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J Am Acad Dermatol ; 84(1): 102-119, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32454102


BACKGROUND: There is lack of uniformity in the reflectance confocal microscopy (RCM) terminology for melanocytic lesions. OBJECTIVE: To review published RCM terms for melanocytic lesions and identify redundant, synonymous terms. METHODS: A systematic review of original research articles adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted until August 15, 2018. Two investigators gathered all published RCM terms used to describe melanoma and melanocytic nevi. Synonymous terms were grouped based on similarity in definition and in histopathologic correlation. RESULTS: Out of 156 full-text screened articles, 59 studies met the inclusion criteria. We identified 209 terms; 191 (91.4%) corresponding to high-magnification/cellular-level terms and 18 (8.6%) corresponding to low-magnification/architectural patterns terms. The overall average use frequency of RCM terms was 3.1 times (range, 1-31). By grouping of individual RCM terms based on likely synonymous definitions and by eliminating terms lacking clear definition, the total number of RCM terms could be potentially reduced from 209 to 40 terms (80.8% reduction). LIMITATIONS: Non-English and non-peer-reviewed articles were excluded. CONCLUSIONS: This systematic review of published RCM terms identified significant terminology redundancy. It provides the basis for subsequent terminology consensus on melanocytic neoplasms.

Am J Clin Oncol ; 43(11): 813-819, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32889891


AIM: Conduct a systematic review of available evidence on food and beverage intake during cancer treatment. OBJECTIVE: Determine what food or beverages consumed during cancer treatment might prevent recurrence, subsequent malignancies, treatment-related toxicity, or death. BACKGROUND: Food and beverage intake, as well as weight status, can integrate with cancer treatment to mitigate treatment-related toxicities, support treatment success, and prevent recurrence. Yet, evidence-based recommendations are lacking. METHODS: We searched PubMed, Embase, and Cochran for research studies conducted within the last 10 years on food and beverage consumption during cancer treatment, with no restrictions on age or cancer type. Two reviewers independently extracted information on intervention type, diet, and outcomes; these data were confirmed by a third reviewer. RESULTS: Nineteen studies were selected from 1551 potential studies. Nine were randomized controlled trials, analyzing high protein diets, short-term fasting, low-fat diets, FODMAP diet, or comparing consumption of 1 specific food or nutrient, including Concord grape juice, onions, and fiber. The remaining 10 studies were observational or retrospective and tracked treatment symptoms, general dietary intake, or weight status as well as consumption of specific foods including nuts, coffee, sugar-sweetened beverages. CONCLUSIONS: Available evidence suggests food can be effective at ameliorating cancer treatment-related toxicities and improving prognosis, but more research is needed.

Int J Radiat Oncol Biol Phys ; 107(4): 827-835, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32311418


PURPOSE: Clinical trials have described variation in radiation therapy plan quality, of which contour delineation is a key component, and linked this to inferior patient outcomes. In response, consensus guidelines have been developed to standardize contour delineation. This investigation assesses trends in contouring guidelines and examines the methodologies used to generate and deliver recommendations. METHODS AND MATERIALS: We conducted a literature search for contouring guidelines published after 1995. Of 11,124 citations, 332 were identified for full-text review to determine inclusion. We abstracted articles for the intent of the consensus process, key elements of the methodology, and mode of information delivery. A Fisher exact test was used to identify elements that differed among the guidelines generated for clinical trials and routine care. RESULTS: Overall, 142 guidelines were included, of which 16 (11%) were developed for a clinical trial. There was an increase in guideline publication over time (0 from 1995-1999 vs 65 from 2015- 2019; P = .03), particularly among recommendations for stereotactic radiation and brachytherapy. The most common disease sites were head and neck (24%), gastrointestinal (12%), and gynecologic (12%). Methods used to develop recommendations included literature review (50%) and image-based methods (45%). Panels included a median of 10 physicians (interquartile range, 7-16); 70% of panels represented multidisciplinary expertise. Guidelines developed for a clinical trial were more likely to include an image-based approach, with quantitative analysis of contours submitted by the panel members and to publish a full set of image-based recommendations (P < .005). CONCLUSIONS: This review highlights an increase in consensus contouring recommendations over time. Guidelines focus on disease sites, such as head and neck, with evidence supporting a correlation between treatment planning and patient outcomes, although variation exists in the approach to the consensus process. Elements that may improve guideline acceptance (ie, image-based consensus contour analysis) and usability (ie, inclusion of a full image set) are more common in guidelines developed for clinical trials.

CA Cancer J Clin ; 67(3): 194-232, 2017 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-28436999


Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.

Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Terapias Complementares , Ansiedade/terapia , Neoplasias da Mama/psicologia , Depressão/terapia , Fadiga/terapia , Feminino , Humanos , Linfedema/terapia , Transtornos do Humor/terapia , Náusea/terapia , Doenças do Sistema Nervoso Periférico/terapia , Qualidade de Vida , Transtornos do Sono-Vigília/terapia , Estresse Psicológico/terapia , Vômito/terapia
Med Ref Serv Q ; 35(3): 274-84, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27391178


Library orientation at an academic health sciences library consisted of a five-minute overview within new student orientation. Past experience indicated this brief presentation was insufficient for students to learn about library resources. In 2014, an effort was made to supplement orientation by developing an online game aimed at enabling students to become self-sufficient through hands-on learning. A gaming model was chosen with expectations that competition and rewards would motivate students. Although the pilots suffered from low participation rates, the experience merits further research into the potential of a broader model of online library instruction in the health sciences environment.

Comportamento de Busca de Informação , Internet , Bibliotecas Médicas , Jogos de Vídeo , Humanos , Aprendizagem , Estudantes