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Medical Specialties Commons™

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Articles 1231 - 1260 of 2016

Full-Text Articles in Medical Specialties

Evaluating Ct Perfusion Deficits In Global Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage, H. Baradaran, V. Fodera, D. Mir, K. Kesavobhotla, J. Ivanidze, U. Ozbek, A. Gupta, J. Claassen, P. C. Sanelli Jan 2015

Evaluating Ct Perfusion Deficits In Global Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage, H. Baradaran, V. Fodera, D. Mir, K. Kesavobhotla, J. Ivanidze, U. Ozbek, A. Gupta, J. Claassen, P. C. Sanelli

Journal Articles

BACKGROUND AND PURPOSE: Global cerebral edema is an independent predictor of mortality and poor outcomes after aneurysmal SAH. Global cerebral edema, a complex disease process, is thought to be associated with an altered cerebral autoregulatory response. We studied the association between cerebral hemodynamics and early global cerebral edema by using CTP. MATERIALS AND METHODS: We retrospectively studied consecutive patients with aneurysmal SAH with admission CTP performed at days 0-3. Two neuroradiologists classified global cerebral edema and hydrocephalus on NCCT performed concurrently with CTP. Global cerebral edema was defined as diffuse effacement of the sulci and/or basal cisterns or diffuse disruption …

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Sparsity Techniques In Medical Imaging, R. Fang, T. Chen, D. Metaxas, P. Sanelli, S. Zhang Jan 2015

Sparsity Techniques In Medical Imaging, R. Fang, T. Chen, D. Metaxas, P. Sanelli, S. Zhang

Journal Articles

No abstract provided.

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Effect Of Reconstruction Algorithms On The Accuracy Of (99m)Tc Sestamibi Spect/Ct Parathyroid Imaging, K. J. Nichols, G. G. Tronco, C. J. Palestro Jan 2015

Effect Of Reconstruction Algorithms On The Accuracy Of (99m)Tc Sestamibi Spect/Ct Parathyroid Imaging, K. J. Nichols, G. G. Tronco, C. J. Palestro

Journal Articles

The superiority of SPECT/CT over SPECT for (99m)Tc-sestamibi parathyroid imaging often is assumed to be due to improved lesion localization provided by the anatomic component (computed tomography) of the examination. It also is possible that this superiority may be related to the algorithms used for SPECT data reconstruction. The objective of this investigation was to determine the effect of SPECT reconstruction algorithms on the accuracy of MIBI SPECT/CT parathyroid imaging. We retrospectively analyzed preoperative MIBI SPECT/CT parathyroid imaging studies performed on 106 patients. SPECT data were reconstructed by filtered back projection (FBP) and by iterative reconstruction with corrections for collimator …

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Carotid Artery Stenosis: Cost-Effectiveness Of Assessment Of Cerebrovascular Reserve To Guide Treatment Of Asymptomatic Patients, A. Pandya, A. Gupta, H. Kamel, B. B. Navi, P. C. Sanelli, B. R. Schackman Jan 2015

Carotid Artery Stenosis: Cost-Effectiveness Of Assessment Of Cerebrovascular Reserve To Guide Treatment Of Asymptomatic Patients, A. Pandya, A. Gupta, H. Kamel, B. B. Navi, P. C. Sanelli, B. R. Schackman

Journal Articles

PURPOSE: To project and compare the lifetime health benefits, health care costs, and incremental cost-effectiveness of a decision rule based on assessment of cerebrovascular reserve (CVR) compared with medical therapy and immediate revascularization in asymptomatic patients with carotid artery stenosis for prevention of stroke. MATERIALS AND METHODS: The three strategies compared included immediate revascularization (carotid endarterectomy) and ongoing medical therapy (with antiplatelet, statin, and antihypertensive agents plus lifestyle modification), medical therapy-based treatment with revascularization only for patients who progressed, and use of a CVR-based decision rule for treatment in which patients with CVR impairment undergo immediate revascularization and all others …

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The Role Of Factor Xa Inhibitors In Venous Thromboembolism Treatment, K. P. Cabral, J. E. Ansell Jan 2015

The Role Of Factor Xa Inhibitors In Venous Thromboembolism Treatment, K. P. Cabral, J. E. Ansell

Journal Articles

Three factor Xa inhibitors have been studied in the treatment of venous thromboembolism, both for acute therapy and as extended therapy to prevent recurrent events. Rivaroxaban, apixaban, and edoxaban have all proven to be effective in Phase III clinical trials for this indication when compared to current standard of therapy with similar or less bleeding. Nevertheless, the agents all offer different pharmacological profiles, which have an impact on patient selection and potential advantages in clinical practice.

