Cardio-oncology has emerged as a vital subspecialty as the population of cancer patients with cardiovascular comorbidities and treatment-related cardiotoxicities grows. Despite its clinical importance, concerns have been raised as to the integration of cardio-oncology into cardiology training. To understand the global landscape of cardio-oncology training, the International Cardio-Oncology Society (IC-OS) carried out a survey of cardio-oncology education. An electronic survey of international cardiology trainees was conducted between March and July 2024. The survey assessed the extent of cardio-oncology teaching, clinical exposure, awareness of cardio-oncology guidelines and professional societies, and interest in future fellowship, research and career in cardio-oncology. 131 cardiology trainees from across the globe responded to the survey, (51
Aims: Determine the prevalence of cleft lip and/or palate in patients treated in the maternal and child health care program from 2018 to 2024. Design and Setting: Observational, descriptive, and cross-sectional study. Patients: A review of medical records was carried out, consisting of 559 patients, which allowed quantifying the types of malformations. Results: They demonstrate an increasing number of patients treated over the years; it is not possible to know if this reflects an increase in births of children with malformations or the effect of access to timely and public care. Conclusions: The results highlight higher prevalence in vulnerable populations for different causes, multifactorial nature of the etiology, and the need to maintain an early detection program to reduce the burden derived from the malformation.
Tyrosine kinase inhibitors (TKIs) discontinuation is the standard option for patients with chronic myeloid leukaemia (CML) in deep molecular response (MR) with imatinib. This study aimed to evaluate the efficacy and safety of one year consolidation with ponatinib on treatment-free remission (TFR) rate. This was a multicenter open-label, single-arm, phase II, exploratory clinical trial including patients with CML treated ≥4 years with imatinib therapy, and MR4.0 ≥12 months. Patients entered the TFR phase after receiving ponatinib at 15 mg/day for one year. Twenty three patients received ponatinib and 19 completed consolidation. Among the patients with detectable BCR::ABL1, 70
Measurable residual disease (MRD) assessment is, from the methodological point of view, ready for prime time in multiple myeloma (MM). Abundant evidence underscores the value of MRD status determined using highly sensitive next-generation flow cytometry and next-generation sequencing tests in evaluating response to treatment and, therefore, prognosis in patients with this disease. MRD response assessment and monitoring might present a range of opportunities for individualized patient management. Moreover, the considerable amounts of high-quality and standardized MRD data generated in clinical trials have led to the acceptance of MRD negativity as an early end point for accelerated regulatory approval of treatments for MM. The data leave no doubt that the efficacy of new regimens in inducing deeper and durable MRD-negative responses is connected with prolonged survival. Yet, several evidential, technical and practical challenges continue to limit the implementation of MRD-guided treatment strategies in routine practice, and the use of MRD as a surrogate end point remains controversial to some. In this Review, we draw on past and present research to propose opportunities for overcoming some of these challenges, and to accelerate the use of MRD assessment for improved clinical management of patients with MM. Multiple myeloma is a malignancy at the forefront of measurable residual disease (MRD) assessment. In this Review, the authors describe the evolution of MRD analysis in multiple myeloma from technical and clinical standpoints, and discuss opportunities and challenges for MRD-guided management of this disease.
BACKGROUND & AIMS:Latin America is a region of great interest for studying the clinical presentation of idiosyncratic drug-induced liver injury (DILI). A comprehensive analysis of patients enrolled into the LATINDILI Network over a decade is presented. METHODS:Demographics, clinical presentation, histological findings and outcome of prospectively recruited DILI cases in the LATINDILI Network were analyzed. Suspected culprit drugs were classified according to the Anatomical Therapeutic Chemical classification. Causality was assessed using the Roussel Uclaf Causality Assessment Method (RUCAM) scale. RESULTS:Overall, 468 idiosyncratic DILI cases were analyzed (62% women; mean age, 49 years). Hepatocellular injury predominated (62%); jaundice was present in 60% of patients, and 42% were hospitalized. Of the cases, 4.1% had a fatal outcome, and 24 patients (12%) developed chronic DILI. The most common drug classes were systemic anti-infectives (31%), musculoskeletal agents (12%), antineoplastic and immunomodulating agents (11%), and herbal and dietary supplements (9%). Notably, none of the patients with DILI due to antibacterials or immunosuppressants had a fatal outcome. In fact, Hy's law showed to have drug-specific predictive value, with anti-tuberculosis drugs, nimesulide, and herbal and dietary supplements associated with the worst outcome, whereas DILI caused by amoxicillin-clavulanate, nitrofurantoin, and diclofenac, which fulfilled Hy's law, did not have a fatal outcome. CONCLUSION:Features of DILI in Latin America are comparable to other prospective registries. However, the pattern of drugs responsible for DILI differs. An increasing incidence of herbal and dietary supplements, with high mortality rate, and likewise, nimesulide and nitrofurantoin, was noted. Thus, public health policies should raise awareness of the potential adverse effects of these compounds.
