Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Diagnostic Criteria of Nontuberculous Mycobacterial Lung Disease Key Laboratory Features of NTM Health Careand Hygiene-associated Disease Prevention Prophylaxis and Treatment of NTM Disease Introduction Methods Taxonomy Epidemiology Pathogenesis Host Defense and Immune Defects Pulmonary Disease Body Morphotype Tumor Necrosis Factor Inhibition Laboratory Procedures Collection, Digestion, Decontamination, and Staining of Specimens Respiratory Specimens Body Fluids, Abscesses, and Tissues Blood Specimen Processing Smear Microscopy Culture Techniques Incubation of NTM Cultures NTM Identification Antimicrobial Susceptibility Testing for NTM Molecular Typing Methods of NTM Clinical Presentations and Diagnostic Criteria Pulmonary Disease Cystic Fibrosis Hypersensitivity-like Disease Transplant Recipients Disseminated Disease Lymphatic Disease Skin, Soft Tissue, and Bone Disease

/pdf/an-official-ats-idsa-statement-diagnosis-treatment-and-1jy41yfwpp.pdf

An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases.

To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today?s complex modern health systems. This information may be provided in a variety of forms ? ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations.

Health literacy : a prescription to end confusion

https://cdr.lib.unc.edu/downloads/nz8061892

Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013

The nematode Caenorhabditis elegans ages and dies in a few weeks, but humans can live for 100 years or more. Assuming that the ancestor we share with nematodes aged rapidly, this means that over evolutionary time mutations have increased lifespan more than 2,000-fold. Which genes can extend lifespan? Can we augment their activities and live even longer? After centuries of wistful poetry and wild imagination, we are now getting answers, often unexpected ones, to these fundamental questions.

The genetics of ageing

https://www.pharllc.com/wp-content/uploads/2013/05/AED-L-vs-S-HL-Utilization-and-Cost.pdf

Annual health care costs and utilization in adults taking long or short acting antiepileptic monotherapy

387Background: NET comprise a broad set of rare tumors. Almost 2/3 arise in the gastrointestinal (GI) tract. NCCN guidelines for unresectable GI NET recommend somatostatin analogues (SSA) first, however, guidelines do not recommend a particular sequence for remaining therapies. Our objective is to describe real world treatment patterns of GI NET. Methods: This retrospective study combined 2 claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques. Treatments included SSA, cytotoxic chemotherapy (CC), targeted therapy (TT), interferon (IF) and combinations. Patients ≥ 18 years, with ≥ 1 inpatient or ≥ 2 outpatient claims for GI NET who received pharmacologic treatment from 7/1/09-6/30/14 were identified. A 6 month clean period prior to first treatment ensured patients were newly treated. Patients were followed until end of enrollment. Results: We identified 2,258 newly treated GI NET patients. 59.6% started first line therapy with SSA monotherapy, 33.3% CC...

Treatment patterns of gastrointestinal neuroendocrine tumors (NET).

Introduction:The 12-gene colon cancer Recurrence Score assay is a clinically validated predictor of recurrence risk instage II colon cancer patients. A survey was performed characterizing the assay’s impact on treatmentrecommendations for these patients.Methods:USmedicaloncologists(n¼346)whoorderedtheassayfor 3stageIIcoloncancerpatientswereaskedtocomplete a web-based survey regarding their most recent such patient. Physicians surveyed representedusers of the assay within the first 2 years of commercial availability which may include ‘early adopters’.Results:Most of 116 eligible physicians were in community practice (86%), with median 14.5 years’ experience(range ¼2–40). Mean patient age was 61 years (range 32–85); 81% had T3 disease, and 38% hadcomorbidities. Of 76 patients tested for mismatch-repair/microsatellite-instability (MMR/MSI), 13 (17%)were MMR-deficient/MSI-high; 46 (61%) MMR-proficient/MSI-low; and 17 (22%) unknown. Most patients(84%) had 12 nodes examined. Median Recurrence Score result was 20 (range¼1–77). Before assay,treatment recommendations were specified for 92 (79%) patients, with no recommendation for 24 (21%).Of the 92 with pre-assay recommendations, chemotherapy was planned for 52 (57%) and observation for40 (43%); the assay changed recommendations for 27 (29%). Treatment intensity decreased for 18 (67%)andincreasedfornine(33%)patients;itwasmorelikelytodecreaseforlowerRecurrenceScorevaluesandincrease for higher values (p50.001).Conclusion:For stage II colon cancer patients receiving Recurrence Score testing, 29% of treatment recommendationswere changed. Use of the assay may lead to reductions in treatment intensity. Study limitations includeretrospective design, data gathering during the first 2 years of assay availability only, and potential non-representativeness of respondents.

