1.Dysphagia and anorexia as presentations of leptomeningeal carcinomatosis.
Aiyer R1, Engelman E2, Xue W3, Yu E4. BMJ Case Rep. 2016 Apr 12;2016. pii: bcr2016214666. doi: 10.1136/bcr-2016-214666.
A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.
2.Pilot study of biological monitoring of four antineoplastic drugs among Canadian healthcare workers.
Poupeau C1, Tanguay C1, Plante C2, Gagné S3, Caron N3, Bussières JF4. J Oncol Pharm Pract. 2016 Apr 15. pii: 1078155216643860. [Epub ahead of print]
PURPOSE: There are health risks to workers occupationally exposed to antineoplastic drugs. We hypothesized that implementing a biological monitoring program would be feasible. The goal was to present the results of our pilot cross-sectional study of biological monitoring of four antineoplastic drugs.
3.Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches.
Negrei C1, Bojinca V2, Balanescu A2, Bojinca M3, Baconi D1, Spandidos DA4, Tsatsakis AM5, Stan M1. Exp Ther Med. 2016 Apr;11(4):1177-1183. Epub 2016 Feb 2.
Rheumatic diseases are highly prevalent chronic disorders and the leading cause of physical disability worldwide, with a marked socio-economic impact. Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology with an autoimmune pathogenesis, characterised by arthropathy with chronic, deforming, destructive evolution and multiple systemic manifestations. The management of RA has undergone significant changes as far as objectives and approaches are concerned, ending in the current strategy known as 'treat to target'. The therapeutic array of RA includes several categories of medicinal products, of varying potential. There are several criteria for the classification of medicinal products used against this disease, one of the most important and modern of which divides such substances according to their effects on the progress of the disease: symptom-modifying antirheumatic drugs (including non-steroidal anti-inflammatory drugs and corticoids), disease-modifying antirheumatic drugs (including various substances, such as gold salts, antimalarials, sulfasalazine, D-penicillamine; non-specific immunosuppressive medication, such as methotrexate, cyclophosphamide, azathioprine and leflunomide) and biological therapy is a recent addition, providing new insight into the treatment of this disease.
4.Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH).
Lee JJ1, Bykerk VP2, Dresser GK3, Boire G4, Haraoui B5, Hitchon C6, Thorne C7, Tin D7, Jamal S8, Keystone EC9, Pope JE10. Clin Med Insights Arthritis Musculoskelet Disord. 2016 Apr 4;9:37-43. doi: 10.4137/CMAMD.S38092. eCollection 2016.
OBJECTIVES: The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA).