keyword
https://read.qxmd.com/read/38524010/eye-plaque-brachytherapy-for-choroidal-malignant-melanoma-a-case-report-on-the-use-of-innovative-technology-to-expand-access-improve-practice-and-enhance-outcomes
#1
Paul Mobit, Claus Chunli Yang, Mary R Nittala, Rui He, Hiba Z Ahmed, Gary Shultz, Albert Lin, Srinivasan Vijayakumar
Our institute established an eye plaque interstitial brachytherapy (EPIBT) program in 2007 using the Collaborative Ocular Melanoma Study (COMS) eye plaque. In this case report, we demonstrated an eye plaque treatment planned and executed using Eye Physics Plaque (Los Alamitos, CA) for a 72-year-old male patient with an extra-large tumor with a maximum width of 18.6 mm and height of 13.7 mm. The use of a customized eye plaque, manufactured through three-dimensional (3D) printing, has empowered us to plan and administer treatment for this patient with uveal melanoma...
February 2024: Curēus
https://read.qxmd.com/read/38505775/case-report-febrile-infection-related-epilepsy-syndrome-in-a-14-year-old-girl-with-multiple-organ-failure-and-lethal-outcome
#2
Lars Ruttkowski, Ines Wallot, Marie Korell, Elke Daur, Peter Seipelt, Andreas Leonhardt, Stefanie Weber, Nadine Mand
We report a case of an otherwise healthy 14-year-old girl with febrile infection-related epilepsy syndrome (FIRES), multiple organ failure (MOF), and ultimately a lethal outcome. This is a rare case of FIRES with MOF and consecutive death. Only a few cases have been described in the literature. The adolescent girl was initially admitted to our pediatric emergency department with a first episode of generalized tonic-clonic seizures after a short history of fever a week before admission. Seizures progressed rapidly into refractory status epilepticus without any evidence of the underlying cause, and treatment subsequently had to be escalated to thiopental anesthesia...
2024: Frontiers in Neuroscience
https://read.qxmd.com/read/38497569/the-role-of-surgery-and-deescalation-for-hpv-related-oropharyngeal-cancer
#3
JOURNAL ARTICLE
Kevin J Contrera, Mihir R Patel, Barbara Burtness, Ranee Mehra, Robert L Ferris
Recently published and ongoing trials are helping to define the role of transoral robotic surgery for oropharyngeal cancer. Evidence to date supports the use of surgery as a valuable tool in the multidisciplinary deescalation of low-risk human papillomavirus-related oropharyngeal squamous cell carcinoma.
March 18, 2024: Cancer
https://read.qxmd.com/read/38461117/avoiding-locoregional-overtreatment-in-older-adults-with-early-stage-breast-cancer
#4
REVIEW
Eliza H Lorentzen, Christina A Minami
Advances in the treatment of older women with early-stage breast cancer, particularly opportunities for de-escalation of therapy, have afforded patients and providers opportunity to individualize care. As the majority of women ≥65 have estrogen receptor-positive, HER2-negative disease, locoregional therapy (surgery and/or radiation) may be tailored based on a patient's physiologic age to avoid either over- or undertreatment. To determine who would derive benefit from more or less intensive therapy, an accurate assessment of an older patient's physiologic age and incorporation of patient-specific values are paramount...
February 13, 2024: Clinical Breast Cancer
https://read.qxmd.com/read/38415305/reducing-physical-restraint-use-in-the-medical-behavioral-unit
#5
JOURNAL ARTICLE
Evan M Dalton, Kathleen Raymond, Brian Kovacs, Kristin Vespe, Virginia Kaufmann, Matthew Lasoski, Claire Gunnison, Julie Beauchamps, Emily Kane, Gabriela Andrade
OBJECTIVES: Children with behavioral health conditions often experience agitation when admitted to children's hospitals. Physical restraint should be used only as a last resort for patient agitation because it endangers the physical and psychological safety of patients and employees. At the medical behavioral unit (MBU) in our children's hospital, we aimed to decrease the weekly rate of physical restraint events per 100 MBU patient-days, independent of patient race, ethnicity, or language, from a baseline mean of 14...
