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  1 / 21156 MEDLINE  
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[PMID]:29378685
[Au] Autor:Khin MO; Bromham N; Harrison M; Eadon H; Guideline Committee
[Ad] Endereço:National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London NW1 4RG, UK.
[Ti] Título:Assessment and management of oesophago-gastric cancer: summary of NICE guidance.
[So] Source:BMJ;360:k213, 2018 01 29.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias Esofágicas/diagnóstico
Neoplasias Esofágicas/terapia
Guias de Prática Clínica como Assunto
Neoplasias Gástricas/diagnóstico
Neoplasias Gástricas/terapia
[Mh] Termos MeSH secundário: Gerenciamento Clínico
Seres Humanos
Avaliação de Sintomas/normas
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k213


  2 / 21156 MEDLINE  
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[PMID]:29348269
[Au] Autor:Hanna FWF; Issa BG; Sim J; Keevil B; Fryer AA
[Ad] Endereço:Staffordshire University, University Hospital of North Midlands, Stoke-on-Trent, UK Fahmy.hanna@uhns.nhs.uk.
[Ti] Título:Management of incidental adrenal tumours.
[So] Source:BMJ;360:j5674, 2018 01 18.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias das Glândulas Suprarrenais/terapia
Gerenciamento Clínico
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Neoplasias das Glândulas Suprarrenais/sangue
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem
Catecolaminas/sangue
Glucocorticoides/sangue
Seres Humanos
Mineralocorticoides/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Catecholamines); 0 (Glucocorticoids); 0 (Mineralocorticoids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5674


  3 / 21156 MEDLINE  
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[PMID]:28741230
[Au] Autor:Velayudhan L; Ffytche D; Ballard C; Aarsland D
[Ad] Endereço:Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, Box PO 70, De Crespigny Park, London, SE5 8AF, UK.
[Ti] Título:New Therapeutic Strategies for Lewy Body Dementias.
[So] Source:Curr Neurol Neurosci Rep;17(9):68, 2017 Sep.
[Is] ISSN:1534-6293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias. Disease-modifying approaches are aimed at preventing, slowing or ameliorating the production, aggregation and deposition of pathological proteins, including immunotherapy targeting α-synuclein and an ongoing trial using ambroxol which increases glucocerebrosidase activity to lower the levels of the protein alpha-synuclein. Other disease-modifying clinical trials are using agents to augment insulin signalling, stem cell therapy, reducing amyloid pathology and gene therapy.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Doença por Corpos de Lewy/diagnóstico
Doença por Corpos de Lewy/terapia
[Mh] Termos MeSH secundário: Inibidores da Colinesterase/uso terapêutico
Terapia Genética/tendências
Seres Humanos
Doença por Corpos de Lewy/imunologia
Doença de Parkinson/diagnóstico
Doença de Parkinson/imunologia
Doença de Parkinson/terapia
Piperidinas/uso terapêutico
Transplante de Células-Tronco/tendências
Ureia/análogos & derivados
Ureia/uso terapêutico
alfa-Sinucleína/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cholinesterase Inhibitors); 0 (Piperidines); 0 (alpha-Synuclein); 8W8T17847W (Urea); JZ963P0DIK (pimavanserin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1007/s11910-017-0778-2


  4 / 21156 MEDLINE  
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[PMID]:29266232
[Au] Autor:Bagaria SP; Gabriel E; Mann GN
[Ad] Endereço:Department of Surgery, Mayo Clinic, Jacksonville, FL.
[Ti] Título:Multiply recurrent retroperitoneal liposarcoma.
[So] Source:J Surg Oncol;117(1):62-68, 2018 Jan.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Retroperitoneal liposarcomas (RPLPS) are rare tumors that represent at least 50% of all retroperitoneal sarcomas. Surgical resection remains the standard of care. Unfortunately, many RPLPS patients will develop a local recurrence and subsequently die in the absence of distant metastasis. This review outlines the factors that predict local recurrence and influence the management of first and subsequent multiply recurrent RPLPS.
[Mh] Termos MeSH primário: Lipossarcoma/patologia
Recidiva Local de Neoplasia/terapia
Neoplasias Retroperitoneais/patologia
[Mh] Termos MeSH secundário: Gerenciamento Clínico
Seres Humanos
Lipossarcoma/complicações
Lipossarcoma/terapia
Recidiva Local de Neoplasia/diagnóstico
Recidiva Local de Neoplasia/etiologia
Neoplasias Retroperitoneais/complicações
Neoplasias Retroperitoneais/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24929