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Reducing The Risk For Waterborne Nosocomial Neonatal Legionellosis, J. S. Cervia Jan 2015

Reducing The Risk For Waterborne Nosocomial Neonatal Legionellosis, J. S. Cervia

Journal Articles

No abstract provided.

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Romidepsin In Peripheral And Cutaneous T-Cell Lymphoma: Mechanistic Implications From Clinical And Correlative Data, S. E. Bates, R. Eisch, A. Ling, D. Rosing, M. Turner, S. Pittaluga, H. M. Prince, M. H. Kirschbaum, S. L. Allen, R. L. Piekarz, +15 Additional Authors Jan 2015

Romidepsin In Peripheral And Cutaneous T-Cell Lymphoma: Mechanistic Implications From Clinical And Correlative Data, S. E. Bates, R. Eisch, A. Ling, D. Rosing, M. Turner, S. Pittaluga, H. M. Prince, M. H. Kirschbaum, S. L. Allen, R. L. Piekarz, +15 Additional Authors

Journal Articles

Romidepsin is an epigenetic agent approved for the treatment of patients with cutaneous or peripheral T-cell lymphoma (CTCL and PTCL). Here we report data in all patients treated on the National Cancer Institute 1312 trial, demonstrating long-term disease control and the ability to retreat patients relapsing off-therapy. In all, 84 patients with CTCL and 47 with PTCL were enrolled. Responses occurred early, were clinically meaningful and of very long duration in some cases. Notably, patients with PTCL receiving romidepsin as third-line therapy or later had a comparable response rate (32%) of similar duration as the total population (38%). Eight patients …

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Therapeutic Potential Of New B Cell-Targeted Agents In The Treatment Of Elderly And Unfit Patients With Chronic Lymphocytic Leukemia, K. R. Rai Jan 2015

Therapeutic Potential Of New B Cell-Targeted Agents In The Treatment Of Elderly And Unfit Patients With Chronic Lymphocytic Leukemia, K. R. Rai

Journal Articles

Chronic lymphocytic leukemia (CLL), the most common adult leukemia in the Western world, is primarily a disease of the elderly, with most patients >= 65 years of age and having at least one major comorbidity. Aggressive chemoimmunotherapy regimens recommended to achieve remission and improve survival in young, fit patients are often poorly tolerated in elderly and/or less physiologically fit ("unfit") patients, necessitating alternative treatment options. Although patient age, fitness, and comorbidities are key considerations in the selection of a treatment regimen, historically, clinical trials have been limited to young, fit patients by virtue of the ethical concerns associated with potential …

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Multicenter Randomized Controlled Trial On Duration Of Therapy For Thrombosis In Children And Young Adults (The Kids-Dott Trial): Pilot/Feasibility Phase Findings, N. A. Goldenberg, T. Abshire, P. J. Blatchford, L. Z. Fenton, J. L. Halperin, W. R. Hiatt, C. M. Kessler, J. M. Kittelson, A. C. Spyropoulos, S. Schulman, +4 Additional Authors Jan 2015

Multicenter Randomized Controlled Trial On Duration Of Therapy For Thrombosis In Children And Young Adults (The Kids-Dott Trial): Pilot/Feasibility Phase Findings, N. A. Goldenberg, T. Abshire, P. J. Blatchford, L. Z. Fenton, J. L. Halperin, W. R. Hiatt, C. M. Kessler, J. M. Kittelson, A. C. Spyropoulos, S. Schulman, +4 Additional Authors

