Cancer Patient Beliefs and Attitudes Regarding Immune Checkpoint Inhibitor Therapy

The development and widespread use of immune checkpoint inhibitors (ICIs) have advanced the field of oncology in a short period of time. Despite this, patient perception regarding this new medication class has not been adequately assessed, which may affect treatment decisions and adherence. The Belief about Medicines Questionnaire (BMQ) is a validated survey composed of 18 questions which analyzes patient’s beliefs about the necessity of prescribed medication and concern about the potential adverse events caused by the medication. General medication overuse and harm are also determined. This is the first study to utilize the BMQ for patients on ICI therapy

Risk of Venous Thromboembolism: The Prothrombin-G20210A Mutation and Combined Oral Contraceptives

The risk of venous thromboembolism in oral contraceptive pill users becomes dramatically increased in patients with inherited thrombophilias. The often undiscovered prothrombotic genetic conditions pose a potentially deadly threat to its generally young demographic. When thrombosis is discovered in oral contraceptive pill users with a strong family history of related events, it becomes essential to screen for prothrombotic genetic conditions and further mitigate any associated modifiable risk factors. Here we present a case of pulmonary embolism requiring cardiopulmonary resuscitation in 30-year-old female found to have a Prothrombin G20210A on oral contraceptive pills. The emergent management of the critical case, as well as the subsequent evaluation for prothrombotic conditions and the role of potential screening is discussed

Remodeling of mechanical junctions and of microtubule-associated proteins accompany cardiac connexin43 lateralization.

<p>BACKGROUND: Desmosomes and adherens junctions provide mechanical continuity between cardiac cells, whereas gap junctions allow for cell-cell electrical/metabolic coupling. These structures reside at the cardiac intercalated disc (ID). Also at the ID is the voltage-gated sodium channel (VGSC) complex. Functional interactions between desmosomes, gap junctions, and VGSC have been demonstrated. Separate studies show, under various conditions, reduced presence of gap junctions at the ID and redistribution of connexin43 (Cx43) to plaques oriented parallel to fiber direction (gap junction "lateralization").</p> <p>OBJECTIVE: To determine the mechanisms of Cx43 lateralization, and the fate of desmosomal and sodium channel molecules in the setting of Cx43 remodeling.</p> <p>METHODS: Adult sheep were subjected to right ventricular pressure overload (pulmonary hypertension). Tissue was analyzed by quantitative confocal microscopy and by transmission electron microscopy. Ionic currents were measured using conventional patch clamp.</p> <p>RESULT: Quantitative confocal microscopy demonstrated lateralization of immunoreactive junctional molecules. Desmosomes and gap junctions in lateral membranes were demonstrable by electron microscopy. Cx43/desmosomal remodeling was accompanied by lateralization of 2 microtubule-associated proteins relevant for Cx43 trafficking: EB1 and kinesin protein Kif5b. In contrast, molecules of the VGSC failed to reorganize in plaques discernable by confocal microscopy. Patch-clamp studies demonstrated change in amplitude and kinetics of sodium current and a small reduction in electrical coupling between cells.</p> <p>CONCLUSIONS: Cx43 lateralization is part of a complex remodeling that includes mechanical and gap junctions but may exclude components of the VGSC. We speculate that lateralization results from redirectionality of microtubule-mediated forward trafficking. Remodeling of junctional complexes may preserve electrical synchrony under conditions that disrupt ID integrity.</p