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Bisphosphonates are used to treat a number of bone related diseases such as osteosarcoma, malignant hypercalcemia, osteomyelitis. Developing novel drug delivery systems may overcome the adverse reactions caused by traditional administration. This study uses a combination of molecular docking studies and correlation techniques between structure – physical and chemical properties to assess how different bisphosphonates (alendronate, risedronate, pamidronate, zoledronate) interact with polydopamine in order to later design new formulations. The structure of polydopamine is still under discussion therefore, its bisphosphonate binding properties have not been completely established. Polydopamine was modeled by repeated docking of tetrameric subunits combined in two ways which led to simple and mixed oligomers. Fingerprint descriptors, namely electronegativity of the OMO-UMO quantum molecular states, were used for the correlation studies. The correlation coefficients suggest that several atom species such as nitrogen and carbon have increased contributions to the formation of both HOMO and LUMO molecular states. The results showed that the most stable complex was obtained with risedronate for both simple and mixed dopamine oligomers (-186.00 kJ/mol and -184.92 kJ/mol).

Background Immune checkpoint inhibitors (ICIs) represent an effective cancer immunotherapy yet are associated with immune-related adverse events (irAEs). The aim of this study was to characterize irAEs involving the peripheral nervous system (PNS-irAEs) in a real-world cohort of ICI-treated patients. Methods Cancer patients treated with ICIs between January 2014 and March 2022 were included. Patients with PNS-irAEs were identified and divided into two groups: (1) cranial/peripheral neuropathies and (2) myasthenia gravis (MG) and/or myositis. Clinical characteristics and outcomes, measured with the modified Rankin Scale (mRS), were compared among the two groups. Results Among 920 ICI-treated patients, 20 patients (2.17%) developed a PNS-irAEs. The median latency from ICI exposure was 8.8 weeks and the median time from onset to clinical nadir was 3.5 weeks. Eleven patients developed a neuropathy: polyneuropathy (n = 4), cranial neuropathy (n = 3), small-fiber neuropathy (n = 3), brachial plexopathy (n = 1). Nine patients presented MG and/or myositis: concomitant MG and myositis (n = 6), isolated myositis (n = 2), exacerbation of MG (n = 1). Immunosuppressive treatment and/or ICI withdrawal determined a significant clinical improvement, expressed by a mRS reduction, in the neuropathy group (p = 0.004), but not in the MG/myositis group (p = 0.11). Overall, death due to irAEs occurred in four patients (20%), all with MG/myositis. Compared to patients with neuropathies, those with MG/myositis had a shorter latency onset (p = 0.036), developed more frequently concomitant non-neurologic irAEs (p = 0.028) and showed a higher mortality rate (p = 0.026). Conclusions In our large cohort of ICI-treated patients, 2.17% developed PNS-irAEs. Compared to ir-neuropathies, ir-MG/myositis tend to occur earlier from ICI exposure and present a worse response to treatment and a higher mortality.

Purpose To assess efficacy and safety of cone beam computed tomography (CBCT) in the radiofrequency ablation (RFA) of osteoid osteoma (OO) in children and adolescents, and to compare technical success, clinical success, radiation dose and procedure duration time of CBCT guidance to conventional computed tomography (CT) guidance. Materials and methods Between 2015 and 2019, 53 consecutive percutaneous RFA were performed on pediatric patients with CBCT or conventional CT guidance, respectively, in 24 and 29 children and adolescents with 24-month follow-up. Dose area product (DAP) and dose length product (DLP) were recorded, respectively, for CBCT and conventional CT and converted to effective doses (ED). Results CBCT and conventional CT groups were similar in terms of patient age and weight, tumor size and tumor location. Technical success was achieved in all cases. Primary clinical success was 91.67% (22/24) for the CBCT group and 89.66% (26/29) for the conventional CT group. Mean DAP was 64.75Gycm2 (range 6.0–266.7). Mean DLP was 972.62mGycm (range 337–2344). ED was significantly lower in the CBCT group compared to the conventional CT group (0.34 mSv vs. 5.53 mSv, p = 0.0119). Procedure duration time was not significantly longer in the CBCT group (102.25 min vs. 92.34 min, p = 0.065). No major complication was registered. Minor complications were observed in 4 patients (2 in CBCT; 2 in conventional CT). Conclusions Compared to conventional CT guidance, CBCT guidance for percutaneous OO ablation shows similar technical and clinical success rates, with reduced radiation dose and equivalent procedure duration time. This technique helps sparing dose exposure to pediatric patients.

