BackgroundBacillus Calmette-Guérin (BCG) has been successfully used as immunotherapy to treat non-muscle invasive bladder cancer (NMIBC) for more than four decades. BCG is the only intravesical agent ...shown to reduce the risk of progression of NMIBC to muscle-invasive disease. Unfortunately, BCG therapy is not a universal panacea and it still fails in up to 40% of patients. Many of these patients, especially in the high-risk category (T1 high-grade disease, carcinoma in situ) will require aggressive therapy like cystectomy or in selected cases, bladder-sparing options like chemo-radiation. This prospective cohort study was designed to document efficacy and toxicity of half dose (40 mg) BCG.Materials and MethodsEligibility criteria include intermediate and high-grade NMIBC and carcinoma in situ after 3 weeks of TURBT. Weekly BCG therapy (40 mg, half dose) was given for 6 weeks as induction and a weekly dose for 3 weeks at 3, 6, 9 and 12 months was given as maintenance therapy. The entire procedure was done as an outdoor procedure.Results18 patients were included in the study from 2018 to 2021. Cystitis is the most common symptom experienced by all patients to varied extent but fortunately all are self-limiting. 2 patients had fever which subsided with paracetamol. No serious adverse effect observed in any of the 18 patients, and all were discharged on the same day of admission. After 36 months of mean follow up period, 8 patients had recurrence, 1 patient died, and 1 patient had stuck foley catheter after BCG vaccine instillation which was managed conservatively.ConclusionsBCG therapy is an effective treatment in intermediate and high-grade NMIBC and carcinoma in situ after TURBT. With half dose of BCG toxicity is low and the cost of treatment is just over 20$ per dose. S. Acharya: None.
A
bstract
A longstanding question in superstring/
M
theory is does it predict supersymmetry below the string scale? We formulate and discuss a necessary condition for this to be true; this is the ...mathematical conjecture that all stable, compact Ricci flat manifolds have special holonomy in dimensions below eleven. Almost equivalent is the proposal that the landscape of all geometric, stable, string/
M
theory compactifications to Minkowski spacetime (at leading order) are supersymmetric. For simply connected manifolds, we collect together a number of physically relevant mathematical results, emphasising some key outstanding problems and perhaps less well known results. For non-simply connected, non-supersymmetric Ricci flat manifolds we demonstrate that many cases suffer from generalised Witten bubble of nothing instabilities.
Rare inherited disorders of fibrinogen ACHARYA, S. S.; DIMICHELE, D. M.
Haemophilia : the official journal of the World Federation of Hemophilia,
November 2008, Letnik:
14, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Fibrinogen, a hexameric glycoprotein encoded by three genes –FGA, FGB, FGG– clustered on chromosome 4q is involved in the final steps of coagulation as a precursor of fibrin monomers required for the ...formation of the haemostatic plug. Inherited disorders of fibrinogen abnormalities are rare and not as well clinically characterized as some other inherited bleeding disorders. To characterize the clinical manifestations, molecular defects and treatment modalities of these rare disorders, a Medline search from January 1966 to September 2007 for these disorders reported in large studies and registries was undertaken. Inherited fibrinogen disorders can manifest as quantitative defects (afibrinogenemia and hypofibrinogenemia) or qualitative defects (dysfibrinogenemia). Quantitative fibrinogen deficiencies may result from mutations affecting fibrinogen synthesis, or processing while qualitative defects are caused by mutations causing abnormal polymerization, defective cross‐linking or defective assembly of the fibrinolytic system. Clinical manifestations vary from being asymptomatic to developing catastrophic life‐threatening bleeds or thromboembolic events. Management of bleeds includes use of purified plasma‐derived concentrates, cryoprecipitate or fresh frozen plasma. Use of some of these products carries risks of viral transmission, antibody development and thromboembolic events. Establishment of registries in Iran, Italy and North America has fostered a better understanding of these disorders with an attempt to explore molecular defects. Rare Bleeding Disorder Registries developed through the United States and international efforts hopefully will encourage development and licensure of safer, effective products.
Objective To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles. Design Retrospective cohort study. Setting Not applicable. Patient(s) A total of 239,127 fresh IVF ...cycles from the 2008–2010 Society for Assisted Reproductive Technology registry were stratified into cohorts based on World Health Organization BMI guidelines. Cycles reporting normal BMI (18.5–24.9 kg/m2 ) were used as the reference group (REF). Subanalyses were performed on cycles reporting purely polycystic ovary syndrome (PCOS)–related infertility and those with purely male-factor infertility (34,137 and 89,354 cycles, respectively). Intervention(s) None. Main Outcome Measure(s) Implantation rate, clinical pregnancy rate, pregnancy loss rate, and live birth rate. Result(s) Success rates and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for all pregnancy outcomes were most favorable in cohorts with low and normal BMIs and progressively worsened as BMI increased. Obesity also had a negative impact on IVF outcomes in cycles performed for PCOS and male-factor infertility, although it did not always reach statistical significance. Conclusion(s) Success rates in fresh autologous cycles, including those done for specifically PCOS or male-factor infertility, are highest in those with low and normal BMIs. Furthermore, there is a progressive and statistically significant worsening of outcomes in groups with higher BMIs. More research is needed to determine the causes and extent of the influence of BMI on IVF success rates in other patient populations.
A
bstract
Hidden sector glueball dark matter is well motivated by string theory, compactifications of which often have extra gauge groups uncoupled to the visible sector. We study the dynamics of ...glueballs in theories with a period of late time primordial matter domination followed by a low final reheating temperature due to a gravitationally coupled modulus. Compared to scenarios with a high reheating temperature, the required relic abundance is possible with higher hidden sector confinement scales, and less extreme differences in the entropy densities of the hidden and visible sectors. Both of these can occur in string derived models, and relatively light moduli are helpful for obtaining viable phenomenology. We also study the effects of hidden sector gluinos. In some parts of parameter space these can be the dominant dark matter component, while in others their abundance is much smaller than that of glueballs. Finally, we show that heavy glueballs produced from energy in the hidden sector prior to matter domination can have the correct relic abundance if they are sufficiently long lived.
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