Esophageal Cancer

2008 ◽  
Vol 6 (9) ◽  
pp. 818 ◽  
Author(s):  
_ _
Keyword(s):  
Esophageal Cancer ◽  
Supportive Care ◽  
High Body Mass Index ◽  
The United States ◽  
Best Supportive Care ◽  
Major Health Problem ◽  
Major Health ◽  
Caucasian Race ◽  
History Of ◽  
Recent Version

Upper gastrointestinal (GI) tract cancers originating in the esophagus, gastroesophageal (GE) junctions, and stomach constitute a major health problem worldwide; esophageal cancer is the eighth most common cancer worldwide. An estimated 16,470 new cases of and 14,280 deaths from esophageal cancer will occur in the United States in 2008. Risk factors associated with development of esophageal cancer include age, male gender, Caucasian race, high body mass index, Barrett's esophagus, and history of gastroesophageal reflux disease. Important updates for the 2009 guidelines include a new page on “Principles of Best Supportive Care” that gives specific recommendations for esophageal cancer best supportive care throughout the guidelines. To view the NCCN Clinical Practice Guidelines in Oncology on Gastric Cancers, please visit the NCCN Web site at www.nccn.org. For the most recent version of the guidelines, please visit NCCN.org

Gastric Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (1) ◽  
pp. 28 ◽  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Major Health Problem ◽  
Major Health ◽  
Recent Version ◽  
Upper Gastrointestinal

Carcinomas originating in the upper gastrointestinal tract constitute a major health problem around the world. In fact, experts estimate that approximately 34,700 new cases of upper gastrointestinal carcinomas and 25,000 deaths will have occurred in the United States in 2002. This article summarizes the NCCN clinical practice guidelines for managing gastric cancer, which portray uniformity in the systemic approach to cancer in the United States. The article also discusses anticipated future advances in the treatment of gastric carcinoma. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States

2021 ◽  
Author(s):  
Nathaniel J Rhodes ◽  
Atheer Dairem ◽  
William J Moore ◽  
Anooj Shah ◽  
Michael J Postelnick ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Drug Therapy ◽  
Supportive Care ◽  
The United States ◽  
Primary Objective ◽  
Point Prevalence ◽  
Medical Centers ◽  
Academic Medical ◽  
History Of ◽  
Secondary Objective

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.

scholarly journals Complementary roles of gasotransmitters CO and H2S in sleep apnea

2017 ◽  
Vol 114 (6) ◽  
pp. 1413-1418 ◽  
Author(s):  
Ying-Jie Peng ◽  
Xiuli Zhang ◽  
Anna Gridina ◽  
Irina Chupikova ◽  
David L. McCormick ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Sleep Apnea ◽  
The United States ◽  
Major Health Problem ◽  
Major Health ◽  
Spontaneously Hypertensive ◽  
Effector Molecule ◽  
Genetic Ablation ◽  
Gaseous Molecule ◽  
Pharmacologic Inhibition

Sleep apnea, which is the periodic cessation of breathing during sleep, is a major health problem affecting over 10 million people in the United States and is associated with several sequelae, including hypertension and stroke. Clinical studies suggest that abnormal carotid body (CB) activity may be a driver of sleep apnea. Because gaseous molecules are important determinants of CB activity, aberrations in their signaling could lead to sleep apnea. Here, we report that mice deficient in heme oxygenase-2 (HO-2), which generates the gaseous molecule carbon monoxide (CO), exhibit sleep apnea characterized by high apnea and hypopnea indices during rapid eye movement (REM) sleep. Similar high apnea and hypopnea indices were also noted in prehypertensive spontaneously hypertensive (SH) rats, which are known to exhibit CB hyperactivity. We identified the gaseous molecule hydrogen sulfide (H2S) as the major effector molecule driving apneas. Genetic ablation of the H2S-synthesizing enzyme cystathionine-γ-lyase (CSE) normalized breathing inHO-2−/−mice. Pharmacologic inhibition of CSE withl-propargyl glycine prevented apneas in bothHO-2−/−mice and SH rats. These observations demonstrate that dysregulated CO and H2S signaling in the CB leads to apneas and suggest that CSE inhibition may be a useful therapeutic intervention for preventing CB-driven sleep apnea.

