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https://www.readbyqxmd.com/read/28724280/management-of-benign-and-malignant-pancreatic-duct-strictures
#1
Enad Dawod, Michel Kahaleh
The diagnosis and management of pancreatic strictures, whether malignant or benign, remain challenging. The last 2 decades have seen dramatic progress in terms of both advanced imaging and endoscopic therapy. While plastic stents remain the cornerstone of the treatment of benign strictures, the advent of fully covered metal stents has initiated a new wave of interest in calibrating the pancreatic duct with fewer sessions. In malignant disease, palliation remains the priority and further data are necessary before offering systematic pancreatic stenting...
July 20, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28721899/gaps-in-radiation-therapy-awareness-results-from-an-educational-multi-institutional-survey-of-us-internal-medicine-residents
#2
Narek Shaverdian, Sun Mi Yoo, Ryan Cook, Eric M Chang, Naomi Jiang, Ye Yuan, Kiri Sandler, Michael Steinberg, Percy Lee
PURPOSE: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. METHODS AND MATERIALS: A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721328/dramatic-regression-of-a-fungating-breast-lesion-treated-with-radiation-therapy
#3
Robert W Gao, Shane Edlund, Jianling Yuan
Although advances in screening mammography have dramatically improved the early detection of breast cancer, a subset of breast cancer cases still present as locally advanced disease. Some of these patients develop fungating lesions, which are difficult to manage and can have a severe impact on the quality of life. Palliative treatment options include surgery, intra-arterial chemotherapy, and radiation therapy. Herein, we describe the case of a patient who presented with a fungating breast mass and demonstrated an immediate and durable response to radiation therapy with a significantly improved quality of life...
June 16, 2017: Curēus
https://www.readbyqxmd.com/read/28719596/the-influence-of-fcgr2a-and-fcgr3a-polymorphisms-on-the-survival-of-patients-with-recurrent-or-metastatic-squamous-cell-head-and-neck-cancer-treated-with-cetuximab
#4
T Magnes, T Melchardt, C Hufnagl, L Weiss, C Mittermair, D Neureiter, E Klieser, G Rinnerthaler, S Roesch, A Gaggl, R Greil, A Egle
FCGR2A-H131R and FCGR3A-V157F are single-nucleotide polymorphisms known to influence the outcome of patients treated with rituximab, cetuximab and trastuzumab. We investigated the impact of these polymorphisms on the clinical outcome of 103 patients with recurrent or metastatic squamous cell carcinoma of the head and neck treated with a platinum compound, fluorouracil and cetuximab as palliative first-line therapy. The survival of patients with FCGR2A-131H/H and/or FCGR3A-157V/V genotypes was significantly longer compared with patients carrying 131R and 157F alleles (median progression-free survival (PFS): 5...
July 18, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28717717/management-and-care-of-women-with-invasive-cervical-cancer-american-society-of-clinical-oncology-resource-stratified-clinical-practice-guideline
#5
Linus T Chuang, Sarah Temin, Rolando Camacho, Alfonso Dueñas-Gonzalez, Sarah Feldman, Murat Gultekin, Vandana Gupta, Susan Horton, Graciela Jacob, Elizabeth A Kidd, Kennedy Lishimpi, Carolyn Nakisige, Joo-Hyun Nam, Hextan Yuen Sheung Ngan, William Small, Gillian Thomas, Jonathan S Berek
PURPOSE: To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer. METHODS: ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations...
