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Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies in patients with locally advanced or metastatic platinum-resistant urothelial carcinoma.

To compare the real-life experience and data of clinical trials on ATZ treatment in metastatic urothelial carcinoma.

Patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy from an expanded access program were retrospectively studied. Data of patients were obtained from their files and hospital records. Safety was evaluated for patients treated with at least one cycle of ATZ.

The primary endpoint was objective response rate (ORR). The secondary endpoints are overall survival (OS), progression-free survival (PFS), duration of response, and safety profile of patients. Kaplan-Meier methods were used to calculate median follow-up and estimate PFS and OS.

Data of 115 enrolled patients were analyzed. Most of the patients (92.3%, n = 106) had received chemotherapy regimen only once priotherapy. ATZ is an effective and tolerable treatment for patients with locally advanced or metastatic platinum-resistant urothelial carcinoma in our study, similar to previously reported trials.

Atezolizumab is effective and well-tolerated in patients with metastatic urothelial cancer who progressed with first-line chemotherapy, consistent with the outcomes of the previous clinical trials in this setting.

Atezolizumab is effective and well-tolerated in patients with metastatic urothelial cancer who progressed with first-line chemotherapy, consistent with the outcomes of the previous clinical trials in this setting.

The aim of this study is to characterize the pattern and the severity of coronary artery lesions in cardiac amyloidosis.

We retrospectively compared patients with heart failure who were tested positive (i.e., biopsy or gene tests - HF/CA+) against those who tested negative (HF/CA-) for cardiac amyloidosis. Groups were compared demographically and angiographically for qualitative and quantitative variables to determine patterns of involvement in the major epicardial coronary vessels.

The study included 110 heart failure patients, of whom, 55 patients (88 lesions) were in the HF/CA+ group, and 55 patients (66 lesions) were HF/CA-. Despite the advanced age of HF/CA+ patients (74.5±11.0years vs. 54.1±15.0years; p=0.05), no severe calcification was found in the HF/CA+ group (0.0% vs. 4.5%; p=0.018). The HF/CA+ group also had fewer ostial lesions (3.4% vs. 15.1%; p=0.0095) and a higher, albeit not significant, Thrombolysis in Myocardial Infarction frame count (30.4±12.6 vs. 26.6±11 frames; p=0.06). In the HF/arious methods to determine the deposition of the protein have been studied. However, the pattern or severity of disease in the coronary vasculature using coronary angiography has not yet been investigated. Patients with heart failure and cardiac amyloidosis had numerous lesions in the coronaries that were less calcified with less ostial involvement and reduced anterograde blood flow compared to amyloid-negative heart failure patients.

An ancillary advantage of bioresorbable scaffolds is the possibility of non-invasive imaging assessment of the treated coronary segment. Cardiac computed tomography angiography (CCTA) studies of resorbable magnesium scaffolds (RMS) are scarce.

In this collaborative, international study, nine patients who had an RMS implanted underwent CCTA as part of follow-up assessment. Core-lab blinded quantitative and qualitative assessment was performed by an independent CCTA investigator.

Eight studies were amenable for quantitative analysis, and the blinded CT investigator successfully located and evaluated patency of RMS in all cases. The CCTA follow-up in-scaffold percentage diameter stenosis and area stenosis was 22.2% (12.4-30) and 39.1% (0.23-0.50), in keeping with mild in-scaffold late loss and underlying plaque growth. Moreover, a detailed coronary plaque characterization at treated segments was feasible (fibrous plaque in 69.9%, fibrofatty in 17.13%, necrotic in 4.78% and calcium in 5.72%). As in 6 out of 8 cases, the presentation was an acute coronary syndrome, these preliminary results could suggest plaque stabilization and a good coronary vessel healing with RMS.

Non-invasive, follow-up assessment of RMS with CCTA is feasible. Further CCTA studies for either clinical or research purposes with the present and upcoming generation of resorbable magnesium scaffolds are warranted.

Non-invasive, follow-up assessment of RMS with CCTA is feasible. Further CCTA studies for either clinical or research purposes with the present and upcoming generation of resorbable magnesium scaffolds are warranted.

The purpose of this study was to analyze the potential of ultrasound with a high frequency probe (24-MHz) in the assessment of the long thoracic nerve (LTN) and describe ultrasonographic landmarks that can be used for standardization.

Ultrasonography analysis of the LTN was done on 2 LTNs in a cadaver specimen and then on 30 LTNs in 15 healthy volunteers (12 men, 3 women; mean age, 28.8±3.8 [SD] years; age range 24-39 years) by two independent radiologists (R1 and R2) using a 24-MHz probe. Interrater agreement was assessed using Kappa test (K) and intraclass correlation coefficient (ICC).

In the cadaver, dissection confirmed that the India ink was injected near the LTN in the middle scalene muscle. In volunteers, visibility of the LTN above the clavicle was highly reproducible for the branches arising from C5 (R1 87% [26/30]; R2 90% [27/30]; K=0.83) and from C6 (R1 100% [30/30]; R2 97% [29/30]; K=0.94). Where the nerve emerged from the middle scalene muscle, the mean diameter was 0.85±0.24 (SD) mm (range 0.4-1.6mm) for R1 and 0.9±0.23 (SD) mm (range 0.4-1.7mm) for R2 (ICC 0.96; 95% CI 0.92-0.98%). Along the thoracic wall, where LTN run along the lateral thoracic artery, the mean diameter was 0.83±0.19 (SD) mm (range 0.5-1.27mm) for R1 and 0.89±0.21 (SD) mm (range 0.6-1.2mm) for R2 (ICC 0.86; 95% CI 0.72-0.93%).

