Post Evaluations Research Articles

Computed tomography-guided cryoablation in treating adrenal metastases: a retrospective single-center study.

To assess the effectiveness and safety of computed tomography (CT)-guided cryoablation for treating adrenal metastases (AMs). This study included 12 patients treated with 13 CT-guided cryoablation procedures for AMs between 2016 and 2020. Patients were selected based on specific criteria, including tumor size ≤5 cm and suitability for surgery. Procedures were performed by expert radiologists, with comprehensive monitoring for complications and regular post-treatment evaluations. The primary technical success rate was 91.7%, with a secondary success rate of 100% following repeat procedures. Over an 8-24-month follow-up period, local tumor recurrence was observed in 16.7% of patients, and systemic progression occurred in five (41.6%) patients. The average overall survival duration was 26.4 ± 5.6 months. CT-guided cryoablation is a feasible and effective treatment option for AMs, demonstrating high technical success rates and manageable complications. This study highlights CT-guided cryoablation as a promising treatment for AMs, offering a minimally invasive alternative to surgery with good local control and safety profile. Further research, including multi-center studies, is needed to confirm these findings.

Evaluation of a New Technique of Gingival Smile Reduction after Hyaluronic Acid Infiltration: A Cohort Study Focusing on Gingival Exposure and Patient-Oriented Outcomes.

A gummy smile is the visualization of more than 3 mm of gingiva above the maxillary incisors. This study aimed to evaluate the long-term effects on aesthetics and patient satisfaction of a new hyaluronic acid infiltration technique in reducing the gummy smile. Fifty patients with gummy smiles were treated using hyaluronic acid infiltration points by applying 0.1 mL per injection at specific points. Post-treatment evaluations were performed one week, one month, three months, six months, and 12 months later. A questionnaire assessed patient satisfaction, willingness to recommend the treatment, and side effects (pain and bruising during and after treatment). An average reduction of 2.5 mm in gingival exposure during smiling was observed. After one week, the reduction was constant. At six months, 40% of the original gingival exposure was recovered, and recovery was complete at 12 months. Patient satisfaction was 82.1%, and 100% of patients would recommend the treatment. Bruising, swelling, and pain decreased to 0% from the first month. In conclusion, this technique is a safe and effective option to improve the smile's appearance with minimal complications.

The Effects of Photobiomodulation Therapy in Cubital Tunnel Syndrome, Clinical Trial.

Aim: We aimed to evaluate the effects of laser therapy together with rest splint and exercise on muscle strength, function, activities of daily living, and pain in individuals suffering from cubital tunnel syndrome (CuTS) by comparing it with placebo treatment. Materials and Methods: This prospective, single-blind, and randomized controlled study was conducted with 64 patients with CuTS in total. They were divided into two groups by randomization: Group 1 (n = 32) was provided with low-energy laser therapy + splint + exercise, and Group 2 (n = 32) was provided with low-energy sham laser therapy + splint + exercise. Patients in both groups received resting splints and nerve release exercises. Pretreatment and posttreatment (3rd week, 3rd month) evaluations were made with the Visual Analog Scale (VAS), the Quick Disability of Arm, Shoulder, and Hand Questionnaire, hand grip strength, fingertip grip strength, the Patient-Rated Ulnar Nerve Evaluation Scale (PRUNES), and Short Form-12. An electrophysiological evaluation was performed at baseline and at the 3rd month. Results: We observed significant improvements in both groups regarding pain, function, muscle strength, health profile, and quality of life in the early posttreatment (3rd week) stage and at the 3rd-month follow-up. When both groups were compared, a significant difference was determined between the VAS-Rest, VAS-Movement, PRUNES-Pain, PRUNES-Function, and PRUNES-Total parameters in the posttreatment (3rd week follow-ups), as well as PRUNES-Pain scores in the post-treatment (3rd month) stage, of the groups in favor of those in Group 1 (p < 0.05). Conclusion: The findings of our study have shown that in the treatment of CuTS, laser treatment is superior to placebo in the short term, but they have equivalent effects in the medium term. Further studies with large patient populations are needed to provide more diverse information about the therapeutic effectiveness of low-intensity laser therapy.

Empowering Wellness: A Comprehensive Narrative Review of Cancer Prehabilitation from Treatment Onset to Surveillance.

