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https://www.readbyqxmd.com/read/28812301/changing-treatment-paradigms-for-brain-metastases-from-melanoma-part-1-diagnosis-prognosis-symptom-control-and-local-treatment
#1
REVIEW
Vyshak Alva Venur, Pauline Funchain, Rupesh Kotecha, Samuel T Chao, Manmeet S Ahluwalia
Melanoma is the third most common cause of brain metastases, after lung and breast cancer. The management of melanoma brain metastases can be broadly divided into symptom control and therapeutic strategies. Supportive treatments include corticosteroids to reduce peritumoral edema, antiepileptics for seizure control, and medications to preserve cognitive function. Until recently, therapeutic strategies consisted primarily of local treatments, including surgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS)...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28811003/the-impact-of-thoracic-endovascular-aortic-repair-on-long-term-survival-in-type-b-aortic%C3%A2-dissection
#2
Xiaoying Lou, Edward P Chen, Yazan M Duwayri, Ravi K Veeraswamy, William D Jordan, Carl A Zehner, Bradley G Leshnower
BACKGROUND: Currently, optimal medical therapy is first-line therapy for uncomplicated acute type B aortic dissection (aTBAD) despite poor long-term outcomes. This study examines the impact of thoracic endovascular aortic repair (TEVAR) in the acute and chronic phases on short-term and long-term survival of patients presenting with aTBAD. METHODS: A review of the Emory aortic database from 2000 to 2016 identified 398 patients diagnosed with aTBAD. At index hospitalization, complicated patients underwent TEVAR (aTEVAR [thoracic endovascular aortic repair in the acute phase], n = 80) and uncomplicated patients received optimal medical therapy (n = 318)...
August 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28810883/treatment-of-localized-gastric-and-gastroesophageal-adenocarcinoma-the-role-of-accurate-staging-and-preoperative-therapy
#3
REVIEW
Brian Badgwell, Prajnan Das, Jaffer Ajani
Gastric cancer is the third most common cause of cancer death worldwide, although it is not in the top 10 causes of cancer death in Northern America. Due to clear differences in incidence, screening, risk factors, tumor biology, and treatment between gastric cancers from Eastern and Western countries, our treatment is primarily guided by trials from Western countries. Patients undergo an extensive staging evaluation including high-quality CT imaging, endoscopic ultrasound, and diagnostic laparoscopy with peritoneal washings for cytology...
August 15, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#4
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810098/a-rare-case-of-pulmonary-lymphomatoid-granulomatosis
#5
Ukamaka Nwakife Nwadibia, Kalyan Chakravarthy Potu, Eric A Larson, Galal Ahmed
In this report, we discuss an unusual case of pulmonary lymphomatoid granulomatosis (LYG), a rare form of angiocentric and angiodestructive lymphoproliferative disorder. This disease is thought to be caused by Epstein-Barr virus-induced lymphoproliferation. A 39-year-old male with no signi ficant past medical history presented with flu-like symptoms. Upon further evaluation, laboratory studies noted pancytopenia, and a chest X-ray showed bilateral nodular densities. A computerized tomography (CT) scan demonstrated bilateral pulmonary nodules and splenomegaly...
January 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28807744/primary-stenting-is-not-necessary-in-benign-central-venous-stenosis
#6
Lynsey E Rangel, Sean P Lyden, Daniel G Clair
OBJECTIVE: To evaluate central venous stenosis (CVS) etiologies and presentation within a vascular surgery practice. We evaluated endovascular treatment modalities and the patency rates of our interventions. METHODS: 5 year retrospective review of endovascular intervention for CVS. Patient demographics, medical comorbidities, and variables were collected including etiology, indwelling device, previous upper extremity (UE) deep venous thrombosis (DVT), long term UE indwelling device (defined as greater than 30 days), malignancy status, hypercoagulable disorders, history of radiation or mediastinal fibrosis or masses, and anticoagulation and/or antiplatelet therapy...
August 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28805568/complementary-and-alternative-medicine-and-exercise-in-nonmotor-symptoms-of-parkinson-s-disease
#7
Indu Subramanian
The use of complementary and alternative medicine (CAM) therapy in nonmotor symptoms (NMS) for Parkinson disease (PD) is growing worldwide. Well-performed, systematic evidence-based research is largely lacking in this area and many studies include various forms of CAM with small patient numbers and a lack of standardization of the approaches studied. Taichi, Qigong, dance, yoga, mindfulness, acupuncture, and other CAM therapies are reviewed and there is some evidence for the following: Taichi in sleep and PDQ39; dance in cognition, apathy, and a mild trend to improved fatigue; yoga in PDQ39; and acupuncture in depression, PDQ39, and sleep...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805309/safety-of-herpes-zoster-vaccination-among-inflammatory-bowel-disease-patients-being-treated-with-anti-tnf-medications
#8
N Khan, Y Shah, C Trivedi, J D Lewis
BACKGROUND: The risk of herpes zoster (HZ) is elevated in inflammatory bowel disease (IBD) patients treated with anti-TNF medications. While it is optimal to give herpes zoster vaccine prior to initiation of therapy clinical circumstances may not always allow this. AIM: To determine the safety of giving herpes zoster vaccine while patients are on anti-TNF therapy. METHODS: We conducted a retrospective cohort study involving IBD patients who were followed in the Veterans Affairs (VA) healthcare system between 2001 and 2016...
