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https://www.readbyqxmd.com/read/28649895/the-safety-and-efficacy-of-palbociclib-in-the-treatment-of-metastatic-breast-cancer
#1
Johannes Ettl, Nadia Harbeck
Palbociclib (Ibrance(®)) is the first-in-class CDK4/6 inhibitor which has been introduced into clinical practice for the treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). It is an orally administered drug, which acts by selectively inhibiting cyclin-dependant kinases CDK4 and CDK6. Given together with anti-estrogens like letrozole and fulvestrant it enhances the antiproliferative effect of these drugs without compromising the favorable toxicity profile of endocrine therapy...
June 26, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28649893/radium-223-dichloride-for-the-treatment-of-castration-resistant-prostate-cancer-with-symptomatic-bone-metastases
#2
Nicholas J Vogelzang
Castration-resistant prostate cancer (CRPC) is associated with the development of bone metastases, increased mortality, and a reduction in the patient's quality of life (QOL). The management of metastatic CRPC (mCRPC) has rapidly evolved over the past decade, with a number of available therapeutic agents improving overall survival. Radium-223 dichloride (radium-223), the first targeted alpha therapy, improves survival accompanied by QOL benefits with a favorable safety profile. It is approved in over 40 countries for the treatment of patients with CRPC with symptomatic bone metastases and no known visceral metastatic disease...
June 26, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28648901/the-asia-pacific-clinical-practice-guidelines-for-the-management-of-frailty
#3
Elsa Dent, Christopher Lien, Wee Shiong Lim, Wei Chin Wong, Chek Hooi Wong, Tze Pin Ng, Jean Woo, Birong Dong, Shelley de la Vega, Philip Jun Hua Poi, Shahrul Bahyah Binti Kamaruzzaman, Chang Won, Liang-Kung Chen, Kenneth Rockwood, Hidenori Arai, Leocadio Rodriguez-Mañas, Li Cao, Matteo Cesari, Piu Chan, Edward Leung, Francesco Landi, Linda P Fried, John E Morley, Bruno Vellas, Leon Flicker
OBJECTIVE: To develop Clinical Practice Guidelines for the screening, assessment and management of the geriatric condition of frailty. METHODS: An adapted Grading of Recommendations, Assessment, Development, and Evaluation approach was used to develop the guidelines. This process involved detailed evaluation of the current scientific evidence paired with expert panel interpretation. Three categories of Clinical Practice Guidelines recommendations were developed: strong, conditional, and no recommendation...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#4
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645959/formal-consensus-to-identify-clinically-important-changes-in-management-resulting-from-the-use-of-cardiovascular-magnetic-resonance-cmr-in-patients-who-activate-the-primary-percutaneous-coronary-intervention-ppci-pathway
#5
Maria Pufulete, Rachel C Brierley, Chiara Bucciarelli-Ducci, John P Greenwood, Stephen Dorman, Richard A Anderson, Jessica Harris, Elisa McAlindon, Chris A Rogers, Barnaby C Reeves
OBJECTIVE: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus)...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645585/thrombocytopenia-and-neurosurgery-a-literature-review
#6
REVIEW
Daphne Li, Taylor Glor, G Alexander Jones
The absence of evidence-based guidelines for platelet transfusion surrounding invasive neurosurgical procedures leads to uncertainty in management. Multiple studies have illuminated this lack of high quality data, and subsequent reliance on expert opinion. The generally accepted threshold for platelet transfusion has hovered around 100,000/μl. We have conducted a review of available clinical literature, in order to identify any evidence that may support or refute these general guidelines, in an attempt to clarify the need for platelet transfusion in the patient requiring neurosurgical intervention...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645463/etiologies-of-chronic-cough-in-pediatric-cohorts-chest-guideline-and-expert-panel-report
#7
Anne B Chang, John J Oppenheimer, Miles Weinberger, Cameron C Grant, Bruce K Rubin, Richard S Irwin
BACKGROUND: In children (aged ≤14-years) there is no published systematic review on the etiologies of chronic cough or, the relationship between obstructive sleep apnea (OSA) and chronic cough. We thus undertook systematic reviews based on key questions (KQs) using the PICO format. The KQs were: Among children with chronic (>4 weeks) cough: (1) are the common etiologies different from adults? (2) are the common etiologies age and/or setting dependent? and; (3) is obstructive sleep apnea (OSA) an etiology of chronic cough in children? METHODS: We used the CHEST expert cough panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28644756/immunological-effects-of-hypomethylating-agents
#8
Katherine E Lindblad, Meghali Goswami, Christopher S Hourigan, Karolyn A Oetjen
Epigenetic changes resulting from aberrant methylation patterns are a recurrent observation in hematologic malignancies. Hypomethylating agents have a well-established role in the management of patients with high-risk myelodysplastic syndrome or acute myeloid leukemia. In addition to the direct effects of hypomethylating agents on cancer cells, there are several lines of evidence indicating a role for immune-mediated anti-tumor benefits from hypomethylating therapy. Areas Covered: We reviewed the clinical and basic science literature for the effects of hypomethylating agents, including the most commonly utilized therapeutics azacitidine and decitabine, on immune cell subsets...
