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Книги з теми "Risk of recurrence"

Автор: Grafiati

Опубліковано: 6 липня 2024

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1

Veronique, Benk, and Canadian Coordinating Office for Health Technology Assessment., eds. Impact of radiation wait times on risk of local recurrence of breast cancer: Early stage cancer with no chemotherapy. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 2004.

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2

Paula, Wells, and Halstead Regina, eds. Rectal cancer: Etiology, pathogenesis and treatment. Hauppauge, NY: Nova Science Publishers, 2009.

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3

Virginia Institute of Marine Science. Recurrent flooding study for Tidewater Virginia: To the Governor and the General Assembly of Virginia. Richmond: Commonwealth or Virginia, 2013.

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4

Beenstock, Michael. Recurrence Risk in Autism Spectrum Disorders. Nova Science Publishers, Incorporated, 2021.

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5

Beenstock, Michael. Recurrence Risk in Autism Spectrum Disorders. Nova Science Publishers, Incorporated, 2021.

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6

Lancee, Wilhelmus Johannes. The influence of mood variation on risk for recurrence of herpes labialis. 1992.

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7

Predictable and Avoidable: Repairing Economic Dislocation and Preventing the Recurrence of Crisis. Taylor & Francis Group, 2013.

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8

McKinlay Gardner, R. J., and David J. Amor. Deriving and Using A Risk Figure. Edited by R. J. McKinlay Gardner and David J. Amor. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199329007.003.0004.

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Risk is a central concept in genetic counseling. Risk is the probability that a particular event will happen. Risks may be discussed in terms of recurrence or of occurrence—the probability that an event will happen again, or that it will happen for the first time, respectively. Risk can also be presented as odds: the ratio of two mutually exclusive probabilities. This chapter provides a basic review of risk assessment, with a particular focus on its application to chromosome abnormalities. The concept of penetrance is introduced. The ways in which risk figures may be conveyed to patients in the clinic are discussed.

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9

Carr, Nicola. Reducing the Risk of Breast Cancer Recurrence: A Natural Approach with a Focus on Stage 3 Breast Cancer. Independently Published, 2022.

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10

Lung Cancer: Ultimate Guide for Natural Healing to Reduce the Risk of Recurrence and Live a Healthy Life. Independently Published, 2020.

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11

Pezzuto, Ivo. Predictable and Avoidable: Repairing Economic Dislocation and Preventing the Recurrence of Crisis. Taylor & Francis Group, 2016.

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12

Pezzuto, Ivo. Predictable and Avoidable: Repairing Economic Dislocation and Preventing the Recurrence of Crisis. Taylor & Francis Group, 2016.

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13

Iqbal, Muhammad Waqas, Ghalib Jibara, Michael E. Lipkin, and Glenn M. Preminger. Evaluation of stone formers. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0014.

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Urolithiasis is among the most common urologic disorders with high incidence and recurrence rates. High environmental temperatures, prevalence of the Western diet, obesity, age, gender, and race are among the common risk factors associated with this disease. The primary goal of evaluating these patients is to provide a simple, economic, and effective workup, which yields information that is directly applicable to providing relevant medical preventative measures. The management of urolithiasis requires a relevant history, targeted physical exam, appropriate chemistry, urinary and stone analyses results, radiological imaging to accurately identify number, location, and size of stones, as well as a metabolic evaluation. All stone formers whether single or recurrent should have a basic evaluation to identify any factors that may predispose to recurrent stone formation. Comprehensive metabolic evaluations are offered to patients at increased risk of recurrence or morbidity from stone disease, or have difficult to treat stones.

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14

Holistic Cancer Care: An Herbal Approach to Preventing Cancer, Helping Patients Thrive During Treatment, and Minimizing the Risk of Recurrence. Storey Publishing, LLC, 2023.

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15

Cabrera, Chanchal. Holistic Cancer Care: An Herbal Approach to Preventing Cancer, Helping Patients Thrive During Treatment, and Minimizing the Risk of Recurrence. Storey Publishing, LLC, 2023.

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16

Bagrodia, Aditya, and Yair Lotan. Low and intermediate risk non-muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0076.