Cancer prehabilitation, defined as a process occurring between cancer diagnosis and the onset of acute treatment, is highlighted for its ability to enhance physical and mental health results while decreasing overall healthcare costs. This summary introduces the concept of cancer prehabilitation and emphasises the crucial role of oncology nurses in rehabilitation care. The cancer treatment plan of prehabilitation requires timely and efficient assessment across the care continuum, focusing on enhancing outcomes at every stage of cancer. The battle with cancer involves three different assessments with distinct goals: i) prehabilitation evaluation before treatment, ii) early post-treatment evaluations of rehabilitation and iii) final evaluations of health promotion. Analyses and treatments for significant side effects or complications associated with the treatment specifically for prehabilitation are recommended. The roles of coordination, counseling, preparing for discharge and teaching are outlined as integral components of a cancer nurse's responsibilities in the prevention of cancer. A literature search from March 2016 to June 2023 was conducted using the keywords 'neoplasms,' 'cancer,' 'prehabilitation,' 'continuum of care,' 'care continuum,' 'patient care continuity,' 'epidemiology,' 'therapeutics,' 'health,' 'prevention and control' and 'guidelines as topic.' The findings suggest that care coordinators or navigators for cancer should be educated to assess the physical and psychological status of patients once a cancer diagnosis is confirmed, particularly for those awaiting surgery at home. To enhance their competence in prehabilitation care, oncology nurses are encouraged to gain knowledge of certain tumours' outcomes and cancer-related treatments. Additionally, improving the ability to evaluate patients' functional status and emotional distress is crucial for oncology nurses involved in cancer prehabilitation.

Subjective and objective evaluation of nasal obstruction in patients treated at the Hospital de Clínicas, Paraguay

Nasal obstruction is characterized by insufficient airflow and increased resistance in the nasal cavities, affecting patients’ quality of life and sleep. This study aims to compare the efficacy of medical and surgical treatment in patients with Nasal obstruction, using subjective evaluations (NOSE and VAS scales) and objective evaluations (active anterior rhinomanometry). This is an experimental and prospective longitudinal study conducted at the Hospital de Clínicas, Paraguay. Forty patients with Nasal obstruction were included, divided into medical treatment (nasal corticosteroids) and surgical treatment (turbinoplasty, septoplasty, or both) groups. Pre- and post-treatment evaluations were performed using the NOSE and VAS scales, and active anterior rhinomanometry. The sample included 52.5% men and 47.5% women, with an average age of 32.18±11.59 years. The main cause of Nasal obstruction was chronic rhinitis (62.5%). Treatments showed significant improvements in subjective and objective evaluations. In the medical group, VAS improved by 2.63 points in women and 2.00 in men, while the surgical group showed more pronounced improvements. The NOSE also showed significant reductions, especially in patients undergoing combined turbinoplasty and septoplasty. Active anterior rhinomanometry reflected an increase in overall nasal flow in all treated groups. Both medical and surgical treatments are effective in improving Nasal obstruction, with greater benefits observed in surgical treatments. Subjective and objective evaluations are valuable and complementary tools for assessing treatment in patients with Nasal obstruction. These results highlight the importance of a comprehensive evaluation in the management of Nasal obstruction.

Three-dimensional Analysis of Lifting Effects after High-intensity Focused Ultrasound (Ultraformer-MPT) across Seven Facial Aesthetic Units Considering SonoAnatomy.

This investigation delves deep into the lifting degree for each area of noninvasive facial rejuvenation through high-intensity focused ultrasound (HIFU). The study meticulously examines the lifting effects of HIFU treatment across seven distinct facial aesthetic-units, using advanced three-dimensional scanner analysis. The study examined a cohort of 50 patients treated with HIFU. Pre- and immediate posttreatment evaluations were conducted using three-dimensional scanner analysis, allowing for precise quantification of lifting effects across seven aesthetic units. Treatment protocols were tailored to leverage five cartridges with micropulsed mode options, optimizing outcomes based on sonographic anatomy. The forehead was lifted by 1.24 mm; crow's feet, 2.25; malar region, 2.46; posterior cheek, 3.40; jowl, 2.90; mandible, 3.09; and neck, 3.53. The forehead showed a lift of 1.24 mm, attributed to the thin tissue requiring a cautious approach to avoid discomfort. A lift of 2.25 mm in the crow's feet area demonstrated the efficacy of HIFU in addressing fine lines and wrinkles. Significant lift of 2.47 mm in the malar region highlights HIFU's effectiveness in addressing mid-face laxity and restoring volume to the cheeks. The most substantial lift of 3.38 mm in the posterior cheek underscores targeted energy application for enhanced lifting and contouring. Notable lifting effect of 2.90 mm in the jowl area benefits sagging along the jawline, refining facial contour. Lift of 3.10 mm in the mandible shows improvement of lower facial laxity, defining the jawline. The highest lift of 3.55 mm in the neck region addresses laxity and sagging for a defined neck profile.

