Patients with head and neck squamous cell carcinoma typically present with dysphagia, odynophagia, and weight loss. Treatment of the disease with surgery or concurrent chemoradiation often results in local inflammation and limits further oral intake. Percutaneous endoscopic gastrostomy has been a common and effective means of nutritional support in these patients.

Click on the PDF icon at the top of this introduction to read the full article.

Patients with head and neck squamous cell carcinoma typically present with dysphagia, odynophagia, and weight loss. Treatment of the disease with surgery or concurrent chemoradiation often results in local inflammation and limits further oral intake. Percutaneous endoscopic gastrostomy has been a common and effective means of nutritional support in these patients.

Click on the PDF icon at the top of this introduction to read the full article.

Patients with head and neck squamous cell carcinoma typically present with dysphagia, odynophagia, and weight loss. Treatment of the disease with surgery or concurrent chemoradiation often results in local inflammation and limits further oral intake. Percutaneous endoscopic gastrostomy has been a common and effective means of nutritional support in these patients.

Click on the PDF icon at the top of this introduction to read the full article.

LAS VEGAS – Both heating and cooling techniques can provide effective results for patients seeking to improve their appearance with body sculpting, Christopher Zachary, MD, said at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.

Whether the clinician chooses devices that use radiofrequency, laser, or cryolipolysis to target fat, the key is bulk treatment, Dr. Zachary, professor and chair of the department of dermatology at the University of California, Irvine, said in a video interview.

When cooling or heating the fat, “it has to been done in bulk; it has to be done for a certain length of time,” he said, noting that treatment times vary with devices, from 5 to 60 minutes. “I can’t stress enough the importance of bulk cooling or bulk heating,” which induce a chronic reaction “that results in localized fat reduction,” he added.

Dr. Zachary disclosed relationships with multiple companies, including Solta, Zeltiq, Scion, Amway, and Candela. SDEF and this news organization are owned by the same parent company.

LAS VEGAS – Both heating and cooling techniques can provide effective results for patients seeking to improve their appearance with body sculpting, Christopher Zachary, MD, said at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.

Whether the clinician chooses devices that use radiofrequency, laser, or cryolipolysis to target fat, the key is bulk treatment, Dr. Zachary, professor and chair of the department of dermatology at the University of California, Irvine, said in a video interview.

When cooling or heating the fat, “it has to been done in bulk; it has to be done for a certain length of time,” he said, noting that treatment times vary with devices, from 5 to 60 minutes. “I can’t stress enough the importance of bulk cooling or bulk heating,” which induce a chronic reaction “that results in localized fat reduction,” he added.

Dr. Zachary disclosed relationships with multiple companies, including Solta, Zeltiq, Scion, Amway, and Candela. SDEF and this news organization are owned by the same parent company.

LAS VEGAS – Both heating and cooling techniques can provide effective results for patients seeking to improve their appearance with body sculpting, Christopher Zachary, MD, said at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.

Whether the clinician chooses devices that use radiofrequency, laser, or cryolipolysis to target fat, the key is bulk treatment, Dr. Zachary, professor and chair of the department of dermatology at the University of California, Irvine, said in a video interview.

When cooling or heating the fat, “it has to been done in bulk; it has to be done for a certain length of time,” he said, noting that treatment times vary with devices, from 5 to 60 minutes. “I can’t stress enough the importance of bulk cooling or bulk heating,” which induce a chronic reaction “that results in localized fat reduction,” he added.

Dr. Zachary disclosed relationships with multiple companies, including Solta, Zeltiq, Scion, Amway, and Candela. SDEF and this news organization are owned by the same parent company.

Acute myeloid leukemia (AML) is characterized by clonal proliferation of myeloid precursors with a reduced capacity to differentiate into mature cellular components.¹ Acute promyeloctic leukemia (APL; previously called AML-M3), a subtype of AML, is further characterized by a balanced translocation t(15;17) (q24.1;q21.1). It is an interesting model in cancer research because it responds to the differentiation and apoptosis induction therapy using arsenic trioxide (ATO) and all-trans retinoic acid (ATRA).²

Click on the PDF icon at the top of this introduction to read the full article.

