Phase 1 trial of TPI 287, a microtubule stabilizing agent, in combination with bevacizumab in adults with recurrent glioblastoma.

Background: Recurrent glioblastoma (rGBM) has limited treatment options. This phase 1 protocol was designed to study the safety and preliminary efficacy of TPI 287, a central nervous system penetrant microtubule stabilizer, in combination with bevacizumab (BEV) for the treatment of rGBM.

Methods: GBM patients with up to 2 prior relapses without prior exposure to anti-angiogenic therapy were eligible.

Spliceosome mutations are associated with clinical response in a phase 1b/2 study of the PLK1 inhibitor onvansertib in combination with decitabine in relapsed or refractory acute myeloid leukemia.

PLK1 is overexpressed in acute myeloid leukemia (AML). A phase 1b trial of the PLK1 inhibitor onvansertib (ONV) combined with decitabine (DAC) demonstrated initial safety and efficacy in patients with relapsed/refractory (R/R) AML. The current study aimed to identify molecular predictors of response to ONV + DAC in R/R AML patients.

Anthracycline-induced cardiotoxicity - are we about to clear this hurdle?

Anthracyclines have contributed significantly to remarkable improvements in overall survival and are regarded as the most effective cytostatic drug for cancer treatment in various malignancies. However, anthracyclines are a significant cause of acute and chronic cardiotoxicity in cancer patients, and long-term cardiotoxicity can lead to death in about one-third of patients. Several molecular pathways have been implicated in the development of anthracycline-induced cardiotoxicity, although the underlying mechanisms of some molecular pathways are not fully elucidated.

The need for cardiac surgery differential tariffs in Israel at the era of aging population and emerging technology: Importance of procedure type and patient complexity as assessed by EuroSCORE.

Background: Reimbursement for cardiac surgical procedures in Israel is uniform and does not account for diversity in costs of various procedures or for diversity in patient mix. In an era of new and costly technology coupled with higher risk patients needing more complex surgery, these tariffs may not adequately reflect the true financial burden on the caregivers. In the present study we attempt to determine whether case mix and complexity of procedures significantly affect cost to justify differential tariffs.

Friend Support and the Parenting of Latina Adolescent Mothers: The Moderating Role of Maternal Age.

Objectives: This study examined the role of maternal age in the relation between social support from friends and parenting adjustment in a sample of young Latina mothers and their 18-month-old children (=168).

Methods: Hierarchical multiple regression analyses tested friend social support types (emotional, socializing, child care) as differential predictors of maternal behavior (sensitivity, cognitive growth-fostering, detachment) displayed during mother-child play interactions. To consider maternal development, the moderating role of maternal age on these associations was tested.

A Phase Ib Study of Onvansertib, a Novel Oral PLK1 Inhibitor, in Combination Therapy for Patients with Relapsed or Refractory Acute Myeloid Leukemia.

Purpose: The Polo-like kinase 1 (PLK1) is a master regulator of mitosis and overexpressed in acute myeloid leukemia (AML). We conducted a phase Ib study of the PLK1 inhibitor, onvansertib, in combination with either low-dose cytarabine (LDAC) or decitabine in patients with relapsed or refractory (R/R) AML.

Patients And Methods: Onvansertib was administered orally, in escalating doses, on days 1-5 in combination with either LDAC (20 mg/m; days 1-10) or decitabine (20 mg/m; days 1-5) in a 28-day cycle.

Medicaid Utilization among Middle-age and Older Adults: A Health and Retirement Study Longitudinal Analysis (1998 to 2014).

With over fifteen million older adults in the United States relying on the means-tested Medicaid program for healthcare coverage, there has been concern over rising Medicaid costs among this rapidly growing age group. Few studies have longitudinally examined trends among older beneficiaries over time to identify factors related to Medicaid utilization and to better understand how potential coverage changes might impact this group. This study used the 1998 to 2014 waves of the Health and Retirement Study (N = 8,162) to analyze a representative sample of those aged 50 and older to ascertain demographic, health, and economic factors associated with Medicaid utilization over a sixteen-year period.

Is There a Need for a Pulmonary Artery Catheter in Cardiac Surgery Today?

Pulmonary artery catheters are a useful tool for hemodynamic monitoring in high-risk patients during surgery and while in intensive care. However, there are major risks inherent to the device, and with modern day technology, their routine use has decreased. We discuss the need for routine insertion of pulmonary artery catheters in cardiac surgery.

Dyadic synchrony among young Latina mothers and their toddlers: The role of maternal and child behavior.

