CBD-oil as a potential solution in case of severe tamoxifen-related side effects.

Tamoxifen may lead to bothersome side effects contributing to non-compliance and decreased quality of life. Patients searching for relief are increasingly turning to cannabinoids such as CBD-oil. However, CBD-oil might affect tamoxifen pharmacokinetics (PK) through CYP2D6 inhibition.

[Incidental detection of maternal malignancy in non-invasive prenatal test].

Since 2017, the non-invasive prenatal test (NIPT) has been offered to all pregnant woman in the Netherlands in the context of the TRIDENT-2 study, which has been implemented as a trial within the Dutch national screening programme for Down's, Edwards' and Patau's syndrome. The NIPT examines cell-free DNA in maternal blood. A small proportion of this DNA is of placental origin, but a vast proportion originates from the expectant mother.

A rare cause of dysregulated metabolic syndrome: cortisol-producing adrenocortical carcinoma.

Adrenocortical carcinoma is a rare and highly malignant disease which can cause hypercortisolism leading to dysregulation of blood pressure and glucose levels. Most patients present with advanced disease. We describe the classic presentation of a functional adrenocortical carcinoma in a patient with metabolic syndrome.

Tivozanib: a new treatment option for renal cell carcinoma.

Tivozanib is a tyrosine kinase inhibitor that targets all vascular endothelial growth factor receptors (VEGFRs), causing inhibition of angiogenesis. It has recently been approved by the European Medicines Agency (EMA) for first-line treatment of adult patients with advanced renal cell carcinoma (RCC) and for adult patients who are VEGFR and mammalian target of rapamycin (mTOR) pathway inhibitor-naive, following disease progression after one prior treatment with cytokine therapy for advanced RCC. This review will focus on mechanisms of action, early drug development and results of published and ongoing clinical trials of tivozanib.

Implementation of sepsis bundles in public hospitals in Brazil: a prospective study with heterogeneous results.

Background: Public hospitals in emerging countries pose a challenge to quality improvement initiatives in sepsis. Our objective was to evaluate the results of a quality improvement initiative in sepsis in a network of public institutions and to assess potential differences between institutions that did or did not achieve a reduction in mortality.

Methods: We conducted a prospective study of patients with sepsis or septic shock.