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Journal of Clinical Medicine

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https://www.readbyqxmd.com/read/28891981/feasibility-of-serial-6-min-walk-tests-in-patients-with-acute-heart-failure
#1
Sean P Collins, Michael Thorn, Richard M Nowak, Phillip D Levy, Gregory J Fermann, Brian C Hiestand, Tillman Douglas Cowart, Robert P Venuti, William R Hiatt, ShiYin Foo, Peter S Pang
BACKGROUND: Functional status assessment is common in many cardiovascular diseases but it has undergone limited study in the setting of acute heart failure (AHF). Accordingly, we performed a pilot study of the feasibility of the six-minute walk test (6MWT) at the emergency department (ED) presentation and through the hospitalization in patients with AHF. METHODS AND RESULTS: From November 2014 to February 2015, we conducted a multicenter, observational study of ED patients, aged 18-85 years, whose primary ED admission diagnosis was AHF...
September 11, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28869530/unexplained-dyspnea-in-a-young-adult-with-epstein-barr-virus-infectious-mononucleosis-pulmonary-involvement-or-co-infection-with-mycoplasma-pneumoniae-pneumonia
#2
Burke A Cunha, Scarlet Herrarte Fornos
Clinically, in young immunocompetent adults, Epstein-Barr virus (EBV) usually manifests as infectious mononucleosis (IM). Typical clinical findings of EBV IM include fever, profound fatigue, pharyngitis, bilateral posterior cervical adenopathy, and splenomegaly. Respiratory involvement with EBV IM may occur, but is distinctly rare. We present a case of a 20 year old female who with classic EBV IM, but was inexplicably dyspneic and hypoxemic. Further diagnostic testing confirmed co-infection with Mycoplasma pneumoniae...
September 4, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28850085/acute-kidney-injury-in-heart-failure-revisited-the-ameliorating-impact-of-decongestive-diuresis-on-renal-dysfunction-in-type-1-acute-cardiorenal-syndrome-accelerated-rising-pro-b-naturetic-peptide-is-a-predictor-of-good-renal-prognosis
#3
REVIEW
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi, Mohan Sengodan, Karen Flores Rosario
There is mounting evidence that forward heart failure as manifested by low cardiac output alone does not define the degree of renal dysfunction in cardiorenal syndrome. As a result, the term "congestive renal failure" was coined in 2012 by Ross to depict the role of renal venous hypertension in type 1 acute cardiorenal syndrome. If so, aggressive decongestive therapies, either through mechanical ultrafiltration with dialysis machines or pharmacologic ultrafiltration with potent diuretics, would lead to improved cardio and renal outcomes...
August 29, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28850053/il-23-and-th17-disease-in-inflammatory-arthritis
#4
REVIEW
Toru Yago, Yuki Nanke, Manabu Kawamoto, Tsuyoshi Kobashigawa, Hisashi Yamanaka, Shigeru Kotake
IL-23, which is composed of p19 and p40 subunits, is a proinflammatory cytokine that contributes to the formation and maintenance of Th17 cells in inflammatory autoimmune diseases. IL-23 is a human osteoclastogenic cytokine and anti-IL-23 antibody attenuates paw volume and joint destruction in CIA rats. IL-23 levels in serum and synovial fluid are high in rheumatoid arthritis (RA) patients, and IL-23 may be a useful biomarker for the diagnosis of RA. In addition, IL-23 affects the pathogenesis of inflammation and bone destruction through interaction with other cytokines such as IL-17 and TNF-α...