August 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#9
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28803668/when-does-atopic-dermatitis-warrant-systemic-therapy-recommendations-from-an-expert-panel-of-the-international-eczema-council
#10
Eric L Simpson, Marjolein Bruin-Weller, Carsten Flohr, Michael R Ardern-Jones, Sebastien Barbarot, Mette Deleuran, Thomas Bieber, Christian Vestergaard, Sara J Brown, Michael J Cork, Aaron M Drucker, Lawrence F Eichenfield, Regina Foelster-Holst, Emma Guttman-Yassky, Audrey Nosbaum, Nick J Reynolds, Jonathan I Silverberg, Jochen Schmitt, Marieke M B Seyger, Phyllis I Spuls, Jean-Francois Stalder, John C Su, Roberto Takaoka, Claudia Traidl-Hoffmann, Jacob P Thyssen, Jorien van der Schaft, Andreas Wollenberg, Alan D Irvine, Amy S Paller
BACKGROUND: Although most patients with atopic dermatitis (AD) are effectively managed with topical medication, a significant minority require systemic therapy. Guidelines for decision making about advancement to systemic therapy are lacking. OBJECTIVE: To guide those considering use of systemic therapy in AD and provide a framework for evaluation before making this therapeutic decision with the patient. METHODS: A subgroup of the International Eczema Council determined aspects to consider before prescribing systemic therapy...
August 10, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28802905/thoracic-oncology-clinical-trial-eligibility-criteria-and-requirements-continue-to-increase-in-number-and-complexity
#11
Sandra Garcia, Ajit Bisen, Jingsheng Yan, Xian-Jin Xie, Suresh Ramalingam, Joan H Schiller, David H Johnson, David E Gerber
BACKGROUND: Eligibility criteria and screening procedures are designed to optimize the scientific yield and maximize the safety of clinical trials. However, they may also heighten trial complexity, hinder enrollment, decrease generalizability, and increase costs. We analyzed the types and number of eligibility criteria and screening procedures among thoracic oncology clinical trials sponsored or endorsed by the Eastern Cooperative Oncology Group (ECOG). METHODS: We identified trials and obtained protocols from the ECOG website...
July 24, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28801124/changing-our-approach-to-stage-d-heart-failure
#12
REVIEW
Miriam Becnel, Hector O Ventura, Selim R Krim
Despite the tremendous progress made in the management of heart failure (HF), many patients reach advanced stages. This paper aims to present a practical approach to the stage D HF patient who is no longer responding to optimal medical therapy. We discuss all available therapies for this patient population. We also offer some important caveats with regard to identification, risk stratification, evaluation and treatment including early patient referral to a center with an advanced HF program. Given the changing landscape of heart transplantation and an impending change in the allocation system, we also intend to engage a discussion on the need for a paradigm shift towards left ventricular assist device therapy in this population...
August 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28798906/cerebral-sinovenous-thrombosis
#13
REVIEW
Rebecca Ichord
Cerebral sinovenous thrombosis (CSVT) is a rare but serious cerebrovascular disorder affecting children from the newborn period through childhood and adolescence. The incidence is estimated at 0.6/100,000/year, with 30-50% occurring in newborns. Causes are diverse and are highly age dependent. Acute systemic illness is the dominant risk factor among newborns. In childhood CSVT, acute infections of the head and neck such as mastoiditis are most common, followed by chronic underlying diseases such as nephrotic syndrome, cancer, and inflammatory bowel disease...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28798274/disparities-of-trastuzumab-use-in-resource-limited-or-resource-abundant-regions-and-its-survival-benefit-on-her2-positive-breast-cancer-a-real-world-study-from-china
#14
Jianbin Li, Shusen Wang, Yongsheng Wang, Xiaojia Wang, Haibo Wang, Jifeng Feng, Qingyuan Zhang, Tao Sun, Quchang Ouyang, Yongmei Yin, Yinhua Liu, Cuizhi Geng, Min Yan, Zefei Jiang
BACKGROUND: Trastuzumab is a key component of therapy for human epidermal growth receptor 2 (HER2) positive breast cancer. Because real-world data are lacking, the present research was conducted to evaluate the the actual use of and the effectiveness of trastuzumab in the real world in China. METHODS: Inpatients with HER2 positive invasive breast cancer from 13 hospitals in Eastern China (2010-2015, n = 1,139) were included in this study. We aimed to assess the actual use of trastuzumab and to evaluate potential efficacy from trastuzumab in real-world research...
