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<br /> EUROPEAN MEDICAL JOURNAL<br /> ISSN 2397-6764 Vol 2.3 • August 2017 • europeanmedical-journal.com<br /> CONTENTS<br /> EDITORIAL BOARD...................................................................................................................................... 4<br /> FEATURES<br /> • HOW I MANAGE MYELOFIBROSIS...................................................................................................... 12<br /> Anca Lupu<br /> • HOW I DIAGNOSE HYPEREOSINOPHILIC SYNDROMES............................................................... 15<br /> Simon Kavanagh, Jeffrey H. Lipton<br /> SYMPOSIUM REVIEWS<br /> • MANAGEMENT OF MULTIPLY RELAPSED AGGRESSIVE NON-HODGKIN LYMPHOMA:<br /> NEW PERSPECTIVES.............................................................................................................................. 22<br /> • REDEFINING LATER-LINE THERAPY IN METAS<a title="EMJ 2.3 2017 page 1" href="http://viewer.zmags.com/publication/034ce3a9?page=1"> EUROPEAN MEDICAL JOURNAL ISSN 2397-6764 </a> <a title="EMJ 2.3 2017 page 2" href="http://viewer.zmags.com/publication/034ce3a9?page=2"> CONTENTS EDITORIAL BOARD.......................</a> <a title="EMJ 2.3 2017 page 3" href="http://viewer.zmags.com/publication/034ce3a9?page=3"> EUROPEAN MEDICAL JOURNAL • THE ROLE OF SELECTIV</a> <a title="EMJ 2.3 2017 page 4" href="http://viewer.zmags.com/publication/034ce3a9?page=4"> EDITORIAL BOARD EDITOR-IN-CHIEF Prof Markus Pec</a> <a title="EMJ 2.3 2017 page 5" href="http://viewer.zmags.com/publication/034ce3a9?page=5"> EUROPEAN MEDICAL JOURNAL AIMS AND SCOPE • T</a> <a title="EMJ 2.3 2017 page 6" href="http://viewer.zmags.com/publication/034ce3a9?page=6"> EUROPEAN MEDICAL JOURNAL 2.3 AUGUST 2017 Directo</a> <a title="EMJ 2.3 2017 page 7" href="http://viewer.zmags.com/publication/034ce3a9?page=7"> Welcome A warm welcome to the summer 2017 edit</a> <a title="EMJ 2.3 2017 page 8" href="http://viewer.zmags.com/publication/034ce3a9?page=8"> Not yet registered to meet us at the ESMO Congres</a> <a title="EMJ 2.3 2017 page 9" href="http://viewer.zmags.com/publication/034ce3a9?page=9"> Foreword </a> <a title="EMJ 2.3 2017 page 10" href="http://viewer.zmags.com/publication/034ce3a9?page=10"> EMJ Hematology 5.1 2017 Includes a sel</a> <a title="EMJ 2.3 2017 page 11" href="http://viewer.zmags.com/publication/034ce3a9?page=11"> Review of the European Association of Urology Con</a> <a title="EMJ 2.3 2017 page 12" href="http://viewer.zmags.com/publication/034ce3a9?page=12"> HOW I MANAGE MYELOFIBROSIS *Anca Lupu Pres</a> <a title="EMJ 2.3 2017 page 13" href="http://viewer.zmags.com/publication/034ce3a9?page=13"> years, together with the already known prognostic</a> <a title="EMJ 2.3 2017 page 14" href="http://viewer.zmags.com/publication/034ce3a9?page=14"> REFERENCES 1. Brunner AM et al. A populati</a> <a title="EMJ 2.3 2017 page 15" href="http://viewer.zmags.com/publication/034ce3a9?page=15"> HOW I DIAGNOSE HYPEREOSINOPHILIC SYNDROMES *Simon</a> <a title="EMJ 2.3 2017 page 16" href="http://viewer.zmags.com/publication/034ce3a9?page=16"> unexplained organ dysfunction/damage. Th</a> <a title="EMJ 2.3 2017 page 17" href="http://viewer.zmags.com/publication/034ce3a9?page=17"> Hypereosinophilia • Two eosinophil counts >1.5</a> <a title="EMJ 2.3 2017 page 18" href="http://viewer.zmags.com/publication/034ce3a9?page=18"> Respiratory