Clinical Challenges: Determining When to Stop MS Therapy as Patients Age
Stopping multiple sclerosis (MS) treatment as patients age can be a fraught decision, but there are some signposts to help guide the way. This neurological disease of inflammatory damage to the brain most commonly starts in the second or third decade of life, and then by the fifth decade patients see declines in the frequency […]
Yes, It Matters Who Manages Sedation During Interventional Radiology Procedures
SAN FRANCISCO — Following interventional radiology procedures such as coronary angioplasty, patients were more likely to be discharged home, rather than to a nursing or long-term care facility, when sedation was provided by trained anesthesia specialists, a researcher said. Odds of an “adverse discharge” were lower by 32% (OR 0.68, 95% CI 0.57-0.81) when anesthesia […]
Nurse-to-Patient Staffing Ratios Win Some Hard-Fought Ground
For nearly 2 decades, only one state — California — governed the number of patients assigned to a hospital nurse. Recently, Oregon became the second. Advocates of nurse-to-patient ratios are hopeful other states will follow. The primary barrier? Hospitals. Hospital groups and some nurse executives say ratios are a one-size-fits-all response to a dynamic system. […]
Steroid Fails to Boost Survival in Advanced HIV Patients With TB Meningitis
Adding dexamethasone to treatment for tuberculous (TB) meningitis among heavily immunosuppressed HIV-positive patients in a low-resource setting did not significantly improve survival or confer any other measured benefits, a randomized controlled trial showed. Among 520 HIV-positive adults in Vietnam and Indonesia who received a year of chemotherapy for TB meningitis, 44.1% of those who also […]
HER3-Targeted Drug Active in Advanced/Metastatic Breast Cancer
An antibody-drug conjugate (ADC) targeting HER3 produced objective responses in as many as 43% of patients with advanced breast cancer, a prospective clinical trial showed. Responses to patritumab deruxtecan (HER3-DXd) occurred in the three major types of breast cancer, ranging from 22.6% in triple-negative breast cancer (TNBC) to 30.1% in hormone receptor (HR)-positive/HER2-negative breast cancer […]
Bladder-Sparing Neoadjuvant Protocol Gets High Marks for MIBC
More than 40% of patients with muscle-invasive bladder cancer (MIBC) avoided immediate cystectomy after achieving a clinical complete response (cCR) with a chemoimmunotherapy combination, a prospective study showed. Overall, 33 of 76 patients with MIBC achieved a cCR by stringently defined criteria following transurethral resection of bladder tumor (TURBT) and treatment with gemcitabine, cisplatin, and […]
FDA OKs Another Injectable for Rare Kidney Disorder
Nedosiran (Rivfloza), a once-monthly RNA interference (RNAi) injection, gained FDA approval for certain patients with primary hyperoxaluria type 1 (PH1), drugmaker Novo Nordisk announced Monday. The lactate dehydrogenase A-directed small interfering RNA is indicated to lower urinary oxalate levels in patients ages 9 years and older with relatively preserved kidney function, defined as an eGFR […]
New Insight Into Hyperglycemia Risk With PI3K Inhibitor for Breast Cancer
Severe hyperglycemia has emerged as a common side effect among patients with PIK3CA-mutated breast cancer treated with the PI3K inhibitor alpelisib (Piqray), especially patients treated outside a clinical trial, a retrospective study showed. Overall, 61.5% of 247 patients developed any degree of hyperglycemia, which reached grade 3/4 severity in 29%. Any grade of hyperglycemia occurred […]
Cancer Risk in NAFLD Higher With Early Disease Onset
The risk for cancer in patients with nonalcoholic fatty liver disease (NAFLD) was highest among those with early-onset disease and declined at later ages of diagnosis, a matched cohort study found. Examining more than 60,000 participants from a prospective Chinese dataset revealed that the increased risk of malignancy with NAFLD was highest among patients diagnosed […]
Link Between Psoriasis, Heart Disease Tracks to Coronary Microvascular Dysfunction
Almost a third of patients with severe psoriasis had echocardiographic evidence of asymptomatic coronary microvascular dysfunction (CMD), a prospective study showed. Doppler echocardiography showed that 31.5% of 448 patients with psoriasis had CMD. Every 1-point increase in the Psoriasis Area and Severity Index (PASI) score and 1-year increase in psoriasis duration correlated with a 5% […]