October 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716617/dignity-therapy-and-life-review-for-palliative-care-patients-a-qualitative-study
#6
Dean Vuksanovic, Heather Green, Shirley Morrissey, Sharelle Smith
CONTEXT: Dignity Therapy (DT) is a psychotherapeutic intervention whose aim is to bolster the sense of purpose, meaning and sense of dignity in patients with terminal disease. OBJECTIVES: The aim of this study was to explore, compare and better understand the content of standard DT, waitlist DT (WDT) and Life Review (LR) that utilised the DT interview protocol but omitted the creation of legacy documents. METHODS: Efficacy of these interventions was previously documented in a sample of 56 participants...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716616/relationship-between-spirituality-meaning-in-life-psychological-distress-wish-for-hastened-death-and-their-influence-on-quality-of-life-in-palliative-care-patients
#7
Mathieu Bernard, Florian Strasser, Claudia Gamondi, Giliane Braunschweig, Michaela Forster, Karin Kaspers-Elekes, Silvia Walther Veri, Gian Domenico Borasio
CONTEXT: Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic underlying these components is essential for the development of interventions tailored to the palliative context. OBJECTIVES: The aims were to explore (i) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients, and (ii) the extent to which these non-physical determinants influence QOL...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716615/development-of-a-protocol-for-successful-palliative-care-consultation-in-population-of-patients-receiving-mechanical-circulatory-support
#8
Shilpee Sinha, Carey Belcher, Alexia Torke, Joycelyn Howard, Marco Caccamo, James A Slaven, Irmina Gradus-Pizlo
BACKGROUND: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. MEASURES: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) prior to MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716129/current-knowledge-on-feline-injection-site-sarcoma-treatment
#9
REVIEW
Katarzyna Zabielska-Koczywąs, Anna Wojtalewicz, Roman Lechowski
Feline injection-site sarcomas (FISS) are malignant skin tumours of mesenchymal origin, the treatment of which is a challenge for veterinary surgeons. The role of surgery, radiotherapy and chemotherapy in FISS treatment has been studied, and a correlation between "clean" surgical margins and disease-free survival has been shown. In addition, clean surgical margins are one of the most important factors for achieving a low recurrence rate. The most effective method of FISS treatment includes combining radical surgery with pre- or postoperative radiotherapy...
July 17, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#10
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711545/antiulcer-properties-of-fruits-and-vegetables-a-mechanism-based-perspective
#11
REVIEW
Choudhary Harsha, Kishore Banik, Devivasha Bordoloi, Ajaikumar B Kunnumakkara
Gastric ulcer is the damage caused to mucosal layer of the stomach under the action of various factors like high levels of acid and pepsin, invasion by Helicobacter pylori, etc. Although most cases have been controlled and the rate of ulcer occurrence has reduced over the last few decades, gastric ulcer still holds a prime concern today. A range of palliative medicines comprising proton pump inhibitors, H2 receptor antagonists, COX-2 inhibitors (coxibs) is widely in use and patients have also been administered with acid suppression therapies...
July 12, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28711371/extubation-to-high-flow-nasal-cannula-in-critically-ill-surgical-patients
#12
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Danielle Polevoi, Richard Liang, Galinos Barmparas, Eric J Ley
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used to reduce reintubations in patients with respiratory failure. Benefits include providing positive end expiratory pressure, reducing anatomical dead space, and decreasing work of breathing. We sought to compare outcomes of critically ill surgical patients extubated to HFNC versus conventional therapy. METHODS: A retrospective review was conducted in the surgical intensive care unit of an academic center during August 2015 to February 2016...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28710776/outcomes-of-patients-diagnosed-with-acute-myeloid-leukemia-after-solid-organ-transplantation
#13
Konstantinos Lontos, Mounzer Agha, Anastasios Raptis, Jing-Zhou Hou, Rafic Farah, Robert L Redner, Annie Im, Kathleen A Dorritie, Alison Sehgal, James Rossetti, Melissa Saul, William E Gooding, Abhinav Humar, Michael Boyiadzis
