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https://www.readbyqxmd.com/read/29040507/aortic-valve-replacement-improves-survival-in-severe-aortic-stenosis-with-gradient-area-mismatch
#1
Yujing Mo, Guy Van Camp, Giuseppe Di Gioia, Emanuele Barbato, Tomas Ondrus, Filip Casselman, Marc Vanderheyden, Bernard De Bruyne, Jozef Bartunek, Martin Penicka
OBJECTIVES: To investigate whether and in which patients with catheter-derived low pressure gradient (PG, <40 mmHg) severe (aortic valve area ≤ 1 cm2) aortic stenosis and preserved left ventricular ejection fraction, early aortic valve replacement (AVR) might improve survival. METHODS: We investigated a total of 506 consecutive patients (age 75 ± 9 years, 58% men) with either moderate aortic stenosis (MAS) or severe aortic stenosis (SAS) and preserved left ventricular ejection fraction (≥50%) as defined at catheterization...
October 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29036751/-diagnosis-and-management-of-vestibular-schwannomas-an-interdisciplinary-challenge
#2
Steffen Rosahl, Christopher Bohr, Michael Lell, Klaus Hamm, Heinrich Iro
Vestibular schwannomas expand slowly in the internal auditory canal, in the cerebellopontine angle, inside the cochlear and the labyrinth. Larger tumors can displace and compress the brainstem. With an annual incidence of 1:100 000 vestibular schwannoma represent 6-7% of all intracranial tumors. In the cerebellopontine angle they are by far the most neoplasm with 90% of all lesions located in this region. Magnetic resonance imaging (MRI), audiometry, and vestibular diagnostics are the mainstays of the clinical workup for patients harboring tumors...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29033123/diagnosis-and-treatment-of-otitis-media-with-effusion-codepeh-recommendations
#3
Faustino Núñez-Batalla, Carmen Jáudenes-Casaubón, Jose Miguel Sequí-Canet, Ana Vivanco-Allende, Jose Zubicaray-Ugarteche
The incidence and the prevalence rates of otitis media with effusion (OME) are high. However, there is evidence that only a minority of professionals follow the recommendations provided in clinical practice guidelines. For the purpose of improving diagnosis and treatment of OME in children to prevent and/or reduce its impact on children's development, the Commission for the Early Detection of Deafness (CODEPEH) has deeply reviewed the scientific literature on this field and has drafted a document of recommendations for a correct clinical reaction to of OME, including diagnosis and medical and surgical treatment methodology...
October 13, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/29031683/-focal-therapies-an-alternative-option-for-low-risk-prostate-cancer-management
#4
Souhil Lebdai, Luca Lunelli, Pierre Bigot, Olivier Cussenot, Abdel-Rahmene Azzouzi
Recommended options for low-risk prostate cancer treatment are active surveillance, radical treatments or watchful waiting. Focal therapies are currently assessed for low risk prostate cancer treatment. Focal therapies can be performed in research protocols. Oncologic results of these focal treatments are encouraging and show excellent tolerance with few complications. Radical treatments are still possible after focal therapies failure. Focal therapies are a possible solution to over-treatment issue of low risk prostate cancers...