scholarly journals Hepatotoxicity Associated with Use of the Weight Loss Supplement Garcinia cambogia: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Jiten P. Kothadia ◽  
Monica Kaminski ◽  
Hrishikesh Samant ◽  
Marco Olivera-Martinez
Keyword(s):  
Weight Loss ◽  
Fatty Acid Biosynthesis ◽  
Weight Maintenance ◽  
The United States ◽  
Review Of The Literature ◽  
Acid Biosynthesis ◽  
Major Health Problem ◽  
Garcinia Cambogia ◽  
Major Health ◽  
Therapeutic Doses

The use of herbal and dietary supplements for weight loss is becoming increasingly common as obesity is becoming major health problem in the United States. Despite the popularity of these natural supplements, there are no guidelines for their therapeutic doses and their safety is always a concern. Garcinia cambogia extract with its active ingredient “hydroxycitric acid” is a component of many weight loss regimens. It suppresses fatty acid biosynthesis and decreases appetite. However, its prolonged use in weight maintenance is unknown. Here we describe a case of acute hepatitis after the use of Garcinia cambogia for weight loss.

scholarly journals Fatal Heat Stroke in a Schizophrenic Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
María Jesús Gómez Ramos ◽  
Francisco Miguel González Valverde ◽  
Carmen Sánchez Álvarez ◽  
Lisa Ortin Katnich ◽  
Francisco Pastor Quirante
Keyword(s):  
Supportive Care ◽  
Multiorgan Failure ◽  
Heat Stroke ◽  
Best Supportive Care ◽  
Histological Evaluation ◽  
Life Threatening ◽  
History Of ◽  
Body Cooling ◽  
Salt And Water Balance ◽  
Obesity Hypertension

Objective. The case of a patient who developed a fatal post-exertional heat stroke is reported.Case Report. A 20-year-old man with a history of morbid obesity, hypertension, and schizophrenia was admitted to our intensive care unit because of multiorgan failure due to severe heat stroke. He had been working under the sun. Treatment included aggressive body cooling but, in spite of the best supportive care, the patient succumbed in a few hours. We concluded that the adverse event was possibly associated with his obesity and the use of antipsychotics. Histological evaluation revealed lesions consistent with severe hyperthermia and shock.Conclusions. Heat stroke is an uncommon clinical entity characterized by systemic heat and loss of the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control. When heat stroke is diagnosed early and supportive care begins promptly the prognosis is optimal but it becomes a life-threatening disease when treatment is delayed. Lack of physical acclimatization and the use of certain medications that interfere with salt and water balance can impair thermoregulation under conditions of high environmental temperature. Health professionals must be adequately prepared to prevent, recognise, and treat them urgently.

Management of Suicidal Drug Overdose

1979 ◽  
Vol 1 (6) ◽  
pp. 179-182
Author(s):  
Andrea Marks
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Drug Overdose ◽  
Suicide Attempts ◽  
The United States ◽  
Major Health Problem ◽  
Female Ratio ◽  
Major Health ◽  
Troubled Youth ◽  
Male To Female

