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Our recommendations can be adopted by other emergency departments to create and run their own emergency department telehealth initiatives.

The authors examined patients' perceptions of the factors affecting their recovery from anti-

-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, which is a rare, severe immune-mediated neurological disorder.

Seven patients completed semistructured interviews exploring their experience of recovery. Participants were interviewed between 7 and 41 months after the initiation of treatment. Interviews were transcribed and subjected to qualitative content analysis.

Facilitators of recovery included the presence of a support system and treatment-related factors. Barriers to recovery included perceived psychiatric stigma, insufficient illness education, and lifestyle disruptions to accommodate ongoing treatment. Adverse physical, psychological, and neurocognitive sequelae of anti-NMDAR encephalitis continued to affect participants' daily functioning. Selleck Diphenyleneiodonium Most participants described strategies to manage neurocognitive deficits, fatigue, and anxiety.

Anti-NMDAR encephalitis contributes to persistent burden on patients, their families, and health services after the resolution of acute symptoms. Physical, psychological, and cognitive changes contribute to long-term disease morbidity. To optimize recovery and reduce disability, further attention must be directed toward illness education, reducing stigma, and role disruption. Longer-term disability support may benefit those who do not fully recover.

Anti-NMDAR encephalitis contributes to persistent burden on patients, their families, and health services after the resolution of acute symptoms. Physical, psychological, and cognitive changes contribute to long-term disease morbidity. To optimize recovery and reduce disability, further attention must be directed toward illness education, reducing stigma, and role disruption. Longer-term disability support may benefit those who do not fully recover.

Trastuzumab is a monoclonal antibody which could induce the activation of a humoral immune response generating anti-drug antibodies (ADAs). Such response depends of the protein nature and the route of administration (intravenous or subcutaneous). The formation of these antibodies could block the action of trastuzumab (ADA-Tras) and forming immune complexes which decrease its efficacy, so it would be interesting to determine the presence of ADA-Tras in patients treated with trastuzumab.

The blood samples were centrifuged to separate the plasma. The presence of ADA-Tras in plasma was determined using an ELISA-type automated immunoassay.

Fifty-one women with non-metastatic HER2-positive breast cancer treated with trastuzumab were included. Two groups were studied patients treated intravenously and subcutaneously. In neither case was there any presence of ADA-Tras.

This study may be the first ever conducted under usual clinical practice conditions to detect the presence of ADA-Tras in patients with non-metastatic HER2-positive breast cancer. We have wanted to show the antibodies anti-trastuzumab determination as a possible tool that would enable comparison of potential differences in immunogenic behavior between trastuzumab and its biosimilars.

This study may be the first ever conducted under usual clinical practice conditions to detect the presence of ADA-Tras in patients with non-metastatic HER2-positive breast cancer. We have wanted to show the antibodies anti-trastuzumab determination as a possible tool that would enable comparison of potential differences in immunogenic behavior between trastuzumab and its biosimilars.Objective Regular pap smears are effective in reducing cervical cancer incidence and mortality. Migrant women have been reported to utilize cervical cancer screening less often than non-migrant women. However, inconsistent results, e.g. from Germany, have also been reported. This study examines disparities in the use of annual pap smears among 20-69 year old migrant and non-migrant women in neighboring Austria.Method Data from a nationwide population-based survey of 7633 women is used of whom 504 (6.6%) were migrants from European Union countries and 251 (3.3%) were migrants from non-European Union countries. Logistic regression analysis was conducted to account for socio economic and health differences between the three population groups.Results The study shows that as compared to the non-migrant women, migrant women from European Union and non-European Union countries were at lower odds of having received a pap smear in the last 12 months (adjusted odds ratio  = 0.80, 95% confidence interval = 0.66-0.96 and adjusted odds ratio = 0.74, 95%-confidence interval = 0.57-0.97, respectively). Disparities were similar with respect to utilization in the last 36 months (adjusted odds ratio = 0.60, 95% confidence interval = 0.46-0.77 and adjusted odds ratio = 0.58, 95% confidence interval = 0.40-0.82, respectively).Conclusions The findings are in agreement with research from the majority of other countries. They suggest barriers that migrants encounter in the health system and highlight the need for diversity-sensitive health care strategies.Presently, disability athletes remain under-represented in organisational stressor research. Our study sought to bring novel insights to this area by determining the organisational stressors experienced by international disability footballers. Twelve current international disability footballers (10 male, 2 female) from a range of UK impairment squads took part in the study. Semi-structured interviews were completed with each participant, and data were analysed by content analysis procedures. Organisational stressors data were abstracted into Arnold, Wagstaff, Steadman and Pratt's (2017) concepts, and Arnold and Fletcher's (2012) four general dimensions leadership and personnel issues, cultural and team issues, logistical and environmental issues, and performance and personal issues, revealing a series of football-specific nuances. Our study is the first exploration of the prevalence of organisational stressors within international disability football. Our study also provides practitioners with an understanding of the common and unique organisational stressors faced by international disability footballers. Finally, we suggest a series of practical recommendations for policy development within disability football organisations to aid athletes to effective manage organisational stressors.Background Vaccines against whooping cough (pertussis) and seasonal-influenza are recommended for pregnant women in England. Uptake however varies regionally and by ethnicity. Pregnant women are traditionally vaccinated in primary care, though some hospitals now offer vaccines through antenatal clinics. This mixed-methods evaluation describes the demographic characteristics of women seen in a hospital midwife-led antenatal vaccine clinic and explores vaccine decision making. Methods Descriptive statistics of women seen in a London hospital's midwife-led vaccine clinic were generated from electronic routine maternity records, including data on ethnicity, parity, age and deprivation indices. Reasons for vaccine decline given by women to midwives were categorized by themes. link2 Qualitative interviews of women seen in the clinic were also undertaken. Results Between 1st April 2017 and 31st March 2018 the vaccine clinic saw 1501 pregnant women. Of these, 83% received pertussis vaccine and (during flu season) 51% received influenza vaccine, from the clinic. Fewer Black Afro-Caribbean women seen by the clinic were vaccinated, compared to other ethnicities with only 68% receiving pertussis and 34% flu vaccines respectively (p less then .05). Among all women delivering at the hospital over the year, 42%, (1334/3147) were vaccinated by the clinic. Qualitative interviews found that reassurance from healthcare professionals, particularly midwives, was the most important factor influencing maternal vaccine decisions. Conclusions Midwife-led hospital clinics can offer an effective alternative to primary care provision for vaccines in pregnancy. Consistent with previous work, vaccine uptake varied by ethnicity. Midwives play a key role in the provision of vaccine services and influence women's vaccine decisions.

