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https://www.readbyqxmd.com/read/29035643/role-of-bone-modifying-agents-in-metastatic-breast-cancer-an-american-society-of-clinical-oncology-cancer-care-ontario-focused-guideline-update
#1
Catherine Van Poznak, Mark R Somerfield, William E Barlow, J Sybil Biermann, Linda D Bosserman, Mark J Clemons, Sukhbinder K Dhesy-Thind, Melissa S Dillmon, Andrea Eisen, Elizabeth S Frank, Reshma Jagsi, Rachel Jimenez, Richard L Theriault, Theodore A Vandenberg, Gary C Yee, Beverly Moy
Purpose To update, in collaboration with Cancer Care Ontario (CCO), key recommendations of the American Society of Clinical Oncology (ASCO) guideline on the role of bone-modifying agents (BMAs) in metastatic breast cancer. This focused update addressed the new data on intervals between dosing and the role of BMAs in control of bone pain. Methods A joint ASCO-CCO Update Committee conducted targeted systematic literature reviews to identify relevant studies. Results The Update Committee reviewed three phase III noninferiority trials of dosing intervals, one systematic review and meta-analysis of studies of de-escalation of BMAs, and two randomized trials of BMAs in control of pain secondary to bone metastases...
October 16, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29031431/implementing-an-antibiotic-stewardship-program-at-a-long-term-acute-care-hospital-in-detroit-michigan
#2
Ammara Mushtaq, Reda A Awali, Suganya Chandramohan, Amar Krishna, Caitlin Biedron, Olufemi Jegede, Teena Chopra
BACKGROUND: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH). METHODS: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29030654/predictive-and-prognostic-value-of-tumor-volume-and-its-changes-during-radical-radiotherapy-of-stage%C3%A2-iii-non-small-cell-lung-cancer-a%C3%A2-systematic-review
#3
Lukas Käsmann, Maximilian Niyazi, Oliver Blanck, Christian Baues, René Baumann, Sophie Dobiasch, Chukwuka Eze, Daniel Fleischmann, Tobias Gauer, Frank A Giordano, Yvonne Goy, Jan Hausmann, Christoph Henkenberens, David Kaul, Lisa Klook, David Krug, Matthias Mäurer, Cédric M Panje, Johannes Rosenbrock, Lisa Sautter, Daniela Schmitt, Christoph Süß, Alexander H Thieme, Maike Trommer-Nestler, Sonia Ziegler, Nadja Ebert, Daniel Medenwald, Christian Ostheimer
PURPOSE: Lung cancer remains the leading cause of cancer-related mortality worldwide. Stage III non-small cell lung cancer (NSCLC) includes heterogeneous presentation of the disease including lymph node involvement and large tumour volumes with infiltration of the mediastinum, heart or spine. In the treatment of stage III NSCLC an interdisciplinary approach including radiotherapy is considered standard of care with acceptable toxicity and improved clinical outcome concerning local control...
October 13, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#4
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29027693/efficacy-and-safety-of-golimumab-in-crohn-s-disease-a-french-national-retrospective-study
#5
C Martineau, B Flourié, P Wils, T Vaysse, R Altwegg, A Buisson, A Amiot, G P de Chambrun, V Abitbol, M Fumery, X Hébuterne, S Viennot, D Laharie, L Beaugerie, S Nancey, H Sokol
BACKGROUND: Anti-tumour necrosis factor (TNF) agents have improved the care of Crohn's disease (CD). After the first anti-TNF discontinuation, it is possible to switch to another anti-TNF. Three anti-TNF agents are available for ulcerative colitis (infliximab, adalimumab and golimumab), but only the first 2 have been approved for CD because golimumab has not been studied for this indication. AIM: To report the efficacy and safety of golimumab in CD. METHODS: Crohn's disease patients who received golimumab were identified in 12 French tertiary centres and were retrospectively analysed...
October 13, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29024370/classification-of-heat-related-illness-symptoms-among-florida-farmworkers
#6
Abby D Mutic, Jacqueline M Mix, Lisa Elon, Nathan J Mutic, Jeannie Economos, Joan Flocks, Antonio J Tovar-Aguilar, Linda A McCauley
BACKGROUND: Farmworkers working in hot and humid environments have an increased risk for heat-related illness (HRI) if their thermoregulatory capabilities are overwhelmed. The manifestation of heat-related symptoms can escalate into life-threatening events. Increasing ambient air temperatures resulting from climate change will only exacerbate HRI in vulnerable populations. We characterize HRI symptoms experienced by farmworkers in three Florida communities. METHODS: A total of 198 farmworkers enrolled in 2015-2016 were asked to recall if they experienced seven HRI symptoms during the previous work week...