Evaluation of the efficacy of low-level laser therapy in the treatment of ulnar neuropathy at the elbow in terms of symptoms and clinical and electrophysiological findings: a randomized, prospective, double-blind clinical trial.

Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy and presents with symptoms such as pain, paresthesia, and weakness in the elbow. Provocative tests and electrophysiological examinations are helpful in the diagnosis of UNE. Low-level laser therapy is one of the conservative treatments of UNE however, limited results were reported on the effectiveness of low-level laser therapy (LLLT) in the treatment of UNE. In our study, we aimed to the efficacy of LLLT in reducing symptoms and providing clinical and electrophysiological improvement in patients with UNE. This study with a randomized-sham controlled, and double-blind design included 68 patients aged 18-60 years who were diagnosed with UNE. LLLT was applied to the first group, and sham laser was applied to the second group. The VAS pain, paresthesia, and weakness scores, grip strength, and provocative test positivity were evaluated in clinical examination. The QuickDASH questionnaire was administered to assess functional status. Electrophysiologically, motor distal latency (MDL) differences, sensory distal latency (SDL), motor and sensory nerve conduction velocity (NCV) were examined. Evaluations were performed before treatment and on the 15th day and at the third month after treatment. The LLLT group showed improvement in symptoms, clinical findings, motor NCV, and MDL at both post-treatment evaluations and sensory NCV on the post-treatment 15th day (p < 0.05). The comparison of post-treatment changes between the two groups revealed that the LLLT group had greater improvement in VAS day and night pain scores at both post-treatment evaluation times, QuickDASH scores at the third month, and sensory NCV on the 15th day (p < 0.05) compared to the SL group. There were no significant differences between the groups in terms of the post-treatment changes in VAS weakness scores, grip strength and electrophysiological findings (p > 0.05). It was observed that splinting alone was effective in UNE, but the addition of LLLT, one of the conservative treatment methods, enhanced treatment outcomes.

A clinical trial evaluation of handwashing products and educational resources to improve hand hygiene in paediatric patients and school children.

It is widely acknowledged that good hand hygiene (HH) is an important non-pharmaceutical method for reducing the transmission of infectious diseases. Children are at high risk of infection due to their immature immune systems. Hospital transmitted infections are a cause for concern worldwide, with poor HH suggested to be responsible for up to 20% of cases. Patients, in particular paediatric patients, are often overlooked when it comes to the promotion of hand hygiene compliance (HHC) in hospitals. This report describes the clinical evaluation of the 'Soaper Stars'; a collection of child-friendly HH products with linked educational resource, developed using the COM-B approach to behaviour change, and designed to encourage correct HH in paediatric patients and in schools. The Soaper Star products were distributed on paediatric wards in five UK hospitals, and the use of the products around mealtimes was evaluated. Workshops teaching the 'why when and how' of handwashing were run in four UK primary schools with pre and post evaluations conducted to establish impact on knowledge. Over 300 children were involved. The Soaper Stars products stimulated a 38% increase in HHC compared to when only hospital-issued products were available, and verbal feedback from families indicated that having the Soaper Star products encouraged improved HHC by all visitors, not just the patient. Workshops in four schools (283 pupils) showed an increase in knowledge around the transmission of infection and the need for good HH that was sustained for at least 4 weeks. The results of this study demonstrate that providing children with the age-appropriate knowledge about why HH is necessary, and the child-friendly means to maintain their HH, will lead to greater HHC, not just by individual children, but also their families.

