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https://www.readbyqxmd.com/read/29217398/is-neoadjuvant-chemoradiation-with-dose-escalation-and%C3%A2-consolidation-chemotherapy-sufficient-to-increase-surgery-free-and-distant-metastases-free-survival-in-baseline%C3%A2-ct3-rectal-cancer
#1
Guilherme Pagin São Julião, Angelita Habr-Gama, Bruna Borba Vailati, Patricia Bailão Aguilar, Jorge Sabbaga, Sérgio Eduardo Alonso Araújo, Adrian Mattacheo, Flavia Andrea Alexandre, Laura Melina Fernandez, Diogo Bugano Gomes, Joaquim Gama-Rodrigues, Rodrigo Oliva Perez
Patients with cT3 rectal cancer are less likely to develop complete response to neoadjuvant chemoradiation (nCRT) and still face significant risk for systemic relapse. In this setting, radiation (RT) dose-escalation and consolidation chemotherapy in "extended" nCRT regimens have been suggested to improve primary tumor response and decrease the risks of systemic recurrences. For these reasons we compared surgery-free and distant-metastases free survival among cT3 patients undergoing standard or extended nCRT...
November 26, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29208728/imaging-in-low-grade-glioma-a-guide-for-neurologists
#2
REVIEW
Jennifer Larsen, Nigel Hoggard, Fiona M McKevitt
The management of low-grade glioma (LGG) is shifting as evidence has emergedthat refutes the previously commonplace imaging-based 'watch and wait' approach, in favour of early aggressive surgical resection. This coupled with the recent 2016 update to the World Health Organisation Classification of Tumours of the Central Nervous System is changing LGG imaging and management. Recently in Practical Neurology the contemporary management of low-grade glioma and the changes to this grading system were discussed in detail...
December 5, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29208027/animations-designed-to-raise-patient-awareness-of-prudent-antibiotic-use-patient-recall-of-key-messages-and-their-immediate-effect-on-patient-attitude
#3
Donna M Lecky, Harpal Dhillon, Neville Q Verlander, Cliodna A M McNulty
OBJECTIVES: This study aimed to determine if patients recalled key messages from antibiotic animations shown on digital displays in General Practice waiting rooms, and if watching them changed patients' immediate intentions to consult their GP for upper respiratory tract infections, seek antibiotics and self-care. RESULTS: The pre intervention focus group found the animations intergenerational, informative and educational. 3119 patients were observed in 3 GP practices during project team visits; 145 (4...
December 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29204849/human-intestinal-spirochetosis-mimicking-ulcerative-colitis
#4
Shin Nishii, Masaaki Higashiyama, Sho Ogata, Shunsuke Komoto, Suguru Ito, Akinori Mizoguchi, Hisato Terada, Hirotaka Furuhashi, Takeshi Takajo, Kazuhiko Shirakabe, Chikako Watanabe, Kengo Tomita, Shigeaki Nagao, Soichiro Miura, Ryota Hokari
Human intestinal spirochetosis (HIS) is a colorectal infection caused by the Brachyspira species of intestinal spirochetes, whose pathogenicity in humans remains unclear owing to the lack of or mild symptoms. We monitored the 5-year clinical course of a woman diagnosed with HIS in whom ulcerative colitis (UC) had been suspected. Following a positive fecal occult blood test, she underwent a colonoscopic examination at a local clinic where she was diagnosed with "right-sided" UC concomitant with incidentally detected HIS, and was referred to our hospital...
December 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29200472/surveillance-or-self-surveillance-behavioral-cues-can-increase-the-rate-of-drivers-pro-environmental-behavior-at-a-long-wait-stop
#5
Rose Meleady, Dominic Abrams, Julie Van de Vyver, Tim Hopthrow, Lynsey Mahmood, Abigail Player, Ruth Lamont, Ana C Leite
By leaving their engines idling for long periods, drivers contribute unnecessarily to air pollution, waste fuel, and produce noise and fumes that harm the environment. Railway level crossings are sites where many cars idle, many times a day. In this research, testing two psychological theories of influence, we examine the potential to encourage drivers to switch off their ignition while waiting at rail crossings. Two field studies presented different signs at a busy rail crossing site with a 2-min average wait...
