The United States decided to "allow" Ukraine to use the weapons it and other Western nations donated to strike targets deep within Russian territory.

https://www.naturalnews.com/2024-09-15-us-desperately-trying-ignite-wwiii-before-election.html

aturase and decreased delta-5 desaturase activities are associated with AO and increased metabolic risk in children who are obese and overweight.Primary surgical repair remains the traditional treatment for patients with critical duct-dependent coarctation of the aorta (CoA). Initial surgical repair might not be possible or associated with higher risks if additional comorbidities arise in small infants and neonates. Balloon angioplasty (BA) has been described as a rescue strategy for these children. We describe the feasibility of a palliative BA and rescue stent implantation via an alternative antegrade right-axillary artery approach in an initially inoperable infant with pneumonia and respiratory failure and severe CoA, where the stenosis was not passable by traditional retrograde femoral access. This case adds new aspects to the therapy of critical CoA Stent implantation provides a bridge to surgery in critically ill infants and does not preclude successful surgical repair. Further, if the classic retrograde approach is not possible, the right axillary artery access should be considered as an alternative to pass the stenosis.Objective The aim of this study was to investigate the clinical characteristics and factors associated with pediatric hypertension and target organ damage (TOD). Methods We retrospectively reviewed clinical data from 205 children with hypertension treated in our hospital from 2007 to 2018. The patients were classified based on the type of hypertension (primary, secondary) and presence of TOD (heart, brain, retina). Logistic regression analysis was performed to identify the factors independently associated with hypertension and TOD. Results There were 107 males, 97 females, and one intersex in this study, with an age range of 0.1-17.9 years. Majority of cases (177, 86.3%) had secondary hypertension, while 13.7% had primary hypertension. The most frequent cause of secondary hypertension was renal disease (59.32%). https://www.selleckchem.com/products/epacadostat-incb024360.html Elevated serum creatinine level (odds ratio [OR] = 7.22, 95% confidence interval [95% CI] = 1.6-32.62, P = 0.01), blood urea nitrogen (OR = 6.33, 95% CI = 1.81-22.19, P = 0.004), serum uric acid level (OR = 3.66, 95% CI = 1.20-11.22, P = 0.023), and albuminuria (OR = 3.72, 95% CI = 1.50-9.26, P = 0.005) were independently associated with secondary hypertension. Elevated serum uric acid and blood urea nitrogen levels were associated with left ventricular hypertrophy (OR = 6.638, 95% CI = 1.349-32.657, P = 0.02) and hypertensive encephalopathy (OR = 4.384, 95% CI = 1.148-16.746, P = 0.031), respectively. Triglyceride level correlated with hypertensive retinopathy (P = 0.001). Conclusion Pediatric hypertension was most often secondary, with renal disease as the leading cause. Elevated levels of serum uric acid, blood urea nitrogen, serum creatinine, and albuminuria may indicate secondary hypertension in childhood. Elevated serum uric acid, blood urea nitrogen, and triglyceride levels were associated with left ventricular hypertrophy, hypertensive encephalopathy, and hypertensive retinopathy, respectively.Introduction The outbreak of the novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a range of emergency measures worldwide. Early in the pandemic, children were suspected to act as drivers of the COVID-19 spread in the population, which was based on experiences with influenza virus and other respiratory pathogens. Consequently, closures of schools and kindergartens were implemented in many countries around the world, alongside with other non-pharmaceutical interventions for transmission control. Given the grave and multifaceted consequences of contact restriction measures for children, it is crucial to better understand the effect size of these incisive actions for the COVID-19 pandemic. Therefore, we systematically review the current evidence on transmission of SARS-CoV-2 to and by children. Data Sources PubMed and preprints uploaded on medRxiv. Study Selection Original research articles, case reports, brief communications, and commentaon and thereby design more effective non-pharmaceutical interventions to reduce disease transmission.Objective End-of-life(EOL) care decision-making for infants and children is a painful experience. The study aimed to explore the clinical factors influencing the EOL