RESUMO
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have renal and cardiovascular benefits in addition to their glucose-lowering potential. Data on the efficacy and safety of SGLT2i in Australian Aboriginal and Torres-Strait Islanders are lacking. We conducted a single-centre retrospective study assessing the safety and effects on glycaemic control and albuminuria of SGLT2i in Aboriginal and Torres Strait Islander patients with type 2 diabetes mellitus.
Assuntos
Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose , Simportadores , Humanos , Austrália/epidemiologia , Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucose , Estudos Retrospectivos , Sódio , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêuticoAssuntos
Medidas de Resultados Relatados pelo Paciente , Sistema de Registros , Macroglobulinemia de Waldenstrom/epidemiologia , Antineoplásicos/uso terapêutico , Austrália , Ensaios Clínicos como Assunto , Estudos de Viabilidade , Saúde Global/estatística & dados numéricos , Humanos , Padrões de Prática Médica , Qualidade de Vida , Macroglobulinemia de Waldenstrom/tratamento farmacológico , Macroglobulinemia de Waldenstrom/psicologiaRESUMO
In a phase I study of autologous chimeric antigen receptor (CAR) anti-LeY T-cell therapy of acute myeloid leukemia (AML), we examined the safety and postinfusion persistence of adoptively transferred T cells. Following fludarabine-containing preconditioning, four patients received up to 1.3 × 109 total T cells, of which 14-38% expressed the CAR. Grade 3 or 4 toxicity was not observed. One patient achieved a cytogenetic remission whereas another with active leukemia had a reduction in peripheral blood (PB) blasts and a third showed a protracted remission. Using an aliquot of In111-labeled CAR T cells, we demonstrated trafficking to the bone marrow (BM) in those patients with the greatest clinical benefit. Furthermore, in a patient with leukemia cutis, CAR T cells infiltrated proven sites of disease. Serial PCR of PB and BM for the LeY transgene demonstrated that infused CAR T cells persisted for up to 10 months. Our study supports the feasibility and safety of CAR-T-cell therapy in high-risk AML, and demonstrates durable in vivo persistence.
Assuntos
Imunoterapia Adotiva , Leucemia Mieloide Aguda/terapia , Antígenos do Grupo Sanguíneo de Lewis/imunologia , Receptores de Antígenos de Linfócitos T/imunologia , Linfócitos T/imunologia , Idoso , Medula Óssea/imunologia , Feminino , Humanos , Leucemia Mieloide Aguda/imunologia , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Condicionamento Pré-Transplante , Vidarabina/análogos & derivados , Vidarabina/uso terapêuticoRESUMO
The HealthGap study aimed to understand cardiovascular risk among Indigenous Australians in Victoria using linked administrative data. A key challenge was differing spatial coverages of sources: state-level data for risk factors but cardiovascular outcomes for three hospitals. Catchments were defined based on hospital postcodes to estimate denominator populations for risk modelling: first- and second-order neighbours, and spatial distribution of outcomes ('spatial event distribution'). Catchment coverage was assessed through proportions of patients presenting to study hospitals from catchment postcodes. The spatial event distribution performed best, capturing 82% events overall (first-order:40%; second-order:64%) and 65% Indigenous (27% and 45%). No approach excluded proximal non-study hospitals. Spatial event distributions could help define denominator populations when geographic information on outcome data is available but may not avoid potential misclassification.
Assuntos
Doenças Cardiovasculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/epidemiologia , Área Programática de Saúde , Fatores de Risco , Vitória/epidemiologiaRESUMO
The Australian Partnership for Preparedness Research on InfectiouS disease Emergencies (APPRISE) has developed a virtual biobank to support infectious disease research in Australia. The virtual biobank (https://apprise.biogrid.org.au) integrates access to existing distributed infectious disease biospecimen collections comprising multiple specimen types, including plasma, serum, and peripheral blood mononuclear cells. Through the development of a common data model, multiple collections can be searched simultaneously via a secure web portal. The portal enhances the visibility and searchability of existing collections within their current governance and custodianship arrangements. The portal is easily scalable for integration of additional collections.