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This randomized clinical trial compares the efficacy of ivermectin vs placebo in shortening symptom duration among adult outpatients in the US with symptomatic mild to moderate COVID-19.
In Reply The presence and role of atrial fibrosis in the arrhythmogenesis of AF has been extensively studied and is considered a key component of the arrhythmic substrate in patients with AF. Delayed-enhancement MRI provides a well-validated noninvasive method of assessing the burden of atrial disease and has been shown to have an important clinical role in predicting response to catheter ablation therapy.
To the Editor The emergence of delayed-enhancement magnetic resonance imaging (MRI) has set the stage for advancements in visualization and quantification of left atrial fibrosis. Among patients with atrial fibrillation (AF) undergoing catheter ablation, the DECAAF I trial showed an association between the extent of atrial fibrosis and the likelihood of arrhythmia recurrence. Consequently, atrial fibrotic burden gained clinical importance and became a potential target to improve procedural outcomes.
This placebo-controlled, crossover randomized clinical trial compares the effects of spinal cord burst stimulation vs placebo stimulation in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.
This study assesses the association between COVID-19 mRNA booster immunization compared with vaccination with the primary mRNA vaccination series alone and odds of hospitalization for COVID-19.
This clinical trial assesses whether paroxetine plus oxycodone or quetiapine plus oxycodone combinations decreased the ventilatory response to hypercapnia compared with oxycodone alone.
Objective
Liver regeneration remains one of the biggest clinical challenges. Here, we aim to transform the spleen into a liver-like organ via directly reprogramming the splenic fibroblasts into hepatocytes in vivo.
Design
In the mouse spleen, the number of fibroblasts was through silica particles (SiO2) stimulation, the expanded fibroblasts were converted to hepatocytes (iHeps) by lentiviral transfection of three key transcriptional factors (Foxa3, Gata4 and Hnf1a), and the iHeps were further expanded with tumour necrosis factor-α (TNF-α) and lentivirus-mediated expression of epidermal growth factor (EGF) and hepatocyte growth factor (HGF).
Results
SiO2 stimulation tripled the number of activated fibroblasts. Foxa3, Gata4 and Hnf1a converted SiO2-remodelled spleen fibroblasts into 2×106 functional iHeps in one spleen. TNF-α protein and lentivirus-mediated expression of EGF and HGF further enabled the total hepatocytes to expand to 8×106 per spleen. iHeps possessed hepatic functions—such as glycogen storage, lipid accumulation and drug metabolism—and performed fundamental liver functions to improve the survival rate of mice with 90% hepatectomy.
Conclusion
Direct conversion of the spleen into a liver-like organ, without cell or tissue transplantation, establishes fundamental hepatic functions in mice, suggesting its potential value for the treatment of end-stage liver diseases.
Annals of Internal Medicine, Volume 175, Issue 10, Page JC115, October 2022.
Annals of Internal Medicine, Volume 175, Issue 10, Page JC112, October 2022.
This clinical trial compares the amount of opioids used by patients who underwent arthroscopic knee or shoulder surgery randomized to a pain management protocol involving patient education, nonsteroidal anti-inflammatories, and acetaminophen or to the current pain management care.
To the Editor We have read with great interest the article by Kim et al comparing the risks for several comorbidities between Korean patients with palmoplantar pustulosis (PPP) and psoriasis vulgaris (PSV) or pompholyx. They conducted a large cohort study that suggested that patients with PPP have an overlapping comorbidity profile with patients with PSV; however, the risk for comorbidities may substantially differ. Although whether PPP is a distinct entity or a subtype of psoriasis remains an ongoing debate, their findings deepen this discussion. We speculate that adding subgroup analyses based on PPP subtypes could potentially lead to more significant findings.
In Reply We appreciate the suggestions of Yatsuzuka and Murakami regarding our study that reported the risk of comorbidities in patients with palmoplantar pustulosis (PPP) compared with those with psoriasis vulgaris (PSV) or pompholyx. They suggested 2 additional subgroup analyses based on subtypes of PPP.
To the Editor We commend Palma et al for presenting a randomized comparison of primary surgery vs radiation therapy for human papillomavirus–positive oropharyngeal cancer. However, we would caution against generalized applicability of ORATOR2 outcomes.
This randomized clinical trial assesses whether etoposide plus cisplatin or irinotecan plus cisplatin is a more effective treatment regimen in terms of overall survival in patients with advanced neuroendocrine carcinoma of the digestive system.
This randomized clinical trial explores if enhanced self-measured blood pressure (SMBP) paired with a connected smartphone application is superior to standard SMBP for blood pressure reduction or patient satisfaction.
This randomized clinical trial evaluates the combination of psychotherapy with psilocybin vs active placebo in patients with alcohol use disorder.