INCIDENCE AND EPIDEMIOLOGY Suicide is the third leading cause of death among adolescents, and yet for each fatality it is estimated that between 50 to 200 adolescents survive a suicide attempt. Most of the survivors have taken overdoses of drugs commonly found at home. The rate of suicide attempts that do not result in death peaks in adolescence. The male to female ratio is 1/2 and self-poisoning is usually the method. In contrast, suicide fatality rates generally increase with age. Overall, suicide is the ninth leading cause of death in the United States; the male to female ratio is 3/1; and the method used most often is fire-arms. Clearly, suicidal behavior by adolescents is a major health problem in the United States today. The usual challenge for the pediatrician is first managing an acute drug overdose and then facilitating subsequent psychosocial evaluation of the troubled youth. The key challenge is identification of disturbed individuals and their families prior to any suicidal acts. DIAGNOSIS AND PHYSIOLOGIC MANAGEMENT Most young people who present with a suicidal drug overdose are not comatose; many are asymptomatic. In such situations a careful history may be obtained from the patient to determine: the events surrounding the ingestion, which drug or drugs were taken, how much, and when the ingestion occurred.

Sociodemographic and clinical features of patients with depressive disorder in Khartoum, Sudan

2011 ◽  
Vol 26 (S2) ◽  
pp. 2192-2192
Author(s):  
A. Omer
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Psychiatric Treatment ◽  
Previous History ◽  
Somatic Symptoms ◽  
Psychiatric Clinic ◽  
Major Health Problem ◽  
Major Health ◽  
Prevalence Of Depression ◽  
History Of

Introduction and objectiveIt's known worldwide that depression is becoming a major health problem and its prevalence is increasing. Unfortunately very few studies were done in our country to verify this. The main objective of this study is to find out the prevalence of depression among patients attending a general psychiatric clinic, and demonstrate their Sociodemographic and clinical features.Type of studyThis is a descriptive retrospective study carried in Khartoum, Sudan.MethodFiles of patients attending a private psychiatric clinical in Khartoum in the period June 2005- June 2010 was reviewed. Only those with diagnosis of depression were chosen, socio demographic date and clinical features were documented, results were shown below.Result and discussionTotal numbers of patients with depression were 137 (11.4%) those with schizophrenia are (13%), meaning that patients with schizophrenia are brought with relatives more than patients with depression. Females are more than males (56.2%), the majority are between ages 41---60 (40.9%), married (65%), (14.9%) has got family history of psychiatric disorders, (52%) has previous history of psychiatric treatment. Regarding clinical features, depressed mood is the commonest symptom (98.5%), loss of interest (91.9%), reduced energy (57%), guilt feelings (17.9%) and (35.8%) of our samples expressed suicidal ideations. The commonest type of somatic symptoms is generalized aches and pain (30.7%). (8%) presented with nihilistic delusions. The most common prescribed antidepressants are SSRI.

A Description of How Advanced Practice Nurses Screen for Osteoporosis in Maryland

2016 ◽  
Vol 9 (1) ◽  
pp. 60-68
Author(s):  
Walton Reddish
Keyword(s):  
Nurse Practitioners ◽  
Urban Areas ◽  
Survey Methods ◽  
Advanced Practice Nurses ◽  
The United States ◽  
Advanced Practice ◽  
Major Health Problem ◽  
Major Health ◽  
Doctor Of Nursing Practice ◽  
Practice Nurses

Osteoporosis is a major health problem in the United States, yet the evidence suggests that practitioners often fail to screen for osteoporosis risk and, as a result, underdiagnose and fail to treat the disease. Because little is known about how well advanced practice nurses (APNs) evaluate osteoporotic risk, determining the extent to which they screen may enhance our understanding of the scope of APN diagnostic practice. The purpose of this study was 3-fold: (a) to determine if APNs routinely screen for osteoporotic risks, (b) to ascertain how they screen, and (c) to identify barriers that influence osteoporosis screening. Survey methods were used to poll members of the Nurse Practitioner Association of Maryland (n = 357) who identified themselves as adult, family, geriatric, and women’s health nurse practitioners. The results suggest that master’s-prepared APNs screen for osteoporosis more so than APNs with doctor of nursing practice (DNP) degrees. In addition, adult APN screened more often than family APNs and APNs in urban areas screened more frequently than rural-based APNs. Logistic regression failed to predict which APNs were likely to screen for osteoporosis.

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