Abstract B043: Improving quality of life for Hispanic breast cancer survivors: A culturally tailored education intervention

Abstract Purpose: To evaluate the effectiveness of the Breast Cancer Education Intervention (BCEI) program in increasing knowledge and awareness of survivorship topics among survivor advocates and survivors, and to assess the impact of survivorship care plans on quality of life. Breast cancer survivorship care is crucial for improving the quality of life among survivors. Hispanic/Latino women face greater challenges and disparities in accessing survivorship care due to cultural, socioeconomic, and systemic barriers. The BCEI program, adapted from the National Cancer Institute’s model, aims to address these disparities through culturally tailored survivorship education and support. Methods: The BCEI program was piloted with a group of 8 Hispanic/Latino breast cancer survivors, in collaboration with Cancer Support Community Arizona (CSCAZ). This six-month program, created and delivered in Spanish, consisted of bi- monthly in-person sessions and phone check-ins. The educational sessions featured topics such as emotional and physical changes, lifestyle behaviors, nutrition, exercise, and psychological distress along with the introduction of a personalized survivorship care plan. These sessions provided a sense of community and emotional support with essential knowledge and understanding of the cancer journey, addressing gaps caused by language barriers in clinical settings, and the lack of Spanish language support groups. Survivor advocates underwent specialized training to effectively support the survivor participants. Data for the BCEI program was collected through pre and post survey evaluations, participant check-ins, and qualitative feedback. Survivors were paired with bilingual Patient Navigators, who connected them to resources in the community. Results: Preliminary results show a significant improvement in survivors’ knowledge and satisfaction with survivorship care. Participants demonstrated an increased awareness of the importance of survivorship care plans and showed positive changes in lifestyle behaviors. The results highlighted the program’s cultural tailoring and sense of community as key success factors. Conclusion: The Breast Cancer Education Intervention program demonstrates potential in addressing health disparities in breast cancer survivorship among Hispanic/Latino women. Building on this success, we are expanding the BCEI program to include a second iteration focused on Black and African American breast cancer survivors, who also face similar challenges and disparities. The program will be implemented in collaboration with the Coalition of Blacks Against Breast Cancer (CBBC). Citation Format: Idali Cuellar, Farhia M. Omar. Improving quality of life for Hispanic breast cancer survivors: A culturally tailored education intervention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B043.

Research on the soothing Liver - Qi stagnation method in the treatment of postoperative papillary thyroid carcinoma patients' concomitant depression: A randomized controlled clinical trial.

Postoperative papillary thyroid carcinoma (P-PTC) patients often grapple with depression fueled by the looming threat of recurrence. While the Liver-Qi stagnation method is frequently employed for depression management, a notable scarcity of clinical trials exists regarding its application in patients with P-PTC and concurrent depression. This study presents a randomized controlled clinical trial, aiming to establish the efficacy of the Liver-Qi stagnation method in alleviating depression in patients with P-PTC. In this randomized controlled clinical trial, P-PTC patients diagnosed with concomitant depression were systematically enrolled. Subjects were randomly assigned to either the control or test group, both receiving standard treatment comprising Levothyroxine sodium tablets and decoction of benefiting Qi and nourishing Yin. Additionally, the test group received supplementation with bupleuri radix-paeoniae alba radix (CH-BS) alongside the baseline therapy. The intervention spanned 12 weeks. Pre- and post-treatment evaluations were conducted using the Hamilton Depression Scale (HAMD), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Traditional Chinese Medicine (TCM) syndrome score scale. Concurrently, blood inflammatory factors and serum 5-hydroxytryptamine (5-HT) levels were measured to comprehensively assess treatment outcomes. During the 12-week intervention, the test group demonstrated a significant reduction in HAMD scores compared to the control group (P < .05). Moreover, post-treatment serum 5-HT levels were significantly elevated in the test group compared to the control group (P < .05). Findings gleaned from the EORTC QLQ - C30 revealed a noteworthy improvement in social function and overall quality of life scores within both groups post-treatment in comparison to baseline (P < .05). Concurrently, post-treatment scores for fatigue and insomnia symptoms witnessed a significant decrease compared to baseline (P < .05). Notably, the test group exhibited superior scores in the emotional domain in contrast to the control group (P < .05). Both groups exhibited a substantial decrease in TCM syndrome scores from baseline (P < .05). Noteworthy increases were found in IFN-γ < 2.44 rate (62.86%) and IL-6 < 2.44 rate (74.29%) in the test group compared to pretreatment levels (P < .05). The soothing Liver-Qi stagnation method induces a rise in serum 5-HT levels, reducing depression-related inflammatory factors, culminating in the alleviation of depression for P-PTC.

