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Surgery pharmacotherapy

Thomas Magg, Tilmann Schober, Christoph Walz, Julia Ley-Zaporozhan, Fabio Facchetti, Christoph Klein, Fabian Hauck
Epstein-Barr virus positive (EBV+ ) smooth muscle tumors (SMTs) constitute a very rare oncological entity. They usually develop in the context of secondary immunodeficiency caused by human immunodeficiency virus infection or immunosuppressive treatment after solid organ transplantation. However, in a small fraction of predominantly pediatric patients, EBV+ SMTs may occur in patients with primary immunodeficiency disorders (PIDs), such as GATA2 and CARMIL2 deficiency. In secondary immunodeficiencies and when the underlying condition can not be cured, the treatment of EBV+ SMTs is based on surgery in combination with antiretroviral and reduced or altered immunosuppressive pharmacotherapy, respectively...
2018: Frontiers in Immunology
Stefania Chetcuti Zammit, Reena Sidhu
PURPOSE OF REVIEW: The objective is to provide an overview on the cause of small bowel bleeding. We discuss the role of small bowel endoscopy in the management of small bowel bleeding and provide an outline of pharmacotherapy that can be additionally beneficial. RECENT FINDINGS: Small bowel capsule endoscopy (SBCE) is the initial diagnostic investigation of choice in small bowel bleeding. Computed tomography (CT) can be helpful in the context of small bowel tumours...
March 7, 2018: Current Opinion in Gastroenterology
Jean Wong, Raviraj Raveendran, Junior Chuang, Zeev Friedman, Mandeep Singh, Jayadeep Patras, David T Wong, Frances Chung
BACKGROUND: Patients who smoke put themselves at increased risk for serious surgical complications, yet it is not currently routine practice to educate patients about the risk of complications due to smoking. Computer-based smoking cessation programs are increasingly being utilized in the general population and may overcome some of the barriers such as lack of time, knowledge, and training to provide interventions. Our objective was to develop and implement a patient e-learning program designed for surgical patients as part of a multifaceted program aimed at assisting them to quit smoking and to determine the factors cross-sectionally and longitudinally associated with abstinence...
March 5, 2018: Anesthesia and Analgesia
Alessandro Capucci, Laura Cipolletta, Federico Guerra, Irene Giannini
The main aim of current research on the field of atrial fibrillation (AF) treatment is to find new antiarrhythmic drugs with less side effects. Areas covered: Dronedarone and vernakalant showed promising result in term of efficacy and safety in selected patients. Ranolazine and colchicine are obtaining a role as a potential antiarrhythmic drug. Ivabradine is used in experimental studies for the rate control of AF. Moreover, new compounds (vanoxerine, moxonidine, budiodarone) are still under investigation. Monoclonal antibodies or selective antagonist of potassium channel are under investigation for long term maintenance of sinus rhythm...
March 6, 2018: Expert Opinion on Emerging Drugs
Gitanjali Srivastava, Caroline Apovian
PURPOSE OF REVIEW: Obesity is a global health crisis with detrimental effects on all organ systems leading to worsening disease state and rising costs of care. Persons with obesity failing lifestyle therapies need to be escalated to appropriate pharmacological treatment modalities, medical devices, and/or bariatric surgery if criteria are met and more aggressive intervention is needed. The progression of severe obesity in the patient population coupled with related co-morbidities necessitates the development of novel therapies for the treatment of obesity...
March 5, 2018: Current Obesity Reports
A Benjamin Srivastava, Alex T Ramsey, Leslie D McIntosh, Thomas C Bailey, Sherri L Fisher, Louis Fox, Mario Castro, Yinjiao Ma, Timothy B Baker, Li-Shiun Chen, Laura J Bierut
Introduction: Effective smoking cessation medications are readily available but may be underutilized in hospital settings. In our large, tertiary care hospital, we aimed to: 1) characterize patient tobacco use prevalence across medical specialties, 2) determine smoking cessation pharmacotherapy prescription variation across specialties, and 3) identify opportunities for improvement in practice. Methods: Using electronic health records at Barnes Jewish Hospital (BJH), we gathered demographic data, admitting service, admission route, length of stay, self-reported tobacco use, and smoking cessation prescriptions over a 6-year period, from 2010 to 2016...
