Patients with metastatic triple-negative breast cancer were treated with standard chemotherapy or the anti–Trop-2 antibody–drug conjugate sacituzumab govitecan. Patients receiving the drug conjugate ...had significantly longer progression-free and overall survival as well as more frequent myelotoxic effects and diarrhea.
Purpose: The primary objective of the study was to understand the therapeutic inertia in treatment and management of plaque psoriasis among dermatologists, along with determining the preferred ...treatment choices for management of plaque psoriasis; it also included the resulting treatment satisfaction among patients. The secondary objective was to identify the gaps in terms of knowledge and attitude among dermatologists and the expectations of patients. Patients and Methods: A multicentre, cross-sectional quantitative survey was conducted among dermatologists and patients with moderate to severe plaque psoriasis across India. The interviews were conducted either face to face or via telephone between September and November 2020, using structured and validated questionnaires based on specific themes. The data obtained were statistically analysed, wherever applicable. Results: Overall, 207 adult patients with moderate-to-severe plaque psoriasis and 303 dermatologists were interviewed. Post experiencing symptoms, 44% of the patients visited general physicians for treatment and there was an average 7.8-month delay by the patients to consult a dermatologist. Approximately one-fourth of patients used home remedies before seeking medical help. Onethird of dermatologists used the Psoriasis Area and Severity Index (PASI) for assessing the disease severity. Majority of dermatologists preferred combination therapy for their patients. The lack of quick resolution and side effects were the major reasons for changing the treatment. Overall, only 35% of the patients complied to current treatment. Satisfaction with existing forms of therapies was highest for mild plaque psoriasis (62%) as confirmed by dermatologists, while 52% of the overall patients were satisfied with their therapy. Majority of the patients (64%) affirmed living with plaque psoriasis impacted their lives. Conclusion: This first-of-its-kind survey in India highlighted the gaps in terms of the disease journey between dermatologists and patients. The survey emphasises the need for shared decision-making and may benefit dermatologists in suggestive modifications of the treatment algorithm and disease management in clinical settings. Keywords: therapeutic inertia, psoriasis, adherence, treatment expectations, treatment goals, diagnosis
•Chemotherapy induces microbiome disruption, inflammation, and cognitive decline.•The resulting microbiome disruption relates to cognitive decline and inflammation.•Those cognitively impaired have ...unique chemotherapy-induced microbiome alterations.
Chemotherapy is notorious for causing behavioral side effects (e.g., cognitive decline). Notably, the gut microbiome has recently been reported to communicate with the brain to affect behavior, including cognition. Thus, the aim of this clinical longitudinal observational study was to determine whether chemotherapy-induced disruption of the gut microbial community structure relates to cognitive decline and circulating inflammatory signals. Fecal samples, blood, and cognitive measures were collected from 77 patients with breast cancer before, during, and after chemotherapy. Chemotherapy altered the gut microbiome community structure and increased circulating TNF-α. Both the chemotherapy-induced changes in microbial relative abundance and decreased microbial diversity were related to elevated circulating pro-inflammatory cytokines TNF-α and IL-6. Participants reported subjective cognitive decline during chemotherapy, which was not related to changes in the gut microbiome or inflammatory markers. In contrast, a decrease in overall objective cognition was related to a decrease in microbial diversity, independent of circulating cytokines. Stratification of subjects, via a reliable change index based on 4 objective cognitive tests, identified objective cognitive decline in 35% of the subjects. Based on a differential microbial abundance analysis, those characterized by cognitive decline had unique taxonomic shifts (Faecalibacterium, Bacteroides, Fusicatenibacter, Erysipelotrichaceae UCG-003, and Subdoligranulum) over chemotherapy treatment compared to those without cognitive decline. Taken together, gut microbiome change was associated with cognitive decline during chemotherapy, independent of chemotherapy-induced inflammation. These results suggest that microbiome-related strategies may be useful for predicting and preventing behavioral side effects of chemotherapy.
BACKGROUND:
Hypertrophic cardiomyopathy is recognized in infants of diabetic mothers, and when it occurs it is generally benign and transient. We describe a case of fetal cardiac death caused by ...hypertrophic cardiomyopathy in an infant of a diabetic mother.
CASE:
Hydrops fetalis caused by hypertrophic cardiomyopathy resulted in the death of a macrosomic male fetus of a young woman who had well-controlled diabetes mellitus and was treated with insulin therapy during pregnancy.
CONCLUSION:
It is important to monitor fetal heart function in macrosomic infants of diabetic mothers. Hypertrophic cardiomyopathy might explain otherwise unexplained fetal deaths in women with diabetes.
Alysicarpus sanjappae, a new species (Leguminosae: Papilionoideae) from the Western Ghats of India, is described and illustrated. It resembles A. heyneanus Wight & Arn., but differs in having a ...prostrate habit, stems and branches strigose with a line of distant hairs, leaves usually 1-foliolate mixed with 3-foliolate, stipules and stipels distinctly ciliate only at the tip, secondary bracts, a glabrous pedicel, dark brown hairs present only on the margins at the tip of all sepals, a yellow corolla tinged with red, and rugose pods, as long as or slightly longer than the sepals.