December 2017: Environment and Behavior
https://www.readbyqxmd.com/read/29200168/spontaneous-regression-in-a-patient-with-infantile-fibrosarcoma
#6
Sameer Farouk Sait, Enrico Danzer, Daniel Ramirez, Michael P LaQuaglia, Meyers Paul
Infantile fibrosarcoma usually presents as a rapidly growing mass on the extremities or trunk. We describe spontaneous regression in a 5-month-old female infant with biopsy proven, molecularly confirmed, right leg infantile fibrosarcoma currently at 26 months of age with no signs of local recurrence. Previously reported cases of spontaneous regression are reviewed, suggesting a benign clinical course in some cases. Although evidence for spontaneous regression is anecdotal in this rare tumor type, physicians should weigh the risks and benefits of surgery and chemotherapy against watchful waiting...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29194083/management-of-reducible-ventral-hernias-clinical-outcomes-and-cost-effectiveness-of-repair-at-diagnosis-versus-watchful-waiting
#7
Lindsey L Wolf, Julius I Ejiofor, Ye Wang, Myriam G Hunink, Elena Losina, Adil H Haider, Douglas S Smink
OBJECTIVE: To compare long-term clinical and economic outcomes associated with 3 management strategies for reducible ventral hernia: repair at diagnosis (open or laparoscopic) and watchful waiting. BACKGROUND: There is variability in ventral hernia management. Recent data suggest watchful waiting is safe; however, long-term clinical and economic outcomes for different management strategies remain unknown. METHODS: We built a state-transition microsimulation model to forecast outcomes for individuals with reducible ventral hernia, simulating a cohort of 1 million individuals for each strategy...
November 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29189611/appropriate-and-inappropriate-treatment-of-acute-otitis-media-in-the-pediatric-emergency-department
#8
Sarah Rothman, Jacob Pitaro, Asher Hackett, Eran Kozer, Haim Gavriel, Limor Muallem-Kalmovich, Ephraim Eviatar, Tal Marom
BACKGROUND: Over-treatment of acute otitis media (AOM) with antibiotics is common, and poses a high burden on healthcare systems. METHODS: Records of children 6-36 months of age with AOM visiting a university-affiliated pediatric emergency department (PED) between 2014-2016 were reviewed for the treatment given: watchful waiting (WW) vs. antibiotics. If antibiotics were prescribed, the type and duration were recorded. We evaluated appropriate and inappropriate treatment rates of eligible AOM cases, in respect to the local guidelines, which encourage WW in most mild-moderate cases...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29188200/management-and-outcomes-of-gleason-six-prostate-cancer-detected-on-needle-biopsy-a-single-surgeon-experience-over-6%C3%A2-years
#9
Brayden March, George Koufogiannis, Mark Louie-Johnsun
Objective: To assess the management and oncological outcomes in men diagnosed with Gleason score (GS) 6 prostate cancer on needle biopsy in a regional centre, as compared with published international data. Materials and methods: A retrospective analysis was conducted of patients who were diagnosed with GS 6 prostate cancer via transrectal ultrasound-guided or transperineal biopsy between June 2009 and September 2015 under the care of a single surgeon. Data were obtained from a prospectively collected database...
December 2017: Prostate International
https://www.readbyqxmd.com/read/29185155/successful-treatment-of-follicular-lymphoma-with-second-generation-tyrosine-kinase-inhibitors-administered-for-coexisting-chronic-myeloid-leukemia
#10
Shin-Ichiro Fujiwara, Yuya Shirato, Takashi Ikeda, Shin-Ichiro Kawaguchi, Yumiko Toda, Shoko Ito, Shin-Ichi Ochi, Takashi Nagayama, Kiyomi Mashima, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Kaoru Morita, Ryoko Yamasaki, Yasufumi Kawasaki, Miyuki Sugimoto, Masahiro Ashizawa, Chihiro Yamamoto, Kaoru Hatano, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo Muroi, Yoshinobu Kanda
Tyrosine kinase inhibitors (TKIs) are standard therapy for chronic myeloid leukemia (CML). However, the effects of these agents on mature B cell lymphoma are not well known. We describe a 50-year-old man who was diagnosed with CML in the chronic phase and treated with imatinib. After 3 years of imatinib therapy that achieved a complete cytogenetic response of CML, he developed Philadelphia-negative follicular lymphoma (FL). Rituximab monotherapy induced a partial response of FL, and he subsequently achieved a major molecular response (MMR) of CML...