March 1, 2024: Pediatrics
https://read.qxmd.com/read/38346971/a-new-function-for-drug-combination-dose-finding-trials
#6
JOURNAL ARTICLE
Jiacheng Xiao, Weijia Zhang
Combination drugs play an essential role in treating cancers. The challenging part of the combination drugs are to specify the dose-toxicity ordering, which means the sequences of dose escalation and de-escalation in process of dose findings should be pre-determined. In the paper, we extend a novel function of the continual reassessment method based on the combination of the normal distribution for drug-combination dose-finding trials and systematically evaluate its performance using a template of four performance measures EARS (Efficiency, Accuracy, Reliability, Selection)...
February 12, 2024: Scientific Reports
https://read.qxmd.com/read/38327111/new-therapeutic-targets-for-endometrial-cancer-a-glimpse-into-the-preclinical-sphere
#7
REVIEW
Ilan Bruchim, Ilaria Capasso, Ariel Polonsky, Shilhav Meisel, Vanda Salutari, Haim Werner, Domenica Lorusso, Giovanni Scambia, Francesco Fanfani
INTRODUCTION: Endometrial cancer (EC) is the only gynecologic malignancy showing increasing trends in incidence and mortality. While standard treatment has been effective primarily for early-stage EC, precision medicine with tailored therapy has revolutionized the management of this disease. Genome sequencing analyses have identified four sub-types of EC. Treatments for primary and metastatic disease can now be tailored more accurately to achieve better oncologic results. AREAS COVERED: This review provides an overview of the most relevant and updated evidence in the literature regarding EC molecular analysis and its role in risk classification, prognostication, and guidance for tailored and target therapies in early and advanced/metastatic stages...
February 7, 2024: Expert Opinion on Therapeutic Targets
https://read.qxmd.com/read/38263583/a-validated-assay-to-quantify-osimertinib-and-its-metabolites-az5104-and-az7550-from-microsampled-dried-blood-spots-and-plasma
#8
JOURNAL ARTICLE
Bharat Venkatesh, Alex Yuile, Matthew J McKay, Sathya Narayanan, Helen Wheeler, Malinda Itchins, Nick Pavlakis, Stephen J Clarke, Mark P Molloy
BACKGROUND: Osimertinib is an oral small-molecule tyrosine kinase receptor inhibitor used to treat non-small cell lung cancer (NSCLC) with a sensitizing epidermal growth factor receptor mutation. Patients may experience drug toxicity and require dose deescalation. The study aimed to quantitate osimertinib and its 2 active metabolites, AZ5104 and AZ7550, in microsampled dried blood spots (DBS) collected from patients with NSCLC using a hemaPEN device and compare them with plasma drug levels...
November 27, 2023: Therapeutic Drug Monitoring
https://read.qxmd.com/read/38247610/improving-clostridioides-difficile-infectious-disease-treatment-response-via-adherence-to-clinical-practice-guidelines
#9
JOURNAL ARTICLE
Dalia Adukauskienė, Rytis Mickus, Asta Dambrauskienė, Tomas Vanagas, Agnė Adukauskaitė
Clostridioides difficile ( C. difficile ) is a predominant nosocomial infection, and guidelines for improving diagnosis and treatment were published in 2017. We conducted a single-center, retrospective 10-year cohort study of patients with primary C. difficile infectious disease (CDID) at the largest referral Lithuanian university hospital, aiming to evaluate the clinical and laboratory characteristics of CDID and their association with the outcomes, as well as implication of concordance with current Clinical Practice Guidelines...
January 4, 2024: Antibiotics
https://read.qxmd.com/read/38212185/extracorporeal-carbon-dioxide-removal-to-de-escalate-venovenous-extracorporeal-membrane-oxygenation-in-severe-covid-19-acute-respiratory-distress-syndrome
#10
JOURNAL ARTICLE
Gaetano Cambria, Audrey E Spelde, Salim E Olia, Mauer Biscotti, Emily Mackay, Michael Ibrahim, Marisa Cevasco, Christian Bermudez, William Vernick, Jacob Gutsche, Asad A Usman
OBJECTIVES: In a subset of patients with COVID-19 acute respiratory distress syndrome (ARDS), there is a need for extracorporeal membrane oxygenation (ECMO) for pulmonary support. The primary extracorporeal support tool for severe COVID-19 ARDS is venovenous (VV) ECMO; however, after hypoxemic respiratory failure resolves, many patients experience refractory residual hypercarbic respiratory failure. Extracorporeal carbon dioxide removal (ECCO2 R) for isolated hypercarbic type II respiratory failure can be used in select cases to deescalate patients from VV ECMO while the lung recovers the ability to exchange CO2 ...
