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https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#1
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28795129/placental-site-trophoblastic-tumor-with-sole-metastasis-to-breast-a-case-report
#2
Kimberly Nagamine, Sophia Iwasaki, David Shimizu, Pamela Tauchi-Nishi, Keith Terada
Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic neoplasia (GTN). It most commonly occurs after a delivery but may arise after any type of pregnancy. PSTT arises after neoplastic transformation of intermediate trophoblastic cells. The most commonly reported symptoms are abnormal bleeding or amenorrhea. Due to the rarity of this disease, evidence on prognostic factors as well as optimal treatment is limited. While treatment for early-stage disease is usually limited to surgery, multimodal treatment with chemotherapy and surgery may be important for metastatic disease...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28754175/case-report-term-birth-after-fertility-sparing-treatments-for-stage-ib1-small-cell-neuroendocrine-carcinoma-of-the-cervix
#3
Pei-Ying Wu, Ya-Min Cheng, Geok Huey New, Cheng-Yang Chou, Chun-Ting Chiang, Hung-Wen Tsai, Yu-Fang Huang
BACKGROUND: Advances in cervical cancer management for childbearing women have led to less radical approaches. Use of fertility-sparing treatment to treat small cell neuroendocrine carcinoma (SCNEC) is challenging owing to the aggressive nature of the disease, even in early stage disease. CASE PRESENTATION: A 25-year-old nulligravida woman presented with malodorous vaginal discharge and was diagnosed to have an exophytic cervical SCNEC. A magnetic resonance image scan showed no evidence of parametrial invasion or distant metastasis...
July 28, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28744781/lung-function-in-pregnancy-in-langerhans-cell-histiocytosis
#4
Elżbieta Radzikowska, Elżbieta Wiatr, Monika Franczuk, Iwona Bestry, Kazimierz Roszkowski-Śliż
Pulmonary Langerhans cell histiocytosis (LCH) is a rare disease, affecting usually young people. The course of the disease is variable. In some pulmonary LCH patients a severe lung destruction and progression in spite of chemotherapy is observed, but in others just a cessation of smoking induces a regression of the disease. In the present study we seek to determine the influence of pregnancy on pulmonary function in LCH patients, an unchartered area of research. We addressed the issue by investigating eight pregnant women out of the 45 women hospitalized with the diagnosis of pulmonary LCH in the period from 2000 to 2015...
July 26, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28737775/fertility-preservation-issues-in-pediatric-hematopoietic-stem-cell-transplantation-practical-approaches-from-the-consensus-of-the-pediatric-diseases-working-party-of-the-ebmt-and-the-international-bfm-study-group
#5
A Balduzzi, J-H Dalle, K Jahnukainen, M von Wolff, G Lucchini, M Ifversen, K T Macklon, C Poirot, T Diesch, A Jarisch, D Bresters, I Yaniv, B Gibson, A M Willasch, R Fadini, L Ferrari, A Lawitschka, A Ahler, N Sänger, S Corbacioglu, M Ansari, R Moffat, A Dalissier, E Beohou, P Sedlacek, A Lankester, C D De Heredia Rubio, K Vettenranta, J Wachowiak, A Yesilipek, E Trigoso, T Klingebiel, C Peters, P Bader
Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy...
July 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28737125/taxanes-in-combination-with-platinum-derivatives-for-the-treatment-of-ovarian-cancer%C3%A2-during-pregnancy-a-literature-review%C3%A2
#6
Xiaoling Zheng, Yao Zhu, Yunchun Zhao, Shisen Feng, Caihong Zheng
Ovarian cancer is one of the most common types of solid carcinoma diagnosed during pregnancy. Taxane plus a platinum derivative is a combination therapy that is predominantly used in the treatment of ovarian cancer in non-pregnant women. Pregnancy adds various complexities to a course of treatment. In pregnant patients diagnosed with cancer during the first trimester, the risks of fetal malformations and fetal loss increase following the administration of cytotoxic drugs, and this is higher with multi-agent vs...
July 24, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28728581/a-gestational-choriocarcinoma-of-the-ovary-diagnosed-by-dna-polymorphic-analysis-a-case-report-and-systematic-review-of-the-literature
#7
Nan Jia, Yan Chen, Xiang Tao, Enzhi Ou, Xin Lu, Weiwei Feng
BACKGROUND: Choriocarcinoma of the ovary is rare. This tumor can arise from gestational tissue or pure germ cells of the ovary, the former results in gestational choriocarcinoma. The clinical characteristics and histology of both tumor types are identical, differentiation of these tumors is necessary for effective treatment. One strategy for the differentiation of these tumors types is to identify the presence of paternal DNA by DNA polymorphic analysis. CASE PRESENTATION: In the present case, a 27-year-old patient with a history of amenorrhea, lower abdominal pain and vaginal bleeding received a laparoscopic dissection of cystic mass of the right ovary according to an initial diagnosis of ectopic pregnancy...
July 20, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28723855/four-year-outcomes-after-cessation-of-tenofovir-in-immune-tolerant-chronic-hepatitis-b-patients
#8
Vincent Wai-Sun Wong, Aric J Hui, Grace Lai-Hung Wong, Rosita Suk-Yi Chan, Angel Mei-Ling Chim, Angeline Oi-Shan Lo, Henry Lik-Yuen Chan
GOALS: To study the long-term outcome after cessation of antiviral therapy in immune-tolerant patients. BACKGROUND: Experience in the treatment of immune-tolerant chronic hepatitis B is scanty. Some immune-tolerant patients may receive temporary antiviral therapy, such as for prevention of vertical transmission at pregnancy or prophylaxis for chemotherapy. STUDY: This was a follow-up study of a phase 2 trial at 2 centers. Immune-tolerant patients received tenofovir disoproxil fumarate and/or emtricitabine for 4 years and were followed for another 4 years after treatment cessation...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28717722/gestational-trophoblastic-neoplasia-treatment-at-the-butaro-cancer-center-of-excellence-in-rwanda
#9
Ignace Nzayisenga, Roanne Segal, Natalie Pritchett, Mary J Xu, Paul H Park, Edgie V Mpanumusingo, Denis G Umuhizi, Donald P Goldstein, Ross S Berkowitz, Vedaste Hategekimana, Clemence Muhayimana, Fidel Rubagumya, Temidayo Fadelu, Neo Tapela, Tharcisse Mpunga, Rahel G Ghebre
PURPOSE: Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. PATIENTS AND METHODS: A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28703077/acute-myeloid-leukemia-during-pregnancy-a-systematic-review-and-meta-analysis
#10
Netanel A Horowitz, Israel Henig, Oryan Henig, Noam Benyamini, Liat Vidal, Irit Avivi
Data regarding clinical characteristics, therapy, maternal and fetal outcomes of pregnancy-associated acute myeloid leukemia (PA-AML) are limited. This study (including 138 cases published between 1955 and 2013) provides comprehensive assessment of these clinical parameters and may serve as a platform for developing management recommendations. Most patients (58%) received anthracycline-cytarabine-based regimens (ACBRs), which were associated with significantly increased complete remission (CR: 91%). Yet, the maternal overall survival (OS: ∼30%) was relatively low, probably reflecting reduced application of risk-adapted consolidation and allogeneic stem cell transplantation (allo-SCT)...
July 13, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28700986/chemotherapy-during-pregnancy-cases-of-hodgkin-s-and-non-hodgkin-s-lymphoma-chronic-myeloid-leukemia-breast-cancer-nasopharyngeal-cancer-and-choriocarcinoma
#11
Kemal Beksac, Gokcen Orgul, Ozgur Ozyuncu, Murat Yurdakok, Kadri Altundag, Mehmet S Beksac
BACKGROUND: The use of chemotherapeutics during pregnancy is a dilemma for both the patient and the clinician. We report here our 11 years' experience with the use of chemotherapy during pregnancy. PATIENTS: 13 patients undergoing chemotherapy during their current pregnancy were evaluated. The medical data of 5 patients with hematologic malignancies (2 Hodgkin's, 2 non-Hodgkin's lymphoma, and 1 chronic myeloid leukemia), 6 patients with breast cancer, 1 patients with nasopharyngeal cancer, and 1 patient with choriocarcinoma were retrospectively obtained from the 'perinatal database' of Hacettepe University for the period of January 2002 through March 2016...
2017: Oncology Research and Treatment
https://www.readbyqxmd.com/read/28684142/neuraxial-anesthesia-in-a-patient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-in-pregnancy-management-for-cesarean-delivery-and-oophorectomy
#12
L Demma, S Norris, J Dolak
We describe the neuraxial anesthetic management of a 28-year-old primigravid patient with severe, treatment-refractory anti-N-methyl-D-aspartate receptor encephalitis undergoing cesarean delivery. The presence of an ovarian teratoma was suspected although not confirmed by imaging. The severity of symptoms, ineffective immunotherapy and the need for chemotherapy necessitated cesarean delivery and resection of a suspected teratoma at 28weeks estimated gestational age. A combined spinal-epidural technique was used...
May 11, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28676785/atypical-teratoid-rhabdoid-tumor-two-case-reports-and-an-analysis-of-adult-cases-with-implications-for-pathophysiology-and-treatment
#13
Christopher Dardis, Jared Yeo, Kelly Milton, Lynn S Ashby, Kris A Smith, Shwetal Mehta, Emad Youssef, Jenny Eschbacher, Kathy Tucker, Laughlin Dawes, Neil Lambie, Elizabeth Algar, Elizabeth Hovey
We present the first quantitative analysis of atypical teratoid rhabdoid tumors (ATRT) in adults, including two patients from our own institutions. These are of interest as one occurred during pregnancy and one is a long-term survivor. Our review of pathological findings of 50 reported cases of adult ATRT leads us to propose a solely ectodermal origin for the tumor and that epithelial-mesenchymal transition (EMT) is a defining feature. Thus, the term ATRT may be misleading. Our review of clinical findings shows that ATRT tends to originate in mid-line structures adjacent to the CSF, leading to a high rate of leptomeningeal dissemination...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28668822/when-cancer-patients-suddenly-have-a-positive-pregnancy-test
#14
Daniela Groza, Donat Duerr, Mathias Schmid, Beatrix Boesch
We present the case of non-small cell lung cancer (NSCLC) in a 48-year-old woman with an active history of smoking. The patient initially presented to her general practitioner with a progressive swelling on the neck. Further investigations diagnosed a metastatic lung tumour, and palliative chemotherapy was started. After 5 months of treatment, by newly reported amenorrhoea, cautiously before a restaging CT scan of the abdomen, a pregnancy test was performed and was positive. Both the gynaecological examination and the hormonal panel yielded no signs of pregnancy...
July 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28649094/current-management-of-pregnancy-associated-breast-cancer
#15
H Hy Yu, P Sy Cheung, R Cy Leung, T N Leung, W H Kwan
Pregnancy-associated breast cancer is the most common malignancy during pregnancy with an expected rise in incidence. The belief in the need for termination of pregnancy and that chemotherapy is contra-indicated during pregnancy is challenged by recent evidence. Patients can consider breast-conserving surgery and sentinel lymph node biopsy with acceptably low fetal risk from radiation exposure. A range of chemotherapeutics is possible in the second trimester in terms of drug class and frequency. Hormone therapy and monoclonal antibody therapy are contra-indicated during pregnancy and lactation...
June 26, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28647996/-curative-effects-and-influenced-factors-of-primary-chemotherapy-with-single-agent-methotrexate-on-low-risk-gestational-trophoblastic-neoplasia
#16
X D Wu, L L Chen, T Shen, S S Chen, Q Q Chen, J L Qin, Y F Fu, W G Lü
Objective: To evaluate the efficacy of primary chemotherapy with single-agent methotrexate (MTX) for low-risk gestational trophoblastic neoplasia and to analysis the influenced factors. Methods: We retrospectively reviewed 259 cases with low-risk gestational trophoblastic neoplasia whose primary chemotherapies were MTX 0.4 mg·kg(-1) (maximum 25 mg) daily for 5 days every other week. Patients' data between January 2001 and June 2015 was collected and the relationships of different factors to outcomes of chemotherapy were also evaluated...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28645785/contraceptive-counseling-in-reproductive-aged-women-treated-for-breast-cancer-at-a-tertiary-care-institution-a-retrospective-analysis
#17
Sara L Johansen, Klaira Lerma, Kate A Shaw
OBJECTIVE: The objective was to assess the frequency of documented contraceptive and fertility preservation counseling for women treated for breast cancer. STUDY DESIGN: We conducted a chart analysis of female breast cancer patients (n=211) ages 18-45 years receiving chemotherapy treatment at Stanford Comprehensive Cancer Center from 2010 to 2014. Primary outcomes of contraceptive counseling and fertility preservation counseling documentation were assessed for frequency...
June 20, 2017: Contraception
https://www.readbyqxmd.com/read/28645262/acute-myeloid-leukemia-and-pregnancy-clinical-experience-from-a-single-center-and-a-review-of-the-literature
#18
Nicola Stefano Fracchiolla, Mariarita Sciumè, Francesco Dambrosi, Francesca Guidotti, Manuela Wally Ossola, Giovanna Chidini, Umberto Gianelli, Daniela Merlo, Agostino Cortelezzi
BACKGROUND: Acute myeloid leukemia (AML) accounts for more than two thirds of leukemia during pregnancy and has an incidence of 1 in 75,000 to 100,000. Its clinical management remains a challenging therapeutic task both for patient and medical team, given to the therapy-attributable risks for mother and fetus and the connected counseling regarding pregnancy continuation. METHODS: We provided a review of updated literature and a comprehensive description of five maternal/fetal outcomes of AML cases diagnosed concomitantly to pregnancy and treated at our Institution from 2006 to 2012...
June 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28645120/acute-abdomen-secondary-to-ruptured-epithelial-ovarian-cancer-during-pregnancy-the-relevance-of-teamwork
#19
Carlos Manuel Ortiz-Mendoza, Sandra Adriana Vera-Vázquez, Manuel Gómez-Rodríguez, José Luis López-Gómez, Leticia Bornstein-Quevedo
Acute abdomen secondary to epithelial ovarian cancer rupture during pregnancy is a rare event. Our aim is to present how the work of a coordinated multidisciplinary team in a case of ruptured epithelial ovarian cancer during pregnancy is feasible to obtain the best results possible. A 34-year-old woman during the 37th week of her first gestation presented with an acute abdomen. During laparotomy, a ruptured 16.5-cm left ovarian tumor was detected; the tumor was extirpated and sent to pathologic evaluation. In the meantime, a Kerr cesarean section was performed, and a healthy female neonate was born...
June 23, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28626764/does-chemotherapy-for-gynecological-malignancies-during-pregnancy-cause-fetal-growth-restriction
#20
REVIEW
Nabil Abdalla, Magdalena Bizoń, Robert Piórkowski, Paweł Stanirowski, Krzysztof Cendrowski, Włodzimierz Sawicki
Cancer and pregnancy rarely coincide. Gynecological cancers are among the most common malignancies to occur during pregnancy, and chemotherapy with or without surgery is the primary treatment option. The main concern of administering chemotherapy during pregnancy is congenital malformation, although it can be avoided by delaying treatment until after organogenesis. The dose, frequency, choice of chemotherapeutic agents, time of treatment commencement, and method of administration can be adjusted to obtain the best maternal treatment outcomes while simultaneously minimizing fetal toxicity...
2017: BioMed Research International
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