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Antibiotics for otitis media with effusion (OME) in children.

BACKGROUND: Otitis media with effusion (OME) is an accumulation of fluid in the middle ear cavity, common amongst young children. The fluid may cause hearing loss. When persistent, it may lead to developmental delay, social difficulty and poor quality of life. Management of OME includes watchful waiting, autoinflation, medical and surgical treatment. Antibiotics are sometimes used to treat any bacteria present in the effusion, or associated biofilms. OBJECTIVES: To assess the effects (benefits and harms) of oral antibiotics for otitis media with effusion (OME) in children. SEARCH METHODS: Th…

Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.

BACKGROUND: Otitis media with effusion (OME), or 'glue ear', is very common in children, especially between the ages of one and three years … effects on the tympanic membrane are common after grommet insertion. Therefore an initial period of watchful waiting seems to be an appropriate management strategy for most children with OME. As no evidence is yet available for the subgroups of children with speech or language delays, behavioural and learning problems or children with defined clinical syndromes (g …

[Surgical treatment of polypoid lesions of gallbladder].

INTRODUCTION: Polypoid lesions of the gallbladder can be divided into benign and malignant categories. Malignant polypoid lesions include carcinomas of the gallbladder, which is the fifth most common malignancy of the gastrointestinal tract and the most common malignancy of the biliary tract. Benign polypoid lesions of the gallbladder are divided into true tumors and pseudotumors. Pseudotumors account for most of polypoid lesions of the gallbladder, and include polyps, hyperplasia, and other miscellaneous lesions. Adenomas are the most common benign neoplasms of the gallbladder. Cholesterol po

[Construction of a model based on multipoint full-layer puncture biopsy for predicting pathological complete response after neoadjuvant therapy for locally advanced rectal cancer].

Objective: To investigate the value of transanal multipoint full-layer puncture biopsy (TMFP) in predicting pathological complete response (pCR) after neoadjuvant radiotherapy and chemotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and to establish a predictive model for providing clinical guidance regarding the treatment of LARC. Methods: In this multicenter, prospective, cohort study, we collected data on 110 LARC patients from four hospitals between April 2020 and March 2023: Beijing Chaoyang Hospital of Capital Medical University (50 patients), Beijing Friendship Hos

Colombian Consensus on the Treatment of Placenta Accreta Spectrum (PAS).

INTRODUCTION: Placenta accreta spectrum (PAS) is a condition associated with massive postpartum bleeding and maternal mortality. Management … e surgical options (total and subtotal hysterectomy, one-stage conservative surgical management and watchful waiting) must be included in a protocol known by the entire interdisciplinary team. In situations in which an antepartum diagnosis is lacking, that is to say, in the face of intraoperative finding of PAS (evidence of purple bulging or neovascularization of …

Decongestants and antihistamines for acute otitis media in children.

RATIONALE: Acute otitis media (AOM) is one of the most common bacterial infections in children worldwide, and the most common reason for prescribing antibiotics. Although serious complications (e.g. mastoiditis or meningitis) are rare, the infection causes acute pain and can lead to hearing impairment. Since AOM often resolves spontaneously, current treatment guidelines recommend an approach of watchful waiting (no initial antibiotics). However, decongestants and antihistamines, administered orally or nasally, might reduce inflammation and mucosal oedema in the middle ear and help resolve AOM …

Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair.

BACKGROUND: An inguinal hernia occurs when part of the intestine protrudes through the abdominal muscles. In adults, this common condition is much more likely in men than in women. Inguinal hernia can be monitored by 'watchful waiting', but if symptoms persist or worsen, surgery is usually required, which can be open or laparoscopic. Laparoscopic (keyhole) repair of inguinal hernias in adults is generally performed using either the transabdominal preperitoneal (TAPP) or the totally extraperitoneal (TEP) method. Both methods include the use of mesh placed in front of the peritoneal lining of th…

Neoadjuvant Immunotherapy Alone for Patients With Locally Advanced and Resectable Metastatic Colorectal Cancer of dMMR/MSI-H Status.

BACKGROUND: The use of programmed death-1 blockade has a significant therapeutic effect in patients with mismatch repair-deficient/microsatellite instability-high metastatic colorectal cancer. However, data on preoperative single-agent programmed death-1 blockade are rare. OBJECTIVE: This study aims to evaluate the effectiveness and safety of preoperative programmed death-1 blockade as a conversion strategy in patients with locally advanced and resectable metastatic mismatch repair-deficient/microsatellite instability-high colorectal cancer. DESIGN: This is a retrospective observational stud

Prediction of Pathologic Complete Response for Rectal Cancer Based on Pretreatment Factors Using Machine Learning.

BACKGROUND: Pathologic complete response after neoadjuvant therapy is an important prognostic indicator for locally advanced rectal cancer and may give insights into which patients might be treated nonoperatively in the future. Existing models for predicting pathologic complete response in the pretreatment setting are limited by small data sets and low accuracy. OBJECTIVE: We sought to use machine learning to develop a more generalizable predictive model for pathologic complete response for locally advanced rectal cancer. DESIGN: Patients with locally advanced rectal cancer who underwent neo

Therapy of newly diagnosed follicular lymphoma.

Newly diagnosed follicular lymphoma is relatively common and can be effectively treated with several differing approaches. Although the disease is often considered incurable, it is highly responsive to therapy when indicated. This review discusses the indications for treatment, risk stratification systems, treatment options with supporting clinical trial data, and expected therapeutic outcomes in newly diagnosed follicular lymphoma.

Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers.