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Bladder cancer is a common disease that affects more males than females. Most bladder tumours are histologically typed as urothelial cell carcinoma, and these are best divided into cancers invading the muscularis propria and non-invasive malignancies confined to the bladder. The latter are the majority of cancers and include low risk, indolent cancers that may recur within the bladder but not progress to invasion or metastases, and a proportion that subsequently progress to muscle invasion. The risk of intravesical recurrence or progression to invasion from a non-invasive bladder cancer can be stratified as low, intermediate, and high using various pathological factors (such as tumour grade, stage, size, multiplicity, and the presence of carcinoma in situ). In this chapter, we will give an overview of bladder cancer and focus upon tumours at low or intermediate risk of developing future progression to invasion.

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17

Chong, Ji Y., and Michael P. Lerario. Can I Go Home Now? Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190495541.003.0027.

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Transient ischemic attack (TIA) is a risk factor for subsequent stroke. A TIA diagnosis should incorporate findings on brain MRI and noninvasive angiography, if available. Some patients with TIA are at high risk of early recurrence. Rapid evaluation and treatment reduce that risk. Some new data suggest that short-term dual antiplatelet therapy may reduce stroke recurrence in patients with TIA or minor stroke.

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18

Alschuler, Lise. The definitive guide to thriving after cancer: A five-step integrative plan to reduce the risk of recurrence and build lifelong health. 2013.

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19

De Braganca, Kevin C., and Roger J. Packer. Medulloblastoma. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0139.

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Medulloblastoma is the most common malignant brain tumor in pediatric patients. Patients are presently stratified to either standard or high-risk groups based on clinical and pathologic criteria. Approximately 80% of patients with standard risk disease are cured of their primary disease. High-risk and recurrent disease groups have a poorer outcome; 5-year progression-free survival is only 65% with high-risk disease. Disease control after recurrence is very poor. Treatment is multimodal and also aims to limit short- and long-term toxicities. Recent identification of four molecular subtypes of medulloblastoma may change risk assignment and therapy. Addressing the medical and psychosocial issues of survivors continues to improve the quality of life for these patients beyond the disease’s treatment.

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20

Naess, Halvor. Long-term prognosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0016.

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Knowledge of prognosis is important for patients in the prime of life in order to make informed decisions about treatment, choice of education, and profession. Median first-year mortality after first-ever cerebral infarction among young adults is about 4% while median annual average mortality after the first year is about 1.7%. Likewise, median first-year recurrence rate of cerebral infarction is 2% and thereafter 1.5% per year. Risk factors for recurrent cerebral infarction include hypertension, diabetes mellitus, symptomatic atherosclerosis, and smoking. Recurrent cerebral infarction and mortality are associated with increasing number of traditional risk factors. About 10% of patients develop post-stroke seizures within 6 years of the acute stroke. Almost 90% of patients report good functional outcome (modified Rankin Scale score ≤2) on long-term follow-up, but up to 30–50% of patients do not resume employment. Many patients have cognitive impairment. Fatigue and depression are also common on long-term follow-up.

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21

Iqbal, Muhammad Waqas, Michael E. Lipkin, and Glenn M. Preminger. Prevention of other non-calcium stones. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0016.

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Urolithiasis is a worldwide problem with an increase in incidence and prevalence affecting the quality of life of millions of people. While there have been significant advances in minimally invasive and endourological techniques to treat urinary stones, stone recurrence remains a substantial medical problem posing considerable social and financial burdens. Although debate continues on optimal metabolic workup in stone formers, identification of metabolic risk factors and medical preventive therapy is known to decrease stone recurrence. Specific treatment measures include targeted medical therapy tailored to individual stone types. In this chapter we discuss the current specific as well as non-specific measures to prevent non-calcium-based stones.

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22

Sybert, Virginia P. Practical Inheritance. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780195397666.003.0001.

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Genetic disorders are unique among diseases in that they affect families and generations, not just individuals. In the diagnosis and discussion of an inherited disorder, the recurrence risk must always be included. Will it happen again? Who is at risk to inherit? What is the magnitude of that risk? How severely will the condition be manifested? The answers to these questions depend on the mode of inheritance and the penetrance and expression of the gene(s) for the disorder.

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23

Dietz, Laura J., Laura Mufson, and Rebecca B. Weinberg. Family-based Interpersonal Psychotherapy for Depressed Preadolescents. Oxford University Press, 2018. http://dx.doi.org/10.1093/med-psych/9780190640033.001.0001.