February 22, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Dóra Antal-Uram, László Harsányi, Dóra Perczel-Forintos
Inflammatory bowel disease (Crohn's disease and colitis ulcerosa) is a chronic, long-term condition that causes chronic inflammation in the digestive tract, and shows an increasing incidence and prevalence worldwide. Changes in disease activity over time affect psychological distress which increases the risk of exacerbations. Beside somatic symptoms (such as abdominal pain, diarrhoea and weight loss), psychiatric comorbidity (in particular major depression, anxiety, social phobia) is common in patients with Crohn's disease...
March 2018: Orvosi Hetilap
Rodger J Elble, Ludy Shih, Jeffrey W Cozzens
Essential tremor is the most common form of pathologic tremor. Surgical therapies disrupt tremorogenic oscillation in the cerebellothalamocortical pathway and are capable of abolishing severe tremor that is refractory to available pharmacotherapies. Surgical methods are rapidly improving and are the subject of this review. Areas covered: A PubMed search on January 18, 2018 using the query essential tremor AND surgery produced 839 abstracts. 379 papers were selected for review of the methods, efficacy, safety and expense of stereotactic deep brain stimulation (DBS), stereotactic radiosurgery (SRS), focused ultrasound (FUS) ablation, and radiofrequency ablation of the cerebellothalamocortical pathway...
February 23, 2018: Expert Review of Neurotherapeutics
Joanna M Zakrzewska, Ning Wu, John Y K Lee, Brian Werneburg, Deborah Hoffman, Ying Liu
BACKGROUND AND AIM: Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan database to examine treatment patterns among patients with TN. METHODS: Included patients were aged ≥18 years, newly diagnosed with TN (≥2 TN diagnoses ≥14 days apart; no diagnosis in the prior year), continuously enrolled 1 year pre-index, with ≥3 years' follow-up post-index...
February 19, 2018: Clinical Journal of Pain
Shuai Wang, Han Liu, Qi Wang, Zhihua Cheng, Siqiao Sun, Yang Zhang, Xiwei Sun, Zhongying Wang, Liqun Ren
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be valuable prognostic markers for a variety of pathological conditions including solid tumors, sepsis and others. However, the prognostic values of the NLR and PLR in patients with acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT) have not been elucidated. The aim of this study was to determine the predictive value of the NLR and PLR for poor prognosis in patients with AMAE and AMAT...
February 8, 2018: Annals of Vascular Surgery
Artem Pastukhov, Tatiana Borisova
Deep and profound hypothermia is successfully practiced in the prevention of ischemic stroke consequences and aortic arch cardiac surgery accompanied by reduction of cerebral circulation. Hypothermia is a current neuroprotection standard in hypoxic/ischemic encephalopathy. Drug-hypothermia administration is proposed as a new approach in pharmacotherapy for neonatal seizures. Also, hypothermia is useful as neuroprotective approach in long-term interplanetary space missions. We recently revealed gradual dynamics of hypothermia-induced decrease in transporter-mediated release and uptake of L-[14C]glutamate in presynaptic rat brain nerve terminals (synaptosomes), thereby confirming potent unspecific neuroprotective effect of hypothermia...
February 8, 2018: Therapeutic Hypothermia and Temperature Management
Jae Won Lee, Sang Ki Lee, Won Sik Choy
Diagnosis of Complex regional pain syndrome (CRPS) is made primarily on a clinical basis, and no specific test is known to confirm or exclude CRPS diagnosis. That is, there aren't specific diagnostic tools and instrumental tests are made only for identifying an etiology at the basis of the CRPS. Numerous therapeutic methods have been introduced, but none have shown definitive results. When symptoms persist, patients experience permanent impairment and disability. Therefore, early recognition of CRPS, along with proper treatment, is important for minimizing permanent loss of function...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Avital Perry, Christopher Salvatore Graffeo, Christopher Marcellino, Bruce E Pollock, Nicholas M Wetjen, Fredric B Meyer
Background  Pediatric pituitary adenoma is a rare skull base neoplasm, accounting for 3% of all intracranial neoplasms in children and 5% of pituitary adenomas. Compared with pituitary tumors in adults, secreting tumors predominate and longer disease trajectories are expected due to the patient age resulting in a natural history and treatment paradigm that is complex and controversial. Objectives  The aims of this study were to describe a large, single-institution series of pediatric pituitary adenomas with extensive long-term follow-up and to conduct a systematic review examining outcomes after pituitary adenoma surgery in the pediatric population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Masakazu Minetama, Mamoru Kawakami, Masafumi Nakagawa, Yuyu Ishimoto, Keiji Nagata, Daisuke Fukui, Tadashi Sumiya, Tomoko Kitagawa, Takahiro Miyake, Yoshio Yamamoto, Nana Sakon, Toshiko Matsuoka, Yukihiro Nakagawa
BACKGROUND: The efficacy of physical therapy for patients with lumbar spinal stenosis (LSS) has been reported only for the short term, and few reports have compared outcomes of surgical treatment with nonsurgical treatment after physical therapy. The purpose of this study was to assess 2-year outcomes of LSS patients treated with surgery or under follow-up observation after physical therapy for 6 weeks. METHODS: Patients presenting with neurogenic claudication, radiologically-confirmed central LSS affecting both legs and refractory symptoms to pharmacotherapy of more than 3 months were enrolled...
