Cancer is a leading cause of death worldwide, though new therapies have increased patient survival. These therapies, however, have also raised concerns for cardiovascular toxicities, such as cardiomyopathies, coronary artery disease, hypertension and arrhythmias. Pulmonary arterial hypertension (PAH) is a rare condition that carries a poor prognosis and is often diagnosed at an advanced stage. The annual incidence in the general population is estimated to be between 1 and 2 cases per million. The highest prevalence occurs during the third and fourth decades of life; however, there are cases whose are identified after the sixth decade. It has increasingly become evident that various cancer therapies can exacerbate pulmonary hypertension, significantly impacting patient prognosis. It is recognized that oncologic treatments can cause endothelial dysfunction, including the pulmonary vasculature, and can have thrombotic effects, worsening PAH in patients with this disease. The objective of this study is to describe our experience with patients with a concomitant diagnosis of PAH and cancer, who received prostanoid therapy to be able to complete specific cancer treatments. The PULmonary Artery HYpertension and Cancer (PULAHYCA) pilot study is an observational study of patients with a cancer diagnosis planning to initiate a specific oncologic treatment, with PAH detected during baseline assessment. Patients with PAH due to group 1and group 4 were included, defined as per the 2022 European Society of Cardiology (ESC) guidelines, that require a mean pulmonary artery pressure (mPAP) greater than 20 mm Hg at rest, increased pulmonary artery resistance of more than 2 Wood units and wedge pressure less than 15 mm Hg. The PAH risk category was established according to the ESC guidelines and the REVEAL Lite 2 score. Patients with an intermediate risk with a diagnosis of more than 6 months were included. After screening 349 PH patients, 12 patients were included in the study. All participants had a normal ejection fraction and were treated with a combination of a 5- phosphodiesterase inhibitor, an endothelin receptor antagonist, and treprostinil. Eight patients were classified under group 1 pulmonary hypertension, and four under group 4 pulmonary hypertension. During the 12-month follow-up, patients demonstrated significant clinical and hemodynamic improvement. Functional capacity, measured by the six-minute walk test (6MWT), increased significantly from 325 [304–440] meters at baseline to 401 [315–455] meters at 12 months (p = 0.0014). B-type natriuretic peptide (BNP) levels decreased notably from 321 [205–506] pg/ml to 188 [100–229] pg/ml (p = 0.0001). Pulmonary vascular resistance (PVR) also showed a significant reduction, from 3.8 [3.3–4.2] Woods Units (WU) to 3.5[2.5–3.7] WU (p = 0.00018). All patients survived during the study period and could complete their cancer treatment, which included. The PULAHYCA PILOT study demonstrates that treatment with subcutaneous Treprostinil in intermediate-risk PH patients undergoing initial oncologic therapy enables completion of cancer treatment, leading to either remission or chronic disease control. Furthermore, beyond the oncologic benefit, patients exhibited improvements in both clinical status and objective markers of pulmonary hypertension severity.
Els alumnes solen imaginar que el moviment aparent del Sol en el cel és més aleatori del que realment és; no hi veuen gaires regularitats. Per altra banda, tampoc els queda clara quina és la causa de les estacions, que solen relacionar amb una distància variable de la Terra al Sol o ho barregen amb que hi hagi dia i nit. Per treballar aquests dos problemes, proposem una situació d’aprenentatge basada en el marc de l’Activitat Científica Escolar per a primer d’ESO basades en la observació, la modelització i el diàleg de manera que un problema resolt condueix a una altre fins a arribar a una explicació convincent per a l’alumnat i a poder aplicar aquests coneixements.
A significant number of Virtual Reality (VR) applications focus on mindfulness, using biosensor technologies (e.g., ECG) to provide real-time feedback on users' physiological states. However, the measurement of data for the human body is complex. Commercial devices often lack precision, while medical-grade sensors require controlled environments, which can lead to disruptions and break immersion, affecting the flow of VR experiences. Thus, complicating the evaluation of mindfulness. Pinch To Awaken XR is a VR art game that utilizes wearable interfaces to measure breathing from a holistic perspective. Showcased as an Extended Reality (XR) performance, it uses first-person research methods by embodying both the researcher and performer, placing the body as the central source of inquiry. This case study reveals that integrating a performative approach can enhance the flow and engagement in mindfulness VR experiences, while also offering a novel approach for evaluating biosensing interfaces in HCI user studies, using a body-centered design.