This work aimed to report the demographic and clinical characteristics of two new cases with non-paraneoplastic anti-Hu-associated gut motility impairment, and perform a thorough revision covering anti-Hu-associated paraneoplastic (PGID) and non-paraneoplastic (nPGID) gastrointestinal dysmotility. Several case series have clearly established a relationship between certain type of cancers, the development of circulating anti-Hu antibodies, and the concomitant usually severe gastrointestinal dysmotility; in contrast, a few studies focused on anti-Hu-associated nPGID. We searched for studies regarding anti-Hu-associated gastrointestinal manifestations and extracted data concerning clinical characteristics of patients, including specific demographic, oncological, neurological, gastrointestinal, histological, and treatment response features. Forty-nine articles with a total of 59 cases of anti-Hu-associated gastrointestinal dysmotility were analyzed. The patients’ age at symptom onset significantly differed between PGID and nPGID (median 61 vs 31 years, p

Stiff person syndrome is a rare condition characterised by prolonged stiffness with superimposed muscle spasms. Immunotherapy relies mainly on intravenous immunoglobulin, steroids and plasma exchange. Azathioprine or rituximab are other possible options. We describe two patients who showed a good clinical response with intravenous immunoglobulin and persistence of the clinical improvement after shifting to equivalent dosage of subcutaneous immunoglobulin. Both patients received a diagnosis of stiff person syndrome based on their clinical symptoms (episodes of stiffness and spasms) and presence of antiglutamic acid decarboxylase. Treatment with intravenous immunoglobulin was started with improvement of symptoms as reported by patients and confirmed also by the spasm frequency scale and modified Ashworth scale. After clinical stabilisation in order to avoid the hospitalisation required for intravenous immunoglobulin treatment a switch to subcutaneous immunoglobulins was made. After one year of follow-up from the switch, the patients show clinical stability. Their scores on the modified Ashworth scale, spasm frequency scale and on the 10 Meter Walking Test were also stable. Subcutaneous formulation of immunoglobulin could be as effective as intravenous immunoglobulin in the maintenance treatment of Stiff person syndrome, although studies involving a larger cohort of patients are needed in order to confirm our anecdotal experience.

Gender identity conversion efforts (GICE) have been widely debated as potentially damaging treatment approaches for transgender persons. The association of GICE with mental health outcomes, however, remains largely unknown.To evaluate associations between recalled exposure to GICE (by a secular or religious professional) and adult mental health outcomes.In this cross-sectional study, a survey was distributed through community-based outreach to transgender adults residing in the United States, with representation from all 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and US military bases overseas. Data collection occurred during 34 days between August 19 and September 21, 2015. Data analysis was performed from June 8, 2018, to January 2, 2019.Recalled exposure to GICE.Severe psychological distress during the previous month, measured by the Kessler Psychological Distress Scale (defined as a score ≥13). Measures of suicidality during the previous year and lifetime, including ideation, attempts, and attempts requiring inpatient hospitalization.Of 27 715 transgender survey respondents (mean [SD] age, 31.2 [13.5] years), 11 857 (42.8%) were assigned male sex at birth. Among the 19 741 (71.3%) who had ever spoken to a professional about their gender identity, 3869 (19.6%; 95% CI, 18.7%-20.5%) reported exposure to GICE in their lifetime. Recalled lifetime exposure was associated with severe psychological distress during the previous month (adjusted odds ratio [aOR], 1.56; 95% CI, 1.09-2.24; P .001) compared with non-GICE therapy. Associations were found between recalled lifetime exposure and higher odds of lifetime suicide attempts (aOR, 2.27; 95% CI, 1.60-3.24; P .001) and recalled exposure before the age of 10 years and increased odds of lifetime suicide attempts (aOR, 4.15; 95% CI, 2.44-7.69; P .001). No significant differences were found when comparing exposure to GICE by secular professionals vs religious advisors.The findings suggest that lifetime and childhood exposure to GICE are associated with adverse mental health outcomes in adulthood. These results support policy statements from several professional organizations that have discouraged this practice.

