Do Herbal Supplements and Probiotics Complement Antibiotics and Diet in the Management of SIBO? A Randomized Clinical Trial.

Small intestinal bacterial overgrowth (SIBO) arises from dysbiosis in the small intestine, manifesting with abdominal symptoms. This study aims to assess the efficacy of combined antibiotic therapy, herbal supplements, probiotics, and dietary modifications in SIBO management. A total of 179 SIBO-diagnosed patients underwent clinical evaluation and breath testing. Patients were categorized into hydrogen (H2-SIBO) and methane (CH4-SIBO) groups. The control group received standard antibiotic therapy and a low-FODMAP diet, while the intervention group received additional herbal antibiotics, probiotics, and prebiotics. After treatment, both groups exhibited reduced gas levels, particularly in CH4-SIBO. Clinical remission rates were higher in the intervention group, especially in CH4-SIBO cases. Logistic regression analysis showed gas concentrations at diagnosis as significant predictors of treatment success. In conclusion, adjunctive herbal supplements and probiotics did not significantly impact gas levels, but showed potential for clinical improvement, especially in CH4-SIBO.

ATOMICC trial: a randomized, open-label, phase II trial of anti-PD1, dostarlimab, as maintenance therapy for patients with high-risk locally advanced cervical cancer after chemoradiation.

BACKGROUND: Currently, women diagnosed with high-risk locally advanced cervical cancer are at high risk of recurrence after treatment with concurrent chemoradiation and represent a population with high unmet need. PRIMARY OBJECTIVE: The primary objective is to evaluate the progression-free survival of high-risk locally advanced cervical cancer patients who have achieved a partial or complete response after chemoradiation after receiving dostarlimab as maintenance therapy. STUDY HYPOTHESIS: The study aims to demonstrate that the use of dostarlimab, as maintenance therapy, would significantly increase progression-free survival in these patients. TRIAL DESIGN: ATOMICC trial is a phase II, randomized, open-label, multicenter study to assess the efficacy and safety of anti-PD1, dostarlimab, as maintenance therapy in patients with high-risk locally advanced cervical cancer who have achieved a partial or complete response after chemoradiation. The control arm entails a clinical and radiological follow-up, with no further treatment (current standard of care). ATOMICC trial is an investigator-driven trial sponsored by GEICO (Grupo Español de Investigación en Cáncer de Ovario) and supported by GlaxoSmithKline (GSK). MAJOR INCLUSION/EXCLUSION CRITERIA: Women aged over 18 years with a biopsy-confirmed squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix meeting the following staging criteria: International Federation of Gynecology and Obstetrics (FIGO) 2009 stages IB2, IIA2, IIB with pelvic lymph node involvement, FIGO stages IIIA, IIIB, IVA, and any FIGO 2009 stage with para-aortic lymph node involvement are eligible for the trial. All patients must have achieved a partial or complete response after definitive concurrent chemoradiation. Women diagnosed with FIGO stage IVB, having undergone a previous hysterectomy, or having a history of active autoimmune disease will not be considered eligible. PRIMARY ENDPOINT: Progression-free survival defined as the time from the date of randomization to the date of first disease progression or death due to any cause, whichever occurs first. SAMPLE SIZE: A total of 132 patients are expected to be recruited in the study, using a 1:2 (control:experimental arm) randomization allocation ratio. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: The trial was launched in Q2-2019 and the trial is estimated to be closed for recruitment in Q3-2022. Results are expected to be released in Q3-2024. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov (NCT03833479).

Secured Perimeter with Electromagnetic Detection and Tracking with Drone Embedded and Static Cameras.

Perimeter detection systems detect intruders penetrating protected areas, but modern solutions require the combination of smart detectors, information networks and controlling software to reduce false alarms and extend detection range. The current solutions available to secure a perimeter (infrared and motion sensors, fiber optics, cameras, radar, among others) have several problems, such as sensitivity to weather conditions or the high failure alarm rate that forces the need for human supervision. The system exposed in this paper overcomes these problems by combining a perimeter security system based on CEMF (control of electromagnetic fields) sensing technology, a set of video cameras that remain powered off except when an event has been detected. An autonomous drone is also informed where the event has been initially detected. Then, it flies through computer vision to follow the intruder for as long as they remain within the perimeter. This paper covers a detailed view of how all three components cooperate in harmony to protect a perimeter effectively, without having to worry about false alarms, blinding due to weather conditions, clearance areas, or privacy issues. The system also provides extra information of where the intruder is or has been, at all times, no matter whether they have become mixed up with more people or not during the attack.

Systemic treatment of newly diagnosed advanced epithelial ovarian cancer: From chemotherapy to precision medicine.

