RocScholar (Rochester Regional Health)
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Plasmacytoid dendritic cell-associated acute myeloid leukemia (pDC-AML) a comprehensive review
No full textCardioembolic versus Cryptogenic Stroke: A Case Report and Discussion
No full textIschemic strokes account for about 85% of cerebrovascular accidents. About 30–40% of ischemic strokes are classified as cryptogenic, which is defined as an ischemic stroke of the brain without a clear etiology. This case report presents a 56-year-old male with a history of uncontrolled hypertension who was admitted to a community hospital for cardioembolic versus cryptogenic stroke. It is essential for clinicians to be familiar with cryptogenic stroke and its implications for patient care
Diagnostic accuracy of PET/CT scan in differentiating malignant and bland thrombi in cancer patients: A systematic review
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Impact of blood transfusion on clinical outcomes in patients hospitalized with acute promyelocytic leukemia: A nationwide analysis
No full textSevere trastuzumab-induced pneumonitis refractory to steroid therapy
No full textTrastuzumab has been widely used in breast cancers. Despite its efficacy, trastuzumab-induced pneumonitis (TIP) remains a rare yet potentially fatal complication. While corticosteroids are the mainstay of treatment, steroid-refractory cases pose significant challenges due to the lack of standardised guidelines and limited data on additional therapies. We describe a case of grade 4 TIP in a female in her early 70s, initially managed with steroids and intravenous immunoglobulin, resulting in minimal clinical improvement. Due to the lack of response, advanced immunosuppressive therapy with infliximab was initiated which led to a marked improvement in her condition. This suggests that infliximab may be used to treat severe, corticosteroid-resistant TIP, particularly in cases when conventional therapy is ineffective. The findings obtained here urge additional research to better characterise further interventions like infliximab in TIP therapy and highlight the need for updated guidelines that incorporate advanced immunosuppressive medicines
Effect of Breast Cancer Receptor Subtypes and CSF Cytology Status on Survival of Patients With Leptomeningeal Disease
No full textBackground: It is unclear whether breast cancer (BC) subtypes or CSF cytology results are associated with overall survival (OS) among patients with BC leptomeningeal disease (LMD). This single-institution retrospective study compares OS among BC patients with LMD across various breast cancer subtypes and CSF cytology results.
Methodology: The study enrolled BC patients diagnosed with LMD between 2010 and 2023. Breast cancer subtypes were classified as A. ER+/HER2-, HER2+, or triple-negative BC (TNBC); B. HER2+, HER2-Low, HER2-Zero. CSF cytology subtypes included CSF+, CSF-, or CSF not tested (NT). OS was summarized via Kaplan-Meier analysis and compared using log-rank test. Cox models were used for multivariate analyses.
Results: Out of 69 patients registered, median OS (95% CI) for ER+/HER2- (n = 33), HER2+ (n = 12) and TNBC (n = 24) subtypes were 8.0 (3.02, 24.8), 5.71 (1.61, not estimated) and 3.2 (1.11, 4.95) months (P = .17). In multivariate analysis, TNBC was associated with worse OS versus ER+/HER2- [Hazard Ratio (HR), 95% CI: 2.64, 1.23-5.80, P = .04]. HER2 subtypes (HER2-Zero, n = 21; HER2-Low, n = 32; HER2+, n = 12) showed no significant differences in OS. Median OS (95% CI) for CSF+ (n = 16), CSF- (n = 18), and CSF NT (n = 35) groups were 3.54 (1.61, 12.72), 13.41 (4.95, 61.93) and 3.28 (1.44, 6.92) months (P = .04). Multivariate analysis showed both CSF+ and CSF NT were associated with shorter OS compared to CSF- group [HR (95% CI) 4.50 (1.75, 12.11) for CSF+ vs. CSF-; 2.91 (1.45, 6.26) for CSF NT vs. CSF-; P = .002].
Conclusion: TNBC LMD group was associated with worse OS than ER+/HER2- BC LMD when adjusting for other prognostic factors. CSF- LMD patients had better OS than CSF+ or CSF NT LMD
Efficacy and safety of gastric peroral endoscopic myotomy across different etiologies of gastroparesis: systematic review and meta-analysis
No full textBackground and aims: Gastric peroral endoscopic myotomy (G-POEM) is an emerging treatment for refractory gastroparesis. Although its efficacy and safety have been analyzed in previous systematic reviews and meta-analyses, no studies have compared its effectiveness based on etiology. Our study aims to evaluate the efficacy and safety of G-POEM by etiologies of gastroparesis.
Methods: We conducted a comprehensive search in major databases until October 2023, focusing on the efficacy and safety of G-POEM by etiology. Our primary outcome was clinical success based on etiology, with an additional subgroup analysis on Gastroparesis Cardinal Symptom Index (GCSI) scores before and after G-POEM based on etiology using standard meta-analysis methods and the random-effects model. Heterogeneity was assessed using I2 statistics.
Results: In our analysis of 15 studies (7 retrospective, 8 prospective) involving 982 patients (mean patient age, 50.81 years; mean follow-up, 21 months), postsurgical conditions were the most common etiology in G-POEM (290 cases), followed by idiopathic factors (287 cases) and diabetes (286 cases). Subgroup analysis revealed pooled clinical success rates of 65% (95% confidence interval [CI], 51-77; I2 = 46%) for diabetes, 70% (95% CI, 46-86; I2 = 73%) for postsurgical conditions, and 60% (95% CI, 41-77; I2 = 68%) for idiopathic etiologies. Our research also indicated that G-POEM significantly improved GCSI scores: 1.7 (95% CI, -.01 to 3.5; P = .052) for diabetes, 1.34 (95% CI, -.07 to 2.62; P = .038) for postsurgical conditions, and 1.5 (95% CI, .36-2.75; P = .01) for idiopathic patients.
Conclusions: Based on this meta-analysis, G-POEM is effective and safe for treating refractory gastroparesis irrespective of the etiology, with significant improvements in clinical success rates and GCSI scores
RRH Library Newsletter, Winter 2025
Full text linkNewsletter sections include: New Database: Embase; St. Lawrence Health New Database Access; EBSCOhost New Database User Interface; Discovery Tool Updat