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We report self-starting mode-locking of a diode-pumped super-stretched unidirectional ring laser based on a 26 m cladding-pumped Yb3+-fiber and an internal grating dispersion compensation. The long fiber resulted in an extremely high pulse stretching ratio inside the cavity of about 500 which is more than one order of magnitude above previously demonstrated laser systems. This system was passively mode-locked by nonlinear polarization rotation and generated pulses with 40 nm bandwidth at 1095 nm, a pulse energy of about 9.5 nJ and an output power of 630 mW. [Copyright &y& Elsevier]

We report on an all solid state master oscillator fiber power amplifier system emitting either single frequency radiation at 1064 nm or tunable narrow linewidth radiation in the wavelength range from 1035 to 1105 nm by using a nonplanar ring oscillator or a tunable fiber ring laser as seed source, respectively. The maximum output power of the system was 9.3 W and stayed above 8 W at all wavelengths. The relative amount of amplified spontaneous emission in the amplified output was below 5×10−5 at wavelengths from 1080 to 1095 nm. [Copyright &y& Elsevier]

Serious adverse events that occur with the administration of iron dextran are due to the high molecular weight preparations. Conclusions that iron sucrose and ferric gluconate are safer than iron dextran may be premature. Published literature comparing safety profiles of available parenteral iron products is reviewed. Administration of iron salts to pre-dialysis patients with chronic kidney disease may not be optimal. We recommend the total dose infusion of low molecular weight iron dextran as an option for iron replacement.Kidney International (2008) 73, 528–530. doi:10.1038/sj.ki.5002779 [ABSTRACT FROM AUTHOR]

The phase III VISION trial demonstrated that 177Lu-PSMA-617 radioligand therapy (RLT) improved overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) who previously received taxane-based chemotherapy and at least one androgen receptor pathway inhibitor (ARPI). As a result, Lu-PSMA-617 radioligand therapy (RLT) improved overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) who previously received taxane-based chemotherapy and at least one androgen receptor pathway inhibitor (ARPI). As a result Lu-PSMA-617 radioligand therapy (RLT) improved overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) who previously received taxane-based chemotherapy and at least one androgen receptor pathway inhibitor (ARPI). As a result, 177Lu-PSMA-617 therapy has been approved in this patient population by the U.S. Food and Drug Administration for up to six cycles (7.4 GBq per cycle) every 6 weeks. Unfortunately, this treatment is not curative and patients relapse even after initially favorable responses. When this occurs, patients have limited treatment options given they have had prior chemotherapy and ARPI regimens. Re-administration of Lu-PSMA-617 therapy has been approved in this patient population by the U.S. Food and Drug Administration for up to six cycles (7.4 GBq per cycle) every 6 weeks. Unfortunately, this treatment is not curative and patients relapse even after initially favorable responses. When this occurs, patients have limited treatment options given they have had prior chemotherapy and ARPI regimens. Re-administration of Lu-PSMA-617 therapy has been approved in this patient population by the U.S. Food and Drug Administration for up to six cycles (7.4 GBq per cycle) every 6 weeks. Unfortunately, this treatment is not curative and patients relapse even after initially favorable responses. When this occurs, patients have limited treatment options given they have had prior chemotherapy and ARPI regimens. Re-administration of 177Lu-PSMA-617 in patients who previously benefited from therapy and had limited toxicity seems to be a promising option. Small retrospective studies have reported favorable outcomes. Further prospective data with larger sample sizes are needed to confirm these findings. RE-LuPSMA is an investigator-initiated, single-arm, single-center, open-label, phase 2 clinical trial (NCT06288113). This study plans to enroll 40 patients with progressive mCRPC who previously completed 4-6 cycles of 177Lu-PSMA-617 therapy with a favorable response. Favorable response is defined as a prostate-specific antigen (PSA) decline ≥50% during the first regimen. Progression following the first regimen is defined using imaging or PSA (two consecutive PSA increases ≥3 weeks apart). Patients who received another line of prostate cancer therapy within two months of completing the first regimen of Lu-PSMA-617 therapy with a favorable response. Favorable response is defined as a prostate-specific antigen (PSA) decline ≥50% during the first regimen. Progression following the first regimen is defined using imaging or PSA (two consecutive PSA increases ≥3 weeks apart). Patients who received another line of prostate cancer therapy within two months of completing the first regimen of Lu-PSMA-617 therapy with a favorable response. Favorable response is defined as a prostate-specific antigen (PSA) decline ≥50% during the first regimen. Progression following the first regimen is defined using imaging or PSA (two consecutive PSA increases ≥3 weeks apart). Patients who received another line of prostate cancer therapy within two months of completing the first regimen of 177Lu-PSMA-617 are excluded. Patients must meet PSMA PET/CT VISION criteria. PSMA PET/CT must have been completed within 8 weeks of the planned first cycle of re-challenge therapy. Upon enrollment, participants will receive up to 6 additional cycles of Lu-PSMA-617 are excluded. Patients must meet PSMA PET/CT VISION criteria. PSMA PET/CT must have been completed within 8 weeks of the planned first cycle of re-challenge therapy. Upon enrollment, participants will receive up to 6 additional cycles of Lu-PSMA-617 are excluded. Patients must meet PSMA PET/CT VISION criteria. PSMA PET/CT must have been completed within 8 weeks of the planned first cycle of re-challenge therapy. Upon enrollment, participants will receive up to 6 additional cycles of 177Lu-PSMA-617 (7.4GBq every 6 weeks). Patients will follow-up every 6 months until 2 years from the end of re-challenge therapy. The primary endpoint is 12-month OS measured from the start of re-challenge therapy. The study will have 80% power to detect a difference between the null hypothesis of 50% and the study hypothesis of 71%. Secondary endpoints include adverse event rates, PSA response rates (proportion of patients with a PSA decrease of ≥50%), biochemical progression-free survival (time until PSA level increases 25% and 2 ng/mL above the nadir), radiographic progression-free survival, and health-related quality of life changes (measured using Functional Assessment of Cancer Therapy - Radionuclide Therapy [FACT-RNT] and Brief Pain Inventory [Short Form]). Enrollment has started with a planned study duration of 4 years of which subject accrual occurs in the first 12 months. TBD. TBD. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to assess the genotype-phenotype of PINK1 mutations. We genotyped eight known mutations in three clinic-based cohorts with Parkinsonism and found one homozygous p.L347P mutation in PINK1. Clinically, hypo-osmia and profound diurnal variation of symptoms were identified as novel features; fluorodopa positron emission tomography revealed striking decline in striatal fluorodopa uptake. We suggest that it may be possible to clinically separate this form of Parkinsonism from dopa-responsive dystonia and Parkin-related Parkinsonism. Furthermore, as this mutation has only been reported in Filipinos (two originated from Luzon island), our results support the hypothesis of a common founder. [Copyright &y& Elsevier]

