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https://www.readbyqxmd.com/read/28324284/nonoperative-management-or-watch-and-wait-for-rectal-cancer-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy-a-critical-appraisal
#1
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28318939/early-metabolic-improvement-after-bariatric-surgery-the-first-steps-toward-remission-of-type-2-diabetes
#2
REVIEW
Thomas Grenier-Larouche, Anne-Marie Carreau, André C Carpentier
The introduction of bariatric surgery into clinical practice in the 1980s was followed by a relatively long watch-and-wait period before the very rapid accumulation of scientific literature, over the past decade, concerning its clinical effectiveness and safety and its mechanisms of action in the treatment of obesity. These surgical procedures now emerge as the most effective therapeutic modality to induce long-term remission of type 2 diabetes. Recent research has shed light on the potential mechanisms leading to the profound improvement of glucose homeostasis following most bariatric surgery procedures...
March 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28318726/low-risk-prostate-cancer-identification-management-and-outcomes
#3
REVIEW
Marco Moschini, Peter R Carroll, Scott E Eggener, Jonathan I Epstein, Markus Graefen, Rodolfo Montironi, Christopher Parker
CONTEXT: The incidence of low-risk prostate cancer (PCa) has increased as a consequence of prostate-specific antigen testing. OBJECTIVE: In this collaborative review article, we examine recent literature regarding low-risk PCa and the available prognostic and therapeutic options. EVIDENCE ACQUISITION: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms: prostate cancer, low risk, active surveillance, focal therapy, radical prostatectomy, watchful waiting, biomarker, magnetic resonance imaging, alone or in combination...
March 15, 2017: European Urology
https://www.readbyqxmd.com/read/28315827/contemporary-management-of-low-grade-glioma-a-paradigm-shift-in-neuro-oncology
#4
REVIEW
Caroline Hayhurst
Supratentorial diffuse intrinsic low-grade gliomas represent a distinct but heterogenous group of tumours, with the propensity to grow and to differentiate into malignant tumours. They have been historically viewed in the 'benign' spectrum of intrinsic brain tumours, so a watch-and-wait policy was often adopted. With recent advances in our understanding of the natural history of these tumours, combined with advances in surgical technique, an aggressive approach is now recommended. Increasing quality evidence of the impact of tumour resection and multicentre trials of adjuvant radiotherapy and chemotherapy have led to a new algorithm for low-grade glioma management...
March 18, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28302004/a-new-perspective-for-infantile-hepatic-hemangioma-in-the-age-of-propranolol-experience-at-baskent-university
#5
Faik Sarıalioğlu, Nalan Yazıcı, Ayşe Erbay, Fatih Boyvat, Şenay Demir, Figen Özçay, Nihal Uslu
Propranolol was first used in 2008 to treat hemangioma; its efficacy and safety have since changed the classical treatment indications. Infantile hepatic hemangioma presents as a spectrum of clinical conditions varying from simple asymptomatic lesions to lethal complications. Tufted hemangioma and Kaposiform hemangioendothelioma are congenital vascular tumors that lead to Kasabach-Merritt syndrome. Hemangiomas, like pure arteriovenous malformations, can cause hyperdynamic heart failure, and diffuse nodular-type hemangiomas can present with hypothyroidism...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28286923/maintenance-therapies-in-indolent-lymphomas-should-recent-data-change-the-standard-of-care
#6
REVIEW
Michael T Tees, Ian W Flinn
The overall benefit of maintenance therapy for patients with an indolent lymphoma continues to go unanswered. A myriad of variables contribute to the lack of clear clinical guidance. First, the disease course is slow and treatment may not be required for years, requiring a long follow-up to prospectively study. Second, due to the long lag time from study initiation to conclusion, many of the induction therapies used at the onset of the study may not be favored at present, providing a conclusion that cannot be reconciled with current clinical practice...
March 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28282699/-diagnostic-approaches-to-suspected-choroidal-melanoma
#7
C Girbardt, M Rehak, P Wiedemann
Whenever funduscopy reveals possible choroidal melanoma, all available information must be gathered to either confirm or exclude the diagnosis. Well-defined funduscopic criteria are available, which can already lead to a high degree of diagnostic certainty. Additional technical examinations can be used to exclude possible differential diagnoses. In cases where no clear diagnosis can be established, it is possible to take a biopsy or to watch and wait in order to observe possible growth. Whenever the diagnosis of a choroidal melanoma is established, cancer staging has to be performed in order to search for possible metastases...
