Notes

Digital camera Tomosynthesis as opposed to Standard Radiography pertaining to Assessing Osteonecrosis in the Femoral Mind.
The vast majority of patients with light-chain (AL) amyloidosis are not eligible for stem cell transplant and are treated with conventional chemotherapy. Conventional regimens are based on various combinations of dexamethasone, alkylating agents, proteasome inhibitors, and immunomodulatory drugs. The choice of these regimens requires a careful risk stratification, based on the extent of amyloid organ involvement, comorbidities, and the characteristics of the amyloidogenic plasma cell clone. Most patients are treated upfront with bortezomib and dexamethasone combined with cyclophosphamide or melphalan. Cyclophosphamide does not compromise stem cell mobilization and harvest and is more manageable in renal failure. Melphalan can overcome the effect of t(11;14), which is associated with lower response rates and shorter survival in subjects treated with bortezomib and dexamethasone, or in combination with cyclophosphamide. Lenalidomide and pomalidomide are the mainstay of rescue treatment. They are effective in patients exposed to bortezomib, dexamethasone, and alkylators, but deep hematologic responses are rare. Ixazomib, alone or in combination with lenalidomide, increases the rate of complete responses in relapsed/refractory patients. Conventional chemotherapy regimens will represent the backbone for future combinations, particularly with anti-plasma-cell immunotherapy, that will further improve response rates and outcomes. © 2020 S. Karger AG, Basel.BACKGROUND The prediction of positive surgical margins (SM) after radical prostatectomy (RP) is important for planning the surgical modality and adjuvant therapy in patients with prostate cancer (PCa). OBJECTIVES To investigate factors affecting SM positivity in patients diagnosed with PCa who underwent RP using the PCa database of the Urooncology Association (Turkey). METHODS Patients who underwent RP due to clinically T1c-T3 PCa and who had detailed SM data for the RP specimen were included in the study. Pathological data of 12 core transrectal ultrasound prostate biopsies and RP were evaluated. Patients were divided into 2 groups (SM positive and SM negative) according to SM status after RP. Data were compared between the groups. Factors affecting SM positivity, the number of positive SM sites, and the location of positive SM were separately evaluated with regression models. RESULTS A total of 2,643 patients from 6 different centers (median age 63 years) with a prostate-specific antigen (PSA) level of 7.3 biopsy GS, and biopsy PNI positivity were found to be predictive factors affecting SM positivity. The most important factors affecting posterolateral positive SM were biopsy PNI and nsRP, indicating that the nsRP approach may cause positive SM in the posterolateral margin of the prostate (neurovascular bundle location) in patients with positive PNI on biopsy. © 2020 S. Karger AG, Basel.OBJECTIVE To evaluate the sensitivity and specificity of pseudoexfoliation syndrome diagnosis in pseudophakic patients and potential means of improving it. METHODS This prospective, nonrandomized study comprised 41 consecutive patients (41 eyes) scheduled for cataract surgery at a tertiary medical center during 2016-2017. Preoperatively, all patients underwent a detailed slit-lamp examination, including gonioscopic assessment of the iridocorneal angle. The examination was performed by a glaucoma specialist who completed an assessment form documenting the presence/absence of clinical signs of pseudoexfoliation syndrome. It was repeated 1-2 weeks postoperatively by a second, masked, glaucoma specialist. RESULTS Sixteen patients (39.0%) were diagnosed with pseudoexfoliation syndrome preoperatively The diagnosis was confirmed postoperatively in 11/16 patients (68.8% sensitivity) and in an additional patient not diagnosed preoperatively (96% specificity). The ability to diagnose pseudoexfoliation syndrome postoperatively was significantly worse than preoperatively (Z=12.161, p less then 0.0001). Pupillary border deposits (75% of cases) and Sampaolesi line (83.3%) were the cornerstones of postoperative diagnosis; anterior capsular deposits were evident in only 41.6% of cases diagnosed postoperatively (31.3% of the originally diagnosed cases). CONCLUSIONS Underdiagnosis of pseudoexfoliation syndrome is common in pseudophakic patients and may have significant implications for future management. Careful attention to pupillary border anatomy and meticulous gonioscopic assessment of the iridocorneal angle are essential for accurate diagnosis. Preoperative documentation of pseudoexfoliation syndrome could help prevent this diagnostic pitfall. © 2020 S. Karger AG, Basel.PURPOSE To compare the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME), as well as their risk factors in patients with early onset diabetes (EOD, ≤40 years) and late onset diabetes (LOD, >40 years). METHODS Patients were recruited from a community-based study, Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), conducted between July 2012 and May 2013 in China. The presence and severity of the DR and DME were determined by a modified Early Treatment Diabetic Retinopathy Study (ETDRS) retinopathy scale of six-field fundus photographs. RESULTS A total of 1932 patients (796 male, 41.2%) with gradable fundus photography were included. The prevalence of any DR and DME was 67.0% (95% confidence interval [CI] 60.3-73.7%) and 39.3% (95% CI 32.1-46.5%) in the EOD patients respectively, which were both significantly higher than that in the LOD patients (DR 41.9%, 39.6-44.2%, p less then 0.001; DME 14.4%, 12.7-16.1%, p less then 0.001). Insulin use was associated with both presence of DR and DME in both EOD and LOD patients. Besides insulin use, high level of income (odds ratio [OR], 95% CI 0.05, 0.01-0.51) was negatively associated with DR, and higher high density lipoprotein (OR, 95% CI 4.14, 1.44-11.91) was associated with DME, among EOD patients. CONCLUSION In this sample of patients with type 2 diabetes, both the prevalence of DR and DME were apparently higher in patients who developed diabetes ≤40 years of age than those who developed it later. © 2020 S. selleck chemical Karger AG, Basel.
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