Acute myeloid leukemia (AML) is characterized by clonal proliferation of myeloid precursors with a reduced capacity to differentiate into mature cellular components.¹ Acute promyeloctic leukemia (APL; previously called AML-M3), a subtype of AML, is further characterized by a balanced translocation t(15;17) (q24.1;q21.1). It is an interesting model in cancer research because it responds to the differentiation and apoptosis induction therapy using arsenic trioxide (ATO) and all-trans retinoic acid (ATRA).²

Click on the PDF icon at the top of this introduction to read the full article.

Acute myeloid leukemia (AML) is characterized by clonal proliferation of myeloid precursors with a reduced capacity to differentiate into mature cellular components.¹ Acute promyeloctic leukemia (APL; previously called AML-M3), a subtype of AML, is further characterized by a balanced translocation t(15;17) (q24.1;q21.1). It is an interesting model in cancer research because it responds to the differentiation and apoptosis induction therapy using arsenic trioxide (ATO) and all-trans retinoic acid (ATRA).²

Click on the PDF icon at the top of this introduction to read the full article.

Background Elderly cancer patients are a special population, and their management should include specialists in oncology, geriatrics, palliative care, and social work. Based on this approach, we designed a multidisciplinary care model (MCM) and prospectively assessed its results.

Objectives To evaluate the applicability of the MCM, to describe the geriatric features of our sample, and to assess the impact of the MCM on treatment choices.

Methods Patients older than 69 years of age with solid tumors were included. The MCM included the following decision algorithm: Patients with an unequivocal condition of frailty, assessed in the corresponding tumor committee, were directly referred to the palliative care team (Group A). In the other cases (Group B), patients over age 79 years underwent the Comprehensive Geriatric Assessment (CGA) and patients aged between 70 and 79 years completed a frailty test. If the frailty test was positive, CGA was also per formed.

Results 295 patients meeting the inclusion criteria were identified during one year. 186 (63%) were included in the MCM. A total of 66 CGA were performed. CGA modified the therapeutic plan in 5 patients older than 80 (13.8%), and in 2 septuagenarian patients (6.6%).

Limitations This study was designed to evaluate the feasibility of a multidisciplinary approach in geriatric oncology patients in a real clinical setting. Therefore, some variables were not fully controlled in the design, such as the willingness of different specialists to refer their patients to the model.

Conclusions MCM in elderly oncology patients is feasible in a general hospital, although several reasons often hinder patient recruitment for this kind of program. CGA can modify the therapeutic plan, especially in the octogenarian population.

Funding/sponsorship This study has been financially supported by a grant from the Fundació Joan Costa Romà. 

Click on the PDF icon at the top of this introduction to read the full article.​

Background Elderly cancer patients are a special population, and their management should include specialists in oncology, geriatrics, palliative care, and social work. Based on this approach, we designed a multidisciplinary care model (MCM) and prospectively assessed its results.

Objectives To evaluate the applicability of the MCM, to describe the geriatric features of our sample, and to assess the impact of the MCM on treatment choices.

Methods Patients older than 69 years of age with solid tumors were included. The MCM included the following decision algorithm: Patients with an unequivocal condition of frailty, assessed in the corresponding tumor committee, were directly referred to the palliative care team (Group A). In the other cases (Group B), patients over age 79 years underwent the Comprehensive Geriatric Assessment (CGA) and patients aged between 70 and 79 years completed a frailty test. If the frailty test was positive, CGA was also per formed.

Results 295 patients meeting the inclusion criteria were identified during one year. 186 (63%) were included in the MCM. A total of 66 CGA were performed. CGA modified the therapeutic plan in 5 patients older than 80 (13.8%), and in 2 septuagenarian patients (6.6%).

Limitations This study was designed to evaluate the feasibility of a multidisciplinary approach in geriatric oncology patients in a real clinical setting. Therefore, some variables were not fully controlled in the design, such as the willingness of different specialists to refer their patients to the model.

Conclusions MCM in elderly oncology patients is feasible in a general hospital, although several reasons often hinder patient recruitment for this kind of program. CGA can modify the therapeutic plan, especially in the octogenarian population.

Funding/sponsorship This study has been financially supported by a grant from the Fundació Joan Costa Romà. 

