Antibody Drug Conjugates

Antibody drug conjugates (ADCs) continue to change the treatment paradigm of breast cancer and recent regulatory approvals of next generation ADCs are shifting how breast cancer is classified and treated. ADCs combine precision targeting with traditional cytotoxic treatment allowing for the delivery of highly potent chemotherapeutic agents to malignant cells. This chapter will cover ADCs used for the treatment of breast cancer including pharmacology, novel mechanism of action, pharmacokinetic and pharmacodynamic properties, clinical outcomes and role in breast cancer therapy, key toxicities and monitoring

Precision Genomic Practice in Oncology: Pharmacist Role and Experience in an Ambulatory Care Clinic

Recent advancements in molecular testing, the availability of cost-effective technology, and novel approaches to clinical trial design have facilitated the implementation of tumor genome sequencing into standard of care oncology practices. Current models of precision oncology practice include specialized clinics or consultation services based on a molecular tumor board (MTB) approach. MTBs are comprised of interprofessional teams of clinicians and scientists who evaluate tumors at the molecular level to guide patient-specific targeted therapy. The practice of precision oncology utilizing MTB-based models is an emerging approach, transforming precision genomics from a novel concept into clinical practice. This rapid shift in practice from cytotoxic therapy to targeted medicine poses challenges, yet brings exciting opportunities to clinical pharmacists practicing in hematology and oncology. Only a few precision genomics programs in the United States have a strong pharmacy presence with oncology pharmacists serving in leadership roles in research, interpreting genomic sequencing, making treatment recommendations, and facilitating off-label drug procurement. This article describes the experience of the precision medicine clinic at the Indiana University Health Simon Cancer Center, with emphasis on the role of the pharmacist in the precision oncology initiative

Evaluation of a Pharmacist Led Oral Chemotherapy Clinic: A Pilot Program in the Gastrointestinal Oncology Clinic at an Academic Medical Center

Oral chemotherapy represents a major patient-centric advancement in therapy convenience. However, ownership of safe and correct administration of these agents requires significant patient education. To address this challenge, an in-person pharmacist-led oral chemotherapy education clinic in gastrointestinal oncology patients within an academic medical center was created and assessed. In this pilot program, a medication-specific quiz was administered to patients before and after education performed by a pharmacist to assess patient understanding of their new oral chemotherapy. A five-question satisfaction survey was also administered at the conclusion of the pharmacist clinic visit. Primary outcome was the percentage difference between pre-and post-education quiz scores. Secondary outcomes included patient satisfaction, time to treatment initiation, and number of pharmacist interventions. Frequencies and medians were used to describe categorical and continuous variables, respectively. Of the 18 patients analyzed, 50% were male and median age was 59.5 years. Approximately 28% had colon cancer, and 61% were treated with capecitabine. The median post-education scores improved from a pre-education score of 75% to 100%. Overall, seventeen of the eighteen patients responded with "strongly agree" to all satisfaction survey statements. An in-person oncology pharmacist-led oral chemotherapy education session demonstrated an improvement in patients' understanding of their new oral chemotherapy treatment

Knowledge, attitude and perceptions of Muslim cancer patients regarding cancer treatment during Ramadan: Results from a tertiary care hospital Karachi

Objective: To assess the knowledge and attitude of Muslim cancer patients regarding cancer treatment during Ramadan.Methods: This cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from July to August 2015, and comprised cancer patients. .Adult Muslim cancer patients receiving active oncological treatment or on surveillance were included. Patients on only supportive treatment were excluded. SPSS 19 was used for data analysis.Results: Of the 265 patients, 87(32.8%) were males and 178(67.2%) were females. The overall mean age was 49±13.87 years. Besides, 184(70.9%) patients belonged to the middle class. Breast cancer was the most common cancer 106(40.6%). Overall, 153(57.9%) patients had stage II disease. Further, 201(80%) patients had 0-1 performance status. Moreover, 180(72%) patients were receiving different forms of chemotherapeutic agents. It was found that 113(54.3%) patients sought advice regarding fasting. Most of the patients who observed fast, i.e. 214(81%), had an early stage disease and 19(7.1%) were on hormonal therapy. Patients who did not fast mostly attributed this to fatigue 69(26.3%). Conclusion: Only half of the patients sought advice on fasting and those having early disease more.Conclusions: Only half of the patients sought advice on fasting and those having early disease more frequently observed fast

Effect Of Coating Thickness On The Microstructure And Mechanical Properties Of AL-SI (LM6) Alloy Lost Wax Casting / Mohamad Ridzuan Mohamad Kamal...[et al.]

