Publications by authors named "Spinner M"

Veterinary intervention in zoological species can be complicated by species-specific social dynamics. African wild dogs are a pack species and removal or separation of an individual may disrupt established pack hierarchy resulting in conspecific aggression. Therefore, medical interventions that optimize a quick return to health are ideal to minimize the duration of absence from the pack.

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Case Summary: A 5-month-old male castrated domestic shorthair cat was evaluated for acute onset of emesis. Abdominal radiographs identified a suspected colonic foreign body and abdominal-focused assessment with sonography for trauma, triage and tracking (AFAST) evaluation revealed a large amount of peritoneal effusion. Cytology of the peritoneal effusion was consistent with a septic exudate.

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Article Synopsis
  • Brentuximab vedotin and PD-1 inhibitors have shown effectiveness in treating classic Hodgkin lymphoma (cHL), but patients who relapse require improved therapies, leading to the exploration of new treatments.
  • The review discusses various emerging immunotherapy options, including novel PD-1/PD-L1 inhibitors, checkpoint inhibitors targeting multiple pathways, and advanced therapies like CAR-T and NK cell therapies, backed by key safety and efficacy data from phase 1-2 trials.
  • Experts believe that novel combinations and precision medicine strategies, along with better response tracking methods, can enhance treatment outcomes for cHL patients by identifying who will benefit most from these emerging therapies.
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Background: Some people with multiple sclerosis (pwMS) avoid exercise due to overheating. Evidence from a variety of cooling treatments shows benefits for pwMS.

Objective: Conduct a randomized controlled trial of antipyretic treatment before exercise in pwMS.

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Myelodysplastic neoplasms (MDS) are clonal disorders of bone marrow failure exhibiting a variable risk of progression to acute myeloid leukemia. MDS exhibit certain prognostic genetic or cytogenetic abnormalities, an observation that has led to both the pathologic reclassification of MDS in the 2022 World Health Organization (WHO) and International Consensus Classification (ICC) systems, as well as to an updated prognostic schema, the Molecular International Prognostic Scoring System (IPSS-M). This single-institution study characterized the molecular patterns and clinical outcomes associated with the 2022 WHO and ICC classification schemas to assess their clinical utility.

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Most patients with classic Hodgkin lymphoma (cHL) are cured with combination chemotherapy, but approximately 10-20% will relapse, and another 5-10% will have primary refractory disease. The treatment landscape of relapsed/refractory (R/R) cHL has evolved significantly over the past decade following the approval of brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, and the PD-1 inhibitors nivolumab and pembrolizumab. These agents have significantly expanded options for salvage therapy prior to autologous hematopoietic cell transplantation (AHCT), post-transplant maintenance, and treatment of relapse after AHCT, which have led to improved survival in the modern era.

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Background: Although dyspnea is a primary symptom of chronic obstructive pulmonary disease (COPD), its treatment is suboptimal. In both COPD and acute anxiety, breathing patterns become dysregulated, contributing to abnormal CO, dyspnea, and inefficient recovery from breathing challenges. While pulmonary rehabilitation (PR) improves dyspnea, only 1-2% of patients access it.

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In the pre-novel agent era, the median postprogression overall survival (PPS) of patients with classic Hodgkin lymphoma (cHL) who progress after autologous stem cell transplant (ASCT) was 2 to 3 years. Recently, checkpoint inhibitors (CPI) and brentuximab vedotin (BV) have improved the depth and durability of response in this population. Here, we report the estimate of PPS in patients with relapsed cHL after ASCT in the era of CPI and BV.

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Brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) is increasingly used for frontline treatment of stage III/IV classical Hodgkin lymphoma (cHL). Peripheral neuropathy (PN) was the most common and treatment-limiting side effect seen in clinical trials but has not been studied in a nontrial setting, in which clinicians may have different strategies for managing it. We conducted a multisite retrospective study to characterize PN in patients who received BV + AVD for newly diagnosed cHL.

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Objective: To investigate physical activity levels of individuals with ataxia and correlate fitness to ataxia severity.

Design: An observational study SETTING: An outpatient ataxia clinic in a large, tertiary, urban hospital in the US.

Participants: Individuals with cerebellar ataxia (N=42).

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Article Synopsis
  • The study investigated the impact of intratumoral hypoxia on chimeric antigen receptor T-cell (CAR-T) therapy in non-Hodgkin's Lymphoma (NHL) using a PET imaging technique called [F]FAZA.
  • Of the 16 patients scanned, a minimal number showed significant hypoxia, with only one patient meeting the threshold for intratumoral hypoxia and experiencing early treatment failure.
  • Due to the low incidence of positive scans indicating hypoxia, the study was halted for being unlikely to yield meaningful results, and future research may focus on a more selective patient group.
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Introduction: Wound related complications (WRC) are a significant source of morbidity in kidney transplant recipients, and may be mitigated by surgical approach. We hypothesize that the anterior rectus sheath approach (ARS) may decrease WRC and inpatient opiate use compared to the Gibson Approach (GA).

Methods: This double-blinded randomized controlled trial allocated kidney transplant recipients aged 18 or older, exclusive of other procedures, 1:1 to ARS or GA at a single hospital.