Transcatheter Arterial Embolization for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Retrospective Study of 44 Patients.

To investigate the preliminary treatment outcomes of transcatheter arterial embolization (TAE) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This retrospective study included patients with refractory CP/CPPS who underwent TAE between April 2022 and February 2023. All patients had persistent pelvic pain for at least 3months, a total score of at least 15 on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and lacked evidence of infection. All procedures were performed by injecting imipenem/cilastatin sodium (IPM/CS) from bilateral prostatic arteries ± internal pudendal arteries. NIH-CPSI, pain numeric rating scale (NRS), and complications were evaluated at 1, 3, and 6months after the initial TAE and at the final follow-up. Out of 48 patients, 44 were included in this study, with four excluded because of loss of follow-up. No severe procedure-related complications were observed. Pretreatment and post-treatment evaluations at 1, 3, and 6months after the initial TAE and at the final follow-up (mean 16.6months) revealed a decrease in the mean NIH-CPSI scores from 27 ± 6 to 21 ± 8, 20 ± 9, 17 ± 9, and 18 ± 9, respectively (all P < 0.001). Pain NRS scores were also decreased from 7.0 ± 1.6 to 4.8 ± 2.5, 4.1 ± 2.6, 3.7 ± 2.4, and 3.4 ± 2.3, respectively (all P < 0.001). The proportions of clinical success, defined as a reduction of at least 6 points from baseline in the NIH-CPSI, at 6months after TAE and at the final follow-up were 70 and 64%, respectively. This study provides evidence of the feasibility of TAE using IPM/CS for CP/CPPS, suggesting both symptomatic improvement and safety.

Assessment of the Short-Term Efficacy of a Wet-Cupping Therapy Session in Alleviating Symptoms of Fibromyalgia Syndrome: A Single-Arm Clinical Trial

Fibromyalgia holds significant importance in both primary care and physical treatment settings due to its high prevalence and the challenges associated with its diagnosis and management. This study aims to assess the short-term efficacy of a wet-cupping therapy session in alleviating symptoms of Fibromyalgia Syndrome (FMS). This study employed a prospective, single-arm intervention design. Baseline and post-treatment evaluations encompassed a comprehensive battery of assessment tools: Socio-Demographic Questionary, Visual Analog Scale (VAS) for Pain, Fatigue Severity Scale (FSS), Beck Depression Scale (BDS), Fibromyalgia Impact Questionnaire (FIQ). A total of 20 eligible individuals were enrolled in the study. Significant alterations in pain perception, as measured by the VAS, were evident both prior to treatment and at the end of the first week of treatment (p &lt; 0.001). Additionally, significant favorable effects of the treatment were observed on FSS and BDS levels during the initial week of therapy (p = 0.001, p = 0.01; respectively). Moreover, a marked improvement was identified in FIQ scores after treatment compared to baseline (p &lt; 0.001). Across all evaluated clinical indicators, cupping therapy exhibited a significant positive influence on FMS. In conclusion, wet cupping therapy yields favorable outcomes in terms of pain perception, fatigue reduction, mood enhancement, and the overall impact of fibromyalgia syndrome. Thus, it offers a promising avenue for therapeutic intervention among individuals afflicted by this condition.

Mechanisms of treatment effects using allogeneic, umbilical cord-derived mesenchymal stromal stem cells (MSCs) in knee osteoarthritis: a pharmacological clinical study protocol

