Drug Regimen for Patients after a Pneumonectomy

Pneumonectomy is an entire lung removal and is indicated for both malignant and benign diseases. Due to its invasiveness and postoperative complications, pneumonectomy is still associated with high mortality and morbidity. Appropriate postoperative management is crucial in pneumonectomy patients to improve quality of life and overall survival rates. Diverse drug regimens are under development to be used in adjuvant chemotherapy or to improve respiratory health after a pneumonectomy. The most common causes for a pneumonectomy are non-small cell lung cancer, malignant pleural mesothelioma, and tuberculosis; thus, an appropriate drug regimen is necessary. The uncommon incidence of pneumonectomy cases remains the major obstacle in studies of postoperative drug regimens. As the majority of current studies include post-lobectomy and post-segmentectomy patients, it is highly recommended that further research of postoperative drug regimens be focused on post-pneumonectomy patients.

Download Full-text

Superselective Radioembolization of Hepatocellular Carcinoma: 5-Year Results of a Prospective Study

Nuklearmedizin ◽

10.1055/s-0038-1629756 ◽

1994 ◽

Vol 33 (05) ◽

pp. 206-214 ◽

Cited By ~ 1

Author(s):

J. Triller ◽

H. U. Baer ◽

Livia Geiger ◽

H. F. Beer ◽

C. Becker ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Survival Rates ◽

Absorbed Dose ◽

Pulmonary Complications ◽

Pulmonary Shunt ◽

Recurrent Tumour ◽

Activity Distribution ◽

A Prospective Study ◽

Overall Survival Rates

SummaryTwenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after ≥300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided.

Download Full-text

Respiratory health impacts quality of life for adults with OI

Bone Abstracts ◽

10.1530/boneabs.7.p105 ◽

2019 ◽

Author(s):

Elizabeth Yonko ◽

Erin Carter ◽

Robert Sandhaus ◽

Cathleen Raggio

Keyword(s):

Quality Of Life ◽

Respiratory Health ◽

Health Impacts

Download Full-text

Quality of cytogenetic investigations: problems and ways for improvement

Nauchno-prakticheskii zhurnal «Medicinskaia genetika» ◽

10.25557/2073-7998.2020.03.22-24 ◽

2020 ◽

pp. 22-24

Author(s):

В.Г. Антоненко ◽

Н.В. Шилова ◽

Е.Н. Лукаш ◽

Э.Р. Бабкеева ◽

В.Н. Малахов

Keyword(s):

Quality Assessment ◽

Russian Federation ◽

Chromosomal Analysis ◽

Common Causes

Представлены результаты экспертной оценки качества цитогенетических исследований в лабораториях РФ в системе межлабораторных сличительных испытаний «ФСВОК» в 2018-2019 гг. Обсуждаются наиболее частые причины неудовлетворительных результатов экспертизы и возможные пути улучшения качества цитогенетических исследований. We report the results of quality assessment for preparation of cytogenetic slides and chromosomal analysis in the laboratories of Russian Federation in the system of the interlaboratory comparative examinations “FSVOK” in 2018-2019. Common causes of poor results of assessment and the ways for improvement of quality for cytogenetic investigations are discussed.

Download Full-text

How to Help Your Patients Enroll in the New-Onset Refractory Status Epilepticus (NORSE) and Febrile Infection-Related Epilepsy Syndrome (FIRES) Family Registry, and Other Rare Epilepsy Registries

Epilepsy Currents ◽

10.1177/1535759721998329 ◽

2021 ◽

pp. 153575972199832

Author(s):

Karnig Kazazian ◽

Marissa Kellogg ◽

Nora Wong ◽

Krista Eschbach ◽

Raquel Farias Moeller ◽

...

Keyword(s):

Status Epilepticus ◽

Refractory Status Epilepticus ◽

Epilepsy Syndrome ◽

Neurologic Disorder ◽

Mortality And Morbidity ◽

Refractory Status ◽

Rigorous Research ◽

Active Epilepsy ◽

New Onset

New-onset refractory status epilepticus (NORSE) is a rare clinical presentation of refractory status epilepticus (RSE) that occurs in people without active epilepsy or preexisting neurologic disorder. Febrile infection-related epilepsy syndrome (FIRES) is a subcategory of NORSE. New-onset refractory status epilepticus/FIRES are becoming increasingly recognized; however, information pertaining to disease course, clinical outcomes, and survivorship remains limited, and mortality and morbidity are variable, but often high. The objective of the NORSE/FIRES Family Registry is to (1) provide an easily accessible and internationally available multilingual registry into which survivors or NORSE/FIRES surrogates or family members of people affected by NORSE/FIRES or their physicians can enter data in a systematic and rigorous research study from anywhere in the world where internet is available; and (2) to examine past medical history, outcomes, and quality of life for people affected by NORSE/FIRES.

