Medical Specialties Commons^™

A Phase 1 And Randomized Controlled Phase 2 Trial Of The Safety And Efficacy Of The Combination Of Gemcitabine And Docetaxel With Ontuxizumab (Morab-004) In Metastatic Soft-Tissue Sarcomas, R. L. Jones, S. P. Chawla, S. Attia, P. Schoffski, H. Gelderblom, B. Chmielowski, A. Le Cesne, B. A. Van Tine, J. C. Trent, R. G. Maki, +7 Additional Authors

Journal Articles

No abstract provided.

Developmental Subtypes Assessed By Dna Methylation-Iplex Forecast The Natural History Of Chronic Lymphocytic Leukemia, B. Giacopelli, Q. Zhao, A. S. Ruppert, A. Agyeman, C. Weigel, Y. Z. Wu, M. M. Gerber, K. G. Rabe, K. R. Rai, C. C. Oakes, +16 Additional Authors

Journal Articles

© 2019 by The American Society of Hematology Alterations in global DNA methylation patterns are a major hallmark of cancer and represent attractive biomarkers for personalized risk stratification. Chronic lymphocytic leukemia (CLL) risk stratification studies typically focus on time to first treatment (TTFT), time to progression (TTP) after treatment, and overall survival (OS). Whereas TTFT risk stratification remains similar over time, TTP and OS have changed dramatically with the introduction of targeted therapies, such as the Bruton tyrosine kinase inhibitor ibrutinib. We have shown that genome-wide DNA methylation patterns in CLL are strongly associated with phenotypic differentiation and patient outcomes. …

Devices For Endoscopic Hemostasis Of Nonvariceal Gi Bleeding (With Videos), M. A. Parsi, A. R. Schulman, H. R. Aslanian, M. S. Bhutani, K. Krishnan, D. R. Lichtenstein, J. Melson, U. Navaneethan, A. J. Trindade, J. T. Maple, +4 Additional Authors

Journal Articles

© 2019 American Society for Gastrointestinal Endoscopy Background: Endoscopic intervention is often the first line of therapy for GI nonvariceal bleeding. Although some of the devices and techniques used for this purpose have been well studied, others are relatively new, with few available outcomes data. Methods: In this document, we review devices and techniques for endoscopic treatment of nonvariceal GI bleeding, the evidence regarding their efficacy and safety, and financial considerations for their use. Results: Devices used for endoscopic hemostasis in the GI tract can be classified into injection devices (needles), thermal devices (multipolar/bipolar probes, hemostatic forceps, heater probe, argon …

A Sleep Medicine Curriculum For Pulmonary And Pulmonary/Critical Care Fellowship Programs A Multisociety Expert Panel Report, D. A. Schulman, C. A. Piquette, M. M. Alikhan, E. Freedman, S. Kumar, J. Mccallister, B. Mokhlesi, J. Santamauro, E. Singas, K. R. Casey, +2 Additional Authors

Journal Articles

No abstract provided.

Predictors Of Overtesting In Pulmonary Embolism Diagnosis, S. Richardson, E. Lucas, S. Cohen, M. Zhang, G. Qiu, S. Khan, T. Mcginn

Journal Articles

© 2019 Background: The benefits of computed tomography pulmonary angiography (CTPA) for pulmonary embolism (PE) diagnosis must be weighed against its risks, radiation-induced malignancy, and contrast-induced nephropathy. Appropriate use of CTPA can be assessed by monitoring yield, the percentage of tests positive for PE. We identify factors that are associated low CTPA yield, which may predict overtesting. Methods: This was a retrospective cohort study of six emergency departments between June 2014 and February 2017. The electronic health record was queried for CTPAs ordered for adult patients in the emergency department. We assessed the following patient factors: age, gender, body mass …

5-0 Polypropylene Versus 5-0 Fast Absorbing Plain Gut For Cutaneous Wound Closure: A Randomized Evaluator Blind Trial, D. B. Eisen, A. R. Zhuang, A. Hasan, V. R. Sharon, H. Bang, M. K. Crispin

Journal Articles

No abstract provided.

