The “Elpis” Registry on Percutaneous Coronary Interventions: A Three-Year Experience

The advent of percutaneous coronary intervention (PCI) transformed the treatment of obstructive coronary artery disease (CAD) by creating a less invasive revascularization option to coronary-artery bypass grafting (CABG).1 Although, randomized controlled clinical trials (RCTs) are the gold standard in medical research, there is not always the possibility to conduct properly designed RCTs. The gap between evidence from RCTs and clinical practice can be filled by epidemiological studies and properly designed registries.2 The results of the Hellenic Heart Registry on Percutaneous Coronary Interventions (HHR-PCI), a national registry of patients with stable angina or acute coronary syndromes who underwent PCI, were only recently published.3 The purpose of the current study is to report the experience of a newly formed Catheterization laboratory at a tertiary hospital of Athens and to compare its findings to those reported by the HHR-PCI... (excerpt

Monoclonal Antibodies in the Treatment of Diffuse Large B-Cell Lymphoma: Moving beyond Rituximab

Although rituximab has revolutionized the treatment of diffuse large B-cell lymphoma (DLBCL), a significant proportion of patients experience refractory disease or relapse early after the end of treatment. The lack of effective treatment options in the relapsed/refractory (R/R) setting had made the prognosis of these patients dismal. The initial enthusiasm for novel anti-CD20 antibodies had been short-lived as they failed to prove their superiority to rituximab. Therefore, research has focused on developing novel agents with a unique mechanism of action. Among them, two antibody-drug conjugates, namely polatuzumab vedotin (PolaV) and loncastuximab tesirine, along with tafasitamab, an anti-CD19 bioengineered antibody, have been approved for the treatment of R/R DLBCL. Whereas PolaV has been FDA and EMA approved, EMA has not approved loncastuximab tesirine and tafasitamab yet. Results from randomized trials, as well as real-life data for PolaV have been promising. Novel agents as bispecific antibodies bridging CD3 on T-cells to CD20 have shown very promising results in clinical trials and are expected to gain approval for treatment of R/R DLBCL soon. As the therapeutic armamentarium against DLBCL is expanding, an improvement in survival of patients with R/R and higher cure rates might soon become evident

Monoclonal Antibodies in the Treatment of Diffuse Large B-Cell Lymphoma: Moving beyond Rituximab

Although rituximab has revolutionized the treatment of diffuse large B-cell lymphoma (DLBCL), a significant proportion of patients experience refractory disease or relapse early after the end of treatment. The lack of effective treatment options in the relapsed/refractory (R/R) setting had made the prognosis of these patients dismal. The initial enthusiasm for novel anti-CD20 antibodies had been short-lived as they failed to prove their superiority to rituximab. Therefore, research has focused on developing novel agents with a unique mechanism of action. Among them, two antibody-drug conjugates, namely polatuzumab vedotin (PolaV) and loncastuximab tesirine, along with tafasitamab, an anti-CD19 bioengineered antibody, have been approved for the treatment of R/R DLBCL. Whereas PolaV has been FDA and EMA approved, EMA has not approved loncastuximab tesirine and tafasitamab yet. Results from randomized trials, as well as real-life data for PolaV have been promising. Novel agents as bispecific antibodies bridging CD3 on T-cells to CD20 have shown very promising results in clinical trials and are expected to gain approval for treatment of R/R DLBCL soon. As the therapeutic armamentarium against DLBCL is expanding, an improvement in survival of patients with R/R and higher cure rates might soon become evident

Safety of research bronchoscopy in mild-moderate and severe asthma

SUMMARY. OBJECTIVES: Fiberoptic bronchoscopy (FB) as a research tool has contributed considerably to the understanding of the pathogenesis of asthma, but there are concerns regarding its safety, especially in patients with severe asthma. The aim of this study was to document safety data on FB and sampling techniques in asthma research. METHODS: A total of 75 subjects (36 mild-moderate asthmatics, 25 severe asthmatics and 14 healthy control subjects), participating in three studies, underwent research FB. Depending on the study, endobronchial and nasal biopsy, bronchioalveolar lavage (BAL) and bronchial brushing were performed, according to established guidelines. Pulmonary function tests were performed prior to bronchoscopy and 2 hours after the procedure. Daily peak expiratory flow (PEF) measurements were recorded 5 days before and 5 days after bronchoscopy in the 30 patients participating in the first two studies. RESULTS: FB was tolerated well. None of the patients or healthy control subjects developed severe adverse reactions during or after bronchoscopy. Only two patients with severe asthma presented mild adverse events; one demonstrated immediate and complete occlusion of the middle lobe segmental bronchial lumen after BAL instillation and another developed mild desaturation (SaO2 91%). There were no significant changes in FEV1 and PEF measurements after bronchoscopy. CONCLUSIONS: Research FB can be performed safely in patients with asthma, including those with severe disease, with careful assessment and adherence to guidelines. Pneumon 2010, 23(1):34-47

Impact of simple, specific, verbal instructions on the quality of bowel preparation in hospitalized patients undergoing colonoscopy: a multicenter randomized controlled trial

Background and study aims Bowel preparation for colonoscopy is frequently inadequate in hospitalized patients. We explored the impact of specific verbal instructions on the quality of inpatients bowel preparation and factors associated with preparation failure. Patients and methods Randomized (1:1), two strata (mobilized vs. bedridden; 3:2) trial of consecutive inpatients from four tertiary centers, who received either specific, verbal instructions or the standard of care (SOC) ward instructions about bowel preparation. The rate of adequate bowel preparation (Boston Bowel Preparation Score [BBPS] = 6, no segment < 2) comprised the primary endpoint. Mean BBPS score, good (BBPS score = 7, no segment score < 2) and excellent (BBPS = 9) were among secondary endpoints. Results We randomized 300 inpatients (180 mobile) aged 71.7 +/- 15.1 years in the intervention (49.7%) and SOC (50.3%) groups, respectively. Overall, more patients in the intervention group achieved adequate bowel preparation, but this difference did not reach statistical significance neither in the intention- to- treat [90/149 (60.4%) vs. 82/151 (54.3%); P = 0.29] nor in the per-protocol analysis [90/129 (69.8%) vs. 82/132 (62.1%); P = 0.19]. Overall BBPS score did not differ statistical significantly in the two groups, but the provision of specific verbal instructions was associated with significant higher rates of good (58.1% vs. 43.2%; P= 0.02) and excellent (31.8% vs. 16.7%; P = 0.004) bowel preparation compared to the SOC group. Administration of same-day bowel preparation and patient American Society of Anesthesiologists score > 2 were identified as risk factors for inadequate bowel preparation. Conclusions Provision of specific verbal instructions did not increase the rate of adequate bowel preparation in a population of mobilized and bedridden hospitalized patients