Breast cancer is one of the most prevalent malignant diseases in women. The development of dose dense chemotherapy regimens has improved clinical outcomes but has been associated with increased ...hematological toxicity. Currently there is a paucity of data on the use of lipegfilgrastim in dose dense AC treatment in early breast cancer. The purpose of this study was to assess the use of lipegfilgrastim in the treatment of early breast cancer and to examine the incidence of treatment-related neutropenia during the dose dense AC phase and subsequent paclitaxel treatment.
This was a single arm, non-interventional, prospective study. The primary endpoint was to determine the rate of neutropenia defined as ANC of < 1.0 × 10
/L, during four cycles of dose dense AC with lipegfilgrastim support. The secondary endpoints were the incidence of febrile neutropenia, (temperature > 38 °C and ANC < 1.0 × 10
/L), treatment delays, premature treatment cessation and toxicity.
Forty-one participants were included in the study. Of the 160 planned dose dense AC treatments, 157 were administered, and 95% (152/160) of these were given on time. The rate of treatment delay was 5% (95% CI 2.2 to 9.9%) due to infection (4) and mucositis (1). Four (10%) patients developed febrile neutropenia. The most frequently occurring adverse event was grade 1 bone pain.
Lipegfilgrastim is an effective option in the prophylaxis of chemotherapy-induced neutropenia, and its use in everyday anti-cancer treatment can be considered.
When accessing medical care, lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) individuals face many known challenges, including stigma, discrimination, and health disparities. ...Transgender and nonbinary individuals often encounter physicians and staff who are not knowledgeable about gender-affirming services and the transition journey. Finding an affirming physician can be a trial-and-error process, causing concern and uncertainty. In 2021, Kaiser Permanente Mid-Atlantic States (KPMAS) researchers published a study examining the gaps in care and experience for transgender and nonbinary patients within the KPMAS healthcare system. KPMAS realized an opportunity to both close the gaps in care identified by transgender and nonbinary patients and enhance services for the broader LGBTQ+ patient community by creating Pride Medical at Capitol Hill—an additional and optional care site for individuals who identify as LGBTQ+. During the analysis timeframe of 30 June 2021 through 30 November 2022, 586 patients accessed care through 763 visits. A total of 675 visits (88%) were for primary care and 88 (12%) for OB/GYN. Over 50% (n = 384) of total visits were conducted virtually. The plurality of patients seen identified as a man (35%; n = 204) and gay (30%; n = 176). Postvisit survey results showed that 92% of survey respondents strongly agreed that the physician treated them with courtesy and respect, and 72% of survey respondents rated their overall care as excellent. Survey results show high acceptability of this program among the patients served. Pride Medical does not carve out care. The program offers patients access to a more specialized team of physicians—a similar model to other specialties—that is easily found by the division name Pride Medical. Layering additional specialty divisions on top of existing care, for interested patients, could be an option for other medical groups and health systems seeking to offer additional options of care for interested LGBTQ+ patients.
How is one to define a contemporary anthropology of Ireland? Can one begin with current work or is it necessary to move further back in time to the anthropological ancestors of a putative 'Irish' ...tradition of anthropology? To give an example, in an otherwise staid functionalist account of kinship and inheritance patterns on Tory Island in the North of Ireland, Robin Fox (1978:160) writes offhandedly that 'immediate orgasm is the goal and boast of sophisticates.' Any reader might be taken aback at such an egregious 'ethnographic' claim today. This brief segue into the pragmatics of sexual practices on an island off the Irish coast is not, however, an aberration in the anthropological literature on Ireland. Rather, anthropologists have perennially arrived on Irish shores with the aim of accounting for the ethnic Irish, circumscribing what Michel-Rolph Trouillot (1991) calls a 'savage slot' for Ireland in anthropology and, in doing so, creating 'zones of cultural invisibility' (Rosaldo 1988:78). Such recurrent lapses in the ethnographic imagination and the texts produced in and against this exoticizing tradition are our chief concerns here. In this article, we are concerned with an anthropology of Ireland long encumbered by a history of exoticization and misrepresentation. We offer a thoughtful unpacking of how the anthropology of Ireland has developed through an examination of several important book-length texts, based in the political-geographic jurisdiction of Southern Ireland. Taking our starting point in a brief overview of the history of early anthropological work on Ireland, we show how ethnographic representations of Ireland and the Irish reflect the shortcomings of early anthropological theory and method. We also sketch the tropes that our anthropological ancestors deployed -- representations of an edge people; a stable, homogenous national community; a society marked by repressed sexuality; and a pathological nation -- that have issued forth from a short list of notable work on Ireland. These representations were of stereotypical, 'stage' Irish that relied on narrow readings of an evolving national question in Ireland since at least the 18th century (see Moore 2011). They formed a series of procrustean refractions of southern, religious, rural, anomicidyllic, ethnic Irish identities. In the reproduction of this homogenizing narrative in anthropological accounts, however, controversy followed, marking out for a long time a particular public understanding of what anthropologists in Ireland were doing. Adapted from the source document.
Activation of the phosphoinositide-3 kinase (PI3K) pathway is a resistance mechanism to anti-human epidermal growth factor receptor 2 (HER2) therapy. This phase Ib trial was conducted to determine ...the maximum tolerated dose (MTD) of copanlisib, an intravenous (IV) pan-class I PI3K inhibitor, combined with trastuzumab.
Patients with advanced HER2-positive breast cancer and disease progression following at least one prior line of HER2 therapy in the metastatic setting were treated with copanlisib (45 or 60 mg) IV on days 1, 8 and 15 of a 28-day cycle with a fixed dose of trastuzumab 2 mg/kg weekly.
Twelve patients were enrolled. The MTD was determined as copanlisib 60 mg plus trastuzumab 2 mg/kg weekly. The most common adverse events of any grade occurring in more than two patients were hyperglycaemia (58%), fatigue (58%), nausea (58%) and hypertension (50%). Stable disease was confirmed at 16 weeks in six participants (50%).
mutations were detected in archival tumour of six participants (50%).
hotspot mutations, were detectable in pre- and on-treatment plasma of all participants. Pre- and post-treatment tumour biopsies for two patients identified temporal genomic heterogeneity, somatic mutations in the
gene, which encodes a PI3K-like protein kinase, and emergent somatic mutations related to protein kinase signalling.
Copanlisib and trastuzumab can be safely administered with fair overall tolerability. Preliminary evidence of tumour stability was observed in patients with heavily pre-treated, metastatic HER2 positive breast cancer. Several potential biomarkers were identified for further study in the current phase 2 clinical trial. NCT: 02705859.
This article examines the experiences of walkers along the Spanish Camino de Santiago pilgrimage. It explores their journeys as exercises in narrative adjustment, social practices, and somatic ...experiences of a crippling loss of control over the course of their lives. Using a phenomenological method of descriptions, the article argues that mobility is a trope that expresses existential issues in a bodily idiom. It draws attention to the value of inter-subjective experience as a potential source of existential mobility, one that finds metaphorical expression in the slow daily rhythms structuring pilgrims' journeys and that impacts on the researcher as much as the pilgrims. (Author abstract)
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