Safety and Efficacy of PD-1 Inhibitors Among HIV-Positive Patients With Non–Small Cell Lung Cancer

Introduction

Despite widespread administration of programmed death receptor 1 (PD-1) pathway inhibitors among individuals with NSCLC, little is known about the safety and activity of these agents among human immunodeficiency virus (HIV) – infected patients since this population has largely been excluded from immunotherapy clinical trials.

The athlete’s heart: Is this an entity in paediatrics?

A case report of a boy who demonstrates features of an athlete's heart, associated with dilatation of the coronary artery, is presented. The importance of distinguishing this benign condition from pathologic causes such as cardiomyopathy, and risk of sudden death in these athletes is discussed.     

Relation among serum and tissue concentrations of lutein and zeaxanthin and macular pigment density

BACKGROUND: Lutein and zeaxanthin are the only carotenoids in the macular region of the retina (referred to as macular pigment [MP]). Foods that are rich in lutein and zeaxanthin can increase MP density. Response to dietary lutein and zeaxanthin in other tissues has not been studied. OBJECTIVE: The objective of this study was to examine tissue responses to dietary lutein and zeaxanthin and relations among tissues in lutein and zeaxanthin concentrations. DESIGN: Seven subjects consumed spinach and corn, which contain lutein and zeaxanthin, with their daily diets for 15 wk. At 0, 4, 8, and 15 wk and 2 mo after the study, serum, buccal mucosa cells, and adipose tissue were analyzed for carotenoids, and MP density was measured. RESULTS: Serum and buccal cell concentrations of lutein increased significantly from baseline during dietary modification. Serum zeaxanthin concentrations were greater than at baseline only at 4 wk, whereas buccal cell and adipose tissue concentrations of zeaxanthin did not change. Adipose tissue lutein concentrations peaked at 8 wk. Changes in adipose tissue lutein concentration were inversely related to the changes in MP density, suggesting an interaction between adipose tissue and retina in lutein metabolism. To investigate the possibility of tissue interactions, we examined cross-sectional relations among serum, tissue, and dietary lutein concentrations, anthropometric measures, and MP density in healthy adults. Significant negative correlations were found between adipose tissue lutein concentrations and MP for women, but a significant positive relation was found for men. CONCLUSION: Sex differences in lutein metabolism may be an important factor in tissue interactions and in determining MP density.     

Amniotic cavity accumulation of magnesium with prolonged magnesium sulfate tocolysis

In seven women, continuous intravenous tocolysis with magnesium sulfate for 4-28 days resulted in high amniotic fluid magnesium levels (10.54 mg% +/- 1.83 SD). In all cases the amniotic fluid magnesium level greatly exceeded the maternal serum level in a sample collected simultaneously. Additionally, when amniorrhexis and delivery occurred within one hour of each other, the fetal magnesium levels uniformly exceeded the maternal levels in paired maternal and cord blood samples.     

En bloc resection of epithelial ovarian tumors with concomitant rectosigmoid colectomy: the KEMH experience

Between the years 1984 and 1988, 43 patients with bulky advanced stage epithelial ovarian carcinoma underwent en bloc pelvic resection with excision of the rectosigmoid colon as part of their primary cytoreductive surgery. Optimal cytoreduction was accomplished in over 70% of cases, and all women had complete debulking of their pelvic tumor. Primary anastomosis of the bowel was feasible in all cases and only two covering colostomies were performed. There were no postoperative leaks or fistulas. The postoperative morbidity was reflected by a mean postoperative hospital stay of 16 days. Our results suggest that this technique facilitates optimal cytoreduction of bulky pelvic tumor with an acceptably low morbidity in woman with advanced ovarian carcinoma.     

The effect of laparoscopic ablation or danocrine on pregnancy rates in patients with stage I or II endometriosis undergoing donor insemination.

The effect of treatment on stages I and II endometriosis was evaluated in 61 women with laparoscopically proven disease who were undergoing therapeutic donor insemination. Only treatment cycles completed after diagnostic laparoscopy were used for analysis. To evaluate fecundity, we performed life-table analysis on 343 treatment cycles of therapeutic donor insemination in 67 patients with stage I or II endometriosis and compared it with 212 cycles in 43 patients with no female infertility factors. Average monthly fecundity and cumulative conception rates over six cycles were calculated for each group. A significant difference was found when patients with laparoscopically proven normal anatomy were compared with those with endometriosis (P = .002). The fecundity did not differ significantly between stage I and stage II endometriosis (P greater than .05). Neither ablation during laparoscopy nor medical treatment with danocrine improved the fecundity of patients with early-stage endometriosis (P greater than .05).     

Abnormal findings on hysterosalpingography: effects on fecundity in a donor insemination program using frozen semen.

OBJECTIVE: We sought to evaluate the effect of abnormal baseline hysterosalpingography (HSG) on subsequent fecundity during the first six cycles of treatment. METHODS: Hysterosalpingography was performed on 208 asymptomatic ovulatory women with no history of pelvic disease who were referred for donor insemination. The findings were categorized into five groups: 1) normal study, 2) uterine anomaly or filling defect with bilateral tubal patency, 3) normal uterine anatomy with unilateral tubal patency, 4) normal uterine anatomy with bilateral tubal blockage, and 5) normal uterine anatomy with hydrosalpinx. Subjects in groups 4 and 5 received inseminations only if patency of at least one fallopian tube was demonstrated with laparoscopy. Life-table analysis was performed to calculate the average monthly fecundity and cumulative conception rates for each group. The Mantel-Haenszel test was used to compare group fecundities. RESULTS: A total of 1460 donor insemination cycles were performed. The number of cycles in each group were as follows: group 1, 1173 (80%); group 2, 153 (10%); group 3, 90 (6.2%); group 4, 16 (1.1%); and group 5, 28 (1.9%). None of the patients in group 4 or 5 conceived. The cumulative conception rates in the first three groups were 46, 34, and 40%, respectively, and were not significantly different from one another (P greater than .05). Although a high incidence of uterine filling defects and unilateral tubal blockage was observed (19.2%), the incidence of an abnormal HSG finding that significantly decreased fecundity was only 2.8%. CONCLUSION: In women with no history of tubal or uterine disease, routine HSG before initiation of donor insemination is of limited value for identifying decreased treatment fecundity.