Five years after stem cell transplant complications, he’s an active teenager
Drew at 2014 Be the Match Walk in NYC. His stem cell donor lives in Germany. “It’s eye-opening to realize how fragile life really is when you’re young.” Drew D’Auteuil certainly knows whereof he speaks. He is a 16-year-old animal-loving, skiing, rowing, volleyball-playing, honor roll student and licensed driver with braces and a shock of red hair. In April 2010, five months after receiving a stem cell transplant to treat the blood disorder severe aplastic anemia, Drew suffered rare, life-threatening complications. One day Drew was biking with a friend near his New Hampshire home, suffering little more than a mild cough. The next day he was in the intensive care unit at Boston Children’s Hospital, intubated because of respiratory failure. Soon other organs were failing, too. Quick action by ICU and transplant clinicians saved the boy’s life. Although the donor stem cells that would replace his failing bone marrow with healthy marrow were engrafting well, Drew developed Idiopathic pneumonitis syndrome (IPS), a dangerous inflammation of the lungs that occasionally arises in transplant patients who receive stem cells from an unrelated donor. “IPS is a very rare but known complication of stem cell transplant, with a high fatality rate,” says Dr. Allison O’Neill, Drew’s pediatric hematologist/oncologist at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “Drew’s ICU and tr...
Conclusion: This paper addresses the clinical implications of performing numerous CT examinations in patients with cancer, providing clinicians with information regarding methods to reduce risk factors in this patient population.Blood Purif 2018;46:56 –69
Conclusions: RDLs are frequently observed in high-risk patients for gastric cancer after eradication. M-NBI demonstrated significantly superior diagnostic efficacy with respect to RDL.Digestion 2018;98:48 –55
This study showed that ESE-16 exposure leads to the aggregation of acidic vesicles, identified as lysosomes, not accompanied by an induction of autophagy. Therefore, ESE-16 disrupts normal endocytic vesicle maturation likely through the inhibition of the microtubule function.Pharmacology 2018;102:9 –16
Authors: PMID: 29669092 [PubMed - in process]
Abstract Pain reduction is a primary goal of physical therapy for patients who present with acute or persistent pain conditions. The purpose of this review is to describe a mechanism-based approach to physical therapy pain management. It is increasingly clear that patients need to be evaluated for changes in peripheral tissues and nociceptors, neuropathic pain signs and symptoms, reduced central inhibition and enhanced central excitability, psychosocial factors, and alterations of the movement system. In this Perspective, 5 categories of pain mechanisms (nociceptive, central, neuropathic, psychosocial, and movemen...
Abstract The variability and delay in utilizing evidence in clinical practice are barriers to improving care, quality, and cost in health care, as charged by the "triple aim" framework. Scientific research provides an avenue not only to further the field of pain research, but also to study and change the patterns and processes that drive systemic and individual clinical practices. Implementation science is an emerging field that can be integrated with more traditional effectiveness research to accomplish a combination of aims within the same study. This type of concurrent study of effectiveness and imple...
Conclusions: The sustained effort to self-manage chronic pain could be exhausting, and motivation could wane over time following intervention. Providing intermittent support in the form of booster sessions and peer support groups may be important. Person-centered care via shared decision making and guided problem solving is essential to facilitating ongoing self-management. PMID: 29669089 [PubMed - in process]
Abstract Geriatric low back pain (LBP) can have a profound impact on physical activity and can cause a decline in physical function, which is a major health risk for older adults. Within the last decade, physical therapist management of LBP has shifted from an emphasis on pathoanatomical mechanisms, such as spine degeneration, to addressing psychological distress factors. Although this approach is promising, the complexity of LBP in older adults (including biological, psychological, cognitive, and social influences), which may differ from that in younger adults, must be considered. Further, outcome assessment shou...
In conclusion, understanding the psychological processes underlying the etiology of chronic pain provides testable ideas and a path forward for improving treatment interventions. PMID: 29669087 [PubMed - in process]
Conclusions: This pilot trial demonstrated that home-based telephone-supported PA interventions were feasible, acceptable, and safe for older adult veterans. The results provide support for a larger trial investigating these interventions. PMID: 29669086 [PubMed - in process]
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