symptoms may be prominent but ar</a> <a title="EMJ 2.3 2017 page 19" href="http://viewer.zmags.com/publication/034ce3a9?page=19"> Microbiological investigations should be performe</a> <a title="EMJ 2.3 2017 page 20" href="http://viewer.zmags.com/publication/034ce3a9?page=20"> proposal on criteria and classification of eo</a> <a title="EMJ 2.3 2017 page 21" href="http://viewer.zmags.com/publication/034ce3a9?page=21"> ESMO 2017 Industry Satellite Symposium INT</a> <a title="EMJ 2.3 2017 page 22" href="http://viewer.zmags.com/publication/034ce3a9?page=22"> MANAGEMENT OF MULTIPLY RELAPSED AGGRESSIVE NO</a> <a title="EMJ 2.3 2017 page 23" href="http://viewer.zmags.com/publication/034ce3a9?page=23"> Treatment Landscape of B-Cell Non- Hodgkin Lymph</a> <a title="EMJ 2.3 2017 page 24" href="http://viewer.zmags.com/publication/034ce3a9?page=24"> May-Aug </a> <a title="EMJ 2.3 2017 page 25" href="http://viewer.zmags.com/publication/034ce3a9?page=25"> achievement of clinical response) demonstrate</a> <a title="EMJ 2.3 2017 page 26" href="http://viewer.zmags.com/publication/034ce3a9?page=26"> Table 1b: Selection of Phase II/III monotherapy s</a> <a title="EMJ 2.3 2017 page 27" href="http://viewer.zmags.com/publication/034ce3a9?page=27"> Mechanism of Action and Unique Chemical Structure</a> <a title="EMJ 2.3 2017 page 28" href="http://viewer.zmags.com/publication/034ce3a9?page=28"> PIX301 was a multicentre, randomised, active</a> <a title="EMJ 2.3 2017 page 29" href="http://viewer.zmags.com/publication/034ce3a9?page=29"> profile of pixantrone in comparison with some of t</a> <a title="EMJ 2.3 2017 page 30" href="http://viewer.zmags.com/publication/034ce3a9?page=30"> 2015;126:3773. 12. Pharmacyclics LLC. Ibrut</a> <a title="EMJ 2.3 2017 page 31" href="http://viewer.zmags.com/publication/034ce3a9?page=31"> REDEFINING LATER-LINE THERAPY IN METASTATIC COL</a> <a title="EMJ 2.3 2017 page 32" href="http://viewer.zmags.com/publication/034ce3a9?page=32"> therapy for patients who have not previousl</a> <a title="EMJ 2.3 2017 page 33" href="http://viewer.zmags.com/publication/034ce3a9?page=33"> Under normal circumstances, systemic FTD is </a> <a title="EMJ 2.3 2017 page 34" href="http://viewer.zmags.com/publication/034ce3a9?page=34"> manageable; guidelines are available for the</a> <a title="EMJ 2.3 2017 page 35" href="http://viewer.zmags.com/publication/034ce3a9?page=35"> By contrast, reintroduction refers to the reiniti</a> <a title="EMJ 2.3 2017 page 36" href="http://viewer.zmags.com/publication/034ce3a9?page=36"> 53.8% [complete response: 5.1%; partial response:</a> <a title="EMJ 2.3 2017 page 37" href="http://viewer.zmags.com/publication/034ce3a9?page=37"> REFERENCES 1. Ferlay J SI et al. GLOBOCAN 2012 v</a> <a title="EMJ 2.3 2017 page 38" href="http://viewer.zmags.com/publication/034ce3a9?page=38"> MANAGEMENT OF B-CELL LYMPHOMA: WHER</a> <a title="EMJ 2.3 2017 page 39" href="http://viewer.zmags.com/publication/034ce3a9?page=39"> healthy individuals and development of FL; while </a> <a title="EMJ 2.3 2017 page 40" href="http://viewer.zmags.com/publication/034ce3a9?page=40"> Table 1: Hurdles and unmet needs in follicular ly</a> <a title="EMJ 2.3 2017 page 41" href="http://viewer.zmags.com/publication/034ce3a9?page=41"> diagnosed Stage III or IV indolent or mantle-cell</a> <a title="EMJ 2.3 2017 page 