Gifted education today faces a significant challenge in reaching equity as well as excellence. This is reflected in the disproportionate underrepresentation of children from Black, Hispanic, Native, and low-income families. This pattern of underrepresentation within programs for students with gifts and talents is pervasive and pernicious and impacts gifted education programming across all 50 states in the United States of America. This article describes the efforts of Milwaukee Public Schools, a large urban school district in Wisconsin, to address the need for both equity and excellence within their gifted education programming. The U~STRARS~PLUS model formed the foundation for changing the culture of the schools from “at risk” to “at potential”. Dedicated leadership and the combination of securing external support, developing internal trust, and building capacity across the district were critical to creating a strength-based focus within the schools. While the journey is not over, the authors hope that others can learn from Milwaukee’s experiences.
CD23 is highly expressed on the cell surface of certain B-cell malignancies including chronic lymphocytic leukemia (CLL). Lumiliximab (L-mab), a macaque-human chimeric anti-CD23 antibody, has been reported to have antitumor activity against CLL in preclinical studies. In this 46 patient, Phase I, multicenter study, single-agent L-mab was evaluated as a treatment for patients with relapsed or refractory CLL. Therapy consisted of intravenous L-mab given as 6 regimens: (1) 125 mg/m2/wk for 4 weeks; (2) 250 mg/m2/wk for 4 weeks; (3) 375 mg/m2/wk for 4 weeks; (4) 500 mg/m2/wk for 4 weeks; (5) 500 mg/m2 for 3 doses during Week 1, then 500 mg/m2/wk during Weeks 2 to 4; and (6) 500 mg/m2 three times a week for 4 weeks. Pharmacokinetics (PK) and pharmacodynamic measurements were evaluated in patients with adequate data. L-mab and anti-L-mab antibody concentrations in plasma were measured by ELISA. L-mab coating of CLL cells and CD23 density on CLL cells were evaluated by flow cytometry. The absence of sustained L-mab concentrations did not allow PK calculations at the 125 mg/m2/wk and 250 mg/m2/wk dose levels. Doses at 375 mg/m2/wk or higher resulted in coating of CD23 binding sites on CLL cells and saturable PK (see table). Anti-L-mab antibody formation was not detected. CD23 density on CLL cells did not change during or after L-mab treatment. In summary, L-mab exhibits saturable PK, low clearance, and low volume of distribution without an immunogenic response. No down regulation of CD23 expression was observed on CLL cells in any dose group, and complete coating of CD23 sites was observed. Median Pharmacokinetic Parameters Treatment Group n C max(μ g/mL) Clearance (mL/m2/day) Volume of Distribution (mL/m2) Half-life (days) 1 3 39 - - - 2 3 84 - - - 3 8 180 310 3.02 7.9 4 9 245 335 3.22 7.3 5 8 430 406 3.45 5.4 6 9 654 293 3.58 10.6
A 64-year-old male presents with acute encephalopathy and upon further evaluation, he was found to have lymphadenopathy in the neck and parotid region. Subsequent lumbar puncture (LP) revealed the presence of blast cells in the CSF concerning for leukemic meningitis. A lymph node biopsy was consistent with CD5 positive DLBCL. He was started on chemotherapy with Hyper-CVAD and intrathecal methotrexate, improving his clinical condition but he was lost to follow up.Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Diagnosis is based on symptoms and excisional lymph node biopsy with immunotyping. It is extremely important to have a lymph node biopsy if suspicious for lymphoma because of its aggressive nature. Indicators for such include CD5 positivity and extranodal involvement. The risk factors for CNS involvement in DLBCL include high International Prognostic Index (IPI) score, bone marrow involvement, and extranodal involvement such as bone, lung and testis.The purpose of the report is to emphasize the importance of ruling out lymphoma when diffuse lymphadenopathy is present in the setting of encephalopathy; the potential of aggressive behavior of this disease including involvement of the CNS; and discussing the overall social determinants of health for this patient resulting in delayed diagnosis and lack of an optimal treatment plan to be carried out.
Multiple primary malignancies (MPM) are an increasing trend seen in oncology due to factors of increased survival time of patients, environmental exposures and hereditary risk factors. The increase of diagnoses is also seen with more screenings as well as longer life expectancies. We present a 70 year old female who initially presented with trouble swallowing. It was revealed she had squamous cell carcinoma (SCC) of her epiglottis. PET scan work up revealed uptake in her left breast. Bilateral mammogram, ultrasound and biopsy revealed her left breast had invasive ductal carcinoma (IDC) and her right had invasive lobular carcinoma (ILC). With her smoking history and strong family history of cancer, she was highly susceptible to developing multiple primary malignancies She did not continue routine health screenings including mammogram and low dose CT chest which may have prevented or discovered her malignancies at an early stage. This is an emphasis on the importance of routine health surveillance and screening especially in the primary care setting.
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