Click on the PDF icon at the top of this introduction to read the full article.​

Background Elderly cancer patients are a special population, and their management should include specialists in oncology, geriatrics, palliative care, and social work. Based on this approach, we designed a multidisciplinary care model (MCM) and prospectively assessed its results.

Objectives To evaluate the applicability of the MCM, to describe the geriatric features of our sample, and to assess the impact of the MCM on treatment choices.

Methods Patients older than 69 years of age with solid tumors were included. The MCM included the following decision algorithm: Patients with an unequivocal condition of frailty, assessed in the corresponding tumor committee, were directly referred to the palliative care team (Group A). In the other cases (Group B), patients over age 79 years underwent the Comprehensive Geriatric Assessment (CGA) and patients aged between 70 and 79 years completed a frailty test. If the frailty test was positive, CGA was also per formed.

Results 295 patients meeting the inclusion criteria were identified during one year. 186 (63%) were included in the MCM. A total of 66 CGA were performed. CGA modified the therapeutic plan in 5 patients older than 80 (13.8%), and in 2 septuagenarian patients (6.6%).

Limitations This study was designed to evaluate the feasibility of a multidisciplinary approach in geriatric oncology patients in a real clinical setting. Therefore, some variables were not fully controlled in the design, such as the willingness of different specialists to refer their patients to the model.

Conclusions MCM in elderly oncology patients is feasible in a general hospital, although several reasons often hinder patient recruitment for this kind of program. CGA can modify the therapeutic plan, especially in the octogenarian population.

Funding/sponsorship This study has been financially supported by a grant from the Fundació Joan Costa Romà. 

Click on the PDF icon at the top of this introduction to read the full article.​

In the November podcast for The Journal of Community and Supportive Oncology, the Editor-in-Chief, Dr David Henry, presents an in-depth interview on myelodysplastic syndromes that he conducted with Dr David Steensma of the Dana-Farber Cancer Institute in Boston as well as a number of articles that focus on hematologic malignancies. The latter include Original Reports on using split-dose R-CHOP to administer cytotoxic chemo-immunotherapy to elderly patients with DLBCL and on outcomes of tumor lysis syndrome in pediatric patients with hematologic malignancies, a Case Report on acute-onset hypokalemic paralysis with arsenic trioxide therapy in patient with acute promyelocytic leukemia, and a Community Translations report on the approval of ofatumumab for patients with chronic lymphocytic leukemia. Also in the line-up are a review by JCSO Editor, Dr David Cella, about value-based cancer care from the patient perspective, and articles on multidisciplinary treatment planning in elderly patients with cancer and palliative concurrent chemoradiation for gastrostomy site metastasis.

Listen to the podcast below.

In the November podcast for The Journal of Community and Supportive Oncology, the Editor-in-Chief, Dr David Henry, presents an in-depth interview on myelodysplastic syndromes that he conducted with Dr David Steensma of the Dana-Farber Cancer Institute in Boston as well as a number of articles that focus on hematologic malignancies. The latter include Original Reports on using split-dose R-CHOP to administer cytotoxic chemo-immunotherapy to elderly patients with DLBCL and on outcomes of tumor lysis syndrome in pediatric patients with hematologic malignancies, a Case Report on acute-onset hypokalemic paralysis with arsenic trioxide therapy in patient with acute promyelocytic leukemia, and a Community Translations report on the approval of ofatumumab for patients with chronic lymphocytic leukemia. Also in the line-up are a review by JCSO Editor, Dr David Cella, about value-based cancer care from the patient perspective, and articles on multidisciplinary treatment planning in elderly patients with cancer and palliative concurrent chemoradiation for gastrostomy site metastasis.

Listen to the podcast below.

