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  1. Article: From Diagnosis to Treatment: Navigating the Clinical Challenges of Dialyzer-Associated Thrombocytopenia.

    Jose, Ann / Varughese, Tony / De, Shreemayee / Alam, Bisma / Sheth, Vishad

    Cureus

    2023  Volume 15, Issue 5, Page(s) e38891

    Abstract: Thrombocytopenia is a common lab finding. The two fundamental groups are lack of production versus overconsumption of platelets. When common causes of thrombocytopenia have been ruled out and less common causes, such as thrombotic microangiopathic ... ...

    Abstract Thrombocytopenia is a common lab finding. The two fundamental groups are lack of production versus overconsumption of platelets. When common causes of thrombocytopenia have been ruled out and less common causes, such as thrombotic microangiopathic conditions, have been considered, it is important to keep in mind that patients undergoing dialysis may develop thrombocytopenia from the dialyzer itself. This case is of a 51-year-old male who presented originally with celiac artery dissection and acute kidney injury requiring emergent dialysis. He ultimately developed thrombocytopenia during his hospitalization. It was initially presumed to be from thrombocytopenic purpura without improvement after plasmapheresis. No clear etiology was identified until it was suspected that the dialyzer was the source of thrombocytopenia. After changing the dialyzer type, the patient's thrombocytopenia resolved. Dialyzer-associated thrombocytopenia is a rare but reversible complication of hemodialysis. It is important to keep this differential in mind for patients undergoing hemodialysis.
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.38891
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Process for Delivering Timely Antibiotics to Febrile Bone Marrow Transplant Patients in the Emergency Department.

    Finefrock, Douglas / Varughese, Tony / Ding, James / Sanders, Angeline / Hewitt, Kevin

    JCO oncology practice

    2021  Volume 17, Issue 9, Page(s) e1375–e1381

    Abstract: Purpose: Patients with a history of a bone marrow transplant (BMT) have a higher risk of infectious complications because of an immunocompromised state. It has been shown that giving timely antibiotics in 1 hour or less from presentation to the ... ...

    Abstract Purpose: Patients with a history of a bone marrow transplant (BMT) have a higher risk of infectious complications because of an immunocompromised state. It has been shown that giving timely antibiotics in 1 hour or less from presentation to the emergency department (ED) decreases morbidity and mortality in this patient population. We hypothesize that a quality improvement (QI) process, termed BMT Fever, will improve timely administration of antibiotics for this population presenting to the ED.
    Methods: This is a QI process designed to improve the administration of antibiotics to BMT patients with a subjective or objective fever presenting to the ED. The percent of patients receiving antibiotics within 1 hour or less was compared pre- and post-intervention.
    Results: Upon implementation of the BMT Fever QI process, the percentage of patients with febrile BMT receiving antibiotics within 1 hour or less per fiscal quarter significantly improved from six out of 28 patients (21%) to 147 out of 173 patients (85%),
    Conclusion: By implementing a QI process that addresses five structural obstacles, we were able to improve our timely administration of antibiotics to patients with febrile BMT presenting to the ED.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Fever/drug therapy ; Fever/etiology ; Humans ; Quality Improvement ; Retrospective Studies
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-01-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3028198-2
    ISSN 2688-1535 ; 2688-1527
    ISSN (online) 2688-1535
    ISSN 2688-1527
    DOI 10.1200/OP.20.00430
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 7198: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Folfirinox vs. Gemcitabine + Nab-Paclitaxel as the First-Line Treatment for Pancreatic Cancer: A Systematic Review and Meta-Analysis.

    Merza, Nooraldin / Farooqui, Sabeeh Khawar / Dar, Sophia Haroon / Varughese, Tony / Awan, Rehmat Ullah / Qureshi, Lamaan / Ansari, Saad Ali / Qureshi, Hadi / Mcilvaine, Jamie / Vohra, Ishaan / Nawras, Yusuf / Kobeissy, Abdallah / Hassan, Mona

    World journal of oncology

    2023  Volume 14, Issue 5, Page(s) 325–339

    Abstract: Background: The efficacy and safety of Folfirinox (FFX) or gemcitabine + nab-paclitaxel (GnP) to be used as the first-line drugs for pancreatic cancer (PC) is yet to be established. We conducted an analysis of retrospective studies to assess the ... ...