Synchronous interactions are an important indicator of parent-child relationship quality with positive implications for child development. Latina adolescent mothers face several demographic challenges that place them at risk for less synchronous interactions. To identify factors that may facilitate more optimal parent-child relationships in this population, our study examined maternal sensitivity and children's behavioral styles as joint predictors of dyadic synchrony among young Latina mothers and their toddlers.

Delayed aortic dissection and valve thrombosis after transcatheter aortic valve implantation.

We report a case of a 78-year-old female who presented with type A aortic dissection 22 months following transcatheter aortic valve implantation (TAVI). In addition, preoperative echocardiogram showed high gradients across the aortic prosthesis which was found to be thrombosed. At surgery, the intimal tear appeared to be non-acute and anatomically related to the rim of the valve cage.

Outcomes of transcatheter aortic valve implantation compared with surgical aortic valve replacement in geriatric patients with chronic kidney disease .

Background: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD.

Hyponatremia Predicts Poor Outcomes in Patients With Chronic Kidney Disease Undergoing Heart Operation.

Background: Preoperative hyponatremia adversely affects outcomes of cardiothoracic operation. However, in patients with chronic kidney disease, the association of sodium levels on postoperative events has never been evaluated. We investigated the impact of preoperative hyponatremia on outcomes after cardiac operation in patients with non-dialysis-dependent chronic kidney disease.

Safety and Tolerability Study of an Intravenously Administered Small Interfering Ribonucleic Acid (siRNA) Post On-Pump Cardiothoracic Surgery in Patients at Risk of Acute Kidney Injury.

Introduction: Patients undergoing on-pump cardiac surgery are at an increased risk of acute kidney injury. QPI-1002, a small interfering ribonucleic acid, is under clinical development for the prevention of acute kidney injury. The safety, tolerability, and pharmacokinetics of QPI-1002 was evaluated in this first-in-man, Phase 1 study of a small, interfering ribonucleic acid in patients at risk of acute kidney injury after on-pump cardiac surgery.

Neutrophil-Lymphocyte Ratio: Prognostic Impact in Heart Surgery. Early Outcomes and Late Survival.

Background: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery.

Methods: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery.

The role of SU-AVR in tomorrow's practice of AVR.

Conventional aortic valve replacement (C-AVR) is the golden standard in the treatment of severe aortic stenosis (AS). Despite its tremendous success there are many problems associated with the procedure. A large segment of the AS population is not suitable for surgery because of the excessive risk.

Preoperative aldosterone receptor blockade and outcomes of cardiac surgery in patients with chronic kidney disease .

Background And Aims: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown.

Materials And Methods: This is an observational study that included adult CKD patients undergoing cardiac surgery.

Psychological Adjustment among Young Puerto Rican Mothers: Perceived Partner Support and the Moderating Role of Latino Cultural Orientation.

Adolescent mothers face multiple stressors and are at risk for experiencing high levels of depressive symptoms and parenting stress. This study examined the interplay of Latino cultural orientation and perceived support from romantic partners in protecting the adjustment of young, low-income, Puerto Rican mothers ( = 103; age = 18.0 yrs; = 1.

Untreated Mitral Regurgitation Does Not Affect Survival of Elderly Patients Undergoing TAVI.

Background: The study aim was to examine the impact of concomitant significant mitral regurgitation (MR) in patients undergoing transcatheter aortic valve implantation (TAVI). TAVI has become an acceptable mode of treatment for high-surgical risk patients with aortic stenosis (AS) requiring valve replacement. A significant number of patients have concomitant MR which cannot be addressed by TAVI alone, and therefore may not be considered candidates for this procedure.

High platelet reactivity on aspirin in patients with acute ST elevation myocardial infarction.

Background: Despite dual antiplatelet treatment, major ischemic events are common following ST elevation myocardial infarction (STEMI). We aimed to assess high platelet reactivity on aspirin (HPR-aspirin) and its association with P2Y12i (HPR-P2Y12i) during the acute phase of STEMI.

Methods: We included all consecutive patients admitted for STEMI treated by primary angioplasty in our center for 1year.

A role for the androgen receptor in the treatment of male breast cancer.

Male breast cancer (BC) is relatively rare, making up less than 1% of all breast cancer cases in the United States. Treatment guidelines for male BC are derived from studies on the treatment of female BC, and are based molecular and clinical characteristics, such as hormone receptor positivity. For female estrogen receptor positive (ER+) breast cancers, the standard of care includes three classes of endocrine therapies: selective estrogen receptor modulators, aromatase inhibitors, and pure anti-estrogens.