Articles: treatment.
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Limited information is available regarding the clinical features and outcomes of advanced human epidermal growth factor receptor 2 (HER2)-mutant non-small cell lung cancer (NSCLC) in Taiwan, despite expanding treatment options for this distinct subtype. The present study explored the clinical features and outcomes of HER2-mutant NSCLC in a real-world setting. ⋯ This study highlights the clinical features and outcomes of advanced HER2-mutant NSCLC in Taiwan. PC + ICI may be more effective than other regimens as first-line therapy. The prognostic role of HER2 exon 20 insertion mutations warrants further investigation.
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Spinal vertebral fractures pose a significant healthcare burden due to their frequency and impact on quality of life, resulting in substantial social costs. Minimally invasive surgery (MIS) offers advantages over traditional open surgery (OS), such as reduced tissue damage, less postoperative pain, and shorter hospital stays, although it involves higher implant costs. Research comparing the overall direct costs of these interventions is limited. This study aims to compare the direct hospital-care costs associated with OS and MIS for thoracolumbar vertebral fractures in Spain. ⋯ The study demonstrates that MIS is not inferior to OS in terms of costs, with some advantages like reduced blood bank expenses. Further high-quality randomized controlled trials with economic evaluations are needed for more definitive conclusions.
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Open spinal dysraphism is a congenital malformation that causes major morbidity. Its consequences include sensory and motor impairment as well as bladder- and bowel dysfunction. It is often also associated with prenatal ventriculomegaly, which, in turn, necessitates postnatal treatment with a ventriculoperitoneal shunt in approximately 80% of cases. Prenatal therapy with coverage of neural tube defect can reduce the shunt rate and preserve motor function. In this review, we describe the different surgical procedures and their outcomes. ⋯ Prenatal surgery improves motor function and reduces the shunt rate but long-term outcomes beyond adolescence are still lacking. Transparent and interdisciplinary counseling is essential in prenatal communication to inform parents not only about the potential benefits of this treatment, but also about its limitations and risks.
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Lung transplantation is the treatment of choice for end-stage nonmalignant lung disease. It has become a routine procedure through advances in donor lung preservation, extracorporeal membrane oxygenation, immunosuppression, intensive care medicine, and follow-up care. ⋯ Despite all the advances in lung transplantation, acute and - above all - chronic graft dysfunction still pose a major challenge for large-volume transplantation centers. Immunosuppression that is individually tailored to prevent both graft rejection and infection is important for these patients' long-term survival. Xenotransplantation and so-called lung bioengineering may become available in the future as alternatives to allotransplantation.