IMPORTANCEPatients with breast cancer and brain metastases (BM) have a poor prognosis and high clinical need for novel treatments; however, historically, studies have often excluded these patients. Although the BEACON study did not meet its primary end point, treatment with etirinotecan pegol vs chemotherapy of the physician's choice for patients with advanced breast cancer demonstrated a significant improvement in overall survival (OS) for the prespecified patient subgroup with preexisting, pretreated, and nonprogressive BM.OBJECTIVE To compare clinical outcomes in patients with BM treated with etirinotecan pegol vs chemotherapy of the physician's choice in a confirmatory trial. DESIGN, SETTING, AND PARTICIPANTSThis study was a phase 3, open-label, randomized clinical trial (ATTAIN) in patients with metastatic breast cancer and a history of stable pretreated BM who experienced disease progression while receiving chemotherapy in the metastatic setting. The trial took place at 47 sites in 10 countries, and patients were enrolled between March 7, 2017, and November 6, 2019.INTERVENTIONS Patients were randomized to receive etirinotecan pegol, 145 mg/m 2 , every 21 days or chemotherapy (eribulin, ixabepilone, vinorelbine, gemcitabine, paclitaxel, docetaxel, or nab-paclitaxel). MAIN OUTCOMES AND MEASURESThe primary end point was OS. Key secondary end points included progression-free survival, objective response rate, duration of response, and the clinical benefit rate. RESULTS A total of 178 female patients (9 [5.1%] Asian, 8 [4.5%] Black or African American, and 123 [69.1] White individuals) were randomized to receive treatment with etirinotecan pegol (92 [51.7%]; median [range] age, 53 [27-79] years) or chemotherapy (86 [48.3%]; median [range] age, 52 [24-77] years). Median OS was similar in both groups (etirinotecan pegol, 7.8 months; chemotherapy, 7.5 months; hazard ratio [HR], 0.90; 95% CI, 0.61-1.33; P = .60). Median progression-free survival for non-central nervous system metastases per blinded independent central review for etirinotecan pegol vs chemotherapy was 2.8 and 1.9 months (HR, 0.72; 95% CI, 0.45-1.16; P = .18) and 3.9 vs 3.3 months, respectively, for central nervous system metastases (HR, 0.59; 95% CI, 0.33-1.05; P = .07). Safety profiles between the groups were largely comparable. CONCLUSIONS AND RELEVANCEThe results of the ATTAIN randomized clinical trial found no statistically significant difference in outcomes between treatment with etirinotecan pegol and chemotherapy in patients with BM. However, this study represents one of the largest published trials dedicated to patients with breast cancer and BM and may help to inform further research.
On children, HIIT program is being used by coaches as a way of rapid improvement. The values of the intervals vary from the target of the period. The study's purpose was to find out if HIIT in different interval protocols improves children's swimming performance. In the study participated 18 rookie swimmers (9 boys and 9 girls), aged 11.6 ±1.5. The HIIT protocol in both groups included the set of 2 × 4 × 17.5 m (freestyle and freestyle kick, respectively). The first group (HIIT 1) had a 10 sec interval while the second (HIIT 2)-a 1 min between the HIIT reps. Swimmers performed in 35 m freestyle (35F) and 2 min free kick (2' FK) trials at maximum effort. The performance (T), the number of strokes (SN) and the stroke length (SL) were measured at 35F, the covered distance at 2' FK and the heart rate (HR), the rated perception of exertion (RPE) at 35F and 2' FK. Regarding the results, all parameters improved significantly (p = 0.01). The use of a 4-week swimming program with training 4 times per week, in which two were HIIT, improved children's performance and efficiency in swimming. Intervals of 10 sec or 1 min did not alter the improvement.
Sprint interval training (SIT) sets are commonly used by coaches in the training routine of swimmers competing in short-distance events; however, data regarding their relevance to competitive events are scarce. The aim of this study was to examine whether performance variables differed or correlated between a 4 × 50-m maximal swimming set (with a work-to-rest ratio of 1:4) and the 100-m freestyle event. Eleven male and 16 female competitive swimmers aged 16.1 ± 1.1 years participated in the study. All swimmers trained at least six times a week and had training experience of more than 4 years. They completed the two freestyle tests on different days, in random and counterbalanced order. In each test, speed, blood lactate, stroke rate (SR), and stroke index (SI) were measured. Speed, blood lactate, and SR were higher at the 4 × 50 m compared to the 100 m and were positively correlated between tests (p < 0.001). The SI did not differ significantly, but was positively correlated between tests. Males were faster and had a higher SI than females, but genders did not differ in lactate. Since performance variables were better in the SIT set and correlated with those in the 100-m bout, we suggest that the 4 × 50-m set can be used to improve performance in the 100-m freestyle event. Moreover, this set can help coaches identify which swimmers will swim fastest in the event.
A lifestyle factor which contributes to the remission of Crohn’s disease (CD) is physical activity. The effect seems to positively impact the disease’s symptoms, improving the quality of life, especially on patients in remission. Due to the lack of clinical studies about the effects of physical activity on active CD patients, the purpose of the present case study was to record the influence of swimming training (aerobic type of exercise) on an athlete with active CD. In this study participated a 22-year-old male, who is an elite swimmer and who was diagnosed in 2019 with CD. The research was conducted over the last three years (2019–2022). Both the athlete and doctor consented to the clinical examinations by the author. According to the present study, immediate medical examination and the prescription of anti-TNF-α therapy is probably the most appropriate solution for someone who is diagnosed with CD symptoms. Moreover, patient participation in any sport activity is discouraged because of the potential danger of exacerbation of the symptoms. Therefore, for the sake of patient safety, physical activity should only be encouraged when the disease is in remission.
In 1932, Burrill B. Crohn first published his report on a disease that mainly affects young adults by causing inflammation in the intestines and, specifically, the ileum [1] [...]
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