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https://www.readbyqxmd.com/read/28805590/nonmotor-fluctuations-in-parkinson-s-disease
#1
Christiana Franke, Alexander Storch
The advanced stage of Parkinson's disease (PD) is characterized by motor complications such as motor fluctuations and dyskinesias induced by long-term levodopa treatment. Recent clinical research provides growing evidence that various nonmotor symptoms such as neuropsychiatric, autonomic, and sensory symptoms (particularly pain) also show fluctuations in patients with motor fluctuations (called nonmotor fluctuations or NMF). However, NMF have not yet been adequately considered in routine care of advanced PD patients and only few therapeutic studies are available...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805564/deep-brain-stimulation-and-nonmotor-symptoms
#2
Elliot Hogg, Jeffrey Wertheimer, Sarah Graner, Michele Tagliati
Deep brain stimulation (DBS) is currently the treatment of choice for advanced Parkinson's disease (PD). Several brain targets, including the subthalamic nucleus and the globus pallidus internus, have been successfully employed, with excellent motor outcomes. Despite less established knowledge, DBS may be a powerful tool for managing a wide variety of nonmotor symptoms (NMS) in PD patients, either directly or indirectly due to motor benefit or reduction of dopaminergic drug load. After an assessment of global nonmotor outcomes of DBS, as measured by currently available clinical scales and questionnaires, this chapter will address DBS effects on four main NMS categories: neurobehavioral, including cognitive and neuropsychiatric symptoms, autonomic dysfunction, including orthostatic hypotension, constipation, and urinary dysfunction, sleep disturbances, including insomnia, REM sleep behavior disorder, and restless leg syndrome, to conclude with sensory symptoms, mainly focusing on pain...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28803353/palliative-care-in-ovarian-carcinoma-patients-a-personalized-approach-of-a-team-work-a-review
#3
REVIEW
Yakir Segev, Lior Segev, Meirav Schmidt, Ron Auslender, Ofer Lavie
Most ovarian cancer patients are diagnosed in an advanced stage; and after the initial treatment experience disease recurrence, which eventually becomes palliative. Many questions arise in this setting including how to address patients in the palliative setting, how to discuss end-of-life issues, and how to manage symptoms. In this review, we discuss the timing and setting of end-of-life discussion in the context of end-stage ovarian cancer. We review the approach to relieving disease burden by improving and decreasing symptoms...
August 12, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28800754/current-concepts-in-bone-metastasis-contemporary-therapeutic-strategies-and-ongoing-clinical-trials
#4
REVIEW
Andrew S Gdowski, Amalendu Ranjan, Jamboor K Vishwanatha
BACKGROUND: Elucidation of mechanisms regulating bone metastasis has progressed significantly in recent years and this has translated to many new therapeutic options for patients with bone metastatic cancers. However, the rapid rate of progress in both the basic science literature and therapies undergoing clinical trials makes staying abreast with current developments challenging. This review seeks to provide an update on the current state of the science in bone metastasis research and give a snap shot of therapies in clinical trials for bone metastatic cancer...
August 11, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/28799837/effectiveness-of-deformity-correction-surgery-for-primary-degenerative-sagittal-imbalance-a-meta-analysis
#5
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim, Seung-Jae Hyun
OBJECTIVE As life expectancy continues to increase, primary degenerative sagittal imbalance (PDSI) is diagnosed in an increasing number of elderly people. Although corrective surgery for this sagittal deformity is becoming more popular, the effectiveness of the procedure remains unclear. The authors aimed to collate the available evidence on the effectiveness and complications of deformity-correction surgery in patients with PDSI. METHODS The authors carried out a meta-analysis of clinical studies regarding deformity correction in patients with PDSI...
