Even though the cases described by these reports are, by definition, exceptional, the decline of their publication implies a significant loss of scientific information and clinical knowledge regarding certain pathologies.

There has been a decline in publication of case reports in journals of Endocrinology in recent years, both in absolute and relative terms. Even though the cases described by these reports are, by definition, exceptional, the decline of their publication implies a significant loss of scientific information and clinical knowledge regarding certain pathologies.

The impact of clinical trial participation on overall survival is unclear. We hypothesized that enrollment in a therapeutic drug clinical trial is associated with longer overall survival in patients with metastatic non-small cell lung cancer (NSCLC).

We linked electronic medical record and Washington State cancer registry data to identify patients with metastatic NSCLC diagnosed between January 1, 2007, and December 31, 2015 who received treatment at a National Cancer Institute-designated cancer center. The exposure was trial enrollment. The primary outcome was overall survival, defined as the date of second-line treatment initiation to date of death or last follow-up. We used a conditional landmark analysis starting at the date of second-line treatment initiation and propensity scores with inverse probability of treatment weighting to estimate the association between trial enrollment and survival.

Of 215 patients, 40 (19%) participated in a second-line trial. Trial participants were more likely to be never smokers (45% vs 27%), have a good performance status (88% vs 77%) and have EGFR (48% vs 14%) and ALK mutations (8% vs 5%) than nonparticipants. Trial participants had similar overall survival to nonparticipants (HR 1.05; 95% CI, 0.72, 1.53; p=0.81) after adjusting for sociodemographic and disease characteristics.

Accounting for the immortal time bias and selection bias, trial participation does not appear detrimental to survival. This finding may be reassuring to patients and supports programs and policies to improve clinical trial access.

Accounting for the immortal time bias and selection bias, trial participation does not appear detrimental to survival. This finding may be reassuring to patients and supports programs and policies to improve clinical trial access.

Pharmacy stands increasingly on the frontline of patient care, yet current studies of clinical decision-making by pharmacists only capture deliberative processes that can be stated explicitly. Decision-making incorporates both deliberative and intuitive processes. Clinical Judgement Analysis (CJA) is a method novel to pharmacy that uncovers intuitive decision-making and may provide a more comprehensive understanding of the decision-making processes of pharmacists.

This paper describes how CJA potentially uncovers the intuitive clinical decision-making processes of pharmacists. Using an illustrative decision-making example, the application of CJA will be described, including METHOD An illustrative study was used, applying an established method for CJA. The decision to initiate anticoagulation, alongside appropriate risk judgements, was chosen as the context. Expert anticoagulation pharmacists were interviewed to define and then refine variables (cues) involved in this decision. Decision tasks with sixty scocesses of pharmacists not uncovered by the current literature. This provides a springboard for more in-depth explorations; explorations that are vital to the understanding and ongoing development of the role of pharmacists.The aim of the study was to investigate safety and if extracorporeal photopheresis (ECP) may change health criteria (HC) and quality of life (QoL).

560 patients (33 % women) were treated with ECP for a total of 13,871 procedures during a 17-years period. Mean age was 48 years (±18, range 3-81 years). Self-estimation of QoL was graded 0 (suicidal) up to 10 (best ever) and HC 0 (Bed ridden, ICU condition) up to 10 (athletic). Adverse events were analyzed. ANOVA and paired comparisons were performed.

Patients were treated due to graft versus host disease (GVHD, n = 317), skin lymphoma (n = 70), solid organ transplants (n = 47), skin diseases (n = 20) and other diseases (n = 106). Adverse events (AEs) were registered in 5.4 % of the first treatments and in 1.2 % of the subsequent procedures. Severe AEs were present in 0.04 % of all procedures. No patient died due to the procedure. Tingling and stitching were the most common AE. For those with GVHD an improvement was noticed within approximately 10 procedures of ECP in the severity stage, QoL (from a mean of 6.1 to 6.8, p < 0.002) and the HC (6.1 -> 6.4, p < 0.014) and improved further with added procedures.

Photopheresis is an established therapy with few side effects. The present study of soft variables indicate that GVHD shows benefits upon ECP within approximately 10 procedures in regard to the severity of mainly skin GVHD, and lower baseline levels of HC and QoL.

Photopheresis is an established therapy with few side effects. The present study of soft variables indicate that GVHD shows benefits upon ECP within approximately 10 procedures in regard to the severity of mainly skin GVHD, and lower baseline levels of HC and QoL.

The transverse upper gracilis (TUG) flap provides a good alternative to the gold standard DIEP in breast reconstruction. However, flap volume estimates are subjective, making preoperative planning potentially challenging.

To derive a reliable, accurate, and reproducible mathematical algorithm for the preoperative calculation of TUG flap volumes.

Nineteen consecutive patients with 30 TUG flaps were prospectively included. On the assumption that the TUG flap resembles two isosceles prisms, the formula of the volume of a prism was used to calculate their preoperative flap weights. These were then intraoperatively compared to the actual flap weights. A regression equation was calculated from the correlation analysis of 10 random flaps. This was then applied to the remaining 20 flaps to assess for improved reliability and weight prediction accuracy.

