PARP Inhibitor Olaparib Use in a BRCA1-Positive Patient With Metastatic Triple-Negative Breast Cancer, Without the Initial Use of Platinum-Based Chemotherapy, Showing Significant Rapid Near Resolution of Large Liver Metastasis While Patient Experienced Gout-Like Symptoms.

Triple-negative breast cancer (TNBC) accounts for 20% of breast cancers diagnosed worldwide. This subtype of breast cancer tends to behave more aggressively, and unlike other breast cancer subtypes, there are no standard targeted treatments for most patients. However, up to 20% of patients with TNBC harbor a breast cancer gene mutation, particularly in .

Intravenous Acetaminophen-Induced Hypotension: A Review of the Current Literature.

Recent literature suggests that intravenous (IV) administration may cause hypotension in hospitalized patients; data further suggest that this effect is most pronounced in the critically ill. The purpose of this review is to identify and evaluate current literature that addresses the incidence and implications of IV acetaminophen-induced hypotension. A literature search of MEDLINE, Cochrane, and EMBASE databases was performed (2002-2019) using the following terms: , and .

Concurrent Squamous Cell Carcinoma and Chronic Lymphocytic Leukemia Presenting as an Enlarging Neck Mass.

Chronic lymphocytic leukemia (CLL) patients are at an increased risk for developing more aggressive lymphomas via Richter's transformation and of developing secondary malignancies. Despite the known association for secondary cancers, oropharyngeal cancers occur rarely. We present a case of a woman with a history of CLL who presented to our facility via transfer for impending airway compromise.

Improving Developmental Screening, Discussion, and Referral in Pediatric Practice.

Although pediatricians' use of standardized screening tools for identifying developmental delays has increased, only 63% of pediatricians report performing standardized screening as recommended. The purpose of the current quality improvement project was to improve developmental monitoring, screening, and referral for developmental concerns by pediatricians. Twenty-eight pediatricians completed an in-person meeting, monthly webinars, and individualized feedback from an Expert Work Group on progress across a 3-month action period.

Therapy-Related Cardiac Risk in Childhood Cancer Survivors: An Analysis of the Childhood Cancer Survivor Study.

Purpose: The impacts of radiotherapy dose and exposed cardiac volume, select chemotherapeutic agents, and age at exposure on risk for late-onset cardiac disease in survivors of childhood cancer remain unresolved.

Patients And Methods: We determined the rates of severe to fatal cardiac disease in 24,214 5-year survivors in the Childhood Cancer Survivor Study diagnosed between 1970 and 1999 at a median age of 7.0 years (range, 0 to 20.

Impact of Diabetes Mellitus and Chronic Kidney Disease on Cardiovascular Outcomes and Platelet P2Y Receptor Antagonist Effects in Patients With Acute Coronary Syndromes: Insights From the PLATO Trial.

Background There are limited data on how the combination of diabetes mellitus ( DM ) and chronic kidney disease ( CKD ) affects cardiovascular outcomes as well as response to different P2Y receptor antagonists, which represented the aim of the present investigation. Methods and Results In this post hoc analysis of the PLATO (Platelet Inhibition and Patient Outcomes) trial, which randomized acute coronary syndrome patients to ticagrelor versus clopidogrel, patients (n=15 108) with available DM and CKD status were classified into 4 groups: DM +/ CKD + (n=1058), DM +/ CKD - (n=2748), DM -/ CKD + (n=2160), and DM -/ CKD - (n=9142). The primary efficacy end point was a composite of cardiovascular death, myocardial infarction, or stroke at 12 months.

Erenumab: A First-in-Class Monoclonal Antibody for Migraine Prevention.

To review the pharmacology, efficacy, and safety of the calcitonin gene-related peptide (CGRP) inhibitor erenumab for migraine preventive therapy. A MEDLINE/PubMed search (January 2000 to January 2019) was conducted using the keywords , and . Additional articles were identified by hand from references.

Andexanet alfa: A Novel Factor Xa Inhibitor Reversal Agent.

The purpose of this article is to review the available clinical trial data for andexanet alfa and its role in clinical practice. A MEDLINE/PubMed search was conducted (January 2000 to January 2019) using the keyword for clinical trials. References of identified articles were searched by hand for additional citations.

Smart In-Vehicle Technologies and Older Drivers: A Scoping Review.

In-vehicle technologies may decrease crash risk in drivers with age-related declines. Researchers determined the impact of in-vehicle information systems (IVIS) or advanced driving assistance systems (ADAS) on driving. Through a scoping review, the effect of IVIS or ADAS on older drivers' convenience (i.

Augmentation of Cancer Cachexia Components With Targeted Acupuncture in Patients With Gastrointestinal Cancers: A Randomized Controlled Pilot Study.

Introduction: Patients with gastrointestinal (GI) cancer-associated cachexia are at risk of high morbidity and mortality. This randomized single-blind pilot study compared the complementary use of targeted acupuncture (TA) with nontargeted acupuncture (NTA) for halting cachexia symptoms.