June 23, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28644735/fetal-and-neonatal-alloimmune-thrombocytopenia-evidence-based-antenatal-and-postnatal-management-strategies
#9
Dian Winkelhorst, Dick Oepkes, Enrico Lopriore
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare but potentially lethal disease, leading to severe bleeding complications in 1 in 11.000 newborns. It is the leading cause of thrombocytopenia in healthy term-born neonates. Areas covered: This review summarizes the antenatal as well as postnatal treatment, thus creating a complete overview of all possible management strategies for FNAIT. Expert commentary: The optimal antenatal therapy in order to prevent bleeding complications in pregnancies complicated by FNAIT is non-invasive treatment with weekly intravenous immunoglobulin (IVIG)...
June 23, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28641582/a-multicentre-randomised-controlled-trial-of-levetiracetam-versus-phenytoin-for-convulsive-status-epilepticus-in-children-protocol-convulsive-status-epilepticus-paediatric-trial-consept-a-predict-study
#10
Stuart R Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland, Jocelyn Neutze, Susan Donath, Cynthia Sharpe, Simon Harvey, Andrew Davidson, Simon Craig, Natalie Phillips, Shane George, Arjun Rao, Nicholas Cheng, Michael Zhang, Kam Sinn, Amit Kochar, Christine Brabyn, Franz E Babl
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28639459/approach-to-the-management-of-patients-with-hidradenitis-suppurativa-a-consensus-document
#11
Afsaneh Alavi, Charles Lynde, Raed Alhusayen, Marc Bourcier, Isabelle Delorme, Ralph George, Melinda Gooderham, Wayne Gulliver, Sunil Kalia, Danielle Marcoux, Yves Poulin
BACKGROUND: Hidradenitis suppurativa (HS) is a painful, debilitating, and poorly understood condition, which is suboptimally diagnosed, managed, and treated. Evidence supporting various treatment modalities is sparse. OBJECTIVES: To incorporate scientific evidence and expert opinions to develop useful guidance for the evaluation and management of patients with HS. METHODS: An expert panel of Canadian dermatologists and surgeons developed statements and recommendations based on available evidence and clinical experience...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28637619/practical-considerations-for-diagnosis-and-management-of-patients-and-carriers
#12
REVIEW
Charlotte M Niemeyer, Cristina Mecucci
Newly diagnosed children and adults with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) need to be screened for presence of a genetic predisposition syndrome because the information on the genetic status is likely to influence clinical care and management of the patient and the family. Scenarios in which genetic counseling is advised include presence of a mutation on somatic screen that can be associated with a germline predisposition, hematologic or cytogenetic characteristics suggestive of an underlying susceptibility syndrome, non-hematological phenotype suspicious for a familial condition, history of previous malignancy, or a family history of cancer, cytopenia, autoimmunity, or organ-system manifestation fitting a predisposition syndrome...
April 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28636484/bezlotoxumab-anti-toxin-b-monoclonal-antibody-to-prevent-recurrence-of-clostridium-difficile-infection
#13
Javier A Villafuerte Gálvez, Ciarán P Kelly
Clostridium difficile infection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targeting C.difficile toxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI. Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28636280/getting-on-the-same-page-communication-patient-involvement-and-shared-understanding-of-decisions-in-oncology
#14
Aaron L Leppin, Marleen Kunneman, Julie Hathaway, Cara Fernandez, Victor M Montori, Jon C Tilburt
BACKGROUND: Patients and clinicians do not often agree on whether a decision has been made about cancer care. This could be explained by factors related to communication quality and/or the type of decision being made. METHODS: We used a self-developed coding scheme to code a random sample of 128 encounters in which patients and clinicians either agreed (n=64) or disagreed (n=64) that a cancer care decision was made and tested for associations between concordance and key communication behaviours...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28635066/consensus-development-of-quality-indicators-for-end-of-life-care-for-elders-in-japan
#15
Harue Masaki, Nobuko Kawai, Keiko Matsumoto, Miyoko Kuwata, Sachiko Yoshioka, Midori Nishiyama, Ryoko Uchino, Hiroko Nagae, Megumi Teshima, Sayuri Sakai, Kazuko Endo
AIMS AND OBJECTIVES: Quality indicators for end-of-life care have been published; however, none have been developed specifically for nursing in the cultural and traditional context of Japan. This study aimed to develop and build a consensus of quality indicators for end-of-life care for elders in Japan from the perspective of nursing science. METHODS: To develop the quality indicators, we used a literature review, expert panel process, and the Delphi technique among clinical nurse specialists in geriatrics...