Dissertação (mestrado) — Universidade de Brasília, Faculdade de Economia, Administração, Contabilidade e Gestão de Políticas Públicas, Programa de Pós-Graduação em Administração, Mestrado Profissional em Administração Pública, 2022. A implementação de uma Política Nacional de Segurança Pública requer um sistema nacional integrado dos órgãos de segurança pública da União, dos Estados, do Distrito Federal e dos Municípios, em articulação com a sociedade. Para isto, foi instituído o Sistema Único de Segurança Pública, a Política e o Plano Nacional de Segurança Pública e Defesa Social, com previsão de que os entes federados também instituam suas políticas e planos estaduais de segurança pública. Neste sentido, a dissertação teve como objetivo averiguar em que medida os Planos Estaduais de Segurança Pública têm sido formulados a partir da Política e do Plano Nacional de Segurança Pública e Defesa Social, considerando suas capacidades estatais. A unidade de investigação do estudo foi a Secretaria Estadual de Segurança Pública. A pesquisa foi de caráter descritiva, com a utilização de métodos quantitativos e qualitativos. A pesquisa buscou na literatura subsídios para compreensão dos aspectos relacionados à implementação de políticas públicas intergovernamentais a serem executadas em nível estadual, identificando trabalhos relacionados ao federalismo e políticas públicas, bem como subsídios para explicar a capacidade dos estados na formulação de políticas públicas. Foi aplicado um questionário, respondido por pontos focais indicados pelos secretários estaduais de segurança pública das 27 Unidades da Federação, buscando respostas para os objetivos específicos da pesquisa. Concluise que das 27 Unidades da Federação, apenas 1/3 possuem planos estaduais de segurança pública classificados como de alta aderência à Política e ao Plano Nacional de Segurança Pública e Defesa Social e seis delas nem sequer possuem tais planos. No âmbito da implementação da política nacional de segurança pública, identificou-se a necessidade de aprimoramento da coordenação vertical, de responsabilidade do Ministério da Justiça e Segurança Pública, e da coordenação horizontal, incentivando-se a colaboração entre as secretarias estaduais de segurança pública. No âmbito das capacidades estatais, verificou-se a necessidade de aprimoramento dos atributos relacionados à dimensão político-relacional, que tem o potencial de exercer maior influência no processo de formulação dos planos estaduais, corroborando com a literatura sobre capacidades estatais. Pretende-se que a pesquisa contribua para ampliar a literatura sobre o tema na área de segurança pública e para auxiliar na tomada de decisão para formulação e implementação de políticas de segurança pública. Além disso, almeja-se que o modelo aplicado para análise de aderência dos planos estaduais e das capacidades estatais seja aplicado em outras pesquisas. The implementation of a National Public Security Policy requires an integrated national system of public security bodies from the Union, the States, the Federal District and the Municipalities, in articulation with society. For this, the Unified Public Security System, the National Public Security and Social Defense Policy and Plan was instituted, with provision for the federated entities to also institute their state public security policies and plans. In this sense, the dissertation aimed to find out to what extent the State Public Security Plans have been formulated from the National Public Security and Social Defense Policy and Plan, considering their state capabilities. The investigation unit of the study was the State Department of Public Security. The research was descriptive, using quantitative and qualitative methods. The research sought in the literature subsidies for understanding aspects related to the implementation of intergovernmental public policies to be carried out at the state level, identifying works related to federalism and public policies, as well as subsidies to explain the capacity of states in the formulation of public policies. A questionnaire was applied, answered by focal points indicated by the state secretaries of public security of the 27 Federation Units, seeking answers to the specific objectives of the research. It is concluded that of the 27 Federation Units, only 1/3 have state plans for public security classified as having high adherence to the Policy and the National Plan for Public Security and Social Defense and six of them do not even have such plans. Within the scope of the implementation of the national public security policy, the need to improve vertical coordination, which is the responsibility of the Ministry of Justice and Public Security, and horizontal coordination, was identified, encouraging collaboration between state public security secretariats. In terms of state capabilities, there was a need to improve attributes related to the political-relational dimension, which has the potential to exert greater influence on the process of formulating state plans, corroborating the literature on state capabilities. It is intended that the research contributes to expand the literature on the subject in the area of public security and to assist in decision making for the formulation and implementation of public security policies. In addition, it is hoped that the model applied to the analysis of adherence to state plans and state capacities is applied in other research.

