miércoles, 11 de noviembre de 2026
A Man on Ibrutinib Develops Cerebral Aspergillosis Wolfgang Paik
https://www.medscape.com/viewarticle/man-ibrutinib-develops-cerebral-aspergillosis-2026a100173i?src=
Cerebral aspergillosis can present without fever or systemic inflammation in patients receiving targeted hematologic therapies, with subtle cognitive, language, and gait deficits that may mimic those of stroke or encephalopathy. Although neuroimaging can identify multifocal enhancing lesions with extensive edema, it may not distinguish fungal, bacterial, or neoplastic diseases. Therefore, histopathologic examination of resected tissue may be necessary to establish a diagnosis.
Oncology News: Q&A: The Long Shadow of Financial Toxicity in Cancer Care (+...)
Oncology News
Q&A: The Long Shadow of Financial Toxicity in Cancer Care
As care costs continue to rise, financial toxicity is a key barrier to equitable cancer treatment.
Medscape Medical News, November 11, 2026
https://www.medscape.com/index/list_13474_0
Uncertainty reduction as a candidate primary reinforcer: an evolutionary and neural account Alan Lincoln1,* (++...)
https://www.academia.edu/3071-4087/2/3/10.20935/AcadNeurosci8451
This integrative review proposes that the reduction in uncertainty may function as a candidate primary reinforcer in humans. The proposed mechanism is positive prediction error coding by the mesolimbic dopamine system within nucleus accumbens and lateral habenula (NAc-LHb) opponent-process circuitry, gated and refined by later cerebellar and cortical additions. Because the dopaminergic signal responds to prediction resolution rather than to what is predicted, certainty operates as a reinforcer across sensory, motor, social, and propositional domains. The case is developed through three converging arguments: functional, mechanistic, and phylogenetic. The review first documents the conservation of NAc-LHb prediction error circuitry from lampreys to mammals and the matching law as a quantitative description of behavioral allocation. It then traces cerebellar emergence, forward modeling, and an ultrafast disynaptic cerebellum-to-NAc pathway that modulates reward valuation before cortical evaluation completes. It further traces cortical evolution into executive and language-supporting structures, integrating recent causal and human electroencephalogram (EEG) evidence for hierarchical cortical predictive coding as a layer above subcortical and cerebellar contributions. Finally, it addresses system integration and articulates a synthesis between free energy minimization and behavior-analytic motivating operations, proposing that motivating operations are the behavioral implementation of free energy gradients across domains, such that the list of primary reinforcers is principled rather than arbitrary. A falsifiable empirical test is proposed: pairing an arbitrary neutral cue with the resolution of a probabilistic prediction should produce conditioning curves quantitatively similar to those produced by pairing with food or water. On balance, uncertainty reduction is not yet established as a primary reinforcer in the same sense as food or water, but it is a strong candidate for a trans-domain motivational process that can recruit reward, aversion, precision-weighting, and belief-updating systems. Implications are noted for healthy belief revision, neurodevelopmental and psychiatric conditions, and contemporary digital information environments.
https://www.academia.edu/journals/academia-neuroscience-and-brain-research/articles?source=journal-top-nav
Read our latest HIV Drug Therapy Glasgow 2026 content (++++)
Safety, pharmacokinetics, and antiviral activity of a combination of TMB-365 and TMB-380 in people living with HIV suppressed with antiretroviral therapy in the USA: a phase 1b/2a, open-label, dose-escalation study
Free with registration until Nov 19, 2026
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(26)00148-7/abstract?utm_campaign=conferencealerts&utm_medium=email&dgcid=hubspot_email_conferencealerts_hivglasgow26&_hsenc=p2ANqtz--GKBEzW8lbKNdxpPqI3pLeNWKucj7cfs9rrHPxONZYYipZcycdPbdpQC2qCdHv8nH8oG36OIqH6rhP8CZToUcfg0ZOyQ&_hsmi=448348523&utm_content=448348523&utm_source=hs_email
Long-acting antibody-based regimens might reduce treatment burden for people living with HIV. We aimed to assess safety, pharmacokinetics, and antiviral activity of TMB-365, a CD4-directed monoclonal antibody, combined with TMB-380, a long-acting broadly neutralising monoclonal antibody targeting gp120 CD4-binding site.
