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Background COVID-19 is a novel viral disease. Severe courses may present as ARDS. Several publications report a high incidence of coagulation abnormalities in these patients. We aimed to compare coagulation and inflammation parameters in patients with ARDS due to SARS-CoV-2 infection versus patients with ARDS due to other causes. Methods This retrospective study included intubated patients admitted with the diagnosis of ARDS to the ICU at Munich university hospital. 22 patients had confirmed SARS-CoV2-infection (COVID-19 group), 14 patients had bacterial or other viral pneumonia (control group). Demographic, clinical parameters and laboratory tests including coagulation parameters and thromboelastometry were analysed. Results No differences were found in gender ratios, BMI, Horovitz quotients and haemoglobin values. The median SOFA score, serum lactate levels, renal function parameters (creatinine, urea) and all inflammation markers (IL-6, PCT, CRP) were lower in the COVID-19 group (all: p, Highlights • COVID-19 patients presented with higher coagulatory potential than non-COVID-ARDS. • DIC scores were lower in COVID-19 ARDS patients. • An intensified anticoagulation regimen might be advisable. • Use of platelet inhibitors may be considered.

Objectives: Telehealth (via videocall) was rapidly implemented by the South Australian Adult Cystic Fibrosis (CF) Service in March 2020 due to the Novel Coronavirus 2019 pandemic. Home spirometers were distributed as part of objective patient assessment. Our aim was to assess patient satisfaction with the telehealth service in CF multidisciplinary clinic via online survey. Methods: All patients of the CF service were invited to complete an online survey designed to assess satisfaction with telehealth, which was undertaken through the consumer organisation Cystic Fibrosis South Australia. A quantitatively driven concurrent mixed-methods design was chosen, with statistical analysis of symmetrical five-point Likert responses using IBM SPSS Statistics for Windows v.26 and coding of unstructured responses for thematic analysis. Results: To date 57/160 patients (35.6%) completed the survey, with some item non-responses. 37/57 (64.9%) participants were aged ≤35 years of age, 42/53 (79.2%) had ≥2 telehealth appointments, and 46/53 (86.7%) found it easy/very easy to access. 18/48 (37.5%) of participants had technical issues. Despite this 48/52 (92.3%) felt satisfied/very satisfied with engagement of CF team via telehealth. 38/50 (76%) found telehealth more convenient with significant time saved. The thematic analysis added depth to quantitative analysis by identification of six key themes: convenience, ease of access, maintaining the therapeutic relationship, comprehensive care, safety, and patient centred care. Conclusion: Most patients reported high satisfaction with telehealth and would like a hybrid clinic with the option of telehealth or in person review for clinics into the future.

This study examined the psychosocial histories of 134 male, juvenile offenders, focusing on race and the probability of being diagnosed with internalizing and/or externalizing psychological disorders at the time of their sentencing to a correctional institution for committing serious and violent crimes as minors. In addition, based on case file information, the author investigated offenders' histories with child maltreatment, court-ordered probation, and counseling services received as part of the child welfare and/or juvenile justice system. RESULTS from logistic regression analyses indicated the probability for White youth to be diagnosed with internalizing disorders was over 19 times that of Black youth; however, rates of externalizing disorders were similar across groups. Although maltreatment histories were comparable based on race, White youth received more counseling services, were significantly older at the time of diagnosis, and were more likely to be diagnosed with internalizing and comorbid disorders. Issues regarding multicultural assessment in the child welfare and juvenile justice system are discussed, specifically highlighting the potential for attributional bias in the diagnostic and treatment recommendation process. Language: en

Summary Background Gemcitabine (Gemzar®) and 5-fluorouracil (5-FU) plus folinic acid (FA) both have proven activity in the treatment of patients with advanced pancreatic cancer. The present study was initiated to investigate the efficacy of gemcitabine in combination with 5-FU-FA. Patients and methods Thirty-eight patients, median age 60 years (range 34–70) with inoperable, stage IV, pancreatic cancer were enrolled into the study and treated on an outpatient basis. All except one patient received at least one cycle of treatment with gemcitabine (1000 mg/m2 followed by FA (200 mg/m2 and 5-FU (750 mg/m2 administered as a 24-hour continuous infusion on days 1, 8, 15 and 22 of a 42-day schedule. No patient had received prior chemotherapy or radiotherapy. All 38 patients were assessed for efficacy, toxicity and time to progressive disease. Results Two patients (5%), achieved a partial response and thirty-four patients (89%) achieved stable disease. There were two early deaths (≤4 weeks). The median time to progression was 7.1 months (range 0.4–18.1+; 95% confidence interval (95% CI): 5.3–7.9 months). Three patients had a progression-free interval of greater than 12 months and 12 of 38 patients (32%) survived longer than 12 months. The median overall survival was 9.3 months (range 0.5–26.5; 95% CI: 7.3–13.0 months). The incidence of grade 3 and 4 toxicities was low. Conclusions The combination of gemcitabine and 5-FU-FA is active and well tolerated and seems to offer an improvement in progression-free interval over both gemcitabine monotherapy and 5-FU-FA therapy.