October 11, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29031036/-the-role-of-chemotherapy-in-the-treatment-of-low-grade-gliomas
#5
R Lakomý, T Kazda, A Poprach, P Pospíšil, R Jančálek, P Šlampa
BACKGROUND: The standard postsurgical options for low-grade gliomas include watchful waiting or radiotherapy depending on the risk factors for recurrence. The use of chemotherapy for the treatment of this disease is generally controversial, although the recently published results of the first of two large randomized phase III clinical trials (RTOG 9802 a EORTC 22033-26033), focusing on the evaluation of chemotherapy for the upfront treatment of newly diagnosed low-grade gliomas, are reassuring in this respect...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/29026567/proactive-use-of-eltrombopag-before-the-onset-of-clinical-bleeding-in-two-children-with-immune-thrombocytopenia-and-lifestyle-restrictions
#6
Shayla Bergmann
Children with immune thrombocytopenia (ITP) are often managed using a watch-and-wait approach to avoid conventional treatment that may be poorly tolerated. However, in some patients, this approach may lead to lifestyle restrictions due to risk of injury-related bleeding. Eltrombopag is a well-tolerated new option that may help these children.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29025288/-state-of-the-art-molecular-diagnostics-and-therapy-of-chronic-lymphocytic-leukaemia-in-the-era-of-new-targeted-therapies
#7
Tímea Gurbity Pálfi, Viktória Fésüs, Csaba Bödör, Zita Borbényi
Chronic lymphoid leukaemia (CLL) has a heterogeneous clinical course depending on many clinical and molecular prognostic markers, which play an important role in the selection of the best treatment option. So far, TP53 disruption is the key prognostic and predictive factor assisting treatment decisions, especially in the era of novel therapies. Asymptomatic patients in early stages of the disease will still benefit from watchful waiting. In the frontline setting, chemoimmunotherapy is still the standard care in the majority of standard risk CLL patients...
October 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29018927/whole-body-magnetic-resonance-in-indolent-lymphomas-under-watchful-waiting-the-time-is-now
#8
EDITORIAL
Massimo Galia, Domenico Albano, Corrado Tarella, Caterina Patti, Luca Maria Sconfienza, Antonino Mulè, Pierpaolo Alongi, Massimo Midiri, Roberto Lagalla
ᅟ: The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by 'indolent' clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging...
October 10, 2017: European Radiology
https://www.readbyqxmd.com/read/28988673/predictive-value-of-cortical-transit-time-on-mag3-for-surgery-in-antenatally-detected-unilateral-hydronephrosis-caused-by-ureteropelvic-junction-stenosis
#9
Jun Nyung Lee, Jun-Koo Kang, Shin Young Jeong, So Mi Lee, Min Hyun Cho, Yun-Sok Ha, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon, Sung Kwang Chung
BACKGROUND: In children with antenatally detected hydronephrosis caused by ureteropelvic junction (UPJ) stenosis, the main challenge is preserving renal function by identifying children who require early surgical intervention from those for whom watchful waiting may be appropriate because of the potential for spontaneous resolution without a significant loss of renal function. OBJECTIVE: To assess the impact of initial cortical transit time (CTT) on technetium-99m mercaptoacetyltriglycerine (MAG3) diuretic renogram on the need for surgery in children with antenatally detected unilateral hydronephrosis caused by UPJ stenosis...
September 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28985309/comparing-watchful-waiting-with-antidepressants-for-the-management-of-subclinical-depression-symptoms-to-mild-moderate-depression-in-primary-care-a-systematic-review
#10
Maria Iglesias-González, Ignacio Aznar-Lou, Montse Gil-Girbau, Patricia Moreno-Peral, M Teresa Peñarrubia-María, Maria Rubio-Valera, Antoni Serrano-Blanco
Background: The benefits of watchful waiting (WW) over antidepressants (ADs) for the treatment of depression in primary care (PC) are unclear. Objective: We aimed to systematically review the evidence supporting either WW or ADs for the treatment of subclinical depressive symptoms and mild-moderate depression in a PC setting. Methods: This systematic review was registered at PROSPERO (42016036345). Four electronic sources (EMBASE, PubMed, PsycINFO, Web of Knowledge) were systematically searched from inception to November 2016 for controlled trials comparing WW and ADs in PC following established guidelines...
