#ASCO2017 – Abiraterone for Prostate Cancer
Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer – New England Journal of Medicine (free) AND Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy – New England Journal of Medicine (free)
Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 20175 May, 2017 | 20:29h | UTC
Invited commentary: Surgical Site Infection Prevention – What We Know and What We Do Not Know – JAMA Surgery (free)
Commentary: ‘Long-Awaited’ CDC Guidelines on SSI Prevention Released – Medscape (free registration required)
Transplantation of HCV-infected-kidneys into uninfected recipients seems feasible in this era of direct-acting antiviral agents, maybe shortening waiting times for those willing to take the risk.
“How frequently should indwelling urinary catheters be changed? Are catheter washouts effective? Which type of catheter reduces rates of urinary tract infection?”. This post look at the evidence regarding urinary catheter care.
Source: ASCO Issues Guideline on Castrate-Resistant Prostate Cancer – Medscape (free registration required)
Mortality Trends After a Voluntary Checklist-based Surgical Safety Collaborative – Annals of Surgery (link to abstract – free PDF available)
Sources: Global Health NOW Newsletter (free) AND South Carolina Hospitals Saw Surgery Deaths Drop After Implementing WHO Checklist – AJMC News (free) AND A simple checklist prevents deaths after surgery, a large new study suggests – The Washington Post (a few articles per month are free)
See also: WHO Surgical Safety Checklist – World Health Organization (free) AND A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population – New England Journal of Medicine (free)
Invited commentary: Asymptomatic Microscopic Hematuria – Rethinking the Diagnostic Algorithm (free)
Routine urinalysis for screening is not presently recommended by any major health organization, but asymptomatic microscopic hematuria is a common incidental finding. This study suggests that the combination of renal ultrasound and cystoscopy is the most cost-effective approach for the evaluation of these patients.
“Extended thromboprophylaxis is warranted in some procedures (eg, open and robotic cystectomy) but not others (eg, robotic prostatectomy without pelvic lymph node dissection in low-risk patients)”
“Extended prophylaxis is warranted for some procedures (eg, kidney transplantation procedures in high-risk patients) but not others (transurethral resection of the prostate and reconstructive female pelvic surgery in low-risk patients)”
Prostate Cancer Screening – Conflicting views on the new USPSTF draft recommendations
In favor of screening: New Official Prostate Cancer Screening Guidelines Announced: Too Little, Too Late? – Forbes (free) AND Federal Task Force Softens Opposition To Routine Prostate Cancer Screening – NPR
Against screening: The new recommendations for prostate cancer screenings are a bad deal – STAT News (free)
Prostate Cancer Screening Draft Recommendations – U.S. Preventive Services Task Force (free)
For those aged 55 to 69 it recommends “informed, individualized decision making based on a man’s values and preferences”. According to a useful infographic from the draft recommendations, the benefits are likely small. For every 1000 men offered PSA based screening over a period of 10-15 years, the test would avoid cancer spreading in 3 men and death from prostate cancer in 1-2 men, with the undesired consequences of false positives and subsequent procedures in many patients.
Browse Appropriateness Criteria Topics (free)
This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.
Observational data suggests there might be a link.
Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)
“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.
Adverse Effects of Prostate Cancer Treatments Vary – MedPage Today (free registration required)
Study 1 – Link to abstract ($ required for full-text): Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years – JAMA
Study 2 – Link to abstract ($ required for full-text): Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer – JAMA