scholarly journals Optimizing the Diagnosis and Biomarker Testing for Patients with Intrahepatic Cholangiocarcinoma: A Multidisciplinary Approach

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 392
Author(s):  
May T. Cho ◽  
Sepideh Gholami ◽  
Dorina Gui ◽  
Sooraj L. Tejaswi ◽  
Ghaneh Fananapazir ◽  
...  
Keyword(s):  
Treatment Options ◽  
Biliary Tree ◽  
Physician Education ◽  
Community Healthcare ◽  
Heterogenous Group ◽  
Treatment Paradigm ◽  
Tissue Acquisition ◽  
Biomarker Testing ◽  
Standard Practices ◽  
The University

Cholangiocarcinoma (CCA) is a heterogenous group of malignancies originating in the biliary tree, and associated with poor prognosis. Until recently, treatment options have been limited to surgical resection, liver-directed therapies, and chemotherapy. Identification of actionable genomic alterations with biomarker testing has revolutionized the treatment paradigm for these patients. However, several challenges exist to the seamless adoption of precision medicine in patients with CCA, relating to a lack of awareness of the importance of biomarker testing, hurdles in tissue acquisition, and ineffective collaboration among the multidisciplinary team (MDT). To identify gaps in standard practices and define best practices, multidisciplinary hepatobiliary teams from the University of California (UC) Davis and UC Irvine were convened; discussions of the meeting, including optimal approaches to tissue acquisition for diagnosis and biomarker testing, communication among academic and community healthcare teams, and physician education regarding biomarker testing, are summarized in this review.

scholarly journals Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes

2021 ◽  
pp. 1-7
Author(s):  
Herwig Strik ◽  
Werner Cassel ◽  
Michael Teepker ◽  
Thomas Schulte ◽  
Jorge Riera-Knorrenschild ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Cancer Patients ◽  
Treatment Options ◽  
Ethics Committee ◽  
Breathing Disorders ◽  
The One ◽  
Diagnosis Therapy ◽  
The University ◽  
Insomnia Symptoms

<b><i>Introduction:</i></b> On the one hand, sleep disorders in cancer patients are reported in 30–50% of cancer patients. On the other hand, specific causes for these sleep disorders are little known. This study was done to evaluate factors which may affect sleep of cancer patients. To our knowledge, this is the first study which includes return to work as one factor of sleep disturbance. <b><i>Methods:</i></b> 107 patients with various types of cancer treated in 2 hospitals were interviewed with a battery of questionnaires after having given informed consent. The questionnaires intended to detect abnormalities of sleep and related pain, breathing disorders, restless legs syndrome, depression, rumination, medication, and psychosocial distress. The study was approved by the ethics committee of the University of Marburg. <b><i>Results:</i></b> The analysis of the 6 sleep-related questionnaires indicated a sleep disorder of any kind in 68% of all patients. Insomnia symptoms were present in 48 patients (44.9%). Pain, depression, anxiety, and worries about the workplace were significantly related to sleep disorders. <b><i>Conclusion:</i></b> Sleep disorders are common in cancer patients. The causes are manifold and should be considered by caregivers during diagnosis, therapy, and aftercare of cancer patients. Tumour patients should actively be asked about sleep disorders. If these are present, they should be addressed, and as they have a large impact on quality of life, treatment options should be offered in cooperation with sleep specialists.

Marketing Love: Romance Publishers Mills & Boon and Harlequin Enterprises, 1930–1990

2021 ◽  
pp. 1-31
Author(s):  
DENISE HARDESTY SUTTON
Keyword(s):  
Consumer Goods ◽  
Marketing Strategies ◽  
Direct Mail ◽  
Popular Romance ◽  
British Publisher ◽  
Product Standardization ◽  
University Of Calgary ◽  
Standard Practices ◽  
The University ◽  
Book Publishers

When Harlequin Enterprises acquired British publisher Mills & Boon in 1972, the merged firm became the world’s dominant publisher of popular romance novels. Little is known, however, about the role that innovative marketing strategies played in the growth of these two romance publishing companies, especially their use of product sampling, direct mail, product standardization, and what was known at Mills & Boon as the “personal touch.” Through research in the Mills & Boon company archive at the University of Reading, the Grescoe Archive at the University of Calgary, as well as an analysis of company histories, trade publications, interviews, and marketing techniques, this study reveals how Harlequin and Mills & Boon took a different approach to product promotion than traditional publishers. Their innovation was to incorporate consumer goods marketing strategies, familiar to other industries, that disrupted and redefined standard practices of book publishers.

