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https://www.readbyqxmd.com/read/28743035/current-trials-to-reduce-surgical-intervention-in-ductal-carcinoma-in-situ-of-the-breast-critical-review
#1
REVIEW
M Toss, I Miligy, A M Thompson, H Khout, A R Green, I O Ellis, E A Rakha
The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach...
July 22, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28740585/testosterone-and-the-heart
#2
Travis Goodale, Archana Sadhu, Steven Petak, Richard Robbins
Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes. Reduced T levels in men with congestive heart failure (CHF) portends a poor prognosis and is associated with increased mortality. Studies have reported a reduced CV risk with higher endogenous T concentration, improvement of known CV risk factors with T therapy, and reduced mortality in T-deficient men who underwent T replacement therapy versus untreated men...
April 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28740372/pharmacological-treatment-of-osteoporosis-in-the-oldest-old
#3
REVIEW
A Vandenbroucke, F P Luyten, J Flamaing, E Gielen
The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70-75 years...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28737051/pharmacokinetic-pharmacodynamic-drug-evaluation-of-benralizumab-for-the-treatment-of-asthma
#4
Maria Gabriella Matera, Luigino Calzetta, Barbara Rinaldi, Mario Cazzola
In many severe asthmatics, eosinophils cause inflammation and airways hyperresponsiveness, resulting in frequent exacerbations, impaired lung function, and reduced quality of life. Interleukin-5 (IL-5) is a key cytokine for eosinophil growth, differentiation, recruitment, activation, and survival. Anti-IL-5-based therapies (mepolizumab and reslizumab are humanized monoclonal antibodies (hmAbs) that recognize free IL-5, benralizumab is a hmAb directed at the α subunit of the IL-5R) target the IL-5-signaling in eosinophilic asthma...
July 24, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28736906/dental-pulp-stem-cells-and-the-management-of-neurological-diseases-an-update
#5
REVIEW
Ibrahim Mortada, Rola Mortada, Mohamad Al Bazzal
Medical research in regenerative medicine has brought promising perspectives for the use of stem cells in clinical trials. Stem cells are undifferentiated cells capable of multilineage differentiation and available in numerous sources in the human body. Dental pulp constitutes an attractive source of these cells since collecting mesenchymal stem cells from this site is a noninvasive practice that can be performed after a common surgical extraction of supernumerary or wisdom teeth. Thus, tissue sacrifice is very low and several cytotypes can be obtained owing to these cells' multipotency, in addition to the fact that they can be cryopreserved and stored for long periods...
July 24, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28736630/current-biologics-for-treatment-of-biliary-tract-cancers
#6
REVIEW
Diana Y Zhao, Kian-Huat Lim
Biliary tract cancers (BTC) is a group of malignancies that arise from the epithelial cells of the biliary tree. These cancers are typically classified by anatomic site of origin: intrahepatic cholangiocarcinoma (IHCC) and extrahepatic cholangiocarcinoma (EHCC), and gallbladder cancer (GBC). To date, complete surgical resection remains the mainstay of treatment especially for earlier stage disease. Unfortunately, most patients present with advanced or metastatic disease, when systemic chemotherapy is the only treatment option...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#7
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#8
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28726525/working-memory-capacity-and-addiction-treatment-outcomes-in-adolescents
#9
Jon M Houck, Sarah W Feldstein Ewing
BACKGROUND: Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Working memory depends upon brain structures and functions that change markedly during neurodevelopment and that can be negatively impacted by substance use...
July 20, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28723375/the-effects-of-exercise-on-fatigue-quality-of-life-and-psychological-function-for-men-with-prostate-cancer-systematic-review-and-meta-analyses
#10
REVIEW
Vishal Vashistha, Balwinder Singh, Sukhdeep Kaur, Larry J Prokop, Dharam Kaushik
CONTEXT: Conflicting data exists on the role of exercise interventions in patients with prostate cancer (PCa) regarding quality of life (QOL) endpoints. OBJECTIVE: To evaluate the effects of exercise interventions on fatigue, QOL, depression, and anxiety in PCa patients. EVIDENCE ACQUISITION: We searched seven major databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, and Scopus) for randomized control trials (RCTs) of supervised exercise interventions for men with PCa from database inception to October 2015...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28722322/advanced-methods-for-dose-and-regimen-finding-during-drug-development-summary-of-the-ema-efpia-workshop-on-dose-finding-london-4-5-december-2014
#11
F T Musuamba, E Manolis, N Holford, Sya Cheung, L E Friberg, K Ogungbenro, M Posch, Jwt Yates, S Berry, N Thomas, S Corriol-Rohou, B Bornkamp, F Bretz, A C Hooker, P H Van der Graaf, J F Standing, J Hay, S Cole, V Gigante, K Karlsson, T Dumortier, N Benda, F Serone, S Das, A Brochot, F Ehmann, R Hemmings, I Skottheim Rusten
Inadequate dose selection for confirmatory trials is currently still one of the most challenging issues in drug development, as illustrated by high rates of late-stage attritions in clinical development and postmarketing commitments required by regulatory institutions. In an effort to shift the current paradigm in dose and regimen selection and highlight the availability and usefulness of well-established and regulatory-acceptable methods, the European Medicines Agency (EMA) in collaboration with the European Federation of Pharmaceutical Industries Association (EFPIA) hosted a multistakeholder workshop on dose finding (London 4-5 December 2014)...