OBJECTIVES: Patients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address. SETTING AND DESIGN: Set within the UK's Haematological Malignancy Research Network (an ongoing populatio

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… Available: https://bloodcancer.org.uk/understanding-blood-cancer/watch-wait/ [Accessed Jun 2023]. 7. Bewarder M, Stilgenbauer S, Thurner L, et al. Current treatment options in CLL. Cancers (Basel) 2021;13:2468. 10.3390/cancers13102468 8. Matasar MJ, Luminari S, Barr PM, et al. … Incurable, invisible and inconclusive: watchful waiting for chronic lymphocytic leukaemia and implications for doctor-patient communication. Eur J Cancer Care (Engl) 2012;21:67–77. 10.1111/j.1365-2354.2011.01278.x 16. Lamers J, Hartmann M, Goldschmidt H, et al. …

Long-Term Clinical Outcomes of Optimizing Combination Therapy for Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma: A Retrospective Study.

INTRODUCTION: Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma progresses with advancing disease stage. However, no standard treatment approach has been established. This single-center retrospective study evaluated clinical and radiological characteristics, treatment modalities, and long-term prognosis of pulmonary MALT lymphoma. METHODS: The study included 42 patients diagnosed with pulmonary MALT lymphoma between October 2004 and July 2019. Primary therapeutic modalities were determined using modified Ann Arbor staging. Therapeutic response was evaluated via computed tomography a

Opportunities for shared decision-making about major surgery with high-risk patients: a multi-method qualitative study.

BackgroundLittle is known about the opportunities for shared decision-making when older high-risk patients are offered major surgery. This study examines how, when, and why clinicians and patients can share decision-making about major surgery.MethodsThis was a multi-method qualitative study, combining video recordings of preoperative consultations, interviews, and focus groups (33 patients, 19 relatives, 36 clinicians), with observations and documentary analysis in clinics in five hospitals in the UK undertaking major orthopaedic, colorectal, and/or cardiac surgery.ResultsThree opportunities f

Decrease in early mortality for newly diagnosed multiple myeloma patients in the Netherlands: a population-based study.

Identification of risk factors for early mortality (EM) in multiple myeloma (MM) patients may contribute to different therapeutic approaches in patients at risk for EM. This population-based study aimed to assess trends in EM and risk factors for EM among MM patients diagnosed in the Netherlands. All MM patients, newly diagnosed between 1989 and 2018, were identified in the Netherlands Cancer Registry. Patients were categorized into three calendar periods (1989-1998, 1999-2008, 2009-2018) and into five age groups (≤65, 66-70, 71-75, 76-80, >80 years). EM was defined as death by any cause ≤180

Enhancing medication adherence with blister-packed oral oncolytics: A case example in chronic lymphocytic leukemia.

IntroductionMedication nonadherence is a prevalent issue in the oncology population and can be costly on the healthcare system while leading to worsened outcomes, including increased mortality. One intervention that has been shown to help promote medication adherence to oral therapies for chronic conditions is blister-packaging. However, no literature is available assessing the potential impact of blister-packaging in oncology. Therefore, we aimed to quantify the impact of blister-packaging oral oncolytics on medication adherence and healthcare costs.MethodsAn economic model was designed to as

Diagnostic discordance in amyloidosis: lessons from proteomic amyloid typing.

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… waiting | Planned tafamidis | Watchful waiting | Supportive care Post-MS management | Dara-VCD | BDR | Hematologic reassessment | Dara-VRD | No treatment initiated Impact of MS on management | Change in therapy | Treatment initiation | Diagnostic reassessment | Initiation of clone-directed therapy | … Patient 4: a 68-year-old man with chronic kidney disease, proteinuria, and an IgG λ monoclonal gammopathy was initially managed with a watchful waiting strategy, as bone marrow biopsy showed 11% plasma cells without myeloma-defining events. …

Противоречия в мрачной миеломе: поиск оптимального подхода к началу лечения.

В настоящем комментарии основное внимание уделяется данным в пользу начала лечения на раннем этапе или осторожной стратегии ожидания и просмотра в множестве миеломы.

What Predicts Complete Response to Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer?

BACKGROUND: Total neoadjuvant therapy in the treatment of stage II and III rectal cancer involves the administration of either induction or consolidation chemotherapy with chemoradiation before surgery. Total neoadjuvant therapy is associated with an increased complete response rate, which is defined as the proportion of patients who either had a pathological complete response after surgery or sustained a clinical complete response for at least 1 year under surveillance. OBJECTIVE: To identify the predictors of complete response to total neoadjuvant therapy and compare different diagnostic to

Rectal Cancer in the Elderly: To Operate or Not to Operate? A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group.

BACKGROUND: Patients older than 70 years account for 44% of all rectal cancer cases. Although surgery is the criterion standard treatment, elderly patients can also be offered other treatments, such as total neoadjuvant therapy with watch and wait. OBJECTIVE: This study aimed to investigate whether postoperative 90-day mortality is higher in elderly patients than in younger patients. DESIGN: This nationwide retrospective study included all consecutive resections of rectal cancer performed between 2005 and 2016 using data from the RALAR study. Patients were divided into 2 groups based on age:

Indian Expert Opinion on Cancer Care during COVID-19 Pandemic.

Coronavirus pandemic has increased human disease burden, as well as economic distress globally. Being in an immunocompromised state, patients with cancer comprise an important at-risk population for novel coronavirus disease 2019 (COVID-19) infection. It is necessary to modify individualized clinical management for every cancer patient in the context of the ongoing COVID-19 pandemic. Simultaneously, additional safety precautions for the cancer care providers are mandatory. This review will provide general recommendations in the Indian context optimizing the same.