    Abstract Background: The efficacy and safety of Folfirinox (FFX) or gemcitabine + nab-paclitaxel (GnP) to be used as the first-line drugs for pancreatic cancer (PC) is yet to be established. We conducted an analysis of retrospective studies to assess the efficacy and safety of these two regimens by comparing their survival and safety outcomes in patients with PC.
    Methods: We conducted an extensive review of two electronic databases from inception till February 2023 to include all the relevant studies that compared FFX with GnP published and unpublished work. Retrospective studies were only included. Overall survival (OS) and progression-free survival (PFS) were pooled using hazard ratios (HRs), while objective response rate (ORR) and safety outcomes were pooled using odds ratios (ORs) with 95% confidence interval (CI) using the random effects model.
    Results: A total of 7,030 patients were identified in a total of 21 articles that were shortlisted. Pooled results concluded that neither FFX nor GnP was associated to increase the OS time (HR: 0.93, 95% CI: 0.83 - 1.04; P = 0.0001); however, FFX was more likely associated with increased PFS when compared to GnP (HR: 0.88, 95% CI: 0.81 - 0.97; P < 0.0001). ORR proved to be non-significant between the two regimens (OR: 0.90, 95% CI: 0.64 - 1.27; P = 0.15). Safety outcomes included neutropenia, anemia, thrombocytopenia and diarrhea. GnP was more associated with diarrhea (OR: 1.96, 95% CI: 1.22 - 3.15; P = 0.001), while FFX was seen to cause anemia (OR: 0.70, 95% CI: 0.51 - 0.98; P = 0.10) in PC patients. Neutropenia and thrombocytopenia were in-significant in the two drug regimens (OR: 1.10, 95% CI: 0.92 - 1.31; P = 0.33 and OR: 0.83, 95% CI: 0.60 - 1.13; P = 0.23, respectively).
    Conclusion: FFX and GnP showed a significant difference in increasing the PFS, while no difference was observed while measuring OS. Safety outcomes showed that FFX and GnP shared similar safety profiles as FFX was associated with hematological outcomes, while GnP was more associated with non-hematological outcomes.
    Language English
    Publishing date 2023-09-20
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2548989-6
    ISSN 1920-454X ; 1920-454X
    ISSN (online) 1920-454X
    ISSN 1920-454X
    DOI 10.14740/wjon1604
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Safety and Efficacy of Powered Non-Thermal Endoscopic Resection Device for Removal of Colonic Polyps: A Systematic Review and Meta-Analysis.

    Ahmed, Zohaib / Ramai, Daryl / Merza, Nooraldin / Badal, Joyce / Iqbal, Umair / Arif, Syeda F / Al-Hillan, Alsadiq / Varughese, Tony / Lee-Smith, Wade / Nawras, Ali / Alastal, Yaseen / Khara, Harshit S / Confer, Bradley D / Diehl, David L / Adler, Douglas G

    Gastroenterology research

    2023  Volume 16, Issue 5, Page(s) 254–261

    Abstract: Background: Endoscopic mucosal resection is a frequently employed method for removing colonic polyps. Nonetheless, the recurrence of these polyps over a healed submucosal base can complicate the extraction of leftover lesions through standard procedures. ...

    Abstract Background: Endoscopic mucosal resection is a frequently employed method for removing colonic polyps. Nonetheless, the recurrence of these polyps over a healed submucosal base can complicate the extraction of leftover lesions through standard procedures. EndoRotor
    Methods: We conducted an exhaustive review of existing literature using databases such as Medline, Embase, Web of Science, and the Cochrane Library until January 2023. Our aim was to find all studies that assessed the safety of non-thermal endoscopic resection devices in removing colonic polyps. The primary outcome we focused on was the rate of technical success. Secondary outcomes that we considered included the frequency of remaining lesions and instances of adverse events. To analyze these data, we used comprehensive meta-analysis software.
    Results: Our analysis incorporated three studies comprising 54 patients who underwent resection of 60 lesions. The combined technical success rate was 93.9% (95% confidence interval (CI): 77.7-98.6%, I
    Conclusion: Our research indicates that the EndoRotor
    Language English
    Publishing date 2023-10-21
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2475913-2
    ISSN 1918-2813 ; 1918-2805
    ISSN (online) 1918-2813
    ISSN 1918-2805
    DOI 10.14740/gr1638
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Phase 1b dose-finding study of rituximab, lenalidomide, and ibrutinib (R2I) in patients with relapsed/refractory mantle cell lymphoma.