July 19, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28722159/commentary-changes-are-still-needed-on-multiple-co-primary-endpoints
#12
Christy Chuang-Stein, Jianjun David Li
The Food and Drug Administration in the United States issued a much-awaited draft guidance on 'Multiple Endpoints in Clinical Trials' in January 2017. The draft guidance is well written and contains consistent message on the technical implementation of the principles laid out in the guidance. In this commentary, we raise a question on applying the principles to studies designed from a safety perspective. We then direct our attention to issues related to multiple co-primary endpoints. In a paper published in the Drug Information Journal in 2007, Offen et al...
July 19, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28721913/clinical-utility-of-epstein-barr-virus-dna-testing-in-the-treatment-of-nasopharyngeal-carcinoma-patients
#13
REVIEW
Kelly Y Kim, Quynh-Thu Le, Sue S Yom, Raymond H W Ng, K C Allen Chan, Scott V Bratman, John J Welch, Rao L Divi, Raymond A Petryshyn, Barbara A Conley
Epstein-Barr virus (EBV) DNA analysis has been shown to be useful for early detection, prognostication, and monitoring of treatment response of nasopharyngeal carcinoma (NPC), and the recent literature provides growing evidence of the clinical utility of EBV DNA testing, particularly to inform treatment decisions for NPC patients. Despite the fact that NPC is a rare disease, the NRG Oncology cooperative group has successfully activated a phase 2/3 randomized clinical trial for NPC with international partners and in that process has discovered that the development of a harmonized EBV DNA test is absolutely critical for integration into clinical trials and for future deployment in clinical and central laboratories...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#14
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28717370/classic-high-lateral-tension-and-triangular-resection-methods-to-prevent-dog-ear-and-elongation-scar-in-patients-undergoing-abdominoplasty-a-comparative-open-label-clinical-trial
#15
Hossein Abdali, Mohammadbagher Heydari, Mahmood Omranifard, Mahdi Rasti
BACKGROUND: One of the most common operations in the plastic surgery curse is abdominoplasty. Several methods were recommended for achieving better results. In the present study, efficacy of a new method compared with classical high lateral tension on preventing dog ear and elongation scar was evaluated. MATERIALS AND METHODS: in an open-label, randomized clinical trial, seventy patients who were candidates for abdominoplasty were selected and randomly divided into two groups...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28716141/the-german-day-care-study-multicomponent-non-drug-therapy-for-people-with-cognitive-impairment-in-day-care-centres-supplemented-with-caregiver-counselling-detamaks-study-protocol-of-a-cluster-randomised-controlled-trial
#16
Elisa-Marie Behrndt, Melanie Straubmeier, Hildegard Seidl, Stephanie Book, Elmar Graessel, Katharina Luttenberger
BACKGROUND: It is the wish of both people with cognitive impairment and their informal caregivers for the impaired person to live at home for as long as possible. This is also in line with economic arguments about health. The existing structure of day-care services for the elderly can be used to achieve this. Due to the current lack of empirical evidence in this field, most day-care centres do not offer a scientifically evaluated, structured intervention, but instead offer a mixture of individual activities whose efficacy has not yet been established...
July 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28715063/peripehral-artery-atherosclerotic-disease-and-sleep-disordered-breathing-paradise-trial-protocol-for-an-observational-cohort-study
#17
Filip M Szymański, Zbigniew Gałązka, Anna E Płatek, Dariusz Górko, Tomasz Ostrowski, Karolina Adamkiewicz, Paweł Łęgosz, Anna Ryś, Karolina Semczuk, Krzysztof Celejewski, Krzysztof J Filipiak
BACKGROUND: Peripheral arterial disease (PAD) is in fact a group of disease entities with different symptoms and course but a common underlying cause that is atherosclerosis. Atherosclerosis is known to be aggravated by several cardiovascular risk factors, including obstructive sleep apnea (OSA). AIM: Following paper is a protocol for Peripehral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial, which aims to describe the prevalence of OSA in PAD patients scheduled for revascularization and to determine the effect of OSA on the procedure outcomes...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28714410/management-of-blood-pressure-and-heart-rate-in-patients-with-acute-stroke
#18
Carlo Maida, Antonino Tuttolomondo, Domenico Di Raimondo, Antonio Pinto
BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia...
July 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28711339/imaging-department-organization-in-a-stroke-center-and-workflow-processes-in-acute-stroke
#19
REVIEW
Zarina Abdul Assis, Bijoy K Menon, Mayank Goyal
The imaging department is an integral part of the stroke management task force and plays a critical role. Accurate and timely interpretation of images obtained in the emergency department and involvement in decision-making has contributed immensely in stroke care. In fact, the treatment paradigm has changed considerably after the recent positive endovascular clinical trials; and so is the hospital workflow and treatment site. As a result, the imaging department has become the site of maximum activity during an acute stroke protocol...
June 20, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28708988/early-colonisation-of-urban-indoor-carcasses-by-blow-flies-diptera-calliphoridae-an-experimental-study-from-central-spain
#20
Daniel Martín-Vega, Carla Martín Nieto, Blanca Cifrián, Arturo Baz, Luisa M Díaz-Aranda
Due to their ubiquity and synanthropy, blow flies (Diptera: Calliphoridae) are generally the first colonisers of cadavers and, therefore, frequently used to estimate a minimum post-mortem interval (minPMI). Whereas in outdoor situations blow flies are expected to locate and colonise exposed cadavers within hours or even minutes after death, it is usually assumed that the colonisation of a cadaver indoors might be delayed for an uncertain period of time. This uncertainty severely limits the informativity of minPMI estimates based on entomological evidence...
July 8, 2017: Forensic Science International
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