Guyatt G, Rennie D, editors and The Evidence-Based Medicine Working Group. Users' guides to the medical literature. A manual for evidence-based clinical practice. Chicago: AMA Press, 2002



The JAMA series on how to use the medical literature has been expanded and put into book and CD-ROM format. The Evidence-Based Medicine Working Group along with editors Gordon Guyatt and Drummond Rennie have provided practitioners with a valuable resource for evaluating evidence relevant to their practice. The authors of this “how to” book have made certain that it includes challenges to all levels of users of evidence, from beginners to experts. The material is presented in 3 formats: a 700 page manual for evidence-based practice (EBP) (Manual) that is thorough and comprehensive; a 440 page pocket version of the essentials of EBP (Essentials) that provides an indepth discussion of the basics; and a hyperlinked CD-ROM that contains the contents of the Manual and is included with both hardcopy versions. The Essentials book is small enough to keep in a large pocket, although the print is small and may be difficult for really tired eyes to read. The Manual …

https://ebn.bmj.com/content/ebnurs/5/1/8.full.pdf

Users' Guides to the Medical Literature

s ?gnised types or, as we should prefer to call them, genera, ^Cles and varieties of tumours. In carrying out this project, \\ve Particularly when making out the series of indexes that e required, we soon made acquaintance with difficulties of enclature and of classification. These difficulties occur 0Ve?*t daily in the course of routine examinations and are th^00.1116 or evaded in varying fashion. It may be argued cl \\ln the present state of our knowledge, a satisfactory j^Slficati?n of tumours is not possible, or that it is easy to Co^ e Ossifications from an armchair for one who is not deeply p0j^erned in using them. But those remarks seem to miss the

Classification of Tumours.

Human immunoglobulin preparations for intravenous or subcutaneous administration are the cornerstone of treatment in patients with primary immunodeficiency diseases affecting the humoral immune system. Intravenous preparations have a number of important uses in the treatment of other diseases in humans as well, some for which acceptable treatment alternatives do not exist. We provide an update of the evidence-based guideline on immunoglobulin therapy, last published in 2006. Given the potential risks and inherent scarcity of human immunoglobulin, careful consideration of its indications and administration is warranted.

Update on the use of immunoglobulin in human disease: A review of evidence

Clinical gynecologic oncology

In 17.9% of the patients with cancer in our selected population, PET/MR imaging furnished information, especially on staging of the liver, lymph nodes, bones, and pelvis, that was unavailable with PET/CT and that affected clinical management.

https://pubs.rsna.org/doi/pdf/10.1148/radiol.13131306

Clinical Impact of PET/MR Imaging in Patients with Cancer Undergoing Same-Day PET/CT: Initial Experience in 134 Patients—A Hypothesis-generating Exploratory Study

ObjectiveThe correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. This study was aimed at evaluating the role of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (P

18F-FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus?

ObjectiveRecurrent carcinoma endometrium has a poor prognosis. However, successful salvage with long-term survival has been achieved after hormone therapy, radical surgery, and radiotherapy/chemotherapy in patients with recurrent disease. Conventional imaging (CI) and tumor marker have limited accur

Carcinoma endometrium: role of 18-FDG PET/CT for detection of suspected recurrence.

Aim To determine the efficacy of positron emission tomography-computed tomography using F-18 fluoro-deoxy-glucose (F-18 FDG PET-CT) in diagnosing the recurrence of renal cell carcinoma (RCC) in patients treated earlier with partial or radical nephrectomy. Methods We assessed 63 patients with suspected recurrent RCC after nephrectomy. PET-CT findings were interpreted as positive if the focal area of FDG uptake in the abdomen or outside the abdomen was more than the surrounding background tissue. The final diagnosis of the recurrence of RCC was based on histological examination and/or clinical follow-up and conventional imaging modalities. Results A total of 103 PET-CT studies were done in these 63 patients, of which 63 studies were true positive, 30 studies were true negative, seven studies were false negative and remaining three studies were false positive. In 63 true-positive scans, PET-CT showed 109 lesions. Of these, 28 lesions were in the lungs, 21 lesions were at a locoregional site, 21 were in the bones, 12 in the retroperitoneal lymph nodes and 27 at other sites. The sensitivity, specificity and accuracy of PET-CT were 90, 91 and 90%, respectively. Conclusion Our results seem to confirm the useful role of PET-CT in the evaluation of post-surgical recurrence in patients who had undergone radical surgery for RCC.

Role of FDG PET-CT in recurrent renal cell carcinoma.

Purpose The purpose of the present study was to evaluate the role of 18F-fluorodeoxyglucose (FDG) PET-CT in detecting recurrent disease in posttherapy patients of uterine sarcoma and compare the same with conventional imaging (CI). Methods A total of 15 FDG PET-CT studies were acquired in 12 posttherapy uterine sarcoma patients. The images were evaluated by two experienced nuclear medicine physicians in consensus. Clinical/imaging follow-up (minimum 6 months) and histopathology were taken as the reference standard. All the patients had also undergone CI (CT or MRI or ultrasonography) of the chest, abdomen, and pelvis. The diagnostic accuracy of FDG PET-CT was calculated and compared with that of CI. Results The median age of the patients was 51.5 years (interquartile range: 47.5-53). Histopathology was leiomyosarcoma in six, carcinosarcoma in five, and endometrial stromal sarcoma in one patient. Six FDG PET-CT studies were carried out for suspected recurrence and nine for posttherapy surveillance. Six FDG PET-CTs were positive and nine were negative for recurrence. The sensitivity, specificity, and accuracy of FDG PET-CT were 85.7, 100, and 93.3%, respectively, on per study-based analysis, and 80, 100, and 83.3% on per lesion-based analysis. PET-CT showed higher sensitivity and specificity compared with CI for both study-based and lesion-based analysis. However, no significant difference was found between FDG PET-CT and CI either in the study-based or in the lesion-based analysis (P not significant). Conclusion FDG PET-CT is a highly sensitive and specific modality for detecting recurrence in posttherapy patients with uterine sarcoma. However, it provides no significant advantage over CI for this purpose.

Role of FDG PET-CT in detecting recurrence in patients with uterine sarcoma: comparison with conventional imaging

Intravenous immunoglobulin (IVIg) is a biologic agent that is being increasingly used in the treatment of autoimmune and chronic inflammatory disorders. It is approved by the US FDA for the treatment of primary immunodeficiencies, immune thrombocytopenic purpura, Kawasaki disease, bone marrow transplantation in patients aged over 20 years, chronic B-cell lymphocytic leukemia, and pediatric AIDS. IVIg has been used off-label for several diseases, clinical symptoms and syndromes.

Sunil Jeph

Papers

18F-FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus?

Carcinoma endometrium: role of 18-FDG PET/CT for detection of suspected recurrence.

Role of FDG PET-CT in recurrent renal cell carcinoma.

Role of FDG PET-CT in detecting recurrence in patients with uterine sarcoma: comparison with conventional imaging

Intravenous immunoglobulin therapy in autoimmune mucocutaneous blistering diseases: a review of the evidence for its efficacy and safety.