Real-world treatment patterns, survival outcomes, and health care resource utilization for locally advanced or metastatic urothelial carcinoma in Spain.

PURPOSE: Real-world evidence on locally advanced or metastatic urothelial carcinoma (la/mUC) management in Spain is limited. This study describes patient characteristics, treatment patterns, survival, and health care resource utilization (HCRU) in this population. METHODS/PATIENTS: This retrospective observational study included all adults with a first diagnosis/record of la/mUC (index date) from January 2015 to June 2020 at nine university hospitals in Spain. Data were collected up to December 31, 2020 (end of study), death, or loss to follow-up. Patient characteristics, treatment patterns, median overall survival (OS) and progression-free survival (PFS) from index date (Kaplan-Meier estimates), and disease-specific HCRU were described. RESULTS: Among 829 patients, median age at diagnosis was 71 years; 70.2% had ≥ 1 comorbidity, and 52.5% were eligible for cisplatin. Median follow-up was 12.7 months. Most (84.7%) patients received first-line systemic treatment; of these, 46.9% (n = 329) received second-line and 16.6% (n = 116) received third-line therapy. Chemotherapy was the most common treatment in all lines of therapy, followed by programmed cell death protein 1/ligand 1 inhibitors. Median (95% confidence interval) OS and PFS were 18.8 (17.5-21.5) and 9.9 (8.9-10.5) months, respectively. Most patients required ≥ 1 outpatient visit (71.8%), inpatient admission (56.6%), or emergency department visit (56.5%). CONCLUSIONS: Therapeutic patterns were consistent with Spanish guideline recommendations. Chemotherapy had a role in first-line treatment of la/mUC in Spain during the study period. However, the disease burden remains high, and new first-line treatments recommended in the latest European guidelines should be made available to patients in Spain.

Clinical profile of malaria at a tertiary care teaching hospital in North India.

INTRODUCTION: Despite recent reductions in the overall malaria case incidence, malaria remains an important public health issue. There has been a change in clinical and epidemiological profile of malaria in our country and vivax malaria known to be benign has been reported to cause severe complications. Therefore, the present study was conducted to delineate the clinical profile of malaria, proportion of severity, spectrum of complications, and presence of comorbidities among adult patients admitted at a tertiary health-care center in North India. MATERIALS AND METHODS: This was an observational prospective study conducted in all adult patients (>15 years of age) diagnosed to have Plasmodium vivax malaria, Plasmodium falciparum, and mixed malarial infection at a tertiary care teaching hospital on the basis of peripheral smear or rapid diagnostic tests. RESULTS: The study included 295 patients, the most common species was vivax (62%) followed by falciparum (29%) and mixed plasmodium spp. (9%). The mean age of the patients was 34.23 ± 15.7 years, with 64% male and 36% female. Out of all patients, 23% patients had at least one component of severe malaria. Severe anemia (hemoglobin <5 mg/dl), thrombocytopenia (platelet count <1 lac/cmm), and acute kidney injury were significantly greater in patients with P. vivax. Presence of comorbid conditions was observed in a significant proportion (32%) of patients. CONCLUSION: P. vivax is the plasmodium species which is responsible for most of the cases. Its potential to cause life-threatening illness is the cause of concern. The role of comorbid conditions in influencing the clinicaloutcome of malaria should be further explored.

Sound mind vs sound heart.

Depressive and anxiety disorders have both have been associated with an increased risk of cardiovascular disease. This article highlights the multifactorial and bidirectional interaction between cardiovascular diseases, depression and anxiety, and the need for early assessment, diagnosis and intervention.

Therapeutic influence of zinc and ascorbic acid against lead induced biochemical alterations.

The influence of co-administration of zinc (10 mg/kg, intraperitoneal [ip]) and ascorbic acid (10, 20 and 30 mg/kg, ip) against lead (lead acetate; 35 mg/kg, ip for 3 days) induced biochemical alterations was studied in young albino rats. The results revealed significant fall in hemoglobin content, on the other hand significant raise in the activity of serum transaminases and serum alkaline phosphatase after lead administration. Significant increase in lipid peroxidation and decreased level of reduced glutathione in liver showed oxidative stress due to lead exposure. Total protein content in liver and kidney were diminished after lead exposure. Activity of acid phosphatase in liver and kidney and alkaline phosphatase in kidney was increased significantly. Zinc and ascorbic acid treatment showed moderate therapeutic efficacy when administered individually, whereas more pronounced protective effects were observed after combined therapy of zinc and different doses of ascorbic acid. The results thus, suggested that co-administration of zinc and ascorbic acid may be useful in restoration of lead induced biochemical alterations.

Reversal of effects of intra peritoneally administered beryllium nitrate by tiron and CaNa3DTPA alone or in combination with alpha-tocopherol.

To evaluate therapeutic efficacy of chelating agents tiron (Sodium-4,5-dihydroxy-1,3-benzene disulphonate) and CaNa3DTPA (Calcium trisodium diethylene triamine pentaacetic acid) in presence of alpha-tocopherol against beryllium induced toxicity, adult female albino rats were exposed to beryllium nitrate for 28 days followed by therapy with tiron (471 mg/kg, i.p.) and CaNa3DTPA (35 mg/kg, i.p.) alone and in combination with alpha-tocopherol (25 mg/kg, p.o.). Results revealed non-significant fall in haemoglobin and total serum protein content while significant fall in blood sugar level and activity of serum alkaline phosphatase. On the other hand, significant rise in the activity of serum transaminases and LDH was noticed after beryllium administration. Significant increase in total and esterified cholesterol was found in liver and kidney after toxicity. Significant increase in lipid peroxidation and decreased level of reduced glutathione in both the organs showed oxidative stress due to beryllium exposure. Histopathological and ultrastructural observations of liver and kidney revealed lesions due to beryllium toxicity followed by recovery due to combined therapy. CaNa3DTPA showed moderate therapeutic efficacy; however, its effectiveness was enhanced with alpha-tocopherol to some extent. Tiron in combination with alpha-tocopherol exerted statistically more beneficial effects in reversal of beryllium induced biochemical, histopathological and ultrastructural alterations.

Effect of the alcohol extract of the seeds of Mucuna pruriens on free radicals and oxidative stress in albino rats.

In vitro and in vivo studies were made with an alcohol extract of the seeds of Mucuna pruriens (Fabaceae) to investigate its antioxidant property. In vitro studies were carried out in rat liver homogenate to investigate the chemical interaction of various phytochemicals with different species of free radicals. The effect was also checked on iron-induced lipid peroxidation, oxidation of GSH content, and its interaction with hydroxyl and superoxide radicals. There was no change on the rate of aerial oxidation of GSH content but it significantly inhibited FeSO(4) induced lipid peroxidation. It also inhibited the specific chemical reactions induced by superoxides and hydroxyl radicals. The removal of these species was through direct chemical interaction. An in vivo study on albino rats for 30 days showed no toxic effect up to a dose of 600 mg/kg body weight, on oral administration. There was no change in the level of TBA-reactive substances, reduced glutathione content and SOD activity in the liver. The activity of serum GOT, GPT and alkaline phosphatase was also unchanged. Thus it could be concluded that the alcohol extract of the seeds of M. pruriens has an antilipid peroxidation property, which is mediated through the removal of superoxides and hydroxyl radicals.