Chimeric antigen receptor (CAR) T-cell therapy is an emerging highly effective treatment for refractory haematological malignancies. Unfortunately, its therapeutic benefit may be hampered by treatment-related toxicities, including neurotoxicity. Early aggressive treatment is paramount to prevent neurological sequelae, yet it potentially interferes with the anti-cancer action of CAR T-cells. We describe four CAR T-cells infused patients who presented with reiterative writing behaviours, namely paligraphia, as an early manifestation of neurotoxicity, and eventually developed frontal predominant encephalopathy (one mild, three severe). Paligraphia may represent an early, specific, and easily detectable clinical finding of CAR T-cell therapy-related neurotoxicity, potentially informing its management.

We report the longest follow-up of clinical and biochemical features of two previously reported adult mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) patients treated with liver transplantation (LT), adding information on a third, recently transplanted, patient. All three patients overcame the early post-operative period and tolerated immunosuppressive therapy. Plasma nucleoside levels dramatically decreased, with evidence of clinical improvement of ambulation and neuropathy. Conversely, other features of MNGIE, as gastrointestinal dysmotility, low weight, ophthalmoparesis, and leukoencephalopathy were essentially unchanged. A similar picture characterized two patients treated with allogenic hematopoietic stem cell transplantation (AHSCT). In conclusion, LT promptly and stably normalizes nucleoside imbalance in MNGIE, stabilizing or improving some clinical parameters with marginal periprocedural mortality rate as compared to AHSCT. Nevertheless, restoring thymidine phosphorylase (TP) activity, achieved by both LT and AHSCT, does not allow a full clinical recovery, probably due to consolidated cellular damage and/or incomplete enzymatic tissue replacement.

Carbapenemase-producing Enterobacterales (CPE) represent a serious threat to public health worldwide. Elderly patients are at increased risk of colonisation/infection with CPE. This study aimed to evaluate the persistence of CPE colonisation and the genotypic characteristics of persistent strains in elderly people discharged from Italian hospitals. A longitudinal study was conducted in two Italian cities (March 2018 to September 2020) enrolling 137 patients aged ≥65 years with CPE intestinal colonisation at hospital discharge. CPE colonisation was evaluated after 4, 8 and 12 months. Competing risk analysis was used to explore the association between baseline characteristics and persistence at 4 months. For all isolates, carbapenemase typing and multilocus sequence typing were performed. Persistent isolates underwent whole-genome sequencing. Of 137 patients, 91% carried carbapenemase-producing Klebsiella pneumoniae (CP-KP) and 8.8% carried carbapenemase-producing Escherichia coli. Although a large number of patients were lost to follow-up owing to death or withdrawal, 28/65 patients (43.1%) remained colonised at Month 4; 16/42 (38.1%) and 5/28 (17.9%) were found colonised up to Months 8 and 12, respectively. Colonisation persistence was more frequent in patients with bacteraemia or complicated urinary tract infection while in hospital and in those staying in long-term care facilities (LTCFs). Clonal characteristics of CP-KP isolates did not appear to influence persistence. Isolates obtained from each persistent carrier were identical or highly related by SNP phylogenetic analysis. Identification of patients at higher risk of persistent intestinal carriage after hospital discharge can prompt control measures to limit the transmission of CPE in the community, especially in LTCF settings.

This commentary is a critique of a recent systematic review of the evidence for the use of puberty blockers for youth with gender dysphoria (GD) by Rew et al. (2021). In our view, the review suffers from several methodological oversights including the omission of relevant studies and suboptimal analysis of the quality of the included studies. This has resulted in an incomplete and incorrect assessment of the evidence base for the use of puberty blockers. We find that Rew et al.'s conclusions and clinician recommendations are problematic, especially when discussing suicidality. A key message of the review's abstract appears to be that puberty blockers administered in childhood reduce adult suicidality. However, the study used for the basis of this conclusion (Turban et al., 2020) did not make a causal claim between puberty blockers and decreased adult suicidality. Rather, it reported a negative association between using puberty blockers and lifetime suicidal ideation. The study design did not allow for determination of causation. Our commentary concludes by demonstrating how the GD medical literature, as it moves from one publication to the next, can overstate the evidence underpinning clinical practice recommendations for youth with GD.

This paper explores the therapeutic process between analyst and Josh, a trans man whose life had fallen apart after transition. Repetitive enactments involving hiding, deceiving and mystification constituted a prolonged therapeutic impasse. The analyst's struggle with these binds and with countertransference confusion and anxiety, ultimately illuminated zones that had remained off-limits for a prolonged period of time. Where the couple had been snared in a bind structured by gender, they were now able to access a history of violation and to ask more profound questions about connection, aloneness, authenticity and loss.

