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    Acalabrutinib Plus Bendamustine-Rituximab in Untreated Mantle Cell Lymphoma

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    The combination of the Bruton tyrosine kinase inhibitor ibrutinib with bendamustine-rituximab for first-line treatment of mantle cell lymphoma (MCL) prolonged progression-free survival (PFS), but without improvement in overall survival (OS), likely because of toxicity. Acalabrutinib was shown to be efficacious and less toxic than ibrutinib in a head-to-head trial in chronic lymphocytic leukemia and therefore might lead to better outcomes in MCL.Patients 65 years and older with previously untreated MCL received acalabrutinib (100 mg twice daily) or placebo (until disease progression or unacceptable toxicity), plus six cycles of bendamustine (90 mg/m2 once daily; days 1 and 2) and rituximab (375 mg/m2 as a single dose; day 1) followed by rituximab maintenance in responding patients for 2 years. Crossover to acalabrutinib at disease progression was permitted. The primary end point was PFS per the independent review committee; overall response rate and OS were secondary end points.In total, 598 patients were randomly assigned, with 299 in each arm. At a median follow-up of 49.8 months using the reverse Kaplan-Meier method, the median PFS was 66.4 months in the acalabrutinib arm and 49.6 months in the placebo arm (hazard ratio [HR], 0.73 [95% CI, 0.57 to 0.94]; P = .0160). Benefit was seen across all subgroups, including those with high-risk features. Overall response/complete response rates were 91.0%/66.6% and 88.0%/53.5% in the acalabrutinib and placebo arms, respectively. OS was not significantly different (HR, 0.86 [95% CI, 0.65 to 1.13]; P = .27). Grade 3 or greater adverse events were reported in 88.9% and 88.2% in the acalabrutinib and placebo arms, respectively.The combination of acalabrutinib with bendamustine-rituximab significantly improved PFS. Clinical benefit of acalabrutinib with bendamustine-rituximab was achieved with manageable toxicity

    Long-term prognosis after coronary bifurcation PCI-A nationwide observational study

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    BACKGROUND: Long-term outcomes of percutaneous coronary intervention (PCI) for bifurcation lesions are underexplored. We investigated long-term PCI outcomes for proximal LAD bifurcation lesions involving D1.; METHODS: Using Swedish registries, we included all patients undergoing LAD-D1 bifurcation PCI with drug-eluting stents between 2010 and 2020. Patients were stratified into two groups: simple PCI and complex PCI. The simple PCI group included those with stents in the proximal LAD only, while complex PCI involved the kissing balloon technique or a 2-stent approach for the proximal LAD and D1. A multivariable Cox regression model was used to estimate event rates of major adverse clinical events (MACE), defined as all-cause death or a new myocardial infarction. Secondary outcomes included target segment revascularization or coronary artery by-pass graft surgery (CABG) and definite stent thrombosis.; RESULTS: A total of 6,796 individuals were analyzed: 2,007 underwent complex PCI and 4,789 simple PCI. Baseline characteristics were comparable between groups. The complex PCI group was slightly younger, more often male, and more frequently taking statins. At 1-year, MACE rates were lower in the complex PCI group (6.2% vs 7.9%; adjusted HR 0.74, 95% CI 0.59-0.93, p=0.010). The result was driven by lower all-cause mortality (3.6% vs. 5.0%; adjusted HR 0.73, 95% CI 0.54-0.98, p=0.036). No significant differences in myocardial infarction, target segment revascularization, CABG, stent thrombosis, stroke, or bleeding were observed between groups, persisting at five years.; CONCLUSION: Over a five-year period, complex PCI of LAD/D1 bifurcation lesions was associated with better outcome than simple PCI in a routine clinical setting. Copyright: © 2025 Katona et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

    Az embercsempészés bűntette miatt indult büntetőügyek büntetőeljárási sajátosságai a Szegedi Járásbíróság 2022–2023. évi joggyakorlatának tükrében

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    The paper focuses on the criminal procedure characteristics of the criminal cas­es related to human trafficking received by the Szeged District Court between 1 March 2022 and 30 June 2023. Its aim is to explore the adjudicative activity of the before-mentioned court and through this to identify and explain the problems aris­ing in the case law. It also examines the question of whether and in which areas the use of algorithmic decision making and deep learning tools could be considered in many criminal cases with the same criminological characteristics

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