Introduction: The Allurion® gastric balloon (AGB) is an innovative option for treating overweight individuals and those with grade I obesity, or as a bridging treatment for bariatric surgery, or for patients who do not desire surgical intervention. This study aimed to evaluate the efficacy and safety of the AGB in a multicentric cohort. Materials and Methods: A retrospective analysis of consecutive cases treated with AGB (≥18 years old with body mass index [BMI] ≥27) was performed in eight centers in three countries in Latin America (Argentina, Chile, and Perú), between September 2021 and September 2022, with a 12-month follow-up. Results: In total, 402 patients were included (median BMI of 32.81 kg/m2). Mean total weight loss percentage was 8.3%, 11.6%, and 14.9% at 3, 6, and 12 months, respectively, with a follow-up of 93.03%, 75.37%, and 40.54%. The adverse event rate was 1.24% (n = 5). During the first 7 days, 34.58% (n = 139) experienced concomitant symptoms, and 1.99% (n = 8) asked for endoscopic balloon extraction because of intolerance. The complication rate was 6.46% (n = 26). Readmission index was 4.97% (n = 20), and reintervention was 2.23% (n = 9). Balloon elimination was experienced by 5.7% of patients in the first 14 days, 29.10% (n = 117) before the third month, and 62.68% (n = 252) after the 16th week. Early deflation rate was 2.73% (n = 11). Digestive track elimination was perceived by 26.61%. Conclusions: AGB is a safe and effective option for the treatment of overweight and obesity in Latin America. Lifestyle changes and continuous support with a multidisciplinary team are essential to achieving good mid- to long-term outcomes.
e15697 Background: Peripheral eosinophilia (PEBC), defined as an absolute eosinophil count (AEC) > 0.5 × 10⁹/L, has emerged as a biomarker in solid tumors, including gastrointestinal (GI) malignancies. While eosinophilia is well-documented in hematologic cancers, its role in solid tumors remains unclear. Evidence suggests increased eosinophil levels correlate with favorable responses to immune checkpoint inhibitors (ICIs) and may influence immune-related adverse events (irAEs), but its predictive value requires further investigation. Methods: This single-center observational study includes retrospective and prospective cohorts of 63 patients with GI tumors treated with ICIs from 2019 to 2024. All patients received at least one cycle of treatment, with PEBC monitored during the first six months. PEBC was assessed to determine its association with treatment response and irAEs incidence/severity. Clinical outcomes, including progression-free survival (PFS) and overall survival (OS), will be analyzed using R software (v4.4.2), with statistical significance set at p < 0.05. Results: Between March 2019 and November 2024, 63 patients with gastrointestinal tumors were included (median age: 58.8 years, 40 male (63.4%). The most common tumor sites were colon 26 (41.2%), esophagus 12 (19%), and stomach 12 (19%). Mismatch repair deficiency (dMMR) was observed in 33 (52.3%) with loss MLH1/PMS2 17(26.9%), and BRAF V600E mutations detected in 2 (3.1%). Eosinophilia ( > 500/μL) was present in 17 (26.9%), with a median peak eosinophil count of 520.7/μL (range: 0–2160/μL). At the time of ICIs treatment, no patient was receiving corticosteroids at doses equivalent to ≥10 mg prednisolone daily. ICIs were used as first-line therapy in 46 (73%), with 30 (47.6%) receiving monotherapy and 33 (52.4%) combination regimens. The overall response rate was 50 (79.8%), and 44 (69.8%) of patients remained alive at the time of analysis. irAEs occurred in 37 (58.7%), with 13 (20.6%) Grade 1, 13 (20.6%) Grade 2, 8 (12.6%) Grade 3, and 2 (3.2%) Grade 4. Higher eosinophil levels correlated with response (mean PEBC: 588.8 vs. 282.6; p = 0.0003) and survival (mean PEBC: 613.0 vs. 307.1; p = 0.0005). Patients with irAEs had lower progression risk (HR = 0.42, 95% CI: 0.25–0.73, p = 0.0018). Cox regression showed responders had improved OS (HR = 3.75, 95% CI: 1.81–7.76, p = 0.0004), while irAEs reduced mortality risk by 43.2% (HR = 0.57, 95% CI: 0.33–0.96, p = 0.035). Conclusions: This study, conducted in a public hospital in Argentina, suggests that peripheral eosinophilia is associated with improved treatment response and increased irAEs in GI cancer patients receiving ICIs. Elevated eosinophil counts correlated with better survival and response rates, while also being linked to higher irAEs. These findings support eosinophilia as a cost-effective biomarker for efficacy and toxicity prediction in immunotherapy. Further research is warranted to elucidate the underlying mechanisms and validate its predictive value in larger, multi-center studies.