March 2024: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/38143988/vaginal-dose-reduction-by-changing-the-ovoid-loading-pattern-in-image-guided-intracavitary-brachytherapy-of-cervix
#11
JOURNAL ARTICLE
Ramya Rangarajan
AIM: Locally advanced cervical cancer is frequently treated using a combination of external beam radiotherapy and brachytherapy. Radiotherapy often leads to vaginal morbidity, which poses a significant problem. This study aims to analyze the impact of reducing ovoid loading on dosimetry. MATERIALS AND METHODS: We analyzed forty-five CT-based intracavitary brachytherapy plans from fifteen patients. Three plan sets were created for the 45 applications: a standard loading plan (A), a plan with reduced ovoid loading (B), and a tandem-only loading plan (C)...
December 2023: Journal of Obstetrics and Gynaecology of India
https://read.qxmd.com/read/38098972/remdesivir-therapy-for-severe-pediatric-covid-19-in-singapore-a-single-center-retrospective-observational-cohort-study
#12
JOURNAL ARTICLE
Valerie Xue Fen Seah, Rina Yue Ling Ong, Kai Qian Kam, Koh Cheng Thoon, Natalie Woon Hui Tan, Jiahui Li, Karen Donceras Nadua, Chia Yin Chong, Chee Fu Yung
BACKGROUND AND AIMS: There is a paucity of information on remdesivir (RDV) use in severe pediatric coronavirus disease 2019 (COVID-19). We aimed to explore the effectiveness of RDV as the cumulative proportion of pediatric COVID-19 patients deescalated from Day 5 of high dependency or intensive care unit (HD/ICU). METHODS: All children ≤18 years admitted to Singapore's largest pediatric hospital from January 1, 2020 to March 18, 2022 were reviewed retrospectively...
December 2023: Health Science Reports
https://read.qxmd.com/read/38085894/pediatric-neuro-oncology
#13
JOURNAL ARTICLE
Fatema Malbari
OBJECTIVE: This article reviews the most common pediatric brain tumors, neurocutaneous syndromes, treatment-related neurotoxicities, and the long-term outcomes of survivors. LATEST DEVELOPMENTS: In the era of molecular diagnostics, the classification, management, and prognostication of pediatric brain tumors and neurocutaneous syndromes has been refined, resulting in advancements in patient management. Molecular diagnostics have been incorporated into the most recent World Health Organization 2021 classification...
December 1, 2023: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/38066843/thrombotic-anti-pf4-immune-disorders-hit-vitt-and-beyond
#14
JOURNAL ARTICLE
Andreas Greinacher, Theodore E Warkentin
Antibodies against the chemokine platelet factor 4 (PF4) occur often, but only those that activate platelets induce severe prothrombotic disorders with associated thrombocytopenia. Heparin-induced thrombocytopenia (HIT) is the prototypic anti-PF4 disorder, mediated by strong activation of platelets through their FcγIIa (immunoglobulin G [IgG]) receptors (FcγRIIa). Concomitant pancellular activation (monocytes, neutrophils, endothelium) triggers thromboinflammation with a high risk for venous and arterial thrombosis...
December 8, 2023: Hematology—the Education Program of the American Society of Hematology
https://read.qxmd.com/read/38002643/immediate-postoperative-covid-19-infection-after-lung-transplantation-a-systematic-review-and-case-series
#15
REVIEW
Jack K Donohue, Eric J Hyzny, Sarah Clifford, Ernest G Chan, Jenalee Nicole Coster, Masashi Furukawa, Pablo G Sanchez
BACKGROUND: With new variants challenging the effectiveness of preventive measures, we are beginning to recognize the reality that COVID-19 will continue to pose an endemic threat. The manifestations of COVID-19 in lung transplant recipients during index admission are poorly understood with very few cases reported in recent lung transplant recipients. Optimal management of immunosuppression and antiviral therapy in recent transplant recipients is challenging. METHODS: We performed a retrospective analysis identifying lung transplant recipients at our institution who contracted COVID-19 in the immediate postoperative period (within index admission)...