Attitudes to antipsychotics: a multi-site survey of Canadian psychiatry residents

2018 ◽  
Vol 13 (6) ◽  
pp. 318-338
Author(s):  
Anees Bahji ◽  
Neeraj Bajaj
Keyword(s):  
First Generation ◽  
Treatment Options ◽  
Similar Efficacy ◽  
Psychiatry Residents ◽  
Training Experience ◽  
Content Type ◽  
Electronic Survey ◽  
Site Survey ◽  
Long Acting ◽  
The University

Purpose The purpose of this paper is to identify the training needs of the next generation of psychiatrists, and barriers in prescribing first-generation antipsychotics (FGAs), long-acting injectable (LAIs) antipsychotics and clozapine. Design/methodology/approach An electronic survey was sent to psychiatry residents (N= 75/288, 26 percent) at four Canadian residency programs in late December 2017. The survey was based on an instrument originally developed at the University of Cambridge and consisted of 31 questions in 10 content domains. Findings Nearly 80 percent of residents were aware that FGAs and second-generation antipsychotics (SGAs) have similar efficacy. However, extra-pyramidal symptoms and lack of training experience were the leading concerns associated with the prescribing of FGAs. Although over 90 percent of residents felt confident about initiating an oral SGA as a regular medication, only 40 percent did so with FGAs. Confidence with initiating LAIs and clozapine was 60 and 61 percent, respectively. Practical implications The survey highlights the need for better training in the use of FGAs, clozapine and LAIs. These medications can be effectively used in providing patients with the most appropriate evidence-based treatment options to improve treatment outcomes, while ensuring that these resources are not lost to the future generations of psychiatrists. Originality/value The survey may be the first of its kind to assess antipsychotic prescribing attitudes in Canadian psychiatry residents in multiple sites.

scholarly journals Non-Invasive Cerebellar Stimulation in Neurodegenerative Ataxia: A Literature Review

2020 ◽  
Vol 21 (6) ◽  
pp. 1948 ◽  
Author(s):  
Alberto Benussi ◽  
Alvaro Pascual-Leone ◽  
Barbara Borroni
Keyword(s):  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Physiological Activity ◽  
Treatment Options ◽  
Non Invasive ◽  
Therapeutic Trials ◽  
Degenerative Disorders ◽  
Heterogenous Group ◽  
Cerebellar Ataxias ◽  
Specific Stimulation

Cerebellar ataxias are a heterogenous group of degenerative disorders for which we currently lack effective and disease-modifying interventions. The field of non-invasive brain stimulation has made much progress in the development of specific stimulation protocols to modulate cerebellar excitability and try to restore the physiological activity of the cerebellum in patients with ataxia. In light of limited evidence-based pharmacologic and non-pharmacologic treatment options for patients with ataxia, several different non-invasive brain stimulation protocols have emerged, particularly employing repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) techniques. In this review, we summarize the most relevant rTMS and tDCS therapeutic trials and discuss their implications in the care of patients with degenerative ataxias.

Common Bile Duct MALT Lymphoma: Case Report and Review of the Literature

2006 ◽  
Vol 72 (1) ◽  
pp. 85-88
Author(s):  
Justin Boccardo ◽  
Anjay Khandelwal ◽  
Dongjiu Ye ◽  
Bruce E. Duke
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Biliary Tree ◽  
Review Of The Literature ◽  
Helicobacter Pylori Treatment ◽  
Rare Diagnosis

We report a rare case of common bile duct mucosa-associated lymphoid tissue (MALT) lymphoma treated with pancreatico-duodenectomy with a partial gastrectomy. MALT lymphoma involving the biliary tree is extremely rare. Diagnosis is difficult and treatment options are controversial. Even though Helicobacter pylori treatment is effective in the early stages of the disease, surgery is still helpful especially when obstruction, perforation, or bleeding is present.