Download Full-text

Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues

Innovation in Aging ◽

10.1093/geroni/igaa057.317 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 96-96

Author(s):

Victoria Raveis ◽

Simona Kwon

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivor ◽

Breast Cancer Survivors ◽

Cancer Survival ◽

Survival Rates ◽

Extended Period ◽

Health Issues ◽

Age Related

Abstract Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”

Download Full-text

Case-finding for COPD clinic acceptability to patients in GPs across Hampshire: a qualitative study

npj Primary Care Respiratory Medicine ◽

10.1038/s41533-021-00216-0 ◽

2021 ◽

Vol 31 (1) ◽

Author(s):

Danielle Rose ◽

Emma Ray ◽

Rachael H. Summers ◽

Melinda Taylor ◽

Helen Kruk ◽

...

Keyword(s):

Negative Impact ◽

Case Finding ◽

Lifestyle Changes ◽

Self Management ◽

Mortality And Morbidity ◽

Telephone Interviews ◽

Shared Information ◽

Risk Patients ◽

Perceived Effects

AbstractDespite high mortality and morbidity, COPD remains under-diagnosed. Case-finding strategies are possible, but patients’ perspectives are unexplored. Using qualitative methods, we explored the patient perspective of a case-finding intervention among at-risk patients in primary care. Semi-structured telephone interviews were transcribed and thematic analysis utilised. Seven patients without (mean age 64.5 years (58–74), n = 4) and 8 with obstructed spirometry (mean age 63.5 (53–75), n = 4) were interviewed. Themes identified were motives, challenges and concerns regarding attending the clinic. These included wanting to be well; to help with research; concern over negative impact to life from COPD diagnosis; perceived utility of the clinic; quality of information given; staff manner, approachability and knowledge; and perceived effects of the clinic on lifestyle, self-management and symptoms. The intervention was generally deemed useful and reassuring, although shared information was too detailed or irrelevant for some. Several reported positive lifestyle changes, improved symptoms and improved self-management.

Download Full-text

The Road to Better Management in Resistant Hypertension–Diagnostic and Therapeutic Insights

Pharmaceutics ◽

10.3390/pharmaceutics13050714 ◽

2021 ◽

Vol 13 (5) ◽

pp. 714

Author(s):

Elisabeta Bădilă ◽

Cristina Japie ◽

Emma Weiss ◽

Ana-Maria Balahura ◽

Daniela Bartoș ◽

...

Keyword(s):

Blood Pressure ◽

Resistant Hypertension ◽

Renin Angiotensin System ◽

Drug Regimen ◽

Secondary Hypertension ◽

Adverse Outcomes ◽

Uncontrolled Hypertension ◽

White Coat Hypertension ◽

Mineralocorticoid Receptor Antagonist ◽

Mortality And Morbidity

Resistant hypertension (R-HTN) implies a higher mortality and morbidity compared to non-R-HTN due to increased cardiovascular risk and associated adverse outcomes—greater risk of developing chronic kidney disease, heart failure, stroke and myocardial infarction. R-HTN is considered when failing to lower blood pressure below 140/90 mmHg despite adequate lifestyle measures and optimal treatment with at least three medications, including a diuretic, and usually a blocker of the renin-angiotensin system and a calcium channel blocker, at maximally tolerated doses. Hereby, we discuss the diagnostic and therapeutic approach to a better management of R-HTN. Excluding pseudoresistance, secondary hypertension, white-coat hypertension and medication non-adherence is an important step when diagnosing R-HTN. Most recently different phenotypes associated to R-HTN have been described, specifically refractory and controlled R-HTN and masked uncontrolled hypertension. Optimizing the three-drug regimen, including the diuretic treatment, adding a mineralocorticoid receptor antagonist as the fourth drug, a β-blocker as the fifth drug and an α1-blocker or a peripheral vasodilator as a final option when failing to achieve target blood pressure values are current recommendations regarding the correct management of R-HTN.

Download Full-text

EPEN-49. RESPONSE OF RECURRENT EPENDYMOMA TO MEMMAT BASED METRONOMIC ANTIANGIOGENIC COMBINATION THERAPY UTILIZING TAPERED BEVACIZUMAB AND MAINTENANCE THERAPY WITH CELECOXIB AND FENOFIBRATE

Neuro-Oncology ◽

10.1093/neuonc/noaa222.182 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii317-iii317

Author(s):

Eileen Gillan

Keyword(s):

Combination Therapy ◽

Maintenance Therapy ◽

Survival Rates ◽

Disease Free Survival ◽

Time To Progression ◽

Free Survival ◽

Dismal Prognosis ◽

Recurrent Ependymoma ◽

Disease Free

Abstract Recurrent ependymomas have a dismal prognosis (2 year survival rates 29% OS and 23% EFS) and are relatively resistant to conventional chemotherapy. We previously reported five relapsed ependymoma patients treated with a MEMMAT based metronomic antiangiogenic combination therapy. All patients are currently alive, including four patients who were multiply relapsed with at least three recurrences. These four patients received between 44–52 weeks of therapy with minimal toxicity. Three had recurrent disease within an average of 44 months (median 42 months) after discontinuation of therapy. One patient who received the following tapering bevacizumab schedule: q3 weeks x 3, q4 weeks x 4 and q5 weeks x 5 followed by maintenance therapy with fenofibrate and celecoxib is in complete remission 12 months post treatment. This regimen was well tolerated with good quality of life in this patient population. Our results suggest that the chosen anti-angiogenic drug combination prolonged the time to progression in these multiply relapsed patients and thus may be particularly beneficial for patients with recurrent ependymoma. Tapered bevacizumab and maintenance therapy with celecoxib and fenofibrate may be modifications worth further investigation for prolonged disease free survival in relapsed ependymoma patients.

