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unknown primary site guidelines

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https://www.readbyqxmd.com/read/29554827/one-stage-operation-for-superficialization-of-native-radio-cephalic-fistula-in-obese-patients
#1
Takao Okawa, Masaaki Murakami, Ryo Yamada, Satoshi Tanaka, Kiyoshi Mori, Noriko Mori
PURPOSE: The population of obese patients is increasing in general and also at hemodialysis initiation. For successful cannulation of arteriovenous fistula, the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines suggest that the required maturation parameters are at a depth of <6 mm. There are several reports describing two-stage superficialization of arteriovenous fistulas in obese cases. Therefore, we investigated the utility and complications of one-stage superficialization of radio-cephalic fistula...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29543400/transoral-endoscopic-base-of-tongue-mucosectomy-for-investigation-of-unknown-primary-cancers-of-head-and-neck
#2
Sebastian Wallis, Lorcan O'Toole, Laszlo Karsai, Jose Jemy
Cancer of the unknown primary (CUP) makes up 2-4% of new head and neck squamous cell carcinoma (SCC) diagnoses. This scenario is recognised as a diagnostic challenge for head and neck surgeons. For all patients with proven cervical lymph node metastatic SCC without a clinically apparent primary site, the current UK guidelines recommends PET-CT, panendoscopy with directed biopsies and bilateral tonsillectomy as a standard of care. This article is protected by copyright. All rights reserved.
March 15, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29376110/documentation-of-contraception-and-pregnancy-intention-in-medicaid-managed-care
#3
Heike Thiel de Bocanegra, Alia McKean, Philip Darney, Erin Saleeby, Denis Hulett
Context: Clinical guidelines recommend the documentation of pregnancy intention and family planning needs during primary care visits. Prior to the 2014 Medicaid expansion and release of these guidelines, the documentation practices of Medicaid managed care providers are unknown. Methods: We performed a chart review of 1054 Medicaid managed care visits of women aged 13 to 49 to explore client, provider, and visit characteristics associated with documentation of immediate or future plans for having children and contraceptive method use...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29230692/seom-clinical-guideline-on-unknown-primary-cancer-2017
#4
F Losa, G Soler, A Casado, A Estival, I Fernández, S Giménez, F Longo, R Pazo-Cid, J Salgado, M Á Seguí
Cancer of unknown primary site is a histologically confirmed cancer that manifests in advanced stage, with no identifiable primary site following standard diagnostic procedures. Patients are initially categorized based on the findings of the initial biopsy: adenocarcinoma, squamous-cell carcinoma, neuroendocrine carcinoma, and poorly differentiated carcinoma. Appropriate patient management requires understanding several clinical and pathological features that aid in identifying several subsets of patients with more responsive tumors...
January 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29159978/ahns-series-do-you-know-your-guidelines-guideline-recommendations-for-head-and-neck-cancer-of-unknown-primary-site
#5
Antoine Eskander, Tamer Ghanem, Amit Agrawal
This article reviews the clinical practice guidelines for head and neck oncology focusing on the management of head and neck cancers of unknown primary (CUP). The primary purpose of this series is to raise awareness of the current guidelines in head and neck oncology by reviewing the recommendations and the evidence supporting such recommendations, particularly those published by the National Comprehensive Cancer Network (NCCN). We review the importance of a thorough history and physical examination, the impact of the American Joint Committee on Cancer (AJCC) eighth edition changes and the importance of immunohistochemistry, the timing and type of imaging, the role of panendoscopy and tonsillectomy (palatine and lingual), and the role of surgery, radiation, and chemotherapy in the primary management of these tumors...
March 2018: Head & Neck
https://www.readbyqxmd.com/read/29105289/predictors-of-care-for-patients-with-cancer-of-unknown-primary-site-in-three-australian-hospitals
#6
Simon Y S Tan, Siobhan O'Neill, David Goldstein, Robyn L Ward, Benjamin Daniels, Claire M Vajdic
AIM: Cancer of unknown primary site (CUP) is a medically challenging malignancy with a poor prognosis. We describe an incident tertiary CUP patient cohort and identify factors predictive of specific types of health care. METHODS: We reviewed the medical records of 217 patients diagnosed with CUP (2006-2011) in three public hospitals in New South Wales, Australia. We systematically abstracted data and performed multivariable logistic regression to identify factors predictive of tumor biopsy, surgery, chemotherapy, radiotherapy and palliative care...