scholarly journals Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

2020 ◽  
Vol 08 (10) ◽  
pp. E1315-E1320
Author(s):  
Benedetto Mangiavillano ◽  
Leonardo Sosa-Valencia ◽  
Pierre Deprez ◽  
Pierre Eisendrath ◽  
Carlos Robles-Medranda ◽  
...  
Keyword(s):  
Treatment Options ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Fine Needle ◽  
Oncological Treatment ◽  
Pancreatic Masses ◽  
Tissue Acquisition ◽  
Acquisition Technique

Abstract Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.

scholarly journals Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

2011 ◽  
Vol 93 (8) ◽  
pp. 591-595 ◽  
Author(s):  
JS Williamson ◽  
D Ingrams ◽  
H Jones
Keyword(s):  
Quality Of Life ◽  
Laryngeal Cancer ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Social Eating ◽  
Basic Functions ◽  
Primary Radiotherapy ◽  
The University

INTRODUCTION Laryngeal cancer treatment inherently affects life's most basic functions and significantly affects quality of life (QOL). We aimed to identify which aspects of QOL and which patients are most affected by the various treatment options. METHODS The University of Washington Quality of Life (UW-QOL) questionnaire was administered to all patients with laryngeal cancer treated at a single institution over a seven-year period (2003–2010). RESULTS In total, 41 patients responded. All had been treated for squamous cell carcinoma of the larynx. Questionnaires were completed at a median of 18.5 months after treatment. The overall quality of life was 81.1/100 as assessed by the UW-QOL scale, with only 4.9% reporting ‘poor’ or worse QOL. Neither patient age nor time after treatment significantly affected any aspect of QOL. Patients undergoing primary radiotherapy reported the best QOL. Those undergoing chemoradiotherapy or combined surgical treatment and chemoradiotherapy reported the worst QOL, particularly in terms of social eating, taste and saliva production. Patients with a T stage ≥2 and those with nodal metastases reported a significantly worse QOL. CONCLUSIONS Overall, QOL in our patients was good. This study highlights the aspects of QOL most affected by various treatments for laryngeal cancer and identifies areas in which therapeutic intervention may be focused. It also provides information to guide clinicians when assisting patients to make informed decisions regarding treatment of their head and neck cancer.

Study of ten anatomical variants of the foot and ankle

1996 ◽  
Vol 86 (11) ◽  
pp. 532-537 ◽  
Author(s):  
DM Chaney ◽  
MS Lee ◽  
MA Khan ◽  
WA Krueger ◽  
VJ Mandracchia ◽  
...  
Keyword(s):  
Sample Size ◽  
Treatment Options ◽  
Total Sample ◽  
Occurrence Rate ◽  
Anatomical Variants ◽  
Flexor Digitorum Brevis ◽  
Physician Awareness ◽  
Definition Of ◽  
Flexor Digitorum ◽  
The University

This study examined the occurrence rate of ten lower extremity anatomical variants occurring over a 6-year period from 1988 to 1994 in a sample range of 166 to 279 cadavers at the University of Osteopathic Medicine and Health Sciences. Literature review of these anomalies shows similar findings for all presented structures with the exception of two. The peroneus quartus muscle was found to be significantly less prevalent than previous studies have indicated. This difference may be attributed to the larger sample size used in this study or differences of interpretation of the definition of the peroneus quartus muscle. Additionally, the flexor digitorum brevis tendon to the fifth digit was found to be absent much more than Sarrafian reports in a total sample size of 926. The importance of these anatomical variants, both in surgery and while using advanced diagnostic imaging such as computed tomography and magnetic resonance imaging, should be realized by the podiatric physician. Awareness of these variants will decrease confusion when considering treatment options.

