Based on the findings from this review of real-world comparative effectiveness studies, risks of FN and FN-related complications were generally lower for prophylaxis with pegfilgrastim versus prophylaxis with short-acting G-CSFs.

SUMMARY The present study was designed to measure norepinephrine release during sympathetic nerve stimulation and evaluate the presynaptic inhibitory and facilitatory actions of a-adrenoceptor and /3-adrenoceptor agonists respectively, in the isolated perfused kidney of normotensive WistarKyoto (WKY) and spontaneously hypertensive rats (SHR). Periarterial nerve stimulation (0.25 to 32 Hz) caused a significantly greater release of norepinephrine, which was measured as total tritium overflow, in the SHR. The vasoconstrictor responses to periarterial nerve stimulation as well as to norepinephrine, angiotensin II, and barium chloride were also significantly greater in the SHR. Presynaptic actions of tramazoltne, an a 2 -adrenoceptor agonist, and salbutamol, a /3 2 -adrenoceptor agonist, on norepinephrine release were determined during periarterial nerve stimulation at 2 Hz.

Objective: Patients with profound cardiogenic shock may require venoarterial (VA) extracorporeal membrane oxygenation (ECMO) for circulatory support most commonly via the femoral vessels. The rate of cardiac recovery in this population remains low, possibly because peripheral VA-ECMO increases ventricular afterload. Whether direct ventricular unloading in peripheral VA-ECMO enhances cardiac recovery is unknown, but is being more frequently utilized. A randomized trial is warranted to evaluate the clinical effectiveness of percutaneous left ventricle venting to enhance cardiac recovery in the setting of VA-ECMO.Methods: We describe the rationale, design, and initial testing of a randomized controlled trial of VA-ECMO with and without percutaneous left ventricle venting using a percutaneous micro-axial ventricular assist device.Results: This is an ongoing prospective randomized controlled trial in adult patients with primary cardiac failure presenting in cardiogenic shock requiring peripheral VA-ECMO, designed to test the safety and effectiveness of percutaneous left ventricle venting in improving the rate of cardiac recovery. Conclusions:The results of this nonindustry-sponsored trial will provide critical information on whether left ventricle unloading in peripheral VA-ECMO is safe and effective. (JTCVS Open 2021;8:393-400) Schematic of the REVERSE Randomized Controlled Study.

Knowledge and skill acquisition related to vascular access are traditionally individual institutional educational initiatives. Australia currently has no national evidence based education programme for renal nurses. A survey of Australian and New Zealand Nephrology Educators' conducted in 2009, identified the need for more effective and consistent delivery of clinical education for nurses using innovative, web-based approaches supporting the tenets of e-learning methodologies. This paper discusses the development, implementation and proposed evaluation of a peer reviewed Australasian e-learning programme on buttonhole cannulation. It will further highlight the benefits of inter-organisational partnerships and how these partnerships can facilitate positive change in teaching and learning practices. This project has unique characteristics that collectively provide value, distinction and innovation to nurses, patients and renal departments. As the e-learning programme was founded on a platform of evidence-based practice it is therefore easily transferable to an international context.

Objectives The burden and treatment landscape of rheumatoid arthritis (RA) is poorly understood. This research aimed to identify evidence on quality of life, caregiver burden, economic burden, treatment patterns and clinical outcomes for patients with moderate RA in the United Kingdom. Methods A systematic literature review was performed across multiple databases and screened against pre-defined inclusion criteria. Results 2,610 records were screened; seven studies presenting evidence for moderate RA were included. These patients were found to incur substantial burden, with moderate to severe levels of disability. Compared with patients in remission, moderate RA patients reported higher levels of disability and decreased EQ-5D utility scores. The majority of patients did not feel that their current therapy adequately controlled their disease or provided sufficient symptom relief. In the United Kingdom, NICE have not approved advanced therapies (such as biological disease-modifying anti-rheumatic drugs) for patients with moderate disease, which restricts access for these patients. Conclusion The evidence available on the burden of moderate RA is limited. Despite current treatments, moderate RA still has a substantial negative impact, given that a DAS28 disease activity score defined as being in the moderate range does not qualify them for access to advanced therapies in the United Kingdom. For these patients, there is a particular need for further studies that investigate their burden and the impact of treating them earlier. Such information would help guide future treatment decisions and ensure the most effective use of resources to gain the best outcomes for patients with moderate RA.