No abstract

We assessed the outcomes of pomalidomide and dexamethasone treatment in relapsed/refractory multiple myeloma (RRMM) patients with ≥1 prior line of therapy. We analyzed the data of all RRMM patients treated with pomalidomide and dexamethasone at nine Czech centers between 2013 and 2018. The source of the data was the Registry of Monoclonal Gammopathies of the Czech Republic. Primary endpoints included response rates based on International Myeloma Working Group criteria and survival measures, including progression-free survival (PFS) and overall survival (OS). Secondary endpoints were toxicities and previous treatment patterns, including refractory to lenalidomide, and their impact on final outcomes. The overall response rate was 51.8% and the clinical benefit rate (including patients with minimal response) was 67.1%, with 0.6% of complete responses, 8.5% of very good partial responses, and 42.1% of partial responses (PR). Overall, 16.5% of patients had a minimal response, and 32.3% had stable disease /progression. Median PFS was 8.8 months and the median OS was 14.2 months. In patients who achieved ≥PR, the median PFS and OS were significantly longer compared to non-responders (median PFS (12.1 vs. 4.5 months, p≤0.001 respectively), median OS (22.1 vs. 7.7 months, p≤0.001, respectively). The most frequent adverse events (AEs) were neutropenia (29.9%) and anemia (18.9%), non-hematological AEs included infections (14.6%) and fatigue (7.3%). Our analysis confirmed the effectiveness of pomalidomide and dexamethasone in a real-world setting. This therapy achieved reasonable outcomes comparable to the data from clinical trials even though this was an unbiased cohort of patients.

Riziko je tématem, které je hluboce spjato s historií vzniku a rozvoje sociální práce. Riziko bylo dokonce kontextuální podmínkou vzniku a rozvoje sociální práce jako moderní společenské instituce, která se na přelomu 19. a 20. století začala v USA a v západní Evropě rozvíjet jako profese, jejíž úkol byl mnohými spatřován právě v eliminaci důsledků dramatických společenských procesů vyvolávajících obavu, pocit rizika a nejistotu. V uplynulých 20 letech se téma rizika opět vrátilo do diskursu sociálních věd a s novými akcenty je tematizováno také v sociální práci. V našem příspěvku se zabýváme konceptem rizika jako inherentním aspektem sociální práce. Na základě 16 provedených rozhovorů se sociálními pracovníky a pracovnicemi analyzujeme přítomnost (vědomí) rizika a rizikovosti v jejich činnostech. Cílem příspěvku je identifikovat zdroje rizika v sociální práci a porozumět prožívání nejistoty, rizika a rizikovosti v činnostech sociálních pracovníků a pracovnic, kteří působí v oblasti sociálně právní ochrany dětí.

Background:Background: Multiple myeloma (MM) is the second most common hematological malignancy of the elderly. The bone marrow is infiltrated by malignant plasma cells. MM may progress into so-called extramedullary disease (EMD) -EMD occurs when a subclone of malignant plasma cells migrates out of the bone marrow and infiltrates soft tissues. Despite recent progress, pathogenesis of EMD still needs to be clarified. Aims:Aims: We focused on the analysis of low molecular weight molecules in peripheral blood of 20 MM and 20 EMD patients using MALDI-TOF mass spectrometry to create a tool for identification of MM and EMD, and discrimination of individual types. Methods:Methods: Matrix-Assisted Laser Desorption/Ionization Time-of Flight Mass Spectrometry (MALDI-TOF MS) has become an indispensable research tool, which is used for analysis of biomolecules and various organic molecules. Artificial Neural Networks (ANN) are components of artificial intelligence inspired by biological neural networks. Using ANN, we can model complex non-linear systems, as previously published. In our previous study, we recorded mass spectra of MM and healthy donor samples. ANN specifically predicted MM samples with high sensitivity, specificity and accuracy. The same approach as applied on MM and EMD. Results:Results: The RStudio was used for statistical analysis, where the data were evaluated using Principal Component Analysis (PCA) and Partial least squares discriminant analysis (PSL-DA). Using MALDI-TOF MS, it was possible to distinguish between samples of MM patients and healthy donors, as well as MM and EMD patients. Informative patterns in mass spectra served as inputs for ANN that specifically distinguished between healthy donors and patients.

The authors present the topic of professional social workers and social pedagogues' attitudes and practice towards complementary (healthcare, psychotherapy, special education) and alternative (ayurveda, homeopathy, music therapy, yoga, meditation) medicine for children with autism spectrum disorders in Indian Kerala. Field research was conducted directly in the Indian state of Kerala with professional social workers using a qualitative research strategy in the form of semi-structured interviews. The aim of the study was to gain better understanding of the cultural context and specific features of psychiatric social work in India.