BackgroundKnee osteoarthritis (KOA) presents a prevalent orthopedic condition causing substantial impairment in the quality of life and imposing a significant societal and economic burden. Mesenchymal stromal/stem cells (MSCs), known for their regenerative properties and immunomodulatory effects, have emerged as a promising therapeutic avenue in regenerative medicine. Despite MSCs' therapeutic potential, their precise mechanisms of action in KOA remain underexplored.MethodsConducted as a randomized, open-label clinical trial, 20 patients will be enrolled, with 10 in the intervention group and 10 in the control group. The primary focus will be to explore the molecular mechanisms associated with MSC therapy. Biomarkers and gene expressions related to cartilage metabolism, inflammation, immune modulation, and pain in the synovial fluid, blood, and tissue samples will be analyzed. Patients will undergo pre- and post-treatment evaluations using patient-reported outcome measures (PROMs) and comprehensive clinical assessments.DiscussionThis is an exploratory study with the goal to provide comprehensive insights into the therapeutic effects of MSCs on a molecular level, potentially paving the way for optimized and more effective MSC-based therapies in the management of KOA, as well as furthering the development of novel treatment strategies.Trial registrationClinicalTrials.gov, NCT06078059. Registered on 5 October 2023.

Cooking Well with Diabetes: A Healthy Cooking School for Diabetes Prevention and Management.

One in ten Americans suffers from type 2 diabetes, which, if not managed well, can result in severe complications, disability, and premature death. Diabetes education classes can play a pivotal role in providing practical education on diabetes and self-care behaviors, with a particular emphasis on dietary management, which is often regarded as the most demanding diabetes self-care behavior. The Texas A&M AgriLife Extension Service developed Cooking Well with Diabetes (CWWD), a four-week interactive diabetes education series, with each week consisting of a lecture on healthy eating coupled with cooking lessons featuring diabetes-friendly recipes. The current study aimed to examine the effectiveness of CWWD in improving the frequency of healthy food preparation and consumption of program participants. Secondary data from 2017 to 2023 was analyzed involving 1574 adults from 59 predominantly rural Texas counties. Data from self-reported pre and post evaluations showed improvements in healthy food preparation and consumption behaviors. The curriculum enabled Extension Educators to introduce healthful dietary behaviors to a diverse group of clients. The curriculum can be adapted by Extension Educators in other states reaching a broader audience. The findings will inform future research aimed at planning and implementing successful diabetes education programs.

Relevance of distinctions and parallels between the US and EU guidelines for determination of comparative effectiveness and safety of the orally inhaled drug products

Approval of drug products for market registration warrants, among other data, evidence to support their safety and effectiveness in the target populations. The extent of investigations to provide the supporting evidence varies between the new innovator products and their follow-on versions generally referred to as Generic Drugs Products in the United States and Hybrids in the Europe. The new drug applications entail large data sets encompassing both nonclinical and clinical product developments. Safety and effectiveness in man is studied in sequentially phased clinical trials, including post marketing evaluations (Where applicable). However, for the generic/hybrid products the safety and effectiveness are established through determination of bioequivalence in head-to-head comparison between the originator and the follow-ons. Methods for documentation of bioequivalence for drug products that reach target site(s) through systemic circulation are aligned worldwide. However, establishing bioequivalence of orally inhaled drug products is complex as drug delivery to the local site(s) of action is independent of the systemic circulation. Documentation of bioequivalence gets further complicated due to the Drug-Device combination nature of these products. The guidelines for establishment of BE of locally acting orally inhaled drugs products vary among certain geographies. This article examines the scientific underpinning of distinctions and similarities between the US and EU guidelines.

Unveiling the Mechanism of Liangxue Siwu Decoction in Treating Rosacea Through Network Pharmacology and in-vitro Experimental Validation.

Rosacea, a recurring dermatological disorder, demands effective therapeutic approaches. Traditional Chinese medicine, particularly Liangxue Siwu Decoction (LXSWD), has shown promise in managing inflammatory skin diseases, such as rosacea. This study focuses on uncovering LXSWD's specific effects on the inflammatory symptoms of rosacea. Our research investigates LXSWD's therapeutic effectiveness in rosacea treatment and delves into its underlying mechanisms. Network pharmacology was utilized to identify LXSWD's key components and their targets in rosacea management, which were then validated by molecular docking. An in vivo rosacea-like model in LL-37-induced mice was developed, subdividing them into control, model, and LXSWD groups. The LXSWD group received oral administration (25.0 g/kg/day) for six days before model induction. Post-treatment evaluations included skin tissue analyses to verify our network pharmacology predictions. Key active ingredients in LXSWD, such as quercetin, kaempferol, and luteolin, were identified alongside central target proteins like TNF and MMPs. Our molecular docking study confirmed the interactions between these ingredients and targets. Analyses through GO and KEGG pathways indicated LXSWD's role in mitigating inflammation, particularly influencing the TNF and IL-17 pathways. LXSWD treatment in vivo markedly alleviated LL-37-induced symptoms in mice, showing a marked reduction in inflammatory cytokines (p < 0.05) and modulation of crucial genes (p < 0.05). These results, supported by immunofluorescence analysis and Western blot, underline the modulatory effects of LXSWD on MMPs, offering significant protection against rosacea's inflammation alterations (p < 0.05). Integrating network pharmacology, molecular docking, and in vivo experiments, this study elucidates LXSWD's potential mechanisms in rosacea treatment. It offers a novel theoretical framework for its clinical use in managing rosacea.