October 12, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/29021649/follow-up-urodynamics-in-patients-with-neurogenic-bladder
#7
REVIEW
Sanjay Sinha
INTRODUCTION: Neurogenic bladder patients are at long-term risk of secondary upper urinary tract damage. Symptoms are unreliable and follow-up urodynamics is the only method of ascertaining safety of bladder pressures. This review examines the recommendations, shortcomings and utilization of existing guidelines. The evidence with regard to follow-up urodynamics in different settings relevant to neurogenic bladder is evaluated and an algorithm is proposed. METHODS: A pubmed search was conducted for studies on follow-up urodynamics in patients with neurogenic bladder...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29018966/safety-and-cost-benefit-of-an-ambulatory-program-for-patients-with-low-risk-neutropenic-fever-at-an-australian-centre
#8
Benjamin W Teh, Christine Brown, Trish Joyce, Leon J Worth, Monica A Slavin, Karin A Thursky
BACKGROUND: Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. METHODS: Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program...
October 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29017221/-biologicals-in-the-treatment-of-bronchial-asthma
#9
I Haasler, C Taube
Biologicals are a therapeutic option for patients with severe asthma. Difficult asthma in patients with untreated comorbidities or persistent trigger factors is much more common than severe refractory asthma. Optimized medical treatment, adherence to medication, elimination of trigger factors and treatment of comorbidities are essential before escalating the therapy with a biological. A careful phenotyping of patient with severe asthma is necessary because all available biological are only effective in certain phenotypes of the disease...
October 2017: Pneumologie
https://www.readbyqxmd.com/read/28993141/therapeutic-inertia-amongst-general-practitioners-with-interest-in-diabetes
#10
Samuel Seidu, Tun Than, Deb Kar, Amrit Lamba, Pam Brown, Azhar Zafar, Rizwan Hussain, Ahmed Amjad, Mathew Capehorn, Elizabeth Martin, Kevin Fernando, Jim McMoran, David Millar-Jones, Shahzada Kahn, Nigel Campbell, Richard Brice, Rahul Mohan, Mukesh Mistry, Naresh Kanumilli, Joan St John, Richard Quigley, Colin Kenny, Kamlesh Khunti
INTRODUCTION: As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists...
October 6, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28992562/a-phase-ib-dose-escalation-study-of-the-safety-and-pharmacokinetics-of-pictilisib-in-combination-with-either-paclitaxel-and-carboplatin-with-or-without-bevacizumab-or-pemetrexed-and-cisplatin-with-or-without-bevacizumab-in-patients-with-advanced-non-small-cell
#11
Jean-Charles Soria, Alex A Adjei, Rastilav Bahleda, Benjamin Besse, Charles Ferte, David Planchard, Jing Zhou, Joseph Ware, Kari Morrissey, Geetha Shankar, Wei Lin, Jennifer L Schutzman, Grace K Dy, Harry J M Groen
AIM: The phosphatidylinositol 3-kinase (PI3K) pathway is a potential therapeutic target in non-small cell lung cancer (NSCLC). This study aimed to evaluate the pan-PI3K inhibitor pictilisib in combination with first-line treatment regimens that were the standard of care at the time of study, in patients with NSCLC. PATIENTS AND METHODS: A 3 + 3 dose-escalation study was performed using a starting daily dose of 60 mg pictilisib on days 1-14 of a 21-day cycle...
October 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28985192/incorporating-supportive-care-into-the-hemodialysis-unit
#12
Rebecca J Schmidt
PURPOSE OF REVIEW: Advance care planning is underutilized in patients with dialysis-dependent kidney failure and the provision of high intensity rather than supportive care is a standard practice in most hemodialysis units wherever challenges to incorporating palliative or supportive care into unit processes remain formidable. RECENT FINDINGS: The practice of advance care planning empowers patients, families and physicians and drives decisions about future treatment that align with patients' values, wishes and changing clinical circumstances...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28983464/radiotherapy-dosing-for-locally-advanced-non-small-cell-lung-carcinoma-mtd-or-alara
#13
REVIEW
Nitin Ohri
Locally advanced non-small cell lung cancer (LA-NSCLC) is typically treated with thoracic radiotherapy, often in combination with cytotoxic chemotherapy. Despite tremendous advances in the evaluation, treatment techniques, and supportive care measures provided to LA-NSCLC patients, local disease progression and distant metastases frequently develop following definitive therapy. A recent landmark randomized trial demonstrated that radiotherapy dose escalation may reduce survival rates, highlighting our poor understanding of the effects of thoracic radiotherapy for LA-NSCLC...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28982549/achieving-a-3-star-society-of-thoracic-surgery-lobectomy-ranking-by-using-continuing-process-improvement-lean-methodology-and-root-cause-analysis
#14
Robert J Cerfolio, Douglas J Minnich, Benjamin Wei, Caroline Watson, Malcolm M DeCamp
Our purpose is to identify the metrics used by the Society of Thoracic Surgeons (STS) to rank lobectomy and to show our process to improve. This is a review of our STS data for lobectomy and our results using the process of root cause analysis and lean methodology to improve our outcomes. The STS metrics are 30-day mortality, pneumonia, adult respiratory distress syndrome, bronchopleural fistula, pulmonary embolus, initial ventilator support greater than 48 hours, reintubation and respiratory failure, tracheostomy, myocardial infarction, or unexpected return to the operating room...