  5 / 21156 MEDLINE  
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[PMID]:29194633
[Au] Autor:Constantinidou A; Jones RL
[Ad] Endereço:Medical School University of Cyprus & The BoC Oncology Centre, Nicosia, Cyprus.
[Ti] Título:Systemic therapy in retroperitoneal sarcoma management.
[So] Source:J Surg Oncol;117(1):87-92, 2018 Jan.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is paucity of randomized controlled data on the role of systemic therapy in retroperitoneal sarcomas. The type of systemic therapy used is guided by the histological subtype. The majority of retroperitoneal sarcomas comprising liposarcomas and leiomyosarcomas are by and large chemotherapy insensitive. There is an urgent need for more efficacious systemic therapies in the management of early and advanced stage retroperitoneal sarcomas.
[Mh] Termos MeSH primário: Neoplasias Retroperitoneais/terapia
Sarcoma/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Gerenciamento Clínico
Seres Humanos
Neoplasias Retroperitoneais/patologia
Sarcoma/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24933


  6 / 21156 MEDLINE  
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[PMID]:28460438
[Au] Autor:Chen X; Zhu W; Tan J; Nie H; Liu L; Yan D; Zhou X; Sun X
[Ad] Endereço:Chinese Cochrane Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, Sichuang, China.
[Ti] Título:Early outcome of early-goal directed therapy for patients with sepsis or septic shock: a systematic review and meta-analysis of randomized controlled trials.
[So] Source:Oncotarget;8(16):27510-27519, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Various trials and meta-analyses have reported conflicting results concerning the application of early goal-directed therapy (EGDT) for sepsis and septic shock. The aim of this study was to update the evidence by performing a systematic review and meta-analysis. Multiple databases were searched from initial through August, 2016 for randomized controlled trials (RCTs) which investigated the associations between the use of EGDT and mortality in patients with sepsis or septic shock. Meta-analysis was performed using random-effects model and heterogeneity was examined through subgroup analyses. The primary outcome of interest was patient all-cause mortality including hospital or ICU mortality. Seventeen RCTs including 6207 participants with 3234 in the EGDT group and 2973 in the control group were eligible for this study. Meta-analysis showed that EGDT did not significantly reduce hospital or intensive care unit (ICU) mortality (relative risk [RR] 0.89, 95% CI 0.78 to 1.02) compared with control group for patients with sepsis or septic shock. The findings of subgroup analyses stratified by study region, number of research center, year of enrollment, clinical setting, sample size, timing of EGDT almost remained constant with that of the primary analysis. Our findings provide evidence that EGDT offers neutral survival effects for patients with sepsis or septic shock. Further meta-analyses based on larger well-designed RCTs or individual patient data meta-analysis are required to explore the survival benefits of EDGT in patients with sepsis or septic shock.
[Mh] Termos MeSH primário: Sepse/terapia
Choque Séptico/terapia
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Terapia Combinada
Gerenciamento Clínico
Mortalidade Hospitalar
Seres Humanos
Unidades de Terapia Intensiva
Razão de Chances
Viés de Publicação
Ensaios Clínicos Controlados Aleatórios como Assunto
Sepse/diagnóstico
Sepse/mortalidade
Choque Séptico/diagnóstico
Choque Séptico/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15550


