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https://www.readbyqxmd.com/read/28550608/shifting-paradigms-in-the-medical-management-of-type-2-diabetes-reflections-on-recent-cardiovascular-outcome-trials
#1
Faramarz Ismail-Beigi, Etie Moghissi, Mikhail Kosiborod, Silvio E Inzucchi
An important challenge in the management of patients with type 2 diabetes is cardiovascular disease (CVD) prevention. While it is well established that intensive glycemic control prevents the onset and slows the progression of certain microvascular complications, such a strategy utilized in multiple clinical trials over the past few decades has failed to show a similar benefit with regard to cardiovascular events, including mortality. Despite this, a major hope has been the discovery of glucose-lowering medications that simultaneously improve cardiovascular outcomes...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28549439/anesthetic-management-of-cesarean-section-in-cases-of-placenta-accreta-with-versus-without-abdominal-aortic-balloon-occlusion-study-protocol-for-a-randomized-controlled-trial
#2
Qinjun Chu, Dan Shen, Long He, Hongwei Wang, Xianlan Zhao, Zhimin Chen, Yanli Wang, Wei Zhang
BACKGROUND: Placenta accreta (PA), a severe complication during delivery, is closely linked with massive hemorrhage which could endanger the lives of both mother and baby. Moreover, the incidence of PA has increased dramatically with the increasing rate of cesarean deliveries in the past few decades. Therefore, studies evaluating the effects of different perioperative managements based on different modalities in the treatment of PA are necessary. Among the numerous treatment measures, prophylactic abdominal aortic balloon occlusion (AABO) in combination with cesarean section for PA seems to be more advantageous than others...
May 26, 2017: Trials
https://www.readbyqxmd.com/read/28549427/developing-an-australian-first-recovery-model-for-parents-in-victorian-mental-health-and-family-services-a-study-protocol-for-a-randomised-controlled-trial
#3
Darryl Maybery, Melinda Goodyear, Andrea Reupert, Jade Sheen, Warren Cann, Kim Dalziel, Phillip Tchernagovski, Brendan O'Hanlon, Henry von Doussa
BACKGROUND: A considerable number of people with a mental illness are parents caring for dependent children. For those with a mental illness, parenting can provide a sense of competence, belonging, identity and hope and hence is well aligned to the concept of personal recovery. However, little research has focused on the recovery journey of those who are parents and have a mental illness. This randomised controlled trial aims to (i) evaluate the effectiveness of an intervention model of recovery for parents (Let's Talk about Children) in three different mental health service sectors and (ii) examine the economic value of a larger roll out (longer term) of the parent recovery model...
May 26, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28546917/challenges-in-the-delivery-of-therapies-to-melanoma-brain-metastases
#4
Gautham Gampa, Shruthi Vaidhyanathan, Brynna-Wilken Resman, Karen E Parrish, Svetomir N Markovic, Jann N Sarkaria, William F Elmquist
Brain metastases are a major cause of morbidity and mortality in patients with advanced melanoma. Recent approval of several molecularly-targeted agents and biologics has brought hope to patients with this previously untreatable disease. However, patients with symptomatic melanoma brain metastases have often been excluded from pivotal clinical trials. This may be in part attributed to the fact that several of the approved small molecule molecularly-targeted agents are substrates for active efflux at the blood-brain barrier, limiting their effective delivery to brain metastases...
December 2016: Current Pharmacology Reports
https://www.readbyqxmd.com/read/28545482/a-plea-to-provide-best-evidence-in-trials-under-sample-size-restrictions-the-example-of-pioglitazone-to-resolve-leukoplakia-and-erythroplakia-in-fanconi-anemia-patients
#5
Florian Lasch, Kristina Weber, Mwe Mwe Chao, Armin Koch
In planning a clinical trial for demonstrating the efficacy of pioglitazone to resolve leukoplakia and erythroplakia in Fanconi anemia patients we had to discuss the need for a randomized controlled trial particularly under sample-size restrictions as very promising results were available from a single-arm clinical trial. Unfortunately, at a later stage, we had to suffer from the fact that single-arm clinical trials may sometimes mislead. When revisiting our planning at a later stage of a grant application, results of a randomized controlled trial had become available which were less impressive, but may still be of clinical interest...