In the November podcast for The Journal of Community and Supportive Oncology, the Editor-in-Chief, Dr David Henry, presents an in-depth interview on myelodysplastic syndromes that he conducted with Dr David Steensma of the Dana-Farber Cancer Institute in Boston as well as a number of articles that focus on hematologic malignancies. The latter include Original Reports on using split-dose R-CHOP to administer cytotoxic chemo-immunotherapy to elderly patients with DLBCL and on outcomes of tumor lysis syndrome in pediatric patients with hematologic malignancies, a Case Report on acute-onset hypokalemic paralysis with arsenic trioxide therapy in patient with acute promyelocytic leukemia, and a Community Translations report on the approval of ofatumumab for patients with chronic lymphocytic leukemia. Also in the line-up are a review by JCSO Editor, Dr David Cella, about value-based cancer care from the patient perspective, and articles on multidisciplinary treatment planning in elderly patients with cancer and palliative concurrent chemoradiation for gastrostomy site metastasis.

Listen to the podcast below.

Background Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. It is challenging to deliver standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in the very elderly or elderly with comorbidities because of age-related changes in metabolism and performance.

Objectives To describe outcomes of a unique approach to the delivery of standard R-CHOP chemotherapy in split-doses for the treatment of elderly DLBCL patients.

Methods We performed a single center, retrospective analysis of all patients with DLBCL treated with split-dose R-CHOP during January 2007-April 2015. The patients received R-CHOP at a 50% dose reduction on days 1 and 15 of each 28-day cycle (split dose), with full dose rituximab on day 1 for up to 6 cycles. The total amount of chemotherapy delivered during each 28-day cycle of split-dose R-CHOP was equivalent to the cumulative dose in each 21-day cycle of standard R-CHOP.

Results We identified 22 patients who had been treated with split-dose R-CHOP (median age, 81 years). 10 patients had a Charlson Comorbidity Index score of 2 or more, and 13 were aged 80 or older. 12 patients completed their prescribed treatments, and 10 required further de-escalation or early termination owing to toxicity. All of the patients who completed therapy were in a complete remission at the end of treatment. The median overall survival for the entire cohort was 47 months, and median progression-free survival was 43 months.

Limitations Retrospective, single institution study, small cohort Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Funding/sponsorship Cancer Center Research Training Program, NCI 5-T32 CA09615-25 (fellowship funding for Dr Shah).
 

Click on the PDF icon at the top of this introduction to read the full article.
 

Background Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. It is challenging to deliver standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in the very elderly or elderly with comorbidities because of age-related changes in metabolism and performance.

Objectives To describe outcomes of a unique approach to the delivery of standard R-CHOP chemotherapy in split-doses for the treatment of elderly DLBCL patients.

Methods We performed a single center, retrospective analysis of all patients with DLBCL treated with split-dose R-CHOP during January 2007-April 2015. The patients received R-CHOP at a 50% dose reduction on days 1 and 15 of each 28-day cycle (split dose), with full dose rituximab on day 1 for up to 6 cycles. The total amount of chemotherapy delivered during each 28-day cycle of split-dose R-CHOP was equivalent to the cumulative dose in each 21-day cycle of standard R-CHOP.

Results We identified 22 patients who had been treated with split-dose R-CHOP (median age, 81 years). 10 patients had a Charlson Comorbidity Index score of 2 or more, and 13 were aged 80 or older. 12 patients completed their prescribed treatments, and 10 required further de-escalation or early termination owing to toxicity. All of the patients who completed therapy were in a complete remission at the end of treatment. The median overall survival for the entire cohort was 47 months, and median progression-free survival was 43 months.

Limitations Retrospective, single institution study, small cohort Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Funding/sponsorship Cancer Center Research Training Program, NCI 5-T32 CA09615-25 (fellowship funding for Dr Shah).
 

Click on the PDF icon at the top of this introduction to read the full article.
 

Background Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. It is challenging to deliver standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in the very elderly or elderly with comorbidities because of age-related changes in metabolism and performance.

Objectives To describe outcomes of a unique approach to the delivery of standard R-CHOP chemotherapy in split-doses for the treatment of elderly DLBCL patients.

Methods We performed a single center, retrospective analysis of all patients with DLBCL treated with split-dose R-CHOP during January 2007-April 2015. The patients received R-CHOP at a 50% dose reduction on days 1 and 15 of each 28-day cycle (split dose), with full dose rituximab on day 1 for up to 6 cycles. The total amount of chemotherapy delivered during each 28-day cycle of split-dose R-CHOP was equivalent to the cumulative dose in each 21-day cycle of standard R-CHOP.