Despite optimal first-line treatment based on debulking surgery and platinum-paclitaxel chemotherapy, most of the patients with advanced ovarian cancer (AOC) will eventually relapse. Over the last decades, different strategies have been assessed to improve AOC patients' outcomes in the front-line treatment. However, first line treatment landscape of AOC had not undergone major changes until the last three years. In the present review, we will navigate through the different therapeutic approaches developed in first-line AOC which range from variations in dose/administration via of conventional carboplatin-based chemotherapy to the incorporation of anti-angiogenic agents and PARP inhibitors.

Engineering Behavior and Characteristics of Wood Ash and Sugarcane Bagasse Ash.

Biomasses are organic materials that are derived from any living or recently-living structure. Plenty of biomasses are produced nationwide. Biomasses are mostly combusted and usually discarded or disposed of without treatment as biomass ashes, which include wood and sugarcane bagasse ashes. Thus, recycling or treatment of biomass ashes leads to utilizing the natural materials as an economical and environmental alternative. This study is intended to provide an environmental solution for uncontrolled disposal of biomass ashes by way of recycling the biomass ash and replacing the soils in geotechnical engineering projects. Therefore, in this study, characteristic tests of wood and sugarcane bagasse ashes that are considered the most common biomass ashes are conducted. The test of chemical compositions of biomass ashes is conducted using energy dispersive X-ray spectroscopy (EDS), and Scanning Electron Microscope (SEM), and heavy metal analysis is also conducted. Engineering behaviors including hydraulic conductivity, constrained modulus and shear modulus are examined. Also, coal fly ash Class C is used in this study for comparison with biomass ashes, and Ottawa 20/30 sands containing biomass ashes are examined to identify the soil replacement effect of biomass ashes. The results show that the particle sizes of biomass ashes are halfway between coal fly ash Class C and Ottawa 20/30 sand, and biomass ashes consist of a heterogeneous mixture of different particle sizes and shapes. Also, all heavy metal concentrations were found to be below the US Environmental Protection Agency (EPA) maximum limit. Hydraulic conductivity values of Ottawa 20/30 sand decrease significantly when replacing them with only 1%-2% of biomass ashes. While both the constrained modulus and shear modulus of biomass ashes are lower than Ottawa 20/30 sand, those of mixtures containing up to 10% biomass ashes are little affected by replacing the soils with biomass ashes.

Transformation of vulvar pseudolymphoma (lymphoma-like lesion) into a marginal zone B-cell lymphoma of labium majus.

Lymphomas arising in the female genital tract are extremely uncommon. Diffuse large B-cell lymphoma and follicular lymphoma are the most common types. We describe the case of an 80-year-old woman with a recurrent lesion in the vulva initially diagnosed as a lymphoma-like lesion and evolving 7 years later into a marginal zone B-cell lymphoma (lymphoplasmacytic lymphoma). Diagnosis was based on the monotypic pattern of the plasmacellular component and the clonal rearrangement of immunoglobulin heavy chain genes. No previous cases of vulvar marginal zone B-cell lymphoma arising in the context of a persistent lymphoma-like lesion have been reported. We highlight the importance of differentiating benign from malignant lymphoid infiltrates in the vulva.

Is hysterosalpingography able to diagnose all uterine malformations correctly? A retrospective study.

BACKGROUND: Mullerian duct anomalies are an uncommon but often a treatable cause of infertility. MATERIAL AND METHODS: From January 2002 until November 2003, a total of 705 hysterosalpingographies were realised of which 658 were analysed retrospectively in order to determine the importance of uterine malformations in infertile and sterile patients. In ten cases, the results of hysterosalpingography were compared with hysteroscopy and laparoscopy. RESULTS: The frequency of uterine malformations in infertile and sterile women was 10%. In this population, arcuate uterus (57.6%) was the most common malformation, followed by subseptate uterus (18.2%), uterus bicornis unicollis (10.6%), uterus bicornis bicollis (3.0%), septate uterus (6.1%), unicornuate uterus (3.0%) and unicornuate uterus with double vagina (1.5%). DISCUSSION: Our bibliographic research confirmed that arcuate uterus is the most frequent congenital malformation, but in gestations it does not show a significantly reduced live birth rate. Nevertheless, the septate uterus presents an important decrease of live birth rate that can be improved significantly by doing hysteroscopic metroplasty. As this is a completely different surgical intervention compared to bicornuate uterus, a correct diagnosis is very important. Differentiation of these two malformations is quite difficult by hysterosalpingographic exploration, wherefore an additional exploration by means of endovaginal or three-dimensional ultrasound is recommended.