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https://www.readbyqxmd.com/read/29054496/cancer-immunotherapy-a-paradigm-shift-in-the-treatment-of-advanced-urologic-cancers
#1
REVIEW
David M Gill, Neeraj Agarwal
The recent resurgence of immunotherapy has transformed the therapeutic field of advanced urologic cancers. In this seminars issue, we evaluate the role of emerging and recently approved immunotherapeutic agents in advanced prostate, urothelial, and renal cell carcinoma. In each of these fields, we discuss recent regulatory approvals as well as promising ongoing clinical trials. Finally, we discuss incidence and management of immune related adverse events specifically associated with PD-1/PD-L1 inhibitors.
October 17, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29053029/the-evidence-on-effectiveness-of-weekly-vs-triweekly-cisplatin-concurrent-with-radiotherapy-in-locally-advanced-head-and-neck-squamous-cell-carcinoma-hnscc-a-systematic-review-and-meta-analysis
#2
Jc Kennetth Jacinto, Jayson Co, Michael Benedict Mejia, Eugenio Emmanuel Regala
OBJECTIVE: This study aims to synthesize the current available evidences on the effectiveness of weekly vs triweekly cisplatin concurrent with radiotherapy in the primary and adjuvant treatment of locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: A systematic review and meta-analysis of literature were undertaken to assess the effectiveness of weekly vs triweekly schedule in primary and adjuvant treatment for HNSCC with adverse risk features...
November 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29052790/efficacy-and-safety-of-glecaprevir-pibrentasvir-in-hcv-infected-japanese-patients-with-prior-daa-experience-severe-renal-impairment-or-genotype-3-infection
#3
Hiromitsu Kumada, Tsunamasa Watanabe, Fumitaka Suzuki, Kenji Ikeda, Ken Sato, Hidenori Toyoda, Masanori Atsukawa, Akio Ido, Akinobu Takaki, Nobuyuki Enomoto, Koji Kato, Katia Alves, Margaret Burroughs, Rebecca Redman, David Pugatch, Tami J Pilot-Matias, Preethi Krishnan, Rajneet K Oberoi, Wangang Xie, Kazuaki Chayama
BACKGROUND: Once-daily, orally administered, co-formulated glecaprevir (NS3/4A protease inhibitor) and pibrentasvir (NS5A inhibitor) (G/P) demonstrated pangenotypic activity and high sustained virologic response (SVR) rates in studies outside Japan. Here we report safety and efficacy in a subset of Japanese patients with chronic HCV infection who received G/P 300/120 mg in a phase 3, open-label, multicenter study (CERTAIN-1). METHODS: This analysis focuses on three difficult-to-treat subgroups: HCV GT1/2-infected patients who failed to achieve SVR after treatment with a direct acting antiviral (DAA)-containing regimen; GT1/2-infected patients with severe renal impairment (estimated glomerular filtration rate < 30 mL/min/1...
October 20, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29052568/genetic-testing-of-the-mucin-1-gene-variable-number-tandem-repeat-single-cytosine-insertion-mutation-in-a-chinese-family-with-medullary-cystic-kidney-disease
#4
Nuo Si, Ke Zheng, Jie Ma, Xiao-Lu Meng, Xue-Mei Li, Xue Zhang
BACKGROUND: Medullary cystic kidney disease (MCKD) is clinically indistinguishable from several other autosomal-dominant renal diseases; thus, molecular genetic testing is needed to establish a definitive diagnosis. A specific type of single cytosine insertion in the variable number tandem repeat (VNTR) of the mucin 1 (MUC1) gene is the only known cause of MCKD1; however, genetic analysis of this mutation is difficult and not yet offered routinely. To identify the causative mutation/s and establish a definitive diagnosis in a Chinese family with chronic kidney disease, clinical assessments and genetic analysis were performed, including using a modified genotyping method to identify the MUC1- VNTR single cytosine insertion...
