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Eltrombopag for advanced myelodysplastic syndromes or acute myeloid leukaemia and severe thrombocytopenia (ASPIRE): a randomised, placebo-controlled, phase 2 trial

In this study (ASPIRE), we aimed to assess eltrombopag, an oral thrombopoietin receptor agonist, for thrombocytopenia (grade 4) treatment in adult patients with advanced MDS or AML. Methods ASPIRE consisted of an open-label, double-blind phase for 8 weeks and a randomised, double-blind phase (parts 1 and 2, reported here) for 12 weeks, and an open-label extension (part 3). Eligible patients were men and women aged 18 years or older, with intermediate-2 or high-risk MDS or AML, with bone marrow blasts of 50% or less, and had either grade 4 thrombocytopenia due to bone marrow insufficiency (platelet counts <25 × 109 per L) or grade 4 thrombocytopenia before platelet transfusion, with 25 × 109 platelets per L or greater after transfusion. Additionally, eligible patients had at least one of the following within the screening period of 4 weeks: platelet transfusion, symptomatic bleeding, or platelet count of less than 10 × 109 per L. During part 1, patients received eltrombopag, and dose-escalation criteria for part 2 were determined. In part 2, we randomly allocated patients 2:1 using an interactive voice-response system to eltrombopag or placebo, stratified by baseline platelet count (<10 × 109 platelets per L vs ≥10 × 109 platelets per L) and disease (MDS vs AML). In parts 1 and 2, patients received supportive standard of care and initiated eltrombopag or placebo at 100 mg per day (50 mg per day for patients of east-Asi...
Source: The Lancet Haematology - Category: Hematology Source Type: research

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The prognostic value of high sensitivity C-reactive protein in a multi-ethnic population after>10 years of follow-up: The Multi-Ethnic Study of Atherosclerosis (MESA). Int J Cardiol. 2018 Aug 01;264:158-164 Authors: Cainzos-Achirica M, Miedema MD, McEvoy JW, Cushman M, Dardari Z, Greenland P, Nasir K, Budoff MJ, Al-Mallah MH, Yeboah J, Blumenthal RS, Comin-Colet J, Blaha MJ Abstract BACKGROUND: The prognostic value of hsCRP in contemporary multi-ethnic populations is unclear, particularly in statin users. The aim of this study was to characterize the prognostic utility of hsCRP for atheroscleroti...
Source: Atherosclerosis - Category: Cardiology Authors: Tags: Int J Cardiol Source Type: research
CONCLUSIONS: SMCs of coronary APs as well as from the underlying media from young SCD victims exhibit strong contractile phenotype. In the setting of critical stenosis, both intima and media SMC contractility might contribute to transient coronary spasm leading to myocardial ischemia and SCD. PMID: 29776555 [PubMed - in process]
Source: Atherosclerosis - Category: Cardiology Authors: Tags: Int J Cardiol Source Type: research
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Source: Daily Express - Health - Category: Consumer Health News Source Type: news
LONDON (Reuters) - Roche's new hemophilia drug Hemlibra dramatically reduced bleeding in a broad population of hemophilia patients, results from two clinical trials showed on Monday, setting it up to take a dominant market position.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
CONCLUSIONS: Ring-shaped thread counter traction makes the most difficult duodenal ESD safer and easier without complications. PMID: 29764299 [PubMed - as supplied by publisher]
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
A 3-year-old female presented with 4 months of recurrent fevers, abdominal pain, hematuria, and proteinuria with negative urine cultures. On examination, she was hypertensive with bruises over her left cheek. Labs were remarkable for serum creatinine 0.78 mg/dl (estimated glomerular filtration rate of 48.3 ml/min per 1.73 m2 using the revised Schwartz formula); hemoglobin 8.5 gm/dl; hematocrit 27.9%; platelet 92 × 103/ul; urinalysis with 11–20 red blood cells/high-power field; spot urine protein/creatinine ratio 1.97 mg/mg; low haptoglobin; elevated lactate dehydrogenase; and schistocytes on peripheral smear.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
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More than 300 people have taken the manufacturers of allegedly faulty hip replacements to the High Court.
Source: BBC News | Health | UK Edition - Category: Consumer Health News Source Type: news
Authors: Mrwebi KP, Goon DT, Owolabi EO, Adeniyi OV, Seekoe E, Ajayi AI Abstract Early discontinuation of implanon, a long-acting, reversible contraceptive among reproductive age women in South Africa is a serious public health concern. The aim of this study was to examine the reasons for discontinuation of implanon among its previous users. This descriptive cross-sectional study involved 188 consecutively selected participants in two large family planning clinics in Buffalo Metropolitan Municipality, East London, South Africa. Descriptive statistics was conducted using SPSS version 22.0. The mean duration of use w...
Source: African Journal of Reproductive Health - Category: African Health Tags: Afr J Reprod Health Source Type: research
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Source: African Journal of Reproductive Health - Category: African Health Tags: Afr J Reprod Health Source Type: research
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