Weekly Adalimumab Treatment Decreased Disease Flare In Hidradenitis Suppurativa Over 36 Weeks: Integrated Results From The Phase 3 Pioneer Trials, H. H. Van Der Zee, M. Longcore, Z. Geng, A. Garg

Journal Articles

No abstract provided.

Association Of Antipsychotic Polypharmacy Vs Monotherapy With Psychiatric Rehospitalization Among Adults With Schizophrenia, J. Tiihonen, H. Taipale, J. Mehtala, P. Vattulainen, C. U. Correll, A. Tanskanen

Journal Articles

No abstract provided.

Erratum: This Article Corrects: Best Practices For Evaluation And Treatment Of Agitated Children And Adolescents (Beta) In The Emergency Department: Consensus Statement Of The American Association For Emergency Psychiatry (Western Journal Of Emergency Medicine (2019) 20: 2 (409-419) Doi: 10.5811/Westjem.2019.1.41344), R. Gerson, N. Malas, V. Feuer, G. H. Silver, R. Prasad, M. M. Mroczkowski

Journal Articles

No abstract provided.

Neural Computations Of Threat In The Aftermath Of Combat Trauma, P. Homan, I. Levy, E. Feltham, C. Gordon, J. Hu, J. Li, R. H. Pietrzak, S. Southwick, J. H. Krystal, D. Schiller, +1 Additional Author

Journal Articles

© 2019, The Author(s), under exclusive licence to Springer Nature America, Inc. By combining computational, morphological, and functional analyses, this study relates latent markers of associative threat learning to overt post-traumatic stress disorder (PTSD) symptoms in combat veterans. Using reversal learning, we found that symptomatic veterans showed greater physiological adjustment to cues that did not predict what they had expected, indicating greater sensitivity to prediction errors for negative outcomes. This exaggerated weighting of prediction errors shapes the dynamic learning rate (associability) and value of threat predictive cues. The degree to which the striatum tracked the associability partially mediated the positive …

Cholinergic Control Of Inflammation, Metabolic Dysfunction, And Cognitive Impairment In Obesity-Associated Disorders: Mechanisms And Novel Therapeutic Opportunities, E. H. Chang, S. S. Chavan, V. A. Pavlovh

Journal Articles

No abstract provided.

Electroconvulsive Therapy Modulates Resting-State Eeg Oscillatory Pattern And Phase Synchronization In Nodes Of The Default Mode Network In Patients With Depressive Disorder, A. Takamiya, J. Hirano, B. Yamagata, S. Takei, T. Kishimoto, M. Mimura

Journal Articles

© 2019 Takamiya, Hirano, Yamagata, Takei, Kishimoto and Mimura. Introduction: Electroconvulsive therapy (ECT) has antidepressant effects, but it also has possible cognitive side effects. The effects of ECT on neuronal oscillatory pattern and phase synchronization, and the relationship between clinical response or cognitive change and electroencephalogram (EEG) measurements remain elusive. Methods: Individuals with unipolar depressive disorder receiving bilateral ECT were recruited. Five minutes of resting, eyes-closed, 19-lead EEG recordings were obtained before and after a course of ECT. Non-overlapping 60 artifact-free epocs of 2-s duration were used for the analyses. We used exact low resolution electromagnetic tomography (eLORETA) to compute …

Improvement Of Psychiatrists’ Clinical Knowledge Of The Treatment Guidelines For Schizophrenia And Major Depressive Disorders Using The ‘Effectiveness Of Guidelines For Dissemination And Education In Psychiatric Treatment (Eguide)’ Project: A Nationwide Dissemination, Education, And Evaluation Study, Y. Takaesu, K. Watanabe, S. Numata, M. Iwata, N. Kudo, S. Oishi, T. Takizawa, K. Nemoto, T. Kishimoto, R. Hashimoto, +38 Additional Authors

