What is the prognosis for primary amyloidosis (AL) and what is the evidence for management?

PROGNOSIS:
Kyle RA, et al. Long-term survival (10 years or more) in 30 patients with primary amyloidosis.
Blood. 1999 Feb 1;93(3):1062-6. PMID: 9920856
Highlights:
Fig. 1 Survival curve for 810 patients with systemic amyloidosis
Table 2 Comparison of patients survival

Br J Haematol. 2004 Jun;125(6):681-700. Guidelines on the diagnosis and management of AL amyloidosis.
Highlights:
These guidelines include prognostic factors at the bottom of p. 686.

THERAPY:
Br J Haematol. 2004 Jun;125(6):681-700. Guidelines on the diagnosis and management of AL amyloidosis.
Recommendations and evidence for chemotherapy and stem cell transplantation, pp. 687-693
Summary of treatment recommendations, pp.693 and following.

Recent trials
Jaccard A, et al. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. N Engl J Med. 2007 Sep 13;357(11):1083-93.
Highlights:
RCT 100 pts in two groups
Fig. 2, Survival curves by hematologic responses and treatment group
Fig. 3, Survival according to risk group and according to treatment group among patients with low-risk disease

Does early endoscopic intervention affect mortality in patients with obstructive gallstones

Here is the link to RCT of 120 patients randomized to receive conservative management or endocscopic procedures within the first 72 hours of presentation.

Oría A, et al. Early endoscopic intervention versus early conservative management in patients with acute gallstone pancreatitis and biliopancreatic obstruction: a randomized clinical trial. Ann Surg. 2007 Jan;245(1):10-7.
PubMed Central fulltext

ATTN: Here is the systematic review I identified when I recently reran the search in PubMed clinical queries and changed the term "gall bladder" to "gallstones" in the search box (gallstones AND surgery AND mortality)

Ayub K, Imada R, Slavin J. Endoscopic retrograde cholangiopancreatography in gallstone-associated acute pancreatitis. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD003630.
PMID: 15495060

Search terms are important!

What is the PPV of the CA-125 for ovarian malignancy in patients presenting with an ovarian mass?

Benjapibal M, Neungton C. Pre-operative prediction of serum CA125 level in women with ovarian masses. J Med Assoc Thai. 2007 Oct;90(10):1986-91.
PMID: 18041413
Prospective study of 120 women with ovarian masses, gold standard=histopathology, PPV=57.0%

How I found it...

In Pubmed Clinical Query-Diagnosis, Narrow:
CA-125 AND positive predictive value AND cohort studies

What are the diagnostic and management considerations for patients with hyponatremia?

Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
PMID 10824078

Review of diagnosis and management of hyponatremia in hypovolemic patients.

Douglas I. Hyponatremia: why it matters, how it presents, how we can manage it. Cleve Clin J Med. 2006 Sep;73 Suppl 3:S4-12. PMID: 16970147

Review article that includes an illustration of an algorithm for classifying hyponatremia.

For patients with neutopenic fever, how does oral administration of antibiotics compare to IV administration at preventing death?

Vidal L, et al. Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD003992.
PMID: 15495074

Systematic review and meta-analysis of studies comparing oral and IV delivery of antibiotics.
From the Pubmed record, use Find it @ Emory to go to the fulltext at Wiley Interscience. At the Wiley site, you'll have to paste the title of the review to pull it up.
Check out the Analyses section of the review to see tables comparing the data related to various clinical outcomes, including mortality.