Journal Articles

BACKGROUND: Randomized controlled trials (RCTs) on pediatric venous thromboembolism (VTE) treatment have been challenged by unsubstantiated design assumptions and/or poor accrual. Pilot/feasibility (P/F) studies are critical to future RCT success. METHODS: The Kids-DOTT trial is a multicenter RCT investigating non-inferiority of a 6-week (shortened) versus 3-month (conventional) duration of anticoagulation in patients aged < 21 years with provoked venous thrombosis. Primary efficacy and safety endpoints are symptomatic recurrent VTE at 1 year and anticoagulant-related, clinically relevant bleeding. In the P/F phase, 100 participants were enrolled in an open, blinded-endpoint, parallel-cohort RCT design. RESULTS: No eligibility violations or randomization errors occurred. Of the enrolled patients, 69% were randomized, 3% missed the randomization window, and 28% were followed in prespecified observational cohorts for completely occlusive thrombosis or persistent antiphospholipid antibodies. Retention at 1 year was 82%. Interobserver agreement between local and blinded central determination of venous occlusion by imaging at 6 weeks after diagnosis was strong (k-statistic = 0.75; 95% confidence interval [CI] 0.48-1.0). The primary efficacy and safety event rates were 3.3% (95% CI 0.3-11.5%) and 1.4% (95% CI 0.03-7.4%). CONCLUSIONS: The P/F phase of the Kids-DOTT trial has demonstrated the validity of vascular imaging findings of occlusion as a randomization criterion, and defined randomization, retention and endpoint rates to inform the fully powered RCT.

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On The Safety Of Intravenous Iron, Evidence Trumps Conjecture, M. Auerbach, J. Adamson, A. Bircher, C. Breymann, S. Fishbane, A. Gafter-Gvili, C. Gasche, J. Gilreath, G. Grazzini, A. Shander, +7 Additional Authors Jan 2015

On The Safety Of Intravenous Iron, Evidence Trumps Conjecture, M. Auerbach, J. Adamson, A. Bircher, C. Breymann, S. Fishbane, A. Gafter-Gvili, C. Gasche, J. Gilreath, G. Grazzini, A. Shander, +7 Additional Authors

Journal Articles

No abstract provided.

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The Orbit Bleeding Score: A Simple Bedside Score To Assess Bleeding Risk In Atrial Fibrillation, E. C. O'Brien, D. N. Simon, L. E. Thomas, E. M. Hylek, B. J. Gersh, J. E. Ansell, P. R. Kowey, K. W. Mahaffey, P. Chang, E. D. Peterson, +3 Additional Authors Jan 2015

The Orbit Bleeding Score: A Simple Bedside Score To Assess Bleeding Risk In Atrial Fibrillation, E. C. O'Brien, D. N. Simon, L. E. Thomas, E. M. Hylek, B. J. Gersh, J. E. Ansell, P. R. Kowey, K. W. Mahaffey, P. Chang, E. D. Peterson, +3 Additional Authors

Journal Articles

BACKGROUND: Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. OBJECTIVES: We sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based AF population. METHODS: We analysed data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), a prospective registry that enrolled incident and prevalent AF patients at 176 US sites. Using Cox proportional hazards regression, we identified factors independently associated with major bleeding among patients taking oral anticoagulation (OAC) over a median …

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Phase Ii, Multicenter, Randomized Trial Of Cpx-351 (Cytarabine: Daunorubicin) Liposome Injection Versus Intensive Salvage Therapy In Adults With First Relapse Aml, J. E. Cortes, S. L. Goldberg, E. J. Feldman, D. A. Rizzeri, D. E. Hogge, M. Larson, A. Pigneux, C. Recher, G. Schiller, J. E. Kolitz, +3 Additional Authors Jan 2015

Phase Ii, Multicenter, Randomized Trial Of Cpx-351 (Cytarabine: Daunorubicin) Liposome Injection Versus Intensive Salvage Therapy In Adults With First Relapse Aml, J. E. Cortes, S. L. Goldberg, E. J. Feldman, D. A. Rizzeri, D. E. Hogge, M. Larson, A. Pigneux, C. Recher, G. Schiller, J. E. Kolitz, +3 Additional Authors