August 29, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28825656/use-of-fgf-21-as-a-biomarker-of-mitochondrial-disease-in-clinical-practice
#5
Alireza Morovat, Gayani Weerasinghe, Victoria Nesbitt, Monika Hofer, Thomas Agnew, Geralrine Quaghebeur, Kate Sergeant, Carl Fratter, Nishan Guha, Mehdi Mirzazadeh, Joanna Poulton
Recent work has suggested that fibroblast growth factor-21 (FGF-21) is a useful biomarker of mitochondrial disease (MD). We routinely measured FGF-21 levels on patients who were investigated at our centre for MD and evaluated its diagnostic performance based on detailed genetic and other laboratory findings. Patients' FGF-21 results were assessed by the use of age-adjusted z-scores based on normalised FGF-21 values from a healthy population. One hundred and fifty five patients were investigated. One hundred and four of these patients had molecular evidence for MD, 27 were deemed to have disorders other than MD (non-MD), and 24 had possible MD...
August 21, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28805717/the-fragility-index-in-a-cohort-of-pediatric-randomized-controlled-trials
#6
Travis J Matics, Nadia Khan, Priti Jani, Jason M Kane
Data suggest inadequacy of common statistical techniques for reporting outcomes in clinical trials. The Fragility Index can measure how many events the statistical significance hinges on, and may facilitate better interpretation of trial results. This study aimed to assess the Fragility Index in pediatric randomized controlled trials (RCTs) with statistically significant findings published in high-quality medical journals. A Fragility Index was calculated on included trials with dichotomous positive outcomes...
August 14, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28783093/impact-of-larger-sputum-volume-on-xpert-%C3%A2-mtb-rif-assay-detection-of-mycobacterium-tuberculosis-in-smear-negative-individuals-with-suspected-tuberculosis
#7
Sharlaa Badal-Faesen, Cynthia Firnhaber, Michelle A Kendall, Xingye Wu, Beatriz Grinsztejn, Rodrigo Otavio da Silva Escada, Michel Fernandez, Evelyn Hogg, Ian Sanne, Pamela Johnson, David Alland, Gerald H Mazurek, Debra A Benator, Anne F Luetkemeyer
As a strategy to improve the sensitivity of nucleic acid-based testing in acid-fast bacilli (AFB) negative samples, larger volumes of sputum (5-10 mL) were tested with Xpert(®) MTB/RIF from 176 individuals with smear-negative sputum undergoing tuberculosis evaluation. Despite larger volumes, this strategy had a suboptimal sensitivity of 50% (4/8).
August 7, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28758960/ultrasound-for-early-detection-of-joint-disease-in-patients-with-hemophilic-arthropathy
#8
REVIEW
Matteo Nicola Dario Di Minno, Gianluigi Pasta, Sonia Airaldi, Federico Zaottini, Antonio Storino, Ernesto Cimino, Carlo Martinoli
Joint bleeding represents the most commonly reported type of hemorrhage in patients affected by hemophilia. Although the widespread use of prophylaxis has been able to significantly reduce the onset of arthropathy, it has been shown that a non-negligible percentage of patients develop degenerative changes in their joints despite this type of treatment. Thus, periodic monitoring of the joint status in hemophilia patients has been recommended to identify early arthropathic changes and prevent the development or progression of hemophilic arthropathy...
July 31, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28749442/long-term-effects-of-pregnancy-complications-on-maternal-health-a-review
#9
REVIEW
Ran Neiger
Background: Most pregnancy-related medical complications appear to resolve at delivery or shortly thereafter. Common examples are preterm labor, placental abruption, preeclampsia, and gestational diabetes. Women who developed such complications are known to be at increased risk of developing similar complications in future pregnancies. It has recently become evident that these women are at an increased risk of long term medical complications. Methods: A search through scientific publications in English regarding the association of obstetric complications and long-term maternal illness...
July 27, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28757597/statins-muscle-disease-and-mitochondria
#10
REVIEW
Radha Ramachandran, Anthony S Wierzbicki
Cardiovascular disease (CVD) accounts for >17 million deaths globally every year, and this figure is predicted to rise to >23 million by 2030. Numerous studies have explored the relationship between cholesterol and CVD and there is now consensus that dyslipidaemia is a causal factor in the pathogenesis of atherosclerosis. Statins have become the cornerstone of the management of dyslipidaemia. Statins have proved to have a very good safety profile. The risk of adverse events is small compared to the benefits...
