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watch and wait

Marleen M Roos, Egbert-Jan M M Verleisdonk, Floris B M Sanders, Arno W Hoes, Rebecca K Stellato, Geert W J Frederix, Rogier K J Simmermacher, Josephina P J Burgmans
BACKGROUND: Groin pain is a frequent complaint in surgical practice with an inguinal hernia being at the top of the differential diagnosis. The majority of inguinal hernias can be diagnosed clinically. However, patients with groin pain without signs of an inguinal hernia on anamnesis or physical examination provide a diagnostic challenge. If ultrasonography shows a hernia that could not be detected clinically, this entity is called a clinically occult hernia. It is debatable if this radiological hernia is the cause of complaints in all patients with inguinal pain...
June 18, 2018: Trials
Muhammad Ali Khan, Zubair Khan, Claudio R Tombazzi, Chiranjeevi Gadiparthi, Wade Lee, C Mel Wilcox
BACKGROUND: Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients. AIMS: We conducted this systematic review and meta-analysis of randomized controlled trials to compare the early cholecystectomy versus wait and watch strategy after ES...
June 16, 2018: Journal of Clinical Gastroenterology
Kenichi Miyamoto, Noriko Fukuhara, Dai Maruyama, Taro Shibata, Kenichi Nakamura, Kenichi Ishizawa, Kunihiro Tsukasaki, Hirokazu Nagai
A randomized phase III trial comparing watchful waiting with first-line rituximab for advanced stage follicular lymphoma commenced in Japan in December 2016. Watchful waiting is the current standard treatment for stages III and IV (Ann Arbor classification) follicular lymphoma with low tumour burden. This study aimed to confirm the superiority of early administration of first-line rituximab in terms of event-free survival to watchful waiting for stages III and IV follicular lymphoma with low tumour burden. A total of 290 patients will be accrued from 50 Japanese institutions within 5 years...
June 13, 2018: Japanese Journal of Clinical Oncology
Virginia Velasco-Tirado, Angela Romero-Alegria, Javier Pardo-Lledías, Montserrat Alonso-Sardón, Amparo Lopez-Bernus, Jose Quiñones Sampedro, Luis Muñoz Bellvis, Alicia Iglesias Gomez, Antonio Muro, Juan Luis Muñoz Bellido, Manuel Iglesias-Iglesias, Marcelo Fernando Jimenez Lopez, Moncef Belhassen-García
Background: Management options for cystic echinococcosis (CE) remain a serious problem. The main aim of this study was to examine the selection and complications of treatment applied in patients with CE. The second aim was to evaluate the mortality rate and causative factors. Methods: A retrospective descriptive study of patients diagnosed with CE between 1998 and 2015 was conducted, according to ICD-9 (code 122·0 to 122·9) criteria in the Complejo Asistencial Universitario of Salamanca, Spain...
June 12, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Haige Ye, Aakash Desai, Dongfeng Zeng, Jorge Romaguera, Michael L Wang
The natural history of mantle cell lymphoma (MCL) undergoing chemotherapy is a cyclical pattern of remission followed by recurrence of disease due to acquired chemotherapy resistance. The median age of the occurrence of MCL is 65 years, so half of the newly diagnosed MCL patients are considered "elderly." The tolerance to long-term chemotherapy in elderly patients is decreased; hence, the response to frontline therapy used is of paramount importance. We hope that our review may guide clinicians in treating such populations in a more personalized and evidence-based manner...
June 12, 2018: Oncologist
Saba Pasha, Brice Ilharreborde, Keith Baldwin
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: To determine the differences in the sagittal spinopelvic parameters between the non-scoliotic controls, pre-operative, and different time points post-operative in Lenke 1 and 5 adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: The post-operative changes in the sagittal profile of Lenke 1 and 5 AIS at varying time points after posterior spinal fusion (PSF) has not been rigorously demonstrated; studies performed have had conflicting results...
June 8, 2018: Spine
N J Battersby, R O Perez, N Baxter, B Moran, G Brown
As part of an approach to improve tumour regression and increase the proportion of patients with complete clinical and radiological response, Dr Perez reviews the methods and evidence base for augmenting therapy and thus augmenting response rates preoperatively. Much of the data reviewed were in the context of patients undergoing a watch-and-wait approach for rectal cancer after initial treatment with chemoradiotherapy.