Journal Articles

BACKGROUNDCPX-351 is a liposome-encapsulated fixed-molar-ratio formulation of cytarabine and daunorubicin that exploits molar ratio-dependent drug-drug synergy to enhance antileukemic efficacy. METHODSThis phase II study randomized 125 patients 2:1 to CPX-351 or investigators' choice of first salvage chemotherapy. Patients with acute myeloid leukemia (AML) in first relapse after initial Complete Remission (CR) lasting 1 month were stratified per the European Prognostic Index (EPI) into favorable, intermediate, and poor-risk groups based on duration of first CR, cytogenetics, age, and transplant history. Control salvage treatment was usually based on cytarabine and anthracycline, often with 1 or more additional agents. Survival at 1 year …

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Feasibility And Cardiac Safety Of Trastuzumab Emtansine After Anthracycline-Based Chemotherapy As (Neo) Adjuvant Therapy For Human Epidermal Growth Factor Receptor 2-Positive Early-Stage Breast Cancer, I. E. Krop, T. M. Suter, C. T. Dang, L. Dirix, G. Romieu, C. Zamagni, M. L. Citron, M. Campone, N. Xu, M. Smitt, L. Gianni Jan 2015

Feasibility And Cardiac Safety Of Trastuzumab Emtansine After Anthracycline-Based Chemotherapy As (Neo) Adjuvant Therapy For Human Epidermal Growth Factor Receptor 2-Positive Early-Stage Breast Cancer, I. E. Krop, T. M. Suter, C. T. Dang, L. Dirix, G. Romieu, C. Zamagni, M. L. Citron, M. Campone, N. Xu, M. Smitt, L. Gianni

Journal Articles

Purpose Trastuzumab emtansine (T-DM1), an antibody-drug conjugate comprising the cytotoxic agent DM1, a stable linker, and trastuzumab, has demonstrated substantial activity in human epidermal growth factor receptor 2 (HER2) -positive metastatic breast cancer, raising interest in evaluating the feasibility and cardiac safety of T-DM1 in early-stage breast cancer (EBC). Patients and Methods Patients (N = 153) with HER2-positive EBC and prechemotherapy left ventricular ejection fraction (LVEF) >= 55% received (neo) adjuvant doxorubicin plus cyclophosphamide or fluorouracil plus epirubicin plus cyclophosphamide followed by T-DM1 for four cycles. Patients could then receive three to four cycles of optional docetaxel with or without …

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Ferric Pyrophosphate Citrate (Triferic) Administration Via The Dialysate Maintains Hemoglobin And Iron Balance In Chronic Hemodialysis Patients, S. N. Fishbane, A. K. Singh, S. H. Cournoyer, K. K. Jindal, P. Fanti, C. D. Guss, V. H. Lin, R. D. Pratt, A. Gupta Jan 2015

Ferric Pyrophosphate Citrate (Triferic) Administration Via The Dialysate Maintains Hemoglobin And Iron Balance In Chronic Hemodialysis Patients, S. N. Fishbane, A. K. Singh, S. H. Cournoyer, K. K. Jindal, P. Fanti, C. D. Guss, V. H. Lin, R. D. Pratt, A. Gupta

Journal Articles

BACKGROUND: Administration of ferric pyrophosphate citrate (FPC, Triferic) via hemodialysate may allow replacement of ongoing uremic and hemodialysis-related iron losses. FPC donates iron directly to transferrin, bypassing the reticuloendothelial system and avoiding iron sequestration. METHODS: Two identical Phase 3, randomized, placebo-controlled trials (CRUISE 1 and 2) were conducted in 599 iron-replete chronic hemodialysis patients. Patients were dialyzed with dialysate containing 2 microM FPC-iron or standard dialysate (placebo) for up to 48 weeks. Oral or intravenous iron supplementation was prohibited, and doses of erythropoiesis-stimulating agents were held constant. The primary efficacy end point was the change in hemoglobin (Hgb) concentration from …

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Full-Length Soluble Urokinase Plasminogen Activator Receptor Down-Modulates Nephrin Expression In Podocytes, M. Alfano, P. Cinque, G. Giusti, S. Proietti, M. Nebuloni, S. Danese, S. D'Alessio, M. Genua, P. C. Singhal, J. Mikulak, +5 Additional Authors Jan 2015

