Author: Urbina, Luciana ; Cercenado, Emilia ; Vicente, Teresa ; De la Villa, Sofía ; Muñoz, Patricia ; Padilla, Belén ; Serrano, Julia ; Sánchez-Martínez, Celia

OBJECTIVEWe analyse the effectiveness of short courses of adequate treatment in patients with episodes of carbapenemase-producing Enterobacterales bloodstream-infections (CPE-BSI).METHODSPatients with first monomicrobial CPE-BSI episodes who received ≥72 h of appropriate treatment from 2014-2022 were selected. Detection of CPE was established on the basis of phenotypic antibiogram and confirmation by PCR and/or immunochromatographic methods. Patients were classified in short treatment group (STG) those who received 3-10 days of appropriate treatment, and long treatment (LTG) those receiving >10 days. Unfavourable outcome consisted in a composite of global 30-day mortality and/or persistent bacteremia and/or recurrent bacteremia. Inverse probability of treatment weighting (IPTW) analysis was performed to compare the outcome between the two study groups.RESULTSWe included 105 CPE-BSI episodes: 99 were caused by OXA-48-like, 4 VIM and 2 KPC carbapenemases. Thirty-nine patients (37.1%) were included in the STG and 66 (62.9%) in LTG. The STG group presented frequent treatment with ceftazidime-avibactam (43.6% vs. 24.2%, P = 0.03) and lower in-hospital stay (21 days vs. 32 days, P = 0.02). Overall, 28 patients (26.7%) presented unfavourable outcome: IPTW analysis showed no differences in the outcome between STG to LTG groups (24.2% vs. 30.8%, weighted-risk difference 6.6%, P = 0.44). Patients with unfavourable outcome presented more frequently source other than urinary-biliary (46.4% vs. 23.4%, P = 0.02), received less frequently ceftazidime-avibactam (14.3% vs. 37.7%, P = 0.02) and presented frequently with absence of source control when indicated (28.6% vs. 13.0%, P = 0.06).CONCLUSIONSShort treatment durations for CPE-BSI episodes may be effective, as long as they are appropriate and source control is performed.

23 Sep 2024·Surgical endoscopy

Subtotal versus total gastrectomy for distal diffuse-type gastric cancer.

Article

Author: Pacheco, Francisco A ; Torres, Osvaldo A ; Molina, Hector E ; Muñoz, Florencia D ; Arriagada, Francisco J ; Veloso, Francisca A ; Schaub, Thomas P ; Gajardo, Jorge A

INTRODUCTIONDiffuse-type gastric carcinoma in an aggressive form of gastric cancer. Surgery is the only potentially curative treatment. It is controversial whether patients with diffuse-type gastric carcinoma should undergo total or subtotal gastrectomy when feasible. The aim of this study is to analyze the oncologic outcomes and overall survival of patients diagnosed with distal diffuse-type gastric cancer undergoing subtotal versus total gastrectomy with curative intent.METHODSThis retrospective study included all patients with histologically confirmed diffuse-type distal gastric carcinoma and clinical staging cT1-4M0, who underwent surgery with curative intent between 2011 and 2020 in a Tertiary Referral Hospital in Chile. Clinical and pathological staging was conducted using the 8th Edition of the American Joint Committee on Cancer Classification. STG group was comprised by patients who underwent subtotal gastrectomy and TG group by patients who underwent total gastrectomy. Both groups were compared in relation to sociodemographic variables, pathology reports and perioperative data which were obtained from electronic medical records. Data analysis was obtained with Stata 16.1 Statistical Software.RESULTSOne hundred and thirty patients underwent curative intent surgery. Subtotal gastrectomy with D2-lymphadenectomy was completed in 68 patients (52%). An R0 resection was achieved in all patients. Median number of resected lymph nodes, tumor size, proximal margin and depth of invasion were similar in both groups. Pathologic staging was similar between both groups, the most frequent being Stage 3(54%). After a median follow-up of 47 months [0.3-157], no difference was observed in overall survival between both groups (5-year-OS 63% in STG group versus 51% in TG group, p = 0.097).CONCLUSIONSOncologic and survival outcomes were similar in patients submitted to subtotal and total gastrectomy, suggesting that a subtotal gastrectomy with D2-lymphadenectomy for distal diffuse-type gastric carcinoma is not associated with a decrease in median overall survival and is an adequate surgical approach when technically feasible.