Results We identified 22 patients who had been treated with split-dose R-CHOP (median age, 81 years). 10 patients had a Charlson Comorbidity Index score of 2 or more, and 13 were aged 80 or older. 12 patients completed their prescribed treatments, and 10 required further de-escalation or early termination owing to toxicity. All of the patients who completed therapy were in a complete remission at the end of treatment. The median overall survival for the entire cohort was 47 months, and median progression-free survival was 43 months.

Limitations Retrospective, single institution study, small cohort Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Conclusions Split-dose R-CHOP allowed administration of curative-intent therapy in an elderly population with encouraging outcomes.

Funding/sponsorship Cancer Center Research Training Program, NCI 5-T32 CA09615-25 (fellowship funding for Dr Shah).
 

Click on the PDF icon at the top of this introduction to read the full article.
 

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams

Background Tumor lysis syndrome (TLS) is serious complication of anticancer chemotherapy, leading to substantial morbidity and mortality in adults and pediatric patients.

Objective To report the incidence and outcomes of TLS in pediatric patients with hematologic malignancies at a center in Pakistan.

Methods Retrospective chart review of 317 pediatric patients with hematologic malignancies during January 2008-December 2013. Demographic features and clinical and laboratory parameters of TLS, with immediate and 6-month outcomes were determined using a semi-structured questionnaire.

Results Median age at diagnosis was 9 years, with the 79.2% patients being male. Laboratory TLS was present in 36 patients (11.4%), with 27 (8.5%) developing clinical TLS and 13 (4.1%) requiring intensive care support. Hyperphosphatemia was the most frequent metabolic abnormality (14.2%), followed by hypocalcemia (13.9%), hyperuricemia (12.6%), and hyperkalemia (1.3%). 45 patients (14.2%) developed acute kidney injury (AKI). Patients who developed TLS had a signficantly higher white blood cell count at initiation of chemotherapy (142.0 x 109/L [SD, 173.1] vs 31.5 x 109/L [SD, 58.0]; P = .01) and a higher incidence of AKI (58.3% vs 8.5% of patients; P < .001).

Limitations Retrospective design of study, high rate of loss to follow-up, and unavailability of lactate dehydrogenase levels in a majority of patients.

Conclusion The incidence of TLS pediatric hematologic malignancies was 11.4% at our center. The main cause of death was sepsis. Hyperphosphatemia was the common metabolic derangement and hyperkalemia was the least common. TLS warrants intensive supportive care to prevent further morbidity and decrease mortality.

Click on the PDF icon at the top of this introduction to read the full article.

Background Tumor lysis syndrome (TLS) is serious complication of anticancer chemotherapy, leading to substantial morbidity and mortality in adults and pediatric patients.

Objective To report the incidence and outcomes of TLS in pediatric patients with hematologic malignancies at a center in Pakistan.

Methods Retrospective chart review of 317 pediatric patients with hematologic malignancies during January 2008-December 2013. Demographic features and clinical and laboratory parameters of TLS, with immediate and 6-month outcomes were determined using a semi-structured questionnaire.

Results Median age at diagnosis was 9 years, with the 79.2% patients being male. Laboratory TLS was present in 36 patients (11.4%), with 27 (8.5%) developing clinical TLS and 13 (4.1%) requiring intensive care support. Hyperphosphatemia was the most frequent metabolic abnormality (14.2%), followed by hypocalcemia (13.9%), hyperuricemia (12.6%), and hyperkalemia (1.3%). 45 patients (14.2%) developed acute kidney injury (AKI). Patients who developed TLS had a signficantly higher white blood cell count at initiation of chemotherapy (142.0 x 109/L [SD, 173.1] vs 31.5 x 109/L [SD, 58.0]; P = .01) and a higher incidence of AKI (58.3% vs 8.5% of patients; P < .001).

Limitations Retrospective design of study, high rate of loss to follow-up, and unavailability of lactate dehydrogenase levels in a majority of patients.

Conclusion The incidence of TLS pediatric hematologic malignancies was 11.4% at our center. The main cause of death was sepsis. Hyperphosphatemia was the common metabolic derangement and hyperkalemia was the least common. TLS warrants intensive supportive care to prevent further morbidity and decrease mortality.

