Abstract Secretion of monoclonal immunoglobulins (MIg) detected in the serum and/or urine is one of the typical features of multiple myeloma (MM). However, some patients secrete MIg in quantities below “measurable” (termed oligosecretory MM) and others have no detectable MIgs by standard serum and urine immunofixation (termed non-secretory MM). In a cohort of 852 consecutive patients with active myeloma, we identified 100 (11.7%) patients with oligo/non-secretory MM, including...
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Abstract Germinotropic lymphoproliferative disorder is a rare and rather enigmatic novel entity with distinctive clinicopathological features, one of which is the typical co-infection by Human herpesvirus 8 and Epstein-Barr virus. Human herpesvirus 8 is a lymphotropic virus detected in Kaposi sarcoma, multicentric Castleman disease, primary effusion lymphoma, Human herpesvirus 8-positive diffuse large B cell lymphoma not otherwise specified, and germinotropic lymphoproliferative...
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Abstract Patients with newly diagnosed chronic phase chronic myeloid leukemia (CP CML) can be effectively treated with tyrosine kinase inhibitors (TKIs) and achieve a lifespan similar to the general population. The success of TKIs, however, requires long-term and sometimes lifelong treatment; thus, patient-assessed health-related quality of life (HRQoL) has become an increasingly important parameter for treatment selection. Bosutinib is a TKI approved for CP CML in newly diagnosed...
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IntroductionSince December 2019, a cluster of cases with contact history of live animals in Huanan seafood wholesale market of Wuhan city developed an unexplained course of pneumonia. A novel virus was identified and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Later on, WHO declared that the outbreak constitutes a Public Health Emergency of International Concern and named the disease COVID-19. As of 6 April 2020, more than 1 270 000 human infections with the novel coronavirus...
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Epidemics and pandemics in human history are not the exception but the rule. Bill Gates was prophetic in 2015 ‘if anything kills ten million people in the next few decades, it is likely to be an infectious virus rather than a war. Not missiles, microbes’.The Black Death (1347), the Great Plague of London (1665) and the Spanish Flu outbreak which killed 50 million people occurred in 1918. In 1997, the H5N1 bird flu epidemic occurred and was followed, in 2002, by the coronavirus outbreaks of severe...
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ObjectiveTo describe the spectrum and outcome of central nervous system complications associated with immune checkpoint inhibitors (CNS-ICI).MethodsPatients with CNS-ICI were identified and their characteristics compared with ICI-related peripheral neuropathy (PN-ICI).ResultsWe identified 19 patients with CNS-ICI. The patients were receiving nivolumab (n=8), pembrolizumab (n=6), a combination of ipilimumab-nivolumab (n=3), ipilimumab-durvalumab (n=1), or atezolizumab (n=1). Underlying malignancies...
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Encephalitis as an immune-related adverse event has different features than encephalitis in regular clinical practiceWith the increasing use of immune checkpoint inhibitors (ICIs), neurologists encounter more immune-related adverse events (irAEs). Since the mortality rate of encephalitis occurring as an irAE (irEncephalitis) is as high as 19%,1 it is as lethal a condition as myocarditis. Vogrig et al2 proposed the classification of central nervous system complications associated with autoantibodies....
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Distribution of plaques in the cerebrum in multiple sclerosisAuthors: Brownell B, Hughes JTYear Published: 1962Number of times cited: 590Published 58 years ago this seminal work from Oxford has been cited nearly 600 times. What did it describe and why is it considered so important?Multiple sclerosis (MS) remains an enigmatic disease (or syndrome), reluctant to give up its secrets: visualised on MRI, an inflammatory vapour trail in the cerebrospinal fluid, characteristic in its clinical manifestations...
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IntroductionVariants in the GBA1 gene have been identified as a common risk factor for Parkinson’s disease (PD). In addition to pathogenic mutations (those associated with Gaucher disease), a number of ‘non-pathogenic’ variants also occur at increased frequency in PD. Previous studies have reported that pathogenic variants adversely affect the clinical course of PD. The role of ‘non-pathogenic’ GBA1 variants on PD course is less clear. In this study, we report the effect of GBA1 variants in incident...
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Abstract Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanisms. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities...
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Abstract Introduction This study aimed to evaluate the short-term cost-effectiveness of insulin degludec 200 units/mL (degludec) versus insulin glargine 300 units/mL (glargine U300) from a Dutch societal perspective. Methods A previously published model estimated costs [2018 euros (EUR)] and effectiveness [quality-adjusted life years (QALYs)] with...
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Abstract Introduction A post-marketing surveillance (PMS) study was conducted to confirm the long-term risk–benefit profile of sitagliptin administered to Japanese patients with type 2 diabetes mellitus (T2DM) under real-world conditions. Methods This prospective, multicentre, open-label PMS collected data from 3326 patients receiving sitagliptin according...
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Abstract Introduction Once-weekly semaglutide 1 mg is a novel glucagon-like peptide-1 receptor agonist (GLP-1 RA) for the treatment of type 2 diabetes that has demonstrated significantly greater reductions in glycated haemoglobin (HbA1c) and body weight than the GLP-1 RA once-daily liraglutide 1.2 mg in the SUSTAIN 10 trial. The present analysis aimed to evaluate the long-term cost-effectiveness of once-weekly semaglutide 1 mg versus...