June 19, 2017: Family Practice
https://www.readbyqxmd.com/read/28984519/surgical-management-of-incidentally-discovered-diffusely-infiltrating-low-grade-glioma
#11
Michael Opoku-Darko, Stefan T Lang, James Artindale, J Gregory Cairncross, Robert J Sevick, John J P Kelly
OBJECTIVE Occasionally, diffusely infiltrating low-grade gliomas (LGGs) are identified as incidental findings in patients who have no signs or symptoms that can be ascribed to the tumors. The diagnosis of incidental, asymptomatic LGGs has become more frequent due to the vast increase in access to medical imaging technology. While management of these lesions remains controversial, early surgery has been suggested to improve outcome. The authors set out to identify and review the characteristics and surgical outcomes of patients who underwent surgical intervention for incidental LGG...
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28981360/malignancy-rate-histologic-grade-and-progression-of-bosniak-category-iii-and-iv-complex-renal-cystic-lesions
#12
Pedro N Mousessian, Fernando I Yamauchi, Thais C Mussi, Ronaldo H Baroni
OBJECTIVE: The primary purpose of this study is to determine the malignancy rate, histologic grade, and initial stage of surgically treated complex renal cysts classified as Bosniak category III or IV. For nonsurgical lesions, a secondary objective was to evaluate lesion progression on follow-up examinations. MATERIALS AND METHODS: We searched our database for cystic lesions classified as Bosniak III or IV category on CT or MRI from January 2008 to April 2016. Surgically resected lesions, per category, were correlated with information on pathologic reports to obtain malignancy rates...
October 5, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28979089/long-term-evaluation-of-spontaneous-release-of-epiretinal-membrane-and-its-possible-pathogenesis
#13
Teruyo Kida, Seita Morishita, Masanori Fukumoto, Takaki Sato, Hidehiro Oku, Tsunehiko Ikeda
PURPOSE: To investigate the characteristics in spontaneous release of epiretinal membrane (ERM) during watchful waiting and to introduce a possible mechanism of pathogenesis as a photo essay. METHODS: Records from all patients with ERM were obtained from Osaka Medical College Hospital from January 2001 to October 2012. Visual acuity (VA), fundus photo, and optical coherence tomography (OCT) were reviewed using the medical records. For statistical analysis, VA measured with a Landolt chart was converted to the logarithm of the minimum angle of resolution (logMAR)...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28977486/anatomical-distribution-of-residual-cancer-in-patients-with-oesophageal-squamous-cell-carcinoma-who-achieved-clinically-complete-response-after-neoadjuvant-chemoradiotherapy
#14
Yin-Kai Chao, Wen-Yu Chuang, Chi-Ju Yeh, Hsien-Kun Chang, Chen-Kan Tseng
OBJECTIVES: Recent advances in neoadjuvant chemoradiotherapy (nCRT) have significantly increased the rates of pathological complete response achieved by patients with oesophageal cancer. Consequently, a watchful waiting strategy based on 'active endoscopic surveillance and surgery as needed' has been proposed for cases without clinical evidence of disease after neoadjuvant chemoradiotherapy. Here, we investigated whether endoscopic surveillance is a reliable tool for the detection of the initially unidentified residual cancer in this patient group...
July 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28974541/when-to-start-and-when-to-stop-antifibrotic-therapies
#15
REVIEW
Sebastiano Emanuele Torrisi, Mauro Pavone, Ada Vancheri, Carlo Vancheri
Idiopathic pulmonary fibrosis (IPF) is characterised by progressive changes of the lung architecture causing cough and dyspnoea and ultimately leading to lung failure and death. Today, for the first time, two drugs that may reduce the inexorable progression of the disease are available, suggesting that treatment with specific drugs for IPF should be started as soon as diagnosis is made. This applies to any disease and particularly to IPF, which is marked by a 5-year survival comparable or even worse than many cancers...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28958043/remodelling-of-the-aorta-after-a-catheter-induced-acute-aortic-dissection
#16
Athanasios Antoniou, Ioannis Ntalas, Amit Gupta, Rizwan Attia
Iatrogenic acute aortic dissection during percutaneous coronary intervention is an extremely rare but critical complication. Although sealing the entry point with a coronary stent is an option to treat localized dissections, more extensive cases may require surgical intervention. We present a case of Type A aortic dissection that occurred during an angioplasty of a chronically occluded right coronary artery. Despite the extent of the dissection, a 'watch-and-wait' strategy was chosen, and repeated imaging a few days later revealed that the aorta had been remodelled to its normal anatomy...