Journal Articles

© 2019 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology Aim: Although treatment guidelines for pharmacological therapy for schizophrenia and major depressive disorder have been issued by the Japanese Societies of Neuropsychopharmacology and Mood Disorders, these guidelines have not been well applied by psychiatrists throughout the nation. To address this issue, we developed the ‘Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)’ integrated education programs for psychiatrists to disseminate the clinical guidelines. Additionally, we conducted a systematic efficacy evaluation of the programs. …

Merging Orthovoltage X-Ray Minibeams Spare The Proximal Tissues While Producing A Solid Beam At The Target, F. A. Dilmanian, S. Krishnan, W. E. Mclaughlin, B. Lukaniec, J. T. Baker, S. Ailawadi, K. N. Hirsch, R. F. Cattell, R. Roy, J. G. Eley, +14 Additional Authors

Journal Articles

© 2019, The Author(s). Conventional radiation therapy of brain tumors often produces cognitive deficits, particularly in children. We investigated the potential efficacy of merging Orthovoltage X-ray Minibeams (OXM). It segments the beam into an array of parallel, thin (~0.3 mm), planar beams, called minibeams, which are known from synchrotron x-ray experiments to spare tissues. Furthermore, the slight divergence of the OXM array make the individual minibeams gradually broaden, thus merging with their neighbors at a given tissue depth to produce a solid beam. In this way the proximal tissues, including the cerebral cortex, can be spared. Here we present experimental …

Evidence For The Role Of Mindfulness In Cancer: Benefits And Techniques., R. Mehta, K. Sharma, L. Potters, A. G. Wernicke, B. Parashar

Journal Articles

Mindfulness is being used increasingly in various aspects of cancer management. Benefits of mindfulness practices are being observed to manage the adverse effects of treatment, symptoms from cancer progression, and the cost-effectiveness compared to conventional contemporary management strategies. In this review article, we present clinical trial data showing the benefits of mindfulness in various aspects of cancer management as well as techniques that have been commonly used in this practice.

Local Radiation Therapy For Palliation In Patients With Multiple Myeloma Of The Spine, D. Mark, P. Gilbo, R. Meshrekey, M. Ghaly

Journal Articles

No abstract provided.

A Model-Based Method For Assessment Of Salivary Gland And Planning Target Volume Dosimetry In Volumetric-Modulated Arc Therapy Planning On Head-And-Neck Cancer., H. Zhang, Y. Cao, J. Antone, A. C. Riegel, M. Ghaly, L. Potters, A. Jamshidi

Journal Articles

This study examined the relationship of achievable mean dose and percent volumetric overlap of salivary gland with the planning target volume (PTV) in volumetric-modulated arc therapy (VMAT) plan in radiotherapy for a patient with head-and-neck cancer. The aim was to develop a model to predict the viability of planning objectives for both PTV coverage and organs-at-risk (OAR) sparing based on overlap volumes between PTVs and OARs, before the planning process. Forty patients with head-and-neck cancer were selected for this retrospective plan analysis. The patients were treated using 6 MV photons with 2-arc VMAT plan in prescriptions with simultaneous integrated boost …

Endoscopic Identification Of Endoluminal Esophageal Landmarks For Radial And Longitudinal Orientation And Lesion Location, F. Emura, R. Gomez-Esquivel, C. Rodriguez-Reyes, P. Benias, J. Preciado, M. Wallace, L. Giraldo-Cadavid

Journal Articles

© The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location. METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination. A sub-study was also performed using white light followed by endoscopic ultrasound (EUS) in 25 consecutive patients to confirm the findings. The scope orientation throughout the exam was maintained at the natural axis, where the left esophageal quadrant corresponds to the area …

Delivering Challenging News: An Illness-Trajectory Communication Curriculum For Multispecialty Oncology Residents And Fellows, D. Cannone, M. Atlas, A. Fornari, M. L. Barilla-Labarca, M. Hoffman

