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https://www.readbyqxmd.com/read/28231577/response-evaluation-in-head-and-neck-oncology-definition-and-prediction
#1
T K Hoffmann, P J Schuler, S Laban, R Grässlin, M Beer, A J Beer, U Friebe-Hoffmann, L Bullinger, P Möller, T Wiegel
Curative treatment of head and neck squamous cell carcinoma includes surgery and/or (chemo)radiation, whereas in the palliative setting, chemotherapy and/or immunotherapy represent(s) the standard approach. With regard to quality control, methods for determining treatment response are sorely needed. For surgical therapy, histopathology is the standard quality control. Established criteria for high-risk patients include resection margins of the primary tumor and extracapsular extension of lymph node metastases...
February 24, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28228705/her2-orientated-therapy-in-early-and-metastatic-breast-cancer
#2
REVIEW
Severine Iborra, Elmar Stickeler
Due to the enhanced understanding of molecular oncology and signaling pathways in breast cancer (BC), therapy management has undergone a major transformation, especially with the emergence of treatment tailored to individual disease characteristics. In the case of HER2-positive early or metastatic BC, targeted therapies are well established and remain a major focus of ongoing research. The introduction of anti-HER2 biologicals such as trastuzumab, pertuzumab, and T-DM1 has made targeted and personalized treatment possible and has clearly improved disease-free and overall survival in patients with HER2-positive BC...
December 2016: Breast Care
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#3
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28221214/an-integrative-review-of-psychosocial-concerns-among-young-african-american-breast-cancer-survivors
#4
Timiya S Nolan, Jennifer Frank, Silvia Gisiger-Camata, Karen Meneses
BACKGROUND: African American (AA) women are more likely to be given a diagnosis of breast cancer at an early age, experience morbidity after treatment, and exhibit disparities in survivorship. Although psychosocial well-being is largely studied among breast cancer survivors, data are sparse regarding young AA survivors. OBJECTIVE: This integrative review examined psychosocial concerns in survivorship among young AA survivors using a quality-of-life framework. METHODS: PubMed, CINHAL, EMBASE, PsychINFO, and Scopus were searched for articles exploring psychosocial well-being in young AA survivors...
February 17, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28216773/staff-and-caregiver-attitude-to-coercion-in-india
#5
B N Raveesh, S Pathare, E O Noorthoorn, G S Gowda, P Lepping, J G F Bunders-Aelen
OBJECTIVES: The objective of this study was to assess attitudes of Indian psychiatrists and caregivers toward coercion. MATERIALS AND: Methods: The study was conducted at the Department of Psychiatry, Krishna Rajendra Hospital, Mysore, India. Staff Attitude to Coercion Scale (SACS), a 15-item questionnaire, was administered to self-selected psychiatrists across India and caregivers from Mysore to measure attitudes on coercion. Data were analyzed using descriptive statistics and investigating differences in subgroups by means of Chi-square test, Student's t-test, and analysis of variance...
December 2016: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#6
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#7
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28182774/benefits-and-unintended-consequences-of-antimicrobial-de-escalation-implications-for-stewardship-programs
#8
Josie Hughes, Xi Huo, Lindsey Falk, Amy Hurford, Kunquan Lan, Bryan Coburn, Andrew Morris, Jianhong Wu
Sequential antimicrobial de-escalation aims to minimize resistance to high-value broad-spectrum empiric antimicrobials by switching to alternative drugs when testing confirms susceptibility. Though widely practiced, the effects de-escalation are not well understood. Definitions of interventions and outcomes differ among studies. We use mathematical models of the transmission and evolution of Pseudomonas aeruginosa in an intensive care unit to assess the effect of de-escalation on a broad range of outcomes, and clarify expectations...
2017: PloS One
https://www.readbyqxmd.com/read/28182564/global-strategy-for-the-diagnosis-management-and-prevention-of-chronic-obstructive-lung-disease-2017-report-gold-executive-summary
#9
Claus F Vogelmeier, Gerard J Criner, Fernando J Martinez, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Rongchang Chen, Marc Decramer, Leonardo M Fabbri, Peter Frith, David M G Halpin, M Victorina López Varela, Masaharu Nishimura, Nicolas Roche, Roberto Rodriguez-Roisin, Don D Sin, Dave Singh, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha, Alvar Agusti
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: i) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; ii) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; iii) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; iv) nonpharmacologic therapies are comprehensively presented and; v) the importance of comorbid conditions in managing COPD is reviewed...
January 30, 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28178130/de-escalation-empirical-antibiotic-therapy-improved-survival-for-patients-with-severe-aplastic-anemia-treated-with-antithymocyte-globulin
#10
Rong Fu, Tong Chen, Jia Song, Guojin Wang, Lijuan Li, Erbao Ruan, Hui Liu, Yihao Wang, Huaquan Wang, Limin Xing, Yuhong Wu, Hong Liu, Wen Qu, Zonghong Shao
We aimed to investigate the efficacy and safety of de-escalation empirical therapy for controlling infection in patients with severe aplastic anaemia (SAA) treated with antithymocyte globulin (ATG). Eighty-seven ATG-treated SAA patients who had microbiological culture-confirmed infections from 2006 to 2015 in our center were retrospectively analyzed. The efficacy of de-escalation and non-de-escalation therapy was compared. Among all 87 patients, 63 patients were treated with de-escalation therapy and 24 patients with non-de-escalation therapy...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28175117/p496-successful-dose-de-escalation-to-adalimumab-40mg-every-three-weeks-in-patients-with-crohn-s-disease
#11
M Ferrante, S Van Steenbergen, S Bian, V Ballet, S Vermeire, G Van Assche, A Gils
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28172644/p438-adalimumab-dose-escalation-and-de-escalation-in-ulcerative-colitis-incidence-and-predictors-of-success-a-real-life-belgian-cohort-study
#12
S Van de Vondel, F Baert, C Reenaers, P Bossuyt, P Hindryckx, S Vanden Branden, L Amininejad, P Dewint, J F Rahier, M Ferrante
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28167509/results-from-a-phase-i-ii-open-label-dose-finding-study-of-pralatrexate-and-oral-bexarotene-in-patients-with-relapsed-refractory-cutaneous-t-cell-lymphoma
#13
Madeleine Duvic, Youn H Kim, Pier Luigi Zinzani, Steven Horwitz
PURPOSE: Pralatrexate is a folic acid analog metabolic inhibitor similar to methotrexate,that has shown tolerability and efficacy with an overall response rate of 45% in a phase 1 dose de-escalation study of patients with relapsed/refractory cutaneous T-cell lymphoma CTCL. EXPERIMENTAL DESIGN: The object of this phase I/II open-label, multi-center clinical trial was to determine the maximum tolerated dose (MTD) and recommended dose of pralatrexate plus oral bexarotene in 34 patients with relapsed/refractory CTCL who had failed prior systemic therapies...
February 6, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28165691/de-escalate-tense-talk-five-simple-strategies-to-help-keep-things-cool
#14
Ann M Garrido
The tensions of the wider world all too frequently erupt in our nation's emergency rooms in the form of gunshot wounds and domestic battery, gang brawls and road rage accidents. As health care professionals, you generally are called into action after things have taken a turn toward violence. Even as you suture and bandage and console frightened family members, I imagine you sigh: "Why did things have to go this far?"
July 2016: Health Progress
https://www.readbyqxmd.com/read/28164724/jak-inhibition-in-inflammatory-bowel-disease
#15
Pablo Olivera, Silvio Danese, Laurent Peyrin-Biroulet
Current available treatments for inflammatory bowel disease (IBD) have some limitations and new options are needed. Several new molecules are being tested for the treatment of IBD and other immune-mediated inflammatory diseases. Among them, Janus kinase (JAK) inhibitors seem to have the lead, since tofacitinib has received regulatory approval in 2012 for the treatment of rheumatoid arthritis, and also it has shown a favorable risk-benefit ratio in phase 3 studies for ulcerative colitis, both in anti-TNF naïve and anti-TNF experienced patients...
February 4, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28164321/dose-de-escalation-to-adalimumab-40-mg-every-3-weeks-in-patients-with-crohn-s-disease-a-nested-case-control-study
#16
S Van Steenbergen, S Bian, S Vermeire, G Van Assche, A Gils, M Ferrante
BACKGROUND: Data on dose de-escalation in patients with Crohn's disease (CD) are limited. AIM: To evaluate outcomes of dose de-escalation from adalimumab (ADM) every other week (EOW) to every three weeks (ETW). METHODS: We selected patients with CD receiving maintenance therapy with ADM 40 mg ETW with serum levels (SL) available before and after dose de-escalation. Sex- and age-matched controls continuing ADM 40 mg EOW were identified. Patient reported outcome, C-reactive protein (CRP) and serum albumin were collected...
February 6, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#17
(no author information available yet)
: 53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28150362/global-strategy-for-the-diagnosis-management-and-prevention-of-chronic-obstructive-lung-disease-2017-report
#18
Claus F Vogelmeier, Gerard J Criner, Fernando J Martinez, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Rongchang Chen, Marc Decramer, Leonardo M Fabbri, Peter Frith, David M G Halpin, M Victorina López Varela, Masaharu Nishimura, Nicolas Roche, Roberto Rodriguez-Roisin, Don D Sin, Dave Singh, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha, Alvar Agusti
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: i) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; ii) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; iii) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; iv) nonpharmacologic therapies are comprehensively presented and; v) the importance of comorbid conditions in managing COPD is reviewed...
February 2, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28149885/potential-biomarkers-for-radiosensitivity-in-head-and-neck-cancers
#19
COMMENT
Sherly Pardo-Reoyo, J L Roig-Lopez, Eddy S Yang
Radiotherapy is a mainstay of treatment for head and neck cancer. However, the morbidity of treatment remains a clinical challenge. Molecular profiling has provided further insight into tumor biology and tumor sensitivity to radiation, and this information could be used to personalize treatment. In this review, we discuss published signatures of radiosensitivity and discuss the pathways that may be important in dictating radiation sensitivity. Applications of these signatures could result in less morbidity if dose de-escalation efforts are successful...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28148790/immunization-with-low-doses-of-recombinant-post-fusion-or-pre-fusion-rsv-f-primes-for-vaccine-enhanced-disease-in-the-cotton-rat-model-independent-of-the-presence-of-a-th1-biasing-gla-se-or-th2-biasing-alum-adjuvant
#20
Kirsten Schneider-Ohrum, Corinne Cayatte, Angie Snell Bennett, Gaurav Manohar Rajani, Patrick McTamney, Krystal Nacel, Leigh Hostetler, Lily Cheng, Kuishu Ren, Terrence O'Day, Gregory A Prince, Michael P McCarthy
: Respiratory syncytial virus (RSV) infection of children previously immunized with a non-live, formalin-inactivated (FI)-RSV vaccine was associated with serious enhanced respiratory disease (ERD). Consequently, detailed studies of potential ERD are a critical step in the development of non-live RSV vaccines targeting RSV-naïve children and infants. The fusion glycoprotein (F) of RSV in either its post- or pre-fusion conformation is a target for neutralizing antibodies and therefore an attractive antigen candidate for a pediatric RSV subunit vaccine...
February 1, 2017: Journal of Virology
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