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https://www.readbyqxmd.com/read/27918901/clinical-utility-of-methicillin-resistant-staphylococcus-aureus-nasal-polymerase-chain-reaction-assay-in-critically-ill-patients-with-nosocomial-pneumonia
#1
Melanie N Smith, Michael J Erdman, Jason A Ferreira, Petra Aldridge, Christopher A Jankowski
PURPOSE: This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. MATERIALS AND METHODS: This retrospective, single-center study included adult patients admitted to an intensive care unit with suspected nosocomial pneumonia. Patients must have received an MRSA nasal PCR assay and respiratory culture within predetermined time intervals...
November 15, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27918781/the-role-of-adjuvant-chemotherapy-in-surgically-managed-p16-positive-oropharyngeal-squamous-cell-carcinoma
#2
S Andrew Skillington, Dorina Kallogjeri, James S Lewis, Jay F Piccirillo
Importance: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has a favorable prognosis, and p16 immunohistochemistry is a surrogate marker of high-risk HPV infection and strong prognosticator. Given this favorable prognosis, treatment de-escalation for p16-positive OPSCC is now being considered with the goal of decreasing treatment-associated morbidity without compromising tumor control. The role of adjuvant chemotherapy in this setting is becoming increasingly unclear...
December 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27917735/top-1-of-inpatients-administered-antimicrobial-agents-comprising-50-of-expenditures-a-descriptive-study-and-opportunities-for-stewardship-intervention
#3
Jennifer Dela-Pena, Luiza Kerstenetzky, Lucas Schulz, Ron Kendall, Alexander Lepak, Barry Fox
OBJECTIVE To characterize the top 1% of inpatients who contributed to the 6-month antimicrobial budget in a tertiary, academic medical center and identify cost-effective intervention opportunities targeting high-cost antimicrobial utilization. DESIGN Retrospective cohort study. PATIENTS Top 1% of the antimicrobial budget from July 1 through December 31, 2014. METHODS Patients were identified through a pharmacy billing database. Baseline characteristics were collected through a retrospective medical chart review...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27913497/response-adapted-frontline-therapy-for-hodgkin-lymphoma-are-we-there-yet
#4
Peter W M Johnson
Treating Hodgkin lymphoma by using chemotherapy with or without radiotherapy is highly successful, with substantially fewer deaths from lymphoma than from other causes in recent studies of both early-stage and advanced-stage disease. Long-term toxicity is a major consideration in this context, and recent trials have used functional imaging with [(18)F]fluorodeoxyglucose (FDG) positron emission tomography early in the course of treatment (interim PET) to assess response and modulate subsequent therapy. In early-stage disease, this has allowed omission of consolidation radiotherapy after a good response to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy, and trials have shown that this can be done without detriment to overall survival, despite a small increase in rates of recurrence of ∼5%...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27898208/-design-and-implementation-of-an-outpatient-parenteral-antimicrobial-therapy-program-in-primary-care-the-experience-at-a-second-level-hospital
#5
M Ruiz-Campuzano, E García-Vázquez, J J Hernández-Roca, J Gómez-Gómez, M Canteras-Jordana, E Mené-Fenor, A Hernández-Torres, A Peláez-Ballesta
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) programs are a good assistance option in a wide variety of infectious diseases. Our aim was to design and implement an OPAT program in the area of influence of a second-level hospital, with no Home Hospitalization Service available, being necessary close collaboration between hospitalization and Primary Care teams, describe our cohort, analyse the antimicrobial treatment indicated and evaluate the prognostic and risk factors associated with readmission and mortality...
November 28, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27896522/tapering-biologics-in-rheumatoid-arthritis-a-pragmatic-approach-for-clinical-practice
#6
Aleksander Lenert, Petar Lenert
Optimal rheumatoid arthritis (RA) therapy in daily clinical practice is based on the treat-to-target strategy. Quicker escalation of therapy and earlier introduction of biological disease-modifying anti-rheumatic drugs have led to improved outcomes in RA. However, chronic immunosuppressive therapy is associated with adverse events and higher costs. In addition, our patients frequently express a desire for lower dosing and drug holidays. Current clinical practice guidelines from the American College of Rheumatology and European League Against Rheumatism suggest that rheumatologists consider tapering treatment after achieving remission...
November 28, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27894364/the-changing-landscape-of-oropharyngeal-cancer-management
#7
D Hamilton, M K Khan, J O'hara, V Paleri
BACKGROUND: Oropharyngeal cancer is increasing in prevalence in the UK and this is thought to be due to the emergence of disease related to human papilloma virus. METHOD: A literature review was conducted on the diagnosis and latest management of oropharyngeal cancer. RESULTS: In non-smokers, human papilloma virus related disease is thought to have better outcomes, but this casts doubt on previous research which did not stratify patients according to human papilloma virus status...
November 29, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27893418/high-risk-hpv-genotypes-and-p16ink4a-expression-in-a-cohort-of-head-and-neck-squamous-cell-carcinoma-patients-in-singapore
#8
Louise Soo Yee Tan, Petersson Fredrik, Liang Ker, Feng Gang Yu, De Yun Wang, Boon Cher Goh, Kwok Seng Loh, Chwee Ming Lim
Human papillomavirus (HPV), especially HPV16 genotype, is associated with oropharyngeal squamous cell carcinoma (OPSCC). We aim to determine the prevalence and characterize the high-risk (HR)-HPV genotypes in head and neck SCC (HNSCC) in a South-East Asian multi-ethnic society in Singapore and examine its prognostic significance.159 HNSCC archival tissue samples were retrieved and tumour DNA was screened for 18 HR-HPV genotypes using a PCR-based assay (Qiagen, digene HPV genotyping RH test). P16 protein overexpression was identified using immunohistochemistry (IHC)...
November 22, 2016: Oncotarget
https://www.readbyqxmd.com/read/27883296/adjuvant-trastuzumab-a-10-year-overview-of-its-benefit
#9
Matteo Lambertini, Noam F Pondé, Cinzia Solinas, Evandro de Azambuja
Anti-HER2 targeted therapy is one of the key advances in the treatment of breast cancer that have occurred in the last 20 years. In the adjuvant setting, the use of trastuzumab has led to prolonged and sustained survival benefit with very little toxicity as also confirmed by the 10-year follow-up results from the pivotal trials. Despite the survival improvement, several key issues are not entirely resolved in this field. These issues have led to multiple research efforts in de-escalating or escalating the standard treatment with chemotherapy and 1 year of adjuvant trastuzumab...
November 24, 2016: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/27880665/the-current-treatment-landscape-candidiasis
#10
Matteo Bassetti, Maddalena Peghin, Jean-Francois Timsit
The epidemiology of Candida species infection has changed over recent decades, influenced by local hospital-related factors, patient predisposing conditions and type of antifungal agents administered. A shift from Candida albicans as the predominant pathogen towards an increasing prevalence of the species Candida glabrata and Candida parapsilosis amongst critically ill patients has been documented. Changes in Candida species distribution may impact treatment recommendations due to differences in susceptibility to antifungal agents among species...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27872953/a-phase-i-study-of-afatinib-combined-with-paclitaxel-and-bevacizumab-in-patients-with-advanced-solid-tumors
#11
James Spicer, Sheeba Irshad, Joo Ern Ang, Deborah Enting, Rebecca Kristeleit, Martina Uttenreuther-Fischer, Karine Pemberton, Katy Pelling, David Schnell, Johann de Bono
PURPOSE: The combination of afatinib, an irreversible ErbB family blocker, with paclitaxel and bevacizumab was assessed in patients with advanced solid tumors. METHODS: This phase I study used a 3 + 3 design to determine the maximum tolerated dose (MTD) of afatinib combined with paclitaxel and bevacizumab. Safety, pharmacokinetics, and anti-tumor activity were also assessed. The starting dose was oral afatinib 40 mg once daily plus intravenous paclitaxel (fixed dose 80 mg/m(2), Days 1, 8, and 15 of a 4-week cycle) and intravenous bevacizumab 5 mg/kg every 2 weeks...
November 21, 2016: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27872355/acceptance-of-pharmacist-driven-antimicrobial-stewardship-recommendations-with-differing-levels-of-physician-involvement-in-a-children-s-hospital
#12
Leah Molloy, Eric McGrath, Ronald Thomas, Keith S Kaye, Michael J Rybak
This prospective interventional study assessed whether a pharmacist-physician team in a setting where physician support is not provided for daily antimicrobial stewardship (AS) activities would improve later acceptance of pharmacist recommendations once multidisciplinary efforts stopped and the pharmacist again worked alone. This was measured by AS recommendation acceptance rate during 3 study phases wherein AS recommendations were provided by a pharmacist alone (Phase 1), a pharmacist and a physician together (Phase 2), and then a pharmacist alone again (Phase 3)...
November 20, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27866835/over-using-chemotherapy-in-the-adjuvant-setting
#13
Giuseppe Curigliano, Carmen Criscitiello, Angela Esposito, Giancarlo Pruneri
Avoidance of unnecessary or ineffective treatment should be one of the main goals in adjuvant breast oncology today. Unfortunately, both patients and doctors hunt for tiny statistical differences in survival curves. This search could not only lead to an oncological approach of unlimited addition that we will not be able to afford, but would also end inevitably in indeterminate overtreatment with substantial risks of unexpected toxic effects eating away whatever progress we might make. "Do not harm" remains the main principle in medicine...
November 17, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27866067/escalating-and-de-escalating-treatment-in-her2-positive-early-breast-cancer
#14
REVIEW
Heikki Joensuu
The current standard adjuvant systemic treatment of early HER2-positive breast cancer consists of chemotherapy plus 12months of trastuzumab, with or without endocrine therapy. Several trials have investigated modifications of the standard treatment that are shorter and less resource-demanding (de-escalation) or regimens that aim at dual HER2 inhibition or include longer than 12months of HER2-targeted treatment (escalation). Seven randomized trials investigate shorter than 12months of trastuzumab treatment duration...
November 10, 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27864449/what-are-the-critical-steps-in-processing-blood-cultures-a-prospective-audit-evaluating-current-practice-of-reporting-blood-cultures-in-a-centralised-laboratory-serving-secondary-care-hospitals
#15
Manjula Meda, James Clayton, Reela Varghese, Jayakeerthi Rangaiah, Clive Grundy, Farnaz Dashti, David Garner, Katherine Groves, Karen Fitzmaurice, E Hutley
AIMS: To assess current procedures of processing positive blood cultures against national standards with an aim to evaluate its clinical impact and to determine the utility of currently available rapid identification and susceptibility tests in processing of blood cultures. METHODS: Blood cultures from three secondary care hospitals, processed at a centralised laboratory, were prospectively audited. Data regarding processing times, communication with prescribers, changes to patient management and mortality within 30 days of a significant blood culture were collected in a preplanned pro forma for a 4-week period...
November 18, 2016: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27863194/pomalidomide-for-symptomatic-kaposi-s-sarcoma-in-people-with-and-without-hiv-infection-a-phase-i-ii-study
#16
Mark N Polizzotto, Thomas S Uldrick, Kathleen M Wyvill, Karen Aleman, Cody J Peer, Margaret Bevans, Irini Sereti, Frank Maldarelli, Denise Whitby, Vickie Marshall, Priscila H Goncalves, Vikram Khetani, William D Figg, Seth M Steinberg, Jerome B Zeldis, Robert Yarchoan
Purpose Kaposi's sarcoma (KS) is a multicentric tumor caused by Kaposi's sarcoma-associated herpesvirus. Unmet needs include therapies that are oral, anthracycline sparing, and deliverable in resource-limited settings. We evaluated pomalidomide, an oral immune modulatory agent, in patients with symptomatic KS. Methods The primary objectives were to assess tolerability, pharmacokinetics, and activity. Initial dosage level was 5 mg once per day for 21 days per 28-day cycle, with a de-escalated level of 3 mg if not tolerable, and aspirin 81 mg once per day thromboprophylaxis...
December 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27850332/693-de-escalation-of-antibiotics-in-culture-positive-critically-ill-adults-with-pneumonia
#17
Peter Zepke, Jeffrey Fish
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850331/692-practice-patterns-for-antibiotic-de-escalation-in-mrsa-culture-negative-sepsis
#18
Farid Sadaka, Matthew Korobey, Alexis Dumm, Greggory Wegener, Rachna Kumar, Alex Bryant, Jackyln O'Brien
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850302/663-antimicrobial-de-escalation-practices-across-a-broad-sample-of-icus-in-the-united-states
#19
Omar Badawi, Sunil Swami, Hsiaoting Regelman, Erkan Hassan
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836860/prospective-multicenter-clinical-trial-of-everolimus-as-primary-therapy-in-waldenstrom-macroglobulinemia-wmctg-09-214
#20
Steven P Treon, Kirsten Meid, Christina Tripsas, Leonard T Heffner, Herbert Eradat, Ashraf Z Badros, Lian Xu, Zachary R Hunter, Guang Yang, Christopher J Petterson, Joshua Gustine, Jorge J Castillo, Jeffrey Matous, Irene M Ghobrial
PURPOSE: Everolimus inhibits mTOR, a component of PI3K/AKT pro-survival signaling triggered by MYD88 and CXCR4 activating mutations in Waldenstrom's Macroglobulinemia (WM). EXPERIMENTAL DESIGN: We evaluated everolimus in a prospective, multicenter study of 33 symptomatic, previously untreated WM patients. Intended therapy consisted of everolimus (10 mg/day) until progression or unacceptable toxicity. Dose de-escalation was permitted. The study was registered at www...
November 11, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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