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Most pivotal transcatheter aortic valve replacement (TAVR) trials have excluded patients with bicuspid aortic stenosis (AS). This study compared TAVR in low-risk patients with bicuspid AS to those with tricuspid AS, incorporating data from prospective trials.

We selected prospective US low-risk TAVR trials containing a bicuspid arm for this meta-analysis, examining outcomes at 30 days. Study results were pooled using a hierarchical Bayesian random-effects model.

Included were 3 Food and Drug Administration (FDA)-approved investigational device exemption (IDE) trials that enrolled a total of 1810 low-risk patients with symptomatic severe AS for TAVR. We compared 380 bicuspid patients with 1430 tricuspid patients. Event rates at 30 days overall were low, with similar mortality (odds ratio [OR], 0.38; 95% credible interval [CrI] 0.08, 1.78; I

, 0%), non-disabling stroke (OR, 0.45; 95% CrI 0.15, 1.07; I

, 9%), and permanent pacemaker implantation (OR, 0.86; 95% CrI 0.41, 1.47; I

, 59%). There were statistically significant differences in disabling stroke (OR, 0.16; 95% CrI 0.01, 0.90; I

, NA) and coronary obstruction (OR, 0.21; 95% CrI 0.05, 0.91) that disappeared after sensitivity analysis by adding a single event to the tricuspid arm. Hemodynamics were similar at 30 days.

Preliminary data from the FDA-approved IDE trials of low-risk patients with bicuspid AS undergoing TAVR demonstrated 30-day outcomes comparable to low-risk tricuspid patients, except for a trend toward higher stroke in bicuspid patients. Randomized trials are warranted to reassure the safety and long-term outcome of TAVR in patients with severe bicuspid AS.

Preliminary data from the FDA-approved IDE trials of low-risk patients with bicuspid AS undergoing TAVR demonstrated 30-day outcomes comparable to low-risk tricuspid patients, except for a trend toward higher stroke in bicuspid patients. Randomized trials are warranted to reassure the safety and long-term outcome of TAVR in patients with severe bicuspid AS.

Anal cancer is a rare disease, more prevalent in women. Men who have sex with men (MSM) are a high-risk neglected population.

The primary objective was to assess quality of life (QoL) and sexual function (SxF) among MSM treated with radical chemoradiation for anal cancer. Secondary objectives were to assess survivals and to describe the sexual habits of the target population.

Prospective single institution trial of MSM who were treated for anal cancer with curative intent between 2015 and 2019. QoL and SxF were the primary end-points and were assessed by validated questionnaires and sexual inventory. Overall survival, locoregional relapse-free, distant metastases free, and colostomy-free survivals were evaluated.

Quality of life and sexual function.

Nineteen patients were accrued between November 2015 and August 2019. Median age was 59.3 years. Stage III disease was 53.4% and mean tumor size was 5.4 cm. Fifteen (79.0%) patients were living with HIV (PLHIV). Median follow-up was 21.8 months. Mean oved its treatment represent a burden to MSM regarding QoL and SxF. Mauro GP, da Conceição Vasconcelos KGM, Carvalho HDA, Quality of Life and Sexual Function of Men Who Have Sex With Men Treated for Anal Cancer A Prospective Trial of a Neglected Population. J Sex Med 2021;181461-1466.

Anal cancer and its treatment represent a burden to MSM regarding QoL and SxF. Mauro GP, da Conceição Vasconcelos KGM, Carvalho HDA, Quality of Life and Sexual Function of Men Who Have Sex With Men Treated for Anal Cancer A Prospective Trial of a Neglected Population. J Sex Med 2021;181461-1466.

Routine positron emission tomography/computed tomography (PET/CT) has been recommended even for clinical stage I non-small-cell lung cancer (NSCLC). In spite of the progress in the screening procedure, and revisions to TNM classification, there is no evidence to support brain imaging screening of patients assessed with the current staging protocol including PET/CT.

We retrospectively investigated the frequency of extrathoracic metastasis in 466 consecutive patients with clinical stage T1-2 N0 NSCLC with the complete staging assessment comprised of thin-section CT, PET/CT, and brain contrast-enhanced magnetic resonance imaging between 2008 and 2016. All patients were reclassified according to the eighth edition of the tumor, node, and metastasis (TNM) classification.

Among all patients, 70% of the tumors were pure solid and 30% had part-solid ground-glass opacity on thin-section CT, and 388 (83%) and 78 (17%) were classified into clinical stages T1 and T2, respectively. Eight patients (1.7%) had extrathoracic metastasis, including 3 (0.6%) with brain metastasis, and all showed pure-solid tumors. Apabetalone chemical structure The frequency of extrathoracic and brain metastasis was 1.0% and 0.5% in 388 T1 patients, and 5.0% and 3.0% in 78 T2 patients. Although brain metastases were detected in 2 of 7 patients (29%) with PET/CT detectable extrathoracic metastases and 1 of 459 patients (0.2%) without PET/CT detectable extrathoracic metastasis, there were no neurologically asymptomatic brain metastases in patients with early-stage NSCLC confirmed by PET/CT.

Routine screening of brain imaging is unnecessary in patients with early-stage NSCLC, assessed with the current staging protocol including PET/CT.

Routine screening of brain imaging is unnecessary in patients with early-stage NSCLC, assessed with the current staging protocol including PET/CT.Agree-disagree (AD) or Likert questions (e.g., “I am extremely satisfied strongly agree … strongly disagree”) are among the most frequently used response formats to measure attitudes and opinions in the social and medical sciences. This review and research synthesis focuses on the measurement properties and potential limitations of AD questions. The research leads us to advocate for an alternative questioning strategy in which items are written to directly ask about their underlying response dimensions using response categories tailored to match the response dimension, which we refer to as item-specific (IS) (e.g., “How satisfied are you not at all … extremely”). In this review we 1) synthesize past research comparing data quality for AD and IS questions; 2) present conceptual models of and review research supporting respondents’ cognitive processing of AD and IS questions; and 3) provide an overview of question characteristics that frequently differ between AD and IS questions and may affect respondents’ cognitive processing and data quality.