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Family-based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents presents the rationale and basic principles for interpersonal psychotherapy (IPT) and for interpersonal psychotherapy for depressed adolescents (IPT-A), a developmental adaptation that is designed to treat adolescents, ages 12 to 18 years, with depression. The heart of this book introduces family-based interpersonal psychotherapy for depressed preadolescents (FB-IPT), a psychosocial treatment for preadolescent depression for children between 7 and 12 years. FB-IPT is conceptually rooted in an interpersonal model of depression and in developmental research on the antecedents of depression in youth. FB-IPT focuses on improving two domains of interpersonal impairment in depressed preadolescents—parent–child conflict and peer impairment—as a means to decrease preadolescents’ depressive symptoms. Stronger interpersonal skills and relationships buffer depressed preadolescents from stressors that arise during this important developmental period. Research shows that preadolescent depression is an important public health concern because it is often a gateway condition that increases the risk for recurrent depression in adolescence. Preteen depression not only interferes with normative social development at a formative period but also results in residual impairments in interpersonal functioning, which may increase risk for recurrent depression into adolescence and adulthood. Effective interventions for depression in the preadolescent period that target family and interpersonal risk factors may reduce risk for depression recurrence in adolescence. Chapters 5 through 17 of this Therapist Guide describe in detail the steps for conducting FB-IPT with depressed preadolescents and their parents.

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24

Silverman, Debra T., Stella Koutros, Jonine D. Figueroa, Ludmila Prokunina-Olsson, and Nathaniel Rothman. Bladder Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0052.

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In the United States, an estimated 74,000 new cases of bladder cancer and 16,000 deaths occur annually. Because of favorable survival, approximately 578,000 persons are alive after diagnosis. Recurrence after treatment is common, necessitating lifelong surveillance and care, making bladder cancer the most costly malignancy from diagnosis to death. The median age at diagnosis has increased from 67 years in 1980 to 73 years in 2008–2012. Incidence rates rise dramatically with age, suggesting that as the US population ages, the burden of bladder cancer in the United States will continue to grow. Worldwide over 1.3 million cases are estimated to occur annually. Cigarette smoking is the principal known cause of bladder cancer, along with various chemical exposures. Recent studies suggest that, over the past two decades, the risk for current smokers has increased from three times the risk of nonsmokers to about four to five times the nonsmoker risk.

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25

McKinlay Gardner, R. J., and David J. Amor. Down Syndrome, Other Full Aneuploidies, Polyploidy, and the Influence of Parental Age. Edited by R. J. McKinlay Gardner and David J. Amor. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199329007.003.0013.

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This chapter reviews the archetypical chromosome disorder, namely Down syndrome (DS; trisomy 21), and the various different chromosomal forms that may be the basis of it: standard trisomy 21, translocation trisomy, both de novo and inherited, and other rare forms. The concept of dosage imbalance as the basis of the pathogenesis is reviewed, and the “DS critical region” on chromosome 21 is examined. Reproductive risks associated with each of these DS types are discussed. The chapter considers the other full autosomal trisomies, T13 and T18, and also (mosaic) T9. Triploidy, as the basis of hydatidiform mole, is reviewed. Also reviewed are the influence of parental, mostly maternal, age, in the genesis of these aneuploidies, and the effect of secular change on these observations. Tables provide precise age-related risk figures for recurrence risk of T21 and more general figures for other trisomies.

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26

Tuxen, David V. Pathophysiology and causes of airflow limitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0110.

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Exacerbations of asthma or chronic obstructive pulmonary disease (COPD) can be life-threatening emergencies, and require careful management to minimize the risks of morbidity and mortality. Prompt, full bronchodilator therapy, careful observation and appropriate mechanical ventilation technique is required. Dynamic hyperinflation of the lungs occurs in all patients, and must be careful assessed and regulated. Excessive dynamic hyperinflation can result in respiratory tamponade, hypotension, circulatory failure, pneumothoraces and, in severe cases, cardiac arrest. Intravenous or continuous nebulized salbutamol commonly causes lactic acidosis that should be detected and managed. Prolonged paralysis during difficult mechanical ventilation can result in severe necrotizing myopathy. Pneumothoraces in ventilated patients with asthma are usually under tension, redistribute ventilation to the contralateral lung, and risk a second tension pneumothorax. Patients surviving mechanical ventilation for asthma and COPD have an increased risk of recurrence and death. All these problems require awareness, avoidance or detection and management

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27

Beal, Jules C., and Emilio Perucca. Medical Management of Epilepsy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0044.