Organ transplant recipients are at an increased risk for subsequent cancer including acute myeloid leukemia (AML). Treatment of AML following solid transplantation represents a clinical challenge since most patients have significant co-morbidities at the time of AML diagnosis. In the current study, we evaluated the treatment and outcomes of patients who developed AML following solid organ transplantation at our institution and reviewed the literature on outcomes for these patients. The study cohort consisted of 14 patients (median age 66 years, range 52-77 years) with newly diagnosed AML following solid organ transplantation...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28708751/use-of-non-pharmacological-interventions-for-comforting-patients-in-palliative-care-a-scoping-review
#14
Adriana Coelho, Vítor Parola, Daniela Cardoso, Miguel Escobar Bravo, João Apóstolo
BACKGROUND: Palliative care aims to provide the maximum possible comfort to people with advanced and incurable diseases. The use of non-pharmacological interventions to promote comfort in palliative care settings has been increasing.However, information on implemented and evaluated interventions, their characteristics, contexts of application, and population is scattered in the literature, hampering the formulation of accurate questions on the effectiveness of those interventions and, consequently, the development of a systematic review...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28708043/reirradiation-spine-stereotactic-body-radiation-therapy-for-spinal-metastases-systematic-review
#15
Sten Myrehaug, Arjun Sahgal, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben Slotman, Antonio De Salles
OBJECTIVE Spinal metastases that recur after conventional palliative radiotherapy have historically been difficult to manage due to concerns of spinal cord toxicity in the retreatment setting. Spine stereotactic body radiation therapy (SBRT), also known as stereotactic radiosurgery, is emerging as an effective and safe means of delivering ablative doses to these recurrent tumors. The authors performed a systematic review of the literature to determine the clinical efficacy and safety of spine SBRT specific to previously irradiated spinal metastases...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#16
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28707168/acupuncture-for-cancer-related-fatigue-in-lung-cancer-patients-a-randomized-double-blind-placebo-controlled-pilot-trial
#17
Chien-Shan Cheng, Lian-Yu Chen, Zhou-Yu Ning, Chen-Yue Zhang, Hao Chen, Zhen Chen, Xiao-Yan Zhu, Jing Xie
BACKGROUND: Cancer-related fatigue (CRF) is a distressing symptom that is the most common unpleasant side effect experienced by lung cancer patients and is challenging for clinical care workers to manage. METHODS: We performed a randomized, double-blind, placebo-controlled pilot trial to evaluate the clinical effect of acupuncture on CRF in lung cancer patients. Twenty-eight patients presenting with CRF were randomly assigned to active acupuncture or placebo acupuncture groups to receive acupoint stimulation (LI-4, Ren-6, St-36, KI-3, and Sp-6) twice per week for 4 weeks, followed by 2 weeks of follow-up...
July 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28707137/surface-modification-of-esophageal-stent-materials-by-a-polyethylenimine-layer-aiming-at-anti-cancer-function
#18
Kun Zhang, Yuxin Bai, Xiaofeng Wang, Qian Li, Fangxia Guan, Jingan Li
Esophageal cancer is difficult to cure globally and possesses high mortality rate, and it is generally accepted that palliative care such as stent implantation is the main therapy method for esophageal cancer in later period. However, the restenosis caused by tumor cells and inflammatory cells seriously interferes the stent clinical application and limits its long-term services. To solve this problem, series of drug delivery stents were developed and proven rather effective in the early stage of implantation, but more serious restenosis occurred after the drug delivery was over, which endangered the patients' life...
August 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28706578/systemic-treatment-of-hepatocellular-carcinoma-past-present-and-future
#19
REVIEW
Esther Una Cidon
Hepatocellular carcinoma (HCC) is a common neoplasia which represents the second leading cause of cancer related death. Most cases occur in developing countries, but its incidence is rising in Western countries due to hepatitis C. Although hepatitis therapies have evolved and the HCC screening has increased in several areas, 40% present with advanced disease which is only amenable for palliative systemic treatment. HCC continues posing a challenge, in part due to the inherent chemoresistance of this neoplasia, the pharmacologic challenges due to an ill liver, difficulty in assessing radiological responses accurately, etc...
June 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28706092/development-of-an-intervention-to-support-patients-and-clinicians-with-advanced-lung-cancer-when-considering-systematic-anticancer-therapy-protocol-for-the-pact-study
#20
Despina Anagnostou, Stephanie Sivell, Simon Noble, Jason Lester, Anthony Byrne, Catherine Sampson, Mirella Longo, Annmarie Nelson
INTRODUCTION: Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options...
July 12, 2017: BMJ Open
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