IMPORTANCEOpioid prescriptions for treatment of pain in emergency departments (EDs) are associated with long-term opioid use. The temporal pattern of opioid prescribing in the context of the opioid epidemic remains unknown. OBJECTIVE To examine the temporal pattern of opioid prescribing within an ED for varying pain conditions between 2009 and 2018. DESIGN, SETTING, AND PARTICIPANTS A population-based, cross-sectional study was conducted at the ED of an urban academic medical center. All patients treated within that ED between January 1, 2009, and December 31, 2018, were included. MAIN OUTCOMES AND MEASURESThe proportion of patients prescribed an opioid for treatment of pain in the ED temporally by condition, condition type, patient demographics, and physician prescriber.

Prostate cancer is a significant burden and cause of mortality in Latin America. This article reviews the treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC) and provides consensus recommendations to assist Latin American prostate cancer specialists with clinical decision making. A multidisciplinary expert panel from Latin America reviewed the available data and their individual experience to develop clinical consensus opinions for the use of life-prolonging agents in mCRPC, with consideration given to factors influencing patient selection and treatment monitoring. There is a lack of level 1 evidence for the best treatment sequence or combinations in mCRPC. In this context, consensus recommendations were provided for the use of taxane-based chemotherapies, androgen receptor axis-targeted agents and targeted alpha therapy, for patients in Latin America. Prostate-specific antigen (PSA) changes alone, during treatment, should be treated with caution; PSA may not be a suitable biomarker for radium-223. Bone scans and computed tomography are the standard imaging modalities in Latin America. Imaging should be prompted during treatment where symptomatic decline and/or significant worsening of laboratory evaluations are reported, or where a course of therapy has been completed and another antineoplastic agent is under consideration. Recommendations and guidance for treatment options in Latin America are provided in the context of country-level variable access to approved agents and technologies for treatment monitoring. Patients should be treated with the purpose of prolonging overall survival and preserving quality of life through increasing the opportunity to administer all available life-prolonging therapies when appropriate.Electronic supplementary materialThe online version of this article (10.1007/s12032-018-1105-8) contains supplementary material, which is available to authorized users.

Objetivo: las mutaciones de EGFR son una de las alteraciones genómicas más comunes que se encuentran en el cáncer de pulmón de células no pequeñas (CPCNP). A pesar de que los medicamentos dirigidos contra la tirosina quinasa dependiente de EGFR han demostrado ser seguros y efectivos, todavía hay una proporción de pacientes cuyo pronóstico sigue siendo desfavorable debido a la presencia o el desarrollo de mecanismos de resistencia. Por lo tanto, en este estudio se analizaron los mecanismos de resistencia primaria frente a los inhibidores de tirosina quinasa (ITQ) en una cohorte de pacientes latinoamericanos tratados con osimertinib.

Objetivos: se analizó el costo de oportunidad basado en el modelamiento farmacoeconómico en pacientes con NSCLC con mutaciones en KRAS p.G12C, con el fin de mostrar la pérdida del beneficio clínico en los sistemas de salud.