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The case of the ‘Esperanza patient’ whose HIV infection vanished naturally

Researchers have reported that a woman living with HIV in Argentina is now the second person whose immune system rid itself of the virus. She was diagnosed with HIV-1 in 2013. Researchers found that she might potentially be an “elite controller” of the virus, showing no signs of active HIV infection in the 8 years since her diagnosis.

The Esperanza patient is just the second person reported to have possibly staved off the virus naturally- ultimately erasing any signs of active HIV without the assistance of medical therapies like stem cell transplants. The first was a woman from California, Loreen Willenberg, who is now 67 years old. She was diagnosed with HIV in 1992, and her immune system apparently performed the same function of naturally eliminating HIV.

Source: Healthline

Subcutaneous Inj. vedolizumab appears to be effective maintenance therapy in IBD-UC

Subcutaneous vedolizumab appears to be an effective and safe maintenance therapy for some patients with moderate to severe active Crohn’s disease, according to results of a phase-3 trial. Vedolizumab, the first gut-selective biologic for the treatment of inflammatory bowel disease, now offers IV and SC routes of administration for maintenance therapy.

Source: Journal of Crohn’s and Colitis

Dapagliflozin might reduce the risk for ventricular arrhythmias in HFrEF

The addition of dapagliflozin to standard therapy reduced the relative risk for the primary composite endpoint of any serious ventricular arrhythmia, resuscitated cardiac arrest, or sudden death by 21%. Dapagliflozin and other SGLT2 inhibitors have favorable effects on adverse cardiac remodeling, which contributes to sudden death and ventricular arrhythmia. They’ve also been shown to reduce cardiac chamber size, left ventricular hypertrophy, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels over time, consistent with a reduction in in myocardial wall stress.

Source: Medscape

FDA approves new indication for Rivaroxaban in PAD

The US FDA has approved an expanded peripheral artery disease (PAD) indication for the direct oral anticoagulant rivaroxaban to include patients who have undergone recent lower-extremity revascularization due to symptomatic PAD. The approved regimen in this patient population is rivaroxaban 2.5 mg twice daily with aspirin 100 mg once daily. Rivaroxaban with aspirin is the first and only treatment indicated for both coronary artery disease (CAD) and PAD.

Source: Medscape

A new monoclonal antibody named CIS43LS prevents malaria in new trial

A new monoclonal antibody discovered and developed at the National Institutes of Health safely prevented malaria for up to 9 months in people who were exposed to the malaria parasite. The small clinical trial is the first to show an antibody capable of preventing malaria in people. A total of 25 participants received at least one dose of an antibody named CIS43LS, and four of them received a second dose. Among adults who had never had malaria infection or vaccination, CIS43LS prevented malaria.

Source: NEJM

Icotinib is the best adjuvant chemotherapy for EGFR-mutant NSCLC

Icotinib is a highly selective, first-generation EGFR tyrosine kinase inhibitor (TKI) approved in China as first-line monotherapy in patients with NSCLC with somatic EGFR mutations. Following complete resection of EGFR-mutant stage-II to -IIIA non-small-cell lung cancer (NSCLC), icotinib significantly improves disease-free survival and has fewer side effects than chemotherapy, according to interim results of a phase-3 trial underway in China.

Source: The Lancet Respiratory Medicine

Physicians wearing white coats rated more experienced

Physicians wearing white coats were rated as significantly more experienced and professional than peers wearing casual attire. Regardless of their attire, however, female physicians were more likely to be judged as appearing less professional and were more likely to be misidentified as medical technicians, physician assistants, or nurses, found research published in JAMA Network Open.

A white coat with scrubs attire was most preferred for surgeons (mean preference index, 1.3), whereas a white coat with business attire was preferred for family physicians and dermatologists (mean preference indexes, 1.6 and 1.2, respectively; P < .001.

While casual attire, such as fleece or softshell jackets emblazoned with the names of the institution and wearer, has become more popular attire for physicians in recent years.

Source: JAMA Network

Restoring pulmonary endothelial cells reverses emphysema in mice

Correcting endothelial dysfunction in both human tissue and an elastase-induced murine model of emphysema shows promise in stopping and reversing the course of the disease, according to an international group of researchers.

EC loss and dysfunction were also hallmarks of emphysematous lungs harvested from the elastase-treated mice. The team found that intravenous delivery of healthy lung ECs from genetically identical mice reversed these phenotypes.

“We also found,” continued Dr. Racanelli, “that removing a specific molecule from the cells had a similar result.” In particular the researchers observe that “Leucine-rich a-2-glycoprotein- 1 (LRG1) was a driver of emphysema, and deletion of Lrg1 from endothelial cells rescued vascular rarefaction and alveolar regression.” LRG1 upregulation, they note ,”directly correlated with severity of the COPD phenotype.”

Source: Journal of Experimental Medicine

New investigational helmet device shrinks glioblastoma

A case report describes a novel helmet device that generates a noninvasive oscillating magnetic field and that shrunk a glioblastoma tumor by about a third.

The patient had end-stage recurrent glioblastoma and had undergone all standard therapy options. He wore the device for 5 weeks but died from an unrelated injury, so the treatment period was cut short.

A brain scan showed a 31% reduction of contrast-enhanced tumor volume, and an autopsy of his brain confirmed the rapid response to the treatment.

Source: Frontiers in Oncology

Lenvatinib plus Gefitinib therapy promising in liver cancer

In patients with advanced liver cancer who were unresponsive to lenvatinib, adding gefitinib (an EGFR inhibitor) led to a clinically meaningful response in a proof-of-concept study. 12 patients with advanced liver cancer who were unresponsive to lenvatinib treatment showed meaningful clinical responses after treatment with lenvatinib plus geftinib. Specifically, after 4-8 weeks of combination treatment, four patients had a partial response, four had stable disease and four showed disease progression.

 

Source: Reuters Health

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