Journal Articles

Introduction: Published curricula to teach communication skills for postgraduate fellows in oncology are few in number despite the fact that oncologists conduct many difficult discussions with their patients and their families. Such discussions may include disclosing initial diagnosis or relapse of a patient's cancer or relaying a poor prognosis or change to palliative care. Methods: An eight-module course on communication in oncology practice was delivered over 2 months for palliative and oncology fellows and radiation oncology residents. Learners were given a precourse survey in which they were asked to rate their proficiency in various communication tasks. Each learner then participated …

Safety And Efficacy Of Belimumab Plus Standard Therapy For Up To Thirteen Years In Patients With Systemic Lupus Erythematosus, D. J. Wallace, E. M. Ginzler, J. T. Merrill, R. A. Furie, W. Stohl, W. W. Chatham, A. Weinstein, J. D. Mckay, W. J. Mccune, A. Heath, +4 Additional Authors

Journal Articles

© 2019 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. Objective: To investigate the long-term safety and efficacy of intravenous (IV) belimumab plus standard of care (SOC) therapy for systemic lupus erythematosus (SLE) in patients with active, autoantibody-positive SLE. Methods: The study was designed as a multicenter, open-label, continuation study of IV belimumab given every 4 weeks in conjunction with SOC therapy in patients with SLE who completed a phase II, double-blind study. Adverse events (AEs) and laboratory data were monitored from the first belimumab dose (in either study) until 24 …

Long-Term Safety Of Single-Agent Ibrutinib In Patients With Chronic Lymphocytic Leukemia In 3 Pivotal Studies, S. E. Coutre, J. C. Byrd, P. Hillmen, J. C. Barrientos, P. M. Barr, S. Devereux, T. Robak, T. J. Kipps, A. Schuh, S. M. O’Brien, +9 Additional Authors

Journal Articles

© 2019 by The American Society of Hematology Ibrutinib, a first-in-class once-daily oral Bruton tyrosine kinase inhibitor indicated for chronic lymphocytic leukemia (CLL), is continued until progressive disease or unacceptable toxicity. We conducted an integrated safety analysis of single-agent ibrutinib from randomized phase 3 studies PCYC-1112 (RESONATE, n 5 195) and PCYC-1115/1116 (RESONATE-2, n 5 135), and examined longer-term safety separately in the phase 1b/2 PCYC-1102/1103 study (n 5 94, 420 mg/d). In the integrated analysis (ibrutinib treatment up to 43 months), the most common adverse events (AEs) were primarily grade 1/2; diarrhea (n 5 173, 52% any-grade; n 5 …

Which Clinical And Biochemical Predictors Should Be Used To Screen For Diabetes In Patients With Serious Mental Illness Receiving Antipsychotic Medication? A Large Observational Study, A. J. Mitchell, D. Vancampfort, P. Manu, C. U. Correll, M. Wampers, R. Van Winkel, W. Yu, M. De Hert

Journal Articles

© 2019 Mitchell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective We aimed to investigate which clinical and metabolic tests offer optimal accuracy and acceptability to help diagnose diabetes among a large sample of people with serious mental illness in receipt of antipsychotic medication. Methods A prospective observational study design of biochemical and clinical factors was used. Biochemical measures were fasting glucose, insulin and lipids, oral glucose tolerance testing (OGTT), hemoglobin …

The High Cost Of Low Value Care, T. Mcginn, S. Cohen, S. Khan, S. Richardson, M. Oppenheim, J. Wang

Journal Articles

The main focus of this study is bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From our work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, we integrated the highly validated Wells' criteria into the electronic health record at two of our major academic tertiary hospitals. The Wells' clinical decision support tool triggered for patients being evaluated for PE and therefore determined a patients' pretest probability for having a PE. There were 12,759 patient visits representing 11,836 patients, 51% had …

Correction: Posttraumatic Stress Disorder Prevalence And Risk Of Recurrence In Acute Coronary Syndrome Patients: A Meta-Analytic Review., D. Edmondson, S. Richardson, L. Falzon, K. W. Davidson, M. A. Mills, Y. Neria

Journal Articles

© 2019 Edmondson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. There are a number of errors in the citations in Table 1. Please see the correct Table 1 here. (Table presented).