October 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29052559/efficacy-and-safety-of-niaoduqing-particles-for-delaying-moderate-to-severe-renal-dysfunction-a-randomized-double-blind-placebo-controlled-multicenter-clinical-study
#5
Ying Zheng, Guang-Yan Cai, Li-Qun He, Hong-Li Lin, Xiao-Hong Cheng, Nian-Song Wang, Gui-Hua Jian, Xu-Sheng Liu, Yu-Ning Liu, Zhao-Hui Ni, Jing-Ai Fang, Han-Lu Ding, Wang Guo, Ya-Ni He, Li-Hua Wang, Ya-Ping Wang, Hong-Tao Yang, Zhi-Ming Ye, Ren-Huan Yu, Li-Juan Zhao, Wen-Hua Zhou, Wen-Ge Li, Hui-Juan Mao, Yong-Li Zhan, Zhao Hu, Chen Yao, Ri-Bao Wei, Xiang-Mei Chen
BACKGROUND: Chronic kidney disease (CKD) with moderate-to-severe renal dysfunction usually exhibits an irreversible course, and available treatments for delaying the progression to end-stage renal disease are limited. This study aimed to assess the efficacy and safety of the traditional Chinese medicine, Niaoduqing particles, for delaying renal dysfunction in patients with stage 3b-4 CKD. METHODS: The present study was a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial...
October 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29051480/nox4-functions-as-a-mitochondrial-energetic-sensor-coupling-cancer-metabolic-reprogramming-to-drug-resistance
#6
Karthigayan Shanmugasundaram, Bijaya K Nayak, William E Friedrichs, Dharam Kaushik, Ronald Rodriguez, Karen Block
The molecular mechanisms that couple glycolysis to cancer drug resistance remain unclear. Here we identify an ATP-binding motif within the NADPH oxidase isoform, NOX4, and show that ATP directly binds and negatively regulates NOX4 activity. We find that NOX4 localizes to the inner mitochondria membrane and that subcellular redistribution of ATP levels from the mitochondria act as an allosteric switch to activate NOX4. We provide evidence that NOX4-derived reactive oxygen species (ROS) inhibits P300/CBP-associated factor (PCAF)-dependent acetylation and lysosomal degradation of the pyruvate kinase-M2 isoform (PKM2)...
October 19, 2017: Nature Communications
https://www.readbyqxmd.com/read/29051331/intravenous-zanamivir-in-hospitalized-patients-with-influenza
#7
John S Bradley, Jeffrey L Blumer, José R Romero, Marian G Michaels, Flor M Munoz, David W Kimberlin, Barbara Pahud, Roberta L DeBiasi, Go Yamamoto, Grace Roberts, Mohammad Hossain, Denise Shortino, Phillip J Yates, Bryan Adams, Amanda Peppercorn
BACKGROUND: Children with severe influenza infection may require parenteral therapy if oral or inhaled therapies are ineffective or cannot be administered. Results from a study investigating intravenous (IV) zanamivir for the treatment of hospitalized infants and children with influenza are presented. METHODS: This phase II, open-label, multicenter, single-arm study assessed the safety of investigational IV zanamivir in hospitalized children with influenza. Safety outcomes included treatment-emergent adverse events (TEAEs), clinical laboratory measurements, and vital signs...
October 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/29050923/a-systematic-review-of-in-hospital-worsening-heart-failure-as-an-endpoint-in-clinical-investigations-of-therapy-for-acute-heart-failure
#8
Cândida Fonseca, Aldo Pietro Maggioni, Filipa Marques, Inês Araújo, Daniel Brás, Ronald B Langdon, Carlo Lombardi, Paulo Bettencourt
BACKGROUND: In-hospital worsening heart failure (WHF) occurs frequently in patients hospitalized for acute heart failure (AHF) and has strongly negative prognostic associations. It may be a useful endpoint in studies of AHF management but important questions remain regarding optimization of its definition and variability in its incidence. METHODS: Our objective was to survey the full extent of clinical interest in WHF and assess the impact of baseline variables and trial design on outcomes...
October 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29050621/association-of-chronic-kidney-disease-with-in-hospital-outcomes-of-transcatheter-aortic%C3%A2-valve-replacement
#9
Tanush Gupta, Kashish Goel, Dhaval Kolte, Sahil Khera, Pedro A Villablanca, Wilbert S Aronow, Anna E Bortnick, David P Slovut, Cynthia C Taub, Jorge R Kizer, Robert T Pyo, J Dawn Abbott, Gregg C Fonarow, Charanjit S Rihal, Mario J Garcia, Deepak L Bhatt
OBJECTIVES: This study sought to determine the association of chronic kidney disease (CKD) with in-hospital outcomes of transcatheter aortic valve replacement (TAVR). BACKGROUND: CKD is a known independent risk factor for worse outcomes after surgical aortic valve replacement (SAVR). However, data on outcomes of patients with CKD undergoing TAVR are limited, especially in those on chronic dialysis. METHODS: The authors used data from the 2012 to 2014 National Inpatient Sample database to identify all patients ≥18 years of age who underwent TAVR...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29049508/outcomes-in-women-and-minorities-compared-with-white-men-1-year-after-everolimus-eluting-stent-implantation-insights-and-results-from-the-platinum-diversity-and-promus-element-plus-post-approval-study-pooled-analysis
#10
Wayne Batchelor, David E Kandzari, Scott Davis, Luis Tami, John C Wang, Islam Othman, Osvaldo S Gigliotti, Amir Haghighat, Sarabjeet Singh, Mario Lopez, Gregory Giugliano, Phillip A Horwitz, Jaya Chandrasekhar, Paul Underwood, Craig A Thompson, Roxana Mehran
Importance: There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI). Objective: To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents. Design, Settings, and Participants: The PLATINUM Diversity study was a single-arm study enrolling women and minorities. Patient-level pooling with the PROMUS Element Plus Post-Approval Study was prespecified...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29049458/long-term-outcomes-of-multiple-arterial-coronary-artery-bypass-grafting-a-population-based-study-of-patients-in-british-columbia-canada
#11
Aihua Pu, Lillian Ding, Jungwon Shin, Joel Price, Peter Skarsgard, Daniel R Wong, John Bozinovski, Guy Fradet, James G Abel
Importance: Although the long-term survival advantage of multiple arterial grafting (MAG) vs the standard use of left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG) has been demonstrated in several observational studies, to our knowledge its safety and other long-term clinical benefits in a large, population-based cohort are unknown. Objective: To compare the safety and long-term outcomes of MAG vs LITA+SVG among overall and selected subgroups of patients...
October 11, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29047367/effectiveness-and-safety-of-beta-blockers-in-the-management-of-hypertension-in-older-adults-a-systematic-review-to-help-reduce-inappropriate-prescribing
#12
REVIEW
Anna Vögele, Tim Johansson, Anna Renom-Guiteras, David Reeves, Anja Rieckert, Lisa Schlender, Anne-Lisa Teichmann, Andreas Sönnichsen, Yolanda V Martinez
BACKGROUND: The benefit from a blood pressure lowering therapy with beta blockers may not outweigh its risks, especially in older populations. The aim of this study was to look for evidence on risks and benefits of beta blockers in older adults and to use this evidence to develop recommendations for the electronic decision support tool of the PRIMA-eDS project. METHODS: Systematic review of the literature using a stage approach with searches for systematic reviews and meta-analyses first, and individual studies only if the previous searches are inconclusive...
October 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29047344/efficacy-and-safety-of-metformin-in-the-management-of-type-2-diabetes-mellitus-in-older-adults-a-systematic-review-for-the-development-of-recommendations-to-reduce-potentially-inappropriate-prescribing
#13
REVIEW
Lisa Schlender, Yolanda V Martinez, Charles Adeniji, David Reeves, Barbara Faller, Christina Sommerauer, Thekraiat Al Qur'an, Adrine Woodham, Ilkka Kunnamo, Andreas Sönnichsen, Anna Renom-Guiteras
BACKGROUND: Metformin is usually prescribed as first line therapy for type 2 diabetes mellitus (DM2). However, the benefits and risks of metformin may be different for older people. This systematic review examined the available evidence on the safety and efficacy of metformin in the management of DM2 in older adults. The findings were used to develop recommendations for the electronic decision support tool of the European project PRIMA-eDS. METHODS: The systematic review followed a staged approach, initially searching for systematic reviews and meta-analyses first, and then individual studies when prior searches were inconclusive...