August 11, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28797849/the-international-association-for-hospice-and-palliative-care-iahpc-advancing-hospice-and-palliative-care-worldwide
#6
Liliana De Lima, Lukas Radbruch
The International Association for Hospice and Palliative Care (IAHPC) is a membership based organization dedicated to the development and improvement of hospice and palliative care worldwide. The mission of IAHPC is to improve the quality of life of adults and children with life-threatening conditions and their families. The vision of IAHPC is universal access to high-quality palliative care, integrated into all levels of healthcare systems in a continuum of care with disease prevention, early diagnosis and treatment, to assure that any patient's or family caregiver's suffering is relieved to the greatest extent possible...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28795860/access-to-palliative-care-consultation-and-advance-care-planning-for-adults-with-high-risk-leukemia
#7
Ashley T Freeman, William A Wood, Alexandra Fox, Laura C Hanson
BACKGROUND: Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. METHODS: We enrolled all patients with high-risk leukemia (acute leukemia ≥65 years or relapsed leukemia >18 years) admitted to the University of North Carolina Cancer Hospital from October 1, 2015, to August 1, 2016...
August 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28795293/endoscopic-palliation-of-pancreatic-cancer
#8
REVIEW
Vishal B Gohil, Jason B Klapman
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction...
August 9, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28793905/the-liverpool-care-pathway-a-systematic-review-discarded-in-cancer-patients-but-good-enough-for-dying-nursing-home-patients
#9
Bettina S Husebø, Elisabeth Flo, Knut Engedal
BACKGROUND: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying people with dementia...
August 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28792784/improved-pain-control-in-terminally-ill-cancer-patients-by-introducing-low-dose-oral-methadone-in-addition-to-ongoing-opioid-treatment
#10
Per Fürst, Staffan Lundström, Pål Klepstad, Sara Runesdotter, Peter Strang
BACKGROUND: Cancer pain is often not well controlled and there is a need for improved treatment strategies. Methadone exhibits unique properties among opioids and recent reports show promising results from adding a low dose of methadone to regular opioid therapy. OBJECTIVE: To examine the effects of oral low-dose methadone added to regular scheduled opioids in terminally ill patients with complex cancer-related pain. DESIGN: This was a retrospective chart review...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28791814/the-effects-of-recombinant-human-granulocyte-colony-stimulating-factor-mouthwash-on-radiotherapy-induced-oral-mucositis-in-locally-advanced-nasopharyngeal-carcinoma-patients
#11
Gai Liang, Wei Du, Qinghua Ke, Bing Huang, Jiyuan Yang
BACKGROUND: Acute oral mucositis is a common complication of radiotherapy for nasopharyngeal carcinoma (NPC) patients. OBJECTIVES: The aim of the study was to observe the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on radiotherapy-induced oral mucositis in locally advanced NPC patients. MATERIAL AND METHODS: The study involved 64 locally advanced NPC patients that were randomly allocated to receive either rhG-CSF mouthwash (2 μg/mL rhG-CSF; group A, n = 34) or a compounded mouth rinse (10 μg/mL vitamin B12, 0...
May 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#12
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#13
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28791278/venous-thromboembolism-in-pediatric-vascular-anomalies
#14
REVIEW
Taizo A Nakano, Chadi Zeinati
The presence of a vascular anomaly suggests that capillaries, veins, arteries, and/or lymphatic vessels have demonstrated abnormal development and growth. Often dilated and misshaped, these vessels augment normal flow of blood and lymphatic fluids that increases the overall risk to develop intralesional thrombosis. Abnormal endothelial and lymphoendothelial cells activate hemostasis and hyperfibrinolytic pathways through poorly understood mechanisms, which contribute to the development of localized intravascular coagulopathy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28781040/advancements-in-evidence-based-analgesia-in-exotic-animals
#15
REVIEW
Julie A Balko, Sathya K Chinnadurai
The importance of appropriate recognition, assessment, and treatment of pain in all veterinary species, including exotic animals, cannot be overstated. Although the assessment of pain perception in nondomestic species is still in its infancy, this does not preclude appropriate analgesic management in these species. Although analgesic drug selection is often based on data extrapolated from similar species, as the pharmacokinetics and pharmacodynamics of many drugs can vary greatly between species, an evidence-based approach to analgesic therapy should be used whenever possible...