November 3, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28977975/prognostic-clinicopathologic-factors-in-carcinoma-of-unknown-primary-origin-a-study-of-106-consecutive-cases
#7
Junjeong Choi, Ji Hae Nahm, Sang Kyum Kim
A heterogeneous group of cancers for which the site of origin remains occult after detailed investigations is defined as carcinomas of unknown primary origin (CUPs). Because patients with CUP have a dismal prognosis, we have analyzed CUPs to highlight the implication of clinicopathologic factors related with patient survival. A total of 106 consecutive cases of CUP were collected. A two-step strategy of immunohistochemistry to assess CUPs according NCCN Guidelines is used to separate carcinomatous tumors and subtype carcinomas...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28821264/impact-of-early-initiation-versus-national-standard-of-care-of-antiretroviral-therapy-in-swaziland-s-public-sector-health-system-study-protocol-for-a-stepped-wedge-randomized-trial
#8
Fiona J Walsh, Till Bärnighausen, Wim Delva, Yvette Fleming, Gavin Khumalo, Charlotte L Lejeune, Sikhathele Mazibuko, Charmaine Khudzie Mlambo, Ria Reis, Donna Spiegelman, Mandisa Zwane, Velephi Okello
BACKGROUND: There is robust clinical evidence to support offering early access to antiretroviral treatment (ART) to all HIV-positive individuals, irrespective of disease stage, to both improve patient health outcomes and reduce HIV incidence. However, as the global treatment guidelines shift to meet this evidence, it is still largely unknown if early access to ART for all (also referred to as "treatment as prevention" or "universal test and treat") is a feasible intervention in the resource-limited countries where this approach could have the biggest impact on the course of the HIV epidemics...
August 18, 2017: Trials
https://www.readbyqxmd.com/read/28797451/post-operative-therapy-following-transoral-robotic-surgery-for-unknown-primary-cancers-of-the-head-and-neck
#9
Sapna A Patel, Aarthi Parvathaneni, Upendra Parvathaneni, Jeffrey J Houlton, Ron J Karni, Jay J Liao, Neal D Futran, Eduardo Méndez
OBJECTIVES: Our primary objective is to describe the post- operative management in patients with an unknown primary squamous cell carcinoma of the head and neck (HNSCC) treated with trans-oral robotic surgery (TORS). MATERIALS & METHODS: We conducted a retrospective multi-institutional case series including all patients diagnosed with an unknown primary HNSCC who underwent TORS to identify the primary site from January 1, 2010 to June 30, 2016. We excluded those with recurrent disease, ≤6months of follow up from TORS, previous history of radiation therapy (RT) to the head and neck, or evidence of primary tumor site based on previous biopsies...
September 2017: Oral Oncology
https://www.readbyqxmd.com/read/28659177/a-bayesian-network-and-heuristic-approach-for-systematic-characterization-of-radiotherapy-receipt-after-breast-conservation-surgery
#10
Milton Soto-Ferrari, Diana Prieto, Gitonga Munene
BACKGROUND: Breast-conservation surgery with radiotherapy is a treatment highly recommended by the guidelines from the National Comprehensive Cancer Network. However, several variables influence the final receipt of radiotherapy and it might not be administered to breast cancer patients. Our objective is to propose a systematic framework to identify the clinical and non-clinical variables that influence the receipt of unexpected radiotherapy treatment by means of Bayesian networks and a proposed heuristic approach...
June 28, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28615149/cardiovascular-and-metabolic-effects-of-metformin-in-patients-with-type-1-diabetes-removal-a-double-blind-randomised-placebo-controlled-trial
#11
John R Petrie, Nishi Chaturvedi, Ian Ford, Martijn C G J Brouwers, Nicola Greenlaw, Therese Tillin, Irene Hramiak, Alun D Hughes, Alicia J Jenkins, Barbara E K Klein, Ronald Klein, Teik C Ooi, Peter Rossing, Coen D A Stehouwer, Naveed Sattar, Helen M Colhoun
BACKGROUND: Metformin might reduce insulin requirement and improve glycaemia in patients with type 1 diabetes, but whether it has cardiovascular benefits is unknown. We aimed to investigate whether metformin treatment (added to titrated insulin therapy) reduced atherosclerosis, as measured by progression of common carotid artery intima-media thickness (cIMT), in adults with type 1 diabetes at increased risk for cardiovascular disease. METHODS: REMOVAL was a double-blind, placebo-controlled trial undertaken at 23 hospital diabetes clinics in five countries (Australia, Canada, Denmark, the Netherlands, and the UK)...
August 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#12
Margaret Hedgecock Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012 to 2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgment...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28454832/rationale-and-design-of-the-coronary-computed-tomographic-angiography-for-selective-cardiac-catheterization-relation-to-cardiovascular-outcomes-cost-effectiveness-and-quality-of-life-conserve-trial
#13
RANDOMIZED CONTROLLED TRIAL
Sang-Eun Lee, Fay Y Lin, Yao Lu, Hyuk-Jae Chang, James K Min
Although coronary computed tomography angiography (CCTA) has shown promise as a "gatekeeper" to invasive coronary angiography (ICA) in longitudinal cohort studies, it remains unknown whether the strategy of selective ICA by initial performance of CCTA is either safe or effective when compared with a direct ICA strategy in patients with an American Heart Association (AHA)/American College of Cardiology (ACC) guideline-directed indication for ICA. OBJECTIVES: The CONSERVE trial is a prospective randomized multicenter trial to determine the clinical effectiveness of "selective catheterization" vs "direct catheterization" strategies for stable patients with suspected but without known coronary artery disease, who meet AHA/ACC guideline indication for ICA...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28447766/supervised-dosing-with-a-long-acting-opioid-medication-in-the-management-of-opioid-dependence
#14
REVIEW
Rosella Saulle, Simona Vecchi, Linda Gowing
BACKGROUND: Opioid dependence (OD) is an increasing clinical and public health problem worldwide. International guidelines recommend opioid substitution treatment (OST), such as methadone and buprenorphine, as first-line medication treatment for OD. A negative aspect of OST is that the medication used can be diverted both through sale on the black market, and the unsanctioned use of medications. Daily supervised administration of medications used in OST has the advantage of reducing the risk of diversion, and may promote therapeutic engagement, potentially enhancing the psychosocial aspect of OST, but costs more and is more restrictive on the client than dispensing for off-site consumption...
April 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28444105/clinical-pathological-and-demographic-factors-associated-with-development-of-recurrences-after-surgical-resection-in-elderly-patients-with-neuroendocrine-tumors
#15
C Shen, A Dasari, Y Chu, D M Halperin, S Zhou, Y Xu, Y T Shih, J C Yao
Background: Incidence of locoregional neuroendocrine tumors (NETs) is rising. However, after curative resection, the patterns and risk factors associated with recurrence remain unknown. Consensus guidelines recommend surveillance every 6-12 months for up to 10 years after surgery for resected, well-differentiated NETs irrespective of patient demographics, site, grade or stage of tumor with few exceptions. Patients and methods: From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified localized and regional stage NET patients who underwent surgical resection between January 2002 and December 2011...
July 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28423684/prognostic-clinicopathologic-factors-in-carcinoma-of-unknown-primary-origin-a-study-of-106-consecutive-cases
#16
Junjeong Choi, Ji Hae Nahm, Sang Kyum Kim
A heterogeneous group of cancers for which the site of origin remains occult after detailed investigations is defined as carcinomas of unknown primary origin (CUPs). Because patients with CUP have a dismal prognosis, we have analyzed CUPs to highlight the implication of clinicopathologic factors related with patient survival. A total of 106 consecutive cases of CUP were collected. A two-step strategy of immunohistochemistry to assess CUPs according NCCN Guidelines is used to separate carcinomatous tumors and subtype carcinomas...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/27882839/real-world-drug-costs-of-treating-hepatitis-c-genotypes-1-4-with-direct-acting-antivirals-initiating-treatment-at-fibrosis-0-2-and-3-4
#17
MULTICENTER STUDY
Timothy A Bach, Kathy Zaiken
BACKGROUND: Direct-acting antivirals (DAA) for the treatment of hepatitis C virus (HCV) have drastically improved outcomes but are also very costly. For this reason, priority for treatment is often given to patients with a higher fibrosis score at baseline by payers and providers rather than treating all eligible patients. Simulation studies have suggested that waiting to treat patients until fibrosis 3-4 may be more costly and result in worse outcomes; however, real-world implications are unknown...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27747807/lung-adenocarcinoma-with-anaplastic-lymphoma-kinase-alk-rearrangement-presenting-as-carcinoma-of-unknown-primary-site-recognition-and-treatment-implications
#18
John D Hainsworth, F Anthony Greco
BACKGROUND: Molecular cancer classifier assays are being used with increasing frequency to predict tissue of origin and direct site-specific therapy for patients with carcinoma of unknown primary site (CUP). OBJECTIVE: We postulated some CUP patients predicted to have non-small-cell lung cancer (NSCLC) by molecular cancer classifier assay may have anaplastic lymphoma kinase (ALK) rearranged tumors, and benefit from treatment with ALK inhibitors. METHODS: We retrospectively reviewed CUP patients who had the 92-gene molecular cancer classifier assay (CancerTYPE ID; bioTheranostics, Inc...
March 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27584967/pathophysiology-and-treatment-of-hyperhidrosis
#19
REVIEW
Tomoko Fujimoto
Primary focal hyperhidrosis is a disease of unknown cause with profuse perspiration of local sites (head, face, palms, soles of feet, and axillae) that adversely affects daily life. Guidelines have been proposed in the USA [<citeref rid="ref1">1</citeref>], Canada [<citeref rid="ref2">2</citeref>], and Japan [<citeref rid="ref3">3</citeref>]. The symptoms impair quality of life, with significant negative effects on daily existence and personal relationships. The current goal in medical practice for patients with hyperhidrosis is to provide guidance and encourage coping skills for a normal daily life, as well as give appropriate advice regarding treatment options...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27442514/professional-practices-and-diagnostic-issues-in-neuroendocrine-tumour-pathology-results-of-a-prospective-one-year-survey-among-french-pathologists-the-pronet-study
#20
Jean-Yves Scoazec, Anne Couvelard, Geneviève Monges, Serge Guyétant, Segolène Bisot-Locard, Xavier Parot, Côme Lepage
INTRODUCTION: Many changes have recently occurred in the practice of neuroendocrine tumour (NET) pathology. We therefore aimed to evaluate how pathologists have adapted their daily practice to the most recent international guidelines for diagnostic and prognostic evaluation. PROCEDURES: A 12-month prospective study (PRONET) was carried out among French pathologists between August 2010 and July 2011. Data were collected using an anonymous electronic case report form...
2017: Neuroendocrinology
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