Full-Length Soluble Urokinase Plasminogen Activator Receptor Down-Modulates Nephrin Expression In Podocytes, M. Alfano, P. Cinque, G. Giusti, S. Proietti, M. Nebuloni, S. Danese, S. D'Alessio, M. Genua, P. C. Singhal, J. Mikulak, +5 Additional Authors

Journal Articles

Increased plasma level of soluble urokinase-type plasminogen activator receptor (suPAR) was associated recently with focal segmental glomerulosclerosis (FSGS). In addition, different clinical studies observed increased concentration of suPAR in various glomerular diseases and in other human pathologies with nephrotic syndromes such as HIV and Hantavirus infection, diabetes and cardiovascular disorders. Here, we show that suPAR induces nephrin down-modulation in human podocytes. This phenomenon is mediated only by full-length suPAR, is time-and dose-dependent and is associated with the suppression of Wilms' tumor 1 (WT-1) transcription factor expression. Moreover, an antagonist of alpha v beta 3 integrin RGDfv blocked suPAR-induced suppression of …

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Harvest, A Longitudinal Patient Record Summarizer, J. S. Hirsch, J. S. Tanenbaum, S. Lipsky Gorman, C. Liu, E. Schmitz, D. Hashorva, A. Ervits, D. Vawdrey, M. Sturm, N. Elhadad Jan 2015

Harvest, A Longitudinal Patient Record Summarizer, J. S. Hirsch, J. S. Tanenbaum, S. Lipsky Gorman, C. Liu, E. Schmitz, D. Hashorva, A. Ervits, D. Vawdrey, M. Sturm, N. Elhadad

Journal Articles

OBJECTIVE: To describe HARVEST, a novel point-of-care patient summarization and visualization tool, and to conduct a formative evaluation study to assess its effectiveness and gather feedback for iterative improvements. MATERIALS AND METHODS: HARVEST is a problem-based, interactive, temporal visualization of longitudinal patient records. Using scalable, distributed natural language processing and problem salience computation, the system extracts content from the patient notes and aggregates and presents information from multiple care settings. Clinical usability was assessed with physician participants using a timed, task-based chart review and questionnaire, with performance differences recorded between conditions (standard data review system and HARVEST). RESULTS: HARVEST displays …

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Investigation Of Body Image As A Mediator Of The Effects Of Bowel And Gi Symptoms On Psychological Distress In Female Survivors Of Rectal And Anal Cancer, C. Benedict, V. M. Rodriguez, J. Carter, L. Temple, C. Nelson, K. Duhamel Jan 2015

Investigation Of Body Image As A Mediator Of The Effects Of Bowel And Gi Symptoms On Psychological Distress In Female Survivors Of Rectal And Anal Cancer, C. Benedict, V. M. Rodriguez, J. Carter, L. Temple, C. Nelson, K. Duhamel

Journal Articles

PURPOSE: Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. METHODS: Participants (N = 70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), …

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Hypersensitivity To Intravenous Iron: Classification, Terminology, Mechanisms And Management, J. Szebeni, S. Fishbane, M. Hedenus, S. Howaldt, F. Locatelli, S. Patni, D. Rampton, G. Weiss, J. Folkersen Jan 2015

Hypersensitivity To Intravenous Iron: Classification, Terminology, Mechanisms And Management, J. Szebeni, S. Fishbane, M. Hedenus, S. Howaldt, F. Locatelli, S. Patni, D. Rampton, G. Weiss, J. Folkersen

Journal Articles

Intravenous (IV) iron therapy is widely used in iron deficiency anemias when oral iron is not tolerated or ineffective. Administration of IV iron is considered a safe procedure, but severe hypersensitivity reactions (HSRs) can occur at a very low frequency. Recently, new guidelines have been published by the European Medicines Agency (EMA) with the intention of making IV-iron therapy safer; however, the current protocols are still non-specific, non-evidence-based empiric measures which neglect the fact that the majority of IV-iron reactions are not Ig-E-mediated anaphylactic reactions. The field would benefit from new specific and effective methods for the prevention and treatment …

