Primer registro de ácaros (Gamasida: Laelapidae) parásitos de roedores silvestres en Uruguay, con nuevos registros de hospedadores

Information is presented for the first time on laelapid mites associated with wild rodents in Uruguay. Specimens of the following species were identified: Laelapinae: Androlaelaps fahrenholzi (Berlese), Androlaelaps rotundus (Fonseca), Gigantolaelaps wolffsohni (Oudemans), Laelaps paulistanensis (Fonseca), Laelaps manguinhosi (Fonseca) and Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). Most of the ectoparasite-host associations are reported for the first time. New host and locality records presented in this study are in accordance with previous findings on the same and/or related host species in nearby South American localities.Se presenta por primera vez infonnación sobre ácaros lelápidos asociados a roedores silvestres en Uruguay. Se identificaronespecímenes de las siguientes especies: Laelapinae:Androlaelaps fahrenholzi (Berlese). Androlaelaps rotundus (Fonseca). Gigantolaelaps wolffsohni (Oudemans). Laelapspaulistanensis Fonseca. Laelaps manguinhosi Fonseca y Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). La mayoría de las asociaciones ectoparásitohospedador se registran por primera vez. Los nuevos registros de hospedador y localidad que se presentanen este estudio coinciden con hallazgos previos en las mismas, o estrechamente relacionadas, especies hospedadoras en localidades cercanas de Sud América.Centro de Estudios Parasitológicos y de Vectore

Primer registro de ácaros (Gamasida: Laelapidae) parásitos de roedores silvestres en Uruguay, con nuevos registros de hospedadores

Information is presented for the first time on laelapid mites associated with wild rodents in Uruguay. Specimens of the following species were identified: Laelapinae: Androlaelaps fahrenholzi (Berlese), Androlaelaps rotundus (Fonseca), Gigantolaelaps wolffsohni (Oudemans), Laelaps paulistanensis (Fonseca), Laelaps manguinhosi (Fonseca) and Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). Most of the ectoparasite-host associations are reported for the first time. New host and locality records presented in this study are in accordance with previous findings on the same and/or related host species in nearby South American localities.Se presenta por primera vez infonnación sobre ácaros lelápidos asociados a roedores silvestres en Uruguay. Se identificaronespecímenes de las siguientes especies: Laelapinae:Androlaelaps fahrenholzi (Berlese). Androlaelaps rotundus (Fonseca). Gigantolaelaps wolffsohni (Oudemans). Laelapspaulistanensis Fonseca. Laelaps manguinhosi Fonseca y Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). La mayoría de las asociaciones ectoparásitohospedador se registran por primera vez. Los nuevos registros de hospedador y localidad que se presentanen este estudio coinciden con hallazgos previos en las mismas, o estrechamente relacionadas, especies hospedadoras en localidades cercanas de Sud América.Centro de Estudios Parasitológicos y de Vectore

Securing Information Technology in Healthcare

Information technology (IT) has great potential to improve healthcare quality while also improving efficiency, and thus has been a major focus of recent healthcare reform efforts. However, developing, deploying and using IT that is both secure and genuinely effective in the complex clinical, organizational and economic environment of healthcare is a significant challenge. Further, it is imperative that we better understand the privacy concerns of patients and providers, as well as the ability of current technologies, policies, and laws to adequately protect privacy. The Securing Information Technology in Healthcare (SITH) workshops were created to provide a forum to discuss security and privacy for experts from a broad range of perspectives, from officers at large healthcare companies, startups and nonprofits, to physicians, researchers and policy makers

Primer registro de ácaros (Gamasida: Laelapidae) parásitos de roedores silvestres en Uruguay, con nuevos registros de hospedadores