care to withhold/withdraw life-sustaining treatment (WLST) in Chinese pediatric intensive care unit (PICU). Methods A 14-year retrospective study (2006-2019) for pediatric patients who died in PICU was conducted. Based on the mode of death, patients were classified into WLST group (death after WLST) and fCPR group (death after full intervention, including cardiopulmonary resuscitation). Intergroup differences in the epidemiological and clinical factors were determined. Results There were 715 patients enrolled in this study. Of these patients, 442 (61.8%) died after WLST and 273 (38.2%) died after fCPR. Patients with previous hospitalizations or those who had been transferred from other hospitals more frequently chose WLST than fCPR (both P less then 0.01), and the mean PICU stay duration was significantly longer in the WLST group (P less then 0.05). WLST patients were more frequently complicated with chronic underlying disease, especially tumor (P less then 0.01). Sepsis, diarrhea, and cardiac attack (all P less then 0.05) were more frequent causes of death in the fCPR group, whereas tumor as a direct cause of death was more frequently seen in the WLST group. Logistic regression analysis demonstrated that previous hospitalization and underlying diseases diagnosed before admission were strongly associated with EOL care with WLST decision (OR 1.6; P less then 0.05 and OR 1.6; P less then 0.01, respectively). Conclusions Pediatric patients with previous hospitalization and underlying diseases diagnosed before admission were associated with the EOL care to WLST.Introduction COVID-19 is associated with a novel multi-system inflammatory syndrome that shares some characteristics with Kawasaki's Disease. The syndrome manifestation is delayed relative to COVID-19 onset, with a spectrum of clinical severity. Clinical signs may include persistent fever, gastrointestinal symptoms, cardiac inflammation and/or shock. Case Presentation We measured 59 inflammatory and endothelial injury plasma analytes in an adolescent girl that presented with malaise, fever, cough, strawberry tongue and jaundice. Her COVID-19 status was positive with detection of 2 SARS-CoV-2 viral genes using polymerase chain reaction. She was treated with intravenous immunoglobulin prior to blood draw, but our plasma measurements suggested a unique analyte expression pattern associated with inflammation, endothelial injury and microvascular glycocalyx degradation. Conclusions COVID-19 is associated with a multi-system inflammatory syndrome and a unique inflammatory and endothelial injury signature. Summary Analyte markers of inflammation and endothelial cell injury might serve as putative biomarkers and/or be investigated further as potential therapeutic targets.Low frequency noises are predominant in neonatal intensive care units (NICUs). Some studies affirm that neonates can perceive noises from 113 Hz, and can therefore be affected by sound sources with high spectral content at low frequencies (e.g., incubator engine, air fan). Other studies suggest that reverberation amplifies noise within incubators. In this paper, the reverberation time (T, T 30) within an incubator with standard dimensions was measured in one-third octave bands. To get reliable results, the T was measured in 15 positions at the neonate's ear height, in a room with low T values (to reduce the influence of the room in the results), using an impulsive sound method. Results show a heterogeneous T distribution at the neonate's ear height, with maximum average T differences between positions of 1.07 s. The highest average T of all microphone positions is 2.27 s at 125 Hz, an extremely high mean value for such a small space. As the frequency of electrical devices in America is 60 Hz, some harmonics lay within the one-third octave band of 125 Hz, and therefore may create a very reverberant and inappropriate acoustic environment within the audible spectrum of neonates. As the acoustic environment of the incubator and the room are coupled, it is expected that the results are higher in the NICUs than in the room where the measurements were conducted, as NICUs are more reverberant. Therefore, it is recommended that the T will be limited in the international standards, and that incubator designers take it into account.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection spreads through droplet and aerosols. Household contacts have a high risk of infection and transmission outside the home can occur at closed and open locations. We studied the transmission risk at open environment among contacts of construction laborers.