Gemcitabine (Gemzar) has a significant impact upon survival and quality of life for patients with pancreatic cancer, compared with 5-fluorouracil (5-FU). This phase I study was initiated to define the recommended dose of 5-FU delivered as a 24 h infusion in combination with gemcitabine (1000 mg/m2) and folinic acid (200 mg/m2) in patients with inoperable pancreatic cancer, treated on an outpatient basis. Drugs were administered weekly for 4 weeks out of 6 weeks. Sixteen chemonaive patients (median age 59 years, range 51-66) were enrolled, 15 had stage IV and one stage III disease. The median Karnofsky performance score (KPS) was 70 (range 60-80). Six patients received 5-FU 750 mg/m2, eight received 5-FU 1000 mg/m2 and two received 5-FU 1250 mg/m2. The maximum tolerated dose of 5-FU was 1000 mg/m2. Hepatotoxicity was dose limiting. One patient who received 5-FU 1250 mg/m2 died as a result of hepatorenal failure. There was one partial response, nine patients had stable disease for more than 3 months and 13 patients had improved KPS. The median time to progressive disease was 31 weeks (range 5-50 weeks). A phase 11 trial is underway to further assess the activity of this combination at the recommended dose of 750 mg/m2 5-FU.

Tuberculosis occurred in 5 (1.2%) of 462 liver transplant recipients. De novo infection was assumed in 4 patients and a recurrent infection in 1. The clinical courses varied, from asymptomatic open lung tuberculosis to disseminated disease with cerebral tuberculoma and convulsions. Four patients survived with anti-tuberculous triple-drug therapy. Very few cases of tuberculosis after liver transplantation have been reported (4 patients in the medical literature and 5 patients in this paper). However, the incidence, course of infection, and outcome seem to be similar to those of tuberculosis in renal transplant recipients, approximately 150 cases of which are known.

LBA4504 Background: Prognosis of patients (pts) with PC is dismal, even after curatively intended resection. Whereas gemcitabine-based chemotherapy is standard in advanced PC, the role of adjuvant chemotherapy is still under discussion. Methods: CONKO-001, a prospective, open, multicenter, controlled phase 3 study was designed to evaluate the efficacy and toxicity of gemcitabine in PC pts after complete (R0 or R1) resection. After stratification for R0/R1, nodal tumour involvement and tumour stage pts were randomized to receive either gemcitabine (G) (1g/m2 d 1, 8 and 15 every 4 weeks) for 6 months or observation (O). Pts in the observation group received no specific anticancer treatment. Primary study endpoint was disease free survival (DFS), secondary endpoints included OS and toxicity. The study was powered to detect a significant difference in DFS with 90% probability at a significance level of .05 on all eligible patients. Results: Between July 1998 and December 2004 368 pts were randomized and 354 w...

LBA4013 Background: Chemotherapy with Gemcitabine 1 g/m2 given on d 1, 8, 15 every four weeks is standard therapy in inoperable pancreatic cancer. The value of adjuvant therapy has not been clearly defined and no data on randomised trials with Gemcitabine in the adjuvant setting is available. Methods: This study was designed to evaluate the efficacy and toxicity of Gemcitabine in patients with resectable pancreatic cancer. Within 6 weeks after operation, patients were randomised to receive Gemcitabine or observation after stratification for positive or negative resection margins, nodal tumor involvement and tumor stage. Gemcitabine was administered at a dosage of 1g/m2 days 1, 8 and 15 every 4 weeks for 6 months. Patients in the observation arm received no specific postoperative treatment. Primary endpoint was disease free survival (DFS), secondary endpoints included overall survival (OS) and side effects in both groups. The study was powered to detect a significant difference with 90% probability at a si...