First inflammatory risk score for aortic endoprostheses

OBJETIVO: Propor um escore de risco inflamatório para tratamento endovascular dos aneurismas da aorta. MÉTODOS: Vinte e cinco pacientes foram seguidos do período pré-operatório até 3º mês de pós-operatório (1 hora, 6 horas, 24 horas, 48 horas, 7 dias, 1 mês, 2 meses e 3 meses). Variáveis inflamatórias avaliadas foram proteína C reativa, velocidade de hemossedimentação, interleucinas (IL-6, IL8), fator de necrose tumoral alfa, L-selectina, molécula de adesão intercelular (ICAM-1), transfusão de hemáceas, volume de cristalóide, volume de contraste, material da prótese, número de próteses, contagem total de leucócitos e linfócitos. O teste de Spearman apontou as variáveis candidatas ao maior risco inflamatório, segundo P < 20%. A regressão logística apontou variáveis selecionáveis para escore final segundo P < 10%. A análise da curva ROC revelou valores de corte para variáveis selecionadas pela regressão logística. RESULTADOS: Variáveis apresentadas pelo teste de Spearman foram: volume de cristalóide (P = 0,04), material da prótese (P = 0,04), volume de contraste (P=0,02), IL-8 préoperatória (P= 0,10), ICAM-1 1 mês (P=0,03) e L-selectina 1 mês (P = 0,06). A regressão logística revelou que os valores do volume de cristalóide e IL-8 pré-operatória são primordiais para constituição do escore de risco inflamatório para tratamento endovascular dos aneurismas da aorta. O escore de risco seria dividido em três categorias (leve, moderado e grave), com base em intervalos numéricos das duas variáveis selecionadas e as categorias seriam correlacionadas com achados clínicos CONCLUSÃ: Volume de cristalóide e IL-8 pré-operatória são variáveis que poderiam contribuir para categorizar risco inflamatório e, desse modo, ter um papel prognóstico no tratamento endovascular dos aneurismas da aorta.OBJECTIVE: To purpose an inflammatory risk score for aortic aneurysm endovascular treatment. METHODS: Twenty-five patients were followed-up from preoperative period to third month postoperatively (1-hour, 6-hour, 24-hour, 48-hour, 7-day, 1-month, 2- month and 3month). Inflammatory variables were C-reactive protein, hemosedimentation velocity, interleukins (IL-6, IL-8), tumor necrosis factor-Alpha, L-selectin, intercellular adhesion molecule (ICAM-1), red blood cells transfusion, volume of crystalloid, volume of contrast, type of endoprosthesis, number of endoprostheses, total count of leukocytes and lymphocytes. Spearman test defined the variables considered as candidates to higher inflammatory risk based on P < 20%. Logistic regression defined the variables considered as selected for final score based on P < 10%. ROC curve analysis revealed the cut-off values for variables selected by logistic regression. RESULTS: Variables defined by Spearman test were: volume of crystalloid (P=0.04), type of endoprosthesis (P=0.04), volume of contrast (P=0.02), preoperative IL-8 (P = 0.10), 1 - month ICAM-1 (P=0.03) and 1-month L-selectin (P=0.06). Logistic regression revealed that volume of crystalloid and preoperative IL-8 values are relevant for composition of inflammatory risk score for aortic aneurysm endovascular treatment. Risk score would be divided into three categories (mild, moderate and severe) based on numeric intervals of these two variables and the categories would be correlated to clinical findings. CONCLUSION: Volume of crystalloid and preoperative IL-8 are variables that might contribute to categorize inflammatory risk and thereby might play a prognostic role for aortic aneurysm endovascular treatment

Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital

BackgroundPeople in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.Materials and methodsWe conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.ResultsThe use of bladder catheters (OR 79.30; p &lt; 0.0001) and central venous catheters (OR, 45.12; p &lt; 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p &lt; 0.0001) and prolonged ICU stay (p &lt; 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p &lt; 0.0001).ConclusionWe suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU

Prácticas científicas y pensamiento crítico en la enseñanza de las ciencias

Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Físico-Químicas y Naturales; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Profesorado y Licenciatura en Ciencias Biológicas. Epistemología e Historia de la Biología, Didáctica y Educación para la Salud; Argentina.Fil: Astudillo, Carola. Universidad Nacional del Comahue. Investigación Educativa; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Secretaría de Ciencia y Tecnología. Prácticas de Enseñanza y Formación Docente en Ciencias Biológicas, Ambiente y Salud; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Físico-Químicas y Naturales. Enseñanza de las Prácticas Experimentales en Ciencias y Subsecretaria de Vinculación Educativa; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba; Argentina.Fil: Bermudez, Gonzalo M. A. FLACSO-Argentina; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Enseñanza de la Ciencia y la Tecnología. Cátedras de Didáctica General y Didáctica Especial; Argentina.Fil: Bermudez, Gonzalo M. A. Consejo Nacional de Investigaciones Científicas y Técnicas Psicología y Educación; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de La Plata; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional del Litoral; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Río Cuarto; Argentina.Fil: Cano-Iglesias, María José. Universidad de Cádiz. Ciencias Químicas; España.Fil: Cano-Iglesias, María José. Universidad de Málaga; España.Fil: Cebrián Robles, Daniel. Universidad de Málaga. Didáctica de las Ciencias Experimentales; España.Fil: Cebrián Robles, Daniel. Miembro del Grupo ENCIC (HUM-974); España.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba; Argentina.Fil: D’Aloisio, Florencia. FLACSO-Argentina; Argentina.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba; Argentina.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Profesorado en Ciencias Biológicas; Argentina.Me gustaría en primer lugar hacer un poco de historia para contextualizar el origen de este libro que es, sin duda, un valioso aporte para la Didáctica de las Ciencias. En agosto de 2018 se abrió por primera vez la convocatoria para postularse a la carrera de Doctorado en Educación en Ciencias Básicas y Tecnología. Este programa es cogestionado entre la Facultad de Matemática, Astronomía, Física y Computación, la Facultad de Ciencias Exactas, Físicas y Naturales y la Facultad de Ciencias Químicas, todas ellas unidades académicas de la Universidad Nacional de Córdoba. Una carrera de posgrado que ya posee más de treinta estudiantes pero que es tan joven, que está a punto de ser testigo de su primera defensa de tesis doctoral. En el marco de este proyecto de posgrado, en septiembre de 2021, Maricel Occelli, Leticia García y Claudio Sosa, ofrecieron el curso Prácticas científias y cuestiones socio científias en la enseñanza de las ciencias: aportes desde la didáctica de la Biología. Este curso cruza, de manera muy conveniente, dos líneas de investigación tradicionalmente consideradas separadas. El estudio de las prácticas científias, su aprendizaje y su enseñanza, ha crecido fundamentalmente de la mano de los estudios sobre la Naturaleza de la Ciencia, bajo el reclamo constante de incluir en las aulas de ciencias no sólo los productos del conocimiento científio sino también sus procesos, sus múltiples dinámicas de construcción y validación. Por otra parte, la inclusión de problemáticas socio científias en las aulas ha sido considerada a partir de estudios curriculares, con el objetivo de involucrar a los estudiantes en problemas sociales y científios auténticos, ligados a su comunidad, a sus intereses, a su identidad, y sobre los que pueden ser críticos e intervenir. Dos líneas de investigación de por sí relevantes en el ámbito de la Didáctica de las Ciencias, que al ponerlas en contacto se nutren mutuamente. Razón por la cual interpreto que el trabajo realizado es un aporte fundamental a nuestro campo. Aunque no el único. Este libro es un producto de ese curso. Los capítulos que lo componen son (mayoritariamente) de autoría de estudiantes del curso. Los doctorandos que tomaron el curso fueron invitados a producir un trabajo que pusiera en contacto la problemática abordada en el curso con sus proyectos de tesis. Aquí reside, desde mi perspectiva, el segundo gran aporte de este libro. Promover y sostener la escritura de los capítulos por parte de investigadores en formación, es un aporte enorme para la formación de investigadores noveles. Estos investigadores en formación no sólo son invitados a analizar puntos de encuentro entre los contenidos del curso y sus tesis doctorales (tarea que implica un grado de flxibilidad cognitiva apreciable), sino que también son invitados a transitar prácticas habituales en toda comunidad académica: la escritura de artículos científios. En síntesis, pienso que el aporte de este libro es doble: aporta al campo de la Didáctica de las Ciencias, y también aporta a la formación de investigadores noveles en Didáctica de las Ciencias. Un mérito que vale la pena destacar.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Físico-Químicas y Naturales; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Profesorado y Licenciatura en Ciencias Biológicas. Epistemología e Historia de la Biología, Didáctica y Educación para la Salud; Argentina.Fil: Astudillo, Carola. Universidad Nacional del Comahue. Investigación Educativa; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Secretaría de Ciencia y Tecnología. Prácticas de Enseñanza y Formación Docente en Ciencias Biológicas, Ambiente y Salud; Argentina.Fil: Astudillo, Carola. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Físico-Químicas y Naturales. Enseñanza de las Prácticas Experimentales en Ciencias y Subsecretaria de Vinculación Educativa; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba; Argentina.Fil: Bermudez, Gonzalo M. A. FLACSO-Argentina; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Enseñanza de la Ciencia y la Tecnología. Cátedras de Didáctica General y Didáctica Especial; Argentina.Fil: Bermudez, Gonzalo M. A. Consejo Nacional de Investigaciones Científicas y Técnicas Psicología y Educación; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Córdoba; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de La Plata; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional del Litoral; Argentina.Fil: Bermudez, Gonzalo M. A. Universidad Nacional de Río Cuarto; Argentina.Fil: Cano-Iglesias, María José. Universidad de Cádiz. Ciencias Químicas; España.Fil: Cano-Iglesias, María José. Universidad de Málaga; España.Fil: Cebrián Robles, Daniel. Universidad de Málaga. Didáctica de las Ciencias Experimentales; España.Fil: Cebrián Robles, Daniel. Miembro del Grupo ENCIC (HUM-974); España.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba; Argentina.Fil: D’Aloisio, Florencia. FLACSO-Argentina; Argentina.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba; Argentina.Fil: D’Aloisio, Florencia. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Profesorado en Ciencias Biológicas; Argentina

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5–11 December, to 17.5% (25/143 samples) in the week 12–18, to 65.9% (89/135 samples) in the week 19–25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased fromone in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5-11 December, to 17.5% (25/143 samples) in the week 12-18, to 65.9% (89/135 samples) in the week 19-25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased from one in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons. In conclusion, we designed an RT-qPCR assay capable to detect the Omicron variant, which can be successfully used for the purpose of wastewater-based epidemiology. We also described the history of the introduction and diffusion of the Omicron variant in the Italian population and territory, confirming the effectiveness of sewage monitoring as a powerful surveillance tool

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score &gt; 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p &lt; 0.001), RR = 2.19 for ICU admission (p &lt; 0.001), and RR = 2.43 for death (p &lt; 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe