Medical Management of Wilms Tumor

2019 ◽  
Author(s):  
Sei-Gyung K. Sze ◽  
Elisabeth T. Tracy ◽  
Jonathan C. Routh ◽  
Henry E. Rice ◽  
Daniel S. Wechsler
Keyword(s):  
Late Effects ◽  
Wilms Tumor ◽  
Treatment Strategies ◽  
The United States ◽  
Current Treatment ◽  
Childhood Cancers ◽  
Improve Risk Stratification ◽  
Risk Patients ◽  
Cure Rates ◽  
Radiotherapy Treatment

Wilms tumor (WT) is the most common renal tumor of childhood and accounts for 5-7% of all childhood cancers. Remarkable progress in the treatment of WT has been made in the last several decades through collaborative clinical trials in the United States and Europe. With a multimodal approach including chemotherapy, surgery, and radiation therapy, overall survival for WT is greater than 90%. However, there remains a subgroup of patients for which cure remains a challenge, and late effects of therapy are significant. New insights into clinical and biologic prognostic markers are being used to improve risk stratification and to tailor therapy to individual patients. Current treatment strategies aim to maintain excellent survival while reducing late effects for low-risk patients and optimize therapy to improve cure rates for high-risk patients. This review contains 1 figures, 4 tables, and 45 references.  Key Words: chemotherapy, COG, kidney neoplasms, nephroblastoma, NWTS, pediatric cancer, radiotherapy, treatment outcome, SIOP, Wilms tumor

Anosmia: Differential Diagnosis, Evaluation, and Management

2017 ◽  
Vol 31 (1) ◽  
pp. e3-e7 ◽  
Author(s):  
George A. Scangas ◽  
Benjamin S. Bleier
Keyword(s):  
Differential Diagnosis ◽  
Negative Impact ◽  
Treatment Strategies ◽  
Communication Disorders ◽  
The United States ◽  
Current Treatment ◽  
Olfactory Dysfunction ◽  
Olfactory Testing ◽  
Smell Disorders

The ability to scrutinize our surroundings remains heavily dependent on the sense of smell. From the ability to detect dangerous situations such as fires to the recollection of a fond memory triggered by an odor, the advantages of an intact olfactory system cannot be overstated. Outcomes studies have highlighted the profound negative impact of anosmia and parosmia on the overall quality of life. The National Institute on Deafness and Other Communication Disorders estimates that ∼1.4% of the United States population experiences chronic olfactory dysfunction and smell loss. Efforts have focused on improving both the diagnosis of olfactory dysfunction through olfactory testing and improved reporting of treatment outcomes of olfactory training. The purpose of this article was to review the differential diagnosis, workup, and current treatment strategies of anosmia and smell disorders.

scholarly journals The 30 Top-Cited Articles on Os Odontoideum: A Bibliometric Study

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Weixin Li
Keyword(s):  
Clinical Management ◽  
Treatment Strategies ◽  
The United States ◽  
Current Treatment ◽  
Os Odontoideum ◽  
Journal Title ◽  
University Of Iowa ◽  
Total Citation ◽  
Average Citation ◽  
Number Of Citations

Objective: To evaluate the top 30 most-cited articles in the literature on os odontoideum. Methods: A search using the Web of Science database and the search phrase "os odontoideum" was conducted. The 30 most-cited articles on osodontoideum were analyzed. The study was performed in May 2020. We searched for articles published between 1920 and 2020. Articles were sorted and ranked according to the total number of citations. We evaluated the following information of each article, including first author, journal, title, number of citations, average citation per year, and author affiliation. Results: A total of 357 studies matched our search criteria, of which the top 30 most-cited ranged between 232 and 60 citations. The article by Dickman et al. published in Neurosurgery, was the most-cited article with a total citation of 232, followed by Dickman et al. with 221 and Smoker et al. with 179. Menezes was the most cited first authors, with 4 articles, followed by Dickman with 3 articles. Child's Nervous System, Journal of Neurosurgery, and Spine were three most frequent destination journals. Most of the articles originated from the United States (n=24) and University of Iowa Hospitals and Clinics published 6 articles and was the highest in the number of most-cited articles. Most of the articles focused on the clinical management of osodontoideum (83.3%). Conclusion: The current study confers a better understanding of current treatment strategies and the advances in the management of osodontoideum. It helps guide the clinical management and academic achievements.

scholarly journals Current Targeted Therapies for the Fight against Non-Small Cell Lung Cancer

2020 ◽  
Vol 13 (11) ◽  
pp. 374
Author(s):  
Lisa Mustachio ◽  
Jason Roszik
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Targeted Therapies ◽  
Treatment Strategies ◽  
The United States ◽  
Current Treatment ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancers

Lung cancers contribute to the greatest number of cancer-related deaths worldwide and still pose challenges in response to current treatment strategies. Non-small cell lung cancer (NSCLC) accounts for over 85% of lung cancers diagnosed in the United States and novel therapeutics are needed for the treatment of this disease. First and second generation targeted therapies against specific mutated or rearranged oncogenes in NSCLCs show anti-tumor activity and also increase survival. However, many NSCLC patients eventually develop resistance to these therapies or do not properly respond if they have central nervous system metastases. Thus, this review summarizes recent developments and findings related to the generation of novel targeted therapies recently or currently being developed to tackle hurdles that prior therapies were not able to overcome.

Peripartum Cardiomyopathy

2017 ◽  
Author(s):  
Emily J. Baird
Keyword(s):  
Heart Failure ◽  
Treatment Strategies ◽  
The United States ◽  
Current Treatment ◽  
Peripartum Cardiomyopathy ◽  
Clinical Suspicion ◽  
Maternal Deaths ◽  
Pregnancy And Lactation ◽  
Peripartum Period ◽  
Pathophysiologic Mechanisms

Peripartum cardiomyopathy (PPCM) is an idiopathic form of heart failure that manifests during the last month of pregnancy or the first 5 months postpartum. Although the incidence is relatively low, the maternal impact is high, with up to 12% of maternal deaths in the United States resulting from sequelae of PPCM. Risk factors are poorly understood at the present time, as are the pathophysiologic mechanisms. Timely diagnosis continues to be a challenge, since many of the symptoms of PPCM mimic those commonly encountered during the normal peripartum period. Management of PPCM parallels current heart failure guidelines, with special consideration to the safety of medications and interventions during pregnancy and lactation. This chapter discusses proper clinical suspicion, processes for diagnosis, and current treatment strategies as well as the overall prognosis.

scholarly journals Case Study of Onychomycosis Patients Treated with 1,064-nm Nd:YAG Laser

2018 ◽  
Vol 10 (2) ◽  
pp. 216-225 ◽  
Author(s):  
Rachel Bertolani do Espírito Santo ◽  
Patrícia Duarte Deps
Keyword(s):  
Laser Treatment ◽  
Laser Therapy ◽  
Nd:Yag Laser ◽  
Evaluation Method ◽  
Treatment Strategies ◽  
Severity Index ◽  
Current Treatment ◽  
Significant Difference ◽  
Cure Rates

Onychomycosis is the most frequent nail disease, with an estimated prevalence of 2–8%. Current treatment strategies include the use of oral and topical antifungals, despite low cure rates following these treatments. The objectives of this study were to assess the therapeutic response of patients with onychomycosis to 1,064-nm Nd:YAG laser treatment, the clinical evaluation method available for this therapy, and the possible side effects of this treatment. Twenty patients with onychomycosis underwent laser therapy. A total of 34 nails with onychomycosis were assessed according to the Onychomycosis Severity Index (OSI). This index generates scores that classify onychomycosis as mild, moderate, or severe. The OSI was determined before treatment and after a mean follow-up period of 8 months. The comparison between the initial and the final OSI for all 34 nails treated with laser therapy showed a significant difference; however, a low association was shown between these variables. A general reduction in the area of involvement and in the OSI numerical scores was observed. These data show a trend toward improvement in onychomycosis treated with 1,064-nm Nd:YAG laser. The OSI allowed an adequate clinical assessment of the response to laser therapy. Laser treatment did not cause marked discomfort in most patients, indicating that laser is a well-tolerated procedure.

Novel Approaches to the Treatment of Acute Myeloid Leukemia

Hematology ◽  
2011 ◽  
Vol 2011 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Gail J. Roboz
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Residual Disease ◽  
Molecular Genetic ◽  
Treatment Strategies ◽  
Standard Of Care ◽  
The United States ◽  
Current Treatment ◽  
Treatment Standards ◽  
Acute Myeloid

Abstract Approximately 12 000 adults are diagnosed with acute myeloid leukemia (AML) in the United States annually, the majority of whom die from their disease. The mainstay of initial treatment, cytosine arabinoside (ara-C) combined with an anthracycline, was developed nearly 40 years ago and remains the worldwide standard of care. Advances in genomics technologies have identified AML as a genetically heterogeneous disease, and many patients can now be categorized into clinicopathologic subgroups on the basis of their underlying molecular genetic defects. It is hoped that enhanced specificity of diagnostic classification will result in more effective application of targeted agents and the ability to create individualized treatment strategies. This review describes the current treatment standards for induction, consolidation, and stem cell transplantation; special considerations in the management of older AML patients; novel agents; emerging data on the detection and management of minimal residual disease (MRD); and strategies to improve the design and implementation of AML clinical trials.