August 10, 2017: Oncologist
https://www.readbyqxmd.com/read/28797248/the-role-of-bariatric-surgery-to-treat-diabetes-current-challenges-and-perspectives
#15
REVIEW
Chrysi Koliaki, Stavros Liatis, Carel W le Roux, Alexander Kokkinos
Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to treat T2DM, especially in light of accumulating evidence that surgery with gastrointestinal manipulations may result in T2DM remission (metabolic surgery). The major mechanisms mediating the weight loss-independent effects of bariatric surgery comprise effects on tissue-specific insulin sensitivity, β-cell function and incretin responses, changes in bile acid composition and flow, modifications of gut microbiota, intestinal glucose metabolism and increased brown adipose tissue metabolic activity...
August 10, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28796864/individualized-adaptive-stereotactic-body-radiotherapy-for-liver-tumors-in-patients-at-high-risk-for-liver-damage-a-phase-2-clinical-trial
#16
Mary Feng, Krithika Suresh, Matthew J Schipper, Latifa Bazzi, Edgar Ben-Josef, Martha M Matuszak, Neehar D Parikh, Theodore H Welling, Daniel Normolle, Randall K Ten Haken, Theodore S Lawrence
Importance: Patients with preexisting liver dysfunction could benefit the most from personalized therapy for liver tumors to balance maximal tumor control and minimal risk of liver failure. We designed an individualized adaptive trial testing the hypothesis that adapting treatment based on change in liver function could optimize the therapeutic index for each patient. Objective: To characterize the safety and efficacy of individualized adaptive stereotactic body radiotherapy (SRBT) for liver tumors in patients who have preexisting liver dysfunction...
August 10, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28796560/facial-emotion-decoding-in-patients-with-parkinson-s-disease
#17
Marco De Risi, Giancarlo Di Gennaro, Angelo Picardi, Sara Casciato, Liliana G Grammaldo, Alfredo D'Aniello, Deborah Lanni, Stefano Meletti, Nicola Modugno
PURPOSE: In line with the growing attention on non-motor symptoms and disturbance of affective and emotional processing in Parkinson's disease, we aimed to study different aspects of facial emotion expression evaluation in a group of PD without cognitive decline in treatment with common antiparkinsonian drugs, matched for sex, age, and education with healthy subjects. MATERIALS AND METHODS: The study was conducted on 30 patients (13 male; mean age: 63.3±6.7; mean age of disease onset: 56...
August 10, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28795284/dermatofibrosarcoma-protuberans
#18
REVIEW
Alvaro E Acosta, Catalina Santa Vélez
Dermatofibrosarcoma protuberans (DFSP) is a slow growing tumor with a very low metastatic potential but with significant subclinical extension and great capacity for local destruction. Thus, the first surgeon approached with such challenging tumor must attempt to cure the patient with a method that spares healthy tissue and ensures an optimal oncological, functional, and esthetic result. The treatment of DFSP often requires a multidisciplinary approach. Depending on location, dermatologic surgeons, surgical oncologists, head and neck surgeons, neurosurgeons, plastic surgeons, and occasionally medical oncologists may be involved with the management...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28792170/consensus-on-basal-insulin-in-the-management-of-type-2-diabetes-which-when-and-how
#19
Samit Ghosal, Binayak Sinha, Anirban Majumder, Ashok Kumar Das, Awadhesh Kumar Singh, Biswajit Ghoshdastidar, Debasish Maji, Ghanshyam Goyal, Jagat Jyoti Mukherjee, Kalyan Kumar Gangopadhyay, Mathew John, Sanjay Chatterjee, Shalini Jaggi, Subir Ray, Sujoy Majumdar, Surendra Kumar Sharma
INTRODUCTION: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28791494/adherence-with-perindopril-therapy-a-pilot-study-using-therapeutic-drug-monitoring-of-perindoprilat-and-an-evaluation-of-the-clearance-estimation
#20
Martin Šíma, Martin Vodička, Věra Marešová, Tomáš Šálek, Radomír Čabala, Ondřej Slanař
Background Although measurement of drug serum levels is an objective direct method for testing compliance, it can be distorted by "white-coat compliance" or by variations in drug elimination. Objective The aim of this prospective study was to evaluate the prevalence of noncompliance with perindopril therapy in adult out-patients using pharmacokinetic simulations. The additional aim was to compare the predictive performance of two glomerular filtration rate markers-creatinine and cystatin C. Setting Department of Cardiology, Tomas Bata Regional Hospital in Zlín, Czech Republic...
August 8, 2017: International Journal of Clinical Pharmacy
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