Download Full-text

Risk of 30-day hospital readmission associated with medical conditions and drug regimens of polymedicated, older inpatients discharged home: a registry-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-052755 ◽

2021 ◽

Vol 11 (7) ◽

pp. e052755

Author(s):

Filipa Pereira ◽

Henk Verloo ◽

Taushanov Zhivko ◽

Saviana Di Giovanni ◽

Carla Meyer-Massetti ◽

...

Keyword(s):

Cohort Study ◽

Hospital Readmission ◽

Hospital Readmissions ◽

Drug Regimen ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Day Hospital ◽

Medical Conditions ◽

Older Inpatients ◽

Drug Regimens

ObjectivesThe present study analysed 4 years of a hospital register (2015–2018) to determine the risk of 30-day hospital readmission associated with the medical conditions and drug regimens of polymedicated, older inpatients discharged home.DesignRegistry-based cohort study.SettingValais Hospital—a public general hospital centre in the French-speaking part of Switzerland.ParticipantsWe explored the electronic records of 20 422 inpatient stays by polymedicated, home-dwelling older adults held in the hospital’s patient register. We identified 13 802 hospital readmissions involving 8878 separate patients over 64 years old.Outcome measuresSociodemographic characteristics, medical conditions and drug regimen data associated with risk of readmission within 30 days of discharge.ResultsThe overall 30-day hospital readmission rate was 7.8%. Adjusted multivariate analyses revealed increased risk of hospital readmission for patients with longer hospital length of stay (OR=1.014 per additional day; 95% CI 1.006 to 1.021), impaired mobility (OR=1.218; 95% CI 1.039 to 1.427), multimorbidity (OR=1.419 per additional International Classification of Diseases, 10th Revision condition; 95% CI 1.282 to 1.572), tumorous disease (OR=2.538; 95% CI 2.089 to 3.082), polypharmacy (OR=1.043 per additional drug prescribed; 95% CI 1.028 to 1.058), and certain specific drugs, including antiemetics and antinauseants (OR=3.216 per additional drug unit taken; 95% CI 1.842 to 5.617), antihypertensives (OR=1.771; 95% CI 1.287 to 2.438), drugs for functional gastrointestinal disorders (OR=1.424; 95% CI 1.166 to 1.739), systemic hormonal preparations (OR=1.207; 95% CI 1.052 to 1.385) and vitamins (OR=1.201; 95% CI 1.049 to 1.374), as well as concurrent use of beta-blocking agents and drugs for acid-related disorders (OR=1.367; 95% CI 1.046 to 1.788).ConclusionsThirty-day hospital readmission risk was associated with longer hospital length of stay, health disorders, polypharmacy and drug regimens. The drug regimen patterns increasing the risk of hospital readmission were very heterogeneous. Further research is needed to explore hospital readmissions caused solely by specific drugs and drug–drug interactions.

Download Full-text

Glycomic-Based Biomarkers for Ovarian Cancer: Advances and Challenges

Diagnostics ◽

10.3390/diagnostics11040643 ◽

2021 ◽

Vol 11 (4) ◽

pp. 643

Author(s):

Francis Mugeni Wanyama ◽

Véronique Blanchard

Keyword(s):

Ovarian Cancer ◽

Survival Rates ◽

Post Translational Modification ◽

Diagnostic Biomarkers ◽

Diagnostic Strategies ◽

Delay In Diagnosis ◽

Common Causes ◽

New Biomarkers ◽

Cure Rates ◽

Developed World

Ovarian cancer remains one of the most common causes of death among gynecological malignancies afflicting women worldwide. Among the gynecological cancers, cervical and endometrial cancers confer the greatest burden to the developing and the developed world, respectively; however, the overall survival rates for patients with ovarian cancer are worse than the two aforementioned. The majority of patients with ovarian cancer are diagnosed at an advanced stage when cancer has metastasized to different body sites and the cure rates, including the five-year survival, are significantly diminished. The delay in diagnosis is due to the absence of or unspecific symptoms at the initial stages of cancer as well as a lack of effective screening and diagnostic biomarkers that can detect cancer at the early stages. This, therefore, provides an imperative to prospect for new biomarkers that will provide early diagnostic strategies allowing timely mitigative interventions. Glycosylation is a protein post-translational modification that is modified in cancer patients. In the current review, we document the state-of-the-art of blood-based glycomic biomarkers for early diagnosis of ovarian cancer and the technologies currently used in this endeavor.

Download Full-text