Cleveland Clinic journal of medicine
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Personalized targeted therapy for advanced non-small cell lung cancer (NSCLC) primarily relies on the concept of "oncogene addiction," in which multiple genetic abnormalities are addicted to one or a few genes for tumor cell maintenance and survival. Several molecular aberrations have been identified in NSCLC, with subsequent development of drugs targeted to these aberrations; gefitinib, erlotinib, and cetuximab for the treatment of NSCLC harboring epidermal growth factor receptor mutation or overexpression, and crizotinib for the treatment of NSCLC with the EML4-ALK fusion translocation oncogene being some examples. ⋯ Cellular heterogeneity within an oncogene-addicted tumor can cause resistance to targeted therapy after an initial response. As our understanding of tumor heterogeneity and tumor resistance mechanisms evolves, more rational therapies and combinations of therapies can be expected.
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Synthetic legal intoxicating drugs (SLIDs), such as those commonly contained in products sold over the counter as "bath salts" and "incense," have risen tremendously in popularity in the past few years. These drugs can have powerful adverse effects, including acute psychosis with delusions, hallucinations, and potentially dangerous, bizarre behavior.
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Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions.