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https://www.readbyqxmd.com/read/27905893/computational-prediction-of-multidisciplinary-team-decision-making-for-adjuvant-breast-cancer-drug-therapies-a-machine-learning-approach
#1
Frank P Y Lin, Adrian Pokorny, Christina Teng, Rachel Dear, Richard J Epstein
BACKGROUND: Multidisciplinary team (MDT) meetings are used to optimise expert decision-making about treatment options, but such expertise is not digitally transferable between centres. To help standardise medical decision-making, we developed a machine learning model designed to predict MDT decisions about adjuvant breast cancer treatments. METHODS: We analysed MDT decisions regarding adjuvant systemic therapy for 1065 breast cancer cases over eight years. Machine learning classifiers with and without bootstrap aggregation were correlated with MDT decisions (recommended, not recommended, or discussable) regarding adjuvant cytotoxic, endocrine and biologic/targeted therapies, then tested for predictability using stratified ten-fold cross-validations...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27899191/genetic-predisposition-to-endocrine-tumors-diagnosis-surveillance-and-challenges-in-care
#2
REVIEW
Elisabeth Joye Petr, Tobias Else
Endocrine tumor syndromes, eg, multiple endocrine neoplasia types 1 and 2, were among the first recognized hereditary predisposition syndromes to tumor development. Over time, the number of endocrine tumor syndromes has significantly expanded, eg, with the recent inclusion of hereditary paraganglioma syndromes. Associations of non-endocrine tumors with hereditary endocrine tumor syndromes and endocrine tumors with non-classical endocrine tumor syndromes have emerged. These findings have certainly expanded the scope of care, necessitating a multidisciplinary approach by a team of medical professionals and researchers, integrating shared patient decision-making at every step of surveillance, diagnosis, and treatment...
October 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/27884013/guidelines-for-growth-hormone-and-insulin-like-growth-factor-i-treatment-in-children-and-adolescents-growth-hormone-deficiency-idiopathic-short-stature-and-primary-insulin-like-growth-factor-i-deficiency
#3
Adda Grimberg, Sara A DiVall, Constantin Polychronakos, David B Allen, Laurie E Cohen, Jose Bernardo Quintos, Wilma C Rossi, Chris Feudtner, Mohammad Hassan Murad
BACKGROUND/AIMS: On behalf of the Drug and Therapeutics, and Ethics Committees of the Pediatric Endocrine Society, we sought to update the guidelines published in 2003 on the use of growth hormone (GH). Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, GH deficiency (GHD), and primary IGF-I deficiency (PIGFD), we focused on these three diagnoses, thereby adding recombinant IGF-I therapy to the GH guidelines for the first time...
November 25, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27882481/assessment-criteria-for-vitamin-d-deficiency-insufficiency-in-japan-proposal-by-an-expert-panel-supported-by-the-research-program-of-intractable-diseases-ministry-of-health-labour-and-welfare-japan-the-japanese-society-for-bone-and-mineral-research-and-the
#4
Ryo Okazaki, Keiichi Ozono, Seiji Fukumoto, Daisuke Inoue, Mika Yamauchi, Masanori Minagawa, Toshimi Michigami, Yasuhiro Takeuchi, Toshio Matsumoto, Toshitsugu Sugimoto
Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by a low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world...
November 23, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#5
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27865597/expert-consensus-of-general-surgery-residents-proficiency-with-common-endocrine-operations
#6
Roy Phitayakorn, Rachel R Kelz, Emil Petrusa, Rebecca S Sippel, Cord Sturgeon, Kepal N Patel, Nancy D Perrier
BACKGROUND: Proficiency with common endocrine operations is expected of graduating, general surgery residents. However, no expert consensus guidelines exist about these expectations. METHODS: Members of the American Association of Endocrine Surgeons were surveyed about their opinions on resident proficiency with common endocrine operations. RESULTS: Overall response rate was 38%. A total of 92% of the respondents operate with residents. On average, they believed that the steps of a total thyroidectomy for benign disease and a well-localized parathyroidectomy could be performed by a postgraduate year 4 surgery resident...
November 16, 2016: Surgery
https://www.readbyqxmd.com/read/27864651/all-in-the-family-analyzing-the-impact-of-family-history-in-addition-to-genotype-on-medullary-thyroid-carcinoma-aggressiveness-in-men2a-patients
#7
Kristin L Long, Carol Etzel, Thereasa Rich, Samuel Hyde, Nancy D Perrier, Paul H Graham, Jeffrey E Lee, Mimi I Hu, Gilbert J Cote, Robert Gagel, Elizabeth G Grubbs
Several guidelines for patients with multiple endocrine neoplasia 2A (MEN2A) take into account genotype and family history of medullary thyroid carcinoma (MTC) disease aggressiveness. We sought to determine if an association exists independent of genotype, which could provide important information for counseling MEN2A patients in management of their MTC. Pedigrees of patients with ≥5 family members with MEN2A were retrospectively reviewed. Analysis was performed among kindreds with the most frequently observed codon mutation (RET 634)...
November 18, 2016: Familial Cancer
https://www.readbyqxmd.com/read/27856201/daily-practice-management-of-pt1a-b-pn0-breast-carcinoma-a-prospective-french-odissee-cohort-study
#8
Florence Dalenc, Frédérique Penault-Llorca, Monique Cohen, Gilles Houvenaeghel, Jean-Marc Piat, Philippe Liegeois, Laurent Puyuelo, Jean-Philippe Suchaud, Mohammed Zouai, Magali Lacroix-Triki, Nina Radosevic-Robin, Chahinez Benkanoun, Hanane Attar-Rabia, Marie-Pierre Chauvet, Joseph Gligorov, Yazid Belkacemi
BACKGROUND: Most breast cancer (BC) tumors ≤10 mm have an excellent prognosis. The subgroups with a higher risk for distant recurrence requiring adjuvant systemic therapy are not precisely defined in current international guidelines. PATIENTS AND METHODS: The OBSERVATOIRE DES PETITS CANCERS DU SEIN HER2 +/- (ODISSEE) study was a prospective, multicenter, cohort study that aimed to describe the daily adjuvant management and outcome of 616 patients with unifocal, invasive pT1a-b pN0 nonmetastatic BC who underwent surgery...
August 31, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/27849384/assessing-referrals-and-improving-information-availability-for-consultations-in-an-academic-endocrinology-clinic
#9
Chase D Hendrickson, Saumya Saini, Avin Pothuloori, John N Mecchella
OBJECTIVE: Outpatient specialty consultations rely on the timeliness and completeness of referral information to facilitate a valuable patient-specialist interaction. This project aimed to increase essential diagnostic information availability at the initial consultation for patients referred for common endocrine conditions frequently lacking such data - diabetes mellitus, thyroid nodule, thyrotoxicosis, and hypercalcemia. METHODS: At an endocrinology clinic at an academic medical center in rural New England, providers see several thousand new patients annually, the majority of whom are referred by providers external to the clinic's healthcare system...
November 16, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27845703/older-swedish-adults-with-high-self-perceived-health-show-optimal-25-hydroxyvitamin-d-levels-whereas-vitamin-d-status-is-low-in-patients-with-high-disease-burden
#10
Martin Carlsson, Pär Wanby, Lars Brudin, Erik Lexne, Karin Mathold, Rebecca Nobin, Lisa Ericson, Ola Nordqvist, Göran Petersson
Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people ≥75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy...
