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35-2.73). The secondary safety (clinically relevant non-major bleeding) outcome occurred in 333/15474 patients in the DOAC group (2.2%) and 191/15418 patients in the placebo group (1.2%) with an OR 1.75 (95% CI 1.46-2.1). The extended use of venous thrombolism prophylaxis post-discharge results in decreased venous thromboembolism events but increased bleeding risk. Our cost-effective analysis of extended DOAC use versus placebo showed superiority of the DOAC group. CONCLUSION In conclusion, given the mortality benefit and cost-benefit, extended thromboprophylaxis is a beneficial strategy to efficiently reduce the risk of venous thromboembolism. Published by Elsevier Inc.Three siblings with inhalational elemental mercury toxicity presented with fever, rash, and upper respiratory tract symptoms. The patients were heavily exposed to elemental mercury that was spilled in their home and then vacuumed. Initial whole blood mercury levels were elevated at >200 µg/L, 153 µg/L and 130 µg/L (Mayo Clinic Laboratories lab reference range less then 9 µg/L) for Cases 1, 2, and 3, respectively. All three required chelation with succimer. Clinically significant elemental mercury toxicity can resemble an infectious illness. Severe morbidity and mortality can be prevented if heavy metal poisoning is considered early, through a detailed history including an environmental exposure history. For elemental mercury spills in the home, safe and effective clean-up steps are needed. Improved public health education is needed to prevent similar household exposures. This study investigated the occurrence of digenean trematode larvae in snails from the Kenyan part of Lake Victoria. The survey included caenogastropod snails that have received less focus in parasitological studies in Africa their trematodes are largely unknown. Out of 1145 snail specimens, 149 (13.0%) were infected with Digenea. The highest prevalence (P) was recorded in Melanoides tuberculata (64.5%), followed by Pila ovata (15.4%), Radix natalensis (9.5%), Bulinus ugandae (9.1%), Bellamya unicolor (8.9%), Biomphalaria pfeifferi (7.3%) and Biomphalaria sudanica (4.4%). Morphological and molecular analyses revealed 17 digenean species. Contrary to reports of low diversity of Digenea in caenogastropods, P. ovata harboured 8 species - at least twice as many as in each of the pulmonates. The following taxa are reported for the first time in the Lake Victoria region Haplorchis pumilio, Thapariella prudhoei, Nudacotyle sp., Renicola sp. and Bolbophorus sp. An unknown cercaria belonging to the genus Haematoloechus is reported from P. ovata a xiphidiocercaria possessing a long sword-shaped stylet (47-71 µm) which does not match any available literature records. From this study, H. pumilio from M. tuberculata (P = 69.4%), Fasciola gigantica from R. natalensis (P = 1.9%) and Bolbophorus sp. from Bu. ugandae (P = 4.6%) are species of veterinary or medical importance. Snails from the study site with little direct anthropogenic influence had the highest prevalence and diversity of digenean larvae, indicating that environmental conditions influence trematode occurrence. Despite the approval of 8 new drugs for acute myeloid leukemia (AML) since 2017, the disease remains challenging, given the significant toxicity associated with available treatments and relatively low cure rates, especially in older adults. Although advantageous for patients, self-congratulatory rejoicing about the new agents would be extremely premature. Questions abound about the need for a specific versus less specific FLT3 inhibitor (eg, midostautin) in the upfront setting and whether a single agent (gilteritnib), albeit better than chemotherapy, is sufficient for relapsed disease. Is the new liposomal formulation of daunorubicin/cytarabine better than '3 + 7' only in secondary AML? Should only those newly diagnosed patients with core binding factor AML routinely receive gemtuzumab ozogamicin? The isocitrate dehydrogenase inhibitors were approved based on non-randomized data; thus, one wonders whether single-agent isocitrate dehydrogenase inhibitor therapy is appropriate for relapsed patients. Glasdegib, an orally available hedgehog inhibitor, is approved in conjunction with low-dose cytarabine in unfit patients but is rarely used in favor of a combination of hypomethylating agents or low-dose cytarabine with venetoclax, which are hopeful newly approved combinations for the older and/or unfit previously untreated. Perhaps venetoclax-based combinations should be more widely used, but the data is currently lacking. Thus, a temperate approach, more clinical research, and a critical analysis of the available data remain important in this "optimistic" new era of AML therapeutics. BACKGROUND Most studies addressing the impact of hematopoietic stem cell transplantation (SCT) on pulmonary function test (PFT), and the various factors affecting that impact have been performed on the allogenic type. find more Few have addressed PFT changes in autologous SCT. This study describes PFT changes seen in autologous SCT recipients and addresses the various factors impacting these changes. PATIENTS AND METHODS We reviewed the medical records of 223 consecutive adult autologous SCT recipients. We collected pre-transplant and post-transplant data, as well as PFT data and long-term mortality. RESULTS A total of 123 patients with lymphoma receiving the BEAM (carmustine, etoposide, aracytin, and melphalan) conditioning regimen had a significant 5% drop in mean forced vital capacity and total lung capacity but no significant change in forced expiratory volume in one second/forced vital capacity ratio nor in diffusion lung capacity of carbon monoxide adjusted to volume. Fifteen percent of the patients with lymphoma had a clinically significant drop of 15% in their lung volume parameters. The patients with multiple myeloma receiving the melphalan conditioning regimen had no significant change in any of the PFT parameters. Smoking, baseline PFT parameters, and radiation did not affect lung function or mortality. CONCLUSIONS Autologous SCT impact on lung function depends on the disease and conditioning regimen. It leads to a drop in lung volumes but no obstruction or decrease in diffusion in patients with lymphoma receiving the BEAM regimen. Autologous SCT did not affect lung functions in patients with multiple myeloma, and these patients may not need screening PFTs.