Radiopaque beads loaded with doxorubicin in the treatment of patients with hepatocellular carcinoma: A retrospective, multi-center study.

BACKGROUND AND AIMS: Radiopaque drug-eluting beads are an emerging treatment option for patients with hepatocellular carcinoma (HCC). The primary objective of this study was to evaluate overall disease and target tumor response of non-resectable HCC after TACE with a doxorubicin-loaded radiopaque microsphere. METHODS: Data were abstracted from records of patients with unresectable HCC who received TACE with doxorubicin-loaded radiopaque LC Bead LUMITM microspheres at one of five United States centers between February 2016 - November 2017. Response was measured using modified response criteria in solid tumors. Primary efficacy endpoints included objective response rate (ORR) and disease control rate (DCR) at first assessment post-treatment, both overall and for targeted tumors. ORR was the sum of complete and partial response. DCR was ORR plus stable disease. Toxicity was calculated using common terminology criteria for adverse events. RESULTS: Eighty-two patients were included. Overall ORR and DCR were 47.6% (39/82) and 76.8% (63/82), respectively. ORR and DCR of target tumors were 56% and 98%, respectively. Five patients experienced adverse events (5/82, 6.1%). No grade 4-5 toxicities occurred. CONCLUSIONS: TACE with drug-loaded radiopaque beads is a promising treatment for unresectable HCC. Prospective studies should evaluate whether radiopaque beads reduce off-target distribution of microspheres.

Geographic and demographic correlates of autism-related anti-vaccine beliefs on Twitter, 2009-15.

This study examines temporal trends, geographic distribution, and demographic correlates of anti-vaccine beliefs on Twitter, 2009-2015. A total of 549,972 tweets were downloaded and coded for the presence of anti-vaccine beliefs through a machine learning algorithm. Tweets with self-disclosed geographic information were resolved and United States Census data were collected for corresponding areas at the micropolitan/metropolitan level. Trends in number of anti-vaccine tweets were examined at the national and state levels over time. A least absolute shrinkage and selection operator regression model was used to determine census variables that were correlated with anti-vaccination tweet volume. Fifty percent of our sample of 549,972 tweets collected between 2009 and 2015 contained anti-vaccine beliefs. Anti-vaccine tweet volume increased after vaccine-related news coverage. California, Connecticut, Massachusetts, New York, and Pennsylvania had anti-vaccination tweet volume that deviated from the national average. Demographic characteristics explained 67% of variance in geographic clustering of anti-vaccine tweets, which were associated with a larger population and higher concentrations of women who recently gave birth, households with high income levels, men aged 40 to 44, and men with minimal college education. Monitoring anti-vaccination beliefs on Twitter can uncover vaccine-related concerns and misconceptions, serve as an indicator of shifts in public opinion, and equip pediatricians to refute anti-vaccine arguments. Real-time interventions are needed to counter anti-vaccination beliefs online. Identifying clusters of anti-vaccination beliefs can help public health professionals disseminate targeted/tailored interventions to geographic locations and demographic sectors of the population.

Contained Rupture of an Abdominal Aortic Aneurysm With Extensive Vertebral Body and Retroperitoneal Space Destruction.

Chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion most commonly presents with symptoms of low back pain. Although not well known, vertebral body erosion or destruction may be seen in up to 25% of patients with sealed or contained rupture of an abdominal aortic aneurysm. This appearance on cross-sectional imaging may mimic a malignant or infectious process. Although these cases can present a diagnostic challenge, published cases of chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion demonstrate clinical and imaging similarities that, when recognized, can assist in diagnosis.