Close contacts of 18 SARS-CoV-2 infected construction laborers were assessed for symptomatic or asymptomatic infection. Contacts were classified as a) persons at residence of index case b) persons at workplace (open and closed environment), and c) persons outside the index case residence or workplace who are traceable. Relative risk of infection among contacts at different locations and observed parameters were compared between them.

Four hundred and ninety-six contacts were assessed. The secondary transmission rate was maximum among household contacts (n=28, 43.7%) followed by contacts at closed environment at workplace (n=44, 26%), traceable other contacts (n=8, 15.7%) and contacts at open environment at workplace (n=3, 1.4%). Relative risk of SARS-CoV-2 infection among household contacts was 30.9 (CI 9.7-98.3, p<0.001) compared to open environmental work contacts and 1.68 (CI 1.15-2.44, p=0.006) compared to closed environmental work contacts. Relative risk was 18.3 (CI 5.8-58.2, P<0.001) among closed environmental work contacts compared to open environmental work contacts. One index and one secondary case died.

The low secondary transmission rate of SARS-CoV-2 infection among open environmental contacts emphasizes the fact that free air flow has the ability to dilute or probably blow away the virus particles and lowers the transmission risk substantially.
The low secondary transmission rate of SARS-CoV-2 infection among open environmental contacts emphasizes the fact that free air flow has the ability to dilute or probably blow away the virus particles and lowers the transmission risk substantially.
Coronavirus disease (COVID-19) has led to a global pandemic among patients of all ages around the world. A new delayed inflammatory syndrome, with potentially severe evolution, has been described in the pediatric population, a population previously considered to be less vulnerable to the severe forms of COVID-19.

We describe the first clinical case of multisystem inflammatory syndrome (MIS-C) in a 7-year-old child of the Ternopil region, Ukraine. Our clinical case fulfills the Royal College of Paediatrics and Child Health definition of MIS-C temporarily associated with COVID-19 -systemic disease with long-term fever, multiorgan dysfunction, laboratory evidence of hyperinflammation, positive SARS-CoV-2 tests, and the absence of an alternative cause that would explain the clinical picture. The patient was treated according to the treatment guidelines and subsequently was discharged with the resolution of his clinical symptoms.

This clinical case draws the attention of general practitioners and pediatricians to the importance of timely diagnosis of a rare, but potentially severe multisystem inflammatory syndrome temporarily associated with COVID-19 in children.

Northern Premier League Premier Division, Southern Football League Premier Central, Southern Football League Premier South, and Isthmian League Premier Division (degree 7, 22 teams each, leagues running in parallel): The champions in each division are automatically promoted; subsequent 4 groups in every division compete in play-offs, with the play-off winners additionally promoted. There are rules on how the ball can be handled; for instance, gamers operating with the ball must intermittently bounce or touch it on the bottom. You can even check yourself by making a rule that the ball should be hit earlier than it involves a cease. Luckily, the intentional grounding rule makes it harder for quarterbacks to get rid of the ball. When the Bumpus' canine get to his chook, Ralphie's dad is completely devastated. Ralphie's previous man wouldn't mind getting rid of his nemeses, the Bumpus' canines. https://click4r.com/posts/g/17880575/seven-humorous-nfl-titans-quotes What message does Ralphie's Little Orphan Annie secret decoder ring spell out? On its strategy to a 4-7 season, SMU was given little likelihood to beat the Midshipmen. The stadium's capacity was later expanded to a seating capability of 12,592 followers in 1948. Given the growth of the college and its fan base, the Aztecs discovered themselves in need of a bigger venue, but the previously proposed enlargement to 45,000 seats was delayed till 1966. During this last year in Aztec Bowl, the Aztecs received their first of three consecutive "small faculty" (Division II) Nationwide Championships.

Prior to the 2014 season, Washington revealed a brand new uniform set that featured three jersey, four pant, and three helmet colour choices to allow for a myriad of combos on the sector. Soon, you will run yourself ragged -- and will perhaps be just a little quicker in your toes on your next sport on the sector. A 2009 poll put the odds of achieving even a primary degree of fame (i.e., 10 p.c of survey contributors had even heard of this person) at 1 in 62,986. That is simply a bit of higher than the percentages of being struck and killed by lightning, at 1 in 83,930. But true family title standing, where 80 p.c of survey respondents had heard of the particular person? The Bengals earned its crew name from founder Paul Brown, who wished to pay homage to different "Bengals" groups that had previously performed for the city. They're led by QB Cam Newton, who alternates between radiant smiles and pouty-face scowls.