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Original article Effect of the 12-gene colon cancer assay results on adjuvant treatment recommendations in patients with stage II colon cancer

On‐demand treatments can treat OFF episodes in Parkinson's disease, however, there is limited information regarding when to prescribe them.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/mdc3.13690

Expert Consensus on the Use of On‐Demand Treatments for OFF Episodes in Parkinson's Disease: A Modified Delphi Panel

Abstract Background Osilodrostat, a potent oral inhibitor of 11β-hydroxylase, demonstrated efficacy in normalizing urinary free cortisol (UFC) in Cushing's disease (CD) patients; however, information describing its use in clinical practice is limited. We present osilodrostat dosing and titration information from a real-world cohort of endogenous Cushing's syndrome (CS) patients, focused on CD. Methods ILLUSTRATE, a retrospective chart review study analyzed confirmed endogenous CS patients who initiated osilodrostat treatment May 1, 2020 - October 29, 2021. Forty-two adult patients with endogenous CS and a prescription for osilodrostat were included in this real-world study. We describe the experience with initial osilodrostat dose, dose titration, and persistence in the CD subset (n=34, 81%). Results In patients with CD (n=34) the mean total daily starting dose was 3.4 mg (SD 1; median 4 mg; range 1-6 mg/day). Twenty-one patients (62%) were initiated on 2 mg BID, 9 (27%) on 1 mg BID, and 1 each (3%) on 1 mg QD, 2 mg QD, 3 mg BID and 4 mg QD. In CD patients with multiple documented clinical encounters (n=26), 16 initiated at 4 mg/day, of which the dose was interrupted or down-titrated in 4 patients (25%) within 71 days of treatment initiation; 2/4 of these patients experienced hypocortisolism related symptoms and permanently discontinued. Five of the 16 patients (31%) were maintained on 4 mg/day throughout the observation period, with a mean (SD) treatment duration of 273 (median 278 days; SD 92) days. Seven of 16 patients (44%) had a dose up-titration; in 6/7 patients, initial dose increase was incremental (1-2 mg BID), and the mean (SD) time to up-titration was 78 (SD 25; median 83; range 40-108) days. In the 10 of 26 CD patients who initiated therapy at <2 mg BID, 6 (60%) did not require dose reduction or interruption, all of which had up-titration in small increments (1-2 mg/day) and/or first titration at ≥80 days. Treatment persistence for those enrolled ≥ 6 months prior to study end was 95.8%, mean (SD) duration of therapy was 339.2 (106.8) days. Osilodrostat was generally well tolerated. Symptoms related to decreased cortisol levels were reported in 10/26 patients (38%), including 3 patients with adrenal insufficiency and 7 patients with glucocorticoid withdrawal symptoms. Conclusion ILLUSTRATE captures real-world US data describing the experience of CD patients treated with osilodrostat. Importantly, one-third (11/34) of patients were initiated on a dose lower than 4 mg/day (lower than starting dose previously used in clinical trials). Of 16 patients initiated at 4 mg/day, 4 (25%) required interruption or down-titration and 5 (31%) remained on the initial dose throughout the observation period. Overall, consistent with prior research data, patients with a gradual dose up-titration (i. e., prolonged titration interval) tended to have greater persistence with therapy. There were no new safety findings. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

/pdf/lbmon177-dosing-and-titration-of-osilodrostat-in-a-real-1pacm4ed.pdf

LBMON177 Dosing And Titration Of Osilodrostat In A Real-world Cohort Of US Patients With Endogenous Cushing's Disease: Analysis Of The ILLUSTRATE Study

Michael S. Broder

Papers

Annual health care costs and utilization in adults taking long or short acting antiepileptic monotherapy

Treatment patterns of gastrointestinal neuroendocrine tumors (NET).

Original article Effect of the 12-gene colon cancer assay results on adjuvant treatment recommendations in patients with stage II colon cancer

Expert Consensus on the Use of On‐Demand Treatments for OFF Episodes in Parkinson's Disease: A Modified Delphi Panel

LBMON177 Dosing And Titration Of Osilodrostat In A Real-world Cohort Of US Patients With Endogenous Cushing's Disease: Analysis Of The ILLUSTRATE Study