May 25, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28545380/from-stem-cell-biology-to-the-treatment-of-lung-diseases
#6
Dorina Esendagli, Aysen Gunel-Ozcan
The exposure of lung to noxious agents or gasses leads to injury, which further enhances repair mechanisms by promoting the proliferation and differentiation of lung stem cells. These cells could help preserve the anatomical structure and the function of the organ. Unfortunately in many lung diseases 'this scenario' is changed and injury progresses despite repair mechanisms or conventional treatment. This review summarizes the research on lung stem cells by giving an overview to the biology, function, niches and signaling that play role in lung stem cells and further to the regeneration of the lung...
May 23, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28540564/digital-breast-tomosynthesis-dbt-recommendations-from-the-italian-college-of-breast-radiologists-icbr-by-the-italian-society-of-medical-radiology-sirm-and-the-italian-group-for-mammography-screening-gisma
#7
Daniela Bernardi, Paolo Belli, Eva Benelli, Beniamino Brancato, Lauro Bucchi, Massimo Calabrese, Luca A Carbonaro, Francesca Caumo, Beatrice Cavallo-Marincola, Paola Clauser, Chiara Fedato, Alfonso Frigerio, Vania Galli, Livia Giordano, Paolo Giorgi Rossi, Paola Golinelli, Doralba Morrone, Giovanna Mariscotti, Laura Martincich, Stefania Montemezzi, Carlo Naldoni, Adriana Paduos, Pietro Panizza, Federica Pediconi, Fiammetta Querci, Antonio Rizzo, Gianni Saguatti, Alberto Tagliafico, Rubina M Trimboli, Marco Zappa, Chiara Zuiani, Francesco Sardanelli
This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7‰ and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets...
May 25, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28536833/development-of-standardized-image-interpretation-for-68ga-psma-pet-ct-to-detect-prostate-cancer-recurrent-lesions
#8
Stefano Fanti, Silvia Minozzi, Joshua James Morigi, Frederik Giesel, Francesco Ceci, Christian Uprimny, Michael S Hofman, Matthias Eiber, Sarah Schwarzenbock, Paolo Castellucci, Cristina Bellisario, Stéphane Chauvie, Fabrizio Bergesio, Louise Emmett, Uwe Haberkorn, Irene Virgolini, Markus Schwaiger, Rodney J Hicks, Bernd J Krause, Arturo Chiti
METHODS: After primary treatment, biochemical relapse (BCR) occurs in a substantial number of patients with prostate cancer (PCa). PET/CT imaging with prostate-specific membrane antigen based tracers (68Ga-PSMA) has shown promising results for BCR patients. However, a standardized image interpretation methodology has yet to be properly agreed. The aim of this study, which was promoted and funded by European Association of Nuclear Medicine (EANM), is to define standardized image interpretation criteria for 68Ga-PSMA PET/CT to detect recurrent PCa lesions in patients treated with primary curative intent therapy (radical prostatectomy or radiotherapy) who presented a biochemical recurrence...
May 23, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28536452/exploring-the-trails-less-travelled-trail-in-cancer-biology-and-therapy
#9
REVIEW
Silvia von Karstedt, Antonella Montinaro, Henning Walczak
The discovery that the tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) can induce apoptosis of cancer cells without causing toxicity in mice has led to the in-depth study of pro-apoptotic TRAIL receptor (TRAIL-R) signalling and the development of biotherapeutic drug candidates that activate TRAIL-Rs. The outcome of clinical trials with these TRAIL-R agonists has, however, been disappointing so far. Recent evidence indicates that many cancers, in addition to being TRAIL resistant, use the endogenous TRAIL-TRAIL-R system to their own advantage...