The next day, January 3, 2021, Eastman drafted a six-web page memo that imagined several situations for January 6th, solely some of which led to President Trump's victory. Excessive factors in the course of the season embody a blowout win in opposition to No. 8 Iowa and a home victory over No. 22 Colorado. He began his tenure with an 0-10 season in 1954, the first winless season in KU historical past. On January 16, 2016, the UAB football team announced its slate of non-convention opponents for when it returned to play in the 2017 season. The younger quarterback who had only thrown one go before this match (an interception, by the best way) not only managed to fill in for Vick, he additionally orchestrated a diligent 4th quarter 9 minute play that covered 80 yards to take the go forward point and defeat the new York Giants 17-10 on Sunday Night. He challenged the College of North Dakota to a football match in 1890, however didn't have enough players until 1894, the primary official 12 months of football at NDSU. Located in Saint-Denis, a Parisian suburb, the stadium has an all-seater capability of 81,338. France's first match on the stadium was played on 28 January 1998 in opposition to Spain.

The first step towards watching dwell football in your pc is to find a reliable streaming platform. The World Cup is essentially the most prestigious association football tournament on the earth, as effectively because the most widely considered and adopted single sporting event on the planet. Yellow Jacket Alley - "Yellow Jacket Alley" is an occasion staged earlier than every sport. Poland's remaining group sport was with Ukraine on 21 June, at the Stade Vélodrome in Marseille, a recreation they gained 1-0 with a purpose from Jakub Błaszczykowski. For this reason, Barcelona was house to a gaggle of British immigrants. After a number of Commodore sixty four years a new period of cheap Pc's and graphical user interfaces helped develop his curiosity to the purpose of building home Computer's and networks. The house workforce may be penalized 5 yards or can lose a day out. 2022 - The Bulldogs beat TCU 65-7 within the CFP National Championship Game to finish 15-0 for the primary time in class history and declare the nationwide championship. Starting in 1998, TCU began as soon as again incorporating black into the uniforms. Wood, Rob. "Swamp Football." Topend Sports Network.

Skilled crew sports embrace football, basketball, baseball and hockey. What are the possibilities of changing into a professional athlete? Not even secret agents are immune to advertising. The NFL team logos are often printed on hats, t-shirts, espresso mugs and even pennants. Of these however, Washington's solely consensus national championship was in 1991, when the workforce completed No. 1 within the Coaches' Poll. Like SEC males's basketball, ladies's basketball used the divisional alignment for scheduling functions by the 2011-12 season; nonetheless, the girls's scheduling format was considerably completely different from the males's. Do you are feeling like you've got a pretty good grasp of the gamers who fill the rosters of teams across the league? Similar to in tennis, you might play both singles or doubles. He likes to play hide and seek. Why does Randy hide beneath the sink? The actual rules to swamp football -- and there are rules, as well as tournaments held all over the world yearly -- are pretty just like a six-individual-a-aspect soccer recreation. And whereas it must be fun to have a swamp in your yard, for those of us who do not, the rules just name for a sopping wet pitch.

Gen Zero Ep60 (Endgame of Russia-Ukraine war?) by Dr. Paul Cottrell

https://www.brighteon.com/4d009333-80bd-4092-a166-677c70ee3335

5%; outpatients 67/290, 23.1%; p≤0.05) and sterile site isolates (sterile 83/171, 48.5%; non-sterile 416/1678, 24.8%; p≤0.01). The vast majority of S. pneumoniae isolates (12/14; 85%) was found to be penicillin resistant by oxacillin disk diffusion. While identification of Group B streptococci was rare (n=137) due to of lack of diagnostic measures available, the number of enterococcal isolates identified increased significantly due to implementation of improved microbiological work-up (2015 n=7; 2016 n=26; 2017 n=83). Conclusion Compared with published studies from neighboring nations, the rates of antimicrobial resistance among gram positive isolates at NCMCH, particularly with respect to S. aureus and S. pneumoniae, were much higher. Further improvement of microbiological diagnostics and collaboration of stakeholders is required to address the pressing infection control and stewardship issues and to ensure reliable identification of relevant pathogens in Mongolia.Introduction Hydatid cyst is caused by an infection by the larval stage of Echinococcus granulosus. Patients with cystic echinococcosis often remain asymptomatic until the hydatid cysts grow large enough to cause symptoms and signs. The cysts grow in the course of several years before reaching maturity and the rate of growth depends on the location of the cyst. Methods This study was conducted in the Central region of Iran and involved all patients diagnosed with hydatid disease from 2012 to 2016 with the records identifed from 10 centers for disease control. Descriptive statistics including range and percentage were used in analyzing the patient characteristics. Results Hydatid disease was confirmed in 84 cases. The mean age of patients was (23.1±5.1) years (range 15-53 years) and 55.9% of cases were female. Single organ involvement was found in 86.9% of cases. 98.8% cases were successfully treated. The most common sites of infection were lung (42.9%), followed by liver (38.1%), and joint liver/lung (10.7%). The diagnosis was established by abdominal ultrasound, abdominal CT, and serology in all patients. The diagnosis was confirmed by histology in 80 (95.2%) of cases. All of cases were treated with albendazole, and 80 (95.2%) of cases had surgical intervention. The prevalence of human hydatidosis in our study was 1.16 per 100,000 population. Conclusions Hydatid disease is common in Iran and should be a focus of public health interventions. The organ sites affected in this study include lung and liver.Introduction Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period. Methods A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women's socio-demographic characteristics and their knowledge and attitude towards maintaining bone health. Results Participants' age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants' attitude towards bone health. Conclusion This study showed that the age and education levels have significantly different knowledge of bone health.Pediatric cases of a brainstem glioma are one of the most difficult tumors to treat. In children, this type of cancer is perhaps the most dreaded of cancers due to its poor prognosis, yet it remains an area of intense research. In the case presented herein, conventional chemotherapy and radiotherapy treatments were not showing any improvement. The patient was then treated with high-dose intravenous vitamin C (IVC) and endolaser therapy. A significant reduction in glioma's size was achieved in 2 months with this adjunct therapy. These results present a possibility of decreasing brainstem glioma progression with adjuvant IVC and endolaser therapy. © The Author(s) 2020.Background The emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment. Objective The study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council. https://www.selleckchem.com/products/cay10603.html Methods The study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure. Results The current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses' Evidence-Based ty to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure. © The Author(s) 2019.Introduction Nowadays, during formation and development of medicine, the main sector of health care is the protection of maternity and childhood. According to the Ministry of Health of Ukraine, inflammatory diseases of the reproductive system make up 60-65% of all gynecological diseases, among them inflammation of the fallopian tubes and ovaries is 79,6%, which occurs predominantly at young age. The aim is to study the microscopic structure of the oviducts wall in different anatomical parts during the embryonic period of human ontogenesis. Material and Methods Were studied uterine tubes of the 4-10 months’ embryos. We used a light microscopy method and morphometry to describe the peculiarities of oviducts’ infundibulum, isthmus and ampullary part in fetus from 81 mm to 375 mm PCL. Results The histotopography of the oviducts tunics and its parts (infundibulum, ampullary part, isthmus and uterine part) in the fetal period of ontogenesis is described in the article. The thickness of the oviduct wall in the dynamics of the fetal period increases in the direction from the infundibulum to the uterine part of the tube. The main part of the thickness of the oviduct wall is presented by muscles. The thickness of the circumferential muscle layer predominates over the thickness of the longitudinal in 2.5-2.8 times. Mucosa is thicker the isthmus, thinnest in the ampullary part of the uterine tube. Conclusions The thickness of the infants oviduct wall in the dynamics increases in the direction from its infundibulum to the uterine part. The main part of the thickness of the oviduct wall is the tunica muscularis. The thickness of the circular muscle layer predominates the thickness of the longitudinal 2.5-2.8 times. Mucosa is thicker in the isthmus, the thinnest in the ampullary part. It is expedient to study the histotopography of the oviduct in the neonatal period of human ontogenesis.Inhibitor of apoptosis protein (IAP) antagonists have shown activity in preclinical models of head and neck squamous cell carcinoma (HNSCC), and work across several cancer types has demonstrated diverse immune stimulatory effects including enhancement of T cell, NK cell, and dendritic cell function. However, tumor-cell-intrinsic mechanisms for this immune upregulation have been largely unexplored. In this study, we show that ASTX660, an antagonist of cIAP1/2 and XIAP, induces expression of immunogenic cell death (ICD) markers in sensitive HNSCC cell lines in vitro. Experiments in syngeneic mouse models of HNSCC showed that ASTX660 can also enhance radiation-induced ICD in vivo. On a functional level, ASTX660 also enhanced killing of multiple murine cell lines by cytotoxic tumor-infiltrating lymphocytes, and when combined with XRT, stimulated clonal expansion of antigen-specific T lymphocytes and expression of MHC class I on the surface of tumor cells. Flow cytometry experiments in several human HNSCC cell lines showed that MHC class I (HLA-A,B,C) was reliably upregulated in response to ASTX660 + TNFα, while increases in other antigen processing machinery (APM) components were variable among different cell lines. These findings suggest that ASTX660 may enhance anti-tumor immunity both by promoting ICD and by enhancing antigen processing and presentation. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.Background We investigate the role of family history of cancer (FHC) and diagnosis of metachronous and/or synchronous multiple neoplasms (MN), during anti-PD-1/PD-L1 immunotherapy. Design This was a multicenter retrospective study of advanced cancer patients treated with anti-PD-1/PD-L1 immunotherapy. FHC was collected in lineal and collateral lines, and patients were categorized as follows FHC-high (in case of cancer diagnoses in both the lineal and collateral family lines), FHC-low (in case of cancer diagnoses in only one family line), and FHC-negative. Patients were also categorized according to the diagnosis of MN as follows MN-high (>2 malignancies), MN-low (two malignancies), and MN-negative. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and incidence of immune-related adverse events (irAEs) of any grade were evaluated. Results 822 consecutive patients were evaluated. 458 patients (55.7%) were FHC-negative, 289 (35.2%) were FHC-low, and 75 (9.1%) FHC-high, respectively. 29 (3.5%) had a diagnosis of synchronous MN and 94 (11.4%) of metachronous MN. 108 (13.2%) and 15 (1.8%) patients were MN-low and MN-high, respectively. The median follow-up was 15.6 months. No significant differences were found regarding ORR among subgroups. FHC-high patients had a significantly longer PFS (hazard ratio [HR] = 0.69 [95% CI 0.48-0.97], p = .0379) and OS (HR = 0.61 [95% CI 0.39-0.93], p = .0210), when compared to FHC-negative patients. FHC-high was confirmed as an independent predictor for PFS and OS at multivariate analysis. No significant differences were found according to MN categories. FHC-high patients had a significantly higher incidence of irAEs of any grade, compared to FHC-negative patients (p = .0012). Conclusions FHC-high patients seem to benefit more than FHC-negative patients from anti-PD-1/PD-L1 checkpoint inhibitors. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.Gastrointestinal stromal tumor (GIST) is a devastating disease, especially in the setting of metastasis. The natural progression of GIST has been significantly altered by the development of small molecule tyrosine kinase inhibitors (TKIs), including imatinib, sunitinib, and regorafenib, all of which are FDA approved. However, TKIs are not always well-tolerated, and the refractory disease continues to be a problem. For these reasons, alternative treatments are needed. In this report, we discuss a patient with metastatic wild-type (WT) GIST refractory to multiple TKIs, but with a durable clinical response to the anti-programmed cell death protein 1 (PD-1) antibody, nivolumab. This report suggests that continued research evaluating checkpoint inhibitors in GIST is warranted. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.