Articles: outcome.
-
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.).
-
Randomized Controlled Trial Multicenter Study
Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation.
Whether transcatheter mitral-valve repair improves outcomes in patients with heart failure and functional mitral regurgitation is uncertain. ⋯ Among patients with heart failure with moderate to severe functional mitral regurgitation who received medical therapy, the addition of transcatheter mitral-valve repair led to a lower rate of first or recurrent hospitalization for heart failure or cardiovascular death and a lower rate of first or recurrent hospitalization for heart failure at 24 months and better health status at 12 months than medical therapy alone. (Funded by Abbott Laboratories; RESHAPE-HF2 ClinicalTrials.gov number, NCT02444338.).
-
The optimal management strategy for pediatric patients with symptomatic moyamoya disease (MMD) is not well established. This systematic review and meta-analysis compares surgical vs conservative management and direct/combined bypass (DB/CB) vs indirect bypass (IB) for pediatric patients with symptomatic MMD. ⋯ Surgical revascularization yielded more favorable clinical outcomes than conservative management in this meta-analysis. Clinical outcomes were similar between DB/CB vs IB techniques. Surgical flow augmentation, either by DB/CB or IB, seems to benefit pediatric patients with symptomatic MMD.
-
Military personnel confront heightened risks of musculoskeletal injuries (MSIs) because of the demanding nature of their duties, contributing to restricted active duty and financial burdens. Although preventable factors like training and physical fitness influence some injuries, understanding the enduring effects of previous MSIs on physical fitness in military personnel remains a critical gap. This study aimed to systematically review and meta-analyze this impact. ⋯ Military personnel with prior MSIs exhibit enduring deficits in isokinetic peak muscle force, particularly in knee and shoulder regions. However, evidence on the impact of previous injuries on other physical fitness components remains limited. Further research is crucial to understanding the multifaceted impact of MSIs on diverse aspects of physical performance, informing comprehensive injury prevention strategies and optimizing performance outcomes among military personnel.
-
The International Society of Nephrology proposes an acute kidney disease (AKD) management strategy that includes a risk score to aid AKD identification in low- and low-middle-income countries (LLMICs). We investigated the performance of the risk score and determined kidney and patient outcomes from AKD at multiple LLMIC sites. ⋯ The use of a risk score can aid AKD identification in LLMICs. High rates of persistent kidney disease and mortality after discharge highlight the importance of AKD follow-up in low-resource settings.