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Epilepsy affects approximately 65 million people worldwide, leading to significant morbidity and mortality including injuries, psychiatric comorbidities, social stress, and the risk of sudden death. The best indicator of quality of life in patients with epilepsy is seizure freedom. The chapter discusses the medical management of epilepsy, focusing on decision making, when to initiate treatment, how to choose an appropriate medication, and how to proceed when a medication fails. The treatment of epilepsy is a highly individualized process that must take into account an individual’s seizure type, risk of seizure recurrence, age, sex, medical comorbidities, and personal goals and preferences.

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28

Sybert, Virginia. Genetic Skin Disorders. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780195397666.001.0001.

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This lavishly-illustrated resource represents a comprehensive survey of well over 300 distinct inherited dermatologic conditions. Each disease entry follows a consistent format, containing sections devoted to dermatologic features, associated clinical abnormalities, histopathology, biochemical and molecular information, treatment, mode of inheritance and recurrence risk, prenatal diagnosis, and information on differential diagnosis. Any clinician faced with a patient in whom the possibility for a genetic disorder of the skin exists will find this book a practical tool of immense interest.

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29

McKinlay Gardner, R. J., and David J. Amor. Sex Chromosome Aneuploidy and Structural Rearrangement. Edited by R. J. McKinlay Gardner and David J. Amor. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199329007.003.0015.

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There are four major sex chromosome abnormalities due to complete aneuploidy. Otherwise unassisted, infertility is practically inevitable in XXY Klinefelter syndrome and 45,X Turner syndrome. The other two conditions, XXX and XYY, apparently have little effect on fertility; furthermore, they are not discernibly associated with any increased risk for chromosomally abnormal offspring. This chapter first discusses these classic pure sex chromosomal aneuploidies. Then, deletion/duplication states of the X and Y chromosomes are reviewed, whether large and known since classical cytogenetics, or those only having come to light due to the power of twenty-first century molecular karyotyping. Recurrence risks are considered both for those who (if fertile, naturally or via in vitro fertilization) might themselves have such an abnormality, and for normal parents having had an affected child.

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30

Taylor, Eric N., and Gary C. Curhan. Epidemiology of nephrolithiasis. Edited by Mark E. De Broe. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0199.

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Nephrolithiasis is common, costly, and painful. The prevalence of nephrolithiasis, defined as a history of stone disease, varies by age, sex, race, and geography while the incidence of nephrolithiasis, defined as the first stone event, varies by age, sex, and race. Epidemiologic studies have quantified the burden of kidney stone disease and expand our understanding of risk factors. A variety of dietary, non-dietary, and urinary risk factors contribute to the risk of stone formation and the importance of these varies by age, sex, and body mass index.Low fluid intake, high urinary oxalate or calcium or uric acid, and low urinary citrate are all associated with nephrolithiasis. These results from epidemiologic studies can be considered in the clinical setting when devising treatment plans to reduce stone recurrence.

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31

Turney, Ben, and John Reynard. Epidemiology of stone disease. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0012.

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In developed countries, the lifetime prevalence of kidney stones is around 10% and most commonly affects people in the working age-group. The incidence is increasing internationally. After passage of a first stone, the risk of recurrence is high. Direct and indirect costs involved in treating stones are considerable. Intrinsic risk factors include age, gender, genetics, and metabolic syndromes. The incidence of stone disease peaks between the ages of 20 and 60 years. While historically the male to female ratio was around 3:1, the gender gap is closing. The reasons for increased incidence are due in part to increased detection through better imaging but also due to environmental factors (e.g. diet, obesity, diabetes, dehydration) which put more people with an underlying genetic predisposition at risk. Despite the increasing prevalence of kidney stones, the majority are categorized as idiopathic.

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32

Evans, Lilliana R. Recurrent Pregnancy Loss: Prevalence, Risk Factors and Outcomes. Nova Science Publishers, Incorporated, 2016.

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33

Burge, Peter. Dupuytren’s disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.006007.

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♦ Dupuytren’s disease is characterised by contracture of a finger resulting from thickening and shortening of the palmar fascia♦ A genetic component to the aetiology is apparent, smoking, alcohol and diabetes can increase the risk♦ The pathogenesis of Dupuytren’s disease remains elusive♦ Non-surgical treatment options include splintage, steroid injection and collagenase injection♦ Surgery cannot cure the disease but can straighten bent digits and minimize recurrence♦ Operative methods can be considered with regards to incision, management of the diseased fascia and closure techniques♦ Operative complications include injury of digital nerves and arteries

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34

Brommelhoff, Jessica A. Depression in Dementia Syndromes. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.007.

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Depressive symptoms are common in many dementia syndromes, and depressive disorders are much more common in older adults with dementia than in cognitively intact older adults. Depression may be a risk factor for, or a prodromal feature of, subsequent dementia. Several neuropathological mechanisms have been suggested to explain these relationships, including the role of underlying cerebrovascular risk factors for depression and cognitive impairment. Depression also may be present in dementia as an emotional reaction to cognitive decline, or as a recurrence of early and midlife depression. Differential diagnosis between depression and dementia is essential, but complicated by problems in assessment, overlapping symptoms between the two conditions, and other medical co-morbidities. Pharmacological treatment of depression in dementia may also be complicated by medical co-morbidity, and can run the risk for adverse reactions or interactions between medications. Psychotherapy and psychosocial interventions, however, hold some promise for effective reduction of depressive symptoms.

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35

Turney, Ben, and John Reynard. Kidney stones. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0013.

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The composition of kidney stones is variable and the predisposing factors multifactorial. Consequently, a detailed evaluation of the patient’s lifestyle, diet, fluid intake, medical history, drug history, urinary tract anatomy, blood, and urine biochemistry and stone composition is required determine predisposing factors for stone formation in an individual patient. Combinatorial subtle variants in biochemistry may act synergistically to increase risk of stone formation/recurrence. Many medications may alter blood and/or urine biochemistry and predispose to stone formation. Corticosteroids increase absorption of calcium from the gut and cause hypercalciuria. Topirimate (for seizures or migraines), sulphasalazine (for rheumatoid arthritis), diuretics containing triamterene, acetazolamide (for myotonia), antacids containing trisilicate, calcium supplements, vitamin D supplements, vitamin C in high doses, indinavir (for HIV), and some herbal medicines (containing ephedrine) all increase stone risk.

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36

Flinter, Frances. Antenatal diagnosis and pre-implantation genetic testing. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0302_update_001.

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Routine pregnancy screening (e.g. ultrasound scan) may lead unexpectedly to the identification of an underlying renal problem whose aetiology may not be apparent immediately. It is important to recognize genetic causes so that associated problems in other organs can be anticipated and the recurrence risk for future pregnancies established. Specific diagnosis at a cytogenetic or molecular level may be essential if the options of early prenatal diagnosis or pre-implantation genetic diagnosis are to be available to the couple in future pregnancies. This chapter discusses the topics of antenatal screening, prenatal diagnosis (including invasive and non-invasive diagnosis and counselling) and intervention, and pre-implantation genetic diagnosis.

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37

Turc, Guillaume, David Calvet, and Jean-Louis Mas. Cardiac aetiology. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0005.

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Cardiac aetiology accounts for approximately 20% of strokes in young adults. Although atrial fibrillation is a leading cause of stroke in the general population, it is uncommon in young adults. In such patients, more diverse causes of ischaemic stroke are observed, including valvular heart diseases, infective endocarditis, Libman–Sacks endocarditis, dilated cardiomyopathies, congenital heart diseases, myocardial infarction, and intracardiac tumours. Patent foramen ovale is commonly observed in young adults with ischaemic stroke, but this association may be incidental in a sizeable proportion of patients. Young adults who are the most likely to have a stroke-related patent foramen ovale are also those with the lowest recurrence risk.

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38

McKinlay Gardner, R. J., and David J. Amor. Autosomal Structural Rearrangements. Edited by R. J. McKinlay Gardner and David J. Amor. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199329007.003.0014.

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This chapter considers the question of autosomal deletions and duplications, first from the aspect of presumed mechanisms by which they may arise, and then followed by a lengthy (but not encyclopedic) listing of specific imbalances. This listing is informed by the increased knowledge enabled by modern molecular karyotyping, and a number of conditions are those only of twenty-first century discovery. Conditions are listed by the chromosome involved, and each section is headed by a diagram showing the specific segments under consideration. In each, wherever known, a comment is made on possible de novo versus inherited forms, and inferences are drawn as to any recurrence risk in a future pregnancy.

