Bratisl Med J
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ASCT has been considered the standard of care for younger patients with NDMM, however, not all the studies published so far have uniformly demonstrated the complete superiority of ASCT over chemotherapy at standard doses. A systematic review and meta-analysis of randomized studies has shown a significant benefit with single ASCT in terms of prolonged progression-free survival (PFS), but not of overall survival (OS). In our retrospective analysis we investigated the impact of high dose (HD) chemotherapy followed by ASCT in special population of patients with high risk cytogenetic profile on the PFS and treatment outcome. ⋯ HD chemotherapy followed by ASCT remains the standard of care for NDMM eligible for high dose chemotherapy. Our results confirm the benefit of ASCT even in the presence of HRCA. Lower PFS in the HRCA subgroup might indicate the need for more intensive treatment, which may be achieved by tandem ASCT defined as two ASCT performed within a period of no more than six months. Additionally, as three- and four-drug induction therapies are becoming increasingly available and effective, resulting in high minimal residual disease (MRD) negative rates, it is important to continue discussing and further personalizing upfront ASCT to avoid overtreatment and possible toxicities especially in the non-high-risk patient population (Tab. 5, Fig. 2, Ref. 9).
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Observational Study
Prevalence of diastasis m. rectus abdominis and pelvic floor muscle dysfunction in postpartum women.
The aim of this study was to determine the prevalence of Diastasis of the rectus abdominis muscles (DRAM) and pelvic floor muscle dysfunction (PFMD) in postpartum women. Design: The observational prospective study. ⋯ The average IRD distance at rest and during the load test confirmed the first grade of DRAM out of four degrees of severity. Moderate and medium DRAM occurred according to location in an average of one-third of the cases. The highest percentage of DRAM was above the navel, and the lowest percentage below the navel. PFMD was detected in an average of one-third of cases. It is important to monitor these parameters with a view to improving the quality of life index in the future (Tab. 5, Ref. 22).
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The current report describes the combined unusual origin of the left inferior phrenic and left gastric arteries observed during a routine dissection of the upper abdominal region. ⋯ The identification of anatomic vascular abnormalities of the abdominal aorta and its branches is clinically important in surgical and invasive arterial procedures and preoperative knowledge of vascular anomalies should prevent iatrogenic vascular trauma and complications during surgery (Fig. 3, Ref. 14).
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This study estimated delirium incidence in Slovak COVID-19 patients, explored treatment associations and examined the impact on hospitalization and mortality. ⋯ This study provides insights into delirium incidence in Slovak COVID-19 patients, treatment associations, and the importance of managing psychiatric symptoms and treatment choices for optimal outcomes (Tab. 6, Ref. 33).