November 10, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37997444/crp-predicts-the-need-to-escalate-care-after-initial-debridement-for-musculoskeletal-infection
#16
JOURNAL ARTICLE
Stephanie N Moore-Lotridge, Joshua R Daryoush, Colby C Wollenman, Joseph T Gibian, Samuel R Johnson, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: Musculoskeletal infections (MSKIs) are a major cause of morbidity in the pediatric population and account for nearly 1 in every 10 consultations with a pediatric orthopaedic provider at a tertiary care center. To prevent or deescalate the risk of adverse medical and musculoskeletal outcomes, timely medical intervention in the form of antibiotics and potential surgical debridement is required. While there have been numerous studies indicating the value of laboratory testing during the initial workup of a child with MSKI, few studies to date have examined the utility of longitudinal assessment of laboratory measures in the acute setting to monitor the efficacy of antibiotic therapy and/or surgical intervention...
November 24, 2023: Journal of Pediatric Orthopedics
https://read.qxmd.com/read/37995155/evaluating-the-effect-of-gestational-exposure-to-perfluorohexane-sulfonate-on-placental-development-in-mice-combining-alternative-splicing-and-gene-expression-analyses
#17
JOURNAL ARTICLE
Yihao Zhang, Jia Lv, Yi-Jun Fan, Lin Tao, Jingjing Xu, Weitian Tang, Nan Sun, Ling-Li Zhao, De-Xiang Xu, Yichao Huang
BACKGROUND: Perfluorohexane sulfonate (PFHxS) is a frequently detected per- and polyfluoroalkyl substance in most populations, including in individuals who are pregnant, a period critical for early life development. Despite epidemiological evidence of exposure, developmental toxicity, particularly at realistic human exposures, remains understudied. OBJECTIVES: We evaluated the effect of gestational exposure to human-relevant body burden of PFHxS on fetal and placental development and explored mechanisms of action combining alternative splicing (AS) and gene expression (GE) analyses...
November 2023: Environmental Health Perspectives
https://read.qxmd.com/read/37962072/assessment-of-the-safety-of-nivolumab-in-people-living-with-hiv-with-advanced-cancer-on-antiretroviral-therapy-the-aids-malignancy-consortium-095-study
#18
JOURNAL ARTICLE
Lakshmi Rajdev, Chia-Ching Jackie Wang, Himanshu Joshi, Shelly Lensing, Jeannette Lee, Juan Carlos Ramos, Robert Baiocchi, Lee Ratner, Paul G Rubinstein, Richard Ambinder, David Henry, Howard Streicher, Richard F Little, Elizabeth Chiao, Dirk P Dittmer, Mark H Einstein, Ethel Cesarman, Ronald Mitsuyasu, Joseph A Sparano
BACKGROUND: Although immunotherapy has emerged as a therapeutic strategy for many cancers, there are limited studies establishing the safety and efficacy in people living with HIV (PLWH) and cancer. METHODS: PLWH and solid tumors or Kaposi sarcoma (KS) receiving antiretroviral therapy and a suppressed HIV viral load received nivolumab at 3 mg/kg every 2 weeks, in two dose deescalation cohorts stratified by CD4 count (stratum 1: CD4 count > 200/µL and stratum 2: CD4 count 100-199/µL)...
November 14, 2023: Cancer
https://read.qxmd.com/read/37955898/police-violence-in-health-care-settings-in-us-media-coverage
#19
JOURNAL ARTICLE
Altaf Saadi, Victor E Ray
IMPORTANCE: Hospitals do not collect or share data tracking their policing and security activities despite their reliance on police and security personnel, including armed officers. Thus, little is known about how hospital security is associated with patient and staff safety. OBJECTIVE: To examine the harms exerted by health care-affiliated police and security personnel. DESIGN, SETTING, AND PARTICIPANTS: For this qualitative study, data were collected using a systematic Media Cloud search for US news media coverage from January 2011 to May 2022...
November 1, 2023: JAMA Network Open
https://read.qxmd.com/read/37948591/the-use-of-positron-emission-tomography-imaging-to-guide-radiation-therapy
#20
REVIEW
Bridget F Koontz, Mohit S Kasibhatla
Positron emission tomography (PET)-based biologic radiation planning has the potential to improve tumor control by improving the accuracy of radiation delivery, allow for rational adaptive treatment, and decrease the likelihood of both acute and late side effects. 18F-fluorodeoxyglucose (FDG) PET is a widely used and effective diagnostic tool for many metabolically active tumors, including lymphoma and lung, head and neck, gastrointestinal, and gynecologic cancers. For these tumors, PET evidence has initially focused on more accurate staging but is evolving to allow for the escalation or deescalation of the radiotherapy dose depending on the PET-determined response to initial therapy...
October 2023: Clinical Advances in Hematology & Oncology: H&O
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