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Freeman Torres posted an update 6 months, 2 weeks ago
Finally, there is growing appreciation that IBS can present in patients with known but stable organic gastrointestinal diseases, such as quiescent IBD or coeliac disease. Recognising functional gut symptoms in these individuals is paramount so that potentially harmful escalations in immunosuppressive therapy can be avoided and attention can be focused on addressing disorders of gut-brain interaction. This Review endeavours to aid clinicians who practise adult gastroenterology in recognising the potential overlap between IBS and organic gastrointestinal diseases and highlights areas in need of further research and clarity.
Unless women start effective contraception after oral emergency contraception, they remain at risk of unintended pregnancy. Most women in the UK obtain emergency contraception from community pharmacies. We hypothesised that pharmacist provision of the progestogen-only pill as a bridging interim method of contraception with emergency contraception plus an invitation to a sexual and reproductive health clinic, in which all methods of contraception are available, would result in increased subsequent use of effective contraception.
We did a pragmatic cluster-randomised crossover trial in 29 UK pharmacies among women receiving levonorgestrel emergency contraception. Women aged 16 years or older, not already using hormonal contraception, not on medication that could interfere with the progestogen-only pill, and willing to give contact details for follow-up were invited to participate. In the intervention group, women received a 3-month supply of the progestogen-only pill (75 μg desogestrel) plus a rapid access %, 48·6-68·2), than in the control group (mean 40·5%, 29·7-51·3 ; p=0·011).The difference remained significant after adjusting for age, current sexual relationship, and history of effective contraception use, and was robust to the effect of missing data (assuming missingness at random). No serious adverse events occurred.
Provision of a supply of the progestogen-only pill with emergency contraception from a community pharmacist, along with an invitation to a sexual and reproductive health clinic, results in a clinically meaningful increase in subsequent use of effective contraception. Widely implemented, this practice could prevent unintended pregnancies after use of emergency contraception.
National Institute for Health Research (Health Technology Assessment Programme project 15/113/01).
National Institute for Health Research (Health Technology Assessment Programme project 15/113/01).
Selinexor combined with dexamethasone has shown activity in patients with heavily pre-treated multiple myeloma. In a phase 1b/2 study, the combination of oral selinexor with bortezomib (a proteasome inhibitor) and dexamethasone induced high response rates with low rates of peripheral neuropathy, the main dose-limiting toxicity of bortezomib. We aimed to evaluate the clinical benefit of weekly selinexor, bortezomib, and dexamethasone versus standard bortezomib and dexamethasone in patients with previously treated multiple myeloma.
This phase 3, randomised, open-label trial was done at 123 sites in 21 countries. Patients aged 18 years or older, who had multiple myeloma, and who had previously been treated with one to three lines of therapy, including proteasome inhibitors, were randomly allocated (11) to receive selinexor (100 mg once per week), bortezomib (1·3 mg/m
once per week), and dexamethasone (20 mg twice per week), or bortezomib (1·3 mg/m
twice per week for the first 24 weeks and once per week tnd dexamethasone is a novel, effective, and convenient treatment option for patients with multiple myeloma who have received one to three previous lines of therapy.
Karyopharm Therapeutics.
Karyopharm Therapeutics.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection carries a substantial risk of severe and prolonged illness; treatment options are currently limited. We assessed the efficacy and safety of inhaled nebulised interferon beta-1a (SNG001) for the treatment of patients admitted to hospital with COVID-19.
We did a randomised, double-blind, placebo-controlled, phase 2 pilot trial at nine UK sites. Adults aged 18 years or older and admitted to hospital with COVID-19 symptoms, with a positive RT-PCR or point-of-care test, or both, were randomly assigned (11) to receive SNG001 (6 MIU) or placebo by inhalation via a mouthpiece daily for 14 days. The primary outcome was the change in clinical condition on the WHO Ordinal Scale for Clinical Improvement (OSCI) during the dosing period in the intention-to-treat population (all randomised patients who received at least one dose of the study drug). The OSCI is a 9-point scale, where 0 corresponds to no infection and 8 corresponds to death. Multiple a treatment-emergent adverse event was headache (seven patients in the SNG001 group and five in the placebo group). There were three deaths in the placebo group and none in the SNG001 group.
Patients who received SNG001 had greater odds of improvement and recovered more rapidly from SARS-CoV-2 infection than patients who received placebo, providing a strong rationale for further trials.
Synairgen Research.
Synairgen Research.Bacterial blight (BB), caused by Xanthomonas oryzae pv. oryzae (Xoo) is a major threat to rice production as it accounts for loss up to 50% of annual rice grain yield. Xoo causes leaf tissue necrosis and as a result there is downregulation of the photosynthetic mechanisms of plant. Measurement of chl a fluorescence is an easy, fast, non-invasive and highly sensitive technique that can be used to understand plant health by measuring alterations in PSII activity, in response to different biotic and abiotic stresses. In the present investigation, rice seeds were bio-primed with two bacterial spp. (e.g. Bacillus subtilis and B. megaterium) and one fungal strain (i.e. 8-Cyclopentyl-1,3-dimethylxanthine Trichoderma erinaceum). The induction of defence against BB disease by bio-priming with biotic agents, was studied as response in alteration of PSII and defence enzymes activity. Field experiment was conducted with the best biotic agent; i.e. B. subtilis obtained from all experiments to study whether defence induction by it have any side effect on rice yield and biomass.
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