42" href="http://viewer.zmags.com/publication/034ce3a9?page=42"> With most current regimens offering similar PFS, </a> <a title="EMJ 2.3 2017 page 43" href="http://viewer.zmags.com/publication/034ce3a9?page=43"> In the REMARC study, where elderly patients who r</a> <a title="EMJ 2.3 2017 page 44" href="http://viewer.zmags.com/publication/034ce3a9?page=44"> REFERENCES 1. Le Guyader-Peyrou S et al. C</a> <a title="EMJ 2.3 2017 page 45" href="http://viewer.zmags.com/publication/034ce3a9?page=45"> with rituximab versus placebo in combinat</a> <a title="EMJ 2.3 2017 page 46" href="http://viewer.zmags.com/publication/034ce3a9?page=46"> EDITOR’S PICK Fifteen years ago, ren</a> <a title="EMJ 2.3 2017 page 47" href="http://viewer.zmags.com/publication/034ce3a9?page=47"> Table 1: Diagnostic criteria for multiple myeloma</a> <a title="EMJ 2.3 2017 page 48" href="http://viewer.zmags.com/publication/034ce3a9?page=48"> in the levels of monoclonal light chains m</a> <a title="EMJ 2.3 2017 page 49" href="http://viewer.zmags.com/publication/034ce3a9?page=49"> plasma exchange.24 In fact, the combination </a> <a title="EMJ 2.3 2017 page 50" href="http://viewer.zmags.com/publication/034ce3a9?page=50"> On light microscopy, two-thirds of patients prese</a> <a title="EMJ 2.3 2017 page 51" href="http://viewer.zmags.com/publication/034ce3a9?page=51"> Renal Impairment. J Clin Oncol. 2016; 34(13):1544</a> <a title="EMJ 2.3 2017 page 52" href="http://viewer.zmags.com/publication/034ce3a9?page=52"> of nodular mesangial lesions in a patient with </a> <a title="EMJ 2.3 2017 page 53" href="http://viewer.zmags.com/publication/034ce3a9?page=53"> EUROPEAN MEDICAL JOURNAL provides influential arti</a> <a title="EMJ 2.3 2017 page 54" href="http://viewer.zmags.com/publication/034ce3a9?page=54"> TREATMENT OPTIONS IN CARDIOGENIC SHOCK WITH </a> <a title="EMJ 2.3 2017 page 55" href="http://viewer.zmags.com/publication/034ce3a9?page=55"> CS post-AMI. The lack of efficacy may be because </a> <a title="EMJ 2.3 2017 page 56" href="http://viewer.zmags.com/publication/034ce3a9?page=56"> Table 1: Summary Trial name </a> <a title="EMJ 2.3 2017 page 57" href="http://viewer.zmags.com/publication/034ce3a9?page=57"> ERV was flagged as the most important treatment st</a> <a title="EMJ 2.3 2017 page 58" href="http://viewer.zmags.com/publication/034ce3a9?page=58"> (no IABP) group crossed over into the IABP group </a> <a title="EMJ 2.3 2017 page 59" href="http://viewer.zmags.com/publication/034ce3a9?page=59"> short-term circulatory support for ≤6 h</a> <a title="EMJ 2.3 2017 page 60" href="http://viewer.zmags.com/publication/034ce3a9?page=60"> Cardiogenic shock, post-acute myocardial infarcti</a> <a title="EMJ 2.3 2017 page 61" href="http://viewer.zmags.com/publication/034ce3a9?page=61"> REFERENCES 1. Lim HS. Cardiogenic Shock: Failure</a> <a title="EMJ 2.3 2017 page 62" href="http://viewer.zmags.com/publication/034ce3a9?page=62"> ventricular assist device. J Vasc Surg. 2015</a> <a title="EMJ 2.3 2017 page 63" href="http://viewer.zmags.com/publication/034ce3a9?page=63"> PEYRONIE’S DISEASE: RECENT TREATMENT </a> <a title="EMJ 2.3 2017 page 64" href="http://viewer.zmags.com/publication/034ce3a9?page=64"> Table 1: Non-surgical treatment options. Oral tre</a> <a title="EMJ 2.3 2017 page 65" href="http://viewer.zmags.com/publication/034ce3a9?page=65"> trauma and genetic susceptibility that leads to t</a> <a title="EMJ 2.3 2017 page 