The prism volume equation used to clinically calculate flap volumes was Geometric flap weight = (h

bT)/2+ (h

bT)/2, (h = height, b = base, T = flap thickness); all in centimetres. Geometric and actual flap weights were found to be significantly correlated (r

 = 0.977) generating the following regression formula predicted TUG weight = 0.924 × geometric weight + 26.601. When this was applied to the remaining 20 flaps, no significant difference was found (p = 0.625) between predicted and actual flap weights, demonstrating an increased accuracy of predicting flap volume.

The proposed formula provides the clinician with a more accurate and reliable estimation of available TUG flap volume and may potentially aid with preoperative planning and patient consultations.

The proposed formula provides the clinician with a more accurate and reliable estimation of available TUG flap volume and may potentially aid with preoperative planning and patient consultations.

Data is limited how well patient-reported longer-term outcome measures (PROMs) explain medically graded reduced capacity for work (RCW).

This prospective study investigates the association of RCW with several PROMs in addition to demographic and injury-related variables in significantly injured of working age.

Patients (New Injury Severity Score, NISS≥8) were recruited consecutively. RCW, as registered by the largest Swiss accident insurer, was tested against demographic, trauma and treatment characteristics, and patients’ contemporaneous two year rating of functional outcome and quality of life following trauma with measures such as the Short-Form (SF)-36 or Trauma Outcome Profile (TOP), using uni- and multivariable analysis.

140 patients (mean 42 years, 2-year RCW rate 21%) participated in the longer-term follow-up of self-rated outcome. In multivariable analysis, all investigated baseline factors together accounted for 48% of the variance explaining 2-year postinjury RCW with 31% contributed by demographic, injury or treatment related variables, and 17% by patients’ condition at hospital discharge. Patients’ self-rated longer-term outcome provided 61% of the information on concurrent RCW, whereby 53% identified worsening of physical function (SF-36) and additional 8% constraints in daily activities (TOP). Four variables (Glasgow Outcome Scale at the time of hospital discharge and SF-36 physical functioning, TOP daily activities, SF-36 role physical at two years) explained 71% of RCW, corresponding to an area under the curve (AUC) of 0.95.

Objectively graded RCW 2 years after injury was found to be well explained by the combined information of patients’ subjective longer-term outcome together with basic patient, trauma and treatment characteristics.

Objectively graded RCW 2 years after injury was found to be well explained by the combined information of patients’ subjective longer-term outcome together with basic patient, trauma and treatment characteristics.

To investigate whether participation in sport during the developmental stages of life is associated with cardiorespiratory fitness (CRF) in adulthood.

Observational longitudinal study.

Participants were Generation 2 of the Raine Study. Questionnaires related to participation in sport were administered at ages 5, 8, 10, 14 and 17 years. These data were used to develop sex-specific trajectories of sports participation (for males) Consistent Participators, Drop-Outs and Joiners; and (females) Consistent Participators, Non-Participators and Drop-Outs. At age 28.3 ± 0.6 years, participants completed a graded maximal exercise test (i.e. V̇O

peak test). A General Linear Model assessed differences in CRF between trajectories.

402 participants n = 231 (57.5%) male, n = 171 (42.5%) female were included in the study. In males, Consistent Participators (all p < 0.001) and Joiners (p < 0.050) had greater fitness than Drop-Outs. In females, Consistent Participators had greater fitness than Non-Participators mple dichotomous question regarding sports participation over the childhood and adolescent period can be implemented to predict better fitness outcomes in young adulthood. Childhood and adolescence could be an opportune stage in life for parents, schools and governments to facilitate participation in sport and prevent drop out, as it may have an impact on long term risk reduction, with associated health and economic benefits.

This study aimed to investigate air drag and lift during the in-run and flight phase of ski and snowboard slopestyle and big air, to allow more valid modeling of jumps and hence reduce injury risk.

We present an experimental, multiple single athlete study based on wind tunnel measurements of 4 skiers and 3 snowboarders.

Measurements were carried out in a closed loop wind tunnel, measuring airflow speed and 3D forces acting on the athletes. Athletes performed trials in typical postures at 35, 60 and 85 km/h wearing slim-, regular- and wide fit apparel. Drag and lift area (c

A; c

A) were calculated and analyzed using linear and multiple regression to describe their dependencies on posture, apparel and speed.

c

A values were higher than earlier assumed and ranged from 0.3 to 0.95 m

for skiers and from 0.35 to 0.55 m

for snowboarders, primarily dominated by posture, and followed by apparel. c

A ranged from -0.1 to 0.45 m

for skiers and from 0.04 to 0.17 m

for snowboarders. To facilitate more valid jump modeling posture- and apparel-dependent formulations for air drag coefficients were provided and the consequences of sport specific differences on modeling were highlighted.