July 25, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28753995/the-role-of-th17-cells-in-the-pathogenesis-of-behcet-s-disease
#11
REVIEW
Yuki Nanke, Toru Yago, Shigeru Kotake
Behcet's disease (BD) is a polysymptomatic and recurrent systemic vasculitis with a chronic course and unknown cause. The pathogenesis of BD has not been fully elucidated; however, BD has been considered to be a typical Th1-mediated inflammatory disease, characterized by elevated levels of Th1 cytokines such as IFN-γ, IL-2, and TNF-α. Recently, some studies reported that Th17-associated cytokines were increased in BD; thus, Th17 cells and the IL17/IL23 pathway may play important roles in the pathogenesis of BD...
July 21, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28753982/th17-in-animal-models-of-rheumatoid-arthritis
#12
REVIEW
Motomu Hashimoto
IL-17-secreting helper CD4 T cells (Th17 cells) constitute a newly identified subset of helper CD4 T cells that play a key role in the development of rheumatoid arthritis (RA) in its animal models. Recently, several models of spontaneous RA, which elucidate the mechanism of RA onset, have been discovered. These animal models shed new light on the role of Th17 in the development of autoimmune arthritis. Th17 cells coordinate inflammation and promote joint destruction, acting on various cells, including neutrophils, macrophages, synovial fibroblasts, and osteoclasts...
July 21, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28753976/effects-of-assault-type-on-cognitive-behaviour-therapy-for-coexisting-depression-and-alcohol-misuse
#13
Kylie A Bailey, Amanda L Baker, Patrick McElduff, Mark A Jones, Christopher Oldmeadow, David J Kavanagh
Although assault exposure is common in mental health and substance misusing populations, screening for assaults in treatment settings is frequently overlooked. This secondary analysis explored the effects of past sexual (SA) and physical (PA) assault on depression, alcohol misuse, global functioning and attrition in the Depression and Alcohol Integrated and Single focussed Intervention (DAISI) project, whose participants (N = 278) received cognitive behaviour therapy (CBT) for their depression and/or alcohol misuse...
July 21, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28753924/omega-3-polyunsaturated-fatty-acids-for-the-treatment-of-iga-nephropathy
#14
REVIEW
Junichi Hirahashi
IgA nephropathy is a common disease that causes end-stage renal failure and requires renal replacement therapy. The main purpose of therapeutic intervention in this disease is not limited to improvement of prognosis and prevention of transition to end-stage renal failure, but also prevention of the occurrence of cardiovascular lesions, which increases risk in patients with chronic kidney disease. Steroids and immunosuppressants have been widely used as remission induction therapies; however, the balance between their therapeutic benefits and detrimental side-effects are controversial...
July 19, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28753922/evidence-of-oxidative-stress-and-secondary-mitochondrial-dysfunction-in-metabolic-and-non-metabolic-disorders
#15
REVIEW
Karolina M Stepien, Robert Heaton, Scott Rankin, Alex Murphy, James Bentley, Darren Sexton, Iain P Hargreaves
Mitochondrial dysfunction and oxidative stress have been implicated in the pathogenesis of a number of diseases and conditions. Oxidative stress occurs once the antioxidant defenses of the body become overwhelmed and are no longer able to detoxify reactive oxygen species (ROS). The ROS can then go unchallenged and are able to cause oxidative damage to cellular lipids, DNA and proteins, which will eventually result in cellular and organ dysfunction. Although not always the primary cause of disease, mitochondrial dysfunction as a secondary consequence disease of pathophysiology can result in increased ROS generation together with an impairment in cellular energy status...