January 29, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Inna Belfer, Netanya I Pollock, Jodi L Martin, Katherine G Lim, Carolyn De La Cruz, Gijsberta Van Londen, Stephanie R Nunziato-Virga, Katherine Stranieri, Adam M Brufsky, Haibin Wang
Introduction: Chronic pain is a common and debilitating complication following breast surgery. One of the most challenging for treatment is the neuropathic pain condition, postmastectomy pain syndrome (PMPS). Gabapentin is a pharmacotherapy for neuropathic pain disorders; however, its once-daily, gastroretentive formulation, Gralise, has not been evaluated in PMPS. Objective: To evaluate the safety and effectiveness of Gralise in patients with moderate-to-severe PMPS...
May 2017: Pain Reports (Baltimore, Md.)
Amanda Velazquez, Caroline M Apovian
Obesity is a chronic, relapsing disease that necessitates a multidisciplinary approach to management. Behavioral changes are the foundation to management, but adjunctive therapy is often warranted, including pharmacologic therapies and/or bariatric surgery. Until recently, treatment options included only short-term therapy (≤12 weeks), and paths beyond that schedule were challenging, as knowledge of the biology of obesity was lacking. With increased recognition of obesity as a chronic, complex medical disease, newer agents have been approved as long-term therapy, and the cornerstone of treatment is chronic behavior and lifestyle change...
January 2018: Annals of the New York Academy of Sciences
Arivalagan Pugazhendhi, Thomas Nesakumar Jebakumar Immanuel Edison, Indira Karuppusamy, Brindhadevi Kathirvel
Cancer is an abnormal condition leading to uncontrolled cell division which causes damage to the body tissues. Around 100 types of cancer are studied so far namely breast cancer, lung cancer, skin cancer, prostate cancer, colon cancer and lymphoma. Major cancer therapies include chemotherapy, surgery and radiations but their major drawbacks are non-specifically distributed antitumor agents, uneven delivery of drug concentration to the tumour and low monitoring. Nanoparticles (NPs) are the newly trending field of nanomedicine implied in cancer therapy...
January 20, 2018: International Journal of Pharmaceutics
Yuda Handaya, Agung Maryanto, Marijata
Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic constipation (slow transit constipation) and treated with conventional therapy, but did not improve. For that reason, side-to-side ileosigmoidostomy shunting surgery was performed...
December 2017: Annals of Coloproctology
Ashley Jaggi, Francis Fatoye
Myriad treatment modalities are available for neurogenic bladder (NGB) including behavioral therapies, oral pharmacotherapy, catheterization and surgical procedures. Little is known about how NGB patients are managed in the real world, how well patterns relate to clinical guidelines and how strategies may have changed over time. To address this gap, a systematic review (SR) was conducted using MEDLINE and EMBASE [1996-2017]. The inclusion criteria for studies were: (I) published in English; (II) conducted in human subjects; (III) reporting the treatment patterns/use in NGB; (IV) conducted in a real world setting...
December 2017: Translational Andrology and Urology
Donald E Greydanus, Marisha Agana, Manmohan K Kamboj, Saad Shebrain, Neelkamal Soares, Ransome Eke, Dilip R Patel
This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity...
January 9, 2018: Disease-a-month: DM
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