March 10, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28281094/clinical-features-and-inflammatory-markers-in-pediatric-pneumonia-a-prospective-study
#8
Are Stuwitz Berg, Christopher Stephen Inchley, Hans Olav Fjaerli, Truls Michael Leegaard, Morten Lindbaek, Britt Nakstad
In this prospective, observational study on previously healthy children <18 years, we aimed to study the diagnostic ability of clinical features and inflammatory markers to (i) predict pathologic chest radiography in suspected pneumonia and (ii) differentiate etiology in radiological proven pneumonia. In 394 cases of suspected pneumonia, 265 (67%) had radiographs consistent with pneumonia; 34/265 had proof of bacterial etiology. Of the cases, 86.5% had received pneumococcal conjugate vaccine. In suspected pneumonia, positive chest radiography was significantly associated with increasing C-reactive protein (CRP) values, higher age, and SpO2 ≤92% in multivariate logistic regression, OR 1...
March 9, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28275803/-chinese-expert-consensus-on-the-use-of-topical-timolol-maleate-treatment-of-infantile-hemangiomas
#9
Jia-Wei Zheng, Xu-Kai Wang, Cheng-Hong Jiang, Zhong-Ping Qin, Xin-Dong Fan, Yao-Wu Yang, Ran Huo, Shao-Hua Liu, Ji-Hong Zhao, Xiao-Yong Wang, De-Kai Zhou, Shao-Rong Lei
Non-selective β-blocker propranolol has been proved by FDA as the first-line agent for infantile hemangioma (IH) with dramatic response. To reduce the side effects caused by systemic administration of propranolol, timolol maleate treatment has been increasingly used as an alternative to systemic β-blockers and watchful waiting for many IH patients in recent years. However, the appropriate indications, drug dosage, dosing regimen, time for initiation, optimal duration, monitoring for side effects still remains controversial...
December 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/28270340/adult-t-cell-leukemia-lymphoma-treatment-in-bahia-brazil
#10
Pedro Dantas Oliveira, Ítala Gomes, Victor Hugo Gomes Souza, Ernesto Cunha Pires, Glória Bomfim Arruda, Achiléa Bittencourt
BACKGROUND: Adult T-cell leukemia/lymphoma is a peripheral disease associated with human T-cell lymphotropic virus type 1. Treatment is carried out according to clinical type with watchful waiting being recommended for less aggressive types. Aggressive adult T-cell leukemia/lymphoma is generally treated with chemotherapy and/or antivirals. The objective of this study was to correlate the survival of patients diagnosed in Bahia, Brazil, with the therapeutic approaches employed and to evaluate what issues existed in their treatment processes...
January 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/28270089/tissue-elasticity-bridges-cancer-stem-cells-to-the-tumor-microenvironment-through-micrornas-implications-for-a-watch-and-wait-approach-to-cancer
#11
Shengwen Calvin Li, Long T Vu, Jane Jianying Luo, Jiang F Zhong, Zhongjun Li, Brent A Dethlefs, William G Loudon, Mustafa H Kabeer
Targeting the tumor microenvironment (TME) through which cancer stem cells (CSCs) crosstalk for cancer initiation and progression, may open up new treatments different from those centered on the original hallmarks of cancer genetics thereby implying a new approach for suppression of TME-driven activation of CSCs. Cancer is dynamic, heterogeneous, evolving with the TME and can be influenced by tissue-specific elasticity. One of the mediators and modulators of the crosstalk between CSCs and mechanical forces is miRNA, which can be developmentally regulated, tissue- and cell-specific...
March 6, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28267003/prediction-of-pathological-complete-response-using-endoscopic-findings-and-outcomes-of-patients-who-underwent-watchful-waiting-after-chemoradiotherapy-for-rectal-cancer
#12
Kazushige Kawai, Soichiro Ishihara, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Teppei Morikawa, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. OBJECTIVE: This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28258383/-new-worldwide-guidelines-for-treatment-of-inguinal-hernia-the-most-important-recommendations-from-herniasurge
#13
D Weyhe
SURGICAL TECHNIQUES: In the HerniaSurge guidelines the highest evidence is found with respect to recommendations for mesh-based surgery techniques. This includes Lichtenstein as well as the minimally invasive TEP/TAPP surgery. For discreet symptomatic or asymptomatic inguinal hernia, watchful waiting is an option if the state of health and social situation are taken into account; however, femoral hernia should be treated promptly with a mesh technique, with laparoendoscopic techniques being the more favored option...
March 3, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28258074/cost-effectiveness-of-watchful-waiting-in-acute-otitis-media
#14
Di Sun, T J McCarthy, Danica B Liberman
BACKGROUND: American Academy of Pediatrics guidelines for acute otitis media (AOM) allow for children meeting certain criteria to undergo watchful waiting (WW). The cost-effectiveness of this policy has not been evaluated in the United States. METHODS: A retrospective review of a random selection of 250 patients ≤18 years old with AOM in the emergency department of a tertiary care children's hospital was used to characterize current practice of AOM management...