Methods: GI cancer patients with cachexia undergoing chemotherapy were assigned to receive 8 weekly sessions of either TA (n = 15) or NTA (n = 15) following a specific acupuncture protocol.

Lysosomal Leukodystrophies Lysosomal Storage Diseases Associated With White Matter Abnormalities.

The leukodystrophies are a group of genetic metabolic diseases characterized by an abnormal development or progressive degeneration of the myelin sheath. The myelin is a complex sheath composed of several macromolecules covering axons as an insulator. Each of the leukodystrophies is caused by mutations in genes encoding enzymes that are involved in myelin production and maintenance.

Myxoid Myofibroblastoma of the Breast With Atypical Cells.

The differential diagnosis of myxoid lesions in the breast is broad and includes both benign and malignant entities. Assessment is particularly challenging on core biopsy specimens. Myofibroblastoma, initially thought to be more common in the adult male breast, is being recognized with increasing frequency in the female breast.

Hispanic Dementia Family Caregiver's Knowledge, Experience, and Awareness of Self-Management: Foundations for Health Information Technology Interventions.

Purpose: As a first step toward developing a web-based Family-Health Information Management System intervention, we explored Hispanic dementia family caregiver's knowledge, use, and awareness of self-management principles and skills to address health and health care needs for themselves and the person with dementia (PWD).

Method: Twenty caregivers and 11 caregiver counselors attended an English or Spanish language focus group ranging from 4 to 6 participants. We conducted a directed content analysis informed by Lorig and Holman's conceptualization of self-management.

Ertugliflozin: A New Option in the SGLT-2 Inhibitor Market for the Treatment of Type 2 Diabetes Mellitus.

Objective: The purpose of this article is to review the pharmacological aspects of ertugliflozin and its clinical trials, which led to Food and Drug Administration (FDA) approval for the treatment of type 2 diabetes mellitus (T2DM).

Data Sources: A MEDLINE/PubMed (May 2013 to October 2018) search was conducted using the following keywords: ertugliflozin, sodium glucose co-transporter 2 inhibitor, SGLT2 inhibitor, type 2 diabetes mellitus, hyperglycemia. Study Selection and Data Extraction Quantify: We included English-language articles evaluating ertugliflozin pharmacology, pharmacokinetics, efficacy, and safety in humans for blood glucose reduction in human subjects.

Incident-to Billing for Pharmacists.

The inclusion of pharmacists on care teams has been shown to improve clinical and economic health outcomes. However, a significant barrier to the widespread incorporation of pharmacists into care teams is the ability to financially support the salary of the pharmacist. A mechanism to improve the ability of pharmacists to generate clinical revenue already exists in the form of incident-to billing, although there remains considerable uncertainty regarding the criteria for incident-to billing and specifically how pharmacists can use this model to capture revenue for clinical services.

Recent Updates in the Pharmacological Management of Sepsis and Septic Shock: A Systematic Review Focused on Fluid Resuscitation, Vasopressors, and Corticosteroids.

Objective: Describe recent developments in the pharmacological management of sepsis and septic shock, focusing on fluid resuscitation, vasopressors, and corticosteroids.

Data Sources: A literature search limited to randomized controlled trials written in the English language reporting mortality and other clinically relevant outcomes that were published from July 1, 2016, to August 31, 2018, in patients aged ≥ 18 years. Titles and abstracts were reviewed for relevance.

NUT (Nuclear Protein in Testis) Carcinoma: A Report of Two Cases With Different Histopathologic Features.

NUT (nuclear protein in testis) carcinoma (NC) is an aggressive carcinoma characterized by rearrangements of the NUT gene on chromosome 15q14. Histologically, it is a poorly differentiated carcinoma composed of monotonous, medium-sized, round cells with scant amphophilic or eosinophilic cytoplasm. Foci of abrupt keratinization are often seen.

Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

Background: Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT).

Cognitive Performance and Locomotor Adaptation in Persons With Anterior Cruciate Ligament Reconstruction.

Background: Persons with anterior cruciate ligament reconstruction (ACLR) show deficits in gait and neuromuscular control following rehabilitation. This altered behavior extends to locomotor adaptation and learning, however the contributing factors to this observed behavior have yet to be investigated.

Objective: The purpose of this study was to assess differences in locomotor adaptation and learning between ACLR and controls, and identify underlying contributors to motor adaptation in these individuals.

Plain Language to Communicate Physical Activity Information: A Website Content Analysis.

Plain language techniques are health literacy universal precautions intended to enhance health care system navigation and health outcomes. Physical activity (PA) is a popular topic on the Internet, yet it is unknown if information is communicated in plain language. This study examined how plain language techniques are included in PA websites, and if the use of plain language techniques varies according to search procedures (keyword, search engine) and website host source (government, commercial, educational/organizational).

The Role and Influence of Prostate Cancer Caregivers Across the Care Continuum.

Background: Black men endure a disproportionate burden of morbidity and mortality related to prostate cancer (CaP). Increasingly family members are assuming the role of providing care and support to family members with chronic disease. Understanding the role and influence of the caregiver is a necessary part of developing resources to assist individuals learning to provide care.