October 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29047047/impact-of-bariatric-surgery-on-outcomes-of-patients-with-inflammatory-bowel-disease-a-nationwide-inpatient-sample-analysis-2004-2014
#14
Prabin Sharma, Thomas R McCarty, Basile Njei
PURPOSE: There is a paucity of data regarding the benefits of bariatric surgery in patients with inflammatory bowel disease (IBD). The primary aim of this study was to evaluate the role of bariatric surgery on clinical outcomes among hospitalized patients with IBD. MATERIALS AND METHODS: The United States (US) National Inpatient Sample database was queried between 2004 and 2014 for discharges with co-diagnoses of morbid obesity and IBD. Hospitalizations with a history of prior-bariatric surgery were also identified...
October 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29045285/milrinone-dosing-and-a-culture-of-caution-in-clinical-practice
#15
Luke Yong Zheng Chong, Kumar Satya, Bernard Kim, Robert Berkowitz
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease since the drug is primarily cleared by renal excretion...
October 17, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29045250/clinical-decision-making-for-immunotherapy-in-metastatic-renal-cell-carcinoma
#16
Manuela Schmidinger
PURPOSE OF REVIEW: To review the treatment options in metastatic renal cell carcinoma (mRCC) in the light of new immunotherapy results. RECENT FINDINGS: Second-line treatment strategies for treatment of mRCC after progression on first-line VEGF-targeted therapy have recently undergone a major change. Treatment guidelines currently recommend the use of either nivolumab, a programmed cell death 1 (PD-1) inhibitor, or cabozantinib, an inhibitor of multiple receptor tyrosine kinases, as preferred choices...
October 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/29044018/-insulin-therapy-in-special-conditions
#17
León E Litwak, Alicia Elbert, Cristina Faingold, Luis A Grosembacher, Adrián Proietti, Félix Puchulu
Hyperglycemia during hospitalization is a common condition associated with poor prognosis. To date, insulin is the best strategy to treat hyperglycemia in these patients. An adequate glycemic control is associated with better clinical results. Nevertheless, glycemic goals are still controversial due to the increase of hypoglycemia and other adverse events. Diabetes mellitus is still the main cause of chronic renal failure in our country and its treatment deserves a special analysis considering that insulin pharmacokinetics is altered...
2017: Medicina
https://www.readbyqxmd.com/read/29042076/perioperative-outcomes-after-reoperative-carotid-endarterectomy-are-worse-than-expected
#18
Brianna M Krafcik, Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Reoperative carotid endarterectomy (CEA) can be technically challenging because of significant scarring as a consequence of the initial CEA procedure. There are limited data that describe outcomes after reoperative CEA, and as such, our goal was to determine the effect of reoperative CEA on perioperative outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried for patients undergoing index and reoperative CEA between 2005 and 2014...
October 14, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29041948/effect-of-levosimendan-on-prognosis-in-adult-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#19
Qi-Hong Chen, Rui-Qiang Zheng, Hua Lin, Jun Shao, Jiang-Quan Yu, Hua-Ling Wang
BACKGROUND: Small trials suggest that levosimendan is associated with a favorable outcome in patients undergoing cardiac surgery. However, recently published larger-scale trials did not provide evidence for a similar benefit from levosimendan. We performed a meta-analysis to assess the survival benefits of levosimendan in patients undergoing cardiac surgery and to investigate its effects in subgroups of patients with preoperative low-ejection fraction (EF). METHODS: We identified randomized clinical trials through 20 April 2017 that investigated levosimendan therapy versus control in patients undergoing cardiac surgery...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29040554/frailty-syndrome-an-emerging-clinical-problem-in-the-everyday-management-of-clinical-arrhythmias-the-results-of-the-european-heart-rhythm-association-survey
#20
Stefano Fumagalli, Tatjana S Potpara, Torben Bjerregaard Larsen, Kristina H Haugaa, Dan Dobreanu, Alessandro Proclemer, Nikolaos Dagres
The age of patients presenting with complex arrhythmias is increasing. Frailty is a multifaceted syndrome characterized by an increased vulnerability to stressors and a decreased ability to maintain homeostasis. The prevalence of frailty is associated with age. The aims of this European Heart Rhythm Association (EHRA) EP Wire survey were to evaluate the proportion of patients with frailty and its influence on the clinical management of arrhythmias. A total of 41 centres-members of the EHRA Electrophysiology Research Network-in 14 European countries completed the web-based questionnaire in June 2017...
October 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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