veal melanoma (UM) is the most common primary malignant intraocular tumor in adults with an incidence of 5.1 cases per million in the United States (1-3). Up to 50% of patients with UM develop metastatic disease (3). The liver is the primary site of metastasis in greater than 90% of patients, and less than 10% of patients are candidates for surgical resection due to multiplicity of tumors at the time of diagnosis (3). Currently, there are no effective systemic therapies for patients with metastatic UM. In general, without treatment, median overall survival (OS) following detection of hepatic metastases is reportedly less than 6 months, with a 1-year survival of 10%-15% (3). Most commonly, patient death is due to growth of hepatic metastases ultimately leading to hepatic failure. Therefore, stabilization of liver metastases is essential to prolonging OS for patients with metastatic UM. Transarterial catheter-directed therapies used to control the growth of UM hepatic metastases include immunoembolization, chemoembolization, and percutaneous hepatic perfusion (4-15). A few retrospective studies have also reported encouraging results following radioembolization (RE) of UM hepatic metastases (4-7). In 2009, a small multicenter trial reported a 1-year survival of 80% for patients with UM treated with RE (4). In 2011, a median OS of 10.0 months was reported for patients treated with RE following failure of both immunoembolization and chemoembolization (5). In addition, a larger retrospective trial reported a median OS of 12.3 months following RE of 71 patients with UM hepatic metastases (6). The purpose of our study was

Objective To determine the incidence of hyperlipidemia after first anticonvulsant treatment for seizures, using a large US administrative claims database. Methods We obtained data from the MarketScan Commercial and Medicare databases for 2005‐2009 for all adult patients newly treated with an anticonvulsant for seizures who had no previous history of hyperlipidemia or treatment with a lipid‐lowering agent. We divided the population based upon whether they were treated with an enzyme‐inducing anticonvulsant (phenytoin, carbamazepine, phenobarbital, primidone) or a noninducing anticonvulsant (all others). The primary outcome measure was a new diagnosis of hyperlipidemia during subsequent follow‐up. We accounted for a large number of demographic and clinical covariates. Results Of 11 374 subjects, 8778 (77%) were prescribed noninducers and 2596 (23%) were prescribed inducers. New hyperlipidemia diagnoses were seen in 14.6% of the patients started on inducing anticonvulsants and 10.7% of the patients started on noninducing anticonvulsants (P < .001). Both hyperlipidemia and the use of inducers were significantly associated with older age and male gender. After accounting for covariates, inducer prescription was still associated with 23% higher odds of a subsequent diagnosis of hyperlipidemia (odds ratio = 1.225, 95% confidence interval = 1.066‐1.408, P < .001). Significance The use of enzyme‐inducing anticonvulsants in patients with newly diagnosed epilepsy was associated with a significant increase in subsequent diagnoses of hyperlipidemia, suggesting that the lipid‐elevating properties of these agents are of genuine clinical importance. This adds to the body of data demonstrating that these agents are likely associated with additional hassle, cost, and morbidity.

CC was rare compared to LC. CC was associated with poor outcomes and impairment of both clotting factor and platelet-mediated coagulation components.

To evaluate the effects of race and insurance status on the use of brachytherapy for treatment of cervical cancer.METHODS: This is a retrospective cohort study of the National Cancer Database. We identified 25,223 patients diagnosed with stage IB2 through IVA cervical cancer who received radiation therapy during their primary treatment from 2004 to 2015. A univariate analysis was used to assess covariate association with brachytherapy. A multivariable regression model was used to evaluate the effect of race and insurance status on rates of brachytherapy treatment. The Cox proportional hazards model and the multiplicative hazard model were used to evaluate overall survival. P,.05 indicated a statistically significant difference for comparisons of primary and secondary outcomes.RESULTS: Non-Hispanic black patients received brachytherapy at a significantly lower rate than non-Hispanic white patients (odds ratio [OR] 0.93; 95% CI 0.86-0.99; P5.036); Hispanic (OR 0.93; 95% CI 0.85-1.02; P5.115) and Asian (OR 1.13; 95% CI 0.99-1.29; P5.074) patients received brachytherapy at similar rates. Compared with patients with private insurance, those who were uninsured (OR 0.72; 95% CI 0.65-0.79; P,.001), had Medicaid (OR 0.83; 95% CI 0.77-0.89; P,.001) or Medicare insurance (OR 0.85; 95% CI 0.78-0.92; P,.001) were less likely to receive brachytherapy. Brachytherapy was not found to be a mediator of race and insurance-related disparities in overall survival.CONCLUSION: Racial and insurance disparities exist for those who receive brachytherapy, with many patients not receiving the standard of care, but overall survival was not affected.