November 28, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29184475/management-of-the-complete-clinical-response
#11
REVIEW
Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Ivana Castro, Debora Raffaele
Organ preservation is considered in the management of selected patients with rectal cancer. Complete clinical response observed after neoadjuvant chemoradiation for rectal cancer is one of these cases. Patients who present complete clinical response are candidates to the watch-and-wait approach, when radical surgery is not immediately performed and is offered only to patients in the event of a local relapse. These patients are included in a strict follow-up, and up of 70% of them will never be operated during the follow-up...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184450/coexisting-multiple-myeloma-lymphoma-and-non-small-cell-lung-cancer-a-case-report-and-review-of-the-literature
#12
Parth Khade, Srinivas Devarakonda
Multiple myeloma is a plasma cell dyscrasia characterized by neoplastic proliferation of plasma cells, producing a monoclonal immunoglobulin. Small lymphocytic lymphoma (SLL) is a neoplasm consisting of monoclonal B-cell lymphocyte proliferation. We present an extremely rare case of coexisting multiple myeloma, SLL, and squamous cell carcinoma of the lung in a 74-year-old female patient. She initially presented with a midline mass with pain in the lumbar area. Debulking surgery was performed, and pathology showed plasmacytoma...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29178296/cor-triatriatum-dexter-associated-with-atrial-septal-defect-management-in-a-complex-clinical-case
#13
Fabiola B Sozzi, Claudia Montanaro, Laura Bacà, Giacomo M Viani, Massimo Zilocchi, Ciro Canetta, Roberto Meazza, Laura Pavone, Federico Lombardi
The coexistence of an atrial septal defect and a prominent eustachian valve is a rare congenital anomaly, rarely reported in literature. Differentiation between a giant eustachian valve and cor triatriatum dexter can be difficult. A case of a large atrial septal defect associated with cor triatriatum dexter diagnosed by echocardiography in an asymptomatic woman is reported. A watchful waiting strategy was adopted.
November 2017: Echocardiography
https://www.readbyqxmd.com/read/29169431/monoclonal-igm-gammopathy-and-waldenstr%C3%A3-m-s-macroglobulinemia
#14
Alexander Grunenberg, Christian Buske
BACKGROUND: 3.2-3.5% of persons over age 50 have a monoclonal gammopathy. Monoclonal gammopathies have many causes, including cancer. 10-20% of monoclonal gammopathies are of isotype IgM. A systematic approach to the differential diagnosis of IgM gammopathies is essential because of the different therapeutic implications of the various underlying conditions. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed and current guidelines from Germany and abroad...
November 3, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29166877/a-prospective-study-examining-the-role-of-myocardial-fibrosis-in-outcome-following-mitral-valve-repair-in-degenerative-mitral-regurgitation-rationale-and-design-of-the-mitral-finder-study
#15
Boyang Liu, Nicola C Edwards, Desley A H Neal, Christopher Weston, Gerard Nash, Nicolas Nikolaidis, Thomas Barker, Ramesh Patel, Moninder Bhabra, Richard P Steeds
BACKGROUND: The optimal management of chronic severe primary degenerative mitral regurgitation (MR) is to repair the valve but identification of the optimal timing of surgery remains challenging. Current guidelines suggest 'watchful waiting' until the onset of symptoms or left ventricular (LV) dysfunction but these have been challenged as promoting 'rescue surgery'. Better predictors are required to inform decision-making in relation to the necessity and timing of surgery. Chronic volume overload is a stimulus for adverse adaptive LV remodelling...