66" href="http://viewer.zmags.com/publication/034ce3a9?page=66"> The side effects include myalgias, arthralgi</a> <a title="EMJ 2.3 2017 page 67" href="http://viewer.zmags.com/publication/034ce3a9?page=67"> of being non-continuous and therapy precluding re</a> <a title="EMJ 2.3 2017 page 68" href="http://viewer.zmags.com/publication/034ce3a9?page=68"> Table 2: Types of grafts used in Peyronie’s disea</a> <a title="EMJ 2.3 2017 page 69" href="http://viewer.zmags.com/publication/034ce3a9?page=69"> Association Education and Research, Inc. Peyronie</a> <a title="EMJ 2.3 2017 page 70" href="http://viewer.zmags.com/publication/034ce3a9?page=70"> algorithm for the treatment of Peyronie’s disease</a> <a title="EMJ 2.3 2017 page 71" href="http://viewer.zmags.com/publication/034ce3a9?page=71"> SIGNIFICANCE OF ASYMPTOMATIC BACTERIURIA </a> <a title="EMJ 2.3 2017 page 72" href="http://viewer.zmags.com/publication/034ce3a9?page=72"> ABU is fairly common in the general population am</a> <a title="EMJ 2.3 2017 page 73" href="http://viewer.zmags.com/publication/034ce3a9?page=73"> characteristics; namely, diabetes, female </a> <a title="EMJ 2.3 2017 page 74" href="http://viewer.zmags.com/publication/034ce3a9?page=74"> Table 1: Recommendations for screening of asympto</a> <a title="EMJ 2.3 2017 page 75" href="http://viewer.zmags.com/publication/034ce3a9?page=75"> renal allograft among those who developed ABU aft</a> <a title="EMJ 2.3 2017 page 76" href="http://viewer.zmags.com/publication/034ce3a9?page=76"> 15. Sheiner E et al. Asymptomatic bacte</a> <a title="EMJ 2.3 2017 page 77" href="http://viewer.zmags.com/publication/034ce3a9?page=77"> in spinal cord injury patients on condom catheter</a> <a title="EMJ 2.3 2017 page 78" href="http://viewer.zmags.com/publication/034ce3a9?page=78"> THE ROLE OF SELECTIVE SEROTONIN REUPTAKE I</a> <a title="EMJ 2.3 2017 page 79" href="http://viewer.zmags.com/publication/034ce3a9?page=79"> EJACULATION AND THE EJACULATORY NEURAXIS Ejacula</a> <a title="EMJ 2.3 2017 page 80" href="http://viewer.zmags.com/publication/034ce3a9?page=80"> approximately three-fold, versus an estimated</a> <a title="EMJ 2.3 2017 page 81" href="http://viewer.zmags.com/publication/034ce3a9?page=81"> of-sexual-function/. Last accessed: 2 Aug</a> <a title="EMJ 2.3 2017 page 82" href="http://viewer.zmags.com/publication/034ce3a9?page=82"> DO PREOPERATIVE ALPHA BLOCKERS </a> <a title="EMJ 2.3 2017 page 83" href="http://viewer.zmags.com/publication/034ce3a9?page=83"> the majority of these pass spontaneously. In the </a> <a title="EMJ 2.3 2017 page 84" href="http://viewer.zmags.com/publication/034ce3a9?page=84"> Assess for eligibility (N=174) 15 patients exclud</a> <a title="EMJ 2.3 2017 page 85" href="http://viewer.zmags.com/publication/034ce3a9?page=85"> Level I evidence exists, supporting the rol</a> <a title="EMJ 2.3 2017 page 86" href="http://viewer.zmags.com/publication/034ce3a9?page=86"> Among these 41 (33%) patients, 25 (61</a> <a title="EMJ 2.3 2017 page 87" href="http://viewer.zmags.com/publication/034ce3a9?page=87"> CONTEMPORARY EVIDENCE, TREATMENT STRATEGIES, AND</a> <a title="EMJ 2.3 2017 page 88" href="http://viewer.zmags.com/publication/034ce3a9?page=88"> CHRONIC TOTAL OCCLUSIONS PCI </a> <a title="EMJ 2.3 2017 page 89" href="http://viewer.zmags.com/publication/034ce3a9?page=89"> A) J-CTO SCORING SYSTEM Entry shape of lesion </a> <a title="EMJ 2.3 2017 