Treatment of patients with advanced medullary thyroid carcinoma (MTC) is still a challenge. For more than 2 decades, it has been known that the cholecystokinin 2 receptor is a promising target for the treatment of MTC with radiolabeled minigastrin analogs. Unfortunately, kidney toxicity has precluded their therapeutic application so far. In 6 consecutive patients, we evaluated with advanced 3-dimensional dosimetry whether improved minigastrin analog ¹⁷⁷Lu-DOTA-(d-Glu)₆-Ala-Tyr-Gly-Trp-Nle-Asp-PheNH₂ (¹⁷⁷Lu-PP-F11N) is a suitable agent for the treatment of MTC. Methods: Patients received 2 injections of about 1 GBq (~80 μg) of ¹⁷⁷Lu-PP-F11N with and without a solution of succinylated gelatin (SG, a plasma expander used for nephroprotection) in a random crossover sequence to evaluate biodistribution, pharmacokinetics, and tumor and organ dosimetry. An electrocardiogram was obtained and blood count and blood chemistry were measured up to 12 wk after the administration of ¹⁷⁷Lu-PP-F11N to assess safety. Results: In all patients, ¹⁷⁷Lu-PP-F11N accumulation was visible in tumor tissue, stomach, and kidneys. Altogether, 13 tumors were eligible for dosimetry. The median absorbed doses for tumors, stomach, kidneys, and bone marrow were 0.88 (interquartile range [IQR]: 0.85–1.04), 0.42 (IQR: 0.25–1.01), 0.11 (IQR: 0.07–0.13), and 0.028 (IQR: 0.026–0.034) Gy/GBq, respectively. These doses resulted in median tumor-to-kidney dose ratios of 11.6 (IQR: 8.11–14.4) without SG and 13.0 (IQR: 10.2–18.6) with SG; these values were not significantly different (P = 1.0). The median tumor-to-stomach dose ratio was 3.34 (IQR: 1.14–4.70). Adverse reactions (mainly hypotension, flushing, and hypokalemia) were self-limiting and not higher than grade 1. Conclusion: ¹⁷⁷Lu-PP-F11N accumulates specifically in MTC at a dose that is sufficient for a therapeutic approach. With a low kidney and bone marrow radiation dose, ¹⁷⁷Lu-PP-F11N shows a promising biodistribution. The dose-limiting organ is most likely the stomach. Further clinical studies are necessary to evaluate the maximum tolerated dose and the efficacy of ¹⁷⁷Lu-PP-F11N.

Continuous glucose monitor (CGM) readings are delayed relative to blood glucose, and this delay is usually attributed to the latency of interstitial glucose levels. However, CGM-independent data suggest rapid equilibration of interstitial glucose. This study sought to determine the loci of CGM delays. Electrical current was measured directly from CGM electrodes to define sensor kinetics in the absence of smoothing algorithms. CGMs were implanted in mice, and sensor versus blood glucose responses were measured after an intravenous glucose challenge. Dispersion of a fluorescent glucose analog (2-NBDG) into the CGM microenvironment was observed in vivo using intravital microscopy. Tissue deposited on the sensor and nonimplanted subcutaneous adipose tissue was then collected for histological analysis. The time to half-maximum CGM response in vitro was 35 ± 2 s. In vivo, CGMs took 24 ± 7 min to reach maximum current versus 2 ± 1 min to maximum blood glucose (P = 0.0017). 2-NBDG took 21 ± 7 min to reach maximum fluorescence at the sensor versus 6 ± 6 min in adipose tissue (P = 0.0011). Collagen content was closely correlated with 2-NBDG latency (R = 0.96, P = 0.0004). Diffusion of glucose into the tissue deposited on a CGM is substantially delayed relative to interstitial fluid. A CGM that resists fibrous encapsulation would better approximate real-time deviations in blood glucose.

Caribbean Coffee Traders Limited, CCTL, is moving ahead with plans for a US$30-million bond placement, the proceeds from which it will likely use to expand the Starbucks chain it operates in three regional markets. The initial franchise agreement...

WITH THE productive sector experiencing a shortage of foreign exchange for the past two months, the Jamaican Manufacturers and Exporters Association, JMEA, says it has appealed to the Bank of Jamaica, BOJ, for direct access to US currency for three...

11 February 2020

Invitation Only Research Event

Event participants

Richard King, Senior Research Fellow, Energy, Environment and Resources Department, Chatham House
Chair: Duncan Brack, Associate Fellow, Energy, Environment and Resources Department, Chatham House

29 January 2020

Policymakers are in danger of sleepwalking into ineffective carbon dioxide removal solutions in the quest to tackle climate change. This paper warns against overreliance on bioenergy with carbon capture and storage (BECCS). 

A report release and presentation of first-ever U.S. estimates on the actual economic costs of skill underutilization for immigrants, their families, and the U.S. economy, in terms of forgone earnings and unrealized federal, state, and local taxes.

