Successful desensitisation to paclitaxel with omalizumab.

We present the case of a patient with failed desensitisation to paclitaxel that was ultimately successful with omalizumab treatment. Our patient, a female aged between 20-25 and diagnosed with a triple negative breast cancer, received first-line treatment with carboplatin and paclitaxel. During the second cycle of paclitaxel, she experienced heat, dyspnoea, facial angioedema and vomiting. Skin tests for allergic reactions returned negative results, and drug provocation tests showed a positive result (anaphylaxis). Rapid drug desensitisation (RDD) was carried out with two bags of dilutions but at the beginning of the infusion, the patient experienced symptoms again, so the infusion was stopped. Therefore, the use of omalizumab, already reported as a successful adjuvant in desensitisation to other drugs, was considered. The anti-immunoglobulin E (IgE) monoclonal antibody was administered off-label before the first programmed desensitisation with success: total dose of paclitaxel was infused without any reaction. The patient was able to receive the complete chemotherapy treatment.

Clinical and inflammatory characteristics of patients with asthma in the Spanish MEGA project cohort.

INTRODUCTION: The MEGA (MEchanism underlying the Genesis and evolution of Asthma) project is a multicenter cohort study carried out in eight Spanish hospitals, gathering clinical, physiological, and molecular data from patients with asthma and multimorbidities in order to gain insight into the different physiopathological mechanisms involved in this disorder. MATERIAL AND METHODS: We report the baseline clinical and physiological characteristics and biomarker measures of adult participants in the project with the aim of better understanding the natural history and underlying mechanisms of asthma as well as the associated multimorbidities across different levels of severity. We carried out a detailed clinical examination, pulmonary function testing, measurement of fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick tests, chest computed tomography scan, asthma questionnaires, and multimorbidity assessment in 512 asthmatic patients. RESULTS: When compared to patients with milder disease, severe asthmatic patients showed greater presence of symptoms, more exacerbations, lower asthma control, increased airflow obstruction, and higher frequency of chronic rhinosinusitis with nasal polyps, severe rhinitis, anxiety and depression, gastroesophageal reflux, and bronchiectasis. CONCLUSION: The MEGA project succeeded in recruiting a high number of asthma patients, especially those with severe disease, who showed lower control and higher frequency of multimorbidities.

Estudio comparativo de la limpieza de las preparaciones para anclaje intrarradicular inmediatas y mediatas / A comparative study of the cleaning of immediate and mediate preparations for intra-radicular anchorage

El propósito del presente estudio fue evaluar la capacidad de limpieza luego de la preparación para anclaje intrarradicular con diferentes métodos. Se emplearon 30 caninos humanos extraídos, cuyos conductos radiculares fueron instrumentados y posteriormente obturados con cemento de Grossman y conos de gutapercha con la técnica híbrida. Los especímenes se dividieron al azar en 3 grupos. Grupo I: preparación para anclaje intrarradicular inmediata; grupo II: preparación medianta, limpieza con Endobrush cilíndrico embebido en alcohol a los 7 días de la obturación endodóntica y limpieza con Endobrush cilíndrico embebido en alcohol por 10 seg. Los dientes fueron radiografiados en sentido orto-radial y mesio-distal. A continuación se seccionaron los especímenes a la altura de los tercios cervical, medio y apical de la preparación para anclaje. Las radiografías fueron evaluadas con una lupa X3 y los cortes transversales por medio de un microscopio óptico a X10. Los resultados no mostraron diferencias estadísticas significativas entre los grupos ni entre los diferentes tercios de cada grupo (p>0.05). La frecuencia y cantidad de material obturador remanente fueron mayores en las caras libres que en las caras proximales. En tanto, en las imágenes radiográficas no fue posible detectar restos pequeños de material obturador; éstos sí fueron observados en el análisis microscópico. Como conclusión podemos señalar que el emplo del Endobrush cilíndrico embebido en alcohol no mejoró la limpieza obtenida por la preparación convencional.