Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3):A Nonrandomized Multicenter Study

Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN

Non-specific effects of measles, mumps, and rubella (MMR) vaccination in high income setting: population based cohort study in the Netherlands.

Objectives To investigate whether measles, mumps, and rubella (MMR) vaccine has positive non-specific effects in a high income setting and to compare rates of hospital admissions for infections between children aged ≤2 years who received live MMR vaccine and those who received an inactivated vaccine against diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b (DTaP-IPV-Hib) as their most recent vaccination.Design Nationwide population based cohort study.Setting In the Netherlands, DTaP-IPV-Hib+pneumococcal vaccination (PCV) is recommended at ages 2, 3, 4, and 11 months and MMR + meningococcal C (MenC) vaccination at age 14 months. Data from the national vaccine register were linked to hospital admission data.Participants 1 096 594 children born in 2005-11 who received the first four DTaP-IPV-Hib+PCV vaccines.Main outcome measures Hazard ratio for admission to hospital for infection in children with MMR+MenC compared with the fourth DTaP-IPV-Hib+PCV as their most recent vaccination. Cox regression was performed with most recent vaccination as time dependent variable, adjusted for potential confounders. Analyses were repeated with admission for injuries or poisoning as a negative control outcome. In addition, rate of admission for infection was compared between the fourth and third DTaP-IPV-Hib+PCVas most recent vaccination.Results Having had MMR+MenC as the most recent vaccination was associated with a hazard ratio of 0.62 (95% confidence interval 0.57 to 0.67) for admission to hospital for infection and 0.84 (0.73 to 0.96) for injuries or poisoning, compared with the fourth DTaP-IPV-Hib+PCV as most recent vaccination. The fourth DTaP-IPV-Hib+PCV as most recent vaccination was associated with a hazard ratio of 0.69 (0.63 to 0.76) for admission to hospital for infection, compared with the third DTaP-IPV-Hib+PCV as most recent vaccination.Conclusions Healthy vaccinee bias could at least partly explain the observed lower rate of admission to hospital with infection after MMR vaccination. The lower rate is associated with receipt of any additional vaccine, not specifically MMR vaccine. This emphasises the caution required in the interpretation of findings from observational studies on non-specific effects of vaccination

Different higher order kinematics between star-forming and quiescent galaxies based on the SAMI, MAGPI, and LEGA-C surveys

We present the first statistical study of spatially integrated non-Gaussian stellar kinematics spanning 7 Gyr in cosmic time. We use deep, rest-frame optical spectroscopy of massive galaxies (stellar mass ⁠) at redshifts z = 0.05, 0.3, and 0.8 from the SAMI, MAGPI, and LEGA-C surveys, to measure the excess kurtosis h4 of the stellar velocity distribution, the latter parametrized as a Gauss–Hermite series. We find that at all redshifts where we have large enough samples, h4 anticorrelates with the ratio between rotation and dispersion, highlighting the physical connection between these two kinematic observables. In addition, and independently from the anticorrelation with rotation-to-dispersion ratio, we also find a correlation between h4 and M⋆, potentially connected to the assembly history of galaxies. In contrast, after controlling for mass, we find no evidence of independent correlation between h4 and aperture velocity dispersion or galaxy size. These results hold for both star-forming and quiescent galaxies. For quiescent galaxies, h4 also correlates with projected shape, even after controlling for the rotation-to-dispersion ratio. At any given redshift, star-forming galaxies have lower h4 compared to quiescent galaxies, highlighting the link between kinematic structure and star-forming activity

Evolution in the orbital structure of quiescent galaxies from MAGPI, LEGA-C, and SAMI surveys: direct evidence for merger-driven growth over the last 7 Gyr

We present the first study of spatially integrated higher-order stellar kinematics over cosmic time. We use deep rest-frame optical spectroscopy of quiescent galaxies at redshifts z = 0.05, 0.3, and 0.8 from the SAMI, MAGPI, and LEGA-C surveys to measure the excess kurtosis h4 of the stellar velocity distribution, the latter parametrized as a Gauss-Hermite series. Conservatively using a redshift-independent cut in stellar mass (⁠⁠) and matching the stellar-mass distributions of our samples, we find 7σ evidence of h4 increasing with cosmic time, from a median value of 0.019 ± 0.002 at z = 0.8 to 0.059 ± 0.004 at z = 0.06. Alternatively, we use a physically motivated sample selection based on the mass distribution of the progenitors of local quiescent galaxies as inferred from numerical simulations; in this case, we find 10σ evidence. This evolution suggests that, over the last 7 Gyr, there has been a gradual decrease in the rotation-to-dispersion ratio and an increase in the radial anisotropy of the stellar velocity distribution, qualitatively consistent with accretion of gas-poor satellites. These findings demonstrate that massive galaxies continue to accrete mass and increase their dispersion support after becoming quiescent

The LEGA-C and SAMI Galaxy Surveys:Quiescent Stellar Populations and the Mass-Size Plane across 6 Gyr

We investigate the change in mean stellar population age and metallicity ([Z/H]) scaling relations for quiescent galaxies from intermediate redshift ($0.60\leq z\leq0.76$) using the LEGA-C Survey, to low redshift ($0.014\leq z\leq0.10$) using the SAMI Galaxy Survey. We find that, similarly to their low-redshift counterparts, the stellar metallicity of quiescent galaxies at $0.60\leq z\leq 0.76$ closely correlates with $M_*/R_\mathrm{e}$ (a proxy for the gravitational potential or escape velocity), in that galaxies with deeper potential wells are more metal-rich. This supports the hypothesis that the relation arises due to the gravitational potential regulating the retention of metals, by determining the escape velocity required by metal-rich stellar and supernova ejecta to escape the system and avoid being recycled into later stellar generations. On the other hand, we find no correlation between stellar age and $M_*/R_\mathrm{e}^2$ (stellar mass surface density $\Sigma$) in the LEGA-C sample, despite this being a strong relation at low redshift. We consider this change in the age--$\Sigma$ relation in the context of the redshift evolution of the star-forming and quiescent populations in the mass--size plane, and find our results can be explained as a consequence of galaxies forming more compactly at higher redshifts, and remaining compact throughout their evolution. Furthermore, galaxies appear to quench at a characteristic surface density that decreases with decreasing redshift. The $z\sim 0$ age--$\Sigma$ relation is therefore a result of building up the quiescent and star-forming populations with galaxies that formed at a range of redshifts and so a range of surface densities

Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis

Cervical cancer screening might contribute to the prevention of anal cancer in women. We aimed to investigate if routine cervical cancer screening results-namely high-risk human papillomavirus (HPV) infection and cytohistopathology-predict anal HPV16 infection, anal high-grade squamous intraepithelial lesions (HSIL) and, hence, anal cancer.International Agency for Research on Cance

Bone sarcomas: ESMO–EURACAN–GENTURIS–ERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up

Production costs have been covered by ESMO from central funds

Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis