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https://www.readbyqxmd.com/read/28342647/recurrence-patterns-after-a-decreased-dose-of-40gy-to-the-elective-treated-neck-in-head-and-neck-cancer
#1
Daan Nevens, Fréderic Duprez, Jean-François Daisne, Julie Schatteman, Aline Van der Vorst, Wilfried De Neve, Sandra Nuyts
PURPOSE: To investigate the patterns of regional recurrences with emphasis on recurrences in the electively irradiated lymph node regions after dose de-escalation to 40Gy (EQD2Gy) in head and neck cancer. METHODS AND MATERIALS: Two hundred thirty-three patients treated with radio(chemo)therapy using 40Gy (EQD2Gy) to the elective lymph node regions were included. All regional recurrences were reconstructed and projected on the initial radiotherapy planning Computed Tomography studies to identify the localization of recurrence...
March 22, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28340333/the-randomized-crm-an-approach-to-overcoming-the-long-memory-property-of-the-crm
#2
Joseph S Koopmeiners, Andrew Wey
The primary object of a Phase I clinical trial is to determine the maximum tolerated dose (MTD). Typically, the MTD is identified using a dose-escalation study, where initial subjects are treated at the lowest dose level and subsequent subjects are treated at progressively higher dose levels until the MTD is identified. The continual reassessment method (CRM) is a popular model-based dose-escalation design, which utilizes a formal model for the relationship between dose and toxicity to guide dose finding. Recently, it was shown that the CRM has a tendency to get "stuck" on a dose level, with little escalation or de-escalation in the late stages of the trial, due to the long-memory property of the CRM...
March 1, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#3
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339695/incidence-and-outcomes-of-infections-caused-by-multidrug-resistant-enterobacteriaceae-in-children-2007-2015
#4
Sharon B Meropol, Allison A Haupt, Sara M Debanne
Background.: The escalating incidence of invasive disease caused by multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) is a global concern. Scant published studies in which the epidemiology of these infections in children is described exist; previous studies focused mainly on adults, described circumscribed populations, or lacked clinical detail. The objective of this study was to examine and describe the incidence, risk factors, and outcomes associated with MDR-GNE infection in children...
February 22, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#5
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337715/is-incremental-hemodialysis-ready-to-return-on-the-scene-from-empiricism-to-kinetic-modelling
#6
REVIEW
Carlo Basile, Francesco Gaetano Casino, Kamyar Kalantar-Zadeh
Most people who make the transition to maintenance dialysis therapy are treated with a fixed dose thrice-weekly hemodialysis regimen without considering their residual kidney function (RKF). The RKF provides effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status, and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life, although these effects may be confounded by patient comorbidities...
March 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28337425/post-prostatectomy-image-guided-radiotherapy-the-invisible-target-concept
#7
REVIEW
Florent Vilotte, Mickael Antoine, Maxime Bobin, Igor Latorzeff, Stéphane Supiot, Pierre Richaud, Laurence Thomas, Nicolas Leduc, Stephane Guérif, Jone Iriondo-Alberdi, Renaud de Crevoisier, Paul Sargos
In the era of intensity-modulated radiation therapy, image-guided radiotherapy (IGRT) appears crucial to control dose delivery and to promote dose escalation while allowing healthy tissue sparing. The place of IGRT following radical prostatectomy is poorly described in the literature. This review aims to highlight some key points on the different IGRT techniques applicable to prostatic bed radiotherapy. Furthermore, methods used to evaluate target motion and to reduce planning target volume margins will also be explored...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28337167/research-recommendations-for-improving-measurement-of-treatment-effectiveness-in-depression
#8
Kaloyan Kamenov, María Cabello, Mónica Nieto, Renaldo Bernard, Elisabeth Kohls, Christine Rummel-Kluge, José L Ayuso-Mateos
Background: Despite the steadily escalating psychological and economic burden of depression, there is a lack of evidence for the effectiveness of available interventions on functioning areas beyond symptomatology. Therefore, the main objective of this study was to give an insight into the current measurement of treatment effectiveness in depression and to provide recommendations for its improvement. Materials and Methods: The study was based on a multi-informant approach, comparing data from a systematic literature review, an expert survey with representatives from clinical practice (130), and qualitative interviews with patients (11) experiencing depression...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28336834/-parenteral-calcimimetics-for-the-treatment-of-secondary-hyperparathyroidism
#9
Naoto Hamano, Masafumi Fukagawa
The oral calcimimetics, cinacalcet, is reported to be effective on secondary hyperparathyroidism resistant to classical treatment like phosphate binders or vitamin D receptor activator. The problem that gastrointestinal adverse events cause poor adherence, drug discontinuation, and insufficient dose escalation remains unsolved. The novel injectable calcimimetic, etelcalcetide, is recently developed and is expected to reduce such adverse events and improve the therapeutic effects on moderate to severe secondary hyperparathyroidism...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28336784/evaluation-of-the-effect-of-fingolimod-treatment-on-microglial-activation-using-serial-pet-imaging-in-multiple-sclerosis
#10
Marcus Sucksdorff, Eero Rissanen, Jouni Tuisku, Salla Nuutinen, Teemu Paavilainen, Johanna Rokka, Juha Rinne, Laura Airas
Traditionally, multiple sclerosis (MS) has been considered a white matter (WM) disease with focal inflammatory lesions. It is, however, becoming clear that significant pathology, such as microglial activation, also takes place outside the plaque areas, i.e. in areas of normal appearing white matter (NAWM) and gray matter (GM). Microglial activation can be detected in vivo using an 18 kDa translocator protein (TSPO) binding radioligands and positron emission tomography (PET). It is unknown whether fingolimod affects microglial activation in MS...
March 23, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28336527/a-phase-i-clinical-trial-of-single-agent-selinexor-in-acute-myeloid-leukemia
#11
Ramiro Garzon, Michael Savona, Rachid Baz, Michael Andreeff, Nashat Gabrail, Martin Gutierrez, Lynn Savoie, Morten Mau-Sorensen, Nina Wagner-Johnston, Karen Yee, T J Unger, Jean Richard Saint-Martin, Robert Carlson, Tami Rashal, Trinayan Kashyap, Boris Klebanov, Sharon Shacham, Michael Kauffman, Richard Stone
Selinexor is a novel, first-in-class, Selective Inhibitor of Nuclear Export (SINE) compound, which blocks XPO1 function, leads to nuclear accumulation of tumor suppressor proteins (TSPs) and induces cancer cell death. A phase I dose-escalation study was initiated to examine the safety and efficacy of selinexor in patients with advanced hematological malignancies. Ninety-five patients with relapsed or refractory acute myeloid leukemia (AML) were enrolled between January 2013 and June 2014 to receive 4, 8 or 10 doses of selinexor in 21- or 28-day cycle...
March 23, 2017: Blood
https://www.readbyqxmd.com/read/28336111/hepatoprotective-effects-of-curcumin-in-rats-after-bile-duct-ligation-via-downregulation-of-rac1-and-nox1
#12
Zohreh-Al-Sadat Ghoreshi, Razieh Kabirifar, Fatemeh Safari, Alireza Karimollah, Ali Moradi, Ebrahim Eskandari-Nasab
OBJECTIVES: New evidence has proven the hepatoprotective activity of curcumin; however, its underlying mechanisms remain to be elucidated. The aim of this study was to investigate the protective effect of curcumin on hepatic damage by measuring the antioxidant capacity and expression level of Rho-related C3 botulinum toxin substrate (Rac1), Rac1-Guanosine triphosphate (Rac1-GTP), and NADPH oxidase 1(NOX1) in biliary duct-ligated (BDL)-fibrotic rat model. METHODS: Wistar rats weighing 200 to 250 g were divided into four groups (n = 8 for each): sham group, sham+Cur group (received curcumin 100 mg/kg daily), BDL+Cur group, and BDL group...
April 2017: Nutrition
https://www.readbyqxmd.com/read/28335798/treatment-of-mucocutaneous-manifestations-in-beh%C3%A3-et-s-disease-with-anakinra-a-pilot-open-label-study
#13
Peter C Grayson, Yusuf Yazici, Melissa Merideth, H Nida Sen, Michael Davis, Elaine Novakovich, Elizabeth Joyal, Raphaela Goldbach-Mansky, Cailin H Sibley
BACKGROUND: The effect of IL-1 blocking therapy on mucocutaneous manifestations of Behçet's disease is incompletely understood. METHODS: Six patients with Behçet's disease and ongoing oral/genital ulcers for ≥1 month were enrolled into an adaptive, two-phase clinical trial and included in the analysis. Study duration was 6 months with extension up to 16 months. All were treated non-blinded with anakinra 100 mg subcutaneous daily with the option to escalate the dose to 200 mg in partial responders after 1 month and 300 mg after 6 months...
March 24, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28335778/radiation-dose-escalation-based-on-fdg-pet-driven-dose-painting-by-numbers-in-oropharyngeal-squamous-cell-carcinoma-a-dosimetric-comparison-between-tomotherapy-ha-and-rapidarc
#14
Sarah Differding, Edmond Sterpin, Nicolas Hermand, Bianca Vanstraelen, Sandra Nuyts, Nathalie de Patoul, Jean-Marc Denis, John Aldo Lee, Vincent Grégoire
PURPOSE: Validation of dose escalation through FDG-PET dose painting (DP) for oropharyngeal squamous cell carcinoma (SCC) requires randomized clinical trials with large sample size, potentially involving different treatment planning and delivery systems. As a first step of a joint clinical study of DP, a planning comparison was performed between Tomotherapy HiArt® (HT) and Varian RapidArc® (RA). METHODS: The planning study was conducted on five patients with oropharyngeal SCC...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28335614/therapeutic-targeting-of-protein-kinase-ck2-gene-expression-in-feline-oral-squamous-cell-carcinoma-a-naturally-occurring-large-animal-model-of-head-and-neck-cancer
#15
Claire Cannon, Janeen Trembley, Betsy Kren, Gretchen Unger, M Gerard O'Sullivan, Ingrid Cornax, Jaime Modiano, Khalil Ahmed
Protein kinase CK2 (CK2) is a highly promising target for cancer therapy and anti-CK2 gene expression therapy has shown effectiveness in rodent models of human head and neck cancer (HNC). To date, there has been no large animal model of cancer in which to further explore anti-CK2 therapies. Feline oral squamous cell carcinoma (FOSCC) has been proposed as a large animal model for human HNC and we have previously shown that CK2 is a rational target in FOSCC. We hypothesized that a novel tenfibgen coated tumor-specific nanocapsule carrying RNAi oligonucleotides targeting feline CK2α and CK2α' (TBG-RNAi-fCK2αα') would be safe in cats with FOSCC...
March 23, 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28334621/sequential-cyclophosphamide-bortezomib-dexamethasone-unmasks-the-harmful-cardiac-effect-of-dexamethasone-in-primary-light-chain-cardiac-amyloidosis
#16
Fabien Le Bras, Valerie Molinier-Frenkel, Aziz Guellich, Jehan Dupuis, Karim Belhadj, Soulef Guendouz, Karima Ayad, Magali Colombat, Nicole Benhaiem, Claire Marie Tissot, Anne Hulin, Arnaud Jaccard, Thibaud Damy
Chemotherapy combining cyclophosphamide, bortezomib and dexamethasone is widely used in light-chain amyloidosis. The benefit is limited in patients with cardiac amyloidosis mainly because of adverse cardiac events. Retrospective analysis of our cohort showed that 39 patients died with 42% during the first month. A new escalation-sequential regimen was set to improve the outcomes. Nine newly-diagnosed patients were prospectively treated with close monitoring of serum N-terminal pro-brain natriuretic peptide, troponin-T and free light chains...
March 20, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28333157/consensus-approach-to-nasal-high-flow-therapy-in-neonates
#17
B A Yoder, B Manley, C Collins, K Ives, A Kugelman, A Lavizzari, M McQueen
OBJECTIVE: Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations. STUDY DESIGN: Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28332765/combating-blood-stream-infections-during-induction-chemotherapy-in-children-with-acute-myeloid-leukemia-single-center-results-in-india
#18
Divya Subburaj, Ramya Uppuluri, Dhaarani Jayaraman, Venkateshwaran Vellaichamyswaminathan, Sathishkumar Kandath, Revathi Raj
Optimal management of infectious complication is the biggest challenge in children receiving chemotherapy for acute myeloid leukemia (AML). We have analyzed the data of children undergoing AML induction chemotherapy at our center from 2002 to 2016 and found that Gram-negative infections are more predominant when compared to the published literature. There also has been a surge in multidrug-resistant (MDR) infections over the last 4 years, which has increased the need for supportive care and escalated the cost of care...
March 23, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28332328/paediatric-high-flow-nasal-cannula-therapy-in-children-with-bronchiolitis-a-retrospective-safety-and-efficacy-study-in-a-non-tertiary-environment
#19
Michelle Davison, Mike Watson, Leesa Wockner, Frances Kinnear
OBJECTIVE: The objective was to examine the safety and efficacy of high-flow nasal cannula (HFNC) therapy for children with bronchiolitis in a non-tertiary paediatric setting. METHODS: This was a single-centre retrospective study conducted over 26 months (March 2013-April 2015) on children aged 1-23 months with suspected bronchiolitis, who commenced on HFNC therapy in either the ED or the ward. Changes with respect to baseline data were analysed for effect on work of breathing (WOB), heart rate (HR) and respiratory rate (RR)...
April 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28331050/first-in-human-clinical-trial-of-oral-onc201-in-patients-with-refractory-solid-tumors
#20
Mark N Stein, Joseph R Bertino, Howard L Kaufman, Tina Mayer, Rebecca Moss, Ann Silk, Nancy Chan, Jyoti Malhotra, Lorna Rodriguez-Rodriguez, Joseph Aisner, Robert D Aiken, Bruce G Haffty, Robert S DiPaola, Tracie Saunders, Andrew Zloza, Sherri Damare, Yasmeen Beckett, Bangning Yu, Saltanat Najmi, Christian Gabel, Siobhan Dickerson, Ling Zheng, Wafik S El-Deiry, Joshua Allen, Martin Stogniew, Wolfgang Oster, Janice M Mehnert
Purpose ONC201 is a small molecule selective antagonist of the G protein-coupled receptor DRD2 that is the founding member of the imipridone class of compounds. A first-in-human phase I study of ONC201 was conducted to determine its recommended phase II dose (RP2D). Experimental Design This open-label study treated 10 patients during dose escalation with histologically-confirmed advanced solid tumors. Patients received ONC201 orally once every 3 weeks, defined as one cycle, at doses from 125 to 625 mg using an accelerated titration design...
March 22, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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