Click on the PDF icon at the top of this introduction to read the full article.

Background Tumor lysis syndrome (TLS) is serious complication of anticancer chemotherapy, leading to substantial morbidity and mortality in adults and pediatric patients.

Objective To report the incidence and outcomes of TLS in pediatric patients with hematologic malignancies at a center in Pakistan.

Methods Retrospective chart review of 317 pediatric patients with hematologic malignancies during January 2008-December 2013. Demographic features and clinical and laboratory parameters of TLS, with immediate and 6-month outcomes were determined using a semi-structured questionnaire.

Results Median age at diagnosis was 9 years, with the 79.2% patients being male. Laboratory TLS was present in 36 patients (11.4%), with 27 (8.5%) developing clinical TLS and 13 (4.1%) requiring intensive care support. Hyperphosphatemia was the most frequent metabolic abnormality (14.2%), followed by hypocalcemia (13.9%), hyperuricemia (12.6%), and hyperkalemia (1.3%). 45 patients (14.2%) developed acute kidney injury (AKI). Patients who developed TLS had a signficantly higher white blood cell count at initiation of chemotherapy (142.0 x 109/L [SD, 173.1] vs 31.5 x 109/L [SD, 58.0]; P = .01) and a higher incidence of AKI (58.3% vs 8.5% of patients; P < .001).

Limitations Retrospective design of study, high rate of loss to follow-up, and unavailability of lactate dehydrogenase levels in a majority of patients.

Conclusion The incidence of TLS pediatric hematologic malignancies was 11.4% at our center. The main cause of death was sepsis. Hyperphosphatemia was the common metabolic derangement and hyperkalemia was the least common. TLS warrants intensive supportive care to prevent further morbidity and decrease mortality.

Click on the PDF icon at the top of this introduction to read the full article.

The Food and Drug Administration has approved daratumumab in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy.

The drug was approved last year as monotherapy for patients with multiple myeloma who have received at least three prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or who are double refractory to a proteasome inhibitor and an immunomodulatory agent.

[email protected]

On Twitter @nikolaideslaura

The Food and Drug Administration has approved daratumumab in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy.

The drug was approved last year as monotherapy for patients with multiple myeloma who have received at least three prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or who are double refractory to a proteasome inhibitor and an immunomodulatory agent.

[email protected]

On Twitter @nikolaideslaura

The Food and Drug Administration has approved daratumumab in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy.

The drug was approved last year as monotherapy for patients with multiple myeloma who have received at least three prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or who are double refractory to a proteasome inhibitor and an immunomodulatory agent.

[email protected]

On Twitter @nikolaideslaura

CHICAGO – Smoking appears to be a modifiable risk factor for progression of chronic kidney disease associated with primary hypertension in patients treated with ACE inhibitors, Bethany Roehm, MD, reported at a meeting sponsored by the American Society of Nephrology.

Significantly increased albuminuria was noted in patients with chronic kidney disease who continued to smoke after initiating ACE inhibitor therapy, based on results from a 5-year follow-up study of 108 patients who smoked cigarettes at study entry – 25 of whom quit smoking within the first year of the study – and 108 patients who never smoked.

CHICAGO – Smoking appears to be a modifiable risk factor for progression of chronic kidney disease associated with primary hypertension in patients treated with ACE inhibitors, Bethany Roehm, MD, reported at a meeting sponsored by the American Society of Nephrology.

Significantly increased albuminuria was noted in patients with chronic kidney disease who continued to smoke after initiating ACE inhibitor therapy, based on results from a 5-year follow-up study of 108 patients who smoked cigarettes at study entry – 25 of whom quit smoking within the first year of the study – and 108 patients who never smoked.

CHICAGO – Smoking appears to be a modifiable risk factor for progression of chronic kidney disease associated with primary hypertension in patients treated with ACE inhibitors, Bethany Roehm, MD, reported at a meeting sponsored by the American Society of Nephrology.

Significantly increased albuminuria was noted in patients with chronic kidney disease who continued to smoke after initiating ACE inhibitor therapy, based on results from a 5-year follow-up study of 108 patients who smoked cigarettes at study entry – 25 of whom quit smoking within the first year of the study – and 108 patients who never smoked.