Over the past decade, immigrant investor programs have proliferated around the world, and Chinese applicants have dominated in a number of countries. In 2015, about 9,000 Chinese millionaires moved to other countries, many through so-called golden visa programs. This article explores the social and cultural factors driving well-off Chinese to move abroad and examines perceptions of elite emigration in China.

Experts on this Spanish language webinar examine the operation of today’s interior immigration enforcement system and how state and local governments, civil society, and consulates are responding.    

Citizenship and integration policies are often thought of as markers for whether a country is welcoming to immigrants. Yet research suggests that public opinion and political rhetoric play a bigger role in immigrants' sense of belonging. This article explores how boundaries between "us" and "them" are drawn through popular conceptions of nationhood and political rhetoric, and their impact on immigrants' belonging.

This report analyzes the exploitation of migrants in three spheres: the domestic care sector, the labor market, and the sex industry. It details several obstacles governments face in their efforts to weaken the "bad actors" that profit from exploitation, and shows how one of the biggest challenges facing law enforcement is that serious criminals and lawbreakers often operate on the edge of legality and exploit legal routes wherever possible.

A Spanish language webinar examining the operation of today’s interior enforcement system and how state and local governments, civil society, and consulates are responding.    

In his first public address on his inaugural official visit to Washington, DC, IOM Director General António Vitorino discusses his vision for IOM; reforms in the UN system; coordination with other organizations in addressing humanitarian protection; and the operational steps IOM is taking to respond to forced migration and displacement.

One of the least developed countries in sub-Saharan Africa, the Democratic Republic of the Congo has experienced significant migration outflows and inflows tied to political and economic crises in recent decades. While most Congolese migrants head to neighboring countries, destinations have diversified, with an uptick in those leaving for opportunities in Europe and beyond. This country profile explores historical and contemporary patterns of migration to and from DR Congo.

The Netherlands has witnessed a rise in far-right populism, challenging its reputation as a humanitarian haven. Yet, public fears equating immigration with a rise in religious extremism do not necessarily reflect the facts. This profile explores historical and contemporary migration in a country where population growth relies largely on immigration, and analyzes to what extent policymaking has been shaped by rising populism.

In his first public address during his inaugural formal visit to Washington, DC. International Organization for Migration (IOM) Director General António Vitorino discussed his vision for the agency; reforms in the UN system designed to address migration matters better; the coordination of efforts between IOM, the UN High Commissioner for Refugees, and other international partners in addressing humanitarian protection; and the operational steps IOM is taking to respond to forced migration and displacement in hotspots around the world, including Venezuela, Bangladesh, and Libya.

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.

OBJECTIVE

Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.

Abbe Herzig, AMS Director of Education In the midst of the upheaval due to the Coronavirus, students and faculty are transitioning to new virtual classrooms. Many of us haven’t chosen to learn or teach, but here we are, making the … Continue reading →

Former American Basketball Association commissioner and NBA executive Mike Storen died Thursday after a lengthy battle with a rare form of cancer. He was 84.

Joseph Tran
Oct 1, 2012; 30:173-178
Practical Pointers

Sep 1, 2010; 28:176-176
Patient Information

Evan M. Benjamin
Jan 1, 2002; 20:
Practical Pointers

Apr 1, 2018; 36:202-202
Patient Education

OBJECTIVE

We examined the association of lactation duration with incident type 2 diabetes among women with a history of gestational diabetes mellitus (GDM).

Police and firefighters in Michigan came to the rescue of a family of baby geese that wandered out onto a busy highway and fell into a storm sewer.

This article explores post-deportation dynamics and challenges returnees face in the Democratic Republic of the Congo (DRC). Even as European countries focus on increasing returns of migrants deemed not to have a right to stay, little attention has been given to conditions at return—even to a country such as the DRC where allegations of serious human-rights violations against returned migrants have been reported for years.

Angelo Avogaro
May 1, 2011; 34:S285-S290
Hypertension

TODAY Study Group
Jun 1, 2013; 36:1758-1764
TODAY Study

Robert R. Henry
Mar 1, 2015; 38:412-419
Evolving Tactics With Inhibition of Sodium-Glucose Cotransporters

Tadej Battelino
Aug 1, 2019; 42:1593-1603
International Consensus Report

Michaela Diamant
Oct 1, 2014; 37:2763-2773
Emerging Technologies and Therapeutics

Itamar Raz
Jun 1, 2013; 36:1779-1788
Diabetes Care Expert Forum

Robert R. Henry
Dec 1, 2015; 38:2258-2265
Special Article Collection: Insulin

Samy Suissa
Jan 1, 2018; 41:6-10
Perspectives in Care

William T. Cefalu
Jan 1, 2018; 41:14-31
Diabetes Care Expert Forum

Gina Agiostratidou
Dec 1, 2017; 40:1622-1630
Continuous Glucose Monitoring and Risk of Hypoglycemia

Dorothee Deiss
Dec 1, 2006; 29:2730-2732
BR Emerging Treatments and Technologies

Thomas Danne
Dec 1, 2017; 40:1631-1640
Continuous Glucose Monitoring and Risk of Hypoglycemia