August 18, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28980026/-bacterial-sepsis-diagnostics-and-calculated-antibiotic-therapy
#15
REVIEW
D C Richter, A Heininger, T Brenner, M Hochreiter, M Bernhard, J Briegel, S Dubler, B Grabein, A Hecker, W A Krüger, K Mayer, M W Pletz, D Störzinger, N Pinder, T Hoppe-Tichy, S Weiterer, S Zimmermann, A Brinkmann, M A Weigand, Christoph Lichtenstern
The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed focus and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account for selection of anti-infection treatment...
October 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28974331/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2016
#16
REVIEW
Deanna Horner, Diana Altshuler, Chris Droege, Joel Feih, Kevin Ferguson, Mallory Fiorenza, Kasey Greathouse, Leslie Hamilton, Caitlin Pfaff, Lauren Roller, Joanna Stollings, Adrian Wong
PURPOSE: To summarize select critical care pharmacotherapy guidelines and studies published in 2016. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 31 journals monthly for relevant pharmacotherapy articles and selected 107 articles for review over the course of 2016. Of those included in the monthly CCPLU, three guidelines and seven primary literature studies are reviewed here. The guideline updates included are as follows: hospital-acquired pneumonia and ventilator-associated pneumonia management, sustained neuromuscular blocking agent use, and reversal of antithrombotics in intracranial hemorrhage (ICH)...
September 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28971697/the-benefit-of-low-dose-prophylaxis-in-the-treatment-of-hemophilia-a-focus-on-china
#17
Runhui Wu, Koon Hung Luke
Currently full dose prophylaxis is the standard of care in the treatment of hemophilia (World Federation of Hemophilia). However, the high costs prevent the use of standard or intermediate dose prophylaxis in China and other developing countries. Low dose prophylaxis would be a viable alternative treatment. At present global research data on the use of low dose prophylaxis is limited. Areas covered: Since 2007, China has been developing low dose prophylaxis as a high priority (90 % of moderate and severe hemophilia boys suffer joint disease by age 6 - 9)...
October 3, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28960738/de-escalation-techniques-used-and-reasons-for-seclusion-and-restraint-in-a-forensic-psychiatric-hospital
#18
Satu Kuivalainen, Katri Vehviläinen-Julkunen, Olavi Louheranta, Anu Putkonen, Eila Repo-Tiihonen, Jari Tiihonen
In Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de-escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4-year period (1 June 2009-31 May 2013) were retrospectively investigated and analysed by content analysis...
October 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28960096/cellular-immunotherapy-for-septic-shock-ciss-a-phase-i-clinical-trial
#19
Lauralyn A McIntyre, Duncan J Stewart, Shirley H J Mei, David Courtman, Irene Watpool, John Granton, John Marshall, Claudia Dos Santos, Keith R Walley, Brent W Winston, Kenny Schlosser, Dean A Fergusson
RATIONALE: In septic animal models mesenchymal stem (stromal) cells (MSCs) modulate inflammation, enhance tissue repair and pathogen clearance, and reduce death. OBJECTIVES: We conducted a Phase I dose escalation trial of MSCs in septic shock with the primary objective to examine the safety and tolerability of MSCs. METHODS: We enrolled nine participants within 24 hours of admission to the intensive care unit. A control cohort of 21 participants were enrolled before starting the MSC interventional cohort to characterize expected adverse events (AEs) and to serve as a comparator for the intervention cohort...
September 29, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28959774/reducing-dnacpr-complaints-to-zero-designing-and-implementing-a-treatment-escalation-plan-using-quality-improvement-methodology
#20
Elizabeth Shermon, Laura Munglani, Sarah Oram, Linda William, Julian Abel
INTRODUCTION: Do Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form...
2017: BMJ Open Qual
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