01 Jul 2024·Journal of Bodywork and Movement Therapies

Strength training improves functional capacity of individuals with chronic heart failure: Randomized clinical trial

Article

Author: Vieira, Marcelo Carvalho ; Souza, Wallace Machado Magalhães de ; Serra, Salvador Manoel ; Nascimento, Pablo Marino Correa ; Reis, Michel Silva

INTRODUCTIONChronic heart failure (CHF) is characterized by dyspnea, exercise intolerance and impaired quality of life. Physical exercise is a key point in the treatment of these outcomes.OBJECTIVETo evaluate the effect of 24 weeks of two different training strategies on functional capacity, muscle strength and quality of life in individuals with CHF.METHODSThe following tests and evaluations were performed before and after 24 weeks of training: exercise test, one-repetition maximum test (1- RM) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Subjects were randomized according to the modality they would perform first: aerobic training group (ATG - n=6) or strength training group (STG - n=7).RESULTSThe sample consisted of 13 individuals (10 men), aged 55 ± 12 years and a left ventricular ejection fraction (LVEF) of 38.8 ± 5.3%. There was a significant increase in V'O 2peak only in STG (STG: 26.92 ± 9.81 vs 30.52 ± 8.39 mL.kg -1 .min -1 - p=0.025; ATG: 19.60 ± 7,00 vs 22.42 ± 8.54 mL.kg -1 .min -1 - p=0.119). Both groups showed significant improvements in muscle strength (STG: 45 ± 17 vs 51 ± 20 kg - p=0.001; ATG: 38 ± 19 vs 42 ± 20 kg - p=0.012). There was no significant difference in quality of life (STG: 30 ± 18 vs 24 ± 20 - p=0.109; ATG: 36 ± 16 vs 26 ± 15 - p=0.143).CONCLUSIONThe early implementation of strength training improves functional capacity and muscle strength of individuals with CHF.

News (Medical) associated with mdc STG

13 Sep 2022

·www.biospace.com

MedinCell Signs a Licence Agreement With the Medicines Patent Pool to Fight Malaria Transmission, as Part of Its Global Health Mission

GENEVA, Switzeland & JACOU, France--(BUSINESS WIRE)-- The licence agreement complements the collaboration between Medincell and the health agency Unitaid that funds the development of mdc-STM, an investigational long-acting injectable formulation for the prevention of malaria. The Medicines Patent Pool (MPP) is a United Nations-backed public health organisation working to increase access to, and facilitate the development of life-saving medicines for low- and middle-income countries. The licence agreement relates to a 3-Month active injectable formulation of ivermectin using Medincell’s BEPO® technology to fight malaria transmission. The licence agreement aims to ensure that the product be widely distributed in low- and middle-income countries if proven effective and safe. Malaria remains endemic in 91 countries leading to 627,000 deaths in 2020. Children under 5 are the most vulnerable, accounting for 80% of deaths. Click here to access the full press release About MedinCell MedinCell is a pharmaceutical company at premarketing stage that develops a portfolio of long-acting injectable products in various therapeutic areas by combining its proprietary BEPO® technology with active ingredients already known and marketed. Through the controlled and extended release of the active pharmaceutical ingredient, MedinCell makes medical treatments more efficient, particularly thanks to improved compliance, i.e. compliance with medical prescriptions, and to a significant reduction in the quantity of medication required as part of a one-off or chronic treatment. The BEPO® technology makes it possible to control and guarantee the regular delivery of a drug at the optimal therapeutic dose for several days, weeks or months starting from the subcutaneous or local injection of a simple deposit of a few millimeters, fully bioresorbable. MedinCell collaborate with tier one pharmaceuticals companies and foundations to improve Global Health through new therapeutic options. Based in Montpellier, MedinCell currently employs more than 150 people representing over 30 different nationalities.

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