The LTN can be analyzed with ultrasound using high-frequency probe by using the C5 and C6 roots, the middle scalene muscle above the clavicle and the lateral thoracic artery on the chest wall as landmarks.

The LTN can be analyzed with ultrasound using high-frequency probe by using the C5 and C6 roots, the middle scalene muscle above the clavicle and the lateral thoracic artery on the chest wall as landmarks.

Postorgasmic illness syndrome (POIS) is a rare syndrome of unknown etiology where patients experience distressing physical and psychological after ejaculatory sequelae.

To better characterize the epidemiology, symptomatology, disease course, and treatment of POIS, with specific interest placed on examining relationships between disease presentation and measures of disease burden.

A 30-item questionnaire was distributed to an online community of patients with POIS from June 2019 to January 2020. We assessed diagnostic criteria and clusters of symptomatology described in prior studies. Outcome measures include self-reported measures of symptom severity, disease burden, and behavioral changes. Statistical correlations were assessed with Pearson's chi-squared (χ

) and ordinal regression analyses.

The main outcome measures of this study are self-reported measures of symptom severity, disease burden, and behavioral changes.

The sample consisted of 302 men (mean age 32.6±11.4years, mean age of onset 19.1±ered in English and within 1 online community, that results were self-reported, and that the response rate was low (32%).

Characterizing symptom cluster, but not number of diagnostic criteria, may offer prognostic value, and investigation to elucidate pathophysiology and potential treatments for POIS is necessary. Natale C, Gabrielson A, Tue Nguyen HM, etal. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;172229-2235.

Characterizing symptom cluster, but not number of diagnostic criteria, may offer prognostic value, and investigation to elucidate pathophysiology and potential treatments for POIS is necessary. Natale C, Gabrielson A, Tue Nguyen HM, et al. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;172229-2235.

Soft tissue surgery to address in-toeing gait in young cerebral palsy (CP) patients may be an alternative in some cases to femoral derotation osteotomy (FDO), which is the currently accepted treatment. The relative contribution of muscular contracture, spasticity and bone deformity is still controversial. In this study, we determined the outcomes of soft tissue surgery on hip internal rotation (HIR) when femoral anteversion was less than 45° and the soft tissues were identified as being the cause.

This prospective study included select adolescent patients who were operated in the context of single-event multilevel surgery. The soft tissues' contribution to the HIR was identified beforehand. The surgical procedures focused on the hamstrings, adductor magnus and gluteus minimus muscles.

Over a 6-year period, 21 patients (mean age 14 years) and 25 lower limbs were treated. The HIR improved by an average of 17.4°±4.8° (95% CI). The gait deviation index and gait profile score also improved significantly. At is technique has its place alongside FDO in certain CP patients who do not have severe femoral anteversion.

Cystoscopy is noted to be more painful in men. Research has been done to support the use of video in men to reduce pain; it would follow that video would be useful in reducing pain in women as well.

The aim of this study was to evaluate the effect of watching a relaxing video during cystoscopy on the pain and anxiety levels of female patients.

The study was a single-center, parallel, randomized, controlled, nonblinded trial.

This study was carried out in the cystoscopy unit of a training and research hospital in Turkey.

Sixty female patients aged 18years and older undergoing rigid cystoscopy for the first time and under local anesthesia.

The participants were randomized into two equal groups video and control. Data were collected with Visual Analog Scale, State-Trait Anxiety Scale, and hemodynamic parameters.

A statistically significant difference was found between the two groups in terms of pain levels during and after cystoscopy (p<.001). check details Pain levels were significantly lower in the video group during and after the procedure. A statistically significant difference was also found between the groups in terms of anxiety levels before and after cystoscopy (p<.05). Anxiety levels were significantly lower in the video group after the procedure. Satisfaction levels were higher in the video group (p<.001).

According to this study, watching a relaxing video during cystoscopy had a positive effect on pain, anxiety, satisfaction levels, and hemodynamic parameters of the patients.

According to this study, watching a relaxing video during cystoscopy had a positive effect on pain, anxiety, satisfaction levels, and hemodynamic parameters of the patients.

Outcomes of medical treatments tend to be highly variable. Some of the underlying variance is due to well-known factors such as age, gender, ethnicity, and effects of local weather. There are also less obvious influences including variations in solar wind, the Earth's geomagnetic field, and the interplanetary magnetic field. This study explored possible effects of these local and solar/geomagnetic variables on the outcomes of energy medicine treatments. The context was a pilot clinical trial involving 17 energy medicine practitioners who treated a total of 190 participants presenting with hand and wrist pain.

Eighteen environmental variables were correlated against changes in subjective pain and against changes in objective measures of nerve conduction velocity.

The results showed that local barometric pressure, interplanetary magnetic field, lunar illumination, proton fluence, electron fluence, and solar radio flux showed statistically significant relationships with these health outcomes (at p < 0.05 or better) before correction for multiple comparison corrections.