March 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28257541/risk-factors-for-outpatient-use-of-antibiotics-in-children-with-acute-respiratory-illnesses
#15
Sophie R Zhao, Marie R Griffin, Barron L Patterson, Rachel L Mace, Dayna Wyatt, Yuwei Zhu, H Keipp Talbot
OBJECTIVES: Antibiotics for acute respiratory illness (ARI) constitute most pediatric medication use and contribute to the emergence of antimicrobial resistance. We investigated antibiotic prescription risk factors for ARI in pediatric clinics and clinical follow-up in individuals prescribed and not prescribed antibiotics. METHODS: In this observational study, we enrolled children ages 2 to 17 years old presenting with ARI with fever to two academic pediatric primary care outpatient clinics during influenza season 2013-2014...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257328/management-of-men1-related-nonfunctioning-pancreatic-nets-a-shifting-paradigm-results-from-the-dutchmen1-study-group
#16
Sjoerd Nell, Helena M Verkooijen, Carolina R C Pieterman, Wouter W de Herder, Ad R Hermus, Olaf M Dekkers, Anouk N van der Horst-Schrivers, Madeleine L Drent, Peter H Bisschop, Bas Havekes, Inne H M Borel Rinkes, Menno R Vriens, Gerlof D Valk
OBJECTIVE: To assess if surgery for Multiple Endocrine Neoplasia type 1 (MEN1) related nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs) is effective for improving overall survival and preventing liver metastasis. BACKGROUND: MEN1 leads to multiple early-onset NF-pNETs. The evidence base for guiding the difficult decision who and when to operate is meager. METHODS: MEN1 patients diagnosed with NF-pNETs between 1990 and 2014 were selected from the DutchMEN1 Study Group database, including > 90% of the Dutch MEN1 population...
March 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28256956/on-a-prolonged-interval-between-rectal-cancer-chemo-radiotherapy-and-surgery
#17
Bengt Glimelius
Preoperative radiotherapy (RT) or chemoradiotherapy (CRT) is often required before rectal cancer surgery to obtain low local recurrence rates or, in locally advanced tumours, to radically remove the tumour. RT/CRT in tumours responding completely can allow an organ-preserving strategy. The time from the end of the RT/CRT to surgery or to the decision not to operate has been prolonged during recent years. After a brief review of the literature, the relevance of the time interval to surgery is discussed depending upon the indication for RT/CRT...
March 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28253904/a-mobile-technology-intervention-to-reduce-sedentary-behaviour-in-2-to-4-year-old-children-mini-movers-study-protocol-for-a-randomised-controlled-trial
#18
Katherine L Downing, Jo Salmon, Trina Hinkley, Jill A Hnatiuk, Kylie D Hesketh
BACKGROUND: Sedentary behaviour (e.g. television viewing, sitting time) tracks over time and is associated with adverse health and developmental outcomes across the lifespan. Young children (5 years or younger) spend up to 12 h/day sedentary, of which around 2 h is spent in screen time (e.g. watching television). Interventions to reduce sedentary behaviour in early childhood report mixed results and many have limited potential for scalability. Mobile phones offer a wide-reaching, low-cost avenue for the delivery of health behaviour programmes to parents but their potential to reduce young children's sedentary behaviour has not been widely tested...
March 3, 2017: Trials
https://www.readbyqxmd.com/read/28249653/management-of-the-clinically-node-negative-neck-in-squamous-cell-carcinoma-of-the-maxilla
#19
Michiel H M A Joosten, Remco de Bree, Ellen M Van Cann
OBJECTIVE: The management of the clinically node negative (N0) neck in patients with squamous cell carcinoma of the maxilla (MSCC) is a matter of debate. In this retrospective cohort study the incidence of occult metastases is determined in clinically N0 MSCCs, as well as histopathological factors associated with occult metastases. PATIENTS AND METHODS: 95 patients with clinically N0 MSCCs had maxillectomy. 18 patients with elective treatment of the neck were excluded...
March 2017: Oral Oncology
https://www.readbyqxmd.com/read/28237193/evaluating-frameworks-that-provide-value-measures-for-health-care-interventions
#20
Jeanne S Mandelblatt, Scott D Ramsey, Tracy A Lieu, Charles E Phelps
The recent acceleration of scientific discovery has led to greater choices in health care. New technologies, diagnostic tests, and pharmaceuticals have widely varying impact on patients and populations in terms of benefits, toxicities, and costs, stimulating a resurgence of interest in the creation of frameworks intended to measure value in health. Many of these are offered by providers and/or advocacy organizations with expertise and interest in specific diseases (e.g., cancer and heart disease). To help assess the utility of and the potential biases embedded in these frameworks, we created an evaluation taxonomy with seven basic components: 1) define the purpose; 2) detail the conceptual approach, including perspectives, methods for obtaining preferences of decision makers (e...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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