July 19, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28708111/an-evaluation-of-ischaemic-preconditioning-as-a-method-of-reducing-ischaemia-reperfusion-injury-in-liver-surgery-and-transplantation
#16
REVIEW
Francis P Robertson, Barry J Fuller, Brian R Davidson
Liver Ischaemia Reperfusion (IR) injury is a major cause of post-operative liver dysfunction, morbidity and mortality following liver resection surgery and transplantation. There are no proven therapies for IR injury in clinical practice and new approaches are required. Ischaemic Preconditioning (IPC) can be applied in both a direct and remote fashion and has been shown to ameliorate IR injury in small animal models. Its translation into clinical practice has been difficult, primarily by a lack of knowledge regarding the dominant protective mechanisms that it employs...
July 14, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28708082/pathogenic-role-of-il-17-producing-immune-cells-in-obesity-and-related-inflammatory-diseases
#17
REVIEW
Marwa Chehimi, Hubert Vidal, Assia Eljaafari
Obesity is associated with low-grade chronic inflammation. Indeed, adipose tissues (AT) in obese individuals are the former site of progressive infiltration by pro-inflammatory immune cells, which together with increased inflammatory adipokine secretion induce adipocyte insulin resistance. IL-17-producing T (Th17) cells are part of obese AT infiltrating cells, and are likely to be promoted by adipose tissue-derived mesenchymal stem cells, as previously reported by our team. Whereas Th17 cell are physiologically implicated in the neutralization of fungal and bacterial pathogens through activation of neutrophils, they may also play a pivotal role in the onset and/or progression of chronic inflammatory diseases, or cancer, in which obesity is recognized as a risk factor...
July 14, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28698517/the-plasticity-of-th17-cells-in-the-pathogenesis-of-rheumatoid-arthritis
#18
REVIEW
Shigeru Kotake, Toru Yago, Tsuyoshi Kobashigawa, Yuki Nanke
Helper T (Th) cells play an important role in the pathogenesis of autoimmune diseases, including rheumatoid arthritis (RA). It has been revealed that Th17 cells can shift to Th1 cells (i.e., "nonclassic Th1 cells"), which are reported to be more pathogenic than Th17 cells per se. Thus, the association of Th cells in the pathogenesis of autoimmune disease has become more complicated. We recently reported using peripheral blood from untreated and early-onset RA patients that the ratio of CD161+Th1 cells (i.e...
July 10, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28686179/when-less-is-good-is-none-better-the-prognostic-and-therapeutic-significance-of-peri-transplant-minimal-residual-disease-assessment-in-pediatric-acute-lymphoblastic-leukemia
#19
REVIEW
Adam Lamble, Rachel Phelan, Michael Burke
The measurement of minimal residual disease (MRD) in pediatric acute lymphoblastic leukemia (ALL) has become the most important prognostic tool of, and the backbone to, upfront risk stratification. While MRD assessment is the standard of care for assessing response and predicting outcomes for pediatric patients with ALL receiving chemotherapy, its use in allogeneic hematopoietic stem cell transplant (HSCT) has been less clearly defined. Herein, we discuss the importance of MRD assessment during the peri-HSCT period and its role in prognostication and management...
July 7, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28678161/t-helper-17-cells-in-primary-sj%C3%A3-gren-s-syndrome
#20
REVIEW
Kiyoshi Matsui, Hajime Sano
Primary Sjögren's syndrome is an autoimmune disease characterized by diffuse infiltration of lymphocytes into exocrine glands and other tissues. The infiltrating lymphocytes have been identified as subsets of B cells and T cells, including T helper 17 cells, T regulatory cells and follicular helper T cells. The role of these cells in the development of the syndrome is now known, as is their impact on the production of proinflammatory cytokines such as IL-6, IL-17, IL-22 and IL-23. In particular, experimental animal models and patients suggest that a shift in Th17/Treg balance toward the proinflammatory Th17 axis exacerbates primary Sjögren's syndrome and other autoimmune disorders...
July 5, 2017: Journal of Clinical Medicine
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