May 24, 2017: Nature Reviews. Cancer
https://www.readbyqxmd.com/read/28535552/stem-cell-therapy-for-chronic-pain-management-review-of-uses-advances-and-adverse-effects
#10
Krishnan Chakravarthy, Yian Chen, Cathy He, Paul J Christo
BACKGROUND: This review article outlines the recent advances, uses, and adverse effects of cell-based therapy for chronic pain management. Cell based therapies are gaining increasing ground as novel treatment modalities for a variety of pain pathologies that include, but are not limited to, neuropathic pain and degenerative disc disease. As these treatment modalities become more common practice, we have focused our review to provide pain practitioners and other practicing physicians an understanding of the technology and to summarize key clinical data and existing clinical trials that are being pursued by clinical investigators worldwide...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28534875/dose-dependent-social-cognitive-effects-of-intranasal-oxytocin-delivered-with-novel-breath-powered-device-in-adults-with-autism-spectrum-disorder-a-randomized-placebo-controlled-double-blind-crossover-trial
#11
D S Quintana, L T Westlye, S Hope, T Nærland, T Elvsåshagen, E Dørum, Ø Rustan, M Valstad, L Rezvaya, H Lishaugen, E Stensønes, S Yaqub, K T Smerud, R A Mahmoud, P G Djupesland, O A Andreassen
The neuropeptide oxytocin has shown promise as a treatment for symptoms of autism spectrum disorders (ASD). However, clinical research progress has been hampered by a poor understanding of oxytocin's dose-response and sub-optimal intranasal delivery methods. We examined two doses of oxytocin delivered using a novel Breath Powered intranasal delivery device designed to improve direct nose-to-brain activity in a double-blind, crossover, randomized, placebo-controlled trial. In a randomized sequence of single-dose sessions, 17 male adults with ASD received 8 international units (IU) oxytocin, 24IU oxytocin or placebo followed by four social-cognitive tasks...
May 23, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28534250/advancing-immunotherapy-in-metastatic-breast-cancer
#12
REVIEW
Mariam Mansour, Zhi Ling Teo, Stephen J Luen, Sherene Loi
Despite many advances in the treatment of breast cancer, the development of metastatic disease remains an incurable and frequent cause of cancer death for women worldwide. An improved understanding of the role of host immunosurveillance in modulating breast cancer disease biology, as well as impressive survival benefits seen to checkpoint blockade in other malignancies have provided great hope for an expanding role of immunotherapies in breast cancer management. While these novel therapies are currently being investigated in clinical trials, signals of efficacy, and tolerability in early phase studies suggest these will eventually make their way into standard practice algorithms...
June 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28529551/history-and-current-state-of-immunotherapy-in-glioma-and-brain-metastasis
#13
REVIEW
Tresa McGranahan, Gordon Li, Seema Nagpal
Malignant brain tumors such as glioblastoma (GBM) and brain metastasis have poor prognosis despite conventional therapies. Successful use of vaccines and checkpoint inhibitors in systemic malignancy has increased the hope that immune therapies could improve survival in patients with brain tumors. Manipulating the immune system to fight malignancy has a long history of both modest breakthroughs and pitfalls that should be considered when applying the current immunotherapy approaches to patients with brain tumors...
May 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28529550/hormonoresistance-in-advanced-breast-cancer-a-new-revolution-in-endocrine-therapy
#14
REVIEW
Paule Augereau, Anne Patsouris, Emmanuelle Bourbouloux, Carole Gourmelon, Sophie Abadie Lacourtoisie, Dominique Berton Rigaud, Patrick Soulié, Jean Sebastien Frenel, Mario Campone
Endocrine therapy is the mainstay of treatment of estrogen-receptor-positive (ER+) breast cancer with an overall survival benefit. However, some adaptive mechanisms in the tumor emerge leading to the development of a resistance to this therapy. A better characterization of this process is needed to overcome this resistance and to develop new tailored therapies. Mechanisms of resistance to hormone therapy result in activation of transduction signal pathways, including the cell cycle regulation with cyclin D/CDK4/6/Rb pathway...
May 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28522928/systematic-review-of-open-versus-laparoscopic-versus-robot-assisted-nephroureterectomy
#15
Emma Mullen, Kamran Ahmed, Ben Challacombe
Upper tract urothelial carcinoma is a relatively uncommon malignancy. The gold standard treatment for this type of neoplasm is an open radical nephroureterectomy with excision of the bladder cuff. This systematic review compares the perioperative and oncologic outcomes for the open surgical method with the alternative surgical management options of laparoscopic nephroureterectomy and robot-assisted nephroureterectomy (RANU). MEDLINE, EMBASE, PubMed, and Cochrane Library databases were searched using a sensitive search strategy...