You Are Not Alone! Care Professionals‘ Acceptance of Telemedicine in Nursing Homes Comparing Pre- and Post-Implementation Evaluations

A lack of personnel in care institutions and high proportions of older people in need of care pose central challenges for today’s aging society, often resulting in the hospitalization of geriatric patients. In many cases, these hospitalizations are not medically necessary and cause deterioration of health. Applying telemedicine in nursing homes represents one approach aimed at a reduction of unnecessary hospitalizations of geriatric patients and supporting care personnel in medically uncertain situations. For a sustainable and successful implementation of technical innovations such as telemedical consultations, the care personnel’s perspectives and acceptance are especially essential. The Optimal@NRW project implemented telemedical consultations in 24 nursing homes in Germany, investigating medical and economic efficiency and in particular also the social acceptance of digital care in nursing homes. This paper presents quantitative results comparing the acceptance evaluations before (PRE: N = 130) and after (POST: N = 87) the implementation of the telemedical consultations in the nursing homes from the perspective of care professionals. The results showed positive evaluations of the telemedical consultations in both evaluation phases: POST evaluations especially showed a lower evaluation of perceived barriers of using telemedical consultations in nursing homes. This study’s insights enable one to derive guidelines and recommendations regarding the communication and information of telemedical applications considering the needs and wishes of care personnel as a central user group.

A survey of the prevalence and patterns of neuropsychological assessment practices across epilepsy surgery centers in India: Toward establishing a national guideline.

Neuropsychology plays an important role in optimizing epilepsy management, but there are no practice guidelines for low- and middle-income countries with emerging services. The National Epilepsy Surgery Support Activity Network (NESSAN), a national working group that supports and optimizes epilepsy surgery programs in India, explored the present status of pre- and post epilepsy surgery neuropsychological assessment practices across India as an initial step in developing national evidence-based test guidelines. An online survey was conducted using two questionnaires, one for neurologists and the second for neuropsychologists and speech-language pathologists working in epilepsy surgery centers. The questions to neurologists covered the setting, description, and nature of the neuropsychology services provided for adults and children as part of the epilepsy surgery program, and their perceptions about the importance and indications for neuropsychological assessment in epilepsy surgery. The questions to neuropsychologists inquired about their qualifications and training, pre- and postsurgical assessment procedures, and domain-specific cognitive tests and scales for mood, quality of life, and language evaluations. Forty-three centers responded, and neuropsychology services were available at three fourth of the centers, but a dedicated full-time neuropsychologist was available in only 16% of centers. Ninety percent of the neurologists considered neuropsychological evaluation an indispensable part of presurgical evaluation. However, only a few of them believed that the results influenced their decision about the extent of resection and ruling against surgery. The survey found considerable heterogeneity in terms of qualifications and training of neuropsychologists, evaluation procedures, test protocols, and normative data that will need to be harmonized to ensure uniform practice across the country. We believe that the results from this survey provide a road map for implementing measures to minimize existing inadequacies and harmonize neuropsychology services in India and as well as in other countries with emerging neuropsychology services. PLAIN LANGUAGE SUMMARY: Neuropsychological assessment is an integral part of the pre- and post epilepsy surgery evaluations. In India, the National Epilepsy Surgery Support Activity Network (NESSAN), a body of multidisciplinary professionals, conducted a survey to examine existing neuropsychology practices. The responses from 43 centers across the country revealed considerable heterogeneity in tests and few trained and qualified neuropsychologists. In low- and middle-income countries (LMIC) with emerging neuropsychology services, there is a need to have uniform test protocols, specialized training, and guidelines for optimizing neuropsychology services across all the epilepsy surgery centers.

