The IM exerts a direct influence in the development of PH in rats with diet-induced NASH and dysbiosis; PH, insulin resistance, and endothelial dysfunction revert when a healthy IM is restored. (Hepatology 2018;67:1485-1498).

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Summary:Cyclophosphamide with granulocyte colony stimulating factor (G-CSF) is commonly used to mobilize stem cells in multiple myeloma. Timing of collection is variable and incidence and severity of side effects is substantial. To optimize timing of collection, to reduce side effects and to limit costs of the procedure, we evaluated vinorelbine, a drug shown to have activity in multiple myeloma, in combination with G-CSF as mobilizing regimen. A total of 19 consecutive patients with advanced stage multiple myeloma received one dose of vinorelbine 35 mg/m 2 intravenously on day 1 in an outpatient setting and G-CSF 10 lg/kg/day from day 4 divided in two daily doses. Median CD34+ cell blood counts measured on day 8 of mobilization were 142 Â 10 6 /l (range 57-467). One 15-l apheresis on day 8 resulted in sufficient stem cells (median 11.1 Â 10 6 CD34+ cells/kg, range 6.2-36.0 prior and median 7.5 Â 10 6 CD34+ cells/kg, range 4.0-20.2 postpositive CD34+ cell selection) for transplantation. Hematopoietic recovery was swift with ANC 40.5 Â 10 9 /l on day 11 median (range 10-15) and platelets 420 Â 10 9 /l on day 12 median (range 10-15) after reinfusion of the stem cells on day 0. No episodes of febrile neutropenia were observed during mobilization. In our institutions cost reduction for the procedure was about 1700 euros compared to the mobilization with cyclophosphamide and G-CSF. Vinorelbine and G-CSF allow precise timing and harvesting of sufficient stem cells, and might be an alternative to cyclophosphamide in the mobilization of stem cells for autologous transplantation in multiple myeloma.

The value of computer tomography in the investigation of carcinomas of the renal pelvis was analysed in 22 patients. In 88% of cases it was possible to differentiate tumours confined to stages I and II from tumours in the advanced stages III and IV. Computer tomographic signs of stages III and IV were demonstration of infiltration into the surrounding tissues and into the renal parenchyma as well as the presence of regional lymph node metastases. Computer tomography should follow urography wherever there is a suspicion of a pelvic carcinoma in order to define the tumour more precisely.

Background As treatment interruptions occur during psoriasis management in clinical practice, it is important to know the duration of clinical response after treatment withdrawal. Objectives To report time to and predictors of relapse in patients who were tildrakizumab 100 and 200 mg responders (≥75% improvement in Psoriasis Area and Severity Index, PASI 75) at week 28 re‐randomized to placebo from reSURFACE 1 trial. Methods Post hoc analysis of adult patients with moderate‐to‐severe plaque psoriasis from a 64‐week phase 3 trial. Relapse was primarily defined as loss of PASI 75 response. Both relapses defined as loss of PASI 90 and loss of absolute PASI < 2 response were included as sensitivity analyses. PASI 75, PASI 90 and PASI < 2 responders re‐randomized to placebo at week 28 and followed up until week 64 were included. The Kaplan–Meier (KM) estimates of the 64‐week relapse rate were calculated. The log‐rank test to compare KM curves from responders to tildrakizumab 100 and 200 mg was used. Independent predictors of relapse were explored. Results Median time to loss of PASI 75/PASI 90/PASI < 2 response from week 28 was 142/111/112 days with tildrakizumab 100 mg and 172/140/113 days with tildrakizumab 200 mg, respectively (all not significant). Around 20% of patients did not relapse (either maintained a PASI 75 response or were lost to follow‐up) during the 36‐week period. Increase in body mass index (BMI) (hazard ratio, HR [95% confidence interval, CI] for loss of PASI 75 response: 1.0345 [1.0112–1.0582]) and increase in disease duration (HR [95% CI]: 1.0151 [1.0028–1.0275] for loss of PASI 75 response) were associated with an increased risk of relapse, regardless of the relapse definition. Conclusions When treatment is interrupted, tildrakizumab provides durable maintenance of efficacy with a median time to loss of PASI 75 response of 5–6 months, irrespective of the dose. Interventions on modifiable risk factors for relapse, such as BMI, may improve personalized long‐term psoriasis management.