scholarly journals Melittin Increases Cisplatin Sensitivity and Kills KM-H2 and L-428 Hodgkin Lymphoma Cells

2020 ◽  
Vol 22 (1) ◽  
pp. 343
Author(s):  
Teresa Kreinest ◽  
Ines Volkmer ◽  
Martin S. Staege
Keyword(s):  
Hodgkin Lymphoma ◽  
Tumor Cells ◽  
Abc Transporters ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Lipid Bilayer Membranes ◽  
Bilayer Membranes ◽  
Resistant Disease ◽  
Cisplatin Sensitivity ◽  
Cure Rates

Hodgkin lymphoma (HL) is neoplasia with high cure rates. However, not all patients can be cured with the current treatment. Chemo-resistance of tumor cells is one factor involved in treatment failure. In addition to its pore-forming activity on lipid bilayer membranes, the toxin melittin from bee venom is an inhibitor of several cancer-related signaling pathways. Moreover, melittin analogs have been shown to inhibit the activity of ATP binding cassette (ABC) transporters which are known to play important roles in the chemo-resistance of tumor cells. Therefore, we tested the toxicity of melittin for HL cell lines KM-H2 and L-428 and whether melittin can increase the chemo-sensitivity of cisplatin-resistant HL cells. We found high toxicity of melittin for KM-H2 and L-428 cells. In co-cultures with normal blood cells, melittin preferentially killed KM-H2 and L-428 cells. In addition, we observed increased cisplatin sensitivity of chemo-resistant L-428 cells after treatment with melittin. ABC transporter activity was not reduced after treatment with melittin. Our data suggest that melittin or melittin analogs might be promising agents for the future development of treatment strategies for HL patients with resistant disease.

scholarly journals Challenges in the management of Wilms Tumor in a developing country: A twenty years experience from a single centre in Pakistan.

2021 ◽  
Author(s):  
Muhammad Khan ◽  
Ata Maaz ◽  
Muhammad Ashraf
Keyword(s):  
Wilms Tumor ◽  
Childhood Cancers ◽  
Single Centre ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Resource Poor ◽  
Prior Surgery ◽  
Cure Rates ◽  
Work Up

Background: Wilms Tumour (WT) is one of the most curable childhood cancers. High cure rates seen in the high-income countries are not duplicated in low and middle-income countries due to several constraints. We reviewed our data over the last 20 years in order to highlight some of these challenges. Methods: This is a retrospective review of medical notes of children with WT under the age of 18 years presenting to our institution between 1 November 1997 and 30 November 2017. Demographic, presentation and treatment details were recorded and factors associated with poor outcome were analysed. Results: Of the 211 children presenting with WT 117(55.5%) were males. Median age at presentation was 3 (Range 0-18) years. One hundred and twelve (53.7%) of these presented without any prior treatment, while 72 (34.1%) presented after tumour excision. Metastatic status was available for 178 patients; 117 (68%) had localised tumours, 36(21.8%) had metastatic disease and 25(11.9%) presented with recurrent mass. Thirty-nine (18.4%) patients refused treatment and 6(2.8%) died before starting treatment. During treatment, 23(13.4%) children died and 21(12.2%) abandoned. Only 99 patients finished treatment, 83 (83.8%) of whom are well off therapy and 15 (15.2%) have relapsed. Six (40%) of the 15 children who relapsed are alive after salvage therapy, while the remaining 9 (60%) have died. Conclusions: Our data highlights the challenges of managing WT in resource poor environments. Prior surgery, incomplete staging work-up and abandonment are some of the most frequently encountered barriers. A multipronged approach is required to overcome these challenges.

Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

2008 ◽  
Vol 15 (3) ◽  
pp. 66-72 ◽  
Author(s):  
José G. Centeno
Keyword(s):  
Stroke Rehabilitation ◽  
Culturally Diverse ◽  
Treatment Strategies ◽  
The United States ◽  
Intervention Strategies ◽  
Steady Increase ◽  
Clinical Procedures ◽  
Bilingual Speakers ◽  
Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Ernemann ◽  
Bender ◽  
Melms ◽  
Brechtel ◽  
Kobba ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Carotid Bifurcation ◽  
Current Treatment ◽  
Long Term Results ◽  
Clinical Indication ◽  
Interventional Treatment ◽  
Special Focus ◽  
Brachiocephalic Artery ◽  
Treatment Concepts ◽  
Angioplasty And Stenting

Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.

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