We report two weightlifters, presenting with progressive atrophy and weakness of the medial portion of pectoralis major muscle. We discuss possible differential diagnoses and propose a clinical and neurophysiological approach. Our cases highlight that the syndrome may be unilateral or bilateral, probably due to anatomical susceptibility and hyper-training. We review this rare syndrome and promote its awareness and full diagnostic assessment, aiming to its prompt recognition in weightlifters.

Background: Little is known regarding the impact of socioeconomic factors on the use of evidence-based therapies and outcomes in patients with heart failure with reduced ejection fraction across Asia. Methods: We investigated the association of both patient-level (household income, education levels) and country-level (regional income level by World Bank classification, income disparity by Gini index) socioeconomic indicators on use of guideline-directed therapy and clinical outcomes (composite of 1-year mortality or HF hospitalization, quality of life) in the prospective multinational ASIAN-HF study (Asian Sudden Cardiac Death in Heart Failure). Results: Among 4540 patients (mean age: 60±13 years, 23% women) with heart failure with reduced ejection fraction, 39% lived in low-income regions; 34% in regions with high-income disparity (Gini ≥42.8%); 64.4% had low monthly household income (P interaction Conclusions: These findings highlight the importance of socioeconomic determinants among patients with heart failure in Asia and suggest that attention should be paid to address disparities in access to care among the poor and less educated, including those from wealthy regions. Registration: URL: https://clinicaltrials.gov ; Unique Identifier: NCT01633398.

Objective: To explore a developmental understanding of childhood gender dysphoria and to compare it to the prevailing paradigm, gender-affirming care. Conclusion: Viewing gender dysphoria through a contemporary developmental frame generates a different understanding of the nature of the phenomenon and its treatment and raises ethical questions about our current gender-affirming approach.

Objective: To explore some of the emerging complexities in the management of childhood gender dysphoria. Conclusion: The authors raise questions about the gender-affirmation approach and highlight concerns about informed consent and research ethics.

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Se usa un conjunto de modelos VAR con parámetros cambiantes en el tiempo y volatilidad estocástica (TVP-VAR-SV) para estimar el efecto traspaso del tipo de cambio (ERPT) a precios a través del tiempo para Perú para el período 1995Q2- 2019Q4. De acuerdo con los criterios de selección Bayesiana como la Log Verosimilitud Marginal y el DIC, los modelos con mejor ajuste permiten que la mayoría de los parámetros cambien en el tiempo, destacando el rol cambiante en el tiempo de la varianza de los choques. Los resultados se dividen en dos partes: i) los ERPTs a precios del importador y productor muestran una reducción notable desde fines de la década de los noventa hasta 2008. Sin embargo, post Crisis Financiera Internacional (CFI), en particular a partir de 2014, todos los modelos estimados indican que ambos ERPT tienden a incrementarse notablemente hasta el 2019. Estos hallazgos están en línea con la nueva literatura que emplea modelos TVPVAR- SV y que postula el resurgimiento del ERPT luego de la CFI. El resurgimiento del ERPT se explica por la depreciación de la moneda doméstica como consecuencia de la finalización del Quantitative Easing, caída en los precios de las materias primas y eventos políticos internacionales recientes (Brexit y guerra comercial entre EE.UU. y China); ii) el ERPT a precios del consumidor muestra evidencia de una reducción significativa y sostenida durante toda la muestra. Dicha reducción está acorde con la literatura existente y está sustentada por el contexto de baja inflación (adopción del Esquema de Metas Explícitas de Inflación) y la credibilidad del Banco Central. Los resultados son robustos a un conjunto de análisis de sensibilidad que comprende: cambios en la variable asociada al choque externo como en la actividad económica doméstica, así como cambios en los valores de las priors.

