MKSAP: 54-year-old man with dysphagia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated for a 4-month history of intermittent, nonprogressive solid-food dysphagia. He has a long-standing history of heartburn that has been well controlled with once-daily proton-pump inhibitor (PPI) therapy for the past 5 years. Results of a screening colonoscopy 4 years ago were normal. There is no family history of colorectal cancer. Physical examination findings are unremarkable. Upper endoscopy reveals a 3-cm hiatal hernia, an esophageal (Schatzki) ring, and approximately six polyps smaller than 4 mm in the fundus and upper body of the stomach. The duodenum is normal. The esophageal ring is dilated, and biopsy of random gastric polyps confirms fundic gland polyps without dysplasia. Which of the following is the most appropriate next step in management? A. Perform APC gene testing B. Perform excision of all fundic gland polyps C. Repeat colonoscopy D. Stop PPI therapy E. Reassurance Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Publication date: 15 February 2021Source: Journal of Hazardous Materials, Volume 404, Part BAuthor(s): Yanhua Liu, Yang Li, Shanshan Dong, Lu Han, Ruixin Guo, Yourong Fu, Shenghu Zhang, Jianqiu Chen
Authors: Musio F Abstract INTRODUCTION: Anemia has and will continue to be a central theme in medicine particularly as clinicians are treating a burgeoning population of complex multi-organ system processes. As a result of multiple randomized controlled trials (RCTs), meta-analyses, and societal recommendations overly restrictive paradigms and under-administration of erythropoiesis stimulating agents (ESAs) have likely been followed by clinicians among all specialties. AREAS COVERED: A review of anemia in the context of chronic kidney disease, hematologic malignancies and cancer is presented with focus on the e...
Publication date: January 2021Source: Urology Case Reports, Volume 34Author(s): Nina Al-Saadi, Safa Al-Musawi, Yousuf Khan, Daben Dawam
CONCLUSIONS: Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use. PMID: 33032462 [PubMed - as supplied by publisher]
Authors: Matti B, Zargar-Shoshtari K Abstract Prostate cancer represents a significant health burden worldwide. The cancer incidence had substantially increased since the introduction of prostate specific antigen (PSA) in cancer screening. This had led to considerable debates among health professionals and epidemiologists, since PSA as a screening tool seemed to be far from perfect. In New Zealand, the controversy was quite prominent in the last three decades, with some advocating the benefits of screening, while others concerned regarding the risk of harms. With the absence of an organised screening programme and ...
CONCLUSION: This study found that childhood cancer survivors in New Zealand had a high prevalence of developmental dental abnormalities and it identified potential risk factors related to their cancer treatment. Inequitable access to oral rehabilitation for this patient group argues for a mechanism for consistent improved access to publicly funded dental care across district health boards in New Zealand. PMID: 33032302 [PubMed - in process]
Authors: Zarrabi A, Mark S PMID: 33032299 [PubMed - in process]
Authors: Peng C, Cohen DJ Abstract INTRODUCTION: Esophageal squamous cancer remains an important cause of mortality worldwide with two new immunotherapy drugs recently approved for metastatic disease. AREAS COVERED: The authors review the epidemiology and genomics of esophageal squamous cell carcinoma. They also examine prior trials involving targeted agents under investigation as well immunotherapies that have been approved and novel combinations. EXPERT OPINION: Great advances have been made in characterizing the molecular changes in esophageal carcinoma. However, relatively few drugs have shown benefit i...
This article summarizes the rationale for, and development of CDK inhibitors in melanoma, with their evolution from pan-CDK inhibitors to highly specific agents, throughout clinical trials and finally their potential future use. EXPERT OPINION: Whilst CDK inhibitors have been practice changing in breast cancer management, their efficacy is yet to be proven in melanoma. Combination with BRAF/MEK inhibitors has been hindered by dose-limiting toxicities, but their role may yet to be found within the spectrum of biomarker-derived personalized melanoma management. The effect that CDK inhibitors can have as an adjunct to imm...
CONCLUSIONS: The cfDNA level in the CSF can be used as a supplemental marker for diagnosing LMS in hematologic malignancy patients. PMID: 33029963 [PubMed]
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