page 90" href="http://viewer.zmags.com/publication/034ce3a9?page=90"> CTOs are a subset of coronary artery disea</a> <a title="EMJ 2.3 2017 page 91" href="http://viewer.zmags.com/publication/034ce3a9?page=91"> maximum tolerated dose). The study recruited</a> <a title="EMJ 2.3 2017 page 92" href="http://viewer.zmags.com/publication/034ce3a9?page=92"> as Hyperion™ (Asahi Intecc, Aichi, Japan), which </a> <a title="EMJ 2.3 2017 page 93" href="http://viewer.zmags.com/publication/034ce3a9?page=93"> technique. These techniques have been essential i</a> <a title="EMJ 2.3 2017 page 94" href="http://viewer.zmags.com/publication/034ce3a9?page=94"> Table 1 continued. Study N Design Primary</a> <a title="EMJ 2.3 2017 page 95" href="http://viewer.zmags.com/publication/034ce3a9?page=95"> Table 1 continued. Study N Design Primary</a> <a title="EMJ 2.3 2017 page 96" href="http://viewer.zmags.com/publication/034ce3a9?page=96"> an enzyme that degrades Type 1 collagen, and may </a> <a title="EMJ 2.3 2017 page 97" href="http://viewer.zmags.com/publication/034ce3a9?page=97"> 02 June 2017. 24. Morino Y et al. Predicting succ</a> <a title="EMJ 2.3 2017 page 98" href="http://viewer.zmags.com/publication/034ce3a9?page=98"> FETAL PERICARDIOCENTESIS </a> <a title="EMJ 2.3 2017 page 99" href="http://viewer.zmags.com/publication/034ce3a9?page=99"> in the literature (Table 1). The incidence is abo</a> <a title="EMJ 2.3 2017 page 100" href="http://viewer.zmags.com/publication/034ce3a9?page=100"> Table 1: Causes of pericardial effusion. Cardiac </a> <a title="EMJ 2.3 2017 page 101" href="http://viewer.zmags.com/publication/034ce3a9?page=101"> and the regression of pericardial fluid, adv</a> <a title="EMJ 2.3 2017 page 102" href="http://viewer.zmags.com/publication/034ce3a9?page=102"> Table 2: Reported cases of fetal pericardiocentes</a> <a title="EMJ 2.3 2017 page 103" href="http://viewer.zmags.com/publication/034ce3a9?page=103"> Table 2 continued. Reference Cause GE PC </a> <a title="EMJ 2.3 2017 page 104" href="http://viewer.zmags.com/publication/034ce3a9?page=104"> REFERENCES 1. Yoo SL et al. Normal pericardial </a> <a title="EMJ 2.3 2017 page 105" href="http://viewer.zmags.com/publication/034ce3a9?page=105"> INHERITED BONE FAILURE SYNDROMES, FOCUS ON THE H</a> <a title="EMJ 2.3 2017 page 106" href="http://viewer.zmags.com/publication/034ce3a9?page=106"> of 65 per million.3,4 Today, we recognise </a> <a title="EMJ 2.3 2017 page 107" href="http://viewer.zmags.com/publication/034ce3a9?page=107"> occurs in ˜10–25% of patients. This gives rise to</a> <a title="EMJ 2.3 2017 page 108" href="http://viewer.zmags.com/publication/034ce3a9?page=108"> arteriovenous malformations.1,33,34 More than 90%</a> <a title="EMJ 2.3 2017 page 109" href="http://viewer.zmags.com/publication/034ce3a9?page=109"> Telomere ends that have shortened below a critica</a> <a title="EMJ 2.3 2017 page 110" href="http://viewer.zmags.com/publication/034ce3a9?page=110"> not elevated ADA. Elevated ADA distinguishes</a> <a title="EMJ 2.3 2017 page 111" href="http://viewer.zmags.com/publication/034ce3a9?page=111"> to pursue testing and genetic counselling referra</a> <a title="EMJ 2.3 2017 page 112" href="http://viewer.zmags.com/publication/034ce3a9?page=112"> 793-802. 37. Gutierrez-Rodrigues F et al. Direct </a> <a title="EMJ 2.3 2017 page 113" href="http://viewer.zmags.com/publication/034ce3a9?page=113"> NON-CLASSIC MYELOPROLIFERATIVE NEOPLASMS: ARE WE </a> <a title="EMJ 2.3 2017 page 114" href="http://viewer.zmags.com/publication/034ce3a9?page=114"> risk of malignant transformation and myelofibrosis</a> <a title="EMJ 2.3 2017 page 115" href="http://viewer.zmags.com/publication/034ce3a9?page=115"> Table 2: Diagnostic criteria for chronic neutroph</a> <a title="EMJ 2.3 2017 page 116" href="http://viewer.zmags.com/publication/034ce3a9?page=116"> Splenectomy is not recommended for management of </a> <a title="EMJ 2.3 2017 page 117" href="http://viewer.zmags.com/publication/034ce3a9?page=117"> FIP1L1-PDGFRA gene fusion by reverse transcriptio</a> <a title="EMJ 2.3 2017 page 118" href="http://viewer.zmags.com/publication/034ce3a9?page=118"> Acquired resistance to imatinib can occur because</a> <a title="EMJ 2.3 2017 page 119" href="http://viewer.zmags.com/publication/034ce3a9?page=119"> mutation may help to establish an MPN diagnosis, </a> <a title="EMJ 2.3 2017 page 120" href="http://viewer.zmags.com/publication/034ce3a9?page=120"> 36. Jovanovic JV et al. Low-dose imatinib mesylat</a> <a title="EMJ 2.3 2017 page 121" href="http://viewer.zmags.com/publication/034ce3a9?page=121"> NOVEL IMMUNOTHERAPY AGENTS FOR ACUTE LYMPHOBLAS</a> <a title="EMJ 2.3 2017 page 122" href="http://viewer.zmags.com/publication/034ce3a9?page=122"> proportion of patients experience a rel</a> <a title="EMJ 2.3 2017 page 123" href="http://viewer.zmags.com/publication/034ce3a9?page=123"> anti-CD19 CAR-T cells. CD19 is considered a</a> <a title="EMJ 2.3 2017 page 124" href="http://viewer.zmags.com/publication/034ce3a9?page=124"> Chalicheamicin Inotuzumab ozogamicin Monoclonal</a> <a title="EMJ 2.3 2017 page 125" href="http://viewer.zmags.com/publication/034ce3a9?page=125"> is that there is a continuous renewal of </a> <a title="EMJ 2.3 2017 page 126" href="http://viewer.zmags.com/publication/034ce3a9?page=126"> Certainly, much remains to be explored in </a> <a title="EMJ 2.3 2017 page 127" href="http://viewer.zmags.com/publication/034ce3a9?page=127"> Blood. 2010;116(21):170. 34. Jabbour E et al. Pha</a> <a title="EMJ 2.3 2017 page 128" href="http://viewer.zmags.com/publication/034ce3a9?page=128"> A THEORETICAL VIEW OF OVARIAN CANCER RELAPSE *Gon</a> <a title="EMJ 2.3 2017 page 129" href="http://viewer.zmags.com/publication/034ce3a9?page=129"> First-line Platinum-sensitive</a> <a title="EMJ 2.3 2017 page 130" href="http://viewer.zmags.com/publication/034ce3a9?page=130"> THE CANCER STEM CELL THEORY We know that tumo</a> <a title="EMJ 2.3 2017 page 131" href="http://viewer.zmags.com/publication/034ce3a9?page=131"> Thus, according to this theory, OC may be regarde</a> <a title="EMJ 2.3 2017 page 132" href="http://viewer.zmags.com/publication/034ce3a9?page=132"> ‘driver event’ for CSC to abandon their quiescent</a> <a title="EMJ 2.3 2017 page 133" href="http://viewer.zmags.com/publication/034ce3a9?page=133"> CANCER STEM CELLS AS A TARGET One of the most im</a> <a title="EMJ 2.3 2017 page 134" href="http://viewer.zmags.com/publication/034ce3a9?page=134"> 9. Monk BJ et al. Trabectedin plus pegylate</a> <a title="EMJ 2.3 2017 page 135" href="http://viewer.zmags.com/publication/034ce3a9?page=135"> recombination deficiency and ovarian cancer. Eu</a> <a title="EMJ 2.3 2017 page 136" href="http://viewer.zmags.com/publication/034ce3a9?page=136"> SUBSCRIBE TO RECEIVE THE LATEST PUBLICATIONS, NEW</a>