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39

Parikh, Roshni A., and David M. Williams. Proximal Arterial Occlusion During Treatment of Pelvic High-Flow Arteriovenous Malformations. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0029.

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Pelvic arteriovenous malformations (AVMs) are a cause of significant morbidity. Surgical management of AVMs poses a risk of massive intraoperative hemorrhage, surrounding organ injury, and incomplete removal of the nidus. Unfortunately, treatment is associated with high recurrence rates. Endovascular treatment is the preferred method of treatment; however, the high-flow nature of these lesions poses a challenge, risking nontarget treatment. It is important to provide adequate proximal arterial occlusion before injecting the sclerosant. This chapter outlines the steps involved in creating temporary stasis proximally within an arterial feeder to extend the contact time between the sclerosant and the recipient vessel wall while simultaneously accessing the arterial feeder more distally to deliver the sclerosant.

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40

Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing-Range Personnel, Board on Environmental Studies and Toxicology, Committee on Toxicology, Division on Earth and Life Studies, and National Research Council. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. National Academies Press, 2013.

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41

Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing Range Personnel, Board on Environmental Studies and Toxicology, Committee on Toxicology, Division on Earth and Life Studies, and National Research Council. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. National Academies Press, 2013.

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42

Walsh, Richard A. A New Loss of Order. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190607555.003.0013.

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The priority in the investigation of sporadic adult-onset ataxia is to identify potentially treatable causes, to improve gait or to reduce risk of recurrence. Disorders such as multiple sclerosis, alcohol-related cerebellar degeneration, and vitamin B12 deficiency are far more common than rarer causes such as paraneoplastic syndromes or recessive genetic disorders. Routine biochemistry, magnetic resonance imaging, and cerebrospinal fluid studies are typically performed as part of the workup to guide any further intervention and investigations. Advances in genetic testing using next-generation sequencing are revealing that many patients with presumed nongenetic sporadic ataxias have a genetic cause for their symptoms. Expert opinion to guide genetic testing in cases in which no alternative cause of ataxia is found is advisable.

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43

Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. National Academies Press, 2013.

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44

Bradley, John C. The Psychopharmacological Treatment of Individuals at Risk of Recurrent Suicidal Behavior. Edited by Phillip M. Kleespies. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199352722.013.40.

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Mental illness is the primary risk factor for suicidal ideation, attempts, and completion. Effective treatment of the psychiatric condition is the foundational strategy to reduce the risk of suicide associated with these conditions, but few medications can be demonstrated to independently reduce the risk of suicide. This chapter will describe how psychopharmacological treatment can be included as a component of bio-psycho-social treatments within the context of a recovery model for suicide prevention. The evidence for medication therapies will be reviewed both for specific behavioral health conditions and for any reduced suicide risk independent of general therapeutic effects to treat underlying conditions. A framework strategy will be described for the integration of evidence-based clinical decision making to provide the most effective treatment that also specifically targets suicide risk for patients.

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45

Bentham, James R. The genetics of congenital heart disease. Edited by José Maria Pérez-Pomares, Robert G. Kelly, Maurice van den Hoff, José Luis de la Pompa, David Sedmera, Cristina Basso, and Deborah Henderson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757269.003.0022.

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Congenital heart disease (CHD) is defined as a structural cardiac malformation resulting from an abnormality of development; 8% of CHD is inherited in a Mendelian fashion and 12% results from chromosomal imbalance. Recurrence risk and new research suggest that even the remaining 80% of patients without an identifiable familial or syndromic basis for disease may have an identifiable genetic cause. The potential to understand these mechanisms is increasing with the advent of new sequencing techniques which have identified multiple or single rare variants and/or copy number variants clustering in cardiac developmental genes as well as common variants that may also contribute to disease, for example by altering metabolic pathways. Work in model organisms such as mouse and zebrafish has been pivotal in identifying CHD candidate genes. Future challenges involve translating the discoveries made in mouse models to human CHD genetics and manipulating potentially protective pathways to prevent disease.

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Ball, Steve, and Sajid Kalathil. Adrenocortical cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0094.

