scholarly journals Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists

Critical Care ◽  
2011 ◽  
Vol 15 (4) ◽  
pp. R197 ◽  
Author(s):  
Maxime Cannesson ◽  
Gunther Pestel ◽  
Cameron Ricks ◽  
Andreas Hoeft ◽  
Azriel Perel
Keyword(s):  
High Risk ◽  
Hemodynamic Monitoring ◽  
North American

scholarly journals Adjuvant vs. salvage radiation therapy in men with high-risk features after radical prostatectomy: Survey of North American genitourinary expert radiation oncologists

2018 ◽  
Vol 13 (5) ◽  
Author(s):  
Shearwood McClelland 3rd ◽  
Kiri A. Sandler ◽  
Catherine Degnin ◽  
Yiyi Chen ◽  
Timur Mitin
Keyword(s):  
Radiation Therapy ◽  
High Risk ◽  
Radical Prostatectomy ◽  
North American ◽  
Randomized Clinical Trials ◽  
Current View ◽  
Adjuvant Radiation ◽  
Exact Test ◽  
Salvage Radiation Therapy ◽  
Radiation Oncologists

Introduction: The management of patients with high-risk features after radical prostatectomy (RP) is controversial. Level 1 evidence demonstrates that adjuvant radiation therapy (RT) improves survival compared to no treatment; however, it may overtreat up to 30% of patients, as randomized clinical trials (RCTs) using salvage RT on observation arms failed to reveal a survival advantage of adjuvant RT. We, therefore, sought to determine the current view of adjuvant vs. salvage RT among North American genitourinary (GU) radiation oncology experts. Methods: A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to opinions regarding adjuvant vs. salvage RT for this patient population. Treatment recommendations were correlated with practice patterns using Fisher’s exact test. Results: Forty-two of 88 radiation oncologists completed the survey; 23 (54.8%) recommended adjuvant RT and 19 (45.2%) recommended salvage RT. Recommendation of active surveillance for Gleason 3+4 disease was a significant predictor of salvage RT recommendation (p=0.034), and monthly patient volume approached significance for recommendation of adjuvant over salvage RT; those seeing <15 patients/month trended towards recommending adjuvant over salvage RT (p=0.062). No other demographic factors approached significance. Conclusions: There is dramatic polarization among North American GU experts regarding optimal management of patients with highrisk features after RP. Ongoing RCTs will determine whether adjuvant RT improves survival over salvage RT. Until then, the almost 50/50 division seen from this analysis should encourage practicing clinicians to discuss the ambiguity with their patients.

scholarly journals Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study

2021 ◽  
Author(s):  
Matheus Almeida Souza ◽  
Daniel Goble ◽  
Paige Arney ◽  
Edgar Ramos Vieira ◽  
Gabriela Silveira-Nunes ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
North American ◽  
Force Plate ◽  
South American ◽  
Risk Of Falling ◽  
Men And Women ◽  
Falls Risk ◽  
South Americans ◽  
North And South

This study aimed to characterize the risk of falling in low, moderate and high risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69 % and female: 61.87 %), with no differences between men and women. Also, no differences were found between North vs. South Americans, nor for falls risk levels when male and female groups were compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years&rsquo; normative age-range. The prevalence of low falls risk was ~ 61-65 % and the prevalence of moderate to high risk was ~ 16-19 %. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.

Azacitidine With Or Without Entinostat For The Treatment Of Therapy-Related Myeloid Neoplasm: Further Results Of The E1905 North American Leukemia Intergroup Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2777-2777
Author(s):  
Thomas Prebet ◽  
Zhuoxin Sun ◽  
Rhett Ketterling ◽  
Peter L. Greenberg ◽  
Amer M. Zeidan ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
High Risk ◽  
North American ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
De Novo ◽  
Response Rates ◽  
High Response ◽  
Myeloid Neoplasm ◽  
Acute Myeloid