In major surgery, the implementation of multidisciplinary, multimodal and individualized strategies, collectively termed Patient Blood Management, aims to identify modifiable risks and optimise patients' own physiology with the ultimate goal of improving outcomes. Among the various strategies utilized in Patient Blood Management, timely detection and management of preoperative anaemia is most important, as it is in itself a risk factor for worse clinical outcome, but also one of the strongest predisposing factors for perioperative allogeneic blood transfusion, which in turn increases postoperative morbidity, mortality and costs. However, preoperative anaemia is still frequently ignored, with indiscriminate allogeneic blood transfusion used as a 'quick fix'. Consistent with reported evidence from other medical specialties, this imprudent practice continues to be endorsed by non-evidence based misconceptions, which constitute serious barriers for a wider implementation of preoperative haemoglobin optimisation. We have reviewed a number of these misconceptions, which we unanimously consider should be promptly abandoned by health care providers and replaced by evidence-based strategies such as detection, diagnosis and proper treatment of preoperative anaemia. We believe that this approach to preoperative anaemia management may be a viable, cost-effective strategy that is beneficial both for patients, with improved clinical outcomes, and for health systems, with more efficient use of finite health care resources. [ABSTRACT FROM AUTHOR]

Introduction Le taux de réussite d’une ponction lombaire (PL) chez un nourrisson réalisée par un interne est faible (50 %), malgré un Mastery Training et un Just-In-Time-Training (JITT). Le stress altère la performance des gestes techniques. L’objectif était d’étudier la performance et le taux de réussite d’une PL sur mannequin et sur nourrissons de moins d’un an et le stress ressenti par les internes. Méthodes Une étude prospective a été menée aux urgences pédiatriques (CHU de Poitiers). Les internes ont été formés par Mastery Training et JITT avant chaque PL clinique. Ont été évalués : la performance (score/6), le taux de réussite (LCR avec < 1000 hématies/mm 3 ) et le stress ressenti (échelle : 0–10). Résultats Les internes ont réalisé 42 PL. Le taux de réussite sur mannequin était de 95 % contre 55 % sur nourrissons ( p = 0,0002) et le score de performance de 5,21 ± 1,0 vs 5,07 ± 1,18 (NS). Lorsque la PL sur nourrissons échouait, le score de performance était significativement plus faible ( p = 0,001), le nombre d’essais significativement plus élevé ( p = 0,0046) et le niveau de stress plus élevé (3,8 ± 1,25 vs 4,31 ± 1,55). Conclusion Malgré un taux de réussite sur mannequin élevé, celui sur nourrissons reste faible. Le stress ressenti semble être un facteur d’échec de PL chez les nourrissons. [ABSTRACT FROM AUTHOR]

Introduction Le taux de réussite d’une PL chez un nourrisson réalisée par un interne est faible (50 %), malgré un Mastery Training et un Just-In-Time-Training (JITT). Le stress altère la performance des gestes techniques. L’objectif était d’étudier la performance et le taux de réussite d’une PL sur mannequin et sur nourrissons de moins d’un an et le stress ressenti par les internes. Méthodes Une étude prospective a été menée aux urgences pédiatriques (CHU de Poitiers). Les internes ont été formés par Mastery Training et JITT avant chaque PL clinique. Ont été évalués : la performance (score/6), le taux de réussite (LCR avec < 1 000 hématies/mm 3 ) et le stress ressenti (échelle 0–10). Résultats Les internes ont réalisé 42 PL. Le taux de réussite sur mannequin était de 95 % contre 55 % sur nourrissons ( p = 0,0002) et le score de performance de 5,21 ± 1,0 vs 5,07 ± 1,18 (NS). Lorsque la PL sur nourrissons échouait, le score de performance était significativement plus faible ( p = 0,001), le nombre d’essais significativement plus élevé ( p = 0,0046) et le niveau de stress plus élevé (3,8 ± 1,25 vs 4,31 ± 1,55). Conclusion Malgré un taux de réussite sur mannequin élevé, celui sur nourrissons reste faible. Le stress ressenti semble être un facteur d’échec de PL chez les nourrissons. [ABSTRACT FROM AUTHOR]