The Role Of Vitamin D In Elderly Inflammatory Bowel Disease Patients, D. Kagolanu, I. Levine, S. Katz

Journal Articles

© 2019 Gastro-Hep Communications Inc. All rights reserved. The role of vitamin D has long been discussed in many chronic diseases, and its significance in inflammatory bowel disease has recently gained attention. This article reviews vitamin D homeostasis, the involvement of vitamin D in the pathophysiol-ogy of inflammatory bowel disease, and vitamin D deficiency as a result of inflammatory bowel disease. In addition, this article explores the possibility of age, specifically in the elderly population, as a risk factor for developing vitamin D deficiency in patients with inflammatory bowel disease.

Fibrillary Glomerulonephritis: An Update, J. L. Rosenstock, G. S. Markowitz

Journal Articles

© 2019 International Society of Nephrology Fibrillary glomerulonephritis (FGN) is a rare proliferative form of glomerular disease characterized by randomly oriented fibrillar deposits with a mean diameter of 20 nm. By immunofluorescence (IF), the deposits stain for IgG, C3, and κ and λ light chains, suggesting that the fibrils may be composed of antigen-antibody immune complexes. A recent major advance in our understanding of the pathogenesis of FGN resulted from the discovery that a major component of the fibrils is DNA-J heat-shock protein family member B9 (DNAJB9), and immunohistochemical staining for DNAJB9 now makes it possible to diagnose FGN in …

Advanced Imaging In Surveillance Of Barrett's Esophagus: Is The Juice Worth The Squeeze?, S. A. Cerrone, A. J. Trindade

Journal Articles

No abstract provided.

Recruitment Via Social Media: Advantages And Potential Biases, C. Benedict, A. L. Hahn, M. A. Diefenbach, J. S. Ford

Journal Articles

© The Author(s) 2019. Background: Adolescent and young adult (AYA) cancer survivors are under-represented in research. Social media is increasingly used for recruitment given its ability to reach large audiences. Differences in participant characteristics and potential biases due to recruitment source are not well understood. Purpose: This study aimed to: (a) compare recruitment strategies (hospital-based v. social media) in enrollment metrics, and (b) among enrolled participants, evaluate group differences in patient characteristics and patient reported outcomes (PROs). Methods: Preliminary data from a cancer and fertility study with female AYAs were evaluated. Hospital-based recruitment used electronic medical records (EMR) to identify …

Ileal Adenocarcinoma With Liver Metastasis In Patient With Crohn's Disease: A 9-Year Survival., J. P. Kothadia, D. H. Nagaraju, S. Katz, H. Bruckner, S. H. Itzkowitz, M. Schwartz

Journal Articles

Small bowel adenocarcinoma is a rare but well-known complication of Crohn's disease. The diagnosis of small bowel adenocarcinoma remains difficult since its presentation is highly variable and mimics active or obstructive Crohn's disease. The diagnosis is often delayed and typically detected only at surgery in an advanced stage with a poor prognosis. We report a case of metastatic ileal adenocarcinoma in a patient with Crohn's disease with prolonged survival. Our case describes serial promising treatment options of these advanced malignancies and raises a possible role for checkpoint immunotherapy.

Behavioral Economics Implementation: Regret Lottery Improves Mhealth Patient Study Adherence., S. A. Husain, K. Diaz, J. E. Schwartz, F. E. Parsons, M. M. Burg, K. W. Davidson, I. M. Kronish

Journal Articles

Background: Nonadherence to study protocols reduces the generalizability, validity, and statistical power of longitudinal studies.

Purpose: To determine whether an automated electronically-delivered regret lottery would improve adherence to an intensive mHealth self-monitoring protocol as part of a longitudinal observational study.

Methods: We enrolled 77 adults into a 52-week study requiring five daily ecologic momentary assessments (EMA) of stress and daily accelerometer use. We performed a pre/post single-arm study to evaluate the efficacy of a lottery intervention in improving adherence to this protocol. Midway through the study, participants were invited to enter a weekly regret lottery ($50 prize, expected value

Results: …