Princess Alexandra Hospital (United Kingdom)

Ho G., Collgros H., Sinz C., Melhoranse-Gouveia B., Gallo B., Chew C.Y., Ip K., Koutsis J., Lo S.N., Schwartz-Aldea R., Herbert H., Ferguson P., Gribbin H.G., Mar V., Soyer H.P., et. al.

Cutaneous confocal microscopy (CCCM) facilitates in vivo visualisation of skin at a cellular level. Use of a "store and forward" approach for remote CCM interpretation (Remote-CCM) across multiple sites has not been tested and may increase access to non-invasive diagnosis.

Boroumand F., Bakar S., Gately R., Lim W., Lopez da Cruz P., Sabanayagam D., Van Zwieten A., Wong G., zhu L., TeixeiraPinto A.

Jefferis J., Mallett A., Rangan G., Cho Y., Viecelli A., Vangaveti V., Johnson D., Hawley C.

Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem syndrome associated with kidney failure and cardiovascular disease. Cardiovascular disease is a major cause of morbidity and mortality in patients receiving kidney replacement therapy (KRT). We sought to evaluate cardiovascular disease, morbidity and mortality in Australian and New Zealand patients with ADPKD commencing KRT.

Brown E., Albakr R., Bieber B., Sylvertooth D., Jesudason S., Johnson D., Kawanishi H., Nitta K., Kim Y., Kanjanabuch T., Naljayan M., Pecoits-Filho R., Pisoni R.L., Perl J., Albakr R.

Peritoneal dialysis (PD) has many advantages as a home treatment. While sex differences exist in the diagnosis and management of numerous different diseases, including kidney disease, there is a limited understanding of whether sex influences PD outcomes. Using the prospective worldwide Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS), we have been able to describe some initial significant sex disparities in several important PD outcomes.

Viecelli A., Valks A., Baer R., Cherian R., Jaure A., Johnson D., Kiriwandeniya C., Liu W., Lok C., Madhan K., Sautenet B., Snoeijs M., Wilkie M., Hawley C., Cippà P., et. al.

A functioning vascular access (VA) is crucial to providing adequate hemodialysis (HD) and considered a critically important outcome by patients and healthcare professionals. VALID (Vascular Access outcome measure for function: a vaLidation study In hemoDialysis) aimed to validate a core outcome measure for VA function established via consensus among 918 health professionals and 237 patients and caregivers from 58 different countries.

Lerner A., Lee A.J., Yan H., Van Griethuysen J., Bartlett A.D., Veli M., Jiang Y., Luong M., Naban N., Kane C., Conibear J., Papadatos-Pastos D., Ahmad T., Chao D., Anand G., et. al.

AbstractAims We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres. Materials and methods This multi-institutional retrospective cohort study included 226 metastatic NSCLC patients. Outcomes were number and severity of immune-related adverse events (irAEs), median progression-free survival (mPFS) and median overall survival (mOS). Results Within our cohort, 119/226 (53%) patients developed irAEs. Of these, 54/119 (45%) experienced irAEs affecting two or more organ systems. The most common irAEs were diarrhoea and rash. The development of an irAE was associated with better mOS (20.7 versus 8.0 months; P < 0.001) and mPFS (12.0 versus 3.9 months; P < 0.001). The development of grade 3/4 toxicities was associated with worse outcomes compared with the development of grade 1/2 toxicities (mOS 6.1 months versus 25.2 months, P < 0.01; mPFS 5.6 months versus 19.3 months, P=0.01, respectively). Females had a higher proportion of reported grade 3/4 toxicities (13/44 [29.5%] versus 10/74 [13.5%], P=0.03). Using a multiple Cox regression model, the presence of irAEs was associated with a better overall survival (hazard ratio=0.42, 95% confidence interval 0.29–0.61; P < 0.01) and better PFS (hazard ratio 0.38, 95% confidence interval 0.27–0.53; P < 0.001). Conclusion In this multicentre retrospective cohort study, the development of at least one irAE was associated with significantly longer mPFS and mOS; however, more severe grade 3 and 4 irAEs were associated with worse outcomes. Delayed-onset irAEs, after the 3-month timepoint, were associated with better clinical outcomes.

Sewpaul Y., Huynh R., Hartland A.W., Leung B., Teoh K.H., Rashid M.S.

Purpose To determine whether non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors affect healing rate, functional outcomes, and patient satisfaction after rotator cuff repair. Methods Medline, EMBASE, PsychINFO and the Cochrane Library were searched for randomized controlled trials (RCTs) investigating the use of NSAIDs and COX-2 inhibitors after arthroscopic rotator cuff repair. Primary outcomes included healing and retear rate, determined by radiological imaging. Secondary outcomes included shoulder-specific outcome measures and the visual analog scale (VAS). Risk of bias was graded using the Cochrane risk-of-bias v2.0 tool. The GRADE framework was used to assess certainty of findings. Results Seven RCTs with a total of 507 patients were included (298 randomized to NSAID/COX-2 vs 209 randomized to control). NSAIDs use did not yield a difference in retear rate (P = .77). NSAIDs were shown to significantly reduce pain in the perioperative period (P = .01); however, no significant difference was present at a minimum of 6 months (P = .11). COX-2 inhibitors did not significantly reduce pain (P = .15). Quantitative analysis of ASES and UCLA scores showed NSAIDs significantly improved functional outcomes versus control (P = .004). COX-2 inhibitors did not significantly improve functional outcomes (P = .15). Two trials were deemed "low" risk of bias, four trials were graded to have "some concerns", and one trial was graded to have "high" risk of bias. Retear rate and functional PROMs were deemed to have "low" certainty. VAS pain scale was graded to have "moderate" certainty. Conclusions This systematic review and meta-analysis indicates that NSAIDs do not affect healing rate after arthroscopic rotator cuff repair, but they do significantly improve postoperative pain and functional outcomes. No significant difference was seen in pain or functional outcomes with the use of COX-2 inhibitors. Level of Evidence Level I, meta-analysis of randomized controlled trials.