Information is presented for the first time on laelapid mites associated with wild rodents in Uruguay. Specimens of the following species were identified: Laelapinae: Androlaelaps fahrenholzi (Berlese), Androlaelaps rotundus (Fonseca), Gigantolaelaps wolffsohni (Oudemans), Laelaps paulistanensis (Fonseca), Laelaps manguinhosi (Fonseca) and Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). Most of the ectoparasite-host associations are reported for the first time. New host and locality records presented in this study are in accordance with previous findings on the same and/or related host species in nearby South American localities.Se presenta por primera vez infonnación sobre ácaros lelápidos asociados a roedores silvestres en Uruguay. Se identificaronespecímenes de las siguientes especies: Laelapinae:Androlaelaps fahrenholzi (Berlese). Androlaelaps rotundus (Fonseca). Gigantolaelaps wolffsohni (Oudemans). Laelapspaulistanensis Fonseca. Laelaps manguinhosi Fonseca y Mysolaelaps microspinosus Fonseca; Haemogamasinae: Eulaelaps stabularis (Koch). La mayoría de las asociaciones ectoparásitohospedador se registran por primera vez. Los nuevos registros de hospedador y localidad que se presentanen este estudio coinciden con hallazgos previos en las mismas, o estrechamente relacionadas, especies hospedadoras en localidades cercanas de Sud América.Centro de Estudios Parasitológicos y de Vectore

The STOP COVID 2 study: Fluvoxamine vs placebo for outpatients with symptomatic COVID-19, a fully remote randomized controlled trial

BACKGROUND: Prior randomized clinical trials have reported benefit of fluvoxamine ≥200 mg/d vs placebo for patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: This randomized, double-blind, placebo-controlled, fully remote multisite clinical trial evaluated whether fluvoxamine prevents clinical deterioration in higher-risk outpatients with acute coronavirus disease 2019 (COVID-19). Between December 2020 and May 2021, nonhospitalized US and Canadian participants with confirmed symptomatic infection received fluvoxamine (50 mg on day 1, 100 mg twice daily thereafter) or placebo for 15 days. The primary modified intent-to-treat (mITT) population included participants who started the intervention within 7 days of symptom onset with a baseline oxygen saturation ≥92%. The primary outcome was clinical deterioration within 15 days of randomization, defined as having both (1) shortness of breath (severity ≥4 on a 0-10 scale or requiring hospitalization) RESULTS: A total of 547 participants were randomized and met mITT criteria (n = 272 fluvoxamine, n = 275 placebo). The Data Safety Monitoring Board recommended stopping early for futility related to lower-than-predicted event rates and declining accrual concurrent with vaccine availability in the United States and Canada. Clinical deterioration occurred in 13 (4.8%) participants in the fluvoxamine group and 15 (5.5%) participants in the placebo group (absolute difference at day 15, 0.68%; 95% CI, -3.0% to 4.4%; log-rank CONCLUSIONS: This trial did not find fluvoxamine efficacious in preventing clinical deterioration in unvaccinated outpatients with symptomatic COVID-19. It was stopped early and underpowered due to low primary outcome rates. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT04668950

Brief Report: Safety and Antitumor Activity of Alectinib Plus Atezolizumab From a Phase 1b Study in Advanced ALK-Positive NSCLC

INTRODUCTION: Alectinib is a preferred first-line treatment option for advanced ALK-positive NSCLC. Combination regimens of alectinib with immune checkpoint inhibitors are being evaluated for synergistic effects. METHODS: Adults with treatment-naive, stage IIIB/IV, or recurrent ALK-positive NSCLC were enrolled into a two-stage phase 1b study. Patients received alectinib 600 mg (twice daily during cycle 1 and throughout each 21-d cycle thereafter) plus atezolizumab 1200 mg (d8 of cycle 1 and then d1 of each 21-d cycle). Primary objectives were to evaluate safety and tolerability of alectinib plus atezolizumab. Secondary objectives included assessments of antitumor activity. RESULTS: In total, 21 patients received more than or equal to 1 dose of alectinib or atezolizumab. As no dose-limiting toxicities were observed in stage 1 (n = 7), the starting dose and schedule were continued into stage 2 (n = 14). Median duration of follow-up was 29 months (range: 1-39). Grade 3 treatment-related adverse events occurred in 57% of the patients, most often rash (19%). No grade 4 or 5 treatment-related adverse events were reported. Confirmed objective response rate was 86% (18 of 21; 95% confidence interval [CI]: 64-97). Median progression-free survival was not estimable (NE) (95% CI: 13 mo-NE), neither was median overall survival (95% CI: 33 mo-NE). CONCLUSIONS: The combination of alectinib and atezolizumab is feasible, but increased toxicity was found compared with the individual agents. With small sample sizes and relatively short follow-up, definitive conclusions regarding antitumor activity cannot be made

