Two successful pregnancies in a woman with chronic myeloid leukemia exposed to nilotinib during the first trimester of her second pregnancy: case study

The occurrence of chronic myeloid leukemia in pregnancy is rare and its management poses a clinical challenge for physicians treating these patients. We report a 30-year-old woman with chronic myeloid leukemia who became pregnant twice successfully. Philadelphia-positive CML in its chronic phase was diagnosed at 16 weeks of her first gestation. At that time, she received no treatment throughout her pregnancy. At 38 weeks of gestation, a normal infant was delivered by cesarean section. At six weeks postpartum, the patient underwent imatinib mesylate therapy but she could not tolerate the treatment. The treatment was then changed to nilotinib at 400 mg orally b.i.d. Two years later, she became pregnant again while she was on nilotinib 200 mg b.i.d. The unplanned pregnancy was identified during her 7.4 weeks of gestation. Because the patient elected to continue her pregnancy, nilotinib was stopped immediately, and no further treatment was given until delivery. Neither obstetrical complications nor structural malformations in neonates in both pregnancies were observed. Both babies' growth and development have been normal. Although this experience is limited to a single patient, the success of this patient demonstrates that the management of chronic myeloid leukemia in pregnant women may be individualized based on the relative risks and benefits of the patient and fetus.

Do her??ico ao cotidiano: li????es aprendidas na condu????o de projetos horizontais

Este Caderno traz o relat??rio elaborado pela Mesa-Redonda de Pesquisa A????o sobre a Gest??o de Iniciativas Horizontais, do Centro Canadense para o Desenvolvimentoda Gest??o do Canad??, que objetiva avaliar iniciativas e pesquisas realizadas,identificar li????es e oferecer orienta????es pr??ticas a gerentes sobre efic??ciaem gest??o horizontal

Travelling to India: Eliza Fay’s narrative account of her voyages

Eliza Fay’s Original Letters from India (1817), initially sold to the Calcutta Gazette to pay off her debts, aroused the curiosity and interest of Edward M. Forster, while he was doing research for his best-selling novel, A Passage to India. In his own words, “Eliza Fay is a work of art.” (apud Fay 7) The value of E. Fay’s travelogue, comprising not one, but three voyages to India (in 1779, 1784, 1796) can be easily explained if we take into account the scope of its geographical coverage, the hardships of its historical context (the political chaos brought about by the fall of the Mughal empire and the consolidation of the British rule in the Indian subcontinent) and the heroism of the first person-narrator that emerges behind the descriptive sketches and the scenes of adversity and imminent danger. Thus the current analysis will focus on the E. Fay’s adventurous mode of narrating, e.g., the discursive situatedness of the traveller visà- vis the Other(s) (European and non-European peoples and loci) and the constraints imposed by the patriarchal idealization of the domestic Woman and their alleged feebleness.

Emma Darwin, a century of family letters, 1792-1896, ed. by her daughter Henrietta Litchfield ...

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Emma Darwin, a century of family letters, 1792-1896, ed. by her daughter Henrietta Litchfield ...

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The Sanctified ‘Adultress’ and Her Circumstantial Clause: Bathsheba’s Bath and Self-Consecration in 2 Samuel 11

Bathsheba's actions in 2 Sam. 11.2-4 identify crucial aspects of her character. Past commentators interpret these words in connection with menstrual purification, stressing the certain paternity of David's adulterine child. This article demonstrates that the participles rōheset and mitqaddesšet and the noun mittum'ātāh do not denote menstrual cleansing. Bathsheba's washing is an innocent bath. She is the only individual human to self-sanctify, placing her in the company of the Israelite deity. The syntax of the verse necessitates that her action of self-sanctifying occurs simultaneously as David lies with her. The three focal terms highlight the important legitimacy of Bathsheba before the Israelite deity, her identity as a non-Israelite, her role as queen mother of the Solomonic line, and her full participation in the narrative.

Variation d'expression des récepteurs hormonaux et d'HER-2 dans l'évolution du cancer du sein : quelles implications en pratique clinique [Hormone receptors and HER-2 changes during breast cancer progression: clinical implications].

Breast cancer remains a major public health problem. Even if there is an increase in this cancer curability, metastatic breast cancer remains a lethal disease in the vast majority of cases. Therapeutic advances in the chemotherapeutic and targeted therapies fields induced an increase in survival, however the proportion of long survivors remains low. Phenotypic instability, an early process initiated during tumour progression, and continued on the metastatic stage of the disease, can be one of the putative hypotheses explaining these results. An increasing amount of scientific data are pledging for a reanalysis of the phenotypic profile regarding hormone receptors and HER-2 status of metastatic lesions in order to identify drugable targets and allow individualisation of the treatment of these metastatic breast cancer patients. Phenotypic changes between the primary tumour and the paired metastatic lymph nodes are a challenging pitfall, raising the question of which site has to be assessed in the adjuvant treatment decision process. This article presents a comprehensive analysis of the frequency of theses phenotypic changes altogether with new modalities to evaluate this phenotypic status.

La crisis del drama en la contemporaneidad: Attempts on her life de Martin Crimp

Attempts on her life es una obra que desafía la posibilidad de su propia representación. El tratamiento del personaje; la ausencia de diálogo strictu sensu; una acción que se desarrolla en el relato de los locutores; espacio y tiempo que no acaban de definirse sino en el hic et nunc del espectáculo: todo esto convierte la obra de Crimp en parámetro ideal para detectar el estado de la llamada crisis del drama en la contemporaneidad. Este trabajo quiere centrarse en la relevancia que las características formales y de contenido de la obra cobran dentro del ámbito dramatúrgico y filosófico contemporáneos

Report of Working Group set up by the Tanaiste in March 2006 to examine the nature and extent of Haemochromatosis in Ireland and to advise her on the action necessary to address the problems caused by Haemochromatosis

It was agreed at a meeting on 15th February, 2006, between Ms Mary Harney, TD, Tanaiste and Minister for Health and Children and Dr Maurice Manning that a Working Group would be set up to examine all of the issues relating to haemochromatosis in Ireland and to advise her on the actions necessary to address these issues. Read the Report (PDF, 709kb)  

Combination of trastuzumab and letrozole after resistance to sequential trastuzumab and aromatase inhibitor monotherapies in patients with estrogen receptor-positive, HER-2-positive advanced breast cancer: a proof-of-concept trial (SAKK 23/03).

A sequential treatment design was chosen in this trial to ensure complete resistance to single-agent non-steroidal aromatase inhibitor (AI) and trastuzumab both given as monotherapy before receiving the combination of a non-steroidal AI and trastuzumab. Key eligibility criteria included postmenopausal patients with advanced, measurable, human epidermal growth factor receptor-2 (HER-2)-positive disease (assessed by FISH, ratio (≥2)), hormone receptor (HR)-positive disease, and progression on prior treatment with a non-steroidal AI, e.g. letrozole or anastrozole, either in the adjuvant or in the advanced setting. Patients received standard dose trastuzumab monotherapy in step 1 and upon disease progression continued trastuzumab in combination with letrozole in step 2. The primary endpoint was clinical benefit rate (CBR) in step 2. Totally, 13 patients were enrolled. In step 1, six patients (46%) achieved CBR. Median time to progression (TTP) was 161 days (95% confidence interval (CI): 82-281). In step 2, CBR was observed in eight out of the 11 evaluable patients (73%), including one patient with partial response. Median TTP for all the 11 patients was 188 days (95% CI: 77-not reached). Results of this proof-of-concept trial suggest that complete resistance to both AI and trastuzumab can be overcome in a proportion of patients by combined treatment of AI and trastuzumab, as all patients served as their own control. Our results appear promising for a new treatment strategy that offers a chemotherapy-free option for at least a subset of patients with HR-positive, HER-2-positive breast cancer over a clinically relevant time period.

Her [i.e. Herr Eugen] Schiffer, ministre allemand de la justice : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58185

[Archives de la Parole]. , Don durang : sung at the making over of the bride (Hō song) ; Aṛandi Durang : marriage song sung at the first day of the marriage feast, when the bride is about to leave her parents (Hō song) / [Sir George Grierson], éd. ; Linguistic survey of India ; Choeur de femmes, chant ; accompagnement de percussions

[Traditions. Asie. Inde. Chotā Nāgpur]