Summary Background Despite preventive vaccines for oncogenic human papillomaviruses (HPVs), cervical intraepithelial neoplasia (CIN) is common, and current treatments are ablative and can lead to ...long-term reproductive morbidity. We assessed whether VGX-3100, synthetic plasmids targeting HPV-16 and HPV-18 E6 and E7 proteins, delivered by electroporation, would cause histopathological regression in women with CIN2/3. Methods Efficacy, safety, and immunogenicity of VGX-3100 were assessed in CIN2/3 associated with HPV-16 and HPV-18, in a randomised, double-blind, placebo-controlled phase 2b study. Patients from 36 academic and private gynaecology practices in seven countries were randomised (3:1) to receive 6 mg VGX-3100 or placebo (1 mL), given intramuscularly at 0, 4, and 12 weeks. Randomisation was stratified by age (<25 vs ≥25 years) and CIN2 versus CIN3 by computer-generated allocation sequence (block size 4). Funder and site personnel, participants, and pathologists were masked to treatment. The primary efficacy endpoint was regression to CIN1 or normal pathology 36 weeks after the first dose. Per-protocol and modified intention-to-treat analyses were based on patients receiving three doses without protocol violations, and on patients receiving at least one dose, respectively. The safety population included all patients who received at least one dose. The trial is registered at ClinicalTrials.gov (number NCT01304524 ) and EudraCT (number 2012-001334-33). Findings Between Oct 19, 2011, and July 30, 2013, 167 patients received either VGX-3100 (n=125) or placebo (n=42). In the per-protocol analysis 53 (49·5%) of 107 VGX-3100 recipients and 11 (30·6%) of 36 placebo recipients had histopathological regression (percentage point difference 19·0 95% CI 1·4–36·6; p=0·034). In the modified intention-to-treat analysis 55 (48·2%) of 114 VGX-3100 recipients and 12 (30·0%) of 40 placebo recipients had histopathological regression (percentage point difference 18·2 95% CI 1·3–34·4; p=0·034). Injection-site reactions occurred in most patients, but only erythema was significantly more common in the VGX-3100 group (98/125, 78·4%) than in the placebo group (24/42, 57·1%; percentage point difference 21·3 95% CI 5·3–37·8; p=0·007). Interpretation VGX-3100 is the first therapeutic vaccine to show efficacy against CIN2/3 associated with HPV-16 and HPV-18. VGX-3100 could present a non-surgical therapeutic option for CIN2/3, changing the treatment outlook for this common disease. Funding Inovio Pharmaceuticals.
Southeast Asia SarDesai, D. R.
2013, 20180131, 2012, 2018-01-31, 2012-12-04
eBook
Southeast Asia: Past and Present offers a balanced and readable account of the region from ancient to modern times, covering traditional history as well as current events. D. R. SarDesai achieves a ...delicate balance exploring the importance of the period of European colonial rule in Southeast Asia without overemphasis as he introduces students to the regions and peoples of Myanmar, Thailand, Malaysia, Brunei, Singapore, Indonesia, East Timor, Laos, Cambodia, Vietnam, and the Philippines. Readers will find insightful introductions at the beginning of each part to aid in understanding the global and political implications of the events discussed.
The seventh edition is thoroughly updated to offer coverage of current events, including the historic 2012 elections in Myanmar and Aung San Suu Kyi’s successful bid for election to the Parliament, the rise of Yingluck Shinawatra to the position of prime minister of neighboring Thailand, and the consolidation of the ASEAN and its consideration of China’s claim to the South China Sea. Combining thematic and chronological approaches with the study of colonialism, nationalism, historical and cultural heritage, and current events, Southeast Asia manages to convey an Asian point of view throughout.
The second edition of Southeast Asian History: Essential Readings (978-0-8133-4857-5) is also available from D. R. SarDesai and Westview Press as a complementary or a standalone text.
Systemic Lupus Erythematosus (SLE) is a multisystem disorder characterized by production of numerous autoantibodies, some of which have pathogenic consequences and result in considerable morbidity. ...Herein, we present a case of 48-year-old female with SLE having autoimmune hemolytic anemia, autoimmune thrombocytopenia, renal involvement, and recurrent flares of skin manifestations. She did not respond to the conventional therapy and was controlled and treated with Rituximab, a chimeric, monoclonal antiCD20 antibody, which specifically depletes B lymphocytes.
Designed to stand on its own, or to accompany the seventh edition of D. R. SarDesai's Southeast Asia: Past and Present , this updated reader includes classic and recent works on the history of ...Southeast Asia. SarDesai has selected literary and historical writings that address crucial controversies in the region of Southeast Asia. The readings are organized in four sections- Cultural Heritage, Colonial Interlude, Nationalist Response, and the Fruits of Freedom- and cover the entire range of Southeast Asian history from ancient to contemporary times. Geographically, the book includes Myanmar, Thailand, Malaysia, Brunei, Singapore, Indonesia, East Timor, Laos, Cambodia, Vietnam, and the Philippines. The revised second edition retains the most popular readings from the first edition, while replacing some of the historical chapters, updating the contemporary and recent coverage, and adding new readings to pertinent subject areas. Southeast Asian History: Essential Readings provides valuable context and critical background to events of this region.
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