November 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29135694/impact-of-prostate-cancer-and-its-treatment-on-the-outcomes-of-ileal-pouch-anal-anastomosis
#16
Lei Lian, Jean Ashburn, Erick M Remer, Feza H Remzi, Manoj Monga, Bo Shen
BACKGROUND: There are scant published data in the impact of prostate cancer and its treatment on functional outcomes and quality of life (QOL) in patients with ileal pouch-anal anastomosis (IPAA). The aim of the study was to evaluate the influence of prostate cancer and its treatment on functional outcomes and QOL in patients with IPAA. METHODS: Patients with IPAA with prostate cancer were compared to age and pouch duration-matched controls without prostate cancer in a 1:2 ratio...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29134456/european-hernia-society-guidelines-on-prevention-and-treatment-of-parastomal-hernias
#17
REVIEW
S A Antoniou, F Agresta, J M Garcia Alamino, D Berger, F Berrevoet, H-T Brandsma, K Bury, J Conze, D Cuccurullo, U A Dietz, R H Fortelny, C Frei-Lanter, B Hansson, F Helgstrand, A Hotouras, A Jänes, L F Kroese, J R Lambrecht, I Kyle-Leinhase, M López-Cano, L Maggiori, V Mandalà, M Miserez, A Montgomery, S Morales-Conde, M Prudhomme, T Rautio, N Smart, M Śmietański, M Szczepkowski, C Stabilini, F E Muysoms
BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched...
November 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29134378/organ-preservation-in-rectal-cancer-after-chemoradiation-should-we-extend-the-observation-period-in-patients-with-a-clinical-near-complete-response
#18
Britt J P Hupkens, Monique Maas, Milou H Martens, Marit E van der Sande, Doenja M J Lambregts, Stéphanie O Breukink, Jarno Melenhorst, Janneke B Houwers, Christiaan Hoff, Meindert N Sosef, Jeroen W A Leijtens, Maaike Berbee, Regina G H Beets-Tan, Geerard L Beets
BACKGROUND: To assess whether extending the observation period in patients with a near clinical complete response (near cCR) after chemoradiation (CRT) leads to an impaired oncological outcome. METHODS: Patients who had a clinical complete response (cCR) 8-10 weeks after CRT restaging with magnetic resonance imaging and endoscopy were offered a watch-and-wait strategy (W&W1), while patients with a near cCR were offered to undergo local excision or a second restaging 6-12 weeks later...
November 13, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29127531/impact-of-a-robotic-surgical-system-on-treatment-choice-for-men-with-clinically-organ-confined-prostate-cancer
#19
Takashi Kobayashi, Kent Kanao, Motoo Araki, Naoki Terada, Yasuyuki Kobayashi, Atsuro Sawada, Takahiro Inoue, Shin Ebara, Toyohiko Watanabe, Tomomi Kamba, Makoto Sumitomo, Yasutomo Nasu, Osamu Ogawa
BACKGROUND: Introducing a new surgical technology may affect behaviors and attitudes of patients and surgeons about clinical practice. Robot-assisted laparoscopic radical prostatectomy (RALP) was approved in 2012 in Japan. We investigated whether the introduction of this system affected the treatment of organ-confined prostate cancer (PCa) and the use of radical prostatectomy (RP). METHODS: We conducted a retrospective multicenter study on 718 patients with clinically determined organ-confined PCa treated at one of three Japanese academic institutions in 2011 (n = 338) or 2013 (n = 380)...
November 11, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29119531/the-non-operative-management-of-asymptomatic-liver-hydatids-ending-echinococcophobia
#20
Farrokh Saidi, Farrokh Habibzadeh
BACKGROUND: Cystic echinococcosis is common in many countries and involves the liver in 75% of cases. The current belief is that all incidentally discovered asymptomatic liver hydatids must be subjected to some types of interventional treatments pre-emptively for fear of some presumably impending complications. We conducted this study to assess the prognosis of patients with liver hydatids without any surgical interventions. Furthermore, we tried to predict the outcome of the cyst using two radiological signs...
November 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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