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Postgraduate Medicine

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https://www.readbyqxmd.com/read/27858510/patterns-of-naloxone-use-in-hospitalized-patients
#1
Lisa Yung, Kelly C Lee, Chih Hsu, Timothy Furnish, Rabia S Atayee
OBJECTIVES: Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS: Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were admitted to and received naloxone in the medical-surgical, telemetry, intermediate care, or obstetrics/gynecology units from May 1(st), 2014 to April 30(th), 2015...
December 1, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27901398/discriminating-between-neuropathic-pain-and-sensory-hypersensitivity-using-the-chronic-pain-questions-cpq
#2
Karin S Coyne, Brooke M Currie, Sean Donevan, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Lucy Abraham, Christine Thompson, Alesia Sadosky, Marina Brodsky
OBJECTIVE: The Chronic Pain Questions (CPQ) were developed for clinical use with the aim of supporting primary care physicians in the screening, assessment and monitoring of patients with chronic pain. The purpose of this study was to examine the ability of the CPQ to discriminate between patients with neuropathic pain (NeP) versus those with sensory hypersensitivity (SH). METHODS: Adult men and women with a diagnosis of a NeP or SH condition were recruited from 5 clinical sites across the United States...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27901359/buprenorphine-transdermal-system-utilization
#3
Laura Wallace, Aditi Kadakia
OBJECTIVES: To evaluate utilization patterns in patients initiating buprenorphine transdermal system (BTDS), CIII, and estimate the proportion decreasing their total opioid dose over time. METHODS: This retrospective cohort study used data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database from January 1, 2011 through December 31, 2015. Eligible individuals were adults aged 18-64 years newly dispensed BTDS (index prescription) who had at least six months of insurance coverage prior to (baseline period) and following (study period) the index prescription...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27894216/bone-effects-of-canagliflozin-a-sodium-glucose-co-transporter-2-inhibitor-in-patients-with-type-2-diabetes-mellitus
#4
Thomas C Blevins, Azeez Farooki
Canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor approved for the treatment of type 2 diabetes mellitus (T2DM), lowers blood glucose by inhibiting renal glucose reabsorption and increasing urinary glucose excretion. It has been reported that SGLT2 inhibitors may have potential adverse effects on bone, including increased fracture risk and decreased bone mineral density (BMD). Across clinical studies, canagliflozin was not associated with meaningful changes in serum or urine calcium, vitamin D, or parathyroid hormone...
November 28, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27883297/patients-perception-of-parkinson-s-disease-associated-pain-following-initiation-of-rotigotine-a-multicenter-non-interventional-study
#5
Lars Timmermann, Christian Oehlwein, Gerhard Ransmayr, Holger Fröhlich, Edgar Will, Hanna Schroeder, Thomas Lauterbach, Lars Bauer, Jan Kassubek
OBJECTIVES: To evaluate Parkinson's disease (PD)-associated pain as perceived by the patients (subjective characterization), and how this may change following initiation of rotigotine transdermal patch. METHODS: SP1058 was a non-interventional study conducted in routine clinical practice in Germany and Austria in patients experiencing PD-associated pain (per the physician's assessment). Data were collected at baseline (ie, before rotigotine initiation) and at a routine visit after ≥25 days (-3 days allowed) of treatment on a maintenance dose of rotigotine (end of study [EoS])...
November 24, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27882816/long-term-studies-of-treatments-for-type-2-diabetes
#6
A Enrique Caballero
There is a relative lack of long-term data for individual glucose-lowering therapies for the treatment of type 2 diabetes mellitus. A systematic search of published literature reporting data of approximately ≥3 years of follow-up from randomized controlled trials and their extensions was conducted. Trials to evaluate the efficacy and/or safety of glucose-lowering drugs currently approved for the treatment of adults with type 2 diabetes were included. Search results included long-term published data for traditional oral glucose-lowering drugs, insulin, α-glucosidase inhibitors, and incretin-based therapies...
November 24, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27882804/a-comparison-of-high-frequency-chest-wall-oscillation-and-intrapulmonary-percussive-ventilation-for-airway-clearance-in-pediatric-patients-with-tracheostomy
#7
Aneela Bidiwala, Linda Volpe, Claudia Halaby, Melissa Fazzari, Christina Valsamis, Melodi Pirzada
OBJECTIVES: The aim of this study was to compare two modes of airway clearance, the intrapulmonary percussive ventilation system (IPV) to high frequency chest wall oscillation system (HFCWO) in medically complex pediatric patients with tracheostomy requiring long term care. METHODS: This was a single center, retrospective study comparing the number of respiratory illnesses, lower respiratory tract infections (LRTI), utilization of bronchodilator and systemic steroids, and respiratory illnesses requiring acute care hospitalizations...
November 24, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27813442/cardiovascular-effects-of-dipeptidyl-peptidase-4-inhibitor-in-diabetic-patients-with-and-without-established-cardiovascular-disease-a-meta-analysis-and-systematic-review
#8
Shishi Xu, Xinyue Zhang, Lizhi Tang, Fang Zhang, Nanwei Tong
OBJECTIVES: We aim to conduct a meta-analysis, by stratifying diabetic patients with or without clinical cardiovascular diseases (CVD), to explore whether there are different cardiovascular effects of dipeptidyl peptidase-4 inhibitors (DPP-4is) on these two different classes of diabetic patients. METHODS: We searchedMedline,Embase, theCochrane Libraryand ClinicalTrials.gov for relevant randomized controlled trials (RCTs). The included trials are divided into CVD (+) trials (subjects with established CVD), and CVD (-) trials (subjects with no CVD)...
November 17, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27849427/generalized-high-bone-mineral-density-on-bone-density-scanning-a-case-of-gastric-carcinoma-with-bone-metastasis
#9
Pianpian Fan, Qin Wang, Chunyan Lu, Deicai Chen
Generalized high bone mineral density (BMD) on Dual-energy X-ray absorptiometry (DXA) scanning most commonly reflects metabolic bone disease. However, some malignancies could also stimulate the underlying processes. We reported that a 41-year-old female was referred for lumbago. She did not complain of any symptoms in the digestive system. DXA revealed high BMD in the lumbar vertebras. Marked increase in bone mass was observed in an X-ray of chest compared with one conducted 6 months previously. Additionally, an X-ray of the axial skeleton showed diffuse sclerotic change...
November 16, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27846789/impact-of-breakthrough-pain-on-community-dwelling-cancer-patients-results-from-the-national-breakthrough-pain-study
#10
Nathaniel P Katz, Kavita L Gajria, Alicia C Shillington, Judith J Stephenson, Qing Harshaw
OBJECTIVE: To characterize cancer-related breakthrough pain (BTcP) among community-dwelling patients with cancer. METHODS: Data from the National Breakthrough Pain Study, a cross-sectional observational survey describing breakthrough pain (BTP) in the community, were analyzed for a subset of patients with BTcP. Eligible patients were community-dwelling adults with commercial insurance and insurance claims consistent with cancer and chronic pain who consented to a structured telephone interview...
November 16, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27846754/distinction-of-hypertriglyceridemic-waist-phenotype-from-simple-abdominal-obesity-interaction-with-sex-hormone-binding-globulin-levels-to-confer-high-coronary-risk
#11
Ahmet Karagöz, Altan Onat, Mesut Aydın, Günay Can, Barış Şimşek, Murat Yüksel
OBJECTIVE: The associations of total testosterone (TT) and sex hormone-binding globulin (SHBG) with the hypertriglyceridemic waist (HtgW) phenotype and coronary heart disease (CHD) risk have scarcely been examined. We explored such cardiometabolic risk mediations in middle-aged adults. METHODS: Participants (n=1924) in a population-based study were studied by forming categories consisting of abdominal obesity, hypertriglyceridemia, both (HtgW), or none ("healthy")...
November 16, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27841714/efficacy-and-safety-of-empagliflozin-in-type-2-diabetes-mellitus-a-meta-analysis-of-randomized-controlled-trials
#12
R Devi, Ghanshyam Mali, Indrani Chakraborty, Mazhuvancherry Kesavan Unnikrishnan, Suhaj Abdulsalim
OBJECTIVES: The prevalence of diabetes has increased in the recent decades and optimum glycemic control is required to reduce morbidity and mortality. We meta-analyzed randomized controlled trials in order to assess the efficacy and safety of empagliflozin compared to placebo in type 2 diabetes mellitus patients. METHODS: We included double-blind, placebo controlled trials of empagliflozin that evaluated glycemic efficacy and safety (10 mg or 25 mg) either as monotherapy or as add-on to existing diabetes pharmacotherapy...
November 14, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27829325/a-novel-electromechanical-autoinjector-autotouch%C3%A2-for-self-injection-of-etanercept-real-world-use-and-benefits
#13
David H Collier, Bojena Bitman, Andrew Coles, Lyrica Liu, Sandeep Kumar, Clinton Judd
OBJECTIVES: We assessed the ability of patients with autoimmune inflammatory diseases to successfully use the investigational AutoTouch™ reusable autoinjector as well as patient preference for AutoTouch™ versus the currently marketed single-use prefilled etanercept SureClick® autoinjector. METHODS: Two multicenter studies were performed: a Home Use Study and a Patient Preference Study. In the Home Use Study, 77 patients with rheumatoid arthritis (RA) or psoriatic arthritis self-administered etanercept once weekly for 5 weeks...
November 9, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27766929/pulmonary-sarcoidosis-an-update
#14
Vidya Ramachandraiah, Wilbert Aronow, Dipak Chandy
Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. A recent development in establishing the diagnosis of pulmonary sarcoidosis is endobronchial ultrasound that increases the yield of transbronchial needle aspiration of hilar and/or mediastinal lymph nodes...
November 2, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27797301/relationship-between-lifestyle-factors-and-hyperhomocysteinemia-in-general-chinese-population-a-cross-sectional-study
#15
Shuang Chen, Xiaofan Guo, Siyuan Dong, Zhao Li, Yingxian Sun
OBJECTIVE: Hyperhomocysteinemia (Hhcy) is a known cardiovascular disease (CVD) risk factor. Observational studies had supported the role of lifestyle factors such as physical activity, diet and alcohol consumption in CVD prevention. Our study aimed to determine the relationship between Hhcy and lifestyle factors in general Chinese population. METHODS: In this cross-sectional study, a total of 7135 adults (3320 men and 3815 women) aged 35 years or older were recruited from the rural Northeast China...
October 31, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27782769/prescription-opioid-abuse-and-misuse-gap-between-primary-care-investigator-assessment-and-actual-extent-of-these-behaviors-among-patients-with-chronic-pain
#16
Beatrice Setnik, Carl L Roland, Glenn C Pixton, Kenneth W Sommerville
OBJECTIVES: To compare the results of two open-label primary care-based studies that examined investigator assessment of patient risk for prescription opioid misuse, abuse, and diversion relative to patient self-reports and urine drug tests (UDTs). METHODS: Risk assessment data from two open-label, multicenter, primary care-based US studies in patients with chronic pain were compared. RESULTS: In one study (n = 1487), 54.4% of patients were at moderate, 24...
October 26, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27766928/changes-in-vital-signs-as-predictors-of-bacterial-infection-in-home-care-a-multi-center-prospective-cohort-study
#17
Jun Hamano, Yasuharu Tokuda
OBJECTIVES: To explore whether the combination of changes in heart rate and body temperature can predict bacterial infection in home care patients. METHODS: This multicenter, prospective cohort study was conducted in Japan from March 2012 through December 2013 and involved three clinics. The study population comprised all patients who received regular home visit services for at least 3 months and met one of the following inclusion criteria: 1) fever over 37.5°C at home visit, 2) physician's clinical suspicion of fever, or 3) physician's suspicion of bacterial infection...
October 21, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27756166/kocuria-kristinae-infection-during-adalimumab-treatment
#18
Murali K Kolikonda, Priyanga Jayakumar, Srividya Sriramula, Steven Lippmann
A common inhabitant of skin, the Kocuria kristinae of the Micrococcaceae family, has gained attention in recent years because it can induce pathology in humans. Reported is a Kocuria kristinae-caused abdominal abscess in a patient treated for rheumatoid arthritis with adalimumab. The tumor necrosis factor (TNF) inhibitor drugs are known to cause various bacterial, viral, and fungal infections. This is the first known case where an opportunistic infection with Kocuria has presented with an abdominal abscess in an immunocompromised individual who is on long term TNF inhibitors...
October 18, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27748629/tnf-alpha-antagonist-induced-lupus-on-three-different-agents
#19
Bindu Madhavi Mudduluru, Shalin Shah, Steven Shamah, Arun Swaminath
Tumor necrosis factor alpha (TNF alpha) antagonists are biologic agents used in the management of inflammatory conditions such as rheumatoid arthritis, seronegative spondyloarthropathies and inflammatory bowel disease. These agents have been recently shown to cause a syndrome called anti-TNF induced lupus (ATIL), a rare condition which has similar clinical manifestations to idiopathic systemic lupus erythematosus (SLE). Given that extra-intestinal manifestations of inflammatory bowel disease include arthritis, it can be difficult to separate arthritis due to underlying disease from drug-induced arthritis...
October 17, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27744763/a-review-of-trazodone-use-in-psychiatric-and-medical-conditions
#20
Hani Raoul Khouzam
Trazodone is an antidepressant that is FDA-approved for the treatment of depression. It has been used by mental health and primary care providers for the treatment of multiple psychiatric and medical conditions .This review describes trazodone mechanism of action, formulation, dosage and adverse effects and then summarizes the beneficial effects of trazodone in the treatment of various psychiatric and medical conditions such as major depression, as well non-approved FDA indications such as insomnia,anxiety disorders, posttraumatic stress disorder, obsessive compulsive disorder, feeding and eating disorders, substance use disorders, behavioral disturbances associated with cognitive dysfunction, sexual dysfunction, certain pain conditions, and rehabilitation after acute ischemic stroke...
October 17, 2016: Postgraduate Medicine
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