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3-6 Months After Injury.

Fractional ablative CO2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries,which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended;however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients. Patients who received three or more laser treatment sessions and completed both pre- and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4-8-week intervals. Patients starting treatment before 6 months after injury were classified as the early-stage intervention group and those beginning treatment at 6-12 months after injury were classified as the late-stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser-assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two-way ANOVA, Student's t-test, and Mann-Whitney U-test were used to compare scores from the pre- to posttreatment evaluations. There were no significant differences between the groups for any of the demographic or scar-specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early- and middle-stage initiation showed scar symptom improvement in five out of six scales. In the late-stage intervention, the Patient and Observer Scar Assessment Scale-Patientaverage score did not show improvement. In the early-stage intervention, the Vancouver Scar Scaletotal did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in either group. The Scar Comparison Scaledemonstrated the greatest improvement across groups. Laser treatment led to scar improvement in at least one scale at each stage of initiation. Both intervention timelines resulted in equivalent outcomes, and early intervention should be considered when initiating FLSR treatment in burn scars to alleviate symptoms earlier.

PMB-CT01 (BAFFR-CAR T cell) therapy to examine preliminary safety and clinical responses in patients with B-cell malignancies who are ineligible for or failed CD19-directed therapy, including CD19-negative disease.

6534 Background: CD19-targeted therapies have shown remarkable efficacy in patients with B-cell malignancies. However, relapse with CD19 loss as a mechanism of tumor escape is common and represents a serious challenge. Patients who are ineligible for or have failed prior CD19-directed therapy have limited salvage options and a very poor prognosis. The B-cell activating factor receptor (BAFF-R) is functionally expressed in B-cell acute lymphoblastic leukemia (B-ALL) and non-Hodgkin lymphomas (NHL), including in patients with CD19-negative relapse (Qin et al., Sci Transl Med. 2019). As a critical regulator of B-cell function and survival, BAFF-R may be less prone to downregulation by tumors as a mechanism of antigen escape. Methods: We are conducting two phase 1 clinical trials of BAFFR-CAR T cells in patients with relapsed/refractory (r/r) B-ALL (NCT04690595) and NHL (NCT05370430). Primary endpoints are dose limiting toxicities (DLTs) and all other toxicities. Secondary endpoints include response rate, minimal residual disease (MRD) negative rate, PFS and OS. Response is evaluated using European LeukemiaNet criteria for B-ALL and Lugano 2014 for NHL. Results: As of Feb. 1st, 2024, 1 B-ALL and 3 NHL patients have completed treatment and post-treatment evaluations. Each received 50M BAFFR CAR T cells (starting dose level in both trials). The B-ALL patient had CD19/CD20/CD22-negative disease, and had received prior blinatumomab. NHL patients #1 and #2 both had CD19-expressing mantle cell lymphoma (MCL) and had received prior CD19 CAR T cells. Patient #2 had also received a CD3/CD20 bispecific antibody. NHL patient #3 had CD19/CD20-negative T cell/histiocyte-rich large B-cell lymphoma (THRBCL) and had not received prior CD19 CAR T cells. There were no DLTs, all patients had Gr. 1 cytokine release syndrome, and 2/3 NHL patients had Gr. 1 immune effector cell-associated neurotoxicity syndrome. Robust CAR T cell expansion was seen in all patients with a peak on days 12-14 post-infusion. The B-ALL and the 2 MCL patients reached MRD-negative complete response (CR) at 1 month post-treatment. The THRBCL patient had partial response (PR) at 1 month that converted to CR at 3 months. The B-ALL patient successfully transitioned to allogeneic HCT while in CR at 3 months post-infusion. Responses are ongoing in all NHL patients at 14, 10, and 8 months for patients #1, #2 and #3, respectively. Additional patients have been enrolled at the next dose level (200M CAR T cells). Results for these patients will be presented at the meeting. Conclusions: With a 100% CR rate at 3 months in the first 4 patients and durable responses at dose level 1, BAFFR-CAR T cells are a promising therapeutic option for patients with r/r B-cell malignancies who are ineligible or failed prior CD19-targeted therapy, including with CD19 antigen loss. Clinical trial information: NCT04690595 , NCT05370430 .