Real-world use of granulocyte colony-stimulating factor in ambulatory breast cancer patients: a cross-sectional study

Purpose: To prevent febrile neutropenia (FN), European Organisation for Research and Treatment of Cancer (EORTC) guidelines recommend primary prophylaxis with granulocyte colony-stimulating factors (PPG) for patients at high risk (≥ 20%) of FN. In Belgium, the use of PPG is restricted by specific reimbursement criteria. The impact of these criteria on PPG use and adherence to guidelines is unknown. Methods: This multicentre, cross-sectional, observational study aimed to describe PPG use by FN risk category in breast cancer patients who were scheduled to receive myelosuppressive chemotherapy in outpatient clinics in Belgium during a 2-week period between 13 October and 12 December 2014. Results: In total, 490 patients were enrolled. Median age was 57.0 years. Based on their chemotherapy regimen, 53.9, 5.1 and 41.0% of patients were at a low, intermediate and high risk of FN, respectively. Overall, 39.8% of patients received PPG (17.0, 12.0 and 73.1% of those receiving low-, intermediate- and high-risk regimens, respectively). In the high-risk category, PPG was used in 89.9% of dose-dense and in 25.0% of classical chemotherapy regimens. PPG use was adherent to EORTC guidelines in 75.3% of patients (30.6% appropriate use, 44.7% appropriate non-use). EORTC guidelines would recommend PPG use in 46.1% of this study population (n = 226), and its use was reimbursable in Belgium in 76.1% of these patients (n = 172), but only 66.4% of them received PPG (n = 150). Conclusions: Both Belgian reimbursement criteria and physician decision-making led to a proportion of patients for whom PPG treatment was recommended but finally not receiving it. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Internal Hernia After One Anastomosis Gastric Bypass (OAGB). Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

Background: Internal hernia (IH) represents a relatively common and well-known complication after Roux-en-Y gastric bypass. IH after one anastomosis gastric bypass (OAGB) is less frequent and rarely reported in the literature. This study presents a series of IH after OAGB observed in a high-volume bariatric center. Methods: Data of patients who underwent OAGB with an afferent limb of 150 cm between May 2010 and September 2019 were prospectively collected and retrospectively analyzed. Data of patients undergoing surgery for IH during follow-up were collected and analyzed. Results: Ninety-six patients out of 3368 with a history of OAGB had intestinal incarceration in the Petersen’s orifice (2.8%). Specificity and sensitivity of computed tomography scans in the diagnosis of IH were 59% and 76%, respectively. The mean timeframe between OAGB and surgery for IH was 21.9±18.3 months. Mean body mass index at the time of IH surgery was 24.7 ± 3.6. Surgery was completed laparoscopically in 96.8% of cases. Nine patients (9.3%) had signs of bowel hypovascularization. In all patients, the herniated bowel was repositioned, and the Petersen’s orifice was closed, without the need for bowel resection. Mean hospital stay was 1.9 ± 4.8 days. The postoperative morbidity rate was 8.3%. Long-term IH relapse was observed in 14 patients; signs of bowel hypovascularization due to incarceration in a small orifice was observed in eight of these patients (57%). Conclusions: Incidence of IH after OAGB is 2.8%. IH is associated with a low rate of bowel ischemia and the need for intestinal resection

Partial migration and spawning movements of humpback chub in the Little Colorado River are better understood using data from autonomous PIT tag antennas

Choosing whether or not to migrate is an important life history decision for many fishes. Here we combine data from physical captures and detections on autonomous passive integrated transponder (PIT) tag antennas to study migration in an endangered fish, the humpback chub (Gila cypha). We develop hidden Markov mark-recapture models with and without antenna detections and find that the model fit without antenna detections misses a large proportion of fish and underestimates migration and survival probabilities. We then assess survival and growth differences associated with life history strategy and migration for different demographic groups (small male, small female, large male, large female). We find large differences in survival according to life history strategy, where residents had much lower over-winter survival than migrants. However, within the migratory life history strategy, survival and growth were similar for active migrants and skipped migrants for all demographic groups. We discuss some common challenges to incorporating detections from autonomous antennas into population models and demonstrate how these data can provide insight about fish movement and life history strategies.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Effects of treatment and seed source on germination of eastern redcedar seed /

no.26

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Purpose: The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods: Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results: Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion: OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting