Stability Characterization of the Novel Anti-Cancer HM-10/10 HDL-Mimetic Peptide.

Epithelial adenocarcinoma of the ovary and colon are associated with the highest rates of cancer-related deaths in women in the U.S. The literature supports the role of HDL-associated apolipoproteins in the treatment of cancer and other pro-inflammatory diseases. Previously, we developed a novel 20-amino acid mimetic peptide, HM-10/10, which potently inhibits tumor development and growth in colon and ovarian cancer. Here, we report the properties of HM-10/10 relative to its stability in vitro. The results demonstrated that HM-10/10 had the highest half-life in human plasma compared to plasma from other species tested. HM-10/10 demonstrated stability in human plasma and simulated gastric environment, increasing its promise as an oral pharmaceutical. However, under conditions modeling the small intestine, HM-10/10 demonstrated significant degradation, likely due to the peptidases encountered therein. Furthermore, HM-10/10 demonstrated no evidence of time-dependent drug-drug interactions, although it demonstrated CYP450 induction slightly above cutoff. As proteolytic degradation is a common limitation of peptide-based therapeutics, we are pursuing strategies to improve the stability properties of HM-10/10 by extending its bioavailability while retaining its low toxicity profile. HM-10/10 holds promise as a new agent to address the international women's health crisis of epithelial carcinomas of the ovary and colon.

Understanding Health Disparities in Preeclampsia: A Literature Review.

Preeclampsia is a multifactorial pathology with negative outcomes in affected patients in both the peripartum and postpartum period. Black patients in the United States, when compared to their White and Hispanic counterparts, have higher rates of preeclampsia. This article aims to review the current literature to investigate how race, social determinants of health, and genetic profiles influence the prevalence and outcomes of patients with preeclampsia. Published studies utilized in this review were identified through PubMed using authors' topic knowledge and a focused search through a Medline search strategy. These articles were thoroughly reviewed to explore the contributing biosocial factors, genes/biomarkers, as well as negative outcomes associated with disparate rates of preeclampsia. Increased rates of contributing comorbidities, including hypertension and obesity, which are largely associated with low access to care in Black patient populations lead to disparate rates of preeclampsia in this population. Limited research shows an association between increased rate of preeclampsia in Black patients and specific APOL1, HLA-G, and PP13 gene polymorphisms as well as factor V Leiden mutations. Further research is required to understand the use of certain biomarkers in predicting preeclampsia within racial populations. Understanding contributing biosocial factors and identifying genes that may predispose high-risk populations may help to address the disparate rates of preeclampsia in Black patients as described in this review. Further research is required to understand if serum, placental, or urine biomarkers may be used to predict individuals at risk of developing preeclampsia in pregnancy. KEY POINTS: · Prevalence of preeclampsia in the U.S. is higher in Black patients compared to other racial groups.. · Patients with preeclampsia are at risk for poorer health outcomes both during and after delivery.. · Limited research suggests specific biomarkers or gene polymorphisms contribute to this difference; however, explanations for this disparity are multifactorial and further investigation is necessary..

Angular and Interstitial Ectopic Pregnancies: A Clarification of Terms and Literature Review.

Angular pregnancy is an exceedingly rare diagnosis, with less than 100 reported cases. Angular pregnancy is important to distinguish from ectopic pregnancies due to the fact that they have the potential to be viable while true ectopic pregnancies do not. As such, angular pregnancy requires starkly different management. Inappropriate use of the terms angular, interstitial, and cornual indicates a general misunderstanding of what makes these diagnoses unique. Misunderstanding leads to misdiagnosis and consequent mismanagement. Our experience with cases of women with angular and interstitial ectopic pregnancies is instructive as it illustrates effective diagnosis and differing management of these two diagnoses. In the two angular pregnancy cases, transvaginal ultrasonography was employed to confirm the diagnosis, which showed a lack of the interstitial line sign, contiguity of the decidua and endometrium, and an endomyometrial mantle thickness between 5 and 8 mm. One patient's angular pregnancy ultimately ruptured and was successfully managed with fully robotic cornual resection and unilateral salpingectomy, while the other progressed to term normally without complication. The patient with an interstitial ectopic pregnancy was also managed surgically, although with laparoscopic cornuotomy and salpingectomy.

Developing and implementing an effective framework for collaboration: the experience of the CS2day collaborative.

Organizations from varied sectors have pursued collaboration to better fulfill their missions, facilitate decision making, solve more complex problems, and respond more rapidly to a changing environment. While these benefits are evident through the products and services provided, few organizations evaluate the factors that contribute to the success or failure of the collaboration itself. The CS2day Collaborative was formed by 9 separate organizations with a common goal of increasing smoking quit rates through health care professional education. To better understand the factors that influence successful collaboration, the authors applied criteria established by the Wilder Foundation to the functioning of this health care education collaborative. Factors analyzed include the influence of the environment, membership, process and structure, communication, purpose, and resources. Factors relevant to continuing medical education/continuing professional development (CME/CPD) including accreditation, conflict of interest resolution and management, guideline dissemination, continuous assessment and interprofessional education influenced the collaborative structure. Specific examples provided illustrate how diverse organizations can work together effectively to address a public health need. While the CS2day Collaborative was not formed with prior knowledge of these factors, they provide a useful framework for examining how this collaborative was developed and has operated.