Monthly Archives: January 2013

Tarceva for Kidney cancer

Papillary Renal Cell Carcinoma makes up approximately 10% to 20% of kidney cancers. These tumors are thought of as being relatively resistant to immunotherapy with some of the newer drugs,  of the groups TKI and mTOR inhibitors. Examples of such drugs are Sutent and Torisel. For this reason, Tarceva(erlotinib) has been studiedespecially in the papillary renal cell cancer. There is a reported response rate in low teens and the disease control rate

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Tarceva for papillary renal cell carcinoma – pro
docs with patient

Papillary Renal Cell Carcinoma represents approximately 10% to 20% of kidney cancers. These tumors are thought of as being realtively resistant to immunotherapy with TKI and mTOR inhibitors and Tarceva(erlotinib) has been studied in this subgroup. There is a reported response rate in low teens and the disease control rate (defined as stable disease for 6 weeks, or confirmed partial response or complete response using RECIST [Response Evaluation Criteria

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Why do doctors do medico-legal consulting?
Close up of a Medical History form and a doctor's Stethoscope

Why do physicians do medicolegal? Doctors are, well, doctors. Their training and work experience shape their approach to problems and socialize them to view issues though the clinical prism. However, the broad education of a physician also prepares him or her  to address a variety of other questions in medicine in an effective and a comprehensive manner. Many physicians have, in addition to their clinical skills, well developed ability to reason,

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Rituxan and vasculitis

The U.S. Food and Drug Administration in April 2011approved Rituxan (rituximab), in combination with glucocorticoids (steroids), to treat patients with Wegener’s granulomatosis (WG) and microscopic polyangiitis (MPA), two rare disorders that cause blood vessel inflammation (vasculitis). Case reports and sereis suggest that it may also be effective in otehr types of vasculitis, particularly those with antineutrophil cytoplasmic antibody (ANCA)–associated

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Rituxan for leukocytoclastic vasculitis – pro
Two doctors working together

The U.S. Food and Drug Administration in April 2011approved Rituxan (rituximab), in combination with glucocorticoids (steroids), to treat patients with Wegener’s granulomatosis (WG) and microscopic polyangiitis (MPA), two rare disorders that cause blood vessel inflammation (vasculitis). Case reports and sereis suggest that it may also be effective in various subsets of vasculitis patients, particularly those with antineutrophil cytoplasmic antibody

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MRI for low back pain

Low back pain (LBP) is one of the most common reason for physician visits in the United States. Under the pressuer to "do something", MRI is often quickly performed. Unfortunately, several randomized clinical trials have shown that among patients without clinical signs and symptoms indicating serious underlying conditions, early MRI imaging before a trial of conservative therapy, does not improve overall outcomes. It must be remembered that the

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Sprycel after failing Gleevec

On June 28, 2006, the U.S. Food and Drug Administration approved dasatinib (Sprycel; Bristol-Myers Squibb), a new small-molecule inhibitor of multiple tyrosine kinases, for the treatment of adults with chronic phase, accelerated phase, or myeloid or lymphoid blast phase chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+) ALL) with resistance or intolerance to prior therapy including imatinib. The

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Sprycel second line after Gleevec- pro
image9

On June 28, 2006, the U.S. Food and Drug Administration approved dasatinib (Sprycel; Bristol-Myers Squibb), a new small-molecule inhibitor of multiple tyrosine kinases, for the treatment of adults with chronic phase, accelerated phase, or myeloid or lymphoid blast phase chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+) ALL) with resistance or intolerance to prior therapy including imatinib. The

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Is Myelodysplastic syndrome a cancer? – pro
Close up of microscope slide under the objectives. Selective focus.

Whether a condition is a cancer or not in a contractual context can be analyzed using some widely accepted definitions of the word “cancer”. Myelodysplastic syndrome is a name given to variety on conditions characterized by defects in inter-cellular communications, deficient hematopoietic  cell production and genetic changes that increase the risk of  developing of acute leukemia. It used to be called “preleukemia”.  World Health Organizations

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Bone marrow aspiration and biopsy

A fever of unknown origin is often worked up with a bone marrow, but this test is not appropraite before a full workup failes to reveal other explanation of fever. A  bone marrow aspiration and biopsy is not the appropriate tests for workup of fever that is not FUO. For example, the medically necessary approach to rule out a suspected lymphoma involves locating a lymph area that may be invovled by it. This test remains important in investigating

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