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https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#1
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3(-)) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29132473/-progress-in-clinical-studies-of-chimeric-antigen-receptor-engineered-t-cells-for-treatment-of-childhood-cancer
#2
Ya-Ru Ni, Xiao-Jun Xu, Yong-Min Tang
Nowadays, the 5-year survival rate of childhood cancer patients can be more than 80%, but some patients with relapse and refractory cancers have shown no good response to traditional strategies. Chimeric antigen receptor engineered T (CAR-T) cell therapy is promising for these patients. CAR-T cells recognize the tumor-associated antigens in a non-major histocompatibility complex-restricted manner, so their anti-tumor ability is enhanced. There are four generations of CAR-T cells now. The complete remission rate of pediatric patients with relapse and refractory acute lymphoblastic leukemia can be as high as 90% when treated with CD19-targeting CAR-T cells...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29130003/spontaneous-tumor-lysis-syndrome-due-to-uterine-leiomyosarcoma-with-lung-metastases
#3
Vivek Alaigh, Debapriya Datta
Tumor lysis syndrome (TLS) is an oncologic emergency characterized by a combination of metabolic derangements (hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia) caused by rapid turnover from cell destruction in certain cancers. These metabolic derangements can lead to seizures, cardiac arrhythmias, renal failure, and death. TLS is usually seen after the initiation of chemotherapy for hematologic malignancies. TLS occurring spontaneously, without initiation of chemotherapy, is rare and its occurrence in solid tumors is rarer still...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29122155/rituximab-hypersensitivity-evaluation-desensitization-and-potential-mechanisms
#4
Johnson T Wong, Aidan Long
BACKGROUND: Rituximab (Rituxan) hypersensitivity (RITS) can be severe and limits the ability to further administer the treatment. Understanding its pattern and desensitization may permit administration in difficult cases. OBJECTIVE: Analyze RITS patient characteristics, hypersensitivity pattern, and desensitization outcomes to optimize management. METHODS: Twenty-five patients with RITS were referred to the Allergy/Immunology Unit at Massachusetts General Hospital over 5 1/2 years...
November 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29082835/efficacy-and-safety-of-bispecific-t-cell-engager-blinatumomab-and-the-potential-to-improve-leukemia-free-survival-in-b-cell-acute-lymphoblastic-leukemia
#5
Josep-Maria Ribera
Immunotherapy is a promising modality of treatment of neoplastic diseases, including acute lymphoblastic leukemia (ALL). The CD19/CD3-bispecific T cell-engaging (BiTE®) monoclonal antibody blinatumomab can transiently bind cytotoxic T cells to CD19(+) target B cells of ALL inducing their serial lysis. Areas covered: This review focuses on the efficacy and safety of blinatumomab used for the treatment of relapsed/refractory (R/R) ALL and minimal residual disease (MRD)-positive B-cell precursor (BCP) ALL in adults and children, as well as the future prospects of this drug in the treatment of ALL...
October 30, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29078931/oncologic-metabolic-emergencies
#6
REVIEW
Jonathan Wagner, Sanjay Arora
Cancer and its therapies may lead to several metabolic emergencies that emergency providers (EPs) should be well-versed in identifying and managing. With prompt recognition and treatment initiation in the emergency department, lives can be saved and quality of life maintained. Most oncologic metabolic emergencies occur in advanced cancer states, but some follow initiation of treatment or may be the presenting syndrome that leads to the cancer diagnosis. This article reviews the 2 most emergent oncologic metabolic diagnoses: tumor lysis syndrome and hypercalcemia of malignancy...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29078243/-endovascular-therapy-of-chronic-venous-outflow-obstruction
#7
Michael Lichtenberg, Houman Jalaie
Current national and international guidelines recommend endovascular therapy of iliofemoral thromboses in young patients, as a treatment option to avoid the post-thrombotic syndrome. Possible techniques include endovascular local lysis therapy, as well as pharmacomechanical or purely mechanical procedures. Endovascular therapy of chronic obstruction of the inferior V. cava or pelvic veins is an effective therapy for patients suffering from post-thrombotic syndrome. If there is involvement of the V. femoralis communis, hybrid operations may be considered in which an AV fistula is formed or endophlebectomy is carried out...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29070107/-clinical-analysis-of-7-children-with-mature-b-cell-acute-lymphoblastic-leukemia
#8
Jun Wang, Qin Lu, Lu-Lu He, Xiao-Yan Sun, Meng-Jiao Sun, Yong-Jun Fang
OBJECTIVE: To evaluate the efficacy of CCCG-BNHL-2015 protocol in treatment of children with mature B-cell acute lymphoblastic leukemia (mature B-ALL). METHODS: Seven pediatric patients with newly diagnosed mature B-ALL were treated by CCCG-BNHL-2015 protocol (risk group R4) in Children's Hospital of Nanjing Medical University from November 2014 to January 2017. RESULTS: The median age of patients at initial diagnosis was 7.2 years (range 4...
October 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29055517/enhanced-cd8-cytolytic-t-cell-responses-in-the-peripheral-circulation-of-patients-with-sarcoidosis-and-non-l%C3%A3-fgren-s-disease
#9
Venkata Ramanarao Parasa, Helena Forsslund, Tobias Enger, Daniel Lorenz, Susanna Kullberg, Anders Eklund, Magnus Sköld, Jan Wahlström, Johan Grunewald, Susanna Brighenti
BACKGROUND: The role of CD4(+) T cells in the immunopathogenesis of pulmonary sarcoidosis is well-established, while less is known about the phenotype and function of CD8(+) cytolytic T cells (CTLs). METHODS: CD8(+) CTLs were explored in peripheral blood and bronchoalveolar lavage (BAL) samples obtained from up to 25 patients with sarcoidosis and 25 healthy controls. The proportion of CTLs was assessed by the expression of cytolytic effector molecules perforin, granzyme B and granulysin in CD8(+) T cells, using flow cytometry...
October 13, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29050112/-clinical-pathologic-characteristics-and-treatment-outcomes-of-19-relapsed-pediatric-b-cell-lymphoma
#10
S Huang, L Jin, J Yang, Y L Duan, M Zhang, C J Zhou, X L Ma, Y H Zhang
Objective: To review the clinical-pathology characteristics of 19 relapsed pediatric mature B cell lymphoma and to find the risk factors for recurrence and the feasible treatment after relapse. Method: Data of 212 pediatric B cell lymphomas cases in Beijing Children's Hospital from January 2006 to June 2015 were collected retrospectively. All the patients were treated according to the B cell lymphoma regimen of Beijing Children's Hospital. During the study period, 19 of 212 cases were relapsed; the clinio-pathological characteristics of relapsed patients before treatment and after relapse were analyzed retrospectively, the treatment outcomes after relapse were summarized and the patients were followed-up...
October 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29049090/pharmacomechanical-thrombolysis-for-deep-vein-thrombosis-in-may-thurner-syndrome
#11
Mayank Roy, Morris Sasson, Armando Rosales-Velderrain, Savannah Moon, Mark Grove, Terry King
OBJECTIVE: Patients with May-Thurner syndrome presenting with acute deep vein thrombosis benefit from early lysis of clot and endovascular treatment. We evaluated the outcome of patients with May-Thurner syndrome who presented with deep vein thrombosis, managed with pharmacomechanical thrombolysis as the primary mode of intervention, in combination with angioplasty and stent placement. METHODS: We reviewed all patients with May-Thurner syndrome managed in our institution between January 2009 to December 2015...
October 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29045996/sicko-development-of-a-multi-disciplinary-training-concept-for-paediatric-oncology
#12
Petra Tiroke, Birte Sänger, Urs Mücke, Lea Berndt, Henrike Wittenbecher, Lorenz Grigull
Background Treating children with cancer requires multiple different skills. For the healthcare personnel (HCP) in Germany the practice of ongoing training to improve professional skills is almost non-existent. Therefore, we developed a programme called 'SICKO' to support HCPs skills and attitudes by means of a multidisciplinary workshop. Methods Following a qualitative analysis, we then designed a modular (3 day) workshop. During day one (8 h) participants learn practical skills, the fundamentals of chemotherapy, and effective communication skills...
November 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29024798/hysteroscopic-management-of-asherman-s-syndrome-special-issue-report-on-uterine-surgery-in-the-journal-of-minimally-invasive-gynecology
#13
Zaraq Khan, Jeffrey M Goldberg
In developed countries, Asherman's Syndrome is almost always the result of a prior intrauterine operative trauma. This is often asymptomatic but may result in hypo- or amenorrhea and can contribute to infertility and pregnancy complications. We will review their etiology, clinical implications, and the systems which have been proposed to classify their extent. The numerous methods reported for performing lysis of intrauterine adhesions will be summarized along with the clinical results. Current strategies to prevent recurrence of intrauterine adhesions have not been conclusively shown to be clinically effective but the potential for endometrial regeneration using stem cells is an exciting modality under investigation...
October 9, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28994490/computed-tomographic-findings-in-205-dogs-with-clinical-signs-compatible-with-middle-ear-disease-a-retrospective-study
#14
Audrey Belmudes, Charline Pressanti, Paul Y Barthez, Eloy Castilla-Castaño, Lionel Fabries, Marie C Cadiergues
BACKGROUND: Computed tomography (CT) is considered to be the reference method to evaluate middle ear structures. OBJECTIVES: To evaluate the presence and severity of CT changes in the middle ear and establish if any specific clinical presentations are associated with otitis media. ANIMALS: Medical records of animals referred for CT with history and clinical signs consistent with middle ear disease. METHODS: Retrospective evaluation of CT examinations of tympanic bullae performed over a six year period...
