Publications by authors named "Mary-Lou Smith"
Article Synopsis
- - This review focuses on health-related quality of life (HRQOL) for children with severe epilepsy that doesn't respond to medication and looks at how epilepsy surgery affects HRQOL.
- - Factors that negatively impact a child's HRQOL include cognitive and emotional issues, parental anxiety, family stress, and specific epilepsy-related challenges.
- - Post-surgery studies show that many children experience HRQOL improvements, mainly related to achieving seizure freedom, but more long-term research is needed to better understand how and when these improvements happen.
Article Synopsis
- The study examined how knowledge of circulating tumor DNA (ctDNA) status influences treatment decisions in women with high-risk triple-negative breast cancer after chemotherapy.
- A survey with 286 participants simulated scenarios involving ctDNA outcomes and patient willingness to accept adjuvant therapy based on perceived recurrence risks and treatment toxicities.
- Results indicated that negative ctDNA status led to less acceptance of adjuvant therapy, while positive ctDNA status made the benefits of treatment more significant than concerns about side effects.
Article Synopsis
- - The International League Against Epilepsy's (ILAE) Task Force created recommendations for diagnosing and treating anxiety and depression in kids with epilepsy after reviewing studies on screening measures and treatment effectiveness.
- - Key recommendations for diagnosis include universal screening, closer monitoring for high-risk children, and using multiple sources to assess symptoms while emphasizing the importance of recognizing symptoms for better treatment outcomes.
- - For treatment, individualized plans are advised, with monitoring for mild cases and referrals for more severe conditions, alongside the development of clinical care pathways and age-appropriate psychosocial interventions.
Article Synopsis
- The study aimed to assess how palbociclib treatment affects health-related quality of life (HRQoL) in patients with hormone receptor-positive, HER2-negative advanced or metastatic breast cancer through a systematic review of literature up to June 2023.
- A total of 15 studies, including randomized controlled trials and real-world evidence studies, indicated that HRQoL is generally maintained or even improved in patients treated with palbociclib compared to monotherapy.
- The findings showed consistent positive effects on individual patient outcomes like pain and fatigue, with comparable results across diverse patient groups, suggesting that HRQoL is largely preserved when palbociclib is added to endocrine therapy.
Article Synopsis
- Insular epilepsy is increasingly recognized as a significant issue in patients with epilepsy, warranting more research into its cognitive and psychological impacts to enhance clinical care and identify surgery candidates.
- A scoping review was conducted, analyzing 39 studies that assessed cognitive and behavioral outcomes in individuals with insular epilepsy, focusing on standardized psychological measures.
- Findings show that both children and adults with insular epilepsy often experience lower cognitive functioning and behavioral challenges, but their outcomes tend to remain stable after surgical interventions involving the insula, helping neuropsychologists better understand patient needs before and after surgery.
Article Synopsis
- The Advocate-BREAST project aims to enhance the breast cancer patient experience through targeted education and patient-centered research.* -
- A survey sent to nearly 7,000 breast cancer survivors revealed high satisfaction with care but identified significant concerns regarding symptoms and support, particularly around issues like sexual dysfunction and emotional health.* -
- Patients expressed a need for better psychological support and clear educational resources, leading to proposed Quality Improvement projects focusing on holistic care and wellness programs.*
Article Synopsis
- - The study, Advocate-BREAST80+, assessed the needs of breast cancer patients aged 80 and older (P80+) compared to younger patients (P80-).
- - A survey was conducted with 6,918 participants from the Mayo Clinic Breast Disease Registry, finding that P80+ were less likely to receive certain therapies and were significantly less satisfied with information about side effects and management.
- - While P80+ reported lower anxiety levels, they were much less involved in clinical trials and showed little interest in participating in future studies, highlighting a need for improved education and support for this age group.
Article Synopsis
- Breast cancer treatment involves a team of specialists from surgical, radiation, and medical oncology fields.
- The NCCN Guidelines provide recommendations for various types of breast cancer, including different stages and specific conditions like Paget's disease and treatment during pregnancy.