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Identification And Characterization Of Distinct Il-17f Expression Patterns And Signaling Pathways In Chronic Lymphocytic Leukemia And Normal B Lymphocytes, B. Sherry, P. Jain, P. Y. Chiu, L. Leung, S. L. Allen, J. E. Kolitz, K. R. Rai, J. Barrientos, S. Liang, R. Hawtin, N. Chiorazzi Jan 2015

Identification And Characterization Of Distinct Il-17f Expression Patterns And Signaling Pathways In Chronic Lymphocytic Leukemia And Normal B Lymphocytes, B. Sherry, P. Jain, P. Y. Chiu, L. Leung, S. L. Allen, J. E. Kolitz, K. R. Rai, J. Barrientos, S. Liang, R. Hawtin, N. Chiorazzi

Journal Articles

Chronic lymphocytic leukemia (CLL) is characterized by a progressive accumulation of B lymphocytes. T cell abnormalities are a common feature of CLL and contribute to impaired immune function in these patients. T cells are ineffective in eliminating the leukemic clone and may actually promote tumor growth and survival. Previous work from our laboratory documented elevated circulating levels of IL-17A-producing Th17 cells in CLL patients as compared to healthy age-matched control subjects. These high circulating Th17 levels associated with better prognostic markers and significantly longer overall survival, even among patients whose clones used unmutated IGHVs (U-CLL). Recent studies suggest that Th17 …

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Integrating Targeted Drugs With Taxanes And Platinums: Opportunities And Challenges, D. Kudlowitz, E. Teplinsky, F. Muggia Jan 2015

Integrating Targeted Drugs With Taxanes And Platinums: Opportunities And Challenges, D. Kudlowitz, E. Teplinsky, F. Muggia

Journal Articles

In ovarian cancer, multiple attempts to adjust the standard taxane/platinum doublet by adding cytotoxic therapy or varying scheduling, dosage, and delivery have been met with limited success. Alternative methods to improve the grim prognosis of ovarian cancer, including molecular therapies, are currently under investigation. Efforts have been made to study tyrosine kinase inhibitors (including imatinib and pazopanib), Src kinase inhibitors and histone deacetylase inhibitors (HDACi) in combination with taxanes/platinums in order to improve efficacy. Unfortunately, while many pre-clinical and early phase clinical trials argue that the utilization of these molecular targets may enhance survival, only modest benefit has been seen …

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Integrating Real Time Data To Improve Outcomes In Acute Kidney Injury, J. S. Hirsch, S. Mohan Jan 2015

Integrating Real Time Data To Improve Outcomes In Acute Kidney Injury, J. S. Hirsch, S. Mohan

Journal Articles

Critically ill patients with acute kidney injury requiring renal replacement therapy have a poor prognosis. Despite well-known factors, which contribute to outcomes, including dose delivery, patients frequently miss the target dose and volume removal. One major barrier to effective care of these patients is the traditional dissociation of dialysis device data from other clinical information systems, notably the electronic health record (EHR). This lack of integration and the resulting manual documentation leads to errors and biases in documentation and missed opportunities to intervene in a timely fashion. This review summarizes the technological advancements facilitating direct connection of dialysis devices to …

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Apolipoprotein L1 (Apol1) Variants (Vs) A Possible Link Between Heroin-Associated Nephropathy (Han) And Hiv-Associated Nephropathy (Hivan), X. Lan, T. K. Rao, P. N. Chander, K. Skorecki, P. C. Singhal Jan 2015

Apolipoprotein L1 (Apol1) Variants (Vs) A Possible Link Between Heroin-Associated Nephropathy (Han) And Hiv-Associated Nephropathy (Hivan), X. Lan, T. K. Rao, P. N. Chander, K. Skorecki, P. C. Singhal

Journal Articles

In 1970s, Heroin-associated Nephropathy (HAN), one form of focal and segmental glomerulosclerosis (FSGS), was a predominant cause of End-stage Kidney Disease (ESKD) in African-Americans (AAs). In 1980s, with the surge of Acquired Immune Deficiency Syndrome (AIDS) in AAs, HAN more or less disappeared, and the incidence of Human Immunodeficiency Virus associated Nephropathy (HIVAN) markedly increased. Recent studies in AAs have identified APOL1 variants (Vs) as a major risk factor for the development and progression of non-diabetic kidney diseases including idiopathic FSGS and hypertension-attributed nephrosclerosis. These observations have also offered partial insights into the mechanisms of development, and higher rate of …

