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Should Palliative Chemotherapy Be Used at All?

Palliative chemotherapy doesn't improve survival and is associated with clear harms at the end of life.  
medscape.com
about 4 years ago
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First Precision Medicine Chemoprevention Trial Disappoints

In the first precision-based chemoprevention study, erlotinib failed to significantly prevent the development of oral cancer in patients with oral premalignant lesions.  
medscape.com
about 4 years ago
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New Genentech Drug Targets Cancer's First Line of Defense

Pat Salber (@docweighsin) has a conversation with Alan Sandler MD about Atezolizumab, Genentech's new cancer immunotherapy. Unlike standard chemotherapy, thi...  
youtube.com
about 4 years ago
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Levomepromazine for the treatment of nausea and vomiting in people with advanced disease | Cochrane

This is an update of the review published in 2013. Nausea (feeling sick) and vomiting (being sick) are common and unpleasant symptoms that are often experienced by people with advanced disease. There are several different drug therapies which are available to treat these symptoms, known as antiemetics. Levomepromazine was originally used to treat schizophrenia but is also used to control nausea and vomiting. It can be given as a tablet or as an injection.  
cochrane.org
about 4 years ago
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Double Hit Diffuse Large B-cell Lymphomas

What novel agents can be incorporated into chemotherapy platforms for this high risk subset of double hit diffuse large B-cell lymphoma?  
medscape.com
about 4 years ago
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Exercise Improves Asthma Control, Study Suggests

Aerobic exercise could be an adjunct to pharmacotherapy in inactive adults with asthma, according to preliminary results from the Ex-Asthma study.  
medscape.com
about 4 years ago
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Different doses of platelet transfusion for preventing bleeding in people with low platelet counts due to treatment-induced bone marrow failure | Cochrane

We evaluated the evidence about whether low-dose platelet transfusions (platelet transfusions containing a lower number of platelets (1.1 x 1011/m2 ± 25%)) given to prevent bleeding in people with low platelet counts were as effective and safe as standard-dose (2.2 x 1011/m2 ± 25%) or high-dose platelet transfusions (platelet transfusions containing a larger number of platelets (4.4 x 1011/m2 ± 25%)) given regularly to prevent bleeding (prophylactically). Our target population was children and adults with blood cancers who were receiving intensive chemotherapy treatments or stem cell transplantation.  
cochrane.org
about 4 years ago
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Acute diarrhoea in children: racecadotril as an adjunct to oral rehydration | relevance-to-nice-guidance-programmes | Advice | NICE

Racecadotril was not considered appropriate for a NICE technology appraisal and is not currently planned into any other NICE work programme.  
nice.org.uk
about 4 years ago
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Intravenous fluid therapy in adults in hospital | Guidance and guidelines | NICE

It contains recommendations about general principles for managing IV fluids, and applies to a range of conditions and different settings. It does not include recommendations relating to specific conditions.  
nice.org.uk
about 4 years ago
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Ovarian cancer (advanced): bevacizumab 7.5 mg/kg in combination with paclitaxel and carboplatin for first-line treatment | Key-points-from-the-evidence | Advice | NICE

One large (n=1528), open-label, randomised controlled trial (RCT; ICON7) that assessed the efficacy and safety of bevacizumab 7.5 mg/kg for treating ovarian cancer was identified; quality of life outcomes from this study were also reported separately (Stark et al. 2013). ICON7 found that interim analysis of overall survival data showed no benefit for adding bevacizumab to standard chemotherapy compared with standard chemotherapy alone, except in a subgroup deemed at high risk for progression. In this subgroup median results for progression-free survival after a median follow-up of 19 months were 10.5 months with standard chemotherapy and 15.9 months with standard chemotherapy plus bevacizumab. Adding bevacizumab to standard chemotherapy resulted in a small but clinically relevant reduction in quality of life.  
nice.org.uk
about 4 years ago
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Critical Care