    Ip, Andrew / Petrillo, Alessandra / Della Pia, Alexandra / Lee, Geeny G / Gill, Sarvarinder / Varughese, Tony / Zenreich, Joshua / Gutierrez, Martin / Zhang, Jiayu / Ahn, Jaeil / Bharani, Vishnu / Nejad, Ava S / Pascual, Lauren / Feldman, Tatyana A / Leslie, Lori A / Goy, Andre H

    Leukemia & lymphoma

    2023  Volume 64, Issue 14, Page(s) 2225–2235

    Abstract: Mantle cell lymphoma (MCL) is a rare non-Hodgkin lymphoma that frequently becomes chemoresistant over time. The distinct mechanisms of ibrutinib and lenalidomide provided a judicious rationale to explore the combination with anti-CD20 immunotherapy. In ... ...

    Abstract Mantle cell lymphoma (MCL) is a rare non-Hodgkin lymphoma that frequently becomes chemoresistant over time. The distinct mechanisms of ibrutinib and lenalidomide provided a judicious rationale to explore the combination with anti-CD20 immunotherapy. In this phase 1b study (NCT02446236), patients (
    MeSH term(s) Adult ; Humans ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Lenalidomide/administration & dosage ; Lenalidomide/adverse effects ; Lymphoma, Mantle-Cell/drug therapy ; Lymphoma, Mantle-Cell/pathology ; Piperidines/administration & dosage ; Piperidines/adverse effects ; Piperidines/therapeutic use ; Rituximab/administration & dosage ; Rituximab/adverse effects ; Treatment Outcome ; Dose-Response Relationship, Drug ; Recurrence
    Chemical Substances ibrutinib (1X70OSD4VX) ; Lenalidomide (F0P408N6V4) ; Piperidines ; Rituximab (4F4X42SYQ6)
    Language English
    Publishing date 2023-12-25
    Publishing country United States
    Document type Clinical Trial, Phase I ; Journal Article
    ZDB-ID 1042374-6
    ISSN 1029-2403 ; 1042-8194
    ISSN (online) 1029-2403
    ISSN 1042-8194
    DOI 10.1080/10428194.2023.2259528
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2997: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Impact of proton-pump inhibitors on the efficacy of immune checkpoint inhibitors in non-small cell lung cancer: A systematic review and meta-analysis.

    Dar, Sophia / Merza, Nooraldin / Qatani, Ahmad / Rahim, Mehek / Varughese, Tony / Mohammad, Asna / Masood, Fahad / Reza, Fizza Zehra / Wan, Schuchen / Almas, Talal

    Annals of medicine and surgery (2012)

    2022  Volume 78, Page(s) 103752

    Abstract: Introduction: Immune checkpoint inhibitors (ICI) is a rapidly evolving treatment modality for stage IV non-small cell lung cancer (NSCLC). Concomitant proton pump inhibitor (PPI) use can potentially reduce the clinical efficacy of ICIs; however, the ... ...

    Abstract Introduction: Immune checkpoint inhibitors (ICI) is a rapidly evolving treatment modality for stage IV non-small cell lung cancer (NSCLC). Concomitant proton pump inhibitor (PPI) use can potentially reduce the clinical efficacy of ICIs; however, the consensus in recent literature has been conflicting. This study aims to analyze overall survival (OS) and progression-free survival (PFS) outcomes in patients with NSCLC on ICI and concomitant PPI therapy.
    Methods: A literature search was done in 3 databases (Pubmed/Medline, Embase, and Cochrane Central). All studies meeting the inclusion criteria assessing the impact of PPIs on the efficacy of ICI in NSCLC patients were systematically identified. A random-effects network meta-analysis evaluated OS and PFS in the two arms.
    Results: Four studies with 2,940 patients are included in our analysis. ICI usage alone was associated with significantly better OS [HR = 1.46, 95% CI = 1.27-1.67, P < 0.00001] and PFS [HR = 1.31, 95% CI = 1.17-1.47, P < 0.00001] when compared to concomitant PPI and ICI therapy.
    Conclusion: The concomitant use of PPIs during ICI therapy significantly worsens clinical outcomes with shorter OS and increased risk of disease progression in patients with NSCLC.
    Language English
    Publishing date 2022-05-14
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2022.103752
    Database MEDical Literature Analysis and Retrieval System OnLINE

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