New study compares long-term side effects from different prostate cancer treatments
Prostate cancer therapies are improving over time. But how do the long-term side effects from the various options available today compare? Results from a newly published study are providing some valuable insights. Investigators at Vanderbilt University and the University of Texas MD Anderson Cancer Center spent five years tracking the sexual, bowel, urinary, and hormonal status of nearly 2,000 men after they had been treated for prostate cancer, or monitored with active surveillance (which entails checking the tumor periodically and treating it only if it begins to grow). Cancers in all the men were still confined to the prostate when diagnosed. Dr. Karen Hoffman, a radiation oncologist at MD Anderson and the study’s first author, said the intent was to provide information that could help men choose from among the various therapeutic options. “Surgical and radiation techniques have changed significantly in the last few decades, and at the same time, active surveillance has become an increasingly acceptable strategy,” she said. “We wanted to understand the adverse events associated with contemporary approaches from the patient’s perspective.” Roughly two-thirds of the men enrolled in the study had “favorable risk” cancer, which is nonaggressive and slow-growing. A quarter of these men chose active surveillance, and the rest were treated with one of three different methods: nerve-sparing prostatectomy (an operation to remove the ...
CONCLUSIONS: Gaps in memory and various memory types were common after ICU admission, whose prevalence waned over time. Compared with nightmares and fearful memories, gaps in memories were most strongly associated with poor mental health and quality of life. Identifying patients with gaps in memories might be an objective way of planning interventions to improve their long-term outcomes.
CONCLUSIONS: Currently, available evidence does not unequivocally support the clinical effectiveness of andexanet alfa or prothrombin complex concentrate to reverse factor Xa inhibitor-associated acute major bleeding, nor does it permit conventional meta-analysis of potential superiority. Neither reversal agent was significantly associated with increased effectiveness or a higher rate of venous thromboembolic event. These results underscore the importance of randomized controlled trials comparing the two reversal agents and may provide guidance in designing institutional guidelines.
CONCLUSIONS: These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who require mechanical ventilation. These recommendations should be viewed as a starting point to improve clinical trials and help reduce methodological heterogeneity in future clinical trials.
If it hurts – take notice, and avoid it. Learn from it. If there are other people around, make sure your behaviour is noticeable so they take care of you and don’t do what you just did. If they look after you, you’ll probably do the same thing again when you hurt, if they don’t you probably won’t. This is one description of pain behaviour and how it works. It’s the only part of our pain experience that we can share directly with one another (actions and words). The “doing” part is also the part that is most affected by pain – even distress is signalled to others &nd...
Last week, I became involved in two situations of pain between the eyes that seemed to potentially be presentations of very serious medical conditions. Autumn took a call from her sister late on Friday afternoon. Her sister had been tested for COVID the day before and told Autumn she instantly felt a severe pain betweenRead more …The art and uncertainty of triage originally appeared inKevinMD.com.
Hi, I was wondering if anyone knows of any pain management docs in Scranton, PA or surrounding area (private practice or hospital employed). I'm looking to learn more about local market and network. Thank you.
I've been getting a variety of lectures about various SCS waveforms from my faculty during fellowship, industry events, and society meetings. I think neuromodulation in general (not just SCS) is a fascinating therapy and has a lot of promise. However, I've become a bit disillusioned by the influence of industry in our understanding of these therapies that WE prescribe and implant into our patients. I've heard a lot about the novel mechanisms of action of the various different waveforms... Read more
CONCLUSIONS: Triamcinolone bladder neck injections for post-RP VUAS are a useful and safe treatment for recurrent stenosis. PMID: 32807289 [PubMed - as supplied by publisher]
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