A 79-year-old woman presented with a 10-day history of rapidly progressive bilateral visual loss with more prominent involvement of the right eye. Her medical history was significant for an infiltrative breast carcinoma treated with mastectomy and chemotherapy (cyclophosphamide, doxorubicin, and paclitaxel) 1 year before, complicated by bilateral foot paresthesias and decreased sensation. The patient achieved complete remission from cancer and maintained regular oncologic follow-up. On admission, vision was limited to hand motion in the right eye and markedly reduced in the left eye (20/50), so that she was unable to read. Color vision was untestable in the right eye and remained intact in the left eye. A right relative afferent pupillary defect (RAPD) was observed. Intraocular pressure was normal, whereas funduscopic evaluation revealed bilateral optic disc swelling. Extraocular movements were full and not painful and other cranial nerves were intact. The rest of the neurologic examination was unrevealing, apart from signs of a distal symmetric sensory polyneuropathy.

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disease caused by thymidine phosphorylase (TP) enzyme defect. As gastrointestinal changes do not revert in patients undergone TP replacement therapy, one can postulate that other unexplored mechanisms contribute to MNGIE pathophysiology. Hence, we focused on the local TP angiogenic potential that has never been considered in MNGIE. In this study, we investigated the enteric submucosal microvasculature and the effect of hypoxia on fibrosis and enteric neurons density in jejunal full-thickness biopsies collected from patients with MNGIE. Orcein staining was used to count blood vessels based on their size. Fibrosis was assessed using the Sirius Red and Fast Green method. Hypoxia and neoangiogenesis were determined via hypoxia-inducible-factor-1α (HIF-1α) and vascular endothelial cell growth factor (VEGF) protein expression, respectively. Neuron-specific enolase was used to label enteric neurons. Compared with controls, patients with MNGIE showed a decreased area of vascular tissue, but a twofold increase of submucosal vessels/mm(2) with increased small size and decreased medium and large size vessels. VEGF positive vessels, fibrosis index, and HIF-1α protein expression were increased, whereas there was a diminished thickness of the longitudinal muscle layer with an increased interganglionic distance and reduced number of myenteric neurons. We demonstrated the occurrence of an angiopathy in the GI tract of patients with MNGIE. Neoangiogenetic changes, as detected by the abundance of small size vessels in the jejunal submucosa, along with hypoxia provide a morphological basis to explain neuromuscular alterations, vasculature breakdown, and ischemic abnormalities in MNGIE. NEW & NOTEWORTHY Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is characterized by a genetically driven defect of thymidine phosphorylase, a multitask enzyme playing a role also in angiogenesis. Indeed, major gastrointestinal bleedings are life-threatening complications of MNGIE. Thus, we focused on jejunal submucosal vasculature and showed intestinal microangiopathy as a novel feature occurring in this disease. Notably, vascular changes were associated with neuromuscular abnormalities, which may explain gut dysfunction and help to develop future therapeutic approaches in MNGIE.

Purpose To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites. Methods and materials Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered. Results Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up. Conclusion Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.

No abstract available

Background Data comparing outcomes in heart failure ( HF ) across Asia are limited. We examined regional variation in mortality among patients with HF enrolled in the ASIAN ‐HF (Asian Sudden Cardiac Death in Heart Failure) registry with separate analyses for those with reduced ejection fraction ( EF ; Methods and Results The ASIAN ‐ HF registry is a prospective longitudinal study. Participants with symptomatic HF were recruited from 46 secondary care centers in 3 Asian regions: South Asia (India), Southeast Asia (Thailand, Malaysia, Philippines, Indonesia, Singapore), and Northeast Asia (South Korea, Japan, Taiwan, Hong Kong, China). Overall, 6480 patients aged >18 years with symptomatic HF were recruited (mean age: 61.6±13.3 years; 27% women; 81% with HF and reduced r EF ). The primary outcome was 1‐year all‐cause mortality. Striking regional variations in baseline characteristics and outcomes were observed. Regardless of HF type, Southeast Asians had the highest burden of comorbidities, particularly diabetes mellitus and chronic kidney disease, despite being younger than Northeast Asian participants. One‐year, crude, all‐cause mortality for the whole population was 9.6%, higher in patients with HF and reduced EF (10.6%) than in those with HF and preserved EF (5.4%). One‐year, all‐cause mortality was significantly higher in Southeast Asian patients (13.0%), compared with South Asian (7.5%) and Northeast Asian patients (7.4%; P Conclusions This first multinational prospective study shows that the outcomes in Asian patients with both HF and reduced or preserved EF are poor overall and worst in Southeast Asian patients. Region‐specific risk factors and gaps in guideline‐directed therapy should be addressed to potentially improve outcomes. Clinical Trial Registration URL : https://www.clinicaltrials.gov/ . Unique identifier: NCT 01633398.