Chronic myelogenous leukemia (CML) is a myeloproliferative disorder characterized at the molecular level by the expression of Bcr-abl, a 210-kDa fusion protein with deregulated tyrosine kinase activity. Encouraged by the clinical validation of Bcr-abl as the target for the treatment of CML by imatinib, we sought to identify pharmacological agents that could target this kinase by a distinct mechanism. We report the discovery of a new class of Bcr-abl inhibitors using an unbiased differential cytotoxicity screen of a combinatorial kinase-directed heterocycle library. Compounds in this class (exemplified by GNF-2) show exclusive antiproliferative activity toward Bcr-abl-transformed cells, with potencies similar to imatinib, while showing no inhibition of the kinase activity of full-length or catalytic domain of c-abl. We propose that this new class of compounds inhibits Bcr-abl kinase activity through an allosteric non-ATP competitive mechanism.
Aims To examine the impact of various factors affecting nurses' mental health during the COVID‐19 pandemic. Design An online cross‐sectional study. Methods Registered nurses who graduated from a nursing school in Southern California, USA, participated in the study from 20 April–10 May 2020 ( N = 320). Kendall's tau correlations and multivariate logistic regression procedures were performed with stress, anxiety and depression as outcome variables. Results Most nurses reported moderate/high stress (80.1%), while 43% and 26% reported moderate/severe anxiety and depression, respectively. COVID‐19 patient care was positively associated with moderate/severe high stress (OR = 2.25; p = .012) and moderate/severe anxiety (OR = 3.04; p < .001), whereas quarantine was associated with moderate/severe depression (OR = 2.68; p < .001). High levels of family functioning, resilience and spirituality predicted two‐ to sixfold lower odds of moderate/severe stress, anxiety or depression. High resilience, spirituality and family functioning appear to be good coping mechanisms for nurses against stress, anxiety and depression during the pandemic.
The COVID-19 pandemic and consequent lockdown have precipitated significant disruption in the educational system. Nursing students are known to have higher levels of stress and anxiety than other non-nursing students, but there is a dearth of evidence regarding the impacts of the COVID-19 lockdown on their mental health and coping mechanisms. Purpose: The aim of this study was to explore the influence of coping mechanisms as predictors of stress, anxiety, and depression among nursing students during the COVID-19 lockdown. Methods: A cross-sectional online survey was conducted from 20 April to 10 May 2020 among 173 nursing students at a private university in Southern California, USA. Results: Self-reported stress, anxiety, and depression were significantly higher during the lockdown compared to the pre-lockdown period (p < 0.001). Almost a quarter of participants reported high stress, while more than half reported moderate-to-severe symptoms of anxiety and depression. High resilience was negatively associated with high stress (Odds Ratio (OR) = 0.46; 95% Confidence Interval (CI) = 0.22–0.98; p = 0.045), moderate-to-severe anxiety (OR = 0.47; 95%CI = 0.25–0.90; p = 0.022), and moderate-to-severe depression (OR = 0.50; 95%CI = 0.26–0.95; p = 0.036). Similarly, high family functioning was negatively associated with high stress (OR = 0.41; 95%CI = 0.20–0.86; p = 0.018), moderate-to-severe anxiety (OR = 0.41; 95%CI = 0.21–0.80; p = 0.009), and moderate-to-severe depression (OR = 0.41; 95%CI = 0.20–0.81; p = 0.011). High spiritual support was negatively associated with moderate-to-severe depression (OR = 0.48; 95%CI = 0.24–0.95; p = 0.035). Conclusions: During the COVID-19 lockdown, nursing students experienced remarkable levels of poor mental health. High levels of resilience and family functioning were associated with 2- to 2.4-fold lower risk of stress, anxiety, and depression, whereas high spiritual support was associated with 2-fold lower risk of depression. As the pandemic evolves, fostering these coping mechanisms may help students to maintain their psychological wellbeing.
Outpatient management of HDC/ASCR is safe and acceptable for the vast majority of patients. The STOT program resulted in significant reduction in hospital LOS, while the TOT program appears equally safe and further reduces LOS. Hospitalization for HDC/ASCR is unnecessary in most patients.
The purpose of this study was to review the incidence and type of complications associated with the insertion and use of central venous catheters for leukapheresis and high-dose chemotherapy with stem cell rescue. One hundred sixty-seven central venous catheters placed either at the transplant center or by various community surgeons were studied for insertion complications, inability to perform leukapheresis and incidence of infection. The overall incidence of hemo- or pneumothorax was 3.6%. Inability to pherese occurred in 13% of catheters placed by outside surgeons and 6.5% of catheters inserted at the transplant institution. Most often, these were due to malposition of the catheter too high in the superior vena cava or in other veins. Deep venous thrombosis was often related to this malposition and occurred in 4.8% of all patients. Pulmonary embolism was not seen in these patients despite the fact the catheters were often left in place during the thrombotic episode. Early or late-onset infections occurred in 6.5% of patients and were most often exit site infections. The incidence of complications of pheresis catheters is high but might be reduced by more attention to proper placement of the catheter closer to the right atrial/superior vena cava junction, and limiting insertion to a cadre of surgeons familiar with leukapheresis requirements.
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