Brigatinib Versus Crizotinib in ALK Inhibitor–Naive Advanced ALK-Positive NSCLC: Final Results of Phase 3 ALTA-1L Trial

Introduction: In the phase 3 study entitled ALK in Lung cancer Trial of brigAtinib in 1st Line (ALTA-1L), which is a study of brigatinib in ALK inhibitor–naive advanced ALK-positive NSCLC, brigatinib exhibited superior progression-free survival (PFS) versus crizotinib in the two planned interim analyses. Here, we report the final efficacy, safety, and exploratory results. Methods: Patients were randomized to brigatinib 180 mg once daily (7-d lead-in at 90 mg once daily) or crizotinib 250 mg twice daily. The primary end point was a blinded independent review committee–assessed PFS. Genetic alterations in plasma cell-free DNA were assessed in relation to clinical efficacy. Results: A total of 275 patients were enrolled (brigatinib, n = 137; crizotinib, n = 138). At study end, (brigatinib median follow-up = 40.4 mo), the 3-year PFS by blinded independent review committee was 43% (brigatinib) versus 19% (crizotinib; median = 24.0 versus 11.1 mo, hazard ratio [HR] = 0.48, 95% confidence interval [CI]: 0.35–0.66). The median overall survival was not reached in either group (HR = 0.81, 95% CI: 0.53–1.22). Posthoc analyses suggested an overall survival benefit for brigatinib in patients with baseline brain metastases (HR = 0.43, 95% CI: 0.21–0.89). Detectable baseline EML4-ALK fusion variant 3 and TP53 mutation in plasma were associated with poor PFS. Brigatinib exhibited superior efficacy compared with crizotinib regardless of EML4-ALK variant and TP53 mutation. Emerging secondary ALK mutations were rare in patients progressing on brigatinib. No new safety signals were observed. Conclusions: In the ALTA-1L final analysis, with longer follow-up, brigatinib continued to exhibit superior efficacy and tolerability versus crizotinib in patients with or without poor prognostic biomarkers. The suggested survival benefit with brigatinib in patients with brain metastases warrants future study

Nivolumab versus docetaxel in previously treated advanced non-small-cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases

Abstract Background Long-term data with immune checkpoint inhibitors in non-small-cell lung cancer (NSCLC) are limited. Two phase III trials demonstrated improved overall survival (OS) and a favorable safety profile with the anti-programmed death-1 antibody nivolumab versus docetaxel in patients with previously treated advanced squamous (CheckMate 017) and nonsquamous (CheckMate 057) NSCLC. We report results from ≥3 years' follow-up, including subgroup analyses of patients with liver metastases, who historically have poorer prognosis among patients with NSCLC. Patients and methods Patients were randomized 1 : 1 to nivolumab (3 mg/kg every 2 weeks) or docetaxel (75 mg/m2 every 3 weeks) until progression or discontinuation. The primary end point of each study was OS. Patients with baseline liver metastases were pooled across studies by treatment for subgroup analyses. Results After 40.3 months' minimum follow-up in CheckMate 017 and 057, nivolumab continued to show an OS benefit versus docetaxel: estimated 3-year OS rates were 17% [95% confidence interval (CI), 14% to 21%] versus 8% (95% CI, 6% to 11%) in the pooled population with squamous or nonsquamous NSCLC. Nivolumab was generally well tolerated, with no new safety concerns identified. Of 854 randomized patients across both studies, 193 had baseline liver metastases. Nivolumab resulted in improved OS compared with docetaxel in patients with liver metastases (hazard ratio, 0.68; 95% CI, 0.50–0.91), consistent with findings from the overall pooled study population (hazard ratio, 0.70; 95% CI, 0.61–0.81). Rates of treatment-related hepatic adverse events (primarily grade 1–2 liver enzyme elevations) were slightly higher in nivolumab-treated patients with liver metastases (10%) than in the overall pooled population (6%). Conclusions After 3 years' minimum follow-up, nivolumab continued to demonstrate an OS benefit versus docetaxel in patients with advanced NSCLC. Similarly, nivolumab demonstrated an OS benefit versus docetaxel in patients with liver metastases, and remained well tolerated. Clinical trial registration CheckMate 017: NCT01642004; CheckMate 057: NCT01673867