November 11, 2016: Nutrients
https://www.readbyqxmd.com/read/27819155/drugs-for-the-treatment-of-pediatric-type-2-diabetes-mellitus-and-related-co-morbidities
#11
Ozra Tabatabaei-Malazy, Shekoufeh Nikfar, Bagher Larijani, Mohammad Abdollahi
The continuing global epidemic of obesity in adolescents has raised the prevalence of type 2 diabetes mellitus (T2DM). Despite the wealth of information concerning T2DM in adults, rare data are available targeting treatment of T2DM in pediatric. Areas covered: This article has reviewed clinical practice guidelines, particularly the American Diabetes Association and the Pediatric Endocrine Society consensus, jointly with clinical trial data available in databases with respect to the use of available pharmacological options to treat T2DM and its complications in youth...
November 21, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27812706/vitamin-d-deficiency-in-hiv-infected-children
#12
Ayesha Mirza, Saran Wells, Tabitha Gayton, Carmen Smotherman, Azeem Rathore, Dale Kraemer, Mobeen Rathore
OBJECTIVES: Improvement in life expectancy with the use of combination antiretroviral therapy has come with the recognition of the complications associated with chronic human immunodeficiency virus infection. Vitamin D has been of particular interest because of its effect on bone health and immune functions. The purpose of this study was to assess vitamin D status in children in relation to the duration and severity of their human immunodeficiency virus infection and nutritional status, as well as to determine whether there was any effect of seasonality...
November 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27810693/bone-health-and-adherence-to-vitamin-d-and-calcium-therapy-in-early-breast-cancer-patients-on-endocrine-therapy-with-aromatase-inhibitors
#13
Lidija Bošković, Maja Gašparić, Marija Petković, Damir Gugić, Ingrid Belac Lovasić, Željko Soldić, Branka Petrić Miše, Nina Dabelić, Ljubica Vazdar, Eduard Vrdoljak
OBJECTIVES: Randomized trials involving aromatase inhibitors (AIs) in the adjuvant treatment of breast cancer patients have reported increased osteoporosis risk. Bone loss can be reduced with appropriate life style, vitamin D and calcium supplements, and with bisphosphonate therapy. The aim of this analysis was to investigate adherence to vitamin D and calcium in postmenopausal breast cancer patients receiving adjuvant non-steroidal AIs, and oncologists' adherence to the bone health guidelines...
October 27, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27810335/establishing-a-dose-response-relationship-between-acute-resistance-exercise-and-the-immune-system-protocol-for-a-systematic-review
#14
REVIEW
Adam Michael Szlezak, Siri Lauluten Szlezak, James Keane, Lotti Tajouri, Clare Minahan
Exercise immunology research has traditionally focussed on aerobic-exercise, however it has become apparent in more recent years that resistance-exercise can also considerably affect host immunobiology. To date however, no systematic process has been used to establish a dose-response relationship between resistance-exercise and the immune system. The present systematic review was thus conducted to determine the dose-response effects of a bout of resistance-exercise on acute leukocyte counts. In accordance with the PRISMA guidelines, a systematic literature search was conducted in the electronic databases, PubMed, Web of Science, and Google Scholar, over the date range of 1989-2016...
November 1, 2016: Immunology Letters
https://www.readbyqxmd.com/read/27804856/a-papillary-thyroid-carcinoma-in-pediatric-age-an-example-of-a-rare-tumour-managed-within-a-cooperative-comprehensive-project
#15
Claudio Spinelli, Maura Massimino, Giovanna Sironi, Andrea Ferrari, Marta Podda, Stefano Chiaravalli
Though rare in childhood, thyroid cancers represent the most frequent tumours of endocrine glands in childhood and adolescence. Papillary thyroid carcinoma is a non-medullary, follicular-derived differentiated tumour of the thyroid. There is still controversy concerning the therapeutic approach of PTCs in the paediatric population; regarding which should be the extent of the surgical approach, and the need for radioactive iodine (RAI) therapy. The cooperative TREP project (Tumori Rari in Età Pediatrica [Rare Tumours in Paediatric Age]) was launched in Italy in 2000 (under the patronage of AIEOP - Associazione Italiana Ematologia Oncologia Pediatrica) with a view to improving both research the clinical management on the less common paediatric cancers...