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Abstract This article is co-authored by the mother of a patient with spinal muscular atrophy (SMA), two pediatric pulmonologists and the pediatric neurologist in the team. It describes the patient and their family’s experience of living with SMA. This commentary describes the mother’s experience of the diagnosis and treatment process of her daughter’s SMA in an era of emerging treatments for a disease which was until recently considered incurable. SMA diagnosis and management...
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Abstract Purpose To investigate whether the natural progression rate of retinitis pigmentosa can be decreased by subtenon autologous platelet-rich plasma application alone or combination with retinal electromagnetic stimulation. Methods The study includes retrospective analysis of 60 patients with retinitis pigmentosa. Patients constitute three groups...
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Abstract Background Analytical data suggesting that immunoglobulin given intramuscularly (IGIM) may have reduced protection against hepatitis A virus (HAV) infection led to an update in the recommended IGIM dose (0.2 ml/kg). Methods This prospective, open-label, single-arm clinical study evaluated whether a single 0.2 ml/kg dose of IGIM provided protective...
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Abstract Introduction Endometriosis is a common gynecologic disease associated with a significant burden on women’s health and healthcare systems. Currently approved hormonal treatments for endometriosis can be effective in controlling symptoms, but may have clinically relevant side effects that limit their long-term use. Dienogest 2 mg (Visanne; Bayer AG, Berlin, Germany) is a 19-nortestosterone derivative that significantly reduces...
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How do you return a piece of asteroid to Earth? Practice. -- Read more on ScientificAmerican.com
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Pundits hope the pandemic will lead to more humane government policies but fear darker outcomes. -- Read more on ScientificAmerican.com
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They need to be counted accurately to ensure the health and other services they need, and the pandemic has made that task much harder -- Read more on ScientificAmerican.com
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Resilience and strength can often be attained through unexpected routes. -- Read more on ScientificAmerican.com
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His creative and influential ideas spilled over into quantum physics, philosophy and computer science -- Read more on ScientificAmerican.com
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As they’re forced to spend more time together, many are learning the measure of love -- Read more on ScientificAmerican.com
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Only three individuals speak a language from the Great Andamanese family. Will this irreplaceable heritage survive the new threat? -- Read more on ScientificAmerican.com
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Surviving an awful experience can lead to some surprisingly positive psychological effects in many people -- Read more on ScientificAmerican.com
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Pioneering virologist Maurice Hilleman, who is little remembered today, also helped develop nine of the 14 children’s vaccines that are now recommended -- Read more on ScientificAmerican.com
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We should be grateful for the conditions that allow us to exist at all, because they won’t last forever -- Read more on ScientificAmerican.com
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Pandemic news highlights of the week -- Read more on ScientificAmerican.com
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The pandemic is pushing us to make research more open, more efficient and more collaborative -- Read more on ScientificAmerican.com
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The rhetoric of war implies a heedless approach that undermines the practice of medicine -- Read more on ScientificAmerican.com
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Placing too much blame on urban density is a mistake -- Read more on ScientificAmerican.com
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Many hospitalized victims are developing potentially lethal secondary coinfections such as bacterial pneumonia and sepsis -- Read more on ScientificAmerican.com
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It smells like bacteria. But why? -- Read more on ScientificAmerican.com
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Commentary on: Ray, KN, Shi, Z, Gidengil, CA, et al. Antibiotic prescribing during pediatric direct-to-consumer telemedicine visits. Pediatrics 2019;144(2);doi:10.1542/peds.2019-1786B.Implications for practice and researchDirect-to-consumer (DTC) telemedicine consultations among paediatric clients correlate with lower guideline-concordant antibiotic prescribing and increased antibiotics used compared with other settings for acute respiratory infection (ARI).Nurses should be aware of the implications...
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Commentary on: Chen YJ, Cheng SF, Lee PC, Lai CH, Hou IC, Chen CW. Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial. J Clin Nurs. 2020 Feb;29(3-4):503-510. doi: 10.1111/jocn.15088. Epub 2019 Dec 4.Implications for practice and researchVirtual reality (VR) head-mounted sets are a valuable tool to help reduce pain and anxiety for intravenous cannulation in children and caregivers.Further studies should focus on comparison of...
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We, like many other doctors around the country, have been following the covid-19 outbreak in the UK with great interest.Coronaviruses (CoV) are a family of viruses that can cause a spectrum of respiratory illnesses, which range from the common cold, to more severe diseases such as severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV). Covid-19 is a respiratory disease caused by a novel coronavirus, SARS-CoV-2. The disease first emerged in December 2019, associated...
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BackgroundTo assess the prevalence of depression among medical students in their clinical years (fourth, fifth, and sixth years) in a government university in Eastern Province, Saudi Arabia, and its association with the students' sociodemographic characteristics, academic factors, perceived health problems and their perceived readiness to their future specialties.MethodsA cross-sectional study was conducted among 527 clinical-year medical students. The Patient Health Questionnaire (PHQ-9) and questionnaire...
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Propranolol is a frequently prescribed non-selective beta-blocker for the management of hypertension, cardiac arrhythmias, post myocardial infarction, thyrotoxicosis, tremors and migraine prophylaxis.1 Although rare, it may produce dermatological side effects like exacerbation of psoriasis, atopic dermatitis, alopecia and lupus erythematosus reactions.2 Here we describe a case of propranolol-induced acneiform eruption in a patient with no prior history of cutaneous problems.A 28-year-old man presented...
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