October 10, 2017: Veterinary Dermatology
https://www.readbyqxmd.com/read/28983379/hypoglossal-nerve-mononeuropathy-as-the-first-presenting-symptom-of-progressing-multiple-myeloma
#15
Neil B Newman, Vidya Puthenpura, Stephanie Mischell, Gabriela Ferreira
Multiple myeloma (MM) rarely presents with a primary neurological dysfunction, and if it does it is usually due to a plasmacytoma. This is the first case to discuss hypoglossal nerve dysfunction as the first sign of MM progression secondary to severe pathophysiologic bone lysis. A PubMed-based literature search was completed on April 17, 2016 for the terms "multiple myeloma" and "hypoglossal nerve neuropathy". A 73-year-old woman with known MM who received little treatment for several years, presented secondary to dysarthria and at first was thought to have hyperviscosity syndrome...
February 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/28982910/febuxostat-as-a-prophylaxis-for-tumor-lysis-syndrome-in-children-with-hematological-malignancies
#16
Kenji Kishimoto, Ryoji Kobayashi, Daiki Hori, Hirozumi Sano, Daisuke Suzuki, Kunihiko Kobayashi
AIM: The aim of the present study was to determine if febuxostat could prevent tumor lysis syndrome (TLS) in children who received induction chemotherapy for hematologic malignancies. PATIENTS AND METHODS: A retrospective analysis was performed in 45 pediatric patients with hematological malignancies who received febuxostat (10 mg daily, n=20) or allopurinol (300 mg/m(2) daily, n=25) as a prophylaxis for TLS. RESULTS: A significant decrease of serum uric acid (UA) level was observed in patients with febuxostat over the first 2 days (6...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28974999/malignant-posterior-reversible-encephalopathy-syndrome-an-exacting-challenge-for-neurocritical-care-physicians
#17
Shahvaiz Magsi, Atif Zafar
We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG...
October 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28972395/venetoclax-for-the-treatment-of-chronic-lymphocytic-leukemia
#18
REVIEW
Massimo Gentile, Annamaria Petrungaro, Giuseppina Uccello, Ernesto Vigna, Anna Grazia Recchia, Nadia Caruso, Sabrina Bossio, Laura De Stefano, Angela Palummo, Francesca Storino, Massimo Martino, Fortunato Morabito
Venetoclax, an orally bioavailable inhibitor of BCL-2, was approved in 2016 by the United States Food and Drug Administration (FDA) for the treatment of chronic lymphocytic leukemia (CLL) patients with 17p deletion [del(17p)], who have received at least one prior therapy. Areas covered: We focus on the mechanism of action of venetoclax and on the clinical trial data that led to the approval of venetoclax for CLL patients. We also review the studies in which this drug has being explored in combination with other anti-CLL drugs...
November 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28960357/the-effect-of-therapeutic-leukapheresis-on-early-complications-and-outcomes-in-patients-with-acute-leukemia-and-hyperleukocytosis-a-propensity-score-matched-study
#19
Min Hyuk Choi, Yeon Hwa Choe, Yongjung Park, Hyunjin Nah, Sinyoung Kim, Seok Hoon Jeong, Hyun Ok Kim
BACKGROUND: Hyperleukocytosis in acute leukemia is associated with higher early mortality due to the major complications of leukostasis, tumor lysis syndrome (TLS), and disseminated intravascular coagulopathy (DIC). Leukapheresis remains an important modality for the management of patients with acute leukemia and hyperleukocytosis. However, the role of leukapheresis in early mortality is controversial. This study sought to evaluate the prognostic impact of leukapheresis and its beneficial effects on TLS and DIC...
September 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28945711/venetoclax-management-and-care-for-patients-with-relapsed-or-refractory-chronic-lymphocytic-leukemia%C3%A2
#20
Heather Brumbaugh Paradis, Debbie Alter, Diane Llerandi
BACKGROUND: Venetoclax (Venclexta™) is a potent, selective, orally available, small-molecule B-cell lymphoma 2 inhibitor that achieves response rates of about 80% and has an acceptable safety profile for patients with relapsed or refractory chronic lymphocytic leukemia (CLL).
. OBJECTIVES: The aim was to describe treatment management considerations when caring for patients using venetoclax.
. METHODS: A review was done of safety and management considerations based on current clinical practice and 240 patients with CLL who received venetoclax monotherapy on clinical trials from 2011-2016...
October 1, 2017: Clinical Journal of Oncology Nursing
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