To report the outcomes after treating stenotic or occluded femoropopliteal lesions with a drug-coated balloon (DCB) followed by the implantation of a thin-strut self-expanding bare metal stent in the BIOLUX 4EVER trial (

identifier NCT02211664).

The prospective, multicenter, physician-initiated BIOLUX 4-EVER trial was conducted at 5 centers in Belgium and enrolled 120 patients (mean age 70.9±10.5 years; 79 men) with symptomatic stenotic or occluded de novo femoropopliteal lesions. link3 A fifth of the patients had diabetes mellitus and nearly half had previous peripheral artery interventions. The lesions were a mean 83.3±49.5 mm long with a mean reference vessel diameter of 5.26±0.59 mm. Lesions were treated with a Passeo-18 Lux DCB followed by the implantation of a Pulsar-18 bare metal stent. Follow-up visits were conducted at 1, 6, 12, and 24 months postprocedure; the main outcome was primary patency at 12 months.

Technical success was obtained in all patients. Primary patency was observed in 89.9% of pat investigated in the precursor 4-EVER study.

The combination of a Passeo-18 Lux DCB followed by a Pulsar-18 stent implantation produced safe and effective outcomes in the treatment of femoropopliteal lesions at up to 24 months. Adding paclitaxel to the bare nitinol stent platform by predilating with a Passeo-18 Lux DCB seems to increase efficacy at 1 and 2 years compared with the use of bare metal stents only, which were investigated in the precursor 4-EVER study.

To report a single-center series of patients with type B aortic dissection treated with the Multilayer Flow Modulator (MFM).

Over a 36-month period, 23 patients (median age 53 years; 20 men) with complicated type B aortic dissections (2 acute, 5 subacute, and 16 chronic) were treated with the MFM. Primary endpoints of rupture or dissection-related death, overall mortality, and reintervention were evaluated using the Kaplan-Meier method; estimates for freedom from the endpoints are reported with the 95% confidence interval (CI). Secondary outcomes included technical success, adverse events, and aortic remodeling. Clinical and imaging data were collected preoperatively, directly postoperatively, and annually to 36 months for analysis using computational fluid dynamics (CFD).

Initial technical success was 91.3%. The estimates of the endpoints at 12 months were 100% for freedom from rupture or aortic-related death, 95.7% for freedom from overall mortality, and 91.3% for freedom from reintervention. No devicafety of the MFM and its effectiveness in a larger patient cohort.

Recently, some studies have shown that prolonging flush interval is safe and feasible for patients who complete chemotherapy. However, there is no consensus about the optimal flush interval for those patients.

The purpose of this review was to evaluate whether the flush interval could be prolonged based on monthly interval for regular maintenance and to explore the optimal flush interval.

We searched the following databases for articles published between 1 January 1982 and 21 February 2020 PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, and Ovid.

Randomized controlled trials, retrospective and prospective cohort studies of flush interval less than 4 weeks versus longer than 4 weeks for patients who completed chemotherapy, were included.

Two reviewers extracted information and assessed the quality of the articles independently. In total, 389 articles were retrieved, and 4 studies including 862 cases fulfilled the inclusion criteria. There was no statistical heterogeneity (



 = 0,

 > 0.