Low-Grade Lymphoma

Hematology ◽  
2004 ◽  
Vol 2004 (1) ◽  
pp. 203-220 ◽  
Author(s):  
Jane N. Winter ◽  
Randy D. Gascoyne ◽  
Koen Van Besien
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Allogeneic Transplantation ◽  
Low Grade ◽  
Non Hodgkin Lymphoma ◽  
Treatment Paradigm ◽  
Optimal Approach

Abstract Folicular lymphoma (FL), the second most common subtype of non-Hodgkin lymphoma, shows considerable heterogeneity in its clinical behavior, representative of a biology that appears increasingly complex and diverse. As our knowledge of the molecular basis of FL increases, we strive for an integration between the bench and clinic that yields treatments based on our scientific understanding and biomarkers that allow us to prescribe treatment rationally. In Section I, Dr. Randy Gascoyne describes the histologic, cytogenetic and biologic features of FL that underlie its clinical variability. Key aspects of the pathologic diagnosis of FL that have particular relevance to the clinician are highlighted. A proposed model for follicular lymphomagenesis and diffuse large B cell lymphoma transformation has emerged and continues to evolve as the molecular story unfolds. A biologic basis for clinical outcome in FL also appears to be forthcoming. In Section II, Dr. Jane Winter addresses the complex process of selecting among the many treatment options for patients with FL. Previously a simple matter of deciding between oral or intravenous alkylators, clinicians and patients must now struggle to choose among vastly different approaches ranging from “watch and wait” to stem cell transplantation. The introduction of rituximab and radioimmunoconjugates is changing the treatment paradigm, but the optimal approach to integrating these and other new agents remains to be determined. At every decision point, the best approach is always a clinical trial. In Section III, Dr. Koen Van Besien provides a well-documented update on outcomes associated with autologous and allogeneic stem cell transplantation for FL. The results of trials of autologous stem cell transplantation in first remission and recent data supporting a role for graft purging are discussed. Based on the premise that a graft-versus-lymphoma effect is operative in FL, reduced-intensity allogeneic transplantation is the preferred approach in many cases, and recently reported results are summarized. Criteria for patient selection and the optimal role of transplantation in the overall therapeutic plan for the patient with FL are presented.

Identifying education, knowledge and communication gaps in biomarker testing between YO-CRC patients, caregivers, and their medical team.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16115-e16115
Author(s):  
Kim Lynn Newcomer ◽  
Danielle Peterson ◽  
Ronit Yarden ◽  
Keyword(s):  
Online Survey ◽  
Medical Information ◽  
Treatment Plan ◽  
Treatment Options ◽  
Stage Iv ◽  
Public Health Issue ◽  
Medical Team ◽  
Cross Sectional ◽  
Patient Reported ◽  
Biomarker Testing

e16115 Background: The proportion of new young-onset colorectal cancer (YO-CRC) cases diagnosed in young people (20-49) had doubled over the past 3 decades, and it is becoming an alarming public health issue. YO-CRC patients face unique clinical challenges, as many are diagnosed at advanced stages of the disease and subjected to aggressive treatments. With the increase of targeted therapies and precision medicine available, NCCN and ASCO guidelines recommend that all stage IV, metastatic CRC patients be tested for 4 biomarkers in addition to MSI-H. However, not all eligible patients benefit from biomarker testing and biomarker-driven therapies. Methods: We conducted an online survey to assess patients, survivors and caregivers’ knowledge and understanding of biomarker testing and whether they feel empowered to discuss with their doctor different treatment options based on their unique tumor characteristics and their preferences. Results: The cross-sectional study was completed by patients and survivors (N = 885) and unrelated caregivers of YO-CRC patients (N = 203). The median age of patients and survivors was 42, and the median age of caregivers was also 42. The majority of the participants were college graduates. Although 82% of stage IV, YO-CRC patients felt informed before treatment began, only 70% indicated their tumor was tested for biomarkers, and 54% of them received biomarker testing before treatment initiation. Only 33% of patients reported they became aware of biomarkers by their medical team while others indicated resources such as internet searches, family and friends, or patient navigators. Many of the caregivers who reported that they served as a liaison between patients and medical information retrieval felt that they did not fully understand the critical aspects of the patients' medical treatment plan. Conclusions: Multiple studies have shown that patient-centered care improves patients’ outcomes. Our organization encourages patients and their families to use medical information to navigate their journey. Our patient-reported study suggests that there are gaps in patients’ and caregiver’s understanding of biomarker testing that may hinder patient's empowerment for reaching evidence-based shared-decision treatment plan together with their physicians.

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