine for the individualized and most optimal treatment of our patients.

Recent findings
Immunooncological therapy (IOT) has emerged as the treatment of choice in metastatic renal cell carcinoma and we describe the most relevant clinical trials and we will give some differential therapeutic recommendation who might be best treated with which combination therapy considering both oncological efficacy and treatment-related toxicity. New neoadjuvant treatment options for muscle-invasive bladder cancer are reported. With regard to metastatic prostate cancer, the landscape of medical therapy is continuously evolving and the new, and most relevant therapeutic strategies for metastatic hormone-naive and castration-resistant PCA are described. Last, but not least, we highlight latest developments in the management of advanced testis cancer.

Summary
The novel treatment options reported in this article are ready for use in daily routine and already represent or will shortly represent new guideline-recommended therapies.
Fibroblast growth factor receptors across urothelial carcinoma landscape
Authors: Ertl Iris E. , Shariat Shahrokh F. , Mostafaei Hadi , Ilijazi Dafina , Loriot Yohann 
Published: May 2020

Purpose of review
Fibroblast growth factor receptor (FGFR) signalling, especially induced by FGFR3, is a crucial factor in the pathogenesis of urothelial carcinoma and was therefore extensively studied over the last decades. In this review, we summarize the most relevant findings of the past two years.

Recent findings
Recent studies support the concept that FGFR3 mediates a pathway of urothelial carcinogenesis associated with low malignant potential. FGFR3 may represent a highly accurate biomarker for diagnosis and prediction of recurrence, progression or therapy response. The pan FGFR-inhibitor erdafitinib was recently approved for urothelial carcinoma, whereas several other FGFR-targeted drugs are currently undergoing clinical trials.

Summary
Numerous recent studies focus on the role of FGFR3 in different urothelial carcinoma subtypes and its potential clinical application as noninvasive biomarker, as well as therapeutic target.
Essential Case Management Practices Amidst the Novel Coronavirus Disease 2019 (COVID-19) Crisis: Part 1
Authors: Tahan Hussein M. 
Published: May 2020

Objectives:
This is the first of a 2-part article that discusses essential case management practices and strategies amidst the novel coronavirus disease 2019 (COVID-19). The series showcases the potential professional case managers have in support of managing during a crisis such as this global pandemic. Part I discusses reenvisioned roles and responsibilities of case managers and leaders known to address patients' needs during a crisis, with a special focus on telehealth, tele-case management, surge capacity, redeployment, discharge planning, and transitions of care.

Primary Practice Settings:
Applicable to the various case management practice settings across the continuum of health and human services, especially acute care.

Findings Conclusions
The COVID-19 global pandemic crisis has brought an unprecedented challenge to professional case managers and health care professionals. It also has provided opportunities for innovation and partnerships within and across health care organizations and the various care settings where patients/support systems access necessary services. Most importantly, it created a renewed interest in telehealth and facilitated a wider adoption of such approach to care delivery than ever before. This pandemic has also increased the use of nontraditional sites of care, most importantly those that operate virtually on electronic networks and health information system technologies such as remote visits, e-visits, virtual care, and tele-monitoring. Undoubtedly, these have provided new opportunities for tele-case management services and roles for professional case managers in the virtual world of health and human service delivery.

Implications for Case Management Practice:
Professional case managers are integral members of interprofessional health care teams. Their roles are even more necessary during a global pandemic such as COVID-19. The practice of case management will forever change—for the better. The experience of this crisis in health care has brought about ever-lasting implications for case management professionals. It has raised awareness to sites of care never were as popular before, resulting in an increased need and recognition for tele-case management practice and virtual case managers. It has also forced partnerships and collaborations among the diverse contexts of health care organizations (public, private, or both) and other industries, regardless of whether directly involved in the delivery of care or having a support service role. These new and innovative approaches in the provision of care and case management services will without a doubt become routine expectations beyond the current pandemic period. Of special note are the enhanced roles of case managers in discharge planning and transitions of care.