Leveraging Neoadjuvant and Adjuvant Immunotherapy to Break Through the Outcomes Plateau, Prevent Recurrences, and Improve Curability in Early-Stage Cancers
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Chair and Moderator, Jennifer Wargo, MD, MMSc, Patrick M. Forde, MD, Matthew D. Galsky, MD, and Ronan J. Kelly, MD, MBA, discuss Immuno-Oncology in this CME/MOC/NCPD/CPE activity titled “Leveraging Neoadjuvant and Adjuvant Immunotherapy to Break Through the Outcomes Plateau, Prevent Recurrences, and Improve Curability in Early-Stage Cancers.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/CPE information, and to apply for credit, please visit us at https://bit.ly/2Us15XN. CME/MOC/NCPD/CPE credit will be available until December 22, 2022.
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Chair Kun "Kevin" Xiang, MD, PhD, discusses atrial fibrillation in this CME/MOC/NCPD/CPE activity titled “Anticoagulation Therapy in NVAF: A Quality Improvement Initiative.” For the full presentation, downloadable Practice Aids, monograph, and complete CME/MOC/NCPD/CPE information, and to apply for credit, please visit us at https://bit.ly/2UoPplb. CME/MOC/NCPD/CPE credit will be available until June 12, 2025.Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communica...
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Milan J. Anadkat, MD, and Dale V. Reisner discuss generalized pustular psoriasis in this CME activity titled "Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communications Strategies to Improve Shared Decision-Making." For the full presentation, please visit us at www.peervoice.com/HUM870.Improving Outcomes for Pediatric Patients With Uncontrolled Moderate-to-Sever...
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Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, discuss Alzheimer’s disease in this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
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Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.Adapting HIV Treatment for People With Substance Use Disorder
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Chair, Monica Gandhi, MD, MPH, prepared useful Practice Aids pertaining to HIV for this CME/MOC/CE/AAPA activity titled “Adapting HIV Treatment for People With Substance Use Disorder.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/CE/AAPA information, and to apply for credit, please visit us at https://bit.ly/49hgPxT. CME/MOC/CE/AAPA credit will be available until June 4, 2025.Adapting HIV Treatment for People With Substance Use Disorder
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Chair, Monica Gandhi, MD, MPH, discusses HIV in this CME/MOC/CE/AAPA activity titled “Adapting HIV Treatment for People With Substance Use Disorder.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/CE/AAPA information, and to apply for credit, please visit us at https://bit.ly/49hgPxT. CME/MOC/CE/AAPA credit will be available until June 4, 2025.Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evo...
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Chair, Carla M. Nester, MD, MSA, FASN, discusses glomerular kidney disease in this CME activity titled “Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evolving Landscape of Glomerular Kidney Disease Management.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/3wJPTs1. CME credit will be available until June 4, 2025.Experts vs AI: Who Is Better at Monitoring and Treating MASLD and MASH?
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GASTROINTESTINAL INFECTIONS AND GASTRITIS
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Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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