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Annals of Medicine

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https://www.readbyqxmd.com/read/29457514/relapse-of-bullous-pemphigoid-an-update-on-this-stubborn-clinical-problem
#1
Yiman Wang, Xuming Mao, Yanhong Wang, Yueping Zeng, Yidi Liu, Hongzhong Jin, Li Li
Bullous Pemphigoid (BP) is a chronic autoimmune blistering disorder that has a predilection for the elderly. It is characterized by a poor prognosis due to its high mortality rate and the tendency to relapse. The relapse rate of BP ranges from 27.87% to 53% after disease remission, while the majority of relapses occur early (within 6 months) during remission. Clinical interventions aimed to prevent early relapses could reduce potential complications from first-line treatment and make follow-up care easier for clinicians in practice, thus improving the prognosis of BP and the quality of patients' lives...
February 19, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29448840/inverse-association-between-serum-albumin-and-future-risk-of-venous-thromboembolism-interrelationship-with-high-sensitivity-c-reactive-protein
#2
Setor K Kunutsor, Samuel Seidu, Devvrat T Katechia, Jari A Laukkanen
PURPOSE: We aimed to assess the prospective association of serum albumin with venous thromboembolism (VTE) risk and evaluate if the association is independent of or modified by inflammation, as measured by high sensitivity C-reactive protein (hsCRP). DESIGN: We analyzed data of 2,176 men aged 42-61 years free from VTE in the Kuopio Ischemic Heart Disease study, with serum albumin concentrations measured at baseline using Coulter's bromcresol purple colorimetric assays...
February 16, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29363985/pulmonary-hypertension-and-exercise-training-a-synopsis-on-the-more-recent-evidences
#3
Massimo Leggio, Augusto Fusco, Massimo Armeni, Stefania D'Emidio, Paolo Severi, Salvatore Calvaruso, Giorgio Limongelli, Luca Sgorbini, Maria Grazia Bendini, Andrea Mazza
The benefits of exercise training in virtually all humans, including those with a clinically stable chronic disease are numerous. The potential value lies in the fact that functional capacity is oftentimes significantly compromised. Exercise training not only play a role in reversing some of the pathophysiologic processes associated with chronic diseases but also improves clinical trajectory. Given the significant pathologic consequences associated with pulmonary hypertension and its implications for deteriorating right ventricular function as well as the perceived potential for a precipitous and possibly critical drop in cardiac output during periods of physical exertion, exercise training was historically not recommended for these patients...
January 30, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29338438/challenges-in-adult-vaccination
#4
Eduardo de Gomensoro, Giuseppe Del Giudice, T Mark Doherty
Life-long primary prevention interventions beginning and continuing throughout an individual's lifetime are increasingly seen as key to meeting the global healthcare challenges that accompany demographic changes - a concept referred to as "Healthy aging". In this perspective, vaccination is seen as part of a triad, together with healthy diet and exercise. Current adult vaccine coverage is lower than target vaccination rates in most developed countries, and so vaccine preventable diseases continue to present a substantial burden on health and healthcare resources, especially in older individuals...
January 16, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29316825/on-surmounting-the-barriers-to-hpv-vaccination-we-can-do-better
#5
Aria C Attia, Judith Wolf, Ana Nuñez
The major impediment to increased HPV vaccination coverage in young males and females is lack of health care provider recommendation. Despite its efficacy in preventing cervical cancer, HPV vaccination in females (49.5%) and males (37.5%) ages 13 through 17 falls well below the Centers for Disease Control and Prevention's (CDC) Healthy People 2020 target of 80% coverage. Parents' willingness to vaccinate their child has been shown to be much higher when physicians share personal vaccination decisions for their own children as well as what other parents have done at that particular clinic...
January 10, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29308916/maternal-immunization-where-are-we-now-and-how-to-move-forward
#6
Ivo Vojtek, Ilse Dieussaert, T Mark Doherty, Valentine Franck, Linda Hanssens, Jacqueline Miller, Rafik Bekkat-Berkani, Walid Kandeil, David Prado-Cohrs, Andrew Vyse
Pregnancy and the post-partum period are associated with elevated risks to both mother and infant from infectious disease. Vaccination of pregnant women, also called maternal immunization, has the potential to protect pregnant women, fetuses, and infants from several vaccine-preventable diseases. Maternal immunoglobulin G antibodies are actively transferred through the placenta to provide passive immunity to newborns during the first months of life, until the time for infant vaccinations or until the period of greatest susceptibility has passed...
January 8, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29291629/longer-time-spent-in-bed-attempting-to-sleep-is-associated-with-rapid-renal-function-decline-the-dongfeng-tongji-cohort-study
#7
Yizhun Li, Liangle Yang, Hao Wang, Haijing Jiang, Gaokun Qiu, Yiyi Liu, Yang Xiao, Handong Yang, Tangchun Wu, Xiaomin Zhang
INTRODUCTION: Prospective evidence on the relation between time in bed and renal dysfunction remains limited. We aimed to investigate the association of time spent in bed attempting to sleep (TSBS) with renal function decline in a middle-aged and elderly Chinese population. METHODS: About 16,733 eligible participants with a mean age of 62.3 years at baseline were included. Rapid renal function decline was defined as (baseline eGFR - revisit eGFR)/years of follow-up ≥5 mL/min per 1...
January 4, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29224375/autoimmune-rheumatic-diseases-and-the-risk-of-parkinson-disease-a-nationwide-population-based-cohort-study-in-taiwan
#8
Chi-Ching Chang, Tzu-Min Lin, Yu-Sheng Chang, Wei-Sheng Chen, Jau-Jiuan Sheu, Yi-Hsuan Chen, Jin-Hua Chen
BACKGROUNDS: In autoimmune rheumatic diseases (ARDs), the levels of inflammatory mediators are increased and microglia may be activated, resulting in an inflammatory state and the degeneration of dopaminergic neurons. We investigated the association between ARDs and Parkinson disease (PD). METHODS: We identified ARD patients through the Taiwan National Health Insurance Research Database from 2001 to 2012. From the general population, we randomly selected a comparison cohort that was frequency-matched by age (in 5-year increments), sex and index year...
December 20, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29237304/the-role-of-mitochondrial-dysfunction-in-cardiovascular-disease-a-brief-review
#9
Dimitry A Chistiakov, Tatiana P Shkurat, Alexandra A Melnichenko, Andrey V Grechko, Alexander N Orekhov
Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Proper mitochondrial function is necessary in tissues and organs that are of high energy demand, including the heart. Mitochondria are very sensitive to nutrient and oxygen supply and undergo metabolic adaptation to the changing environment. In CVD, such an adaptation is impaired, which, in turn, leads to a progressive decline of the mitochondrial function associated with abnormalities in the respiratory chain and ATP synthesis, increased oxidative stress, and loss of the structural integrity of mitochondria...
December 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29172794/mortality-in-patients-with-atrial-fibrillation-and-common-co-morbidities-a-cohort-study-in-primary-care
#10
Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Jan Sundquist, Kristina Sundquist
OBJECTIVE: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation. METHODS: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45-64, 65-74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities...
November 27, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29172780/understanding-modern-day-vaccines-what-you-need-to-know
#11
Volker Vetter, Gülhan Denizer, Leonard R Friedland, Jyothsna Krishnan, Marla Shapiro
Vaccines are considered to be one of the greatest public health achievements of the last century. Depending on the biology of the infection, the disease to be prevented, and the targeted population, a vaccine may require the induction of different adaptive immune mechanisms to be effective. Understanding the basic concepts of different vaccines is therefore crucial to understand their mode of action, benefits, risks, and their potential real-life impact on protection. This review aims to provide healthcare professionals with background information about the main vaccine designs and concepts of protection in a simplified way to improve their knowledge and understanding, and increase their confidence in the science of vaccination ( Supplementary Material )...
March 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29156997/clinical-manifestations-and-outcomes-of-severe-warfarin-overanticoagulation-from-the-ewa-study
#12
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Aku Virta, K E Juhani Airaksinen
INTRODUCTION: Severe warfarin overanticoagulation is a risk factor for bleeding, but there is little information on its manifestations, prognosis and factors affecting the outcome. We describe the manifestations and clinical outcomes of severe warfarin overanticoagulation in a large group of patients with atrial fibrillation (AF). MATERIAL AND METHODS: All international normalized ratio (INR) samples (n = 961,431) in the Turku University Hospital region between 2003 and 2015 were screened...
March 2018: Annals of Medicine
https://www.readbyqxmd.com/read/28972811/mechanical-dispersion-is-associated-with-poor-outcome-in-heart-failure-with-a-severely-depressed-left-ventricular-function-and-bundle-branch-blocks
#13
Ivan Stankovic, Aleksandra Janicijevic, Aleksandra Dimic, Milica Stefanovic, Radosav Vidakovic, Biljana Putnikovic, Aleksandar N Neskovic
OBJECTIVES: Bundle branch blocks (BBB)-related mechanical dyssynchrony and dispersion may improve patient selection for device therapy, but their effect on the natural history of this patient population is unknown. METHODS: A total of 155 patients with LVEF ≤ 35% and BBB, not treated with device therapy, were included. Mechanical dyssynchrony was defined as the presence of either septal flash or apical rocking. Contraction duration was assessed as time interval from the electrocardiographic R-(Q-)wave to peak longitudinal strain in each of 17 left ventricular segments...
