Across the globe, health care is increasingly in the hands of corporate entities.
Women s health is a vivid example of this trend. Private equity firms, start-ups,
and other private-sector companies are streaming into women s health, appealing to
its historical aims of equity, empowerment, and social justice, while also expecting
big profits. As this industry expands, tensions between profitability, innovation,
quality, and equity are already surfacing within the USA, signalling what other nations
may soon encounter.
The XBB sublineage of the omicron (B.1.1.529) variant of SARS-CoV-2 was first identified
in India in August, 2022, and has since spread rapidly around the world.1,2 A recombinant
of the BA.2.10.1 and BA.2.75 sublineages,3–5 early studies6,7 suggested that XBB was
one of the most immune-evasive strains tested. However, whether the growth advantage
of XBB was sufficient to outcompete other SARS-CoV-2 strains and drive new waves of
infection was unclear.
Early in the COVID-19 pandemic, the RECOVERY trial showed that anti-inflammatory therapy
with 6 mg daily dexamethasone improved survival in patients requiring oxygen supplementation.1
Additional anti-inflammatory therapy with either interleukin-6 (IL-6) inhibitors or
the Janus kinase inhibitor baricitinib was later shown to provide further benefit
to such patients.2,3 However, because IL-6 inhibitors and Janus kinase inhibitors
might be less appropriate for some patients (eg, those who are pregnant or who have
liver or kidney impairment) and are likely to be unavailable in some health-care systems
because of high cost, finding alternatives to these drugs is important.
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We read with interest the comments by Gautam and colleagues related to our Personal
View, in which we proposed that the usual interstitial pneumonia (UIP) pattern found
in idiopathic pulmonary fibrosis and several other interstitial lung disease subtypes
transcends the diagnostic labels currently assigned to them since it exhibits striking
similarities in disease behaviour and pathogenic profile and invariably affects the
clinical course and prognosis.1 However, we do not argue that identical outcomes will
be seen in individual patients with UIP and nor do we advocate uniform UIP management.