May 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Deirdre Lewis, Kevin Hachey, Shannon Fitzgerald, Ruben Vaidya
Rapidly involuting congenital haemangiomas (RICHs) are rare benign vascular tumours of infancy. They are generally asymptomatic, but can present with thrombocytopaenia and coagulopathy. Significant complications including life-threatening bleeding, high-output heart failure and liver failure, though rare, can occur. RICHs generally regress by 12-14 months of age and can be managed clinically with symptomatic treatment, watchful waiting and close monitoring of the size of the haemangioma. Medical management (corticosteroids, propranolol) has not shown to be effective, in contrast to infantile haemangioma which will not regress spontaneously and has been noted to respond to medical therapy...
June 5, 2018: BMJ Case Reports
L Weißbach, C Roloff
BACKGROUND: Treatment of localized low-risk prostate cancer (PCa) is undergoing a paradigm shift: Invasive treatments such as surgery and radiation therapy are being replaced by defensive strategies such as active surveillance (AS) and watchful waiting (WW). OBJECTIVE: The aim of this work is to evaluate the significance of current studies regarding defensive strategies (AS and WW). METHODS: The best-known AS studies are critically evaluated for their significance in terms of input criteria, follow-up criteria, and statistical significance...
June 5, 2018: Der Urologe. Ausg. A
Raffaella Lissandrin, Francesca Tamarozzi, Mara Mariconti, Tommaso Manciulli, Enrico Brunetti, Ambra Vola
Human cystic echinococcosis (CE) is a chronic, complex and neglected infection causing severe disease in humans. Hepatic CE cysts are detected and classified mainly by using ultrasound. Expert opinion and published data suggest that uncomplicated inactive liver cysts do not require treatment and only need to be monitored over time ("Watch and Wait"). Here we update our findings as published in 2014 on the "Watch and Wait" approach applied to inactive, asymptomatic cysts of the liver to keep the medical community informed...
June 4, 2018: American Journal of Tropical Medicine and Hygiene
Aisling Quinlan, Kirsty K O'Brien, Rose Galvin, Colin Hardy, Ronan McDonnell, Doireann Joyce, Ronald D McDowell, Emma Aherne, Claire Keogh, Katriona O'Sullivan, Tom Fahey
OBJECTIVES: Decision analysis study that incorporates patient preferences and probability estimates to investigate the impact of women's preferences for referral or an alternative strategy of watchful waiting if faced with symptoms that could be due to breast cancer. SETTING: Community-based study. PARTICIPANTS: Asymptomatic women aged 30-60 years. INTERVENTIONS: Participants were presented with 11 health scenarios that represent the possible consequences of symptomatic breast problems...
May 31, 2018: BMJ Open
Ryuta Nakae, Tomoji Takigawa, Koji Hirata, Masaya Nagaishi, Akio Hyodo, Kensuke Suzuki
BACKGROUND: Inflow into an aneurysm sac immediately following flow diverter (FD) treatment is an assumed cause of delayed aneurysmal rupture. The significance of delayed post-treatment residual flow occurring months after FD treatment is unknown. CASE DESCRIPTION: A 76-year-old woman with a large intracranial aneurysm measuring 23.0 × 18.1 mm in the cavernous segment of the right internal carotid artery was treated with placement of a single FD (Pipeline Embolization Device [PED]®, Covidien, Irvine, CA, USA)...
May 28, 2018: World Neurosurgery
Jae Hung Jung, Michael C Risk, Robert Goldfarb, Balaji Reddy, Bernadette Coles, Philipp Dahm
BACKGROUND: Traditionally, radical prostatectomy and radiotherapy with or without androgen deprivation therapy have been the main treatment options to attempt to cure men with localised or locally advanced prostate cancer. Cryotherapy is an alternative option for treatment of prostate cancer that involves freezing of the whole prostate (whole gland therapy) or only the cancer (focal therapy), but it is unclear how effective this is in comparison to other treatments. OBJECTIVES: To assess the effects of cryotherapy (whole gland or focal) compared with other interventions for primary treatment of clinically localised (cT1-T2) or locally-advanced (cT3) non-metastatic prostate cancer...
May 30, 2018: Cochrane Database of Systematic Reviews
Haige Ye, Aakash Desai, Tiejun Gong, Dongfeng Zeng, Krystle Nomie, Wendy Chen, Wei Wang, Jorge Romaguera, Michael L Wang
BACKGROUND: Spontaneous regression has been reported in some indolent forms of lymphoma. Mantle cell lymphoma (MCL) is an aggressive lymphoid neoplasm and has a poor prognosis. However, approximately 30% of MCL patients can exhibit indolent clinical behavior. To date, complete spontaneous regression of MCL has not been reported. CASE PRESENTATION: We describe four cases of spontaneous regression of MCL. At the time of presentation, these patients were asymptomatic, with lymph node enlargement and mild to moderate fluorodeoxyglucose (FDG) uptake on FDG-positron emission tomography combined with computed tomography...
May 29, 2018: Cancer communications
Hugin Reistrup, Dennis Bregner Zetner, Krostoffer Andersen, Jacob Rosenberg
In male patients with asymptomatic or minimally symptomatic ventral and inguinal hernias, a watchful waiting strategy should be considered. Even though one third to two thirds of these patients will eventually undergo hernia repair, they may still benefit from a watchful waiting strategy, as hernia repair is associated with a range of complications, e.g. wound infection, haematoma, seroma, fistulas and chronic pain. Delay of hernia repair in these patients is not associated with any significant increase in morbidity or mortality, and the risk of incarceration is very low...
May 28, 2018: Ugeskrift for Laeger
Jonathan Roth, Jehuda Soleman, Dimitris Paraskevopoulos, Robert F Keating, Shlomi Constantini
PURPOSE: Incidental pediatric brain tumors (IPBT) are increasingly being diagnosed. Currently, there is no consensus regarding the need and timing of their treatment. In the current study, we identify trends among pediatric neurosurgeons and oncologists with regard to IPBT management and approval of growth hormone replacement therapy (GHRT). METHODS: A questionnaire presenting six different cases of IPBT was emailed to all members of several leading societies in pediatric neurosurgery and oncology...
May 25, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Etienne L Couture, Thao Huynh
No abstract text is available yet for this article.
June 2018: Canadian Journal of Cardiology
Joshua J Fenton, Meghan S Weyrich, Shauna Durbin, Yu Liu, Heejung Bang, Joy Melnikow
Importance: Prostate cancer is the second leading cause of cancer death among US men. Objective: To systematically review evidence on prostate-specific antigen (PSA)-based prostate cancer screening, treatments for localized prostate cancer, and prebiopsy risk calculators to inform the US Preventive Services Task Force. Data Sources: Searches of PubMed, EMBASE, Web of Science, and Cochrane Registries and Databases from July 1, 2011, through July 15, 2017, with a surveillance search on February 1, 2018...
May 8, 2018: JAMA: the Journal of the American Medical Association
Diana C Patterson, Ronald P Grelsamer
Faced with a patient who presents with unexplained disproportionate pain, a surgeon may be tempted to diagnose a low pain threshold, malingering, poor coping, anxiety, or other emotional condition. However, a variety of conditions must be ruled out before the orthopedist can prescribe watchful waiting. Computed tomography and magnetic resonance imaging can detect occult fractures, acute spinal conditions or vascular occlusions, but early on are inadequate to diagnose a compartment syndrome, necrotizing fasciitis, or reflex sympathetic dystrophy (RSD)...
June 2018: Bulletin of the Hospital for Joint Diseases
Robbie Stewart, Donna Gallagher, Peter Leyden
AIM: The objective of this study is to review the prevalence and degree of hearing loss in children with trisomy 21, their response to intervention and the presence of concomitant pathologies. The project will also highlight the experiences of the children from their parents' and guardians' perspective and the link between perceived service quality and an objective improvement in their hearing after rehabilitation. METHODS: All patients with trisomy 21 who were referred to district general otolaryngology outpatient clinics between 2014 and 2016 were included...
May 22, 2018: Journal of Paediatrics and Child Health
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