Systolic blood pressure was measured in 112 subjects practicing the Transcendental Meditation (TM) and TM-Sidhi programs. The subjects were between the ages of 35 and 64 years. A significant difference was found between the systolic blood pressures of subjects (matched for sex, race, and general educational background) practicing the TM and TM-Sidhi programs and norms for the general population. This difference was independent of diet and exercise patterns but related to length of time meditating. A significant difference was also found between short-term (under 5 years) and long-term (over 5 years) participants of the TM program, covarying for age. No previous reports exist concerning the long-term effects of the TM program on blood pressure. Despite methodological problems associated with cross sectional data, the findings suggest the beneficial effects of the long-term practice of the TM and TM-Sidhi programs on systolic blood pressure. Even if self-selection plays a role, the characteristics of an easily identifiable group already showing traits beneficial to the general population deserves further study.
Reports suggest reasonable efficacy and minimal myelosuppression from combination imatinib and hydroxyurea for recurrent malignant glioma. We retrospectively reviewed 16 patients treated with this regimen who were evaluable for toxicity; 14 were also evaluable for response. The incidence of grade 3-4 hematologic toxicity was 25%. The best radiographic response, by Macdonald criteria, was partial response (PR) in three patients (21%), stable disease (SD) in four (29%), and progressive disease (PD) in seven (50%). One patient with a PR developed therapy-limiting hematologic toxicity on day 19 of treatment, progressing to grade 4 on day 64, and persisting until death on day 127 despite discontinuing both drugs. Another patient with PR and two of four patients with SD also developed grade 3 hematologic toxicity. All patients with grade 3-4 hematologic toxicity had disease control (PR or SD) as best radiographic response, whereas none with PD suffered grade 3-4 hematologic toxicity. Combining imatinib with hydroxyurea is effective in some patients with malignant glioma. However, myelosuppression can persist for months after discontinuing the regimen, precluding further chemotherapy. Disease control may also correlate with hematologic toxicity (p = 0.08), suggesting that glioma and marrow stem cells may share a common sensitivity to this chemotherapy regimen.
The patient is a 79-year-old Caucasian man, who was in his usual state of health until August 2017, when he reported sore teeth during the fitting of a continued positive airway pressure machine. He developed a yellow nasal discharge and was treated with antibiotics. In November 2017, the patient reported left-sided facial numbness and bulging of the left cheek.Computed tomography (CT) scan of the face showed a 4.5 Â 4 cm left maxillary mass with maxillary bone destruction (Figure 1(A)). A biopsy of the mass revealed large malignant cells with oval to round nuclear contours, open chromatin, variably conspicuous eosinophilic nucleoli, and moderately abundant cytoplasm. There is frequent individual cell necrosis, increased mitotic figures, and large areas of zonal tumor necrosis. Tumor cells were positive for CD138, MUM1, and CD4 and negative for PAX5, CD20, CD30, CD3, CD34, ALK, EBV LMP1, and HHV8 LANA1. There was a weak, variable expression of EMA and CD45. Epstein-Barr virusencoded RNA (EBER) in situ hybridization was strongly positive. There was a clonal immunoglobulin heavy chain gene rearrangement. Serology studies for HIV, hepatitis B, and hepatitis C were nonreactive. Serum lactate dehydrogenase level was within normal limits. Positron emission CORRESPONDENCE E391
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