September 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28777213/glenohumeral-instability-related-to-special-conditions-slap-tears-pan-labral-tears-and-multidirectional-instability
#16
Gregory S Van Blarcum, Steven J Svoboda
Glenohumeral instability is one of the more common conditions seen by sports medicine physicians, especially in young, active athletes. The associated anatomy of the glenohumeral joint (the shallow nature of the glenoid and the increased motion it allows) make the shoulder more prone to instability events as compared with other joints. Although traumatic dislocations or instability events associated with acute labral tears (ie, Bankart lesions) are well described in the literature, there exists other special shoulder conditions that are also associated with shoulder instability: superior labrum anterior/posterior (SLAP) tears, pan-labral tears, and multidirectional instability...
September 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28776383/hepatocellular-carcinoma-in-patients-without-advanced-fibrosis-after-eradication-of-hcv-with-antiviral-treatment
#17
Yolanda Sánchez-Torrijos, Jara Eloísa Ternero Vega, Carmen Cepeda Franco
From the last few years, hepatitis C virus and the new direct antiviral treatments are being more and more important. In consequence, case studies like the one we present, the appearance of hepatocelullar carcinoma after its eradication with fibrosis grade 2, are getting special interest. In 2007, our patient was treated with pegylated interferon α-2a and ribavirin, having a sustained virological response after it. In this way, liver fibrosis grade 2 was confirmed by a biopsy. Finally, after corroborating a good liver functioning, the patient was discharged (as, according to the guidebooks, an ultrasound scan of screeing every 6 months was not required)...
August 4, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28774580/advancing-imaging-technologies-for-patients-with-spinal-pain-with-a-focus-on-whiplash-injury
#18
James M Elliott, Mark J Hancock, Rebecca J Crawford, Andrew C Smith, David M Walton
BACKGROUND CONTEXT: Radiological observations of soft-tissue changes that may relate to clinical symptoms in patients with traumatic and non-traumatic spinal disorders are highly controversial. Studies are often of poor quality and findings inconsistent. A plethora of evidence suggests some pathoanatomical findings from traditional imaging applications are common in asymptomatic participants across the life span, which further questions the diagnostic, prognostic, and theranostic value of traditional imaging...
July 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28771447/chronic-pancreatitis
#19
Dennis Yang, Chris E Forsmark
PURPOSE OF REVIEW: Summarize key clinical advances in chronic pancreatitis reported in 2016. RECENT FINDINGS: Early diagnosis of chronic pancreatitis remains elusive. Recent studies suggest that endoscopic ultrasound may be less accurate than previously thought and new MRI techniques may be helpful. Genetic predisposition may independently affect the clinical course of chronic pancreatitis and the risk for pancreatic cancer. Cigarette smoking may have a greater negative impact on chronic pancreatitis than previously thought and moderate alcohol consumption may be protective...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28761738/results-of-the-safety-run-in-part-of-the-metal-metformin-in-advanced-lung-cancer-study-a-multicentre-open-label-phase-i-ii-study-of-metformin-with-erlotinib-in-second-line-therapy-of-patients-with-stage-iv-non-small-cell-lung-cancer
#20
Floriana Morgillo, Morena Fasano, Carminia Maria Della Corte, Ferdinando Carlo Sasso, Federica Papaccio, Giuseppe Viscardi, Giovanna Esposito, Raimondo Di Liello, Nicola Normanno, Annalisa Capuano, Liberato Berrino, Giovanni Vicidomini, Alfonso Fiorelli, Mario Santini, Fortunato Ciardiello
PURPOSE: Our previous works demonstrated the ability of metformin to revert resistance to gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in non-small-cell lung cancer (NSCLC) EGFR/LKB1 wild-type (WT) cell lines. However, the optimal dose of metformin to be used in non-diabetic patients still remains to be defined. The phase I-II trial METformin in Advanced Lung cancer (METAL) was designed to identify the maximum tolerated dose and to evaluate safety and activity of metformin combined with erlotinib in second-line treatment of patients with stage IV NSCLC, whose tumours harbour the WT EGFR gene...
2017: ESMO Open
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