September 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28947096/3d-constructive-interference-into-steady-state-3d-ciss-labyrinth-signal-alteration-in-patients-with-vestibular-schwannoma
#17
Franca Wagner, Evelyn Herrmann, Roland Wiest, Andreas Raabe, Corrado Bernasconi, Marco Caversaccio, Dominique Vibert
OBJECTIVE: To evaluate signal intensity of the inner ear using 3D-CISS imaging and correlated signal characteristics in patients with vestibular schwannoma to neuro-otological symptoms. METHODS: Sixty patients with unilateral vestibular schwannoma were retrospectively reviewed. All patients had had initial and follow-up magnetic resonance imaging (MRI). Individual treatment strategies consisted of "wait-and-watch", surgical tumour resection, stereotactic radiosurgery or both surgery and stereotactic radiosurgery...
September 22, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28946030/follicular-adenoma-in-ectopic-thyroid-a-case-report
#18
Vincenzo Consalvo, Gerarda Barbieri, Amalia Rosaria Rita Rossetti, Mafalda Romano, Rosaria Contieri, Salvatore Tramontano, Carmela Rescigno, Massimo Infranzi, Domenico Lombardi
INTRODUCTION: The term ectopic thyroid refers to the presence of thyroid tissue located far from its usual anatomic placement and with no vascular connection to the main gland. The presence of swelling in atypical locations is diagnostically differentiated from other pathologies like pleomorphic adenoma or carcinoma, inflammatory lesions like sialadenitis, neurogenic tumors, paraganglioma, fibrolipoma and lymphadenopaties of diverse etiologies. PRESENTATION OF CASE: Here we present the case of a submandibular ectopic thyroid in a 67year old woman...
September 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28939587/expression-and-genetic-variation-in-neuroendocrine-signaling-pathways-in-lethal-and-nonlethal-prostate-cancer-among-men-diagnosed-with-localized-disease
#19
Donghao Lu, Jessica Carlsson, Kathryn L Penney, Sabina Davidsson, Swen-Olof Andersson, Lorelei A Mucci, Unnur Valdimarsdóttir, Ove Andrén, Fang Fang, Katja Fall
BACKGROUND: Recent data suggest that neuroendocrine signaling pathways may play a role in the progression of prostate cancer, particularly for early-stage disease. We aimed to explore whether expression of selected genes in the adrenergic, serotoninergic, glucocorticoid, and dopaminergic pathways differs in prostate tumor tissue from men with lethal disease compared to men with nonlethal disease. METHODS: Based on the Swedish Watchful Waiting Cohort, we included 511 men diagnosed with incidental prostate cancer through TURP during 1977-1998 with follow-up up to 30 years...
September 22, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28937269/dose-escalation-using-contact-x-ray-brachytherapy-papillon-for-rectal-cancer-does-it-improve-the-chance-of-organ-preservation
#20
Arthur Sun Myint, Fraser McLean Smith, Simon William Gollins, Helen Wong, Christopher Rao, Karen Whitmarsh, Raj Sripadam, Paul Rooney, Michael Jeremy Hershman, Zsolt Fekete, Kate Perkins, D Mark Pritchard
OBJECTIVE: A watch and wait policy for patients with a complete clinical response (cCR) after external beam chemoradiotherapy (EBCRT) for rectal cancer is an attractive option. However, approximately a third of tumours will regrow, which requires surgical salvage for cure. We assessed whether contact x-ray brachytherapy (CXB) can improve organ preservation by avoiding surgery for local regrowth. METHODS: From our institutional database, we identified 200 of 573 patients treated by CXB from 2003 to 2012...
September 20, 2017: British Journal of Radiology
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