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Adrenocortical cancer (ACC) is rare and associated with poor prognosis. The incidence is estimated at 0.7–2 cases per one million. Overall survival rate at five years for ACC is 37–47%. While the pathogenesis of ACC is incompletely understood, inherited predisposition syndromes are common in childhood ACC. Clinical presentation can be with symptoms and signs of hormone excess (functional tumours), mass effects, or as an incidental radiological finding. A multidisciplinary approach combining radiology, biochemistry, and tissue-based pathology is needed to establish a diagnosis to guide a surgical approach aimed at complete resection of the tumour where possible. At present, recommended first-line therapies for advanced disease are mitotane monotherapy or etopiside, doxorubicin, and cisplatin plus mitotane. Metronomic capecitabine and gemcitabine have been used as alternatives. Adjuvant radiotherapy to the tumour bed should be considered for patients considered to be at high risk of recurrence.

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Dubose, Arielle C., and SreyRam Kuy. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. Edited by SreyRam Kuy and Miguel A. Burch. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0010.

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The landmark COST trial compared outcomes between minimally invasive surgery and open surgical resection for patients with colon cancer. The study found that patients with operable right, left, or sigmoid colon cancer, either laparoscopic-assisted or open colectomy may be offered without compromising the risk of tumor recurrence or mortality. Patients who underwent colectomy via a laparoscopic-assisted approach, compared to open, had a shorter length of hospital stay and required parenteral narcotics and oral analgesics for less time, while having equal rates of intraoperative and postoperative complications. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

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Dietz, Laura J., Jennifer Silk, and Marlissa Amole. Depressive Disorders. Edited by Thomas H. Ollendick, Susan W. White, and Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.19.

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Depressive disorders onset early in development. Depression during childhood and adolescence is associated with serious disruptions in emotional, social, and occupational functioning into adulthood and a high likelihood of recurrence. This chapter discusses clinical manifestations, prevalence, and course of depression presenting in early childhood (ages 3–6), middle childhood/preadolescence (ages 7–12), and adolescence (13–18). An overview is presented of standardized interviews and questionnaires for clinical assessment of depression in children and adolescents; the chapter summarizes research on empirically supported treatments for youth depression. Also included is a case study of a depressed adolescent with treatment plans formulated from both cognitive behavior therapy and interpersonal psychotherapy perspectives. Future directions for research on depressive disorders in youths are discussed, including neuroimaging research using ecologically valid stimuli, empirically supported interventions for younger children and preadolescents, and personalization of psychosocial treatment to youth’s profiles of risk and protective factors to increase effectiveness.

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Thun, Michael J., Martha S. Linet, James R. Cerhan, Christopher Haiman, and David Schottenfeld. Primary Prevention of Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0062.

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Primary prevention has enormous potential to reduce the human, social, and economic costs of cancer worldwide. The following sections discuss the development and application of preventive interventions in six broad areas of public health: tobacco control, the prevention of obesity and physical inactivity, prevention of infection-related cancers, protection against excessive exposure to ultraviolet light, preventive drug therapies (chemoprevention), and the regulation of carcinogenic exposures. All of these areas affect multiple types of cancer and massive numbers of people. Different interventions are at varying stages of development. For example, effective, evidence-based approaches have been developed over several decades to reduce tobacco use, prevent chronic infection with hepatitis B virus, protect children from excessive sun exposure, regulate exposures in high-income countries, and reduce breast cancer incidence and recurrence in high-risk women. More recent efforts are seeking to identify upstream measures to prevent excessive weight gain, reduce caloric intake, and increase physical activity.

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Meijer, Richard P., Alexandre R. Zlotta, and Bas W. G. van Rhijn. Bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0077.

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High-grade non-muscle-invasive bladder cancer (HG-NMIBC) represents the most aggressive spectrum of this non-invasive cancer. This collective term includes all high-grade NMI urothelial carcinoma (UC), such as those without invasion (pTa), those with lamina propria invasion (pT1), and those that are only/have concomitant carcinoma in situ (CIS; pTis). These cancers have a high risk for intravesical recurrence (around 46–78% at five years) and progression (between 6–45% at five years) to muscle-invasive bladder cancer (MIBC). As with all UC, their presentation can be with visible haematuria or irritative lower urinary tract symptoms. The latter are common in patients with CIS. CIS may be detected in isolation (so-called primary CIS) or with a coexisting UC elsewhere (termed concomitant CIS). While urinary cytology has a moderate sensitivity and high specificity (>90%) for the detection of HG-NMIBC, cystoscopy is the most important diagnostic tool.

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