Articles: treatment.
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The standard aortic valve replacement operations in young patients are bioprosthetic or mechanical aortic valve replacement. In this study, we present the long-term results of the Ross operation in young patients. ⋯ The Ross operation with root replacement was associated with high survival rates over 25 years of follow-up. The rates of reoperation and reintervention, the morbidity and mortality, and the rate of endocarditis are low. The Ross operation is thus an effective surgical treatment option for young patients with aortic valve disease.
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Randomized Controlled Trial Multicenter Study
Preoperative Chemoradiotherapy for Resectable Gastric Cancer.
In Western countries, the current standard of care for resectable gastric cancer is perioperative chemotherapy. Preoperative chemoradiotherapy has been considered, but data are limited regarding this treatment as compared with perioperative chemotherapy alone. ⋯ The addition of preoperative chemoradiotherapy to perioperative chemotherapy did not improve overall survival as compared with perioperative chemotherapy alone among patients with resectable gastric and gastroesophageal junction adenocarcinoma. (Funded by the National Health and Medical Research Council and others; TOPGEAR ClinicalTrials.gov number, NCT01924819.).
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Multicenter Study Comparative Study
Transcatheter Repair versus Mitral-Valve Surgery for Secondary Mitral Regurgitation.
Current treatment recommendations for patients with heart failure and secondary mitral regurgitation include transcatheter edge-to-edge repair and mitral-valve surgery. Data from randomized trials comparing these therapies are lacking in this patient population. ⋯ Among patients with heart failure and secondary mitral regurgitation, transcatheter edge-to-edge repair was noninferior to mitral-valve surgery with respect to a composite of death, rehospitalization for heart failure, stroke, reintervention, or implantation of an assist device in the left ventricle at 1 year. (Funded by Abbott Vascular; MATTERHORN ClinicalTrials.gov number, NCT02371512.).
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Randomized Controlled Trial Multicenter Study Comparative Study
Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer.
Neoadjuvant chemotherapy followed by radical cystectomy is the standard treatment for cisplatin-eligible patients with muscle-invasive bladder cancer. Adding perioperative immunotherapy may improve outcomes. ⋯ Perioperative durvalumab plus neoadjuvant chemotherapy led to significant improvements in event-free survival and overall survival as compared with neoadjuvant chemotherapy alone. (Funded by AstraZeneca; NIAGARA ClinicalTrials.gov number, NCT03732677; EudraCT number, 2018-001811-59.).
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IgG4-related disease is a multiorgan, relapsing, fibroinflammatory, immune-mediated disorder with no approved therapy. Inebilizumab targets and depletes CD19+ B cells and may be effective for treating patients with IgG4-related disease. ⋯ Inebilizumab reduced the risk of flares of IgG4-related disease and increased the likelihood of flare-free complete remission at 1 year, confirming the role of CD19-targeted B-cell depletion as a potential treatment for IgG4-related disease. (Funded by Amgen; MITIGATE ClinicalTrials.gov number, NCT04540497.).