Walshvaughn1627

Renal impairment (RI) is associated with poor survival in newly diagnosed multiple myeloma (MM) patients. Renal function recovery has been one of the main therapeutic goals in those patients.

The records from 393 newly diagnosed MM patients in our hospital between January 2012 and December 2016 were retrospectively analyzed. RI was defined as an eGFR<40mL/min according to the novel IMWG criteria. RI patients were categorized based on their renal function at diagnosis severe RI eGFR<30mL/min, and mild RI 30mL/min≤eGFR <40mL/min. We explored whether RI, and particularly severe RI, was an adverse prognostic factor for survival, and investigated the impact of renal function recovery on survival.

Severe RI, hemoglobin <100g/L, LDH≥245U/L, hyperuricemia, 1q21 amplification, and lack of novel agent treatment were associated with decreased overall survival (OS). Severe RI patients with renal response had a median OS of 27months compared with 18months for those patients without renal response (P=.030), but their median OS was still significantly lower than that for patients without severe RI, which was 51months. In severe RI patients, the overall renal response rate in bortezomib-based regimens was significantly higher than that in nonbortezomib-based regimens.

Our results suggest that severe RI is an adverse prognostic factor for survival in newly diagnosed MM patients, restoration of renal function may improve survival, and bortezomib-based regimens may be the preferred treatment in patients with severe RI.

Our results suggest that severe RI is an adverse prognostic factor for survival in newly diagnosed MM patients, restoration of renal function may improve survival, and bortezomib-based regimens may be the preferred treatment in patients with severe RI.

When making a cost-saving it is important to ensure there is no loss of efficacy.

Clinical effectiveness and efficiency of incobotulinumtoxinA compared to onabotulinumtoxinA in facial dystonia is unclear. Our aim is to evaluate switching from onabotulinumtoxinA to incobotulinumtoxinA in the treatment of essential blepharospasm (EB), hemifacial spasm (HFS) and aberrant facial nerve regeneration (AFR).

A retrospective study of a prospective, single-masked switchover audit from onabotulinumtoxinA to incobotulinumtoxinA.

Twenty essential EB, 12 HFS and six AFR patients.

A switchover from stable onabotulinumtoxinA to incobotulinumtoxinA using a 11 unit ratio and contemporaneous efficacy measures. Two nurse injectors performed the injections over a period of 6 years. Each masked patient received three onabotulinumtoxinA and three incobotulinumtoxinA over a minimum of 2 years.

At each visit, a blepharospasm disability score (BDS), Jankovic score (JS), subjective improvement (SI), duration of maximum effect (DME) and complications were recorded. A cost comparison per unit dose was made.

Twenty EB, 12 HFS and six AFR received 114 onabotulinumtoxinA and 114 incobotulinumtoxinA treatments. Both brands had similar efficacy, but SI (P < .01) and DME (P < .05) were higher in the HFS group with incobotulinumtoxinA. Complications included bruising (two onabotulinumtoxinA, one incobotulinumtoxinA) and ptosis (three onabotulinumtoxinA, zero incobotulinumtoxinA). OnabotulinumtoxinA was 33% pricier.

Switching from onabotulinumtoxinA to incobotulinumtoxinA did not result in an inferior outcome for the treatment of facial dystonia and led to a cost-saving for the department.

Switching from onabotulinumtoxinA to incobotulinumtoxinA did not result in an inferior outcome for the treatment of facial dystonia and led to a cost-saving for the department.

BTBD7_hsa_circ_0000563, which is located on chromosome 14, contains conserved binding sites with miR-155/130a and RNA-binding proteins according to bioinformatic prediction. We investigated the association of BTBD7_hsa_circ_0000563 expression in coronary artery segments with atherosclerotic stenosis and identified the proteome-wide BTBD7_hsa_circ_0000563-regulated proteins in human coronary artery.

The atherosclerotic grade and extent in coronary artery segments were determined by hematoxylin and eosin staining. BTBD7_hsa_circ_0000563 expression in eight coronary artery segments from one patient was quantified by RT-qPCR assay. A proteomic approach was adopted to reveal significant differences in protein expression between among four groups differing in their BTBD7_hsa_circ_0000563 expression levels.

The RT-qPCR assay revealed that coronary artery segments with severe atherosclerotic stenosis had significantly low BTBD7_hsa_circ_0000563 levels. The proteomic analysis identified 49 differentially expresshe atherosclerotic changes in human coronary artery segments. Verification, mechanistic, and function studies are needed to confirm whether patients with coronary artery disease would benefit from such personalized medicine in the future.The Sarabkalan Spring serves as a primary water supply to irrigation and domestic use in the Sirvan Region, Iran. FX-909 concentration As it has a highly variable discharge, understanding its teleconnections with large-scale climate variability is crucial. In this study, we first characterize the springshed and its corresponding karst aquifer system using genetic algorithm analysis on the spring discharge, water balance calculations, temporal variations of physicochemical parameters, and stable isotopes along with considering its geological settings. Then, the large-scale climate indices teleconnections with precipitation and spring discharge are studied using wavelet analysis. Results reveal that the springshed contains two karst subaquifers resulting from geological and morphological settings. Unlike most developed karst systems in Zagros, which show one peak, the spring has two principal flow peaks over most hydrological years where the second peak occurs over the dry season. It takes ∼99 d (from lag correlation over 2008-2019) and ∼145 d (from δ18 O measurements over 2018-2019) for rain water to reach the Sarabkalan Spring. Moreover, intense precipitations would result in an increase in discharge and a decrease in electrical conductivity, Ca + Mg, HCO3 , SO4 , Cl, ionic strength, and δ18 O of the spring because of the developed karst conduit(s). It is further found that a positive Pacific Decadal Oscillation phase coupled with El Niño causes an increase in both the precipitation and spring discharge, signifying the influence of the atmospheric circulations of the Pacific Ocean on the spring behavior.