In the work, the effect of slurry and stucco coating thickness on the microstructure and mechanical properties of Al-Si alloy (LM6) produced using the investment casting technique was investigated. A ceramic mold with four different layers (3, 4, 5 and 6 layers) of thickness was prepared using aluminum oxide (Al2O3) together with slurry and stucco. The result shows that the highest tensile strength value obtained from the three layers of coating is 161.67 MPa. Furthermore, an additional layer of coating thickness does not affect the structure of the aluminum alloy (LM6). The microstructure pattern shows an eutectic silicon formation on the wall of the mold at a higher intensity compared to the center. The results also showed that coating thickness has a significant effect on the microstructure located between the wall and the center. Heat transfer of the thinner coating is improved compared to the thicker coating. Indirectly, the formation of high density needle silicon on the wall gives better strength to the alloy

Utilization of electronic order sets based on the Center for Disease Control’s Surviving Sepsis Campaign guidelines in a community hospital

Class of 2018 AbstractSpecific Aims To evaluate the impact of providers’ adherence to selecting order sets based on the Center for Disease Control’s Surviving Sepsis Campaign (CSSC) guidelines when treating sepsis at a community hospital, while secondarily exploring outcomes of this population, including in-hospital mortality and length of stay. Methods This was a retrospective, single-center study. Patients were included if they were 18 years and older with a diagnosis of sepsis at any time during their admission between August 2014 and December 2016. Use of CSSC guideline-based electronic order sets, age, gender, hospital length of stay, and in-hospital all-cause mortality were collected from the electronic health record. Descriptive statistics were used to analyze the data. Main Results A total of 451 patients diagnosed with sepsis at any time during their hospitalization between August 2014 and December 2016 were identified. All patients met the inclusion criteria. Of the 451 admissions, 32.1% were treated based on the CSSC guideline-based electronic order sets. Of the overall study sample, 9% expired during hospitalization and the average hospital length of stay for the entire study population was 5.8 ± 4.8 days. Conclusions During the 28-month study, prescribers adhered to the CSSC guideline-based electronic order sets in less than one-third of the identified sepsis cases, prompting a need for further exploration into the reasons for lack of use and possible re-education of providers on the availability of these order sets.This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, [email protected]

Identification Based on Iris Detection Technique

Iris-biometrics are an alternative way of authenticating and identifying a person because biometric identifiers are unique to people. This paper introduces a method aims to efficient human identification by enhanced iris detection method within acceptable time. After preparing various type of images, then perform a series of pre-processing steps and standardize them, after that use Uni-Net learning, so identify the human by Navie-Bays method is the last step based on the output of Uni-Net which is role as feature extractor for the iris part and another sub-net for non-iris part that may involve identification-outcome. The outcome of this method looked good compared to some high-level methods, so, was accuracy-rate 9855, 99.25, and 99.81 for CASIA-v4, ITT-Delhi, and MMU-database respectively. Also, this paper introduces a method of iris recognition using CNN model which is improved the preprocessed patterns that together from dataset applied some procedures to develop them based on techniques of equalization and acclimate contrast ones. After that characteristic extracted and classified using CNN that comprises of 10 layers with back-propagation schema and adjusted moment evaluation Adam-optimizer for modernize weights. The overall accuracy was 95.31% with utilization time 17.58 (mints) for training-model

PARP Inhibitors for Breast Cancer: Germline <em>BRCA1/2</em> and Beyond

Poly-adenosine diphosphate ribose polymerase (PARP) inhibitors (PARPi) are approved for BRCA1/2 carriers with HER2-negative breast cancer in the adjuvant setting with a high risk of recurrence as well as the metastatic setting. However, the indications for PARPi are broader for patients with other cancer types (e.g., prostate and ovarian cancer), involving additional biomarkers (e.g., ATM, PALB2, and CHEK) and genomic instability scores. Herein, we summarize the data on PARPi and breast cancer and discuss their use beyond BRCA carriers

Study of Water Resources and Waterborne Diseases in Rural Population of Aligarh, Uttar Pradesh, India

Background- Human health and survival depend upon use of uncontaminated and clean water for drinking and other purposes. Groundwater is a good source of fresh water available on the earth, due to its relatively low susceptibility to pollution in comparison to surface water and its large storage capacity. Methods- An observational study was conducted in five villages of Lodha Block of Aligarh District in Uttar Pradesh predominantly having Scheduled Caste population. The objectives of the study were to find out the sources of water, sanitary conditions and prevalence of water-borne diseases in the villages. Results-Main source of water in the area of present study was ground water which is obtained by Hand Pump, Submersible or Tube Well. Sanitary conditions of the villages observed in the study was not satisfactory. Lack of proper sanitation and management of water results in the contamination of the water and causes water-borne diseases. Skin diseases like Pruritus, Fungal Infection were found to be most prevalent followed by diseases of gastro-intestinal diseases like Diarrhoea, Amoebiasis, and Typhoid. Conclusion- Improper disposal of waste water from houses and factories is also continuously contaminating the water resources and resulting in the waterborne diseases. There is need to deliver health education in areas with dominated Scheduled caste population

Effect Of Coating Thickness On The Microstructure And Mechanical Properties Of AL-SI (LM6) Alloy Lost Wax Casting

In the work, the effect of slurry and stucco coating thickness on the microstructure and mechanical properties of Al-Si alloy (LM6) produced using the investment casting technique was investigated. A ceramic mold with four different layers (3, 4, 5 and 6 layers) of thickness was prepared using aluminum oxide (Al2O3) together with slurry and stucco. The result shows that the highest tensile strength value obtained from the three layers of coating is 161.67 MPa. Furthermore, an additional layer of coating thickness does not affect the structure of the aluminum alloy (LM6). The microstructure pattern shows an eutectic silicon formation on the wall of the mold at a higher intensity compared to the center. The results also showed that coating thickness has a significant effect on the microstructure located between the wall and the center. Heat transfer of the thinner coating is improved compared to the thicker coating. Indirectly, the formation of high density needle silicon on the wall gives better strength to the alloy