March 2018: Annals of Medicine
https://www.readbyqxmd.com/read/28985689/effect-of-age-period-and-birth-cohort-on-the-frequency-of-glucose-6-phosphate-dehydrogenase-deficiency-in-sardinian-adults
#14
Giovanni Mario Pes, Alessandra Errigo, Angela Bitti, Maria Pina Dore
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder common in Sardinia. In this study, the frequency variation of G6PD-deficiency across age groups and birth cohorts was investigated using Age-Period-Cohort analysis. METHODS: Data were collected from the clinical records of 11,252 patients (6975 women, age range 17-94 years) who underwent endoscopy between 2000 and 2016 at a teaching hospital (University of Sassari), Italy. G6PD status was assessed by enzymatic assay based on G6PD/6GPD ratio...
February 2018: Annals of Medicine
https://www.readbyqxmd.com/read/28844171/a-clinical-decision-making-algorithm-for-penicillin-allergy
#15
Angèle Soria, Elodie Autegarden, Emmanuelle Amsler, Hafida Gaouar, Amandine Vial, Camille Francès, Jean-Eric Autegarden
BACKGROUND: About 10% of subjects report suspected penicillin allergy, but 85-90% of these patients are not truly allergic and could safely receive beta-lactam antibiotics Objective: To design and validate a clinical decision-making algorithm, based on anamnesis (chronology, severity, and duration of the suspected allergic reactions) and reaching a 100% sensitivity and negative predictive value, to assess allergy risk related to a penicillin prescription in general practise. STUDY DESIGN AND METHODS: All patients were included prospectively and explorated based on ENDA/EAACI recommendations...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28805463/oxygen-uptake-at-aerobic-threshold-is-inversely-associated-with-fatal-cardiovascular-and-all-cause-mortality-events
#16
Setor K Kunutsor, Sudhir Kurl, Hassan Khan, Francesco Zaccardi, Rainer Rauramaa, Jari A Laukkanen
PURPOSE: We aimed to assess the associations of oxygen uptake at aerobic threshold (VO2 at AT) with cardiovascular and all-cause mortality. DESIGN: VO2 at AT was assessed in 1663 middle-aged men in a cohort study. Hazard ratios (HRs) were calculated for sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD) and all-cause mortality. RESULTS: During a median follow-up of 25.6 years, 138 SCDs, 209 fatal CHDs, 333 fatal CVDs and 719 all-cause mortality events occurred...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28797175/role-of-lipids-and-intraplaque-hypoxia-in-the-formation-of-neovascularization-in-atherosclerosis
#17
Dimitry A Chistiakov, Alexandra A Melnichenko, Veronika A Myasoedova, Andrey V Grechko, Alexander N Orekhov
According to the current paradigm, chronic vascular inflammation plays a central role in the pathogenesis of atherosclerosis. The plaque progression is typically completed with rupture and subsequent acute cardiovascular complications. Previously, the role of adventitial vasa vasorum in atherogenesis was underestimated. However, investigators then revealed that vasa vasorum neovascularization can be observed when no clinical manifestation of atherosclerosis is present. Vasa vasorum is involved in various proatherogenic processes such as intimal accumulation of inflammatory leukocytes, intimal thickening, necrotic core formation, intraplaque haemorrhage, lesion rupture and atherothrombosis...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28786719/nutraceutical-approaches-to-metabolic-syndrome
#18
Cesare R Sirtori, Chiara Pavanello, Laura Calabresi, Massimiliano Ruscica
Metabolic Syndrome (MetS), affecting at least 30% of adults in the Western World, is characterized by three out of five variables, from high triglycerides, to elevated waist circumference and blood pressure. MetS is not characterized by elevated cholesterolemia, but is rather the consequence of a complex interaction of factors generally leading to increased insulin resistance. Drug treatments are of difficult handling, whereas well-characterized nutraceuticals may offer an effective alternative. Among these, functional foods, e...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28782992/pdtcm-a-systems-pharmacology-platform-of-traditional-chinese-medicine-for-psoriasis
#19
Dongmei Wang, Jiangyong Gu, Wei Zhu, Fang Luo, Lirong Chen, Xiaojie Xu, Chuanjian Lu
INTRODUCTION: Psoriasis is a refractory skin disorder, and usually requires a lifetime control. Traditional Chinese medicine (TCM) is effective and safe for this disease. However, the cellular and molecular mechanisms of TCM remedies for psoriasis are still not fully understood. TCM contains numerous natural products. Natural products have historically been invaluable as a resource of therapeutic agents. Yet, there is no integrated information about active compounds of TCM for psoriasis...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29166795/pharmacological-interventions-for-preventing-acute-mountain-sickness-a-network-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#20
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: Individuals ascending to high altitude are at a risk of getting acute mountain sickness (AMS). The present study is a network meta-analysis comparing all the interventions available to prevent AMS. METHODS: Electronic databases were searched for randomized clinical trials evaluating the use of drugs to prevent AMS. Incidence of AMS was the primary outcome and incidence of severe AMS, paraesthesia (as side effect of acetazolamide use), headache and severe headache, and oxygen saturation were the secondary outcomes...
November 23, 2017: Annals of Medicine
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