June 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28633627/effectiveness-of-a-motivational-intervention-on-overweight-obese-patients-in-the-primary-healthcare-a-cluster-randomized-trial
#16
Juan Jose Rodriguez-Cristobal, Carlos Alonso-Villaverde, Jose Ma Panisello, Pere Travé-Mercade, Francisca Rodriguez-Cortés, Josep Ramon Marsal, Esther Peña
BACKGROUND: Overweight and obesity are common health problems which increase the risk of developing several serious health conditions. The main difficulty in the management of weight-loss lies in its maintenance, once it is achieved. The aim of this study was to investigate whether a motivational intervention, together with current clinical practice, was more efficient than a traditional intervention, in the treatment of overweight and obesity and whether this intervention reduces cardiovascular risk factors associated with overweight and obesity...
June 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28632418/therapeutic-monitoring-of-unfractionated-heparin-trials-and-tribulations
#17
Israfil Baluwala, Emmanuel Favaloro, Leonardo Pasalic
Heparin is one of the oldest biological medicines with an established role in prevention and treatment of arterial and venous thromboembolism. Published therapeutic ranges for unfractionated heparin (UFH) mostly precede the large increase in the number of activated partial thromboplastin time (APTT) reagent/instrument combinations that now show wide variability. Areas covered: This paper explores the use of UFH, the development of heparin therapeutic ranges (HTRs), and the strengths and limitations of the methods used to monitor heparin's anticoagulant effect...
June 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#18
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28630236/european-evidence-based-recommendations-for-diagnosis-and-treatment-of-childhood-onset-systemic-lupus-erythematosus-the-share-initiative
#19
Noortje Groot, Nienke de Graeff, Tadej Avcin, Brigitte Bader-Meunier, Paul Brogan, Pavla Dolezalova, Brian Feldman, Isabelle Kone-Paut, Pekka Lahdenne, Stephen D Marks, Liza McCann, Seza Ozen, Clarissa Pilkington, Angelo Ravelli, Annet van Royen-Kerkhof, Yosef Uziel, Bas Vastert, Nico Wulffraat, Sylvia Kamphuis, Michael W Beresford
Childhood-onset systemic lupus erythematosus (cSLE) is a rare, multisystem and potentially life-threatening autoimmune disorder with significant associated morbidity. Evidence-based guidelines are sparse and management is often based on clinical expertise. SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) was launched to optimise and disseminate management regimens for children and young adults with rheumatic diseases like cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of cSLE...
June 19, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28628189/-a-statement-the-polish-cardiac-society-working-group-on-pulmonary-circulation-on-screening-for-cteph-patients-after-acute-pulmonary-embolism
#20
Michał Ciurzyński, Marcin Kurzyna, Grzegorz Kopeć, Piotr Błaszczak, Łukasz Chrzanowski, Karol Kamiński, Katarzyna Mizia-Stec, Tatiana Mularek-Kubzdela, Ewa Mroczek, Andrzej Biederman, Piotr Pruszczyk, Adam Torbicki
Both pharmacological and invasive treatment of chronic thromboembolic pulmonary hypertension (CTEPH) is now available in Poland and the awareness of the disease among physicians is growing. Thus, the Polish Cardiac Society's Working Group on Pulmonary Circulation in cooperation with independent experts in this field, have launched the statement on algorithm to guide a CTEPH diagnosis in patients with previous acute pulmonary embolism (APE). In Poland, every year this disease affects about 250 patients. CTEPH should be suspected in individuals after APE with dyspnea, despite at least 3 months period of effective anticoagulation, particularly when specified risk factors are present...
2017: Kardiologia Polska
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