October 31, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27788894/neoadjuvant-systemic-therapy-use-for-younger-patients-with-breast-cancer-treated-in-different-types-of-cancer-centers-across-the-united-states
#16
Jahan J Mohiuddin, Allison M Deal, Lisa A Carey, Jennifer L Lund, Brock R Baker, Timothy M Zagar, Ellen L Jones, Lawrence B Marks, Ronald C Chen
BACKGROUND: Multiple clinical trials have shown that neoadjuvant systemic therapy has a benefit in women who are borderline lumpectomy candidates and in those with locally advanced breast cancers by reducing the mastectomy rate and making inoperable tumors operable. The study aim was to examine the patterns of neoadjuvant chemotherapy and endocrine therapy use among younger women in the United States treated at different types of cancer centers. STUDY DESIGN: Data from the National Cancer Data Base for 118,086 women younger than 65 years with clinical stage IIA (T2N0 only) to IIIC breast cancer...
November 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27787920/phaeochromocytomas-are-diagnosed-incidentally-and-at-older-age-in-neurofibromatosis-type-1
#17
Jessica Moramarco, Nada El Ghorayeb, Nadine Dumas, Serge Nolet, Luce Boulanger, Nelly Burnichon, André Lacroix, Zaki Elhaffaf, Anne-Paule Gimenez Roqueplo, Pavel Hamet, Isabelle Bourdeau
INTRODUCTION: Guidelines do not currently recommend routine systematic hormonal screening for phaeochromocytoma (PHEO) in all/normotensive patients with Neurofibromatosis type 1 (NF1), in contrast to other PHEO predisposing genetic syndromes such as Von Hippel Lindau syndrome and Multiple endocrine neoplasia type 2. OBJECTIVES: To characterise and compare parameters of PHEO in NF1 patients to patients with or without other germline mutations. METHODS: Retrospective chart review of patients with histologically proven PHEO at the Centre Hospitalier de l'Université de Montréal from 2000 through 2015...
October 27, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27783196/management-of-prolactinomas-a-survey-of-physicians-from-the-middle-east-and-north-africa
#18
Salem A Beshyah, Ibrahim H Sherif, Farida Chentli, Amir Hamrahian, Aly B Khalil, Hussein Raef, Mohamed El-Fikki, Selim Jambart
BACKGROUND: Prolactinomas are the commonest functional tumors of the pituitary gland. There are still controversies regarding medical therapy in specific clinical situations. Patients may be managed by different specialists in the Middle East and North Africa (MENA) region and no data exist on patterns of clinical management. OBJECTIVES: To ascertain the diagnostic and therapeutic approaches to prolactinomas among relevant professionals from the MENA region. METHODS: An online survey of a large sample of physicians was conducted...
October 25, 2016: Pituitary
https://www.readbyqxmd.com/read/27769660/rates-of-secondary-hyperparathyroidism-after-bypass-operation-for-super-morbid-obesity-an-overlooked-phenomenon
#19
Michael G White, Marc A Ward, Megan K Applewhite, Harry Wong, Vivek Prachand, Peter Angelos, Edwin L Kaplan, Raymon H Grogan
BACKGROUND: With over 110,000 bariatric operations performed in the United States annually, it is important to understand the biochemical abnormalities causing endocrine dysfunction associated with these procedures. Here we compare 2 malabsorptive procedures, duodenal switch and Roux-en-Y gastric bypass, to determine the role malabsorption plays in secondary hyperparathyroidism in this population. METHODS: Data from all super-obese patients undergoing duodenal switch or Roux-en-Y gastric bypass between August 2002 and October 2005 were prospectively collected...
October 18, 2016: Surgery
https://www.readbyqxmd.com/read/27760535/the-haiti-medical-education-project-development-and-analysis-of-a-competency-based-continuing-medical-education-course-in-haiti-through-distance-learning
#20
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
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