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Introduction: Moving Beyond Chemotherapy, F. Muggia, E. Teplinsky Jan 2015

Introduction: Moving Beyond Chemotherapy, F. Muggia, E. Teplinsky

Journal Articles

Epithelial ovarian cancer and related cancers arising in extrauterine Mullerian epithelium are generally chemosensitive—particularly to the platinum drugs, cisplatin and carboplatin, that form the backbone of first-line treatments upon diagnosis even at early stages. Doublets of platinums with paclitaxel have represented the standard-of-care since the late 1990s, with further notable advances taking place by intraperitoneal administration (in Gynecologic Oncology Group studies) after optimal surgical cytoreduction is achieved, and by divided doses of paclitaxel (in a Japanese GOG study). Adding another agent to improve on these results has otherwise proven to be quite challenging. Nevertheless, continued forays into introducing ‘targeted therapies’ …

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Cardiorenal Syndrome And The Role Of The Bone-Mineral Axis And Anemia, D. M. Charytan, S. Fishbane, J. Malyszko, P. A. Mccullough, D. Goldsmith Jan 2015

Cardiorenal Syndrome And The Role Of The Bone-Mineral Axis And Anemia, D. M. Charytan, S. Fishbane, J. Malyszko, P. A. Mccullough, D. Goldsmith

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The association between chronic kidney disease (CKD) and cardiovascular disease (CVD) is well established, and there is mounting evidence of interorgan cross talk that may accelerate pathologic processes and the progression of organ dysfunction in both systems. This process, termed cardiorenal syndrome (CRS) by the Acute Dialysis Quality Initiative, is considered a major health problem: patients with CKD and CVD are at much higher risk of mortality than patients with either condition alone. To date, the majority of CRS research has focused on neurohormonal mechanisms and hemodynamic alterations. However, mounting evidence suggests that abnormalities in the normal pathophysiology of the …

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Long-Term Follow-Up Of Mcl Patients Treated With Single-Agent Ibrutinib: Updated Safety And Efficacy Results, M. L. Wang, K. A. Blum, P. Martin, A. Goy, R. Auer, B. S. Kahl, W. Jurczak, R. H. Advani, J. C. Barrientos, S. Rule, +14 Additional Authors Jan 2015

Long-Term Follow-Up Of Mcl Patients Treated With Single-Agent Ibrutinib: Updated Safety And Efficacy Results, M. L. Wang, K. A. Blum, P. Martin, A. Goy, R. Auer, B. S. Kahl, W. Jurczak, R. H. Advani, J. C. Barrientos, S. Rule, +14 Additional Authors

Journal Articles

Ibrutinib, an oral inhibitor of Bruton tyrosine kinase, is approved for patients with mantle cell lymphoma (MCL) who have received one prior therapy. We report the updated safety and efficacy results from the multicenter, open-label phase 2 registration trial of Ibrutinib (median 26.7-month follow-up). Patients (N = 111) received oral ibrutinib 560 mg once daily, and those with stable disease or better could enter a long-term extension study. The primary end point was overall response rate (ORR). The median patient age was 68 years (range, 40-84), with a median of 3 prior therapies (range, 1-5). The median treatment duration was …

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Acute Myeloid Leukemia Ontogeny Is Defined By Distinct Somatic Mutations, R. C. Lindsley, B. G. Mar, E. Mazzola, P. V. Grauman, S. Shareef, S. L. Allen, A. Pigneux, M. Wetzler, R. K. Stuart, B. L. Ebert, +9 Additional Authors Jan 2015

Acute Myeloid Leukemia Ontogeny Is Defined By Distinct Somatic Mutations, R. C. Lindsley, B. G. Mar, E. Mazzola, P. V. Grauman, S. Shareef, S. L. Allen, A. Pigneux, M. Wetzler, R. K. Stuart, B. L. Ebert, +9 Additional Authors