2017: Reviews in Urology
https://www.readbyqxmd.com/read/28521748/contextualizing-willingness-to-participate-recommendations-for-engagement-recruitment-enrolment-of-kenyan-msm-in-future-hiv-prevention-trials
#16
Monika Doshi, Lisa Avery, Ronnie P Kaddu, Mary Gichuhi, Gloria Gakii, Elsabé du Plessis, Sumit Dutta, Shamshad Khan, Joshua Kimani, Robert R Lorway
BACKGROUND: The HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, particularly in low- and middle- income countries which bear the greatest global impact. However, in these settings, there is a paucity of vaccine preparedness studies that specifically pertain to MSM. Our study is the first vaccine preparedness study among MSM and female sex workers (FSWs) in Kenya...
May 18, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28516217/prenatal-surgery-for-myelomeningocele-review-of-the-literature-and-future-directions
#17
Gregory G Heuer, Julie S Moldenhauer, N Scott Adzick
Open spina bifida or myelomeningocele (MMC) is one of the most common serious congenital malformations. Historically, this condition has been treated with closure of the MMC defect shortly after birth. The goal of postnatal closure is to cover the exposed spinal cord and prevent infection. However, postnatal surgery does not reverse or prevent the neurologic injury seen in MMC, reverse hindbrain herniation, or prevent hydrocephalus. The neurologic defects result from primary incomplete neurulation and secondary chronic prenatal damage to the exposed neural elements through mechanical and chemical trauma...
May 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28515252/chronic-lymphocytic-leukemia-individualizing-treatment-approach
#18
Andrew D Zelenetz
A host of new therapies are now available for treating patients with chronic lymphocytic leukemia (CLL) in both the upfront and relapsed or refractory settings. Although the optimal use of these agents is still being defined, established and emerging prognostic markers aid in the selection of appropriate treatment with the best chance of success. At the NCCN 22nd Annual Conference, Dr. Andrew Zelenetz discussed the role of the CLL-International Prognostic Index for risk stratification, reviewed optimal first-line therapy options, and then presented updated clinical trial data on the novel agents being used in the relapsed or refractory setting...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28510505/papillary-thyroid-cancer-the-good-and-bad-of-the-good-cancer
#19
Reese W Randle, Norah M Bushman, Jason Orne, Courtney J Balentine, Elizabeth Wendt, Megan C Saucke, Susan C Pitt, Cameron L Macdonald, Nadine P Connor, Rebecca S Sippel
BACKGROUND: Papillary thyroid cancer is often described as the "good cancer" because of its treatability and relatively favorable survival rates. We sought to characterize the thoughts of papillary thyroid cancer patients as they relate to having the "good cancer." METHODS: This qualitative study included 31 papillary thyroid cancer patients enrolled in an ongoing randomized trial. We conducted semi-structured interviews with participants at the pre-operative visit and 2 weeks, 6 weeks, 6 months and 1 year after thyroidectomy...
May 16, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28508983/effect-of-tolvaptan-in-a-patient-with-autosomal-dominant-polycystic-kidney-disease-after-living-donor-liver-transplantation
#20
Kiyotaka Uchiyama, Kazuya Honda, Ryochi Yoshida, Yuka Kamijo, Mai Yanagi, Mineo Nakatsuka, Yoshitaka Ishibashi
Recently, a large randomized placebo-controlled trial indicated a beneficial effect of tolvaptan on the progression of autosomal dominant polycystic kidney disease (ADPKD) with near-normal kidney function. Meanwhile, the evidence of tolvaptan's efficacy in ADPKD with severe renal insufficiency was limited and higher frequency of liver enzyme elevations were observed in patients taking tolvaptan. Liver transplantation (LT) is the only curative treatment for patients with severe polycystic liver disease associated with ADPKD, but considering that liver injuries should be avoided particularly in patients who underwent LT, we must be careful to start tolvaptan in post-LT ADPKD patients...
November 2016: CEN Case Reports
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