Sepsis is a common condition that is associated with significant morbidity, mortality and health-care cost. Pulmonary and non-pulmonary sepsis are common causes of the acute respiratory distress syndrome (ARDS). The mortality from ARDS remains high despite protective lung ventilation, and currently there are no specific pharmacotherapies to treat sepsis or ARDS. Sepsis and ARDS are characterised by activation of the inflammatory cascade. Although there is much focus on the study of the dysregulated inflammation and its suppression, the associated activation of the haemostatic system has been largely ignored until recently. There has been extensive interest in the role that platelet activation can have in the inflammatory response through induction, aggregation and activation of leucocytes and other platelets. Aspirin can modulate multiple pathogenic mechanisms implicated in the development of multiple organ dysfunction in sepsis and ARDS. This review will discuss the role of the platelet, the mechanisms of action of aspirin in sepsis and ARDS, and aspirin as a potential therapy in treating sepsis and ARDS.  
ccforum.com
about 4 years ago
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Comparing different types of chemotherapy for treatment of older people with advanced lung cancer | Cochrane

Worldwide, lung cancer is responsible for most cases of cancer-related death among individuals of both sexes. For adult patients with advanced disease, therapy regimens based on the combination of cisplatin or carboplatin with a different agent are considered the standard of care. However, few elderly patients have been included in relevant trials for chemotherapy, raising concerns about the safety and efficacy of such regimens, which are considered the standard of care for adult patients. As a consequence, older patients are often treated with less intense chemotherapy regimens.  
cochrane.org
about 4 years ago
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Single or combination chemotherapy during preoperative treatment for rectal cancer | Cochrane

Rectal cancer accounts for one-third of all cancers of the large intestine and is an important cause of death worldwide. Radiotherapy and surgery have improved results, but there is still a high proportion of people where the cancer spreads to other parts of the body (distal metastases). In the period before surgery (preoperative period), anti-cancer drugs (chemotherapy) are given to help destroy smaller tumours and enhance the effects of radiotherapy (high-energy radiation that targets the cancer). Chemotherapy also has benefits on organs other than the rectum, making the use of these drugs highly desirable in the preoperative period. Therefore, it is possible that adding a second drug to the chemotherapy regimen (e.g. oxaliplatin) may increase these benefits further.  
cochrane.org
about 4 years ago
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Antibiotic Resistance Predicted to Take Big Toll in Surgery

A new study has shed light on the effect of antibiotic resistance on prophylactic regimens commonly used for surgery and chemotherapy.  
medscape.com
about 4 years ago
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Adherence on Drug Therapy for BPH-Related LUTS Is Different

How common is the problem of non-adherence among patients prescribed drug therapy for BPH-associated LUTS? Find out how the pattern varies between drug classes.  
medscape.com
about 4 years ago
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Nipple-Sparing Mastectomy OK After Neoadjuvant Chemo

Neoadjuvant chemotherapy for breast cancer need not be a contraindication to nipple-sparing mastectomy (NSM), new research from Italy suggests.  
medscape.com
about 4 years ago
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The SPLIT Trial: Saline vs Plasma-Lyte Fluid Therapy - R.E.B.E.L. EM - Emergency Medicine Blog

What is the best fluid to give to our patients who need fluid resuscitation? The answer to this question is not known, but another step in finding the answer was taken with the release of the SPLIT trial  
rebelem.com
about 4 years ago
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Live Hangout with Dr. Gidi Stein, CEO of MedAware Medication Error Prevention Platform |

Though medication errors continue to be a common occurrence, software designed to prevent them often creates its own problems while not really solving the  
medgadget.com
about 4 years ago
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Team Approach Needed to Curb Inappropriate Prescribing

Infectious disease physicians and pharmacists should be involved in setting up antibiotic stewardship programs to minimize divisions, experts advise.  
medscape.com
about 4 years ago
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Does more support increase success amongst people using medications to quit smoking? | Cochrane

Medications (including all types of nicotine replacement therapy, bupropion and varenicline) have been shown to help people quit smoking, and people seeking help to quit smoking will frequently be offered medication (pharmacotherapy). Behavioural support also helps people to quit. Behavioural support may include brief advice or more intensive counselling, and may be provided face-to-face individually or in groups, or by telephone, including 'quitlines'. It has been unclear how much additional benefit is gained from adding support, or providing more intensive support for people who are using medication for a quit attempt.  
cochrane.org
about 4 years ago