- This issue highlights the management of systemic therapies for nonmetastatic breast cancer, both before and after surgery.
Article Synopsis
- Outcomes from vagus nerve stimulation (VNS) improve over time in children with drug-resistant epilepsy, but the benefits of deep brain stimulation (DBS) versus continued VNS optimization were unclear.
- A study involving 18 children aged 8-17 showed that adding DBS after a year of ineffective VNS led to significantly greater seizure reduction (51.9% vs. 12.3%).
- While DBS resulted in fewer bothersome seizures, it did not improve the overall quality of life, suggesting that earlier consideration of DBS could be beneficial for children not responding to VNS.
Article Synopsis
- - The study investigates the link between a specific patient-reported outcome (the GP5 assessment from a cancer therapy scale) and early treatment discontinuation due to side effects in patients with newly diagnosed multiple myeloma.
- - Conducted between February and April 2023, the research analyzed responses from participants in the ECOG-ACRIN E1A11 trial, focusing on treatment regimens involving bortezomib and carfilzomib, with assessments taken at various intervals during treatment.
- - Results from logistic regression will highlight whether higher reported bother from adverse events correlates with a higher likelihood of discontinuing treatment early, adjusting for factors like treatment type, patient demographics, and disease stage.
Article Synopsis
- The epilepsy monitoring unit (EMU) can experience unnoticed changes in cognitive and behavioral health due to medical and environmental factors.
- The psychomotor vigilance task (PVT) was tested on seven children in the EMU, linking their performance to seizure counts, medication levels, and sleep quality.
- Findings showed that performance on the PVT was negatively affected by increased antiseizure medications and epileptiform activity, suggesting this task could help monitor patient responses and guide clinical choices.
Article Synopsis
- The study aimed to assess the quality of life (HRQOL) of parents whose children underwent epilepsy surgery versus those treated with medical therapy over two years.
- Researchers collected data from parents at multiple intervals and adjusted for various factors using a linear mixed model.
- Results indicated similar HRQOL trajectories for both groups, but parents of surgical patients had slightly higher HRQOL, though overall improvement was limited, potentially due to persistent issues in the children.
Article Synopsis
- Regulatory agencies are promoting systematic collection of patient experience data, particularly patient-reported outcomes (PROs), in cancer trials to enhance regulatory decision-making.
- There’s an increasing acknowledgment that understanding cancer treatment tolerability should involve the patients' perspectives, especially regarding side effects that may not be fully reported by clinicians.
- Methodologies for evaluating patient-reported tolerability are being developed, but current methods remain largely descriptive, and inconsistencies in analyses and objectives of PROs present challenges for interpreting the results effectively.
Article Synopsis
- The condition was linked to severe complications, leading to intrauterine fetal demise (IUFD) in both the current and a subsequent male pregnancy, where NIHF also occurred.
- This case highlights the variability of IPEX syndrome's severity and proposes that the newly identified genetic variant could explain the severe outcomes observed in this family’s pregnancies.
Article Synopsis
- The study investigates how pediatric epilepsy surgery impacts long-term cognitive development, alongside its primary goal of achieving seizure freedom.
- A systematic review analyzed 15 studies involving 341 children under 18, assessing their IQ/DQ before and after surgery.
- Findings suggest stabilization of cognitive function over time, with potential improvements linked to stopping antiseizure medications after achieving seizure control.
Article Synopsis
- - Pediatric epilepsy surgery can effectively control seizures, but it carries risks of cognitive and memory decline, particularly after procedures targeting critical brain areas.
- - Advances in noninvasive mapping technologies like fMRI have reduced the reliance on the traditional IAP (Wada Test) for assessing language and memory function prior to surgery, but there remains uncertainty regarding predicting postoperative outcomes.
- - This review introduces a decision tree to guide the use of the IAP during presurgical evaluations, highlighting the need for more research and standardization in functional mapping approaches for pediatric epilepsy patients.
Article Synopsis
- This study looked at how parents' happiness and stress levels changed over the first two years after their child was evaluated for epilepsy surgery.