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Article Synopsis
  • The treatment landscape for relapsed/refractory classic Hodgkin lymphoma has improved significantly in the last decade due to therapies like brentuximab vedotin (BV) and PD-1 inhibitors.
  • A study comparing patient outcomes and practices between 2001-2010 and 2011-2020 showed better overall survival and lower non-relapse mortality in the modern era, particularly after autologous hematopoietic cell transplantation (AHCT).
  • Key factors influencing patient outcomes included age, disease state before AHCT, and the use of PD-1 inhibitors, underscoring the need for further research into immunotherapy for better management of this condition.
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  • A study analyzed the outcomes of different salvage therapies for patients with relapsed or refractory classic Hodgkin lymphoma (R/R cHL) before undergoing autologous stem cell transplant (ASCT) across 14 U.S. hospitals.
  • Among the treatments compared were conventional chemotherapy, brentuximab vedotin (BV) with or without chemotherapy, and checkpoint inhibitor (CPI)-based regimens.
  • Results showed that patients receiving CPI-based treatments had significantly better event-free survival (EFS) and progression-free survival (PFS) rates after 2 years compared to those receiving other therapies, indicating that early use of CPI may be beneficial in this patient population.
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Background: Clotrimazole troches are used as prophylaxis against oropharyngeal candidiasis post-transplant and have limited systemic absorption. Following several occurrences of tacrolimus concentration fluctuations after clotrimazole discontinuation, its use as prophylaxis was discontinued post-kidney transplant.

Methods: We conducted a retrospective cohort study to evaluate the effect of clotrimazole prophylaxis on tacrolimus trough concentrations post-kidney transplant.

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  • Some doctors are debating whether to change treatment for Hodgkin Lymphoma patients who still have cancer after two cycles of ABVD therapy.
  • Researchers looked at data from 15 hospitals to see how many patients with positive PET scans switched their treatment between 2015 and 2019.
  • They found that not many patients changed their treatment, and results showed that those who did aren’t always getting better, so better ways to treat these patients are needed.
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  • Diffuse large B-cell lymphoma (DLBCL) is an aggressive form of non-Hodgkin lymphoma that requires careful risk stratification and treatment based on various clinical factors, with R-CHOP being the standard treatment that is effective for over 60% of patients.
  • For patients with limited-stage DLBCL, radiotherapy can be an option, and elderly patients benefit from geriatric assessments to tailor therapies to their needs and health status.
  • Recent trials, such as POLARIX, indicate that adding polatuzumab vedotin to traditional treatments may enhance patient outcomes, and ongoing research is focused on personalized treatment approaches using advanced technologies like PET scans and circulating tumor DNA analysis.
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We evaluated the impact on survival of antithymocyte globulin conditioning (TLI-ATG) with radiation (RT) boost to high risk or residual disease before allogeneic hematopoietic cell transplant (allo-HCT) for adults with lymphoma (excluding mycosis fungoides and low-grade NHL other than SLL/CLL). Of 251 evaluable patients, 36 received an RT boost within 3 months of allo-HCT at our institution from 2001 to 2016. At the time of TLI-ATG, patients who received boost vs no boost had a lower rate of CR (11% vs 47%, p = 0.

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Prophylaxis is commonly used to prevent central nervous sy stem (CNS) relapse in diffuse large B-cell lymphoma (DLBCL), with no clear standard of care. We retrospectively evaluated 1162 adult patients across 21 US academic centers with DLBCL or similar histologies who received single-route CNS prophylaxis as part of frontline therapy between 2013 and 2019. Prophylaxis was administered intrathecally(IT) in 894 (77%) and using systemic high-dose methotrexate (HD-MTX) in 236 (20%); 32 patients (3%) switched route due to toxicity and were assessed separately.

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  • Angioimmunoblastic T-cell lymphoma (AITL) is a serious subtype of peripheral T-cell lymphoma with distinct characteristics and a generally poor prognosis, affecting mostly older patients with advanced disease.
  • A study analyzed data from 282 AITL patients over 12 years, finding a 5-year overall survival rate of 44% and a progression-free survival rate of 32%, with improved outcomes for those who received stem cell transplants.
  • Key factors influencing survival included age, performance status, and specific lab markers, leading to the development of a new prognostic score that better distinguishes risk levels and highlights the need for more effective treatments.
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Antimicrobial stewardship programs (ASPs) have made immense strides in optimizing antibiotic, antifungal, and antiviral use in clinical settings. However, although ASPs are required institutionally by regulatory agencies in the United States and Canada, they are not mandated for transplant centers or programs specifically. Despite the fact that solid organ transplant recipients in particular are at increased risk of infections from multidrug-resistant organisms, due to host and donor factors and immunosuppressive therapy, there currently are little rigorous data regarding stewardship practices in solid organ transplant populations, and thus, no transplant-specific requirements currently exist.

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Early studies in mouse neurodevelopment led to the discovery of the RE1 Silencing Transcription Factor (REST) and its role as a master repressor of neuronal gene expression. Recently, REST was reported to also repress neuronal genes in the human adult brain. These genes were found to be involved in pro-apoptotic pathways; and their repression, associated with increased REST levels during aging, were found to be neuroprotective and conserved across species.

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Background: GATA2 deficiency is a genetic disorder of hematopoiesis, lymphatics, and immunity caused by autosomal dominant or sporadic mutations in GATA2. The disease has a broad phenotype encompassing immunodeficiency, myelodysplasia, leukemia, and vascular or lymphatic dysfunction as well as prominent pulmonary manifestations.

Research Question: What are the pulmonary manifestations of GATA2 deficiency?

Study Design And Methods: A retrospective review was conducted of clinical medical records, diagnostic imaging, pulmonary pathologic specimens, and tests of pulmonary function.

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