Abstract Background Therapy-related myeloid neoplasm (tMN) includes t-myelodysplasia (tMDS) and t-acute myeloid leukemia (tAML) and are serious late effects of the treatment of cancer. Prognosis of tMN is poor, related to the increased frequency of adverse cytogenetics and other clinical features which predict poor response to conventional treatment. Over the last years, azacitidine (AZA) has become the standard of treatment for high risk MDS (Silverman, JCO 2002; Fenaux, Lancet Oncol 2009) and has shown efficacy in AML. AZA represents an interesting option for patients with tMN considering its safety profile and its efficacy in poor prognosis subgroups of apparently de novo MDS patients including those with monosomy 7. Most prospective trials of AZA have excluded patients with tMN. Most tMN data are retrospective or registry studies (Bally, Leuk Res 2013). This abstract presents the results of 47 t-MN patients prospectively enrolled as a specific cohort in the E1905 study. Methods E1905 study is a randomized phase 2 study from the North American Leukemia Intergroup (NCT00313586, Prebet , ASH 2010) testing 10 days of AZA (50mg/m2/d s.c.) vs. 10 days of AZA + the histone deacetylase inhibitor entinostat (4 mg/m2/d PO days 3 and day 10). 6 cycles of treatment were planned; responding patients could receive up to 24 cycles. MDS, CMML, and AML with myelodysplasia-related changes were included. Patients with tMN were subsequently accrued as a separate cohort after amendment of the protocol. Response was assessed using IWG 2000 criteria (Cheson et al, Blood 2000); the primary endpoint of the overall trial was achievement of a normal hemogram in 25% of treated patients in either treatment arm. Results A total of 47 patients were included. Median age was 70 years (39y-83y), 45% male, and 94% of patients had ECOG PS 0-1. 29 patients could be subclassified as t-MDS and 18 as t-AML. At inclusion, median peripheral blood counts were: neutrophils 1.0 G/l, Platelets 35 G/L, Hemoglobin 9.2 g/l, peripheral blood blasts 0%, marrow blasts 14.0%. 68% of patients were RBC transfusion dependent and 40% platelet transfusion dependent. As expected, the cytogenetic evaluation showed a high frequency of unfavorable risk cytogenetics (74%) as compared to normal or intermediate risk cytogenetics (26%). Baseline characteristics were not statistically different between the 2 arms. 24 patients were treated with AZA monotherapy and 23 with AZA+entinostat. The median number of administered cycles was 4 and was significantly higher in patients treated with AZA monotherapy (6 cycles vs.3 cycles, p=0.008). 8 patients in the combination arm and 1 patient in the AZA monotherapy arm died of infection or hemorrhage before cycle 3. In an intent to treat analysis, overall response rates (CR, PR, or trilineage Hematologic improvement) were 11/24 (46%) in AZA monotherapy (95% CI 26 – 67%) and 4/23 (17%) in the combination arm (95% CI 5 – 39%, p=0.06 comparing the two arms). Median overall survival in the two arms were 12.8 months and 5.7 months (p=0.008). Conclusions In this group of very high risk patients with therapy-related myeloid neoplasms, the use of the novel 50 * 10 schedule of azacitidine monotherapy appears effective, with response rates comparable to those for patients with de novo MDS/AML treated on the same protocol (74 pts, 40% with unfavorable cytogenetics, ORR=32%, median OS=18 months). Because there are no prospective data examining the approved dose schedule of AZA (75 mg/m2/day * 7 days), it is not clear if this surprisingly high response rate derives from the current extended schedule of lower dose AZA, or would be true with standard dose AZA as well. This high response may enable many of these patients to proceed to allogeneic stem cell transplant. Entinostat combined with azacitidine at the dose and schedule applied in E1905 does not appear to be effective and tolerable as compared to azacitidine alone. Disclosures: Prebet: CELGENE: Honoraria. Off Label Use: Use of azacitidine in acute myeloid leukemia. Gore:CELGENE: Equity Ownership, Research Funding.

HEMODYNAMIC MONITORING DURING AUTOLOGOUS BLOOD DONATION FOR HIGH RISK PATIENTS

1988 ◽  
Vol 69 (3A) ◽  
pp. A727-A727 ◽  
Author(s):  
B. D. Spiess ◽  
R. F. Narbone ◽  
K. J. Tuman ◽  
R. J. McCarthy ◽  
R. Sassetti ◽  
...  
Keyword(s):  
High Risk ◽  
Hemodynamic Monitoring ◽  
Blood Donation ◽  
Autologous Blood ◽  
Autologous Blood Donation ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end-stage liver disease

2015 ◽  
Vol 21 (7) ◽  
pp. 881-888 ◽  
Author(s):  
K. Rajender Reddy ◽  
Jacqueline G. O'Leary ◽  
Patrick S. Kamath ◽  
Michael B. Fallon ◽  
Scott W. Biggins ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Liver Transplant ◽  
North American ◽  
End Stage Liver Disease ◽  
The North ◽  
Transplant Candidates ◽  
End Stage

scholarly journals Treatment Precedes Positive Symptoms in North American Adolescent and Young Adult Clinical High Risk Cohort

2016 ◽  
Vol 47 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Kristen A. Woodberry ◽  
Larry J. Seidman ◽  
Caitlin Bryant ◽  
Jean Addington ◽  
Carrie E. Bearden ◽  
...  
Keyword(s):  
Young Adult ◽  
High Risk ◽  
North American ◽  
Adolescent And Young Adult ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
High Risk Cohort
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