SERIES
Antiretroviral therapy, adiposity, and cardiometabolic risk in people with HIV
Free with registration
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(26)00231-6/abstract?utm_campaign=conferencealerts&utm_medium=email&dgcid=hubspot_email_conferencealerts_hivglasgow26&_hsenc=p2ANqtz--yfNAKU-pLsQjfGwTnoYaQ53Mz54ssmVs7-6G_O2JIE1vVE_57j1QwA2pci1z62nbbifPicWyTl9O994a387m1oI8k7A&_hsmi=448348523&utm_content=448348523&utm_source=hs_email
Return to health accounts for only part of the weight gain observed with modern antiretroviral therapy (ART). A fuller account requires integrating recovery from HIV-related catabolism, HIV-associated adipose tissue remodelling, withdrawal of weight-suppressive antiretrovirals, possible direct or permissive effects of newer agents, individual susceptibility, and obesogenic environments. Evidence from ART initiation and switch studies, PrEP trials, and mechanistic research in adipose tissue suggests that ART-associated weight gain is heterogeneous rather than a uniform restorative process. Once adiposity is established, ART switching has a limited ability to reverse weight gain, consistent with the biological persistence of acquired adiposity. Future care should move beyond ART manipulation alone and incorporate early monitoring, body-composition assessment, cardiometabolic prevention, lifestyle intervention, and appropriate antiobesity pharmacotherapy
Weight management in people with HIV
Free with registration
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(26)00229-8/abstract?utm_campaign=conferencealerts&utm_medium=email&dgcid=hubspot_email_conferencealerts_hivglasgow26&_hsenc=p2ANqtz-9HqHYdYVF_MAU9He7oy9aRFg67fN32jhDx8FpGlcBgNlQqY_vhTH137Vb7Dp-WmS5nVvX5jq-LIK9c5ApW5Hdzg8lYLA&_hsmi=448348523&utm_content=448348523&utm_source=hs_email
Excess weight gain in people with HIV is now recognised as a common risk associated with the use of guideline-recommended antiretroviral therapy, such that nearly 50% of people with HIV are living with comorbid obesity. Weight gain and clinical obesity exacerbate cardiovascular–kidney–metabolic health complications in this population and chronic weight management strategies that reduce these risks are now an urgent priority. Behavioural interventions can be offered to improve diet and increase physical activity, including increasing protein intake and promoting regular physical activity. Additionally, there is a growing body of evidence to support the use of GLP-1 receptor agonist therapies in people with HIV, along with a historical literature showing the efficacy of tesamorelin; however, there are sparse data to direct the use of other approved obesity management medicines specific to this population. Finally, bariatric surgical interventions are suggested to be safe and efficacious for those with chronic HIV infection and comorbid obesity. This Series paper identifies a range of key evidence gaps and research priorities for obesity management in people with HIV, including a lack of trials of GLP-1 therapies in people with HIV powered to key clinical outcomes, such as major adverse cardiovascular events and body composition endpoints, implementation science to define models of care, and research on the heterogeneities in clinical outcomes of obesity treatment by sex.
HIV, obesity, and stigma: lessons for programmes, policy, and practice
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https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(26)00236-5/abstract?utm_campaign=conferencealerts&utm_medium=email&dgcid=hubspot_email_conferencealerts_hivglasgow26&_hsenc=p2ANqtz-9d2FIceyi85rQ_VlEiwXkm1pfOBq5ZMAY-DoOHirb9WoWzNPKJwXe_kcw8UtjPOC5QP00LrD57n9Ni6ivqkbxpO0ihQg&_hsmi=448348523&utm_content=448348523&utm_source=hs_email
HIV has generated four decades of activism, research, and policy reform that produced measurement tools, theoretical frameworks, and consensus that stigma undermines prevention, delays treatment, and entrenches inequity. Weight stigma follows a strikingly similar pattern, operating through visibility, assumptions of personal control, and moralised concern, and is now recognised as a public health priority in its own right. These two forms of stigma increasingly intersect in the same bodies: antiretroviral therapy, particularly newer regimens, is associated with substantial weight gain, so that people once stigmatised for wasting now risk a second, contradictory stigma for excess weight. This intersection is complex; internalised stigma from either condition can resurface long after apparent resolution, even when viral suppression has been reached or after major weight loss. HIV and obesity differ in diagnostic certainty, visibility, permanence, and the origins of activism and legal protection, which helps explain why HIV stigma reduction remains decades ahead. Applying the Health Stigma and Discrimination Framework to this intersection clarifies shared drivers, facilitators, manifestations, and outcomes. Community leadership, rejection of false prevention-versus-treatment trade-offs, equitable access to pharmacotherapy, and integration of obesity care into existing HIV services offer a practical path towards reducing both stigmas.
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