Journal Articles

Acute myeloid leukemia (AML) can develop after an antecedent myeloid malignancy (secondary AML [s-AML]), after leukemogenic therapy (therapy-related AML [t-AML]), or without an identifiable prodrome or known exposure (de novo AML). The genetic basis of these distinct pathways of AML development has not been determined. We performed targeted mutational analysis of 194 patients with rigorously defined s-AML or t-AML and 105 unselected AML patients. The presence of a mutation in SRSF2, SF3B1, U2AF1, ZRSR2, ASXL1, EZH2, BCOR, or STAG2 was >95% specific for the diagnosis of s-AML. Analysis of serial samples from individual patients revealed that these mutations occur early …

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Cds, Ux, And System Redesign - Promising Techniques And Tools To Bridge The Evidence Gap, T. Mcginn Jan 2015

Cds, Ux, And System Redesign - Promising Techniques And Tools To Bridge The Evidence Gap, T. Mcginn

Journal Articles

INTRODUCTION: In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the "evidence gap." We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge. ABOUT THE ISSUE: …

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Challenges And Opportunities In Late-Stage Chronic Kidney Disease, S. Fishbane, A. D. Hazzan, C. Halinski, A. T. Mathew Jan 2015

Challenges And Opportunities In Late-Stage Chronic Kidney Disease, S. Fishbane, A. D. Hazzan, C. Halinski, A. T. Mathew

Journal Articles

There is increasing recognition that chronic diseases are a major challenge for health delivery systems and treasuries. These are highly prevalent and costly diseases and frequency is expected to increase greatly as the population of many countries ages. Chronic kidney disease (CKD) has not received the same attention as other chronic diseases such as congestive heart failure; yet, the prevalence and costs of CKD are substantial. Greater recognition and support for CKD may require that the disease no longer be viewed as one continuous disease state. Early CKD stages require less complex care and generate lower costs. In contrast, late-stage …

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Clinical Features, And Gene- And Microrna-Expression Patterns In Adult Acute Leukemia Patients With T(11;19)(Q23;P13.1) And T(11;19)(Q23;P13.3), B. Bhatnagar, J. S. Blachly, J. Kohlschmidt, A. K. Eisfeld, S. Volinia, D. Nicolet, A. J. Carroll, A. M. Block, J. E. Kolitz, C. D. Bloomfield, +3 Additional Authors Jan 2015

Clinical Features, And Gene- And Microrna-Expression Patterns In Adult Acute Leukemia Patients With T(11;19)(Q23;P13.1) And T(11;19)(Q23;P13.3), B. Bhatnagar, J. S. Blachly, J. Kohlschmidt, A. K. Eisfeld, S. Volinia, D. Nicolet, A. J. Carroll, A. M. Block, J. E. Kolitz, C. D. Bloomfield, +3 Additional Authors

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Use And Outcomes Associated With Bridging During Anticoagulation Interruptions In Patients With Atrial Fibrillation: Findings From The Outcomes Registry For Better Informed Treatment Of Atrial Fibrillation (Orbit-Af), B. A. Steinberg, E. D. Peterson, S. Kim, L. Thomas, B. J. Gersh, G. C. Fonarow, P. R. Kowey, K. W. Mahaffey, M. W. Sherwood, J. Ansell, +2 Additional Authors Jan 2015

Use And Outcomes Associated With Bridging During Anticoagulation Interruptions In Patients With Atrial Fibrillation: Findings From The Outcomes Registry For Better Informed Treatment Of Atrial Fibrillation (Orbit-Af), B. A. Steinberg, E. D. Peterson, S. Kim, L. Thomas, B. J. Gersh, G. C. Fonarow, P. R. Kowey, K. W. Mahaffey, M. W. Sherwood, J. Ansell, +2 Additional Authors

Journal Articles

BACKGROUND: Temporary interruption of oral anticoagulation for procedures is often required, and some propose using bridging anticoagulation. However, the use and outcomes of bridging during oral anticoagulation interruptions in clinical practice are unknown. METHODS AND RESULTS: The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry is a prospective, observational registry study of US outpatients with atrial fibrillation. We recorded incident temporary interruptions of oral anticoagulation for a procedure, including the use and type of bridging therapy. Outcomes included multivariable-adjusted rates of myocardial infarction, stroke or systemic embolism, major bleeding, cause-specific hospitalization, and death within 30 days. Of …

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