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Endoscopic sleeve gastroplasty (ESG) was safe and effective for weight loss, during a single-centre five-year follow-up study.

“It is a great procedure, patients are satisfied, and it achieves good results,” Dr. Reem Sharaiha of Weill Cornell Medicine in New York City told Reuters Health by email. “ESG has been gaining momentum among the patient population. Many were interested in the long-term results of endoscopic approaches, including insurances/bariatric surgeons, as most (studies) have not shown durability in the past.”

Dr Sharaiha and colleagues studied 216 patients who underwent ESG at Weill Cornell from 2013-2019 (mean age, 46; 68% women). During the procedure, the endoscopist inserts a suturing device through the mouth and into the stomach, which is sutured to make it smaller.

Study participants had a body mass index of >30 kg/m2 (or >27 with comorbidities) and had failed to achieve a total body weight loss (TBWL) of at least 5% with noninvasive measures such as drugs.

Source: Medscape

The CO-RADS classification is a standardized reporting system for patients with suspected COVID-19 infection developed for a moderate to high prevalence setting.

CO-RADS 1

• COVID-19 is highly unlikely.
• The CT is normal or there are findings that indicate a non-infectious disease like congestive heart failure, sarcoid, histoplasmosis, malignancy, UIP or fibrotic NSIP (if unchanged to prior examination).
• An exemption has to be made for the first few days of a mild infection when the CT can be normal.

CO-RADS 2

• Level of suspicion of COVID-19 infection is low.
• Findings are consistent with other infections like typical bronchiolitis with tree-in-bud and thickened bronchus walls.
• No typical signs of COVID-19.

CO-RADS 3

• COVID-19 unsure or indeterminate.
• CT abnormalities indicating infection, but unsure whether COVID-19 is involved, like widespread bronchopneumonia, lobar pneumonia, septic emboli with ground glass opacities.

CO-RADS 4

• In CO-RADS 4 the level of suspicion is high.
• Mostly these are suspicious CT findings but not extremely typical:
• Unilateral ground glass
• Multifocal consolidations without any other typical finding
• Findings are suspicious of COVID-19 in underlying pulmonary disease.

CO-RADS 5

• Multifocal GGO and consolidation
• PCR positive

CO-RADS 6

• Patient with positive PCR and bilateral GGO.

The investigational anti-PD-1 antibody sintilimab has shown that it improves the efficacy of platinum-based chemotherapy in the first-line treatment of patients with advanced non-squamous non-small cell lung cancer (NSCLC) in a Chinese phase 3 trial dubbed ORIENT-11.

Sintilimab is a fully human IgG4 monoclonal antibody that blocks the binding of programmed death (PD)-1 to PD ligand 1 (PD-L1) or PD-L2 with high affinity, and has received market authorization in China for the treatment of Hodgkin’s lymphoma.

For ORIENT-11, almost 400 patients with advanced non-squamous NSCLC were randomly assigned to sintilimab or placebo plus pemetrexed and platinum-based chemotherapy in a 2:1 ratio.

“The addition of sintilimab to pemetrexed and platinum significantly improved PFS [progression-free survival] compared to placebo,” reducing progression rates by 52%, noted lead investigator Li Zhang, MD, professor of medical oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.

Source: Medscape

New recommendation: WHO recommends that pregnant women testing positive for HBV infection (HBsAg positive) with an HBV DNA ≥ 5.3 log10 IU/mL (≥ 200,000 IU/mL)1 receive tenofovir prophylaxis from the 28th week of pregnancy until at least birth, to prevent mother-to-child transmission of HBV. This is in addition to three-dose hepatitis B vaccination in all infants, including timely birth dose (conditional recommendation, moderate quality of evidence). Use of HBeAg testing, where HBV DNA testing is not available, to determine treatment eligibility for tenofovir prophylaxis to prevent mother-to-child transmission of HBV.

New recommendation: WHO recommends that in settings in which antenatal HBV DNA testing is not available, HBeAg testing can be used as an alternative to HBV DNA testing to determine eligibility for tenofovir prophylaxis to prevent mother-to-child transmission of HBV2 (conditional
recommendation, moderate quality of evidence).

Source: WHO

The combination of the anti-PD-1 antibody pembrolizumab and the multikinase inhibitor lenvatinib provides objective response rates in many patients with advanced gastric cancer, according to results from an early single-arm trial.

Lenvatinib monotherapy was associated with durably stable disease in a phase-1 study of patients with solid tumors, and the combination of lenvatinib plus pembrolizumab has shown promising antitumor activity with manageable safety profiles for several malignancies.

Lenvatinib is a multikinase inhibitor of VEGFR1, VEGFR2, and VEGFR3, and other receptor tyrosine kinases. Pembrolizumab, an antibody targeting PD-1, has also moderate efficacy in biomarker-unselected endometrial cancer.

Source: Medscape