  7 / 21156 MEDLINE  
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[PMID]:27779202
[Au] Autor:Moschini M; Soria F; Briganti A; Shariat SF
[Ad] Endereço:Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
[Ti] Título:The impact of local treatment of the primary tumor site in node positive and metastatic prostate cancer patients.
[So] Source:Prostate Cancer Prostatic Dis;20(1):7-11, 2017 Mar.
[Is] ISSN:1476-5608
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgical treatment of the primary tumor in patients with metastatic prostate cancer (mPCa) is gaining traction. We discuss the biological rational and the existing literature on this approach. METHODS: We reviewed the literature regarding surgical management of advanced and mPCa disease. RESULTS: Surgical removal of the primary tumor despite metastases is becoming a standard in an increasing number of malignancies. Basic science data support the use of surgical removal of the prostate in metastatic PCa. In addition, durable long-term survival has been reported in patients with node-positive PCa treated with radical prostatectomy (RP) as mono or multimodal approach. Based on these data, several groups have demonstrated the feasibility and safety of RP in the metastatic setting. Retrospective series have also reported an improvement in survival for metastatic patients treated with RP in addition to systemic treatment. CONCLUSIONS: Although no level I data exist at this time to support the use of RP in clinically node-positive or mPCa patients, retrospective data together with basic research data and experience from other malignancies suggest that treatment of the primary tumor, in form of a RP, is safe and could improve long-term quality of life and survival. However, prospective evaluations are requested to validate these findings before including in the standard clinical practice.
[Mh] Termos MeSH primário: Prostatectomia
Neoplasias da Próstata/diagnóstico
Neoplasias da Próstata/cirurgia
[Mh] Termos MeSH secundário: Animais
Terapia Combinada
Gerenciamento Clínico
Seres Humanos
Masculino
Modelos Animais
Metástase Neoplásica
Estadiamento de Neoplasias
Prostatectomia/métodos
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/terapia
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1038/pcan.2016.52


  8 / 21156 MEDLINE  
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[PMID]:28470719
[Au] Autor:Ballas SK
[Ad] Endereço:Cardeza Foundation for Hematologic Research, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
[Ti] Título:From total blood exchange to erythrocytapheresis and back to treat complications of sickle cell disease.
[So] Source:Transfusion;57(9):2277-2280, 2017 09.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Erythrocytapheresis is an important procedure in the management of certain complications of sickle cell disease, including acute stroke, stroke prevention, acute chest syndrome, and multiorgan failure. Erythrocytapheresis in sickle cell disease simply entails the removal of the patient's red blood cells containing the abnormal sickle hemoglobin and replacing them with normal red blood cells carrying normal hemoglobin. In these procedures, the patient's plasma is not exchanged but is returned to the patient. Several studies have demonstrated that the plasma of patients with sickle cell disease contains several components that increase blood viscosity and initiate or promote vaso-occlusion. These factors include increased levels of globulins, especially immunoglobulin G, acute-phase reactants, fibrinogen, coagulation factors, inflammatory mediators, and heme in the steady state and increase further during painful crises. This may explain why, in certain complications of sickle cell disease, such as acute chest syndrome, hepatic crisis, and priapism, erythrocytapheresis by itself may not be effective despite repetitive cycles of red blood cell exchange. The use of therapeutic plasma exchange in addition to erythrocytapheresis in these situations seems to be useful in resolving them more efficiently. The role of therapeutic plasma exchange in the management of certain complications of sickle cell disease needs further evaluation. This commentary addresses the role of therapeutic plasma exchange in the management of complications of sickle cell disease.
[Mh] Termos MeSH primário: Anemia Falciforme/terapia
Citaferese/métodos
Transfusão Total/métodos
[Mh] Termos MeSH secundário: Anemia Falciforme/complicações
Viscosidade Sanguínea
Gerenciamento Clínico
Eritrócitos
Seres Humanos
Troca Plasmática/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14154


  9 / 21156 MEDLINE  
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[PMID]:28461147
[Au] Autor:Diel R; Ringshausen F; Richter E; Welker L; Schmitz J; Nienhaus A
[Ad] Endereço:Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Kiel. Member of the German Center for Lung Research (ARCN); Airway Research Center North (ARCN), German Center for Lung Research (DZL) LungClinic Grosshansdorf. Electronic address: roland.diel@epi.uni-kiel.de.
[Ti] Título:Microbiological and Clinical Outcomes of Treating Non-Mycobacterium Avium Complex Nontuberculous Mycobacterial Pulmonary Disease: A Systematic Review and Meta-Analysis.
[So] Source:Chest;152(1):120-142, 2017 07.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pulmonary disease caused by nontuberculous mycobacteria (NTM) is steadily increasing worldwide. METHODS: A systematic review of non-Mycobacterium avium complex studies published prior to October 2016 was conducted with respect to microbiological and clinical outcomes of current treatment regimens. RESULTS: We retrieved 352 citations, which yielded 24 studies eligible for evaluation. Sixteen studies were retrospective chart reviews, three studies were prospective, and only five studies were randomized. The weighted average proportion of sputum culture conversion (SCC) after subtracting posttreatment relapses for patients with M abscessus was 41.2% (95% CI, 28.6%-54.5%) but was 69.8% (95% CI, 41.0%-91.9%) with subspecies M massiliense in macrolide-containing regimens, 80.2% (95% CI, 58.4%-95.2%) in patients with M kansasii, 32.0% (95% CI, 16.5%-49.8%) for M xenopi (MX) and 54.4% (95% CI, 34.7%-73.4%) for M malmoense. SCCs in the total of 55 patients who underwent lung resection and had MX or M abscessus was high at 75.9%. The risk of bias was low in four of five randomized studies. However, heterogeneous use of outcome parameters (eight definitions of "relapse," eight of "treatment success," and four of "cure") hampered comparison of nonrandomized studies as well as producing possible bias by a posteriori exclusion (13.3%) and uncompleted treatment of participants (25.3%). CONCLUSIONS: As a sustained microbiological response without surgery is unsatisfactory in treating M abscessus, MX, and M malmoense, functional and quality of life aspects should be given more emphasis in the individual evaluation of treatment outcome. Further, properly planned studies with sufficient power are needed, as are new drugs or better-tolerated application of current antibiotics, or both.
[Mh] Termos MeSH primário: Pneumopatias
Infecções por Micobactéria não Tuberculosa
Complexo Mycobacterium avium
Micobactérias não Tuberculosas
[Mh] Termos MeSH secundário: Ensaios Clínicos como Assunto
Gerenciamento Clínico
Seres Humanos
Pneumopatias/diagnóstico
Pneumopatias/microbiologia
Pneumopatias/terapia
Técnicas Microbiológicas/métodos
Infecções por Micobactéria não Tuberculosa/diagnóstico
Infecções por Micobactéria não Tuberculosa/microbiologia
Infecções por Micobactéria não Tuberculosa/terapia
Complexo Mycobacterium avium/efeitos dos fármacos
Complexo Mycobacterium avium/isolamento & purificação
Complexo Mycobacterium avium/patogenicidade
Micobactérias não Tuberculosas/efeitos dos fármacos
Micobactérias não Tuberculosas/isolamento & purificação
Micobactérias não Tuberculosas/patogenicidade
Avaliação de Processos e Resultados (Cuidados de Saúde)
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  10 / 21156 MEDLINE  
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[PMID]:28459909
[Au] Autor:Theisen-Toupal J; Ronan MV; Moore A; Rosenthal ES
[Ad] Endereço:Medical Service, VA Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; Uniformed Services University of the Health Sciences, Bethesda, MD.
[Ti] Título:Inpatient Management of Opioid Use Disorder: A Review for Hospitalists.
[So] Source:J Hosp Med;12(5):369-374, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies. Journal of Hospital Medicine 2017;12:369-374.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Medicina Hospitalar/métodos
Médicos Hospitalares
Hospitalização
Transtornos Relacionados ao Uso de Opioides/terapia
Papel do Médico
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos Relacionados ao Uso de Opioides/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2731



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