- It involved 259 parents and tracked their feelings about depression, anxiety, and family support at different times.
- The research found three groups of parents: those who felt good all the time, those who felt a little better over time, and those who struggled but showed some slight improvement, with better outcomes linked to higher family income and children's health.
Article Synopsis
- Limited guidance on psychogenic non-epileptic seizures (PNES) in children led to the creation of consensus recommendations by the ILAE Task Force, who conducted a scoping review and gathered expert opinions through a Delphi process.
- The review of 77 studies revealed that the majority were retrospective, with video electroencephalography (vEEG) being the primary identification method, and better outcomes linked to access to psychological support.
- Key recommendations include taking a thorough developmental history, using vEEG for diagnosis, involving an epilepsy expert post-diagnosis, providing educational materials, and screening for mental health issues in all children with PNES.
Article Synopsis
- Mild (Grade 1) and moderate (Grade 2) adverse events (AEs) are frequently under-reported in phase III clinical trials, which limits understanding of the toxicity burden on patients.* -
- Analysis using data from a specific trial showed that experiencing more G1 and G2 AEs significantly increased patient-reported side-effect bother and the likelihood of treatment discontinuation, especially with symptomatic AEs.* -
- The study emphasizes the need for better reporting of low- and moderate-grade AEs, as they are linked to higher patient discomfort and could impact treatment adherence.*
Article Synopsis
- Cognitive flexibility is essential for effective attention control, but its neural mechanisms remain unclear, especially in children with epilepsy.
- Using advanced techniques like intracranial recordings and deep learning, researchers analyzed brain activity during attention tasks, revealing important brain regions and patterns associated with task performance.
- The study highlighted the dorsal default mode network's key involvement in cognitive flexibility, demonstrating that even with varied electrode placements, consistent networks can be observed, showcasing deep learning's potential in understanding human attention.
Article Synopsis
- The study investigates how pre-operative factors impact health-related quality of life (HRQOL) for children two years after epilepsy surgery, focusing on those with drug-resistant epilepsy.
- It found that a child’s older age at seizure onset and higher HRQOL before surgery significantly predicted better HRQOL outcomes post-surgery.
- The results highlight the importance of assessing and improving a child’s pre-operative quality of life to enhance recovery and overall well-being after epilepsy surgery.
Article Synopsis
- The NCCN Guidelines offer healthcare providers a standardized approach for screening and diagnosing breast cancer, covering various clinical situations and types of breast lesions.
- The guidelines are created by a diverse panel of experts from different medical fields, ensuring comprehensive insights and recommendations.
- The panel meets yearly to assess new data and feedback, allowing them to update screening recommendations based on the latest findings and discussions.
Article Synopsis
- Children HIV-exposed, uninfected (CHEU) may face developmental challenges, especially in attention-related skills, but this hasn't been extensively studied compared to their HIV-unexposed counterparts (CHUU).
- A study involving 55 CHEU and 51 CHUU children at 5.5 years old examined attention issues and developmental outcomes, revealing that very few in either group showed signs of probable ADHD, and no significant differences in attention-related measures were found.
- However, CHEU scored lower on intelligence, visuomotor skills, and academic abilities compared to CHUU, suggesting that while they aren't at a higher risk for attention difficulties, sociodemographic factors like maternal employment could influence their behavioral and neurodevelopmental
Article Synopsis
- The STEEP 2.0 criteria, updated in 2021, established standardized definitions for adjuvant breast cancer end points and emphasized the importance of defining neoadjuvant clinical trial end points separately.
- A specialized working group, NeoSTEEP, focused on neoadjuvant systemic therapy end points, considering various factors like cancer subtypes, imaging, and FDA regulations.
- The group recommended defining pathologic complete response (pCR) as no residual invasive cancer present and suggested additional methodologies for evaluating treatment efficacy, including unique end points for hormone receptor-positive cases.
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer address all aspects of management for breast cancer. The treatment landscape of metastatic breast cancer is evolving constantly. The therapeutic strategy takes into consideration tumor biology, biomarkers, and other clinical factors.
View Article and Find Full Text PDF